Wanna Puke?

So, please don't read this if you are just about to eat, are eating, or plan to eat in the next 36 hours or so. This is the closest I've ever been to throwing up during residency. Alright, now that you are all NOT thinking about food...

I had a patient in clinic Friday morning, whose CC was "ER follow-up for vaginal bleeding." I thought "Great. Hello pelvic exam." So I sent the med student in to get the history. She comes back out like 10 minutes later, and tells me the story. Basically, shes 5 months post-partum, hasn't had a period yet, but now has been bleeding for 3 weeks. The ER only did an US that showed a gestational sac but no fetus, and B-HCG of 18k. They sent her home to follow up with me. Awesome. Then the sutdent remembers "Oh, and told me she was taking a shower when something fell out of her vagina with some blood clots, and she called OB triage, and they told her to bring it to this appointment." Even better. And why was this not the first thing you told me?

So now I'm both disgusted AND curious. I go in the room, talk to her briefly, then ask for this "thing". She points to a Folgers coffee jar inside a plastic bag that is sitting on the counter. I start putting gloves on and she says "Oh don't worry, its wrapped up real good. I kept it in the refrigerator." Gross. Next to the leftover Turkey and stuffing? Needless to say, I still wore gloves.

So I carry this thing into the lab (to send for pathology) and start to unwrap it. It is about half full of dilute blood that is frozen solid. But stuck in the middle is some sort of glob of tissue (I can only assume it was a fetus?). We had to let it sit there all day to thaw out in order to send it off. Freakin disgusting.

I asked Rob to taste it so I could have a Dx. He said "Already did. It's buffalo wing covered with Crisco and trichomonas with a touch of candida." Sick yet?