Text 19297, 148 rader
Skriven 2014-11-13 11:03:00 av NANCY BACKUS (1:123/140)
Kommentar till en text av MICHAEL LOO
Ärende: Re: health 236
======================
-=> Quoting Michael Loo to Nancy Backus on 11-09-14 05:04 <=-
ML>> I am sure that the more ticklish procedures are left to
ML>> the experts, but more and more is becoming routinized.
NB>> Probably true. :)
ML> It's a way to stretch resources and perhaps not coincidentally
ML> to deprofessionalize activities that once required advanced
ML> training and some discretion.
Stretching resources I'd go along with... as to the latter, depending on
who is actually allowed to use the equipment, it might still require
advanced training (just not exactly the same training)... and I'd expect
still require a fair bit of discretion... :)
ML>> Despite my opportunities to compare various aspects of
ML>> the workings of a hospital, I never got a feeling for who
ML>> was or was not capable or authorized to do these things.
NB>> It may well depend on the hospital itself. Also, a lot of my being
NB>> able to observe hospital procedure etc has been not from the bed, but
NB>> from the chair... ;) And with various people that seemed to have a
NB>> hard time staying out of such places... ;> One learns the uniforms
NB>> color code, the badges, etc, after long exposure... :)
ML> I can't figure that kind of thing out in general despite
ML> discovering that peach color means volunteer. It seems that
ML> otherwise, the lighter the color the more prestigious,
ML> except in the OR everyone wears the same green or maybe blue.
There's some differences from hospital to hospital, of course.. maybe
MGH has less of a color-coded system... I've been out of the hospital
for long enough now for the details to be a bit hazy... housekeeping,
patient techs, nurses, respiratory, therapy, anesthesia, doctors each
have a different color... the degree of nurse or doctor have other
clues... ;) I was just thinking last night that one thing that seems to
have gone by the wayside is the nurse's cap... :)
ML>> that calculates the bladder contents to determine whether
ML>> there's a blockage. Pretty weird stuff.
NB>> Ah, yes, I've encountered that one, with neighbor Gwen... that seems
NB>> to be a urology "toy"... I've only seen it in use in the urologist's
NB>> office, and once it was the doc that did it, and the other time(s) it
NB>> was the nurse... It also determines if one has an issue with emptying
NB>> the bladder fully. Lots of specialized scanners... :)
ML> Emptying the bladder ofttimes has issues relating to
ML> blockage, either that or rigidity of muscles. Why the
ML> problem is so common that they have to have a specialized
ML> tool for it I don't know.
The aging of America...? ;) And/or the growth of specialization...?
ML>> I was outside the Canal Zone, of course, but there should
ML>> have been quite a bit of slopover into the general population,
ML>> because both the big cities are quite close to the zone's
ML>> (former) boundaries.
NB>> Of course, maybe they just won't admit to speaking a lick of
NB>> English... but I can conceive of a few scenarios where not much English
NB>> would make it to the common folk... most involving a lack of interest
NB>> in dealing with any but one's own group...
ML> But I was dealing largely with people in the hospitality
ML> industry, where both customer and staff were acutely aware
ML> that the language barrier made interaction less pleasant
ML> and less efficient, and I'm pretty sure the people wished
ML> they had more English (and I wished to have more Spanish).
Newer hires, maybe...?
ML> The issue was already coming up when my old girlfriend, who
ML> doubles as my sometimes legal counsel, suggested a line be
ML> put in, and they said, no, that's for people way sicker than
ML> he is ... but the next day they put in an A-line, rather to
ML> my chagrin. As things got more peculiar the IV team started
ML> talking about a central catheter (meaning another week at
ML> least in stir), and that's when I started getting pushy
ML> about getting out of the joint.
Apparently some disagreement or variation at least in the perception of
how sick you actually were... But then there's more than one criteria
for putting in the more advanced IV options, I suppose... like the
unavailability of usable veins... ;0
ML>> Anyhow, now I've been sent away with no
ML>> antibiotics at all. I asked the discharge nurse just to make
ML>> sure, and that's the way it is.
NB>> That sounds like they may have decided the antibiotics were causing
NB>> some of the problem....?
ML> The surgery department never admits anything.
Sigh.
ML>> of the situation. After all, I rated my pain as 4-5 with waves
ML>> of 6-7 for a phenomenon where most patients report 8-10.
NB>> I have ongoing issues with their 10-score pain scale
ML> I've never, knock wood, had unendurable physical pain, which
ML> I'd define 10 to be. Excruciating, yes, but that makes maybe
ML> 8 or 9. Medicatable, 5 or 6.
When I was pre-gallbladder surgery, I was rating my actual pain well
above 10, but since my body was creatively dealing with it, what I
actually was feeling was a more manageable 8 or so... The body had to
be creative, since originally the doctor accused me of "making it hurt
on the way over" to the appointment... I fired that doctor, and only
went to another when obviously whatever it was wasn't going away... By
then, my muscles told that new doctor what pain I was in, my mind wasn't
registering it much any more... That's part of why the pain scale means
little to me... I actually have to stop and try to feel the pain (which
usually I block out) in order to try to give anything resembling an
accurate answer... Even unendurable pain sometimes has to be endured.
ML>> The Ian trip in spring '15 might make me think a bit about it.
NB>> Especially if it's likely to act up again... sounds like other issues
NB>> there as well, though...
ML> If I can have the thing removed after Singapore and before
ML> the spring, that would be ideal.
Do you think they'll do it electively...?
ML>> Fibrillation means heartbeat of over 100, whereas flutter
ML>> means over 200.
NB>> Fibrillation also has an aspect of irregularity to it
ML> They may go together, but the arrhythmia would go under a
ML> different name.
I'm just going by what the cardio doctors have been telling us about
Richard's condition. They are calling it Afib still, even though the
heartbeat is well in normal range, the only bad thing about it now is
the irregularity...
NB>> Afib is back... he had a second cardioversion, which worked right off,
NB>> but then only lasted about 24 hours.. But the heartbeat isn't fast,
NB>> just irregular, so for the nonce, we are just keeping an eye on it.
ML> Built-in unit? They tried to convince me to have one installed,
ML> but the discomfort and inconvenience prevented me from letting
ML> them do so.
No, a cardioversion is an external procedure... shock the heart into
stopping, then shock it back to beating. In the process the clamor of
the atrial signals hopefully settles down, and the heart behaves itself
again... Not planning to put in anything permanent... the next step is
apparently a medication that messes with the body's electrical system,
so requires a hospital stay of 3 days or so to make sure that it only
helps and doesn't cause other problems...
ttyl neb
... Another holiday based on gluttony and candy.
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