General Medical issues thread

[Flashback]

Good news and must be a relief for everyone. Make sure you look after yourself as well!

Well, now that seems a bit extreme, I don't think I'll ever get around to doing that

 

[k_sheep]

A refusal to process a blood sample happened to me once.
But this was for an emergency blood transfusion. The patient was slowly bleeding out.
We had incorrectly written the DOB.
No sorry we can't process this - even though the medical record number, patients name and other details correct

It is very understandable as a wrong blood transfusion (using a blood sample from potentially a blood sample from someone else) can be deadly.

Indeed. First thing I tell junior doctors in orientation - if you get one letter or one number wrong, or the signatures don't match, or ANY discrepancy - we are NOT processing blood bank samples. Had plenty of junior and senior doctors try to abuse my staff but they get a nasty phone call from me - we will never, ever allow any wiggle room in transfusion medicine. Zero tolerance. It's just not worth it; 'wrong blood in tube' happens WAY too often even with so many checks and balances.

One phrase that stuck with me through my career - a blood transfusion is a liquid transplant (albeit temporary). It should get as much thought and respect as solid organ transplants.

And for those who say 'but you're killing the patient' - no the patient gets as much medivac (O neg or O pos depending on several factors) as they need. We will never deny blood to those who need.

Off my high horse

 

[drron]

Reminds me that as a med student with very little money I worked 2 jobs for a few weeks ove the Christmas holidays. I worked night shift at the Redfern Mail exchange an during the day I worked in the Pathology department of Concord Repat hospital. I became well liked by the junior doctors. On one of my first few days a JRMO rang and I answered the phone. He wanted to know if he could get some blood results as his boss needed to see them. no one else was around so I looked them up and gave them to him. he was overjoyed. He said he had thought he would have to wait until 2pm to get them.
I asked someone from the department who said yes the boss has a rule that no results can be given out until 2pm. I remained quiet over what I had done. So over the next 5 years i was rung by many RMOs.

 

[MelMel]

Is it possible for a vein to “run out” during a blood test or is it operator error? Three tubes required, I was fully hydrated and never had a problem before. She said the first vein “ran out” after one tube and she had to have another go with the resulting bruise. Not on blood thinners.View attachment 431879

Maturing nicely, unfortunately I am going to a wedding on Saturday

 

[Pushka]

View attachment 432338

Maturing nicely, unfortunately I am going to a wedding on Saturday

With that it's possible one of your muscle damage markers might also be high. Lactate dehydronegase. Mine was last time when the vein blew.

I always have to time my blood tests when a future event is imminent. Trouble is I also react to the bandaids they put on and being on thinners I need to have one. Allergy to latex. So not only the bruise but the circle of bandaid remains.

 

[Quickstatus]

Reminds me of my intern days at RPAH.

Boss wanted an INR ASAP.
2am
Pathology tech said it will be ready in morning - he was not going to process one INR until he gets a batch of 5
The apocryphal? back story is they didn't like him but because he covered the overnight shifts that were difficult to cover, they could not get rid of him.

I thought of just going to 4 other random patients to collect blood to get the batch. In the end the Boss consultant apparently rang the Boss of Pathology at 3am and got the INR processed.

 

[andye]

With that it's possible one of your muscle damage markers might also be high. Lactate dehydronegase. Mine was last time when the vein blew.

I always have to time my blood tests when a future event is imminent. Trouble is I also react to the bandaids they put on and being on thinners I need to have one. Allergy to latex. So not only the bruise but the circle of bandaid remains.

When I tore my quad muscle, I went for pre-op blood tests. They were copied to GP surgery and got concerned phone call from them worried that I had hepatitis. Many of the liver enzymes are also in muscle and I had a leg full of blood causing my bilirubin to be high

 

[RooFlyer]

On my way to Hobart for an overnight stay in a hotel, then early to hospital tomorrow where some guy is going to rummage around inside my heart for an hour or so. Hope the tucker at least is good.

 

[blackcat20]

Took Miss TC for a blood test a few weeks back. Ongoing complaints of stomach aches, particularly around dinner time and bed time. The Phlebotomist did a great job, barely a mark left behind. Nothing obvious in her results, coeliacs ruled out. Just some low-ish iron. We have a referral for a scan should it continue or get worse.

 

[love_the_life]

On my way to Hobart for an overnight stay in a hotel, then early to hospital tomorrow where some guy is going to rummage around inside my heart for an hour or so. Hope the tucker at least is good.

Hope the ablation goes well. Watch out for the bruising. Mr LtL had a whopper on one side and not so bad on the other. Assume it will be like MrLtL and you will be awake for the procedure.

 

[love_the_life]

I had the cardiologist this week - x ray showed a moderate enlarged heart (and some minor emphysema). Tests were fine though have an echocardiogram tomorrow morning. His view is that it is probably multi-factoral. In a few words - overweight and under fit.

Mr LtL had his cardiologist today (what is it about getting old?). Very happy with the ICD though did point out it is pacing the heart 100% atrial and 80% ventricle. At least no fibrillations since he has had it though he can feel it doing things from time to time.

Just back from audiologist and a new ear mould with stronger electronics. Next week is optometrist again for macular degeneration.
I feel a bit like Tommy - that deaf, dumb and blind kid (though you can miss the dumb bit) sure plays a mean pinball.

 

[RooFlyer]

Assume it will be like MrLtL and you will be awake for the procedure.

Yeah, that’s what I’m afraid of. Information screed says ‘you’ll be offered sedation’ I intend to ask for the Max - whatever is available.

 

[RooFlyer]

Yeah, that’s what I’m afraid of. Information screed says ‘you’ll be offered sedation’ I intend to ask for the Max - whatever is available.

Yay! Just got a pre op call from the anethatist. I’ll be totally out to it. And thank goodness for that.

 

[TheRealTMA]

Yeah, that’s what I’m afraid of. Information screed says ‘you’ll be offered sedation’ I intend to ask for the Max - whatever is available.

You want the Penfolds Grange sedation not the penfolds Max.

 

[Pushka]

I had the cardiologist this week - x ray showed a moderate enlarged heart (and some minor emphysema). Tests were fine though have an echocardiogram tomorrow morning. His view is that it is probably multi-factoral. In a few words - overweight and under fit.

Mr LtL had his cardiologist today (what is it about getting old?). Very happy with the ICD though did point out it is pacing the heart 100% atrial and 80% ventricle. At least no fibrillations since he has had it though he can feel it doing things from time to time.

Just back from audiologist and a new ear mould with stronger electronics. Next week is optometrist again for macular degeneration.
I feel a bit like Tommy - that deaf, dumb and blind kid (though you can miss the dumb bit) sure plays a mean pinball.

How are your toenails? I think you've got everything else covered! Hope it's all just a matter of tests and tweaks and nothing more.

We have finished our round for routine tests, well, at least for a month for me for monthly blood test. Tuesday one just showed low sodium. Yeah, I can up the salt on my chips!

 

[RooFlyer]

You want the Penfolds Grange sedation not the penfolds Max.

My oath! I tried Penfolds Max Chardonnay on a cruise once - ‘No’.

The Anethatist mentioned fentanyl somewhere along the way, which sounds encouraging. I wonder if that means they won’t let me back into LOFAP?

 

[prozac]

Hope the ablation goes well. Watch out for the bruising. Mr LtL had a whopper on one side and not so bad on the other. Assume it will be like MrLtL and you will be awake for the procedure.

Had my angio at Christmas. First time out of 7 with access via groin. I won't post the extreme bruising photos as they are in never regions. Yes, not nether, never to be shown. Almost right across my lower abdomen, the very lower abdomen and round to my hip. Not keen to have that entry point again, the aftermath was painful.

 

[DejaBrew]

On my way to Hobart for an overnight stay in a hotel, then early to hospital tomorrow where some guy is going to rummage around inside my heart for an hour or so. Hope the tucker at least is good.

Hopefully cryo or pulse field?

 

[RooFlyer]

Hopefully cryo or pulse field?

it’s not Cryo so I assume it’s pulsed field. From what I can gather, they’re going to run what looks like a full household power cord up through my veins from my groin, with various probes, lines and sensors.

To be honest, I was going be happy enough not to know the minute details, but the Anethatist 'helpfully' described it all in great detail today. Of course, I have had several conversations with the Surgeon, but they mainly revolved around risk and recovery, not the ins and outs of what he’s going to be mucking around with.

 

[DejaBrew]

it’s not Cryo so I assume it’s pulsed field. From what I can gather, they’re going to run what looks like a full household power cord up through my veins from my groin, with various probes, lines and sensors.

To be honest, I was going be happy enough not to know the minute details, but the Anethatist 'helpfully' described it all in great detail today. Of course, I have had several conversations with the Surgeon, but they mainly revolved around risk and recovery, not the ins and outs of what he’s going to be mucking around with.

Could be RF ablation then. Pulse field is way newer and to my knowledge, not as widely offered (yet). Regardless, all the best - look forward to hearing about a good outcome.