Monday, October 10, 2011

Folie à deux

Folie à deux, "a madness shared by two"... not exactly a classic case, but remarkable nontheless...

Working triage today, a patient walks in requesting a medication refill... normally this involves review of a patient's medical record, but given he is a new patient, it would involve patient subjective history, a pharmacy med list, or prior medical records.

A list of common question/answers ensue; with one commonality... see if you can spot it;

"what medication" - not sure
" what for" - not sure
"who prescribed it" - not sure
"where was it prescribed" - not sure
"did you bring a list or the bottles" - no, I lost my backpack which they were in, not sure how or where
"how long have you been off the medication"- (no joke) one hundred weeks
"one hundred weeks is over a year..." - well, at least since August (August was two months ago)
"do you know the month/year today" - got this one spot on!

ok, so we were not getting very far with this questioning. A set of vital signs later ensured that the patient was at least not going to drop in the office, saving us some time for investigation.

"so", I commented "there seem to be a lot of details you aren't clear about, can I ask who helps you remember to take your medication?"

"Sure" he replied "my friend steve or my mom"

Excellent, this NP thinks to herself, I may be able to solve this case yet!

"Can you bring your mom or Steve to the next visit?" I inquire.

"no, they are REALLY crazy" our fairly confused patient comments... ahhhh... Folie à deux

Hopefully our lovely social worker will be able to make heads or tails of the case next week, as I called EVERY major pharmacy in the area, and no record of this kind patient exists.

gotta love the creativity of community health, and the opportunity to occasionally feel like your life is a strange movie that never ceases to somehow entertain...

1 comment:

  1. This sounds soooo familiar! It amazes me that people have no clue about their meds sometimes. It can be very dangerous.