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DocLightning
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The Case of the Blue Man

Sun Mar 12, 2017 8:27 am

A colleague called me into an exam room yesterday to give an opinion on a previously healthy 20yo gentleman with a history of sore throat and subjective fever since yesterday evening who woke up this morning and one side of his face was blue. It is painless. He's wondering if I can think of any sort of clotting disorder that might be triggered by viruses.

So as I'm on my way in, I'm pondering various coagulopathies (clotting disorders) and wondering why one half of his face would be affected. So there is this pleasant young man sitting in the room. No marks elsewhere on his body. Sure enough, the left half of his face is dark blue.

And that was when I noticed that the color seemed to spare his pores.

"I'm gonna try something stupid; just humor me for a second." And I grabbed an alcohol pad and the blue wiped right off his face.

There were two medical students in the room. Both of them looked at me as if I had just casually slapped the wall and wine started pouring out. So after everyone calmed down, I asked the patient if he had recently got new bed sheets. Yes, he had.

"So if I had to guess, you're a bit feverish, you sweated into your new pillow case, and the dye bled out all over that side of your face. There's a bathroom down the hall; go wash your face well, and when you get home, wash your sheets separately."

As I walked out of the room, I looked at my colleague and said: "Just so you know, I'm never letting you live this down."

And that, folks, was my act of badassery for the day.
-Doc Lightning-

"The sky calls to us. If we do not destroy ourselves, we will one day venture to the stars."
-Carl Sagan
 
TheF15Ace
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Re: The Case of the Blue Man

Sun Mar 12, 2017 8:35 am

DocLightning wrote:

And that, folks, was my act of badassery for the day.


Image

I assume the doc would be disappointed if one of us didn't post this :lol:
 
petertenthije
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Re: The Case of the Blue Man

Sun Mar 12, 2017 11:00 am

Image
Attamottamotta!
 
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Francoflier
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Re: The Case of the Blue Man

Sun Mar 12, 2017 12:44 pm

Image

It's like a very bad episode of House...
:biggrin:
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ltbewr
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Re: The Case of the Blue Man

Sun Mar 12, 2017 12:54 pm

The other doctors were going off into exotic reasons for the odd coloring and you just used common sense.
That is a good example of why you should always wash machine washable new clothing or cloth item (like bedding) before first use
 
bunumuring
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Re: The Case of the Blue Man

Sun Mar 12, 2017 1:02 pm

Love the recount!
Made me smile and laugh....
Well done, mate.
Cheers,
Bunumuring.
I just wanna live while I'm alive!
 
UltimoTiger777
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Re: The Case of the Blue Man

Sun Mar 12, 2017 3:46 pm

Saw the title and thought it was another of these poor unfortunates:

http://www.nydailynews.com/news/nationa ... -1.1466905
 
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DocLightning
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Re: The Case of the Blue Man

Sun Mar 12, 2017 4:05 pm

TheF15Ace wrote:
DocLightning wrote:

And that, folks, was my act of badassery for the day.


Image

I assume the doc would be disappointed if one of us didn't post this :lol:

Well done,

...asshole. ;)
-Doc Lightning-

"The sky calls to us. If we do not destroy ourselves, we will one day venture to the stars."
-Carl Sagan
 
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Tugger
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Re: The Case of the Blue Man

Sun Mar 12, 2017 5:00 pm

Image
.
Image

Tugg
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DarkSnowyNight
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Re: The Case of the Blue Man

Sun Mar 12, 2017 5:06 pm

ltbewr wrote:
The other doctors were going off into exotic reasons for the odd coloring and you just used common sense.


Yup. This is why most doctors will tell you if you hear hoofbeats, look for horses first, then zebras. ..
Be A Perfectionst, You're Nothing If You're Just Another; Something Material, This Isn't Personal...
 
TheF15Ace
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Re: The Case of the Blue Man

Sun Mar 12, 2017 6:53 pm

DocLightning wrote:
TheF15Ace wrote:
DocLightning wrote:

And that, folks, was my act of badassery for the day.


Image

I assume the doc would be disappointed if one of us didn't post this :lol:

Well done,

...asshole. ;)


When DocLightning calls you an asshole for using the cargo bay and you're like

Image
 
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WildcatYXU
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Re: The Case of the Blue Man

Sun Mar 12, 2017 10:12 pm

I wonder why would that person go to the doctor without thoroughly analyzing his situation first...
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Moose135
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Re: The Case of the Blue Man

Sun Mar 12, 2017 10:58 pm

You're quite the miracle worker, aren't you, Doc? :lol:
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DocLightning
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Re: The Case of the Blue Man

Mon Mar 13, 2017 2:28 pm

WildcatYXU wrote:
I wonder why would that person go to the doctor without thoroughly analyzing his situation first...


I did kind of want to ask how he got all the way to 11:45 in the morning without having washed his face.
-Doc Lightning-

"The sky calls to us. If we do not destroy ourselves, we will one day venture to the stars."
-Carl Sagan
 
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casinterest
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Re: The Case of the Blue Man

Mon Mar 13, 2017 2:33 pm

DocLightning wrote:
WildcatYXU wrote:
I wonder why would that person go to the doctor without thoroughly analyzing his situation first...


I did kind of want to ask how he got all the way to 11:45 in the morning without having washed his face.


So what was the bill for diagnosing bleeding bed sheets?
Older than I just was ,and younger than I will soo be.
 
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DocLightning
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Re: The Case of the Blue Man

Mon Mar 13, 2017 2:37 pm

casinterest wrote:
DocLightning wrote:
WildcatYXU wrote:
I wonder why would that person go to the doctor without thoroughly analyzing his situation first...


I did kind of want to ask how he got all the way to 11:45 in the morning without having washed his face.


So what was the bill for diagnosing bleeding bed sheets?


Dunno. I would have coded it as a 99214, though.
*Acute Upper Respiratory Infection
*Acute pharyngitis
*Disorders of skin pigmentation
-Doc Lightning-

"The sky calls to us. If we do not destroy ourselves, we will one day venture to the stars."
-Carl Sagan
 
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WingsFan
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Re: The Case of the Blue Man

Mon Mar 13, 2017 2:42 pm

DocLightning wrote:
A colleague called me into an exam room yesterday to give an opinion on a previously healthy 20yo gentleman with a history of sore throat and subjective fever since yesterday evening who woke up this morning and one side of his face was blue. It is painless. He's wondering if I can think of any sort of clotting disorder that might be triggered by viruses.

So as I'm on my way in, I'm pondering various coagulopathies (clotting disorders) and wondering why one half of his face would be affected. So there is this pleasant young man sitting in the room. No marks elsewhere on his body. Sure enough, the left half of his face is dark blue.

And that was when I noticed that the color seemed to spare his pores.

"I'm gonna try something stupid; just humor me for a second." And I grabbed an alcohol pad and the blue wiped right off his face.

There were two medical students in the room. Both of them looked at me as if I had just casually slapped the wall and wine started pouring out. So after everyone calmed down, I asked the patient if he had recently got new bed sheets. Yes, he had.

"So if I had to guess, you're a bit feverish, you sweated into your new pillow case, and the dye bled out all over that side of your face. There's a bathroom down the hall; go wash your face well, and when you get home, wash your sheets separately."

As I walked out of the room, I looked at my colleague and said: "Just so you know, I'm never letting you live this down."

And that, folks, was my act of badassery for the day.



Wouldn't a normal person thoroughly wash his face, comb his hair, put a clean set of clothes before stepping out of house, even when you are going to a hospital?
A nice clean face wash would have saved us all from ever encountering this thread.
 
sccutler
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Re: The Case of the Blue Man

Mon Mar 13, 2017 7:09 pm

Doc, your awesomeness continues, unabated.
...three miles from BRONS, clear for the ILS one five approach...
 
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WildcatYXU
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Re: The Case of the Blue Man

Mon Mar 13, 2017 10:14 pm

WingsFan wrote:
Wouldn't a normal person thoroughly wash his face, comb his hair, put a clean set of clothes before stepping out of house, even when you are going to a hospital?
A nice clean face wash would have saved us all from ever encountering this thread.



To be entirely honest, when I went to the hospital few weeks ago, I didn't really care about grooming. I could have washed my face - but I don't really remember...
310, 319, 320, 321, 333, 343, 345, 346, 732, 735, 73G, 738, 744, 752, 762, 763, 77L, 77W, 788, AT4, AT7, BEH, CR2, CRA, CR9, DH1, DH3, DH4, E45, E75, E90, E95, F28, F50, F100, MD82, Saab 340, YAK40
 
DLFREEBIRD
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Re: The Case of the Blue Man

Wed Mar 15, 2017 6:06 am

i was expecting you to say that you found out he somehow got a hold of amiodarone. not that he didn't wash his sheets.
i hope the young man wasn't too embarrassed. While he probably doesn't think this is funny, it sounds so typical of something someone would do at that age. Heck, i just got all over my grown boss for not washing his new sheets, thank goodness they were white.
 
tommy1808
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Re: The Case of the Blue Man

Wed Mar 15, 2017 6:38 am

WildcatYXU wrote:
To be entirely honest, when I went to the hospital few weeks ago, I didn't really care about grooming. I could have washed my face - but I don't really remember...


I am correct to assume it wasn´t a "Oh, half my face is blue.. this is strange" kind of hospital visit, but rather more urgent? I would think usually people shower and put on clean underware before seeing a doctor.... ?

DLFREEBIRD wrote:
it sounds so typical of something someone would do at that age. Heck, i just got all over my grown boss for not washing his new sheets, thank goodness they were white.


Get him some of these:
Image

best regards
Thomas
Crooked Donald Trump an his team are extremely careless in their handling of very sensitive, highly classified information. Not fit! #muchworsethanclinton
 
Airstud
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Re: The Case of the Blue Man

Thu Mar 16, 2017 4:18 am

DocLightning wrote:

Dunno. I would have coded it as a 99214, though.
*Acute Upper Respiratory Infection
*Acute pharyngitis
*Disorders of skin pigmentation



99214 looks more to me like a CPT code than an ICD-9 or ICD-10 code :boggled:


'Luckily" for me I got skin irritation when I was 15 that wasn't diagnosed conclusively but suspected to have been caused by wearing brand-new clothes without washing them first. So now of course I never wear unwashed new..... zzzzz (cargo bay goes here).

But, I disapprove of non-white bed linens. The best part of having to say goodbye to the weekend is the scent of freshly bleached sheets!!
Pancakes are delicious.
 
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DocLightning
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Re: The Case of the Blue Man

Thu Mar 16, 2017 4:28 am

Airstud wrote:
99214 looks more to me like a CPT code than an ICD-9 or ICD-10 code :boggled:


That's because it is. :D I can't be bothered to look up the ICD-10 codes now.

Airstud wrote:
But, I disapprove of non-white bed linens. The best part of having to say goodbye to the weekend is the scent of freshly bleached sheets!!


Where's that damned carg...

Wait, you bleach your sheets EVERY WEEK? :boggled:

Oh, I asked the NP who first saw him. I guess he was feeling pretty sick and woke up just before the appointment, so he hadn't showered or even tried to wash his face and had been kind of stuck in bed for a couple of days.
-Doc Lightning-

"The sky calls to us. If we do not destroy ourselves, we will one day venture to the stars."
-Carl Sagan
 
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VapourTrails
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Re: The Case of the Blue Man

Thu Mar 16, 2017 5:06 am

DocLightning wrote:
So as I'm on my way in, I'm pondering various coagulopathies (clotting disorders) and wondering why one half of his face would be affected. So there is this pleasant young man sitting in the room. No marks elsewhere on his body. Sure enough, the left half of his face is dark blue.

And that was when I noticed that the color seemed to spare his pores.

"I'm gonna try something stupid; just humor me for a second." And I grabbed an alcohol pad and the blue wiped right off his face.

There were two medical students in the room. Both of them looked at me as if I had just casually slapped the wall and wine started pouring out. So after everyone calmed down, I asked the patient if he had recently got new bed sheets. Yes, he had.


:biggrin: Got half way through reading and realised how the rest of it was going to read! Thanks for sharing. Sometimes the answer is just a really basic one eh. Happy ending here, maybe he should have just looked around at his environment before involving medicos! :thumbsup: He won't be making that mistake again or hopefully any similar ones!

I remember a story about someone eating too much beetroot and (no, it was NOT me!) having a panic, before realising the cause!
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Ken777
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Re: The Case of the Blue Man

Thu Mar 16, 2017 6:34 am

DocLightning wrote:


Wait, you bleach your sheets EVERY WEEK? :boggled:


Like the Blue Face you first need to figure out who he was in bed with on the weekend. :drunk:

I use the Old Man Washing Rule - every week all whites go into the washing machine with hot water and with bleach, soap, softer and OxyClean. That gives me the courage to wear them again. Normally everything is wearable except for the U-shorts that had a leak while I was taking UriBel
 
Airstud
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Re: The Case of the Blue Man

Thu Mar 16, 2017 10:15 am

DocLightning wrote:
Airstud wrote:
But, I disapprove of non-white bed linens. The best part of having to say goodbye to the weekend is the scent of freshly bleached sheets!!


Where's that damned carg...

Wait, you bleach your sheets EVERY WEEK? :boggled:



Er... should I not do that? I have been taught that bleach kills germs.

I am terrified of germs.

#bringbacktriclosan #vivabenzalkoniumchloride #cloroxopolis
Pancakes are delicious.
 
Airstud
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Re: The Case of the Blue Man

Sat Apr 01, 2017 9:35 am

*grabs hold of Doc's neck and shakes him*

SHOULD I BE BLEACHING MY SHEETS EVERY WEEK OR NOT, DOC?!?!?!?

#panic
Pancakes are delicious.
 
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DocLightning
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Re: The Case of the Blue Man

Sat Apr 01, 2017 3:39 pm

Airstud wrote:
*grabs hold of Doc's neck and shakes him*

SHOULD I BE BLEACHING MY SHEETS EVERY WEEK OR NOT, DOC?!?!?!?

#panic


I dunno. Ask me a medical question. *snakes out of Airstud's grip*
-Doc Lightning-

"The sky calls to us. If we do not destroy ourselves, we will one day venture to the stars."
-Carl Sagan
 
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WildcatYXU
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Re: The Case of the Blue Man

Sat Apr 01, 2017 3:59 pm

tommy1808 wrote:
WildcatYXU wrote:
To be entirely honest, when I went to the hospital few weeks ago, I didn't really care about grooming. I could have washed my face - but I don't really remember...


I am correct to assume it wasn´t a "Oh, half my face is blue.. this is strange" kind of hospital visit, but rather more urgent? I would think usually people shower and put on clean underware before seeing a doctor.... ?

best regards
Thomas


You'd be correct, Tommy. I didn't really feel good that day. Headache, cramps, diarrhea, fever, tachycardia, really bad tremor. I was shaking so violently that my muscles ached several days after. Since it was only 2 days after we returned from POP, I was afraid I caught some bug down there and it may hit my heart again.
I was so weak that I didn't take a shower. But I did put on fresh underwear.
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BobPatterson
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Re: The Case of the Blue Man

Sun Apr 02, 2017 1:43 pm

Airstud wrote:
Er... should I not do that? I have been taught that bleach kills germs.
I am terrified of germs.


I'm more terrified of bleach odor getting anywhere near my nose. It takes 2-3 re-washings to get rid of it. Fabric softener, too. Some detergents, also.

All of those things can set off my sinuses, and it can be really debilitating.
Facts are fragile things. Treat them with care. Sources are important. Alternative facts do not exist.
 
bgm
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Re: The Case of the Blue Man

Sun Apr 02, 2017 4:12 pm

Funny story, Doc! Sometimes the answers are the most simple ones.

Can we now deduce that Trump sleeps on cheap orange sheets? :D
"When you're born you get a ticket to the freak show. When you're born in America, you get a front row seat." -George Carlin
 
bgm
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Re: The Case of the Blue Man

Sun Apr 02, 2017 4:13 pm

BobPatterson wrote:
Airstud wrote:
Er... should I not do that? I have been taught that bleach kills germs.
I am terrified of germs.


I'm more terrified of bleach odor getting anywhere near my nose. It takes 2-3 re-washings to get rid of it. Fabric softener, too. Some detergents, also.

All of those things can set off my sinuses, and it can be really debilitating.


I agree. I can't imagine that sleeping in a sea of bleach is very good for your skin or respiratory system...
"When you're born you get a ticket to the freak show. When you're born in America, you get a front row seat." -George Carlin
 
tommy1808
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Re: The Case of the Blue Man

Mon Apr 03, 2017 5:33 am

BobPatterson wrote:
I'm more terrified of bleach odor getting anywhere near my nose. It takes 2-3 re-washings to get rid of it. Fabric softener, too. Some detergents, also.

All of those things can set off my sinuses, and it can be really debilitating.


Just make your own, without all the stuff that you may react to. You´ll find lots of recipe´s for hypo-allergic homemade detergent and softener via google.

Takes very little time to mix and is usually quite a bit cheaper than buying.

Airstud wrote:
Er... should I not do that? I have been taught that bleach kills germs.

I am terrified of germs.


so does soap. Bleach is good to keep things white (well, yellowish white) and to kill germs more reliable in fabric that can only be washed rather cold, but 60°C washing and regular soap kills everything living in your sheets.

best regards
Thomas
Crooked Donald Trump an his team are extremely careless in their handling of very sensitive, highly classified information. Not fit! #muchworsethanclinton

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