Fo-shingles, my ningles....

All Imma say is that you have to be careful about who you let doctor (or nurse) on ya these days.

Cuz there are some of us that have no idea what we are doing.

I'm not saying I'm the greatest. Not even close to it.

But there are some really fearless idiots practicing medicine out here right now.

I don't know anybody that is going to get it right 100% of the time. But there are some very basic things, in the course of a medical work-up, that even the most amateur of us, should not miss.

You know, like it might make sense that if a 60 year old man comes in with a stroke and elevated blood pressure, before you discharge him, you might want to check a few things to help me out if you expect me to be his primary care provider.

There's no reason why he was was in the hospital with you for 10 days and I had be the one to figure out that he's also diabetic and the reason that you couldn't get his blood pressure down in the hospital is because his kidneys are jacked up. Yeah. Cuz no one in the hospital had a decent enough stethoscope to have heard that massive aortic bruit during his belly exam. You did do a belly exam, right? (O_o)

And let's talk about shingles. Yes. Shingles.

Prior to graduation, I'd only seen a case of shingles once. And it was not even that bad a case.

So when this lady showed up at the clinic looking like the villain, Two Face, from the Batman movies it wasn't rocket science to know that it could only be one thing. That's right. Shingles.

Rule of Thumb: Shingles, derivative of the chicken pox virus, migrates along the pattern of dermatomes. Which means the rash will only appear on one side or the other.

It is viral. So technically there is no "cure," but only anti-viral medications can suppress the virus in the human body to hopefully keep it at bay.

So no, dear ER provider. Giving this lady Bactrim was not a good idea. Especially since she was allergic to it. Following it with Keflex and Benadryl was also not a good plan of care.

By the time she came to me, she looked like the aliens from that TV show "V." But just on the right side of her body. 

Before I go, another piece of advice for the patients who might put too much faith in their provider.

If they give you a new medication, please make sure they tell you what it is for and what side effects might come with it use.

Because if you show up in my office with your lips looking botoxed and your eyes swollen shut and tell me that you didn't stop taking it because you "thought the medicine was supposed to do that," I can't have any sympathy for you. You just need to be glad that it didn't swell your airway and kill your crazy ass.

So, please. Don't walk into these medical offices thinking that everyone with a medical degree was a straight A student. Some of us only made it out by the skin of our teeth.

Be diligent. Find a provider you really trust and stick with them.

Towanna