I arrived at work to meet the usual morning morning ambush. Some of the prison heavy hitters had their typical medical problems and ER visits over the weekend...seizures, chest pain, pseudoseizures...I have been trying to get the epileptic lady under control since Christmas, and I thought we were finally making head way. Apparently not quite yet. The lady with chest pain is a total wolf-crier with the potential to have a heart attack. She does have heart disease and a stent, but each biweekly episode of chest pain yields an ER diagnosis of "non cardiac chest pain" and a script for benzos (which we don't have in prison anyway).My most interesting patient today was a young woman in her 30s with a history of congestive heart failure. She also told me she had 3 strokes during the same hospital stay "due to stress," which sounded ridiculous. However, she actually did have some past medical records which confirmed her hospitalization for strokes and CHF. Unfortunately, no cause was ever identified for her heart failure at the age of 32, but I suspect many years of meth use might have been at play. She's the only patient I've encountered who underwent a heart biopsy as part of her work up. It's not every day you get a heart biopsy! Gives a whole new meaning to "Take Another Little Piece of My Heart, now baby...." She seemed to be doing pretty well clinically with some minor shortness of breath with exertion. Hopefully her echocardiogram will get approved so we check on the status of her big heart.
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