Fargo, ND - Bertha Jensen was hospitalized two weeks ago for chest pain rule out, but a new complaint every day has prevented doctors from sending her home during the cold winter months. That is, until a breakthrough in discharge planning was discovered by her current Hospitalist.
"When I was a resident in Minneapolis, I took care of at least a dozen cases of Broken Furnace Syndrome every winter," said Hospitalist Dr. David Penter, who is known for his uncanny ability to spot patients with ulterior motives from a mile away.
Broken Furnace Syndrome is any 12/10 symptom that presents during a patient-doctor encounter on the day of planned discharge from the hospital, followed by a completely unrelated symptom after the physician minimizes the first complaint. For example, having a 12/10 headache that is then followed with a complaint of diarrhea after the physician minimizes the headache complaint is pathognomonic for Broken Furnace Syndrome.
Broken Furnace Syndrome occurs in the cold winter months when patients refuse to go home because of problems with their utilities or other social dynamics that have nothing to do with their hospital stay. While often the result of a broken furnace, physicians should also consider variations of the disease in their differential diagnosis, including I Didn't Pay My Gas Bill, My Pipes Froze and I Don't Have Water and even My Mother-In-Law Is in Town and She Thinks She's Going to Stay With Me as the reasons for avoiding discharge.
Every time Bertha's doctor told her she was stable for discharge, a new complaint was suddenly described. "We ruled her out for MI in less than 12 hours and 12 days later she's still laughing it up with the nurses, except for the three minutes the doctors are in the room, then she's complaining of 12/10 nausea," said Dr Penter.
A normal litany of complaints for an 88-year old has kept Bertha hospitalized for nearly two weeks, including headaches, nausea, chest pain, blurry vision, sore throat and restless legs. On day seven of her observation stay, she even complained of diarrhea and constipation in the same night.
On day four of the observation stay, one hospitalist tried to put an end to the madness by spending four hours - on a Saturday - coordinating a stat laprobroncathoscopy between the surgeon, pulmonologist, cardiologist, gastroenterologist, anesthesiologist and pathologist, in anticipation of a Sunday discharge. Despite everything coming back normal, her Sunday discharge was aborted after she complained of not having a ride home.
Dr. Penter confirmed the diagnosis by having his medical student stand outside Bertha's room all day listening to her phone conversations for clues. This allowed Dr. Penter to get his work done while making the medical student feel important.
"We caught her taking to Dan the Furnace Man at around 3 p.m. yesterday. When I presented my findings to her, she complained of 12/10 restless arms, followed by a lump in her throat that she wanted thoroughly checked out."
Tweet
"When I was a resident in Minneapolis, I took care of at least a dozen cases of Broken Furnace Syndrome every winter," said Hospitalist Dr. David Penter, who is known for his uncanny ability to spot patients with ulterior motives from a mile away.
Broken Furnace Syndrome is any 12/10 symptom that presents during a patient-doctor encounter on the day of planned discharge from the hospital, followed by a completely unrelated symptom after the physician minimizes the first complaint. For example, having a 12/10 headache that is then followed with a complaint of diarrhea after the physician minimizes the headache complaint is pathognomonic for Broken Furnace Syndrome.
Broken Furnace Syndrome occurs in the cold winter months when patients refuse to go home because of problems with their utilities or other social dynamics that have nothing to do with their hospital stay. While often the result of a broken furnace, physicians should also consider variations of the disease in their differential diagnosis, including I Didn't Pay My Gas Bill, My Pipes Froze and I Don't Have Water and even My Mother-In-Law Is in Town and She Thinks She's Going to Stay With Me as the reasons for avoiding discharge.
Every time Bertha's doctor told her she was stable for discharge, a new complaint was suddenly described. "We ruled her out for MI in less than 12 hours and 12 days later she's still laughing it up with the nurses, except for the three minutes the doctors are in the room, then she's complaining of 12/10 nausea," said Dr Penter.
A normal litany of complaints for an 88-year old has kept Bertha hospitalized for nearly two weeks, including headaches, nausea, chest pain, blurry vision, sore throat and restless legs. On day seven of her observation stay, she even complained of diarrhea and constipation in the same night.
 |
| Consider Broken Furnace Syndrome for difficult winter discharges. |
Dr. Penter confirmed the diagnosis by having his medical student stand outside Bertha's room all day listening to her phone conversations for clues. This allowed Dr. Penter to get his work done while making the medical student feel important.
"We caught her taking to Dan the Furnace Man at around 3 p.m. yesterday. When I presented my findings to her, she complained of 12/10 restless arms, followed by a lump in her throat that she wanted thoroughly checked out."
Tweet
Tidak ada komentar:
Posting Komentar