Mullberry Whine

poured out before bed

A Tuchus Relaxes

…adapted from Gray’s Anatomy of the Human BodyHenry Gray, 1918…

“So, this is our 69yo M with DM2 with neuropathy, retinopathy, and nephropathy, on hospital day #5 for hyperglycemic hyperosmolar state with seizures,  acute on chronic kidney injury, and sepsis.  On admission, the patient suffered a witnessed seizure, presumed secondary to the HHS; he has had no subseqent seizures on the current antiepileptic regimen.   Also on admission he met criteria for septic shock and had blood culturesx2 positive for MRSA.  He is on day #5 of vanc/zosyn and has been afebrile with stable and normal vital signs for the last 4 days; repeat blood culturesx2 so far negative.  Admission creatinine was 3.1, his baseline running around 1.9-2.1; today’s creatinine is 2.3, and he continues to make appropriate volumes of urine.  His diabetic control has been poor, with average blood sugar at 313.  This is likely secondary to his refusal of the prescribed sliding scale insulin, as well as the jumbo packages of oreos and tootsie rolls his wife has been smuggling him daily.  With regard to his diabetic complications, his neuropathy is poorly controlled on the current gabapentin regimen, with the patient reporting constant burning of bilateral lower extremetries to the level of the malleoli.  Urine analysis shows overt proteinuria, so there has been progression of his previously observed microalbuminuria.  His last ophtho appointment was 3 years ago, at which time his retinopathy was thought to be moderate, but stable.  The patient denies decline in visual acuity since that time.  However, I feel his retinopathy is likely now more severe, as he told me today he felt I had the most nicely-shaped tuchus he’d ever seen on a woman.  I would recommend that we increase his 70/30 insulin from the current 30 units QAM and-“

Suddenly, from his deep, table-rounds induced state of pan-loathing, the attending – normally peremptory to rude, albeit rather detached – giggle-snorts and begins a slow, rising guffaw that sends the rest of the team into peals of laughter.  He claps my shoulder.

“You’re alright, kid,” comes a voice I’ve never before heard in conversational tones.  “What was your name again?”

Endocrine Score Card

* Mullberry – 100
* Unbelievably boring endocrine rounds with unfathomably up-tight and often positively unengageable attending – 0

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10 comments on “A Tuchus Relaxes

  1. kindredspirit23
    September 13, 2012

    You are right; sometimes, you just need to seriously joke…
    Scott

  2. ahyesplans
    September 13, 2012

    This was awesome.

  3. Dr. K
    September 13, 2012

    Love this story Mullberry. Sometimes the doctors are way too serious!!! Ps. If I ever land in the hospital, I will request oreos and tootsie from none other than you 🙂

    • mullberrywhine
      September 14, 2012

      Yes, we can be an uptight group – but once you get us giggling…then you’re in trouble! And I’d bring you all manner of doctor approved treats!

  4. ElizabethWolf
    September 14, 2012

    Please don’t ever stop blogging.

    • mullberrywhine
      September 15, 2012

      As long as there’s still a little juice in these fingers!

  5. Pingback: In 1940′s Fashion « Mullberry Whine

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Nothing under the table.
***
The views expressed on "Mullberry Whine" are NOT intended to diagnose or treat disease.
***
The med-ed related stories described here are based on real events. Details have been changed in accordance with HIPAA de-identification guidelines to protect confidentiality.
***
Mullberry Whine can be enjoyed daily; there is no unsafe quantity. Real wine, though, should be enjoyed in moderation. At-Risk Drinking for males under 65 is defined as >14 alcoholic beverages per week or >4/day, with >7 drinks a week or >3/day being the cut-off for females under 65 and for anyone, male or female, who has graced this planet for 65 years for more. Drink Mullberry Whine like there are no consequences. But drink alcohol responsibly. Your friends, your family, your health-care provider, and your liver - heck, ALL of the organs in your body - will thank you.
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