June 23, 2025 • 23 mins
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We discuss an important patient education story about medication misunderstandings that could have led to serious harm, highlighting the gaps in healthcare instruction.
• Nicole shares her experience with a broken toe and visit to urgent care
• The hosts discuss their current reality TV favorites including Love Island and Dallas Cowboys Cheerleaders
• A patient was discovered not removing the needle cap when trying to administer insulin
• Another patient only took blood pressure medication once weekly during readings instead of daily
• The importance of "teach back" methodology where patients demonstrate understanding
• Different approaches needed for teaching children versus adults about medical care
• Medical literacy varies greatly and providers shouldn't make assumptions about patient knowledge
Stay healthy, and follow the podcast for more patient stories and healthcare insights that might help you, a loved one, or a neighbor.
Production and Content: Edward Delesky, MD & Nicole Aruffo, RN
Artwork: Olivia Pawlowski
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:07):
Hi, welcome to your checkup.
We are the patient educationpodcast, where we bring
conversations from the doctor'soffice to your ears.
On this podcast, we try tobring medicine closer to its
patients.
I'm Ed Dolesky, a familymedicine doctor in the
Philadelphia area.
Speaker 2 (00:22):
And I'm Nicola Ruffo.
I'm a nurse.
Speaker 1 (00:24):
And we are so excited you were able to join us here
again today.
We could probably do a wholeepisode on the things that have
happened to you recently.
Can you set the scene for us?
Speaker 2 (00:38):
It was traumatic.
I am injured.
Speaker 1 (00:46):
It was a simple thing , turned so sideways.
Speaker 2 (00:49):
Oh my gosh.
I know the couch came out ofnowhere.
I stubbed my toe, but Iactually broke.
My toe Blew up like a grapeHeard the crack.
Speaker 1 (01:03):
Yeah.
Speaker 2 (01:03):
Eddie made me go to a beach urgent care to get an
x-ray and I felt kind of sillybeing there, but then she told
me it was broken so I felt kindof better you were like in the
moment.
Speaker 1 (01:14):
You were like rocking in the fetal position on the
exam table, being like I'm gonnafeel so dumb if I, if this
isn't real I was like the, theMA came in Maria she was nice.
Speaker 2 (01:25):
I told her all about it and then the PA came in and
she's like so you stubbed yourtoe.
I'm like, yeah, yeah, I did,but it cracked and it had stuff
throbbing.
Speaker 1 (01:34):
Right.
Normally you stub your toe,you're in a couple moments of
agony and then it goes away.
It becomes a thing thathappened, that you're like,
you're resilient, you bounceback.
No, your bone crumbles.
Oh my god, it was so dramaticmy first broken bone I know.
(01:54):
I was so sad about that, likemy nicky and like your bone, no
like.
Speaker 2 (01:56):
If we want to talk about dramatic, okay, it is not
lost on me that this is fine.
It will get better.
It could could be worse, right.
However, I cannot get over thebruising on my foot.
Every toe is bruised.
Like half of my foot is bruised.
I can't put on a sneaker.
I'm walking in this stupidpost-op shoe, probably for a
couple of weeks.
Speaker 1 (02:17):
Yeah.
It's so dramatic for no reasonand it really takes you down too
Like can't.
Like I mean you're being reallycreative with like exercising
too, but like we were runninggirlies I know I don't want you
to think, I don't want you tothink about that too much my
first wedding dress fitting inlike three weeks let's not go
down that path right now.
(02:38):
Um, all together, getting thex-ray was nice.
She definitely was like so whenwe go to an urgent care, we go
to like a hospital.
We usually operate in disguise.
Speaker 2 (02:47):
Um, this has happened twice I mean yeah, we're not
like being those people no, wedon't, we were there for the
x-ray.
Like we're not there forstellar medical advice or care.
Like we need the image andwe'll go from there right.
Speaker 1 (02:58):
But then when, like she came in and she was like all
right, I have good news and badnews.
The bad news is it's broken andshe never got to.
What she interpreted was thegood news she didn't.
No, she didn't, she juststopped there and she's like the
bad news is it's broken and Ifeel like her good news was like
but the good news is here's areferral to sports medicine,
(03:20):
which is totally the reasonablething to do To ortho.
Speaker 2 (03:22):
yeah yeah, thankfully we have an ortho bestie, so
Eddie sent my x-rays to him.
Speaker 1 (03:30):
I was like hey, can you-, so got to dodge that
doctor's visit and co-pay?
Double-check the work of asimple country doctor with what
I'm thinking here.
Speaker 2 (03:39):
You know we do need to talk about something, though
let's dive in.
What do you want to talk about,though?
Oh, let's, let's dive in.
What do you want to talk about?
Because I'm injured and I'msitting here working.
No, because hr refused to giveme fmla and I feel like I should
be going to the department oflabor after this maybe you have
(04:02):
to of labor after this.
Speaker 1 (04:08):
Maybe you have to to file a complaint.
Yeah, maybe I don't like hr.
I'll say that out loud.
Um, not the people.
The people are great, but youknow, um, I got nothing to say.
You and I both know how this isactually going today and the
function of, uh, what we'retalking about up front here.
Yeah, she never did get to thegood news which I was shocked.
Speaker 2 (04:30):
I have nothing to say on denying my FMLA.
Speaker 1 (04:32):
No, I have absolutely nothing to say to that.
I deny that, I denied.
Speaker 2 (04:36):
Your people can talk to my people.
Speaker 1 (04:37):
Your FMLA.
But then when I asked her, Iwas like, oh, is it displaced?
She gave me this look of likewho taught you that trick?
And we still remained in thisguy's Google medical degree.
Absolutely.
She like totally thought that Ilike had looked up toe fracture
and and, like you know, came upwith that I mean yeah.
Speaker 2 (05:00):
I don't blame her.
Speaker 1 (05:01):
No, I would have thought the same thing.
She wants to keep it moving.
Well, yeah, but like, if thathappens to me, I usually ask
like, oh, like, are you in themedical field?
Like a question like that comesout, then I usually lob up the
like what do you really know?
So, I'm not speaking to likegiving, like the no jargon
information.
We can talk, like you know,compadres.
Speaker 2 (05:32):
Yeah.
Speaker 1 (05:33):
So what else has been going on?
What else has been going on?
Speaker 2 (05:35):
there is no, no, there's nothing um well, we're
deep into love island, such goodrotting for someone who jumps
in and like just listens to thisepisode.
Speaker 1 (05:47):
Can you tell them what love island is?
Speaker 2 (05:49):
yeah, love island is probably some of the best
reality tv and we would know wewatch a lot we watch a lot.
Um, guys, girls, they're on anisland, they're all coupled up
together and then thesebombshells come in.
But the whole shtick of it isthat it's pretty much edited and
put out in real time, like whatyou're watching happened like
(06:10):
two or three days ago becausethey're in Fiji.
So then there's like livevoting you can do.
So that's been really fun.
We've also been watching DCC.
Speaker 1 (06:21):
Oh right.
Speaker 2 (06:22):
Which something OK.
Speaker 1 (06:23):
Not to be forgotten c .
Speaker 2 (06:25):
Oh right, which something okay?
Speaker 1 (06:26):
not to be forgotten, we need to talk about what's
going on in texas.
Actually remember this is lastyear how most reality tv is
produced I mean it's still goingon, I'm sure well, now they're
doing this go ahead sorry okay,the dallas cowboy cheerleaders
these women are like beautiful,stunning flaws.
Speaker 2 (06:42):
They are tense across the board.
And then they're all, for somereason, except for that girl,
kelsey from last year, who gotmarried, and he was like an
actor or something like he'sgood looking.
All these the men that they'rewith, are these like kind of
baby face, a little portly, like, just like it's true men.
(07:06):
I know and I'm like how did youget her?
Speaker 1 (07:09):
because, like, this is crazy I know a couple people
and I might have to like be likeyou got to go to texas, like
you might.
That's, that's where you gottago.
I mean, it is, it is shot.
(07:29):
They're great people.
It's just like maybe one afterthe next.
I know it's consistent.
Speaker 2 (07:34):
The third one we were like what is happening?
How are these men who are likea three getting these like
perfect looking girls?
Speaker 1 (07:44):
it's a pattern too it is.
Speaker 2 (07:45):
It's not just a one-off yeah, I don't know,
maybe they have a lot of moneythat mike has never been the
same since mike yeah, thanksmike really grabbed onto it.
Speaker 1 (07:58):
Um, yeah, that's a.
That's a great point.
I don't understand it.
I see it too.
I'm with you if you watch dccfor no other reason.
Just like, check that out andlet us know what you think.
Maybe we're just beingjudgmental, but um, probably,
but that's fine.
This is a safe space as far asI'm concerned right, this isn't
going to go out to be availableto anyone who wants to listen at
(08:19):
all.
Speaker 2 (08:20):
Um oh, we didn't talk about Jalen on Love Island.
Speaker 1 (08:26):
Oh sweet king.
Speaker 2 (08:28):
The sweet king.
Do you know what's happeningonline with Jalen?
Speaker 1 (08:32):
No.
Speaker 2 (08:33):
Okay, so Jalen was one of the bombshells that came
onto Love Island.
He's this like sweet southerncountry boy.
He was there for like twonights or something like that.
Speaker 1 (08:42):
It was not a long time.
Speaker 2 (08:43):
Ended up, like the other islanders voteders voted
him off.
But he's like so sweet he hangsout with his grandma in his
free time.
He got a passport like hadnever left the country, got a
passport to go to fiji and thenhe got kicked off.
So then he makes a tiktok yeah,it doesn't feel he made a
tiktok like three or four daysago, he got got like 300,000
(09:05):
followers overnight.
He has over a million followersnow, really.
And all of these brands and likeairlines and stuff are
commenting being like we want tofly you out, like get more use
out of your passport, all thisstuff.
So like he's going to do great,wait, that's I know.
Speaker 1 (09:21):
Thanks for telling me .
Speaker 2 (09:21):
This is total news to me.
Thanks for telling me.
Speaker 1 (09:22):
This is total news to me.
Speaker 2 (09:23):
And like people online Would be like.
I can't stop thinking AboutJalen smiling For his first ever
Passport photo To go to Fiji,and then he has to Turn around
and come home.
Speaker 1 (09:33):
Yeah, they, I.
He should have stayed, heshould have.
I don't like what they didthere, but yeah, I like taylor,
I really do.
I think it was a little bit ofa taylor's so funny.
He's so funny.
But I also think that all ofthat was for, like, protecting
him and his relationship withalandria, and it should have I
(09:55):
don't know they should havegiven them another chance.
It was so obvious that it'shood is time to go, and like
they should have given jalenanother chance and it's it warms
my heart to hear that he'sgetting this opportunity.
That's actually really cool andlike who knows what comes after
that.
Speaker 2 (10:11):
But you know, like a million followers hopefully he
has like three tiktoks when Iwas talking about it the other
night.
So he has three tiktoks andlike over a million followers
that's awesome and all thesebrands, like all of his comments
, are just like brands wantingto like send him stuff, fly him
places, do all this stuff.
Speaker 1 (10:32):
That's crazy.
Maybe we need to have some sobstory.
Speaker 2 (10:37):
Let's put your toe out there.
Speaker 1 (10:39):
And then maybe we put a um like those AS ASPCA.
Speaker 2 (10:46):
Oh my God.
Speaker 1 (10:46):
Commercial like those as as pca um oh my god
commercial in the arms of theangels, and then it's your x-ray
with like a very subtlefracture, you really zoom in to
really zoom in and maybe thatwill get us where we want to go
yeah, maybe.
Speaker 2 (11:06):
No, like don't you feel like my foot?
Like I feel like that wassomeone else's x-ray, like my
foot how it looks does not knowI'm what the x-ray was giving a
little, a little curious to seewhat the um, the repeat x-ray
shows.
Speaker 1 (11:21):
Yeah, because you have like tenderness, like in a
lot of places, more than justwhere you stubbed your pinky toe
, I actually shattered my foot.
So I'm glad you're in the boot.
We'll get you another x-raysoon enough, and probably next
week, and we'll see what happens.
Oh my goodness.
All right, what are we going totalk about today?
(11:42):
Nick, we're trying to diversifyour content and we see a lot of
important things throughout ourdays and some powerful stories,
and every once in a while, wewant to include those stories in
a HIPAA compliant way and sharewhat we've learned from
(12:02):
witnessing all of the thingsthat we see.
And so today is one of thoseepisodes and we're going to hear
a story that is very important.
So here we go.
Speaker 2 (12:17):
I mean, it's not like , it's just like a little tidbit
, yeah, but I think it's goodfor patient education, great.
So we discharged this patientrecently and then the nurse
practitioner I work with wastelling me that she last week
got a message from home needleoff the pen, I guess to inject
herself with insulin.
So it was just like I don'tknow where it was going, in the
(12:56):
cap, I guess.
Speaker 1 (12:57):
Oh, my God.
Speaker 2 (12:58):
But I thought that was a good.
So then I think the home carenurse was like show me how you
give your insulin.
Speaker 1 (13:06):
And then she didn't.
Speaker 2 (13:07):
She wasn't taking the cap off, but that's a good um,
like education absolutely justthink like how, because like we
do she wasn't a new.
I don't know if she was a newdiabetic actually.
Whatever, it doesn't matter,but we do like insulin teaching
before someone leaves and thereis a nurse who's like, dedicated
(13:28):
to do, like all the educationfor everyone, who's wonderful,
and I don't think she, you know,didn't tell her to not take the
cap off yeah but it's just oneof those especially.
I don't know what she went homeon.
I don't think it was a pen, buteven like sometimes you can't
because even like the if it wasa pen, kind of like the safety
(13:48):
sleeve over the needle, it'shard to tell if there's a needle
there one would think thatthat's like the cap yeah right,
because it's like oh, here'sthis big honking thing at the
end.
Let me take this off yeah andI'm good to go.
So I mean whenever, like Iwould be doing education, like
teach back, is so important.
So I guess, really like ifyou're, you know, like at the
(14:22):
doctor's office or in thehospital and someone's teaching
you how to do something, I thinkpretty widely you know like
teach back and likedemonstration is pretty, very
common.
But if someone's not asking youto show like you know, show me
back how you would do this athome.
Yep, you should do it.
You'll probably be asked to dothat.
I can't imagine a situationwhere you aren't but oh, I can
think of so many, I guess, Idon't know.
Yeah, I can think of a lot andlike where, because I think
hearing it and then actuallydoing it are two totally
(14:46):
different things I think therewas another guy he I can't
remember exactly, but he hadlike very uncontrolled blood
pressure, had a stroke becauseof it, and then I think it was
(15:06):
the resident that was like orsomeone was talking about, about
like medicine and his I guesslike primary care doctor told
him to like check his bloodpressure at home weekly okay and
then you know, so they couldfigure out meds and whatever.
So he was checking his bloodpressure once a week and only
(15:28):
taking his medicine when hisblood pressure was high.
So he was only taking it once aweek there you go, not every
day, right?
Speaker 1 (15:36):
yeah, these are like such common misunderstandings
that it's very.
Speaker 2 (15:45):
What am I trying to say?
I mean, all those little likenuances are really difficult,
especially if you have zeroexperience.
Right, right, like if you or Ihad an injection of some sort
that we had to do at home, like,yeah, that's fine, where do I
pick it up?
At the pharmacy, like whatever.
But not everyone knows how todo every single little step.
(16:10):
It's kind of like when you werein school I forget what, like
the term for this is but didyour teachers ever do anything
where, like you had to writedown instructions for something
and like the one that, like I'veseen and I've been told like
from my teachers, was like writedown the instructions for how
to make a peanut butter andjelly sandwich?
Speaker 1 (16:29):
Oh, my God Wait yes.
Speaker 2 (16:31):
And then the first one that kids always write is
like put the peanut butter onthe bread.
So then the teacher would takethe jar of peanut butter, put it
on the whole loaf of the breadin the bag.
Speaker 1 (16:41):
Yep.
Speaker 2 (16:42):
And it's like okay, I put the peanut butter on the
bread.
So I think that that's like thebest comparison that I can
think of.
Speaker 1 (16:49):
That's a great example For like patient
education.
This came up when I had acoding class in college and they
were like you have to write allof the instructions for this
device to be able to achievewhat you want, and that the
peanut butter and jelly thingcame up.
And they were like well, wheredo you?
Speaker 2 (17:13):
get the peanut butter and jelly thing came up and
they were like well, where doyou get the peanut butter?
Speaker 1 (17:16):
instead of writing like open the bag, take out a
piece of bread, open the jar ofpeanut butter, get a knife.
You know, which really justinvites that all of us could be
doing better when we are givingdescriptions to people about how
to do things.
And you shouldn't take it forgranted like, oh, this is your
blood pressure medicine versusthis is your blood pressure
medicine that you should takeone pill of every night for the
(17:37):
rest of time or until somethingchanges and you like, need to
keep getting refills.
If you don't get a refill orthe medicine runs out, you need
more of it.
That's a very common one.
Or people think, like if themedicine isn't there anymore,
there's no refills on it.
That like it's not and it's achronic medicine that they just
(17:58):
I'm done taking it I'm donetaking it, which is very common,
but it happens a lot.
Yeah, and diabetes education inthe hospital, I think, is so
important because it's a morefluid open time than a finite
like 20 minute visit outside thehospital.
(18:20):
And so, like we've, we getplenty of people with new
diabetes in the hospital andthey're like, oh, they can teach
it, they can teach them outsidethe hospital, they can teach
them outside.
And I'm like, no, please putthat order in so the nurse can
educate them, because one, thenurses are brilliant.
Speaker 2 (18:36):
They do this all the time.
I actually love doing thediabetes education.
Speaker 1 (18:41):
I guess my question for you is at what age did the
diabetes education go to thechild versus the parent?
Speaker 2 (18:52):
Well, I think a lot of it is like developmentally.
Speaker 1 (18:55):
Okay.
Speaker 2 (18:58):
I don't know if there's like a specific age, but
kids are also pretty.
What's the word I want to use?
Spongy Spongy yeah, they arepretty spongy and they're just
like aware and I feel like theya lot of times kids kind of like
want to be in control of, likenot in control.
(19:23):
What am I trying to say?
Yeah, I guess like in control,or even just like checking a
kid's blood sugar, like theywant to use the lancet
themselves and like prick theirfinger and like I think it kind
of like gives them that sense ofautonomy.
Um, I mean, regardless it goes.
(19:45):
You know, it's both the parentand the kid.
Speaker 1 (19:49):
Did you find it easier to teach?
Speaker 2 (19:51):
You can't be like, fully dependent on an eight year
old to be counting his carbs.
Speaker 1 (19:54):
Right.
Did you find it easier to teachthe child or the parents?
Speaker 2 (20:00):
oh, that depends, okay.
I mean, you know like literacylevel, education level, all very
important.
Speaker 1 (20:10):
Were there certain times when, like common hiccup
points or frustrations thatwould come?
Speaker 2 (20:25):
I mean, yeah, there are, but I think I mean that's
like a very overwhelming thingto be diagnosed with diabetes or
have your kid diagnosed withdiabetes, especially if you
don't know anything about it andit is kind of, you know, just
like wrapping your head around.
It is a little bit difficult, Ithink, especially if you have
like zero medical literacy.
Speaker 1 (20:47):
Right.
Speaker 2 (20:48):
That's really hard.
But then, like sometimes, if itwas I don't know, like whatever
, like school-aged kid, like 10or so, I think sometimes like
the mom would be like reallystressed out about like counting
, because it's a little bit moredetailed in peds versus adults,
where you have to like do acouple like equations, counting
carbs.
Speaker 1 (21:07):
You're dividing stuff they do tend to do that more in
peds than adults.
Speaker 2 (21:11):
I still don't exactly know why, and then sometimes,
like the kid will be like mom,it's like this number and like
oh yeah.
And they're like ready to goand like the mom will be like
freaking out yeah.
Speaker 1 (21:23):
Yeah, because they're like in still like a learning
and growth mode, because they'rein school, they're like
learning every day.
But learning as you get older,I feel like tends to go by the
wayside a lot and it's lessinvited in the adult world.
Well, thank you for coming backto another episode of your
Checkup.
Hopefully you were able tolearn something for yourself, a
(21:45):
loved one or a neighbor.
On this episode.
We hope that this patient storywas nice for you to hear and
you can check out our website.
Follow the podcast so that youcan get updates about when new
episodes come out.
And, most importantly, stayhealthy, my friends.
Until next time.
I'm Ed Dolesky.
Speaker 2 (22:03):
I'm Nicole Arrufo.
Speaker 1 (22:04):
Thank you and goodbye Bye.
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This is not medical advice oran attempt to substitute medical
(22:26):
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You should contact a healthcareprovider for personalized
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for a specific patient.
Thank you.
Hi, welcome to your checkup.
We are the patient educationpodcast, where we bring
conversations from the doctor'soffice to your ears.
On this podcast, we try tobring medicine closer to its
patients.
I'm Ed Dolesky, a familymedicine doctor in the
Philadelphia area.
Speaker 2 (00:22):
And I'm Nicola Ruffo.
I'm a nurse.
Speaker 1 (00:24):
And we are so excited you were able to join us here
again today.
We could probably do a wholeepisode on the things that have
happened to you recently.
Can you set the scene for us?
Speaker 2 (00:38):
It was traumatic.
I am injured.
Speaker 1 (00:46):
It was a simple thing , turned so sideways.
Speaker 2 (00:49):
Oh my gosh.
I know the couch came out ofnowhere.
I stubbed my toe, but Iactually broke.
My toe Blew up like a grapeHeard the crack.
Speaker 1 (01:03):
Yeah.
Speaker 2 (01:03):
Eddie made me go to a beach urgent care to get an
x-ray and I felt kind of sillybeing there, but then she told
me it was broken so I felt kindof better you were like in the
moment.
Speaker 1 (01:14):
You were like rocking in the fetal position on the
exam table, being like I'm gonnafeel so dumb if I, if this
isn't real I was like the, theMA came in Maria she was nice.
Speaker 2 (01:25):
I told her all about it and then the PA came in and
she's like so you stubbed yourtoe.
I'm like, yeah, yeah, I did,but it cracked and it had stuff
throbbing.
Speaker 1 (01:34):
Right.
Normally you stub your toe,you're in a couple moments of
agony and then it goes away.
It becomes a thing thathappened, that you're like,
you're resilient, you bounceback.
No, your bone crumbles.
Oh my god, it was so dramaticmy first broken bone I know.
(01:54):
I was so sad about that, likemy nicky and like your bone, no
like.
Speaker 2 (01:56):
If we want to talk about dramatic, okay, it is not
lost on me that this is fine.
It will get better.
It could could be worse, right.
However, I cannot get over thebruising on my foot.
Every toe is bruised.
Like half of my foot is bruised.
I can't put on a sneaker.
I'm walking in this stupidpost-op shoe, probably for a
couple of weeks.
Speaker 1 (02:17):
Yeah.
It's so dramatic for no reasonand it really takes you down too
Like can't.
Like I mean you're being reallycreative with like exercising
too, but like we were runninggirlies I know I don't want you
to think, I don't want you tothink about that too much my
first wedding dress fitting inlike three weeks let's not go
down that path right now.
(02:38):
Um, all together, getting thex-ray was nice.
She definitely was like so whenwe go to an urgent care, we go
to like a hospital.
We usually operate in disguise.
Speaker 2 (02:47):
Um, this has happened twice I mean yeah, we're not
like being those people no, wedon't, we were there for the
x-ray.
Like we're not there forstellar medical advice or care.
Like we need the image andwe'll go from there right.
Speaker 1 (02:58):
But then when, like she came in and she was like all
right, I have good news and badnews.
The bad news is it's broken andshe never got to.
What she interpreted was thegood news she didn't.
No, she didn't, she juststopped there and she's like the
bad news is it's broken and Ifeel like her good news was like
but the good news is here's areferral to sports medicine,
(03:20):
which is totally the reasonablething to do To ortho.
Speaker 2 (03:22):
yeah yeah, thankfully we have an ortho bestie, so
Eddie sent my x-rays to him.
Speaker 1 (03:30):
I was like hey, can you-, so got to dodge that
doctor's visit and co-pay?
Double-check the work of asimple country doctor with what
I'm thinking here.
Speaker 2 (03:39):
You know we do need to talk about something, though
let's dive in.
What do you want to talk about,though?
Oh, let's, let's dive in.
What do you want to talk about?
Because I'm injured and I'msitting here working.
No, because hr refused to giveme fmla and I feel like I should
be going to the department oflabor after this maybe you have
(04:02):
to of labor after this.
Speaker 1 (04:08):
Maybe you have to to file a complaint.
Yeah, maybe I don't like hr.
I'll say that out loud.
Um, not the people.
The people are great, but youknow, um, I got nothing to say.
You and I both know how this isactually going today and the
function of, uh, what we'retalking about up front here.
Yeah, she never did get to thegood news which I was shocked.
Speaker 2 (04:30):
I have nothing to say on denying my FMLA.
Speaker 1 (04:32):
No, I have absolutely nothing to say to that.
I deny that, I denied.
Speaker 2 (04:36):
Your people can talk to my people.
Speaker 1 (04:37):
Your FMLA.
But then when I asked her, Iwas like, oh, is it displaced?
She gave me this look of likewho taught you that trick?
And we still remained in thisguy's Google medical degree.
Absolutely.
She like totally thought that Ilike had looked up toe fracture
and and, like you know, came upwith that I mean yeah.
Speaker 2 (05:00):
I don't blame her.
Speaker 1 (05:01):
No, I would have thought the same thing.
She wants to keep it moving.
Well, yeah, but like, if thathappens to me, I usually ask
like, oh, like, are you in themedical field?
Like a question like that comesout, then I usually lob up the
like what do you really know?
So, I'm not speaking to likegiving, like the no jargon
information.
We can talk, like you know,compadres.
Speaker 2 (05:32):
Yeah.
Speaker 1 (05:33):
So what else has been going on?
What else has been going on?
Speaker 2 (05:35):
there is no, no, there's nothing um well, we're
deep into love island, such goodrotting for someone who jumps
in and like just listens to thisepisode.
Speaker 1 (05:47):
Can you tell them what love island is?
Speaker 2 (05:49):
yeah, love island is probably some of the best
reality tv and we would know wewatch a lot we watch a lot.
Um, guys, girls, they're on anisland, they're all coupled up
together and then thesebombshells come in.
But the whole shtick of it isthat it's pretty much edited and
put out in real time, like whatyou're watching happened like
(06:10):
two or three days ago becausethey're in Fiji.
So then there's like livevoting you can do.
So that's been really fun.
We've also been watching DCC.
Speaker 1 (06:21):
Oh right.
Speaker 2 (06:22):
Which something OK.
Speaker 1 (06:23):
Not to be forgotten c .
Speaker 2 (06:25):
Oh right, which something okay?
Speaker 1 (06:26):
not to be forgotten, we need to talk about what's
going on in texas.
Actually remember this is lastyear how most reality tv is
produced I mean it's still goingon, I'm sure well, now they're
doing this go ahead sorry okay,the dallas cowboy cheerleaders
these women are like beautiful,stunning flaws.
Speaker 2 (06:42):
They are tense across the board.
And then they're all, for somereason, except for that girl,
kelsey from last year, who gotmarried, and he was like an
actor or something like he'sgood looking.
All these the men that they'rewith, are these like kind of
baby face, a little portly, like, just like it's true men.
(07:06):
I know and I'm like how did youget her?
Speaker 1 (07:09):
because, like, this is crazy I know a couple people
and I might have to like be likeyou got to go to texas, like
you might.
That's, that's where you gottago.
I mean, it is, it is shot.
(07:29):
They're great people.
It's just like maybe one afterthe next.
I know it's consistent.
Speaker 2 (07:34):
The third one we were like what is happening?
How are these men who are likea three getting these like
perfect looking girls?
Speaker 1 (07:44):
it's a pattern too it is.
Speaker 2 (07:45):
It's not just a one-off yeah, I don't know,
maybe they have a lot of moneythat mike has never been the
same since mike yeah, thanksmike really grabbed onto it.
Speaker 1 (07:58):
Um, yeah, that's a.
That's a great point.
I don't understand it.
I see it too.
I'm with you if you watch dccfor no other reason.
Just like, check that out andlet us know what you think.
Maybe we're just beingjudgmental, but um, probably,
but that's fine.
This is a safe space as far asI'm concerned right, this isn't
going to go out to be availableto anyone who wants to listen at
(08:19):
all.
Speaker 2 (08:20):
Um oh, we didn't talk about Jalen on Love Island.
Speaker 1 (08:26):
Oh sweet king.
Speaker 2 (08:28):
The sweet king.
Do you know what's happeningonline with Jalen?
Speaker 1 (08:32):
No.
Speaker 2 (08:33):
Okay, so Jalen was one of the bombshells that came
onto Love Island.
He's this like sweet southerncountry boy.
He was there for like twonights or something like that.
Speaker 1 (08:42):
It was not a long time.
Speaker 2 (08:43):
Ended up, like the other islanders voteders voted
him off.
But he's like so sweet he hangsout with his grandma in his
free time.
He got a passport like hadnever left the country, got a
passport to go to fiji and thenhe got kicked off.
So then he makes a tiktok yeah,it doesn't feel he made a
tiktok like three or four daysago, he got got like 300,000
(09:05):
followers overnight.
He has over a million followersnow, really.
And all of these brands and likeairlines and stuff are
commenting being like we want tofly you out, like get more use
out of your passport, all thisstuff.
So like he's going to do great,wait, that's I know.
Speaker 1 (09:21):
Thanks for telling me .
Speaker 2 (09:21):
This is total news to me.
Thanks for telling me.
Speaker 1 (09:22):
This is total news to me.
Speaker 2 (09:23):
And like people online Would be like.
I can't stop thinking AboutJalen smiling For his first ever
Passport photo To go to Fiji,and then he has to Turn around
and come home.
Speaker 1 (09:33):
Yeah, they, I.
He should have stayed, heshould have.
I don't like what they didthere, but yeah, I like taylor,
I really do.
I think it was a little bit ofa taylor's so funny.
He's so funny.
But I also think that all ofthat was for, like, protecting
him and his relationship withalandria, and it should have I
(09:55):
don't know they should havegiven them another chance.
It was so obvious that it'shood is time to go, and like
they should have given jalenanother chance and it's it warms
my heart to hear that he'sgetting this opportunity.
That's actually really cool andlike who knows what comes after
that.
Speaker 2 (10:11):
But you know, like a million followers hopefully he
has like three tiktoks when Iwas talking about it the other
night.
So he has three tiktoks andlike over a million followers
that's awesome and all thesebrands, like all of his comments
, are just like brands wantingto like send him stuff, fly him
places, do all this stuff.
Speaker 1 (10:32):
That's crazy.
Maybe we need to have some sobstory.
Speaker 2 (10:37):
Let's put your toe out there.
Speaker 1 (10:39):
And then maybe we put a um like those AS ASPCA.
Speaker 2 (10:46):
Oh my God.
Speaker 1 (10:46):
Commercial like those as as pca um oh my god
commercial in the arms of theangels, and then it's your x-ray
with like a very subtlefracture, you really zoom in to
really zoom in and maybe thatwill get us where we want to go
yeah, maybe.
Speaker 2 (11:06):
No, like don't you feel like my foot?
Like I feel like that wassomeone else's x-ray, like my
foot how it looks does not knowI'm what the x-ray was giving a
little, a little curious to seewhat the um, the repeat x-ray
shows.
Speaker 1 (11:21):
Yeah, because you have like tenderness, like in a
lot of places, more than justwhere you stubbed your pinky toe
, I actually shattered my foot.
So I'm glad you're in the boot.
We'll get you another x-raysoon enough, and probably next
week, and we'll see what happens.
Oh my goodness.
All right, what are we going totalk about today?
(11:42):
Nick, we're trying to diversifyour content and we see a lot of
important things throughout ourdays and some powerful stories,
and every once in a while, wewant to include those stories in
a HIPAA compliant way and sharewhat we've learned from
(12:02):
witnessing all of the thingsthat we see.
And so today is one of thoseepisodes and we're going to hear
a story that is very important.
So here we go.
Speaker 2 (12:17):
I mean, it's not like , it's just like a little tidbit
, yeah, but I think it's goodfor patient education, great.
So we discharged this patientrecently and then the nurse
practitioner I work with wastelling me that she last week
got a message from home needleoff the pen, I guess to inject
herself with insulin.
So it was just like I don'tknow where it was going, in the
(12:56):
cap, I guess.
Speaker 1 (12:57):
Oh, my God.
Speaker 2 (12:58):
But I thought that was a good.
So then I think the home carenurse was like show me how you
give your insulin.
Speaker 1 (13:06):
And then she didn't.
Speaker 2 (13:07):
She wasn't taking the cap off, but that's a good um,
like education absolutely justthink like how, because like we
do she wasn't a new.
I don't know if she was a newdiabetic actually.
Whatever, it doesn't matter,but we do like insulin teaching
before someone leaves and thereis a nurse who's like, dedicated
(13:28):
to do, like all the educationfor everyone, who's wonderful,
and I don't think she, you know,didn't tell her to not take the
cap off yeah but it's just oneof those especially.
I don't know what she went homeon.
I don't think it was a pen, buteven like sometimes you can't
because even like the if it wasa pen, kind of like the safety
(13:48):
sleeve over the needle, it'shard to tell if there's a needle
there one would think thatthat's like the cap yeah right,
because it's like oh, here'sthis big honking thing at the
end.
Let me take this off yeah andI'm good to go.
So I mean whenever, like Iwould be doing education, like
teach back, is so important.
So I guess, really like ifyou're, you know, like at the
(14:22):
doctor's office or in thehospital and someone's teaching
you how to do something, I thinkpretty widely you know like
teach back and likedemonstration is pretty, very
common.
But if someone's not asking youto show like you know, show me
back how you would do this athome.
Yep, you should do it.
You'll probably be asked to dothat.
I can't imagine a situationwhere you aren't but oh, I can
think of so many, I guess, Idon't know.
Yeah, I can think of a lot andlike where, because I think
hearing it and then actuallydoing it are two totally
(14:46):
different things I think therewas another guy he I can't
remember exactly, but he hadlike very uncontrolled blood
pressure, had a stroke becauseof it, and then I think it was
(15:06):
the resident that was like orsomeone was talking about, about
like medicine and his I guesslike primary care doctor told
him to like check his bloodpressure at home weekly okay and
then you know, so they couldfigure out meds and whatever.
So he was checking his bloodpressure once a week and only
(15:28):
taking his medicine when hisblood pressure was high.
So he was only taking it once aweek there you go, not every
day, right?
Speaker 1 (15:36):
yeah, these are like such common misunderstandings
that it's very.
Speaker 2 (15:45):
What am I trying to say?
I mean, all those little likenuances are really difficult,
especially if you have zeroexperience.
Right, right, like if you or Ihad an injection of some sort
that we had to do at home, like,yeah, that's fine, where do I
pick it up?
At the pharmacy, like whatever.
But not everyone knows how todo every single little step.
(16:10):
It's kind of like when you werein school I forget what, like
the term for this is but didyour teachers ever do anything
where, like you had to writedown instructions for something
and like the one that, like I'veseen and I've been told like
from my teachers, was like writedown the instructions for how
to make a peanut butter andjelly sandwich?
Speaker 1 (16:29):
Oh, my God Wait yes.
Speaker 2 (16:31):
And then the first one that kids always write is
like put the peanut butter onthe bread.
So then the teacher would takethe jar of peanut butter, put it
on the whole loaf of the breadin the bag.
Speaker 1 (16:41):
Yep.
Speaker 2 (16:42):
And it's like okay, I put the peanut butter on the
bread.
So I think that that's like thebest comparison that I can
think of.
Speaker 1 (16:49):
That's a great example For like patient
education.
This came up when I had acoding class in college and they
were like you have to write allof the instructions for this
device to be able to achievewhat you want, and that the
peanut butter and jelly thingcame up.
And they were like well, wheredo you?
Speaker 2 (17:13):
get the peanut butter and jelly thing came up and
they were like well, where doyou get the peanut butter?
Speaker 1 (17:16):
instead of writing like open the bag, take out a
piece of bread, open the jar ofpeanut butter, get a knife.
You know, which really justinvites that all of us could be
doing better when we are givingdescriptions to people about how
to do things.
And you shouldn't take it forgranted like, oh, this is your
blood pressure medicine versusthis is your blood pressure
medicine that you should takeone pill of every night for the
(17:37):
rest of time or until somethingchanges and you like, need to
keep getting refills.
If you don't get a refill orthe medicine runs out, you need
more of it.
That's a very common one.
Or people think, like if themedicine isn't there anymore,
there's no refills on it.
That like it's not and it's achronic medicine that they just
(17:58):
I'm done taking it I'm donetaking it, which is very common,
but it happens a lot.
Yeah, and diabetes education inthe hospital, I think, is so
important because it's a morefluid open time than a finite
like 20 minute visit outside thehospital.
(18:20):
And so, like we've, we getplenty of people with new
diabetes in the hospital andthey're like, oh, they can teach
it, they can teach them outsidethe hospital, they can teach
them outside.
And I'm like, no, please putthat order in so the nurse can
educate them, because one, thenurses are brilliant.
Speaker 2 (18:36):
They do this all the time.
I actually love doing thediabetes education.
Speaker 1 (18:41):
I guess my question for you is at what age did the
diabetes education go to thechild versus the parent?
Speaker 2 (18:52):
Well, I think a lot of it is like developmentally.
Speaker 1 (18:55):
Okay.
Speaker 2 (18:58):
I don't know if there's like a specific age, but
kids are also pretty.
What's the word I want to use?
Spongy Spongy yeah, they arepretty spongy and they're just
like aware and I feel like theya lot of times kids kind of like
want to be in control of, likenot in control.
(19:23):
What am I trying to say?
Yeah, I guess like in control,or even just like checking a
kid's blood sugar, like theywant to use the lancet
themselves and like prick theirfinger and like I think it kind
of like gives them that sense ofautonomy.
Um, I mean, regardless it goes.
(19:45):
You know, it's both the parentand the kid.
Speaker 1 (19:49):
Did you find it easier to teach?
Speaker 2 (19:51):
You can't be like, fully dependent on an eight year
old to be counting his carbs.
Speaker 1 (19:54):
Right.
Did you find it easier to teachthe child or the parents?
Speaker 2 (20:00):
oh, that depends, okay.
I mean, you know like literacylevel, education level, all very
important.
Speaker 1 (20:10):
Were there certain times when, like common hiccup
points or frustrations thatwould come?
Speaker 2 (20:25):
I mean, yeah, there are, but I think I mean that's
like a very overwhelming thingto be diagnosed with diabetes or
have your kid diagnosed withdiabetes, especially if you
don't know anything about it andit is kind of, you know, just
like wrapping your head around.
It is a little bit difficult, Ithink, especially if you have
like zero medical literacy.
Speaker 1 (20:47):
Right.
Speaker 2 (20:48):
That's really hard.
But then, like sometimes, if itwas I don't know, like whatever
, like school-aged kid, like 10or so, I think sometimes like
the mom would be like reallystressed out about like counting
, because it's a little bit moredetailed in peds versus adults,
where you have to like do acouple like equations, counting
carbs.
Speaker 1 (21:07):
You're dividing stuff they do tend to do that more in
peds than adults.
Speaker 2 (21:11):
I still don't exactly know why, and then sometimes,
like the kid will be like mom,it's like this number and like
oh yeah.
And they're like ready to goand like the mom will be like
freaking out yeah.
Speaker 1 (21:23):
Yeah, because they're like in still like a learning
and growth mode, because they'rein school, they're like
learning every day.
But learning as you get older,I feel like tends to go by the
wayside a lot and it's lessinvited in the adult world.
Well, thank you for coming backto another episode of your
Checkup.
Hopefully you were able tolearn something for yourself, a
(21:45):
loved one or a neighbor.
On this episode.
We hope that this patient storywas nice for you to hear and
you can check out our website.
Follow the podcast so that youcan get updates about when new
episodes come out.
And, most importantly, stayhealthy, my friends.
Until next time.
I'm Ed Dolesky.
Speaker 2 (22:03):
I'm Nicole Arrufo.
Speaker 1 (22:04):
Thank you and goodbye Bye.
This information may provide abrief overview of diagnosis,
treatment and medications.
It's not exhaustive and is atool to help you understand
potential options about yourhealth.
It doesn't cover all detailsabout conditions, treatments or
medications for a specificperson.
This is not medical advice oran attempt to substitute medical
(22:26):
advice.
You should contact a healthcareprovider for personalized
guidance based on your uniquecircumstances.
We explicitly disclaim anyliability relating to the
information given or its use.
This content doesn't endorseany treatments or medications
for a specific patient.
Thank you.
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