Frank uses his cell phone to call for help. Thirty minutes later, Frank finds himself staring at white hospital walls waiting for the doctor and the Emergency Room staff to finish examining Joe. Frank thinks to himself, “What did Joe eat or drink or do that I didn’t to bring on this violent reaction and collapse?”
In the Emergency Room, Joe’s temperature is recorded at 99.1 degrees, his BP is 130/85, and his pulse is 87 beats per minute. He is extremely nauseous and vomits repeatedly. Dr. Smith examines Joe, orders a battery of tests, and interviews Frank about the course of events and contributing factors that might have led up to Joe’s collapse.
Dr. Smith begins, “Tell me about your daily routine, diet, water intake, rest and other activities, Frank.”
“Dr .Smith, Joe and I were very careful about our fluid intake, drinking plenty of water throughout the day, particularly here in Kansas. We stopped regularly to eat and rest, and to stretch our tired muscles and joints. We both experienced stiffness in our fingers, but, come to think of it, Joe had more leg tremors and muscle fatigue.”
“Can you be a little more specific about your diet, Frank?”
“Well, we started off each day with a hearty breakfast, lots of protein, eggs and bacon … easy to cook on the road, you know, plus bread and juice, for our carbohydrate intake, and of course, coffee.”
Dr. Smith asks, “Did Joe follow the same regimen?”
Frank recalls that Joe drank additional high energy drinks during the day, as well as one espresso in the morning and one in the afternoon. “Joe brought his own little espresso coffee pot along,” Frank tells Dr. Smith. He also recounts the fact that both ate high protein snacks like peanuts, and that, “Joe loves chocolate and eats his peanuts, as well as his raisins, chocolate covered!”
Meanwhile, Dr. Smith is given the first laboratory results, blood work, and urinalysis that she ordered.
| Patient Name: | Joseph McGill |
| Date: | July 27, 2004 |
| MDPA/NP: | Ellen Smith, MD |
| Facility: | Prairie Flats Consolidated Health System |
Laboratory Results:
| Hematology | ||
| Test | Pt. Values | Normal Values |
| RBC | 7.3M/microL | 4.2–5.6 M/microL |
| WBC | 13.6 K/mm cubed | 3.8–11.0 K/mm cubed |
| Hgb (Hemoglobin) | 19.3 g/dL | 14–18 g/dL |
| Hct(Hematocrit) | 59% | 39–54% |
| Neutrophils | 93% | 50–81% |
| Urinalysis | ||
| Color | dark gold | straw |
| Osmolality | 1700 mOsm/L | 80–1300 mOsm/L |
| Specific Gravity | 1.086 | 1.0003–1.040 |
Originally published at http://www.sciencecases.org/bicycle_ride/bicycle_ride2.asp
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