General Medical issues thread

[drron]

My problem with my bladder isn't my prostate. No problem passing urine at all. The frequency of urination can be a symptom of Parkinsons. I was hoping the treatment would help that first.

 

[Flyfrequently]

My problem with my bladder isn't my prostate. No problem passing urine at all. The frequency of urination can be a symptom of Parkinsons. I was hoping the treatment would help that first.

I am sure you are aware of the many treatments for Parkinson issues @drron
My friend who has had PD for over a decade had some success with botox for her bladder issues, prior to then having her DBS implanted 2 years ago.

 

[Seat0B]

Good news for Mrs.drron and mainly good news for you too @drron. It’s very debilitating having your sleep so disturbed though so I hope there is some improvement for you soon.

 

[drron]

I am sure you are aware of the many treatments for Parkinson issues @drron
My friend who has had PD for over a decade had some success with botox for her bladder issues, prior to then having her DBS implanted 2 years ago.

Not having any more medical procedures this year. Too much could go wrong and probably would. Want to spend my Christmas in Bangkok.

 

[Quickstatus]

Want to spend my Christmas in Bangkok.

Will you take your e-wchair with you?

 

[drron]

Will you take your e-wchair with you?

Definitely

 

[Quickstatus]

Definitely

Looking forward to the first ever e-wheelchair TR.

 

[Seat0B]

Here’s this week’s update.

Mr Seat0A and I have become those persistent annoying people who keep calling asking for updates and requesting meetings, site visits and anything else that might improve mum’s chances of getting a residential care bed by the looming deadline of 19 Aug.

The summary is we now have applications pending with 7 providers - we added LDK and Arcare this week to the 5 I listed last week. Still no joy.

We have managed to secure a full fee paying (but still affordble) respite care bed at around $200/day for 3 weeks starting on 27 Aug, but still had no clear pathway to bridge the gap between hospital discharge and respite starting until a very amazing conversation with Mum’s wonderful geriatrician. Seems the doctor who will not extend mum’s accute care certificate is her rehab doctor. The geriatrician said “oh I see she’s down for discharge and I heard you don’t have a bed for her yet. I will start reviewing her medications for discharge.” Quick look at mum’s records. “Hmm, polypharmacy I see. That won’t do. I will need to start reviewing her medications, one at a time so I can identify any problems and address that with adjustments or changes to the relevant medication. I think this might take about 7-10 days to allow time for side effects etc to be identified and managed, and unneeded medications to be stopped as I could not possibly discharge a frail lady in her condition with potential drug interaction issues. She will need to be monitored in hospital while her medications are adjusted. I will issue an accute care certificate while I do this review.” All accompanied by a beautiful smile and the smallest of winks.

I am compelled to say how amazing geriatricians are. This is the second one we have dealt with over 10 years (for dad first, now mum) and they both shared characteristics of kindness and empathy, and the genuine desire to see older people have the best life and the best death they can achieve. Geriatric medicine is not sexy. I am sure it does not receive the funding or research interest it deserves, which is odd as every single one of us will get old and die, whilst we will not all suffer cancer or heart disease or any of the more sexy and better funded things that medicine can address (fortunately). A geriatrician’s patients do not really get better, and they all die in a relatively short period of time, compared with say those of a dermatologist or orthopaedic surgeon. Old people are not as cute as babies or children. They usually can’t pay as much as other people. Old people are often grumpy and non-compliant and don’t always appreciate the help they are being given - sometimes because it simply goes over their heads, or sometimes because they do not have a realistic grasp of their own (unfortunately diminished) capabilities. But geriatricians turn up anyway. Someone who chooses this field to specialise in must certainly know they face these aspects with their patients, but they still choose it anyway. Thank you.

Small glimmer of hope - a phone call late on Friday through an unofficial sources alerted us to an upcoming vacancy at the preferred care home. We will have to be on the phone again first thing Monday. And I am sorry for the bereavement that another family is going through to create a vacant room.

 

[Seat0B]

Thinking of you @zig. No need to reply as I know how busy you will be, but just want you to know someone outside your immediate circle cares about you.

 

[tgh]

Thats a heart warming update , persistence with a smile. ….. well done … made my day

 

[Brissy1]

Here’s this week’s update.

Mr Seat0A and I have become those persistent annoying people who keep calling asking for updates and requesting meetings, site visits and anything else that might improve mum’s chances of getting a residential care bed by the looming deadline of 19 Aug.

The summary is we now have applications pending with 7 providers - we added LDK and Arcare this week to the 5 I listed last week. Still no joy.

We have managed to secure a full fee paying (but still affordble) respite care bed at around $200/day for 3 weeks starting on 27 Aug, but still had no clear pathway to bridge the gap between hospital discharge and respite starting until a very amazing conversation with Mum’s wonderful geriatrician. Seems the doctor who will not extend mum’s accute care certificate is her rehab doctor. The geriatrician said “oh I see she’s down for discharge and I heard you don’t have a bed for her yet. I will start reviewing her medications for discharge.” Quick look at mum’s records. “Hmm, polypharmacy I see. That won’t do. I will need to start reviewing her medications, one at a time so I can identify any problems and address that with adjustments or changes to the relevant medication. I think this might take about 7-10 days to allow time for side effects etc to be identified and managed, and unneeded medications to be stopped as I could not possibly discharge a frail lady in her condition with potential drug interaction issues. She will need to be monitored in hospital while her medications are adjusted. I will issue an accute care certificate while I do this review.” All accompanied by a beautiful smile and the smallest of winks.

I am compelled to say how amazing geriatricians are. This is the second one we have dealt with over 10 years (for dad first, now mum) and they both shared characteristics of kindness and empathy, and the genuine desire to see older people have the best life and the best death they can achieve. Geriatric medicine is not sexy. I am sure it does not receive the funding or research interest it deserves, which is odd as every single one of us will get old and die, whilst we will not all suffer cancer or heart disease or any of the more sexy and better funded things that medicine can address (fortunately). A geriatrician’s patients do not really get better, and they all die in a relatively short period of time, compared with say those of a dermatologist or orthopaedic surgeon. Old people are not as cute as babies or children. They usually can’t pay as much as other people. Old people are often grumpy and non-compliant and don’t always appreciate the help they are being given - sometimes because it simply goes over their heads, or sometimes because they do not have a realistic grasp of their own (unfortunately diminished) capabilities. But geriatricians turn up anyway. Someone who chooses this field to specialise in must certainly know they face these aspects with their patients, but they still choose it anyway. Thank you.

Small glimmer of hope - a phone call late on Friday through an unofficial sources alerted us to an upcoming vacancy at the preferred care home. We will have to be on the phone again first thing Monday. And I am sorry for the bereavement that another family is going through to create a vacant room.

My, admittedly limited, experience with geriatricians was like yours. Wonderful people in an unglamerous speciality.

 

[drron]

I was referred back to the Neurologist I had seen before but now for Parkinsons disease. I was triaged as Category 2 with a wait time of moe than 6 months. On top of that he char ged more than the AMA fee and no discount for a retired colleague as I always did which was possibly why I had 15 retired professors on my book.
So I told my GP to refer me to a Geriatrician I know who likes treating Parkinsons.

 

[MARTINE]

I was referred back to the Neurologist I had seen before but now for Parkinsons disease. I was triaged as Category 2 with a wait time of moe than 6 months. On top of that he char ged more than the AMA fee and no discount for a retired colleague as I always did which was possibly why I had 15 retired professors on my book.
So I told my GP to refer me to a Geriatrician I know who likes treating Parkinsons.

The days of bulk billing colleagues I found it all but over now. Only one of my specialists does now…

 

[MARTINE]

Here’s this week’s update.

Mr Seat0A and I have become those persistent annoying people who keep calling asking for updates and requesting meetings, site visits and anything else that might improve mum’s chances of getting a residential care bed by the looming deadline of 19 Aug.

The summary is we now have applications pending with 7 providers - we added LDK and Arcare this week to the 5 I listed last week. Still no joy.

We have managed to secure a full fee paying (but still affordble) respite care bed at around $200/day for 3 weeks starting on 27 Aug, but still had no clear pathway to bridge the gap between hospital discharge and respite starting until a very amazing conversation with Mum’s wonderful geriatrician. Seems the doctor who will not extend mum’s accute care certificate is her rehab doctor. The geriatrician said “oh I see she’s down for discharge and I heard you don’t have a bed for her yet. I will start reviewing her medications for discharge.” Quick look at mum’s records. “Hmm, polypharmacy I see. That won’t do. I will need to start reviewing her medications, one at a time so I can identify any problems and address that with adjustments or changes to the relevant medication. I think this might take about 7-10 days to allow time for side effects etc to be identified and managed, and unneeded medications to be stopped as I could not possibly discharge a frail lady in her condition with potential drug interaction issues. She will need to be monitored in hospital while her medications are adjusted. I will issue an accute care certificate while I do this review.” All accompanied by a beautiful smile and the smallest of winks.

I am compelled to say how amazing geriatricians are. This is the second one we have dealt with over 10 years (for dad first, now mum) and they both shared characteristics of kindness and empathy, and the genuine desire to see older people have the best life and the best death they can achieve. Geriatric medicine is not sexy. I am sure it does not receive the funding or research interest it deserves, which is odd as every single one of us will get old and die, whilst we will not all suffer cancer or heart disease or any of the more sexy and better funded things that medicine can address (fortunately). A geriatrician’s patients do not really get better, and they all die in a relatively short period of time, compared with say those of a dermatologist or orthopaedic surgeon. Old people are not as cute as babies or children. They usually can’t pay as much as other people. Old people are often grumpy and non-compliant and don’t always appreciate the help they are being given - sometimes because it simply goes over their heads, or sometimes because they do not have a realistic grasp of their own (unfortunately diminished) capabilities. But geriatricians turn up anyway. Someone who chooses this field to specialise in must certainly know they face these aspects with their patients, but they still choose it anyway. Thank you.

Small glimmer of hope - a phone call late on Friday through an unofficial sources alerted us to an upcoming vacancy at the preferred care home. We will have to be on the phone again first thing Monday. And I am sorry for the bereavement that another family is going through to create a vacant room.

My fingers and toes are crossed for you @Seat0B
I recall getting one such call and its literally drop everything and camp outside the nursing home checquebook, paperwork and preemptive flowers for the staff. I so so hope you get the resolution you seek soon. Might be a good chance to reaffirm your mum’s wishes with other relatives - and the facility - for when critical decisions to be made given the difficulties you have faced
All the very best to you

 

[Seat0B]

Might be a good chance to reaffirm your mum’s wishes with other relatives - and the facility - for when critical decisions to be made given the difficulties you have faced

100% this conversation is needed. One good outcome of the stroke treatment is that mum is largely in possession of her mental faculties and I think would be open to reviewing some of the decision made along the way for future decisions that will need to be made.

I am also going to insist that she finalises her Advanced Care Plan - we were booked in for GP sign off (compulsory in the ACT) 2 days after she had her stroke and so never got to do it, so she still does not have one in place.

 

[Brissy1]

I was referred back to the Neurologist I had seen before but now for Parkinsons disease. I was triaged as Category 2 with a wait time of moe than 6 months. On top of that he char ged more than the AMA fee and no discount for a retired colleague as I always did which was possibly why I had 15 retired professors on my book.
So I told my GP to refer me to a Geriatrician I know who likes treating Parkinsons.

That's very interesting about geriatrician treating PD, relevant for a relative of mine. Who also has cancer poor lady. So a geriatrician review might be a thought if polypharmacy becomes an issue even though she's only in her 60s.

 

[prozac]

My, admittedly limited, experience with geriatricians was like yours. Wonderful people in an unglamerous speciality.

One of the puzzling medical professions like bottom doctors.

I was referred back to the Neurologist I had seen before but now for Parkinsons disease. I was triaged as Category 2 with a wait time of moe than 6 months. On top of that he char ged more than the AMA fee and no discount for a retired colleague as I always did which was possibly why I had 15 retired professors on my book.
So I told my GP to refer me to a Geriatrician I know who likes treating Parkinsons.

Completely surprised Tuesday week ago when I had a PET scan and was charged nothing at all!
Then on Friday I had the follow-up appointment with my haematologist and Genesis charged me $200. When I questioned why I was being charged for the first time they replied b/c I was not receiving an infusion as well.

 

[Seat0B]

I recall getting one such call and its literally drop everything and camp outside the nursing home checquebook, paperwork and preemptive flowers

Nursing homes (in the ACT at least) have taken a leaf out of the airlines customer service play books and have enhanced application processes to better meet customer their own needs. All the organisations we have contacted only do admissions at a central location now. So going to a particular facility does nothing - they just tell you to make an appointment with the Care Placement Coordinator. Then you run the gauntlet of voicemail “your call is important to us and will be returned shortly” if by shortly you mean 3 days and 3 follow up call from us later. But we now know where her office is, and if we don’t get through by phone Monday we will go up to that office and take up residence until we get a resolution.

 

[andye]

The days of bulk billing colleagues I found it all but over now. Only one of my specialists does now…
[/QUOTE]
I've had a good run with my colleagues over last few years but I do still work in the same hospital
No gap on any consultations or surgery for repair of torn quad by excellent but usually expensive Orthopaedic surgeon . No gap for Urology consult or from private imaging facility for subsequent MRI. No gap on Resp consult for sleep apnoea (sleep study bulk-billed anyway).
Mrsandye (who, as an ED Nurse Unit Manager, is far more important to the functioning of the hospital than I) and mstrandye3 have also been seen for things without gap
My GP also bulkbills me

 

[prozac]

The days of bulk billing colleagues I found it all but over now. Only one of my specialists does now…

...
My GP also bulkbills me
[/QUOTE]
As does my excellent GP of 40yrs.
The cost free imaging was performed at your establishment @andye, and incidentally their process for that procedure was excellent.