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Old 02-17-2021, 06:03 PM   #1126
OrbitalEllipses
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Quote:
Originally Posted by the_saintusa View Post
At least they are acknowledging the problem by having him on a 'special diet' and now TPN.

Is it leaking through the wound / main incision the procedure was performed? Or is it leaking into a pleural space and he has a chest tube / pig tail catheter?

Have the attending physician call you or family.

1. At what point (how many more days on TPN?) will they try and ligate the TD?
2. At what point will they consider an IR intervention? After attempted ligation of the TD?


Sucks not having family around
Oh his daughter and wife are around and have tried to get anyone to talk to them, admit them, or otherwise communicate. The hospital is being obstructionist and using Covid as the excuse to not admit anyone to see him.
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Old 02-17-2021, 10:04 PM   #1127
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Quote:
Originally Posted by OrbitalEllipses View Post
Oh his daughter and wife are around and have tried to get anyone to talk to them, admit them, or otherwise communicate. The hospital is being obstructionist and using Covid as the excuse to not admit anyone to see him.
Like saintusa said, have the family request to speak specifically with the attending surgeon - the one who operated on your uncle.

If they can't achieve that, have them request to speak to the hospital patient advocate or an ombudsman, stating they'd like to file a complaint (don't need to actually file any complaint, it's just to get things moving).
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Old 02-17-2021, 10:15 PM   #1128
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Quote:
Originally Posted by TheCokeCan View Post
Like saintusa said, have the family request to speak specifically with the attending surgeon - the one who operated on your uncle.

If they can't achieve that, have them request to speak to the hospital patient advocate or an ombudsman, stating they'd like to file a complaint (don't need to actually file any complaint, it's just to get things moving).
Exactly.

Ask for an update on the plan for the TD injury.

Call the hospital (the unit he is located), speak to the nurse manager, and leave a message for the surgeon/house staff/house officer etc with your phone number and ask for a call. Explain that you have SERIOUS concerns about the quality of care, and the lack of communication.

State you are concerned, and would like to know the plan.

If there is no communication from the surgeon, than go to patient relations and ask for help.
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Old 02-18-2021, 12:05 AM   #1129
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My cousin wrote the CEO and that got wheels turning and my aunt admitted to see him up to twice a week. There’s a bureaucratic process now in motion to get his doc to agree to the type of surgical procedure his family is requesting.

There’s a reason rich Canadians have private American insurance...
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Old 02-18-2021, 12:17 AM   #1130
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Glad to hear that family can visit.

BUT, without knowing the details of the case, it is pretty hard to know what is needed to be done.

Nobody can force the doctor to do a procedure that they do not believe is indicated, whether you are in Canada or the USA.

What is needed is to know what the plan to manage the TD injury, the algorithm that is being used.

The last thing you want to do is have the surgeon do a procedure that they are not skilled to do, just because you want it done.

I would just use this start of communication as a means to get information such that you can be involved.

If the plan is to let the chyle leak indefinitely than that is not a plan.

Do they want to wait another 2 or 3 days PRIOR to an intervention? Than that makes sense.

What will that intervention be?

The longer you wait, the more difficult it will be to go through the original incision to go after the TD injury.

None of the Canadians that I know that are worth $10M plus do not have 'private American insurance'. Many have gone for imaging (full body) for piece of mind, but none have gone for surgery or care in the USA (unless the procedure is not available in Canada).

Good luck with your uncle.
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Old 02-18-2021, 03:46 AM   #1131
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Quote:
Originally Posted by the_saintusa View Post
If the plan is to let the chyle leak indefinitely than that is not a plan.

Do they want to wait another 2 or 3 days PRIOR to an intervention? Than that makes sense.

What will that intervention be?
Thanks for your input. With my aunt and cousin now having spoken to the surgeon for the first time since the procedure I’m sure those answers will come since for the last 6 days the treatment plan has been unclear or nonexistent.
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Old 02-18-2021, 07:16 AM   #1132
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Orbital... good luck!!

Saint and others, SO NICE to see teh OT helping other OTers!! Thank you!!
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Old 02-18-2021, 09:05 AM   #1133
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Quote:
Originally Posted by OrbitalEllipses View Post
Thanks for your input. With my aunt and cousin now having spoken to the surgeon for the first time since the procedure I’m sure those answers will come since for the last 6 days the treatment plan has been unclear or nonexistent.
I like to think that the plan was clear (to the care team) but not communicated.

End result is lack of understanding / confusion and concern.

Good luck, and let us know how your uncle does.
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Old 02-18-2021, 12:56 PM   #1134
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Quote:
Originally Posted by the_saintusa View Post
I like to think that the plan was clear (to the care team) but not communicated.

End result is lack of understanding / confusion and concern.

Good luck, and let us know how your uncle does.
I second the Saint on this it's highly unlikely there is no plan treating a significant complication like this, but that it's poorly communicated and also likely a highly fluid plan that may change slightly daily based on changes in his medical status.

Good luck that's a tough one to deal with.
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Old 02-19-2021, 02:29 PM   #1135
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Quote:
Originally Posted by the_saintusa View Post
Hematologist will sort out, as will @edkwon.

Microcytic
Normocytic
Macrocytic

Go from there.

As for gross hematuria that cleared up? I would be more concerned about that than the anemia.

Good luck and hopefully something simple.
Gross hematuria hasn't returned. Had it twice. After the 2nd instance had the 1st cystoscopy. Went to the cancer center (Moffitt) for follow up there. They did another cysto, took sample from the bladder, did washes of both ureters (bi-lateral ureteral lavage maybe(?, I'm not a doctor), (those are the dealer options I was referring to above), all that ultimately returned me with a clean bill of renal health.

So, no weenur/kidney cancer apparently! ...and hopefully no more cystoscopies.

And I'll echo the thanks. It's nice to have quick access to 2nd, 3rd opinions. I appreciate the comments.
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Old 04-06-2021, 09:23 AM   #1136
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Hey the doctors of teh OT.

My junior in high school asked to play the JV baseball game last night even though he’s the starting center fielder on the varsity team. I was against this as some younger guys need reps.....

Turf field and he slides into second base feet first. He doesn’t get up right away and the other teams trainer comes out onto the field, looking at his knee.

After several minutes he gets up and slowly walks off. Initial concern is all those pesky ligaments in the knee. No huge swelling right away. This morning there is some swelling on the inside/back of the knee, not huge but some, tender to walk on, but not terrible.

How bad is my kids knee.......obviously we will take him to a real live doctor if needed and will monitor throughout the day. I *think* the swelling could be from banging the knee on the base on the way through while sliding.
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Old 04-06-2021, 09:40 AM   #1137
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I'm no doctor, but when I tore my ACL all I had was minor swelling on the back of the knee.

Hope it's nothing major.

EDIT: That may not be correct...the swelling/pain in the back of the knee may have been from a more recent injury to the meniscus.
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Old 04-06-2021, 09:41 AM   #1138
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Originally Posted by fliz View Post
I'm no doctor, but when I tore my ACL all I had was minor swelling on the back of the knee.

Hope it's nothing major.
Come on man, we aren’t trying to have an ACL injury here!
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Old 04-06-2021, 11:03 AM   #1139
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When I tore my acl my whole knee swelled up. They drained something like 20-30cc of blood from the joint. I'm sure not all are like that. Did he have any kind of burning sensation in the knee?
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Old 04-06-2021, 11:08 AM   #1140
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Originally Posted by Thunderpaw View Post
When I tore my acl my whole knee swelled up. They drained something like 20-30cc of blood from the joint. I'm sure not all are like that. Did he have any kind of burning sensation in the knee?
He didn’t describe it as burning, I feel fairly certain he banged it and then got scared when the other teams trainer came out and mentioned ACL to our coach, there was nothing indicating ACL injury other than his knee hurt. I don’t even think it’s MCL because of where his little bit of swelling is. Currently we are icing and will see where we are in a bit.
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Old 04-22-2021, 07:32 PM   #1141
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what do you guys know about ulnar nerve entrapment? I believe I have something like that going on. Sometimes a faint tingle down the back of my arms, probably more from elbow down and a slight tingling in my pinky and ring fingers, and sometimes into my hand a little. It's not painful, but it's noticeable but it is there. It's been at east a couple weeks now.

should probably call the doc...
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Old 09-03-2021, 09:14 PM   #1142
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Hey shikitikitavi, what in the actual **** am I looking at here?



I realize it's got to be either feet or hands, but...well, look at it.

It's from
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Old 09-03-2021, 09:15 PM   #1143
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dp345

Last edited by Kaiser; 09-03-2021 at 09:34 PM.
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Old 09-04-2021, 09:09 AM   #1144
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Looks like the big toe on the left foot got pulled away from the other 4.
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Old 09-04-2021, 10:27 AM   #1145
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Quote:
Originally Posted by Kaiser View Post
Hey shikitikitavi, what in the actual **** am I looking at here?



I realize it's got to be either feet or hands, but...well, look at it.

It's from
Exploring an Abandoned Children's Asylum - Found Restraints and Old Electronics! - YouTube
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Old 09-05-2021, 07:54 PM   #1146
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TIL my toes don't start at the end of my foot.
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Old 09-05-2021, 08:23 PM   #1147
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TIL my toes don't start at the end of my foot.
They don't bend at the tarsal-metatarsal interfaces, though. Unless you get run over by a car or the like.

Fun history:

Quote:
The Story
The Napoleonic Wars (1803-1815) were brutal and France found itself running short of physicians. Jacques LisFranc de St. Martin, an OBGYN by trade, was pulled in to help wounded soldiers on the battlefield out of necessity.


One day, a solider was dismounting from his horse when his foot became stuck in the stirrups which compromised his blood flow to his lower limb and created a gangrenous foot. LisFranc described the surgery as "amputation of the foot through the tarsometatarsal articulation".


Today, the eponymous injury (a Lisfranc injury) has come to mean a dislocation or fracture-dislocation injury at the tarsometatarsal joints.
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Old 09-06-2021, 10:04 AM   #1148
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Ok horrific.
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Old 09-06-2021, 11:22 AM   #1149
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Not really a question but more random thoughts from my recent back surgery

I'm 6 days post op of having alif surgery with posterior instrumentation. It was l4 l5 vertebrae with collapsed foramen on right side. I stopped taking pain meds day 3 post op due to nausea. Doc recommended tramadol instead of oxycodone but I'm just doing 3000mg Tylenol 3 times a day. Those pain pills make me super dizzy. Not worth it for myself. Needless to say I feel everything. My appetite is barely coming around now. I'm living on fruit and veg smoothies and chicken soup. It's worse than I thought as far as pain and immobility are concerned. I plan to be back better than I was before. My short daily driveway walks are brutal nd beautiful at the same time. I've never been more thankful for my mother. She is here helping her old son with absolute love. No need for modesty or embarrassment because I need help with everything. She's my angel and I'm grateful to call her mom. I've had t1 diabetes for almost my whole life and it's very tough managing that with recovery along with nausea and lack of appetite. My a1c is always 6.2-6.5. I have a cgms I've been using since it's inception and it really is a game changer for diabetes management. I have nighttime headaches and cold sweats randomly. Doc says that's normal considering all the nerves being stretched and the fact that I gave up coffee abruptly after surgery. I don't want or crave it now? Weird. I'm looking forward to next spring. This recovery will take a while. Sorry for the stream of random thoughts. A couple pics for your enjoyment taken this morning. My body is full of scars from bmx, road cycle racing now this.

Have any other member here had this surgery? How was the recovery?









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Old 09-06-2021, 03:28 PM   #1150
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Uh, don't actually do 3000 mg Tylenol three times per day.

1000 mg every 6 hours is fine for a few days. But not 9000 per day.
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