Staph on the increase calls for creative hospitalization

dana · Post by **dana** » Fri May 01, 2009 9:29 pm

Dick, you're not confusing me with pizzamancer are you?

Don't worry.. I'll go back under my bridge soon.

Toolmaker · Post by **Toolmaker** » Sat May 02, 2009 3:12 am

I can see my knuckle creases properly now YAY! Aside from a little redness its looking like the other hand now. I wish I woulda taken a pic of what happened after hospital number #1 irrigated without gloves. Its was quite bright but the pic after day 9 shows a nice tone after being on IV for 7 days. I'm so glad I found out about charge nurses during something like this where I had the ability to get rid of the nurse I was stuck with for 3 days.

I can't stress it enough that one has to be pro-active in their care no matter how minor even with pros. Remember if in doubt get in touch with the "charge nurse" as they are called. They will sort you out and take action against the screwup if you are unlucky enough to get stuck with a bad egg like I did.

The dispute on treatment dana brings up makes me think we could use a thread titled "Learn to heal" in Q&A. Personally I have never heard that its OK to work on someone without gloves but I guess in danas world its normal prodecure. SO.. we will have a nice thread to discuss our opinions on wound treatment and care and maybe some pics of what we all feel are good first aid bags to have handy. I am repacking my roll for this years burn and will take some pics today to post in the thread. I will also try to make the thread as good as the Welding thread if not better.

Feel free to contribute any positive posts when you see it pop up. Trolls like dana and pizzamancer can post whatever tripe they feel makes tgheir life better but since they are on my plonk list I don't have to be bothered with their negativity.

ygmir · Post by **ygmir** » Sat May 02, 2009 3:20 am

TM:
good to hear you're feeling better.......

a healing thread? now, that'll be interesting.........a challenge, to be sure, sorting good info.

I say Cognac.....even if you don't feel better, you don't care..........

dana · Post by **dana** » Sat May 02, 2009 10:32 am

Wow. Plonked by Tool.....

Well I guess that means you won't respond to any of this. A few more comments before I head back to my bridge. As you all can probably tell, I'm on the other side of the stethoscope and tend to have a different perspecitve on these things.

So here's the real story:
Tool, you are a pain in the ass patient.
You had one arm that they could put an IV into because the other one had a cellulitis. You kept losing your IV sites because they kept infiltrating (when the vein blows and the IV fluid and meds start going out into the tissue.) You were blowing the IV sites because you thought you knew better and kept fucking with the IV flow rates yourself. You did that because you thought you knew better than the nurses and you never bothered to ask any questions and/or listen carefully to the answers. The nurses were probably trying to keep minimal flow rate to preserve the IV site. Every time the IV site started infiltrating the nurse was forced to throw away the previous antibiotic IV bag and start over.
This continued until a pissed off surgeon was called to place an IV in your neck.
You also very likely spent a good deal of time bitching and moaning for IV narcotics. You probably were watching the clock to make sure you got it every 4 hours on the dot.
I can guarantee they wrote copious notes in the chart documenting your behavior and comments because you are the sort of patient that is more likely to file a suit if anything goes wrong. I'm sure they were happy when you left hospital #one.

And again, no Bactroban is not indicated for cellulitis - only superficial infections and impetigo. Its very expensive and doesn't penetrate that well to improve deeper infections.

CLINICAL PHARMACOLOGY
Pharmacokinetics: Systemic absorption of mupirocin through intact human skin is minimal.

The only possible use in your case would be to make you less infectious to others.

Finally I have to respond to this:

I lost a dear friend, years ago, in just this manner:
he went in with a heart attack and stroke. no surgery, but, in ICU, of course; He died 3 weeks later, still in ICU, of " blood sepsis", as I understand it, a general infection......how the heck do you get an infection in your blood stream, in ICU, unless someone didn't sterilize something.....?.........

Sorry for the loss of your friend, but this kind of cuts to the heart of the issue. If they had both an MI and a stroke there was a really high chance they were going to die anyway even with the best care. Geekster alluded to "cytokine cascades" in another thread which is part of how these things happen. Anoxic dying tissue starts a downward spiral that often ends with loss of immune function and your bodies own resident pathogens take over. Leakage of bacteria into the blood stream, sepsis and death.
So here's this situation where people tend to automatically assume the hospital fucked up. Do you ask questions and find out whether your assumptions are correct?
The biggest take-home message from this thread that I will heartily agree with is to be your own proactive health advocate. Ask lots of questions and make damn sure you understand your medical care. (This makes for a compliant patient that tends to be really motivated and get better.) If you run into a Doc that doesn't seem to want to answer any questions (because the reimbursement program forces him to run off to the next patient as fast as possible), just ask the simple question - "Isn't it important for me to understand my medical care?"

ygmir · Post by **ygmir** » Sat May 02, 2009 10:44 am

dana wrote: Finally I have to respond to this:
I lost a dear friend, years ago, in just this manner:
he went in with a heart attack and stroke. no surgery, but, in ICU, of course; He died 3 weeks later, still in ICU, of " blood sepsis", as I understand it, a general infection......how the heck do you get an infection in your blood stream, in ICU, unless someone didn't sterilize something.....?.........
Sorry for the loss of your friend, but this kind of cuts to the heart of the issue. If they had both an MI and a stroke there was a really high chance they were going to die anyway even with the best care. Geekster alluded to "cytokine cascades" in another thread which is part of how these things happen. Anoxic dying tissue starts a downward spiral that often ends with loss of immune function and your bodies own resident pathogens take over. Leakage of bacteria into the blood stream, sepsis and death.
So here's this situation where people tend to automatically assume the hospital fucked up. Do you ask questions and find out whether your assumptions are correct?
The biggest take-home message from this thread that I will heartily agree with is to be your own proactive health advocate. Ask lots of questions and make damn sure you understand your medical care. (This makes for a compliant patient that tends to be really motivated and get better.) If you run into a Doc that doesn't seem to want to answer any questions (because the reimbursement program forces him to run off to the next patient as fast as possible), just ask the simple question - "Isn't it important for me to understand my medical care?"

that, madam, is a great answer. thank you.

Although certainly no genius, I'd like to think I can grasp simple concepts and clear explanations.
I did, and politely, ask all the questions suggested, as well as any I could think of......and, go no answers that made any sense at all......I was quite dismayed at the response I got from staff......and, they'd always pass it to the doc. who, of course, was not there, and, didn't return my calls. Sure, I was not a family member, but, also, they were so distraught, I was handling things for them.

had it been explained, in a clear and concise manner, I would have gotten it, I think..........

I bet the took the attitude, as you elude to: "he was going to die anyway"......that's what I took away from them, at least.

And, your "take home" message is a good, and valuable one........

as with so many things, with two sides to a story, the truth lies somewhere in the middle.......and, is subject to perspective.

I thank you for the time you took to clarify, explain, and listen.

dana · Post by **dana** » Sat May 02, 2009 12:23 pm

ygmir wrote:that, madam, is a great answer. thank you.

Although certainly no genius, I'd like to think I can grasp simple concepts and clear explanations.
I did, and politely, ask all the questions suggested, as well as any I could think of......and, go no answers that made any sense at all......I was quite dismayed at the response I got from staff......and, they'd always pass it to the doc. who, of course, was not there, and, didn't return my calls. Sure, I was not a family member, but, also, they were so distraught, I was handling things for them.

had it been explained, in a clear and concise manner, I would have gotten it, I think..........

I bet the took the attitude, as you elude to: "he was going to die anyway"......that's what I took away from them, at least.

I thank you for the time you took to clarify, explain, and listen.

You're most welcome (but its not Madam).
One thing that probably compounded the problem is very strict confidentiality laws. They can't legally discuss the case with anyone but family members unless you have medical power of attorney. HIPAA laws are beaten into everyone's head until they can recite it back in their sleep.
And the only time I have seen the "going to die anyway" thing acted on is when it really may enter directly into therapuetic decisions (like the elderly patient with multiple serious medical problems that comes into the ER in cardiac arrest and the Doc has to decide how aggressive to be with resuscitation efforts.)
Hospitals are slowly getting hip to these issues and often have a laison person to make sure the family is helped to understand what's going on and participate with issues such as .... well how aggressive to be and when to pull the plug. Leaving someone brain dead on a respirator for awhile until pnuemonia takes over does no-one much good.

Honestly, I can tell you two things I've learned real well that have made the practice of medicine much easier and more satisfying. One is to really let down the barriers between patients and myself, allow myself to care more and make damn sure they understand the whole process.
The other is to confront someone like Tool when I think there may be a problem. One of three things are going to happen: I may find out my assumptions are wrong and I'll have to back-track. Or a problem patient that would be difficult to work with/non-compliant will get pissed and leave (or plonk me). Or they will knock off the bullshit and get on board. (I've had enough patients apologize to me and occaisionally it goes the other way.)

edited for snarkiness
You dog, the posting times tell the story.
Speaking of snarkiness, what happened to you Dick? You used to really have it!! Your Bible trivia thread raised snarkiness to an artform. Have all those creative snarky juices dried up.... or just flowing as other bodily juices? maybe a little abstaining...? (I've seen your new signature!! Even us ogres feel revulsion.)

ygmir · Post by **ygmir** » Sat May 02, 2009 1:24 pm

dana wrote:
ygmir wrote:that, madam, is a great answer. thank you.

Although certainly no genius, I'd like to think I can grasp simple concepts and clear explanations.
I did, and politely, ask all the questions suggested, as well as any I could think of......and, go no answers that made any sense at all......I was quite dismayed at the response I got from staff......and, they'd always pass it to the doc. who, of course, was not there, and, didn't return my calls. Sure, I was not a family member, but, also, they were so distraught, I was handling things for them.

had it been explained, in a clear and concise manner, I would have gotten it, I think..........

I bet the took the attitude, as you elude to: "he was going to die anyway"......that's what I took away from them, at least.

I thank you for the time you took to clarify, explain, and listen.
You're most welcome (but its not Madam).

edited for snarkiness
You dog, the posting times tell the story.
)

please excuse the gender error, then, sir.........

a question:
how do posting times make me a dog?...........

dana · Post by **dana** » Sat May 02, 2009 1:29 pm

a question:
how do posting times make me a dog?...........

Take a glance at Dick's last and see if you pick it up.

dana · Post by **dana** » Sat May 02, 2009 1:38 pm

maybe it's too subtle

ygmir · Post by **ygmir** » Sat May 02, 2009 1:46 pm

perhaps so......I'm not the sharpest knife in the drawer.....

Toolmaker · Post by **Toolmaker** » Sat May 02, 2009 1:50 pm

Toolmaker · Post by **Toolmaker** » Sat May 02, 2009 2:17 pm

I would like to note that almost all of what dana has posted is either an outright lie or uninformed innuendo. I don't know why dana has decided to attack me in this fashion since I don't know her at all. She has NO knowledge of my medical history and is obviously in full on troll mode.

Again I'd like to point out that I do NOT know dana and she does NOT know me. All these statements she is making are completely untrue and made up to make her feel better about herself or somesuch.

This is common amongst internet forum trolls. They often have mental/emotional issues and they feel the need to post bullshit to make themselves feel better.

I DID send a PM but got no response from dana as to why she is attacking me and posting these lies but she refused to respond which is typical of a troll.

Moderators please lock the thread or even better delete it completely.

I should know better than to try to share something on here so others don't go through what I did.

Post by **AntiM** » Sat May 02, 2009 2:56 pm

Locked at OP's request.