A to Z 

To come out of hibernation I have decided to write blogs alphabetically. No particular theme except alphabets . So here goes

A: arsenic . Still happens . I have seen one patient in a rural town who got arsenic poisoning from the wood he was using in his fireplace . For some strange reason the wood was treated with arsenic . Perhaps an unhappy wife or a jealous lover . He did not think so .

Why did I order the test ?Because he had weird neurological symptom and labs ( looked like Lyme but the history , demographics and serology  did not fit ) . Neurological Imaging was pretty much normal .

Of course it took me unfortunately almost a month to get to arsenic but once we found it we fixed it.

Not saying it’s common but if you don’t think of it you won’t find it. 

Also if your wife is not happy with you don’t let her near the firewood. 

Dialysis 

“Why do you not have an arterivenous fistula , that’s the stands of care . Why do you get dialysis with a catheter ”

I asked the  somewhat attractive 50 some year old woman laying in the bed 

” I don’t plan to stay on dialysis that long” she said without much emotions

“What do you mean ” I asked

Now her eyes teared. 

“I  been sick for 15 years . I don’t want to continue dialysis . I hate it ”

If she hates dialysis that much why start it in the first place.

She read the question in my eyes

“My parents are still alive.  They are in their 90’s. I have to wait”

Now it all made sense .