General Medical issues thread

andye said:
Always difficult to make clinical judgements (or criticise colleagues) without full history and examination but carotid narrowing doesn't cause vertigo.
Very occasionally (i might see one patient every 2 years), significant vertebral artery (the blood vessels going up the back of the neck rather than the front) narrowing can do so if neck movements cause a kink.
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Took MrsProzac along to see the new neurological doctor at St Leonards yesterday. As expressed by others in this thread he was very good, extraordinarily thorough. He realigned her ear crystals and has referred her for an MRI of the internal auditory canals and a blood test for her cognition. Her hearing in one ear has dropped a bit. She has had vertigo for 12 months so it will be wonderful if this treatment has fixed that part of the problem.

Yesterday I also spoke with my heart surgeon as I am sick of refusing my cardiologist an angioplasty. I have cancelled 2 appointments just so I do not have to argue with him about it. Surgeon has referred me for a chest CT to determine if I in-fact have any heart blockage ( I have had angina ever since cancer) and to see if the residual tumour post chemo is sitting against my heart or an external graft (my suggestion as I do not think I have any heart blockage). His thoughts are that my right side CABG might have been cut and closed by the thoracic surgeon last year when trying to obtain a biopsy from my mediastinum. The surgeon's report did state that RHS mammary vein ( artery?) was cut and it took considerable effort to stem bleeding. CT will show if this is the case.

Just shows that patients need to be their best advocate to avoid unnecessary procedures.
 
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Quickstatus said:
Yes , dont take the "trust me, im a doctor" as gospel.
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Even an angioplasty is not without risks so I avoid if necessary. In one of the seven or so that I've had the LAD was dissected and a 2nd cardiologist called down from level 6 to assist. Lucky for me they were able to patch it using 3 stents, but the outcome could easily have been very different. I can tell you it is quite painful.
 
Why is our care in hospitals so poor? Yes I know most here don't agree with me but our experiences in different places are sub-par and well short of even low expectations.

My wife was in Royal Brisbane 3 times earlier this year with kidney issues. Poor experience each time.

At about 4:00am my wife was really thirsty and needed water. Called nurse who said leave me alone that's not my job and wait until helper arrives at 6:00am. Seriously?

Same nurse rostered evening on different day. I went to nurses station and same nurse came out. Can I please get a jug of water? Sure. Waited close to 90 minutes and nothing so went back and asked for water and another nurse helped us. The original nurse heard and was apologetic. And yes I do realise they're busy but not good enough.

Dad's heart valve leaking again for 3rd time. The past 3 weeks in Concord then RPA. Another valve replacement but he's been kept in hospital as he needs some rehabilitation to help walking. He is 86 years old. They wanted to send him to Balmain which is too far for mum so we requested Canterbury and he has to wait a few more days.

Last night they had to move him from one ward to another. They come and take his bed and leave him behind with his walking stick and walker. Dad can't keep up. He can't walk. He yells at them to stop and points with his walking stick.

They think this is aggressive behaviour and call security. This is an 86 year old man who is not well, sick, confused, stressed and very frail. Security prerry much manhandled dad and stepped on his feet as well. Treated him quite badly. This is not the first time in either hospital.

I spoke with them last night. I spoke with them again this morning. They understand his condition but change the story. 81 year old mum went this morning. She's not well either. One of the cardiologist team spoke to mum. They are aware of the poor treatment. Apologised to mum for the poor treatment. Mum is crying. Mum is stressed. They said they'll send him to Canterbury tomorrow for rehab.

This is really not good enough. Mum wants me to lodge a complaint for the poor treatment. What is the likely outcome if I do complain? Is anything going to be done? Is anything going to change? I know dad may need to be in nursing home but that's a difference story that comes with its own complications. Dad needs to be home. Dad needs familiar surroundings not around strangers who don't care.

Please don't judge me. Your experiences may be different but that doesn't change our experiences at different hospitals. Do people overlook poor treatment or are we just unlucky? I really hope I don't ever need this type of care. I'm seriously thinking of heading to Thailand paying for my own home care.
 
Sorry to hear John.

Hospitals do have to respond to complaints and in my experience they are taken seriously. My advice when writing is to stick to the main points and try not to bring too many minor aspects in.

It's helpful if you ask what you would like to be done e.g discussed with security and nursing teams to reduce the chance of it happening to someone else
 
JohnK said:
What is the likely outcome if I do complain?
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The best way to complain is to write a letter.
There should be a patient liaison or a point of contact for complaints at the hospital.

@JohnK please write a letter
Documenting the dates, times and circumstances.
Document what you would like to happen - a meeting with the nurse manager for example.

Ive never heard of transferring a patient to a different area with the patient walking behind the bed.
 
andye said:
It's helpful if you ask what you would like to be done e.g discussed with security and nursing teams to reduce the chance of it happening to someone else
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That is the exact type of resolution I would hope so that others don't have to go through the same.

@Quickstatus it's beyond incompetence. They wanted the spot dad was in as someone was coming out of ED but surely they can push the bed with patient in the bed to another ward?

Dads clothes are all over the place and mum told me his brand new shoes are also missing. I don't know if these have been misplaced or thrown out.
 
JohnK said:
That is the exact type of resolution I would hope so that others don't have to go through the same.

@Quickstatus it's beyond incompetence. They wanted the spot dad was in as someone was coming out of ED but surely they can push the bed with patient in the bed to another ward?

Dads clothes are all over the place and mum told me his brand new shoes are also missing. I don't know if these have been misplaced or thrown out.
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When I have been moved, generally in-bed and then chest of drawers with my things, bag etc. also moved to my new location.
 
This could be in the WCMO thread.

I've been referred by my cardiologist to an electrical physiologist for assessment and likely to have, a cardiac ablation procedure for afib/flutter. ATM its controlled with amiodarone, which is a nasty thing and not good for long term.

My referring cardiologist went through the procedure with me, talked about the or some risks, showed an animation etc and I left that pretty optimistic.

Before I saw the Electro-phys, I emailed a mate in Canada who has had the procedure 4 times (a very exceptional case) and asked him 'what questions should I ask; what are the risks you've learned?'

So I see the electro-phys. He was later described to me as being 'probably on the spectrum' and that's exactly what it seemed to me, in as much as the consult was 'odd'. I explained that I was very sensitive to properly understanding the risks, and, importantly, what happens next if any of those risks eventuate, as a result of problems with this in previous surgeries. He rather briefly, I thought, explained the procedure, the risks etc. But this was far short of what I had learned from my cardiologist and my mate. No mention of the catheter having to penetrate the arial septum; no mention of the risk of possibly burning through to the oesophagus, which can have catastrophic consequences. I pulled him up on those, and some other things and then he did go through them.

Most of this time he was writing scripts, typing into his computer. I had to ask him to stop that so we can have a proper conversation.

He gives me a photocopy of 'about cardiac ablation' from the Hobart Private Hospital, which, after I read it later, realised was a bit of a joke, so superficial and again, deficient in talking about risks and even the procedure.

Anyway, the electro-phys then slides a consent form across for me to sign; have had risks explained to me, I accept etc etc. I decline, saying I was in no way properly informed yet. OK, he says, we can do it on the day. Damn right!

I left that consult pretty worried and doubting that I'd agree to have the procedure. What else hadn't he mentioned? I felt like a sausage - see prospective patient, tell them enough to get them into it, get consent, do the op - next!

So I had a tele consult with my cardiologist (who is great, and I trust completely) about what happened and again to ask about the risks etc. I left that re-assured and, importantly, that the electro-phys was a good operator.

(BTW as a minor point, I shaved and dressed well to see this guy - just out of respect. He didn't reciprocate - unshaved, very casually dressed; I thought really? This guy's' going to stick a couple of probes into my heart and do some burning? Oh, and, I realised later, no mention of costs.)

I could have the procedure done in Melbourne, but then I would know zero about the guy, so better the devil I know a bit about.
 
In prep for my O/S trip next month (Europe + Caribbean) had Flu and RSV vaccinations last week, and covid (1 year on) coming this week. GP said, sure, have the RSV ($320) but was only luke-warm on the need.

steroi_ injections into finger joints and tendons also coming up, and a week later a CT guided steroi_ injection into lwr R facet joint (all arthritis related). Recent bone scan brought the facet joint injection to priority. Bone scans are really interesting, in what they can reveal!!

Angiogram also done last week in prep for ablation in the new year.

Happy to have all these done now, as I've reached my Medibank safety net and you, dear tax-payers, are being kind enough to give me most of the fees back. 🙏 Vaxes on health fund, of course.
 
RooFlyer said:
I left that consult pretty worried and doubting that I'd agree to have the procedure. What else hadn't he mentioned? I felt like a sausage - see prospective patient, tell them enough to get them into it, get consent, do the op - next!
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Everyone undergoing a procedure should have their questions and concerns answered satisfactorily. Some wont have a single question but others may have a lot. So it is not uncommon to have a longer consult or in some cases more than one consult to get to the point of signing a consent form. And others may be better referred on for a 2nd opinion if still unsure
 
Just over 30 years ago I had had an issue with an angiogram. A couple of hours later a cardio thoracic surgeon visited me and said “take me I am available”.Yes I had a problem with a mostly blocked widowmaker artery.
It was fixed the next morning.
 
Quickstatus said:
Everyone undergoing a procedure should have their questions and concerns answered satisfactorily. Some wont have a single question but others may have a lot. So it is not uncommon to have a longer consult or in some cases more than one consult to get to the point of signing a consent form. And others may be better referred on for a 2nd opinion if still unsure
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Yes, I went back and grilled my regular cardiologist about the whole thing and came away reassured
 
RooFlyer said:
Recent bone scan brought the facet joint injection to priority. Bone scans are really interesting, in what they can reveal!!

Happy to have all these done now, as I've reached my Medibank safety net and you, dear tax-payers, are being kind enough to give me most of the fees back. 🙏 Vaxes on health fund, of course.
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I wonder if I should get a bone scan done, I get soreness with my left hip while running so it would be good to get it checked just to be aware of any possible future issues that might occur. My mum had a hip replacement a few years ago so chances are not great.
 

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