I really don't understand people. The older that I get, the less I understand people.
Take Mr A. He is a 57 year old male who came into hospital a week ago after experiencing numbness down his right side whilst working in the garden. I first saw him two days after his admission on the ward round. His numbness had subsided but not completely gone away and so he was advised that he had suffered a stroke (If his symptoms had completely gone away within 24 hours it would have been a TIA)
The consultant sat down with him and went through his risk factors for stroke. He had smoked 20-30 a day since the age of 20. His cholesterol was reasonable at 5.4 mmols / l and his blood pressure a little raised at 140/92. His father had died from an MI aged 62.
The consultant explained to him that he had had a mild stroke and was at quite high risk of having another one in the next month. He told him that now was a good time to give up smoking and explained how this mild stroke was a warning sign which needed to be heeded. The consultant also said that he was worried that Mr A might have furred up carotid arteries and arranged for a scan to assess the level of furring.
Mr A was clearly terrified and I really felt for him. I visited him after the consultant had left and we chatted about what had been spoken about. His main fear was about his neck arteries being clogged up because he was scared of the treatment that might be needed. We agreed that it was good that this stroke was a mild one, because he was not going to be left with any impairment and so it could be taken as a warning sign.
Next day and Mr A went off for his scan. It was good news.....his carotid arteries were not furred up and so no treatment was needed. Mr A was a happy bunny. So happy, in fact that he took himself straight off to the car park and.....yes, you guessed it, got his fag packet out and started to smoke.
My colleagues and I sat in the canteen and watched him smoking. We were pretty dumbstruck to be honest. When does the penny drop? When do you throw your arms in the air and say "You know what, I have smoked for 37 years and I have just had a stroke that I have completely recovered from. I am a lucky bastard because I have had a warning sign that things need to change"
Instead Mr A's arm in the air moment was "I am a lucky bastard. I have smoked for 37 years and don't have any furred up arteries. I haven't done myself any damage......bring on the fags"
People are funny buggers.
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4 comments:
Hey, this patient seems to be in every hospital I have ever been to :-)
My dad had a stroke last year. He'd stopped smoking some years before but had high cholesterol and had been under extreme stress before it happened. He's recovered well and is making every effort to lower his cholesterol and be a bit more healthy.
My 43 year old brother has just been diagnosed with hypertension and is on betablockers. He's morbidly obese. Is he losing weight? No. Making lifestyle changes? No. Taking his dog for a walk every day? No. He's just going to take the tablets and do bugger all else. I don't understand how he can think that he's not a CVA or an MI waiting to happen but it seems he does. Seems he has a short memory.....
Dear Anna,
I would like to speak with you about adapting one of your posts for an anthology. If you would like to discuss further, please email me at nursesdoctors at gmail.com.
Many thanks!
I see the same every day - we had a patient only yesterday who had part of his lungs removed due to smoking related lung cancer.
He came around from his anaesthetic and IMMEDIATELY started ringing his bell for a nurse to take him outside for a smoke.
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