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f13.net General Forums => General Discussion => Topic started by: schild on August 23, 2008, 08:34:32 PM



Title: Medical question. Cut my hand open.
Post by: schild on August 23, 2008, 08:34:32 PM
So, I just cut my hand by accident on a knife. Sort of. I didn't actually know the knife was there. Picked up a paper towel and it was under it and it sliced into my palm. It's a pretty long gash but super super clean, and barely bled at all. I do not have insurance. I am not going to get stitches. That said, is there anything in particular I should do to deal with it. Right now I've got bandaids holding the wound shut. That said, I took a look and it looks like unless I move it doesn't open, and it only really moves when I grip something hard or use my mouse and have my palm resting. As such, any advice or should I just keep it clean and keep bandaids on it to hold it shut?


Title: Re: Medical question. Cut my hand open.
Post by: Azaroth on August 23, 2008, 08:49:26 PM
All advice would likely hinge on the size, location, and deepness of the cut.

General advice would be to go ahead and keep it super clean, don't eat much sugar or drink much alcohol (depresses immune system), and, well, probably go to the fucking hospital.

Unless it's a really small cut and you're just a big pussy.


Title: Re: Medical question. Cut my hand open.
Post by: Signe on August 23, 2008, 08:54:40 PM
You should get some of those adorable little butterfly bandages.  Maybe you can even get them in cool colours.  You could make a fashion statement.


Title: Re: Medical question. Cut my hand open.
Post by: Nerf on August 23, 2008, 08:55:50 PM
Post pics, and superglue.

Really, superglue, the insta-setting shit, called CA, just hold it together and glue it shut.


Title: Re: Medical question. Cut my hand open.
Post by: Oban on August 23, 2008, 09:00:56 PM
Go to a clinic.

Now that that is out of the way, I would suggest using:

http://www.bandaid.com/productList.do?typeId=4#anchor14 (http://www.bandaid.com/productList.do?typeId=4#anchor14)



Title: Re: Medical question. Cut my hand open.
Post by: Oban on August 23, 2008, 09:04:17 PM
Post pics, and superglue.

Really, superglue, the insta-setting shit, called CA, just hold it together and glue it shut.

DO NOT USE STANDARD SUPER GLUE ON YOUR WOUND!  The chemicals in super glue are very toxic once broken down by your body.


Title: Re: Medical question. Cut my hand open.
Post by: Azaroth on August 23, 2008, 09:23:09 PM
Post pics, and superglue.

Really, superglue, the insta-setting shit, called CA, just hold it together and glue it shut.

DO NOT USE STANDARD SUPER GLUE ON YOUR WOUND!  The chemicals in super glue are very toxic once broken down by your body.

Should someone have to say that?


Title: Re: Medical question. Cut my hand open.
Post by: Nerf on August 23, 2008, 09:31:40 PM
Post pics, and superglue.

Really, superglue, the insta-setting shit, called CA, just hold it together and glue it shut.

DO NOT USE STANDARD SUPER GLUE ON YOUR WOUND!  The chemicals in super glue are very toxic once broken down by your body.

Should someone have to say that?
Quote
[edit] Medical uses
The use of cyanoacrylate glues in medicine was considered fairly early on. Eastman Kodak and Ethicon began studying whether the glues could be used to hold human tissue together after surgery. In 1964, Eastman submitted an application to use cyanoacrylate glues to seal wounds to the United States Food and Drug Administration (FDA). Soon afterward Dr. Harry Coover's glue did find use in Vietnam—reportedly in 1966, cyanoacrylates were tested on-site by a specially trained surgical team, with impressive results. In an interview with Dr. Coover by the Kingsport Times-News, Coover said that the compound demonstrated an excellent capacity to stop bleeding, and during the Vietnam War, he developed disposable cyanoacrylate sprays for use in the battlefield.

“ If somebody had a chest wound or open wound that was bleeding, the biggest problem they had was stopping the bleeding so they could get the patient back to the hospital. And the consequence was—many of them bled to death. So the medics used the spray, stopped the bleeding, and were able to get the wounded back to the base hospital. And many, many lives were saved. ”
—Dr. Harry Coover
 

The original Eastman formula was not FDA approved for medical use, however, because of a tendency to cause skin irritation and to generate heat. In 1998 the FDA approved 2-octyl cyanoacrylate for use in closing wounds and surgical incisions.


http://en.wikipedia.org/wiki/Cyanoacrylate

Just don't puddle it or you'll burn the shit out of yourself.


Title: Re: Medical question. Cut my hand open.
Post by: Salamok on August 23, 2008, 10:33:30 PM
if it is fairly shallow and not actively bleeding you can try liquid bandaid.  Otherwise I'd suggest neosporin ointment and tape+gauze.


Title: Re: Medical question. Cut my hand open.
Post by: schild on August 23, 2008, 10:41:32 PM
if it is fairly shallow and not actively bleeding you can try liquid bandaid.  Otherwise I'd suggest neosporin ointment and tape+gauze.

It wasn't all that shallow, but yea, liquid bandaid working OK thus far.


Title: Re: Medical question. Cut my hand open.
Post by: Nebu on August 23, 2008, 10:46:13 PM
Tetanus shot and the rest hinges on depth.  If you just hit the superficial tissue, I'd use butterfly bandages to connect regular edges, ice it down with immobilization and some triple antibiotic ointment.  If it's deeper, you'd be silly not to see an MD for assessment and stiches. 


Title: Re: Medical question. Cut my hand open.
Post by: Selby on August 23, 2008, 10:52:53 PM
Tetanus shot and the rest hinges on depth.  If you just hit the superficial tissue, I'd use butterfly bandages to connect regular edges, ice it down with immobilization and some triple antibiotic ointment.  If it's deeper, you'd be silly not to see an MD for assessment and stiches. 
Exactly.  Cut my hand open a few years back in just the same way.  Neosporin, bandaids, and immobilization fixed everything good as new after a few weeks.  Still have a scar that is hard to see.


Title: Re: Medical question. Cut my hand open.
Post by: schild on August 23, 2008, 10:54:32 PM
I dont' know what just superficial means, but I couldn't see muscle, but I wouldn't call it entirely shallow either. The only thing this wound would keep me from doing is play Diablo at length.


Title: Re: Medical question. Cut my hand open.
Post by: Azaroth on August 23, 2008, 11:05:04 PM
Can you move all of your fingers? Are you bleeding like a pig?

If not, just watch for infection.

This is only, of course, if you absolutely refuse to go to the hospital. I usually do too, so.


Title: Re: Medical question. Cut my hand open.
Post by: schild on August 23, 2008, 11:11:00 PM
Can you move all of your fingers? Are you bleeding like a pig?

If not, just watch for infection.

This is only, of course, if you absolutely refuse to go to the hospital. I usually do too, so.

I have full hand movement, there's almost no pain, there wasn't any when it was cut either. I mean, it was a cleeeeeeeeeeeean cut. We're talking almost no blood as the skin naturally pushed back together. I had to pull it apart to make sure the bleeding wasn't heavy. Knife was clean also, hadn't cut anything with it since cleaning it last.

Honestly, I'm not worried. I'd planned on cleaning it and putting a liquid bandage on it, just wanted to know if there was something strange/off the beaten path that works better.


Title: Re: Medical question. Cut my hand open.
Post by: FatuousTwat on August 23, 2008, 11:55:45 PM
http://solutions.3m.com/wps/portal/3M/en_US/SH/SkinHealth/brands/steri-strip/

These.

My mother is a nurse, and whenever I used to get cut, and it didn't warrant stitches, she would use them.

I don't have any idea how deep it is or if it DOES require stitches, so I would suggest a doctor. Might cost money, but it beats horrible infections and amputation.


Title: Re: Medical question. Cut my hand open.
Post by: sigil on August 24, 2008, 12:30:20 AM
I had one of these back high school, used sterri strips and triple antibiotic. was fine, although I did develop a small but noticeable scar.


Title: Re: Medical question. Cut my hand open.
Post by: Amarr HM on August 24, 2008, 12:35:07 AM
If its throbbing its a good sign in my experience, means its fighting infection. If it is the case apply antibacterial salve of some sort.


Title: Re: Medical question. Cut my hand open.
Post by: stu on August 24, 2008, 12:36:43 AM
(http://i241.photobucket.com/albums/ff26/stuabrtow/casperfly-1.gif)

I spell gud


Title: Re: Medical question. Cut my hand open.
Post by: schild on August 24, 2008, 12:41:11 AM
No throbbing, not warm or even red around the wound. I don't think it's going to be a problem it's barely bleeding at all if I don't twist my hand a certain way with the bandaid off, thanks all.


Title: Re: Medical question. Cut my hand open.
Post by: MahrinSkel on August 24, 2008, 12:49:36 AM
I've cut my hands open a lot.  Keep it clean, keep anti-biotic on it, try to keep it closed.  If it starts throbbing, turns a deep red or purple, feels hot to the touch, or starts leaking pus (not clear lymph fluid or the dried crusts of the same, but cloudy or thick yellowish discharge you can squeeze out), get to a doctor or an urgent care facility.  Oh, and when was your last tetanus shot?  A clean knife isn't a likely vector, but by the time you feel any symptoms of tetanus, it's probably too late to save the hand.

--Dave

EDIT: Also, clean it well right before you go to bed, then make sure it's dressed such that it won't open in your sleep.  If you don't have gauze and surgical tape, a sterile bandage with antibiotic on the wound and then paper towels and duct tape (*loosely* wrapped) will do the trick.  Yes, you really can fix anything with duct tape.


Title: Re: Medical question. Cut my hand open.
Post by: Lantyssa on August 24, 2008, 02:52:49 AM
Make sure the duct tape isn't touching skin though.  That glue will leave a nasty chemical burn.


Title: Re: Medical question. Cut my hand open.
Post by: Margalis on August 24, 2008, 03:42:43 AM
Masterbating?

Lrn2spell.


Title: Re: Medical question. Cut my hand open.
Post by: Oban on August 24, 2008, 05:14:16 AM
Getting medical advice from the Internet rather than going to a clinic/hospital for something that may negatively affect your ability to masturbate is awesome, for real.


Title: Re: Medical question. Cut my hand open.
Post by: Arnold on August 24, 2008, 05:49:31 AM
So, I just cut my hand by accident on a knife. Sort of. I didn't actually know the knife was there. Picked up a paper towel and it was under it and it sliced into my palm. It's a pretty long gash but super super clean, and barely bled at all. I do not have insurance. I am not going to get stitches. That said, is there anything in particular I should do to deal with it. Right now I've got bandaids holding the wound shut. That said, I took a look and it looks like unless I move it doesn't open, and it only really moves when I grip something hard or use my mouse and have my palm resting. As such, any advice or should I just keep it clean and keep bandaids on it to hold it shut?

I work in a pro kitchen and we see cuts all the time.  And usually they are like your situation, where you aren't actually slicing, but get cut in a stupid way.  Just keep it clean.  SCrub it with soap and then use some antiseptic ointment.  No one goes to the doctor unless they slice off a finger or something.

The worst I ever did was when I was going diving.  The dude ahead of me had newer style booties that have treads like tennis shoes.  He jumped onto a wet log and was fine.  I hald oldschool booties, jumped onto the same log and both my feet flew out from underneath me.  I threw my arms out to keep my head from getting smashed, and got a super nasty, mangled left palm to pay for it.

It was ugly.  I don't even think they could have stitched it if they wanted to.  I was a sharp rock and my palm dug in and twisted.  It was an ugly mash of pulp.

I cleaned the thing up, but the next day I woke up with a red line going up my forearm.  Scared the shit out of me.  I cleaned it again, grabbed a Sharpie and drew a mark where the red line was at.  If it went any higher, I was hightailing it to the emergency room.  But it didn't; it went down.

The scar has faded mostly, but it's pretty nasty.  Like a big X, with a line going through the middle.


Title: Re: Medical question. Cut my hand open.
Post by: Jimbo on August 24, 2008, 07:07:59 AM
Hey Schild, look for a free clinic if you want a chance to have it looked at for free, or a nursing school or med school, where are you at in TX?  Nebu covered a lot of it, but I'll add, if you use a liquid bandage don't get the adhesive of another bandage on it as it will pull off when you change it, nor should you get the liquid bandage wet.  Do keep it immobilized for about 24 hours, then just check the wound for infection.  The big thing is you tetanus immunizations, when was the last time you had one of those?  If it is less than 7 years we recommend getting your booster shot (if you are unsure get it anyway, better to have a sore arm than lock jaw).  I know the CDC says 10 years, but our hospital has moved to a 7 year, that way we keep the immunizations booster up and running, heck the pro staff has thought of 5 years for high risk patients.  Oh, you can get Td shot at the health clinic for usually $5 or check and see if any of the schools will give it to you for free or at cost.

Sometimes I wish they would put Dermabond over the counter, but I'll have to check out the liquid bandage from Band-aids, I usually sweet talk the Dermabond rep for free samples to help friends and family out.  Heck, I've gotten to where I keep a med kit in the car because I'll get asked by all kinds of people sometimes.


Title: Re: Medical question. Cut my hand open.
Post by: Signe on August 24, 2008, 09:24:35 AM
I like the sup cat but I like the pirate cat better.  You can be the pirate cat now.  Maybe you'll get lucky and lose an eye.

(http://groups.msn.com/_Secure/0VgDrAkYbhcu92tbxFugwL4AV*1jUrEPtB*Byr4kev115rlYcHXmyNWBrBH1Cigt2OLAxbeMO9YtWB8PTySRiLEnF7yoaN6KJ7ssy156S*4SqeViVSzo*kxLPdjU!VjNc/Pirate-Cat-Portrait.jpg)


Title: Re: Medical question. Cut my hand open.
Post by: Nebu on August 24, 2008, 10:53:19 AM
Sometimes I wish they would put Dermabond over the counter, but I'll have to check out the liquid bandage from Band-aids, I usually sweet talk the Dermabond rep for free samples to help friends and family out.  Heck, I've gotten to where I keep a med kit in the car because I'll get asked by all kinds of people sometimes.

You and I both know why Dermabond isn't available over the counter.  How many people do you see each week with self-treated wounds oozing puss because they didn't properly irrigate and clean their wound before dressing it?   Yes, cleaning a wound hurts.  It's better than getting lanced/drained a week or two later. 


Title: Re: Medical question. Cut my hand open.
Post by: CharlieMopps on August 24, 2008, 10:54:29 AM
I know an old Indian trick that works wonders...
first make a slurry of Tabasco and table salt
then liberally fill the wound with it (you might need someones help, it'll sting a little)
Let it soak for a while, then rinse with vinegar.  


Title: Re: Medical question. Cut my hand open.
Post by: schild on August 24, 2008, 10:58:50 AM
That sounds insane.


Title: Re: Medical question. Cut my hand open.
Post by: Merusk on August 24, 2008, 11:07:02 AM
I think he's trying to kill you.


Title: Re: Medical question. Cut my hand open.
Post by: Nebu on August 24, 2008, 11:08:14 AM
I know an old Indian trick that works wonders...
first make a slurry of Tabasco and table salt
then liberally fill the wound with it (you might need someones help, it'll sting a little)
Let it soak for a while, then rinse with vinegar.  

This doesn't surprise me.  Capsaicin (the oil in peppers that makes them "hot") has been known to have anticancer and antibiotic activity.  Add in some vinegar (also in Tabasco) to drop the pH and you have a decent antiseptic.  Sure would sting like a bitch though.  I'd still go with antibiotics  :awesome_for_real:


Title: Re: Medical question. Cut my hand open.
Post by: CharlieMopps on August 24, 2008, 11:24:21 AM
I know an old Indian trick that works wonders...
first make a slurry of Tabasco and table salt
then liberally fill the wound with it (you might need someones help, it'll sting a little)
Let it soak for a while, then rinse with vinegar.  

This doesn't surprise me.  Capsaicin (the oil in peppers that makes them "hot") has been known to have anticancer and antibiotic activity.  Add in some vinegar (also in Tabasco) to drop the pH and you have a decent antiseptic.  Sure would sting like a bitch though.  I'd still go with antibiotics  :awesome_for_real:

lol, I totally made that shit up. Don't actually do it.
Or if you do it, post a video, I wanna watch.


Title: Re: Medical question. Cut my hand open.
Post by: schild on August 24, 2008, 11:28:08 AM
You're a bastard, CharlieMopps.


Title: Re: Medical question. Cut my hand open.
Post by: MuffinMan on August 24, 2008, 11:33:20 AM
Wtf I sliced a piece off of my index finger yesterday about an hour after you made this thread. It finally stopped bleeding this morning, I was getting a little worried. Bled like a motherfucker for the first half hour.


Title: Re: Medical question. Cut my hand open.
Post by: schild on August 24, 2008, 11:39:39 AM
My bad yo. This thread be some bad juju, jah.


Title: Re: Medical question. Cut my hand open.
Post by: MuffinMan on August 24, 2008, 11:43:49 AM
Mine happened while I was opening a popsicle. It was the tastiest goddamn popsicle I have ever had.


Title: Re: Medical question. Cut my hand open.
Post by: stu on August 24, 2008, 12:19:09 PM
Masterbating?

Lrn2spell.

If I need any more help with masturbation, you're the first person I'll ask. We should keep this thread about schild's gash.


Title: Re: Medical question. Cut my hand open.
Post by: Oban on August 24, 2008, 01:35:36 PM
Schild is a hermaphrodite now?


Title: Re: Medical question. Cut my hand open.
Post by: Salamok on August 24, 2008, 01:37:06 PM
Tetanus shot and the rest hinges on depth.  If you just hit the superficial tissue, I'd use butterfly bandages to connect regular edges, ice it down with immobilization and some triple antibiotic ointment.  If it's deeper, you'd be silly not to see an MD for assessment and stiches. 

exactly how at risk are you at getting tetanus from a relatively clean/stainless steel kitchen knife that is steralized with some amount a regularity in the dishwasher?


Title: Re: Medical question. Cut my hand open.
Post by: Nebu on August 24, 2008, 02:47:47 PM
Exactly?  I have no clue. 

I'm sure that you'd be fine not getting a shot 99% of the time in the case of a clean knife, but paying $5 at a free clinic for a shot seems like a no-brainer.  Besides, it's good for 7 years.  You never know when you'll step on a nail at the beach. 


Title: Re: Medical question. Cut my hand open.
Post by: Jimbo on August 24, 2008, 03:40:54 PM
And the rusty nail has killed a bunch of people (http://en.wikipedia.org/wiki/Tetanus).  Yeah chances are really low, but I would rather pay the $5 bucks and have a sore arm for a day than risk getting lockjaw.

Thanks for the reminder Nebu, I usually do a pretty detailed history on all the MRSA skin infections, I'm gonna keep that in mind on people that don't wash a cut then close it off.

Oh on the bleeding like a stuck pig, head, hands, and feet bleed and hurt like crazy.  Usually direct pressure for a long time, elevation, and ice (20 mins on, 2 hours off) will do the trick.  I've had a lot of patients come in with finger or toe lac's that "won't stop bleeding".  I usually wrap it up and tell them what to do in the waiting room and go back to triage.  They are amazed when we take off the bandage and it isn't bleeding. 


Title: Re: Medical question. Cut my hand open.
Post by: Nebu on August 24, 2008, 04:23:19 PM
Oh on the bleeding like a stuck pig, head, hands, and feet bleed and hurt like crazy. 

Can you say "scalp laceration"?

Talk about a bleeder... anyone that goes face first into a windshield will be a fan of seatbelts for life afterwards. 



Title: Re: Medical question. Cut my hand open.
Post by: Arnold on August 25, 2008, 04:36:56 AM
Oh on the bleeding like a stuck pig, head, hands, and feet bleed and hurt like crazy. 

Can you say "scalp laceration"?

Talk about a bleeder... anyone that goes face first into a windshield will be a fan of seatbelts for life afterwards. 



Man, I just got a head wound from an awkward cabinet corner that was above my dish drainer that I was strying to fish out something from the back of.\

I had to put direct presseure on my head with a towel for 45 minutes before it stopped.  Then I combed my hair right before I was going to go out that night, and guess what??? Yeah, blood going down my forehead.  Fortunately, it didn't take as long to stuanch the second time, but still a pain.


Title: Re: Medical question. Cut my hand open.
Post by: Oz on August 25, 2008, 08:23:49 AM
when i worked in the ER head wounds were the best.  People would come in and be FREAKING out b/c of all the blood. then they'd get pissed at the triage nurse for not seeming as rushed and hurried as them after she took a look at it.  They are deceptive in how much they bleed in relation to how bad the wound is. 

As for Schild, just keep it clean.  but make sure you don't bind it too tightly.  a friend of mine cut her finger with a scalpel and put the bandaid on so tight that her finger turned blue/green the next day...gotta let blood flow like it should.  BTW she was fine by simply taking the bandaid off for a couple hours and recleaning it.


Title: Re: Medical question. Cut my hand open.
Post by: Oban on August 25, 2008, 08:30:57 AM
Yeah... if your skin turns black/blue or if it smells bad, go to a hospital. 

Odd question, but why do you not have health insurance?  I mean, that is like 70-200 dollars a month that would seem to be critically important to have.


Title: Re: Medical question. Cut my hand open.
Post by: Cyrrex on August 25, 2008, 09:04:10 AM
At a guess, I'm thinking he values his 70-200 worth of groceries over the rarely used medical insurance.


Title: Re: Medical question. Cut my hand open.
Post by: schild on August 25, 2008, 09:21:33 AM
Show me a relatively useful $70 health insurance and I'll get it.


Title: Re: Medical question. Cut my hand open.
Post by: Nebu on August 25, 2008, 09:21:53 AM
At a guess, I'm thinking he values his 70-200 worth of groceries over the rarely used medical insurance.

This is the point where I resist turning this into a Politics thread.


Title: Re: Medical question. Cut my hand open.
Post by: Cyrrex on August 25, 2008, 09:25:34 AM
 :awesome_for_real:

Behind the snarkiness of my response was the thought that Mr. Schild is of very recent employment, and probably has had more basic survival needs.


Title: Re: Medical question. Cut my hand open.
Post by: Hutch on August 25, 2008, 10:05:15 AM
1) Do not, under any circumstances, allow yourself to be taken into the care of any medical professional. Continue to seek advice from free sources like the internet. We'll see you through this, don't you worry.

2) Start working on your story. You cut your hand on a kitchen knife? That's not going to get you laid. You're going to need to work an antagonist and a road trip into it somewhere.

3) Start looking into accessories. Like a hook. Or a really creepy rubber hand. I'd even tell you to go for the full Bruce Campbell, but if you could afford that, this thread wouldn't exist, eh.



Title: Re: Medical question. Cut my hand open.
Post by: schild on August 25, 2008, 10:06:34 AM
The wound just looks like a scratch now. I think I'll be OK. I've gone with much worse than this without something, I'd just never been cut with a kitchen knife, so I asked a question. Yea yea, I know, sarcasm etc, but you know, I've more important things to worry about. Like the asshole inlaws thread.


Title: Re: Medical question. Cut my hand open.
Post by: Hutch on August 25, 2008, 10:17:13 AM
Seriously, I'm glad it got better. You should still make a up a story though.



Title: Re: Medical question. Cut my hand open.
Post by: schild on August 25, 2008, 10:18:54 AM
Seriously, I'm glad it got better. You should still make a up a story though.

Every wound I've ever gotten is from 'nam.


Title: Re: Medical question. Cut my hand open.
Post by: Lantyssa on August 25, 2008, 10:43:39 AM
None from Korea or Iraq?  It's more impressive if you're a veteran of serveral foreign police actions.


Title: Re: Medical question. Cut my hand open.
Post by: NiX on August 25, 2008, 10:47:29 AM
Show me a relatively useful $70 health insurance and I'll get it.
You wanna get married? You can use my free, glorious health care.

Does your wound smell a bit like almonds?


Title: Re: Medical question. Cut my hand open.
Post by: Cyrrex on August 25, 2008, 10:48:20 AM
If you're making up stories, might as well make up the conflict as well.  Say it was from that covert action down in Trinidad & Tobago.  And then they'll be like "what?!" and you'll be all like "fucking right, bitches!" and they'll be all like "woah!".


Title: Re: Medical question. Cut my hand open.
Post by: schild on August 25, 2008, 10:51:13 AM
Show me a relatively useful $70 health insurance and I'll get it.
You wanna get married? You can use my free, glorious health care.

Does your wound smell a bit like almonds?
http://www.videosift.com/video/The-wound-smells-like-almonds-Mustafa


Title: Re: Medical question. Cut my hand open.
Post by: NiX on August 25, 2008, 10:57:56 AM
 :grin:


Title: Re: Medical question. Cut my hand open.
Post by: rattran on August 25, 2008, 11:54:11 AM
Save the money from insurance, and just buy a couple medical books. I mean, it's not like medicine changes much.

I did recently upgrade my 1886 Gould and Pyle's 'Cyclopaedia of Medicine to a 2007 Harrisons though. The new treatments are much less fun.



Title: Re: Medical question. Cut my hand open.
Post by: CharlieMopps on August 25, 2008, 01:14:35 PM
Show me a relatively useful $70 health insurance and I'll get it.

You could get a lifetimes supply of Tabasco and Salt for $70.


Title: Re: Medical question. Cut my hand open.
Post by: Yegolev on August 25, 2008, 01:19:20 PM
That said, is there anything in particular I should do to deal with it.

Masturbate with the other hand.


Title: Re: Medical question. Cut my hand open.
Post by: schild on August 25, 2008, 01:24:07 PM
That said, is there anything in particular I should do to deal with it.
Masturbate with the other hand.
I love you (no homo), man.


Title: Re: Medical question. Cut my hand open.
Post by: Sky on August 25, 2008, 01:36:42 PM
Two pages and no 'just rub some dirt in it you pussy' advice?

Buncha pinko bastards around here.

If I don't see bone, I'll dump in some alcohol, fish out any debris, flush with more alcohol and maybe superglue it if it's huge. If it's in a spot that wears, I'll put on a glow in the dark spongebob bandage. Actually, I did see some bone on my thumb a few months ago and still used this technique. Forgot to put on my demo gloves. Woops.


Title: Re: Medical question. Cut my hand open.
Post by: Yegolev on August 25, 2008, 01:38:56 PM
How can one library contain such manliness?


Title: Re: Medical question. Cut my hand open.
Post by: Nebu on August 25, 2008, 02:00:25 PM
Save the money from insurance, and just buy a couple medical books. I mean, it's not like medicine changes much.

I did recently upgrade my 1886 Gould and Pyle's 'Cyclopaedia of Medicine to a 2007 Harrisons though. The new treatments are much less fun.

Medical knowledge doubles every 5-7 years.  Textbooks are released about a year or two after they are submitted.  Most texts that I've reviewed contain MANY errors (the last review I did had a 31 page report of errors). 

Summary: A book is no substitute for a seasoned practitioner.  (You know this already).


Title: Re: Medical question. Cut my hand open.
Post by: DraconianOne on August 25, 2008, 02:55:45 PM
All you need is some gauze, some safetypins and some antiseptic cleanser. Then you can sort it out yourself:
http://farm1.static.flickr.com/1/2223394_6abdf479fe_o.jpg

edit by schild: don't inline that shit


Title: Re: Medical question. Cut my hand open.
Post by: slog on August 25, 2008, 03:05:50 PM
I think "rub some dirt on it" has to be at least close to the worst advice ever.  Except what that dude said about the Hot sauce of course.


Title: Re: Medical question. Cut my hand open.
Post by: MahrinSkel on August 25, 2008, 03:07:15 PM
That being said, the treatment for minor injuries is pretty simple and doesn't change much: Keep it from getting worse, wait for it to get better.  When you have worked in construction without insurance, anything that won't qualify for a Workman's Comp case is a do-it-yourself kind of thing, and you learn about the remarkable medical properties of duct tape.  I've got scars all over my hands from minor injuries I had to treat myself because a trip to the doctor would have wiped out a day's pay, and the emergency room a week.

--Dave


Title: Re: Medical question. Cut my hand open.
Post by: DraconianOne on August 25, 2008, 03:21:34 PM
As long as it is a minor injury.

Be sure, before you treat it yourself with steri-strips, superglue, duct tape etc that your cut, if it's in the palm of your hand, is shallow and is minor. Infection is one thing but if you've cut deep enough, there are other things you need to be careful about and only a specialist will really be able to help.  Pro-tip - touch the ends of your fingers with a pen or needle: make sure you can still feel it.


Title: Re: Medical question. Cut my hand open.
Post by: schild on August 25, 2008, 03:23:25 PM
As long as it is a minor injury.

Be sure, before you treat it yourself with steri-strips, superglue, duct tape etc that your cut, if it's in the palm of your hand, is shallow and is minor. Infection is one thing but if you've cut deep enough, there are other things you need to be careful about and only a specialist will really be able to help.  Pro-tip - touch the ends of your fingers with a pen or needle: make sure you can still feel it.

I can feel the mouse surface under every finger. Like I said, not too important.


Title: Re: Medical question. Cut my hand open.
Post by: DraconianOne on August 25, 2008, 03:32:54 PM
Well, yeah, that'll do. There's a lot you can get away with.  That "shit" you didn't like me inlining? That was my finger. Four operations and one fused joint later and I can't flex it at all at the first finger joint. I can hardly feel a thing at the end of it.

But the way it's set means that the finger fits a pint glass perfectly.


Title: Re: Medical question. Cut my hand open.
Post by: schild on August 25, 2008, 03:39:57 PM
My pinky toe joint is fused. Both feet.  Residual effect of years and years in cleats and hard practice.

How did you get injured?


Title: Re: Medical question. Cut my hand open.
Post by: DraconianOne on August 25, 2008, 03:56:13 PM
Playing rugby. Someone grabbed my finger and pulled it back, trying to get my hand off the ball but I wasn't letting go for any bastard. It absolutely shattered the joint. I carried on playing for five mnutes before deciding it might need strapping up.

What are cleats?


Title: Re: Medical question. Cut my hand open.
Post by: Hutch on August 25, 2008, 04:58:15 PM
Cleats. Shoes with teeth on the soles. Designed to increase traction while playing sports. Used in baseball, football, and soccer, to name a few.


Title: Re: Medical question. Cut my hand open.
Post by: Tale on August 25, 2008, 05:09:38 PM
You do need a public health system. Watching a discussion about gluing your wounds back together to avoid paying is like watching people discuss eating grass to avoid starvation. Works for cattle and Zimbabweans.


Title: Re: Medical question. Cut my hand open.
Post by: CharlieMopps on August 25, 2008, 06:28:42 PM
Save the money from insurance, and just buy a couple medical books. I mean, it's not like medicine changes much.

I did recently upgrade my 1886 Gould and Pyle's 'Cyclopaedia of Medicine to a 2007 Harrisons though. The new treatments are much less fun.

Medical knowledge doubles every 5-7 years.  Textbooks are released about a year or two after they are submitted.  Most texts that I've reviewed contain MANY errors (the last review I did had a 31 page report of errors). 

Summary: A book is no substitute for a seasoned practitioner.  (You know this already).

I disagree. Having had a major illness in the recent past, I am of the opinion that the vast majority of doctors are idiots that graduated by memorizing the books you are referring to and have no actual real ability at all. You are far better off doing research via the internet and forums, going into a clinic and demanding the appropriate tests. I ended up having to print out abstracts and guidelines from the American Association of Clinical Endocrinologists before they'd even run a blood test on me. 3 weeks later I was getting radiation therapy. Screw doctors... they suck. (although I'm sure they're are a few... very few... exceptions)


Title: Re: Medical question. Cut my hand open.
Post by: Nebu on August 25, 2008, 07:02:34 PM
I disagree. Having had a major illness in the recent past, I am of the opinion that the vast majority of doctors are idiots that graduated by memorizing the books you are referring to and have no actual real ability at all. You are far better off doing research via the internet and forums, going into a clinic and demanding the appropriate tests. I ended up having to print out abstracts and guidelines from the American Association of Clinical Endocrinologists before they'd even run a blood test on me. 3 weeks later I was getting radiation therapy. Screw doctors... they suck. (although I'm sure they're are a few... very few... exceptions)

I'm sure the same could be said for your line of work.  There's one thing that can't be replaced; experience.  The books don't teach you the art of medicine, only the mechanics of it.  Yes, there is a wide range of abilities in medicine.  This is why you, as the consumer, must choose your physician as carefully as you'd choose any other service professional.  Just because you've had bad experiences doesn't necessitate that they're all bad.  Your location could have some impact on your healthcare quality as well. 

I see people try to self-diagnose all the time.  Just like driving, they all think that they're good at it.  Catching the typical isn't hard... it's catching the atypical that takes skill.  I'm guessing this is what your chief complaint is based around.  Please also consider the way that healthcare is managed in this country.  The average GP sees 30-40 patients a day.  There is NO WAY IN HELL anyone is going to od a good job of diagnosing anything given 8 mins with a patient.   I'd argue that for this reason alone that most MDs are pretty fucking amazing that they're still right as often as they are given the system they're forced to work within.


Title: Re: Medical question. Cut my hand open.
Post by: Nerf on August 25, 2008, 11:23:13 PM
So what you're saying is that Schild has lupus?


Title: Re: Medical question. Cut my hand open.
Post by: Azaroth on August 25, 2008, 11:48:03 PM
Save the money from insurance, and just buy a couple medical books. I mean, it's not like medicine changes much.

I did recently upgrade my 1886 Gould and Pyle's 'Cyclopaedia of Medicine to a 2007 Harrisons though. The new treatments are much less fun.

Medical knowledge doubles every 5-7 years.  Textbooks are released about a year or two after they are submitted.  Most texts that I've reviewed contain MANY errors (the last review I did had a 31 page report of errors). 

Summary: A book is no substitute for a seasoned practitioner.  (You know this already).

I disagree. Having had a major illness in the recent past, I am of the opinion that the vast majority of doctors are idiots that graduated by memorizing the books you are referring to and have no actual real ability at all. You are far better off doing research via the internet and forums, going into a clinic and demanding the appropriate tests. I ended up having to print out abstracts and guidelines from the American Association of Clinical Endocrinologists before they'd even run a blood test on me. 3 weeks later I was getting radiation therapy. Screw doctors... they suck. (although I'm sure they're are a few... very few... exceptions)

I'm still trying to find a healthy equilibrium between researching everything myself and trusting a professional.

So far, the only harm in researching I've found is that it contributes to my own paranoia. More often than not, I end up with a positive discovery that most likely would not have been suggested.

As Nebu says though, experience is key here. Doctors are just regular people who, in general practice, probably have done less reading on a condition or treatment than you have (if you're anywhere near as neurotic as I am) and have something potentially wrong with you. They're also far less concerned about you than you are. But they also have a serious base of experience that you can't dismiss.

The key also lies in finding the good doctors. There's a difference between a doctor who went to school twenty years ago and now spends his nights and weekends riding horses and boating with his fat wife after a week of prescribing pills, and a doctor who continues to study, research, read, absorb information, attend various seminars, etc., and make his field of study an integral part of his/her life. Big, big difference.



Title: Re: Medical question. Cut my hand open.
Post by: MahrinSkel on August 26, 2008, 01:39:48 AM
Also a big difference between doctors who like their patients to be well informed, so they don't have to explain as much or fish for as much info, and those that want patients to keep their mouths shut unless he asks them a question.  It's his job, and he's had specialized training, that's why he's getting paid.  But it's my health.  He gets to bury his mistakes, I have to live with them, so he can damned well let me in on the process or I'll find a different doctor.

That being said, I'm not unreasonable, if he says "it could be what you're saying, but it could be this other thing as well.  Go get this test done and schedule a followup," I get the test and schedule the followup.  A lot of it is a generational thing, doctors that began their practice after the Internet have learned to work with a more informed and involved patient.  Older ones don't like having their opinions questioned by a layman.

My doctor trusts me not to come to him with bullshit I read off the internet without checking it out carefully.  I trust him to listen to what I say and then apply his expertise.

--Dave


Title: Re: Medical question. Cut my hand open.
Post by: Nebu on August 26, 2008, 08:23:19 AM
Don't get me wrong though... he was right about the fact that there are some terrible docs out there. 

I encourage patients to question EVERYTHING.  If I had any advice, it's to feed your doctor data rather than suggestions.  Too many patients try to tell the doc what's wrong with them rather than describing symptoms (in detail) and letting the doc come to their own conclusion.  You're paying for their advice and expertise, not for them to agree with you.


Title: Re: Medical question. Cut my hand open.
Post by: Yegolev on August 26, 2008, 08:27:50 AM
You do need a public health system. Watching a discussion about gluing your wounds back together to avoid paying is like watching people discuss eating grass to avoid starvation. Works for cattle and Zimbabweans.

I don't want my taxes to go up so schild can take his minor, pussy-ass wound to the ER and consume cycles better spent on gunshot victims or people with _____ stuck in their anuses.  If you can't handle a cut like that on your own, you fail as a human.  Last I checked, schild doesn't fail as a human so I expect him to put some peroxide on it and get back to his keyboard.  The discussion about avoiding paying could just as easily be due to someone not being able to leave work to get treatment, and therefore still be due to economics.

What would go a long way toward fixing the medical issues in my country is a curtailment of the pharmaceutical industry's moneymaking machine.  I'm even thinking a separate patent mechanism for drugs should be implemented, however since there is a huge amount of money invested into the field this is unlikely to happen without some serious public outcry.  I'd have little problem paying taxes to fund public drug research, for example, since I'm pretty much paying a big tax in the form of the patent on escitalopram.  I like NASA a lot but I'd love a pharmaceutical version of that even more.


Title: Re: Medical question. Cut my hand open.
Post by: Nebu on August 26, 2008, 08:43:06 AM
I don't want my taxes to go up so schild can take his minor, pussy-ass wound to the ER and consume cycles better spent on gunshot victims or people with _____ stuck in their anuses.

Guess what... your taxes are being used so that people can take an ambulance to the ER for a Tylenol.  The healthcare system in this country is broken. 


Title: Re: Medical question. Cut my hand open.
Post by: Baldrake on August 26, 2008, 09:03:27 AM
My taxes yadda...
You know, you come here to forums like this one, and pretty much assume that the Americans who make up the majority see things much just like the rest of us. And then you get comments like this, from an otherwise completely reasonable guy, and think WOAH WOAH WOAH, there are people who actually think like that???

I'm truly not trying to kick off a political firestorm, and certainly not trying to say that every American agrees with Yegolev. Just sitting with my mouth hanging open, observing that basic tenets of what is a reasonable argument can be so different from place to place.


Title: Re: Medical question. Cut my hand open.
Post by: Yegolev on August 26, 2008, 09:08:30 AM
I don't want my taxes to go up so schild can take his minor, pussy-ass wound to the ER and consume cycles better spent on gunshot victims or people with _____ stuck in their anuses.

Guess what... your taxes are being used so that people can take an ambulance to the ER for a Tylenol.  The healthcare system in this country is broken. 

Very much so.  I know this happens.  I come from a poor family.  It would just make me more sad if schild was one of those people calling 911 for Tylenol.

As for my economic views, sorry for making a political comment outside the Thunderdome.  I'd invite everyone to read the entire post, just in case.  If it escalates, I'll move it.


Title: Re: Medical question. Cut my hand open.
Post by: Sky on August 26, 2008, 09:11:02 AM
When my mother was in the ER to get checked out with level 9 pain (ended up being sciatica...maybe...), she was in line behind all those people with a cough or fucking stubbed toe, and they refused to bump her up. She sat for four hours before getting her first pain meds, they wouldn't even give her a fucking glass of water. The doctor on call went on lunch before bringing back her diagnosis. They gave her the only room without a bed. I was blisteringly angry and lucky it didn't turn into a crime scene.

The first pain med they offered was a tylenol. For a level 9 fucking pain.

I very much agree with Yeg, not all americans agree with baldrake  :awesome_for_real: I don't think that's the first time that's been observed, though as Yeg mentions, it is usually observed in Thunderdome. We don't need another hero.

Anyway, doctors want to medicate problems, surgeons want to operate on problems, psychiatrists want to talk about problems. If you've got a hammer, every problem is solved with a nail. Knowing how to perform first aid on yourself is a good step in helping reduce the strain on the shitty health care industry we have.


Title: Re: Medical question. Cut my hand open.
Post by: Cyrrex on August 26, 2008, 09:18:26 AM
Am I the only one that doesn't know what Level 9 pain is?  Pain has levels?  Lazy kids.  Back in my day, we only had one kind of pain and, by God, we liked it!


Title: Re: Medical question. Cut my hand open.
Post by: taolurker on August 26, 2008, 09:25:17 AM
On a scale of 1-10 how painful is it? standard question when they admit you.

I totally hate doctors, and 90% of the time I've seen a doctor they barely examine me, and have even had some of them not even touch me.

In the case of a cut, I doubt the doctor would even do more than look at it, and then some Nurse would come in and clean and stitch it up at the most. Waste of $700 if it's the Emergency room in the US.


Title: Re: Medical question. Cut my hand open.
Post by: Salamok on August 26, 2008, 09:47:15 AM
Anyway, doctors want to medicate problems, surgeons want to operate on problems, psychiatrists want to talk about problems. If you've got a hammer, every problem is solved with a nail. Knowing how to perform first aid on yourself is a good step in helping reduce the strain on the shitty health care industry we have.

My last doc was an ex psychiatrist that went back to school to become an md.  She was awesome!  Of course she went out of business because she spent an hour with every patient.


Title: Re: Medical question. Cut my hand open.
Post by: Baldrake on August 26, 2008, 10:20:03 AM
I'm sorry your mother had to go through that, Sky. But the problem there isn't taxes or access to insurance or people overusing the ER. The problem is a triage nurse who didn't know his/her job.

(We do need more innovative alternatives to the ER for non-serious but urgent complaints, though. Like 24 hour walk-in clinics with nurse practitioners and an attending MD. As Tao pointed out, you don't need a doctor to sew up a simple cut on a hand.)


Title: Re: Medical question. Cut my hand open.
Post by: Yegolev on August 26, 2008, 10:28:33 AM
The problem is a triage nurse who didn't know his/her job.

I agree completely.  Faced with this issue, I can only recommend people learn first aid, but we've already covered that bit.  Changing that nurse from one that works for a private hospital to a government employee/subcontractor is unlikely to solve this particular issue; I submit that it would make it worse, and I can exhibit a Mr. Bean skit as proof.  I'm only griping about taxes because I'm a middle-class American.  It's what we do.  :oh_i_see:


Title: Re: Medical question. Cut my hand open.
Post by: Nebu on August 26, 2008, 11:17:19 AM
95% of patients in the ED don't need to be there.  Period.  It's a huge problem in American healthcare and one unlikely to go away anytime soon.  We need to develop urgent care clinics that can take care of these people in a normal clinical (rather than hospital) setting.  While many of these are currently coming into existence, they are mostly private entities and are still open only a limited number of hours. 



Title: Re: Medical question. Cut my hand open.
Post by: Sky on August 26, 2008, 11:27:16 AM
We have two urgent care facilities, good for crap like notes to get out of work when you have the flu and whatnot. Except that they recently changed their rules and won't see you unless you designate them your primary care physician  :uhrr:


Title: Re: Medical question. Cut my hand open.
Post by: Yegolev on August 26, 2008, 12:01:00 PM
Except that they recently changed their rules and won't see you unless you designate them your primary care physician  :uhrr:

Derrr, whut?  So it's a general practitioner office now, make an appointment, wait in the lobby shit?  Or is it just to appease the All Powerful Insurance Institution?


Title: Re: Medical question. Cut my hand open.
Post by: Nebu on August 26, 2008, 12:04:22 PM
Here's a scary thought: If your ER isn't a trauma unit, it may be served by GP's.  There are many ER's in smaller areas that have contract GP's manning the helm.  Yet another wonderful part of our healthcare system. 


Title: Re: Medical question. Cut my hand open.
Post by: Azaroth on August 26, 2008, 12:12:50 PM
Here's a scary thought: If your ER isn't a trauma unit, it may be served by GP's.  There are many ER's in smaller areas that have contract GP's manning the helm.  Yet another wonderful part of our healthcare system. 

This would be the case in the town I grew up in.

Some pretty scary shit went on because of it.


Title: Re: Medical question. Cut my hand open.
Post by: Nebu on August 26, 2008, 12:16:17 PM
I won't even mention how many anesthesiologists are out there practicing without board certification.  Oops, too late.


Title: Re: Medical question. Cut my hand open.
Post by: schild on August 26, 2008, 12:20:22 PM
When I got my hernia surgery, my anesthesiologist was a shorter version of Kevin Nealand. He was fucking hilarious. There is no way he was a doctor.


Title: Re: Medical question. Cut my hand open.
Post by: rattran on August 26, 2008, 12:49:50 PM
I happen to know a couple decent doctors now, but for the most part except for traumatic injury (like when I destroyed my ankle a couple years ago) I tend to try to self-diagnose. Then make the decision if I'm going to see a doctor.

Too many problems years ago with bad docs. Like the guy who totally fucked up my then girlfriends diagnosis, when it was pretty clearly a case of mumps. After 4 weeks seeing this guy and finally suggesting it looked like mumps, and having him freak the fuck out at me, we went to another doc. Who looked at her, asked if she was born around '79, mentioned there were a few bad batches of vaccine at that time and treated her mumps.


Title: Re: Medical question. Cut my hand open.
Post by: Yegolev on August 26, 2008, 12:59:31 PM
Diseases don't have cool names like "measels" and "mumps" anymore.  I was once able to imagine I was sick in a Winne the Pooh book.  Not so with "bird flu".


Title: Re: Medical question. Cut my hand open.
Post by: Nebu on August 26, 2008, 01:20:40 PM
Diseases don't have cool names like "measels" and "mumps" anymore.  I was once able to imagine I was sick in a Winne the Pooh book.  Not so with "bird flu".

I don't know... necrotizing fasciitis has a nice ring to it.  Straight out of a Grimm's fairy tale.


Title: Re: Medical question. Cut my hand open.
Post by: Oz on August 26, 2008, 01:33:18 PM
Quote
The problem is a triage nurse who didn't know his/her job.

What happened to Sky's mom does truely suck.  However, i doubt it was the triage nurse in the wrong.  3 things to consider with pain:

1. a vast majority of people that go to the ER for pain are actually looking for a fix...this means that triage nurse has to take that into account.  most of the time when you make the addict wait they eventually leave.  I've personally seen this many, many times in the ER.  Sadly this really, really, really, really sucks for people actually in pain (like Sky's mom) b/c they are forced to wait "just in case" they're just looking for a fix.

2.generally, you don't die from pain.  thus, you can wait.

3.pain doesn't spread (ala scary virus/bacteria #23425)



Title: Re: Medical question. Cut my hand open.
Post by: Nebu on August 26, 2008, 01:37:59 PM
ER's are for people that will die soon if they don't get treatment/stabilization.  If what you have won't kill you today, you don't NEED to be in the ER. 


Title: Re: Medical question. Cut my hand open.
Post by: Oz on August 26, 2008, 01:40:26 PM
i totally agree, but i'll be honest.

if i had lvl 8-10 pain like Sky's mom or my dad (kidney stone) then you better believe my ass would skip the urgent care center and head straight for the ER. 


Title: Re: Medical question. Cut my hand open.
Post by: Oban on August 26, 2008, 02:00:18 PM
...and this is why God invented drug dealers.


Title: Re: Medical question. Cut my hand open.
Post by: Nebu on August 26, 2008, 02:06:54 PM
if i had lvl 8-10 pain like Sky's mom or my dad (kidney stone) then you better believe my ass would skip the urgent care center and head straight for the ER. 

This is why narc seekers flood ER's to get a fix.  We need a better mechanic for treating pain than trusting an ER physician (a doc that specializes in patient stabilization, not pain management) to make the call.  Currently anesthesiologists and neurologists are the pain experts. 


Title: Re: Medical question. Cut my hand open.
Post by: Ookii on August 26, 2008, 02:13:39 PM
Don't you just jump the line if you're in an Ambulance?

Edit: I'd also like to note that I'd only every been in a Hospital once before Schild started making a habit of going every six months  :awesome_for_real:


Title: Re: Medical question. Cut my hand open.
Post by: Nebu on August 26, 2008, 02:16:09 PM
Don't you just jump the line if you're in an Ambulance?

Not necessarily.  You get to a bed faster, but may not be treated any faster.  Triage is triage. 


Title: Re: Medical question. Cut my hand open.
Post by: Oz on August 26, 2008, 03:44:54 PM
Quote
Currently anesthesiologists and neurologists are the pain experts.

True, but i doubt you'll see those types of experts in the ER.  Hell, its a rare miracle if you find an ER that has a pediatrician on staff.


Title: Re: Medical question. Cut my hand open.
Post by: CharlieMopps on August 26, 2008, 04:23:17 PM
ER's are for people that will die soon if they don't get treatment/stabilization.  If what you have won't kill you today, you don't NEED to be in the ER. 

Wrong... ER's are for scaring the piss out of your HMO so they fucking listen to you for a change. "Holly shit, we have to pay $1000?!!? He didn't even go to our ER? Crap!"

I wasn't "Allowed" to see a specialist until I went to the ER. 4 months of practically being bedridden and they were too booked up to see me. The DAY AFTER I was in the ER they suddenly had an opening.

I reiterate my hatred for Doctors, their profession and the entire health care industry. The parking lots filled with BMW S-Classes but the skyrocketing cost of healthcare isn't their fault... yea right. Money grubbing bastards that don't even work a 4 day week. If you're out playing golf while I'm sick as hell, laying in bed and there's no opening for me to see you for the next 3 months... you suck




Title: Re: Medical question. Cut my hand open.
Post by: Nebu on August 26, 2008, 04:32:44 PM
I reiterate my hatred for Doctors, their profession and the entire health care industry. The parking lots filled with BMW S-Classes but the skyrocketing cost of healthcare isn't their fault... yea right. Money grubbing bastards that don't even work a 4 day week. If you're out playing golf while I'm sick as hell, laying in bed and there's no opening for me to see you for the next 3 months... you suck

Words... they escape me. 


Title: Re: Medical question. Cut my hand open.
Post by: Yegolev on August 26, 2008, 04:34:40 PM
Charlie, just from your post I can point out that your HMO was your problem, yes?  Insurance companies.  Doctors hate them, too.


Title: Re: Medical question. Cut my hand open.
Post by: CharlieMopps on August 26, 2008, 05:25:47 PM
Charlie, just from your post I can point out that your HMO was your problem, yes?  Insurance companies.  Doctors hate them, too.

Actually, I switched HMO's in the middle of this whole thing because my first HMO sucked so bad. The 2nd HMO was just as bad, I had to file a grievance with their patient relations board in order to get an appointment with a specialist. In my area, the 2 HMOs I've been through are considered the best.

I can understand that Doctors are crippled by their employer... but at the same time, if I'm sick, give me my damned blood test. It's immoral not to. I don't care what your boss says.

Of course, I'm an asshole... so maybe I'm biased.


Title: Re: Medical question. Cut my hand open.
Post by: CharlieMopps on August 26, 2008, 05:34:50 PM
If it makes you feel any better, I don't like dentists either.  :awesome_for_real:


Title: Re: Medical question. Cut my hand open.
Post by: Nerf on August 26, 2008, 05:36:35 PM
I think the lesson here is that junkies really need to put in more effort so it doesn't seem like they're wasting everyones time going to the ER for a fix.

We need PSA's on how you *always* get lots of pain meds for gunshot wounds, you know a few of them are going to hit an artery and sooner or later the problem fixes itself.


Title: Re: Medical question. Cut my hand open.
Post by: CharlieMopps on August 26, 2008, 05:41:21 PM
lol, that's funny. When I was in the ER for my non-emergency, they had a security guard in there... first time I've seen that. He escorted out at least 2 people I saw, that I would have figured were junkies.


Title: Re: Medical question. Cut my hand open.
Post by: Tale on August 26, 2008, 06:18:18 PM
Here's a scary thought: If your ER isn't a trauma unit, it may be served by GP's.  There are many ER's in smaller areas that have contract GP's manning the helm.  Yet another wonderful part of our healthcare system. 

Don't knock the GP. General Practice is a medical specialisation, not a lack of one. It is the specialisation of being the first line of treatment for everything the public throws at you, from hypochondria to infected wounds, so you have to know something about everything, constantly keep up with all the latest research, and be good at figuring out exactly what is wrong in every situation. Many GPs also have a specialisation on the side.

Years ago, I worked for a weekly GPs' newspaper for 18 months. They used to write in, sharing their stories of difficult cases. Many can think outside the square due to all the weird situations general practice has put them in, figuring out problems specialists miss. Also, a good GP in a hospital will be paying attention, flexing medical muscles they possess but rarely get to use.

That said, a lack of ER doctors sucks.


Title: Re: Medical question. Cut my hand open.
Post by: Nebu on August 26, 2008, 07:23:36 PM
Don't knock the GP.

Fair enough.  I have nothing but respect for GP's. 


Title: Re: Medical question. Cut my hand open.
Post by: Sky on August 27, 2008, 10:23:29 AM
Well, I would've taken her to the urgent care. But I can't. Insurance thing, as someone suspected. Not her primary care. Dumb, but hey, it's the medical industry. Tell me again how socialized medicine makes people wait and get shitty care, republicans. Because that's my experience with privatized medicine, only we pay out the fucking ass for it.

Yeah, maybe the triage nurse was right. With my mother literally writhing in agony, white knuckled and grimacing for hours in a wheelchair. She's a fucking awesome actress, apparently. I really wish she'd sue in this case.

Forgot to mention that after a couple hours in the ER, we got sent to 'fast track', which is the hospital's old ER area with a junior GP staffing it (the guy who left the patients sitting around while he took an hour lunch). How I enjoyed hearing the nurses at the desk bitch about work while my mother writhed in pain next to me.


Title: Re: Medical question. Cut my hand open.
Post by: Jimbo on August 27, 2008, 10:35:48 AM
Anyone from Great Brittian able to check something for me?  Article (http://www.slate.com/id/2195851/) on wait times and ED boarding of patients and why it is common, states that GB has said that your wait time is 4 hours or less if you are admitted.  I applaud them if that is true, it might be as GB is hiring nurses like mad.

Yesterday I worked 12 hours, I had one lady who overdosed on elavil that was a true life threating emergency, one respitory patient with COPD and a buttload of problems, a SWAT Team memeber who fast roped in too fast and looked like he blew his ankle to hell (I was like damn you are lucky when I was helping them unload him, fast rope injuries can be nasty), a elderly lady who passed out at her cardiologist office.  Then I had three patients who have been to the ER so much I know them by name and where they live at and what they will request as soon as they get here.  It has gotten bad enough on misuse that we now have a case manager assigned to the ED to help with our load, she is a god send, as she can actually get the social help some patients need.  Too many things that people have had for days and weeks and now just come to the ER because we will see them when the family doctor won't.

Sky I feel sorry for you mom, sciatica sucks from what I've read and seen in patients.  But pain doesn't mean I'm going to move you up in line, unless I can tie it into something else that will raise my suscpicion of index, i.e. your telling me your headache is 8-10 and so is the other person, you tell me yours came on suddenly and it was when you were having sex and it is the worst headache of your life & the other person tells me theres came on like it normally does over time due to stress, wine, and kids, they have had these before, and they have less stress demanor than the sudden headache, well the one with the sudden headache will go before the other person's headache.  Both headache's might be nothing, but I need to evaluate him before the other in ruling out an brain bleed vs headache.  Another thing is Chest pain, yes they all get EKG's since we are a CP center, but if I do an EKG in triage and find you in normal heart beats and you have more signs of anxiety than CP, I can place you in a diffrent care than the go do the cardiac work up tango, same with short of breath.

Pain scale and treatments, well a 9 out of 10 is pretty significant, and everyone handles pain diffrently, but I would still offer her tylenol as 1st drug of choice if she hasn't tried that at home.  Next would be NSAIDS (usually a diffrent type than motrin since most like to take it before coming to the ED too), then move onto the narcotic painkillers as needed.  If she was having spasms then a muscle relaxer is often given with the pain meds.  Steroids can be helpful on the acute attacks of sciatica, but there is some debate going on its effectiveness now (Nebu you hear anything on it?).  I hope she has recovered from it and has had follow-up with a family doc or neurologist if she still has problems.

Emergency Medicine has been getting shafted, i.e. would you ever go to a surgery center and have your surgery done by a GP?  But at the same time a hospital will have an Emergency Department and staff it with doc's who aren't board certified emergency medice physcicians, nor have they done any residency in emergency medicine, but since there aren't a lot of doctors it sucks for what you get sometims (especially where you are at).  If you're male, pretty health, and have an accident near a trauma center in a big city you have a pretty good chances.  If you have it out in the sticks you're in for a rough ride sometimes.


Title: Re: Medical question. Cut my hand open.
Post by: CharlieMopps on August 27, 2008, 01:03:09 PM
Ever think those hypochondriacs might not be hypochondriacs? What do they think they have? Run a blood test, prove them wrong. Put their minds at ease.

A hypochondriac is a person having anxiety regarding a medical condition... the best way to treat them is prove they don't have that medical condition.

In my case, the doctors (many doctors) thought I was a hypochondriac. They were wrong. If I hadn't demanded testing, I would still be undiagnosed and suffering.


Title: Re: Medical question. Cut my hand open.
Post by: MahrinSkel on August 27, 2008, 01:09:28 PM
Almost by definition, proving a hypochondriac is wrong about their complaint is a waste of time.  They either won't believe you, or they'll come up with another rare diagnosis to get hyperventilated about.

As I understand it, most non-Trauma Center ER docs are actually doing ER rotations because their hospital privileges depend on it.  Sometimes this can be good for the patient (if the doc is a specialist for their problem, such as when I showed up at 13 with a broken thumb and my doc happened to be a specialist in hands, given where the break was he probably saved me from a permanently disfigured hand), sometimes not so much (coming in with trauma to the CNS and getting a dermatologist).

--Dave


Title: Re: Medical question. Cut my hand open.
Post by: Draegan on August 27, 2008, 03:38:47 PM
I sliced my hand open once, the skin between your fingers, I ducted taped my fingers together after cleaning it and went back to work.

Duct tape > everyone.


Title: Re: Medical question. Cut my hand open.
Post by: Azaroth on August 27, 2008, 04:39:11 PM
Any sort of hypochondriac bashing or dismissal of supposed hypochondriacs in any way by health care professionals is very dangerous business.

Besides, not believing a doctor can sometimes save your life.

My father's best friend was sent home with the flu. He returned a few days later and finally got some actual test done. A simple chest x-ray followed by a "holy Christ.." had him in an ambulance on the way to a better hospital. His lungs were full of blood clots.

He died in the ambulance.



Title: Re: Medical question. Cut my hand open.
Post by: Amarr HM on August 27, 2008, 07:04:24 PM
I used to work as a pushbike courier and one day while trying to avoid a instadeath collision with a taxi I swerved in the direction of some gridlocked cars, just as I did my front brake cable snapped. So I basically kareened into a rear indicator with my knuckles as speed buffers. The driver got out of his brand new Audi now minus a rear indicator and I tried explaining what happened but was mayhem, we pulled over into a less busy road section (outside Siptu buildings for any Irish people reading) and immediately my hand started pumping (think Michael Palin sketch in National Lampoons) anyway the driver got a bit of a fright seeing that and fecked off leaving me to my own devices.

So I wrapped up my knuckle and cycled home (about a km away) then of course being young stupid and Irish I decided I'd just bandage it up and meet some buddies in a local pub for a pint. Needless to say after a few swigs of Guinness I started feeling woosy and the blood wasn't stopping so I saw sense and went straight to the hospital. I waited seven hours to get my knuckles stitched up by some ham handed doctor injections were so sore and not working I just said stitch it Rambo style I wanna go home. When I got home my girlfiend at the time thought someone was murdered outside our flat as we lived in a fairly rough part of the city at the time.

For years after I was having pains in one of the knuckles I thought he must have stitched it up wrong, bloody useless doctor anyway. Years later I was digging holes down under in some pretty extreme heat and my hand was killing me something awful but I worked on til eventually I noticed something coming out of my knuckle, the tip of a shiny glass shard. I kept working and eventually to my surprise I had found that the doctor had left a 1 and half inch piece of glass in my knuckle, was there for three years.


Title: Re: Medical question. Cut my hand open.
Post by: lamaros on August 27, 2008, 09:17:19 PM
A hypochondriac is a person having anxiety regarding a medical condition...

Err..  :awesome_for_real:





Title: Re: Medical question. Cut my hand open.
Post by: Baldrake on August 29, 2008, 01:56:54 PM
So out of interest, what does it cost to pay for health insurance in the US? Assuming you want basic service that saves you from losing your house if you get a triple bypass?


Title: Re: Medical question. Cut my hand open.
Post by: Sky on August 29, 2008, 02:46:13 PM
My single coverage is $600/mo and not great. Employer picks up half of that, but I have a deductible and it never pays actual costs. Health care is so fucked up.

I'm guessing a lot of people with coverage will lose the house if they have a triple-bypass.


Title: Re: Medical question. Cut my hand open.
Post by: Oz on August 29, 2008, 03:02:43 PM
my family coverage is $132/mo for medical (with very little in terms of deductible), vision is $14/month, and dental is $11/month.


Title: Re: Medical question. Cut my hand open.
Post by: Reg on August 29, 2008, 03:36:34 PM
Do you and Sky live in the same country?


Title: Re: Medical question. Cut my hand open.
Post by: Yegolev on August 29, 2008, 05:25:39 PM
I pay $2600 annually for above-average health care, not the HMO type but the PPO version.  My company subsidizes this very much and is one of the reasons I like working here.


Title: Re: Medical question. Cut my hand open.
Post by: Baldrake on August 29, 2008, 07:51:15 PM
Yeah, I really meant, what does it cost if you're someone like Schild who has nobody to subsidize the bills.


Title: Re: Medical question. Cut my hand open.
Post by: Signe on August 29, 2008, 08:48:39 PM
We pay about the same as Yeg for our PPO coverage, which includes excellent dental.  We have vision, too, but I've noticed that I can usually get better prices using a coupon or a sale.  Righ's company pays for nearly all of it.  My sister, on the other hand, pay about $1500 a month for a much crappier HMO type thingy since her husband works for himself.  When we live in Britain, we just use the NHS, which is great with me.

Personally, I'd rather die than pay for anything.  I'm a cheap fuck when it comes to important shit like heath and staying alive.


Title: Re: Medical question. Cut my hand open.
Post by: Jimbo on August 29, 2008, 11:27:41 PM
I think he could get insurance for $75 a month, but it would have a $7500 deductable.  Sometimes you can find package deals from your insurance agent (get the house, car, life, and health all on the same plan), but not a great way to go, private insurance will be more than health insurance from work.

Hell when I got sick I ended up with about $1200 out of pocket bills that my HMO would only partial pay, and I was In-Network and work for the damn hospital.  Of course I was really sick with a GI Bleed and needed 5 units of blood when I came in...


Title: Re: Medical question. Cut my hand open.
Post by: sinij on August 30, 2008, 12:37:26 AM
I suggest you move somewhere with universal health care and no possibility of draft... like Canada or France.


Title: Re: Medical question. Cut my hand open.
Post by: Fordel on August 30, 2008, 12:58:57 AM
This thread is totally contradicting everything I learned about the US Health Care system on House.  :oh_i_see:


Title: Re: Medical question. Cut my hand open.
Post by: Baldrake on August 30, 2008, 07:28:12 PM
So $75/month gets you basically catastrophic coverage so you don't lose your house over the triple bypass, but everything else you pretty much have to pay yourself?


Title: Re: Medical question. Cut my hand open.
Post by: Merusk on August 30, 2008, 07:34:00 PM
No.  There's probably a limit to the dollar value of services rendered like all other fine medical insurance policies.  At the $75 level I'm willing to bet it caps out about 50-100k.


Title: Re: Medical question. Cut my hand open.
Post by: Lantyssa on August 30, 2008, 08:53:17 PM
I get coverage through the university.  Free since I'm on the plan by myself, but BCBS of Texas isn't the greatest PPO.  It's okay for things like my regular check-ups, but it caps out at around $5000, if they even cover it, so I've already been fucked by it and expect to again eventually.  If I had kids or a husband (haha) to cover, it would be several hundred more per person each month.


Title: Re: Medical question. Cut my hand open.
Post by: Der Helm on August 30, 2008, 09:04:44 PM
Now that you mention it, my health insurance company wants 2400 € for a whole year of insurance. Bad news being that I only make 700€ per month and pay more than 500 € for rent etc. You do the math.


Title: Re: Medical question. Cut my hand open.
Post by: Furiously on August 30, 2008, 10:51:19 PM
When I was insured by one of the big three US defense contractors, I had a $5000.00 per year max and a 20/80% split for costs.

Under my wife's (Which we have to pay about $300 a year each for me and my son), I have a max $100.00 deductable.

I'm just pissed my appendics had burst before I was covered under hers. Also, if you want to get into the ER quick. Tell them you have abdominal pains on your right side and have been suffering for about 2 days.


Title: Re: Medical question. Cut my hand open.
Post by: Jimbo on August 31, 2008, 05:22:29 AM
When I was insured by one of the big three US defense contractors, I had a $5000.00 per year max and a 20/80% split for costs.

Under my wife's (Which we have to pay about $300 a year each for me and my son), I have a max $100.00 deductable.

I'm just pissed my appendix had burst before I was covered under hers. Also, if you want to get into the ER quick. Tell them you have abdominal pains on your right side and have been suffering for about 2 days.

And you just stated the number one reason people come to the ER, abdominal pain.  And that doesn't make me want to jump up and bring you right back (there is more warning signs than just having right side pain, plus some people slip up and tell me the appendix is allready out).


Title: Re: Medical question. Cut my hand open.
Post by: Baldrake on August 31, 2008, 07:49:10 AM
... but it caps out at around $5000...
I'm sorry, but I'm obviously rather dense and need to keep asking questions. So this means that if you have medical expenses beyond $5k in one year, you have to pay? I.e., if you get anything serious at all?

Bottom line, I'm getting the idea that if you want decent coverage, you will need to be spending at least $1,500 / month per person (either paid by you or your employer.) And that coverage is available for less, but won't really cover you if you get seriously sick. Is this a fair summary?


Title: Re: Medical question. Cut my hand open.
Post by: taolurker on August 31, 2008, 09:25:49 AM
Speaking from example, being right now I am covered by insurance from my job, that is a deduction from my paycheck of $120 monthly. It's a decent plan, but has a deductable and co-insurance like every other American Health care plan.

In America, even if you are "covered" by insurance the patient still needs to pay the deductable first, and then after that pays 20% to the insurance's 80% of expenses after that. Usually the coinsurance cap is $5k, so after that it's sometimes all covered by the insurance, but again this can change for coverage. Max for one year is usually around $100k.

Getting sick in this county means debt, plus of course there's the massive amounts of red-tape and paperwork, hoops to jump through, or restrictions associated with the insurance. Seems the insurance profit from it, as do the doctors with their Mercedes, but rarely do sick people actually have the Medical system help them beyond terminal medical necessity.


Title: Re: Medical question. Cut my hand open.
Post by: Nebu on August 31, 2008, 09:52:47 AM
Getting sick in this county means debt, plus of course there's the massive amounts of red-tape and paperwork, hoops to jump through, or restrictions associated with the insurance. Seems the insurance profit from it, as do the doctors with their Mercedes, but rarely do sick people actually have the Medical system help them beyond terminal medical necessity.

Physicians are underpaid for the stress and demands placed upon them.  Some of the highest suicide rates, drug addiction rates, and divorce rates of nearly all professions.  If you think being a physician is such easy money, give it a try.

I urge you to look at two things over the past 10 years: physician salaries and increases in both insurance company salaries and middle management numbers.  The latter two will show you where your healthcare dollars are going.  Big business is driving up the costs of medical care, not physician salaries.   If you didn't know, the highest paid employee in most hospitals has an MBA, not an MD.


Title: Re: Medical question. Cut my hand open.
Post by: Lantyssa on August 31, 2008, 10:15:32 AM
... but it caps out at around $5000...
I'm sorry, but I'm obviously rather dense and need to keep asking questions. So this means that if you have medical expenses beyond $5k in one year, you have to pay? I.e., if you get anything serious at all?
Yep. Awesome, ain't it?


Title: Re: Medical question. Cut my hand open.
Post by: DeathInABottle on August 31, 2008, 10:20:33 AM
Jesus Christ.  Why in hell hasn't the USA just followed the Canadian model already?  Is the HMO lobby really that powerful?


Title: Re: Medical question. Cut my hand open.
Post by: Engels on August 31, 2008, 10:23:07 AM
Jesus Christ.  Why in hell hasn't the USA just followed the Canadian model already?  Is the HMO lobby really that powerful?

because canadians are fuckin phucken russian communists who eat babies and will spawn the antichrist. Jeeze Louise, haven't you been paying attention?


Title: Re: Medical question. Cut my hand open.
Post by: Bunk on August 31, 2008, 11:48:25 AM
Exactly...  :uhrr:

As an employed member of society, I pay nothing for my health care. Gives me full coverage on pretty much any non-elective mediall procedures. I don't have a family doctor, so I go to walk in clinics. They do take a limited number of patients per day, but its not an issue if you don't go to the clinics in the slums. Walk-in visits are free generally, only thing I've ever paid was $90 for a physical. If I have a serious issue, I got ER. Went to ER once for a severe road rash incident, waited about an hour for treatment as I wasn't gushing blood anywhere. Waited an hour another time that I'd had my hockey stick cath between the boards and I butted-ended myself in the "lower abdomen". I've had two surgeries in my life and never paid out of pocket for either. My dental covers all the basics, plus 50% on orthodontics and cosmetic. Even get $200 a year for opital. We do pay for our medications, though there is insurance available to help that.

Now that being all said, we do pay more income tax. My total deductions per monthly are in the $800 - $900 range, which includes taxes, pension plan, unemployment insurance, and the 6% of my salary I put in RSPs (company matches 50% of that). Still sounds a fair bit better than $600 a month for medical insurance, that still has a deducatble.

If I where self employed, I would pay the government a monthly fee for my health coverage, it's free if you are under a certain reported income, but doesn't come anywhere near what Americans pay on the high end. This coverage is manditory, you don't have the choice to opt out of health coverage.


On a diverent note - Sky, having gone through mild sciatica in the past, I do feel for your mom. Not a lot of advice I can give unless you know what the cause is. I was lucky, I had bits of cartlidge broken away between two vertebrae pushing on the nerve, but they worked thier way out and disappeared after about nine months, so I didn't require surgery. Walked with a limp and couldn't golf for a year.

I had my sciatica diagnosed, recieved a cat scan 6 weeks later, had a consultation with a back specialist, and had return visits with my doctor. Total cost to me for those nine months was about $40 for muscle relaxants.



Title: Re: Medical question. Cut my hand open.
Post by: Tebonas on August 31, 2008, 12:14:46 PM
This thread really scares me. If I have a cut I walk to the nearest ER and get patched up. Never thought there could be another way, as a gainfully employed person there should never even be a thought lost on whether to see a doctor or not. Not in a first world industrialized nation!


Title: Re: Medical question. Cut my hand open.
Post by: Furiously on August 31, 2008, 02:45:34 PM
... but it caps out at around $5000...
I'm sorry, but I'm obviously rather dense and need to keep asking questions. So this means that if you have medical expenses beyond $5k in one year, you have to pay? I.e., if you get anything serious at all?
Yep. Awesome, ain't it?

For me it meant I had to do my co-pays, but after $5K, I was covered completely. (until then I paid 20% plus co-pays).


Title: Re: Medical question. Cut my hand open.
Post by: Trippy on August 31, 2008, 03:36:52 PM
I get coverage through the university.  Free since I'm on the plan by myself, but BCBS of Texas isn't the greatest PPO.  It's okay for things like my regular check-ups, but it caps out at around $5000, if they even cover it, so I've already been fucked by it and expect to again eventually.  If I had kids or a husband (haha) to cover, it would be several hundred more per person each month.
That doesn't sound right. What's your max out-of-pocket expense per year on your plan?


Title: Re: Medical question. Cut my hand open.
Post by: Fordel on August 31, 2008, 07:49:20 PM
Quote
We do pay for our medications, though there is insurance available to help that.


The Govt also price controls the cost of drugs, more or less. Hence all the 'Cheap Canadian Pharmaceuticals!' stuff.




As to the ER visits, this is the part that confuses me some. My experiences with them here, are there are two levels of ER. The real ER, where the people who have stab wounds and heart attacks and the like, and the 'fake' ER, where you go wait for your stitches/shots/cast etc. Most hospitals around here also have their own walk-in clinics in my experience, for the mundane things.

Last time I went to a ER, was when I managed to 'scalp' a decent amount of skin from below my thumb, near the palm. I could see all the things that were supposed to be underneath the skin, kinda freaky. Didn't actually hurt all that much though. So yea, I was driven to the hospital, went to the ER entry way, had a nurse check out the wound, clean/bandage do the 'are you allergic to blah blah' etc. Then she sent me to what amounted to the "Please stitch up my idiotic self inflicted wound" waiting area. About 3 or 4 people ahead of me, waited maybe 45 mins, an hour. Across from us was what appeared to be "Please X-Ray my limb to see if I broke it or not" area. Was rather amusing.  :grin:


Left with a few stitches and directions to clean/bandage as required. Went to my Family Doctor to have them removed after a week or so. Could have easily went to a Walk-in as well.


My confusion is around the 'clog' between mundane and real emergencies in US hospitals.


Title: Re: Medical question. Cut my hand open.
Post by: Jimbo on August 31, 2008, 11:14:59 PM
My confusion is around the 'clog' between mundane and real emergencies in US hospitals.

It is a combination factor:

Lack of insurance--for some people the only care they get is the ER.  Family doctors and urgent/walk-in clinics do not have to see a patient if the choose not to, and if you can't pay, most won't take you.  Emergency departments that receive funds from Medicare or Medicaid, have to agree to see all patients and stabilize them.  Very few emergency departments won't participate, so we all have the posters on the wall stating we will see and treat you.  25% of US has no insurance, so they come to the ER.  Of course we will send you a bill, but some people would rather just not pay the bill and deal with a collection agency and bad credit than to be sick.  We actually have stabilized on this sectors use of the ED, it is the people with insurance that have made the ED's busier.

Lack of Patience--a child gets sick and vomits and runs a fever.  It is the weekend, your doctor is closed, your kid is screaming, and you don't want to deal with it, and you want your child fixed now.  It is an unrealistic expectation that we have magic wands I can wave on a patient and make them better (I so have wanted to carry around a wand that sprinkles stripper dust and lights up, and wave it over people when they have crazy requests, but administration is a bunch of assholes who won't see the humor in it).   The people who vomit one time, so they come in instead of trying any home care.

Dispute with a doctor--this can be a chronic or acute illness or injury (chronic--long term and you have a diagnosis of something, acute means it is new), you have seen doctors for it, but you aren't happy with the treatment and want a second opinion.  How the hell a ER is supposed to give you a second opinion when you have been to specialty hospitals is another reason I need the wand...  Or it could be that they just didn't get the education from the office visit due to a lack in communication (this happens with antibiotics and how they work, or what type of home care they needed).  Lack of communication is a big issue on this part.

Population is getting older--I'm not sure the age mean any more, but I see a lot of people that are in the 40's and up, which means more stroke, heart, lung, etc... problems.  I'm also seeing a lot of people alive and warehoused in a nursing home that are kept alive at all cost, instead of letting them die with dignity.  A couple of doctors from India made the comment that we just can't let our elderly go, that we can't let them die with dignity.  Many family members request that you do all that you can do to keep them alive.  Some patients that are in nursing homes end up comatose or demented and if it was not for medical/nursing care they wouldn't be alive, but we are forced to keep them alive at all cost.

Service--Emergency Departments will have a doctor and some nurses at a bare crew even in the slowest of hospitals, they will have lab support, radiology support (including CT, Rad, and Ultrasound), and pharmacology support (meaning you get drugs now), so what might be a long drawn out visit at diffrent departments can be done in one stop, and USA'ers love convenience.  ED's are probably too successful.

Boarding of patients--you might check in and be placed in a chair or bed in the hallway, and wonder why it is so full that you have to wait here instead of normal room.  A lot of time we have done the ED part and we are waiting on a bed upstairs.  Pt's from the ER suck for getting money out of them, so the hospital isn't keen on getting them upstairs that quick, they would rather fill up on direct admits from another hospital (which is usually and established patient that has money), transfers from other surgical departments (that have scheduled and screened and know they are getting paid) or procedure departments, or anywhere but from those huddled masses that will run up a bill, bitch about it, and then not pay.  So they get stuck waiting down in the ER.  Even with states that have a patient to nurse ratio it usually doesn't apply in the ER, so instead of admitting them to the floor and letting them wait in the hallway there until a bed comes open, they keep them down in the ER.  Which screws the other urgent care (like sprains and cuts) that need a bed to get in, get seen, get treated, and get out.  We don't mind that at all, just that we have all the other shit and patients that we can't get rid of because the hospital won't take them yet.


We usually sort people on how sick they are, from level 1's who are going to die if we don't do something, to level 5's which are non threating routine stuff like, "I ran out of meds, can you write me a refill?"  Triage is fluid, and it changes from the moment you step in till the moment you leave.

Do most of you think the cost of health care is because the doctors make too much money?  I don't, I know we don't get paid enough, but the managers of healthcare and the insurance agencies make way too much and have way too much power on how things are done.  The doctors need better pay for many of the services they provide, unfortunately, preventive and medicine type problems are not paid as well as doing a procedure in our health care system.  This leads to the family doctors taking a beating and having to work a ton of hours, while the specialist have it made to make a ton of money and not work as many hours.



Title: Re: Medical question. Cut my hand open.
Post by: sinij on September 01, 2008, 10:10:38 PM
Quote
Do most of you think the cost of health care is because the doctors make too much money?

No pharmas and insurances make too much money. Current US model does not make sense right now, when operating in ideal mode it would collect most money from the patients while delivering least possible care. The system is broken when treating people is seen as an avoidable loss.

You also can't expect market to regulate something that is seen as non-optional; dying or staying ill because treatment is too expensive is not going to regulate market because people are not willing to do it.