January 17th, 2010 by GruntDoc in Better Health Network, Research, True Stories
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Hmmmm:
Emergency spine immobilization may do more harm than good, study says
January 11, 2010 | 3:57 pm
When emergency responders reach a gunshot or stabbing victim, they try to immobilize the spine to reduce the danger of paralysis upon movement of the victim. That effort, however, can have a fatal toll.
A study published in the Journal of Trauma has found that, among these types of trauma victims, those whose spines are held still are twice as likely to die as those whose spines aren’t immobilized.
Read the news article, but they’re talking only (apparently, I don’t get this journal) about penetrating trauma. Those discussing the article wonder if the reason for the increased mortality is “Stay and Play” vs “Load and Go”, the two basic precepts of transporting the ill and injured in prehospital medicine. Read more »
*This blog post was originally published at GruntDoc*
December 31st, 2009 by Steve Novella, M.D. in Better Health Network, News, Research
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Peter Lipson reported Monday about new research suggesting that Multiple Sclerosis may be caused by venous blockage. He correctly characterized some of the hype surrounding this story as “irrational exuberance.”
This is a phenomenon all too common in the media – taking the preliminary research of an individual or group (always presented as a maverick) and declaring it a “stunning breakthrough,” combined with the ubiquitous personal anecdote of someone “saved” by the new treatment.
The medical community, meanwhile, responds with appropriate caution and healthy skepticism. Looks interesting – let’s see some more research. There is a reason for such a response from experts – experience. Read more »
*This blog post was originally published at Science-Based Medicine*
July 24th, 2009 by Bongi in True Stories
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I noticed my use of the phrase ‘call it’ a few times recently. It is something I saw on American TV and not at all something that is common in my neck of the woods. The sort of scene that you would get in gray’s when the junior doctor is pumping the chest shouting ‘I will not let you die, dammit!’ while the senior doctors stand one side and instruct him to ‘call it!’ is pretty foreign to our way of doing things. I even got ragged a bit for using the phrase at all. I thought I’d relate a story from days gone by that illustrates this point.
It was the time of the taxi wars. Now taxis in our country are nothing like you might be thinking. They are fleets of mini-buses, quite often owned by people of questionable legal character. Occasionally rival groups try to take each other out (I mentioned this before here). But roughly at the turn of the millennium there was outright war. When the war came to Pretoria we saw quite a few of the victims, but neurosurgery got the most. A friend of mine was rotating through neurosurgery and this story came from him.
There had been a contact between two different taxi organisations. The casualties were streaming in. The neurosurgeon and my friend, his trusty lackey, were overworked and I think it had affected their sense of humour. So while they were getting another gunshot head ready for surgery and heard another four were en route, they were not amused. When the ambulances arrived the neurosurgeon said he wanted to go out and triage them in the ambulances before they were unloaded. And this is what they did.
The neurosurgeon looked at each patient in turn. The first three he told them to send into casualties for his attention. But the fourth…he took one look at the fourth and exclaimed;
“Vat hom weg! hierdie een is gefok!*”
My colleague laughed the next day when the newspapers reported: “On arrival at the hospital, one taxi driver was declared dead by the neurosurgeon on duty.” Fortunately they did not quote him verbatim.
*take him away! this one is f#@ked!
*This blog post was originally published at other things amanzi*
May 3rd, 2009 by EvanFalchukJD in Better Health Network, True Stories
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My younger brother is an executive producer of the show “Nip/Tuck” and an executive producer of soon-to-air Fox show “Glee.“ Last year, he almost died.
It started when he woke up one day with numbness on one side of his body.
His doctor ordered an MRI. It found bad news: a tumor in his spinal cord, high up in his neck. He was referred to a neurosurgeon.
The plan was straightforward, but dangerous. First, radiation. Then, his spinal cord would be carefully cut open to remove the tumor. He was told he could end up paralyzed, or dead. Concerned, he called me, and we started a case at Best Doctors.
One of our nurses took a history, and we collected his records. Two internists spent hours reviewing them. The records noted our family history of a kind of malformed blood vessel. Our grandfather had hundreds of them in his brain when he died at 101, and our father has dozens of them in his. I have one in my brain, too. This was in my brother’s charts, but none of his doctors had mentioned it.
An expert in these malformations told us a special imaging study should be done to rule this out as a cause of the problem. Best Doctors gave that advice to my brother and his doctors. They agreed.
The test showed this was precisely what he had.
Quickly, the plan changed. He still needed surgery — if the malformation bled, it could also paralyze or kill him. But there would be no radiation, which might have caused the very bleeding we feared. Even if that didn’t happen, the surgeons were prepared to operate on a tumor. They would have been surprised to find a delicate malformation there instead.
In the end, his surgery went well. He is having a good recovery and is busy with his new show. But his case is a constant reminder of how important it is to have the right diagnosis, and how easy it is for things to go wrong.
Even in Hollywood.
October 12th, 2008 by Dr. Val Jones in Celebrity Interviews
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Davis Phinny
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Davis Phinney has won more cycling races than any other American. He is charming, articulate, handsome, and requires a deep brain stimulator to keep him from experiencing incapacitating tremors. Davis was diagnosed with Parkinson’s Disease at age 40.
I attended the Parkinson’s Action Network 15th Annual Morris K. Udall Awards Dinner in Washington DC last week. Davis was interviewed by Diane Rehm and I recorded the conversation for my blog readers. It was an exceptional interview.
Davis explained how he was initially diagnosed – he felt tired, slow, experienced foot cramps and began tripping more frequently. As a young, seemingly invincible athlete who worked long hours, he assumed that he was just tired and in need of a massage. Eventually his symptoms became so persistent that he went to see a physician. After many tests and many different doctors examined him, a retired neurologist made the diagnosis. Davis says that it was a tough blow to his family. He felt as if he were Superman, now saddled with a permanent kryptonite necklace. Read more »
