General Medical issues thread

[MARTINE]

Moving some discussion of FIL's medical matters here rather than the Member Chit Chat.

FIL was let out of hospital on Thursday. Went to visit, along with both SILs on Saturday. MIL tells me she'd spoken to the cardiologist with my AFF suggestions (geriatrician, ACAT, etc). Cardiologist said that wasn't necessary yet. MIL is now saying we all overreacted a bit last week. I don't know if cardiologist has put the cataract surgery and MRI back on the table.

I don't know what else the cardiologist said, but after some googling to understand the scope of a geriatrician's work, so that I can then convey more than "they're doctors for old people" or something as blunt as that, it still seems a good idea to me to help establish a baseline of where FIL is at.

FIL has also been told to do more exercise, and I can see a physio or OT or exercise physiologist type person would be enormously helpful figuring out appropriate exercises around the house and yard. Hopefully we'll have some time together on Weds and I will find out more and try to be gentle (rather than too pushy) with suggestions for further medical advice.

I would reaffirm all of the suggestions.
???MIL interpreting this reality check as an ‘overreaction’ - it is difficult to accept when there is functional decline… it helps when family members attend appointments for symmetrical information.
Also will be much easier to manage future health issues outside of crisis ie trying to get assessments/planning done as a matter of urgency.
All the very best

 

[Pushka]

May I ask how old FIL is?

 

[tgh]

Age has nothing to do with it...

 

[prozac]

May I ask how old FIL is?

I could be wrong but I think 93 has been mentioned.

 

[Katie]

May I ask how old FIL is?

I could be wrong but I think 93 has been mentioned.

FIL is 84; 85 later this year.

MIL is 81 for whatever that might be worth.

 

[Pushka]

FIL is 84; 85 later this year.

MIL is 81 for whatever that might be worth.

Thanks. 85 is starting in my family to be the problematic age. I wonder if assisting older people with alternative care is more difficult to negotiate with them when both are still alive.

Post automatically merged: Aug 11, 2024

Age has nothing to do with it...

No of course not. Except when significant health issues start to emerge and ability to recover eg from significant surgery needs to be taken into account. That’s when the age factor kicks in.

 

[prozac]

FIL is 84; 85 later this year.

MIL is 81 for whatever that might be worth.

That's twice now.
Wishing him many more b'days.

 

[drron]

Today I had a win and a loss.
The win was that I did 16000 steps today the most in 3 months.

The loss was much better. This morning I weighed 80.0 Kg. The last time I weighed 80.0 was when I was 33. So now aiming at 79.5 Kg which I haven’t been since High School.

 

[tgh]

I am in training to climb Sigiriya in February ; on top of my regular step average I am walking the dog against the clock.
This week we have done 2x5k @10:20/km.
I fantasise about getting the average down to 10 but between the dog , the bush tracks and the chorus
of complaint from my knees ….I may be dreaming...

 

[SuePa]

I am in training to climb Sigiriya in February ; on top of my regular step average I am walking the dog against the clock.
This week we have done 2x5k @10:20/km.
I fantasise about getting the average down to 10 but between the dog , the bush tracks and the chorus
of complaint from my knees ….I may be dreaming...

I climbed Sigiriya in Feb, this year. I am, by no means, fit and I didn't have too much trouble, so I'm sure you'll be fine.
Just try and get there early.

 

[tgh]

get there early.

I know that but we are on a ships tour ex Trincomalee and will probably arrive no earlier than about 10.30 so a hot crowded climb will be my lot.
The ship offers a ride in a chopper for $3800us return (they even include lunch) but I decided to suffer in the bus and climb with the great unwashed ….

 

[RooFlyer]

Just try and get there early.

and avoid the Chinese tour groups if you possibly can! Early is good.

 

[Pushka]

and avoid the Chinese tour groups if you possibly can! Early is good.

Hard from a cruise stop.

 

[Quickstatus]

Cardiologist said that wasn't necessary yet

Its too late seeing a geriatrician when there is acute deterioration.

Q: when are you old enough to see a geriatrician?
A: when you are retired and regularly need to see more than one Dr.

 

[tgh]

Q: when are you old enough to see a geriatrician?
A: when you are retired and regularly need to see more than one Dr.

A bit of creative sales pitch here, I opine that if every geriatrician in the world was imported to "Oz , it might still not meet the level of over servicing proposed by QS ( and Martine)
Our gp seems to have almost all oldies as his clients ; he does not list geriatrics as a special interest so we should go somewhere else?
Where ?
I note that of the 13 doctors in our practice ( which is in area with a large aged cohort ) .. only three mention aged care as an interest yet the practice clearly cares for a majority of aged clients.

 

[Quickstatus]

it might still not meet the level of over servicing proposed by QS ( and Martine)

Not overservicing. Such consults do not need to be frequent, but they are very useful to identify the prevailing issues, knit them all together into a logical plan, which can then be managed more or less by the GP.

only three mention aged care as an interest yet the practice clearly cares for a majority of aged clients.

Exactly. Here is more detailed answer of the Q above and what they offer
There is some overlap with GPs - as with any branch of medicine.

 

[tgh]

While I find that almost all the stuff in the pictogram grates my sense of personal responsibility and independence, I do accept that for many folks this level of integrated oversight would be useful. To that end I resile from my criticism of the sales pitch analogy.
My impression of modern day gp practice is that they are so time driven there is no time for general oversight.
One can make a long appointment and have a chat but an oversight process needs structure and follow up.
None of this happens unless the patient drives it and herewith lies the problem I guess.
It seems that I have now comprehensively destroyed my earlier argument and will retreat to the middle distance , contemplate my toes and let someone else have a go.…..
(easy to see it is wet in brisbane today)

 

[Quickstatus]

None of this happens unless the patient drives it and herewith lies the problem I guess.

All that is true. However that assumes the patient has the insight to go down a particular path. Often they dont know what they dont know.

My impression of modern day gp practice is that they are so time driven there is no time for general oversight.

Driven by Medicare, though there have been changes that encourage chronic illness management, but as you say they are generalists. it is not possible to be all things to everyone.

 

[andye]

I do a fair bit of Geriatric Medicine though the majority of my outpatient work is in stroke of all ages.

Most public referrals to Geriatrics are due to cognition, falls and loss of functional independence with a need for services or residential placement.

The prime areas of specialism in Geriatrics are in frailty and multidisciplinary care of multimorbidity though many of my colleagues are also excellent general specialist physicians.

Frailty is an interesting term as it has a colloquial understanding as well as more rigorous scientific definitions.

One of the classic illustrations is from the Rockwood Frailty Scale

4 and above benefit most from Geriatric involvement

Geriatrician referrals for comprehensive assessment have a pretty good Medicare rebursement so gaps in the private sector are not usually too large

 

[Katie]

Thank you @Quickstatus and @andye for the geriatric specialist explanations.