TGIF

Full moon last night. Mercury in retrograde until the 8th. Anything else atmospheric I need to know about? It's been quite the day of excitement.

First I get a text from my girlfriend, Amy, that she was feeling crampy and thinking she was in labor. She was headed to see her doctor. Within three hours I get another text with a photo of her and her beautiful baby boy, Peter Temes Clifton. Talk about fast and furious, and here I thought my labor was rapid fire. He was born 6 lbs 12 oz and 19 inches long and with dark hair! I'm excited, so excited, for them, and wanting to hear all about her birth experience. And, of course, a bit nostalgic for just 4 months ago.

I then see an outpatient with my supervisor for an X-ray swallow study. The patient, a redneck kinda old guy with a history of COPD and recurrent pneumonias - who had previously disregarded all recommendations with regard to safe swallowing - actually seems to have improved since our last evaluation. No aspiration! Only trace penetration! Thin liquids okay! He's waiting for me in the lobby to check him out and tells me he's short of breath since the study. I hear him wheeze and observe significant work of breathing. I promptly tell my supervisor and escort the patient to the ER. Turns out he was having a COPD exacerbation likely caused by microaspiration that was not seen during X-ray. Needless to say, he spent some extra time at the hospital today.

And then I run to see a few patients with their lunches before Alex and the Bean come in for lunch. My patient, Mr. M, codes while I'm in the room. HE CODES WHILE I'M IN THE ROOM!

My chart note read a little something like this:

"I attempted to see Mr. M in his room during lunch for f/u dysphagia management. His SO was present.

Upon entry Pt. was lying supine in bed and his SO appeared to be helping him sit up. She said "I think he choked on some water." She indicated that he had just drank h2o while lying down. I assisted the Pt. to sit upright and instructed him to cough. No productive cough on demand, and I could hear an audible wheeze. His wife attempted to hit him on the back and indicated that "something was really wrong." I alerted an RN outside his room who came in to assist. Subsequently a code was called. Per chart, Pt. was intubated, ventilated, and transferred to the ICU."

I'm not so sure I'd want to be my next patient, hoping third time's NOT the charm. The adrenaline is a bit much to grapple with, but the day sure did fly by. #tgif