Tuesday, November 19, 2013

Taking Pills

"Tell me what brings you in today."

"Well, I just got a positive pregnancy test and I want to know why that happened because I've been taking the birth control like I was told."

"You have been taking pills? And you just had a positive pregnancy test?"

"Yes, how is that even possible?"

"Well, nothing is 100% effective except abstinence. This chart here shows that the chance of failure for perfect use is 0.3%, but about 8% in the real world-meaning about 8 women in 100 using the same birth control as you will get pregnant in one year. Did you take a pill every day?"

"Well, almost every day. I always tried to make sure there was one there."

"...What do you mean?"

"Well, sometimes I noticed it would fall out so I'm not 100% sure there was always a pill there."

"You haven't been taking the pills...in your mouth...as in swallowing them?"

"...No."

"Okay, I think I know what went wrong."

Birth Control Side Effects

"But doctor, how can I be pregnant?! We've been using the birth control."

"Did you take it every day?"

"Yes."

"Did you take active birth control continuously or did you start your next pack of blues when the old pack of blues ended?"

"We took one pill every day in the order they came in the package."

"You keep saying 'we' took the pills. What do you mean by that?"

"Well, the pills made me kind of nauseous so I gave them to my boyfriend to take. They didn't affect him at all."

"Wait, your boyfriend was taking your birth control pills?"

"Well, yeah. I didn't like the way they made me feel."

Hernia

"I think I have a hernia."

"Do you have a sense of fullness when you bear down?"

"Yes."

"Any nausea or vomiting?"

"No."

"Constipation or diarrhea?"

"No."

"Any blood in your stool?"

"No."

"Alright, I'm going to need to check the size of the defect in the abdominal wall to see if you are a candidate for surgery. Can you pull your pants down?...Now give me a cough...It's little."

"....Don't you think that's a little unprofessional, doc?"

Thursday, November 7, 2013

Crying

"Well, your son is healthy and looks likes he's growing well."

"He cries a lot. Is there something you can give him?"

"...To make him stop crying?"

"Yes."

"What did you have in mind?"

"I don't know. You're the doctor."

"He tripled his weight in four months while most babies are considered healthy if they only double their weight in that time so he's getting more than plenty to eat. He doesn't appear to be sick and we want to keep him that way. Are we going to vaccinate today?"

"Yes, but is there something we can give him so he doesn't cry after?"

"Well, he's going to cry because they are shots and they will hurt, but if you notice any fever you can try to give him some tylenol...2.5 mL for his weight."

"Okay."

"I'm not generally a fan of medicating babies into unconsciousness. Your baby is growing well, his ears are clean, his chest sounds good, there's no rash, I don't see any reason why I should give him anything."

"Also, we're going on an airplane. Is there something you can give him to help him not cry?"