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Showing posts with label nurses. Show all posts
Showing posts with label nurses. Show all posts

Wednesday, April 10, 2019

Patient Profiling: Medical Slang Only

This website owner really did her homework! I was stunned when I started searching for more sources with medical slang that can be used around patients because of the PATIENT PROFILING ARTICLE I published today, when I came across this website. I did not realize there were this many slang terms and acronyms in the medical community, but I'm not surprised, more hurt and betrayed than surprised. Additionally, I did not want to offend anyone but I wanted you to be educated, just in case you over hear some of these terms yourself.


I wanted to include all of her research because this is a very extensive article. I am sending her a message thanking her for her hard work and putting this together. I did not want to attach it to my other article, since it is so extensive, so I wanted to publish this article as a companion to the other.


I wanted to share her work and to link to her page here, because this is VERY comprehensive and thorough! You can find her website here: http://messybeast.com/dragonqueen/medical-acronyms.htm







Image Source: http://d140unl57lhvt1.cloudfront.net/hospital-slang-008.png








"DOCTORS' SLANG, MEDICAL SLANG, MEDICAL ACRONYMS, VETERINARY ACRONYMS, & VET SLANG

These have been mostly collected from around the UK and USA, with a few non-English contributions (many thanks to all contributors from around the globe), so you'll only find a few of them used in any single establishment. Some of the acronyms are region-specific and have differing meanings in US and UK. It is noticeable that the US has numerous acronyms and slang terms relating to gun-shot injuries. The slang/acronyms are directed variously at patients, other medical staff or mystifying medical conditions. I haven't included the slang terms for all of the various medical equipment. The veterinary appendix - due to popular demand - is at the foot of the page.

3H enema - Enema that is "high, hot, and a hell of a lot." Reputedly given to patients who give staff a hard time.
3P’s - Pill, Permissiveness and Promiscuity (relates to female patients with sexually transmitted disease)
4F - Fair, fat, female and forty OR fat, forty-ish, flatulent female (both mean abdominal pain patient who is candidate for gall bladder disease)
4H - (US) Haemophiliac, Hispanic, Homosexual, Heroin addict
404 moment – On card rounds - when a patient’s medical records cannot be located (from internet error message: 404 Page Not Found)
5-H-1-T - polite medical term for shit
10th Floor Transfer - dying (floor number is always the next number on from the highest floor in the hospital).
45C - patient is one chromosome short of a full set (thick)

AAA (or Triple A): Ay Ay Ay. Precursor to Status Hispanicus. Wound-up Hispanic female unable to tolerate even the small discomfort of removing an adhesive plaster, but not yet full-blown histrionics.
AALFD - Another A**hole Looking For Drugs
Acades vulgaris - medical students.
Acronymophilia - excessive reliance on TLAs /TLMs & XTLMs (extended 3 letter acronyms)
Acute Lead Poisoning - Gunshot wound
(Acute Lead Poisoning) 185 grain Injection - 9mm gunshot wound
(Acute Lead Poisoning) 240 grain Injection 44 calibre magnum wound
(Acute Lead Poisoning) Air-conditioned - Multiple gun shot wounds
Acute Hyponicotaemia - desperate for nicotine fix (cigarette)
Acute Pneumoencephalopathy - airhead
Adminisphere - where hospital managers work, reckoned to be "another planet"
Administrivia - pointless emails and notices that clog up real medical work
ADR - Ain’t Doing Right
AFU & BR - all f***ed up & beyond repair
AGA - Acute Gravity Attack (fell over)
Aggressive Euthanasia - A procedure that obnoxious patients would benefit from.
ALFI(e) - (Australia) Adelaide's Largest F*cking Idiot
AGMI - Ain't Gonna Make It (won't survive)
Agnostication - Substitute for prognostication; describes the usually vain attempt to answer the question: "How long have I got, doctor?”
AHF - Acute Hissy Fit
Airwolf - air-ambulance (after a popular US TV series)
Albatross - chronically ill patient who will remain with a doctor until one or other of them expire
ALC - a la casa (send the patient home)
ALS - Absolute Loss of Sanity (nutcase)
Amphoterrible - Amphotericin B, an antifungal medication with toxic side-effects
Amyoyo syndrome - Alright motherf*****, you're on your own (seen in head injury patients in Intensive Care); there will be no miracle recovery
Angel lust - a male corpse with an erection (not uncommon). Is also sometimes used to mean death that occurred during intercourse.
AOB - Alcohol On Board
APD - Acute Prozac Deficiency (depression)
Appy - person with suspected appendicitis
APRS - (US) Acute Puerto Rican syndrome (bouts of screaming and yelling)
APTFRAN - Apply Pillow To Face, Repeat As Necessary (for annoying patient)
AQP - Assuming the Q Position: deteriorating or dying with tongue hanging out
AQR - Ain't Quite Right
Arsenic in antifreeze - Melarsoprol (IV sleeping sickness drug) is exactly this!
ART - Assuming/Approaching Room Temperature (dead)
Ash Cash - money for signing a cremation form
Ash Point - where you collect the Ash Cash
Ass Grapes - badly thrombosed or strangulated haemorrhoids
Assmosis - promotion by "kissing ass"
AST - Assuming Seasonal Temperature (dead)
ATD - (US) Acute Tylenol Deficiency (simple fever or head cold)
ATFO - Asked To F*** Off
ATS - Acute Thespian Syndrome: faking illness; known in US as MGM syndrome
Aunt Minnie Lesion - once seen, never forgotten, much like certain aunts at the family wedding
AWTB/AWTF - Away With The Birds/Away With The Fairies; a patient who is totally confused
Ax(e) - surgeon

B-52 - combined 5mg of Haldol IV + 2mg of Ativan IV
Baby catcher - obstetrician
Babygram -x-raying (radiographing) a newborn
Bagged and Tagged (B&T) - Body ready for dispatch to morgue
Bagrinhos - (Brazil) interns ("bullheads" - type of fish that gets in the way of real fishing)
Banana - patient with jaundice
Basement admission - will end up in hospital morgue (located in the hospital basement)
Bash Cash: the money paid for completing accident (insurance) claim forms in A&E
BBCS - Bumps, Bruises, Cuts and Scrapes (i.e. no serious injuries)
BBL Sign (Belly-button Lint Sign) - male, middle-aged, overweight and hairy (an umbilicus that looks like the lint [fluff] trap in a tumble dryer is most common in overweight, hairy, older men). Known as Belly-button Fluff in Britain.
Beached whale - obese patient unable to do much for him/herself except lie there with flailing arms and legs
Beating off Angels - doing CPR in vain on a patient who won't make it
Benny - patient on benefit (welfare payments)
Betty - a patient with diabetes
BFH - Brat From Hell (usually accompanied by PFH - Parent(s) from Hell)
BFH - Big F****ing Head; hydrocephalus as in a "FLK with a BFH" (can be metaphorical for arrogant consultant)
BIT - burp in transit (gas seen in the stomach on an abdominal film)
Black cloud - a doctor who attracts difficult or prolonged cases or an unusually high number of code blues calls
Blade - Surgeon: dashing, bold, arrogant and often wrong, but never in doubt
Blamestorming - apportioning of blame for mistakes, usually to any locum or lowliest medic in sight
Blinky the Fish - radiologist (The 3-eyed, mutant goldfish from The Simpsons is the mascot of many radiology depts).
Blood-Brain Barrier - surgical drapes
Blood Suckers - those who take blood samples, e.g. lab techs
Blown Mind - gunshot wound to the head.
Blue Bloater - obese person in respiratory arrest
Blue Blower - patient with severe lung disease
Blue Pipe - vein (as opposed to 'red pipe' or artery)
BMT - Bowel-Movement Taco (faecal matter trapped in female genitalia)
BMW - Bitch Moan & Whine
Bobbing for apples - unblocking a badly constipated patient with one's finger
BOHICA - Bend Over, Here It Comes Again
Bone Break Need Fix - derogatory term for Orthopaedics
Boneheads - orthopaedics
Bones and Groans - non-specialist general hospital
BoneHo - an off-service resident working in Orthopedics
Boogie or Goober - tumour. A Roasted Goober is a tumour after intensive cobalt treatment; a Healthy Goober is a dead tumour patient.
Bordeaux - bloodstained urine
Bottle return - removing a bottle lodged in the anal canal
Bounce - returning a turfed patient back to original dept (see also turf and buff)
Bounceback - a (usually turfed) patient who keeps returning to the hospital with same condition
Box - to die
Brain Fry - Electroconvulsive Therapy (ECT) for depression
Bronze John's Law - (paediatrics) if the weight of the records exceeds the weight of the child, the prognosis is grim
Brothelizer test - microbiology test (on swab or sample) requested by the Genito-Urinary Clinic or STD clinic to check for sexually transmitted diseases. A positive test result means the patient has "failed the brothelizer test".
Brothel Sprouts - Genital warts
Brown trout - a stool that won't float (as opposed to an air biscuit, which does)
BSS - Bilateral Samsonite Syndrome: patient admitted with both their bags packed in preparation
BTSOOM - Beats The Sh*t Out Of Me
Buff - re-hash the patient's story to make it sound more appropriate for the patient to be referred to another dept (see also turfing and bouncing)
Buff Up - to ready a patient for release
Bug Juice - antibiotics
Bugs in the rug - pubic lice
Bull in the ring - blockage in the large intestine
Bumps and Lumps - junior doctor (intern) cases
BUNDY - But Unfortunately Not Dead Yet
Bungee jumper - a patient who pulls on his catheter tube
Bunnies - Sanitary Towels (sanitary napkins)
Bunny Boiler - (Psych) dangerously obsessive or unbalance woman (based on film "Fatal Attraction")
Burger - sunburned patient with ruptured blisters
Bury the Hatchet - accidently leave a surgical instrument inside a patient.
Butchers - Obstetrics & Gynaecology (also general derogatory term for surgeons)
BVA - Breathing Valuable Air
BWCO - Baby Won't Come Out (needs Caesarian)

C/C- "Cancel Christmas" (dead)
C2 - a "can't c**t"; lazy physician who passes off work to colleagues and often whine
C&T Ward - Coma ward - "cabbages and turnips"
Cabbage - heart bypass i.e. CABG (Coronary Artery Bypass Graft)
Cabbage and tomato ward - Ward for comatose patients
Calcified Penisitis Morbidium - male patient whose ailment is due to excessive or unprotected sex
Callbellectomy - minor operation, sadly not permitted, to remove over-used call bell from patient's hand/reach!
Call Button Jockey/Buzzer Junkie - patient that uses call button all night long for no good reason.
Calling Doctor Blue [to location] - public address system code for "baffling case needing more doctors to take a look in the hope that one of them will know what to do"
Captain Kangaroo - chairman of a paediatrics department.
Category 6 Patient - Triage is Cat 1 (major) to Cat 5 (minor) so Cat 6 means a timewaster
Cath Jockey - cardiologist that catheterizes every patient they see (or one that does cardiac catherizations)
CATS- Cut all to sh*t
Caveman - Derogatory term for Orthopaedic surgeons “so easy a caveman could do it”. Derived from an advert
CBT - Chronic Burger/Biscuit Toxicity (obesity)
cc - Complaint Corner, a patient that complains about everything; BCC is one that behaves nicely to medical staff and complains behind their backs (from business acronyms for carbon copy and blind carbon copy)
CCFCCP - Coo-coo for Co-Co Puffs (dementia or similar)
Ceiling Sign - near-levitation from the bed to the ceiling induced by examining for abdominal tenderness
Celestial discharge - died
Celestial transfer - died (transferred to the Eternal Care Unit)
Cephosplat - Domestos Antibiotic; Kills all known germs
CFT - Chronic Food Toxicity i.e. obesity
CFU - Complete(ly) F*ck(ed) Up
Champagne tap - bloodless lumbar tap
Chandelier's Sign - The result of any test or probing after which the patient must be removed from the chandelier
CHAOS - Chronic Hurts All Over Syndrome (PTSD/Fibromyalgia, etc.)
Chart Biopsy - check chart for other depts' plans on the patient
Chart Dehiscence - drop patient chart and everything falls out.
Chartomegaly - patient is so frequent s/he has a large (and growing) chart
Cheerioma - a patient with a highly aggressive, malignant tumour
CHIBLOC - Closed Head Injury, Brief Loss of Consciousness
Chocolate Hostage - constipated
Choly / Chole - patient with cholecystitis (inflammation of the gallbladder) or cholecystectomy patient.
Chrome Induced Ischaemia - patient that develops inexplicable chest pains when arrested and handcuffed
Chronic Slapping Deficiency - annoying/unruly family members hitting nurse's call button every 5 minutes with minor requests/inane questions or for fun
CIBS - Cast Iron Bum/Butt Syndrome: when the needle goes into the buttocks straight, but comes out curved
CKS - cute kid syndrome
Clip and Strip - remove staples and adhesive sutures
CLL - chronic Low Life
CLOMI - Cat Like Observation and Masterful Inactivity (patient under observation)
Clupea fallacius rufus - red herring
Cock Doc- urologist
Cockroach Factor - a patient's ability to survive trauma or serious treatment is inversely proportional to his contribution to society (see TTI).
Code 0 - (Ambulance) Time-waster/tax-waster (genuine codes are Code 1 [non-serious] to Code 4 [emergency])
Code Azure - message to other medics to do nothing extraordinary to save a very ill patient who will die shortly no matter what is done
Code Brown - faecal incontinence emergency (e.g. of bedlinen)
Code Pink (Triangle) - a likely homosexual (used back when HIV/Aids tests took a while to come back)
Code Pink (Paediatric) - baby taken without permission from maternity/nursery by family or staff
Code Surfer - medic straddling the patient on trolly (gurney) performing chest compressions while patient is being transported
Code Yellow - urinary incontinence emergency
Coffee and a Newspaper - Patient is Constipated (i.e. long time sitting on toilet with drink and reading matter)
Coffin Dodger - survived against expectations, or a very old person
Cold-tea Sign/Cold Tea Syndrome - refers to the several cups of cold tea on the bedside cabinet beside a dead geriatric (i.e. no-one noticed the patient had died)
COPD - Chronic Old Persons Disease (unwell, no specific cause)
COSMONAUT - Cat Owner, Smells, Made Of Nuts And Used Tampons ("mad cat lady" with poor hygiene and body odour)
Crackerjack referral - (UK) It's Friday, it's five to five, it's... (Crackerjack was a popular TV show) i.e. Friday afternoon job
CRAFT - Can’t Remember A F*cking Thing
Cranial rectosis - US: butthead (US term for idiot); UK: head-up-ass (arrogant/arrogant fool)
Cranio-faecal Syndrome - s**thead or s**t for brains
CRAP Score - Cynical Real Alternative Pain Score - an alternative method of scoring pain (see foot of page)
Creepers - geriatrics using walkers and wheelchairs
CRI - Cranial-Rectal Insertion or Cranial-Rectal Inversion (head-up-ass syndrome)
Crinkly - geriatric
Crispy critter - severe burns case
CROACC - Cannot Rule Out Anything, Correlate Clinically
Crock - Hypochondriac.
Crook-U - Prison Ward in a hospital (slang to match ICU - Intensive Care Unit etc)
Crop Rotation - Ambulance shuttle service from nursing home to surgery and back again
CRS - Can’t Remember Sh*t
CRT - Can't Really Treat
Crumble (crumbly) - elderly patient
Crump - (UK) RTA [Road Traffic Accident], (US) crash; trying to die
Crump, Gork or Vedgy - Intensive care patient incapable of movement and apparently unaware of his surroundings.
CTD - Circling the Drain (Close To Death)
CTF - Cletus the Fetus (US). A 23 week, or earlier, births that parents expect to survive against all odds
CTS - Crazier than sh*t
Cuckoo - alternative term for CCU
C*nts and Runts - Maternity and Paediatrics
Cut and Paste - To open a patient, discover that there is no hope, and immediately sew him up (or almost immediately - sometimes young surgeons practice surgical techniques for a while).
CYA - Cover Your Ass; unnecessary procedure/prescription done to avoid being sued

D&D - Divorced and Desperate (middle aged female who visits doctor weekly just for male attention)
D&D - Death and Donuts (night shift)
Dagenham - (psychiatry) or "Three Stops Beyond Barking": severely disturbed/mad (based on British train station names)
DACB - (US) Drunk As Cooter Brown (UK equivalent is PAAF/PIAF)
Dance (or Gown Dance) - the process of tying a surgical gown behind the surgeon's back (requires a 180-degree spin by the surgeon: Shall we dance?)
Dandruff on wheels - scabies or other transmissible flaky skin condition
DBI - Dirt Bag Index: number of tattoos x number of missing teeth = days since the patient last bathed
Death Camp - terminal nursing home
Death Star - that ward in every hospital where patients go to die
De-coke and Re-bore - Dilatation and curettage (gynae) op
Deep fry - cobalt therapy (radiation therapy)
Dement - Alzheimer patient
DENTIST - Doesn't Even Need Treatment - It's Sorted, Truly
Departure lounge - geriatric ward
Dermaholiday - nickname for dermatology dept used by staff in busier depts
DFO - (1) (US) Done Fell Out (anything from fainting to cardiac arrest)
DFO - (2) Drunk and Fell Over
DFO-SFJ - Done Fell Out - Screaming For Jesus
DIFFC - Dropped In For Friendly Chat (i.e. no medical problem)
Digging for Worms - varicose vein surgery
DIIK - Darned if I know
DILF - Doctor I'd Like to F*** (Fornicate with): Nursing slang for good-looking doctor
DILLIGAF - Do I Look Like I Give A F*ck
Dirtball - patient who enters the emergency room filthy and smelling badly
Discharged downstairs - transferred to the morgue
Disco Biscuit – Quaaludes (1980s), Estasy (2000s)
Dishwasher - sterilization machine
DKA - Don't/Doesn't Know Anything (but is explained to relatives as Diabetic Ketoacidosis if challenged)
DMFNFL - Dumb mother f*cker, not fit to live
Doc In A Box - a small clinic/health centre, with ever-changing staff.
Doing the Twirly - circling the drain (about to die)
Donorcycle - motorbike: the biggest cause of donated organs! (hence reckless motorcyclists are known as Organ Donors and rainy days are Donation Days)
Donut of Death - CT scanner
Doorknob Rounds - the entire presentation takes place in 5 seconds while the consultant's hand never leaves the doorknob to the entrance of the patient's room (US hospitals have small single occupancy rooms)
Dose of I Don't Care - pain-killing meds that make patient light-headed
Dose of I Don't Remember - pain-killing meds that leave patient without memory of painful procedure
Dose Sponge - Radiology Worker
DOTS- dead on the spot (of an accident), also FDOTS (F*cking Dead On The Spot)
Double bind trial - Two orthopods looking at an electrocardiogram
Double Whopper with Cheese - Obese female with genital thrush
Double Whopper with Mayo - obese female with vaginal discharge
Double Whopper with Ketchup - obese female with blood-stained vaginal discharge (often post-natal)
Doughnut - CT scanner
DPP - (Brazil) leave patient for the next shift to deal with ("Deixa para o Próximo Plantão")
DPS - Dumb Parent Syndrome
DPS - (General Practice) Droopy Penis Syndrome: a patient wanting Viagra prescription
DPS - (Hospital) Disappearing Penis Syndrome: the usual reaction of the male organ in response to insertion of catheter or endoscope
DQ - Drama Queen
Dr Feelgood - a doctor who is indiscriminate about prescribing drugs
Drinkectomy - separating a drunk from his can of lager (performed in A&E dept)
Drooler - catatonic patient.
Drop a Lung - when medical treatment causes a pneumothorax
DRT - Dead Right There (patient dead at scene of accident)
DRTTTT - Dead Right There, There, There and There (patient dead and in multiple parts at scene of accident)
DSB - Drug-Seeking Behaviour (faking illness to fuel narcotic addiction)
DSP - Dumb Sh*t Profile
DTMA - Don't Transfer to Me Again.
DTS - Danger To Shipping (in a particularly large patient's records)
DWPA - Death/Dying With Paramedic Assistance
DUB - Damn Ugly Baby
Duck - portable urinal for bedridden male hospital patients
Dude Factor - Survival scoring factor based on social worth. A high dude factor = an individual of questionable social worth who survives near-fatal injuries. A low dude factor = professional person who slips in the bathroom sustaining a fatal injury
Dump - patient that nobody seems to want (or to transfer a patient to another hospital); also a verb - arranging for patient to be off-loaded elsewhere
Dunlap Syndrome - belly done lapped over the waistband; obese (spare tyre, Dunlop being a brand of tyre)
DWPA - Death/Dying With Paramedic Assistance
Dys-Synaptogenic - stupid

Eating In - Intravenous feeding
Eating the Bill - (USA) providing care for indigent patients lacking insurance i.e. "We ate the bill on that guy."
ECU - Eternal Care Unit: heaven ("gone to the ECU = dead)
EDDU – eating drinking defecating urinating (but not much else)
EDGATWTTTF - Elevator Doesn't Go All The Way To The Top Floor (thick)
Eiffel Syndrome - (From I-fell on it) patient with a foreign object in the rectum
ELFs - Evil Little F*ckers (irritating children)
Embromed - (Brazil) imaginary health plan: postponement of solution through hoax.
Ego Boost Units - med students/junior doctors that follow a doctor
EMS - Earn Money Sleeping (joke at expense of Emergency Medical Service)
EMT - Extraordinary Masochistic Tendencies (joke at expense of Emergency Medical Technicians)
Engessar - (Brazil) to orient treatment so that the patient can't complain (literally "to place in a cast").
ERCP - Emergency Retrograde Clerking of Patient, an emergency procedure before the consultant rounds
ERNOBW - Engine Running, No One Behind the Wheel (thick)
ESBAM - Eat s**t and Bark At the Moon (or "not ruddy likely" in British English)
Estropício - (Brazil) poor, unkempt obstetric patient ("jeopardy").
Eternal Care - Intensive Care (for a patient who won't come out again)
ETOH - Extremely Trashed or Hammered (2 derivations given: corruption of "Etho" [ethanol addict] or from "EtOH" [chemistry abbreviation for ethanol])
Expensive care - intensive care
Expensive Scare - intensive care

FABIANS - Felt Awful But I'm Allright Now Syndrome
FAC - F*cking Awkward Client
Faecal Encephalopathy - Sh*t for brains
Fallaciopisces rufus - red herring
Family Care Plan - One child gets the sniffles, whole family gets a trip to A&E
Fanger - oral surgeon
Fascinectomy - long, but fascinating procedure
Fascinoma - Interesting pathology, but not as interesting as the ensuing politics over who gets first authorship when the case is written up
Father Jack - (the drunken old priest in Father Ted), confused and elderly patient who constantly shouts and tries to get out of bed
FCBP - Fellow of the College of Bystander Physicians i.e. doctor having a look-see
FD - F*cking drunk
FDGM - Fall Down, Go Boom (see LOLFDGB)
FDSTW - Found Dead Stayed That Way
Feather Count - measure of flakiness (e.g. high feather count)
Feed and Seed - care for vegetative patients in "the garden"
Feet-up General - a quiet district hospital
FFDID - Found Face Down In Ditch
FFDIG - Found Face Down In Gutter
FFF - see 4F (Fat, Fair, Female, Forty = gall bladder disease)
FHHS - (US) Female Hispanic Hysterical Syndrome (screaming and crying)
FIDO - F*ck It, Drive On (a waste of time/hoax ambulance all)
Fighting Darwin - patients refusing essential treatment through stubborness or stupidity
File 13 - The Trashcan
FINE - F*cked up , insecure, neurotic & emotional
Finger Wave - rectal exam
Fireballs of the Uticas - fibroids of the uterus
FIRT - Failed impact resistance test (crash victim)
Fish Filet - vaginal infection with discharge and odour
Fish Filet with Catsup/Ketchup - vaginal infection with discharge, odour and bleeding (e.g. post-natal)
FIT - fart in transit (gas seen in the intestines on an abdominal film)
FITH - F***ed in the head
Fluttering Eye Syndrome - Patient faking unconsciousness
FLBs - those "Funky Looking Beats" found on an EKG that no one can figure out
FLB - Funny Little Bumps (unexplained skin bumps)
Flea - (US) internists, (UK) ethnic nurses (used in 1970s during an influx of imported healthcare staff) i.e. "they get everywhere"
FLK - Funny Looking Kid (sometimes suggests rural inbreeding)
FLK w/ GLM - Funny Looking Kid with a Good Looking Mother
FLKBCOTP - Funny Looking Kid But Check Out The Parents
FLKOFS - Funny Looking Kid, Okay For Sunderland (one of many regional variants of NFN [Normal For Norfolk])
Floating - how ghosts (i.e. med students) get from "here" to "there."
Flower Sign - flowers at a bedside, denotes patient has a supportive family and might be candidate for early discharge
FLP - Funny Looking Parents (hereditary cause suspected for FLK)
FLUF - Funny Little Ugly F*cker
Fluttering Eye Syndrome - Patient faking unconsciousness
FMPS - Fluff My Pillow Syndrome (attention/sympathy seeker), like Call Button Jockey
FOALS NEIGH - F*ck Off And Let Someone Not Extremely Incompetent Get Here
FOB - Found on Bench
FODE - Falling On Deaf Ears
FOL, GOL, FOS - Fat Old Lady, Gone off Legs, Full Of S**t. Confused elderly female, unable to exercise at home, now unable to move unaided and badly constipated as a result (see also Toxic Confusional State).
Fonzie - Unflappable medic (Fonzie was the unltra-cool character in TV series Happy Days)
FOOBA - Found On Ortho Barely Alive (a play on FUBAR - F***ed Up Beyond All Recognition)
FOOSH - Fall Onto Outstretched Hand (as cause of broken wrist/arm)
FOOT - Flat Out On Tarmac (e.g. biker gone down in full flight)
FORD - Found On Road Dead
Foreverectomy - A surgical procedure that lasts a very long time
FOS - Full Of Sh*t (either severely constipated or metaphorically)
FOS - Found On Street: unidentified dead homeless person
FPO - For practice only (FTD)
FPT - (Brazil) beyond help, do not resuscitate ("Fora de Possibilidade Terapêutica").
Frequent Flyer - Someone who is transported to and from hospital on a routine basis (also someone who spends more time at the local hospital then most employees and is known by all staff members including Environmental Services)
Freud Squad - psychiatrists
Friday construction - Anatomical equivalent of the cars made on Fridays, when the workers mind was more on the weekend than the job in hand
Fruit Salad - group of stroke patients, all unable to take care of themselves
FTD - Fixing To Die
FTF - Failed to Fly (botched suicide)
FUBAR - Fucked up beyond all repair/recognition
FUBIL - F**k You Buddy, I'm Leaving. The act of a doctor at a small hospital dumping a critically ill patient on larger hospital on Friday afternoon before he leaves for the weekend
Full Moon - full or overcrowded waiting room/A&E/ER
FUPA - Fat Upper Pussy Area
FURB - Funny, Unusual, Rectal Blockage (people who use inappropriate objects as butt-plugs)

Galloping amputations - gangrene spreading up a limb so more and more has to be removed in consecutive surgeries
Garden - neurosurgical intensive care ward, so called because of the "vegetables" found there.
Gardening - attending to patients in neurological intensive care.
Gassers OR Gas Passers - anaesthetists
Gatekeeper - General practice doctor whose role is to keep costs low by only allowing a certain number of patients to go to specialists
GDA - Gonna die anyway
Genital hurties - genital herpes
Geosphere - Dirt Ball (Geo = dirt + sphere = ball)
Gerifix - that collection of broad spectrum antibiotics, diuretics and bronchodilators prescribed to elderly patients admitted to hospitals in wintertime
Ghost - Derogatory term for med students; they are largely invisible, are absent during difficult situations, silent when asked for volunteers and stealthily evade hard work
GI Rounds - a meal (GI = gastrointestinal)
GLF - Ground Level Fall (tripped over)
GLM - Good Looking Mum
GMG - Gurnicht Mit Gurnicht; Yiddish for "nothing with nothing" (Israel; nonsense jargon used to pacify nervous patients)
GOA - Gone On Arrival (police turn up, ambulance turns up, fire brigade turns up, patient doesn't)
Goat Rodeo/Goat Rope - Emergency scene which goes badly (resembles a bunch of people riding or wrestling goats)
God's Waiting Room - intensive care unit and/or geriatric unit
GOK - God Only Knows
Goldbrick - patient who demands more attention than their (minor) condition warrants.
Golden ass - affluent mother who treats the obstetrics nurses like servants
Golden Child - jaundiced youngster
GOLP - Generalised Old Lady Pains
GOMER - Get Out of My Emergency Room; extended to mean elderly patient who is unable to communicate their symptoms and passed from one department to another
Gomergram - Ordering all available tests because the person is unable to explain what is wrong with them
Gone Camping - patient in oxygen tent
Goober - nutter
Gorillacillin - very powerful antibiotic
GORK - God Only Really Knows
Gork - comatose or brain dead
Gorked - unresponsive and nonverbal, either due to sedation or medical condition
Gorked Out - mental impairment through disease or substance abuse
Go to Ground - fall out of bed or chair
Go to Meet Joe Black/Consult Joe Black - die
Gown's Sign, positive - a patient who leaves (self-discharge ) without official discharge orders
GPH - Goddamns Per Hour
GPO - Good for Parts Only (won't survive)
GRAFOB - Grim Reaper At Foot Of Bed
GRAHOB - Grim Reaper At Head Of Bed
Granny Dumping - dumping elderly relative in A&E; often happens just before Christmas or family holiday aka the hospital granny-sitting service
Granny Farm - old persons' residential home, run by a Granny Farmer
Grape Sign - grapes at a bedside, denotes patient has a supportive family and might be candidate for early discharge
Grapes - haemorrhoids
Gravity Assisted Concrete Poisoning - jumped/fell from height
Gridiron Belly - scarred from multiple ops
GROLIES - (UK) Guardian Reader Of Low Intellect In Ethnic Skirt
GTMJACB - Gone To Meet Jesus, Ain't Coming Back (dead)
GTO - Gomer tip over (elderly person with injury from trip or fall)
GTTL - Gone to the light (died)
GUCCI - Genito-Urinary Clinc, Chlamydial Infection (posh female with sexually transmitted chlamydial infection)
Guessing tubes - stethoscope
Gun and Rifle Club - Trauma ward full of gunshot and stabbing victims
Gutectomy - major gastro-intestinal surgery; also abdominal fat removal (such as liposuction)
Guts and Butts - general surgery

HAIRY PSALMS - Haven't Any Idea Regarding Your Patient, Send A Lot More Serum
Hallucinoma - a mass seen on a scan or x-ray that wasn't really there
HALS - Hit And Left Standing (apparently uninjured but in shock after RTA/MVA)
Hamburger (Helper) - Train or juggernaut vs pedestrian
Hammer - local anesthetic
Hammered - to get numerous admissions while on call
Handbag positive - confused patient (usually elderly lady) lying on hospital bed clutching handbag
Happy feet - (US) patient having a grand mal epileptic seizure (in UK, Happy feet means smelly feet (feet which "hum" [stink])
Happy Little Campers - children in oxygen tents
Hasselhoff – emergency patient with bizarre explanation for their injury (David Hasselhoff's had a bizarre shaving accident in which he hit his head on a chandelier; the broken glass severed 4 tendons and an artery in his right arm)
Hat Trick - trauma patient with 3 tubes into him
HBD - Has Been Drinking or He Be Dead
Head - a brain-injury patient. Usage - "I’ve got a head I’ve got to deal with."
Head Bonk - an otherwise uninjured patient who was struck on the head and presented at A&E just to be sure
Head whack - head injury
Healthy Goober - dead tumour patient.
Hearts and Farts - unit specialising in geriatrics and cardiology
Heel Elevation Ataxia - a woman who appears staggering drunk, but is sober (or slightly tipsy) and can't walk on seriously high stiletto heels
Hepatology Conference - doctors meeting at a pub or bar (no late appointments, I'm going to a hepatology conference)
Hey Docs (or Haydock) - alcoholics handcuffed to wheelchairs in big-city medical wards who chorus "Hey, Doc! when they see a white coat" (sometimes disguised as "Haydock" which is a UK placename)
Hepatology Conference - doctors meeting at a pub or bar (no late appointments, I'm going to a hepatology conference)
Hi 5 - HIV positive ("V" being Roman for 5)
HIBGIA - Had it before, got it again
High Serum Porcelain Level - Patient is a crock of sh*t
High Slug Titre - lazy patient (slug) that won't get out of bed
High Speed Lead Injection - gunshot
Hippo - Hypochondriac or depressive
Hit and Run - the act of operating quickly so as not to be late for another engagement (often a non-medical appointment).
HIVI - Husband Is Village Idiot
HMF - Hysterical Mother Figure
HMO - From phrase, "Hey, Moe!", a concept pioneered by Dr Moe Howard, who discovered that a patient could be made to forget about the pain in his foot if he was poked hard enough elsewhere. Modern "pokes" with same outcome include estimates for private treatment.
HMS: Hysterical Mexican Syndrome
HOPEFUL - Hard-up Old Person Expecting Full Useful Life (i.e. OAPs are not priority for most hospitals)
Hole-in-One - A gunshot wound through the mouth or rectum.
Hollywood code - see Slow Code
HONDA - Hypertensive, Obese, Non-compliant, Diabetic African-American
HOP - house of pain (nursing home)
Hope'n'Scope - exploratory laparoscopy where you hope to find no disease (unless you're the student, in which case you hope to see something interesting)
Horrendoectomy - a long and painful procedures
Horrendoma- an awful unknown disease
Horrendoplasty - A god-awful surgery with a probable poor outcome e.g. difficult operation for 12 hours on a patient with a BMI of 45
Hospital Hobo Syndrome - person who visits multiple hospitals seeking attention or accommodation
Hospitalismo - (Brazil) Revolving-door patient (in-and-out-and-in ....).
Hospital pilantrópico (Brazilo) - (sarcasm) dubiously charitable hospital where profits outweigh philanthropy.
House red - blood
HP - Hispanic Panic (see tachylordia)
HTD - Higher Than a Duck
HTK - Higher Than a Kite
HTT(A) - Hot Tots and Twats (Area): Paediatrics & Ob/Gyn wing of hospital
Humpty-dumpty doctor - a physiotherapist or rehabilitation doctor (from the nursery rhyme verse "all the king's horses and all the king's men could not put humpty together again")
HVLT - High Velocity Lead Poisoning: gunshot wound
Hypoxanaxemia - patient with anxiety symptoms (Xanax deficiency)

Icing on the Cake - lethal tumor discovered in the X-rays of a heart attack victim.
I fell on it - (also Eiffel Syndrome) universal explanation given by a patient with a foreign object in the rectum
Imaginascope - what you use during radiology rounds to see the lesion the clinician is showing you but you don't see
Improving His Claim - Victim of minor accident, needs no treatment but wants something to support his insurance/legal claim.
Inbreds - doctors whose parents are also doctors
Incarcaphobia - patient is hypochondriac prisoner who prefers hospital to jail cell
Incarceritis - becoming dubiously ill when arrested or in court
Incidentaloma - a usually benign mass (needing removal) found on a scan while looking for something else entirely
Infernal Medicine - Internal Medicine department
Insurance Pain - Neck pain secondary to a minor car bump
Insurance Whiplash - Neck pain secondary to a minor car bump
Interesting Case - A patient transferred from a non-specialist hospital who is an unmitigated disaster with no accompanying chart or documentation
International House of Pancakes - neurology ward full of patients (usually stroke victims) all babbling in a different language.
Intubate Junior/Intubate Willy - catheterise a man (often results in DPS - Disappearing Penis Syndrome)
ISQ - In Status Quo ("no change"): often used during the weekend surgical round
ITBNTL - In The Box, Nail The Lid (dead or dying)
IWB - Intercourse With Biscuits (F**king Crackers)

Jack Bauer - a doctor still up and working after 24 hours (after character in "24")
JAFFA - Just Another Fat, F***ing Administrator
Jailitis - becoming dubiously ill while in custody or in a jail cell
Janitor's fracture - a fracture so obvious that a janitor (cleaner) could diagnose it
JAR or JAR Syndrome – Just Ain’t Right (often used when a patient has multiple issues)
JDFR - Just Doesn't Feel Right - most common complaint of LOL's (Little Old Ladies) and SOG's (Sick Old Guys)
JDLR - Just Doesn't Look Right (something is wrong, but no diagnosis has been made yet)
JIC - Jesus is calling
JLD - Just Like Dad (often used to explain an FLK)
JNR- Just Not Right (something is wrong, but no diagnosis has been made yet)
John Thomas sign (UK), Johnson's Sign (US) - according to tradition, the side that the penis (John Thomas, Johnson) points to (if visible on x-ray) will have an abnormality (see also Throckmorton sign).
Journal of Anecdotal Medicine - favourite, but unwritten, source of medical wisdom
J P FROG - Just Plain F***ing Ran Out Of Gas (old age etc)
JPS - Just Plain Stupid (self induced injury involving lack of common sense)

Kaiser Soze - Registrar with an uncanny ability to disappear (not answer phone or pager) when there is work to be done (from movie 'The Usual Suspects')
KFO - Knock the F*cker Out (patient either obnoxious or screaming in pain)
Kidney Stone Squirm - a spot diagnosis in A&E
Killing Fields - that ward in every hospital where patients go to die
Knife-happy - an overly enthusiastic surgeon
Knife and Gun Club - (US) local street gangs or criminal organizations that keep ER in business OR the emergency departments that care for patients with the results of street gang violence
Knuckledragger - Orthopedic Doctor/Surgeon
KOKO - Keep on Keeping on.

Lancelot - a medic who drains abscesses (called Pokemon in the USA)
Lantern Test - shine a torch in the subject's mouth and the eyes light up (no brain)
Larry - Locum, as in "doing a Larry"
Last Flea To Jump Off A Dead Dog - Oncologists (sometimes other disciplines) who seem unable to let people die with diginity
Laying Crepe - dismal prognosis (i.e. prepare the coffin)
LDF - Lying Down Fit
Leave 'Em Dead - Levofed (aka norepinephrine) , the drug given to cardiac patients to prop up their blood pressure until they die in the ambulance
Leeches - those who take blood samples, e.g. lab techs
Lerner/Bernstein Fracture - the injury suffered by a patient who is intent on suing someone over his trip or fall (Lerner/Bernstein are ambulance-chasing lawyers in one region).
LFTWM - Looking for 3 Wise Men (applied to young pregnant females who deny having had intercourse)
LGFD - looks good from door (but not closely examined, possibly an obnoxious patient)
LGFTC - looks good from the corridor (but not closely examined)
Lignocephalic - wooden-headed (i.e. dense [thick] or stubborn)
Lipstick Sign - if a female patient is well enough to put on, she is well enough to be discharged
Liver rounds - staff party, so called because of liver-damaging alcohol
LLS - Looks Like Sh*t
LMC - Low marble count (low IQ)
Load the Boat - call in senior medical staff as ass-covering exercise
LOBNH - Lights On But Nobody Home
Lobster - sunburned patient
LOFD - Looks Okay From Door
LOL - Little Old Lady
LOLFDGB - Little Old Lady, Fall Down, Go Boom
LOLINAD - Little Old Lady In No Acute Distress
LOLITS - US: Little Old Lady In Tennis Shoes (60+ year old); UK: Little Old Lady In Twin-Set (50-60 yera old)
Loop-the-loop - flamboyant surgical rearrangement of the intestines.
Loose Change - dangling limb in need of amputation.
LPT - Low pain threshold
LRO - Luck Ran Out (cheated death before, but not this time)
LWS - (US) Low Wallet Syndrome (No medical insurance or money)

M & Ms - mortality and morbidity conferences where medics discuss epidemics, mistakes and patient deaths
M sign - Patient just goes "Mmmm"
MacTilt - how a Macmillan nurse (cancer care nurse) tilts his or her head to convey sympathy
MAFAT (May-fat) - Mandatory Anasthaesia F**k Around Time, precedes any incision
Map of Antarctica - (NZ) appearance of fatal spontaneous brain haemorrhage on CT scan
MARPs - Mind Altering Recreational Pharmaceuticals
Marriageable Monster - young female patient who has successfully undergone major plastic surgery.
Masochist - Trauma surgeon; Sadomasochist - Neurosurgeon
Matern-a-taxi - when a pregnant woman calls an ambulance because the contractions are every 2 minutes, but she doesn't have a single contraction during a 30 minute journey to hospital
MCBP - Member of the College of Bystander Physicians i.e. doctor having a look-see
Meat hooks - surgical instruments.
Metabolic clinic - the tea room
Metal Poisoning - what a patient allegedly dies of when he's held together with staples (also gunshot wound)
Meth Mouth – common symptom in methamphetamine addicted patients
MFB - Measure for box
MFC - Measure For Coffin
MFD, CFD - Measure For Box, Call For Dirt (severely ill [or dead or nearly so])
MFI - very large myocardial infarction
MGM syndrome - Faker putting on a real good show
Michelin's Disease/Disorder - multiple spare tyres (obese)
MICO - Masterly Inactivity and Catlike Observation
MICOS - Masterly inactivity, cat-like observation and steroids
Microdeckia - Micro = small, deck = deck of cards; patient playing with less that a full deck (low IQ)
MIDI - myocardial infarction during intercourse (heart attack during sex)
MILF - Mother I'd Like to F**k. US version of GLM who is also PHAT
Milk of Amnesia - Propofol
Mini me - Trainee or medical student who copies their senior colleague too much but doesn’t say a lot (from Austin Powers films)
Mobile Drip Stands - Fire Dept (often found at emergencies alongside paramedics)
MOFAT (Moh-fat) - Mandatory Orthopaedic F**k Around Time, precedes any incision (alternative to MAFAT)
Molar masher - dentist
Mononeuronis Asynapsis - thick (one neuron, not connected!)
MooMoo-Mover - the big blue sheet used for moving obese patients
Mow The Lawn/Trim the Hedge - remove a long line of sutures
MTF - Metabolize to Freedom (i.e., let the person sober up, and then they can leave)
MUH - Messed up heart
Mulambo - (Brazil) poor patients in public outpatient clinics (literally rag + beggar)
MU Pain - Made Up pain (especially for sick notes and insurance claims)
Mushroom syndrome - suffered by lowly medics who are kept in the dark and have crap piled on them
MVA Special - CT scan of head, neck, chest, abdomen and pelvis (on car crash patient)
MVA Special With Gravy (aka MVA Full Meal Deal) - MVA Special plus face

n=1 trial - polite term for experimenting on a patient
NAD - Not actually done
Nastioma – mass that looks like aggressive neoplasia
NARS - Not a rocket scientist (low IQ)
Nebulopathy- strange clinical signs with no "normal" disease apparent
Necrophiles - derogatory term for Pathologists (the love the dead)
Nectar of the Gods - coffee; without which many hospital services would shut down
Negative Wallet Biopsy - (US) patient transferred to cheaper hospital because s/he has no insurance/funds
NETMA - Nobody Ever Tells Me Anything (generally a doctor's gripe on a patient's chart)
Neuro-faecal Syndrome - s**t for brains
Neuron - Neurologist.
Neuroslavery - Derogatory term for Neurosurgery based on the extreme long hours compared to orthopaedic surgery
NFF - Normal Fae Fife (Scottish version of NFN below)
NFN - Normal for Norfolk (rural area, suggests inbreeding or quaint rural oddness), might explain FLK
NFP - Normal for Portsmouth - repeat abortion, said to be particularly rife in Portsmouth, Hampshire, UK (a sailing port)
NFR - Not For Resuscitation; used on elderly patients’ charts where the DNR (Do Not Resuscitate) instruction is without the knowledge of the patient themselves or their family
NGMI - Not Going to Make It
NKDA - Not known, didn’t ask
NLPR - No longer playing records (dying)
NOCTOR- Nurse tht has done a 6 week training course and acts like s/he's a Doctor
No Hopeamine - Dopamine
Not even in the ball game - confused, senile patient
NPS - New Parent Syndrome
NQR - Not Quite Right
NQRITH - Not Quite Right In the Head
NSA - Non-Standard Appearance (what a FLK grows into)

O sign - Patient unconscious with mouth open
OAP - Over-Anxious Patient
OB/GYN - actually means Obstetric/Gynaecology, rumoured to mean "Oh Boy-Got You Naked"
OBE - Open Both Ends (known in UK as DNV - Diarrhoea and Vomiting)
OBECALP - placebo (the rationale being that patients don't realise it's "placebo" in reverse)
OBS - Obvious bullsh*t
Obs and gobs - obstetrics and gynaecology
OCWTL - Overcome With The Lord (Tachylordia)
OFIG - One Foot In the Grave
OFIGATOOS - One Foot In the Grave And The Other One Slipping
Ohno-second - The time from making an error (e.g. dropping that hard-to-get sample immediately after you got it) to going "oh-no"
Oil slick - (1991, NZ) - appearance on CT scan of a porencephalic cyst
Old Man's Friend - (US) pneumonia, an illness which often carried off the elderly
Oligoneuronal - "few brain cells" i.e. thick (not very bright) (Note: In the UK, "dumb" means "mute")
OMGWTFBBQ - a person mangled in a car crash
Ooh-Aahs - Those who gather to gawk at an emergency and go "Oooh, Aaah"
OPD - Obnoxious Personality Disorder
Optorectomy- operation to disconnect the eyeball from the anus, due to such a sh*tty outlook on life
Organ recital - a hypochondriac’s medical history
Orthopod - orthopaedic doctor
Osteocephaly - boneheaded
Ostrich Treatment - pretend it's not there and hope it goes away
OTD&DDR - Out The Door and Down The Road.
OTDPDS - Out The Door Pretty Damn Soon
OTLP - n the launch pad (to be discharged to home)
Overpriced Carpenter - orthopaedic doctor

P4P - Penicillin for Prick (peniecille for penile discharge)
P5T/P-to-the-fifth (see PPPPP) - can also mean bad genetic material or syndromic patient with numerous medical system problems
PAAF - Pissed as a fart (also PIAF -PIssed as A Fart)
PAFO - Pissed [Drunk] And Fell Over
Paint - Betadine (medication)
Pale face - (Brazil) child with leukaemia/severe anaemia.
Paninvestigram - order all the tests; for when you haven't got a clue what's going on
Pan-man Scan - Whole body scan (e.g. after car crash)
Paperweight - (NZ) very small patient with severe congenital mental retardation
Papoterapia - (Brazil) to give the patient a pep talk, chitchat therapy ("papo" = chitchat).
Parentectomy - removing parents as an effective cure for a child's problems
Pathology consult - referral when the patient dies
Pathology outpatients - Follow-up for dead people
Paws Up - dead
PBAB - Pine Box At Bedside
PBABLTO - Pine Box at Bedside, Leave Top Off
PBTB - "pine box to bedside"; indicates an imminent demise
PBS - Pretty bad shape
PBOO - Pine Box On Order
PD - Pencil D**k. General US insult. It gets applied to lazy doctors who pass work on to their peers and should not be confused for that other PD, Program Director (US terminology)
Peanut Butter Balls - Phenobarbital
Pecker Checker - either a urologist or a sexual diseases doctor (also the ship's doctor in Naval slang)
Peek and Shriek - open a patient surgically, discover an incurable condition, and close the incision immediately
Pee Pee Docs - urology
PEFYC - Pre Extricated For Your Convenience (RTA victim that has gone through windscreen)
Penal Colony - renal ward/dept, especially when a superbug is on the loose
Percussive maintenance - the sharp tap/bang which cures faulty equipment
Permanent room - as in "He's here so often we should just give him his own room"
Pest control - term applied to psychiatrists by casualty officers
PFH - Parent(s) from Hell (custodians of BFH - Brat From Hell)
PFO - Pissed [Drunk] and Fell Over
PGT - Pissed [Drunk] and Got Thumped
Pharmaceutically Enhanced Personality - stoned or medicated
Pharmaceutically Gifted - admissions with altered mental states as a result of drug use
PHALS - Post-Harmless Accident Lawsuit Syndrome
PHAT - Pretty Hot and Tempting (warning to others)
PHD = Pakistani Healing Dance (a useless procedure performed for benefit of patient and family)
PIA - Pain in the ass
PIAF - PIssed as a fart (also PAAF -Pissed As A Fart)
Pediatron - paediatrician
PID - Pus In 'Dere (PID actually means Pelvic Inflammatory Disease)
PID shuffle - spot diagnosis in A&E (Pelvic Inflammatory Disease)
Pig In A Blanket - Patient (esp an overweight one) in Bed With Fevr
Piles - (at beach resort clinics), sunburn cases: angry, hot and red (better known as lobsters)
Pillow Consult - wanting to smother a difficult patient
Pillow positive - (Wales) patients who are repeated admissions for prolonged periods with no physiological cause of their problems. It is joked they go to hospital with their own pillows ready for admission
Pillow Therapy - describes the urge to smother annoying patient (aggressive euthanasia, tontine treatment).
PIMBA - (Brazil) swollen-footed, drunk, run-over beggar ("Pé Inchado Mulambo Bêbado Atropelado")
Pineboxatosis - collection of conditions which lead to transfer to the ECU, usually accompanied by PBTB with positive Q-sign or O-sign
Pink puffer - patient breathing rapidly due to lung disease
Pinky Cheater - Latex finger cover used in gynecological and proctological examinations.
Pit - the emergency room
PITA - Pain in the ass
Pitiático - (Brazil) patients feigning illness.
Plank Positive - stupid, as in "thick as 2 short planks"
Plano Pafúncio - (Brazil) alleged preferential treatment of relatives of hospital employees.
Player - complaining, irritating patient
Please Consult Us If New (Surgical) Issues Arise - please never page me again
Please Optimize Medical Treatment - don't call us until you've done your job first
PLH - Pray Long and Hard
PLTDP - Practice Limited To Dead People
Plumbii Pendulosus - swinging the lead (malingering) anecdotally used on medical certificates to be presented in Court, esp in Magistrates' Court where the Magistrate is known to the Doctor
Plumboscillation - swinging the lead (malingering)
Plumbum oscillans - Latin for "swinging the lead" (malingering) i.e seeking a sick note to take time off work
Pneumo-cephalic - airhead
PNR - person needed ride i.e. minor ailment but called ambulance instead of taxi
Podo-Oral - Foot in Mouth (i.e. put one's foot in it - rarely used BY senior staff, sometimes used ABOUT them)
Pokemon (pronounced Pokey-man) - the medic who drains abscesses (Lancelot (lance-a-lot) in the UK)
Policeman Lesion - lesion on an X-ray so obvious that a policeman would spot it
Poliesculhambado - (Brazil) multi-f*cked-up patient.
Polybabydaddia - a mother who presents to the ER (Casualty) dept with 8 or 9 kids in tow, most of whom were fathered by a different men
Polydipose Dysfunction - big, fat patient (polydipose being invented plural of adipose [fat])
Pop Drop - granny dumping (dumping elderly relative at Casualty dept)
POPTA - Passed Out Prior To Arrival
Porcelain Level - fictitious blood test ordered to communicate to colleague that the patient is malingering (crock of sh*t)
Porch People, Walmart Greeters - Confused patients sitting in chairs in hall for close observation
PORG - Person Of Restricted/Retarded Growth (dwarf/midget)
Positive Blue Legs Sign - (US) resuscitation behind closed curtains (US ER medics wear blue scrubs)
Positive Gobbler - turkey i.e. faking illness to get out of drill (used by army medics)
Positive Hilton Sign - demanding patient expects Hilton Hotel luxury; indicates patient well enough to leave!
Positive Suitcase Sign - patients who are repeated admissions for prolonged periods with no physiological cause of their problems. They turn up at hospital with packed suitcases ready for admission
Possible This Possible That - consent form in case exploratory surgery
Post-Weekend Fatigue Syndrome - an ailment which presents at GP surgeries on Monday mornings
Pot Plant - person in a Persistant Vegetative State (often used in plural to mean coma ward)
Pox Docs - clap clinic (sexually transmitted disease clinic) doctors
PPP - Piss poor protoplasm
PPP,PPP - Piss-Poor Protoplasm, Probable Placement Problem
PPPPP - piss poor protoplasm poorly put-together (really old and/or decrepit)
PPA - Practicing Professional Alcoholic
PRATFO - Patient Reassured And Told to F*** Off
Pre-Detention Stress Disorder - a person who feigns medical symptoms when police handcuff him
Pre-stiff - terminally comatose patient.
PSLM (Por Si Las Moscas - because of the flies) (South America) - try some medications just in case (on a no-hope case)
Psychoceramics - psycho-geriatrics
Psycode - Code Blue in a psychiatric hospital i.e. patient passing out from the side effects of medication
Pucker Factor - the degree/speed of constriction of the surgeon's anal sphincter is directly proportional to the patient's risk of sudden death
Pumpkin Positive - a penlight shone into the patient's mouth/ear would encounter a brain so small that the whole head would light up
Purple (code purple) - when paramedics are called out to a dead body
Purple Plus - called out to collect a dead body that's started to fester
PVC Challenge - To intubate someone.
PWT - Po' (poor) White Trash (with a condition related to their lifestyle)

Q sign - Patient unconscious/terminal with mouth open and tongue hanging out; "Dotted Q" means flies land on tongue (dead/dying). Reversible Q-sign means you can push the patient's tongue back into the mouth to form the O-sign. Irreversible Q-sign means the tongue keeps falling back out of the mouth after it’s pushed back in (very bad sign)
Q-Tip - Elderly person (white haired old person) (Q-Tip is a cotton bud)
Quackpractor - chiropractor
Qwertyitis - what a doctor suffers from when he spends more time on a computer than with actual patients
QID - Queen in distress (hissy fit)

Rabbit - over-talkative (from slang "Rabbit & Pork - talk)
Radio-I-suppose-otope - imaging agent used in Unclear Medicine (Nuclear Medicine)
Raisin Farm - old person's home, geriatric ward etc (also Raisin Farmer - person who runs old persons' home)
Ralphie McYakkers - young drunks vomiting
Rapid Lead Infusion - obnoxious patient ought to be shot
Rays - radiology dept
RBG - Received by God (a person in receipt of a Celestial Transfer)
RBS - Really Bad Shape
Rear Admiral - proctologist
Rear Admiralty - proctology dept
Rectoencephalitis - head-up-own-ar5e syndrome
Red dot - physicians from India, relates to red dot on their forehead
Red pipe - artery (as opposed to "blue pipe" or vein)
Reeker - smelly patient
Removal men - dept of care of elderly people
Retrospectoscope - instrument of hindsight
Rheumaholiday - rheumatology (considered by hard-pressed juniors to be a less busy dept)
Ringo – (after Beatles drummer Ringo Starr) an expendable team member
Roach - a patient, usually a dirtbag/ingrate, that can't be killed despite near lethal complications of an already serious ailment
ROAD - Dermatologist. Acronym "Retired On Active Duty" Akin to "dermaholiday"
Road Chilli - Unrestrained driver/motorcyclist or passenger, ejected and splattered
Road Map - injuries incurred by going through a car windshield face first.
Road Map Abdomen - scarred from multiple ops (same as Gridiron Belly, Zorro Belly)
Road Pizza - Unrestrained driver/motorcyclist or passenger, ejected and splattered
Road Test - to get a drunk patient to walk up and down a corridor; if they pass they are turfed, if they fail they need a bit longer to sober up.
Roasted Goober - tumour after intensive cobalt treatment.
Rock - a patient that stays on your service forever
Rocket Room - a ward/unit where there are many deaths (many transfers to heaven)
Rocking horse stool - even rarer than hen's teeth
Rooters - indigents and hangers-on who gather in big-city emergency rooms in order to be entertained by legitimate cases.
Rose cottage - mortuary
Rothman's sign - tobacco staining of fingers
Rounding Up The Usual Suspects - Ordering a set of tests for a given set of symptoms
RPVU - Relative Porsche Value Unit: surgical index of potential income from the repair of patient injuries, usually orthopaedic in nature. Fractured finger = a windscreen wiper; a fractured hip = new tyres etc.
RT - Room Temperature (dead)
RTT with a BBB - Rat-a-Tat-Tat with a Baseball Bat (hit with blunt instrument).
Rudy Baga - Patient with terminal brain injury, persistent vegetative state (rutabaga is a vegetable).
Rule of Five - if more than five of the patient's orifices are obscured by tubing, he has no chance
Running Towards the Light - dying

S2 - Sit the f**k down and shut the f**k up
Saddles - Maternity sanitary towels (napkins), so called for their size and the bow-legged effect of wearing them
Samsonite Positive (Positive Samsonite Test) - someone who turns up in emergency with all their luggage (and insists on being admitted to a ward)
San Fran Twist - performing a prostate examination by hooking the index finger in a half-circle upon insertion into the rectum
Sarcoidosis - an actual disease, but a perfectly acceptable answer that may be included in ANY differential diagnosis
SAS - Sick As Sh*t
SBI - Something Bad Inside e.g. undiagnosed cancer/unexpected serious condition found when performing surgery
SBLEO - (pronounced S-B-Leo) Suicide By Law Enforcement Officer
SBOD - Stupid bitch/bastard on drugs
Scepticaemia - chronic condition suffered by two doctors in a debate over which therapy
Scrape and Staple - burns unit
Scratch and sniff - gynaecological examination
Scumdex - 1 pt for every tattoo, extra piercing, IVDU scar, etc. The higher the scumdex, the greater the likelihood of survival. See also TTI
Search and Rescue - Medics allocated to look after the patients dotted in non-medical wards
Sellout - Derogatory term for plastic surgeon in private practice
Sent Over the Hedges - sent to radiology
SEP - Somebody else's problem (not to be confused with sepsis)
September club - the students who have to return after summer holidays for retakes
Serum porcelain - battery of blood tests on an elderly patient
Serum rhubarb - What they test for at tertiary centres
SFS - Stinky Foot Syndrome (often related to homeless)
SF Scale - Sphincter Factor Scale: 1 to 10 scale indicating degree of bowel-loosening in response to an emergency
SHA - Ship His Ass (when patients refuse to be discharged).
SHAD - Syphilitic, Hypochondriac, Alcoholic Degenerate
Shadow gazer - radiologist
Shandy Tap - bloodless lumbar puncture
Shit and Get - to access a trauma patient, say to yourself "Oh Shit!", stabilize and transfer
Sh*ts & Spits - lab tech term for a patient's stool and sputum samples; also the instruction to obtain these samples
Short-Order Chefs - mortuary workers.
Shotgun Labs - to order many lab tests, hoping one will turn up an answer to a puzzling case
Shotgunning - Ordering of a vast array of tests in the hopes that one or other of them will give an idea of what is wrong with a patient
SHPOS - Sub-Human Piece of Sh*t
SHS - Sullen, Hostile, Stupid (often an inner city drug/alcohol addict)
Shy Turd - severe constipation
Sick - Really sick i.e. FTD (Fixing To Die) or CTD (Circling The Drain)
Sidewalk Souffle - (US) suicide-by-jumping
Sieve - a doctor who admits almost every patient he sees
SIG - Stroppy Ignorant Girl
SIG - (certain US regions) self-inflicted gerbil (anecdotal)
Significant History - HIV positive
Silver Bracelet Award - patient is a prisoner brought in wearing cuffs
Silver Goose, Silver Stallion - proctoscope.
Síndrome JEC - (Brazil) terminal patient ("Jesus Está Chamando" = "Jesus is calling").
SIO - Sleeping It Off
Slashers - general surgeons
Slough - a patient inappropriately or unfairly unloaded from one hosptial unit on another
Slow Code (to China) - elderly very ill patient who wants everything done so they will not die. Everyone on the medical team disagrees
Smashola - patient with multiple blunt trauma injuries e.g. from car smash
Smellybridge - area between the anus and the back of the scrotum (perineum)
Smiling Mighty Jesus - (US) spinal meningitis (also Screamin' Mighty Jesus)
Smoke the Anaesthetic Cigar/Smoke the Camel - intubated
Smurf Sign - patient blue or going blue
SNEFS/M SNEFS - Subnormal (or Mentally Subnormal) Even For Suffolk (a rural English county)
Snow - to accidently give a patient too much medication/mixed medication so they go into an altered state of consciousness ("Don't snow that patient with Drug X and Drug Y at the same time!)
Snowed - being in a state of altered consciousness due to too much/mixed medication
SNUD - Sick Nigh Unto Death
SOB, SOB, SOB - Silly Old Bugger/B*stard/Bitch, Sitting Out of Bed/Sitting On Bed, Short Of Breath
SOCMOB - Standing On Corner Minding Own Business (when inexplicably injured)
SODDI - Some Other Doctor Did It (when one medic's botched jobs must be put right/answered for by someone else)
Sofa Surfer - homeless person who sleeps on friends' sofas and floors (ends up at A&E for "3 hots and a cot" when s/he has nowhere else to stay)
Soft Admission - an admission that only a "Sieve" would accept
SOG - Sick Old Guy (male version of LOL (Little Old Lady))
Solomf yoyo - So long, mother-f*****, you're on your own (see "amyoyo syndrome")
Space cadet/Buzz Lightyear - confused patient (dementia or drug-related)
SPAK - Status Post Ass Kicking
Speed bumps - haemorrhoids
Spin the Patient - CT scan
Spots and dots - traditional set of childhood diseases - measles, mumps, and chicken pox
Squash - brain.
Squirrel - eccentric or hypochodriac ("squirrelly") patient who can make life difficult. Found in the phrase "squirrels get sick too" to remind staff that even eccentric patients may have a real medical problem
SRI - Something Wrong Inside (undiagnosable problem)
SSDD - Same Sh*t Different Day (in conjunction with Frequent Flyer)
Stage Mother - person accompanying patient and encouraging patient to exaggerate the complaint (often to obtain a particular diagnosis or to get an unnecessary prescription)
Stamp - skin graft
Status Hispanicus - (US) much like Acute Puerto Rican Syndrome.
Steel Sign - surgical metalwork from previous ops visible on x-ray
St Elsewhere - medical academia's term for any non-teaching hospital
Stem to Stern - throat to pubis incision
Stream team - urology dept
Stupidity Panel - lab test (for patient stupidity) that, when invented, will earns its inventor a fortune (i.e. thick patient)
Sturgeon - surgeon
Sucking The Peace Pipe – intubated
Summer Teeth - some are teeth and some aren't ...
Sunshine - how one addresses an entitled, arrogant patient
Supratentorial - above the falx tentorium/cerebellum i.e. psychosomatic e.g. supratentorial pain
SVRI - Something Very Wrong Inside (usually terminal)
SWAG - Scientific Wild Ass Guess
Sweet Milk/ Mother's Milk - Propofol; a reference to its milky appearance and pain-relieving use
SWI - Something Wrong Inside
SWW - Sick, wet and whiny (infant)
SYB - Save Your Breath (for patients who don't take advice)

Tachylordyosis (with the junctional Jesus) - Usually a middle-aged to older black female American with a complaint of "lordy, lordy, lordy, lordy, lordy, lordy", occasionally with the interspersed "Jesus" i.e. "lordy, lordy, lordy, lordy, Jesus help me, lordy, lordy"
Tachylawdia - as above (variant spelling), but without the "Jesus"
TAPS - Thick As Pig Sh*t
TARFU - Things are really f**cked up
Tash Test - observation suggestive of HIV status (presence of a Freddie Mercury-esque moustache)
TATT (or TAT) - Talks All The Time (also "Tired All The Time")
Tattoo Titre/T&T Sign - indication of patient insanity: more than 5 tattoos indicates likely crazy person
T&T Sign - Tattoo-to-Teeth Sign: survival indicator; those who are tattooed and toothless will survive major injuries
Taint Spot - Perineum: "It ain't this and it ain't that"
Taxidermy Consult - call for a taxidermist's consultation i.e. person about to die
Tax-Sucker - Someone who does not need an ambulance, but calls anyway because it's free
TBC - Total Body Crunch: multiple injuries
TBD - total body dolor i.e. complains of pain everywhere
TBP - Total body pain
TDS - Terminal deceleration syndrome (e.g. RTA death, high-rise syndrome, jump-suicides and parachute-failed-to-open)
TEC - Transfer to Eternal Care i.e. dead
TEETH - Tried Everything Else, Try Homeopathy
Testiculation – (male) consultant holds forth on a subject with expressive hand gestures, but has little knowledge of the subject.
TF BUNDY - Totally f*cked, but unfortunately not dead yet
TFO - Too F*cking Old (person dying of old age).
TFTB - Too Fat To Breathe
Thank You For This Interesting Consult - this is complete b*llsh*t
THC - Three hots and a cot; sought in A&E by the local homeless
The Fish Plant - Gynaecology/Obstetrics Ward (from Newfoundland, where fisheries is the main industry)
The Garden - neurological ICU where the vegetables (coma patients) live
The Promised Land - private practice/final year of medical school
Therapeutic Monitoring - monitoring a patient purely because it makes the doctor feel better.
Thorazine shuffle - the slow, lumbering gait of psychiatric patients dosed up on phenothiazines
Three-toed sloth - patient with diminished capacities, usually from long-term alcoholism
Throckmorton’s Sign - in the unconscious male, the penis points to the injury
TLC - Tube, Lavage & Charcoal (given to poisoning victim)
TLGP -Two Legged Guinea Pig - patient undergoing experimental or extreme treatments
TLR - Two Legged Rat - refers to a patient undergoing experimental or extreme treatments
TMB - Too Many Birthdays: person dying of "old age"
TMI - Three Meaningless Initials (e.g. John Smith, TMI - applied to medics with qualifications rather than ability)
Toaster - defibrillator
TOBP - Tired of Being Pregnant (especially patient demanding caesarian)
TOG - Tears of Gratitude
Tontine Treatment - Urge to put pillow over face of irritating patient (Tontine is a leading brand of pillows in Australia, also a type of will)
Tooth to Tattoo Ratio - Visual determination of basic intelligence. A positive ratio (more teeth then tattoos) is generally better than a negative ratio is bad.
Torture Room - Intensive Care Unit (due to invasive tubes and monitors and experimental treatments).
Tough stick - patient whose veins are hard to find when drawing blood
Toxic Confusional State - Confused, usually elderly, person whose problem is due to constipation (toxic build up in body)
Train Wreck / Shipwreck - a person with more hospital visits/diagnoses then they have years of life
Trambiclínica - (Brazil) a clinic staffed by medical students in order to maximise profits ("fraudulent clinic").
Transcranial Lead Therapy - gunshot wound passing through head
Trans-occipital implants - bullet wound to the head
Trauma Gods - Mythological deities whom A&E personnel believe to be the cause of major emergencies
Trauma Handshake - digital rectal examination - every major trauma patient gets one
Trauma Twinkie - ambulance (one of the smaller or European-style ones)
Treat ’n’ street - A&E's term for quick patient turnaround
Trick cyclists - psychiatrists
Trigger Happy - a medic that gives a shot [injection] for everything or patient that used call button excessively.
TRO - Time ran out
Trubufu - (Brazil) African-Brazilian obstetric patient (literally "fat, ugly black woman").
T-sign (UK) - the number of untouched cups of cold tea at a deceased patient's bedside. Used as an indicator of approximate time of death (i.e. the patient died but nobody noticed)
TSL - To Stupid to Live
TSS - Toxic Sock Syndrome (often related to homeless)
TTFO - Told To F*ck Off
TTJ – transfer to Jesus
TTR - (UK) Tea Time Review (a ripping yarn?)
TTOAST - Take Them Out and Shoot Them
TTR - (US) Tattoo-to-Tooth Ratio (Dirtbag Ratio)
TUBE - Totally Unnecessary Breast Examination (might happen to a GLM)
Turf - get rid of patient by referring to another team (see also buffing, sloughing and bouncing)
Turn and Baste - incontinence care (roll and clean up patient after a code brown)
Turtle's Head - in severe constipation where the anus is dilated and a faecal mass is visible (aka "shy turd") - the problem is, it starts to come out and then, like a turtle's head, it goes back in again!
TVTP - Tried Vancomycin, Try Prayer (Vancomycin is anti-MRSA drug – it’s resistant to anything else)
TWA - third world assassins. Slang for the allegedly poor medical care delivered by physicians who went to medical school in foreign countries
Twitch - hypochondriac
Two beers - the number of beers every patient involved in an alcohol-related automobile accident claims to have drunk before the accident
Two Dudes - a patient who was in a fight "Two dudes jumped me for no reason" (implying the patient would have one against one assailant)
Two Stops Short of West Ham - (Psychiatry) Barking mad. Barking is slang for "mad" and also the name of a station; it is 4 stops from West Ham, but the psych slang follows the formula "2 sandwiches short of a picnic", "Tuppence short of a shilling" (simple-minded/nuts) - the deficit is alway 2 items. Severe madness is "Dagenham" i.e. "3 stops beyond Barking".
TWSAM - Trash Will Survive And Multiply

UBI - Unexplained Beer Injury
UDI - Unidentified Drinking Injury
UFO - Unidentified Frozen Object: unidentified dead homeless person in the winter
UGLI – Ugly: a patient (usually a child) who looks a bit odd but has nothing wrong with them ULPP - Unlicensed Pharmaceutical Provider (drug dealer)
Unborn Farts/Retained Farts - abdominal bloating due to trapped wind (gas)
Unclear medicine - nuclear medicine
Unfascinectomy - long slog of a procedure
Unfascinoma - long procedure, now getting longer or a procedure that fascinates specialist diagnosticians, but isn't fascinating surgeons
UNIVAC - Unusually Nasty Infection, Vultures are Circling
UPF - Un-Passed Fart (gaseous distended abdomen)
Urban Outdoorsman - Homeless person

VAC - Vultures are Circling (dying)
Vampires - those who take blood samples, e.g. lab techs (also slang for blood donor service)
VBA - Valuable Breathing Air i.e. what some patients or doctors are wasting
VBT - Very Bad Thing
VD - Veak and Dizzy; older person feeling vaguely unwell and presents at ER at 2am complaining of feeling "weak and dizzy"
Vedgy - a patient requiring intensive care, incapable of movement
Vegetable garden - Coma ward
Velcro - Family or friends accompanying patient everywhere
Veranda - area in front of nurse's station where the porch people sit (see Porch People)
Very Close Veins - varicose veins
Viaggravation - what a doctor gets from a patient who is demanding erectile dysfunction medication on the NHS (not all areas of the UK provide this on NHS)
VOMIT - Victim Of Modern Imaging Technology (i.e. try treating the patient, not the report from radiology; particularly referring to invasive procedures for false positives.
VIP - Very intoxicated person
Virgin Abdomen - patient that has never had abdominal surgery before and therefore has little intra-abdominal scarring
Vitamin A - Ativan
Vitamin D – Diesel (ambulance term). "Give it some Vitamin D" means drive faster
Vitamin H - Haldol; in the case of a drug addict, it means Heroin
Vitamin K - Ketamine. Also called "Special K" (street name)
Vitamin L - Lasix, Levaquin or other familiar drug beginning with L
Vitamin M – Morphine
Vitamin P - Lasix (diuretic) given to stimulate urination (peeing) in post-operative patients; can also mean Prozac
Vitamin V - Valium, Diazepam or any intravenous sedative; in General Practice it is Viagra
Vitamin Z – Zosyn or Zoloft
VOMIT - Victim Of Modern Imaging Technology (i.e. try treating the patient, not the report from radiology; particularly referring to invasive procedures for false positives.
VTMK - Voice To Melt Knickers (the voice deliberately cultivated by some doctors)

WADHAO - weak and dizzy and hurt all over
WAFTAM - ("woff-tam"): Waste Of F***Ing Time And Money
Wall - a doctor who resists admitting patients at all costs
Wallet Biopsy - (US) free medical test performed by hospital insurance department before patient is treated (UK) similar test in private health sector
Walmart Greeters (Porch People) - Confused patients sitting in chairs in hall for close observation
Ward 101 - The source of referrals that fills the recipient with dread. (after Room 101 in George Orwells novel 1984)
Ward X - the morgue
Weed Puller - Obstetrician
White cloud - a on-call doctor who has uneventful call nights. As opposed to a Black Cloud
White Lizard - the white coloured "cocktail" given for stomach problems (Black Lizard is similar "cocktail" but contains activated charcoal)
White Mice - tampons
Wifty - Mildly confused, but seems oriented most of the time Wig picker - therapist or psychologist
Wilkinson's Syndrome - a patient who has slashed their wrists with a razor blade (after a popular brand of razor)
Will Follow From A Distance - will check your lab results, but will never set foot in your room again
William - (UK) chiropedist i.e. William the corn-curer (William the Conqueror)
Win the Game (or Yahtzee) - to discharge all of the patients from your service, so that you have no inpatients (i.e. no ward rounds) next day.
Winner - a patient with very good luck
Witch doctor - specialist in internal medicine
WITPOMS - Why Is This Patient On My Service
WNL - (Ambulance/casualty) Within Normal Limits, but more often interpreted as We Never Looked
WNL - Will Not Listen; patient won't take medical advice
WoGS - Wrath of God Syndrome (visited upon junior medics by more senior staff)
WOMBAT - Waste Of Money, Brains And Time
Woolly jumper - any non-acute physician
Woolworth's Test - (UK anaesthesia) if you can imagine patient shopping in Woolies, it's safe to give a general anaesthetic
WWI - Walking while intoxicated (and fell over)
Wrinkly - geriatric

YAVIS - Young, attractive, verbal, intelligent, successful.
YMRASU - Your Medical Records Are Screwed Up
YOYO - You're on your own; see "amyoyo" and "solomf yoyo" (also message passed from one doctor to another regarding problem/mystifying cases)

Zebra - an unusually strange or unexpected disease (from the saying "When you hear hoofbeats, the smart money is on horses, not zebras")
Zorro belly - (Brazil) patient who has had multiple abdominal surgeries.

Note: Any dept ending in "-ology" is likely to be nicknamed "-holiday" by those working in busier depts.



THE INFORMAL FAECAL HARDNESS SCALE

As used in microbiology depts runs from "Hard as Bullets" (self-explanatory) to "Could go through the Eye of a Needle" (watery, no solids) with appropriate analogies inbetween.





VETERINARY ACRONYMS

Agroceryosis - lack of groceries i.e. owner hasn't been feeding the animal
BDLDLDL big dog, little dog, little dog lost (usually Chihuahuas that try to fight a German Shepherd)
BSBF buy small bags of food (almost dead)
CFT - chronic food toxicity i.e. obese
CSTO - Cat Smarter Than Owner
DIC - dead in cage or death is coming (technically, it means Disseminated Intravascular Coagulation, which is just as lethal)
DSTO - Dog Smarter Than Owner
HBC - hit by car
HBO – hit by owner
PU - paws up (dead)
ROBO – run over by owner
SBI - something bad inside (undiagnosed cancer etc discovered during surgery)

A number of the human ones are also used e.g. TTJ (Transfer to Jesus), Nastioma/Cheerioma (aggressive tumour).

CRAP Score - Cynical Real Alternative Pain Score

CRAP Score = (OPS+AF) x (SC)x (EC)

OPS = 10-point pain score (Old Pain Scale)
AF = Adjustment Factor (see below)
SC = Story Credibility
EC = Exam Credibility




For LPT (Low Pain Threshold) patients; calculate CRAP score:

* If the patient reports their pain as being more than 10 on the conventional 10-point pain scale, subtract 1 point for every point over
10. If a patient claims their pain is 12, subtract 2 points and start with an 8.
* For every visit the patient has had to your a&E in the past 12 months claiming a "chronic" or "undiagnosed" painful condition subtract 1 point.
* Every time the patient says "ow" when you push on a non-painful or uninjured area of their body, subtract 1 point.
* For every claimed allergy to a non-narcotic pain relief medication, subtract 1 point.
* If they are wearing sunglasses/wrist-splints/neck-brace/insist on wheelchair/lying down, subtract 1 point.
* If they have tape or ECG lead residue on their body from a prior hospital exam, subtract 2 points.
(Waive the wheelchair/neck-brace penalty is the patient is registered with a disability)



For HPT (High Pain Threshold) patients, you add to their reported pain score:

* If a spouse or family member forced them to come in, add 1.
* If patient history shows that every A&E visit for a painful condition related to something torn, broken, ischaemic or perforated, add 2.
* If they have no allergies add 1.
* If they are tachycardic (racing heart) or hypertensive (high blood pressure) add 1.
* If they have visible major injuries they may be in shock and won't feel the true pain till the endorphins wear off




Worked example 1

Young guy/gal goes to A&E for the 7th time in the past year for migraine (-6) reporting his headache as 12 on a 10 point scale (-2). He claims to be allergic to 5 over-the-counter pain meds (-5). He has been to A&E 5 times in the past year claiming other painful ailments e.g. back pain, belly pain, but tests found no disease or injury (-5). He is in the examination cubicle eating crisps/choccy and yelling into his mobile phone. He claims his migraine is a killer. When his abdomen is pressed he claims it is tender (-1), but he hadn't noticed due to the migraine being so bad.
CRAP score = (10 -6 -2 -5 -5 -1) x (0.5) x (1) = -4.5.
Even without Story Credibility of 0.5 and Exam Credibility of 1 that's a CRAP score of -9.




Worked example 2

Limping guy/gal is taken to A&E by spouse, but reports "fuss about nothing" and pain score of 4. Blood pressure and heartbeat are increased (+1). They've taken a couple of aspirin. Examination finds torn ankle ligaments, probable fractured tarsals plus fluid retention around ankle plus abrasions to forehead and forearms. Patient states s/he fell on icy pavement. Patient history over several years shows 3 previous visits for fractures/torn ligaments/open wounds requiring stitching.
OPS + AF = (4 +1 +1 +2) = 7
Even without a Story Credibility and Exam Credibility, that's a CRAP score of +8 and they've sustained real damage.




WHY SLANG?

In the days when patients had no access to their own medical records, some slang recorded uncomplimentary or non-technical observations about them. It is also a way of insulting (humourously or seriously) other staff or depts. Some slang provides a vocabulary where none previously existed or is simply an informal short form. In hospitals, morbid humour, irreverence and euphemism is a way of coping with daily exposure to injury, disease and death. As euphemisms go, "Eternal Care Unit" (died) is little different from the myriad other euphemism for death. Even in the path labs where I did a stint, staff coped with serious situations by seeking refuge in humour. Nowadays, such slang is considered unethical and its use is decreasing in hospitals and surgeries because of the dangers of being sued by patients. However it is being preserved in the medical labs and staff tea rooms where patients do not go! As more and more genuine abbreviations and acronyms come into existence, there is also the danger of being misunderstood.

Many thanks to all the doctors, nurses, medical staff, non-medical hospital staff and other insiders who have emailed their contributions. Some have been personally collected during my stints working in hospital labs. Some of these terms have been in annual reviews of medical slang written by Dr Adam Fox (who has charted the prevalence and decline of medical slang over the last several years) and printed in medical and nursing journals, in newspapers and featured by BBC News. Others have been popularised on TV dramas/series set in hospitals e.g. Casualty, Holby City and ER."

Tuesday, June 26, 2018

Invisible Emergencies Series, Part Two - The Chronically Ill's Perspective

I have been sent a lot of stories from people suffering from Gastroparesis, who have a hard time when they go to the Emergency Room.

When people with Gastroparesis vomit, it can be a life threatening chance of roulette. My doctor told me once that I vomit so forcefully, one day I am going to tear my esophagus and bleed out. He said there is nothing he can do about it.

However, the way Gastroparesis patients are treated by the Emergency Room staff is why a lot of us dread going, and usually do not go unless a family member drags us there. I know from personal experience that a lot of doctors and nurses do not think Gastroparesis is real. There is a nurse I know through a friend, who is an Emergency Room nurse at a nearby hospital, who told me and my husband that Gastroparesis was not a real illness.

Then, there is the opposite. I have met doctors and nurses in the Emergency Room who treat me terribly because either they do not believe that Gastroparesis hurts, or they think I am a drug addict. Since doing research for this series of articles I'm writing, I ran across this article in particular. This may explain a lot when it comes to Emergency Room doctors' thought processes towards those who come in with Gastroparesis: http://www.serenityrehab.org/blog/information/addicts-using-gastroparesis-abuse-prescription-drugs/ which infuriates me. I hope that we can change the stigma on that.

For a previous article I've written comparing patients with a chronic and/or invisible illness vs drug seekers, please click here: http://www.emilysstomach.com/2013/07/gastroparesis-patients-vs-drug-seekers.html

If I go to the Emergency Room, it is because I am REALLY dehydrated and in need of fluids. Furthermore, I do hurt because of projectile vomiting, and doing that straight for at least a week. I used a lot of muscles projectile vomiting and was very, very sore. I even pulled a muscle while vomiting! I could not keep my medication down to even help with the vomiting. If I wanted drugs, I am sure I could walk down a street and get some, and not pay thousands of dollars to go to the Emergency Room, to get stuck eighty million times, for a bag of fluid and a pat on the head.

However, dehydration is SERIOUS and you definitely should go to the Emergency Room if you are dehydrated.


Source: http://lifesignsblog.com/2017/06/08/how-much-water-do-you-need-to-drink-every-day/


Here are the stories that have been shared with me by other Gastroparesis Warriors on their Emergency Room experiences. I hope that it will help bring awareness to this issue. You should never judge a book by its cover.


Taylor writes,


"I was recently diagnosed with GP, my pain started in October and I waited for a month to access if it'd just go away, I'm already disabled from a few chronic conditions so I have a month rule, if it lasts longer than a month I get checked out. Regular doc thought it was an ulcer, sent me to the ER because she thought I was bleeding. The ER Doc found no bleeding and no infection, in the past I've always had that infection with my ulcers, and it didn't feel like my past experiences with ulcers, so I told her that, and pressed that concern with her that I seriously didn't think it was ulcers. She spent maybe all of 10 min. with me, and ignored my opinion of the matter and concluded it was ulcers anyways without any proof. She sent me home with an ulcer med, and that ulcer med almost put me back into the ER I couldn't even keep water down because of that med! Luckily I had my gastro specialist appointment in a week or two by that time. I called my pharmacist and explained what the ulcer med was doing and he told me to stop it immediately because it can have that effect if one is dealing with something else in the stomach, and he was right. I stopped the med, and at my first gastro appointment my doctor told me she highly suspected GP but that we'd need to do some testing first, and started treating me for GP after my endoscopy because she saw all the signs, and then confirmed with the gastric emptying test a month later. My ER experience is the epitome of why I try to stay out of the ER, I know the doctors are stretched and can't know everything, but if something is unknown, maybe not taking a wild guess and sending someone home with questionable meds is the wrong approach. I would have been better off getting a iv for hydration and sent home with anti-nausea pills till my specialist could see me."



Melissa writes,

"It's happened often that the ER doctors do not take me seriously enough but the nurses are by far the worst! I went in a few years back and I was in incredible pain. My body was just not working and I looked like I was 10 months pregnant. I hadn’t pooped in 2 weeks either. I was throwing up bile. My doctor sent them a message that I was coming in at his request and that he wanted a contrast CT scan done immediately … well that didn’t happen. I told them my conditions and expressed that the Gastroparesis and the IBS-C together were really hurting me to the point where I couldn’t even walk. The doctor did an x-ray and told me I was constipated and he was sending me home. I put my foot down and said, NO… Do what my doctor asked. He replied that he didn’t have to follow the doctor’s recommendation and that he was discharging me. No blood work. No IV fluids. Told me to go buy Miralax and take it once a day. I was shocked. I was already on it and taking it 3 times a day at my specialists orders.

The ER doctor also told me to stop eating so much and I wouldn’t get bloated. ARE YOU KIDDING ME? The doctor walked out and the male nurse walked back in and pushed my stomach with a fist and moved it around and then walked out. He proceeded to sit down at the nurses station and they started to gossip about me and that I just wanted pain killers and a quick fix. That he wasn’t going to be the one to give me an enema.

Well…no one did. But it was my stomach that I needed help with. Not my bowels. I was getting a prescription for that from my doctor that evening. But it hurt so bad when he pressed on my stomach like that. I asked for the doctor to come back in and the nurse told me that he had real patients to see and wouldn’t be coming back in.

She told me to get dressed and he had my discharge papers. My husband took me home and I laid there and cried. While the medicine that I got for my IBS-C worked great…It didn’t help my stomach as it's not the same issue.

I have never gone to the ER again after that.

I have literally just laid there and felt like I was dying and cried my eyes out while my husband looked on and couldn’t do anything to help me except keep my hydrated. My GI doc won’t put me on any prescriptions for my Gastroparesis right now because I have irregular EKG’s and that puts me at risk. Ugh. I was on a medication before. A liquid and it was my life saver and the FDA pulled it off the market years ago so now I’m stuck. I am opposite of most and I gain weight very easily because most of the time my body thinks its starving. So stupid. As I type this, I can feel my stomach growing and becoming distressed and there is nothing I can do. I have cut out so much foods that antagonize it to no avail.

I tell the doctors where I’m living at now that I have Gastroparesis and some of them had to look it up online. REALLY?!? We need more awareness. I tell everyone about it and my little sister might have it. She’s getting tested soon."




Emily writes,


"I usually avoid going to the ER because of the ridiculous cost of the ambulance ride and because of stories like the one I am about to tell. A few years ago, I woke up in the middle of the night with excruciating pain. It was the kind where you feel like you’ve swallowed razor blades and your insides are tearing apart. I ran to the bathroom because I couldn’t tell if I had to throw up or use the toilet. I spent about 30 minutes violently throwing up and eventually passed out on the bathroom floor in a cold sweat (something that I am unfortunately very familiar with). When I woke up, it started again. Usually when I have a vomiting episode like that, it passes after I rest and smoke cannabis. Nothing would help this time. The pain was so awful that I couldn’t stop crying and worried that it could be something more than my gastroparesis. I genuinely felt like my organs were tearing to pieces. I lived at home at the time for graduate school and I called my mother from the bathroom floor and asked her to call 911. I told her I desperately needed help and couldn’t stand up and didn’t know how to make the pain stop. I was taken on a stretcher screaming in pain while the EMTs looked at me very strangely. I arrived at the hospital and they laid me in a bed where I dry-heaved between passing out for several hours as my mother begged them to do something for me. After they allowed me to suffer for hours it became clear that they thought I was faking it or I was a drug seeker because I just kept begging them to help take the pain away. My mother screamed at them that I have gastroparesis (I guess they didn’t bother to even check my file) and they finally gave me something to make the pain go away so I could get a few hours of sleep. When the doctor visited me in the morning she quite literally shrugged at me and said there was nothing she could do for my condition. She told me to keep managing as I had been and gave me some Zofran (anti-nausea med). This wasn’t the first time I had been treated like I was faking my condition or turned away as this doctor had done, but it was the most memorable time for me. It was humiliating more than it was helpful and I lost most of my faith in the healthcare system that night."



Maria writes,


"I live in Tempe, AZ. I was diagnosed with Gastroparesis at 16, Im 29 now. I also have chronic pancreatitis a few times a year. I go to the same hospital almost every time. It's only a mile from where I live and almost every nurse and doctor have gotten to know me over the years. That being said, I have had good and bad experiences at the Mesa Banner Desert Hospital. Depending on my flare ups which changes constantly I usually go once a month due to dehydration, vomiting, diarrhea, and abdominal pain. I usually get treated with fluids, pepcid, GI cocktail, Zofran (promethazine or compazine), and morphine or diladid. Sometimes I stay overnight usually if I'm still vomiting but I'm usually good to go hours later and get sent home. Did I mention that all my doctors usually know me by name? I think that has a big role to play when I head to the ER. I have had a few doctors, always someone that does not know me.. They ask me A LOT of questions and will sometimes deny me pain medication and or call me an addict. One time I was in a lot of pain and even my blood pressure showed that I was in pain. It was 145/ 99. I usually have perfect blood pressure so I pointed that out to this Dr. That mentioned that my blood pressure could also be high if I was "withdrawing". I was to weak to argue with her any longer and didn't care. Thankfully my mom was with me and walked around the emergency room until she found a Dr. that has treated me before. That Dr. Talked to mine and was able to get something for pain. She was angry and insisted that I was still a drug addict and made me feel low when I left the hospital. So I have had good and bad experiences before. I don't know if all hospitals are like this but whenever I do go to the emergency it shows every time I have been there. It also shows the medication that was given to me. I don't know if that means much or helps any but this is what usually goes on when I head to the E.R."



Elizabeth writes,


"Hello, i [sic] was diagnosed 5 years ago. My neighborhood hospital also knows me. One night stood out to me i[sic] was told by the e.r.[sic] doctor that I was doing this to myself. I was so livid I told him to leave my room and never come back. I was treated like a seeker of some sort when i[sic] all i [sic] wanted was a bag of I.v. fluids. I will never forget that day. I felt like there was no hope for me at all."




Source: https://s-h-ores.deviantart.com/art/No-Hope-349667350


Below are comments made about the healthcare system, emergency room, and how doctors and nurses treat Gastroparesis patients like drug seekers as summed up by my article here: http://www.emilysstomach.com/2013/07/gastroparesis-patients-vs-drug-seekers.html


My friend Juli writes,

"If I could ask for one thing from the medical professionals whether docs, nurses or other personnel, it would be to actually SEE and LISTEN to the patient in front of them rather than barely glancing at a chart and making assumptions based upon incomplete information. I understand it is overwhelmingly busy, there ARE patients who are malingerers, drama queens, and drug seekers, and dealing with the bureaucracy is a nightmare. I get that, but I think time would actually be saved, not to mention lives and money if there were more effort put into hearing and understanding what the patient is trying to say. Medical personnel may have lots of education and even experience, but patients are experts at living in their bodies."


My friend Brandy writes,

"Canadian ERs can be pretty bad, especially where I live. I have a huge tolerance to hydromorphone, but given enough it works. The last time I went into emergency, they not only treated me as a drug seeker there, but also when I was admitted through the ER and an inpatient. I had a doctor lie to me, he said they had a hospital wide policy not to give these meds IV. If I take these by mouth, they have no affect on me because of my gastroparisis. Then they told me that my only other option was IM (intramuscular), so that meant multiple needle pokes (every 4 hours). I'm a transplant patient and have a compromised immune system. That being said, it's not a good idea to constantly be putting open wounds on a transplant patient. I've actually gotten infections in my hands before just from the IVs they used to give me. Also, to clarify, I asked the nurse from oncology, a general surgeon and 4 ER nurses if there was the aforementioned policy in place. Not one of those people have ever heard of a policy like that in the hospital. Funny thing is, when I emailed the HR department, they told me the doctor was well within his rights to say that, plus within his rights to deny me the proper dosage/method of use for the pain meds. I was in there for a severe kidney infection, on IV antibiotics. I'm never going to that hospital again, and there is one other one that's a little further away but I'm willing to go there instead. And this wasn't the first time I've been treated like that at that particular hospital. The only reason I was going there is because that's where my kidney specialist is. She practices in the renal clinic plus has her own practice. The hospital I used to go there labels everyone as an 'inactive drug seeker'. If you go into the ER and ask for pain meds they then change the label to 'active drug seeker.' I'm not sure they change it if they offer you pain meds cuz[sic] they can clearly see you're uncomfortable, but that can also take hours depending on how long the doctor takes and how busy the ER is. I'm pretty sure they labeled me as a drug seeker as soon as I turned 18. Not only do I have to go to the ER for kidney infections, but back in 2012 I started having issues with my nerves/back, which actually started with the development of my gastroparesis. Turned out it was my tethered cord, but most times I went to the ER, they'd give me a prescription for T3s and send me on my way without further investigation. Took them till 2016 to take me seriously. By that time, I had lost complete sensation in one leg and was having on and off sensation in the other, and the finally took me seriously when I ended up severe back spasms in the ER, being unable to walk or sit comfortably. I now have constant chronic pain and obviously still have the gastroparesis."


My friend Karen writes,

"Luckily my doctor has written a care plan for when I end up In The ER. They are instructed to provide me w [sic] dilaudid, reglan, and benedryl, and Ativan if I am in panick [sic] mode. I have to say that my panic has gone down a lot knowing that the care plan is in place and I don’t have to worry about how I’ll be treated. I do still have asshole nurses giving me an attitude sometimes."


My friend Marlee writes,

"I went to the little clinic at Kroger here in Ohio one time in hopes for them to give me an ANTIBIOTIC for an abscessed tooth I had that was making my face swollen and she looks at me dead in the eye and says with a huge attitude 'I can’t give you pain meds...' I looked back at her and said 'lady I’m not here for pain meds. You can clearly see that I’m doing just fine without them. I would just like an antibiotic so I can go to the dentist and get this fixed. But you obviously think I’m coming in here to get something else' I walked out. I was so pissed that she degraded me and looked at me the way she did... like I’m some kind of druggie... it really hurt my feelings. It really is awful, and it makes us not want to seek help again because we fear that we will be treated the same way."**

**Author's Note: I hate it when the medical staff at the Emergency Room make you feel like less of a person when you need some help. To me, a tooth infection would count as an emergency - at least for some antibiotics until you can see your dentist! There are people who have developed sepsis (blood poisoning) that way and have passed away from it. The first celebrity I can think of that had that issue was an actor who was in Angel: Andy Hallett.


My friend Alexandra writes,

"I went to the ER one time for the second time in a week because I couldn't keep food down and was so dehydrated and in so much pain. I hate going to the ER and I hate being stuck with needles. I learned that my ER doctor had gastroparesis as well and so I felt comfortable with her and let her know I was in pain, but never asked for anything and never eluded to wanting a drug prescription. After I returned a few days later because I still wasn't able to keep things down, apparently she went into the system and called me a drug seeker, and this information was all available to my ALJ for my disability hearing. They used it as grounds to deny me, because my ER doctor ... with the same illness as me ... called me a drug seeker. It also happened in the hospital I was diagnosed with gastroparesis, right down the road from my gastroenterologist... They had to give me 4 bags of fluids because I was so dehydrated, but I still got the side-eye as if I were a drug addict."


My friend Rebeccca writes,

"It became so impossible to get pain medication that worked in Colorado that I just gave up. And now I live in near constant pain, every day. I just stopped talking about it."


My friend Juli writes,

"Would that doctors and nurses actually see and listen to the patient in front of them before jumping to put us into a box![sic] Would that politicians/ and bureaucrats actually sit down and think about what they are doing and think about unintended consequences of the laws and policies they pass GRRRR"



According to Vanessa Blevins from The Mighty (her Facebook Page can be found here: Parenting Through The Fog),

"To the Emergency Room Doctor Who Dismissed Me as a Drug Seeker

I understand. I do. You doctors are under a lot of pressure these days about your opioid prescriptions. It’s been all over the headlines. I also understand that in the emergency department, you see people coming in for a quick fix. I know the drill. I’ve ended an intimate relationship over my own pain medication going missing from my purse. I get it. However, I do think there are actually a few things you don’t quite 'get.'

For starters, I’ll note that my main complaint at triage was not pain, and while I did mention that I was in pain during the course of my triage exam, I also expressed the fact that I drove myself and therefore did not want mind-altering substances so I would be able to drive myself back home.

I came in with vision problems, extreme pressure in my head and what I swear is increased pressure in my spinal column. I had numbness and tingling in my hands and feet, vertigo, hand tremors, and my legs partially stopped working for a moment today. They went heavy and limp and half numb. Those might not be emergent symptoms to you, but they freaked me out! I’m a single mom of three kids. I can’t have body parts randomly giving out on me without explanation! I came as soon as I could, when I had time, and hopefully you would have time, to run some tests. I wanted to leave with answers. What I left with were vision problems, extreme pressure in my head and spine, hand tremors, and legs that went funny as the discharge nurse was walking me out the shortcut. At least the nurses were freaking awesome, as always!

Instead of ordering a simple test, you completely dismissed me. Even after I told you I wasn’t there for your drugs, you belittled me. Instead of providing care and compassion for someone who has been desperately fighting through bureaucratic red tape while still hoping for treatment, you added a whole new mess of red tape. Now thanks to you, I’ve got an ER visit as a drug seeker in my medical file. That is going to affect how I am treated at every emergency room I go to, no matter why I’m there. I actually do have several medical conditions which are commonly treated with narcotic pain medications. I also have a few conditions that cause vomiting. There are times when I can’t keep down my medications. So next time I have to go to the ER because I’ve vomited my legally prescribed and responsibly taken medication, instead of being treated with care and compassion as a person who is facing a lifetime battling chronic illness, I’ll be treated like an addict looking for a fix.

In the chronic illness and chronic pain community, we measure the energy it takes to get us through our days in spoons, and I used spoons I didn’t have in order to drag myself out and go. Did you notice I was wheeled in by medics? That’s because I nearly collapsed in the parking lot, but that’s not emergent. Move along. Nothing to see here. Just a druggie wanting a scrip. I’ve been putting this thing off for months, and no wonder! I’m hurting even worse now, from sitting on the gurney for so long, waiting to be discharged after receiving no medical care.

No, you don’t know what it cost me. I did tell you I had to wait on a sitter for my kids, but what I didn’t tell you is my daughter was still awake when I left. She’s 2 and we’ve never spent more than an hour or so apart in her entire life. Do you have any idea what it cost me to walk out the door and leave her behind, crying that she wanted to go with Mommy? How unbelievably selfish I felt for leaving her? As a mother with chronic illness, I’m often putting my own needs aside in order to care for my children and it took quite a bit of courage to talk myself into leaving my daughter in tears, in order to go take care of my own needs. But I told myself, 'You’ll have some answers when it’s over, so it will be worth it.' I’m not used to being so drastically wrong.

People like me who have an invisible illness often spend years of our lives having doctors tell us it’s all in our heads or we’re making it up for attention or we’re drug seekers until we finally find a doctor who has enough training and compassion to listen to us long enough to find an answer. Even after a diagnosis, many people with chronic illness are still left fighting for recognition in the medical community. Even with medical codes in our charts and diagnoses we can’t even pronounce, and a list of ailments recognized by the ADA and the Social Security Administration, even then we’re faced with judgement, discrimination and mismanagement of care by doctors like you. It takes me weeks, sometimes months, to build up the courage to even make an appointment with a new doctor. I have anxiety attacks on the way to every doctor’s appointment, even ones I’ve been seeing for years. Doctors like you are the reason I’ve been putting this off for so long, and the reason I didn’t want to go tonight. And you’re the reason I wish I had stayed home in my comfy bed and suffered in peace.

I want you to know that even if I had been a drug seeker, I still deserved decent medical care and respect. I had other issues besides pain. I complained of vision problems and sensitivity to light and you stood with a fluorescent light behind your head and expected eye contact. Even if you had no respect for me as the person you suspected I was, you were still supposed to be a professional and perform your job. I got more helpful and courteous medical advice from the discharge nurse who spent more time with me and showed more care for my well-being than you did.

I know you aren’t going to see this. I know you aren’t going to learn anything from tonight’s events. But I know I learned a couple of things. I learned I’m stronger than I thought, to be able to walk out of there with limited use of my legs but my head held high. And I learned I actually can be more passionate about patient rights. I have a feeling that my words are about to reach a lot farther than I could imagine. I know my story isn’t the only one of its kind. Tragically, I’m positive it won’t be the last. But if I share my story, and the next person shares their story, and we all keep sharing our stories, maybe eventually, someday, enough people will get pissed off that things will start to change and doctors who dismiss patients’ pain will be out of a job. Until then, my readers and all their friends are more than welcome to share this.

A version of this post originally appeared on Spoonies for Life."




Source: Invisible Disease Stuff




According to a guest writer for "The Unbroken Smile," Elena shares her story below,

"The Day I Was Labeled A Drug Seeker Because Of My Chronic Pain
October 17, 2017


The Day I Was Labeled a Drug Seeker Because Of My Chronic Pain – Five months ago I was given the wonderful news I was pregnant. I was ecstatic. I already have a 4 year old from my previous marriage and couldn’t wait to have another bundle of joy to adore for years to come. Everything was going wonderfully up until around 10 weeks. I was told the baby wasn’t growing and was implanted inside the C- Section scar. There was no saving either of us. If I didn’t choose to terminate it could end my life. So I reluctantly and with a heavy heart, chose termination in hopes I would get another chance and the soul would return to me for a second chance later in life.

I didn’t have health insurance at the time and my application wasn’t being processed. With little knowledge on my options I chose planned parenthood. Its a day I will never forget. The nurses were cold, I was so afraid. Outside was filled with protesters. “You’re a murderer” they repeated as I passed. I was, and I’m sorry. I paid and began the procedure with no medication. It’s a pain I’ll never forget. Both emotionally and physically. It was cold in the operating room, and the nurses seemed irritated every time I cried in pain. I was told to be quiet. It felt as though my insides were being torn out. The endless cramping, wrenching pain, the emotional toll topped it all. After I was rushed to a waiting room and given crackers. I voiced my concern about pain as my menstrual cramps were hell on its own. I was told the procedure was painless and so will my recovery. I knew they were wrong, and boy were they. I was given a bag of contraception and a look that said “I hope you learned from this” and a have a good day smile.

My drive home was agony. My stomach hurt, I was bleeding heavily, my heart mourned and the cramping was something words can’t express. I had a two hour drive home. I stopped to see my brother for some comfort and during our coffee adventure I chose to try something called Kratom for pain. I went home and crawled into the arms of my fiancee and cried. He held me silently but I could hear his heart breaking.

Days went by and the pain didn’t let up, my bleeding ceased quickly. I started to feel bloated. After days of thinking it wasn’t serious enough to go to the emergency room I finally swallowed my pride and left. I dropped my fiancee off at work and headed over. I explained it all three times to different people. It was 3:30 pm, and they started with IV fluids, CT scan and an ultrasound. I had a feeling they weren’t taking me seriously and at this point I couldn’t even take myself seriously. It’s nothing I told myself. 6 hours go by waiting alone, and not even offered pain relief. Finally after the long wait in a cold empty room the physician and nurse entered my chamber of solitude. He grabbed a chair and sat at a distance while the nurse administered a nausea medication via my IV line. 'I’m baffled you chose planned parenthood firstly. They’re butchers.'

I sat in silence, and shame.

'After reviewing your results from lab and imaging, your uterus is the size of a 13 week pregnancy. Your uterus is filled with lots of blood and infection. We have the OB on call coming in to talk with you. What she wants to do is what we call a dilation and cutterage.'

Fear took over. All I could think of was laying awake, being told to be quiet and that wrenching pain. I expressed my concern and told them they would not come near me. I was not doing that again. At that point a beautiful young doctor came in and introduced her self. Immediately I told her exactly what I told him. She looked concerned, apologized for my terrible experience and assured me I would not be awake or feel a thing. We talked after care and medication for home. For some reason I felt safe with her. She had called my partner and began calling the surgery team. The cramping hurt beyond anything I’ve ever felt.

I finally spoke up and asked for some pain relief. A look of surprise came across her face and asked if I had not received any. She ordered IV Dilaudid and I was down to a 2 pain scale when anesthesia arrived to take me. I began in the operating room near 10 pm on the 4th of July of all days.

When I came to, I felt extreme abdominal pain and soreness in my lower region. I was relieved. It was finally over and free to go home to my comfortable bed and lovely partner. She sat beside me, and explained the procedure was successful BUT she pulled 9 containers and I lost too much blood to be released. That I may need a transfusion. I cried and cried. I was given morphine and my partner was brought in shortly before being brought up to the depressing OB floor. I slept soundly, minus being poked throughout the night. I was released at 7 am, still pale and weak but I insisted. I was given iron pills, antibiotics, ibuprofen and oxycodone.

It was over. Finally over.

Throughout the next week I had a dull ache and ended up calling her office to inquire about the pain. It was a Friday and late so she refilled my oxycodone and an antibiotic until I seen her again. By the time I seen her again the pain was still lingering, a thorough exam was conducted. I was sent home with more pain medications and she was concerned with uterine infection. The pain never let up. Weeks started going by. Pain increasing, pain during intimacy, horrid menstrual cramps with little blood. She was booked every time so ER visits became the normal under the advice of the OB nurse. They treated me wonderfully at first. The first couple times they examined me.

Fast forward 3 whole months. I acquired a tooth abscess and went to the dentist. He couldn’t pull the tooth with the infection and couldn’t fit me in for a month for extraction. In that month I would call because of pain and draining. His advice was to get to the ER since policy prevents him for calling in prescriptions without a visit. This repeated 6 times total. 3 visits were the same ER, one was in a neighboring town as I was visiting my fiancees grandmother. They refused to even look. I contacted my dentist to inform him and he requested I return, by that time I was home so returned to the previous emergency room that I usually go to. There I was given antibiotics and 10 5mg norco. I was sent back a week later for a dental block. Things changed drastically. The physician was rude, argumentative and explained they cannot give me narcotics. I told him I was sent for a dental block only. He administered it and rudely sent me in my way. It continued like this until removal, they were rude and not very compassionate. After removal I ended up with a dry socket, infection and sinus infection.

I visited urgent care and the physicians assistant was rude right when meeting me. I was told they could use a paste to pack it when I spoke to my dentist. I asked her about that and the topic quickly became about narcotics. At this point I was in tears, humiliated and confused. I got up and was ready to leave as she forced a prescription in my hand: 4[sic] 10mg norco! She then stood there and said she pitied me and gave them even against her colleagues recommendation. I did not fill it, and it remains crumpled in my back seat.

The infection and dry socket healed with the help of my dentist’s packing, antibiotics, nasal spray and some Tylenol 3. After finally getting into him. I explained what happened he replied with 'I know you aren’t an addict' that felt good after everything. This was a few weeks ago.

Today I awoke to the usual abdominal pain. I avoid ER and physicians hoping it would pass. It was a stabbing pain, a pain that made it hard to walk. I laid there in tears in the fetal position for hours while my partner looked over at me from his game with sadness. He felt helpless. He knew how the ER has been, and my OB being booked. Which I have an appointment with her finally in four days.

I couldn’t wait.. Something was wrong. I couldn’t see through the tears, I couldn’t hardly move. I reached for my phone and called the hospital nurse line. A wonderful nurse answered and I explained the surgery and pain history. She mentioned endometriosis, and uterine or cervical scarring from having a c section and the two procedures. She recommends I be seen within 8 hours.

Reluctantly both myself and partner get in the car to return to the ER. The one where my OB works in case they need to call her. My partner has only heard whats happened with the other ER docs figuring me a drug seeker. This time he would witness it…

We were taken back by a lovely nurse and the physician was right in while she was getting my blood pressure cuff on. I explained my history, the pain and all the other symptoms. Even told that a nurse sent me here. He listened and was very kind. Listened to my lungs and pushed on my stomach enough to make me jump. He left and ordered labs. Quickly lab came in and started an IV to draw blood and for medication. I was so relieved.

Finally someone was taking me seriously. The nurse returned, informed me they will be giving me fentanyl and something for nausea. A woman came in to have me sign a medical records release the doctor wanted. I was confused as to why he would need it as i thought they were all linked and my procedure and OB records were from this hospital. I signed.

5 [sic] mins later the nurse returned and said instead of fentanyl he wants to give torodol instead. I was okay with that and nodded. She asked me for urine sample, and had no problem. After I was given a CT scan and a internal ultrasound. The ultrasound was painful, and was drawn out. I felt like a giant child crying on the table. I was desperate to find out what was wrong.

I was scared. Scared that if it progresses I may not be able to have another child, and would end up with a hysterectomy like I read online from many women in the same situation. I had also read that even with imaging they cant see Endometriosis or Ashermand[sic] Syndrome. Most had to have invasive surgery. I was more than willing to try that. Just please, make it stop.

'Whats[sic] your pain level after the torodol?' My answer as when I’m in pain is honesty with a little sense of humor. 'Well between a 1 and a 10 my arm is being torn off I give it a 5[sic]' my fiancee just smiled. The nurse was unamused and her demeanor changed towards me. I held my stomach, hunched over and just smiled. My fiancee rubbed my back in an attempt to comfort..

A few hours later the physicians assistant returned saying that my CT and ultrasound came back in 'pristine' condition. He stood there with his arms folded, I was doubled over in pain my eyes watering, and fiancee at the edge of his seat. 'There was a slight hint of a bladder infection' my heart sank. What’s wrong with me? Why am I feeling like this? I doubt a bladder infection can cause me so much pain for 4 months…

I was just checked two weeks ago and nothing… Then it happened. 'What I don’t understand who is your primary doctor? Seeing as you bounce around a lot and one day it was two different emergency rooms in the same day[sic]'

I explained it all. That we were homeless and staying everywhere we could and the day was two different ERs because I had made it to my home area when I was told to go back in. The first ER was nearly 2 hours away so I went to the closest. He smirked and sort of scoffed.

Rattled off how they don’t treat pain to drug seekers, and on his way out said, 'But we will give you some ANTIBIOTICS[sic]' I felt tears building in my eyes as the door slammed. My fiancee was speechless as he’s seen how I am at home. We were discharged with antibiotics.

As we got to the car I took my glasses off and sobbed in the drivers seat. I felt humiliated. I was scared. I was embarrassed. The pain remained as if a butcher knife was being stabbed through my cervix. What will happen now? What are my options? Will anyone help me now? What did I do to deserve this label? A half hour passed as we sat in the parking lot. I sobbed uncontrollably, opened my door because I could feel the contents of my stomach ready to spill any moment. My fiancee picked up the phone and found me some pain medication. He had never seen me cry, maybe tears forming while complaining or wiping away little drops.

We left to pick it up. So this is what it’s become? It was then I realized how many people probably result to street drugs or buying them on the street. Pain is the biggest reason people visit the emergency room.

A lot of us receive the junkie label. We are all just seeking relief. No one deserves this, no one deserves to be unheard, made to feel as if the pain isn’t real, and judged without anyone knowing whats really going on. The signs of a drug seeker can also be logical. We all move around, some say the pain is a 10, some are so frustrated they demand some form of relief. It wreaks havoc on your body and soul. I was told to visit the emergency room or urgent care for my relief by medical professionals and in turn it got me a big red label inside my chart. What can I do? My only hope is that on Tuesday she will hear me out. Otherwise it’s years of constant pain and who knows where a path like that will lead. I can only hope for the best. For myself and anyone else in the world who is in a similar situation."



Source: The Spoonie Blog



According to the Spoonie Blog,

"What to Do When You Have to Resort to the Emergency Room (When You Have a Chronic Illness)


A trip to the ER is no fun, no matter how you spin it. When you’re a chronic pain patient or someone with a chronic illness that can cause bouts of severe pain, it can be a complete and total nightmare.

A patient with chronic pain can help the Emergency Room staff to understand that their medical problems, especially pain, are a legitimate emergency by following a few guidelines and suggestions that will lessen some of the unpleasant drama of going to the ER.

Always bear in mind that the Emergency Room is a last resort, and Urgent Care will almost always turn away a patient with a chronic illness. Hospitals are so wrapped up in covering their asses legally that they have started turning away chronic pain patients much like Urgent Care does, even when the need for treatment is real and immediate.

Your regular healthcare team, especially your Primary Care Physician, is by far your best bet for getting help managing a chronic condition that is spiking out of control, but sometimes the ER is the only option. When that happens, here are some tips to help make your experience more manageable:

Make sure that you have a regular physician who treats your chronic pain. That’s a relationship that all chronic pain patients should establish before they ever set foot in an emergency room. Without this all-important steady doctor-patient relationship, the rest of this list is not really possible. In terms of seeking out aid in the Emergency Room for a spike or flare of pain having to do with an ongoing condition or problem, even having a bad doctor is better than no doctor at all. If you are having trouble finding a primary care physician who actually does care, the best place to start looking are local and even national support groups for your condition(s). They will have lists of hospitals and even specific doctors in your area who have been a good match for others in your situation. If those doctors are not taking patients, don’t be afraid to ask their staff where they would recommend going or if that doctor can make some recommendations of physicians they know to be effective at treating your condition. This search can take a while, but always keep a PCP on file, if you at all can. Not having a primary person who writes your prescriptions and handles your referrals makes the staff in an Emergency Room nervous no matter what.

Show that you have tried to contact your regular doctor before you go to the ER. If you have been in pain for five days and have not alerted your doctor, the ER staff will question how bad your pain really is. Even if the pain struck out of the blue that day, make an effort to contact your regular doctor first. ER staff will be more sympathetic to patients who have called their doctors and been told to go to the emergency room because the doctor was unable to see them. At least you’re showing you made an effort and only using the emergency room as your treatment of last resort, as opposed to the primary place you go for pain medication. This is important, as unfair as it is, they will not give you proper care if you are using the ER too liberally. Having your physician back up your story is never a bad thing, it helps establish legitimacy and urgency, and can help push you through to getting treatment sooner rather than making your wait for four hours “just to make sure you’re really in pain” before giving you any medication or imaging.

Bring a letter from your doctor. A letter from your physician, with a diagnosis and current treatment regimen, is a logical, completely reasonable thing to carry with you, particularly if you’re on a regular dose of opiates in today’s atmosphere of distrust and disbelief of pain patients. Always make sure the letter has your doctor’s name and phone number. That way, if ER doctors want to contact your physicians, they can. This is especially useful if you’re traveling or going to a hospital that you have never visited before.

Bring a list of medications. Bring a list of your medications, instead of relying on memory. Usually the hospital will already have access to the list of everything that you have taken for the past several years, so don’t try to lie about it, you will only hurt yourself in the long run. Always be honest about medications you have taken or have been prescribed. Work cooperatively with emergency room staff. It might not be fair, but if a patient comes in screaming and shouting that they need pain medication right away, the staff isn’t going to like it. Being loud and distressed will call negative attention to your actions and makes hospital staff that much less sympathetic. You might be in agonizing pain, but the staff is going to be more concerned with “drug seeking behavior” than your well-being. So rather than demand things, try to work cooperatively with the staff, even if they’re not being cooperative with you.

If you have an alert card or pamphlet explaining your condition, hand it to them and ask for it to be put in your file. For instance, I keep a card in my wallet explaining that I have Ehlers-Danlos Syndrome and detailing the worst parts of the illness and information that is pertinent to an emergency. I also listed my most severe medical allergies around the border of the card in big black block letters. It’s important for the staff to know what is going to cause more pain & what may help. If you have a rare condition or one that is frequently misunderstood or which is conventionally thought to not cause pain, bring a relevant pamphlet from an awareness or advocacy group with you. Consider buying one of the brand new USB alert bracelets, pendants, or wallet cards. These plug into a computer in an emergency if you can’t speak for yourself, and they can be uploaded with as detailed medical information as you want, from medical history and current doctors with phone number and addresses to info like allergies, current medications, current medical concerns, and alternative treatments/supplements as well. Most manufacturers understand that a computer might not be nearby in an emergency and have a phone number printed on the back of the bracelet that you can call to access the information as well.

Ask for a nurse advocate or make sure someone is with you. This will help you when trying to explain things to the staff. It helps to have another person there to advocate for you.

If at all possible, use the same Emergency Department as the last one you went to, your pain will be that much more believable if you always use the same place. Plus, you might actually get doctors to take an interest in your chronic pain condition and maybe even other conditions that can cause a chronic illness patient to end up in the ER. Think about the ramifications that could have down the road for future patients!

Finally, since there are a lot of easy-to-forget details in this list, especially in the fog/panic/blacking out that happen whilst in horrific pain, I like to keep a folder handy with all those details written down, as well as a copy of most everything I need to bring with me. It isn’t always updated with the newest things I’m taking, so I bring the bottles themselves if I am on anything different since the last list was written. Being organized shows the ER team that not only do you take your condition(s) seriously, but that you have done all you possibly can to avoid the Emergency Room and to only use it as a very last resort.

About two years ago I was turned away from an ER without treatment by an extremely ignorant physician (after toughing it out all night crying and screaming at home), I had to contact and be seen by my pain doctor the next morning and then was sent right back to the same ER, only this time I was told to have them call my pain clinic when I got checked in. I did not want to go back there, but things went a lot smoother the second time, despite my apprehension. I was given the correct sedatives for once, and no one yelled at me or gave me super judgmental looks. I was treated for pain, monitored, and released without being asked to pee in a cup or otherwise treated like an addict. It was the only decent Emergency Room experience I have ever had, other than being in constant, black-out, vomiting, excruciating, unrelenting pain for almost 48 hours prior to finally receiving treatment and not sleeping a single hour of that time, all from an Occipital Nerve Block injection that was supposed to be a diagnostic tool, gone horribly wrong. (Hint: If your gut says “Do not do this, it isn’t safe” then listen to your gut, or it probably isn’t going to turn out well. I knew in my soul that the injection wasn’t going to be a good thing for me, and I don’t even have a minor fear of needles.)

I haven’t been back to the ER since, I have to admit I have stayed at home through even worse pain than that episode since then. No part of my soul trusts the Emergency Room to treat me, as a 26 year old fibromyalgia and chronic fatigue syndrome patient with occipital and trigeminal neuralgia, Spina Bifida Occulta, Joint Hypermobility Syndrome / Ehlers-Danlos Syndrome, with damaged vertebral discs at the top and bottom of my spine and everywhere in between, just to name a few of my chronic pain conditions. None of that matters because what they see is a 26 year old who usually hasn’t showered in days, is twitchy and fidgety (pain makes me move nonstop sometimes), sweating profusely (a fibro symptom having to do with autonomic nervous system dysfunction or dysautonomia), has a hard time walking in a straight line, and usually I am extremely angry or panicky, one or the other. There isn’t a lot of sympathy for me if I don’t do absolutely everything right when I go to the ER.

It’s certainly not fair or acceptable, but the Emergency Room just is not cut out for dealing with us; the tough cases, the ones who can’t be 'fixed' or 'stabilized' because in hospital staff eyes, we are already stabilized and not in any immediate danger. Yet pain is dangerous. Chronic pain over a life time is more damaging to the actual structures of the brain than taking hardcore opiates every single day for the rest of your life. That isn’t to say that there isn’t some middle ground to be found here. I do not advise hardcore opiates for chronic pain on a daily basis, especially at my young age, because if I take heavy opiates now, years down the road when I need surgery or dose titration, eventually there isn’t anything else to elevate to by the time I’m in my late 30’s. That’s not how I want to end up. The only painkillers I currently take are tramadol and medical marijuana for breakthrough pain and seizure activity.

I have learned to make do, but it took years to figure out just how little I can do off of painkillers without my condition deteriorating. I’m still trying to adjust, trying to find the sweet spot between too much and not enough, and knowing that life with a chronic illness will always be a delicate balancing act.

I’m not just saying that heavy opiates are a bad idea, I actually used to take anywhere from two to ten 5mg oxycodone every day while I was working, and while it did not take the pain away, it made me more able to do things, more willing to put myself through pain over and over again all day long. I could still drive at that time, purely thanks to opioid medications, but I don’t think it was healthy to push so hard that I had to pop pain pills like mints, just to stay upright and not cry through my whole shift. At one point I was even on morphine every night to sleep just a couple of hours. Clinics were offering me methadone, which I vehemently turned down.

I had a rough, rough few months when my first visit with a brand new doctor ended with him taking me off oxy and morphine all of a sudden in the middle of a flare, no weaning, just completely off of opiates (and chronic fatigue/ADHD medication at the same time too) cold turkey without even the slightest heads up. I wasn’t even given tramadol by that asshole. I had to call crying in pain four times in one week before he would even write a tiny prescription for 12 (yes, one freaking dozen) during a two month long flare up! So humiliating. He also told me not to go to the ER no matter how much pain I was in. What a complete idiot. His favorite phrase was “at least you’re not in a wheelchair”. I could barely contain my hatred every time he said that or my other personal favorite: “you are a perfectly healthy young woman”. Not my weight, my blood pressure, my mental health, or my chronic pain conditions were healthy about me, so I was partly just shocked he couldn’t think of any reasons I wasn’t healthy.

Yes, middle ground. I understand that 'as-needed' for a chronic pain patient can mean literally anything, from almost never to pretty much always. So I say with caution and leaning more toward the almost never side of things, 'as needed' pain medication can save your life. When you need it, and you really need it, you know best, and you deserve to be treated correctly, efficiently, and even compassionately by ER staff. The above suggestions should help cut down on the emotional trauma that people with chronic pain often associate with going to the Emergency Room. In our greatest time of need, it would be nice to actually be able to count on getting help when we seek out this last resort in our coping toolbox."




Source: In Image







Please, keep your Emergency Room stories coming, because you never know who might be reading this blog or how many lives your stories may touch.

If you are interested in sending Emergency Room Stories (yes, you can send more than one), please email them to emilysstomach[at]gmail.com or you can PM my page: http://www.facebook.com/emilysstomach/.

I would like to include as many stories as I can for this series because everyone deserves to have their voices heard!




Source: Pain Warriors





Sources: Mostly located on the images above




The first part of this series can be found below:
Invisible Emergencies, Part One - The Personal Story Perspective: http://www.emilysstomach.com/2018/06/invisible-emergencies-series-part-1.html