Monday, 1 February 2010


Dear Patient,
I'd like to ask for your help. Please.
When I ask if you have any medical history, can you please do me a favour and give me the information I've asked for? It makes my life a little easier, it may change and probably improve your treatment, and, slightly less importantly, makes me feel a little less stupid when you tell the hospital staff something that you never told me...
There are several ways to garner a history. I normally start with a very simple "do you have any medical problems?"
Often the answer is something along the lines of "Not really, I take medicines for those..."

Then begins the sometimes laborious task of locating said tablets, seeing if what's in the boxes is what it really should be, working out which treats what, and when they're due to be taken. Blood pressure, diabetes, cardiac failure and chronic breathing problems, are easily the most common conditions I meet on a regular basis.

Then there are the less common. Things like sickle cell crisis, Addison's disease, lupus, and a myriad of other ailments that I either haven't heard of, or don't know enough about, that then I have to go and read up on. Whatever it is, I need to know about it.

I admit that if you're in your sixties, and are complaining of chest pain, I don't really need to know about the leg you broke when you fell off your bike 50 years ago, or the fact you had appendicitis when you were in your twenties.
However, if you are in your sixties, and are complaining of chest pain, it might be important to tell me other bits of information.

Information such as the three previous heart attacks you've had in the last two years.

Information such as the fact that this pain feels identical to that experienced in those three previous heart attacks.

Information such as the fact that each time, nothing appeared wrong with the ECG, but your blood tests and later angiograms showed otherwise.

And most importantly, information such as the fact that on each of those occasions, your heart actually stopped whilst you were either on your way to hospital or once you were already there.

That's the sort of stuff we need to know. The important stuff. The sort of detail that may actually help us to help you. Please.

By the way, please say hi and thanks to your heart for not stopping this time. It was good news for both of us...

Much appreciated.


Anonymous said...

It happens in all businesses. Of course, it's not quite the same, but when you ask someone "have you changed anything", they say "no", and then you find out they've done something like re-installed windows without telling you...

Fee said...

Back when I was learning first aid, the teacher told us about a guy who called an ambulance for a nose bleed, but neglected to tell the nice chaps in green he suffered from haemophilia.

When I was a qualified first aider, a young chap who'd hurt himself answered my "are you on any medication or drugs" question with a rundown of every illegal substance he'd ever ingested (and there were plenty!). Then added that he'd taken two Alka Seltzer that morning.

No happy medium, sometimes.

Deborah said...

Or like the chap with the agonising chest pain but with an OK ECG who totally forgot he had a pneumothorax a few years previously and this was EXACTLY the same sort of pain as he had that time too!

slmiller72 said...

Me " do you have any medical problems?"

Pt " ummmmm... no." * looks pleased*

Me " no regular medications to take then?"

Pt *thinks for a bit* " Ohhhhh. I have blood pressure!"

Me *resigned, but knowing look on face* "...and where is your medication for your blood pressure?"

Pt " I'll get it. It's with the rest... Satin or statin something? And Warfarin. 'Coz of my stroke..."

This happens with alarming regularity :)

Anonymous said...

I feel your pain, I work for the NHS too. "Can I have a repeat prescription for the drugs that fix my dicky heart?" Well, errrrr, you have 3 doses of warfarin on the screen, and no yellow book with you, you have lost it you fool!. feel free to follow my blog