thinking it over - can you hear cerumen in your s/l?
Posted By: MDmt on 2008-01-16
In Reply to: ENT help - please
Subject: thinking it over - can you hear cerumen in your s/l?
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- ENT help - please
- thinking it over - can you hear cerumen in your s/l? - MDmt
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Thinking here....can you hear "acute cirrhosis of the liver?"....nm
Subject: Thinking here....can you hear "acute cirrhosis of the liver?"....nm
nm
cerumen
Subject: cerumen
The cerumen was removed from his ear s/l aboriously with great difficulty.
cerumen (ear wax) nm.
Subject: cerumen (ear wax) nm.
xxxx
Cerumen (ear wax) nm
Subject: Cerumen (ear wax) nm
cerumen ??
Subject: cerumen ??
cerumen curette?
Subject: cerumen curette?
cerumen in sinuses
Subject: cerumen in sinuses
think something is wrong - if you are talking cerumen impaction, the doc is not looking in his nose; could be "gross cerumen impaction" if looking in ears, but not sinuses -
Impacted with cerumen
Subject: Impacted with cerumen
S/L accreditus with cerumen.
earwax is cerumen
Subject: earwax is cerumen
nm
cerumen, eosinophils, eosinophilia- have to look again
Subject: cerumen, eosinophils, eosinophilia- have to look again
x
cerumen in his NOSE? don't think so. Try again chickie. nm
Subject: cerumen in his NOSE? don't think so. Try again chickie. nm
.
how about "partial" cerumen, again just guessing
Subject: how about "partial" cerumen, again just guessing
true they can but not cerumen IN the nose.
Subject: true they can but not cerumen IN the nose.
,
"absence" to remove cerumen
Subject: "absence" to remove cerumen
Sounds like...I used cerumen with both a curette and "absence"
Speaking of ears clogged with cerumen, are there
Subject: Speaking of ears clogged with cerumen, are there
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.
wild guess - "fresh cerumen" impaction?
Subject: wild guess - "fresh cerumen" impaction?
cerumen impaction is it! But can there be any other word in front of it instead of fresh?
Subject: cerumen impaction is it! But can there be any other word in front of it instead of fresh?
OBJECTIVE: Left s/l "EEC" is occluded with soft cerumen.
Subject: OBJECTIVE: Left s/l "EEC" is occluded with soft cerumen.
diagnosis: Cerumen impaction.
Can you hear bunion for the first word? And the second can you hear symptomatic or sensory pain?
Subject: Can you hear bunion for the first word? And the second can you hear symptomatic or sensory pain?
Cannot hear adenopathy. Clearly hear *pology. Thank you, though.
Subject: Cannot hear adenopathy. Clearly hear *pology. Thank you, though.
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.
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