Monday, March 10, 2008

What goes around.....

There's this guy that comes in about once every couple of weeks for COPD exacerbation. He smokes 2 packs a day, drinks like a fish, and never bathes. He has a full, greasy beard and long stringy brown hair. He looks kind of like Jesus on meth. And he's an ass. He usually leaves AMA after a couple of breathing treatments and a round of steroids. Occasionally he's got a pneumonia and will stick around for the antibiotics, but he won't let you admit him. After all, the docs upstairs won't write for Budweiser and Marlboro q 15 min PRN.

The last time I saw him for one of his "regular" visits, he was even more of an ass than usual. He was cussing up a storm, wouldn't let us draw any labs or start an IV, and when the RT tried to get ABGs, he actually hit her. (After he hit her I told her I'd help hold him down so that she could get the ABGs from his retinal artery, but she said no go, she was done with him.)

No pneumonia, he took a couple of doses of Xopenex and some Solu-Medrol and headed out the door as usual. This time he wouldn't even sign the AMA form. We all shook our heads and went back to work.

Fast forward a week or so. EMS is bringing in a patient with facial burns. They get here, and who is it? You got it, Jesus on Meth. He was smoking with his oxygen on and set his face on fire.

Gone was the beard and mustache, and his hair was singed into curlicues at least 3 inches back on his scalp. The nasal cannula was melted into his face, his nostrils and the inside of his mouth were black, and he was greeted with an RSI kit and a stat transfer to the Burn Unit at the Trauma Center in the Big City.

That Karma, she is a bitch.


MrHunnybun said...

Karma Indeed!

I'm strangely reassured that it isn't only me who has patients retarded enough to smoke when using oxygen.

The last patient I had like this complained that his cigarettes burned too quickly due to the oxygen comcntration. He felt he should be reimbursed for this in some way.

In the end he resolved this by drilling a hole through the oxygen mask for his cigarette to fit through.

Luckily his brains were not dynamite.

EE said...

He looks kind of like Jesus on meth


MonkeySister said...

You just wait, you are going to get a troll now that says that you are heartless and that you shouldn't be anywhere near patients and blah blah blah, gag, blah....

Thanks for the enlightening thought. I will remember to treat people with respect and kindness. Karma is indeed a pain in the butt...

Your first commenter above was pretty funny too. Every time I picture a guy sitting there with his oxygen mask on and a cigarette shoved in a hole that was cut in it, makes me laugh... Stupid addicts... Don't even get me started... :รพ

Anonymous said...

But will the trolls be chain smokers, tweakers, or religious watchdogs offended by the simile linking Jesus with methamphetamines?

Wimp hiding behind anonymity in the face of the higher power of much holier than moi TROLLS. :-)

Anonymous said...

Natural selection at work.

GuitarGirlRN said...

I caught one of our COPD frequent flyers outside on the ambulance ramp, smokin it up, dragging an O2 tank behind her. At least she was outside so when she blows up, parts of her won't hit any of the other patients.

What's even better is when people smoke with their O2 on, with petroleum jelly on their chapped lips. Way to melt your face!

shrtstormtrooper said...

Let me just tell you, anonymous poster, that I am OFFENDED that Monkeygirl would dare stoop to saying Jesus looks like some crazy guy. I am seriously offended, and I intend to start an all out, long-winded comment battle on why I am so pissed. I'll be rounding up the trolls for this battle.

Just kidding.

I love Karma, and crazy person Jesus comparisons.

NCRN said...

i agree karma and natural selection.
he could have gotten a darwin award if he would have died.

by the way love your blog,i can so relate....

Jamie said...

Don't know if you can really answer this here but what the hell, better than calling into the ED and asking right? lol How many COPD's do you get that AREN'T smokers? My mom was diagnosed a year ago with COPD (she's 43) and has never smoked a cigarette in her life. There are times when we both feel like it is so unfair that she gets it when there are others out there that smoke their whole lives and die without so much as a smokers cough. (I know life is unfair, yadda yadda) Should I be expecting her to be on constant oxygen in her seventies? (her COPD was caught in early stages but she doesn't want to go back for more tests to see if it's progressed since last year... stubborn) Thanks, I really enjoy your blogs.

Mother Jones RN said...

Why don't people understand that:

cigarettes + O2 = BOOM!


ndenunz said...


There are no medications to slow the progression of COPD but certainly by the fact that she does not smoke, it may not progress too fast. She really should go get retested to see if it has progressed. There are medications for symptom management.
Also, regular exercise certainly wouldn't hurt. Hope this is helpful.

HollyB said...

OK, I'm a smoker, and I'm not offended. I believe in God and that a guy named Jesus walked the Earth at one point and I'm not offended.
Both my Grandfathers had the big E and were on O2 and I'm not offended. One would disconnect, go outside to smoke and when he by couldn't do that anymore, switched to chewing tobacco.
Yes, I agree that smokers, myself included are addicts. I've worked with addicts who have kicked alcohol, heroin, even crack and meth but can't give up cigarettes.
And still I'm not offended by ANYthing MG said or any comment here.
I'm commenting with an ID that can be traced back to a blog with an email.
If there ARE any trolls out there, don't start on MG or any of the other commenters. Pick on somebody your own fuckin' size. Come to MY house and we'll talk it over.

Great post! This Idiot got exactly what he deserved from my bitchy Sister Karma.

Derek said...

My folks use oxygen and have a nice big sign on the front door. NO SMOKING, OXYGEN IN USE!

Don't get many visits from chain-smoking neighbors or relatives, for the better I suppose.

And yes, this gut was just trying to give the gene pool a double shot of chlorine. Unsuccessfully.

Julie said...

Karma loves people - she does.

I had a lady that did this. Except she was a sweet old thing and we all loved her. She just couldn't give up her "ciggies". Sigh..........her BOOM killed her after 2 days in the ICU.