MyPoopisGreen

Let me explain something first - stool cards…or as we call them in the office “Poop-y Cards” are used to see if there is any hidden blood in your poop.  Yeah, I have a fun job, I know you are all very jealous.  Anyway, so the point of these cards is that there is a chemical reaction that happens when we place drops of a solution on the card where the patient has placed their stool over a few consecutive days.  There are instructions included in these poop-y card packets, and it really doesn’t take a rocket scientist to figure out that we want the poop spread ON THE CARD!!!

You might all see where this is going, and honestly I’m kind of surprised that over my time in doing these lovely tests that someone has not done this before.  However, there is a first time for everything, and this was definitely a first!  When the stool cards are complete the patient places them in a biohazard approve envelope that is mailed back to the office.  Once we get the packets we then open them up, pop open the back flap on each card and place the solution on each square as well as the control dot.  If something turns blue then that means there is some hidden blood.  If hidden blood is found the doctor is informed and then decides what’s next for the patient.  Sometimes it’s blood tests, sometimes it is a colonoscopy, and sometimes it is repeat stool cards to see if there was a false positive.  Which is always a possibility.  But, the card is really the important part in this whole scenario.  The card is what has the testing capabilities in it.  The card is what allows us to put drops of the solution on it and then see if something turns blue.

A, ummm, a piece of tissue paper full of a sample of poop is not really going to do much for the testing!!!  Yeah, I laughed.  Yeah, I cried, because I was laughing so hard.  Three pieces of tissue paper.  Three samples of poop.  And three things that we could do nothing with and didn’t really want to do anything with besides GET RID OF THEM!!!!  We did show it to the doctor, who also laughed and cried - and then told me that I would have to call the patient to EXPLAIN how to do the stool cards so that we could get an accurate test.  For the love of all things!  Help me!!!!

Oh well.  Guess that’s the way the cookie crumbles in this scenario.  Got a good chuckle out of me, after my other days that consisted of people talking about putting their finger places that it isn’t supposed to go.  STOP TOUCHING THERE!!!!!  AAAAHHH!! No one has any idea.  <Sigh>  Everyone, take care of yourselves.  I’ll write more later.  Ta-ta.

It’s not my job to tell you which clothes to wear, which appointments you should keep, or which foods you CAN’T eat.  Sure, I can advise you.  Sure, I can tell you what might be best in a situation - but WHY are you calling me to tell me that you have diarrhea, you took an Imodium, but should you keep your haircut?  Yes? No?  How am I supposed to know what you want to do?  Does your hair need to be cut?  Do you want to go get it cut today or would you rather reschedule when you are feeling better?  Oh yeah, wait - you NEVER feel better.  You just call and tell me ALL about your issues, even if they aren’t Gastro related and you FREAK OUT if I don’t talk to you, like somehow whether or not you go get your haircut is a dire emergency. Sure!  Go get your haircut!  But don’t you dare stay for a perm or a color that just isn’t a smart idea! Let’s think about these things, people!

I’ll grant you, I’m too nice.  I have my own issues that make me care about the people of this world, and then they drive me nutty and I have to type a blog to make myself feel a little better.  I care, I’m empathetic, sympathetic, and overly kind.  But that doesn’t mean that you call me, from a bathroom in Virginia!!!!, asking me if you can take your medication.  Do I think it will be okay?  Let me ask you this…How do you get up in the morning?  How do you get dressed by yourself?  How do you cross the damn street on your lonesome?  I mean seriously!

I got a phone call from one of my nicer patients, at 4:45 in the afternoon.  I spoke with her, thinking that something needed to be addressed.  “I have tried on 5 different outfits and I’m so bloated they are uncomfortable.  What should I do?”  You’re kidding me right?  You called me to ask me what you should wear because you feel fat?!?

 However, I think my favorite one from this past week was the patient that forgot that she hadn’t taken her fiber for a week.  She’d been suffering with increased stomach issues and she’d been diagnosed with IBS and it’s been about a week that she’s been noticing this.  She took that medication the doctor suggested, but she’s only getting minimal relief and what should she do?  Is something horribly wrong?  Have you been taking your Metamucil? I asked.  Oh.  No.  She ran out last week and hadn’t bought any and hadn’t been taking it.  It’s pure genius! Congratulations to me!

Okay, that was pure sarcasm.  But it’s exhausting having to deal with some of these questions.  I have very little patience left when it comes to actual things in life, because these people SUCK it all away.  I always figure though, at the very least I know what IS crazy, so that if I start experiencing symptoms I can get myself some help.  It’s a good piece of knowledge to possess. <Sigh> Well every one, stay sane!  Talk later.  Oh yeah - take care all.:)

I’m going to reiterate a message that I spoke about in one of my last blogs - Be nice to the office staff that you speak with.  But I’m also going to add something else on to that - Do you honestly think that you are the ONLY patient that the office staff/doctor are dealing with on that day?  I don’t know if it’s because I’m in the field, but I certainly don’t think that I’m the only person that is calling my doctor’s office with a question/complaint/issue.  I know, hell I expect, to wait to hear from my doctor’s office.  And I certainly don’t expect THE DOCTOR to call me back.  The doctors that I work with are overly sympathetic and incredibly nice.  They are the sweetest and most concerned people that I have ever met, they take the time to call a patient back, even in the same day as when the patient has left the message.  However, I think that it is almost above and beyond the call of their duty to constantly be talking to these people - and they will repeatedly call patients to explain things and have discussions with them.  But again, it is the patients that are NICE and that have the expectation that they will talk to the doctor when the doctor can do so.

My gripe is the over-demanding, out of control people, that just EXPECT to talk to the doctor and to hell with the middle men.  That’s not the way to play it people!  And on top of it, please understand that it gets to a certain point that the doctor just isn’t going to call you back anymore.  They aren’t going to talk to you anymore.  There ARE other patients besides you and they can’t keep taking the five or ten minutes out of their day to talk to you about your referral- because NEWSFLASH the doctors know NOTHING about such things.  They take care of the medical side of things.  They can answer what to do about your anemia, or answer questions regarding what was found during your procedure.  They are not the ones to ask what your insurance will cover and what it won’t.  They shouldn’t have to talk to five of the 105 year old’s family members to tell everyone the exact same thing.  If you, as the caretaker, can’t be at the office visit, then trust that the person you are sending with the 105 year old patient will do what you need them to do.  The doctor is not going to call you back to talk to you for “five minutes”  because I know as the Medical Assistant that “five minutes” to you is a reality of 20 or more minutes that the doctor doesn’t have.  They do work all day.  They are on call all night, and they have more than this one little patient to discuss, take care of and be there for.  And P.S. I’m not going to hold a gun to my doctors head and MAKE them call you!  It’s none of my business if the call is made or not, because it’s NOT my decision to make!  Unfortunately I’m still going to hear about it, and I know that I won’t be able to say to this person about holding the gun to my doctor’s head and the fact that my doctor would probably rather I pull the trigger than dial the phone to talk to you!

My final note: You can’t always get what you want.  And yes, that is a Rolling Stones song and I think it would be perfect hold music for the office.  The only thing that would be one better is to have a sign up in the office when the patients check in and check out that makes the comment of “This is NOT Burger King, you cannot have things YOUR WAY!” As comedian Dane Cook says in one of his routines.  But it’s very true!  This is life people, you can’t always get what you want, and the sooner your realize that the happier you might be and you might not be trying quite so hard to make other people miserable when you are feeling bad about yourself.

So that’s my little rant on this day.  I’m very tired, so please forgive me - I do love helping people, but some people are just so rude about things that you almost wonder WHY you are trying to help them at all.  It’s the way of the world I guess…or the phases of the moon?  Oh right, next time, I’ll try to remember to tell you all about the patient that only gets constipated with the New Moon.  It’s amusing, that’s for sure.  In the mean time…take care all!:)

The thought occurs to you… am I expecting too much?  Sometimes I think that I am; which is my bad.  But then I also try and look at things from the other side, and I think - no, these people are just crazy.

Okay, so I’m not a psychologist.  And yes, emotions and pain get the better of you sometimes.  This I realize.  I have been there.  Pain makes a lot of people crazy, because sometimes the pain is so intense and no one believes you because they can’t feel it.  So when I say that I “feel your pain” I actually do try and put my feet in other people’s shoes - which could be a painful experience in and of itself.  Okay, off topic.  Sorry.  Anyway, my point here is that while you might be in pain, and you might not know what is going on, please - PLEASE!!! try and communicate in the most succinct and logical way WHAT your pain is, WHAT you want me to do, and HOW this pain hurts.  I know it’s hard - but if you really think about it, the information you need to relay is right there.

My rant?  I’m a Medical Assistant in Gastroenterology - this means GI problems - you have stomach pain, you have lower abdominal cramps, you have pain down in  your intestines, you have heartburn/acid reflux, you can’t swallow properly, hell you can even have issues with your liver and pancrease and I’m your girl - but back pain?  Not in my realm.  And especially not in my realm if you have been put on Codeine by a completely different doctor and you want to know why you are having a burning sensation under your rib cage, you have skin sensitivity and you can’t in any way explain to me what kind of pain you are having.

“I’ve had back pain for a while, my doctor put me on Codeine without Tylenol in it and I’m having this burning sensation and this abdominal cramping as well as loose stool.”

“So abdominal cramping and loose stool - how much Codeine are you taking?”

“My doctor told me to take one every four hours for the pain.  But I’ve been taking two every three hours because the pain is so bad.  And it’s not abdominal cramping, and I don’t have diarrhea…”

Didn’t you just tell me that you did? <Sigh> “Okay, well, if it’s not abdominal cramping, then what is it? Abdominal pain?”

“It’s the nerves.  There’s this place on my stomach that if you push on it, it really hurts.”

Then don’t push on it.” So is it more like skin tenderness?  You could be having an allergic reaction to the Codeine, maybe you should stop taking it - because you at least sound to have a sensitivity.  But I shouldn’t really be making this decision, you should really call your prescribing doctor, it sounds like you are almost taking too much of it.”

“But there isn’t any tylenol in it, and my back hurts really bad.  I don’t know, I could have a kidney stone, cause I’m subject to those.  I don’t really feel comfortable with what you are telling me.”

No crap, lady.  I have nothing to do with your back pain, or your apparent NEED for codeine! You’ve probably burned a hole in your stomach with that much of a controlled substance -with or without tylenol, which is only saving your liver!!!  And where the hell did ‘I might have a kidney stone’ come from?!? ”I don’t really know what you want me to do.  You expressed that you didn’t want to go to the ER and I feel strongly, that is what you should do.”

“Yeah, I know.  But I just think I should call my other doctor and see how he feels.  I’m just in so much pain. And I don’t know what this abdominal pain is all about…”

“Abdominal pain? Or the skin tenderness?”

“It’s the nerves.  I don’t know, I don’t have diarrhea, and it’s this pain on my left side looping around towards my back. I just feel as though you should know better than I whether this is the codeine…”

Yeah, is your head spinning yet?  I talked with this woman for a good twenty minutes trying to get her to understand that I wouldn’t know if it was her back pain, and that she should really go to the Emergency Room considering she didn’t know where all her pain was coming from and couldn’t get me to understand either.  On top of it, she shouldn’t be taking that much codeine in one sitting, I don’t care who you are!  And on a sidenote, I didn’t prescribe your codeine, so really it’s none of my damn business!!!!  Again I say, I don’t do backs!  You have “the diarrhea”  and I can jump to it - but otherwise call the doctors office that prescribed you the damn medication!!!

So as fun as that all was - I did actually feel bad in the end of that.  I don’t know what was wrong with this lady, and I documented the hell out of my conversation with her.  I couldn’t pin point any particular thing going on with her, other than the fact that she had back pain, was taking too much codeine, and was most likely having a reaction to it.  Most important thing in the medical field - If it isn’t written, it never happened - and you’ve always got to cover your butt.

Take care all.  I’m thinking my next entry will be in regards to anatomy - why people think that I want to know all about their runny noses and coughs is beyond me.  Tell your PCP!:)  Later!