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Author Topic: Medical question. Cut my hand open.  (Read 46193 times)
Oban
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Reply #105 on: August 26, 2008, 12:00:18 PM

...and this is why God invented drug dealers.

Palin 2012 : Let's go out with a bang!
Nebu
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Reply #106 on: August 26, 2008, 12:06:54 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. 

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

-  Mark Twain
Ookii
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Reply #107 on: August 26, 2008, 12:13:39 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
« Last Edit: August 26, 2008, 12:15:19 PM by Ookii »

Nebu
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Reply #108 on: August 26, 2008, 12:16:09 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. 

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

-  Mark Twain
Oz
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Reply #109 on: August 26, 2008, 01:44:54 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.
CharlieMopps
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Reply #110 on: August 26, 2008, 02:23:17 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


Nebu
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Reply #111 on: August 26, 2008, 02:32:44 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. 

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

-  Mark Twain
Yegolev
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Reply #112 on: August 26, 2008, 02:34:40 PM

Charlie, just from your post I can point out that your HMO was your problem, yes?  Insurance companies.  Doctors hate them, too.

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CharlieMopps
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Reply #113 on: August 26, 2008, 03:25:47 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.
CharlieMopps
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Reply #114 on: August 26, 2008, 03:34:50 PM

If it makes you feel any better, I don't like dentists either.  awesome, for real
Nerf
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Reply #115 on: August 26, 2008, 03:36:35 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.
CharlieMopps
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Reply #116 on: August 26, 2008, 03:41:21 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.
Tale
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Reply #117 on: August 26, 2008, 04:18:18 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.
Nebu
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Reply #118 on: August 26, 2008, 05:23:36 PM

Don't knock the GP.

Fair enough.  I have nothing but respect for GP's. 
« Last Edit: August 26, 2008, 05:57:09 PM by Nebu »

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

-  Mark Twain
Sky
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Reply #119 on: August 27, 2008, 08:23:29 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.
Jimbo
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Reply #120 on: August 27, 2008, 08:35:48 AM

Anyone from Great Brittian able to check something for me?  Article 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.
CharlieMopps
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Reply #121 on: August 27, 2008, 11:03:09 AM

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.
MahrinSkel
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Reply #122 on: August 27, 2008, 11:09:28 AM

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).

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Draegan
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Reply #123 on: August 27, 2008, 01:38:47 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.
Azaroth
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Reply #124 on: August 27, 2008, 02:39:11 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.

« Last Edit: August 27, 2008, 02:41:46 PM by Azaroth »

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Amarr HM
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Reply #125 on: August 27, 2008, 05:04:24 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.

I'm going to escape, come back, wipe this place off the face of the Earth, obliterate it and you with it.
lamaros
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Reply #126 on: August 27, 2008, 07:17:19 PM

A hypochondriac is a person having anxiety regarding a medical condition...

Err..  awesome, for real



Baldrake
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Reply #127 on: August 29, 2008, 11:56:54 AM

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?
Sky
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Reply #128 on: August 29, 2008, 12:46:13 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.
Oz
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Reply #129 on: August 29, 2008, 01:02:43 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.
Reg
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Reply #130 on: August 29, 2008, 01:36:34 PM

Do you and Sky live in the same country?
Yegolev
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Reply #131 on: August 29, 2008, 03:25:39 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.

Why am I homeless?  Why do all you motherfuckers need homes is the real question.
They called it The Prayer, its answer was law
Mommy come back 'cause the water's all gone
Baldrake
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Reply #132 on: August 29, 2008, 05:51:15 PM

Yeah, I really meant, what does it cost if you're someone like Schild who has nobody to subsidize the bills.
Signe
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Reply #133 on: August 29, 2008, 06:48:39 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.

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Jimbo
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Reply #134 on: August 29, 2008, 09:27:41 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...
sinij
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Reply #135 on: August 29, 2008, 10:37:26 PM

I suggest you move somewhere with universal health care and no possibility of draft... like Canada or France.

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Fordel
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Reply #136 on: August 29, 2008, 10:58:57 PM

This thread is totally contradicting everything I learned about the US Health Care system on House.  Ohhhhh, I see.

and the gate is like I TOO AM CAPABLE OF SPEECH
Baldrake
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Reply #137 on: August 30, 2008, 05:28:12 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?
Merusk
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Reply #138 on: August 30, 2008, 05:34:00 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.

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Lantyssa
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Reply #139 on: August 30, 2008, 06:53:17 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.

Hahahaha!  I'm really good at this!
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