I hate fish..

I hate fish...especially if theres someone stupid enough to eat the fish and get a fishbone stuck in their throat..these people should only be licensed to eat fillet-o-fish or fish and chips..
here's a few tips if you're contemplating on eating fish

1. before you eat the fish, think really hard..you wouldn't want to see me at the emergency department when you accidentally (or rather stupidly) swallowed the damm bone..
2. just remember this, chicken tastes wayyy better..
3. if you have chosen to ignore advice number 1 and 2, please shut up and concentrate when you're eating..dont talk, laugh or sneeze..look at what you are putting in you're mouth..
4. please, please, please check to see that theres no bone before you swallow..the easiest method to do this is to chew your food..yes..its that simple..chew
5. if you have loose dentures, go get it bloody fixed.. you're in enough sh*t in the first place if you have to wear them.. dont complicate your life further by eating fish..
6. always refer back to rule number 1..

and to the doctors, i'm that tired of repeating myself that i have decided to put this in cyberland..if someone has swallowed a fish bone (stupidly), please do the following:

1. ask them when
2. what fish. (small or big boned)
3. was it fried fish? (cause fried ones are friable)
4. ask if the pain is sharp and pricking on every swallowing of saliva. if it is, the bone is still there.
5. wheres the pain.
      - is it on the left or right side and which level is it.
      - by level, i mean hyoid, thyroid or cricoid level. give those references.. vertebral levels are also ok.
      - saying 'somewhere in the middle of the neck' does not sound to intelligent'
      - if the pain is above the thyroid cartilage, the stupid bone is usually at the tonsils. which leads me to..
6. Look at the oral cavity..really look for the bone at the tonsils and base of tongue..most of the time its there..
7. Look agaiinnn..
6. Do a soft tissue neck x-ray..not cervical x-ray..not AP view..but lateral neck soft tissue..
7. This one is a dont..dont say 'i cant see the fish bone in the xray' as your opening line..usually it cant be seen..so i wouldn't really care if you didn't..what you should look for is:
       - loss of cervical lordosis - means pt is in pain
       - increase of soft tissue at the bit behind the trachea up to the vertebra..any widening shows
          inflammation. its significant if the distance of soft tissue is more then the width of the vertebra.
       - any air trapping in the esophagus. if there is air trapping, thats where the foreign body is..
       - after all that, then you can mention that you cant see the stupid bone that the patient swallowed

i do understand that getting a fishbone stuck is sometimes unavoidable...
on second thought, unless you got some swallowing problem, it is avoidable..
but first time offenders are usually ok..human error..
Its the repeat offenders that tick me off..
seriously, what is wrong with you?

hope you enjoyed the little lecture on a big nuisance..

p/s: sorry folks, i just noticed that this posts has a little too much useful info compared to previous ones..especially the part about advice number 1...later..

- chordwrecker -