Speaking of Whitney, despite it all, I hope she makes the

• Patient with history of cocaine use - - KC
  • Crack cocaine via pipe or bowl...see link - Hayseed
    • Speaking of Whitney, despite it all, I hope she makes the - a musician's mom
  • if they smoke it, they smoke it in a bowl...i think - n/m
    • my ex used a can. nm - MT in MT
      • That's an understatement! - learn something new everyday
    • hmmm,.. could he be saying ball as in an 8 ball? - I think it's an 8th of an ounce. -k
      • I think 8-ball is correct; doubtful anyone "head" smokes only - 1 bowl daily
        • An 8-ball a day!?!? I think they'd be dead. lol - nm
          • No and unfortunately very common in addicts. nm - !!!

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Last line of the report, dictating physician says "I will page Dr. so-and-so and discuss with him."  The title "Dr." was inadvertantly left out (mybad), admittedly an error from typing too fast and didn't catch it.  QA pulled this report and marked it as a "critical error affecting document integrity."  I appealed the ruling arguing that it should be considered merely as a typo as document integrity as it pertains to accurate documentation of patient health care (which is what these documents are for) and proper transcription style had not been affected in any way.  QA board upheld the ruling implying in their reasoning that the doctor could be offended, i.e., his ego could be bruised, by failing to transcribe the title he worked so hard to achieve. 

Your thoughts - typo or critical error affecting document integrity?

You made an assumption that I made my comment based on my "moral compass."  You are the one being presumptive.  As it so happens, I became an MT because the job I used to have did not allow me to go back to school.  I recently got my second bachelor's in psychology, graduating summa cum laude I might add, and have been accepted to grad school for school psychology at one of the most competitive schools in the state.  So I beg your pardon but the information I gave is not my moral compass.  It comes from the extensive education I have received.  In addition, I have experience working with kids with developmental delays and my best friend growing up had autism.  I assure you if a doctor used that word with some of my friends who have children with disabilities, not only would the doctor get an earful so would the AMA.

the word sin in Spanish means without.

borders of the right great toenail were freed from their underlying attachments to the nailbed with a  S/L PARIOSALIVATOR.. 

Any help - please? 

(In review of systems)

NECK: Supple without mass.  ABDOMEN: Soft.  He does have some epigastric discomfort.  No hepatasplenomegaly, S/L mass appreicated, no guarding rebound.

am I hearing this right....if not any ideas?

any ENT MTs who know if there is another product, other than Debrox, or Cerumenix (which was by RX only, but discontinued) to remove chronic earwax, other than going to the ENT to have them irrigated and removed with a curette?

I can't seem to find any drug on the market; prescription or otherwise, other than those mentioned above, which were of no benefit.

Your help is greatly appreciated.  Thanks.

If I'm not 'speaking' clearly it is because I've had to listen to this mush mouth, speed talker for the past 8 hours and am only about 3/4 done with my quota.  I've never had so much trouble... even my ESL doctor makes better sense than this guy.

Interestingly the PET scan revealed minimal FDG uptake in the right thyroid bed consistent with the right anterior tracheal lesion, and also minimal uptake in what is believed to be persistent thymic tissue in the "intra-media-stynum", but nowhere else is it noted.  MRI was reviewed as well.  This confirms a 1.4 cm enlarged lymph node on the right side at the level of C3......

Hi!

I would probably make just a minor adjustment as I think he's talking about edema in both ankles:

EXTREMITIES:  There is edema of the right ankle at the site of fracture times two, trace to 1+ on the left.  Significantly diminished pulses, equal 0-1 DP and PT lower extremities bilaterally.  Normal upper.

As for the rest....looks okay to me...not sure about the "equal" part - sorry!  Good job!

Conus medullaris and the cauda equina are within the normal limits.  Intervertebral disk at L4-5 has mildly diminished signal, indicating desiccation at its interspace.

FINDINGS:  There is a mild bulge centrally with facet osteoarthropathy but no significant canal stenosis. 

**I'm not 100% without actually hearing the dictation that interspace and facet osteoarthropathy are definite, but with years of rad experience that's the best guess I can make for ya, both would be acceptable in that context as you have listed it.  But I at least FINALLY figured out blank #1 (bulge..not bone)!!  Yipee!  LOL Hope this helps ya!   

Thanks for all of that info, I guess I should have elaborated.  The dictation went as follows:  AP, lateral, Merchant, and (s/l) "McKay/Maquet?" views revealed bilateral knee DJD.

I just cannot seem to get a grasp of this guy today. Pt is seen for congestive heart failure. Here are the sentences leading up to my problem:

We will check a BMP today to reevaluate renal function and, if he does have a markedly elevated creatinine, we may not be able to do this (referring to 64-slice CT angiography). I am hopeful that, with ___ and renal protection, we can get by with this. We will also plan on checking a TSH and baseline blood work, including a CBC and BNP for outpatient baseline.     

Sounds like mucavest. I then thought of Mucomyst, but would like to know if anyone agrees because it does not make sense to me.

Thanks for any help! 

Reevaluation of osteoarthritis.  Changed to Darvocet, ____ proteinuria.  s/l "effectid".  Using 3-3 per day.  Losing weight.

Diagnosis: Osteoarthritis, hypertension, hypercholesterolemia, and elevated PSA.