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Post by JC on Dec 5, 2009 19:15:40 GMT -5
INertia yay! You know what's funny is my old primary care physician was talking to me one day and figured out where I worked and she said, Oh I take call sometimes and do rounds there! I thought, oh crap, I've never wanted to work with my own doctor! UGHH sure enough, she came walking in one day. It's SOOOO awkward!!
OSB I'd like to hear the airway story! Maybe you can private message me?? I don't want to thread hijack poor uncomfy unless she's ok with it.
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Post by uncomfortable on Dec 6, 2009 1:18:00 GMT -5
I'm kinda interested to hear the story too lol. Go right ahead!!
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Post by JC on Dec 6, 2009 10:02:06 GMT -5
I have a pretty good airway story too. Maybe we can share?  |
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osb
Junior Member
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Post by osb on Dec 8, 2009 22:28:39 GMT -5
Hmmmm.... (editing out the confidential bits).... If you're sure you want to hear.... Hold onto your stomachs.
This goes way back when I was working as a house officer (er, junior medical registrar? doctor scutbunny?) in bone marrow transplant. Patient was bodybuilder, 250lb of muscle with bull neck and bad leukemia. Got massive chemo. Have any of you seen post-chemo mucositis? All the tissues of the mouth, throat and airway kind of bubble up and slough off. It's horrible. His breathing got squeakier and squeakier.... I was putting up red flags all day, tried humidity, tried helium/oxygen, tried yelling at my boss... eventually I tried hauling in my buddy the anaesthetist - who took one look at the bloody mess and called to OR for an emergent operative airway. Easier said than done. No blood pressure. No blood cells. Him and his guerney and dozens of med pumps wouldn't fit into the elevator. Lurching and shoving, got him to the OR.... where the final squeaks of breathing suddenly stopped. Dead silence for one second, then utter pandemonium: the chemo has turned his airway to glue, neck sliced and fountaining his last few blood cells, surgeon grabbing for anything that looks like a trachea, anaesthesia howling "we're losing him!" (...at this point I'm listening in from the hallway...), and finally the tube goes in. He lives. Everyone exhales. And he inhales.... thank god.
I am told this one still goes down in the annals as "the worst airway incident since the Durban airway fire of 1968..." It's also when I decided to get ICU training, and be the one who 'knows exactly what to do' in these situations. 15 years later.... not sure I feel so much smarter, but at least better prepared, with more tricks in my tool kit.
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osb
Junior Member
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Post by osb on Dec 8, 2009 22:37:25 GMT -5
Oh... Don't know much about the Durban airway fire story.... but I think it goes back to the days of ether anaesthesia, and the first use of electrocautery.... kaboom. Yikes. A story often told by old South African docs. Hope it's apocryphal.
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Post by JC on Dec 9, 2009 6:56:58 GMT -5
Hey cool story! That's gross though. I hate mouths, I don't know what it is but intubating and suctioning just grosses me out! but mucositis is WAY worse! EWWW!
I have a good airway story. hehehehe,
The hospital I used to work at was a stroke center so we got a typical stroke patient roll in and suddenly started to decline. He was already bad when he came in but then he just stopped responding to everything. So the docs decided to go ahead and intubate him but apparently he had a very difficult airway. They tried numerous times to intubate him even using our little portable scope to see down with a camera. They tried nasal, everything. Then they called over the intercom, "code surgical airway," which literally means anesthesia get your ass down here we've given meds and can't intubate, we need a trache. So anesthesia runs down and, of course, tries to intubate him themselves with no luck. We're going on like 8 minutes since we gave the sedation drugs and we've been bagging and bagging him in between attempts. Finally the surgeon says, ALRIGHT we'll trach. Apparently the trache was even difficult because after the incision he was pushing and pushing the tube with so much trouble but finally after a huge blood bath of messing with this guy's trache they finally got it in. Sadly, the tube was not at all stable, it was barely in and any little slight movement would have dislodged it. For some reason we just couldn't advance the dang tube any farther. So we had to act fast to get him to the OR to get the placement right. The only problem was that the tube was so unstable that someone had to hold it completely still as we're flying down the hallway to the OR. So in order for us to keep in completely still, I had to literally straddle the guy on the gurney and ride on top of him on the way to the OR because walking next to him trying to hold it would have dislodged it. So picture this, A team of people flying down the hallway with an unstable airway and there's me staddling the guy with my fingers in his trache hole holding a bloody tube in place. It was an awful messy sight. Then to complicate matters his o2 saturation began to drop upon which we realize that he now had a pneumothorax (collapsed lung).
It was intense! Airways are always a scary thing!
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Post by Karen on Dec 9, 2009 7:13:57 GMT -5
My goodness, those both make my heart beat faster just reading them!
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Post by hellsbells on Jun 21, 2010 15:34:27 GMT -5
So....back to raving about doctors. I changed practice a few months back. First lady GP I've been seeing is nice, and accomodating, but not very proactive in my healthcare. So today I booked an appointment with 'the main man' at the practice who is notorious for running late - and he was, by over an hour. I was his last patient but the consulation lasted about 40 mins! A normal one is 10 but I'd asked for a double. So anyway, he sat and listened to all my ailments and without me asking for it, he's referring me to an endocrinologist! Finally a hormone expert!!
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Post by uncomfortable on Jun 21, 2010 18:02:06 GMT -5
Awesome! I hope that will lead to some more answers for you. I love it when docotrs do things you want without having to ask for it yourself. It feels good to find one that actually does a thorough job!
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Post by Karen on Jun 21, 2010 20:11:24 GMT -5
Wooo hoooooo! Here's hoping it'll lead to more answers for you!
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Post by italialynn on Feb 1, 2011 8:35:06 GMT -5
I have a 'Rave' for the new surgeon I saw yesterday... I don't think in all my years of dealing with this disease have I met a doctor who was so schooled in endo and all the treatments out there, including homeopathic. Even more so than the Center for Endo. I saw Dr. Advincula yesterday at Celebration Hospital in Orlando, FL. He was unbelievable. I had to wait over an hour to see him, but once he was in the room, he talked to me for over a 30 minutes (with my clothes on, important to me!), went over my ENTIRE medical history in detail, and answered every question I had with patience and kindness. I never once felt rushed, and felt he truly understands this disease and all its implications. I liked how he pressed on how important diet, light exercise, and PT is essential for pain relief. They even have an endo support group that meets once a month...they fly in speakers from around the country to speak on different topics. I was floored! What I thought was interesting, was that he compared the way endo acts to cancer. He emphasized that while it doesn't necessarily kill you, the disease itself acts very similiarly to cancer. In order to try and get on top of it, he recommends taking all the visible disease out, and then going on an aromatase inhibitor (like Femara) to stop any disease from growing after the surgery. He also recommends a progesterone supplement on top of that. In my case, we're going to do just that. He's also recommending removing both my utero-sacral ligaments as he feels that's where the majority of my pain is stemming from as most of my pain is from sitting and intercourse. Never heard of that approach before, but he says it's more effective than severing the utero-sacral nerve as it just regenerates. So, we'll see what happens. Surgery #3 is being scheduled for late March, early April. I know this won't be a permanent fix as there isn't one, but I'm hoping he'll just buy me some time of feeling quasi-normal for a while. We'll try to conceive again after the Femara and I'll just go from there. So yay! There are some good doctors out there And best part is, he's in my network! Woo-hoo! |
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Post by chicagogal2 on Feb 1, 2011 8:58:53 GMT -5
That's great news! I'm so happy for you! Good doctors sure make all the difference!
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Post by JC on Feb 1, 2011 9:53:00 GMT -5
OH wow I'm so impressed! I really like how he's giving you more options than the standard hormone crap. Geez! I wanna see him!
My doctor said the same thing about how "it behaves just like cancer." I'm so happy that you have a great doctor. He sounds so promising and refreshing!
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Post by Karen on Feb 1, 2011 10:53:42 GMT -5
I can sense the relief in your post! Makes such a difference to hear a different approach and feel like he understands the entire disease. I'm so excited for you! And since I'm a progesterone freak, I'll be interested in hearing more! Yay for you!! |
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Post by JC on Feb 1, 2011 15:15:39 GMT -5
So how does the aromatase inhibitor dosage work? Will you be on it continuosly? Or is it something you do for 6 months and stop sorta thing? Keep us updated on your progress. I wanna know how this works out for you!
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