|
Mayor Dave posted:Trump poisoning is going to completely melt my brain by age 40
|
#
?
May 29, 2020 02:25
|
|
|
|
| # ? May 30, 2024 22:20 |
|
|
FizFashizzle posted:Patient today was being seen for drug refills and a "spider bite." major props to you. i'm an animal doctor and know i couldn't deal with rock bottom human experiences like that as patients.
|
|
#
?
May 29, 2020 02:25
|
|
|
Yeah, I can see why there are people out there that just sort of gave up on living. If I saw the world from their eyes, it would seem more or less logical. They are essentially committing passive suicide. More or less the same thing happened in Russia during the 1990s.
|
|
#
?
May 29, 2020 02:30
|
|
|
the patients with multiple stage 4 pressure ulcers are the ones that you really feel bad for
|
|
#
?
May 29, 2020 02:33
|
|
|
Helith posted:Thanks, now I'm angry. Please do. I don’t post over there but it’s worth spreading around.
|
|
#
?
May 29, 2020 02:33
|
|
|
2020 is leading bigly for best year for a meth habit.
|
|
#
?
May 29, 2020 02:35
|
|
|
univbee posted:This is a Krokodil-tier story, goddamn. I assure you these are very real tears
|
|
#
?
May 29, 2020 02:35
|
|
|
Bip Roberts posted:2020 is leading bigly for best year for a meth habit. Tracks of My Tears
|
|
#
?
May 29, 2020 02:37
|
|
|
wtf
|
|
#
?
May 29, 2020 02:37
|
|
|
i picked a hell of a year to start smoking meth
|
|
#
?
May 29, 2020 02:37
|
|
|
kopasetic posted:the patients with multiple stage 4 pressure ulcers are the ones that you really feel bad for This is a fun one. Infected foley catheters because they never get changed or bathed is also really great.
|
|
#
?
May 29, 2020 02:44
|
|
|
Shalebridge Cradle posted:Because I have no medial background; if you remove a third of the foot would it take longer for necrosis to set in again than if they had just taken the smallest amount possible? Or does the advantage lie solely in reducing the number of necessary surgeries? For the first part, that just depends. As diabetes progresses, it just murders your distal vasculature and peripheral nervous system. You're not getting good blood flow, and you lose sensation. This leads to wounds you don't notice getting worse and worse until you're in surgery. Private surgeons want to cut off as little as a time because they'll get more money for it. I know this sounds cynical, but I worked inpatient rehab as a CNA and no one got just one foot amputation. The habits that got them there will keep them there. It's sad but the answer to this question lies in treating them when they're 25, not 55. As far as the VA, they're taking into consideration a few things. First, this patient is going to be back. We can buy more time between surgeries by just going ahead and taking off all the toes in one go. Second, they're decreasing the risk of infection from multiple surgeries. The kind of infections you get in hospitals are space bugs and harder/more expensive to treat. Lastly, it starts them earlier into the next phase of their mobility. That sounds awful, but the sooner you can get them learning how to ambulate with assistance, the better for them long term. kopasetic posted:at least in New Orleans, any given night of trauma surgery call is going to feature quite a few necrotic digit or limb amputations. after it gets to a certain point, people seem to stop giving a gently caress until poo poo is literally falling off or you start to see bone. oh man surgery in NO must be loving lit.
|
|
#
?
May 29, 2020 02:45
|
|
|
mod sassinator posted:i picked a hell of a year to start smoking meth its no time 2 stop tho
|
|
#
?
May 29, 2020 02:46
|
|
|
Wait is the third third "as far up as you can" with the VA just popping the leg off from the pelvis
|
|
#
?
May 29, 2020 02:47
|
|
|
Inceltown posted:lol, you skipped the number part Oh thank god, I was worried that number didn't recover.
|
|
#
?
May 29, 2020 02:47
|
|
|
Ok thank you, that all makes a lot of sense.
|
|
#
?
May 29, 2020 02:47
|
|
|
FizFashizzle posted:For the first part, that just depends. As diabetes progresses, it just murders your distal vasculature and peripheral nervous system. You're not getting good blood flow, and you lose sensation. This leads to wounds you don't notice getting worse and worse until you're in surgery. Private surgeons want to cut off as little as a time because they'll get more money for it. I know this sounds cynical, but I worked inpatient rehab as a CNA and no one got just one foot amputation. The habits that got them there will keep them there. It's sad but the answer to this question lies in treating them when they're 25, not 55. drat, I hadn't realised that people would have multiple amputations on the same limb. But the woman you saw would need her whole foot amputated as the infection wound is in her ankle right? How far up her leg would they go?
|
|
#
?
May 29, 2020 02:55
|
|
|
Mayor Dave posted:Trump poisoning is going to completely melt my brain by age 40 already 40, can confirm
|
|
#
?
May 29, 2020 02:57
|
|
|
tangy yet delightful posted:This is a fun one. Infected foley catheters because they never get changed or bathed is also really great. A fistula is a formation of a passage between two different organs in the body, or two different places from the same organ. Generally these shouldn't be there. Increased abdominal surgery is the number one cause of fistula formation. The more you gently caress around in the abdomen, the more two sections of intestine are going to rub together and the more likely the body is going to decide to create a passage between these two. Me as a cna as a patient with an indwelling cath. A catheter is a tube with a balloon and hole on the end. It's placed up the urethra until it enters the bladder. For indwelling, you then inflate the balloon and it just stays there. Yes this is as awful a procedure as it sounds. "Push until it pops" is what you're taught. A lot of the time you don't want to take cath's out. With older men their prostates are so bad that if you take the catheter out before you get them medically under control, you're not getting one back in without surgery. This is bad because peeing is important. When I would clean them, I'd take my little chlorhex wipes, push down the head of the penis so that a little of the tube was exposed, and clean that entire area. This is not a pleasant experience. So what do you do when the catheter is blocked? Some catheters are 2/3 way catheters that will let you inject fluids into it. The guy in my story didn't have one. He had a very simple indwelling catheter. And it was blocked. He hadn't passed urine in over a day. He was starting to show neurological changes. We BVI'd him (bladder scanner) and he had more in his bladder than the machine was able to read. Begrudgingly, the nursing staff decided to pull his catheter and replace it. Worst case scenario, we could straight cath him (small catheter) and just figure out what to do in the morning. Nurses come in. We deflate the balloon and pull the catheter. The guy screams. We look at the tube and it's full of a dark substance. At first we think it's blood that's congealed; that's not uncommon. But then we smell it. A dark substance starts oozing out of the guy's penis. The smell is unmistakable. This guy is literally pissing poo poo. These are some loving battle axe nurses. None of them react. I do. I had to leave the room. He was pissing poo poo for about an hour. The next morning they sent him back to the hospital to figure out what had happened. CT showed he had developed a fistula between his bladder and colon. His bladder had been slowly filling up with poo poo. Urine was backed up all the way into his kidneys. because of the way he was lying in bed, urine had been able to gather and pass until there was too much poo poo and everything got clogged. or so the surgeons think. honestly no one knew for sure and on one really wanted to figure out exactly what or how it had happened. shovelbum posted:Wait is the third third "as far up as you can" with the VA just popping the leg off from the pelvis I've never seen a diabetes amputation at the pelvis. But you'll definitely have conversations about if they need to have a foot or BTK (below the knee) amputation and it all depends on blood flow. Like i've had patients who's lower legs are bright red, hairless, and painful to the touch. They're just not getting bloodflow and there's no reason to keep the leg. The real arguments are if you cut above or below the knee. Below has the possibility of them learning to walk with a prosthetic. Above? No dice.
|
|
#
?
May 29, 2020 03:01
|
|
|
Helith posted:drat, I hadn't realised that people would have multiple amputations on the same limb. This was slightly above her ankle, so the amputation would have to go above the wound, so like right under the calf muscle. but at that point the question is whether it's better to cut there or just go to right below the knee. The consideration is for her moving forward with a prosthetic. And that answer I don't know.
|
|
#
?
May 29, 2020 03:03
|
|
|
FizFashizzle posted:For the first part, that just depends. As diabetes progresses, it just murders your distal vasculature and peripheral nervous system. You're not getting good blood flow, and you lose sensation. This leads to wounds you don't notice getting worse and worse until you're in surgery. Private surgeons want to cut off as little as a time because they'll get more money for it. I know this sounds cynical, but I worked inpatient rehab as a CNA and no one got just one foot amputation. The habits that got them there will keep them there. It's sad but the answer to this question lies in treating them when they're 25, not 55. kinda sounds like those surgeons are violating some sort of ethics rules. increasing risk to patients to increase their revenue over time is obscene
|
|
#
?
May 29, 2020 03:08
|
|
|
FizFashizzle posted:A fistula FUUUUUUUUUUUUUUCK
|
|
#
?
May 29, 2020 03:08
|
|
|
Spergin Morlock posted:kinda sounds like those surgeons are violating some sort of ethics rules. increasing risk to patients to increase their revenue over time is obscene Surgeons? Assholes? NO!
|
|
#
?
May 29, 2020 03:09
|
|
|
FizFashizzle posted:Surgeons? Assholes? NO! lol my dad is an anesthesiologist so i've heard stories.
|
|
#
?
May 29, 2020 03:14
|
|
|
Spergin Morlock posted:kinda sounds like those surgeons are violating some sort of ethics rules. increasing risk to patients to increase their revenue over time is obscene You'd be far more likely to suffer blowback from "cutting too much" than "too little" as a physician. I'm sure the podiatrists aren't big on having these people as patients because of the noncompliance and the huge hassle of multidisciplinary involvement for a medically complicated patient.
|
|
#
?
May 29, 2020 03:17
|
|
|
FizFashizzle posted:A fistula is a formation of a passage between two different organs in the body, or two different places from the same organ. Generally these shouldn't be there. Increased abdominal surgery is the number one cause of fistula formation. The more you gently caress around in the abdomen, the more two sections of intestine are going to rub together and the more likely the body is going to decide to create a passage between these two. Gross
|
|
#
?
May 29, 2020 03:20
|
|
|
|
|
#
?
May 29, 2020 03:23
|
|
|
Any time there is free air in the bladder on ct and there is no recent history of catheterization, it's an immediate r/o rectovesical fistula recommendation by the radiologist. I'd suspect you would need a wonderful diarrhea to fill the bladder with any significant volume of poo poo though. The fistulas are going to be really small, they'd tear and perforate before they would even come close to turning into a log flume ride.
|
|
#
?
May 29, 2020 03:29
|
|
|
Asproigerosis posted:Any time there is free air in the bladder on ct and there is no recent history of catheterization, it's an immediate r/o rectovesical fistula recommendation by the radiologist. oh yeah, this guy had been there a while and had cdiff. that was basically an open tap
|
|
#
?
May 29, 2020 03:31
|
|
|
Home from my second night back at work. We had about half as many tables as we did last night. Several regulars, more than last night. Take-out volume quadrupled, though, I spent most of my night helping the manager handle all the takeout orders. The cooks said they never had even half this much during the shutdown when the place was takeout only. We charge really high prices for takeout, so it was a good night for the place, business wise. The waitresses were griping because there was barely anything to do with the patio being closed (rain) and the low amount of tables. If we get even half of what we got tonight for takeout then I think the restaurant will survive, but it's going to be a hit to our staffing (possibly including me, but I'm not as a high-priority a cut as others as I'm involved in almost all areas of the restaurant). Compliance with COVID protocols was slackening tonight compared to yesterday. I had to tell one of the cooks to wear his drat mask, he'd gone half a hour with it hanging around his neck. He knew better, too. Clientele tonight was much better behaved. Part of this is we had more regulars than the previous night, part of it is I think Day 2 doesn't get as many morons going "OH GOD I just CAN'T live WITHOUT going OUT", part of it was the rain keeping some people home. I am still very pessimistic about anything we're doing actually doing anything meaningful to stem the spread of COVID. At the end of the night, after washing my hands, forearms, and wearing my mask all night, I was eating my dinner and checking something on my phone. After touching my phone I took my fork, ate a bite, and then put the other end of the fork in my mouth for a little bit while thinking about something. All of a sudden I realized I'd been touching my phone from time to time all evening (it's part of how I communicate with others if I need to say something more complex than gestures) but had never wiped it down. 
|
|
#
?
May 29, 2020 03:33
|
|
|
Mayor Dave posted:Trump poisoning is going to completely melt my brain by age 40 For me 40 is 9 years from now and I fully expect us all to be in the poo poo by then
|
|
#
?
May 29, 2020 03:34
|
|
|
Flesh Forge posted:i hope u find ur foot someday my dad found it in the grass. i wanted to keep it and mount it on the wall but the hospital burned it up because they're buzzkills
|
|
#
?
May 29, 2020 03:36
|
|
|
I never really thought about it til now but wearing a mask in a hot kitchen would suck
|
|
#
?
May 29, 2020 03:38
|
|
|
I think my neighbor just shot someone, I'm just going to sit inside and wait this one out quietly
|
|
#
?
May 29, 2020 03:40
|
|
|
FizFashizzle posted:Pissing poo poo WTF, this is horrifying, please keep the stories coming.
|
|
#
?
May 29, 2020 03:43
|
|
|
Serf posted:my dad found it in the grass. i wanted to keep it and mount it on the wall but the hospital burned it up because they're buzzkills What was the story on this
|
|
#
?
May 29, 2020 03:45
|
|
|
facetoucher cat posted:I think my neighbor just shot someone, I'm just going to sit inside and wait this one out quietly start streaming it
|
|
#
?
May 29, 2020 03:47
|
|
|
FizFashizzle posted:What was the story on this i lost my foot in an atv accident as a kid. 22 years ago as of last saturday actually
|
|
#
?
May 29, 2020 03:48
|
|
|
Google Butt posted:start streaming it The building I thought it came from had some dude flipping out there the other day but there's no movement outside at all. I did hear a single wolf/dog howl in the distance I when I went on the porch so that was fun and not at all creepy. There's no sirens, nothing
|
|
#
?
May 29, 2020 03:52
|
|
|
|
| # ? May 30, 2024 22:20 |
|
|
Serf posted:i lost my foot in an atv accident as a kid. 22 years ago as of last saturday actually the only response to this as a kid is "you should see the other guy"
|
|
#
?
May 29, 2020 03:52
|
|
