General Medical issues thread

[Foreigner]

Uncommon surgical risk:

http://www.news.com.au/lifestyle/he...d/news-story/c11341a1824d857f54fa904422a08f11

 

[QF WP]

Well I turn up at hospital this morning at 9.30am as surgical consult was due (Dr had told nurse he'd be there in 30 mins, he was doing reviews in another ward).

Something must have happened, because I sat there for 90 mins and he was a no-show. Uber dropped me back to work as the patient rang to say they are been discharged today..WT

Now better get some work done and organise pick up for this afternoon (edit...scratch that, they've already checked themselves out, so I'm off to pick up).

He'd better have arranged a referral to a Gastroenterologist (we had the name of a good one in the same Hospital)

 

[Pushka]

Not great comms there - suggest your rellie gets their full discharge summary before they leave and that will give future treatment plans. Sometimes they only will email them to the GP, and not give them to the patient which I dont find the least bit acceptable. This seems to be the way in the Public Hospital system but not in Private Hospitals.

 

[Flying mermaid]

1536825[/URL]]Totally understand that kids will keep getting sick. Part of life.

But beating myself up because keep making the same silly mistakes. Yes hindsight is a fantastic thing but I should not have let my wife and daughter go back to a house where 6 people are seriously sick. I should know better. I expect better. But I got into the situation where I thought it was going to be ok.

So yes a harsh judge which explains why I never lived up to expectations. Is that the OCD or another syndrome?

My son is very similar - he always feels he is to blame when things go wrong, but doesn't take credit when things go right.

There are going to be lots of things you will do wrong with your daughter. I would love to be able to start again and change many of my decisions with my 3, but at the end of it all you just have to accept and live with what you have done and look to the future for better decisions. Just a giant learning curve......

 

[Princess Fiona]

Not great comms there - suggest your rellie gets their full discharge summary before they leave and that will give future treatment plans. Sometimes they only will email them to the GP, and not give them to the patient which I dont find the least bit acceptable. This seems to be the way in the Public Hospital system but not in Private Hospitals.

I don't know what happens in SA but that's not the case in public hospitals in NSW.

 

[Pushka]

I don't know what happens in SA but that's not the case in public hospitals in NSW.

That's good to hear. It surprised me when I didn't receive any paperwork at all from the Royal Adelaide. We probably can't afford the ink and paper to print out. It wasn't until I visited the GP the next week that he then rang Medical records and then they sent it to him. Not good enough as it contained instructions.

 

[JohnK]

My son is very similar - he always feels he is to blame when things go wrong, but doesn't take credit when things go right.

There are going to be lots of things you will do wrong with your daughter. I would love to be able to start again and change many of my decisions with my 3, but at the end of it all you just have to accept and live with what you have done and look to the future for better decisions. Just a giant learning curve......

Thanks. Still learning and may never learn. It may look bad from the outside but not that bad. Persevere. Try to do the right thing.

Daughter still in hospital and could be another 2-3 days. Tough cold this one to knock down a whole family that has never been exposed to this particular virus.

 

[Princess Fiona]

That's good to hear. It surprised me when I didn't receive any paperwork at all from the Royal Adelaide. We probably can't afford the ink and paper to print out. It wasn't until I visited the GP the next week that he then rang Medical records and then they sent it to him. Not good enough as it contained instructions.

That's not good at all. Patients should always be discharged with adequate instructions and information for themselves and their GP.

 

[Quickstatus]

The discharge letters are often written poorly by the most junior member of the team

Still waiting for a good national electronic medical record system.

 

[Pushka]

The discharge letters are often written poorly by the most junior member of the team

Still waiting for a good national electronic medical record system.

I wish the mygov health records were completed by medical people. There is nothing in my online file except for prescriptions. I know there are risks in making tests available online but surely it makes for better health care management.

 

[QF WP]

Not great comms there - suggest your rellie gets their full discharge summary before they leave and that will give future treatment plans. Sometimes they only will email them to the GP, and not give them to the patient which I dont find the least bit acceptable. This seems to be the way in the Public Hospital system but not in Private Hospitals.

Got the full Discharge Summary - brevity in the extreme and we have noted that it doesn't include one of the tests (Ultrasound) that was ordered when they were in Emergency - yet the blood test ordered at the same time are there.... also no pain management plan.

Not it sure if the GP got a copy but his name is mentioned on the report - will be following up with him to make sure he gets one.

 

[Quickstatus]

I wish the mygov health records were completed by medical people. There is nothing in my online file except for prescriptions. I know there are risks in making tests available online but surely it makes for better health care management.

This is an introduction of why medicos are slow on the uptake.
My Health Record: Medics speak up - Government News

Great idea (arent't all Pollies full of good ideas) but atrocious in the implementation (familiar story when Pollies are involved).

 

[Pushka]

This is an introduction of why medicos are slow on the uptake.
My Health Record: Medics speak up - Government News

Great idea (arent't all Pollies full of good ideas) but atrocious in the implementation (familiar story when Pollies are involved).

I think our medical practice might be part of the trial as there were brochures at the appointment desk and they were asking people to consent, which I did.

I find the prescription list very helpful.

 

[QF WP]

Well here is the MRCP report (interesting there is no report in the Ultrasound - just the films).

View attachment 83249

There were so many films in the MRCP we have them on disk as well

No-one in the family are happy with the outcome, not least the patient. Given the outcome and recommendation in the report, referral to an interventional Gastroenterologist which is what I am going to be pushing. Waiting until appt with Director of Surgery (the attending Dr when she was admitted) on Tuesday afternoon is neither the step nor the timeframe we expected.

 

[QF WP]

Should be working now - at least it is on my laptop (not sure about accessing via App, I'll go and check)

 

[QF WP]

Attempt 2via the app - don't get a neck strain

 

[Quickstatus]

I tilted the laptop.

Something going on so an ERCP would be indicated - Endoscopic retrograde cholangio-pancreatogram

So its done under sedation - camera inserted into stomach (gastroscope) and then tube inserted into opening of pancreatic duct where it connects into doudenum (part of the bowel after stomach) and Xray dye injected into duct and pictures taken

Sometimes they can also do an endoscopic ultrasound of the area during the ERCP procedure.

Should be done...Good luck

The gallstone and gallbladder can wait.

The other possiblity is that there was a gallstone that lodged in the bile duct causing this problem and then passed (so not visible now) and can cause residual dilation of the bile duct but does not explain the narrowing

 

[QF WP]

My thoughts exactly, which is why I am bemused the the treatment plan - should have been a referral to one of the Holy Spirits' Gastroenterologists and include pain management [still residual pain after eating, due to bruising of common bile duct from likely passing of stones on Monday (10 day ago) and Wednesday (a week ago)]. I don't want to "wait" until review on Tuesday, in case in the meantime there is a blockage. I presume that the Gastro can also investigate the renal cyst or refer to Hepatologist.

 

[Quickstatus]

My thoughts exactly, which is why I am bemused the the treatment plan - should have been a referral to one of the Holy Spirits' Gastroenterologists and include pain management [still residual pain after eating, due to bruising of common bile duct from likely passing of stones on Monday (10 day ago) and Wednesday (a week ago)]. I don't want to "wait" until review on Tuesday, in case in the meantime there is a blockage. I presume that the Gastro can also investigate the renal cyst or refer to Hepatologist.

Renal cyst? - can wait. Renal physician. But its not important.

The wait and see approach is sometimes the best. "Tincture of time". Over time things declare itself. I don't think you would get to the end any quicker with the story you have presented.

In the end if the cause was found to be a gallstone then the treatment is supportive. Low fat diet. No alcohol, eat small amounts. Remove gallbladder when everything settled down in a FEW months. If PSC - then more serious and ultimately difficult to treat and progressive. May need immunosupressants, steroi_s eventually liver transplantation. Lets aim for a gallstone story.

 

[sinophile888]

Lets aim for a gallstone story.

My thoughts entirely.