General Medical issues thread

[Quickstatus]

@RooFlyer

This is behaviour that IMHO crosses the line because it occured during the patient's most vulnerable time - while they are having a procedure done. It cannot and must not occur even when the patient is asleep. Inexcusable irrespective of who is correct.

Complaints should be to AHPRA or OHCC if in Tasmania.

 

[Seat0B]

Sorry to hear about this @RooFlyer. It is very hard to be treated by someone who is angry. I've also had poor experiences with medical staff who were dismissive of my whole condition eg not acting on what turned out to be leukaemia for several years dspite anomalous blood work and other complaints of symptoms from me and being told by a respiratory physician investigating my chronic cough that he did not need to see my video of coughing until I vomited and had a larnygospasm because "everybody coughs." I have not felt empowered to complain about these instances because of the need for on-going treatment and the limited medical options in Canberra. I have however changed GPs, which in itself was an ordeal.

Although, one of my specialists (not my haematologist who is actually lovely and not part of this problem) did invite feedback after he observed that I "sounded angry when describing his role in my missed diagnosis" (which was not doing anything at all about persistently declining platelets, WBC, neutrophils etc over 3 years in the presence of serious bruising and complaints of exhaustion). So we had a good chat, and he said he would take my experience into account in dealing with other patients and would follow up anomalous results more aggressivelyin the future. When I went back a year later, he told me that he had followed up 5 patients with anomalous results - so far 4 showed nothing sinister, but one patient had had a major medical issue detected and that he was glad I had "given him a kick up the bum." This is an older doctor, of many years' experience, so even an old dog can learn a new trick.

 

[Quickstatus]

This is an older doctor, of many years' experience, so even an old dog can learn a new trick.

Because he was empathetic and insightful and good Drs continue learning throughout their careers.

I learnt very early in my career that it matters little how the patient delivered the complaint - whether rude or not. It matters that the underlying issue is discovered and dealt with appropriately.

A complaint is not less worth just because the patient was rude/ short/angry/whatever the behaviour.

@RooFlyer if you don't want to make an official complaint you can write a letter to the radiologist/organisation but I think this is quite serious.

 

[Seat0B]

I learnt very early in my career that it matters little how the patient delivered the complaint - whether rude or not. It matters that the underlying issue is discovered and dealt with appropriately.

You are so right. And this is true for most people's careers, not just in the medical field. It was certainly true for mine. The earlier we learn this, the better.

 

[drron]

I found out that even if the patient thinks that they have a disease that is not universally accepted that you should at least do a few screening tests. From about 30 years ago chronic fatigue syndrome became a very common complaint. I always performed screening tests for fatigue and close to 40% had a medical condition but not CFS. Not all believed my diagnosis especially a fellow who ran a patient support group for CFS. But he had biopsy proven Coeliac disease. He was very angry with me and stormed out never to be seen again. However about a year later his wife rang me to say he was very much better but still told everyone he had CFS. She then told me that she had put him on a gluten free diet without telling him. That was extremely nice of her and made my day.

That said I know that I probably have got quite a few things wrong during my career.

During the last 17 years of my career I had exposure to many medical students. I always told them don’t expect any academic pearls of wisdom from me I am here to help you learn the art of medicine. I always began the first meeting with a demonstration of how to talk to a patient by first gaining their trust. I still miss that.

 

[prozac]

I found out that even if the patient thinks that they have a disease that is not universally accepted that you should at least do a few screening tests. From about 30 years ago chronic fatigue syndrome became a very common complaint. I always performed screening tests for fatigue and close to 40% had a medical condition but not CFS. Not all believed my diagnosis especially a fellow who ran a patient support group for CFS. But he had biopsy proven Coeliac disease. He was very angry with me and stormed out never to be seen again. However about a year later his wife rang me to say he was very much better but still told everyone he had CFS. She then told me that she had put him on a gluten free diet without telling him. That was extremely nice of her and made my day.

That said I know that I probably have got quite a few things wrong during my career.

During the last 17 years of my career I had exposure to many medical students. I always told them don’t expect any academic pearls of wisdom from me I am here to help you learn the art of medicine. I always began the first meeting with a demonstration of how to talk to a patient by first gaining their trust. I still miss that.

I can vouch for you @drron . It is possibly (likely) I would not be here now without your advice I get certain things checked out! My GP was off having a hip-replacement and I was left to the shallow thinking partner who sent me away with antibiotics. Your advice gave me courage the following week to insist on a full blood work-up and chest CT.

 

[TheRealTMA]

What’s the issue with taking 25mg of prednisone daily?

Not recommended according to my GP.
Does seem to relieve gout and arthritic pains etc?

 

[Quickstatus]

What’s the issue with taking 25mg of prednisone daily?

It's the side effects due to long term consumption

 

[andye]

What’s the issue with taking 25mg of prednisone daily?

Not recommended according to my GP.
Does seem to relieve gout and arthritic pains etc?

OK for a few days as short-term effects are few, maybe some sleep disturbance and gastric irritation
Long-term lots of issues:- osteoporosis, hypertension, ulcers, moon-face, central weight gain, muscle weakness and more.
For some serious inflammatory conditions the side-effects are worthwhile but you are always trying to find the minimum effective dose

 

[Quickstatus]

Anaesthetists are unsure how long GLP1 should be stopped before an elective general anaesthetic because of the delayed gastric emptying issue. Some are saying 4 dose equivalents. Some 2. Mounjaro/ozempic is once a week so stop 2-4 weeks prior to elective surgery. Still up in the air about this one.

Ok, the recommendations have changed

Ozempic/Wegovy/ Mounjaro etc
No food, just clear fluids only T-24hrs to T-6hrs prior to anaesthesia

 

[RooFlyer]

It's the side effects due to long term consumption

My current GP flatly refused to prescribe it for me for arthritic inflammation pain (fingers) , as in even 1-2 doses. I didn’t have gout.

I can take NSAIDS like 100 mg Celecoxib but only for five days at a time per month - kidney protection.

A previous GP did prescribe it to me and it cleared the arthritic inflammation up almost instantly.

 

[prozac]

OK for a few days as short-term effects are few, maybe some sleep disturbance and gastric irritation
Long-term lots of issues:- osteoporosis, hypertension, ulcers, moon-face, central weight gain, muscle weakness and more.
For some serious inflammatory conditions the side-effects are worthwhile but you are always trying to find the minimum effective dose

I was taking 100mg a day for 6 days through each 3 week chemo cycle. You didn't want to cross me in the supermarket. Taking at this dosage it apparently stays 12 months in your system and it did affect my large glute muscles alot, but much longer than 12 months. Here I am at 20 months since end of chemo (and and people the past month or so are commenting how well I look, and how I sound! So my suggestion is preds can last much longer than suggested.
This tallies with weight gain @andye , as I am now losing weight the past 2 months without trying.

 

[Quickstatus]

A previous GP did prescribe it to me and it cleared the arthritic inflammation up almost instantly.

Short Bursts are Ok

A third category are the DMARDS or Biologics. Arthritis Australia have a page on it.

 

[drron]

For my gout I take colchicine. Usually 1 dose is sufficient but occasionally need a second. I fortunately don't need it often. The bottle of 30 I got in 2022 still has 12 tablets left.

 

[JohnK]

The current health system is disappointing. Inconsistent.

They promised no one was going to be affected but dad went to ER urgently on the morning they went out on strike. Was not seen for 4-5 hours which was critical. Couldn't pee because of the clots in the bladder caused by warfarin. Developed infection so kept in hospital with catheter inserted. Had also lost a lot of haemoglobin a few times and had to get transfusion which made recovery worse.

Here's where I'm confused. They called mum and my brother to hospital for meeting. Basically told them dad has less than a week to live. I was in Thailand at the time. This was just before Easter. Dad got worse. They did some tests and find he has perforated bladder. (This hospital is beyond belief)

They sent him to Concord urgently for operation. It was not a simple operation and dad looked like he was in his last days.

Surprisingly he started to recover. The doctors and nurses there were really going above and beyond taking care of dad. Chalk and cheese with how he's been treated at our local.hospital.

I flew down to Sydney for the day as soon as I got back from Thailand. Dad was OK. He was hungry. They were mashing his food and he started eating properly for the first time in a while. They kept him there until dad improved enough to send him back to local hospital.

I think dad has been improving each day. He is 87 years old so some of tgeses expected. I'll be going to see him in a few days. He's had enough. He wants to go back home.

Life gets tough as we get older especially if we have to take care of older people.

 

[Brissy1]

The current health system is disappointing. Inconsistent.

They promised no one was going to be affected but dad went to ER urgently on the morning they went out on strike. Was not seen for 4-5 hours which was critical. Couldn't pee because of the clots in the bladder caused by warfarin. Developed infection so kept in hospital with catheter inserted. Had also lost a lot of haemoglobin a few times and had to get transfusion which made recovery worse.

Here's where I'm confused. They called mum and my brother to hospital for meeting. Basically told them dad has less than a week to live. I was in Thailand at the time. This was just before Easter. Dad got worse. They did some tests and find he has perforated bladder. (This hospital is beyond belief)

They sent him to Concord urgently for operation. It was not a simple operation and dad looked like he was in his last days.

Surprisingly he started to recover. The doctors and nurses there were really going above and beyond taking care of dad. Chalk and cheese with how he's been treated at our local.hospital.

I flew down to Sydney for the day as soon as I got back from Thailand. Dad was OK. He was hungry. They were mashing his food and he started eating properly for the first time in a while. They kept him there until dad improved enough to send him back to local hospital.

I think dad has been improving each day. He is 87 years old so some of tgeses expected. I'll be going to see him in a few days. He's had enough. He wants to go back home.

Life gets tough as we get older especially if we have to take care of older people.

They perforated his bladder inserting the catheter??
Well done your Dad, a great survivor. And Concord did well, nice to know.

 

[JohnK]

They perforated his bladder inserting the catheter??
Well done your Dad, a great survivor. And Concord did well, nice to know.

Yes, they perforated dads bladder but didn't notice it for 2-3 days. In the mean time dad was suffering.

Hope dad stays around to see his only granddaughter grow up.