MedWorm.com provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest items from the 'Mr. Hassle's Long Underpants' source. Mon, 17 Nov 2008 22:51:15 +0100 http://feeds.feedburner.com/~r/MrHasslesLongUnderpants/~3/443728049/transcript-of-obamas-election-night-speech.html Already, someone has transcribed this speech.  I’m not the most politically savvy person in the world, probably among the least.  But I’ve never been so enthralled as to listen to a politician speak.  Now I want to go backwards and listen to all the speeches I didn’t hear, even back into his days as a state politician and law student.  He’s always seeming to overcome, but I guess that’s what happens when you are a smart, successful, eloquent, passionate, mixed minority, charismatic leader in the right places at the right times with the right world, political and local circumstances compelling the people to make their opinions count. Here is the transcript of Obama’s Election Night Speech (Source: Mr. Hassle's Long Underpants) Mr. Hassle's Long Underpants blogs http://www.medworm.com/rss/comments.php?id=1938997 Wed, 05 Nov 2008 22:30:52 +0100 1938997 http://feeds.feedburner.com/~r/MrHasslesLongUnderpants/~3/438170560/daylight-savings-time-causes-more-heart-attacks.html Yes, I thought that the study headline seemed odd as well…after all how would a man-made construct…the clock…lead to more heart attack deaths? In a widely report on study from the New England Journal of Medicine, heart attack deaths and hospitalizations dropped 5 % the day after clocks “fell back”, ending daylight savings time. Could the causative factor be, oh, I don’t know…an extra hour of sleep? Americans are chronically sleep deprived, including Doc Shazam.  THe problem is that we think that this is normal…it’s a badge of honor to be able to “function” on 4,5,6 hours of sleep per night. In reality, we only learn to tolerate the chronic fatigue associated with the lack of sleep. What we don’t see is the toll this t... Mr. Hassle's Long Underpants blogs http://www.medworm.com/rss/comments.php?id=1926395 Fri, 31 Oct 2008 15:59:01 +0100 1926395 http://feeds.feedburner.com/~r/MrHasslesLongUnderpants/~3/437052548/uninsureds-dont-tell-the-whole-story-and-a-little-rant.html In this New York Times report of  a recent study, the uninsured did not take up a disproportional amount of volume in the ER for minor complaints.  Uninsured people DO tend to be more informed users of hospital resources because they know that they will get a bill in the mail and have to pay it.  So this is a great study to bring light to a number of issues. What’s truly disturbing is the study’s documentation of how many people come to the ER for minor complaints  As it turns out, people who have public insurance, such as Medicaid, were more likely to crowd into the emergency room for minor complaints, especially in low-income areas. This makes total sense to me…in my experience, the patients that  tend to be most demanding and least appreciative of the services off... Mr. Hassle's Long Underpants blogs http://www.medworm.com/rss/comments.php?id=1924442 Thu, 30 Oct 2008 15:57:55 +0100 1924442 http://feeds.feedburner.com/~r/MrHasslesLongUnderpants/~3/437037233/another-1-google-ranking-for-how-to-fake-wheeze.html I love it!  My post on How to Fake Wheezing and Stay out of Jail is ranked #1 for the google search phrase ‘how to fake wheeze’! Satisfaction indeed. (Source: Mr. Hassle's Long Underpants) Mr. Hassle's Long Underpants blogs http://www.medworm.com/rss/comments.php?id=1924443 Thu, 30 Oct 2008 15:47:32 +0100 1924443 http://feeds.feedburner.com/~r/MrHasslesLongUnderpants/~3/434351148/the-hallway-is-the-new-place-to-be.html When I saw this headline on CNN I was afraid they were going to get the story all wrong.  But this reporter did a good job of explaining at least part of the situation: Hospitals put Patients in Hallways My favorite quote from the article, with which I agree 100% “I wish the $700 billion went for hospitals, roads and bridges and not to bail out those folks on Wall Street,” he said. (Source: Mr. Hassle's Long Underpants) Mr. Hassle's Long Underpants blogs http://www.medworm.com/rss/comments.php?id=1917915 Tue, 28 Oct 2008 05:18:54 +0100 1917915 http://feeds.feedburner.com/~r/MrHasslesLongUnderpants/~3/431377501/can-i-base-my-voting-off-of-this-poll.html 77% Bill Richardson74% Chris Dodd72% Hillary Clinton71% Barack Obama68% John Edwards59% Joe Biden54% John McCain53% Dennis Kucinich53% Mike Gravel49% Mitt Romney44% Rudy Giuliani42% Mike Huckabee42% Tom Tancredo38% Fred Thompson37% Ron Paul2008 Presidential Candidate Matching Quiz Apparently, I’m STILL a democrat. Take the Presidential Candidate Matching Quiz Here. (Source: Mr. Hassle's Long Underpants) Mr. Hassle's Long Underpants blogs http://www.medworm.com/rss/comments.php?id=1905832 Sat, 25 Oct 2008 04:12:07 +0100 1905832 http://feeds.feedburner.com/~r/MrHasslesLongUnderpants/~3/429232100/guess-we-know-which-way-ill-vote.html I’m ranked number 8 on Google for a search on “don’t vote for McCain reason“. (Source: Mr. Hassle's Long Underpants) Mr. Hassle's Long Underpants blogs http://www.medworm.com/rss/comments.php?id=1901408 Thu, 23 Oct 2008 04:06:02 +0100 1901408 http://feeds.feedburner.com/~r/MrHasslesLongUnderpants/~3/427083645/either-its-broken-or-its-not-broken.html To be filed under sports injuries: After a 5 turnover, 41-7 loss against the New ENgland Patriots, Mike Shanahan, head coach of the Denver Bronco’s responds to a reporters question about whether Jay Cutler’s injured finger would need an MRI this week: I don’t think fingers need MRIs, either it’s broken or it’s not broken.   I’m not a doctor, but I think that’s the case. (Source: Mr. Hassle's Long Underpants) Mr. Hassle's Long Underpants blogs http://www.medworm.com/rss/comments.php?id=1894901 Tue, 21 Oct 2008 04:02:41 +0100 1894901 http://feeds.feedburner.com/~r/MrHasslesLongUnderpants/~3/423340961/four-things.html I got tagged by Kim from RN for Life in my comments the other day, and have been ruminating on my answers. Here goes…don’t be shocked. [ed note: OK, this post was drafted 2 years ago, I just decided to publish it after finally thinking of four movies & places] 4 Jobs I Have Had In My Life: Outward Bound Instructor Retail clerk/manager for an outdoor outfitter (backpacking, rockclimbing, kayaking) Summer job at a pet kennel (geese & puppies & kittens, oh my!) Grasscutter/Fence Painter for borough parks 4 Movies I Could Watch Over and Over: The Wall Monday Night Football (does that count?) Men in Black 4 Websites I Visit Regularly: Beginner triathlete My Yahoo stock page Wealthy Affiliate CNN 4 of my Favorite Foods Freshly Brewed Ice Tea Sushi Dark Chocolate, especia... Mr. Hassle's Long Underpants blogs http://www.medworm.com/rss/comments.php?id=1886331 Fri, 17 Oct 2008 04:13:20 +0100 1886331 http://feeds.feedburner.com/~r/MrHasslesLongUnderpants/~3/422467639/john-ritters-widow-inspired.html Somehow John Ritter’s Widow’s remarks following the not-guilty verdict of two physcians angers me to no end.  ”I disagree with the jury’s decision but I believe in the system and I respect it,” said the widow, Amy Yasbeck. “It inspires me even more to find, with these brilliant medical minds, a path to diagnose aortic diseases.” So what is she saying?  It seems to imply that she realizes that brilliant medical minds cannot always definitively diagnose and treat aortic dissection.  And yet she disagrees with the jury?  And why did it take a jury of non-medical laypeople to convince her that the medical minds involved were brilliant?  Could neither she, nor her lawyer, nor the media, nor the hospital’s lawyers convince her of this?  So al... Mr. Hassle's Long Underpants blogs http://www.medworm.com/rss/comments.php?id=1886332 Thu, 16 Oct 2008 09:18:10 +0100 1886332 http://feeds.feedburner.com/~r/MrHasslesLongUnderpants/~3/420749890/shared-health-decisions.html The results of this article are no surprise, and this is a real pet peeve of mine. The article says that many patients who were supposedly participating in “shared health decisions” with their physician either had no input and/or reported it as being a negative experience. That’s no surprise to me. As an ER doc, if a patient comes in with no family members or paperwork, we are forced to do everything possible to keep them alive when we don’t know what their wishes are. Sometimes the family is with them and says, “just keep them comfortable.” Those cases are rare and refreshing. Sometimes there is a stack of paperwork with a list of check-boxes saying No CPR, No Intubation, Yes Antibiotics, etc. But when the family says, “Do everything”, you a... Mr. Hassle's Long Underpants blogs http://www.medworm.com/rss/comments.php?id=1879795 Tue, 14 Oct 2008 17:48:47 +0100 1879795 http://feeds.feedburner.com/~r/MrHasslesLongUnderpants/~3/418443141/net-worth-not-worth-the-hassle.html I am never one to cry that the sky is falling.  When I saw that the market fell below 10,000, I was secretly happy…the market is on sale.  It’s a good time to buy, I thought to myself.  When it fell even further I finally scratched my head and looked at a stock chart…I’d been avoiding it the past few weeks. Today I made the mistake of checking my Vanguard account status.  Ouch. I keep telling myself it’s a good time to buy… (Source: Mr. Hassle's Long Underpants) Mr. Hassle's Long Underpants blogs http://www.medworm.com/rss/comments.php?id=1873018 Sun, 12 Oct 2008 09:10:21 +0100 1873018 http://feeds.feedburner.com/~r/MrHasslesLongUnderpants/~3/417611283/can-obama-create-tax-credits-for-health-insurance.html The Wall Street Journal is reporting that health care analysts are calling John McCain’s plan is “fundamentally correct”…but it seems that their focus is on only one part of his plan…providing tax credits to individuals for buying their own health insurance. Clearly health insurance needs to be affordable for individuals, and the link between employer based health insurance and your job needs to be severed.  Health insurance must be portable, or else it contributes to excess job and work related stress…but it also needs to be affordable…at least until healthcare in the US becomes affordable again. In an op-ed for the Wall Street Journal (10/7), David Gratzer, a senior fellow at the Manhattan Institute, writes that Sen. John McCain’s (R-Ariz.... Mr. Hassle's Long Underpants blogs http://www.medworm.com/rss/comments.php?id=1870627 Sat, 11 Oct 2008 08:59:34 +0100 1870627 http://feeds.feedburner.com/~r/MrHasslesLongUnderpants/~3/416612800/how-to-fake-wheezing-and-avoid-going-to-jail.html First of all, you can’t fake wheezing.  Wheezing occurs deep in the small airways and alveoli.  it is a characteristic noise that cna be heard, even through screaming babies and mumbling old men.  It’s a sound that can’t be mistaken for gurgling, moaning, croup, stridor, coughing or purposely constricting your throat. A wheeze is a wheeze is a wheeze,  and you can’t fake it. So if you’re ever in the situation wher eyouare arrested, and you try to fake an upper respiratory illness and demand that you need to be admitted to the hospital until the doctors get your wheezing under control…don’t even try it…you can’t fake it. But even more important to remember is that if you TRY to fake wheezing, it’s best to do some breathing&#823... Mr. Hassle's Long Underpants blogs http://www.medworm.com/rss/comments.php?id=1870628 Fri, 10 Oct 2008 09:03:40 +0100 1870628 http://feeds.feedburner.com/~r/MrHasslesLongUnderpants/~3/416121063/maddog-knows-my-social-fears.html Maddog Medic is a blogger from way back in the day when there were just a handful of us ER types blogging. He’s still active and still tells the truth. Here is a recent excerpt from a post about the awkwardness of knowing what it is that keeps people alive… An earnest young student asks me a serious question: “What’s the hardest part about being a paramedic?” I look her right in the eye. “Cocktail parties.” I say this with all seriousness. She leans back in her chair, blinking her disbelief. It’s the social that’s the most difficult. I could substitute “Cocktail Parties” with “Family Gatherings”. It’s awkward. I am not a Doctor. It’s just something that I do. It’s a skill that can be learned an... Mr. Hassle's Long Underpants blogs http://www.medworm.com/rss/comments.php?id=1865431 Thu, 09 Oct 2008 20:44:43 +0100 1865431 http://feeds.feedburner.com/~r/MrHasslesLongUnderpants/~3/415595968/massachusettes-plan-gobbling-up-state-funds.html Since instituting mandatory health insurance for all residents of Massachusette’s, a recent study finds that one of the plan’s goals of connecting more patients with PCPs has failed miserably.  Accordign to the Boston Globe, Thousands of newly insured Massachusetts residents are relying on emergency rooms for routine medical care, an expensive habit that drives up healthcare costs and thwarts a major goal of the state’s first-in-the-nation health insurance law. The law framers had hoped that instituting mandatory health insurance, would open the door to primary care offices for many previously unisnured patients.  But instead what they are finding is that these patients are still using ERs as their primary care, increasing the burden on overworked ERs. People flock to E... Mr. Hassle's Long Underpants blogs http://www.medworm.com/rss/comments.php?id=1865432 Thu, 09 Oct 2008 08:54:28 +0100 1865432 http://feeds.feedburner.com/~r/MrHasslesLongUnderpants/~3/408012440/best-chief-complaint-of-the-night.html I was just finishing my shift when I saw this chief complaint pop up on the triage list… “Privates sweaty and bothersome” I finished up my last dication and ran out the door! (Source: Mr. Hassle's Long Underpants) Mr. Hassle's Long Underpants blogs http://www.medworm.com/rss/comments.php?id=1844625 Wed, 01 Oct 2008 07:25:12 +0100 1844625 http://feeds.feedburner.com/~r/MrHasslesLongUnderpants/~3/379274707/one-reason-i-wont-vote-for-mccain.html Is his healthcare advisor’s attitude toward’s Emergency Departments:  In the Los Angeles Times’s (8/28) Booster Shots Blog, Shari Roan wrote that this week, “John McCain campaign advisor” John Goodman “said, in effect, that as long as there are emergency [departments], no one in America is really uninsured.” And… Op-ed columnist Paul Krugman writes in the New York Times (8/29, A21) that according to Goodman, in America, “there’s no such thing as being uninsured. After all, you can always get treatment at an emergency [department].” Furthermore, Goodman “the president of the National Center for Policy Analysis, an important conservative think tank…wants the next president to issue an executive order prohibiting t... Mr. Hassle's Long Underpants blogs http://www.medworm.com/rss/comments.php?id=1746051 Sun, 31 Aug 2008 00:24:24 +0100 1746051 http://feeds.feedburner.com/~r/MrHasslesLongUnderpants/~3/376526612/the-tale-of-the-drunken-cowboy-part-1-of-a-tale-in-3-parts.html The drunken cowboy paced in and out of his room, looking for something.  Looking to make sure no one was watching.  Holding his left arm at his side with his forearm across his chest, he paced out into the hallway once more.  Looking left then right, he turned towards the exit and began walking.  Even his casual cowboy gait looked suspicious. He stopped at admissions and asked one of our petite, 97 pound receptionists, “Are you guys gonna show me how to put this on or what?” he asked, holding out a foil covered fiberglass split, still in it’s package unopened. The receptionist coolly guided him back to his room in the ER to await my evaluation. As I introduced myself, I wrestled the fiberglass package out from under the (obviously) broken arm and sat him down on the b... Mr. Hassle's Long Underpants blogs http://www.medworm.com/rss/comments.php?id=1739027 Wed, 27 Aug 2008 21:35:50 +0100 1739027 http://feeds.feedburner.com/~r/MrHasslesLongUnderpants/~3/360146397/if-youre-not-a-cowboy.html I see a lot of Horse injuries up here in the rocky mountains.  Mostly tourist stables and stuff, but when there are horse shows in town, we seem to get a lot of hunter-jumper injuries…girls getting thrown headfirst from their horse. Which is wierd, because during the rodeo, when guys are deliberately riding horses & bulls getting thrown off, we never see them in the ER.  Those cowboys are tough and refuse to go to the hospital, even if they can’t breath or walk. So my new motto is, “If you’re not a Cowboy, don’t get on a horse.” (Source: Mr. Hassle's Long Underpants) Mr. Hassle's Long Underpants blogs http://www.medworm.com/rss/comments.php?id=1692120 Sat, 09 Aug 2008 07:43:36 +0100 1692120 http://feeds.feedburner.com/~r/MrHasslesLongUnderpants/~3/334161556/no-time-to-say-goodbye.html I’m feeling empty inside tonight. They were a  happy couple in their 70s, traveling every summer as they had done since their grandchildren were first born.  Finally feeling like they had finished raising their own children the couple enjoyed a carefree, low-budget retirement by driving their VW van to National Parks during the summertime. After a sleepless night of indigestion, he wanted to take it easy that day.  They took their van up over the summit of the national park and remarked on the wildflowers in bloom, the wildlife, the birds, the amazing pine scented air. She took photos of him picking flowers for her, candid shots of him daydreaming in the mountain air.  A bystander took a photo of the couple in front of the “Lava Cliffs” sign.  He had brought a santa ... Mr. Hassle's Long Underpants blogs http://www.medworm.com/rss/comments.php?id=1615936 Sun, 13 Jul 2008 10:05:28 +0100 1615936 http://feeds.feedburner.com/~r/MrHasslesLongUnderpants/~3/322676509/do-i-work-in-a-circus.html I rounded the nurses station to drop off a chart only to by confronted by a clown. I did a double take…yes, it was a clown, sitting in a wheelchair. A Pink curly wig donned his head and billowing teal pants with red and pink polka dots spilled through the spokes of the wheels. He sat staring straight ahead. The droop on one side of his face pulled his make-up over to one side and made his painted red nose even more prominent. But it didn’t make me laugh. I quickly examined the clown from head to toe and added some new parts to my neurologic examination. “Raise your eyebrows for me,” I said. His rainbow painted eyebrows tilted his whole forehead to his left as he struggled get them up. “Show me all your teeth.” The cognitive dissonance between a clown wit... Mr. Hassle's Long Underpants blogs http://www.medworm.com/rss/comments.php?id=1554395 Sun, 29 Jun 2008 17:00:16 +0100 1554395 http://feeds.feedburner.com/~r/MrHasslesLongUnderpants/~3/303458843/i-may-actually-vote-mccaintalk-me-out-of-it.html The last time I voted republican was when I was 18.   But the idea of simplified taxes is attractive.  Portable and affordable health insurance? I’m in.  Cleaner energy?  Check.  What’s to dislike so far? This is not a trick post…talk me out of it, please… (Source: Mr. Hassle's Long Underpants) Mr. Hassle's Long Underpants blogs http://www.medworm.com/rss/comments.php?id=1492005 Tue, 03 Jun 2008 05:18:27 +0100 1492005 http://feeds.feedburner.com/~r/MrHasslesLongUnderpants/~3/293607309/lola-the-leaking-basset-hound.html Rather than write my own version of the night, I’ll just post this group poem that was written the next day. Once upon a midnight dreary There I pondered, weak and weary About a hound named Lola Covered with bumps of curious lore. When all at once I heard a knockin’ Lee-Ann cried, “Shazam! This dog is Talking, About an oozing bloody mass that’s Spewing pus upon her fur!” Then the puss soaked, slimy rustling of each fur Sickened me-left with a queezy feeling never felt before My Soul grew stronger, hesitating then no longer “L-A I will help you ferry, and in the process make more merry The journey to the vet, to ensure the health of the ‘lords pet Route 8 and nothing more, Now Dasher, Now Dancer, Now Prancer, Now Vixen. On Comet, On Cupid, On Doner,... Mr. Hassle's Long Underpants blogs http://www.medworm.com/rss/comments.php?id=1454319 Mon, 19 May 2008 16:41:30 +0100 1454319 http://feeds.feedburner.com/~r/MrHasslesLongUnderpants/~3/290006877/a-funny-thing-happened-while-i-was-googling-patcher1048.html My laptop is crazy slow, so I began cleaning up the harddrive…uninstalled programs I no longer use, running CCleaner, etc. Some of the files that were deleted had the directory string “C:\Temp\Patcher\Patcher1048\PBSLocalizedStrings\PBSLocalization\es_ES\PBS.zdct 5.88KB” There were hundreds of these…what the heck are they? So I googled “patcher”, and got millions of hits. Then I googled “patcher1048″ and got ZERO hits.  That’s right, zero. So try googling “Patcher1048″. If I’m lucky, I’ll be the only result.  I wonder how many people search for patcher1048? (Source: Mr. Hassle's Long Underpants) Mr. Hassle's Long Underpants blogs http://www.medworm.com/rss/comments.php?id=1442760 Wed, 14 May 2008 07:56:14 +0100 1442760 http://feeds.feedburner.com/~r/MrHasslesLongUnderpants/~3/285101538/is-my-mother-in-imminent-danger.html I was trying to quickly wrap up my patients for the afternoon, since I had someplace to be at 6pm (a bike race to be specific), when  the nurse taking care of the woman in room F told me that her son had some questions for me. I sighed.  I always want patients and family to understand what is happening, but sometimes I feel like i explain the same thing over & over again (because I do, most of the time).  But this time the questions were different. “I need you to be frank with me,” her son stated solemnly, but peacefully at the same time.  I actually felt soothed by being in the room with the woman whose blood pressure was 88 systolic and her pulse ox was 85%.  “Is my mother in imminent danger of dying?” he asked. I wasn’t quite sure how to answer his... Mr. Hassle's Long Underpants blogs http://www.medworm.com/rss/comments.php?id=1426281 Wed, 07 May 2008 04:16:29 +0100 1426281 http://feeds.feedburner.com/~r/MrHasslesLongUnderpants/~3/283644424/demented-man-fights-off-ex-boxer-in-midnight-attack.html This poor old man with dementia was in a fist fight with another resident.  So the staff tried to commit him to the psychiatric hospital. I got the same basic story from both the patient and the staff.  Apparently, another resident went into his room, and the patient was afraid that he was being attacked, so he took care of the situation and fought back. I felt bad for the little old guy, but was more irritated at the nursing home staff.  There is a misconception that all they have to do is fill out the committment papers, and it’s a done deal…the patient gets admitted to the psych hospital against their will. It’s basically the same as putting someone in prison, and has legal ramifications that are similar. The problem was, that this wasn’t a psychiatric problem... Mr. Hassle's Long Underpants blogs http://www.medworm.com/rss/comments.php?id=1419636 Mon, 05 May 2008 02:50:30 +0100 1419636 http://feeds.feedburner.com/~r/MrHasslesLongUnderpants/~3/282245287/extensor-tendon-repair-in-honduras-part-3.html We created the best sterile field that we could and numbed up the laceration with as much lidocaine with epi as was safe to administer.  We had run the hand under running water to disrupt the clot, and then irrigated with sterile saline. The distal tendons popped into view easily by simply extending all of his fingers flat against the table. They popped out like little white worms and just sat there.  That was easy.  The hard part was findign the proximal ends.  I gently dissected the tissue back towards his wrist, grasping the overlying skin & fat in forceps then cutting the skin with a scalpel. I was shocked when I saw a small whitish object hiding under the retinaculum.  I quickly grasped it with forceps and pulled it out, placed a stich through it and kept it in sight.  I tug... Mr. Hassle's Long Underpants blogs http://www.medworm.com/rss/comments.php?id=1416200 Fri, 02 May 2008 17:32:47 +0100 1416200 http://feeds.feedburner.com/~r/MrHasslesLongUnderpants/~3/278056878/part-2.html They hadn’t eaten since before starting work that morning and by the time they arrived at the clinic, it was late in the afternoon, the hottest time of the day. This is when I met him for the first time. “Doc Shazam, we need you.  We have a  machete injury…” said the 3rd year resident. While minor trauma and fractures is run of the mill for me, the family practice docs that typically staff the medical clinic in the rural mountain village seem to find relief with my presence whenever the presenting complaint is trauma.  So a machete laceration that is right up my alley is gladly referred to me by the other docs. This was the first machete injury I’d seen on this particular trip. Usually we have at least a handful.  It makes me wonder what the villagers do t... Mr. Hassle's Long Underpants blogs http://www.medworm.com/rss/comments.php?id=1400643 Sat, 26 Apr 2008 04:24:58 +0100 1400643 http://feeds.feedburner.com/~r/MrHasslesLongUnderpants/~3/274165412/of-machetes-and-snake-bites.html I just returned from a 2 week trip to rural northern Honduras where muddy roads twist up steep mountain sides, and where farmers manage near vertical fields of corn and beans where mahogany trees once grew. A fifteen year old farmer leaned over in the beating sun, swinging his machete in his right hand while gathering ripe corn with his left.  His 10 year old brother picked up the ears that had fallen to the muddy ground.  The older boy suddenly felt a cool touch on the back of his neck…followed by a slick sensation running down his left arm. With an automatic reaction fueled by terror, the poisonous snake was killed with one swift  swing of his machete.  His left hand began spurting blood from the deep laceration left by the machete.  The snake was dead, but he could no longer ... Mr. Hassle's Long Underpants blogs http://www.medworm.com/rss/comments.php?id=1386025 Sun, 20 Apr 2008 17:05:34 +0100 1386025 http://feeds.feedburner.com/~r/MrHasslesLongUnderpants/~3/262357328/test.html If you are seeing this post, it’s because Doc Shazam successfully migrated to a new server, and none too soon! I”m off to Honduras again for 2 weeks, and the last thing I needed was to deal with a testy host.  One of the OTHER sites on my hosting account was having bandwidth problems, but they shut this site down since it’s the main site with them.  No problem…I just moved it to a new host and server. So if you are looking for a great host, try HostGator.  I’ve got several sites with them, and now Mr. Hassle is here as well. (Source: Mr. Hassle's Long Underpants) Mr. Hassle's Long Underpants blogs http://www.medworm.com/rss/comments.php?id=1344175 Tue, 01 Apr 2008 23:50:53 +0100 1344175 http://feeds.feedburner.com/~r/MrHasslesLongUnderpants/~3/253526991/he-should-have-been-dead.html This gentleman was really, really nice, but he should have been dead before he even got to our hospital.  I wouldn’t be surprised if this was close to a reportable case due to the size of it. He’d had multiple kidney stones in the past and came in complaining of a “Kidney Stone”.  Classic pain, left flank radiating to his left groin.  You know, his pain may have actually been caused by the kidney stone, but that’s not why he should have been dead. Whenever i have a patient with a history of kidney stones, I always review previous CT scans to see how recently one was done, how large the stones were and if there were any in waiting in the kidneys.  Despite being seen by one of our urologists, this guy had no previous CT scans at our hospital. Which means tha... Mr. Hassle's Long Underpants blogs http://www.medworm.com/rss/comments.php?id=1310991 Tue, 18 Mar 2008 09:16:33 +0100 1310991 http://feeds.feedburner.com/~r/MrHasslesLongUnderpants/~3/252353911/nine-minutes-in-the-afternoon.html This guy was real whiny, complaining, “My chest hurts, my chest hurts.”  My very first thought was, “what a wimp”.  He was thirty four years old and appeared relatively healthy.  What could possibly be causing a 34 year old man so much pain that he was squirming in bed?  He wouldn’t look me in the eye and winced everytime I did something to try and examine him. I felt his calves.  No swelling, no tenderness, probably not a PE.  I asked his medical history and “social” habits.  Pretty low risk for MI.  He was thin, but not real tall.  His hands and fingers looked normal to me…probably not Marfan’s or aortic root dissection.  Hmm.  Pericarditis?  The really bad cases usually LOOK awful, like they are having a heart attack.  T... Mr. Hassle's Long Underpants blogs http://www.medworm.com/rss/comments.php?id=1306013 Sun, 16 Mar 2008 09:06:29 +0100 1306013 http://feeds.feedburner.com/~r/MrHasslesLongUnderpants/~3/251678514/john-ritters-doctors-cleared-of-malpractice-charges.html It’s a shame that these doctors had to go through so much grief and stress when in their hearts they (and all of their fellow colleagues) knew that they did what was right and what was best and the patient died anyway. The treating physicians were cleared of malpractice by the jury in Glendale Superior Court. Five years of misery for them…I’m sure it adversely affected their physical and mental health, their relationships with their friends and family and their ability to practice medicine with confidence and giving their patients the best medical treatment possible. I know that John Ritter’s family will never have their husband and father back again…but retaliation and blame is not an appropriate way to deal with greif. Ironic that after a juried trial the do... Mr. Hassle's Long Underpants blogs http://www.medworm.com/rss/comments.php?id=1304934 Fri, 14 Mar 2008 23:22:09 +0100 1304934 http://feeds.feedburner.com/~r/MrHasslesLongUnderpants/~3/247083914/the-inspection.html So here’s the house update… Last week I met with my real estate agent in his office to craft an offer for the house.  I’ve never bought a house before (or made an offer), so this took several hours, and I was very, very tired, having worked the night shift 3 days in a row prior to the meeting. He presented our offer that night, we negotiated a bit over the phone, and I gave them my bottom line final offer. They turned it down. “It’s not over till the fat real estate agent signs,” he said. And we waited. I got a call on Sunday afternoon, they had accepted my offer! Yikes, now the real work starts. Get an inspection, call the mortgage broker, get a credit check (My FICO is 790!) more later… (Source: Mr. Hassle's Long Underpants) Mr. Hassle's Long Underpants blogs http://www.medworm.com/rss/comments.php?id=1284738 Fri, 07 Mar 2008 01:10:29 +0100 1284738 http://feeds.feedburner.com/~r/MrHasslesLongUnderpants/~3/242357390/terrible-towels-at-half-mast-myron-cope-dies-today.html This saddens me to an unbelievable degree. Unless you grew up in Pittsburgh listening to his classic voice and announcing style, and have been waving terrible towels since Pittsburgh’s dynasty decade of the 70s, you probably think of him as not much more than a wierd Pittsburgh icon. But he was much more than that: Cope’s tenure from 1970-2004 as the color analyst on the Steelers’ radio network is the longest in NFL history for a broadcaster with a single team and led to his induction into the National Radio Hall of Fame in 2005. “His memorable voice and unique broadcasting style became synonymous with Steelers football,” team president Art Rooney II said Wednesday. “They say imitation is the greatest form of flattery, and no Pittsburgh broadcaster was i... Mr. Hassle's Long Underpants blogs http://www.medworm.com/rss/comments.php?id=1263374 Wed, 27 Feb 2008 22:27:16 +0100 1263374 http://feeds.feedburner.com/~r/MrHasslesLongUnderpants/~3/242314318/doc-shazam-buying-a-home.html Could it be that finally after 4 decades, Doc Shazam is buying a house? Timeline: 2/26/8: Look at a house with a friend/real estate agent.  Say to self, “I could live here.”  Time: 30 minutes  2/27/8: Call mortgage broker whose business card I got when I overheard him in a coffee shop talking to clients.  Get pre-approved over the phone, says he’ll send me a letter tonight.  Duration of phone call: 10 minutes (or less) Stay tuned. (Source: Mr. Hassle's Long Underpants) Mr. Hassle's Long Underpants blogs http://www.medworm.com/rss/comments.php?id=1261604 Wed, 27 Feb 2008 20:51:19 +0100 1261604 http://feeds.feedburner.com/~r/MrHasslesLongUnderpants/~3/234816015/the-fonz-testifies-regarding-john-ritters-death.html So this really seems like an unnecessary witness providing niether fuel nor water for either side of the case. Henry Winkler recently took the stand to testify in John Ritter’s death. Newspaper reports simply say that they talked about their upcoming lines and the days filming and that was it. Later in his testimonly, Winkler was asked what he thought John’s children would miss the most about their father. What in the world does that have to do with his medical condition and subsequent treatment? Well, it’s really kind of non-news, but the fact that this type of testimony is present in medical malpractice cases just gives me even more encouragment to get really good at my options trading. It took me a second reading to see that this comment was off the record outside the ... Mr. Hassle's Long Underpants blogs http://www.medworm.com/rss/comments.php?id=1230294 Thu, 14 Feb 2008 07:28:29 +0100 1230294 http://feeds.feedburner.com/~r/MrHasslesLongUnderpants/~3/230095452/spontaneous-pneumothorax-just-like-house-did-it.html Today, my favorite x-ray tech emerged with a chart from a patient whom he took from the waiting room to do a chest x-ray.  Waiting times in our ER today were 3-5 hours long, so a little bit of time is saved by taking patients straight from the waiting room to the x-ray area. So Curly the tech came out waving a chart.  “Somebody needs to put a chest tube in this kid,” he nonchalantly stated to nobody in particular.  He ceremoniously spun a slow 360 degrees to see if anyone was listening, then shrugged his shoulders, dropped the chart off to the charge nurse and went back to his dark room, his job was done. A colleague who ended up with his chart a few minutes later asks, “How would you like to to a chest tube in 10, while I do a spinal tap in room 11?” Hmmm…... Mr. Hassle's Long Underpants blogs http://www.medworm.com/rss/comments.php?id=1207277 Wed, 06 Feb 2008 06:17:06 +0100 1207277 http://feeds.feedburner.com/~r/MrHasslesLongUnderpants/~3/227364220/bush-is-simply-an-idiot.html I guess it’s more important to kill 1,000,000 innocent civilians in Iraq for a threat that never existed than it is to be certain that healthcare services are available for your family members when they are ill: Bush’s proposed Medicare budget would cut $15 billion over five years through a reduction of annual updates for inpatient care. It would also cut $25 billion from payments to hospitals serving large numbers of poor people, and $20 billion from payments for capital projects such as putting up new buildings and buying equipment, the New York Time reports Read the rest of the store on the Wall Street Journal’s Health Blog With Bush certain to leave and Edward’s out of the race, I’m more than happy with anyone else to fill the spot. (Source: Mr. Hassle's Long ... Mr. Hassle's Long Underpants blogs http://www.medworm.com/rss/comments.php?id=1194734 Fri, 01 Feb 2008 17:42:03 +0100 1194734 http://feeds.feedburner.com/~r/MrHasslesLongUnderpants/~3/223918780/my-cat-has-asthma.html I arrived home from work around midnight to two hungry cats pacing in circles for their dinner.  After giving them each a scoop of food and fixing myself some trader joe’s pancakes for my own dinner, i settled down with a glass of red wine and TLC’s Trading Spaces to help unwind from the day.  But a strange noise caught my ear.  I looked down to see Louise staring at me, grunting and sniffling.  What’s wrong, Squeezie? I cooed.  She didn’t answer me, just kept making those funny breathing noises. You’d think that as an ER doctor I could figure out what was wrong.  Sure, if she was a newborn, or a toddler, or even a full grown adult I could have examined her nose, her throat, her lungs, etc and try to isolate the problem. But she’s a cat…a ver... Mr. Hassle's Long Underpants blogs http://www.medworm.com/rss/comments.php?id=1180097 Sun, 27 Jan 2008 09:59:25 +0100 1180097 http://feeds.feedburner.com/~r/MrHasslesLongUnderpants/~3/220035513/creative-expansion.html In the field of earth sciences, the phenomenon of “rebound” of the tundra and arctic crusts is well known.  As overlying glaciers, surface ice & snow and tundra melt away, the weight of the water in its various phases is removed.  The underlying soil & earth undergoes what is called “rebound”.  The elevation of the land actually increases as the ground “bounces back”.  This occurs over a time span of centuries if I recall, and the arctic lands are still rebounding from the last little ice age. I often feel this own phenomenon in my own mind.  When I get away from the stress and hassle of work, there is a creative part of my brain that undergoes rebound.  It has spent so much time slumbering under the weight of grown-up responsibilties and a... Mr. Hassle's Long Underpants blogs http://www.medworm.com/rss/comments.php?id=1165299 Sun, 20 Jan 2008 22:06:03 +0100 1165299 http://feeds.feedburner.com/~r/MrHasslesLongUnderpants/~3/219569898/shazam-on-vacation.html Hello from sunny, shiney California.  Since ER docs work in shifts, and typically are contracted for # of hours or # of shifts in a month, it’s not unusual to end up with a block of days off, just as we end up with a block of days working.  When I spotted 7 days off in a row for my busy winter schedule, I didn’t hesitate to schedule a mini-vacation. I’ve been working pretty much non-stop since mid December, and had just about the worst holiday schedule one could get, save for the fact that I didn’t work on Christmas day. I worked Thanksgiving eve, Thanksgiving Day, Christmas eve, New Years Eve and New Years day…all of them evening shifts, so I was unable to get together with friends or family on any of those days.  Often times in order for everyone to see a... Mr. Hassle's Long Underpants blogs http://www.medworm.com/rss/comments.php?id=1162526 Sat, 19 Jan 2008 22:02:50 +0100 1162526 http://feeds.feedburner.com/~r/MrHasslesLongUnderpants/~3/214783881/set-your-nz-flag-at-half-mast-sir-edmund-hillary-has-passed.html Such a sad day for mountaineering… Sir Edmund Hillary has passed away at the age of 88 from a heart attack. If any of my readers is from New Zealand and can send me a copy of this weekend’s Weekend Herald with the 8 page special report, I’d gladly paypal you to cover the cost of postage. (Source: Mr. Hassle's Long Underpants) Mr. Hassle's Long Underpants blogs http://www.medworm.com/rss/comments.php?id=1143434 Fri, 11 Jan 2008 05:06:55 +0100 1143434 http://feeds.feedburner.com/~r/MrHasslesLongUnderpants/~3/214195226/apparently-im-a-democrat.html I just wish John Edwards wasn’t so close to the top… 72% Bill Richardson64% Mitt Romney63% John Edwards62% Hillary Clinton62% Barack Obama60% Tom Tancredo58% John McCain57% Chris Dodd54% Fred Thompson52% Joe Biden50% Mike Huckabee46% Rudy Giuliani44% Mike Gravel44% Ron Paul39% Dennis Kucinich2008 Presidential Candidate Matching Quiz (Source: Mr. Hassle's Long Underpants) Mr. Hassle's Long Underpants blogs http://www.medworm.com/rss/comments.php?id=1140917 Thu, 10 Jan 2008 05:16:55 +0100 1140917 http://feeds.feedburner.com/~r/MrHasslesLongUnderpants/~3/208116634/if-you-love-mr-hassle-nominate-me.html Consider adding your nomination for Best Medical Weblog for 2007 over at MedGadget.  Nomiations are in the comments section of the post explaining the process. There are also a great number of new medical blogs out there this year, so be sure to check the list of the current nominees! (Source: Mr. Hassle's Long Underpants) Mr. Hassle's Long Underpants blogs http://www.medworm.com/rss/comments.php?id=1121697 Sat, 29 Dec 2007 17:30:35 +0100 1121697 http://feeds.feedburner.com/~r/MrHasslesLongUnderpants/~3/203895545/the-learning-curve-of-cardiac-life-support.html There is a post in my archives in wich I ran my first code as a resident without any outside assistance from the attending.  It was nerve-racking, and I’m sure I was up all night afterwards.  I remember those days of the steep learning curve with a little bit of reverence for who I was back then.  WOuld I put myself through that again?  I’m not sure. But I am sure of the fact that I’m a lot more confident than I used to be. It’s exactly because we put ourselves directly in the firing line of bad cases…bad hearts, bad lungs, guns, knives, bats and bricks that we learn to practice emergency medicine. It’s days like the one I’m about tell you that leave me in awe of my responsibility as an ER physician.  This time I was the attending in charge, w... Mr. Hassle's Long Underpants blogs http://www.medworm.com/rss/comments.php?id=1109780 Fri, 21 Dec 2007 07:38:23 +0100 1109780 http://feeds.feedburner.com/~r/MrHasslesLongUnderpants/~3/200098895/wash-your-feet-every-day.html Every once in awhile I realize that Urban Blight Memorial is in a totally different world, and the patients there live a totally different life, despite being less than 10 miles from the downtown of a five time superbowl championship team, and less than 10 miles from where I grew up. Yesterday’s fastest patient exam of the day went a little like this… She was wearing a stained purple sweatshirt that reminded me just a little of an oversized children’s dinosaur character.   “Hey Doc, my feet feel like they’re crawling,” she drawled. Me:  Noticing that her boyfriend/fiance/husband didn’t have many teeth either.   “What’s wrong with them?” Her:  “I just told you.  They’re giving me the creeps.”  She turned tow... Mr. Hassle's Long Underpants blogs http://www.medworm.com/rss/comments.php?id=1094139 Fri, 14 Dec 2007 04:39:18 +0100 1094139 http://feeds.feedburner.com/~r/MrHasslesLongUnderpants/~3/195671491/the-er-gift-card.html Here’s a great viewpoint on the high costs of ER care and what ends up being a “class structure” for healthcare.  Let me know what you think.  If you like the article, give it a Digg. http://www.la2day.com/talk/the_e_r_gift_card_the_perfect_stocking_stuffer Powered by ScribeFire. (Source: Mr. Hassle's Long Underpants) Mr. Hassle's Long Underpants blogs http://www.medworm.com/rss/comments.php?id=1072337 Wed, 05 Dec 2007 19:28:05 +0100 1072337 http://feeds.feedburner.com/~r/MrHasslesLongUnderpants/~3/193599139/things-overheard-in-a-coffee-shop.html An otherwise not-worldly-wise looking woman, sitting at a table right in front of me.  She’s talking about living in Berkley, then moving ‘back east’.  She first mentions a women’s clinic.  Then she mentions a methodone clinic.  Then the people she met while working on a needle exchange program. Here’s the kicker…she’s working on a “Narcan Project”.  She wants to give out Narcan at the methadone clinic.  Wha??? As sympathetic as I can be, somehow I think there is a limit to what you can do for drug abusers.  Powered by ScribeFire. (Source: Mr. Hassle's Long Underpants) Mr. Hassle's Long Underpants blogs http://www.medworm.com/rss/comments.php?id=1064186 Sat, 01 Dec 2007 20:59:18 +0100 1064186