Thursday, December 29, 2011


I remember back in residency, I once had a patient with a bad headache (her usual headache), which she was practically in tears over. Unfortunately, I checked her allergies and they included: morphine, vicodin, percocet, codeine, and motrin. She apparently gets a rash from these medications. So I said to her, "I'll give you some Tylenol."

"No, doctor, that doesn't help...."

OK, so what does that leave me? "How about some aspirin then?" (I knew she wasn't allergic cuz she was already on daily aspirin.)

"No, doctor, that doesn't help either..."

"Well, what do you usually take?"

"Excedrin helps me."

I didn't think we had Excedrin on formulary so I checked the PDR to see what was in Excedrin. It's Tylenol, aspirin, and caffeine. So I just ordered her some Tylenol and aspirin, despite what she told me.

Naturally, the nurse pages me and says exactly what the patient just told me. Tylenol and aspirin aren't going to fix her headache. I said, "But she's allergic to everything! What am I supposed to do?"

"She says Excedrin helps her... but we don't have it."

"But that's just aspirin and tylenol... and caffeine." I thought for a minute, "OK, tell you what. Give her the aspirin and tylenol... and a Coke."

The next time I came into the room, she was sleeping. I guess it worked.


  1. It's an old neurology trick. I use it too. Just mix up your own Excedrin, using either Coke, Diet Coke, or coffee.

  2. I suffer from migraines. I can tell you personally that caffeine is a mainstay (although I go crazy and hit myself with 800 mg of ibuprofen). What really hurts is that Exedrin and Exedrin Migraine are identical but have different packaging and sometimes different prices.

  3. I'm actually kind of surprised the nurse didn't just do the coke on her own.. wait.. that came out wrong.

    There are male nurses, too....