January 29th, 2010 by DrWes in Better Health Network, News
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Swaroup Anand, 23, from Bangalore, is fully conscious as he undergoes open-heart surgery. An epidural to the neck, administered at the city’s Wockhardt Hospital, has numbed his body. Dr Vivek Jawali pioneered the technique ten years ago and has recently released a tutorial on DVD which gives a step-by-step guide to the procedure – sorry, but you can only get a copy if you’re a surgeon or an anaesthetist.
Seems there would be considerable risk of respiratory compromise is the epidural went too high. But according to this video, over 400 cases have been performed, including a bypass with aortic valve replacement!
I don’t know… I’m not sure I could stomach the sound of the bone saw or, worse, if the surgeon said “Oh, crap…”
h/t: Slashdot
Reference:
Chakravarthy MR, Jawali V, Patil TA, Srinivasan KN, Manohar M, Khan J, Jayaprakash K, Das JK, Mahajan V. “High thoracic epidural anaesthesia as the sole anaesthetic technique for minimally invasive direct coronary artery bypass in a high-risk patient.” Ann Card Anaesth. 2003 Jan;6(1):62-4.Musings of a cardiologist and cardiac electrophysiologist.
*This blog post was originally published at Dr. Wes*
January 25th, 2010 by DrWes in Better Health Network, Health Policy
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It’s the fastest growing “specialty” service in medicine: hospitalist medicine. These are the doctors who limit their practice to the care and management of patients admitted to the hospital. It has been wildly popular because it adds a shift-like work schedule to medical care for physicians while supposedly preserving their personal life. It also moves patients through the hospital faster, shortening length of stays. As one of our more esteemed hospitalist bloggers likes to boast: it’s a “WIN-WIN!”
At least until the hospitalist service gets too busy. Read more »
*This blog post was originally published at Dr. Wes*
January 16th, 2010 by DrWes in Better Health Network, True Stories
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Recently, I’ve been recovering from some form of upper respiratory illness – of what form, I have no clue – but it was probably the dreaded H1N1 influenza virus or its equivalent (yes, I took the shots, but to no avail). Last Friday, with surprising reluctance, I conceded defeat and called in sick – something I almost never do. Somehow the thought of spreading contagion while wearing a mask while croaking, sniffling, coughing my way though conversations just didn’t seem like the best thing for me or my patients. Gratefully, I’m on the upswing and only now have a slightly hoarse voice and an occasional cough that’s improving, but it is interesting to reflect on why, despite knowing better, I felt so inclined to keep seeing patients despite my illness. Read more »
*This blog post was originally published at Dr. Wes*
January 11th, 2010 by DrWes in Better Health Network, Health Policy, Opinion
1 Comment »
With the turn of the calendar to the new decade, the reality of health care reform has set in for doctors and patients. Already cuts to physician salaries and patient access to care are becoming starkly apparent to those of us on the front lines of health care.
I wonder why doctors have been so ineffectual relative to the other special interests “at the table,” in the health care debate? One would think that those with the knowledge base and skill to manage their patients would be the ultimate power brokers in the efforts of health care reform. Yet here we are, watching the commoditization of our profession at the hands of lawyers and politicians in Washington, eager to avoid being perceived as the spoiler. Read more »
*This blog post was originally published at Dr. Wes*
January 4th, 2010 by DrWes in Better Health Network, Health Policy, News
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It’s sad that cardiologists have had to sue as their last resort to save their practices:
“Heart specialists on Monday filed suit against Secretary of Health and Human Services Kathleen Sebelius in an effort to stave off steep Medicare fee cuts for routine office-based procedures such as nuclear stress tests and echocardiograms.
The lawsuit, filed in U.S. District Court for the Southern District of Florida, charges that the government’s planned cutbacks will deal a major blow to medical care in the USA, forcing thousands of cardiologists to shutter their offices, sell diagnostic equipment and work for hospitals, which charge more for the same procedures.
Perhaps other professional organizations will be forthcoming with similar suits as private doctors and their patients pay dearly for the reform efforts underway. Read more »
*This blog post was originally published at Dr. Wes*
