hmm...
An elderly lady has been admitted with severe heart failure. She has longstanding bilateral leg oedema for the past 5 years, and as a result she has suffered from a degree of venous eczema. Both her lower legs have looked red for years. She has been a patient of that ward for 2 to 3 weeks now, and the same nurse has been looking after her for the past 7 days.
Now, this evening, I got a worried phone call from her. She was concerned about these red legs which she has never seen before. So I went on to review it. The legs were as red as they were when we looked at it many weeks ago. There are not hot or tender. There are unchanged. The patient herself did not notice any change the in the condition of her legs either.
So I reassured the nurse that there isn't anything to worry about at the moment. I've also explained to her that she has venous eczema. The nurse said, "oh really? I've never seen her legs like this before....it is new." I replied, "well, I have been looking after her, and I am 100% sure that her legs have been like that for many weeks now."
I can only conclude that she hasn't seen those legs while looking after the patient. Or, she was just not paying attention during the ward round, because, we examine her every day, and expose her legs every day....so how could you not have noticed that?
I dunno.
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