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  #1  
Old 10-21-2009, 07:04 AM
Heckity Heckity is offline
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What does my doctor mean?

I have a few health issues. I'm seeing a new doctor for *sigh* a new health problem and he requested the files from some of my other specialists. A file from my neurologist was sent to my home, to my attention, so I read it.

For the most part it is a record of my tests, the conclusions, and conversations the doctor and I had. Some of the records are letters between doctors.

In one letter the neurologist stated in part to another doctor ". . . to follow up with this very interesting patient".

I've seen the Seinfeld episode wherein Elaine is called "difficult" in her chart and subsequently no doctor will see her. Is "very interesting" a code of some sort about me personally, or is it more likely the neurologist is commenting on my "case"?

Just wondering.
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  #2  
Old 10-21-2009, 09:19 AM
Nava Nava is offline
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Judging by the doctors I know, your case.

Do you have anything that nobody has been able to diagnose or anything that puts you "off the charts"?
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  #3  
Old 10-21-2009, 09:29 AM
aruvqan aruvqan is offline
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I agree with Nava, he/she is commenting on your case. I have a couple 'interesting' conditions, and have had parts of me used in lectures as examples of some 'interesting' issues.
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  #4  
Old 10-21-2009, 09:34 AM
KneadToKnow KneadToKnow is offline
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Surely "interesting" is simply a shorthand way of saying "this patient's condition is not a textbook situation, so don't treat it as such."

But it's funny how things can sound when they're in that context. I noticed once on the diagnostic sheet I get a copy of after each office visit that in a mostly empty space near the top were the words "RESEARCH CASE."

It really unnerved me, until I checked one of my (then) wife's similar sheets and saw that hers said it, too. I'm guessing they're actually headings under which little codes can be placed and not indications that we are somehow secretly being monitored for a journal article.

Last edited by KneadToKnow; 10-21-2009 at 09:36 AM..
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  #5  
Old 10-21-2009, 09:47 AM
Heckity Heckity is offline
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Yes, Nava I am a special case, I think. I used to say I'm part of the 5% club. You know, if within the entire population only 5% suffer from a particular condition, I'd be one of those.

For example: 5% have no frontal cavity? That's me. Only 5% reject a dental implant after 5 years. Yup that's me. And on and on. Now, however, they think I might have shifted into the 1% club. I guess 5% was too crowded for me.
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  #6  
Old 10-21-2009, 10:06 AM
FalconFinder FalconFinder is offline
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I was amused to read a doctor's report where I was described as being two years younger than my actual age and "well nourished". Nice way of describing me being overweight! LOL
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  #7  
Old 10-21-2009, 10:28 AM
PoorYorick PoorYorick is offline
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From what I've seen on patient records, it's just one doctor being polite to the referring doctor. Almost every entry I ever read from a referred physician ended with something like, "Thank you for the interesting referral."

Maybe one of the MD's here can confirm.
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  #8  
Old 10-21-2009, 10:40 AM
Sigmagirl Sigmagirl is offline
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I looked at my doctor's notes one time and he wrote down that I was "labile." Not an insult, but I was insulted. (He was talking about my blood tests, not my personality.) Still, hmmmph.
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  #9  
Old 10-21-2009, 10:47 AM
Angel of Doubt Angel of Doubt is offline
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Quote:
Originally Posted by FalconFinder View Post
I was amused to read a doctor's report where I was described as being two years younger than my actual age and "well nourished". Nice way of describing me being overweight! LOL
Heh, I got the term "well developed" back in the early eighties when I was overweight. (all of me was bigger, not just my boobs, so I guess that's not what he meant!)
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  #10  
Old 10-21-2009, 10:48 AM
KneadToKnow KneadToKnow is offline
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Originally Posted by Sigmagirl View Post
I looked at my doctor's notes one time and he wrote down that I was "labile." Not an insult, but I was insulted. (He was talking about my blood tests, not my personality.) Still, hmmmph.
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  #11  
Old 10-21-2009, 10:58 AM
hellpaso hellpaso is offline
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"Well-nourished" just means you're a healthy weight. If they thought you were fat, they would put obese or morbidly obese.

Last edited by hellpaso; 10-21-2009 at 10:59 AM.. Reason: and interesting does sometimes mean "full o' **** (but still open to interpretation)
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  #12  
Old 10-21-2009, 11:22 AM
Heckity Heckity is offline
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Quote:
and interesting does sometimes mean "full o' **** (but still open to interpretation)
Huh. That's what I feared, I think hellpasso. However, the tests have shown some weird things - so I guess I'll rely on it meaning 'interesting case'.
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  #13  
Old 10-21-2009, 11:55 AM
EmAnJ EmAnJ is offline
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Ha, when I was a teen I broke my foot during the summer and had to wear a cast. Boy did that ever stink. When he removed it, he said my foot smelled 'mature'.
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  #14  
Old 10-21-2009, 01:39 PM
BoBettie BoBettie is offline
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Regarding "well developed, well nourished", I did transcription for a doctor who said that for every single patient that she saw. Every single solitary one.
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  #15  
Old 10-21-2009, 01:45 PM
Shot From Guns Shot From Guns is offline
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In the notes for an exam, a doctor once described my mother's breasts as "smaller than normal." It's become a family gag.
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  #16  
Old 10-21-2009, 01:53 PM
Heckity Heckity is offline
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Shot From Guns, that reminded me of the time a radiologist told the nurse who had done my mammogram that my "breasts were unremarkable".

Maybe to you, buddy, I thought.

(I do realize that it was in respect to being 'normal', but still)
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  #17  
Old 10-21-2009, 01:55 PM
LurkMeister LurkMeister is offline
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Originally Posted by PoorYorick View Post
From what I've seen on patient records, it's just one doctor being polite to the referring doctor. Almost every entry I ever read from a referred physician ended with something like, "Thank you for the interesting referral."

Maybe one of the MD's here can confirm.
IANAD, but in my former job I had occasion to see a lot of doctor's reports, and many of them started or ended with a reference to "this interesting patient", which leads me to believe that it's a common convention in the profession.
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  #18  
Old 10-21-2009, 01:57 PM
Shodan Shodan is offline
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My wife was all bent out of shape when the fertility doctor we went to described her as an "elderly nulligravida" in the chart.

I thought "well developed, well nourished" just meant that none of my limbs were stunted or shriveled or anything like that.

I had a problem with my rotator cuff a while back. The doctor tested it by pushing on my arm, found it was weak, and gave me a cortisone shot and some exercises. Six weeks later, I returned, and he held my arm again and said, "Push as hard as you can". I threw him across the room.

He marked the chart, "Patient has regained function in the limb."

Regards,
Shodan
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  #19  
Old 10-21-2009, 01:59 PM
Drain Bead Drain Bead is offline
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Almost every autopsy report I've ever seen says that the deceased's anus was "star-shaped and unremarkable."
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  #20  
Old 10-21-2009, 02:16 PM
AuntiePam AuntiePam is offline
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I used to work for lawyers so I got to read a lot of medical records. One that stood out was a doctor's description of an attractive female patient as "sensual". Hmmmmm.
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  #21  
Old 10-21-2009, 02:36 PM
Qadgop the Mercotan Qadgop the Mercotan is offline
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Quote:
Originally Posted by PoorYorick View Post
From what I've seen on patient records, it's just one doctor being polite to the referring doctor. Almost every entry I ever read from a referred physician ended with something like, "Thank you for the interesting referral."

Maybe one of the MD's here can confirm.
That's a pretty standard bit of politeness from consultant to referring physician.

Said in person, much can be read from inflection and facial expressions. But in writing, it means pretty much what it says.
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  #22  
Old 10-21-2009, 02:50 PM
AskNott AskNott is offline
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Originally Posted by Drain Bead View Post
Almost every autopsy report I've ever seen says that the deceased's anus was "star-shaped and unremarkable."
"Almost every" one? Were there remarkable anuses?
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  #23  
Old 10-21-2009, 02:58 PM
KneadToKnow KneadToKnow is offline
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Richard Nixon was a pretty remarkable anus.
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  #24  
Old 10-21-2009, 03:03 PM
Ferret Herder Ferret Herder is offline
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Quote:
Originally Posted by Shodan View Post
I thought "well developed, well nourished" just meant that none of my limbs were stunted or shriveled or anything like that.
That probably is the case. Working for a pediatric cardiologist, I heard pretty much that exact phrase a lot for kids that looked all right physically.
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  #25  
Old 10-21-2009, 04:41 PM
rekkah rekkah is offline
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Quote:
Originally Posted by Heckity View Post
I've seen the Seinfeld episode wherein Elaine is called "difficult" in her chart and subsequently no doctor will see her. Is "very interesting" a code of some sort about me personally, or is it more likely the neurologist is commenting on my "case"?
Another vote for just meaning a slightly unusual, non-textbook set of medical symptoms, rather than anything about you personally.

My dad once got a copy of some medical notes about him and reported to me with some amused excitement that the doctor had described him as seeming respectable. Unfortunately, when he read out the exact phrase used, I had to break it to him that "well-appearing" just means not looking obviously sick.
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  #26  
Old 10-21-2009, 06:35 PM
ivylass ivylass is offline
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I read a doctor's note where I was described as a "very pleasant 41-year-old woman."

Well, gee, that just made my day.

Ivylad's been described as "unremarkable," but that's a good thing...it means nothing wrong with that particular thing.

Last edited by ivylass; 10-21-2009 at 06:35 PM..
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  #27  
Old 10-21-2009, 06:48 PM
Qadgop the Mercotan Qadgop the Mercotan is offline
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Some more medicalese:

LOL in NAD: Little old Lady in No Acute Distress

PBAB: Pine Box at Bedside

WNL: Within Normal Limits (referring to lab test results. Alternate meaning: We Never Looked)

Microdeckia: Not playing with a full deck.

AHF: Acute Hissy Fit

FTD: Fixin' to die

More at: http://www.messybeast.com/dragonquee...l-acronyms.htm

Last edited by Qadgop the Mercotan; 10-21-2009 at 06:50 PM..
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  #28  
Old 10-21-2009, 07:01 PM
An Arky An Arky is offline
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My dad was a doctor, and when I was a kid, he used to dictate his cases on a tape recorder, to be transcribed later, I suppose. He had a great memory and an acerbic wit, and he didn't use codes that I know of, unless "acute goddamn hypochondria" was code for something else...
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  #29  
Old 10-21-2009, 09:20 PM
needscoffee needscoffee is offline
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My aunt was distraught to read that she had "terminal insomnia" until she found out it meant her insomnia occurred at the end of the sleep cycle.
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  #30  
Old 10-21-2009, 09:38 PM
Canadjun Canadjun is offline
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Quote:
Originally Posted by AskNott View Post
"Almost every" one? Were there remarkable anuses?
IANAMD but I can think of two things that might make them remarkable - really bad hemorrhoids and lots of kinky sex. I'm sure the MDs in the audience can come up with more.
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  #31  
Old 10-21-2009, 10:40 PM
Brynda Brynda is offline
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Psychiatrists (at least I think it is mostly them, never seen it in another type of MD's report) like to say "Patient appears to be stated age." I once had a client who got her report, and apparently the psychiatrist wrote "Patient appears older than stated age." Well, she did, but still...Ouch.
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  #32  
Old 10-21-2009, 10:43 PM
outlierrn outlierrn is offline
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IME difficult pts are usually referred to as
non-compliant
poor historian (difficult here can mean challenging as opposed to jerkiness)

or, drum roll, difficult.



Patient tolerated well
, does not mean it didn't hurt, or that you don't hate me now, merely that you didn't try to die when I did the procedure.



some personal unofficial favs:

Assuming room tempurature

Circling the drain

Impaired rectal cranial clearance

+ smurf/blueberry sign

+ hamster cage sign


LOL/LOM with the dwindles being admitted for discharge to a higher level of care.
You see, medicare often won't pay for an ailing elder to move from their home into a nursing home, you know, before they fall and break their hip or some such. But there's no problem getting them to pay to move the same patient out of the hospital into a nursing home, so sometimes soft admits are done to get the patient into a safe place before something bad happens.

You want more, I got 'em
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  #33  
Old 10-21-2009, 11:58 PM
Nava Nava is offline
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Quote:
Originally Posted by Heckity View Post
Shot From Guns, that reminded me of the time a radiologist told the nurse who had done my mammogram that my "breasts were unremarkable".
Hey, the radiologist who ran my last mamogram and subsequent echogram (I have cysts) said "speaking not as a man but as a doctor, your breasts are happily boring: congratulations."

Speaking as the niece of two bio-aunts, all three (1) of which are breast cancer survivors, I like happily boring breasts!





(1) Yes, I can count. No, no typo. One had breast cancer twice, seven years apart.
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  #34  
Old 10-22-2009, 12:44 AM
elfkin477 elfkin477 is offline
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Hopefully "interesting" doesn't mean a rare disorder, like the one that got my mom's illness written up in the New England Journal of Medicine because they'd never seen an adult with her condition before. (some sort of rare complication of psoriasis that had her covered in welts head to foot for a week)
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  #35  
Old 10-22-2009, 06:12 AM
Ferret Herder Ferret Herder is offline
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Originally Posted by outlierrn View Post
IME difficult pts are usually referred to as
non-compliant
poor historian (difficult here can mean challenging as opposed to jerkiness)

or, drum roll, difficult.
Those first two are usually for specific types of difficult, though, or are as I've seen them. "Non-compliant" means 'doesn't take medicine at all/per instructions' or 'doesn't follow directions.' I've seen such issues with patients not taking medication as specified that I've learned to take a medication history for a returning patient not as 'so you're taking X medication Y times per day?' but 'what are you taking right now? OK, how many times per day? Anything else? How often?' double-checking it against the instructions given at the last visit. I can't think of how many times patients have reported continuing a medication when they were told to discontinue it after the last visit, or taking it at the wrong dose/wrong number of times a day. (Part of this may be that our meds are often eye drops, which people seem to feel more free to use as they feel like rather than instructed, when the instructions were not 'as needed.')

"Poor historian" can be a variety of things: 'sucks at telling us what's wrong,' 'sucks at giving a comprehensive/coherent medical history,' 'expects medical staff to be mind-readers,' and probably some other things I haven't thought of.
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  #36  
Old 10-22-2009, 06:21 AM
corvidae corvidae is offline
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Originally Posted by PoorYorick View Post
From what I've seen on patient records, it's just one doctor being polite to the referring doctor. Almost every entry I ever read from a referred physician ended with something like, "Thank you for the interesting referral."

Maybe one of the MD's here can confirm.
Not an MD, but I spend plenty of time going through patient files, and specialists almost always say something like "thank you for referring this very pleasant patient". I wouldn't take it as anything.
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  #37  
Old 10-22-2009, 06:49 AM
even sven even sven is offline
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When I lived in Cameroon, I'd get my test results back from the labs in French to carry back to our bilingual nurse.

Of course, I peeked. My marginal ability to read French caused more than one near panic attack!
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  #38  
Old 10-22-2009, 07:22 AM
Shodan Shodan is offline
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Quote:
Originally Posted by Qadgop the Mercotan View Post
Some more medicalese:

LOL in NAD: Little old Lady in No Acute Distress

PBAB: Pine Box at Bedside

WNL: Within Normal Limits (referring to lab test results. Alternate meaning: We Never Looked)

Microdeckia: Not playing with a full deck.

AHF: Acute Hissy Fit

FTD: Fixin' to die

More at: http://www.messybeast.com/dragonquee...l-acronyms.htm
I used to support the medical records applications at a local hospital system. The ones the ladies taught me were LOLFOF (Little Old Lady Found on Floor) and the infamous GOMER - Get Out of My Emergency Room.

For some reason the phrase from autopsy that made me smile was "the rectum was grossly unremarkable". I hope I am never that jaded.

Regards,
Shodan
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  #39  
Old 10-22-2009, 08:04 AM
Heckity Heckity is offline
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I don't know Shodan, that my be new greatest aspiration in life - to leave with a grossly unremarkable rectum

My favourite slang so far as provided by Qadgop the Mercotan is Pneumo-cephalic - airhead. I'll be watching my charts for any of those listed!

Last edited by Heckity; 10-22-2009 at 08:06 AM..
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  #40  
Old 10-22-2009, 09:37 AM
Ca3799 Ca3799 is offline
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As a nurse who reads way too many medical records, I agree that "WDWN" (well developed, well nourished) means appropriate weight from thin to chubby, and excluding obese or anorexic. I also agree that "Thanks for the interesting referral" is a common courtesy found in many records.

My favorite is incompetent cervix. My cervix may be incompetent, but the rest of me rocks.
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  #41  
Old 10-22-2009, 10:27 AM
artemis artemis is offline
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Quote:
Originally Posted by Heckity View Post
In one letter the neurologist stated in part to another doctor ". . . to follow up with this very interesting patient".

I've seen the Seinfeld episode wherein Elaine is called "difficult" in her chart and subsequently no doctor will see her. Is "very interesting" a code of some sort about me personally, or is it more likely the neurologist is commenting on my "case"?

Just wondering.
Physician here. Relax - it means nothing. Literally. It's the doctor equivalent of "sincerely yours" at the end of a business letter (are you REALLY saying you sincerely belong to the letter recipient when you write that phrase?). All patients are either "very interesting" or "very pleasant" in doctor-to-doctor correspondence. After all, it wouldn't do to thank another physician for referring this "very routine" or "extremely boring" or "really nasty" patient (even if those things are the truth!).
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  #42  
Old 10-22-2009, 10:53 AM
Mama Zappa Mama Zappa is offline
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Quote:
Originally Posted by Heckity View Post
Shot From Guns, that reminded me of the time a radiologist told the nurse who had done my mammogram that my "breasts were unremarkable".

Maybe to you, buddy, I thought.

(I do realize that it was in respect to being 'normal', but still)
heck, I had that exact remark (well, the "unremarkable") about a CT scan of my sinuses.

Yep, it's down in hard black and white that my head is unremarkable .

I've seen a couple of such letters which said "thank you for referring this nice woman". Huh. Guess my inner bitch wasn't showing that day
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  #43  
Old 10-22-2009, 11:03 AM
Shot From Guns Shot From Guns is offline
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I was very happy to hear at the most recent followup with my hematologist that all my blood test results were, and I quote, "boring." He was also happy that I was immediately excited to hear them described as such.
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  #44  
Old 10-22-2009, 12:03 PM
ivylass ivylass is offline
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Originally Posted by artemis View Post
All patients are either "very interesting" or "very pleasant" in doctor-to-doctor correspondence.

Well, that just deflated my balloon.
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  #45  
Old 10-22-2009, 12:25 PM
Pulp Friction Pulp Friction is offline
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Nurse here. Ditto what the physician said; these are all common phrases and are used automatically.

One of my own reports indicated that I was a "very pleasant, obese man." Cripes, talk about handing you a compliment then kicking you in the nuts.

A bit OT, but this is one of my favorite entries that I have run across: "Papal edema noted". What they meant was the optic disc was enlarged (papilledema), not that the pope was swollen.
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  #46  
Old 10-22-2009, 12:31 PM
Ferret Herder Ferret Herder is offline
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Originally Posted by Pulp Friction View Post
A bit OT, but this is one of my favorite entries that I have run across: "Papal edema noted". What they meant was the optic disc was enlarged (papilledema), not that the pope was swollen.
When I first started in pediatric cardiology, I was startled to hear on a dictation tape what I thought was "painted frame in a valley".
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  #47  
Old 10-22-2009, 03:18 PM
whiterabbit whiterabbit is offline
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Originally Posted by Heckity View Post
And on and on. Now, however, they think I might have shifted into the 1% club. I guess 5% was too crowded for me.
Heh, I have a condition that seems to occur on the order of one in a million births. Even seasoned specialists have been known to get a bit excited when I show up in their office. "I read about that in med school, but I've never seen it."

Yep. Seriously.
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  #48  
Old 10-22-2009, 05:09 PM
Heckity Heckity is offline
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. "I read about that in med school, but I've never seen it."
I hear you, whiterabbit. Sometimes they get excited over my meds too. "So how do you feel that one works for you?" "Oh, I've read about that - is it effective?"

Especially if they're in a different specialty - they don't want to talk about why I've been referred, rather they like to talk about my other conditions. Oh well, it's good to spread the knowledge around, I guess.
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  #49  
Old 10-22-2009, 05:20 PM
Foxy40 Foxy40 is offline
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"Very interesting" is code for...thank you for referring this patient to me and please refer many more in the future.
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  #50  
Old 10-23-2009, 11:11 AM
lavenderviolet lavenderviolet is offline
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Originally Posted by Brynda View Post
Psychiatrists (at least I think it is mostly them, never seen it in another type of MD's report) like to say "Patient appears to be stated age." I once had a client who got her report, and apparently the psychiatrist wrote "Patient appears older than stated age." Well, she did, but still...Ouch.
Yeah, on my psychiatry rotations we were trained to make note of this. I think it's because psychiatric patients quite often have lived a hard life that tends to age you (drugs/alcohol/smoking, poor sleep habits, homelessness) and it can give you a sense of how the person is functioning if they look disheveled and haggard in comparison to a youthful looking, well put together person.
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