Her dry mouth symptoms were about the same, but unfortunately not bad enough to keep her from talking. Her anxiety didn’t seem any worse, even though she had tapered her citalopram by 75%. I gave her instructions for tapering off the citalopram entirely, in the vain hope that she would keep visiting the hairdresser instead of me.
She reluctantly conceded that I hadn’t gone to Disney World, but she wouldn’t let me out of the room until I checked her husband. Her husband wasn’t even my patient, but she was terribly worried about a skin lesion on his left arm. He had on a short-sleeve shirt and, by this time, I would have done anything to escape, so I glanced at his bare left forearm and didn’t see anything unusual. Her husband also seemed startled by his wife’s request, so she reminded him that the problem was in his underarm. I should have protested or charged him for my trouble, but luckily it was just a small lipoma. I reassured them both for the same low price and finally beat a retreat.
The squirrel phoned a few weeks later and said that she wanted to resume citalopram. I had the nurse remind her why I had her go off the medication, with instructions to follow-up with her family doctor. He’s probably wondering what got into me, or perhaps he thinks I have gotten squirrelly in my old age.
Dr. Greenbaum is a rheumatologist who practices in Greenwood, Ind. You may reach him at rhnews@elsevier.com.