Chemo is Awful, But Gravel in The Vagine? Whoa Now.

http://pagingdrgupta.blogs.cnn.com/2010/10/14/how-the-ancient-world-dealt-with-cancer/?hpt=C2

really interesting article on how ancient societies faced/treated cancer.

i assume that one day we'll look back at chemo and radiation with the same horror that we look at blood letting, leaches, and, in this article, injecting gravel into hoo-ha's for uterine cancer. eck!

interesting anyway. :)

Veterinary Medicine Might Have Been the Way to Go

my dog won't stop getting injured. she is a retired greyhound and came to us off the track 4 yrs ago in good shape. but she has a tendency to get wounded just by passing by another dog or by running around our yard, or by stepping foot into the dog park. it's ridiculous. i know for a fact we've spent more on her out of pocket this last couple of years than we have on either me or the BHE.

and this week she had to get a claw amputated! the ligament and claw on one of her front feet. she's limping around all pitiful-like. this was clearly a bigger surgery than i would attempt, but i gotta tell you, for the minor lacerations, i am so tempted to sew her up myself. it's just that i don't want her thinking of me as the bad guy and i don't have a ready supply of lidocaine and stuff. i don't think we could train her to bite down on a strap of leather to get through the pain.

so for now, we're putting our vet's kids through college. you're welcome, susie and george.

Back in MY Day....

we recently launched an electronic (computerized) medical record system at my hospital. i know, i know, we are a bit behind the times. basically, instead of scribbling some illegible order that the unit secretary has to interpret and input into the computer system for the nurse to see and follow those instructions, now we just put our orders directly into the computer ourselves, and they go directly to the nurse's inbox. eventually, progress notes and everything will be on the computer. already, lab and radiology reports, vital signs, lots of stuff has been available exclusively on the computer, so this is just one more step to being paper-free.

there are a lot of positives to this. medication errors should be fewer, and any of us practitioners can access our patients' charts from any computer, which is convenient.

but, the system isn't very intuitive and a lot of people are grumbling. especially our, well, more seasoned physicians. one of my favorite surgeons is brilliant in the OR, but i doubt that he's ever sent an email. watching him attempt to input a simple order for tylenol is like watching a monkey try to do complex math.

things just change so quickly. in the 30 years this favorite MD of mine has been practicing, he went from a simple gall bladder resection taking 5 hours through a blurry, dark camera, cigarette smoke billowing through the halls of the hospital, and all the physicians being treated like gods, to a gall bladders taking 20 minutes, smoking not even being allowed on the hospital campus, and the docs being made to put their own damned orders in a complex computer system. ouch.

the other day i saw a nissan comercial for a remote car starter that uses your cell phone to start the car. for my generation, this makes some sense and doesn't seem all that frightening or sci-fi. but for older generations, this is straight out of the jetsons. it's just too bad that when you text your car to tell it to start, it doesn't fly to greet you at your front door. maybe that's next. :)

A Funny Thing Happened On My Way Into Work...

so, i see weird stuff every day at the hospital. it's just the nature of working with people, i think. people are weird.

yesterday, i saw flesh eating bacteria taking over some poor sap's entire backside before they bothered to come in to get it checked out.

today, i saw an RV parked outside the hospital in the employee parking lot and could totally see inside to some lady blow drying her hair!

what the what?

like i said. people are weird.

Mayhem, Murder, and Medicine

as we near the 5 year anniversary of the devastation of hurricane katrina, news stories and remembrances are popping up. above is a very tragic tale of desperate measures taken during the throws of hurricane katrina and the subsequent legal battle over suspicious deaths of patients. at one of the new orleans hospitals, apparently some 9 patients were not going to be able to be moved/evacuated, presumably because of their degree of dependence (i'm guessing ventilator patients? it never says), and so were given toxic doses of narcotics to facilitate death by the remaining staff physician and pharmacist.

i am dismayed, but not shocked for several reasons. i'm also not entirely sure it was the wrong choice by the caregivers...

during katrina in 2005, i lived in a small town in mississippi, about 3 hrs north of the coast. the hospital where i worked at the time took in patients who were evacuated from our sister hospital in louisiana. from these patients and their families, as well as in local news reports, we heard all sorts of awful stories about hospital wide power failure, then generator failure, and then death for those patients dependent on machines. i heard a lot about MD's having to make tough choices about who could use the remaining resources and who was most likely going to die anyway. there were wings of hospitals quarantined to house the dead and dying with no electricity, no air conditioning, 90 degrees and wet....it was a war zone. and only a scant few of the staff stayed behind to help and didn't evacuate with their families like they were told to do by the state.

things couldn't have been any more bleak and the situation couldn't have been farther from the norm under which these practitioners usually and comfortably practiced (presumably) ethical medicine.

i know i always tend to side with doctors, and i don't know the exact details of these cases. AND the families heart break is compelling. but STILL, if it was as i imagine, put yourself in their shoes... your hospital is drowning, your few staff members have been awake and working for days on end, many of your patients are dying, and you have a choice to either let these few patients who can't get out in time die slow, suffocating, miserable deaths, or you administer meds that will take them quickly.

if that was the situation, wasn't it humane and in fact 'doing less harm' to facilitate death?

you tell me. what would you do?

and then, here's a more happy story about a midwife delivering bebes during the storm.

Post Op Day 2, From the BHE

the OR is really bright and really cold. it took me two days to remember this, because anesthesia is retroactive.

i woke up from surgery on tuesday afternoon, and i'm glad to say the results are considerably better than the surgeon expected. he was able to remove 8 pounds of skin and fat that i wouldn't be able to exercise away or otherwise remove by my own effort. and my amazing wife tells me i look entirely different from every angle. so that starts to make the discomfort i've been in since then generally worth it.

i was told by the doc that i'd be "pretty sore" for about a week. and that's generally true, except that pain meds work. i have a pain pump delivering lidocaine directly into my abdominal muscles and i also have been taking a regular dose of vicodin. so my whole core feels very tight and my range of motion is severely restricted, but my actual pain level is really less than that of a sprained ankle. and that's a pretty crazy thought.

but i have to take a moment to commend the doc, the nurses, the techs, and even the transport personnel at MBH for taking amazing care of me. every single person i encountered at MBH had a big smile and a deep well of concern for my well-being. i felt like a VIP (i kinda was), but i also think my level of care wasn't that much greater than what anyone else receives at MBH. and that is pretty impressive.

most of all, though, i owe a tremendous amount of love and gratitude to the regular author of this blog. she has been incredibly supportive of me from the time i started to losing weight, through keeping it off, through running a marathon, and now through the decision for surgery and my aftercare. she is a model of love and sacrifice, and i'm incredibly blessed to have her.

Post Op Day 1

surgery is done and he's home and feeling pretty good and looking AMAZING.

more details from the BHE to follow.