All Scrubbed Up

All Scrubbed Up Retiring...

2010-04-14T07:11:00.000+02:00

Unfortunately due to other commitments and just generally getting older, SA Doc and myself have to announce that All Scrubbed is retiring. It's been one helluva ride - and thank you to everyone for being part of it. Every comment was highly appreciated and kept us going through the last 2 years.

We'll obviously keep it alive so you can trawl through the archives. There are some doozies!
Hope you enjoyed it as much as we did. Totsiens! Ciao!

Blog closed.

End.

GUEST POST: How to Improve Medical Services in Third World Countries

2010-04-14T07:09:00.000+02:00

The world has become a much smaller place, thanks to technology and globalization. But no matter how connected we are, there still exist huge disparities between the rich and the poor. The gap gets wider with each passing year, for individuals and nations. In the eyes of the developed world, third world countries are perceived as places where the standard of living is poor and where the things they take for granted are considered luxuries. In reality however, third world countries have their share of both the obscenely rich and the dirt poor. And the main reason for their backwardness is not just the paucity of money, but also the lack of awareness and education among the poorer and downtrodden sections of society.

When we consider the state of medical services in these countries, we see that the rich are able to afford any kind of treatment for all kinds of diseases. But for the poor and the middle class, medication is prohibitively expensive simply because quality medical services are only offered by the private sector. The government does offer services for the poor and those who are not able to afford private medical treatment, but the quality of treatment is poor at times. Also, the facilities are often overcrowded and not hygienic, and this makes the middle class hesitant to seek medical treatment at these places.

Improving medical services in third world countries is an uphill climb, but it can be done if:

Tax money is put to better use – to build cleaner and more spacious medical facilities and to pay qualified doctors and other healthcare personnel so that they don’t move away to set up their own private practice or join a private care provider.
Politicians don’t get greedy and swindle public funds that are meant for the improvement of society and the common man.
Bribery is abolished and doctors and healthcare personnel are encouraged to offer better services through various incentives.
People are made more aware of the need for cleanliness and personal hygiene.
Education is made compulsory for children so that they have opportunities to leave behind the squalor and poverty they grew up in.
Smaller towns and villages are better linked by road to cities and larger towns where there are better medical facilities.
Mobile medical services are introduced in remote villages so that diseases are diagnosed in the early stages and the need for emergency care and hospitalization is minimized.
More emphasis is placed on preventive rather than curative care. When this happens and people are more aware of the need for preventive care through the right diet and regular exercise, healthcare begins to look up in any nation, developed or developing.

By-line:

This guest article is written by Teresa Jackson, she writes on the subject of online NP schools . She invites your questions, comments at her email address : teresa.jackson19@gmail.com.

Coffee good for that heart?

2010-03-04T16:27:00.000+02:00

Drinking coffee 'protects the heart'. Researchers have discovered that regular coffee drinkers are less likely to be admitted to hospital with irregular heart beats or rhythms. And the more cups they drink a day, the less likely they are to suffer from the condition. (From The Telegraph).

OK.

But isn't red wine and whiskey good for the heart as well? Hook me up to a combo drip of the 3 of those.

I've thought of SA Doc's next post. WHY COFFEE WILL KILL YOU.

Awesome.

Anyone still listening?

2010-02-24T09:45:00.001+02:00

So, SA Doc is losing a bit of faith in this blog, not finding the time to feed her ghost writer with juicy medical tidbits. Is there anyone out there still reading this?

Time to pack in the towel on 2 years of awesome medical blogging and fun - or should we kick SA Doc in the ass and get some more stories?

Fellatio reduces risk of breast cancer!

2009-12-10T12:04:00.001+02:00

I think that this post should be a warning to all that not all medical information available on the web is true. I constantly have patients bringing me the latest information that they have downloaded from the web about their particular condition. 90% of the time, it is rootin tootin junk. It requires great diplomacy to explain that to them, since these web pages usually gives them false hope about the treatments that they may need (or may be able to avoid).

CLAIM: According to a university study, oral sex may significantly decrease the risk of breast cancer in women.

No, this wasn't a real CNN page (or Associated Press article), nor did North Carolina State University perform a study on the connection between fellatio and breast cancer. (If nothing else, the names of the doctors cited in the article — "Dr. B.J. Sooner," "Dr. Inserta Shafteer," "Dr. Len Lictepeen" — should have given it away as a hoax.)

More info here...

Sies!

Australian Doctors...

2009-11-26T18:55:00.000+02:00

Recently reported by The Daily Maverick...

The Australian Medical Association ran an advertisement in newspapers offering a bounty of A$3,000 (just over R20,000) to anyone who persuades a foreign doctor to work in that country.

We're short 2500 doctors in this bloody country. Oz should leave ours alone!

Your Medical Records Belong To You

2009-10-30T08:44:00.000+02:00

I've been engaging a lot recently with the notion of an electronic health record. For those of you who don't know, this is usually an online version of collated data to do with your health. Simply - your pathology, your doc notes, all the hospital visits, illnesses and drug usage are kept in one secure place. You can access it and most of the time, so can a healthcare provider.

For those of you that are not in tune with the medical world - this is something you have to know about as it is the backbone of the Obama administration. By having an electronic health record, there is a saving on administration as well as all the good things a centralised database brings. eg. Less duplication of tests and better management of healthcare.

Discovery Health in South Africa is launching one next year. It'll be interesting to see how the "population" engages with it.

This blog is very interesting in that it clearly outlines the fact that your medical records belong to YOU. Many people are under the misconception that your doctor owns your medical records - and that the only way to access them is via that doctor. This is not true. Your health. Your body. Your money spent to purchase medication/tests etc.

It belongs to you.

GUEST POST: How to Ensure Healthy Babies For HIV Mothers

2009-10-14T17:57:00.001+02:00

It’s a problem that still plagues most third world countries because the level of awareness is pretty low, because the people are not educated enough, and because HIV/AIDS is still rampant. The most important thing on an HIV positive pregnant woman’s mind is the fear that she will pass on the dreaded disease to her unborn child, and most women opt for an abortion rather than put their child through the same torment that they undergo every day. But the truth is, if you follow the right precautions, babies with HIV mothers are unaffected by this virus.

Combination antiretroviral therapy must be provided to the mother during pregnancy and during labor, and to the child after birth.

Breastfeeding must be avoided as much as possible, and if the mother insists on it or if the child is allergic to other forms of sustenance, they can try the preventive method suggested by a study conducted by the University of North Caroline at Chapel Hill. According to this study, providing the infant with antiretroviral syrup every day or treating the mother with highly active antiretroviral drugs helps prevent mother-to-child HIV transmission.

Mothers must be encouraged to follow hygienic procedures and drink water that is potable or filtered.
Mothers must work closely with their clinicians to monitor the baby and ensure maximum protection for their child.
Doctors must ensure that the mother’s blood does not enter the baby’s bloodstream at the time of birth
A natural birth is a definite no-no in such situations. The mother must be prepared for a C section.
The mother must undergo regular prenatal checks and follow her doctor’s instructions to the letter.
The babies will be monitored closely for up to six weeks after birth.

It’s up to the mother to see that her baby does not suffer from this dreaded disease. As long as she is confident and careful, there’s no reason why her baby cannot be born healthy. Doctors allow a 98 percent chance that HIV mothers will deliver healthy babies.

This guest article was written by Adrienne Carlson, who regularly writes on the topic of nurse practitioner schools . Adrienne welcomes your comments and questions at her email address: adrienne.carlson1@gmail.com

Smoking laws work - Study.

2009-10-12T06:59:00.000+02:00

Quick excerpt here from a 2001 study that proves tobacco laws reduce smoking. This is damn old. We're getting better at it. The source site is also great for other South African public health statistics.

Tobacco consumption declines
by Mokgadi Pela
2001-03-16

Tobacco consumption in South Africa has fallen for eight consecutive years since 1991, a meeting to discuss the Framework Convention on Tobacco Control heard in Sandton, Johannesburg, on the 12th of March. Delivering the keynote address, Dr Derek Yach, of the World Health Organisation, said this was a result of sustained tobacco control measures. He said in 1998-99 more than 30 billion cigarettes were released for consumption, down by 17 percent from the 36 billion released in 1993-94. The work of public health advocates in South Africa thrived. Led by Health Minister Manto Tshabalala-Msimang, South Africa's tobacco control story is now a shining example for the Framework Convention on Tobacco Control of public excellence and political courage. The 11th World Conference on Tobacco held last year in Chicago saluted this leadership with an award recognising her exemplary courage, Yach said. Crucially, the declines have been most significant among the poorest and the youngest groups in the country. New laws banning smoking in public places and the complete ban on tobacco advertising and promotion, which is being incrementally introduced this year, are likely to push the rates down even faster, he added. Yach dismissed claims that tobacco control would lead to job losses. (Source: Sowetan, 13 March 2001)

Tobacco consumption in South Africa has fallen for eight consecutive years since 1991, a meeting to discuss the Framework Convention on Tobacco Control heard in Sandton, Johannesburg, on the 12th of March. Delivering the keynote address, Dr Derek Yach, executive director of non-communicable diseases and menial health at the World Health Organisation, said this was a result of sustained tobacco control measures.

He said in 1998-99 more than 30 billion cigarettes were released for consumption, down by 17 percent from the 36 billion released in 1993-94. The work of public health advocates in South Africa thrived. Led by Health Minister Manto Tshabalala-Msimang, South Africa's tobacco control story is now a shining example for the Framework Convention on Tobacco Control of public excellence and political courage. The 11th World Conference on Tobacco held last year in Chicago saluted this leadership with an award recognising her exemplary courage, Yach said.

Crucially, the declines have been most significant among the poorest and the youngest groups in the country. New laws banning smoking in public places and the complete ban on tobacco advertising and promotion, which is being incrementally introduced this year, are likely to push the rates down even faster, he added. Yach dismissed claims that tobacco control would lead to job losses.

We know from economists around the world that far from causing job losses, people who stop smoking will spend their money on other goods and services, resulting in an increase in employment in those sectors. We know what works in South Africa will work in many other countries, Yach said.

Speaking at the same forum. Tshabalala-Msimang said her department would tighten the laws controlling smoking to ensure that everyone has an environment that's not harmful to their well-being. She said the tobacco industry had shown they'll use any loophole to protect their product. We will also find all the gaps and close them.

Tshabalala-Msimang urged participating nations to pass laws that would ensure that the youth and all vulnerable groups were protected from the harmful effects of smoking.

Source: Sowetan, 13 March 2001

New Smoking Laws

2009-10-09T06:53:00.000+02:00

For those of you who don't know... Smoking laws are getting stricter. YES! Good on ya, South Africa. If only they'd extend it to alcohol (btw, when is SAB going to STOP making quarts in glass bottles? Have you SEEN Friday night at Bara??)

Although he pokes fun and says that smoking laws do nothing - this is not true. There have been large changes in the prevalence of smoking of the first set of laws were passed in South Africa. Same for you overseas? Another post on this soon.

More on iMod.

How to navigate a hospital - the Do's and Don'ts

2009-10-07T18:34:00.000+02:00

Great article on understanding hospitals, the do's, don'ts, knows and nots.

While hospitals can provide a secure refuge when you are seriously ill, remember that hospitals can be scary places! For one thing, the very fact that your doctor wants you to be admitted into hospital means that he thinks you are quite ill and this in itself can generate considerable anxiety! Even worse, hospitals can be very unfriendly places. Not only do hospitals strip you of all your dignity (having to wear a half-open hospital gown which barely covers your body properly does not do much good to your ego!), but also they subject you to painful routines and humiliating rituals performed by a retinue of strangers. Moreover, you could be woken up at any time of the day, (or night), deprived of your privacy, forced to eat unpalatable food, cut off from friends and family, and denied a lot of the independence which you take so much for granted in daily life. Also, remember that hospitals can be dangerous to your health as well! Hospital-acquired infections have become increasingly common ( since a number of sick patients are gathered together under one roof); and errors and mix-ups are not unusual at all, especially in India, where the paramedical staff is often poorly trained.

Check it out here.

The ANC Youth League and Caster Semenya.

2009-09-11T14:43:00.001+02:00

Beware of those basic principles of medical tests!

*ANC YL FULLY BEHIND SOUTH AFRICA¹S GOLDEN GIRL MOKGADI CASTER SEMENYA*
*11 September 2009*

The African National Congress Youth League is fully behind the International
Athletics Associations Federation (IAAF) World Championships Gold Medallist,
Caster Semenya amidst the malicious rumour of a medical report from the
IAAF. The ANC YL has interacted with Athletics South Africa and established
that there was never a legitimate test conducted on Caster Semenya and all
basic principles of medical tests are grossly violated.

The ANC YL calls on the IAAF to distance itself from the Australian Media
reports, and in line with basic medical ethics illegitimate any test done on
Caster Semenya without her concern. Even if a test is done, the ANC YL will
never accept the categorisation of Caster Semenya as a hermaphrodite,
because in South Africa and the entire world of sanity, such does not exist.
The basic, traditional and known method to determine gender has classified
Caster Semenya as female and to us she will remain a female.

The ANC YL is also very concerned by the fact that all the media reports
about Caster Semenya are generated in Australia, which is the most lucrative
destination for South Africa¹s racists and fascists, who refused to live
under a black democratic government. The maltreatment of Caster Semenya is
evidently a coordinated racist attack on Caster Semenya, an African woman
whom the racists never thought will represent South Africa will excellence.

Mokgadi Semenya is our girl and the ANC YL will be convening the prize money
handover ceremony to celebrate her before the end of September 2009. There
is no one who is going to take the Gold Medal and honour from Caster Semenya
for any reason.

*Issued by the African National Congress Youth League *
Contact Floyd Shivambu, ANC YL National Spokesperson

Crickey.

Official Swine Flu South Africa Stats - 12 August 2009

2009-08-12T17:00:00.002+02:00

Death count... wait for it... 2.

Some say, a flash in the pan. Others say, this is how it starts.

We really dunno. SA Doc thinks the pandemonium is a bit OTT (over the top).

GUEST POST: 7 Excellent Open Courseware Collections To Learn About The Human Body

2009-07-27T13:45:00.001+02:00

The human body is a fascinating and intricate construction, and there are many reasons to learn more about it. You may want to know how it works so that you can better understand your own, and thereby make the best decisions possible in regards to good health and maintenance. You may want to understand how it works so that you can move into a profession that works to restore it to health. You may just be curious. Whatever the reason, these 7 excellent open courseware collections to learn about the human body are a great place to begin or to continue your study of the human body.

General Human Anatomy

General Human Anatomy takes a general look at the structure of the body and all its systems. This is a cursory examination of the human body as a structure provided by UC Bekeley and is the perfect start to any study of the human body.

Human Anatomy

Human Anatomy, provided by Emory University, takes the investigation a step farther examining the systems of the human body. It takes a look at the organization of the nervous system and the physical anatomy of each portion of the body. Focuses include the upper and lower extremity, the vertebrae and spinal cord, the head, the neck, the abdomen, and the thorax.

Human Growth And Development

Tufts University's Human Growth and Development takes a look at the human body throughout the lifespan. The development of bodily and cognitive skills during the lifespan can be better understood when you are aware of the progression of physical growth that happens concurrently.

Cell-Matrix Mechanics

Cell-Matrix Mechanics, courtesy of the Massachusetts Institute of Technology (MIT), will teach you about the physical processes of the development of cells and tissues. This will include a look at the growth process both as it occurs naturally with aging and as it occurs with healing after damage to certain tissues.

A Clinical Approach To The Human Brain

A Clinical Approach to the Human Brain, also from MIT, is a collection that will explain how the human brain works both when it is healthy and when it is not. The resources talk about the actual anatomy of the brain and all of its workings. Neurons, synapses, and neurotransmitters are all covered.

Sensation And Perception

MIT's Sensation and Perception is an essential courseware collection. The human body functions in response to its environment, and the senses provide the information that allows the body to avoid danger and to make choices. These resources will cover how signals are received and then transformed into usable information in the body.

Cellular Neurobiology

Cellular Neurobiology, a final contribution from the Mass Institute, will focus on the functioning of the nervous system. It will cover the physical processes at work in synaptic transmission, neurodevelopment, and the way that information is filtered and processed.

The human body is a wonderfully complex construct. These courses will teach you much about its overall functioning while still leaving so much more to learn as you get into specific systems. Everyone should take some time to learn about the human body because everyone has one. If you know about its functioning then you will learn more about how you can keep it working at peak efficiency, and make the best, most informed decisions for the only body you will ever have in this life.

About the Author:
Mary Ward is a freelance author and writes about medical career topics, such as how to select among ultrasound technician schools, tips for job advancement, and more.

An amazing medical sentence...

2009-07-26T20:03:00.000+02:00

What the hell.

“I do not know where family doctors acquired illegibly perplexing handwriting nevertheless, extraordinary pharmaceutical intellectuality counterbalancing indecipherability, transcendentalizes intercommunications incomprehensibleness”.

This is a sentence where the Nth word is N letters long.

e.g. 3rd word is 3 letters long, 8th word is 8 letters long and so on.

An episode of House...

2009-07-14T08:30:00.000+02:00

From GraphJam. Hilarious. All they forgot was the seizures. Why is it that there is at least ONE seizure per episode of House. SA Doc tells me it's a lot more exciting than real life. Even the Baragwanath pit.

Old Time Medicine #8 - You KNOW it works! (46% Alcohol, 100% Opium)

2009-07-13T19:30:00.000+02:00

Opium for new-borns

I'm sure this would make them sleep well (not only the Opium, but 46% alcohol!)

Old Time Medicine #7 - You KNOW it works! (Double BILL on the Cocaine!)

2009-07-10T19:25:00.000+02:00

A double bill for you today. Amazing that these "medicines" existed. Oh but for the old days eh?

Cocaine tablets (1900)

All stage actors, singers teachers and preachers had to have them for a maximum performance. Great to "smooth" the voice.

Cocaine drops for toothache

Very popular for children in 1885. Not only they relieved the pain, they made the children happy!

Old Time Medicine #6 - You KNOW it works! (Asthma Opium? REALLY?)

2009-07-07T19:22:00.000+02:00

Opium? Really?

Awesome.

Old Time Medicine #5 - You KNOW it works! (Paperweight promotion)

2009-07-04T19:20:00.001+02:00

A paper weight

A paper weight promoting C.F. Boehringer & Soehne ( Mannheim , Germany ). They were proud of being the biggest producers in the world of products containing Quinine and Cocaine.

Old Time Medicine #4 - You KNOW it works! (Cocaine Wine for Kids...)

2009-07-02T19:18:00.000+02:00

Maltine

Produced by Maltine Manufacturing Company of New York . It was suggested that you should take a full glass with or after every meal. Children should take half a glass.

Old Time Medicine #3 - You KNOW it works! (The Most Famous Cocaine Wine!)

2009-06-30T19:15:00.001+02:00

Mariani wine

Mariani wine (1875) was the most famous Coca wine of its time. Pope Leo XIII used to carry one bottle with him all the time. He awarded Angelo Mariani (the producer) with a Vatican gold medal.

Old Time Medicine #2 - You KNOW it works! (Coca Wine)

2009-06-28T19:13:00.000+02:00

Coca Wine

Metcalf Coca Wine was one of a huge variety of wines with cocaine on the market. Everybody used to say that it would make you happy and it would also work as a medicinal treatment.

Old Time Medicine #1 - You KNOW it works! (Heroin. Completely Non-Addictive)

2009-06-25T19:08:00.001+02:00

Bayer's Heroin

A bottle of Bayer's heroin. Between 1890 and 1910 heroin was sold as a non-addictive substitute for morphine. It was also used to treat children with strong cough.

The Slice 'n Dice. Surgical Cartoons #3

2009-06-21T18:55:00.000+02:00

Har! Har! From AHAJokes...

The Slice 'n Dice. Surgical Cartoons #2

2009-06-16T18:53:00.000+02:00

Har! Har! Also from CartoonStock.

The Slice 'n Dice. Surgical Cartoons #1

2009-06-12T12:51:00.000+02:00

Har. Har. From CartoonStock.

Full Consent for Care...

2009-06-08T12:39:00.000+02:00

Found on Consent Care . com

Came across this website the other day, thought it was fantastic. If only this was available before. It makes surgeon's lives so much easier - and medical liability less of an issue. By the way... I see it was developed by a bunch of surgeons in Cape Town.

Long live the UCT clan!

Father at 13... No 14.

2009-06-04T12:22:00.000+02:00

What the hell is the world coming to?

By LUCY HAGAN Published: 13 Feb 2009

BOY dad Alfie Patten yesterday admitted he does not know how much nappies cost - but said: "I think it's a lot."

Baby-faced Alfie, who is 13 but looks more like eight, became a father four days ago when his girlfriend Chantelle Steadman gave birth to 7lb 3oz Maisie Roxanne.

He told how he and Chantelle, 15, decided against an abortion after discovering she was pregnant.

This story from the SUN UK took another twist when it was discovered that another 14 year old was actually the Dad.

What is going on in the UK? We've previously blogged on a boy. And yes, I refuse to call him a man, who already had 3 kids at the age of 21. Now... to read about this 13 year old (nay, 14 - love triangle) who is happy to be a father to a child just blows my mind. It's not the "he's trying to be responsible argument". It's the fact that he was actually having SEX. UNPROTECTED SEX. At that age.

Are parents not teaching their kids the right things?

Are schools not teaching sex education? Whatever happened to the frikkin' condom on a banana gig?

Now I hear that it gets even more socially disgraceful. It's not even his. How many boys was the little whore sleeping with?

I hope to God South Africa doesn't aspire to be like England.

End rant.

Alzheimer's. Thought for the Day.

2009-06-01T18:09:00.000+02:00

Thought for the day: There is more money being spent on breast implants and Viagra today than on Alzheimer’s research.

This means that by 2040, there will be a large elderly population with perky boobs and huge erections and absolutely no recollection of what to do with them.

The effects of Swine Flu...

2009-05-18T19:52:00.001+02:00

Horrid disease! Turns a perfectly cute bouncin' baby into THIS...

Swine Flu vs Aids

2009-05-11T18:53:00.000+02:00

90 people get the Swine Flu and everybody wants to wear a mask.

A million people have AIDS and no one wants to wear a condom.

Ironic.

Medical Cartoon: My Medical Education

2009-02-16T17:33:00.001+02:00

Har! Har!

The four stages of life...

2009-02-04T12:18:00.000+02:00

Sad they we all end up on a drip. We should reverse the process!

The eternal battle between good and evil...

2009-02-02T12:51:00.000+02:00

VS...

We're going into trouble for this - aren't we?

The Dangers of FaceBook

2009-01-31T18:43:00.000+02:00

Journal article from Student BMJ:

The Dangers of Facebook

Posted 12/29/2008

Neil Graham; Philippa Moore

Abstract
Increasing numbers of doctors and medical students are turning to websites such as Facebook to make friends, chat, and organise social events. These innovations have made some aspects of life easier and are a powerful tool for communication, but they also blur the line between our personal and professional personas. With the veneer of friendship that's offered on these sites, it's all too easy to reveal more information than is appropriate. If this information falls into the wrong hands, problems can arise about your integrity, employment, and fitness to practise medicine.
Introduction

In a recent study in the Journal of General Internal Medicine, the Facebook profiles of a group of medical students in Florida were scrutinised with the aim of establishing how dangerous Facebook could be in the intersection of personal and professional identities. The study found some profiles publicly displaying photographs of trainee medics drinking to excess, engaging in sexual behaviour, and, in one instance, posing with a dead racoon. Three of the 10 students in the sample had also joined groups on Facebook that could be interpreted as sexist or racist.[1]

Whether the private activities of a medical professional have an impact on their ability to practise is debatable, but it cannot be denied that putting private material in such a public arena has the potential to undermine trust in the profession.

What's interesting about this is that Doctors are normal people (surprised?). We get up to the same shit that others do. That's why Scrubs is such a bloody realistic show! Believe it or not.

The difference now? Our real personalities are available on the web for our patients to see. If we're not careful. Suddenly they know we're not God. Bummer.

How to Cure HIV. The Book.

2009-01-24T18:31:00.001+02:00

OH MY GOD! That picture I used in the last post led me to this book. WTF.

New Revised! Including new research and findings showing what the true causes of HIV & AIDS are and lead directly to their cure! 53 CURED Cases The First Year Cure, not treatment, is the subject of this book. In 1991 Dr. Clark discovered the source of HIV. Once the source became clear the cure became obvious. but would it work? After curing 53 cases in a row, all who used this method, Dr. Clark could wait no longer to present these findings. Since that time many more have been cured, too many to be added to this book. Most important is adding yourself to that list! Electricity can now be used to kill bacteria, viruses and parasites in minutes, not days or weeks as antibiotics require. If you have been suffering from HIV infection or AIDS related illness, learn to build the electronic device that will stop it immediately. It is safe and without side effects ad does not interfere with any treatment you are now on.

Buy it now and save yourself. Crisis. Real medicine is not about anecdotal case studies - it's about randomised control trials.

How to cure HIV

2009-01-23T18:25:00.000+02:00

Sometimes, "lost in translation" can be bloody dangerous. See this site.

"What is this HIV Cure meant for?- This cure for HIV is a holistic HIV cure with A bio Magnetic Cards / Bio Magnetic Tablets and immune enhancing herbal medicines. No side effects in this. This s purely ethical and most successful treatment in the history of HIV. Very easy to use -Even a 10 year old boy can use this. This is most potent HIV cure available.

What is the procedure of action of treatment?
Bio Magnetic Cards Or Bio Magnetic Tablets will perform as very strong fusion inhibitor (entry inhibitor) that completely stop HIV cure from entering CD4 Cells. by creating a negative charge CD4 which will repel negatively charged HIV and prevent it from attaching the surface of CD4. So HIV can not complete its life cycle. Thus it will die in due course and will be expelled from body through excretion like that of urine etc.

What will be result-?
HIV will be destroyed and soon the body will start to gain weight . All symptoms will be subsided and CD4 count will be back to the normal. All opportunistic diseases will be cured as well. The HIV cure will be termed that because HIV 's end is the result of the HIV cure."

HIV is the biggest epidemic we've ever had. This kind of stuff makes me want to cry. It should be taken down. Someone phone Google.

Find your way around the Internet when sick...

2009-01-21T18:20:00.001+02:00

Are you lost? Think you have a rare tropical disease? Which site do you trust?

The Aussie Government launched this initiative:

The Fifty-first World Health Assembly (Resolution WHA51.9, May 1998) requested the Director-General of WHO to develop a guide on medical products and the Internet. The guide was intended to serve as a model for Member States to adapt into locally meaningful advice for Internet users in order to help them to obtain reliable, independent and comparable information on medicinal products. The guide in this booklet has been prepared to meet the Health Assembly request. It has been developed in consultation with drug regulatory authorities, drug information experts, consumer organizations, and the pharmaceutical industry. It is a model guide, designed to be translated into national languages and modified as the local situation may require.

WHO would be grateful to receive any comments on experience gained from the practical use of the guide which would help in developing it further

.

At last. Someone who isn't just indexing all the bullshit diagnoses out there - and someone really trying to help the internet junkies properly embrace the cyberchondria!

It might be old. At least they're thinking right.

Medical Quackery - Cyberchondriacs

2009-01-19T08:10:00.000+02:00

Stumbled across an old, but interesting post. Excerpt below:

"Experts warn there is a great deal of false and misleading information on the Internet. That’s true – I learned the hard way that eating a bucket of chocolate pudding doesn’t alleviate a headache.

But, for me, the outright quackery was far less damaging than the cold, hard, accurate facts. There is no more devastating statistic than a Survival Rate. That number rattles around your brain like it’s the solution to an equation that could save your life. You massage it, you toy with it… “If 75.2% survive, that means 24.8% don’t… and if 24.8% don’t that means almost 1 in 4…” There’s no better, darker way to learn math."

All to often in practice you get patients who come in and tell YOU what they have. They Google'd it and now know that they have some bacterial infection, or rare intestinal disease or worse. They want "augmentin" or something else they read up about... You smile as a doctor, say you just need to check, only to find out that they have a simple cold, or a viral gastro and nothing more..

Just try and Google the symptoms for Inflammatory bowel disease and I bet most of you will think that you have it...

The lesson is this. We study for more than 6 years to DISTINGUISH symptoms and diseases. Anybody can read medical textbooks or google symptoms and will think they have the answer, but medical school teaches you how to work out what is a headache and what is a brain tumour.

Clinical examination is important. You'd be suprised to know what I can diagnose the way you walk into the room, or by simply looking at the back of your eye (and you would laugh at the amount of information we get out of a touch-your-nose-then-my-finger neurological examination).

Ah... sometimes I miss clinical medicine... but only sometimes...

NetCare in an organ transplant scam.

2009-01-17T12:37:00.000+02:00

Yikes. Click on the image to enlarge.

Marketing a Journal Article...

2009-01-16T18:01:00.003+02:00

We received this mail a while ago from Dan Jeffers...

While reviewing blogs and Web sites that discuss blood disorders, I noticed that yours seems to be well-read and well-informed. Your readers may be interested in the recent clinical practice guidelines for von Willebrand Disease (VWD) offered by the National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health. These are the first clinical guidelines in the United States for the diagnosis and management of von Willebrand Disease (VWD), the most common inherited bleeding disorder. The guidelines include recommendations on screening, diagnosis, disease management, and directions for future research. An extensive article on the guidelines is published online Feb. 29 in the journal Haemophilia.

“These are the first guidelines on von Willebrand Disease published in the United States and we are pleased to offer clinicians science-based recommendations in the evaluation and treatment of patients,” said NHLBI Director Elizabeth G. Nabel, M.D. “The disease can be difficult to diagnose, especially in women of child-bearing age and in children, and the danger of excessive bleeding is often under-recognized.”

The guidelines can be found at http://www.nhlbi.nih.gov/guidelines/vwd/index.htm, and are available for purchase or download.

We hope that you will reach out to your audience by posting a link and/or commenting about the recent guidelines. Thanks for helping us spread the word.

Regards,
Dan Jeffers
Internet Marketing Specialist for
National Heart, Lung, and Blood Institute

What interests me most is not the guidelines for Von Willebrands disease (for medical personel can be found here), it's the fact that medical marketing seems to have taken a new turn.

Before, if a new guideline was published, it could be found in the latest journals like the NEMJ, BMJ, AMJ, SAMJ, CME (there are many (x 100) more) and you would get to know about it via word of mouth. Usually a collegue in the specific field of medicine would have either seen it in his journal, heard about it at a conference, or a drug rep would spread the word. Mostly reputable sources.

It is interesting, that in this new landscape of everything being accessible online (don't get me into the exhorbitant prices you pay to access journals) that this seems to be a new way to market. Get it on Blogs, have the medical Bloggers promote it. It's definately a cheaper and perhaps more far reaching marketing tool. But do you always trust the bloggers information?

This at least comes from a reputable site, so I know the info is good. But in the ever increasing world wide web, where a ton of stuff is factitious (see earlier post about men having babies) and where is it getting harder to distinguish legitimate medical sites from the hocus-pocus out there - I am sceptical about the marketing means...

I don't know...

Jury is out for me...

I'm still trying to decide if I like this type of marketing or if it going to create more headaches in the long run with the large, and sometimes painful, website and information verification process.

GUEST POST: Trusting your Doctor – Is it the Right Treatment?

2008-12-03T17:29:00.003+02:00

Welcome to All Scrubbed Up's 4th guest blogger... Sarah Scrafford! Enjoy her views on the patient-doctor relationships. We think this one may draw some comments...

There are some people who treat their doctors like Gods – they think they can do no wrong, that they can cure any malaise, and that they have their best interests at heart. And then there are others who are extremely reluctant to trust anyone connected to the medical field, who move from doctor to doctor in search of the perfect one they can trust but never find one at all, and who generally prefer to treat themselves unless it’s a life-threatening situation. In my opinion, neither extreme is advisable – while you must trust your doctor to do the best for you, it’s also prudent to exercise caution and do a bit of research before you throw yourself at the complete mercy of a total stranger.

We hear horror stories of medical malpractices that occur because of both negligence and/or incompetency; the victims of these tragedies escape with no lasting damage if they’re lucky, but if they’re not, they could end up with chronic conditions, or worse, die. Medical lawsuits are extremely complicated affairs that end up becoming costly and difficult to prove, which is why it’s best to be prepared and do your homework before going to a doctor to seek treatment:

* Talk to other patients: Before you commit yourself to going under the knife of a particular surgeon, talk to his or her other patients so that you get proper feedback from the right sources. Long time patients are your best bet – they’re the ones who know exactly how competent and how trustworthy your soon-to-be physician is.

* Check the Internet: Some doctors have a web presence, but then again, you can’t believe their own publicity. Run a search to see if people have blogged about their efficiencies or inefficiencies – this being the age of free and available information, most people are not hesitant to air their views from a public soapbox, especially when the medium is as vast and diverse as the World Wide Web.

* Talk to your doctor itself: Some doctors are open to honest communication, and if you’re a good judge of character, you’ll know if you’re in good hands or not.

* Use relatives or close friends in the medical community: People who have close connections to the medical industry are usually in the inner loop regarding doctors and their methods of treatment. If you know someone in the medical community, don’t hesitate to pick their brains and seek their opinion.

* Bedside manner is not everything: Don’t be fooled by the bedside manner of doctors – that’s all there is to some of them. Style over substance never works, more so when it’s a question of your life. So take what doctors say with a pinch of salt, and double check your facts if you want to life a long and healthy life.

--- snip ---

This article is contributed by Sarah Scrafford, who regularly writes on the topic of Radiology Technician Schools. She invites your questions, comments and freelancing job inquiries at her email address: sarah.scrafford25@gmail.com.

Stories from Internship: Elephantitis Man

2008-10-30T08:48:00.001+02:00

I'm sure Bongi would agree with me that doctors are only human - and usually have many funny stories to tell from seeing hospital patients - especially during internship. You only have to watch an episode of Scrubs. And yes. Most of the time... Scrubs is true. A lot more realistic than Gray's Anatomy.

This reminds me of a competition that our unit ran for a couple of weeks (between four of us - we left out the two religious interns).

The prize: Lunch. Paid for while you sit and eat it quietly, the rest of the unit picking up the slack of your ward work. As you can understand, a rare gift as an intern.

The Task: Which of our patients had the largest penis?

Yes, it sounds cruel comparing private vital organs, but you all do it on the Net anyway... We weren't cruel or judging. In fact, you would have been disqualified if you laughed, gasped, or in anyway let the patient know what was going on. We became very inventive at showing skin blemishes in the inguinal area on ward rounds, or asking for a second opinion on a catheter insertion.

Needless to say after two weeks we thought we had a winner. Whilst congratulating him before a morning round, one of our religious interns came to ask about the commotion. We told her about the competition and our winner (and the size of the prize penis - "huge" is a good start).

"Can it be any penis, diseased or not?" she asked.

"Anything. This is a hospital of course".

"Well then you should have included me."

Thinking that there was no way our winner could have been surpassed - and also that we couldn't imagine this small, timid girl taking note of any man's penis, we followed...

She lead us down the long corridor and we gathered around a bed.

"Mr X, we need to see how the swelling is going," she said to the patient and removed the bed sheets.

If there has ever been a time that I have had to stifle a gasp it was then.

The man had elephantitis and the timid Intern got one HELL OF A LUNCH!

TLA's

2008-10-28T21:01:00.003+02:00

TLA's (three letter acronyms) are the best. Both in clinical medicine and in the world of medical aids.

They sound intelligent. And mysterious. And that's what Doctors are, aren't they?

My favourite is FOS (full of shit - can be used in psych or gastroenterology).

I once had a patient who was well versed in TLA's and also liked to read files. After examining her and writing notes, I went off to collect some meds (this was in a polyclinic)...

She became all worried after reading her file. The acronym F.L.U stood out. What could it be? A fancy medical term? Fungating Lipo Ulcerations?

When I looked confused, she said that I had used an abbreviation and she was trying to think what it meant - it sounded serious...

I couldn't help but chuckle and tell her she had the FLU and I wasn't abbreviating.

Internet addiction

2008-09-30T18:49:00.001+02:00

And you think it isn't true...

(SA Doc says: Where your world meets mine!). Har. Har.

Check it out...

I do like the bit about seduction:

The Internet itself is a neutral device originally designed to facilitate research among academic and military agencies. How some people have come to use this medium, however, has created a stir among the mental health community by great discussion of Internet addiction. Addictive use of the Internet is a new phenomenon which many practitioners are unaware of and subsequently unprepared to treat. Some therapists are unfamiliar with the Internet, making its seduction difficult to understand.

Manto's Liver

2008-09-23T17:46:00.001+02:00

Spotted on a Times blog...

“The Medical Association of South Africa (MASA) herewith informs the Minister of Health, the Honourable Manto Tshabala-Msimang, that should she resign, now, with her 11 Cabinet colleagues, she would not be obliged to return her liver.”

Some humour following the chaos in South Africa today...

Cyberchondria...

2008-09-12T18:47:00.002+02:00

Have you got it? Excerpt from Associated Content...

Consider this; the Internet is a pure informational gold mind! You can look up practically anything and get immediate gratification to satisfy curiosities or calm suspicions. But what if you have an abnormal anxiety regarding your health? Commonly known as Hypochondriasis or Hypochondria, the Internet has paved the way for its twenty-first century counterpart - Cyberchondria!

The availability of health information plastered all over the Internet has made it easier for those who worry over illnesses or tend to exaggerate symptoms to justify their fears. A common headache now becomes a brain tumor or a simple upset stomach becomes un-curable cancer! Hypochondria and Cyberchondria are devastating obsessions causing obvious distress to those who suffer from it.

These people are not fakers or malingerers – they honestly believe they suffer from life-threatening diseases or disorders! The trouble starts with the amount of information found on the Net, which provides no scientific validity! Cyberchondriacs view any source of information, from old wives tales to comments from a friend or relative to articles posted on the Internet by complete strangers with no medical background as legitimate, regardless of the lack of medical proof. Frequently a symptom of an anxiety disorder or depression, anyone can be stricken with Cyberchondrosis.

Normally it develops in the twenties or thirties and often follows the illness of a close family member or friend however, an illness in the family is not a prerequisite. This obsession of serious medical problems begins to interfere with daily routines. And the quest for justification cost millions in unnecessary medical tests and treatments every year! This disorder causes its sufferers to become obsessively aware of common sensations most people often ignore. These complaints become a central part of their personalities, as he/she honestly believes they are always a serious threat to their overall well-being. Cyberchondriacs tend to concentrate on hard-to-diagnose, vague symptoms, such as fatigue, general muscle aches and strange physical sensations. And surfing the Net provides validation, especially when his/her primary physician may dismiss worries or simply not supply a diagnosis that soothes the anxiety.

We've told you before.. Google Health just ain't, well, good for your health.

Medical Cartoon #4

2008-08-12T20:40:00.002+02:00

From WrongDiagnosis.com. Har har!

UK. Aphthous Fever. Bah.

2008-07-28T09:20:00.005+02:00

The bloody brits... What will they chain-letter next :)

---snip---

Department of Health
Minister for Health
Victoria Quay
Walsgrave Hospital
Coventry

COVENTRY, July 23, 2008

IMPORTANT NOTICE TO PHYSICIANS AND NURSES

CONFIDENTIAL
Subject : New contamination possible in most Towns

Recent studies conducted on "aphthous fever" (for which we have just received conclusive results) indicate that in certain cases this can be transmitted to humans. We foresee a possible contamination in most Health Board areas. Cases have been reported in Norwich, Stevenage, York, Birmingham, Barrow-in-Furness, and more recently in Leicester, Durham and Nottingham.

It was observed that the subjects examined were regular consumers of wine and spirits. Most (97.6%) of the subjects would encounter serious problems with their vision when having gone without alcohol for 1 to 2 days on average.

Extended periods without alcohol would seriously affect the individuals reading capabilities. The subjects would also feel a trembling sensation. In extreme cases, individuals would start to hallucinate and see coloured specks when staring at an object for extended periods.

If you encounter any such patients having these symptoms, please contact the Crisis Centre in Coventry immediately.

Our research to date has resulted in a cure, consumption of alcohol every day for 3 months!!!

Special announcement from the Department of Health & Welfare

2008-07-11T10:31:00.000+02:00

Department of Health & Welfare
Minister for Health

P.O Box 69
Cape Town
8000

Cape Town, June 19, 2008

IMPORTANT NOTICE TO PHYSICIANS

CONFIDENTIAL

Subject : New contamination possible in most Provinces

Recent studies conducted on "aphthous fever" (for which we have just received conclusive results) indicate that in certain cases this can be transmitted to humans. We foresee a possible contamination in most provinces. Cases have been reported in Gauteng (31), Mpumalanga (24), Western Cape (1,145), Northern Cape (10), Kwazulu-Natal (23) and more recently in the Eastern Cape (15).

It was observed that the subjects examined were regular consumers of wine and spirits. Most (97,6%) of the subjects would encounter serious problems with their vision when having gone without alcohol for 1 to 2 days on average.

Extended periods without alcohol would seriously affect the individuals reading capabilities. The subjects would also feel a trembling sensation. In extreme cases, individuals would start to hallucinate and see coloured specks when staring at an object for extended periods.

If you encounter any such patients having these symptoms, please contact the Crisis Centre in Cape Town immediately.

Our research to date has resulted in a cure, consumption of alcohol every day for 3 months with plenty beetroot and garlic!!!

Please pass this document on to everyone you believe at risk!!!

Yours sincerely,

Manto

Special Advisors:
Mr Johnny Walker
Captain Morgan

MindBullet: Take 2 Aspirin and We'll Google You in the Morning...

2008-06-30T19:20:00.004+02:00

Excellent MindBullet from MindBullets.net. They're weekly doses of futurism - health related in this instance...

SA Doc's analysis. It could happen - give it a couple of years. In South Africa, we're in a little bit of a pickle though. No online consultations are allowed - HPCSA law dictates you have to "touch" a patient in order to provide a medical service.

Neurotics and Psychotics

2008-06-23T08:12:00.000+02:00

The difference between a neurotic and a psychotic is that, while a psychotic thinks that 2 + 2 = 5, a neurotic knows the answer is 4, but it worries him.

Thanks to Medical Jokes on Geocities.

Doctor Chart Bloopers #1

2008-06-21T16:50:00.000+02:00

Found these at The Doctor's Lounge. Not from real Doctor's. Obviously. Well. Maybe.

*The lab test indicated abnormal lover function.

*The baby was delivered, the cord clamped and cut, and handed to the pediatrician, who breathed and cried immediately.

*Exam of genitalia reveals that he is circus sized.

*She stated that she had been constipated for most of her life until 1989 when she got a divorce.

*The patient was in his usual state of good health until his airplane ran out of gas and crashed.

*Rectal exam revealed a normal size thyroid. (Long fingers?)

*Between you and me, we ought to be able to get this lady pregnant.

*A midsystolic ejaculation murmur heard over the mitral area.

*The patient lives at home with his mother, father, and pet turtle, who is presently enrolled in day care three times a week.

*Both breasts are equal and reactive to light and accommodation.

*She is numb from her toes down.

*Exam of genitalia was completely negative except for the right foot.

*The patient was to have a bowel resection. However, he took a job as stockbroker instead.

*When she fainted, her eyes rolled around the room.

*Examination reveals a well-developed male lying in bed with his family in no distress.

*She has no rigors or chills but her husband says she was very hot in bed last night.

*She can't get pregnant with her husband, so I will work her up.

*Whilst in Casualty she was examined, X-rated and sent home.

*The patient states there is a burning pain in his penis which goes to his feet.

*On the second day the knee was better and on the third day it had completely disappeared.

*The patient has been depressed ever since she began seeing me in 1983.

*I will be happy to go into her GI system, she seems ready and anxious.

*Patient was released to outpatient department without dressing.

*I have suggested that he loosen his pants before standing, and then, when he stands with the help of his wife, they should fall to the floor.

*The patient is tearful and crying constantly. She also appears to be depressed.

*Discharge status: Alive but without permission.

*The patient will need disposition, and therefore we will get Dr. Blank to dispose of him.

*Healthy-appearing, decrepit 69 year old male, mentally alert but forgetful.

*The patient has no past history of suicides.

*The patient expired on the floor uneventfully.

*Patient has left his white blood cells at another hospital.

*Patient was becoming more demented with urinary frequency.

*The patient's past medical history has been remarkably insignificant with only a 40 pound weight gain in the past three days.

*She slipped on the ice and apparently her legs went in separate directions in early December.

*The patient experienced sudden onset of severe shortness of breath with a picture of acute pulmonary oedema at home while having sex which gradually deteriorated in the emergency room.

*Patient has chest pains if she lies on her left side for over a year.

*He had a left-toe amputation one month ago. He also had a left-knee amputation last year.

*By the time he was admitted, his rapid heart had stopped, and he was feeling much better.

*The patient is a 79-year-old widow who no longer lives with her husband.

*The patient refused an autopsy.

*Many years ago the patient had frostbite of the right shoe.

*The bugs that grew out of her urine were cultured in the Casualty and are not available. I WILL FIND THEM!!!

*The patient left the hospital feeling much better except for her original complaints.

A second penis?

2008-06-13T07:37:00.001+02:00

Founds this on Truemors.com

A baby boy was born with a second penis — on his back. The rare condition is called fetus in fetu. He was rushed to Tianjin Children’s Hospital in China’s Henan province on May 27. The second penis has been surgically removed.

What!?

Who do you let die?

2008-05-20T08:29:00.002+02:00

Interesting article on Yahoo Answers.

Who should MDs let die in a pandemic? Report offers answers

By LINDSEY TANNER, AP Medical Writer Mon May 5, 12:14 AM ET

Doctors know some patients needing lifesaving care won't get it in a flu pandemic or other disaster. The gut-wrenching dilemma will be deciding who to let die.

Now, an influential group of physicians has drafted a grimly specific list of recommendations for which patients wouldn't be treated. They include the very elderly, seriously hurt trauma victims, severely burned patients and those with severe dementia.

The suggested list was compiled by a task force whose members come from prestigious universities, medical groups, the military and government agencies. They include the Department of Homeland Security, the Centers for Disease Control and Prevention and the Department of Health and Human Services.

The proposed guidelines are designed to be a blueprint for hospitals "so that everybody will be thinking in the same way" when pandemic flu or another widespread health care disaster hits, said Dr. Asha Devereaux. She is a critical care specialist in San Diego and lead writer of the task force report.

The idea is to try to make sure that scarce resources — including ventilators, medicine and doctors and nurses — are used in a uniform, objective way, task force members said.

Now. That's quite a thing. We've known for ages that there are systems of selection in medical environments and situations. I suppose just a little scary to see it in print.

Article goes on to say...

_People older than 85.

_Those with severe trauma, which could include critical injuries from car crashes and shootings.

_Severely burned patients older than 60.

_Those with severe mental impairment, which could include advanced Alzheimer's disease.

_Those with a severe chronic disease, such as advanced heart failure, lung disease or poorly controlled diabetes.

... as examples of how detailed this report gets.

What do YOU think?

There are too many humans. Perhaps life isn't quite as sacrosanct as before...

A new pill to cure all...

2008-05-14T14:30:00.001+02:00

Har har!

GUEST POST: Lenshopper.com - Amazing Emergency Room Stories

2008-05-08T14:40:00.003+02:00

Welcome to All Scrubbed Up's 3rd guest blogger... Lenshopper.com! Enjoy their fine fare of humorous anecdotes...

Amazing Emergency Room Stories
Every day hundreds of thousands of people all over the world are rushed to different hospitals emergency rooms. All of them with real injuries and physical complaints but with different reasons as to why they had to be hospitalized. Here are some funny emergency room stories. Whether or not they’re true events is up to you to decide but stranger things have happened. Or?

Tricky Contacts
On a regular Tuesday evening a local emergency room in Pennsylvania gets a visit by a man that can’t remove his contact lenses. Under the obvious influence of alcohol the man complains of his head aching and abnormal pains in his eyes. Explaining to the nurse that he has been trying to remove his without any luck. The contacts will only come out halfway before popping back in. The nurse then uses a suction pump to get the lenses out but with no result.

When the doctor finally examines the man he quickly realizes that the man has in fact not contact lenses but has being trying to remove the membrane of the cornea. Hence the pain in the eyes.

Don’t Ride An Ambulance in San Francisco
After answering a 911 call from an elderly woman paramedics are rushing back to the local San Francisco ER. While driving up an incline ambulance personnel witness how the back doors of the ambulance suddenly fling open. The stretcher with the resting woman flies out the back and rolls down the hills at a horrifying speed. Rolling through a crossing missing ongoing cars by mere inches the stretcher finally comes to a stop and tips over. The woman is found to be without any physical injuries but clearly chocked.

Bungee Jumping With A Foot Loose
Arriving to the emergency room of Tacoma, Washington, Kerry Bingham had spent the night drinking with his friends. After about the 5th pitcher somebody told the story of a friend of a friend of a friend who had bungee jumped from a nearby bridge during rush hour.

Inspired by the story Kerry and his friends decided to follow this dared devil’s example and too bungee jump from the very same bridge. Well there they realize they have no bungee jump cord, a minor detail according to Kerry who is drunk as a skunk by now.

Several minutes later Kerry’s left foot is strapped and secured to a coil of lineman’s cable and he makes the jump only to fall 40 feet before the cable stretches, feel his left foot being torn of his leg and tumble into the cold river beneath.

Miraculously Kerry survives the fall and is picked up by two fishermen and rushed to the local ER. He later thanks god for keeping an eye out for him and swears never to drink again.

Hospital pecking order...

2008-05-04T20:18:00.000+02:00

Okay, okay - so I'm "adapting" another thing from Medical Jokes on Geocities... hope they don't mind, but this was way too good to pass up.

The Surgeon...
Leaps tall buildings in a single bound
Is more productive than a train
Is faster than a speeding bullet
Walks on water
Talks with God

The Resident...
Leaps short buildings in a single bound
Is more powerful than a switch engine
Is faster than a speeding BB gun
Walks on water if the sea is calm
Talks with God if special request is approved

The GP...
Leaps short buildings with a running start and favourable winds
Is almost as powerful as a switch engine
Can fire a speeding bullet
Walks on water in an indoor swimming pool
Is occasionally addressed by God

The MO (Medical Officer)...
Barely clears a picket fence
Loses tug-of-war with a train
Can sometimes handle a gun without inflicting self-injury
Swims well
Talks with animals

The Intern...
Makes high skid marks on a wall when trying to leap buildings
Is run over by a train
Is not issued ammunition
Dog paddles
Talks to walls

The Med Student...
Runs into buildings
Recognizes a train 2 out of 3 times
Wets himself with a water pistol
Cannot stay afloat without a life preserver
Mumbles to himself

THE SISTER...
Lifts buildings and walks under them
Kicks trains off the track
Catches speeding bullets with her teeth and eats them
Freezes water with a single glance
The Sister IS God

Modernising the Medical World.

2008-04-18T10:51:00.004+02:00

In the wake of the official Google Health launch (check it out - looks interesting). Got some comment from SA Doc on modernising the medical world...

I used to work in a practise that was - for lack of a better word - archaic. You've heard of paperless offices. Now try a paper-filled practice. Everything was done in the old fashioned method of pen to paper - the invoices, the patient notes, even the list indicating the link between family name and file number.

Email? Email who? The only computer visible (under the masses of paper) is an old 486 running Windows 3.1. I actually had to relearn how to use that OS.

No matter how I tried to convince the partners to modernise they could not see the advantage. The idea that you could access any information from complete, LEGIBLE patient notes with a CTRL F was beyond them. The idea that billing and ICD10 coding could be done with a couple of drop down choices didn't compute either (pardon the pun).

I love the idea of systemising patient records and details. It makes things simple. It correlates data very well (no more missing lipograms when a page from the file goes missing). Yikes.

More doctors should organise their patients details and medical information. It makes it easier when you practice, it makes it easier for locums, it makes it easier to recall patient illness details when you need to discuss them with another doctor, it makes it easier to correlate lab results and it makes it easier to bill.

From the other side of the fence now (my crossover into the dark side of managed health), I immediately can notice when a doctor is using a system. They can give me detailed information, email me motivations / lab results. They also tend to bill more appropriately and thus (big tip here!)... have their claims approved faster!

It's a pleasure to work with them! Catch a wake up Docs. It's the 21st Century.

Medical... Aids...

2008-04-03T07:20:00.003+02:00

Unfortunate wording of an ad that appeared on All Scrubbed Up. No real alternate option though if you think about it... Medical SCHEME doesn't sound too great. Neither does Aids.

Shouldn't really be making jokes about this, should I?

Zuma vs Google

2008-04-02T17:34:00.001+02:00

Har. Har.

Try searching for Idiot who thinks a shower cures AIDS. It doesn't work anymore. Updated index or fudged funny. Still hilarious though.

WTF Medical Aid Funding Requests #3

2008-04-01T19:40:00.004+02:00

What is a reasonable request from your medical funder? This All Scrubbed Up series looks at funding requests - from the sublime to the ridiculous.

Just remember. A medical aid funder is allocating money to all their members for REAL medical reasons.

Part 3. Your other lips.

Like most medical aids, we don't cover cosmetic surgery. But believe it or not - we always give people the benefit of the doubt. So when a request comes in for something that is seen as plastic surgery, we always ask the member for a doctor's motivation as to why this procedure is NOT cosmetic, thus repairing a functional impairment.

Labial Reductions.

(That means reducing your "other" lips in size - to look good when the lights on. You know.)

Sometimes there are "functional" reasons for this procedure to take place. For instance, the labia are so large, the person can't straddle a horse. I'm not joking.

The best application we received recently was for a member who's motivation for reduction was: she sprayed in every direction when she peed.

Girl's sit on toilets (I think?). HOW is that a problem? I am a Doctor. A Girl Doctor. I'm sorry - I would not want my pink bits operated on to that extent. We all know that mole removal scars hurt for weeks (and everytime in gets cold!). Can. You. Imagine.

GUEST POST: Lobotomy Revisited (by Brian Carty)

2008-03-25T17:06:00.005+02:00

The second guest post from Brian Carty of Hot Medical News, covering the... well, less-covered side of medicine! Enjoy "the history of the lobotomoy"! There's a great video that goes along with this post. Watch it here.

By Brian Carty, MD, MSPH
March 25, 2008

Do you remember Rosemary Kennedy, John F. Kennedy's sister? Maybe not, since she spent most of her life hidden away in an institution in the Midwest. She had a lobotomy, a brain operation for mental illness, in 1941 when she was 23. Her father, Joseph Kennedy, arranged the operation. The procedure left her mentally incapacitated. Whether she was mentally ill, mentally retarded, or both, is unclear, but her disruptive behavior led to the operation and its unfortunate outcome. She died of natural causes on January 7, 2005 at the age of 86.

The lobotomy, also called leucotomy, was devised in 1935 by the Portuguese neurologist Egas Moniz for the treatment of various psychiatric disorders. In this procedure, holes were drilled in the skull and a blade was used to cut nerve fibers from the frontal lobes (the front of the brain, just behind the forehead) to the rest of the brain. The term lobotomy came to include a variety of surgical procedures on the frontal lobes which were performed for psychiatric disorders.

An estimated 50,000 lobotomies were performed in the US in the 1930s and 40s. Although electroconvulsive therapy was introduced in the 1930s, it is useful mainly for the treatment of depression. Otherwise, before effective psychiatric drugs were available in the 1950s, the only other treatments for the severely mentally ill were incarceration and physical restraint.

By today’s standards, conditions in the mental hospitals of the time were unimaginable. Many patients were severely agitated, extremely violent, and incontinent. The hospitals were dirty, overcrowded, and understaffed.

Many severely ill patients benefited from lobotomy with decreases in violence and agitation. However, lobotomy often caused serious adverse effects, including disturbances of mood and personality, euphoria, poor judgment, impulsivity, loss of initiative, intellectual deficits, and seizures.

For many patients, however, a decrease in agitation and violence, even when accompanied by neurologic injury from frontal lobe surgery, was understandably considered an improvement. When the first effective antipsychotic drug, Thorazine (chlorpromazine), was introduced in the US in 1954, the number of lobotomies performed plummeted.

Surgery for psychiatric disorders is still performed rarely today. The procedures have become more selective and less extensive and now include deep brain stimulation with implanted electrodes. Similar surgical procedures and deep brain stimulation are sometimes done for movement disorders and chronic pain. Surgery for psychiatric disorders is still controversial and, when performed, is most often used for treatment-refractory obsessive-compulsive disorder (OCD). OCD is a disorder characterized by obsessive thoughts and compulsive behaviors such as repeated hand washing or checking to see if doors are locked. OCD can severely affect functioning and quality of life.

It is worth noting again that surgery for psychiatric disorders must be judged with reference to conditions which existed at the time the procedures were introduced. Although lobotomy is viewed by many as barbaric, the operation gave many patients a limited improvement which was otherwise unobtainable. The wisdom of hindsight should be applied sparingly; newly introduced medical treatments often cause unintended harm. The history of lobotomy should remind us that future generations will inevitably view our current best treatments as primitive.

GUEST POST: Are Ya Juicin' It? Anabolic-Androgenic Steroid Abuse

2008-03-18T20:42:00.003+02:00

Welcome to our second guest poster on All Scrubbed Up... Brian Carty of HotMedicalNews.com. Here's an indepth look at the effect of steroids in body builders. Chilling stuff.

By Brian Carty, MD, MSPH
March 14, 2008

Irritable, angry, aggressive, but feeling strong and invincible, Mr. A, 32, a bodybuilder and prison guard, stopped at a convenience store to call his boss. Car trouble on the way to work.. He would be late.

Bodybuilder and enhanced performance

[With permission of Steve Michalik. Mr. Michalik, a former Mr. America and Mr. Universe, once used steroids and suffered as a result. He is now an energetic and outspoken opponent of steroid abuse.]

Mr. A was taking his fifth cycle of anabolic-androgenic steroids (abbreviated in this article as "steroids"), and he was "stacking," combining high doses of several different steroids, sometimes referred to by the slang term "juice." The woman working at the convenience store noted his uniform and joked, "You officers use my phone so much, I ought to start charging for it." Mr. A was strangely disturbed by this remark. He felt that the woman had criticized and demeaned him, and he was obsessed by the remark that afternoon and throughout the night. He slept poorly. His wife could not reassure him.

'Roid Rage
Later, he said that he wanted to "scare the lady in return for that remark she made to me." In the morning Mr. A drove back to the convenience store and forced the woman into his car. She fought back, biting his hand and grabbing his revolver which fired through the windshield. Although he subdued her and drove away, when the car stopped she bolted from the car. He shot her in the back as she fled, leaving her permanently paralyzed. Mr. A was later arrested, tried, and sentenced to twenty years in prison. After his arrest and withdrawal from steroids, he developed major depression which resolved in a month.

This case and several other cases of homicide or near-homicide by anabolic steroid abusers are presented in an article by Dr. Harrison Pope, Jr., and Dr. David Katz in the January 1990 Journal of Clinical Psychiatry.

Read more on this subject at Brian's site here (continuation of article)...

Have a Happy Period!

2008-03-10T14:47:00.003+02:00

Never know whether these things are true or not. But bwhahahaha. Funny nonetheless! I'm a boy, and even I cringe at the medical marketing.

This is an actual letter from an Austin woman sent to American company Proctor and Gamble regarding their feminine products. She really gets rolling after the first paragraph. It's PC Magazine's 2007 editors' choice for best webmail-award-winning letter.

Dear Mr. Thatcher,

I have been a loyal user of your 'Always' maxi pads for over 20 years and I appreciate many of their features. Why, without the LeakGuard Core or Dri-Weave absorbency, I'd probably never go horseback riding or salsa dancing, and I 'd certainly steer clear of running up and down the beach in tight, white shorts. But my favorite feature has to be your revolutionary Flexi-Wings. Kudos on being the only company smart enough to realize how crucial it is that maxi pads be aerodynamic. I can't tell you how safe and secure I feel each month knowing there's a little F-16 in my pants.

Have you ever had a menstrual period, Mr. Thatcher? Ever suffered from the curse'? I'm guessing you haven't. Well, my time of the month is starting right now. As I type, I can already feel hormonal forces violently surging through my body. Just a few minutes from now, my body will adjust and I'll be transformed into what my husband likes to call 'an inbred hillbilly with knife skills.' Isn't the human body amazing?

As Brand Manager in the Feminine-Hygiene Division, you've no doubt seen quite a bit of research on what exactly happens during your customers monthly visits from 'Aunt Flo'. Therefore, you must know about the bloating, puffiness, and cramping we endure, and about our intense mood swings, crying, jags, and out-of-control behavior. You surely realize it's a tough time for most women. In fact, only last week, my friend Jennifer fought the violent urge to shove her boyfriend's testicles into a George Foreman Grill just because he told her he thought Grey's Anatomy was written by drunken chimps. Crazy!

The point is, sir, you of all people must realize that America is just crawling with homicidal maniacs in Capri pants... Which brings me to the reason for my letter. Last month, while in the throes of cramping so painful I wanted to reach inside my body and yank out my uterus, I opened an Always maxi-pad, and there, printed on the adhesive backing, were these words: 'Have a Happy Period.'

Are you fu*ing kidding me? What I mean is, does any part of your tiny middle-manager brain really think happiness - actual smiling, laughing happiness is possible during a menstrual period? Did anything mentioned above sound the least bit pleasurable? Well, did it, James? FYI, unless you're some kind of sick S&M freak, there will never be anything 'happy' about a day in which you have to jack yourself up on Asprin and Kahlua and lock yourself in your house just so you don't march down to the local Walgreen's armed with a hunting rifle and a sketchy plan to end your life in a blaze of glory.

For the love of God, pull your head out, man! If you just have to slap a moronic message on a maxi pad, wouldn't it make more sense to say something that's actually pertinent, like 'Put down the Hammer' or 'Vehicular Manslaughter is Wrong', or are you just picking on us?

Sir, please inform your Accounting Department that, effective immediately, there will be an $8 drop in monthly profits, for I have chosen to take my maxi-pad business elsewhere. And though I will certainly miss your Flex-Wings, I will not for one minute miss your brand of condescending bullsh*t. And that's a promise I will keep. Always.

Best,

Wendi Aarons
Austin , TX

Medical Quotes #2

2008-03-06T17:22:00.000+02:00

More quotes... Some philosphical. Some, er, not...

- - - - - - - - - - - - - - -

Medicine is the only profession that labours incessantly to destroy the reason for its own existence. ~James Bryce, 1914

It is not a case we are treating; it is a living, palpitating, alas, too often suffering fellow creature. ~John Brown

The patient does not care about your science; what he wants to know is, can you cure him? ~Martin H. Fischer

Medicines heals doubts as well as diseases. ~Karl Marx

A physician is obligated to consider more than a diseased organ, more even than the whole man - he must view the man in his world. ~Harvey Cushing

Medicine sometimes snatches away health, sometimes gives it. ~Ovid, Tristia

As it takes two to make a quarrel, so it takes two to make a disease, the microbe and its host. ~Charles V. Chapin

Disease is war with the laws of our being, and all war, as a great general has said, is hell. ~Lewis G. Janes

Until a physician has killed one or two he is not a physician. ~Kashmiri Proverb

No man is a good doctor who has never been sick himself. ~Chinese Proverb

Only one rule in medical ethics need concern you - that action on your part which best conserves the interests of your patient. ~Martin H. Fischer

To me the ideal doctor would be a man endowed with profound knowledge of life and of the soul, intuitively divining any suffering or disorder of whatever kind, and restoring peace by his mere presence. ~Henri Amiel

Medicinal discovery,
It moves in mighty leaps,
It leapt straight past the common cold
And give it us for keeps.
~Pam Ayres

When you no longer know what headache, heartache, or stomachache means without cistern punctures, electrocardiograms and six x-ray plates, you are slipping. ~Martin H. Fischer

It is easy to get a thousand prescriptions but hard to get one single remedy. ~Chinese Proverb

Never forget that it is not a pneumonia, but a pneumonic man who is your patient. ~William Withey Gull

It is said to be the manner of hypochondriacs to change often their physician. ~William Cullen, Practice of Physic

The road to medical knowledge is through the pathological museum and not through an apothecary's shop. ~William Withey Gull

A Short History of Medicine
2000 B.C. - "Here, eat this root."
1000 B.C. - "That root is heathen, say this prayer."
1850 A.D. - "That prayer is superstition, drink this potion."
1940 A.D. - "That potion is snake oil, swallow this pill."
1985 A.D. - "That pill is ineffective, take this antibiotic."
2000 A.D. - "That antibiotic is artificial. Here, eat this root."
~Author Unknown

When a lot of remedies are suggested for a disease, that means it cannot be cured. ~Anton Chekhov, The Cherry Orchard

A half doctor near is better than a whole one far away. ~German Proverb

No doctor is better than three. ~German Proverb

I will lift mine eyes unto the pills. Almost everyone takes them, from the humble aspirin to the multi-coloured, king-sized three deckers, which put you to sleep, wake you up, stimulate and soothe you all in one. It is an age of pills. ~Malcolm Muggeridge, 1962

Man may be the captain of his fate, but is also the victim of his blood sugar. ~Wilfrid G. Oakley

Faith and knowledge lean largely upon each other in the practice of medicine. ~Peter Mere Latham

Each patient ought to feel somewhat the better after the physician's visit, irrespective of the nature of the illness. ~Warfield Theobald Longcope

Who ever thought up the word "Mammogram?" Every time I hear it, I think I'm supposed to put my breast in an envelope and send it to someone. ~Jan King

Never go to a doctor whose office plants have died. ~Erma Bombeck

You may know the intractability of a disease by its long list of remedies. ~Alonzo Clark

Here's good advice for practice: go into partnership with nature; she does more than half the work and asks none of the fee. ~Martin H. Fischer

Varicose veins are the result of an improper selection of grandparents. ~William Osler

If you are too smart to pay the doctor, you had better be too smart to get ill. ~African Proverb

When you treat a disease, first treat the mind. ~Chen Jen

Symptoms are the body's mother tongue; signs are in a foreign language. ~John Brown

The doctor of the future will give no medicine but will interest his patients in the care of the human frame, in diet and in the cause and prevention of disease. ~Thomas Edison

Oh the powers of nature. She knows what we need, and the doctors know nothing. ~Benvenuto Cellini

So many come to the sickroom thinking of themselves as men of science fighting disease and not as healers with a little knowledge helping nature to get a sick man well. ~Auckland Geddes, The Practitioner

Where a man feels pain he lays his hand. ~Dutch Proverb

The doctor is often more to be feared than the disease. ~French Proverb

Despite all our toil and progress, the art of medicine still falls somewhere between trout casting and spook writing. ~Ben Hecht, Miracle of the Fifteen Murderers

The Lord hath created medicines out of the earth; and he that is wise will not abhor them. ~Ecclesiasticus 38:4

A drug is that substance which, when injected into a rat, will produce a scientific report. ~Author Unknown

Cancer is a word, not a sentence. ~John Diamond

The medicalization of early diagnosis not only hampers and discourages preventative health-care but it also trains the patient-to-be to function in the meantime as an acolyte to his doctor. He learns to depend on the physician in sickness and in health. He turns into a life-long patient. ~Ivan Illich

Patients may recover in spite of drugs or because of them. ~J.H. Gaddum

He's the best physician that knows the worthlessness of the most medicines. ~Benjamin Franklin

Physiology is the stepchild of medicine. That is why Cinderella often turns out the queen. ~Martin H. Fischer

The field of Western medicine has become literally nothing but medicine. Doctors are on their way out, to be replaced by self-serve pharmaceutical vending machines. ~Grey Livingston

The fact that your patient gets well does not prove that your diagnosis was correct. ~Samuel J. Meltzer

Man is a creature composed of countless millions of cells: a microbe is composed of only one, yet throughout the ages the two have been in ceaseless conflict. ~A.B. Christie

Our profession is the only one which works unceasingly to annihilate itself. ~Martin H. Fischer

On J-Day our profession will have a lot to answer for! We might at least have withheld our hands instead of making them work against God. ~Martin H. Fischer

The doctor may also learn more about the illness from the way the patient tells the story than from the story itself. ~James B. Herrick

Don't think of organ donations as giving up part of yourself to keep a total stranger alive. It's really a total stranger giving up almost all of themselves to keep part of you alive. ~Author Unknown

Most of those evils we poor mortals know
From doctors and imagination flow.
~Charles Churchill

Men are not going to embrace eugenics. They are going to embrace the first likely, trim-figured girl with limpid eyes and flashing teeth who comes along, in spite of the fact that her germ plasm is probably reeking with hypertension, cancer, haemophilia, colour blindness, hay fever, epilepsy, and amyotrophic lateral sclerosis. ~Logan Clendening

Don't take your organs to heaven with you. Heaven knows we need them here. ~Author unknown, attributed to both Dan and Barbara Hladio and Thomas Boyadjis, Sr.

'Tis not always in a physician's power to cure the sick; at times the disease is stronger than trained art. ~Ovid

And lo, The Hospital, grey, quiet, old, Where Life and Death like friendly chafferers meet. ~William Ernest Henley

For the most part, Western medicine doctors are not healers, preventers, listeners, or educators. But they're damned good at saving a life and the other aspects kick the beam. It's about time we brought some balance back to the scale. ~Claire Todae

A sweating ovary or a sick prostate explains most history. ~Martin H. Fischer

The only weapon with which the unconscious patient can immediately retaliate upon the incompetent surgeon is hemorrhage. ~William Stewart Halsted

The public blabbers about preventative medicine, but will neither appreciate nor pay for it. You get paid for what you cure. ~Martin H. Fischer

To save a man's life against his will is the same as killing him. ~Horace

Nowadays the clinical history too often weighs more than the man. ~Martin H. Fischer

Hypochondriacs squander large sums of time in search of nostrums by which they vainly hope they may get more time to squander. ~Mortimer Collins

One doctor makes work for another. ~English Proverb

Doctors are just the same as lawyers; the only difference is that lawyers merely rob you, whereas doctors rob you and kill you, too. ~Anton Chekhov, Ivanov

Let the young know they will never find a more interesting, more instructive book than the patient himself. ~Giorgio Baglivi

Formerly, when religion was strong and science weak, men mistook magic for medicine; now, when science is strong and religion weak, men mistake medicine for magic. ~Thomas Szasz, The Second Sin, 1973

Tooth gives man his sight back

2008-03-05T13:13:00.003+02:00

HUH?

Wat die donder?

27/02/2008 21:16 - (SA). AFP

Dublin - An Irishman blinded by an explosion two years ago has had his sight restored after doctors inserted his son's tooth in his eye, he said on Wednesday.

Bob McNichol, 57, from County Mayo in the west of the country, lost his sight in a freak accident when red-hot liquid aluminium exploded at a re-cycling business in November 2005.

"I thought that I was going to be blind for the rest of my life," McNichol told RTE state radio.

After doctors in Ireland said there was nothing more they could do, McNichol heard about a miracle operation called Osteo-Odonto-Keratoprosthesis (OOKP) being performed by Dr Christopher Liu at the Sussex Eye Hospital in Brighton in England.

The technique, pioneered in Italy in the 1960s, involves creating a support for an artificial cornea from the patient's own tooth and the surrounding bone.

The procedure used on McNichol involved his son Robert, 23, donating a tooth, its root and part of the jaw.

McNichol's right eye socket was rebuilt, part of the tooth inserted and a lens inserted in a hole drilled in the tooth.

The first operation lasted 10 hours and the second five hours.

"It is pretty heavy going," McNichol said. "There was a 65% chance of me getting any sight.

"Now I have enough sight for me to get around and I can watch television. I have come out from complete darkness to be able to do simple things," McNichol said.

Will have to wait for SA Doc to get back from her managed health care world and explain to me the differences between enamel and eyes. :)

Thanks Toby Shapshak for the story...

Medical Quotes #1

2008-03-03T18:04:00.002+02:00

I'm in a quotes phase. Don't know why. But found these beauts. Two part series. Original post here.

- - - - - - - - - - - - - - -

In nothing do men more nearly approach the gods than in giving health to men. ~Cicero

My doctor is nice; every time I see him, I'm ashamed of what I think of doctors in general. ~Mignon McLaughlin, The Second Neurotic's Notebook, 1966

The greatest mistake in the treatment of diseases is that there are physicians for the body and physicians for the soul, although the two cannot be separated. ~Plato

Body and soul cannot be separated for purposes of treatment, for they are one and indivisible. Sick minds must be healed as well as sick bodies. ~C. Jeff Miller

In the sick room, ten cents' worth of human understanding equals ten dollars' worth of medical science. ~Martin H. Fischer

It is a mathematical fact that fifty percent of all doctors graduate in the bottom half of their class. ~Author Unknown

Restore a man to his health, his purse lies open to thee. ~Robert Burton

I got the bill for my surgery. Now I know what those doctors were wearing masks for. ~James H. Boren

A hospital should also have a recovery room adjoining the cashier's office. ~Francis O'Walsh

Did God who gave us flowers and trees,
Also provide the allergies?
~E.Y. Harburg, "A Nose Is a Nose Is a Nose," 1965

I learned a long time ago that minor surgery is when they do the operation on someone else, not you. ~Bill Walton

It is a wise mans part, rather to avoid sickness, than to wishe for medicines. ~Thomas More, Utopia [sic]

I wondher why ye can always read a doctor's bill an' ye niver can read his purscription. ~Finley Peter Dunne

You have a cough? Go home tonight, eat a whole box of Ex-Lax - tomorrow you'll be afraid to cough. ~Pearl Williams

To array a man's will against his sickness is the supreme art of medicine. ~Henry Ward Beecher

A doctor whose breath smells has no right to medical opinion. ~Martin H. Fischer

Surgeons must be very careful
When they take the knife!
Underneath their fine incisions
Stirs the Culprit - Life!
~Emily Dickinson

It is a good thing for a physician to have prematurely grey hair and itching piles. The first makes him appear to know more than he does, and the second gives him an expression of concern which the patient interprets as being on his behalf. ~A. Benson Cannon

A doctor who cannot take a good history and a patient who cannot give one are in danger of giving and receiving bad treatment. ~Author Unknown

One thousand Americans stop smoking every day - by dying. ~Author Unknown

A hypochondriac is one who has a pill for everything except what ails him. ~Mignon McLaughlin, The Second Neurotic's Notebook, 1966

The art of medicine consists in amusing the patient while nature cures the disease. ~Voltaire

A doctor must work eighteen hours a day and seven days a week. If you cannot console yourself to this, get out of the profession. ~Martin H. Fischer

It is sometimes as dangerous to be run into by a microbe as by a trolley car. ~J.J. Walsh

Every disease is a physician. ~Irish Proverb

God heales, and the Physitian hath the thankes. ~George Herbert, Outlandish Proverbs

Drugs are not always necessary. Belief in recovery always is. ~Norman Cousins

I firmly believe that if the whole materia medica could be sunk to the bottom of the sea, it would be all the better for mankind and all the worse for the fishes. ~Oliver Wendell Holmes

There is no curing a sick man who believes himself to be in health. ~Henri Amiel

Doctors think a lot of patients are cured who have simply quit in disgust. ~Don Herold

The only equipment lack in the modern hospital? Somebody to meet you at the entrance with a handshake! ~Martin H. Fischer

The worst thing about medicine is that one kind makes another necessary. ~Elbert Hubbard

When you are called to a sick man, be sure you know what the matter is - if you do not know, nature can do a great deal better than you can guess. ~Nicholas de Belleville

Throw physic to the dogs; I'll none of it. ~William Shakespeare

I recently became a Christian Scientist. It was the only health plan I could afford. ~Betsy Salkind

Poisons and medicine are oftentimes the same substance given with different intents. ~Peter Mere Latham

In the nineteenth century men lost their fear of God and acquired a fear of microbes. ~Author Unknown

Symptoms, then are in reality nothing but the cry from suffering organs. ~Jean Martin Charcot, translated from French

I never read a patent medicine advertisement without being impelled to the conclusion that I am suffering from the particular disease therein dealt with in its most virulent form. ~Jerome K. Jerome, Three Men in a Boat

Diagnosis is not the end, but the beginning of practice. ~Martin H. Fischer

The physician should look upon the patient as a besieged city and try to rescue him with every means that art and science place at his command. ~Alexander of Tralles

Physicians and politicians resemble one another in this respect, that some defend the constitution and others destroy it. ~Author Unknown

A smart mother makes often a better diagnosis than a poor doctor. ~August Bier

When fate arrives the physician becomes a fool. ~Arabic Proverb

Medicines are not meat to live by. ~German Proverb

Treat the patient, not the Xray. ~James M. Hunter

God and the Doctor we alike adore
But only when in danger, not before;
The danger o'er, both are alike requited,
God is forgotten, and the Doctor slighted.
~Robert Owen

Financial ruin from medical bills is almost exclusively an American disease. ~Roul Turley

The hospital is the only proper College in which to rear a true disciple of Aesculapius. ~John Abernethy

A man who cannot work without his hypodermic needle is a poor doctor. The amount of narcotic you use is inversely proportional to your skill. ~Martin H. Fischer

Better to hunt in fields, for health unbought,
Than fee the doctor for a nauseous draught,
The wise, for cure, on exercise depend;
God never made his work for man to mend.
~John Dryden

All Scrubbed Up - Looking for contributors!

2008-03-01T17:56:00.003+02:00

Wanna get under our blog?

All Scrubbed Up is looking for contributors... Drop us a comment with your email address if you're keen to get involved with writing on South Africa's leading medical blog. Share of ad revenue to your posts - part of the package baby!

We want to expand - are you it?

Medical Confessions

2008-02-26T17:57:00.001+02:00

Har. Har. Pretty funny read...

Ever wondered if doctors are frightened of catching what you've got? What their notes really mean? Or how to get round their receptionist? We asked five doctors to spill the beans

Check it out here.

Remembering the old days... Black Eyes & Baragwanath

2008-02-25T19:53:00.003+02:00

Being in managed health care is just... not as dangerous.

For some reason, I thought of this old gem the other day...

It was a dark, stormy night. Aren't all the nights in Bara dark and stormy. Or at least dark. When the lights go out. That's another story.

Was working in Ward 20. Having seen the 1 000 00th TB patient, I got called to case where the patient was tired to a stretcher. This can only mean two things.

One, the patient is dangerous. Two, the patient is psychotic. Both aren’t preferable. And the combo package is even worse.

This particular patient had post-ictal psychosis (for the layman out there, translation: have fit, become psychotic). On trying to get close to her, the poor lady screamed like a banshee and struggled against the restraints. At one point, she managed to slip free of the bonds that held her, requiring two (big manly) doctors to hold her down. My job? Flank and approach armed with large dose of Benzo’s. Unfortunately, she got her arm free and took a nice big swing.

THWACK.

I’ve barely been in a catfight, but before I knew it – I was knocked flat back on my ass. 1 x Well connected shot to the jaw. I left. Ego and jaw bruised, and not particularly caring anymore.

On the ward round the next day, we came across the same patient, who was now lucid and no longer psychotic. She was, however, spoting a nice black eye. Eyes turned towards me. The consultant had heard about the punch.

“Did YOU do that?!” he said.

“No,” I replied. But I wish I had.

Goes to show. Always the bloody doctors who get blamed!?

Zuma and his HIV Shower... the jokes #2

2008-02-19T16:48:00.000+02:00

Dredging more out the archives - Zuma jokes. Aren't politicians meant to be good at spinning stories?

For our international readers - our State President to be got embroiled in THIS fantastic farce...

Zuma and his HIV Shower... the jokes #1

2008-02-18T18:25:00.002+02:00

Har Har... Amusing.

WTF Medical Aid Funding Requests #2

2008-02-12T16:20:00.000+02:00

WTF Medical Aid Funding Requests #1

2008-02-08T15:50:00.000+02:00

Ready! Aim! Operate on my back please!

2008-02-04T13:21:00.000+02:00

Working for a managed care company, I am observing the high number of spinal surgeries that take place in the market (and just think that, what a funder sees is only a fraction of what is actually happening in South Africa...)

South Africa is known to have a low threshold for doing spinal surgery. In the UK, you would have to go through a lot of conservative therapy and years of waiting... AND have severe disease in order to get an op. Here, we see many neurosurgeons going in to do fusions or disc replacements sometimes without severe disease, sometimes even without conservative treatment!

Is this due to the patients who put so much pressure on surgeons to do something about their pain? Sometimes I think these people fit into their own subset, and should be defined by psychiatry for a new personality disorder. We get a constant stream of calls - all exactly the same personality types - fighting tooth 'n nail to get a surgery for disease that is very mild on their MRI.

OR. Is it due to monetary greed on the part of certain local surgeons (believe me... when we're looking at funding requests, we see large subsets from the SAME neurosurgeons, and the SAME areas of the country). Sniff sniff. I smell a pattern.

Back surgery is dangerous... not necessarily curative, and often leads to repeat surgeries. Yet in South Africa, it's itchy trigger fingers all round. I think South Africa (neurosurgeons, medical schools and possibly funders) need to have a serious look at the indications for doing back surgery.

Or before long, we'll set a precedent that could rather have been controlled by Celebrex.

(PS. The surgeons in this picture were ripped straight off the Internet and have NOTHING to do with this article! If you're a back surgeon, send All Scrubbed Up your picture... We'll post your picture up with dollar signs. For free.)

Manto's Liver to Little Johnny: Thank You!

2008-01-31T10:40:00.000+02:00

Manto wishes to thank the Johannesburg Transplant Unit for her new liver. She's sorry little Johnny didn't get the liver instead. And would like to make a toast to all those out there who supported her cause. Cheers! Glug.

The ethics of liver transplants for alcoholics...

2008-01-27T18:45:00.000+02:00

Read an article on the front page of the Citizen, about Discovery Health (Bongi's favourite) refusing to fund a liver transplant on what seems like suspicion of alcohol abuse.

So I want to debate transplants. And the ethical eligibility to receive one. Liver transplants spring to mind.

Many conditions cause end-stage liver disease that would then require a liver transplant for survival. Livers are a scarce resource that do not become available everyday. For instance, in the UK, 17000 people are waiting for a liver transplant. If you're lucky, between 50 and 200 become available every year.

So, how do you allocate organs appropriately and fairly?

Do you want to give a liver to a person, who through large consumption of alcohol caused cirrhosis? Or do you want to give it to a child, who through no fault of their own, has biliary atresia. Or to a woman who developed auto immune hepatitis?

Most international guidelines say that for a person who has alcohol-induced liver failure to become eligible for a transplant, they need to have shown a period of abstinence and/or a period of rehabilitation. Usually 6 months.

After this period - does that make them deserving of a liver transplant? Should the guidelines be abolished as people who are alcoholics have a disease "that they are not in control of"? Even if you will continue to drink and destroy your new liver?

Should self-induced liver disease be deserving at all (taking into account the more deserving children and adults out there, who have had no control of the cause of their liver failure)?

What do you think?

Personally, I will tell the Organ Donation Society NOT to give my liver / organs to anybody who has not been substance abuse rehabilitated. Full stop.

Live Surgery #2 - More open heart surgery!

2008-01-26T19:02:00.000+02:00

Is it just me? Or is that thing beatin' fast!?

Live Surgery #1 - Open Heart Surgery

2008-01-23T22:00:00.000+02:00

Who would've thunk it? The world's video viewing spot of choice, YouTube, has live surgery.

Lock away the kids!

Vitality. Is it vital?

2008-01-17T15:58:00.000+02:00

Question. What does everyone out there (South Africans) think of Vitality? We've just joined. Got our super cheap gym, earning points like crazy. Blah. Blah.

What do you think? Marketing gimmick? Or a real loyalty programme based on a healthly lifestyle?

Private Practice comes to South Africa

2008-01-15T16:18:00.000+02:00

Shudder. This just CAN'T be good.

Some background from IMDB.

A highly regarded neo-natal surgeon and a fellow of the American College of Surgeons, Addison is also a board certified OB-GYN with fellowships in maternal-fetal medicine and medical genetics. She also completed two years of study on cystic fibrosis. In addition, she is also one of only a handful of surgeons in the world who knows how to separate fetal blood vessels. She is increditably wealthy but it was never clearly implied if she was weathy to begin with or if she had to work for her success. Addison met her future husband, Derek Shepherd, in medical school and completed her residency under the supervision of her now good friend, Dr. Richard Webber, whom she, at one point, avoided for almost a year after he taught her a valuable lesson about not getting too close to her patients by putting her on a case in which the patient would inevitably die.

Addie and Derek became extremely successful in their respective fields and each began their own practice in New York. This strained their marriage. After she was caught cheating with Derek's best friend, Mark Sloan, he moved to Seattle to get away from her. There, he met Dr. Meredith Grey with whom he started a relationship. Addison then arrived in Seattle at Richard's behest, and confronted Derek on his affair by introducing herself to Meredith as his wife.

After a period of antagonism between her and Derek (in which he continually referred to her as "Satan"), Addison decided to stay on as head of neo-natal surgery at Seattle Grace, signing a lucrative two-year contract after she and Derek decided to make an effort to work things out, but Derek was still in love with Meredith. After finding out that her husband slept with Meredith at the hospital-sponsored prom, however, Addison (in a drunken haze) called Mark Sloan to Seattle.

She and Derek then agreed that their marriage was over and started divorce proceedings. She asked Mark to go back to New York, but he stayed, expressing his desire to continue their relationship. Addison rebuffed him.When the divorce was finalized, Addison dropped the "Shepherd" from her last name. Wanting to make a fresh start, Derek happily relinquished most of their shared properties (their Brownstone in Manhattan overlooking Central Park and a residence in The Hamptons) to her believing that she deserved it under his initial impression that she only had a one-night stand with Mark while he carried an affair with Meredith.

Later, Addison divulged the whole truth regarding her infidelity to him which led to an emotionally painful encounter in which Derek told her to get out of his life. Addison is believed to have had a good relationship with the Shepherd family, in particular Nancy Shepherd (McBitchy), but, pending Derek's revelation of the true extent of Addison/Mark's relationship, her closeness to the Shepherds is in doubt.

Since arriving at Seattle Grace, Addison has made many friendships with other characters, most notably Callie Torres and Miranda Bailey. Callie and Addison often discuss their current relationships and love lives, which has ultimately led to a very close friendship between the two. Addison is also very good friends with fellow attending, Preston Burke. She has a strained friendship with Mark Sloan and doesn't have a strong friendship with any of the interns, with the exception of Alex Karev, but that friendship is reminiscent to that of hers with Mark Sloan. She has a father-daughter bond with Richard Webber, and is often portrayed to be very close to him. A possibility of a relationship between her and Alex Karev has been hinted at, when she kissed him in Joe's bar. Even after he rejected her affections, she continued to lust after him.

She has (along with Mark) decided to abstain from sex for 60 days. If Dr. Sloan completes the challenge, she is willing to try a real relationship with him; however, it is she who fails. She engages in a sexual encounter with Alex at the hospital and Mark learns of this after witnessing them stumbling out of an on-call room. She is spared from confessing, however, when Mark lies to her by telling her he had broken their promise long before.

According to many of the show's allusions, Addison then decides to pursue Alex Karev. Her advances are once again rejected, however, hinting at the potential departure of Addison though she has expressed immense interest in being the next Chief of Surgery. Addison visited her college friend Naomi in a Private Practice is Los Angeles to get pregnant. It turns out that Addison't cervical count is 2 and she can't become a mother. Dr Pete Finch kisses her to "remind her that she's not dried up"...

Sigh. It sounds truly awful. Has anyone seen it? Thoughts?

Best Of All Scrubbed Up (Part 2)

2008-01-11T16:26:00.000+02:00

Not enough bloggers take the time to go back in the archives and rehash some of their best material... Egotistically speaking of course.

But we're different.

WELCOME TO PART 2 - The Best of All Scrubbed Up

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The World famous WHAT IS THAT?!? Competition

Ah. Nothing draws crowds like a bit of guess-the-gross-thing-on-the-operating-table. This series of posts probably ranks as the most popular we've ever written for All Scrubbed Up. Read Part 1 of the competition here - or click here to browse through all the posts and their respective answers (reveals!).

- - - - -
HIV people CAN have children...

And then a heart-warming piece about an experience SA Doc had with some HIV patients. We must never forget our empathy - especially being South Africans, living in the health environment we do.

Aids is not a disease. It's a human rights issue.
- Nelson Mandela, 2005.

Read the post here.

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And there ends the lesson. What do you think of the BEST OF selection? Let us know in the comments...

Back.

2008-01-10T15:20:00.000+02:00

We're baaaack!

Shutting down... for a while...

2007-12-26T21:45:00.001+02:00

Merry Christmas and a Happy New Year to ALL!

We're going on holiday... back in Jan!

Two vaginas?

2007-12-24T09:20:00.000+02:00

And THIS?!

Click the image to see it full size...

Yowsers. Will have to wait for SA Doc's comment on this. She's still at work.

I think this is two vagina lady's blog: I have two vaginas!

A quote from the article, if you will...

When I was dating, I'd just say, "So I have a little something to tell you." I never got any other reaction except, "Oh, my God, that's so cool," because they'd want to have sex in both sides and see what it felt like. Apparently, the right side is, well, more normal. The left side is a lot smaller. But they're both tight. That's a plus. I've got two G-spots, too, so I've always appreciated men who were extra dexterous with their fingers. I get to have two orgasms at the same time.

So, who calls bullshit?

Best Of All Scrubbed Up (Part 1)

2007-12-18T17:41:00.000+02:00

Not enough bloggers take the time to go back in the archives and rehash some of their best material... Egotistically speaking of course.

But we're different.

So, in case you didn't catch it the first time round - here's a quick series of posts with the REALLY funny stuff, the most viewed, the most commented, the dugg, the undugg...

Welcome to Best of All Scrubbed Up!

- - - - -
Talkin' about foreskin

More than a year ago, we started this blog with but two simple goals. Have some fun and make some statements about the South African (and international medical fraternity). What better way to start than an expose on what really matters to guys.

Their... well, thingies and the end of their thingy.

FORESKIN EXPOSE PART 1 - To chop or not to chop

FORESKIN EXPOSE PART 2 - Revenge of the Sif.

- - - - -
TV Doctor Showdown...

Doctors are all over the tube. They're in our face and up our proverbial skirts. And mostly... (well according to SA Doc at least)... they're a bunch of bollocks. So how would they fair when placed in a real-world tough-gun situation. Say... ummm... a night in Baragwanath in the TRAUMA ward (AFTER a Chiefs vs Pirates soccer game).

Find out here :)

TV Doctor Showdown - Meredith Grey
TV Doctor Showdown - Perry Cox
TV Doctor Showdown - Gregory House

- - - - -
And there ends the lesson. What do you think of the BEST OF selection? Let us know in the comments...

Medical Adwords

2007-12-11T18:09:00.000+02:00

Google Adwords is context sensitive. Meaning it scans your blog posts and displays relevant advertising for your content / supposed audience. This has resulted in billions of dollars. And usually works FOR you.

Sometimes it doesn't.

GUEST POST: Superhero Surgeons - It ain't all Sex, Drugs & Rock 'n Roll (by Bongi)

2007-12-06T13:11:00.000+02:00

Welcome to the third, in an initial series of 3 guest posts by our Mpumalanga HeavyWeight... Bongi. He's witty, he's irreverant - he's a little whack.

But it's all in the name of demystifying the doctor. Or not.

Enjoy SUPERHERO SURGEONS - It ain't all Sex, Drugs & Rock 'n Roll!

If you like Bongi's work - visit him here! Wear a glove. Spread the love.

- - - - -

yes i have an alter ego. yes, i dress in funny clothes with a cap covering my head and a mask covering my face. and yes, dressed as such i try to fight the powers of evil (mainly sepsis and bleeding and cancer and the like). i am ... a superhero.

but there is often little understanding for what goes on under the paper thin masks and baggy gowns we wear. certain …um…occurrences, well, occur with us just as much as with other people.

a common cold behind a theatre mask is no small thing. remember you can’t blow your nose. sniffing loudly only works for a while and attracts all sorts of strange stares. just leaving it is really the only option. the positive side of this is you suffer less from the mild dehydration that accompanies massive loss of …mucus. there is, after all, fluid replacement (it is a very short trip from your nostrils to your mouth over your upper lip). ‘nuf sed. somehow this never appealed to me though. so, for all you budding surgeons out there, when you have a cold, plug your nostrils with tissue before scrubbing up. once you’re scrubbed, it is too late. The side effects are only a slight change in voice which is a small price to pay to avoid the constant lip licking and salty taste throughout the operation.

then there is a running stomach. this may be one reason to excuse yourself, handle the situation and rescrub. however, there is the real problem of dehydration, confounded by long hours of standing and concentration. here may i suggest a drip. the gas monkey (anaesthetist) can quite easily give a quick bolus or change the vaculiter when needed. (quick note, i’m not pulling this out of my thumb. i have actually seen this). stay at home, i hear you say? somehow that just doesn’t work with us doctors. i’m not sure why, but it is very rare that a doctor will stay at home merely because he is sick. what sort of a superhero would that be.

the last problem that can be encountered is best explained by thinking back to my registrarship. i was assisting the prof with some or other laparotomy. my stomach had been giving me trouble for some time. up until just before scrubbing up with the prof i had found it necessary to quietly leave polite conversation to allow the release of colonic gas quite a number of times. but once scrubbed up, this avenue was no longer open to me. what could i do? i simply puckered up and held it all in. this worked well, but became progressively difficult. we were approaching the end of the operation, but i could pucker no more. finally i reached a point where i had no choice. i needed release. i decided to quietly let one slip as to not attract too much attention with loud noises. so, as the professor started to close the sheath, i did just that. i was just inwardly congratulating myself for the stealth with which the…um…operation had been executed when the professor stopped closing and dived back into the abdomen. in a dry voice he quietly says, “someone cut the colon.” as he started carefully moving bowel out of the way to better examine the colon. now imagine my embarrassment when i was forced to say’...

“colon? yes. cut? no”

Designer Surgical Masks

2007-12-03T11:14:00.000+02:00

What will they come up with next? I must say, I fear any surgeon more interested in the effect of his headgear than my gaping wound.

Headgear #1

Headgear #2

The World Famous All Scrubbed Up: "What is THAT?" Competition #3 Part 2 - The Answer!

2007-11-29T20:05:00.000+02:00

Congratulations EmergencyEmm!

Human Papilloma Virus is not rare. This guy had an immune deficiency which allowed a fairly common infection (warts) to get out of hand.

An extract from the original article:

After testing samples of the lesions and Dede's blood, Dr Anthony Gaspari of the University of Maryland concluded that his affliction is caused by the Human Papilloma Virus (HPV), a fairly common infection that usually causes small warts to develop on sufferers.

Dede's problem is that he has a rare genetic fault that impedes his immune system, meaning his body is unable to contain the warts.

The virus was therefore able to "hijack the cellular machinery of his skin cells", ordering them to produce massive amounts of the substance that caused the tree-like growths known as "cutaneous horns" on his hands and feet.

Dede's counts of a key type of white blood cell are so low that Dr Gaspari initially suspected he may have the Aids virus.

But tests showed he did not, and it became clear that Dede's immune condition was something far rarer and more mysterious.

HPV is very common. It’s the virus that causes the warts on your fingers and knees as a kid – and yes, it’s the virus that causes genital warts (yech!). All doctors love those.

As long as you all have good healthy immune systems, your wart virus will never get like this.

Without getting overly medical - here's our favourite source - WikiDoc!

Some HPV types may cause warts while others may cause a subclinical infection resulting in precancerous lesions. All HPVs are transmitted by skin-to-skin contact.

A group of about 30-40 HPVs is typically transmitted through sexual contact and infect the anogenital region. Some sexually transmitted HPVs -- types 6, 11, may cause genital warts. However, other HPV types which may infect the genitals do not to cause any noticeable signs of infection.

Persistent infection with a subset of about 13 so-called "high-risk" sexually transmitted HPVs, including types 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, and 68 — different from the ones that cause warts — may lead to the development of cervical intraepithelial neoplasia (CIN), vulvar intraepithelial neoplasia (VIN), penile intraepithelial neoplasia (PIN), and/or anal intraepithelial neoplasia (AIN). These are precancerous lesions and can progress to invasive cancer. HPV infection is a necessary factor in the development of nearly all cases of cervical cancer.^[1]

Another pic:

So - 1 x guest post on offer to EmergencyEmm if he/she wants it!

The World Famous All Scrubbed Up: "What is THAT?" Competition #3 Part 1

2007-11-26T17:54:00.000+02:00

This one really got to me. I don't know what it is about us mere non-doctor mortals. SA Doc giggled and said "fascinating". I almost threw up.

Anyhoo.

Welcome to the WHAT IS THAT COMPETITION PART #3! Guess the medical thingy in the picture and you could win an AMAZING guest post on All Scrubbed Up valued at millions of emotional dollars!

So... Here we go. What is THAT?!

HINT:

"I've never seen anything like this in my entire career."

- Dr. Gaspari

GUEST POST: Tough Surgeon (by Bongi)

2007-11-22T15:40:00.000+02:00

Second post (in an initial public offering - har har - of 3) by our man with the plan - BONGI!

Enjoy... I didn't. This one was particularly gross for us "mere mortals". Read more of Bongi's stuff here.

- - - - -

A story that i thought quite funny at the time, illustrating us macho surgeons...

sigmoid volvulus. a wonderful condition which is very common in africa. not the type the textbooks talk about found in institutionalised old folk, but the type found in young black adult males. prevalence highest in uganda, decreasing as one moves south, but still pretty common in south africa. so in my registrarship, i became quite good at detorting the volvulus which is the emergency treatment in casualties. if this doesn't work or on sigmoidoscopy (siggy as we called it) if you see any questionable bowel, immediate laparotomy is performed.

anyway the patient came in and had a clear sigmoid volvulus on examination and x-rays. i got the siggy ready to detort and place a flatus tube. now, for the lay person, in this area of blocked colon, the feces has been rotting. yes rotten feces, the only thing to top regular or garden variety feces. the feces is also under extreme pressure, so as you insert the siggy, it deflates with vigor (explosively). many of my friends got showered with this rotten projectile fecal matter and often in their face when they detorted sigmoid volvulus on more than one occasion. i had evolved a way of doing it that decreased my chances of being the proverbial fan that was just about to get hit. yes, i think i was pretty good at it. in fact the picture above is me with my trusty siggy ready to detort a volvulus.

so, getting back to the story; i called the students to see the procedure, because this could be their only chance to see it. i set everything up and started the siggy, with an enterage of students, a house doctor and a rotating medical officer standing to observe. i got to the twist, observed to make sure there was no necrosis and started gently inserting the flatus tube. it slipped easily in. and as usual there was a sudden and massive release through the tube of rotten feces and particularly rancid flatus. i stood there trying to control my gag reflex. it would be considered an acute loss of cool if the tough surgeon was seen to be gaging at anything by his awe struck juniors (tongue in cheek for those who wonder). i just couldn't. i gagged over and over again. now i was struggeling to prevent myself from vomiting. despite this, my prominent thought was that the students would think i was a wimp.

then i looked up. every last one of them had bolted. not one had mannaged to overcome the stench to stay and watch. i laughed. all my ego driven worries about what they would think of me were in vain. obviously if a surgeon nearly gagged then mere mortals (tongue in cheek, flamers) like medical students and doctors would obviously not be able to be in the near vicinity of such a thing.

the patient did well, got his elective colectomy the next week and went on his merry way.

GUEST POST: Fashion Statements (by Bongi)

2007-11-19T10:55:00.000+02:00

Ladies and Germs ... Please give a hearty, clinically clean, surgically scrubbed welcome to our first guest poster - Bongi from Other Things Amanzi! Welcome my man...

This is part of a drive to get more contributions to All Scrubbed Up. We're about a year old now and readership is growing rapidly. More content for you, our medically minded audience.

This is part 1 of a 3 post series. If you like Bongi's work - TELL US! It's a fascinating insight into Mpumalanga medicine (and this time, what they wear!)

- - - - -

Fashion Statements

sometimes we as surgeons are restricted by the most mundane of things. back in my kalafong days, more often than my first world visitors could imagine, entire theater lists would get canceled because of lack of theater attire (scrubs). this gave rise to a funny story and, indirectly to a more recent and somewhat more serious story.

story one.

i arrived in theater one morning in kalafong, ready and eager to operate. there were no theater pants, only tops. i quickly found out there were none available and the matron was on the verge of canceling my list. i checked my gas monkey (anaesthetist). he got one of the last pairs and was dressed for action. the sister was also appropriately attired. it was just me that couldn't enter the theater complex.

not to be blocked by such a minor thing, which was anyway an administrative error and therefore, i reasoned, should not disrupt theater lists, i made a plan. i took a sterile drape and wrapped it around my waist like a sarong and strutted out into theater.

my fashion statement it would seem was too much for the matron, because before i had made even 5 meters, she came rushing up to me with a clean pair of theater pants (she had apparently just created them from subatomic particles using a process of fusion) and insisted i go back to the change room to make myself decent. no fashion sense it seems.

the second story was more recently.

i was called to the theater at the local provincial hospital in the early hours of the morning. it seems they started a laparotomy for a gunshot abdomen and were now in deep water. i dived into my car (i reasoned i would soon be diving into their deep water with them and i wanted to get my eye in) and raced to the hospital, trying to fully wake myself up as i went. i parked and charged to theater.

there i encountered obstacle number one. the change room door was locked. no problem, i would just go in through the main door.

obstacle number two was the main theater doors had been locked using a piece of wood wedged through the door handles. i shouted into theater, but there was no reply. i reflected that, although they had called me in at some ungodly (but not unsurgical) hour, they had not allowed easy access. the telephone call had lead me to believe that the situation was critical. i could not let a mere locked door get in my way. i broke it down. inside i found one of the sisters sound asleep. my supplications to open the door as well as my violent attack on said door had, luckily, not disturbed her no doubt well deserved rest.

obstacle number three awaited me in the change room. there were no shirts. at this stage i was feeling slightly less than my usual cheery self. i was in no mood to waist more time. i dressed in theater pants and entered theater with a naked torso.

there was stunned silence. the medical officer was speechless. he started explaining his operative dilemma, but as he looked up and saw me he went quiet. if i wasn't in such a bad mood i'm sure i would have laughed. i started scrubbing. (i suppose i should say something like my godlike torso faintly illuminated by the one light in the scrub room, but that is implied, of course).

soon i was donned with the operating gown and got to work. no longer blinded with jealousy, no doubt, the medical officer found his voice again and could explain to me the situation. my mood also improved and soon the normal intraoperative banter was being exchanged as if it wasn't 3o'clock in the morning and as if the consultant hadn't just turned up half naked after breaking down the theater door and of course as if there wasn't someone whose life hung in the balance.

The World Famous All Scrubbed Up: "What is THAT?" Competition #2 Part 2 - The Answer!

2007-11-13T16:30:00.000+02:00

SA DOC:

Easy one? Last time I saw one of these I was a student... They're nice and rare... but GREAT to look at!

(Yech! - Andy)

It's a teratoma!

Great definition from Wikipedia..

A teratoma is a type of neoplasm (specifically, a tumor). The word teratoma comes from Greek and means roughly "monstrous tumor". Definitive diagnosis of a teratoma is based on its histology: a teratoma is a tumor with tissue or organ components resembling normal derivatives of all three germ layers. Rarely, not all three germ layers are identifiable. The tissues of a teratoma, although normal in themselves, may be quite different from surrounding tissues, and may be highly inappropriate, even grotesque (hence the monstrous): teratomas have been reported to contain hair, teeth, bone and very rarely more complex organs such as eyeball, torso, and hand. Usually, however, a teratoma will contain no organs but rather one or more tissues normally found in organs such as the brain, thyroid, liver, and lung.

Next time you feel a lump in your groin (and it's helluva painful) - it's more likely to be a ovarian torsion or appendicitis than a teratoma. Don't fret! Teeth and hair are probably NOT growing inside your groin (for men - the pain would occur in your testes - and then NO, it's not appendicitis).

- - - - -
CONGRATULAIONS to EVERYONE. You're all bloody funny!

THe World Famous All Scrubbed Up: "What is THAT?" Competition #2 Part 1

2007-11-09T09:30:00.000+02:00

Right. Next one!

THE CASE: 24 year old female presents with a lump in her right groin. Pain.

HINT: This "thing" can also occur in males.

Pretty, ain't it?

He drank so much - his liver split in half!

2007-11-07T09:20:00.000+02:00

Spotted on Digg recently...

A young father who drank up to 15 bottles of wine a day died of cirrhosis so bad his liver had split in half, his family revealed yesterday.

Steven Massey, described as a 'Jack the lad', would drink his favourite Cassini sparkling perry 'just like he was drinking pop'.

The 21-year-old's death has devastated his parents and four older siblings, who hope his story will send out a shocking message about the perils of boozing.

I CANNOT believe that a 21-year-old could drink themselves to death!? Where the hell were the parents? Don't you think it's disgusting that you get first world countries where people are dying from social diseases.

Then I read a little further on, and this kiddie, Steven Massey, already has THREE CHILDREN! I ask again, where were the parents with the sex education (or at least a fuckin condom!). Bloody hell.

Split in half is fairly melo-dramatic. I guess it was so fragile, it just kinda fell apart. Lovely.

SA DOC's THOUGHT OF THE DAY: Social disorders are the hardest thing to deal with in society. You can't stop people drinking, having sex or taking drugs by reprimanding them. It takes a mindset shift. It takes a social change. And I hope to God first world countries out there (especially the ones who have a superiority complex over us third worlders) are doing something to fix this shit. Ahem. England.

Sorry about the anger, but I thought we only joked about towns where there was nothing to do except drink and have sex?

THe World Famous All Scrubbed Up: "What is THAT?" Competition #1 Part 2 - The Answer!

2007-11-06T19:36:00.000+02:00

Ladies and Germs. I'm proud to announce the winner of the first World Famous "What is THAT?" Competition - ... BONGI! Nice one gal!

SA DOC says:

It's a multifibroid uterus. And yip, the story is true (some details have been changed to protect the patient). I'm not so sure why SA Surgeon (his alias) was so keen to take it out - usually gynae territory apparently.

Next competition coming soon!

(PS. Bongi - if you want your picture on the blog - drop your email in the a comment. AND... as a BONUS PRIZE - you get to write a guest post on SA's biggest medical blog. Keen? Drop us a line!)

The World Famous All Scrubbed Up: "What is THAT?" Competition #1 Part 1

2007-11-03T09:43:00.000+02:00

So here's an idea for the medics and non-medics amoung you. Welcome to the first installation of the All Scrubbed Up "What is THAT" Competition. From time to time, we'll post something up that I've either removed during a surgery - or that we've happened on across the medical web. Your job? Tell us what it is!

WARNING: The following images may not be suitable for children under the age of 16 - and squirmish males.

CLUE: 42 year old woman presents with growing mass in her abdomen for three years.

What is THAT? (Please post your answers as comments - winner gets... uh... their picture on the blog!)

Update: ANSWER HERE!