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doctor-reacts-to-two-and-a-half-men-medical-scenes

Doctor Reacts To Two And A Half Men Medical Scenes

I've watched a lot of different TV shows and reacted to the medical scenes and Charlie Sheen has had his fair share of Health controversies let's check out Two and a Half Men PE sweetheart I have to go I have a patient no you just stay off your feet remember you're very very pregnant yeah I love you too I know I know we're going to have a baby I always find it weird when doctors take personal calls if my phone's ringing and I really need to answer it I'll step outside of the room cuz it just feels like it's disrespectful to the patient it might not be but I just feel like it is so I don't know so Mr Harper you want a vasectomy yes you do that right of course we do in the exam room next door it is an outpatient procedure meaning that you usually don't have to stay overnight unless there's some sort of complication in fact there's two ways of doing a vasectomy there's a traditional vasectomy where you go in they do the incision they locate the vast Defence which is the canal that allows the sperm to pass through they cut it and then they usually cauterize both ends so that it doesn't reattach although that does happen sometimes in the no scalpel approach they just make a little hole where the skin is stretchy stretch out the skin gather the vast Defence cut it right there seal it right there and then put it back in where you don't have to put sutures in I just have a couple of pre- snip questions shoot which by the way you'll still do Post snip if that was one of your questions well good of course if I've done my job right you'll be shooting blanks yeah not right away in fact it's recommended post surgery to get a sperm count and analyze your semen just to make sure that there's no residual sperm still present in fact one of the leading reasons why vasectomies fail is that people have sex too soon after the procedure where you could still have some residual sperm that can last like up to 25 ejaculations all right let's have a look we don't position patients legs into the foot rests we ask them to put their feet in the foot rests because when you do it that way it comes off as aggressive okay all done that was quick you got a little mirror so I can check out the back not that little come on honey those are fighting words breathe with me breathe with me why is he wearing gloves outside of the room we don't do that you take off the gloves if you go outside the room and I'm pretty sure the gloves should be sterile those are not sterile okay let's start snipping Naomi could you get that for me hello where is the sterile gloves where is the chloro prep where is the cleansing of the region anyway as I was oh God what's the matter my chest are you okay I don't know chest pain in his age group with shortness of breath as he's experiencing it is a 911 call let's have a look see huh the Rhythm on the EKG is absolute poo poo that's not real he would be dead according to your test you just had an acute attack of indigestion I don't know what tests would confirm that you can rule out that he had a cardiac issue but you can't confirm that it was indigestion the good news is that you are a perfectly healthy 50-year-old man you can't say that just because you ran a few tests to rule out an MI I'm only 40 tell that to your Li oh all handles not so easy when I'm paying attention is it not so hard either oh my head oh that's a head injury hitting the back of the head presents a lot of issues especially when it comes to balance part of the brain that's responsible for balance sits right there in the back and your visual cortex is back there as well ah you're going to be fine we're just got to stop the bleeding I'm bleeding ah the scalp does bleed a lot so that's not necessarily an extreme reason to panic more so if you're having neurologic signs difficulty being able to see weakness of the face slurring of speech unable to move your tongue appropriately weird Sensations in the arms or legs in those situations you want to move and be as still as possible and allow EMTs to come and transport you to the hospital safely on a backboard with a sepine collar I mean his fall wasn't too hard but the fact that he's bleeding definitely warrants an ER visit at the very least for Staples and we use Staples on the scalp it sounds terrible but it's not that bad we need to see a doctor I just fill this out and have a seat no no no no you don't understand he hit his head he's bleeding did he lose Consciousness no I got a little wooing though a lot of people when they see the sight of blood they faint maybe it's like a protective mechanism follow my finger he's going to be fine whoa that is not how we do a neurologic exam we don't say follow my finger eye muscles intact good there's other cranial nerves to check goes all the way up to 12 okay you're going to feel a little sting nobody said I had to get a shot it's just to numb your skin so you won't feel the stitches what are you going to give me not feel a shot sometimes we could use a cold numbing spray if you feel cold in an area that overwhelms the sensory nerves whereby you might not feel as much pain when we do do the injection of the Lighty cane or whatever numbing agent we choose to use go ahead doc ow ow ow hey hey go easy on the cam no you're squishing my hand there's also a good way to do it where off of a single injection you can keep going amongst that spot so that you only feel one poke even though you're doing across a wider area and I've kind of perfected that technique to make it less painful to do sutures skin biopsies shave biopsies punch biopsies all these things once you per perfect analgesia it goes a long way especially with pediatric patients how many stitches am I going to get oh I don't know three or four that's all Scott prisman got nine when his sister hit him with the ET of sketch I'm surprised they're doing sutures not uh Staples help us out here dck okay I'll go five but one's purely decorative the staple doesn't work like a traditional paper staple where like it hits against the skull it more so grabs the skin and kind of folds in and holds it together even the way we remove it is basically a tool that grabs the staple underneath and then another part that bends it and when it bends it it actually pulls it out out of the skin gently coming down ooh ladder injuries represent a whole segment of holiday issues we got to create a safer ladder like a ladder that has an auto safety in it or something I surprised a fall from that height only created a neck and hand injury no hip no leg no rib seems sus I I have abrasions contusions a severely sprained neck two fractured fingers a severely sprained neck wouldn't necess necessarily require a c collar like that oh sneezing when you have a broken rib is the worst thing on the planet or low back pain actually I've had that happen to me oh Charlie what am I witnessing do I look okay sciatica what happened I pulled my back Alan you're a chiropractor do something okay let's see what we've got here uh is is this tender a little uh on a scale of 1 to 10 I don't know three looks like he's uh palpating the thoracic spine the lower thoracic spine getting to the lumbars maybe in the paraspinals the muscles that surround the spine okay I'm better no you're not now stop moving really I'm fine don't 10 10 that's a 10 one of the tests that we do in a situation to diagnose sciatica is called a straight leg raise and we see by stretching and aggravating the sciatic nerve if that reproduces symptoms come on let's get you back on the bed so I can give you an adjustment no no no no new plan I need someone who can give me drugs and actually for sciatica a lot of the things we do have pretty low evidence levels but we have to do something so very commonly we give overly counter medications like aetam metaphen which is Tylenol or non-steroidal anti-inflammatories a or Advil ibuprofen sometimes we give prescription ones like meloxicam other times we give muscle relaxers sometimes if there's very serious nerve pain we can give steroids which I try to avoid in many conditions physical therapy is my main stay of treatment because that allows the nerve to calm down help secure the back you can do Mobility you could do strengthening and then work your way up to stretching and then we always have obviously as a last resort spinal surgery but I'm very much not a fan of getting there unless absolutely absolutely absolutely necessary and the symptoms are that bad I could help you Charlie I've already isolated the source of your discomfort all that's left would be to realign your vertebrae through a gentle series of manipulations and stretches thereby alleviating your pain how does he know that it's due to a vertebral misalignment that theory uh doesn't really hold up it's been largely disproven actually in many of the instances that's why like when people say your back pain is terrible because of your posture it's like is it because of your posture or is your back pain bad therefore you develop bad posture did the pain start in your lower back best I can tell it's a spasm between L4 and L5 that's not where he was palpating earlier okay I see here your last visit was four years ago a mild hernia brought about by okay I think I'm seeing a pattern here you know what's interesting uh as a side effect for I don't remember if it was Viagra or Calis but it could actually cause very severe lumbar pain as a side effect because if you increase circulation vasil dilation to some of the specific veins of the back it could actually create very severe back pain and it's a known side effect I wonder if that was the ca especially given the fact we knew the history that would be my next question if this was my patient so what's the course of treatment here the pill a shot maybe one of those epidurals we'll see first I'm going to get your blood pressure and take some X-rays I don't like when we jump to x-rays for a nonbony issue like it's very clear that this wasn't a a bony problem given the fact that he was laying down there was no trauma he clearly pulled his back muscle or has some sort of muscular or connective tissue problem so if that's the case let's treat it conservatively let's give him some time and see if it improves jumping to an x-ray is largely getting information that's not going to help definitely create potential harms and that the trade-offs just usually aren't worth it no fractures no dislocations it's like just a simple muscle spazzle why would there be a fracture I don't understand he's a healthy young adult why why fracture okay I'm going to give you a shot which should ease the pain and also allow your muscles to relax what kind of shot is this is this a toor dool injection have you had demol before hold on isn't Demerol an opioid yeah demol is a narcotic why in the world is she hitting him with a narcotic this is clearly at Peak opioid crisis days we would never do this now could you please wait outside I need to give your brother a hernie exam just to make sure he hasn't re-enjoy the area a hernia exam turn your head and cough do you know why we do that because when you cough you bear down we can actually feel the hernia or the abdominal contents poke through the hernia if there was a hernia why the head turned because we don't want people coughing on us on the office they did CPR let's judge them click here to check that out and as always stay happy and healthy [Music]

Dr.

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