{"id":3912,"date":"2013-03-23T06:54:15","date_gmt":"2013-03-23T10:54:15","guid":{"rendered":"http:\/\/blogs.nejm.org\/?p=3912"},"modified":"2015-06-04T14:33:51","modified_gmt":"2015-06-04T18:33:51","slug":"id-doctors-pets-in-the-medical-history-and-a-cute-puppy","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/id-doctors-pets-in-the-medical-history-and-a-cute-puppy\/2013\/03\/23\/","title":{"rendered":"ID Doctors, Pets in the Medical History, and a Cute Puppy"},"content":{"rendered":"<p><a href=\"http:\/\/blogs.nejm.org\/hiv-id-observations\/wp-content\/uploads\/sites\/2\/2013\/03\/louie-9-weeks1.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignright  wp-image-3918\" title=\"louie 9 weeks\" src=\"http:\/\/blogs.nejm.org\/hiv-id-observations\/wp-content\/uploads\/sites\/2\/2013\/03\/louie-9-weeks1.jpg\" alt=\"\" width=\"322\" height=\"322\" \/><\/a>One of the things Infectious Disease doctors get teased about by our non-ID colleagues is our inclusion of pets in medical histories.<\/p>\n<p>It&#8217;s part of the social history, where we list a grab bag of \u00a0potential &#8220;exposures&#8221; that increase the risk of infection &#8212; where someone is from, what they do, plus travel, dietary practices, sex, drugs, alcohol, cigarettes, and PETS!<\/p>\n<p>In our defense, to our critics I remind them that we take the <em>best<\/em> histories &#8212; if you don&#8217;t believe me, read <a href=\"http:\/\/blogs.nejm.org\/index.php\/infectious-diseases-specialists-take-the-best-medical-histories\/2012\/04\/04\/\" target=\"_blank\">this <\/a>&#8212; but must acknowledge that the pet thing is not always relevant. Ok, it barely <em>ever<\/em> is relevant. But it sure is fun.<\/p>\n<p>In order to examine this issue more closely, I offer the following anecdotes and observations &#8212; none of them leading to brilliant pet-related diagnoses &#8212; taken from real life clinical practice:<\/p>\n<ul>\n<li>I once cared for someone who was\u00a0<em>very<\/em> funny &#8212; so much so that he was funny for a living. When I asked him if he had any pets, he told me he had 15 cats. How did he do that? \u00a0His response: \u00a0&#8220;Easy &#8212; when you have 14 cats, you get one more, and if you have 16, one of them dies or runs away.&#8221; (FYI, I think he stole this line.)<\/li>\n<li>A patient told me she was taking her dog&#8217;s deworming medicine for pinworm. She didn&#8217;t have pinworm, by the way, but <a href=\"http:\/\/www.youtube.com\/watch?v=yTSs3JwCiI4\" target=\"_blank\">these were her symptoms<\/a>, so she was convinced. (Warning: video is kind of yucky.) The medication she was taking was something called &#8220;Panacur&#8221; (fenbendazole). While I like that name &#8212; Panacur sure sounds like it cures a lot of things &#8212; it&#8217;s only approved\u00a0for use in sheep, cattle, horses, fish, dogs, cats, rabbits and seals.<\/li>\n<li>Dept. of Irony: \u00a0Asked someone recently if he&#8217;d received his zoster vaccine, and he told me that he refused because the cost was <em>way<\/em> too high ($300), and not covered by insurance. Later, when I asked him about his pets, he told me he&#8217;d paid nearly $3000 for his dog&#8217;s various orthopedic ailments.<\/li>\n<li>It used to be that none of our patients from Haiti had pets. Now lots do. Is there a PhD anthropology thesis in there? I&#8217;d better ask Paul Farmer.<\/li>\n<li>Every so often, someone tells you he\/she has a pet turtle, frog, or lizard. Should you\u00a0warn them of the <a href=\"http:\/\/www.cdc.gov\/features\/salmonellafrogturtle\/\" target=\"_blank\">risk of salmonella<\/a>, and ruin their fun?\u00a0And if not,\u00a0why ask? These are the kind of tough dilemmas ID doctors face every day.<\/li>\n<li>My first opportunity to witness the occasional absurdity of this pet obsession was during my fellowship. One of my attendings, an extremely detail-oriented type even by ID standards, was consulted by a trauma surgeon on a comatose man with fevers during a lengthy hospital stay after a motorcycle accident. She wrote in her note, &#8220;has parakeet named Fruitloop.&#8221; This surprised me, as the patient didn&#8217;t seem like the parakeet type. And I still wonder &#8212; how did my attending find this out? Here&#8217;s the dialogue that might have happened:<br \/>\n<strong>ID doctor:<\/strong> \u00a0Does he have any pets at home?<br \/>\n<strong>Patient&#8217;s Mother<\/strong> (surprised at the question): \u00a0Yes, he has a bird. We&#8217;re taking care of it since the accident.<br \/>\n<strong>ID doctor<\/strong>: \u00a0What kind of bird is it?<br \/>\n<strong>Patient&#8217;s Mother\u00a0<\/strong>(even more surprised): \u00a0It&#8217;s a yellow parakeet.<br \/>\n<strong>ID doctor:<\/strong> \u00a0What is the bird&#8217;s name?<br \/>\n<strong>Patient&#8217;s Mother:<\/strong> \u00a0Fruitloop. (A pause.) Excuse me doctor, are you out of your mind?<\/li>\n<\/ul>\n<p>So here&#8217;s a confession. This post is an excuse to show off a picture of our new puppy.<\/p>\n<p>His name is Louie.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>One of the things Infectious Disease doctors get teased about by our non-ID colleagues is our inclusion of pets in medical histories. It&#8217;s part of the social history, where we list a grab bag of \u00a0potential &#8220;exposures&#8221; that increase the risk of infection &#8212; where someone is from, what they do, plus travel, dietary practices, [&hellip;]<\/p>\n","protected":false},"author":6,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[3,5,8],"tags":[],"class_list":["post-3912","post","type-post","status-publish","format-standard","hentry","category-health-care","category-infectious-diseases","category-patient-care"],"post_mailing_queue_ids":[],"_links":{"self":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/posts\/3912","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/users\/6"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/comments?post=3912"}],"version-history":[{"count":0,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/posts\/3912\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/media?parent=3912"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/categories?post=3912"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/tags?post=3912"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}