A patient comes to the clinic complaining of a fatigue and headache. The person with him says, "he's just not a perky as he usually is."
So, I begin to interview him with the standard questions.
When did you start feeling bad?
Where do you hurt?
Back of my neck.
Do you hurt anywhere else?
Has this happened before?
Do you have high blood pressure?
Any other health problems or conditions?
When did you last take your medicine?
What do you take?
Do you know the names?
No. I can't remember right now.
And so on, and so on......
I take his BP and its 188/111. I do an assessment and find nothing else unusual. So I get him to lay down, give him something for his headache, arrange for him to be taken home and called his doctor.
After I do all this, I go back to check on him and take his BP again. It's gone down a good bit.
You feeling any better?
Any chest pain?
No. You know I had one of those things done to my heart a few months ago (as he points to his groin.)
A heart cath?
One of those things where they go in your leg......
Did they put anything in your heart, a stent?
I don't know.
Did they give you a card to keep in your wallet? (for those who don't know, you usually get a card to carry saying what kind of stent was placed)
(digging around in his wallet) Yeah, this.
Have you been able to remember what medicines you take?
But you did take them this morning?
Yes, but that is the first time in about 2 weeks. I just got it refilled yesterday.
Why didn't you get them filled when you ran out? Are you having trouble paying for them? You know, some pharmacies have some medicines for $4......I can help you.....
No, I don't pay for them, I get them from the health department.
How's your head feeling now? (because mine is about to spin around.)
Well its not as bad as when I have migraines.
Why in the hell didn't you tell me about the cath, the history of migraines, and not taking your medicine for 2 weeks when I first talked to you? And, how in the hell do you not know what someone did to your freaking heart and what the names are of the freaking pills you take?