General Medical issues thread

[MARTINE]

Our office person was on inflatable donut at the river a few weeks ago with friends. They went really fast. The donut tipped up and she was thrown in the air and ended up perpendicular and entering the water head first. My immediate reaction was Concussion and straight to hospital. She didn't. Went to a physio. Stopped doing exercise. Sore neck and headache that has persisted but she is otherwise driving, working etc. Her GP finally referred her for a CT this afternoon and which picked up a brain bleed and she's now in hospital. Hopefully it's the residual of what she received on impact and not a developing one. She is otherwise fully functional. Waiting for the outcome of more tests. Why won't these youngies listen to us oldies?

They always know better… until they dont
For them it is more stressful to lose your phone charger

 

[JohnM]

Had two GPs retired me so this time I got a young ‘un. I made the first appointment a double so I could start training him up.

Poor b@stard...

 

[Katie]

Looks like FIL is heading for palliative care.
He fell over in the kitchen early on Friday, 5am or so. MIL found him. Called an ambulance and spent most of the day in Emergency. Got the all clear and went home around 6-7pm.

He hasn’t been sleeping well, needs to sit up a lot, probably can’t breathe when he lies down. MIL found him this morning in the kitchen, having taken all of today’s meds and trying to refill the containers, which MIL normally looks after. He was quite agitated and clearly confused. MIL called the GP and palliative care service; ended up calling an ambulance. We went up this evening as he was being transferred from emergency to a ward. One of my SILs says he’s likely to be transferred to a palliative care hospital tomorrow.

He was quite agitated in the room, after arriving the nurses did obs and he had a temp. Couldn’t take panadol, so they gave to him in a drip form.

Oh, and the doctor has advised to cease all medications, except those for pain or comfort.
MIL was rather upset there was no antibiotics for an infected scrape on his knee, I tried to suggest that could be revisited in the morning with the doctor.

They’d both rather he be at home, but I suspect as he’s not sleeping and wandering about at night, he’s at risk of having a nasty fall and MIL wouldn’t want to discover him.

Mr Katie seems somewhat OK, one of his sisters is very upset.

 

[DejaBrew]

Sorry to hear that @Katie. Hope he can be made comfortable and the situation calms down a bit for you and the family. No doubt it's a very emotionally difficult and traumatic situation for all involved.

 

[Pushka]

Looks like FIL is heading for palliative care.
He fell over in the kitchen early on Friday, 5am or so. MIL found him. Called an ambulance and spent most of the day in Emergency. Got the all clear and went home around 6-7pm.

He hasn’t been sleeping well, needs to sit up a lot, probably can’t breathe when he lies down. MIL found him this morning in the kitchen, having taken all of today’s meds and trying to refill the containers, which MIL normally looks after. He was quite agitated and clearly confused. MIL called the GP and palliative care service; ended up calling an ambulance. We went up this evening as he was being transferred from emergency to a ward. One of my SILs says he’s likely to be transferred to a palliative care hospital tomorrow.

He was quite agitated in the room, after arriving the nurses did obs and he had a temp. Couldn’t take panadol, so they gave to him in a drip form.

Oh, and the doctor has advised to cease all medications, except those for pain or comfort.
MIL was rather upset there was no antibiotics for an infected scrape on his knee, I tried to suggest that could be revisited in the morning with the doctor.

They’d both rather he be at home, but I suspect as he’s not sleeping and wandering about at night, he’s at risk of having a nasty fall and MIL wouldn’t want to discover him.

Mr Katie seems somewhat OK, one of his sisters is very upset.

Palliative care or more like a nursing home environment?

 

[JohnK]

Wife is out of hospital but still not feeling well. And we are extremely confused at the apparent lack of action.

What do we do going forward? Come back to hospital with each new infection. Seriously?

Apparently they want to do a MAG3 test to determine if the right kidney has damage. Ok there is more than likely damage due to many recurring UTIs. Mention that one possibility is to remove right kidney and ureter. (Don't be stupid, that's not an option!)

So wife's issue is Vesicoureteral reflux. The right valve is not working properly which allows urine back into kidney. Why mention of removing kidney/ureter and not surgical options like ureteral reimplantation or endoscopic injection of a gel-like substance.

Surely endoscopic injection of gel-like substance is the best solution for patient. This is a day procedure. Surely cost should be a concern? Next option should be UTI vaccine.

Urology would not talk to me. The doctor that was looking after my wife had no idea about VUR endoscopic injection. We see Urology in 3 weeks. I need to push here and continue to do research. I may need to invoke Ryan' rule but that could take time. We need something sooner rather than later and not extreme.

How to find a GP to discuss? Do we go to private urologist? What would cost of endoscopic VUR treatment be? Urology has already done a cystoscopy so why not endoscopic VUR treatment. Lots of headaches and feel sorry for wife as she is the one suffering.

 

[Katie]

Palliative care or more like a nursing home environment?

I think palliative care in a hospital. I think his care needs might be higher than a nursing home and perhaps shorter lasting if the doctors are stopping all medications other than pain/comfort meds.

 

[Quickstatus]

PallCare discussion paper

PallCare can also be home based.
Navigating PallCare often require input from Social workers who are invaluable. Some have particular skills with Paediatric PallCare, or Pallcare patients with young children etc etc

Edit PallCare resources contacts

 

[Quickstatus]

So wife's issue is Vesicoureteral reflux

Ok so sounds like your wife is getting to a diagnosis which then opens up treatment options. However there is Primary VUR - more commonly diagnosed in younger patients - typically an impaired valve, and then secondary VUR. Am I correct your wife has got it in one ureter not both?

Urology has already done a cystoscopy so why not endoscopic VUR treatment. Lots of headaches and feel sorry for wife as she is the one suffering.

Your wife needs to see a urologist. There are several treatments that you have mentioned. Best to talk with urologist.
If you can't connect with urologist allocated to you and it sounds like you are having problems with outpatient clinics, then I would suggest get a referral to see one privately.

 

[JohnK]

Ok so sounds like your wife is getting to a diagnosis which then opens up treatment options. However there is Primary VUR - more commonly diagnosed in younger patients - typically an impaired valve, and then secondary VUR. Am I correct your wife has got it in one ureter not both?


Your wife needs to see a urologist. There are several treatments that you have mentioned. Best to talk with urologist.
If you can't connect with urologist allocated to you and it sounds like you are having problems with outpatient clinics, then I would suggest get a referral to see one privately.

I think you 100% correct.

Only right ureter and now right kidney have issue. Note overall kidney function is good. Let's see what MAG3 shows up first and then the next discussion with Urology Outpatients early December.

I want to be prepared. I want to know about treatment options, not wait for them to discuss. We can go private but is Medicare going to cover the Endoscopic VUR treatment?

 

[Quickstatus]

I want to be prepared. I want to know about treatment options, not wait for them to discuss. We can go private but is Medicare going to cover the Endoscopic VUR treatment?

Yes look at your options but reminder that the correct treatment depends on the actual cause of the VUR - ie treatment options are generally not black and white.

Medicare covers treatment for VUR, but the problem is going to be the wait time in a public hospital as VUR is often no more urgent than a lot of other medical conditions

Often the better way is to see a Urologist privately in their rooms who also operates in a public hospital - this way you can avoid outpatient clinics.

 

[RooFlyer]

What would cost of endoscopic VUR treatment be?

We can go private but is Medicare going to cover the Endoscopic VUR treatment?

Given all the history you have outlined, why on earth is that even a consideration for you?

 

[Katie]

PallCare discussion paper

PallCare can also be home based.
Navigating PallCare often require input from Social workers who are invaluable. Some have particular skills with Paediatric PallCare, or Pallcare patients with young children etc etc

Edit PallCare resources contacts

SIL is at hospital with FIL and has just shared pall care's doctor's comments this morning. Dr asked if everyone who needs to know knows, and if they've been to visit. He will be staying in the palliative care/oncology ward he's in and not transferring to St Vincent's.
He was restless and agitated overnight, actively taking off his drip, etc. He was given a little bit of morphine (and maybe something else?) to help calm him and provide rest early this morning.
His body is actively shutting down.

 

[DejaBrew]

So assistant has had her ‘brain’ surgery. The hole drilling seems to have sorted it. Went well. Seems to be perfectly normal with speech and movement and already posted pictures and responded to replies quickly. And she says her headache has gone! probably high on drugs. So relieved.

Great outcome (and very fortunate to get out of it this "easily").

 

[Katie]

FIL passed peacefully tonight, with us all there (well, not younger grandsons and BIL). SIL called Mr Katie at about 5:30 this afternoon knowing he wasn’t planning on getting to hospital until 8, saying he’d best get there. So we all went up and made it to have some time with him before he took his final breath.
He’d been on low doses of morphine throughout the day and actually looked comfortable lying/sleeping in bed, which we hadn’t seen for months.
My MIL did an amazing job keeping him at home until yesterday.

 

[prozac]

I have self-diagnosed as, since last weeks angioplasty, I have now had 4 angina episodes in bed early in the morning. During the angioplasty my cardiologist indicated I was having artery spasm. So today I researched heart/artery/spasm and came up with the diagnosis of coronary artery spasm or vasospastic angina or Prinzmetal's angina. This started shortly after the cancer biopsy thoracic surgery, May 2023. In spite of describing this new angina I never had before running up left side chest to neck and ear, sometimes beginning with ear-ache, no-one has ever connected the dots even when I asked if ear ache can be an angina indicator. Turns out it is.
Advised symptoms;
- usually occurs while at rest late at night and in the early morning (this is me)
- can occur with cold. Me chopping wood in winter without angina and then other occassions left side angina even before lifting axe/splitter
- usually left side running up to neck

Apparently treatment is just nitro lingual spray (Start you cough).
Mentioning in-case others experiencing same and doctors not nailing it.

Back to cardiologist today post angioplasty 23 October. He is happy with result and agrees with my self diagnosed vasospastic angina. Basically I have been telling everyone for 2.5yrs the very specific symptoms that indicate this sort of angina. The angina occurs when a coronary artery spasms and constricts blood flow. No-one came up with this diagnosis until I mentioned it. This is why you need to be all over your symptoms.
On way up to the 6th floor rooms I used the stairs. Whilst strenuous (my glutes still haven't re-built) I was able to reach the top with a heart rate of 96bpm (drug assisted) which I am pleased about.
Back there tomorrow for left and right side ultrasound scans of axilary and branchial viens to check if a 3rd wire can be run for a defib PPM. PPM interrigation on Monday indicated I have 3.7months battery life. I gather there is a margin of safety built in as the change-over will be later in February.

 

[love_the_life]

FIL passed peacefully tonight, with us all there (well, not younger grandsons and BIL). SIL called Mr Katie at about 5:30 this afternoon knowing he wasn’t planning on getting to hospital until 8, saying he’d best get there. So we all went up and made it to have some time with him before he took his final breath.
He’d been on low doses of morphine throughout the day and actually looked comfortable lying/sleeping in bed, which we hadn’t seen for months.
My MIL did an amazing job keeping him at home until yesterday.

Condolences to the family. Wonderful you could spend the last few hours together.