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Saturday, June 1, 2013

Fake Ventolin theories I've actually heard

I know doctors like the backs of my Ventolin stained fingers.  I know that when they are faced with a question from a patient, and they have no clue what the answer is, they just make something up.  I know this because I had a doctor tell me this once.  I also know this because I witness it nearly every day I work.

You see, you guys probably think I make much of the stuff up I write about on this blog, but the fact is I don't make up any of it.  Consider on my first day as a respiratory therapist I heard a doctor explaining the following to a patient: "Think of Ventolin as Scrubbin-Bubbles Bathroom clearner.  It gets deep down into your lungs and scrubs them clean.  It makes breathing easier."

I asked this doctor, "That was a very impressive line you just gave that patient."

He said, "Yes, we doctors make stuff up all the time on the spot.  Patients have no clue about most of the stuff we do, nor why we do it, so sometimes it's easier just to use a metaphor."

Consider the following I have also heard from physicians:

  • (Ventilator Patient) The patient needs a breathing treatment because the humidity will be good for the ventilator circuit
  • (Croupy kid) The humidity will help soothe the patient's airway
  • (Atrial Fib) The treatment will help relax the lungs so the heart doesn't pound so hard.
  • (Pneumonia) The treatment will help you cough up that pneumonia
  • (COPD) Ventolin will help thin your secretions so they are easier to cough up
  • (Pulmonary Edema) The treatment will help allay that wheeze
  • (Post op) The Ventolin will help loosen secretions around the NG tube
  • (Post op) The Ventolin will help prevent blood from congesting in the legs and break up any clots that might make it to the lungs.  
  • (Asthmatic with no symptoms) The Ventolin will help prevent asthma while the patient is in the hospital
  • (CHF) The ventolin will help you cough up secretions
  • (Cold) The Ventolin will help you cough
  • (Cold) The Ventolin will help you stop coughing
  • (Cold) The Ventolin will help clear your nasal congestion
  • (Cold) The Ventolin will stop your nose from running
  • (Asthma) The Ventolin will relax the muscles that wrap around your air passages to make breathing easier (Oh, wait, that one was true)
  • (Heart Failure) I know some disagree with me, but I actually think Ventolin helps with heart failure.  I mean, if a patient wheezes, you order ventolin. (If a patient wheezes, you order Ventolin.  If a patient wheezes, you order Ventolin.  If a patient wheezes, you order Ventolin)
Guys, you just can't make this stuff up.  I have had patients go into utter detail as to why the doctor said they need the breathing treatment.  These doctors come up with these gobbly-gook theories because respiratory therapy medicine is beyond the scope of their knowledge.  Much that is said of respiratory medicine is analogous to folk medicine, Indian medicine, Thompsonian medicine, quack medicine. 

They simply make up stuff that sounds good to them and the patient. It would be like smoking tobacco for asthma, or rubbing tobacco leaves on your skin for psoriasis.  I know this because I have heard them.  Science has no part here, only that the theory "sounds" good and makes the doctor and patient "feel" good.  



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