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Oh my lord, what was I thinking???

Posted By: MT50 on 2007-10-15
In Reply to: So he'd be saying - Please see nurse Unasyn list? - kjlange

Subject: Oh my lord, what was I thinking???

No he would not. Maybe nurse's notes list? Absolutely just guessing on this.


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Lord, help me please (sm)
Subject: Lord, help me please (sm)

The CBC shows white count 6000 with 61% segs, 29% lymphs, 1% band and 9% monos.  Overreactive lispossum with 2+ anisocytosis, 1+ hyperchromasia, microcytosis of 2+, adequate amount of platelets, 1+ poikilocytosis, 0-1+ serocytes and 0-1+ target cells.  Hemoglobin 11.7 and hematocrit 36.9. 


 


I just can't hear it right and need help, please!!!


Lord, perhaps another field would be more appropriate.
Subject: Lord, perhaps another field would be more appropriate.


Praise the Lord!
Subject: Praise the Lord!

I saw your post earlier and this has been eating at me all day, so tonight, believe it or not, I sat down with my GI/GU book and started reading :)  There is a crypt of Littre', also with reference to Littre' gland and Littre' hernia, which is in the male GU system.  You think he was referring to something along those lines?  Maybe I can sleep tonight now :)
Good Lord..
Subject: Good Lord..

Of course.


Thank you.


I think I need a nap.


Oh good lord!
Subject: Oh good lord!

AHHHHH!!!! That is so frustrating! I have listened to this stupid report OVER AND OVER and it was something so simple as aspirin! I hate over analyzing everything!

THANK YOU by the way!
Oh good lord!
Subject: Oh good lord!

I swear I tried every spelling similar to that and I guess didn't try that exact combo! I knew it was similar to that! Thanks! ;)
Oh lord, so obvious, thanks
Subject: Oh lord, so obvious, thanks


Oh lord. Talk about trying to over-complicate! Thank you!
Subject: Oh lord. Talk about trying to over-complicate! Thank you!

:)
Good Lord! That should "makes sense" :)
Subject: Good Lord! That should "makes sense" :)

x
Secured in place, not in plate...oh lordy lord...
Subject: Secured in place, not in plate...oh lordy lord...

x
still thinking
Subject: still thinking

Turns out that the patient is having very high fevers giving impression of left lower lobe pneumonia. Came across a brand name of a drug used in mouthwash called Advexin. They were talking about oral cancers...but then cross-referenced on http://www.pharma-lexicon.com/ and found (generic Mepron) atovaquone, classified as an anti-infective used in both adults and children who are at risk for PCP with initial doses of 750 mg per 5 mL. Since Hodgkin's lymphoma and bone marrow transplant would put this girl in a severely immunocompromised state, I would bet they are giving her a pretty hefty dose of the stuff. Atovaquone it is.

Thanks for helping me.
Thanks, I was thinking along
Subject: Thanks, I was thinking along

those lines, just wanted a second opinion. :-)
that's actually what I was thinking too - nm
Subject: that's actually what I was thinking too - nm

x
Tks. I kept thinking there is another
Subject: Tks. I kept thinking there is another

Like ...there were lewes....or something.  You are probably right, and I finally found it in stedman's and it says *sternal angle* and that seems to fit the way the doctor used it.  Thanks again.
that's what i am thinking
Subject: that's what i am thinking

I was thinking along the lines of this from the begining....compression over lower extremities.....just wish I didn't hear otherwise!  (I hate Monday's)


That's exactly what I was thinking
Subject: That's exactly what I was thinking

but I have this doc all the time and she's never dictated time like that before, so I just wasn't sure.  Thanks to all who replied. 
I was thinking that too...I'd have to say it was:
Subject: I was thinking that too...I'd have to say it was:

Past history notable or is notable for ______.
That's what I was thinking..maybe she
Subject: That's what I was thinking..maybe she

just got ahead of herself when dictating it in the assessment..because I definitely didn't hear an itis at the end...just a gingival or gingivo sound. 


Thanks


that is what I am thinking..thanks
Subject: that is what I am thinking..thanks


What was I thinking
Subject: What was I thinking

of course, para anything with twins, triplets, etc. Thanks for fixing my answer!
I'm thinking it's probably
Subject: I'm thinking it's probably

R&M for "routine and microscopic" 
That's what I was thinking, too.
Subject: That's what I was thinking, too.

.
I am thinking it
Subject: I am thinking it

may be (LIMA) or left internal mammary artery ..... of course you are hearing it.
That's what I was thinking...
Subject: That's what I was thinking...

but was unsure. It's an ESL doctor and she says it twice. It doesn't really sound like there is an F in the pronunciation, though.
that's what I was thinking.
Subject: that's what I was thinking.

That is what I have been doing but I guess I just wanted extra reassurance! Thanks.
I am thinking that is what she must be saying. Thanks. nm
Subject: I am thinking that is what she must be saying. Thanks. nm


I am thinking it might be SM
Subject: I am thinking it might be SM

some kind of rowing exercise...____ rows, but I can't come up with anything better than that.
Thanks, I was thinking that or 0.1. nm
Subject: Thanks, I was thinking that or 0.1. nm

xxx
I was thinking that myself, but just not sure so I sent to QA
Subject: I was thinking that myself, but just not sure so I sent to QA


I was thinking the same, but (sm)
Subject: I was thinking the same, but (sm)

why would he dictate this along with vital signs?  Seems strange ...
I was thinking that too! Thanks!
Subject: I was thinking that too! Thanks!

Thank you for your input!!!
That's what I'm thinking..sm
Subject: That's what I'm thinking..sm

This client requires headings whether or not dictated, so I wanted to make sure I'm correct.

Anyway, I have always typed it under abdomen, but I went looking to make sure, and I did find it in a sample report with it listed under back.

However, I just found a very good article called "Varney's Midwifery" that says it is part of the abdominal exam.

Thanks!
That's what I was thinking.
Subject: That's what I was thinking.

Most of the references I found say that if a patient is unable to consent to surgery, two doctors can sign the consent form on the patient's behalf. I am just not sure if the dictators mean double-doctored or double-documented when they say double doc'd. I do all ops, so it comes up fairly often.
that's what i was thinking too - nm
Subject: that's what i was thinking too - nm


I was thinking that too . . .
Subject: I was thinking that too . . .

He is in rare form today. I think he meant to say compression but it honestly sounds like inspriation. Sigh*** I mightjust sent it through with a flag.
not thinking-- thanks!!
Subject: not thinking-- thanks!!

nm
thanks, that is what I was thinking also. nm
Subject: thanks, that is what I was thinking also. nm

nm
thinking...
Subject: thinking...

The left wrist is inspected showing there to be a visible soft tissue swollen area of the dorsal wrist closer to the radial aspect of the wrist. It is approximately 3 cm in diameter. Mobile tender to palpation and consistent with the ganglion cyst.

I was thinking a comma should go after diameter and before mobile. (where I have a period) What do you think?
I was thinking that too until...
Subject: I was thinking that too until...

...a couple of lines down he said the patient was circumcised. This guy completely rambles. I really didn't know about hair tourniquets until tonight's dictation. (Now If only I could forget the mental image!) Thanks for taking time to answer--this newbie appreciates it.
I was thinking
Subject: I was thinking

false lumen, but that when googled is associated it looks mostly with aorta. Unless you think they could be talking about the abdominal aorta???
that's what I was thinking, but
Subject: that's what I was thinking, but

I'm hearing a "cis" sound in the middle of the word. He also says it again part way down in the report. He says EG junction is 35 cm from the _______ orifice.

Thanks.
Thanks!. That's what I was thinking too.
Subject: Thanks!. That's what I was thinking too.


That's what I was thinking... : - )
Subject: That's what I was thinking... : - )


was thinking that but SM
Subject: was thinking that but SM

there wasnt any mention of the drug at any other part of the report and the word starts with a K or a C.
That's what I was thinking...
Subject: That's what I was thinking...

But I couldn't find anything that came close to matching what it sounds like she's saying.She has an accent which doesn't help at all.
I'm thinking maybe...
Subject: I'm thinking maybe...

...lateral compartment/unicompartmental
thinking 6-mercaptopurine nm
xx
I'm thinking PTCA
Subject: I'm thinking PTCA


I was thinking the same thing
Subject: I was thinking the same thing

I've never heard of anyone being rushed to the ER to be given chemotherapy before.
I'm thinking in reference to
Subject: I'm thinking in reference to


More context would help. I'm thinking it is sm
Subject: More context would help. I'm thinking it is sm

"a soft cast or appliance" because the patient may have been placed in a soft cast or appliance (splint/brace) until the orthopedic doc saw him.