01/19/2025
Saw this post and I thought it was worth sharing that sometimes people miss things. This doctor caught a stroke in his patient and I thought it was a great story to share.
"53yo M presented walking with a hiking stick. He says his wife dropped him at Wendyâs across the street while we were at lunch and he walked over from there. Says he stumbled and fell on the way, light headed when he turned his head to look for traffic.
Says he has been vomiting and feeling sick for a few weeks. Last week, while feeding his cats on his back porch, he turned his head quick while tossing a can in the garbage, âwent woozyâ fell to the grond and vomited, unconscious.
911 was called and in the ER he was worked up for stomach issues with a CT of the abdomen and released, according to his paperwork, with a stomach virus. Was advised to follow up with his P*P
He called the P*P to find out his doctor was out of town and the covering doctor recomended waiting until the doctor more familiar with him gets back, in 10 days.
He had seen me in 2015 for a low back issue, so he presented to our office, after walking over from wendyâs.
During the history, he made it clear that turning his head made him dizzy, nausesous and occasuioanlly loses consciousness.
BP 159/ 120
I referred to the ER, and I thought he was on his way but h3e went home. I called as follow up the next day, Friday, and he was in the ER. I had given him a copy of my daily notes on which I had circled in red several indications for the cervical vasculature to be assessed.
He said âDoc, they say I had a stroke. One of my blood vessels is 80% blocked.â
When I was at Logan, waaaaay back in the 80âs Dr Kettner, the radiologist, used to say âIf yuâre not catching it, youâre missing it.â
I just have this deep down wonder: And i realize the man was a poor historian and a little confusing but, ya know, thatâs where your history taking skills are. What i wonder is: How do you call passing out and vomiting with rotation and extension as a stomach bug?
How?
How does a triage nurse in a P*P office not escalate this?
How does the covering docrtor blow it off?
I canât wait to see what the ER noites say."
I think it's a good story to show that sometimes symptoms should be looked at more closely. Happy to hear that the man got the care he needed in the end.