General Medical issues thread

[Pushka]

It's nearly 2am here, so I'm thinking I might need to wait till perhaps 8 or 9. I was thinking of trying that but not sure how much they would disclose...

If not designated as next of kin or put onto a list for information to be given, I don’t think you will get much information at all.

 

[Quickstatus]

If not next of kin they will not give out info (or should not).
Remember the debacle about the news organisation pretending to be the Queen enquiring about Catherine (Jacintha Saldhana)

More often than not the patient does not want contact for one reason or another. I always suggest that relatives think about what's best for the patient. The question is always : Does wanting to know (add in calling or visiting ) make it better for the patient?

@Flashback - I think rather than raining the hospital, best to speak with the official next of kin and discuss with that person

 

[Flashback]

If not next of kin they will not give out info (or should not).
Remember the debacle about the news organisation pretending to be the Queen enquiring about Catherine (Jacintha Saldhana)

More often than not the patient does not want contact for one reason or another. I always suggest that relatives think about what's best for the patient. The question is always : Does wanting to know (add in calling or visiting ) make it better for the patient?

@Flashback - I think rather than raining the hospital, best to speak with the official next of kin and discuss with that person

As mentioned it's a bit of a complex situation. Mrs FB has been estranged other than this sister, and she messaged Mrs FB just before going into surgery saying she would let her know how it went last night.

 

[Quickstatus]

@Flashback
I.E the NOK is withholding information? (Mrs FB estranged from the NOK?

 

[Flashback]

@Flashback
I.E the NOK is withholding information?

All good, SIL has just messaged me back - all seemed to go OK.

 

[Quickstatus]

Years ago One elderly patient we looked after explicitly said that no member of her family be notified of her hospital admission unless she dies. She also did not specify next of kin which made it impossible if she died. Eventually she nominated her NOK but with the restrictions as above

 

[Flyfrequently]

Years ago One elderly patient we looked after explicitly said that no member of her family be notified of her hospital admission unless she dies. She also did not specify next of kin which made it impossible if she died. Eventually she nominated her NOK but with the restrictions as above

Always a very tricky situation @Quickstatus.

My dear Dad did similar, always said he had "no family, no NOK" as he didn't want us to be troubled by his failing health.

But with 3 of us working in Melbourne hospitals, 2 in ED..... if he wasn't home, we knew where to start looking!

 

[mrsterryn]

With dad having numerous falls and the ambulance often be rung, I would get 2 am calls or 10 pm calls from ambos to advise dad needed to go to hospital and that they had made the determination mum was incapable of being left home safely. Oh also we would get calls from the police when mum would have bad evenings. Which would mean I would have to go over and collect mum and then try to take her home and put her to bed
I wasn't power of attorney at that stage but dad just had physical ailments , cognitively he was all there.
My name , my phone number, my "daughter " status I think was over quite a few hospitals and police stations

 

[mrsterryn]

After having months of dental work done , today the final crowns etc were done.
Over the past five months I was actually quite surprised at how much discomfort lingered over with all the work. I cope with root canals much better than the crowns and bridge
Fortunately my dentist was happy to dispense some decent pain relief

 

[Quickstatus]

Doing a bit of research for an upcoming talk. Part of the talk involves early or rapid discharge.
I came across a comment by Florence Nightingale which I will use:

Hospitals are but an intermediate stage of civilisation the ultimate object is to nurse all the sick at home
(Florence Nightingale, The Times, April 14th 1876)

Hospitals are dangerous and demeaning environments...

 

[Pushka]

Rheumatologist check up. Up until this year it's been a yearly checkup. Of course PMR threw me a curve ball in January. Have been on steroi_s since then, 15mg tapering over the last 6 months. My GP rather worried me about taking steroi_s, she wasn't the one to diagnose PMR but specialist was, after all it's easier to contact specialists these days than GP's. Harrumph. Anyway she talked of osteoporosis and made me have a bone scan which osteo something in my right hip but other areas are OK.

Which raises another question. Why does the medical model compare bones of a 30 something for the benchmark for bones of a 60 plus-er? does medicine expect no degenerative change at all? When compared with my age group I'm way ok.

Back to the topic. Because of the GP I'd been tapering down a bit faster. Subsequently inflammation markers which had been going down nicely, are now rising again. I was down to 6mg from 15mg and about to go to 5mg, now I need to stay on 6 for two months and then 5 until I see her next in 5 months, but have monthly marker checkers in between. I know she will contact me if there's an issue.

It's another interesting question. At what point does GP advice counteract specialist instructions. GP did worry me about long term issues. Specialist wants me to get PMR under control. A battle.

I'd been having trouble with my left upper arm ever since I'd had the Moderna vaccination a year ago. Never resolved Of course later it emerged with evidence that Moderna was a definite no for people like me with APS but that wasn't known at the time. I was lucky. Anyway with PMR it was just another muscle issue. Specialist checked it out yesterday and it is bursitis, in this case because of lupus. Or PMR. Take your pick. Wonder if moderna created the response. Anyway a steroi_ injection yesterday seems to have fixed it up so far but no sleep last night. I dont sleep after steroi_ shots. My second one. I had a frozen shoulder about 12 years ago.

 

[Quickstatus]

Which raises another question. Why does the medical model compare bones of a 30 something for the benchmark for bones of a 60 plus-er? does medicine expect no degenerative change at all? When compared with my age group I'm way ok.

Are you talking about the bone densitometry xrays. (DEXA also called DXA)?

If so, the way a comparison is made is via the T and Z Score
T= compares your bone density with someone of (IIRC) age 30 and same gender
Z= compares BD with someone of your age and same gender.

A score of 1 = one standard deviation away from the norm for age and gender for T and Z
A score of 0 = BD is at the mean for age and gender
A score of -1 generally means a doubling of risk of fracture compared with a score of 0

So for example: some has a T-2 and Z0
Z=0 means no increase in risk of fracture compared to your age group and gender. BUT an associated T-2 means a 4 fold increase in risk of fracture compared to a 30 year old but because Z0, normal preventatives are appropriate. However a Z-1 or more suggests some consideration of intervention is needed above the usual preventatives for a person with Z0 score.

 

[drron]

The problem with PMR is that about 20% of patients will develop Giant cell Arteritis. The complication of which is blindness.
So if you develop a new one sided headache and have tenderness over the temple get it checked out ASAP.
The treatment for proven GCA is ,you guessed it , steroi_s.

 

[Pushka]

The problem with PMR is that about 20% of patients will develop Giant cell Arteritis. The complication of which is blindness.
So if you develop a new one sided headache and have tenderness over the temple get it checked out ASAP.
The treatment for proven GCA is ,you guessed it , steroi_s.

I did have a blinder of a headache back in December just before PMR was diagnosed. Was vomiting for 36 hours due to pain in temple. we had just arrived in Melbourne for the weekend. I was thinking I'd need to go to hospital as it was so bad but being in Melbourne wasn't sure what to do. And yes, my teeth ached badly in the side of the temple that hurt really bad. Headache subsided after about a week and hasn't recurred since I was on steroi_s. I did not put the two together until you mentioned I likely had PMR back in late January. I have not had a recurrence.

 

[Pushka]

Are you talking about the bone densitometry xrays. (DEXA also called DXA)?

If so, the way a comparison is made is via the T and Z Score
T= compares your bone density with someone of (IIRC) age 30 and same gender
Z= compares BD with someone of your age and same gender.

A score of 1 = one standard deviation away from the norm for age and gender for T and Z
A score of 0 = BD is at the mean for age and gender
A score of -1 generally means a doubling of risk of fracture compared with a score of 0

So for example: some has a T-2 and Z0
Z=0 means no increase in risk of fracture compared to your age group and gender. BUT an associated T-2 means a 4 fold increase in risk of fracture compared to a 30 year old but because Z0, normal preventatives are appropriate. However a Z-1 or more suggests some consideration of intervention is needed above the usual preventatives for a person with Z0 score.

Yes, that's it. Scores weren't loaded into my health . I did have a T-2 - just in my right hip. But z were OK - the problematic right hip -1 and even had a couple of ++ in the Z's. At least that's what I remember.

 

[Quickstatus]

Yes, that's it

Diving deeper

The Z score is the measured BMD but then is subtracted from the reference BMD for the age,sex,race and type of bone)
The T score is derived and is the way the Z score can be compared to a reference 30 year old, and is useful for comparison across time and across populations.
T = Z + reference T
(At least thats what I remember - patients are not supposed to ask hard questions #WCMO )

 

[Pushka]

Diving deeper

The Z score is the measured BMD but then is subtracted from the reference BMD for the age,sex,race and type of bone)
The T score is derived and is the way the Z score can be compared to a reference 30 year old, and is useful for comparison across time and across populations.

T = Z + reference T

I could give you my numbers, if only they'd been loaded into my health which is what I asked to happen but the diagnostic lab ignored my request.

 

[Quickstatus]

I could give you my numbers

Z0 and T-2 just says you are not a spring chicken but Cruises are still OK

 

[Pushka]

Z0 and T-2 just says you are not a spring chicken but Cruises are still OK

Best advice ever! I survived a very gruelling trip through Egypt et al with so much walking and treacherous terrain and no issues at all. Did 13kms walking in a day in Athens including up to the Parthenon. So figure I'm fine.

 

[drron]

Z0 and T-2 just says you are not a spring chicken but Cruises are still OK

I say she still is a spring chicken. OK.