Ah well. I wasn't the only one who thought it was hard. I stuck around after the quiz to give Elizabeth some Morinaga Hi-Chews I'd picked up in Dallas over the weekend; those taffies are really addictive =) Then it was back to the clinic.One of the first patients I saw was a middle-aged man with CAD complaining of a 2-week history of leg weakness, slurred speech, and pallor. It didn't really fit the profile of a stroke, and Dr. RR wasn't sure what was going on either...until he checked the medication chart. Apparently the patient saw two different cardiologists at the same cardio clinic, and each doctor gave him a prescription for a beta blocker. So in effect, he was taking twice as much beta blocker as he should have been. Yikes. This is what happens when doctors don't communicate with each other, and why PCPs are responsible for making sure all the medications are correct. Dr. RR immediately cut the patient's beta blocker prescription from 450 mg to 100 mg, and said he expected him to feel much better soon.
Dr. RR also does acupuncture, and I saw my first acupuncture patient today =) Dr. RR stuck several fine needles in specific points on the patient (both wrists, both feet, the arms, and one needle on the head), then put electrodes on the wrist/feet/arm needles (they are specifically paired, yin and yang) for electric stimulation for about 20-30 minutes (the patient rested in a darkened room while we saw other patients). Other patients seen today included an overweight little five-year-old girl (she was 75 lbs; I don't think I weighed that much until I was 10), a guy almost my age with cough-induced costochondritis (the "downside" of his cough was that he couldn't smoke his daily weed for 3 days), and a teenager with a bad case of folliculitis on her legs and arms. A common cause of folliculitis is shaving, and I'd asked, "Well, you don't shave your arms, do you?" Her mother: "Oh, yes she does." *sigh* The things you see in family med.
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