Bundle of Nerves

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Source: http://www.wisegeek.org/

Situation

Mrs. Clark was brought to the hospital due to heartburn. She had her work-up done. She also underwent an endoscopy and she was a bundle of nerves while waiting for the physician to tell her the findings.

Dialogue

Physician:         Good day, Mrs. Clark! Do you feel much better now?

Mrs. Clark:        Hello, doctor! I feel a whole lot better, but I’m a bundle of nerves right now to find out the results of my work-up.

Physician:         Oh, I understand how you feel, Mrs. Clark, but you need to hold your nerve.

Mrs. Clark:        So, can you please reveal the results to me now, doctor?

Physician:         Your endoscopy finding reveals gastroesophageal reflux disease (GERD).

Mrs. Clark:        Oh, I’m relieved to know it’s nothing serious. Is it?

Physician:         As of now, we cannot really tell the gravity of your condition so we might have to run further tests to identify the root cause of your acid reflux. We have also already sent tissue samples for biopsy.  Just stay calm, there’s no reason to fret.

Mrs. Clark:        Thank you, doctor!

Vocabulary

  • Heartburn
  • Bundle of nerves
  • Hold your nerve
  • Endoscopy
  • Gastroesophageal reflux disease
  • Gravity
  • Acid Reflux
  • Biopsy
  • Fret
Heartburn Burning sensation in the chest usually due to acid reflux

Anna experienced heartburn after eating dinner.

Bundle of nerves An extremely nervous or tense person

I am usually a bundle of nerves before a flight.

Hold your nerve To stay calm during difficult situations

She can’t hold her nerve during an exam.

Endoscopy A diagnostic procedure/examination that involves viewing of an internal organ, specifically the esophagus and the stomach by inserting a tiny tube with the aid of an illuminated instrument (an endoscope)

The endoscopy revealed an inflamed esophagus.

Gastroesophageal reflux disease

(GERD)

A digestive disease wherein the esophageal sphincter (the ring of muscles at the bottom of the esophagus) relaxes and fails to close allowing acids and other stomach contents to backflow into the esophagus

I always experience heartburn right after eating. I feel like I have gastroesophageal reflux disease.

Gravity The seriousness, severity of something such as a disease or a situation

The gravity of his heart disease was so severe.

Acid reflux The backflow of stomach acids usually to the esophagus which causes heartburn

I had a bad acid reflux this morning after having coffee.

Biopsy A medical procedure wherein a tissue is taken and sent to the laboratory to analyze the existence of a certain disease, its cause and extent

Andrew is so nervous to know the result of his liver biopsy.

Fret To worry or be anxious

I try not to fret during exams.

 

thinking-time

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Clean Bill of Health

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Situation

Maisie had to skip school because she was sick with the flu. The doctor advised her to stay home until she is given a clean bill of health.

Dialogue

Maisie:              Mom, I wonder when I can go back to school. I already missed so many quizzes.

Mom:                Nah. I don’t think it will be any time soon. You’ve only been away for two days.

Maisie:              So, when do you think I can resume school?

Mom:                Sweetheart, you are sick with the flu and it is considered highly contagious.

Maisie:              Ugh! I’m already getting bummed out here, mom.

Mom:                It’s alright. It’s not going to be much longer. We will visit your doctor this Friday for a follow up check.

Maisie:              And if I’m given a clean bill of health, can I already go to school next Monday?

Mom:                Pretty much.

Vocabulary

  • Clean bill of health
  • Contagious
  • Bummed out
  • Pretty much
Clean bill of health Statement/news that the patient is in good health, usually said by a physician after examining the patient

Maria was given a clean bill of health after all her work-up results came out negative.

Contagious Power/capability of a certain disease to spread from one person to another

Influenza or flu is considered to be a contagious disease.

Bummed out Feeling sad or depressed

Timmy was bummed out during his first few months of living abroad.

Pretty much Almost, kind of, sort of, nearly

She was pretty much late for work because of the heavy traffic.

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As Fit as a Fiddle

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Situation

Grandpa George is already 85-years-old but he is still as fit as a fiddle. He went to visit their family physician, Dr. Myers, for his monthly check-up.

Dialogue

Dr. Myers:                     Hello Mr. George! How are you doing today?

Grandpa George:          Very well, thanks!

Dr. Myers:                     That’s great to know then! I’ve got good news for you. All your work-up results are within the normal range.

Grandpa George:          Oh, that is really wonderful! I mean, I’m still as fit as a fiddle                                                             considering my age.

Dr. Myers:                     Indeed! Your age is actually past the average lifespan of people in the                                           US.

Grandpa George:           I agree. Most of my friends already breathe their last.

Dr. Myers:                     Congratulations on being in good health! Thanks for religiously                                                        visiting my clinic for your regular check-up. See you next month!

Grandpa George:           You’re welcome and thanks as well for helping restore my health.

Vocabulary

  • As fit as a fiddle
  • Check-up
  • Work-up
  • Breathe (one’s) last
  • Religiously
As fit as a fiddle Physically fit, in good health

He may be old but he is still as fit as a fiddle.

Check-up The process during which a patient visits  a doctor for examination or consultation

Grandpa George never misses his monthly check-up.

Work-up A complete medical examination that typically includes the following: medical history-taking, physical assessment, laboratory tests, x-ray and other imaging tests.

His work up reveals normal results

Breathe (one’s) last To die

He managed to see his wife before she breathe her last.

Religiously Obeying or following rules, doing something regularly

He religiously goes to school.

 

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At Death’s Door

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Situation

Sophie, an 18-year-old female, had to be airlifted by the emergency response team after sustaining multiple injuries from a car crash.  She was unconscious and had unstable vital signs. Doctors also suspect that she had several fractures from the accident.

Dialogue

Physician:         Can you identify the patient?

Nurse:              The EMT handed me her driver’s license and it identified her as Sophie Turner, 18 years of age, from 14 E Stonybrook, Connecticut.

Physician:         Please give her Lactated Ringer’s solution to be infused rapidly via two large-bore peripheral intravenous catheters.

Nurse:              Blood pressure is dropping, oxygen saturation is at 90%, and respiratory rate at 7 breaths per minute.

Physician:         Let’s start the endotracheal intubation and place ventilatory monitoring and ECG leads. This patient is at death’s door. We will also conduct a fast abdominal sonogram to determine the extent of her chest or abdominal injury.

Nurse:              I already called the sonography department, doc.

Physician:         Once the procedure is done, you may wheel the patient to the ICU department.

Nurse:              That has been noted, we will transfer the patient after my call to the ICU department about this admission.

Vocabulary

At death’s door A near death experience
Airlift Transportation by air
EMT Emergency Medical Technician
Sustain an injury To suffer or have an injury
Fracture Another term for broken bone
Unconscious Not awake or responding to external stimuli
Infuse To let a fluid substance into a person’s vein
Large-bore intravenous catheter An intravenous line that delivers large amount of fluid
Oxygen saturation The amount of red blood cells (hemoglobin) that has oxygen
Endotracheal intubation Placement of tube through the windpipe or the mouth
Ventilatory Pertaining to something that helps circulate air
Sonogram The image produced during a sonography
Wheel To carry someone through something that has wheels

Analysis

  • When someone is at death’s door, he or she is very ill and almost dying.

Example: He was at death’s door after getting involved in a car accident, but the doctor revived him.

  • When someone or something has to be airlifted, the means of transportation is by air.

Example: The food supply was airlifted to reach the troop.

  • An Emergency Medical Technician or an EMT is a member of the healthcare team trained to respond during emergency. They are also called ambulance technicians in some countries.

Example: The EMTs responded quickly following the car crash.

  • If you sustained an injury, it means you had or suffered an injury after an accident.

Example: She sustained right leg fracture due to fall.

  • A broken bones or fracture can be caused by accidents. It may be due to sports, falls, or vehicular accidents.

Example: Kirsten sustained a fracture on the right arm from a fall.

  • A person becomes unconscious, meaning not awake and responsive to tactile (touch), verbal, and other form of stimulation usually because of an injury.

Example: He became unconscious immediately after getting into a collision with another car.

  • When you infuse something, usually in fluid form, you introduce fluid through a patient’s vein.

Example: Maria received medications via intravenous infusion.

  • A large-bore IV catheter usually utilizes large cannula that delivers large amount of fluids into the patient’s vein in the fastest way. This is used especially during emergencies.

Example: She lost lots of blood and they had to deliver fluids via large-bore IV catheter to prevent shock.

  • Oxygen saturation refers to the amount or fraction of hemoglobin or red blood cells that carry oxygen versus the total amount.

Example: Healthy individuals have an oxygen saturation of 94-100%.

  • A tube is usually inserted through the mouth during endotracheal intubation especially during emergency situations. The tube may also be inserted via the windpipe (trachea) or the nose.

Example: They had to do endotracheal intubation because her ventilation was impaired following an injury to her lungs.

  • Ventilation refers to the movement of air from one space to another. Anything that refers or pertains to ventilation is called ventilator.

Example: She couldn’t really breathe so she has to be assisted by a ventilatory device.

  • Sonography is commonly known as ultrasound. The image produced following this imaging test is called the sonogram.

Example: The sonogram revealed a tumor.

  • When you are being wheeled, you are carried or transported to another place via something that has a wheel.

Example: She was wheeled into the operating room per stretcher.

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Nurse Back to Health

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Situation:

Mr. Sanchez, a 55-year-old man of Hispanic descent, was admitted to the hospital due to angina pectoris. He also complained of dizziness, fatigue, and radiating pain from the jaw down to the neck and the arms. He was profusely sweating when he was brought to the hospital. After being confined at the hospital for 3 days, he is ready to be discharged by his physician.

Dialogue:

Physician:         Good morning, Mr. Sanchez! How are you feeling today?

Mr. Sanchez:     Oh, I felt so much better than when I was brought to the hospital!

Physician:         That’s really good to know. So, are you ready to go home?

Mr. Sanchez:     Yes, doc. You and your healthcare team really took care of me, and helped nurse me back to health.

Physician:         That’s really good to know! And I have good news for you. You can wear your street clothes now, pack up, and you may go home once I’m done with my discharge orders for you. The nurse on duty will discuss it with you in a bit.

(Nurse comes in a few minutes later)

Nurse:              Hello Mr. Sanchez! I am Nurse Beatrice and I’m here to discuss your discharge plan. First up, we will talk about your prescribed diet, which should include lots of fruits, veggies, whole grains, and saturated fats must be avoided.

Mr. Sanchez:     Uh oh. That means no more burritos for me.

Nurse:              Certainly. And, you also have maintenance medications which include aspirin, statins, beta blockers, and clot-preventing drugs. The dosage for each medication is on this sheet. (Hands a piece of paper) Do you have any questions, Mr. Sanchez?

Mr. Sanchez:     I believe there’s none. Thanks for taking care of me during my stay in this hospital.

Nurse:              You’re welcome! We are happy to serve you. Bye.

Mr. Sanchez:     Bye.

Vocabulary:

Nurse back to health To take care of an ill person
Angina pectoris (an-juh-nuh pek-to-ris) Medical term for chest pain
Hispanic descent A person whose ancestors come from a Spanish-speaking country
Dizziness A spinning or whirling sensation
Fatigue Being physically or mentally tired
Radiating pain Pain that spreads to different body parts
Profusely sweating To produce plentiful amount of sweat
Veggies Short term for vegetables
Whole grains A collective term for grains whose bran has not been removed
Saturated fats Unhealthy fat
Statins Medicines that help lower blood cholesterol levels
Beta blockers Medicines that help reduce blood pressure

Analysis:

  • When you nurse someone back to health you help take care of a sick person until he or she returns to the normal healthy state.

Example: My grandma had a stroke and I helped nurse her back to health.

  • Angina pectoris, sometimes just called angina, is the common symptom of coronary artery disease. Angina in layman’s term is chest pain that is usually described as heavy, squeezing chest pain.

Example: He experienced angina after a morning jog.

  • Hispanic and Latino are often interchangeably used. However, they mean entirely different. One is considered to have Hispanic descent if your ancestors or family comes from a Spanish-speaking country. For instance, if you come from Brazil, you are not Hispanic because Brazilians speak Portuguese. Latino, on the other hand, refers to people coming from Mexico.

Example: Jose’s family comes from Mexico. So, he is both Hispanic and Latino.

  • Dizziness is that spinning or whirling sensation even when you are not moving.

Example: High fever caused her dizziness so she had to stay in bed the whole time.

  • Fatigue is the feeling of physical or mental tiredness after a demanding activity.

Example: He experienced fatigue after working 7 days straight.

  • When pain radiates, this means it spreads to other areas of the body.

Example: Angina is often associated with radiating pain.

  • Anything profuse is excessive or plentiful in amount.

Example: There was profuse bleeding from his gunshot wound.

  • Whole grains include wheat, rice, and oats whose bran has not been removed or processed.

Example: White rice does not belong to whole grains because its bran has been processed.

  • Saturated fat is the type of fat usually contained in animal products. Saturated fats are found to raise cholesterol levels. Food that are known to have high saturated fat content include cheese, pizza, hamburger, and burrito.

Example: Saturated fats are linked to diabetes and hypertension, and must be avoided.

Comprehension:

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Go Under the Knife

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Situation:

Sophie was rushed to the hospital due to lower right abdominal pain. The pain is aggravated upon coughing and other jarring movements. The doctor suspects that Sophie is suffering from appendicitis.

 

Surgeon:           Hello Sophie! I’m Crystal Jennings, one of the resident surgeons of Saint Therese Hospital and I’m here to assess your condition. Now, may I have the permission to check your abdomen. (Applies gentle pressure on the lower right side of the abdomen)

 

Sophie:             I’m afraid that hurts. (Does abdominal guarding when her abdomen was pressed)

 

Surgeon:           We will run further tests on you to confirm if it’s appendicitis you’re suffering from. I will have your blood drawn and you may have to undergo urine and imaging tests, but before that, I’ll have you sign this consent first. (Explains the procedure) Do you have any questions?

 

Sophie:             Is it possible that I’ll go under the knife if it’s confirmed that I have appendicitis?

 

Surgeon:           Yes. You will have to undergo appendectomy once appendicitis has been confirmed and other possible medical conditions have been ruled out. Meanwhile, I’ll have the nurse do a skin test on you for your antibiotic therapy. Is there anything else, Miss Sophie?

 

Sophie:             That would be all. Thanks!

 

Surgeon:           Thanks!

Vocabulary:

Go under the knife To have or undergo a surgery
Jarring Shaking, vibrating or sudden movement
Appendicitis Inflammation or swelling of the appendix
Abdominal guarding The act of tensing the abdominal muscles to guard a painful organ
Run tests Conduct a laboratory test
Appendectomy Removal of the appendix
Rule out Remove/eliminate from the possibility or consideration
Skin Test A test done to determine certain medications or chemical components that a person is allergic to
Informed consent A form signed by the patient or an immediate relative that the former allows himself/herself to undergo a treatment or a medical procedure

Analysis:

  • To go or to be under the knife means submitting oneself for surgery.

Example: She had to go under the knife for the removal of her appendix.

  • If something (or someone) jars, (he or she) it is shaking. It may also mean sudden movement.

Example: The jarring movement gave him a headache.

  • Appendicitis is the swelling of the finger-shaped pouch called the appendix, which is located on the lower right side of the abdomen.

Example: Pain located on the lower right side of the abdomen may be caused by appendicitis.

  • When the abdomen is pressed and the abdominal wall muscles get tensed, the tensing is referred to as abdominal guarding. This is usually seen in people suffering from appendicitis or diverticulitis.

Example: She had abdominal guarding when the doctor examined and pressed her abdomen.

  • When health professionals tell you that they will run tests on you, it means you have to undergo certain tests and submit urine, blood and other samples that will be sent to the laboratory to be tested. The results are then relayed to the physician, which will be later on explained to you.

Example: Before surgery is performed, they need to run some tests on her.

  • Appendectomy is a surgical procedure that involves removal of the appendix.  From the words appendix and –ectomy a suffix which means “out and to cut”.

Example: Her appendix was inflamed so she has to undergo an appendectomy.

  • Rule out is a term used in the medical practice, which means to exclude the possibility of or from consideration.

Example: The chest x-ray that was done helped rule out pneumonia.

  • A skin test is a test that helps determine certain substances that a person has an allergic reaction to. This can be done in two ways: through a prick or a puncture, and by injecting a diluted allergen just right below the surface of the skin.

Example: Her skin test result revealed negative allergy for penicillin.

  • An informed consent is a form that a patient signs, which serves as an agreement that he or she understands the benefits and risks of a certain medical intervention.

Example: The doctor made her sign an informed consent after explaining the benefits and risks of the surgery.

Comprehension:

  1. What surgical procedure does Sophie have to undergo?
  2. Have you tried being under the knife? What type of surgery?
  3. Differentiate appendicitis and appendectomy.
  4. What form did the doctor make Sophie sign?

 

 

 

 

 

 

Come Down with a Flu

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Situation:

Carice was under so much stress and she feels like she is coming down with a flu. She is experiencing malaise, joint pains, runny nose, and intermittent fever. Before she takes a turn for the worse, she decided to schedule an appointment with her physician over the phone.

Dialogue:

Secretary: (Phone rings) Hello! You have reached Dr. Anderson’s clinic and it’s her secretary speaking. How may I help you?

Carice: Good morning! This is Ms. Carice Williams and I’d like to set an appointment with Dr. Anderson tomorrow, September the 5th, 2016, at around 9 in the morning.

Secretary: That has been noted, Ms. Carice, but let me check Dr. Anderson’s schedule tomorrow first. Hmmm. It looks like she will not be around tomorrow, but a locum tenens will fill in for her. Would you still want to push through with your appointment?

Carice: Yes. I’m pushing through with it because I’m afraid if I cancel I would take a turn for the worse. I feel like I’m coming down with a flu judging by the symptoms I have. I’m experiencing runny nose, intermittent fever, and malaise.

Secretary: Alright, Ms. Carice. I’m finalizing your appointment. We’ll see you tomorrow then!

Carice: Thanks for the help!

Secretary: You’re very much, welcome!

Vocabulary:

Come down with (a flu) To get sick with a flu, cold, or any illness
Malaise (pronunciation: mah-layz) An overall bodily discomfort
Runny nose Sensation felt when there is excess fluid draining from the nose
Intermittent fever An on and off type of fever
Take a turn for the worse If something, like an illness or a situation, becomes severe
Locum tenens A person who is a temporary substitute, specifically a physician

 

Analysis

  • If you come down with something, it means you get sick with a certain illness like a flu or cold.

Example: My coworker is sick with the flu. I feel like I’m coming down with it, too.

  • Malaise is general body weakness or uncomfortable feeling.

Example: Lack of sleep caused me malaise the following day.

  • If you have allergies or sick with a cold or flu, your body will produce extra mucus and if excess fluid drains from your nasal cavity, you are said to have runny nose.

Example: It’s hard to focus at work with this runny nose.

  • When you have intermittent fever, there are periods that you run a fever and then it subsides.

Example: I already want to return to work, but I still have an intermittent fever.

  • A situation or an illness takes turn for the worse when it becomes severe.

Example: The fever has already subsided then she suddenly took turn for the worse when she started having seizures.

  • A locum tenens is a professional, specifically a physician, who temporarily substitutes another person of the same profession.

Example: Dr. Anderson is on a vacation so a locum tenens stands in for her.

 

Comprehension:

  1. What are the symptoms experienced by Carice?
  2. When is Carice’s appointment with Dr. Anderson?
  3. Who is going to fill in for Dr. Anderson in her absence?
  4. What does a locum tenens do?