General Medical issues thread

[Quickstatus]

Ben Bravery’s book, The Patient Doctor?

No I have not
But Ive heard about it.
Basically medical technology has overtaken the humanity of the patient.
"Who is the patient?" is a very valid question. And the answer is often much more than the person sitting in the chair.

Last week a elderly lady came in with fractured hip. There were the medical concerns which were substantial but her concerns were for her elderly husband who actually needed respite as she was his carer due to dementia, and her 5 cats.
Medicine has to encompass all the facets that make a patient, a patient.....

Sometimes I spend more time speaking with the next of kin than I do with a patient.
And in paediatrics the patient is also the parents.

 

[drron]

I'll have you know @tgh that locum doctors can be extremely good doctors IMHO.

 

[Quickstatus]

locum doctors

I once did a stint in Brewarrina years ago.
An eyeopener.
Referral to higher level care was to Bourke via ambulance.

My 2 main lesson after 2 weeks there:
1)Remember that writing a script can be useless because the patients don't have the $$ to get it filled - even with whatever the pension assistance provides.
2)If you go to the one and only local pub, you will be setting up an after hours consultation service in pub.

 

[drron]

My first ever locum was at Cobar helping the only GP in town. Whilst there a woman presented with a prolonged labour. The previous 4 patients from Cobar had been sent to Dubbo. Results - 3 women returned to Cobar and no babies.
So the GP told me he was going to do a caesarian and I was giving the anaesthetic. Fortunately I had just done an anaesthetic term - the second term of my second year as a resident. result - mother and baby survived. We retired to the bowls club and i never had to buy another drink.

 

[Quickstatus]

he was going to do a caesarian

I never did any real surgery - lancing abscesses and syringing ears with half strength betadine and stitching up superficial lacerations and stabbings after last nights pub events.

One of the reasons there was no surgery was because the operating theatre was the GP's office

 

[Pushka]

I'll have you know @tgh that locum doctors can be extremely good doctors IMHO.

Agree. It was a locum who diagnosed MrP's cancer when a visit to his GP a few weeks earlier told him not to worry about the lump.

 

[mrsterryn]

my husband randomly walked into our local medical centre early 2015. Had had pins and needles down his side a day earlier. Husband hasn't been to see any medical people in decades. So random GP decided he should do a few tests to get a base line for this mid fifties year old bloke.
Results came back. Golf ball sized brain tumour. Not saying your wife's condition is a horrendous condition @JohnK but my husband had already had some interaction with this local GP.
So I can understand that the second doctor would pass it back to the referring doctor. To be the doctor to whom results etc go to.
We still see that GP ,as we have followed him to a new practice.

 

[JohnK]

Your expectation that Drs should all be to the highest standards will never be a reality. If that were the case no Dr in their right mind would be working the 9pm shift. And to be honest 9pm medical centre Drs are there to troubleshoot acute issues. Don't get me wrong, thats not to say that the 9pm doctors cant be excellent. Good GPs can be hard to find but i seriously recommend finding one GP that you have a good relationship with

I think all doctors have to be of a certain standard.

I'm not sure Dr B is capable of diagnosing an acute condition. In my opinion Dr B shouldn't be practising.

By the way Dr A had the 2:00pm-10:00pm last Sunday and today and Monday so we are now going back Monday. Why did we go back yesterday? My wife is keen to sort out her numb toes and we wanted to see the results.

We don't expect miracles but it wouldn't have hurt for Dr B to give us his opinion and any recommended follow up tests. It's good to have multiple opinions.

By the way I wasn't seeking advice on here. I just thought I came across a very strange situation that does not make sense to me.

 

[Hvr]

Basically medical technology has overtaken the humanity of the patient.
"Who is the patient?" is a very valid question. And the answer is often much more than the person sitting in the chair.

I've found Dr Ranjana Srivastava's writing to be interesting.

https://www.theguardian.com/profile/ranjana-srivastava

Media Appearances — Dr Ranjana Srivastava OAM

Selected media appearances by Ranjana Srivastava

www.ranjanasrivastava.com

 

[Freq Flier 2013]

This might take some of you back in time but any good infant teething remedies? My 4.5 month girl is going through it. We have done the baby panadol and gum gels but anything else that would help?
Also used a cold dummy ect..

 

[Quickstatus]

good infant teething remedies

A few birthday parties always works

 

[Pushka]

This might take some of you back in time but any good infant teething remedies? My 4.5 month girl is going through it. We have done the baby panadol and gum gels but anything else that would help?
Also used a cold dummy ect..

Parental patience? I've never found anything that helped. Helps for them to bite down on something soft.

 

[drron]

Changing topics slightly, has anyone ready Ben Bravery’s book, The Patient Doctor? I’m curious about how it has been received among the medical fraternity.

i haven't read the book but a look at a couple of reviews suggest we are on the same page. One of the things that really that I enjoyed about the last 15 years of my life as a locum was the teaching/influencing young doctors on the art of medicine. I told new interns, residents and registrars that you might not learn much academic medicine from me but I will do my best to teach you how to practice medicine.

Always very important to talk to a patient not just about their condition but about themselves. I learnt a lot from some very interesting characters over many years of my career. but more importantly it relaxed the patient and very frequently that meant they told you some different aspects of their history which basically gave you the diagnosis.

And some took that advice to heart and just considering my time as a locum I know of 5 that have become very good physicians and another a director of intensive care. I have related before the story of a student I had at Launceston. I was never sure that she was taking anything in. But she was assigned to my unit for the medical term of my unit and she was a very good intern. She moved to Melbourne with her husband the next year but came back to Launceston as a locum medical registrar on occasions, the first time was at the beginning of her second year of physician basic training. One of the things I would do if I thought my registrar was up to it was let them take charge of the round with me as a medical observer. She was obviously up to it. When she started the round I had a remarkable realisation that she indeed had been listening to me all along as I watched her doing exactly what I would have done in the same situation.

On our final time in the team together I voiced my retirement plans. her reply was -no you won't you love this too much. One of the most satisfying moments of my career.

 

[Freq Flier 2013]

A few birthday parties always works

I can’t wait for her to grow up… but not too fast!

 

[prozac]

This might take some of you back in time but any good infant teething remedies? My 4.5 month girl is going through it. We have done the baby panadol and gum gels but anything else that would help?
Also used a cold dummy ect..

Cut a carrot into strips. Place these in a glass of cold water and leave in the fridge. Give one to baby as required to gum on. The cold soothes the gums.

 

[Pushka]

Cut a carrot into strips. Place these in a glass of cold water and leave in the fridge. Give one to baby as required to gum on. The cold soothes the gums.

I have a sad story about a friend of ours whose toddler choked on a carrot stick in day care about 15 years ago. We personally knew both the father, and the director of the Child Care centre. She resigned immediately.

 

[prozac]

I have a sad story about a friend of ours whose toddler choked on a carrot stick in day care about 15 years ago. We personally knew both the father, and the director of the Child Care centre. She resigned immediately.

That is sad. In reality anything they can eat is a choke hazard.

Life can be tenuous for young children. My young fella started getting febrile temps and convulsions. It was apparent he was allergic to something and our GP referred us to a Allergy Specialist & Immunologist who tested and showed he was allergic to grevillea. Apparently alot of people are and don't know it, particularly park rangers. You know when they say the kids at school misbehave on windy days, ergo the wind affects their behaviour? Pollen, and grevellia pollen in particular. Where was I going with this...that's right, he had a febrile convulsion age 4-5 and stopped breathing, I had to resuscitate him.

 

[Quickstatus]

carrot stick

Sad story. I can understand why the director resigned - she likely felt she was responsible. But most people would say she is not

In any case the raising children website suggests this as suitable for 1-3yr olds and here is what they say about teething issues.
Elsewhere if you look up choking they have a different set of recommendations.

 

[JohnK]

I think I posted on here earlier but not sure.

I need to have 2 teeth extracted. My dentist will not do a tooth extraction without an injection. I refuse to do it. I am happy doing the extraction with just the gas. I've been looking for dentists that will extract teeth without injection. Can't find anyone.

I have checked a detal surgeon and they are charging between $2000-$2500 for both teeth including Medibank rebate but I get the impression he wants to use the injection even if I am under anaesthetic. Way too expensive.

Anyone know a dentist that does teeth extractions without injection? My next step is to try dental clinics in Chiang Mai.

 

[prozac]

I think I posted on here earlier but not sure.

I need to have 2 teeth extracted. My dentist will not do a tooth extraction without an injection. I refuse to do it. I am happy doing the extraction with just the gas. I've been looking for dentists that will extract teeth without injection. Can't find anyone.

I have checked a detal surgeon and they are charging between $2000-$2500 for both teeth including Medibank rebate but I get the impression he wants to use the injection even if I am under anaesthetic. Way too expensive.

Anyone know a dentist that does teeth extractions without injection? My next step is to try dental clinics in Chiang Mai.

You need Painless Peter Potter, Bob Hope in The Paleface.
Sorry, haven't got a real suggestion. I have heard they do great dental in Czech.