14 October 2008

Never fails to amaze me

I've said it before and I'll say it again:

If I'm ever on coumadin, I am going to know why.

It just boggles my mind how often I have the following conversation:

Me:   I see you're on coumadin.  Why are you on coumadin?
Patient: It's a blood thinner.
Me:   I know it's a blood thinner.  Why are you taking a blood thinner?
Patient:   So my blood doesn't clot?
Me:   Do you know why your doctor was worried about blood clots?
Patient:   Well, they're dangerous, aren't they?
Me:   Yes, but have you ever had a blood clot, or an irregular heartbeat, or a stroke?
Patient:   I don't know.
Me:   (hits self in face with the chart)


  1. If I'm ever on coumadin, I am going to know why.

    You need to phrase this as more of a suggestion to the rest of us, as in:

    "If you ever find yourself on coumadin, find out why, it will be so much more helpful to those who will later try not to let you die."


  2. Yeah, this is like those doctors that expect me to know the dosage of my high blood pressure medicine and the name of the medicine. Whatever, that's what I pay you for.

  3. Wow. I am impressed that the patient even KNEW it was a blood thinner.

  4. Doc,

    It isn't just Coumadin.

    Witness a conversation with my Father.

    Me: So, Mom tells me that the Doctor recently changed your diabetes medication. Why did he change it?
    Dad: I don't know.
    Me: What do you mean you don't know? Didn't you ask him?
    Dad: What's the point son? Doc knows what he's doing
    Me: It's not the Doc I'm worried about. Dad, YOU need to know WHY you're taking any particular medication! You need to be aware of it's effects and side effects.
    Dad: Well, I'll ask you Mother...
    Me: Why ask Mom?! Mom isn't the one popping them pills! Dad, you've been a diabetic for over 15 years now! Stop passing the buck onto Mom!

    *sigh* I STILL don't know what meds he's on and why they were changed in the first place....

  5. we had a 90-year-old guy come in for shoulder pain.

    "Are you on any medications at home?" No, he responds.

    Then his home health aide comes in and hands me a list. Among other things, the guy is on coumadin, digoxin, and a couple of other slightly dangerous drugs.

    "You take coumadin and digoxin?"

    Oh, yes, he responds. But they're only precautionary drugs--to prevent me from being sick.


  6. My mother in law and I were having breakfast during a recent vist. Her new husband comes in and plonks a handfull of pills down on the table, which she scoops up and swallows.

    Me: You're on medication? For what?

    MIL: (shrugs) oh I don't know what all he gives me - I just take it.

  7. If you're ever on coumadin, you should stop hitting yourself in the face with charts.

  8. Then there are patients like me, who research the living daylights out of every last thing I eat, take, and wash my hair with.

    I don't know if he likes me very much, but I think my doctor appreciates that I can finish his sentences for him until he remembers, "Oh yes, this is the one who doesn't require twenty minutes of explaining basic pharmacology...next!"

  9. One problem is the lack of curiosity people have about what is going on with their bodies. If I am taking something legal, it must make me better. They don't understanding that a symptom might be related to the medication, the underlying illness, or something else.

    I used to go through this with my father. Friday evening, after the doctor's office closed. He would expect me to make him better long distance, because he didn't want to go to the doctor. The difficulty breathing would have started on Monday, but he waits until Friday evening, so he can claim that he can't go to the doctor for a few days. I should have has a cement clip board to bang against my head, which would be OK, since he was the one taking coumadin. :-)

  10. "One problem is the lack of curiosity people have about what is going on with their bodies."

    And some people are just plain lazy. I see that a lot too.

    I should keep a card in my wallet with all my 3 meds on it and their dosages. Since I can't remember them all.

    This card can be made on the computer, and printed whenever my meds change.

  11. Chuckr44,

    I love patients who have a printed list of what they take. They always seem to leave the most important ones until the end, or forget them entirely, when they try to recall them.

    I make photo copies and give an extra one back to the patient/family. Especially if their list is showing signs of wear and tear.

  12. Coumadin is the new black for the over 50 set. Between our national caffeine habit, an aging population, & more attention paid by doctors, who hasn't been diagnosed with A-fib?

  13. jimii-

    no, the ER doctor is not payed to know why you were put on coumadin by your private physician who may not be available to speak to at 3AM when you arrive with your head bleed, GI bleed, etc.

    the american patient needs to start taking a little more responsibility for their own health.


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