May 13th, 2011 by Edwin Leap, M.D. in True Stories
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Ordinarily, I’m wary of all things dental. I had too many cavities as a child. As a young man, I had a root canal done on the wrong tooth, followed immediately by the correct one. My dental memories are a bit tainted. Not an indictment of the entire profession so much as a kind of PPSD…post procedure stress disorder.
But when I moved to South Carolina, my wife and I found a wonderful general dentist in Dr. Ronald Moore, in Seneca, SC. Rarely would I ascribe the words ‘painless dentistry’ to one of the practitioners of that esteemed profession. But I have to give credit where credit is due. His hygenists, and Dr. Moore, have all been the pinnacle of gentility. Even my children aren’t afraid to go for cleanings. And when I need anesthesia, well Dr. Moore is an artist with a needle. Heck, if he were a tattoo artist, I’d think about it…
Sadly, when I was recently in his office for a crown, he felt that I first needed a root canal. The very words inspire vague nausea and general panic. From my own experience, ‘root canal’ is right up there with ‘waterboarding,’ ‘fingernail removal’ and ’shark attack.’ Read more »
*This blog post was originally published at edwinleap.com*
May 12th, 2011 by GruntDoc in Humor, True Stories
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Laugh if you want, this helps my life, at least at work.
For months after starting my current gig, I would sometimes get to work with everything in all my pockets, and sometimes not.
I’d forget my ID, or my pen, or my phone, or my…well, there you go.
Then my OCD started to kick in, and, a Mental Checklist was born.
I now have to get 6 things, and set them on the table or I screw it up every time.
- ID
- stethoscope
- my phone
- work phone
- pen
- sharp stick (I’ve written about this before, but cannot find it. You should search an ER blog for the word ‘knife’ and then wonder why you bothered).
Last week I apparently went against the checklist, and halfway through the shift realized I’d lost my ID. Of course, after about a combined half-hour of fruitless search I gave up, and found it in my bag on the way out. Geez.
Yeah, it sounds stupid. But if it’s stupid and it works, it’s not stupid.
*This blog post was originally published at GruntDoc*
May 9th, 2011 by GruntDoc in News, True Stories
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Absent other information, the referred to ‘rodent poison’ is probably a superwarfarin. It’s like regular people-coumadin, but superconcentrated. It kills rodentia by causing them to bleed to death.
Which makes the ‘gas effect’ seem really odd, but possibly explainable.
A patient who apparently ingested rodent poison and is emitting potentially harmful gasses has created a hazardous material situation at St. Joseph Mercy Hospital in Ann Arbor.
The man is isolated in his room in the medical intensive care unit on the hospital’s sixth floor, 5301 McAuley at East Huron River Drive, hospital spokeswoman Lauren Jones said this afternoon.
via Patient emits potentially harmful gas; hazmat called to Ann Arbor hospital | Detroit Free Press | freep.com.
Two thoughts: 1) I sincerely hope this patient recovers, and 2) if this is just upper GI bleed smell someones’ going to have rotten egg smell on their face.
I looked up superwarfarins, found a couple of interesting case reports, but none that talk about abnormal gases.
(For the uninitiated, the smell of digested blood is amazingly awful. It’ll make experienced, hard ED staff retch). I can understand why the smell would set off alarms, except that it’s not that uncommon, so it shouldn’t be a surprise.
It’ll be interesting to see what come of this.
Lighting matches in the hospital is a nono, by the way.
*This blog post was originally published at GruntDoc*
May 9th, 2011 by Edwin Leap, M.D. in Opinion, True Stories
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Years ago I had a conversation with a surgeon at our facility. He was unhappy that a seriously injured trauma patient came to our facility after a MVC. ‘These patients shouldn’t come here Ed, they should go to a trauma center!’
Fair enough; we aren’t a trauma center. Not a Level I, not a Level II or III; not even a level 0.5! But we are the only hospital in a large rural county, and the closest, largest facility for portions of a few other counties nearby. The nearest hospital with neurosurgery and thoracic surgery is at least 30 minutes further away.
The problem is, torn blood vessels, crushed spleens, collapsed lungs, swollen brains don’t look at the clock, and cars aren’t designed to wreck only near trauma centers, any more than assailants shoot and stab people only within proximity of appropriate care. (It rather defeats the purpose of attempted murder, you know. )
Recently, my partner had the same conversation with the same surgeon. The patient had been shot twice and was hypotensive. ‘These patients shouldn’t come here!’ We understand, the conditions may not be ideal and trauma is, to be quite honest, fraught with medical and legal peril. Read more »
*This blog post was originally published at edwinleap.com*
May 1st, 2011 by Shadowfax in Health Policy, Opinion
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One interesting comment I have seen come up over and over is the idea that end-of-life costs are the thing that is spiralling out of control and that if we could somehow find a way to curb the costs of futile care, then that would somehow solve the health care inflation crisis. Andrew Sullivan endorsed such an idea the other day, a “Modest Proposal,” which is not nearly as radical or amusing as Swift’s. And indeed, there is a modicum of sense in the idea.
Estimates are that spending in the last six months of a person’s life account for 30-50% of their overall health care costs, and that the spending in the last year of a person’s life accounts for 25% of overall medicare spending. So — simple solution, right? cut down on the futile care, and we’re good to go.
Only problem — as a doctor, I sometimes have a hard time telling when someone is in their last DAY of life, let alone last year. Read more »
*This blog post was originally published at Movin' Meat*
