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nebula.
Sweden1431 Posts
On November 16 2012 01:51 GermanWarHero wrote: Boring blog.....when are you guys gonna write about something exciting like knocking out a Tiger with a choke hold while on your vacation in Africa ? Where's he gonna find a tiger in Africa? | ||
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UmbraaeternuS
Chile476 Posts
Exactly xD | ||
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Antimatterz
United States1010 Posts
The fuck, how are you a doctor and not a writer. 5/5 | ||
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Diglett
600 Posts
On November 14 2012 12:43 UmbraaeternuS wrote:Hospitals should be a place for people to get better... Not for them to go dying. damn... | ||
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Glenn313
United States475 Posts
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UmbraaeternuS
Chile476 Posts
On November 16 2012 08:16 Antimatterz wrote: Every time I read your blogs I feel so many emotions. The fuck, how are you a doctor and not a writer. 5/5 TY sir. I happen to write a little, but despite all the blog critics I think I'm a lousy storyteller. I like to write poetry most of all, but it's in spanish, so meh. On November 16 2012 08:34 Diglett wrote: damn... Oh, you know what I meant... People are often almost "abandoned" in a hospital by their family because of the fear death induces in all of us. Some others go themselves when they are near the end. I don't say ALL people should die in their homes, since there are obviously some cases in which that is not possible... But hospitals should be a place of recovery, not a place to go lie down in your final moments, in a foreign environment, surounded by strangers. It's just that. Death should be a dignified thing, faced with courage and embraced instead of frowned upon... But the current conception of death and severe illness as something that should be left alone and put apart is, at least to my point of view, almost inhuman. On November 16 2012 12:36 Glenn313 wrote: Love the moral at the end. Thank you, sir. I was merely expressing my thoughts on a touchy subject, I'm glad you liked it. | ||
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Moka
Canada942 Posts
I have the utmost respect for you, doctors. | ||
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checo
Mexico1364 Posts
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laLAlA[uC]
Canada963 Posts
Put me to tears it did. | ||
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Ghostcom
Denmark4782 Posts
It seems to me like you gave up prematurely on the treatment, but there are probably a lot of details you are not sharing (for obvious reasons - the oath of silence should not be taken lightly and this is a public forum). Still, the prevalence of mitral regurgitation is around 2% in the elderly population, making it one of the most common heart defects (and the edema of the legs makes it very plausible that it was present before the heartattack) and apparently the only other indicator you had of severity of the attack was the ECG showing a STEMI. Which to top it off is a diagnosis with a pretty good survival when the patient is stable upon arrival at the hospital. The mortality increases rapidly by delay of treatment though, begging the question why in the world she was not sent to PCI almost immediately or at the very least had thrombolysis if you do not have the facilities to provide PCI within 90 minutes. Oh well, this is exactly why I gave up on medical series in the television - lack of details. The moral of the story is decent enough, I just think the case is lacking greatly for it to be justified. Good luck with the throat and happy nerdslaying  | ||
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UmbraaeternuS
Chile476 Posts
On November 17 2012 12:02 Ghostcom wrote: I hate to be the partypooper and I would like to preface this by saying that it is not to knock on your professionalism but rather the idea of blogging about stuff like this. It seems to me like you gave up prematurely on the treatment, but there are probably a lot of details you are not sharing (for obvious reasons - the oath of silence should not be taken lightly and this is a public forum). Still, the prevalence of mitral regurgitation is around 2% in the elderly population, making it one of the most common heart defects (and the edema of the legs makes it very plausible that it was present before the heartattack) and apparently the only other indicator you had of severity of the attack was the ECG showing a STEMI. Which to top it off is a diagnosis with a pretty good survival when the patient is stable upon arrival at the hospital. The mortality increases rapidly by delay of treatment though, begging the question why in the world she was not sent to PCI almost immediately or at the very least had thrombolysis if you do not have the facilities to provide PCI within 90 minutes. Oh well, this is exactly why I gave up on medical series in the television - lack of details. The moral of the story is decent enough, I just think the case is lacking greatly for it to be justified. Good luck with the throat and happy nerdslaying Yes. It was a STEMI, but here PCI is unavailable. The nearest cardio-angio centre is 400 kilometers away. Thus, thrombolitic therapy should have been started, and OFC there are other things I didn't state, such as the fact that the patient was under anticoagulant therapy because of a deep-vein thrombosis that she had a year ago, AND being hypertensive, which are relative counter-indications for thrombolysis, so at that risk, the treatment and admission were at the hands of the family, via an informed consent form... Which they respectfully declined to accept. Also, as the daughters stated, no prior history of heart conditions nor murmurs were known. Generalized oedema was present only the day before the episode which brought her to the ER. She usually had oedema in her lower extremities because of the venous insufficiency which led to her DVT in the first place. Also, I think it's pretty safe to say not many folks actually understand what's going on here in the depth that you do. Let me just state that it is because of that precise fact, and the oath of silence, that I don't like to tell too many details. And it is precisely because of that lack of details that your judgement on this is so biased. You don't have the whole picture, and therefore your whole post is, at least to my eyes, some flame attempt which is completely out of place, instead of an 'informed' case discussion among peers, which is NOT going to happen here, because it's neither the time nor the place. The moral is why I shared this story... And it's, at least to my eyes, pretty much justified. Not to yours, ofc. Partialized information and bias have blinded you to a poignant and wrong conclusion. And thank you. Throat is doing ok and not much nerdslaying going through ATM, mostly reading and watching movies. | ||
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Ghostcom
Denmark4782 Posts
On November 17 2012 13:02 UmbraaeternuS wrote: Yes. It was a STEMI, but here PCI is unavailable. The nearest cardio-angio centre is 400 kilometers away. Thus, thrombolitic therapy should have been started, and OFC there are other things I didn't state, such as the fact that the patient was under anticoagulant therapy because of a deep-vein thrombosis that she had a year ago, AND being hypertensive, which are relative counter-indications for thrombolysis, so at that risk, the treatment and admission were at the hands of the family, via an informed consent form... Which they respectfully declined to accept. Also, as the daughters stated, no prior history of heart conditions nor murmurs were known. Generalized oedema was present only the day before the episode which brought her to the ER. She usually had oedema in her lower extremities because of the venous insufficiency which led to her DVT in the first place. Also, I think it's pretty safe to say not many folks actually understand what's going on here in the depth that you do. Let me just state that it is because of that precise fact, and the oath of silence, that I don't like to tell too many details. And it is precisely because of that lack of details that your judgement on this is so biased. You don't have the whole picture, and therefore your whole post is, at least to my eyes, some flame attempt which is completely out of place, instead of an 'informed' case discussion among peers, which is NOT going to happen here, because it's neither the time nor the place. The moral is why I shared this story... And it's, at least to my eyes, pretty much justified. Not to yours, ofc. Partialized information and bias have blinded you to a poignant and wrong conclusion. And thank you. Throat is doing ok and not much nerdslaying going through ATM, mostly reading and watching movies. I might not have come off clearly in my first post seeing how defensive you have gotten. My point was not that you acted wrong in any way - in fact I think I made it quite clear that I assumed that you acted correctly based on information you for obvious reasons could not, and should not share on a public forum. Let me reiterate this, because it seems like this is the basis of your defensiveness and apparently I was not clear enough in my first post: I do not wish for more details, nor do I wish for a peer discussion, this is a public forum and detailed information should not be provided in such an environment. I do not have the whole picture, and for that exact same reason I did not pass any judgement on you which I think you will notice if you go back and read my post with an open mind - if not, my apologies. I will stand by my conclusion though: When blogging about stuff like this, one should exercise extreme care so as to not give the wrong picture of the basis on which doctors generally make decisions. Less than 6 months ago we had a case in Denmark where a documentary mistakenly portrayed how people are declared brain-dead and thus eligible for organ donors (to top it off the doctor in that case actually made a mistake). This has lead to a massive amount of people retracting their consent to be organ donors - which for obvious reasons is problematic. Take from this what you want, but it sure as hell was not an attempt to flame. To brighten the mood a bit I will leave you this which for some reason always makes me smile: + Show Spoiler + ![[image loading]](http://rlv.zcache.com/i_found_this_humerus_postcard-p239901625585053869baanr_400.jpg) | ||
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IshinShishi
Japan6156 Posts
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Eufouria
United Kingdom4425 Posts
Dying well is something I've been thinking about a lot recently. My grandmother died last month, she had a lung condition so dying at home wasn't really an option or she'd have died within minutes of asphyxiation. But as much as the hospital can do to make the death as peaceful and dignified as possible there is something a little cold to dying in a hospital. I guess we can't all have that perfect Hollywood death where you say goodbye to your loved ones and then close your eyes and drift off. | ||
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