sugar addiction One thing we remained in the study of diabetes in mind: Both sugar shortage and excess sugar can cause confusion and unconsciousness. But the fact that both extremes that cause over-and hypoglycemia, the very different histories and clinical pictures fall only on us again when we saw the first patients with Hyp-O-glycemia. He was old, thin and sullen. His wife had called the ambulance, because he signs of hypoglycaemia was shown. She had tried with good words and jelly sandwich to raise its sugar. But it did not help. He refused. Was sullen and stubborn. He sat at the kitchen table arrived ahead of his bread and jam as the emergency physician. "They scissors to hell, what do you want from me?" Get out of my house! " growled the old man to the ambulance. Measuring blood sugar? Access basket? Not him. The ambulance tried it with good words. Praised the delicious bread and jam. Referred to the concern of the wife. Warned of the sugar-shock. Nothing doing. The old, withered man was weaker, but always aggressive. Tried to scratch an ambulance. Railed against himself. So it was always when he was hypoglycaemic, the woman said. The decisive plan came from the experienced paramedics: The feather bed was spread on the kitchen floor. By joining forces, the little man was laid out and recorded. Now he was active again: cursed, spat, scratched and bit around. Worst insults and curses, he accused the physician on his head. On behalf of his profession was the doctor to blame for all the misery that had happened to the patient: reduced pension amputated leg, failed surgeries and countless hospital stays. Never the doctor, who was now on the patient, had been hitherto so insulted. Nevertheless, he succeeded in an increase in the fragile veins of the struggling old man. And as soon flooded the first twenty milliliters of 40 percent glucose the organism could hear the thrashing and cursing on suddenly. "Excuse me, sir, I have offended you?" he asked timidly. While he was down on his bed acts together and jam bread turned he confessed shamefacedly that These kinds was not made for the first time. He was sorry and he apologize. The blood sugar level, which had been removed after laying the Braunüle showed later a value around 30 mg%. met in his later career the doctor again on hypoglycaemic which herumtigerten restless, confused. And often fought against a helping action. Developmentally, the search for the saving carbohydrates, when we are not to be stopped? Who knows? Only three times was the emergency doctor in the following years when the old man at home. Two-time hypoglycemia. The third time, determination of death. The woman had been shopping.
doctors' strike. Home emergency service. Many patients. Recipe requests. But above all. Work disability certificates. On this first great Day of the year. between an older couple. Well situated. Well dressed. However, it is rather laconic. Looks somehow to "put up". "Only very fast in between, we need a prescription. Will not take long." Really? What's this then? He calls the name. "Unfortunately, the package is now just gone over. You should write to please a wide." he says quite kindly. Unfortunately the doctor to happen too often. That he but your just a big package of painkillers, cough-blockers, sleeping pills, sedatives, antidepressants may write. Because you go on vacation tomorrow. Or father suffered so painfully. They had been robbed. And just today the doctor had indeed closed. will "temazepam" is an addictive sedative trigger that one can not prescribe now that would probably not write the front-neurologist, the doctor explains. To know the two of course. But they rebel. As always. Easy to start such talks. Maybe too friendly. Later outrage. Abuse sometimes. What one except for an inhuman doctor. Whether you have geschworden no oath to help. Whose is the petitioners would probably suspect. An absurdity, the report will be. Brazen impudence. usually calm down the situation again when we offered a compromise. One tablet of oxazepam for the night, for example. Friendly again: whether one can have two non-identical. This time has not been worth the visit for both. But yes you can try again later. Or next weekend. Sometime back a bona fide beginner sitting here.
coma "helpless person behind closed doors"
The doctor found two helpless people, after the door had been broken: the 70-year-old father and his 40-year-old Daughter.
Both unconscious but breathing spontaneously. Both in their beds. In a cool, dark old building, in the first days of winter in the early nineties.
Strange: Next to the bed of the old man took a pail with a little vomit. On the bedside table an open vial MCP, which suggested previous nausea and the presence of a primary care emergency service.
Another was not to find out. As long as the two were already there. What had happened. A collective suicide? Food poisoning? Everything remained unclear.
so for the doctor and the fire department in the two different hospitals. The ICU remained in telephone contact. Perhaps one of the two reports would wake up and can.
The laboratory diagnosis and a neuro-case conference brought no further information.
awoke hours later, but then the daughter in a neighboring hospital. And reported on the problems of the father the day before. Dizziness, nausea and shortness of breath he felt. More and more tired he had become. The emergency service but found nothing and only given an injection. And to this the cold apartment. Onset of winter. Both would have the coal stove is not quite up and running.
There is thus a suspicion which is confirmed by the HbCO value: carbon monoxide poisoning.
And it also explains the pink to dark red color, unusual sound effect in comatose and deep breathing.
Rästelhaft remains, why in the apartment no smoke or odor was noticed similar. Perhaps they had too much on the comatose patient?
Later still put the fire to the coal stove.
A Friday evening in hospital. Plenty of work. Outpatient clinic, intensive care unit, peripheral stations, all the problems only for the duty officer.
She came with back pain. Colicky, pulling into the pool. Chubby, end Thirty. A sensible woman, who was born here, troubled by this unexplained increase in seizures.
access, blood sampling, infusion, resting on the examination table in the outpatient clinic of measuring body temperature. Probably kidney stones or kidney infections, right? Look to the doctor later, the first study Gomer, who was admitted with a fever just next door from the home.
little later: "Doctor, you look again to the lady with the colic, it will not be better."
So, what about this back? Renal bed knocking painful? The belly is quite thick. Very fat. What is it? No air, no ascites, no obesity. A baby! Na clearly, a pregnant belly. The doctor, father of many children, has learned the handles: Here's the back, as the head, pelvis.
The woman is obviously pregnant. "Are you pregnant and that badly." "I get pregnant?" No, certainly not. " Aha.
This lady is pregnant and does not know. Is that it? The doctor thinks of his books and the stories from the tabloid press: hysterical false pregnancies, surprising fall births, abandoned newborns. No one noticed anything. "Women are always potentially pregnant, whether they know it or not before X-ray.. Pregnancy test then you can be sure."
While the patient Doctor explains how a pregnancy is not possible - life partner leave and so on - is looking for the hidden camera. That's not true, right? How can anyone ignore nine months of pregnancy? Or forget? Women are strange creatures. Always have to be prepared for anything. Or is the doctor wrong? Is there abdominal tumors that feel like babies? An ultrasound will bring clarity.
sonography: Yes, look: Here's the back, as the head, the little heart beating fast. A big kid in her belly. No, Doctor, I can not be pregnant. Since coming back spasms. Blow! Of course. The delivery is imminent.
Outdoor, on the Hallway, sitting by the partners. Reconciliation a few weeks ago. Pregnancy? A baby? No, absolutely not. Well, then come with time. Up in the delivery room.
About an hour after its performance in the ambulance, the lady gave birth to a healthy girl. Completely unprepared
. Unexpectedly. Pass without a mother and laboratory controls. Against medical advice, so to speak. At home it was
no children. No strollers. No pink rompers. They were happy anyway.
both. Very much.
Excited The physician notified the patient: "Can you please look over there, the lady is known to be a little excited.. Calm it easy. " found Once in the apartment of the doctor, the lady really excited. Too breathless. The soft, pressed in the leg and the moist rales over the lower half of the lung were clear indications of congestive heart failure . fit given then the hospital discharge letter from the previous year. Global congestive heart failure The excitement thus had a reason, the ambulance picked up the lady, after she got nitro and furosemide and the doctor noticed the. is better it to form their own opinion.
