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Can't understand a couple of words

Posted By: newbielw on 2008-02-12
In Reply to:

Subject: Can't understand a couple of words

If you're transcribing a report about someone with sinusitis, and the doctor says the ___ are red and swollen (and it doesn't sound like nostrils or nares or membranes) what could it be?  And in the PLAN if he says ___ fluids, rest, and follow up within 7 to 10 days....what could he be saying.  It almost sounds like "Push fluids."  Can anyone help?  Thanks!


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New to ortho and have a couple words.
Subject: New to ortho and have a couple words.

s/l *jo-lie-tandis* pain with hyperflexion.  (knee)


 


Negative s/l  *feralmis* test.  (wrist)


 


TIA!


No links but the Stedman's GI & GU Words is great, and you'll need a Pathology/Lab Words book
Subject: No links but the Stedman's GI & GU Words is great, and you'll need a Pathology/Lab Words book or

s
onelook.com, Tessier's Surgical Words, and Sted's Ortho and Rehab Words. Great stuff! nm
,
There are a couple...sm
Subject: There are a couple...sm

Here is a great site with a couple of choices that sound like your term.

http://www.suffolkobgyn.com/medicalTerms#G
a couple T's
Subject: a couple T's

tap water enema
theophylline olmamine enema
tranexamic acid enema
turpentine enema
A couple more....
Subject: A couple more....

he went on to have an aortic valve replacement with a "number tommy five" bioprosthetic valve as well as bypass "sinus tree" vessels


pseudo normal LV filling pressure with "chronkomittent" abnormal relaxation


Patient is New York Heart Association class III in the setting of ischemic cardiomyopathy and "he feels" compensated


beta blockers, carvedilol "a target dose", "aldolsol" inhibitor


 


THANKS!


 


I too would like to know a couple of shortcuts..
Subject: I too would like to know a couple of shortcuts..

such as, I end each letter from my doc with "Thank you for the referral of the patient." Sincerely, John R. Brown, MD JEB/trh. I know there must be a way to store this so that all I have to do is strike 1 key to end my letters, but I don't knave a clue how to do this. Anyone have any suggetstions? Thanks

Couple of lab questions... sm
Subject: Couple of lab questions... sm

Can't catch what Mr. Mush-mouth is saying. 


Postoperative serial white blood cell count demonstrated a stable white blood cell count at 11,900.  s/l *hemansa* hemoglobin stable at 28.9 and 9.4. 


a couple of thoughts
Subject: a couple of thoughts

First to address the issue of subcu - Joint Commission created a list several years ago that deals with this wording - and JC trumps BOS.  From Joint Commissions List of Dangerous Abbreviations:


Abbreviation: S.C. or S.Q. (for subcutaneous)


Potential Problem:  Mistaken as SL for sublingual, or "5 every"


Preferred Term:  Write "Sub-Q", "subQ", or "subcutaneously"


As far as what the man was trying to express to you was his opinion that truncated words (partial words used to express a complete word) should be avoided.  Trach is not a word.  Trachea, tracheostomy, etc., are words.  Alk is not a word.  Alkaline is a word.  There are also lab and other words that are commonly acceptable in their abbreviated form, such as INR, CPAP, MRI, etc.


There are acceptable abbreviations of certain words that are commonplace.  For example, lab is widely accepted to represent laboratory.  Exam is acceptable to represent examination.  HIV is another example.


If you understand the difference between the use of an abbreviation and avoiding the use of truncated words, your work will reflect a much clearer intent of the dictation.


Your company needs to decide which side of the fence it wants to sit on, and it appears there may be some changes in your QA future.  If this man is in charge of QA and you want to continue working there, you might want to begin taking note of what he is saying.


a couple of things......SM
Subject: a couple of things......SM

Jehovah's Witness


myoclonic gammopathy?  not myoclinic


possibly *gammopathy*


*h* in Jehovah's Witness


couple of possibilities (sm)
Subject: couple of possibilities (sm)

If you're sure you're hearing "radio" that could be a "short-speak" way of saying radiograph.

Another possibility is RDI (respiratory disturbance index).
I have a couple of docs that do this. sm
Subject: I have a couple of docs that do this. sm

The terms sound similar anyway, and if they say them a little too fast, or there's a flaw in the sound, these words sound exactly the same.

But sometimes there's a clue in what's being tested, blood or urine, and/or the diagnosis.

Also, if you can slow the sound down a little, sometimes you can hear a slight difference, just enough to know it's one or the other.

If that doesn't help, the best thing would be to send on to QA. If they can't figure it out, the docs may become tired of blanks and learn to enunciate more clearly. How difficult could that be!

Sorry I can't be of more help, but maybe someone else has a foolproof way to tell.
I have a couple of docs that do this. sm
Subject: I have a couple of docs that do this. sm

The terms sound similar anyway, and if they say them a little too fast, or there's a flaw in the sound, these words sound exactly the same.

Is there a clue in the dx?

If you can slow the sound down a little, sometimes you can hear a slight difference, just enough to know it's one or the other.

If that doesn't help, the best thing would be to send on to QA. If they can't figure it out, the docs may become tired of blanks and learn to enunciate more clearly. How difficult could that be!

Sorry I can't be of more help, but maybe someone else has a foolproof way to tell.
Have a couple of questions, please sm
Subject: Have a couple of questions, please sm

Sorry, filling in for somebody and this doctor is really fast -
1. Patient takes a s/l plepharde of medications.
2. Patient still has constipation despite taking s/l Cerafac.

Thanks!
There are a couple of possibilities. Context?
Subject: There are a couple of possibilities. Context?


Here are a couple of links for you to send them....
Subject: Here are a couple of links for you to send them....

http://72.14.253.104/search?q=cache:_yrLOF4eEkIJ:emcrit.org/pdf/Wound%2520Care%2520Syllabi.pdf+XAP+topical+pediatric&hl=en&ct=clnk&cd=13&gl=us (at bottom of page 8)  Hope this helps...When the doc spelled it for me, it was for a laceration repair on a kid.  But, if it's a dental block in the ER, they might be using ZAP for topical in the mouth.  Was something that was really confusing for me at the time, which is why I tried to get some info on it.
Can we have a couple of lines from the report
Subject: Can we have a couple of lines from the report

so we'll know where he is?
Have heard it used a couple of times
Subject: Have heard it used a couple of times

Just another way to say serial cardiac enzymes, I believe
If he already gave you a couple, then it would be 'all other...' nm
Subject: If he already gave you a couple, then it would be 'all other...' nm

s
Thank You! That's it. He always swallows the first couple of letters when I need them the most.
Subject: Thank You! That's it. He always swallows the first couple of letters when I need them the most.


Depends on a couple of things
Subject: Depends on a couple of things

The first point would be the hospital's desires. They may or may not want abbreviations spelled out in a report. Also, usually if it's in a diagnosis somewhere, it almost always has to be spelled out, as most hospitals abide by the joint commission rule of no abbreviations. In a regular physical exam somewhere in the text of the report, most hospitals, clinics, etc., seem to want whatever abbreviations the doc may use, so in that case you would just leave it as it is (although this may differ in correspondence as some places prefer a more formal policy of no abbreviations in letters, so check account specifics).
couple of web sites in case you
Subject: couple of web sites in case you

can use them:

revolutionhealth.com/search
M.D. Anderson Cancer Institute, Houston

pathology.washington

bloodjournal.org
Thanks, she did it with a couple others, so that makes sense
Subject: Thanks, she did it with a couple others, so that makes sense


I can't understand this guy!!!
Subject: I can't understand this guy!!!

OBJECTIVE:  Exam today, anterior rhinoscopy:  The nasal turbinates are edematous.  Left TM is slightly dull, moderately dull, does not move well for Siegle otoscope.  Right TM is somewhat dull.  Nose shows mild edema.  _____ _____ decrease curves. 


 


s/l right crim??? I have noooo idea!


Someone please help me understand . . .
Subject: Someone please help me understand . . .

Will someone please help me understand why there are those who insist on posting sarcastic comments to those who ask questions?  If it is such a bother to them, why do they even visit the word help board?Obviously, their intention is to be rude to someone else . . . displaced anger maybe?  or perhaps they want to make themselves feel superior (self esteem problems)? 
I do not understand either
Subject: I do not understand either

I do not come onto this board much anymore because of those who always have to attack.

I came onto the word board last week and someone just had to post to correct my spelling. I did not feel that was necessary but these type of people just have that need to feel superior than others and they always have to be right.

I feel sorry for these people who feel the need to be rude and sarcastic. They must just be very unhappy people and get pleasure out of knocking others down.

This is my opinion and I am sure I will get that sarcastic, rude person making a comment about my opinion.

does anyone understand this?
Subject: does anyone understand this?

His mother says he is quite active and active in prone?
What I don't understand...
Subject: What I don't understand...

Is why these posts are being answered without the slightest possibility of a test...No thank you's, no help, and easily looked up and answered on one's own.
I still don't understand how
Subject: I still don't understand how

QA would know the doctor meant the trade name rather than the generic name, since they both sound exactly alike!! Whenever I hear that drug, I always type gentamicin, so I guess your QA person would bust me too. Unless the doctor specifically said it was the brand name, I don't know how she can knock you for using the generic!
cannot understand
Subject: cannot understand

While on DUR in IV no (unintelligible) is seen.  Patient is in for midepigastric pain. 
Don't understand that as the 70 would be
Subject: Don't understand that as the 70 would be

x
Don't understand why you think this is so
Subject: Don't understand why you think this is so

funny. Many diseases have their own smell/odor, diabetics have a distinctive breath odor if sugar is not controlled, gangrene has a distinct odor, etc.
I understand what you are saying.
Subject: I understand what you are saying.

There is no such medical phrase as the one you are hearing.  Therefore, it must be something else.  If you can't hear diabetes mellitus, or anything else, you must leave a blank. 


I would do it just as he said. Don't understand
Subject: I would do it just as he said. Don't understand

x
A couple questions relating to pancreas
Subject: A couple questions relating to pancreas

This is a patient with advanced pancreatic cancer.  Here's the part I'm having trouble with.  He was admitted to the hospital.  "The patient did undergo attempts at [s/l ESRT or "e ester tee"?].  However, the tumor was protruding through the duodenum [s/l ambule] and common bile duct cannot be cannulated.  He was determined to be unresectable and underwent a choledochojejunostomy, gastrojejunostomy, and enteroenterostomy for diversion."  Whew!  Any ideas?
Pulling my hair out - just a couple questions
Subject: Pulling my hair out - just a couple questions

This study is a right ilia-femoral ultrasound. 


 


Is it ilia-femoral or iliac-femoral, and what about the hyphen?


 


ALSO......


 


I cannot figure out what he is saying here:


 


PROCEDURE REPORT:  The abdominal aorta and right ilia-femoral (see above..) systems were S/L: insinated or instinated with a Doppler ultrasound transducer. 


 


Thanks for any help!!


A couple questions regarding Cardiology/Hematology
Subject: A couple questions regarding Cardiology/Hematology


He does have some mild jugular venous distention (JVD). He does have a slightly positive patojugular reflex.


He does have a grade 1-2/6 murmur load on the lower left sternal border and apex. The lungs: He continues to have a few fine basaloreals on the posterior lower lobe. The abdomen is somewhat softer today, it is rounded.


A couple of grammar rules are at play here
Subject: A couple of grammar rules are at play here

First of all, both got and gotten are correct forms of the verb get.  However, got is a past tense or past participle depending on whether or not the word "has" or "have" is used in front of it.  Gotten, however, is past participle and should be used with the word "has" or "have" in front of it.


It has gotten increasingly larger - okay.  It gotten increasingly larger - not okay.  It got increasingly larger - okay.  It has got increasingly larger - okay.


So if your doc says it anyway but "It gotten increasingly larger", he is correct.  It's simply a matter of preference.  Brits don't generally use the word "gotten", and therefore, a lot of people think it is not a legitimate word, but it is.


Need help with the MR angiogram in mesage, couple of questions and maybe more :) sm
Subject: Need help with the MR angiogram in mesage, couple of questions and maybe more :) sm

the MR angiogram of the posterior circulation intracranially showed a variant circulation with prominent bilateral “fetal” origin of the PCAs and distal basilar and "P1 segmental" hypoplastic were absent. 
A couple of questions regarding Cardiology/Hematology
Subject: A couple of questions regarding Cardiology/Hematology

Hi, sure hope this helps. I had that recently. It is he has a slight hepatojuglar reflux sometimes referred to as reflex but more correctly it is reflux. Also it is "He continues to have a few basilar rales in the posterior lobe."
Exactly, that is why I don't understand, QA does the same with H&H, they change it H and H. Nm
Subject: Exactly, that is why I don't understand, QA does the same with H&H, they change it H and H. Nm

x
I understand your frustration! sm
Subject: I understand your frustration! sm

I have posted on these boards several times, only asking questions, and have gotten some crazy, rude, ugly, nasty, idiotic, etc., responses.  When people respond and make you out to be an idiot, just because you asked a simple question, THEY are the ones who really look like the idiot!!  I see people criticize others for the least little thing, like in your instance.  They will post a response just to let someone know they misspelled a simple word, when it has nothing at all to do with the question or comment.  They must have a lot of time on their hands, is all I can say!!! 


BTW, I like to vent every once in a while, too!


I understand your frustration...sm
Subject: I understand your frustration...sm

I think we all have at least one doc that drives us up a wall with his dictation ways. I have a couple too, and it is very easy to overlook the *obvious*. Hope you got it worked out.

ks
To understand a Southerner...
Subject: To understand a Southerner...

You just have to overemphasize the vowels, and if all else fails, add a syllable or slacken your jaw and repeat the suspected phrase. You'll figure it out. LOL
I'm from Georgia. ;)
4+ to 5-/5 is the easiest to understand..nm..jmo
Subject: 4+ to 5-/5 is the easiest to understand..nm..jmo

nm
cannot understand word..sm
Subject: cannot understand word..sm

Patient with a knee injury.  Sounds like (This is a pristine type of injury.)  Any suggestions?


 


TIA


ok, I understand - sorry you got attacked..
Subject: ok, I understand - sorry you got attacked..

I get your point and some were rude - but I still think honey and sugar work a lot better than salt and vinegar. 


I totally understand sm
Subject: I totally understand sm

just added another doc to the office I work for. He often says per HPI above and it took me until just now what he meant. I know we I was typing a History & Physical but didn't know what the I was for. I feel really really dumb but at least now I know. LOL
he is spelling and I still can't understand him
Subject: he is spelling and I still can't understand him

6 year old with stomach pain, diarrhea he is awaiting the C-Dif results and prescribed what he spells as Anilia?  10 cc bid  


I can't find it  help 


Is doc hard to understand?
Subject: Is doc hard to understand?


Does he state 20 the first couple of days or does he give any time along with that? SM
Subject: Does he state 20 the first couple of days or does he give any time along with that? SM

If not, I would just type as dictated and maybe put quotations around it if you are certain of what he is saying.  HTH