General Medical issues thread

[admin]

Hi all,

I think it's worth stepping in to make something very clear. Of course, it's incredibly useful to have an army of medical professionals able to help, and that really is what AFF is about - experts passing on their knowledge to those asking questions. As well as that, it helps build a great community, united by travel but also being able to share the many other facets of life.

However, we won't hide the thread for a very simple reason - this is the internet, and if you don't want your medical information on the internet, don't post it. Making this thread members-only would be counter to the purpose of AFF - to be available to everyone that wants to share an experience or ask for advice.

If you're comfortable posting stuff here, then that's fantastic, and we fully encourage you to do so. If you're not comfortable posting on the internet because people will see it, then don't post it here.

This decision is with full support of the moderation team - there is no debate.

The AFF team.

 

[RooFlyer]

Good, thanks..

 

[TheRealTMA]

Went to Wesley ED yesterday and they decided the umbilical hernia was a bit strangulated so kept me in and had surgery last night.

All’s good and excellent service from Wesley.

 

[Pushka]

Went to Wesley ED yesterday and they decided the umbilical hernia was a bit strangulated so kept me in and had surgery last night.

All’s good and excellent service from Wesley.

Well done. Something like that can't be messed with. My son had one when he was 7. The symptoms when things fell into his groin area were alarming but they slipped back into place at night time. Of course he had the operation fairly quickly.

 

[Flyfrequently]

MrEllen10 had his follow up appointment with our Sydney surgeon the other day. After a few follow up tests, everything is looking good and well. He admitted that it was a very interesting, testing and complicated issue, but all is good and hopefully we will not need to see him again. We shook his hand, grateful for his ongoing care and expertise, and gave him a nice bottle of red wine.

During the heart issues we had to put on hold some BCC perineural invasion problems. Finally had further margins cut out of his upper arm a couple of weeks ago ( he is collecting more large scars). Stitches out, pathology tests came back and good news no radiation required.

Mr Ellen10 is finally breathing better, feeling better and enjoying his rehab program and has more energy to do little jobs and enjoy his grand kids. So lots of positives

We are grateful for all the support and knowledge here and encouragement along the journey. And hope to pay it forward to others.

So good to hear @ellen10
Now roll on September and WA !

 

[Quickstatus]

umbilical hernia was a bit strangulated

A bit of abdominal fat tissue got stuck?

 

[mrsterryn]

Just as a giggle on the medical part. Just did our census which I had delayed and delayed as I was just making sure a certain husband didn't end up in hospital lol. Just cause he does so that lol

 

[TheRealTMA]

Wesley ER and surgeon did good job all round. Pleasant experience if one can use that expression at hospital . Had quite disturbing post operative delirium. Very real hallucinations. Seem to have cleared. Also lack of sleep and food contributed I think.

 

[Quickstatus]

post operative delirium.

Causes are multifactorial
Can sometimes subtly manifest as "foggy head" for weeks.
Blokes over 70 are more at risk independently of other factors.

 

[Seat0B]

Well we are in the maw of the medical/aged care interface just now.

Mum has now been in hospital for almost 8 weeks - 1 week in the public hospital and then transferred to private for rehab - which was derailed twice by sepsis, but has recently been underway. Last Wednesday, they called us up to the hospital for a meeting which said:

• your mum cannot be safely discharged home so you will need to arrange residential aged care for her
• her doctor has just signed the last acute care certificate they were willing to give her, and as she is now no longer a medical case, when that certificate expires in two weeks, she will be discharged from hospital
• If you stay past that date, the hospital will bill you $1100-$1200 per day for her to be here

Fortunately, my regular cake bribes to the ward staff yielded a small benefit, in that they had "unofficially" told us this info a week earlier, to give us the best chance to get aged care set up - so really we had/have 3 weeks to get it sorted.

And that is where the trouble begins - we have eventually managed to apply to 5 care homes in our area - but it has been a full time job hounding the gatekeepers to provide us with information and application forms. We have been call screened and ignored, and on one spectacular occasion told that "if the person wanted to speak to you they would return your call. If they are not calling you, they don;t want to speak to you." There has been a fundamental difficulty getting these people to understand that mum is in a private hospital - they just keep saying, well if she is not safe to discharge, they will have to keep her until we find her a bed." We keep trying to say that is not the case, but no one hears us.

We were booked to see a care placement manager at the preferred brand of homes today, and when we arrived, she had fobbed us off to a lower level helper who could not answer any of our questions and said we could talk to the care manager on Friday this week. I finally broke down - just burst into tears and said that mum was going to be discharged only 3 working days after Friday - how on earth were we going to get care in that time. And finally, this person said "oh is she in a private hospital? That certainly changes the urgency." No cough Sherlock, that is what we have been saying in multiple phone and email messages for the last 2 weeks. Anyway, the original care manager now deigned to see us today after all, and so we have advanced slightly. She directed us to a private (ie full fee paying) respite organisation, as there are no funded respite beds available in Canberra in our time frame - apparently you have to book your respite months in advance. They are affordable (ish) at $200 per day - well that's a lot better than $1100, and they have a bed - from 27 August. We are still not too sure what we can do to cover the gap from 19 August when she will be discharged until then. We are hoping for a sky hook - by which we mean a cancellation at the respite centre to cover the gap. She can stay there for 3 weeks, which gives us a bit longer to find a place. So far, none of the places we have filled out reams of application forms for (Uniting Care, Baptist Care, Goodwin Aged Care, BUPA and Southern Cross) have any vacant rooms.

This system is so totally broken. Mum's specialist geriatrician told her and my sister, that we should take her home for 1 night and then go to the ED and say she is on blood thinners and had a fall, and then the public hospital will have to admit her. The physio was even more direct - she said wheel her straight from here to the ED and say she has gastro and they will have to admit her. Even at the respite care, the worker there who was reading us all the rule said we had to discuss her exit plan, and which aged care home would she go to? We said we are still trying to find a place, and she said "oh, so you will just have to take her to the ED then." What a waste of resources.

 

[Quickstatus]

she said wheel her straight from here to the ED and say she has gastro and they will have to admit her.

Sorry to hear.
This is actually the state of the hospital -aged care interface.

Correct.
And don't be embarrassed. Lots of people are doing it.

 

[VPS]

Well we are in the maw of the medical/aged care interface just now.

Mum has now been in hospital for almost 8 weeks - 1 week in the public hospital and then transferred to private for rehab - which was derailed twice by sepsis, but has recently been underway. Last Wednesday, they called us up to the hospital for a meeting which said:

• your mum cannot be safely discharged home so you will need to arrange residential aged care for her
• her doctor has just signed the last acute care certificate they were willing to give her, and as she is now no longer a medical case, when that certificate expires in two weeks, she will be discharged from hospital
• If you stay past that date, the hospital will bill you $1100-$1200 per day for her to be here

Fortunately, my regular cake bribes to the ward staff yielded a small benefit, in that they had "unofficially" told us this info a week earlier, to give us the best chance to get aged care set up - so really we had/have 3 weeks to get it sorted.

And that is where the trouble begins - we have eventually managed to apply to 5 care homes in our area - but it has been a full time job hounding the gatekeepers to provide us with information and application forms. We have been call screened and ignored, and on one spectacular occasion told that "if the person wanted to speak to you they would return your call. If they are not calling you, they don;t want to speak to you." There has been a fundamental difficulty getting these people to understand that mum is in a private hospital - they just keep saying, well if she is not safe to discharge, they will have to keep her until we find her a bed." We keep trying to say that is not the case, but no one hears us.

We were booked to see a care placement manager at the preferred brand of homes today, and when we arrived, she had fobbed us off to a lower level helper who could not answer any of our questions and said we could talk to the care manager on Friday this week. I finally broke down - just burst into tears and said that mum was going to be discharged only 3 working days after Friday - how on earth were we going to get care in that time. And finally, this person said "oh is she in a private hospital? That certainly changes the urgency." No cough Sherlock, that is what we have been saying in multiple phone and email messages for the last 2 weeks. Anyway, the original care manager now deigned to see us today after all, and so we have advanced slightly. She directed us to a private (ie full fee paying) respite organisation, as there are no funded respite beds available in Canberra in our time frame - apparently you have to book your respite months in advance. They are affordable (ish) at $200 per day - well that's a lot better than $1100, and they have a bed - from 27 August. We are still not too sure what we can do to cover the gap from 19 August when she will be discharged until then. We are hoping for a sky hook - by which we mean a cancellation at the respite centre to cover the gap. She can stay there for 3 weeks, which gives us a bit longer to find a place. So far, none of the places we have filled out reams of application forms for (Uniting Care, Baptist Care, Goodwin Aged Care, BUPA and Southern Cross) have any vacant rooms.

This system is so totally broken. Mum's specialist geriatrician told her and my sister, that we should take her home for 1 night and then go to the ED and say she is on blood thinners and had a fall, and then the public hospital will have to admit her. The physio was even more direct - she said wheel her straight from here to the ED and say she has gastro and they will have to admit her. Even at the respite care, the worker there who was reading us all the rule said we had to discuss her exit plan, and which aged care home would she go to? We said we are still trying to find a place, and she said "oh, so you will just have to take her to the ED then." What a waste of resources.

I thought you were going to get a broker to find a home or did you sister kibosh that

I feel for you - it's an awful time

 

[Pushka]

Well we are in the maw of the medical/aged care interface just now.

Mum has now been in hospital for almost 8 weeks - 1 week in the public hospital and then transferred to private for rehab - which was derailed twice by sepsis, but has recently been underway. Last Wednesday, they called us up to the hospital for a meeting which said:

• your mum cannot be safely discharged home so you will need to arrange residential aged care for her
• her doctor has just signed the last acute care certificate they were willing to give her, and as she is now no longer a medical case, when that certificate expires in two weeks, she will be discharged from hospital
• If you stay past that date, the hospital will bill you $1100-$1200 per day for her to be here

Fortunately, my regular cake bribes to the ward staff yielded a small benefit, in that they had "unofficially" told us this info a week earlier, to give us the best chance to get aged care set up - so really we had/have 3 weeks to get it sorted.

And that is where the trouble begins - we have eventually managed to apply to 5 care homes in our area - but it has been a full time job hounding the gatekeepers to provide us with information and application forms. We have been call screened and ignored, and on one spectacular occasion told that "if the person wanted to speak to you they would return your call. If they are not calling you, they don;t want to speak to you." There has been a fundamental difficulty getting these people to understand that mum is in a private hospital - they just keep saying, well if she is not safe to discharge, they will have to keep her until we find her a bed." We keep trying to say that is not the case, but no one hears us.

We were booked to see a care placement manager at the preferred brand of homes today, and when we arrived, she had fobbed us off to a lower level helper who could not answer any of our questions and said we could talk to the care manager on Friday this week. I finally broke down - just burst into tears and said that mum was going to be discharged only 3 working days after Friday - how on earth were we going to get care in that time. And finally, this person said "oh is she in a private hospital? That certainly changes the urgency." No cough Sherlock, that is what we have been saying in multiple phone and email messages for the last 2 weeks. Anyway, the original care manager now deigned to see us today after all, and so we have advanced slightly. She directed us to a private (ie full fee paying) respite organisation, as there are no funded respite beds available in Canberra in our time frame - apparently you have to book your respite months in advance. They are affordable (ish) at $200 per day - well that's a lot better than $1100, and they have a bed - from 27 August. We are still not too sure what we can do to cover the gap from 19 August when she will be discharged until then. We are hoping for a sky hook - by which we mean a cancellation at the respite centre to cover the gap. She can stay there for 3 weeks, which gives us a bit longer to find a place. So far, none of the places we have filled out reams of application forms for (Uniting Care, Baptist Care, Goodwin Aged Care, BUPA and Southern Cross) have any vacant rooms.

This system is so totally broken. Mum's specialist geriatrician told her and my sister, that we should take her home for 1 night and then go to the ED and say she is on blood thinners and had a fall, and then the public hospital will have to admit her. The physio was even more direct - she said wheel her straight from here to the ED and say she has gastro and they will have to admit her. Even at the respite care, the worker there who was reading us all the rule said we had to discuss her exit plan, and which aged care home would she go to? We said we are still trying to find a place, and she said "oh, so you will just have to take her to the ED then." What a waste of resources.

Indeed. And this is why Public Hospitals have fewer beds. I think in SA, maybe just Adelaide, there are 300 beds occupied by aged people simply waiting for a bed. Many are being managed in hotels nearby where floors have been taken over by the health system.

I think you will have to resort to ED.

And this broken system was years in the making and simply ignored. It makes me ask what the whole point of the census actually is when it clearly wasn't used to plan for ageing populations.

 

[Flyfrequently]

Oh dear @Seat0B how stressful and frustrating.
Good that you got the heads up, but pity that this is a reflection on the Aged Care system - in my time it was called "Granny dumping"
Not the way to have to get the care required for our beloved elderly folk.

Hoping a bed becomes available soon.
and thank you for updating when you have so much on your plate.

 

[TheRealTMA]

Causes are multifactorial
Can sometimes subtly manifest as "foggy head" for weeks.
Blokes over 70 are more at risk independently of other factors.

Tapentadol may have contributed as well I suggest.

 

[Quickstatus]

Tapentadol

Definitely on the higher suspicion list, but it is usually a combination of factors. Meaning if he took tapentadol outside of hospital , chances are that he would be oK.

 

[drron]

Definitely on the higher suspicion list, but it is usually a combination of factors. Meaning if he took tapentadol outside of hospital , chances are that he would be oK.

Not always from personal experience.

 

[TheRealTMA]

Definitely on the higher suspicion list, but it is usually a combination of factors. Meaning if he took tapentadol outside of hospital , chances are that he would be oK.

I left with a box of it but have decided to just use Panadol. The pain is minimal not like a knee hip replacement etc where it’s probably needed.

 

[Quickstatus]

I left with a box of it but have decided to just use Panadol.

Always start with that . Strong painkillers can have strong side effects.
Tapentadol + older + post op + post anaesthetic = often increased side effects.

Not always from personal experience.

True, but the side effects appear to be augmented if post op.

 

[Seat0B]

Sorry to hear.
This is actually the state of the hospital -aged care interface.

Correct.
And don't be embarrassed. Lots of people are doing it.

I feel absolutely awful about this. Firstly we have to actually abandon her - wheel her in, check her in and then leave so there is no “social support.” And secondly, that an aged care need requires a hospital bed to be tied up so that someone with genuine medical needs (like she had with the stroke, and the sepsis) gets squeezed. Or more likely they get a bed and someone moderately ill gets squeezed.