All Scrubbed Up

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 trage...

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 ...

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.

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.

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...

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...

From WrongDiagnosis.com . Har har!

The bloody brits... What will they chain-letter next :) ---snip--- D epartment 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 woul...

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, indi...

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.

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 .

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 p...

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!?

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 ...

Har har!

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. W...

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 ...

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 ...

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?

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.

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 motivati...

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 w...

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 an...

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 ther...

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 physicia...

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 o...

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 ...

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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 .

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 ...

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...

Har Har... Amusing.

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 2. No time to eat. Middle Aged Male has a feeding tube because of oesophageal cancer (a feeding tube is a tube straight into your stomache, allowing food to be syringed in). Request is for a feeding pump. One that provides feeds at a continuous rate throughout the day. Reason for needing a pump? Male travels from Pretoria to Johannesburg every day. Spends approximately 4 hours per day in the car. Doesn't have the time to feed himself. Join the club mate.

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 1. Eye are not wearing glasses. Middle age male requests payment in full for laser optic surgery. Male has optical limit, as with most benefits. Reason for requesting full payment: He currently feels that he cannot do occasional activities of daily living, like volleyball and playing with his kids while wearing glasses. In a motivation, the middle aged male said: "They might come off or get broken!". Further information was volunteered. "I can't wear contact lenses, because I couldn't imagine sticking something in my eye."

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...

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.

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 t...

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

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

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?

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 a...

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

We're baaaack!