Insane instructions to give patients

​I can't take it any more.
Logic? Nope.
Common sense? Nope.

Smart folks and simple folks alike have caused me to really beef up my standard instructions for procedures and medical tests. Here's a snapshot of why sometimes I'd like to pull my hair out.

#1) Preterm labor. I have told you very clearly, "Please do not have sex. Please do not put anything in your vagina." My simple instructions could only be clearer if I added in a diagram and an interpretive dance. Why, then, do I see you in the Ob department at 3am, contracting wildly at 26 weeks into your pregnancy as you are post-orgasmic from hours of wild nookie? And now you're somehow mad at ME? Talk to sperm boy over there. Cuddles, not thrusting. Come on, now. Don't make me do the "no-sex interpretive dance". (Actually, anytime I dance, it's pretty much assured no sex will occur within a 10 mile radius. I'm not lithe or seductive. Anyway.)

#2) Clear liquids, part 1. Colonoscopies. Yeah, I get that you don't want a scope, but everyone in your family has colon cancer, so you need the test. You'll thank me after I snip out 10 pre-cancers and save you from having a colostomy and chemotherapy. But until then, please understand me when I tell you that clear liquids do NOT include STEAK, no matter HOW THIN YOU CUT IT. My roto-rooter does not work in solid dooky.

#3) Clear liquids, part 2. Colonoscopies. Yes, I asked you specifically about your alcohol consumption and prayed you told me the truth. Let me now be perfectly obvious: GIN DOES NOT COUNT AS A CLEAR LIQUID. Ok, I get that it is technically CLEAR and you can see through it, and I can see how confusing that must be to you. But for the sake of me giving you IV anesthetic, let me repeat myself. I will NOT give you IV sedation if you smell like booze. If you cannot abstain from alcoholic beverages for 12 hours prior to your procedure, then a colonoscopy will not fix the majority of your health issues and your life will not be foreshortened by a colon problem -- it will be shortened by cirrhosis.

#4) Clear liquids, part 3. GOD HELP ME. Ok, seriously? No, Taco Bell does not count as a clear liquid, either. Please quit arguing with me. I can see what was in your chalupa as it oozilates down the pike. It's not appetizing and it's a waste of everyone's time.

#5) Nothing by mouth (NPO), part 1. "But why?" Because if you drink that triple milk-sugar frappuccino with extra cream, your sky-high triglycerides (which I will be able to see with the NAKED EYE floating like little globs of noncompliance in the blood tube) will make you appear to be diabetic. Pills and insulin will follow. Is that what you want?

#6) NPO, part 2. If you have a 7:30am c-section, please believe me when I say that your 6am sausage and egg McMuffin will NOT be digested in time for the procedure. In fact, it will likely feature heavily in a repeat performance of aforementioned breakfast when you yuke all over the anesthesiologist. Do you even understand how much anesthesia folks HATE patients who vomit? Almost as much as they hate patients who are awake, which c-section patients are. Anesthesia folks don't make good small talk. Trust me, I've heard them try. They're even less chatty when covered in partially-masticated McMuffin.

#7) NPO, part 3. Same goes for scopes. Let's say I'm doing an EGD (upper endoscopy). Let's just say. And let's say you simply could not go from midnight until 8am without eating a hamburger. Let's just say. Would you like to venture a guess as to what I can see in your stomach? That's right: hamburger. Not ulcers, not esophagitis, not gastritis, not celiac disease. Hamburger. And care to tell me what happens to hamburger in the stomach after I pump aforementioned gastric organ full of air? Please refer to above McMuffin discussion.

#8) Botox. I have told you personally and then given you a paper that says not to lift, bend, strain, massage, rub or otherwise do anything that moves the botulinum toxin I've strategically placed in a few key areas. Why in the name of all that holy, would you immediately leave the office and go get a facial? After I SAID NOT TO?? And now you're complaining that your eyelid droops? Crazy folks like you make my eyelids twitch, thanks.

#9) Juvederm. Same deal. You and I have agreed that you WANT it where I put it and you LIKE it where I put it. So why, after paying over a thousand dollars, would you do anything to screw with something that affects your appearance? You can hold off on a facial for 48 hours, I promise your pores will be okay.

#10) Skin lesion removal instructions. Help me out here. When I said keep it dry for 24 hours, how did that translate to "soak neck-deep in a hot tub"? How? Is it somehow a DRY, bubbling, steamy hot tub? I am not familiar with a dry hot tub. I am, however, familiar with WOUND DEHISCENCE which is where the artfully sutured skin freakin' FALLS APART because you are a numbnut. And again, why are you somehow mad at me? I gave you these instructions both verbally and on paper. Might should have texted it, since that's the only thing you're paying attention to...

#11) INSANE BONUS. You know how, when you take antibiotics, a great way to prevent vaginal yeast infections is to consume a cup of yogurt daily? Yogurt totally works. But NOT if you place the yogurt (Yoplait. Blueberry. Yeah.) INTO your vagina. Then it totally doesn't help prevent jack. And after the first 30 minutes of "yippee, blueberry scented no-no area" then it just all starts smelling funky. Let me reassure you that I have not consumed blueberry yogurt in 8 years (either by mouth or vaginally) after a patient told me how they utilized Yoplait. ("Yoplait: It is SO good." No. Just, please. No.)