General Medical issues thread

[markis10]

Disturbing article in the Australian today about a report (by interstate authors) into the Qld Prince Charles Hospital heart transplant unit. Some of the issues...
- only performs ½ the transplants it should,
- 12 month post operative mortally rate 150% of international benchmark (including from fungal infections from mould in the hospital room),
- ½ of all donor hearts are sent interstate,
- categorises patients as not medically suitable, who nevertheless then have successful transplants interstate.

When reviewed, waiting list was "surprisingly(sic) small", just 10 suitable persons on the list. So KPIs met .

$5.9M pa allocated to fix the problem. Meanwhile, permanent 50cent bus subsidies in Brisbane area is a $350M continuing cost (in 2024 $) every year.

Good interview on the 612 Brisbane drive program yesterday at the 19min mark with a transplant survivor and his experience,

 

[Flyfrequently]

On a lighter note, today I'm a week post op from left calf SCC excision and graft with right thigh donor site.
To all the health professionals out there (am one - albeit retired now) who say
"Don't get the dressings wet, just shower with a plastic bag" - it isn't that easy

Think Mr Flyfrequently might just renovate our bathroom for our advancing years!

 

[hydrabyss]

Good interview on the 612 Brisbane drive program yesterday at the 19min mark with a transplant survivor and his experience,

Thanks for posting I found that very interesting. I know from my experience when it comes to what you take and what you do the more you ask and know the better off you will be. Although there are somethings especially those out of your control I would rather not have to think about as being told you need a transplant can be tough but also a second chance if your suitable.

 

[Quickstatus]

Tramadol which is more direct acting.

Tramadol is not direct acting for the opiate effect but is direct acting for the other effects.
It is like codeine - a prodrug. It has to be metabolised to the active drug for the opiate effect, though it is not metabolised to morphine.

So like codeine some people find it does not work and others find it too strong

Codeine is problematic because there is a small group of people called ultrafast metabolisers. This means they are extremely efficient in converting codeine to morphine. It is not recommended in paediatrics because there have been the very rare death because a small child turned out to be an ultrafast metaboliser. Luckily none in Australia but here is a TGA report

Tramadol is less problematic but same precautions apply.

 

[andye]

I can understand why the range of symptoms is confusing g for doctors. But they are real and I have been repeatedly dismissed.

View attachment 479479

Its not something I'd specifically heard about. Seems to be quite recently described (great acronym) but plausible and similar surgeries are performed for trigeminal neuralgia and tinnitus. Neither are 100% succesful.
Any surgery would be next to the brain rather than in it. I'd be keen to ask how many procedures the surgeon has done previously

 

[Beano]

Tramadol is not direct acting for the opiate effect but is direct acting for the other effects.
It is like codeine - a prodrug. It has to be metabolised to the active drug for the opiate effect, though it is not metabolised to morphine.

So like codeine some people find it does not work and others find it too strong

Codeine is problematic because there is a small group of people called ultrafast metabolisers. This means they are extremely efficient in converting codeine to morphine. It is not recommended in paediatrics because there have been the very rare death because a small child turned out to be an ultrafast metaboliser. Luckily none in Australia but here is a TGA report

Tramadol is less problematic but same precautions apply.

and I was told Tramadol was directly accessible. Probably explains why Tramadol is great for me either. I'll stick to the paracetamol.