Saturday, April 18, 2009

Always Ask Further!

Last time we talked about that some assumptions are bad. And it's true that we assume things rather often, and sometimes when we ask further, we might get some surprising answers!;)

When suspecting peptic ulcer in an elderly,

Doc: "Pakcik, do you have gastric pain quite often?"
Pt: "Ya..."
Doc: "Have you passed blackish stool before?"
Pt: "Blackish? No never..."

If ask further, "So what's the colour of your stool?"
Pt: "Oh it's RED. With some blood one."

Isn't red worse than black? But patient might not be aware of it!

When suspecting poor glucose control,

Doc: "Pakcik, do you take your medication?"
Pt: "Ya ya..I always remember."
Doc: "Then do you check your blood sugar at home?"
Pt: "Ya ya..the control is always good."

If ask further, "How good is your good control?"
Pt: "Oh it's always below 25 mmol/L."

Sometimes, you really need to check pt's definitions of "good control"!

When suspecting orthopnea,

Doc: "Pakcik, how many pillows you use to sleep at night?" (classical standard ques)
Pt: "Oh I use two."
Doc: "How long have you been doing that?"
Pt: "Hmm almost 4 years already."

So pt's having orthopnea for 4 years?
If ask further, "Why do you use 2 pillows?"

Pt: "Oh I use one to hug and one below my head."

And all these are real scenarios. Tricky enough? ;-)


Zzzyun said...

haha the last one really tickled me!! so funny la the uncle :P

but its really normal for us to assume things eh..but looks like we gotta ask more Qs!! haha

wicrap said...

the 3rd patient is wicked..haha

Anonymous said...

Shud've started with open questions.. :p

Christie said...

haha..ya ya..exactly..that day i just asked a patient the same question...when i ask further..he told me that he use one to sleep and one to put his legs...>.<"

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