Pulling my hair out - just a couple questions
Posted By: WImom on 2007-06-05
In Reply to:
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!!
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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.
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.
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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?
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.
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."
Kwell...LINDANE (Kwell®, Scabene®) is a treatment for lice infestation of hair, including hair in th
Subject: Kwell...LINDANE (Kwell®, Scabene®) is a treatment for lice infestation of hair, including hair in the pubic area (crabs).
.
Okay, now you are just pulling my leg!
Subject: Okay, now you are just pulling my leg!
pulling on his ears
Subject: pulling on his ears
nm
s/l nasal pulling
Subject: s/l nasal pulling
On exam he has slight minimal retractions, no nasal s/l pulling or pooling.
No pain upon pulling the tragus or **ulna** of either ear.
Subject: No pain upon pulling the tragus or **ulna** of either ear.
nm
yes I know I'm just pulling at straws second guessing myself with the subtalar. THanks.
Subject: yes I know I'm just pulling at straws second guessing myself with the subtalar. THanks.
Pulling tension and varus stressing?
Subject: Pulling tension and varus stressing?
Anyone familiar with this?
The C-arm was brought in and an attempt of a closed reduction was performed <s/l pulling> tension on the arm as well as <s/l varus> stressing and then digital pressure.
TIA!
Haven't heard it, but would guess they're pulling in the middle, giving
Subject: Haven't heard it, but would guess they're pulling in the middle, giving
s
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!
...hair! nm
Subject: ...hair! nm
s
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
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.
nose hair
Subject: nose hair
Looking for the word that means nose hair - s/l brisseye or bruceyeye
Thank you very much
S/l hair-cytism (sm)
Subject: S/l hair-cytism (sm)
Doctor says no complaints of s/l hair cytism or acne.
I'm about to pull my hair out!
Subject: I'm about to pull my hair out!
Infectious disease doctor (foreign) patient has a febrile illness, elevation of protein in spinal fluid. Differential diagnoses include leptospirosis, then what sounds something like "trepadoma paladin", I"m clueless! 
sometimes I want to tear my hair out
Subject: sometimes I want to tear my hair out
but tumescing makes a crazy kind of sense when you look at the definition (at least I think so)!
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?
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!
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.
.
Can't understand a couple of words
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!
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
Have had this same ESL all and ready to pull my hair out!!!
Subject: Have had this same ESL all and ready to pull my hair out!!!
start IV fluids with D5 one-half at (s/l 8) cc per hour - or it could be 18 or 80, but I really think it is 8. Does that sound right? 
S/L HAIR-STEE-TISM
Subject: S/L HAIR-STEE-TISM
THIS UNDER THE HEADING OF SKIN:
SHE DOES HAVE SKIN TAGS AND SIGNIFICANT HAIR-STEE-TISM ABOUT THE CHEST AND ABDOMEN.
I take Biotin for my nails and hair.
Subject: I take Biotin for my nails and hair.
It is a B vitamin.
trichophagia (chewing of hair)
Subject: trichophagia (chewing of hair)
some pregnant women have vitamin deficiencies and they chew their hair(:
could "normal hair" be oropharynx sm
Subject: could "normal hair" be oropharynx sm
WAG but (n)ORmoPHARyx something?
hair plug test?
Subject: hair plug test?
Hair plug test does not reveal any signs of alopecia.
This is said under PE. Assessment is hair thinning.
Dx is hair loss, possible s/l tulogenifludium.
Subject: Dx is hair loss, possible s/l tulogenifludium.
he's probably saying no hair tourniquet in GU exam
Subject: he's probably saying no hair tourniquet in GU exam
It is pretty bad. When my little baby was only a couple of months old, I took off his tiny sock and, to my horror, a piece of hair was wrapped so tight around his teeny little toe that it had swollen and turned purple-red. I so almost panicked. I painstakingly removed it, which was no easy task, and vowed to be ever so more careful that it never happened again...
So how does a hair tourniquet get started?
Subject: So how does a hair tourniquet get started?
You can kind of see how a hair would be so fine, and babies have that sweet baby plumpness so that it would be hard to see the hair until the baby had redness and irritation, but does the hair just sort of get worked into the area from a sock or something that was in the dryer and had a hair already on it? Who knew there were so many things to worry about??
hair splitting corrections
Subject: hair splitting corrections
The registered trademark is spelled ENDO CATCH, but depending on how QA and the AAMT attacks you it could be right or wrong. What's right today is wrong tomorrow and changed back the next day.
It's become petty. If you can spell it, and someone can read it aloud from what you transcribed why isn't that good enough?
PFFTT! We are transcribing doctors who say stupid things like "satting," and "Coumadinized," which aren't even real words and they accept that!
I'm already miffed thinking of how stupid QA and the AAMT are and I have not even finished "coffeeing!" LOL.
S/L ?hercertism? with the regrowth of her hair
Subject: S/L ?hercertism? with the regrowth of her hair
NM
Help! Ready to pull my hair out!!
Subject: Help! Ready to pull my hair out!!
Horrible sound quality, I now have 5 blanks in this report. Need help with this anesthesiology consultation on pending shoulder surgery.
There is no tenderness along the right or left brachial plexus, the ________ groove or supraclavicular region. There is no tenderness along the right or left anterior or medial _________ muscles. The patient's upper extremity shows the _________ muscle mass appears symmetrical.
I'm sorry, the sound is so bad I don't even know what these words sound like. It doesn't help that the dictator has marbles in his mouth!! I just don't have a clue!!
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