Had this nephrologist read the records of the E.R. registrations, then he wouldn't have, run around in a huge circle, to derive at the conclusions that his patient was, diabetic…translated…
"Fifteen days ago, I'd passed out, lost consciousness, gotten sent to the E.R., they'd monitored me for twenty-four hours, and there was, nothing wrong, they'd registered me to cardiology, the cardiologist set up the appointment of implanting the catheters, the coronary stenting………"
The man in his sixties, started ranting to me, giving me no time to write every detail, down. But, as I'd heard catheter, that alarm started sounding off inside of me, because I'd not known how the previous two cardiologists who treated him had, derived at his diagnosis of angina.
During the treatment, I'd hated reading up the records of another cardiologist first, worried that reading the records will cause me to be prejudiced. I'd liked to step by step, go by my own knowledge, to arrive at the diagnoses of my, patients, but now, as I'd heard his previous cardiologists' diagnoses, I can only pretended that I didn't hear, and carefully, start from ground zero.
There are many instances where the consciousness had, changed the evaluative means of the diagnoses, that's gotten into the acronym of AEIOUTIPS, the patients had been in the E.R., stroke, brain lesions, alcohol poisonings, acid toxicities, imbalance of electrolytes………I'd ruled these, more severe out, I'd only needed to, focus on the remaining possible diagnoses.
"Had you lost awareness of everybody else around you?":
"Yes."
"For how long?", I'd allowed the man to discuss it with his wife a bit, they thought it was anywhere from thirty, forty seconds, no more than a minute's time.
"What were you doing?":
"Having lunch. A few days ago, I'd experienced this a couple of times, but they didn't last that long."
Although this is, vital information, I'd worried that I'd, led them astray from the topics, and decided, to not extend any further. "Wait, let's get this time straight, then, we can see a pattern for the previous times."
I'd adjusted, returned back to our original pace, "were you standing up? Sitting down? Or lying down when it happened this latest time?", if he'd fainted standing up, then, the most frequent cases are of the vasovagal syncope.
"As I sat to have my lunch, I'd started sweating out the cold sweats, felt sick to my stomach, wanted to rest, so I'd put my head down onto the tables, and, my hand fell down." The family members added "he seemed to be reaching for the chair close by to steady himself, then, he'd, slipped to the floors, and it took him a short while to regain his consciousness."
If the fainting happened during physical activities, then, it would be embolism of the lungs, the heart valves, or arrythmia. But he'd fainted during a meal, which was a bit, odd, could it be the vasovagal reflex, causing the heart to pulse too slow? But, the ECG from twenty-four hours didn't come up abnormal.
"Were there twitching?" "No." No signs of epilepsy.
"Chest pains?" "Nope." There's no sign of the angina on his ECG either.
"Did you consume alcohol that day?" "nope."
Nothing, I'd pulled it back again, "what are the few past occurrences?"
"Two nights ago at past nine, I was sitting on the couch, watching T.V., I'd felt nauseated, started sweating cold sweat, I'd made myself puked, and it'd felt better. The following afternoon, I'd felt discomfort around my left shoulders, started sweating cold sweats. The third day, led me here into the E.R."
So frequent, and every time, there's the cold sweats, this doesn't sound right.
"Are you diabetic?"
and unfortunately, there's no shared database of medical records across the departments of the hospitals, or the hospitals...like this...image from online
"My glucose was a bit high from before, the doctor said I didn't need to get medicated yet, but my golf buddy told me he had the great medications for diabetes, and shared some with me."
"How long did you take them?" "Three weeks."
"Are you still on them now?" "No, I don't dare to take them anymore!"
"Did similar situation occur after you'd stopped taking the diabetes medications?" "no, it'd been two weeks, I'd felt, fine."
I'd let out a sigh of relief, it seemed, that it was a medication induced low blood sugar, the less severe conditions, the patients get sent to the E.R. for the more severe, the patients will become, vegetable, and even, die.
Looking at my patient, I'd felt that he was blessed, and, maybe, in the future, he may need the catheters for another reason, but not today. I'd started, scolding him, that the medications are personalized, how could he take someone else's meds, especially for diabetes.
And yet, as the inquiries are over, I'd, clicked open his file of medical treatment records, and found that the doctors who'd treated him wrote in Chinese, "These past few weeks, due to high glucose, the clinic treatment sessions didn't give him a prescription, so he'd put himself on the blood sugar meds of his friend's, he'd been on the meds for three weeks, he didn't have any today………", and I'd covered my face, sighed, ahhhhhhhhhhhh, had I, only read, the E.R. notes first, then I wouldn't have, needed to, go the long way around with him.
So, this is how the medical field works, the referrals, they go around, around, and around, and for some unknown reasons, there's no communications between the departments horizontally, which is what's caused this situation, because there's not the opening of the medical records for the patients in the hospitals loaded up to the databases.
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