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[ChairmanPoo]

The surgeons, I should hope.

Have you ever talked to a surgeon?

[Arx]

The surgeons, I should hope.

Have you ever talked to a surgeon?

Never a spine specialist. Hmmmm.

[ChairmanPoo]

https://youtu.be/3rTsvb2ef5k

[wierd]

oh gawd.  That hurts so much Poo.

(Said hypothetical old lady clearly has acidosis, which has contributed to her asystolic state [probable UTI, or other underlying condition, like diabetes], and likely was the source of her fall. I am surprised that the Ortho has determined she has a fracture, given that ensuring she has sufficient blood oxygenation would be such a high priority (since her heart is not fucking beating) that other diagnostics aside from temperature and pH would be precluded until that situation was resolved. But of course. She has a fracture. He needs to fix it. (Slaps forehead))

[scriver]

https://youtu.be/3rTsvb2ef5k

When you're part of the Dwarven Hospital crew but your only skill is Bone Settting

Given MZ's back pain mostly derives from an injury for which he currently has two pins in his spine, I'm not sure that'll help.

It's actually four screws connected by two rods, but who's counting?

There's a hard rod up your back

[Naturegirl1999]

I have a rod in my back too. I had scoliosis so the rod keeps my spine straight.

[scriver]

That furthers my childish dick joke on so many levels

[ChairmanPoo]

Btw a registrar is a trainee -a junior doctor. Its just the way the system works in the UK and Ireland, a good chunk of the day-to-day hospital background running processes fall on their hands. Normally as a hospital consultant you don't directly...consult... with other consultants unless the matter is really serious... instead, you tell your junior doctors to go talk with their junior doctors. The whole thing is weirdly ceremonial and tbh I think its troublesome, for several reasons: it exposes juniors to a level of responsability  they are not really ready to assume, it results on less bedside teaching (because they are on their own) and all too often it's difficult to keep track of what the juniors are actually doing (not least because many consultants cultivate  an environment that makes juniors reluctant to call and ask)

[wierd]

*sigh*

This is the sad thread, so I guess this fits. This is about nobody I care for in particular, but about elder care in the US in general. (Everything stated below, I have had to endure higher level healthcare workers pushing back on.)

Because UTIs are a mainstay of elder co-morbidity, and pernicious to treat because immune function declines as people age, (and some old people just DO NOT follow good bathroom hygiene along with, of course, the growing prevalence of resistant organisms)  there's been increased pushback on treating people that develop them. This is especially troublesome for people with dementia, because many of the diagnostic symptoms for UTI are masked by their dementia. (Such as confusion, agitation, etc.)

There's been a strong push to get 3 symptoms of UTI before even being able to send in a urine specimen for a culture.  Worse yet, there's pushback from hospitals and doctors on treating people that have diagnosed organisms in their urine, if they are not experiencing acidosis, sepsis, or other diagnostic conditions associated with poor health. We are talking nasty organisms too, like VRE.

People literally have to start falling down, breaking a hip, and having heart failure from prolonged acidosis, necessitating a potentially life-ending experience in the ER, before the system here will even treat.  Discovering "Surprise! It's Sepsis!" (From that UTI you fuckers would simply not help us treat, and that we've been reporting to our nursing staff FOR FUCKING MONTHS, and you guys have been shutting them down every time they ask you about it!) when people get admitted is alarmingly common. 

[Naturegirl1999]

*sigh*

This is the sad thread, so I guess this fits. This is about nobody I care for in particular, but about elder care in the US in general. (Everything stated below, I have had to endure higher level healthcare workers pushing back on.)

Because UTIs are a mainstay of elder co-morbidity, and pernicious to treat because immune function declines as people age, (and some old people just DO NOT follow good bathroom hygiene along with, of course, the growing prevalence of resistant organisms)  there's been increased pushback on treating people that develop them. This is especially troublesome for people with dementia, because many of the diagnostic symptoms for UTI are masked by their dementia. (Such as confusion, agitation, etc.)

There's been a strong push to get 3 symptoms of UTI before even being able to send in a urine specimen for a culture.  Worse yet, there's pushback from hospitals and doctors on treating people that have diagnosed organisms in their urine, if they are not experiencing acidosis, sepsis, or other diagnostic conditions associated with poor health. We are talking nasty organisms too, like VRE.

People literally have to start falling down, breaking a hip, and having heart failure from prolonged acidosis, necessitating a potentially life-ending experience in the ER, before the system here will even treat.

This is terrible. It would make more sense to treat people with the pathogen BEFORE symptoms start nearly killing people.

[wierd]

You would think so, since one of the duties we as elder caregivers have is to assure their right to be free from pain--- But NOPE!

No antibiotics, EVEN WITH POSITIVE URINE CULTURE, until they become "symptomatic."

[Naturegirl1999]

You would think so, since one of the duties we as elder caregivers have is to assure their right to be free from pain--- But NOPE!

No antibiotics, EVEN WITH POSITIVE URINE CULTURE, until they become "symptomatic."

WTF? Who decides this?

[wierd]

Usually, it's a decision made by their specialist.  We can't end-run them because that would require violating HIPAA.  If their doctor shuts us down, there's not a whole lot we can do.

Like I said, there's a serious problem with elders, and development of UTIs.  This is especially true with people with dementia, because they are not the most hygienic about their self-care.  (Women who routinely wipe the wrong direction, and because of their dementia, WILL NOT respond to corrective instruction-- and surprise-- continually re-infecting themselves; Men who are ritualistically noncompliant with doctor's orders, eventually causing the doctor to just stop giving a fuck, etc.)


To be fair, these people become evolutionary incubators for resistant organisms because of these behavioral features that we cannot reasonably address (Such as incorrect wiping, and subsequent routine reinfection), so continuing to pump them full of heavier and heavier antibiotics only increases the healthcare crisis in that vein, but on the other hand, you have people with degenerated nervous systems in constant distress.

[Imic]

I don’t understand the American healthcare system. Honestly, I don’t understand America or anything in it. Or anywhere else for that matter. You might think that oh this is an age of technological advancement and all that but we’re no better than we’ve ever been, and we’ll probably never get much better. No matter where you look, every golden age has enormous, gaping holes of problems and when you look back, you think to yourself... How did they live like that? But truth be told, people in the future will look back on us and ask the same questions. People in the past have always done the same thing, and in a way, that’s hopeful, since... Humanity with a capital H will probably make it forward, people have said that We won’t survive something thousands of times in the past, but at the end of the day, that’s very little consolation for all the individual Humans left behind.

[TD1]

Yea, but even by today's standards the American health system is messed up. There have been people on these very forums who haven't gone to hospital because it will financially ruin them.

That's gambling peoples' lives for profit. It's frankly horrible.