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Author Topic: Medical question. Cut my hand open.  (Read 30522 times)
schild
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Reply #70 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.
DraconianOne
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Reply #71 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.

A point can be MOOT. MUTE is more along the lines of what you should be. - WayAbvPar
schild
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Reply #72 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?
DraconianOne
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Reply #73 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?

A point can be MOOT. MUTE is more along the lines of what you should be. - WayAbvPar
Hutch
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Reply #74 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.

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Reply #75 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.
CharlieMopps
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Reply #76 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)
Nebu
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Reply #77 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.

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Nerf
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Reply #78 on: August 25, 2008, 11:23:13 PM

So what you're saying is that Schild has lupus?
Azaroth
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Reply #79 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.


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MahrinSkel
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Reply #80 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.

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Nebu
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Reply #81 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.

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Yegolev
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Reply #82 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.

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Nebu
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Reply #83 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. 

"Always do what is right. It will gratify half of mankind and astound the other."

-  Mark Twain
Baldrake
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Reply #84 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.
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Reply #85 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.

Why am I homeless?  Why do all you motherfuckers need homes is the real question.
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Sky
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Reply #86 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.

Cyrrex
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Reply #87 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!

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taolurker
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Reply #88 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.


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Reply #89 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.
Baldrake
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Reply #90 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.)
Yegolev
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Reply #91 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.  Ohhhhh, I see.

Why am I homeless?  Why do all you motherfuckers need homes is the real question.
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Mommy come back 'cause the water's all gone
Nebu
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Reply #92 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. 


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Sky
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Reply #93 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  swamp poop

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Reply #94 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  swamp poop

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?

Why am I homeless?  Why do all you motherfuckers need homes is the real question.
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Nebu
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Reply #95 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. 

"Always do what is right. It will gratify half of mankind and astound the other."

-  Mark Twain
Azaroth
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Reply #96 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.

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Nebu
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Reply #97 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.

"Always do what is right. It will gratify half of mankind and astound the other."

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schild
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Reply #98 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.
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Reply #99 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.
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Reply #100 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".

Why am I homeless?  Why do all you motherfuckers need homes is the real question.
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Mommy come back 'cause the water's all gone
Nebu
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Reply #101 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.

"Always do what is right. It will gratify half of mankind and astound the other."

-  Mark Twain
Oz
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Reply #102 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)

Nebu
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Reply #103 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. 

"Always do what is right. It will gratify half of mankind and astound the other."

-  Mark Twain
Oz
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Reply #104 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. 
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