Archives for August 2004

Top 10 reasons to have a hysterectomy

Sent by a friend, who’s considering having it done:

10.Raise my Iron level by 4 points in just 45 minutes.

9. I need to stop worrying about waking up dead by bleeding out during the night.

8. Stop scheduling “relations” with spouse, within the safe 4 day window.

7. Put an end to the fear of embarrassment in public places.

6. Be able to order my steaks medium, instead of ‘cut it with a hot knife’.

[Read more…]

Happy Birthday, Symtym


Funny story from a real, long-time ER doc on his birthday.

Happy Birthday!

Jet-powered wheelchair surprise

BBC NEWS | UK | England | Lincolnshire | Jet-powered wheelchair surprise

Giuseppe Cannella had a big surprise for his mother-in-law when he put a jet engine on the back of her wheelchair.

Mr Cannella says the chair can now do top speeds of more than 60mph and has proved the star of a model plane championship during the Bank Holiday.

Not wearing a helmet in the picture. He’ll be needing his own wheelchair soon.

Florida Medmal goings on

DB’s Medical Rants ? Roaring Remy’s comments on the Florida votes
Read for a review of Florida’s medmal reform actions.

Booming business in care for obese – Booming business in caring for obese – Aug 29, 2004

KANSAS CITY, Missouri (AP) — At St. Luke’s Hospital, each of the 14 new neurology intensive care rooms has a feature that’s becoming standard in the health care industry: a patient lift system that can handle 600 pounds.

When people weigh as much as livestock, it makes our jobs in medicine harder. There’s nothing like seeing 8 firefighters haul in a 500+ pound patient and turn her care over to the 110# nurse.

Later in the article, a silly argument appears:

“People would not be doing this if there wasn’t market share to be captured, but the reason there is a market share is that this population has been underserved,” said Walter Lindstrom, founding partner of the San Diego-based Obesity Law and Advocacy Center. “This isn’t just for bariatric surgery. Bariatric patients also need to get their gall bladders taken out or they get cancer.”

The statistics all say this segment of the population is growing exponentially (that’s a better pun than ‘they’ve been overserved, that’s why this has happened’). That there are a lot more manufacturers for this equipment means there’s money to pay for it, not out of some ‘recognition of underservice’.

I always endeavor to

Yahoo! News – Health Photos – AFP


Update: as of 9/2005, the above link is broken. Sorry.

Doctors grow new jaw in man’s back – Doctors grow new jaw in man’s back

LONDON, England (AP) — A German who had his lower jaw cut out because of cancer has enjoyed his first meal in nine years — a bratwurst sandwich — after surgeons grew a new jaw bone in his back muscle and transplanted it to his mouth in what experts call an “ambitious” experiment.

According to this week’s issue of The Lancet medical journal, the German doctors used a mesh cage, a growth chemical and the patient’s own bone marrow, containing stem cells, to create a new jaw bone that fit exactly into the gap left by the cancer surgery.

Tests have not been done yet to verify whether the bone was created by the blank-slate stem cells and it is too early to tell whether the jaw will function normally in the long term.

But the operation is the first published report of a whole bone being engineered and incubated inside a patient’s body and transplanted.

I wonder if this is going to result in residual heterotopic bone growth in his lat muscle in which this was incubated? I’m sure they’ll be following that.

If it was me, I’d take the chance to be able to chew again.

BTW, the Lancet gives the abstract, but you have to be a paid subscriber to read the article.

Dr. Winters’ Regularity

RTT with BBB
Dr. Winters, who got me into this whole blogging thing, has had a dread combination of boredom and life intervene, and has just posted his first in 6 months and a week. This makes him a very brady-irregular poster, and he may need some kind of external pacing.

Anyway, go and read. And encourage him to post monthly. Small steps, small steps.

Tainted flu vaccine discovered – Tainted flu vaccine discovered – Aug 26, 2004

SAN FRANCISCO, California (AP) — The nation’s supply of vaccine for the impending flu season took a big hit Thursday when Chiron Corp. announced it had found tainted doses in its factory.

The company said it will hold up shipment of about 50 million shots — about half the supply U.S. health officials had hoped to have on hand this year — while it investigates what went wrong and determines whether the vaccine is safe to use.

It’s good to know it’s being tested, and I hope it all gets straightened out, and with some Very Public explanations. It’s hard enough getting people to get their flu shots without worrying about the safety of the vaccine.

This also tells us how we can “miss” the right flu strain for the coming year. This represents 50 million doses earmarked for the US, and they’re already made, well before the flu season begins, before anyone in the US has contracted influenza.

I hate writing about Flu in August, it’s unnatural.

Medical Acronyms

We use a lot of abbreviations and acronyms in medicine, but the other day I was introduced to one I hadn’t heard before.

While discussing the care of a severely ill very elderly patient, a colleague said:



“MFB, CFD” he again said. The blank look on my face must have transmitted my incoherence, so he elaborated:

“Measure For Box, Call For Dirt”.

Just another medical acronym for my vocabulary.

Purple Heart Commentary from Vietnam Docs



When I served as a Navy psychiatrist from 1967-69 at St. Alban’s Naval Hospital I heard the war stories of hundreds of courageous, wounded men. Astonishing tales of selfless sacrifice were told by modest men who suffered from uneasy doubt about whether they’d done enough, and were subsequently troubled by depression and anxiety. They were invariably reluctant to talk about themselves and never, ever boasted of what they’d done. They possessed dignity, and in fact tended to be too self demanding and self-critical.
In addition to these men, who often suffered the guilt of survivors, there were of course the schemers and scammers, the sociopaths, troublemakers and cowards. There were the prevaricators and the braggarts—and all of them somehow found their way to the psychiatrist…

The rest of his precis is good, and then he links to a Washington Times OpEd on the same topic.

Drop subjective sports from the Games – Writers – Josh Elliott: Judged sports don’t belong in Olympics – Wednesday August 25, 2004 12:53PM

No athletic event that is judged belongs in the Olympics.

And no exceptions: No gymnastics. No ice skating or boxing. No synchronized swimming or diving. If it can’t be won on the track, in the lane lines or with one more goal than the other folks, it has no place in the world’s premier festival of sport, one that purports to give us the world’s greatest champions.

I agree with the writer. Pretty good article.

Elisabeth Kubler-Ross Died – ‘On Death’ author Kubler-Ross dies – Aug 25, 2004

I’m in denial.

What does it look like…

when a family of 6 who’s been exposed to rabies shows up in the ED? It looks like this:
rabid nurses

The nurses wound up assigning one nurse to this project for about an hour, calculating how much immunoglobulin for each (it’s body-mass based), filling out paperwork, etc. (Yes, there are only 4 charts in the picture, and there’s more than one nurse, but they were all working hard on the project when I walked by).

We’ve had enough rabies scares that I’ve been asked to talk about it at the next big nursing CME class, so that’ll give me even more to blather on about.

Cheating Chernobyl

New Scientist
Interesting interview with a reactor engineer from Chernobyl, on The Night and his life thereafter.