Wednesday, May 3, 2017

#13 Talking About the Elephant in the Room

First of all, I'm rededicating myself to this blog. I got off-track after getting a little behind on paperwork. A nightly (QHS *) post was too ambitious. However, a weekly (Qweek **) post, maybe with a few extras sprinkled in on easy weeks, should be doable. It will just take a few more decades to have enough to make a book and get to the top of the New York Times bestseller list.

So here goes. . .


Dear Dr. Tumoriffic,

How long should I wait before I call you when I, for instance, feel like I have an elephant sitting on my chest for X minutes, can't catch my breath when I walk, etc.?

Signed, 

Ms. Z



Dear Ms. Z,

You are asking a big, and very important question. Basically, what are some really scary symptoms I should call my doctor (or my priest) about really quickly? The answer will not fit in a single post. It deserves several. So, here we go.


How long should I wait before I call you when I feel like I have an elephant on my chest?

Does 'Z' stand for Zookeeper? If so, there is a finite chance that an elephant is literally sitting on on your chest. In that case, I would call immediately. An elephant on your chest is an emergency.

After quickly consulting online textbook, Up-to-Date, I would advise you to give the elephant's wiggly bits a firm pinch. It will stop sitting on you immediately.*** For the root cause, which is a bigger problem, I might refer you to a specialist, say, an animal behaviorist, who will explore important issues such as, "is it an Indian elephant, or an African elephant," and, "why do you dress so much like a chair?"

But, assuming 'Z' does not stand for Zookeeper, don't even call me. Call the ambulance. 'Elephant on my chest' is one of those phrases causes doctors to pee in their panties. ****

'Elephant on chest," especially when paired with 'can't catch my breath' makes us think of a heart attack and other choice horrors, especially when they run with 'nauseated,' 'clammy,' and 'radiating to the left side of my jaw/running down my left arm,' 'feeling of doom,' and so on. And, even if the feeling in your chest is not akin to Jumbo's butt, there may yet be reason to worry. Nearly any kind of chest discomfort may be a reason to call me. 'Elephant on chest' is a textbook description of a the feeling people get when a part of their heart is not getting enough blood, but your body might not have read the textbook. Women, in particular, may have symptoms that are very hard to interpret. 

On the other hand, there are some nonelephantine forms of chest pain that tend not to upset me. I don't get so freaked out when you describe "a sharp, stabbing pain that lasts a couple of seconds at a time."***** I'm fairly unimpressed when you're 21 and just started doing pushups lately and it hurts particularly badly when you move your arm a certain way. I won't get my hair up in a bunch if you have burning chest pain every time you guzzle a bottle of habanero sauce. It all depends on context and who you are. If you're a 75-year-old chain-smoker with diabetes and a history of heart attacks, even a little chest twinge makes me edgy.


Doctor Tumoriffic, how long should I wait to call you when I have a thunderclap headache?

Once again, don't call me. Call the ambulance. Despite what it sounds like, thunderclap headache is not a symptom of severe gonorrhea. It is a horrendous headache that, instead of building slowly, comes on like a 'thunderclap,' It may be that a blood vessel has burst inside your skull, and it is filling said skull with blood. If a surgeon does not put a hole in your head very quickly, the pressure from all that blood will squeeze your brain out through that hole at the bottom of your skull that's really way too small for the average brain. Bad things happen very quickly--like dying. Don't call me. Call the ambulance.

To be continued. . .

Be well,

Dr. Tumoriffic





* 'QHS' is an abbreviation for a Latin phrase that I use to make me look like a smarty pants even if I don't know what it stands for.

** Qweek is an abbreviation for a Latin phrase that lacks a precise English equivalent but roughly translates as an entire week of bad Star Trek: The Next Generation first season reruns.

*** Side effects of this therapy may include being stomped to death by an angry pachyderm.

**** Other such phrases include 'thunderclap headache,' and 'Medicare Access and CHIP Reauthorization Act of 2015.'

****** That can be significantly scarier, though, when you tell me that is that a guy right in front of you who looks like Freddy Kruger, and he's holding a knife.






Happy Springtime!





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