Saw this guy at the clinic last Friday, who was having trouble with his asthma. Kind of a funny looking guy. He bucks the trend in prison by looking much younger than he actually is. I wanted to take a look at his meds and consider prescribing something in addition to an albuterol inhaler, which is all he had. He’d been using it multiple times a day, every day, and as my fellow PA students will all tell you, that’s inappropriate. It means his asthma is poorly controlled.
But in a twist on the Hippocratic Oath, the first rule of prison medicine is “Do No Thing.” Or, do as little as possible. Accordingly, one of the clinicians decided just to have him come back in a few days and see how he was doing.
He came back yesterday, lungs sounding like a squeaky gate hinge, and I decided to see him even though he wasn’t on the schedule. I got a good look at his medications. He had two inhalers. One he said was a short-acting rescue inhaler and the other was supposed to be a longer-acting medicine. He had been using them both several times a day. They were both plain old albuterol, and the “long-acting” one was expired since June of ’08. Damn. Now that’s expired.
Expired medicine in the garbage, he got two nebulizer treatments and a prescription for an inhaled steroid. I also checked him with a peak flow meter before, during and after treatments. He went from 190, to 285, to 320 mL/min. Not perfect, but improved. He also didn't do the test quite right, which is OK. I'm not sure where he’s normally at because even though he’s had asthma since he was a teen, he’d never done a peak flow check. Never? He’d also never had a nebulizer breathing treatment.
He walked out with open airways, breathing deeply and no longer sweating from the work of pushing air out and in.
Subscribe to:
Post Comments (Atom)
No comments:
Post a Comment