Not Heart Failure

I wasn’t giving in to the patient who wanted a prescription for Levaquin after the standard ZeePack didn’t cure his cough. He had a normal chest x-ray and labs the day before but was convinced that he had pneumonia. I tried explaining the difference between bacteria and viruses. I used the “RAID doesn’t work on dandelions” routine. He wasn’t convinced. “I NEED a stronger antibiotic to break this up. Levaquin has worked in the past.” “You know, I think I’m going to start you on some heart medications, instead. Some nitroglycerin and some Lasix for your heart failure.” “Whaaat? I don’t have heart problems. I had a normal stress test a few months ago. Why would you want to start me on heart medications?” “You have risk factors for heart problems and coughing is a sign of heart failure. I should probably start you on Digoxin, too. Ehhh … maybe not. That’s kind of strong medicine to start out with.” “This is ridiculous. My chest x-ray and blood tests were normal yesterday. I don’t have heart failure. I’m calling my doctor and I’m not taking any of those medications.” “Your chest x-ray was normal. That means you don’t have pneumonia, either. And bronchitis is a viral infection. Levaquin isn’t going to help your symptoms any more than the heart medications would. Do you see my point, now?” [long pause] “I’ll just call my doctor.” I can only imagine what conversation sounded like. ———————– This and al...
Source: WhiteCoat's Call Room - Category: Emergency Medicine Doctors Authors: Tags: Patient Encounters Source Type: blogs