"30 year old male, vomiting, abdo pain, NHS111"

30 year old males vomiting are not about to die. OK, one, once, probably vomited and then died but as a rule of thumb, they don't die. His partner was waiting at the door for us in her onsie. Some people don't lend themselves to onsies and this was a prime example but I wisely didn't comment. Or point and laugh. We were led upstairs to our waiting patient.
We were greeted with a sorry, pained expression of pure suffering and angst. Unfortunately, the 1 hour history of vomiting did not warrant the sympathy he was after. I kept my questions and responses to his whimpering at a professional level without indulging in his drama. It really does infuriate me when people won't talk, use their words and attempt full sentences because they feel unwell! They are grown ups, but it is like trying to communicate with a 3 year old who is mid-tantrum!
The patient was a big guy, a very big guy, 25 stone plus. The irony of really fat people only being able to fit into sports wear was not lost me but he had no pride in anything about him. The flat was a tip, I could smell fried food, there were pizza boxes everywhere and a half drunk 2 litre bottle of coke next to him. Clearly, his extensive medical history had had no effect in kick starting a lifestyle change! I could have guessed he had diabetes, high blood pressure and high cholesterol before he offered up the information, I was hardly bold over with shock!
My questions regarding his symptoms continued and led to food that could have caused this non-life threatening episode of vomiting.
"Just a salad."
Yes, I'm judgemental and when I fatter than I am, I started by eating more salads, but I have met a lot of patients and I can spot the ones trying to lose weight and the ones pretending to be trying. This guy was the latter. The who's who of takeaway boxes and fizzy drinks around the place told me everything I needed to know.
"Just a salad?"
"Yeah, well some crisps and that too."
"And that???"
"You know, yogurt, chocolate and stuff."
Before I could ask about the "and stuff" his girlfriend butted in!
"You bloody liar! What else did you have for lunch?"
"Nothing!" he exclaimed.
"OK, what did you have just before lunch?"
"What do you mean?"
"What do I mean? I mean what about those burgers and chips you were shovelling into your face sat in you car round the corner! I bloody saw you! And I bet there were apple pies too, I know you, don't forget that."
"Oh yeah, sorry."
I stepped in before it turned into a slanging match, or before he died of embarrassment!
"So, lunch was a few burgers and chips, some apple pies, some crisps, chocolate, yogurt, and a salad?"
"Yeah, I suppose."

It's so frustrating to watch someone so young just self destruct! I just don't know how these people can get help or even begin to help themselves. It's a sorry state of affairs when dietary advise is harder to come by than junk food! What has to happen for them to realise that this lifestyle is slowly killing them?! I would suggest it's too late for this generation. On the whole it is too fat, too lazy, expects everything for nothing and has a poor work ethic. The money is better invested in the next lot to come through, hopefully then, we will see the benefits in 20 years or so. Until then, I'll just grumble away!
I'm glad to say that at 35 I don't fall into the 25 - 45 category. I agree with you though. The vast majority of folk, certainly below 40, think the world owes them something. When I was an apprentice I had to work hard, I wouldn't take a day off ill and I certainly wasn't late. My 2 apprentices potter about like a geriatric amputee, take 2 days off on the sick if they have been within 300 yards of somebody who might have had a cold in the last month and walk through the door at start time, and then make a drink. Society today is fed on oversensitive PC bull, and access to junk food is easier than dietry advice.
ReplyDeleteFor the 3rd time this week I'll give my theory that seems to spread acriss the board.
Those in the wrong, have the rights.
Love your blog by the way, rant over :-D (for now) ;-)
Oh love it - your comments sum it so well!
DeleteI'm glad to say that at 35 I don't fall into the 25 - 45 category. I agree with you though. The vast majority of folk, certainly below 40, think the world owes them something. When I was an apprentice I had to work hard, I wouldn't take a day off ill and I certainly wasn't late. My 2 apprentices potter about like a geriatric amputee, take 2 days off on the sick if they have been within 300 yards of somebody who might have had a cold in the last month and walk through the door at start time, and then make a drink. Society today is fed on oversensitive PC bull, and access to junk food is easier than dietry advice.
ReplyDeleteFor the 3rd time this week I'll give my theory that seems to spread acriss the board.
Those in the wrong, have the rights.
Love your blog by the way, rant over :-D (for now) ;-)
Thankfully, working in Swiss NHS I have less of those BS calls than you do. But sometimes I get them, and I always take the liberty to tell the patient exactly what's wrong with them (or what isn't). If I have the time I also spend some minutes explaining in minute detail all the gruesome things happening in their bodies in the next few years. Even if it doesn't get to their brains, I feel better for doing so :-) Actually, in this case I would have taken him to a hospital, just so I could call the fire department to get him out of his flat, because that would more or less double costs of the whole operation and usually, insurances don't like that....
ReplyDeleteHow rude. What we are essentially talking about are manners... Why couldnt he be downstairs?? Outrageous...I regularly ask people to move downstairs for assesment...it is innappropriate for us to be struggling in their often squalid bedrooms while they cavort on the bed
ReplyDeleteHow rude. What we are essentially talking about are manners... Why couldnt he be downstairs?? Outrageous...I regularly ask people to move downstairs for assesment...it is innappropriate for us to be struggling in their often squalid bedrooms while they cavort on the bed
ReplyDeleteA sad reflection of society today. Those who contribute the least expect the most. All the while the people who gave this country so much, ask for and so often get nothing. Wrong. As always.. Thank you for all your hard work. The majority of us really appreciate you all. Please keep telling it like it is!
ReplyDelete