I love it when you lie to me...

[trailerparkmedic]

Munchausen syndrome?

If they have Munchausen's, they generally have something physically very wrong with them. An example would be a patient drinking drain cleaner at home in just the right amount to get stomach damage (and eventually surgery) but not overdose or look suspicious. She was recovering from surgery #3 before the social worker realized what was going on.

A foot wound on a diabetic patient? She just wants attention. I bet there weren't even any maggots or anything in it.

[charred]

Dudes and dudettes.....she came back...oh lord, did she come back.

Ill have to share what happened tomorrow, I gotta get ready for work.

... and?

45678910

[mharbourgirl]

Dudes and dudettes.....she came back...oh lord, did she come back.

Ill have to share what happened tomorrow, I gotta get ready for work.

Just hoping for an update.

[Sheldonrs]

Munchausen syndrome?

More likely, Munchsandwich Syndrome. :-)

[Sapphire Silk]

Just hoping for an update.

Me, too.

[Seshat]

A foot wound on a diabetic patient? She just wants attention. I bet there weren't even any maggots or anything in it.

I dunno... I'd be seeking medical monitoring for a foot wound, in that situation. But not ER. Not unless I suspected it was turning gangrenous or septic. (And since I'd be checking it no less than twice a day, my regular doctor or the urgent-care clinic would get it, not the ER.)

[Sapphire Silk]

I dunno... I'd be seeking medical monitoring for a foot wound, in that situation. But not ER. Not unless I suspected it was turning gangrenous or septic. (And since I'd be checking it no less than twice a day, my regular doctor or the urgent-care clinic would get it, not the ER.)

trailerparkmedic was responding to the suggestion the patient might have Munchausen's. She was also being a bit facetious with the maggots bit

Since Munchausen's is a mental illness, this patient might deliberately give herself a foot wound. But tpm wasn't suggesting the patient not seek help for the foot wound

[trailerparkmedic]

What Panacea said. Also, it seems like the patient already has a specialized foot or wound doctor that she sees on a regular basis. She shouldn't have gone to the ER for a problem that she should know from experience can be handled on an outpatient basis with said doctor. This is especially true if she only went to the ER because she didn't want to wait a few days for an appointment.

I STRONGLY encourage all of my diabetic patients to do daily foot checks and tell them to call their doctor for things as insignificant seeming as cracked, dry skin or persistent areas of redness that do not respond to over the counter treatments. I've seen toes, feet and legs up to the knee gone because of untreated wounds in diabetics so I know it's not something to mess with.

About the maggots...don't read this if you're easily squicked out. A friend of mine had a patient in clinicals who had been admitted with a really deep foot wound, like almost to the bone. The nurse put the patient's foot in water (or some sort of liquid) and maggots came out! I don't know if this was a preexisting thing that the patient came to the hospital with, or a therapeutic thing that they were doing in the hospital. Due to the location of my school, we can see some unusual and even extreme treatments. My friend was so grossed out she switched patients.

[Sapphire Silk]

It was not a therapeutic thing (re tpm's hidden story in previous post).

Therapeutic maggots are used in strictly controlled settings, and counted.

Those were there, erm, naturally. I did see a case of that once or twice myself.

Ew.

[blas]

If I may whine, people like this woman (and a few of my medical case coworkers) are the people the insurance people where whining about at our benefit meeting, where we found out we have to have HSAs or overly expensive policies.

I have coworkers who think they know more than doctors, think everything in the world is wrong with them medically, know how to "play" the system, and will go over anyone's head necessary to get whatever care they think they need, whatever drugs they think they need. And all of that going over heads, costs money for non-necessary stuff, which ends up having everyone punished with more unaffordable isurance/ridiculous copays/fees snuck in for supposed 100% covered preventive stuff.

[Sapphire Silk]

If I may whine, people like this woman (and a few of my medical case coworkers) are the people the insurance people where whining about at our benefit meeting, where we found out we have to have HSAs or overly expensive policies.

I have coworkers who think they know more than doctors, think everything in the world is wrong with them medically, know how to "play" the system, and will go over anyone's head necessary to get whatever care they think they need, whatever drugs they think they need. And all of that going over heads, costs money for non-necessary stuff, which ends up having everyone punished with more unaffordable isurance/ridiculous copays/fees snuck in for supposed 100% covered preventive stuff.

Yup. But that's a subject for Fratching If I went there, I'd get in trouble with the mods.

[blas]

No worries, we needn't elaborate.

Just wanted to let ya'll know that no matter how bitter about docs or insurance I may seem, there are areas where I feel so, so dearly for you guys and the BS you have to put up with.

[fireheart]

Maybe, but more likely they're using it for attention, particularly for old folks.

Isn't that the point of Munchausens? (to get attention)

[Syriilord]

Isn't that the point of Munchausens? (to get attention)

Perhaps, but IIRC Munchausens is more about deliberately harming yourself in some fashions as opposed to simply faking symptoms, but IANAP (I Am Not A Psychiatrist)

[Geek King]

Perhaps, but IIRC Munchausens is more about deliberately harming yourself in some fashions as opposed to simply faking symptoms, but IANAP (I Am Not A Psychiatrist)

Yup. Sort of how not every kid who doesn't pay attention in class has ADD. Sometimes they're just bored. Such things need a real diagnosis to confirm what is causing the symptoms.