GomerBlog returns to help distinguish between two similar but often confused entities.
The “G” in G-tube refers to “gastric” or “gastrostomy.” A G-tube is a type of feeding tube in which a tube is inserted through the abdominal wall directly into the stomach so that nutrition can be provided. The G-spot should not be reached by going through the abdominal wall.
The “G” in G-spot does not refer to “gastric” or gastrostomy.” Instead, it refers to the last name of Ernst Grafenberg, the German gynecologist who found it. Some argue the “G” also stands for “Germany” and “gynecology,” but this hasn’t been verified. The G-spot is an erogenous area of the anterior wall of the vagina.
A G-tube can be placed endoscopically by gastroenterologists, radiographically by interventional radiologists, and surgically by general surgeons. In the event it is done by interventional radiology, be sure the patient’s INR is less than 0.
The G-spot should not be approached endoscopically, radiographically, or surgically. However, if consent has been obtained to approach the G-spot, be sure the vagina’s INR is less than 0.
A G-tube should never be placed into the G-spot.
It is appropriate to flush both a G-tube and the G-spot with 30 ml of water every 4 hours. If a G-tube gets clogged, attempt flushing with warm water. Sometimes soda can work, though this isn’t evidence-based. If the G-spot is clogged, it is best to speak with a gynecologist who can come to bedside to flush it with warm water and soda.
Finally, a G-tube has not been shown to reduce the incidence of aspiration pneumonia, whereas the G-spot has been shown to reduce the incidence of aspiration vaginitis.
WASHINGTON, D.C. – The American College of Obstetricians and Gynecologists (ACOG) is modifying the Apgar score to an Apgar(t) score in which troponins will be checked on a newborn infant both 1 and 5 minutes after birth.
“One of the greatest accomplishments in modern medicine is our ability to check troponin levels on anyone irrespective of diagnosis, so it is only fair that newborn infants are included in this process,” explained ACOG spokesperson Dr. Olivia Chung-Patterson. “You’ve noticed babies often cry when they’re born. That’s why we need the trop check. We really need to rule out MI.”
This is bad news for babies, as the likelihood of negative troponins is next to nil due to the sensitivity of the test, so it will make it that much harder for babies to score a perfect score.
The Agpar score, which was developed by Virginia Apgar in 1952, allows for standardized assessment for the fetal-to-neonatal transition. By adding 1 and 5 minute troponins after birth, it will ensure the baby becomes quickly acclimated to what will become a lifetime of unnecessary troponin testing.
Westchester, NY : Local Mother and divorcee Tiffany Smith accompanied her 18 year old daughter Kaycie Smith into the exam room, clinic staff confirmed. Kaycie, who currently lives with her father in
Armonk, stated the encounter was significantly worse than last year, and fears the trend will
continue for future yearly physical exams.
“I don’t know why she insists on being IN the room for my yearly physical. I guess it made
sense when I was like 8 or 9, but now……ugh,” Kaycie shuddered
Kaycie, who revealed she was interested in getting both a prescription for birth control and an
HPV vaccination before attending college now fears she won’t be able to obtain either as long
as her mother is in the room.
While the physician attempted to obtain a sexual history from Kaycie, Mrs. Smith reportedly
interjected, “Of course she hasn’t been having sex! Don’t you dare suggest such a thing! She’s
a normal teenager, Doctor!”
This led to a very uncomfortable discussion about the HPV Vaccine, during which Mrs. Smith
repeatedly claimed that her daughter both wouldn’t need the shot and would also get cancer
from it according to her local mommy facebook page.
Kaycie was seen staring at the floor throughout the altercation and was visibly distraught as Mrs. Smith began googling “Why HPV Vaccine is Bad” on her phone and reading the results aloud to the physician and later on to those in the waiting room.
During the physical itself, Mrs. Smith insisted on being present and would not leave the room
or turn away despite repeated requests from her daughter. The entire situation came to a head
when Mrs. Smith began describing her daughter’s menstrual cycle and asked if her daughter’s
body proportions were “normal.”
A GomerBlog representative caught up with Kaycie and Mrs. Smith after the exam:
“I wasn’t sure at first if I should go in the exam room with my daughter this time,” Mrs. Smith
recalled “I’m usually so confident in my ability to make my children and their doctors visibly
uncomfortable, but last week I tried to go in with my son Kayden and he actually said he didn’t
need me! I was so shocked they had already closed the door before I could respond.
Obviously I was shaken to my core.” “But today I was prepared! I had just gotten 10 likes on my latest social media post, I was feeling good, everything just felt right! So I went right in and sat down next to the exam table, asking prying questions and stopping my daughter from giving any silly answers her doctor.
What a rush!” Kaycie had more to say as her mom discussed vaccine inserts with a pregnant woman in the waiting room:
“I know that since I’m 18 I can legally have her not be in the room, but I’d rather have 20
minutes of awkwardness now than 8 hours of screaming and blaming me for dad leaving her
once we get home. Either way I’m going to University soon, I can just go to a walk-in clinic
there for a ‘Cold’ and get the pills and shots I need.
A recent report in a major peer reviewed medical journal (then poorly summarized in an advertisement laden medical bulletin email) has uncovered yet another disturbing sign of the growing disconnect between America’s youth and the medical establishment. It appears that there has been an alarming increase in inpatient “neonatal falls.” Over 1,600 of the tykes wiped out over the past year.
Not content to simply assume that that this was medical bulletin clickbait, our investigative team set out to uncover the truth behind this sudden spate of tripping tots. Have caregivers forgotten that newborn babies are notoriously unsteady on their feet? Is the opioid epidemic somehow to blame? Anesthesia?
Knowing that burned out physicians, new parents, and nursing staff would likely only muddy the waters further with their “clinical observations” we assembled a panel of hospital administrators and risk management experts who all agreed to speak on the condition of anonymity.
One senior administrator at a major midwestern hospital said, “Look we all know these babies aren’t exactly ready for ballroom dancing, but protocols specifically state that patients are to ambulate a certain number of times a day.” Throwing her hands up in exasperation, she elaborated: “What are we supposed to do? Let the little squirts off the hook just because they’re newborns? Not on my watch.”
Said a risk management expert from a major teaching hospital: “You know, the problem is they’re clumsy as shit. And of course they never want to wait for nursing staff to help them go for a stroll. In our facility we don’t have one case where a baby even bothered to use the call light prior to taking a spill. Hell, we even tried making ‘Call Before You Fall!’ Signs with Elmo on them, but the defiant little F’ers just ignore the signs. Then someone pointed out that some babies can’t read, so we tried making a cartoon sign based on that wacky pain scale with the faces. Turns out posters of cartoon babies falling was a major downer, so we had to scrap it.”
A CEO from the west coast then weighed in. “I completely agree. We’re at a loss. We even looked into making those amazing nonslip hospital socks in newborn size, but that was gonna put a major dent in our budget. I mean, a CEO’s gotta eat, amiright?”
“You know how kids are—they just don’t listen,” said another administrator. “There’s no respect any more. You walk into a NICU room and the yellow babies under the lights don’t even take off their sunglasses when you talk to them. They just let their parents answer all the questions. It’s a societal problem and bad parenting. I think blaming hospitals for bad manners is just another case of blaming the victims—which of course are the hospitals and the administrators. We really need to put the onus on parents and the babies were it truly belongs.”
Overhearing the discussion, a passing pediatric intern was more than willing to set the record straight. “‘Neonatal falls’ sounds way better than ‘dropping babies.’ Nobody was gonna publish an article saying we dropped 1600 babies last year. Truth is, babies are slippery. I’m surprised it doesn’t happen more. I mean have you ever been at a delivery? They’re like little greased pigs.”
Multiple task forces have been convened, along with focus groups, expert panels, and forced weekend retreats for medical staff in an effort to combat the neonatal fall epidemic. Proposed ideas include fully padded foam baby suits that bounce and keeping the umbilical cords really long like leashes to prevent the little buggers from wandering too far.
PITTSBURGH, PA – Sometimes it’s better to acknowledge one’s own shortcomings and move on. That is why we’re saluting a hero, internist Dr. Keisha Boots, for summoning the strength and courage to do something all of us have always wanted to do: she tossed the tall stack of unread New England Journal of Medicine issues sitting in the corner of her office.
“Actually, maybe I’ll hold onto this one”
Most physicians who have a subscription to the New England Journal of Medicine go through the same motions: briefly scan the contents of the Journal when it appears in your mail, stack it with the others confident you’ll get to it one day, and then that day never comes. But whereas the rest of us mortals live in a farce, hanging onto those Journals and believing we will actually read them, Boots has confronted reality head on.
“There’s no way in hell I’m reading these!” she scoffed. She pulled out a large red snow shovel and started scooping up the Journal issues by the dozens, tossing them into the recycling bin, each flick of the wrist accompanied by the largest sighs of relief. “You always want to bend with your knees, not your back,” Boots said, describing the proper technique on how to dispose of Journal articles without hurting your back.
Family medicine doctor, Dr. Carrie Lowe, praises Boots and hopes one day she can be as brave. “Just when I’m about to throw away an issue, there’s this part of me that feels guilty, that I should read at least one article,” says Lowe. “So I hold onto the issue. And never read it. And that’s how the stack builds. We all have stacks. I don’t have it in me to throw them away. But Keisha did. And I really admire that.”
In an attempt to adjust to the diminishing enthusiasm of sick children for clowns, a small hospital in Pittsburgh, Pennsylvania has begun repurposing its hospital clowns. For the past month, the outpatient center at Johnson Medical Center has begun the novel practice of using hospital clowns as chaperones for clinical exams and procedures.
“We found that the recent spike in killer clown movies this past year, combined with the general objective creepiness of clowns since their ominous emergence in the mid nineteenth century was making it challenging for our hospital clowns to successfully comfort the sick children” explained hospital president Amiria Anacondios. “We knew they couldn’t stay in the pediatric ward any longer so naturally we tried using them as exam chaperones instead”.
“Hospital clowns are the perfect group to act as chaperones to ensure a safe environment for both the patient and the doctor during physical exams” explained Kyle Melon of Patient Resources. “They’re unbiased, friendly, comforting and most importantly, seemingly asexual”.
Strange-O and Stare-O are just two of the newly instated chaperone clowns used for this initiative. So far the clowns have been met with mixed reviews. Mixed in the sense that it is a mix of bad reviews with even worse reviews.
“It’s frickin weird” said a patient who received a testicular exam chaperoned by Strange-O. “Half way through the exam, Strange-O just whips out some oranges and starts juggling them. Then he looks at me and chuckles, ‘Now there are two people in this room juggling balls’”.
‘I don’t like it” said one patient who received a pap spear with Stare-O in the room. “Stare-O just kept direct unblinking eye contact with me for the entire thing, while maintaining a soulless open-mouthed, yellow toothed grin”. The patient however clarified that it was still less uncomfortable than having a fresh to rotations male medical student in the room.
“Last week we had issues with Stare-O trying to make balloon animals out of the condoms we give out” recounted nurse Matt Rose. Nurse Rose explained that when he told Stare-O to refrain, the clown silently protested by filing an imaginary nursing complaint form and then passing a non-imaginary stool into an imaginary bed pan. “He basically just on the floor” clarified Nurse Rose.
“While I’ll admit there have been some unfortunate isolated incidents, I am confident that these clowns are nonetheless improving patient comfortability” supported Mrs. Anacondios. “In fact, last week I heard there was a woman who was in tears before her exam, so Strange-O took it upon himself to start coughing and dry heaving for a solid four minutes so he could eventually produce a long moist handkerchief from his mouth, to give to her. Now that’s commitment to care.”
Anacondios added that they plan to extend the use of clowns to other parts of the hospital including the OR once they receive their orders of size XXXL clown-sized shoe covers. She also mentioned that are preliminary talks to amalgamate the clowns with the third year medical students in order to sequester the people in the hospital that no one takes seriously.
Philadelphia, PA – Local health practitioners were stumped yesterday when local soccer mom (and tree hugger) Trina Woods discovered a baby tree growing over the location of her buried placenta. Indeed, this was not an error of punctuation nor a bad pun, but a literal tree with a human fetus hanging from one of the branches. Mrs Woods originally decided to plant the placenta after the rootine delivery of her daughter, little realizing the implications.
On discovery of the new baby tree, local OB/GYN Bonnie Beaver decided to branch out and put in a urgent consult to botany. Local botanist Pete Moss took the call. “This is my chance to shine” he said. “A lot of my classmates thought that I was crazy to go into botanical medicine after my clinic gave me the ax, but this proves them entirely wrong.” Fortunately, Dr. Moss was able to get to the root of the problem, and after some plucking, a healthy baby boy was born.
During the newborn exam, midwive Carrie Dibabi from neonatology diagnosed a rather advanced form of seborrheic dermatitis on the infant’s scalp, discovering that its bark was indeed worse than its bite.