im with CC lately, he's "bluedotting" with me, and we get a call, 26A, a lady is having problems with her surgery site. i had just ate way too much food. i went to a Chinese food buffet place that is one of the best in town and got a to-go box. i put a lot of baby octopus in it and some fried sweet plantains. my stomach was full. we walk in to her house and she was easily 400 lbs, sitting on the couch. she had a bowel obstruction on 12/12/09 (she went to the ED that day vomiting feces) and over the last month she has been in the ED 4 times having "electrolyte problems". about 30 minutes prior to calling 911 her surgical site on her belly, which was cleared a couple days prior by the surgeon, burst open at one end and massive amounts of puss flowed out. i noticed her pants were wet in her crotch area and just assumed she pissed herself. CC said "let me look at it" so he began to pull her pants down to look and i could see right away from how tight her pants were, she was presenting with a distended abdomen. her belly was very tight and rigid. as CC pulled her pants down to expose her scar/site there was a towel there. he pulled the towel down and immediately a sound like "blub, blub" occurred and bubbling puss flowed up and over the top of the towel. i'm not kidding, a crap load of puss came out, that was what had wetted her pants in the front. i spun around and stepped right outside. luckily the puss didn't smell but i was way to full to even attempt to stay in that room. i stood out in the carport and called for Engine 12 to come and give us some "lifting assistance". as we were waiting for them i just stood outside and talked through the door asking her name, history, meds, allergies, family doctor, etc. and then i just walked out to the truck and typed in all the stuff until E12 showed up. CC stayed with her in the house and got a set of vitals, he could tell i was fighting to keep my food down. i'm usually very good with smells and sights but i was just too full at that specific time. the only thing that makes me dry heave at work is smelly vagina, the kind that is so rotten the smell is seeping through the persons jeans. i have never puked on scene or in front of a patient....yet. we loaded her onto the stretcher and took her to the ambulance and took her to the hospital. i told the doc what was going on and we both agreed we may have found the source of her "electrolyte problems". CC was all gung-ho about seeing the puss again so when the doc looked at it he helped her but i stood outside the room, behind the glass door and watched. it didn't come out like it did at the house and her belly looked less distended. i would have loved to see what her CT-scan would have looked like had anyone in her previous visits done one. lesson learned for when i become and PA in an ED, if someone comes in with a recent surgery and they have electrolyte problems maybe i should take a peek under the scar.
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