General Medical issues thread

[drron]

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.

This fellow has an interest in PD. Not all geriatricians do. however it is not uncommon for their patients to have PD.

 

[RooFlyer]

Well, I'm a 'doctor' - I'll have to lean on my GP for mate's rates.

 

[drron]

Well, I'm a 'doctor' - I'll have to lean on my GP for mate's rates.

First you have to agree that you will answer the call of is there a doctor onboard

 

[Seat0B]

Well, I'm a 'doctor' - I'll have to lean on my GP for mate's rates.

Me too! Although I did once have a doctor greet me with “oh, so you’re a real doctor then!”

 

[Flyfrequently]

First you have to agree that you will answer the call of is there a doctor onboard

Like it @drron !!

 

[TheRealTMA]

Well, I'm a 'doctor' - I'll have to lean on my GP for mate's rates.

Medical practitioners charge “real doctors” more.

Ps: explain to me why my physio now calls himself doctor and has doubled his hourly fee?

 

[RooFlyer]

First you have to agree that you will answer the call of is there a doctor onboard

"Hi, yes, I'm a doctor. Thanks for calling - are you interested in my thesis topic?

 

[drron]

I increased my meds 4 days ago and walking more. Will make 10000 steps for the week for the first time since the fall.
Thigh pain getting a little better.
Hopefully works on the bladder soon.

 

[MARTINE]

Well, I'm a 'doctor' - I'll have to lean on my GP for mate's rates.

You’ve got rocks in your head (or brain at least)

 

[MARTINE]

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.

I cannot help but observe it is you and your husband who are currently doing all the heavy lifting right now..look after yourselves too

 

[drron]

Increased my PD meds 5 days ago and the number of bladder calls between 2200 and 0800 has fallen from 5 to 2.

Also different way to reduce my thigh pain, Under the skin on the lateral side you can feel bone and tendons heading in the direction of the knee so I presume a tendinitis. Now I can't take simple anti inflammatory drugs being on a blood thinner. But the pain was getting me down. Taking a 25mg prednisone we had pain gone . Slowly returned so took half dose. Not complete relief but much easier to live with. Not wanting to take too much steroi_ I got our GP to give me some 5mg tablets. enough relief so now less than once a week take a 5 mg dose. At least I get more sleep.

And Wheelchair coming within the next week.

 

[Quickstatus]

presume a tendinitis.

Greater trochanter bursitis?
Ultrasound might help with diagnosis.
steroi_ injection?

 

[drron]

My tendons are heading from the greater trochanter inferiorly. My anatomy was rearranged at the end of February. I have had steroi_ injections previously for bursitis in the right hip and tendonitis in the left hip. Neither worked.

 

[lakeman]

Greater trochanter bursitis?
Ultrasound might help with diagnosis.
steroi_ injection?

View attachment 518478

? Diclofenac gel

 

[Quickstatus]

Diclofenac gel

Lots of management strategies assuming that's what it is.

I find though that topicals tend not to work as bursa sits behind tendons and muscles.

 

[Seat0B]

Breakthrough!

That rumour of a bed at Mum's preferred nursing home became a reality and last night a formal offer eventuated. Contracts signed today. She will move in there tomorrow, which was her discharge date until the "medication review". Talk about cutting it fine. There has been a lot of hurry up and wait in this process.

We are still not finished though - cannot finalise financial details until Services Australia does their review which has a service timeframe of 4-6 weeks from lodgement. We started work on the forms as soon as we knew she had to leave hospital (so 2 weeks ago) but the level of detail and documentation needed took some time to pin down - this for a lady of modest means who is a part pensioner, which means her details are in their damn system anyway.

After that experience, the family hold outs have agreed to getting aged care specific financial advice, and that is booked for tomorrow, which is also our day to collect granddaughter, take her to swimming and then give her dinner. Talk about the sandwich generation! We think the money spent on that will be worthwhile and could save us many thousands down the track if a poor decision about RAD/DAP and the various means tests (for care, for pension etc) is made.

I do feel relieved, but not yet able to sit back and breathe.

 

[RooFlyer]

Now I can't take simple anti inflammatory drugs being on a blood thinner.

Can you not, with food? I've been advised I can take 200mg celecoxib, as long as its with a meal.

 

[ellen10]

Breakthrough!

That rumour of a bed at Mum's preferred nursing home became a reality and last night a formal offer eventuated. Contracts signed today. She will move in there tomorrow, which was her discharge date until the "medication review". Talk about cutting it fine. There has been a lot of hurry up and wait in this process.

We are still not finished though - cannot finalise financial details until Services Australia does their review which has a service timeframe of 4-6 weeks from lodgement. We started work on the forms as soon as we knew she had to leave hospital (so 2 weeks ago) but the level of detail and documentation needed took some time to pin down - this for a lady of modest means who is a part pensioner, which means her details are in their damn system anyway.

After that experience, the family hold outs have agreed to getting aged care specific financial advice, and that is booked for tomorrow, which is also our day to collect granddaughter, take her to swimming and then give her dinner. Talk about the sandwich generation! We think the money spent on that will be worthwhile and could save us many thousands down the track if a poor decision about RAD/DAP and the various means tests (for care, for pension etc) is made.

I do feel relieved, but not yet able to sit back and breathe.

@Seat0B so pleased that you have a break though in your Mum's aged care placement. I know there is still lots to work through, but that is a really nice start for you and your family. I am relieved for you

 

[andye]

This fellow has an interest in PD. Not all geriatricians do. however it is not uncommon for their patients to have PD.

I did some PD when a brand new Geriatrics Consultant in London. Shared the clinic with one of the top ten PD Neurologists in the world. Did feel that maybe my older patients were missing out but he did say that the combination of PD and cognitive impairment even he found hard.

In general, though the slowness and stiffness usually responds well to treatment (usually for many years), tremor is variable in response and "non-motor" symptoms usually don't respond to the dopamine drugs and need different approaches