Jan 222011
 

CC – “Sick”

45M Monday 6:30am

We get this complaint a lot. Can you be a bit more specific? Sick? Well I would imagine so since you’re in the EMERGENCY ROOM.

HPI
Pt: “Well this girl came over on Friday and brought some meth with her. Now I don’t feel so good.”
My thoughts: Wow, I’m single and the girls I date NEVER bring any meth over with them! In fact, girls don’t even come over to my house. What does this guy have that I don’t?
Me: “It’s Monday morning; you haven’t slept since Thursday night correct?
Pt: “yeah”
Me: “And you probably haven’t eaten since then either.”
Pt: “Well not really. We had some Jack-in-the Box”
Me: “Did you shoot the meth?”
Pt: Narrowing his eyes at me in offense. “No way, I would never do that, I’m not a druggie. We snorted it.”
Woah dude, sorry for insulting you. Forgive me for implying that you are a DRUG ADDICT after you just told me you spent the weekend doing meth.

After doing the PE I told him that I felt his symptoms were PROBABLY the result of doing meth all weekend, not sleeping or eating. He was surprised.
“You mean meth can make you feel bad? Dude, I thought I was dying or something.”
He agreed to a liter of saline and to check some basic labs. Results were surprisingly normal for someone who probably didn’t drink or eat for 3 days.

ROS: Positive for headache, shakiness and fatigue

PE: non-focal, disheveled, looked like someone who’s been up screwing and snorting meth for 3 days

Dx: Methamphetamine Abuse

Tx: STOP USING METH! Go home and sleep! Oh yeah, find a new girlfriend because this one is going to have horrible teeth pretty soon and nobody likes that.