Sunday, July 29, 2007

Is Depression on the rise?

GP's tend to deal with a lot of depression and anxiety (and I'm not talking about our own... who tends to us? Another question. Another post).

Is there more depression and anxiety in the 21st century or are we just getting better at recognising it?

The middle of the 20th century saw the rise in early recognition and treatment of psychiatric illnesses. In fact, most of the stigmas surrounding psychiatry, psychologists and psychological drugs were put to bed in the late 70's and early 80's. The rise of Freud and Mommy-consoling. They were heady days.

Back to the present – something is definitely up. It feels like at least 1 out of every 3 patients I see is on some type of an antidepressant or mood stabiliser. I used to have a professor who joked that lithium should be put into the water. Quick, painless alleviation of most of our problems. Imagine a world where the traffic driver is too stoned to cut you off. Wait. They are stoned. And still cut us off? Well, I did say “most” of our problems.

I see at least 3 people per week who arrive complaining of stress, an inability to cope – and of the opinion that medication (not psychological treatment) will help.

Has life really become more stressful in the 21st century? Dual incomes? Pressure for women to succeed and men to become more nuturing? Or have our parents not prepared us properly for the big bad world. Are we, as modern human beings, getting less and less capable of dealing with situations and just getting in with life?

Why do more and more people feel that they have to take medication (and/or drugs) to deal with the everyday stuff? Maybe it has something to do with the fact that everytime you pick up a YOU magazine, you're confronted with pretty looking people advising you seek out your doctor for the latest in smiley medication.

A lot of questions – and not too many answers I'm afraid.

Perhaps we should spend more time teaching stress management in schools? Or organisational skills... teach our children to be more efficient, manage money better, be more emotionally available?

Then maybe our next generation won't have to be permanently medicated to be happy and functional...

Friday, July 13, 2007

Pictures of the PTC (Patient Transport Compartment)...

Here are some pics from the journey...

All the equipment is attached to the back wall above the patient - very nice and compact.

A tiny drawer stocked with more drugs than I've seen in a while!

All the equipment fits into drawers the size of a food trolley!

And everything packed into a small compartment, snug between all the passengers.

Tuesday, July 10, 2007

The PTC (Patient Transport Compartment)...

On very short notice, I was asked to transport a quadraplegic patient to Miami for medical treatment. This might seem like a small task, but you've got to remember that a quadraplegic patient cannot sit in a normal chair unassisted - plus they have a higher rate of complication (basically anything going wrong). Hence the need for dedicated medical staff. And a some pretty funky medical technology...

Introducing the Lufthansa PTC (Patient Transport Compartment).

This is an amazing self-contained unit that fits into the middle of the plane to transport all ICU and critically ill patients. The patient is placed on the bed in the unit and the Lufthansa nurses and a doctor (me, in this case) stay with them in the unit.

What made this PTC so amazing was how well equipped it was. There were ventilators, all kinds of monitors, IV injection pumps and the largest stock of ICU / anaesthetic meds and equipment that I've ever seen. It was definitely better than the ICU I worked in at Helen Joseph.

The nurses were well trained, friendly and professional and the whole experience - phenomenal.

Yes, I was tired... It was like doing an intern shift (36 hours awake), on an airplane, in a 6 square metre space - that's one helluva intern shift. But, at the end of the day, the patient got the best possible care - and that's what counts.

Thanks - and congrats to a wonderful team of nurses. Katherine and Elke - it was a pleasure!

I'll post some pics soon...

Some articles:
*AeroCare Repatriates a Patient From Chicago to Singapore
*CEGA Group

Thursday, July 5, 2007

Misconceptions about Health...

We'd just like to say... if you're getting this kind of advice from your health professional?! CHANGE!

Har. Har. Anyway... Round is a shape. Pah.

Q: I've heard that cardiovascular exercise can prolong life; is this true?

A: Your heart is only good for so many beats, and that's it... don't waste them on exercise. Everything wears out eventually. Speeding up your heart will not make you live longer; that's like saying you can extend the life of your car by driving it faster. Want to live longer? Take a nap.

Q: Should I cut down on meat and eat more fruits and vegetables?

A: You must grasp logistical efficiencies. What does a Goat eat? Hay and corn. And what are these? Vegetables. So a steak is nothing more than an efficient mechanism of delivering vegetables to your system. Need grain? Eat chicken. Mutton is also a food source of field grass (green leafy vegetable). And a pork chop can give you 100% of your recommended daily allowance of vegetable products.

Q: Should I reduce my alcohol intake?

A: No, not at all. Wine is made from fruit. Brandy is distilled wine, that means they take the water out of the fruity bit so you get even more of the goodness that way . Beer is also made out of grain. Bottoms up!

Q: How can I calculate my body/fat ratio?

A: Well, if you have a body and you have fat, your ratio is one to one. If you have two bodies, your ratio is two to one, etc.

Q: What are some of the advantages of participating in a regular exercise program?

A: Can't think of a single one, sorry. My philosophy is: No Pain...Good !

Q: Aren't fried foods bad for you?

A: YOU'RE NOT LISTENING!!! ... Foods are fried these days in vegetable oil. In fact, they're permeated in it. How could getting more vegetables be bad for you?

Q: Will sit-ups help prevent me from getting a little soft around the middle?

A : Definitely not! When you exercise a muscle, it gets bigger. You should only be doing sit-ups if you want a bigger stomach.

Q: Is chocolate bad for me?

A: Are you crazy? HELLO . Cocoa beans! Another vegetable!!! It's the best feel-good food around!

Q: Is swimming good for your figure?

A: If swimming is good for your figure, explain whales to me.

Q: Is getting in-shape important for my lifestyle?

A: Hey! 'Round' is a shape!

Tuesday, July 3, 2007

The price of life…

I’m back! Article about flying patients around soon. With photographic evidence… But first.

Helping with the Whipples the other day got me thinking.

The patient in question has a really bad Pancreatic Carcinoma and has quite severe abdominal pain. The prognosis is poor. Probably 3 months. By doing this palliative whipples (you can do the op for other reasons) - she will first need to recover, but then should have less pain.

The catch is - she is still going to die. We have not solved her cancer problem. We have probably extended her life by 9 months.

Here’s the second catch. She has no medical aid. All the theatre costs, ICU, ward stay, doctor and anaethetist will be paid out of her pocket! It could come to a quiet R100k.

Now is that worth it? Many would say yes. You can’t put a price on life can you? But I’m skeptical.

If I had pancreatic cancer, and I had 3 months to live, I wouldn’t want to spend my money having a huge operation, whiling away the time, drugged up in hospital – just for a few months. Remember, you don’t just skip out happy the next day – it takes TIME to recover from hefty procedures.

I’d rather take my wealth and spend it lavishly to live my remaining days on a deserted island somewhere.

So I told the surgeon…”If you ever open me up, and see the pancreatic tumour, please close me back up and send me packing to the Bahamas!”.

I don’t know if I’m right. But it sure got me thinking.