MedBlogs Grand Rounds 3:12

Up, here:

My Photo Welcome to Grand Rounds Volume 3, Number 12. I know you’ve all been busy getting ready for the holiday season, and I bet you’re tired. Trimming a Christmas tree is hard work. Take a break and relax. Put on some Christmas music, pour yourself a cup of hot chocolate, and enjoy Christmas Grand Rounds with Charlie Brown and the gang.

 A Charlie Brown Grand Round.

Dr. Charles comments on…the impossible

Well, maybe not impossible, but the wildly hopeful: the elimination of diabetes (per Dr. Charles):

In a discovery that has stunned even those behind it, scientists at a Toronto hospital say they have proof the body’s nervous system helps trigger diabetes, opening the door to a potential near-cure of the disease that affects millions of Canadians.

Diabetic mice became healthy virtually overnight after researchers injected a substance to counteract the effect of malfunctioning pain neurons in the pancreas.

“I couldn’t believe it,” said Dr. Michael Salter, a pain expert at the Hospital for Sick Children and one of the scientists. “Mice with diabetes suddenly didn’t have diabetes any more.”

Read it, and wonder: if this pans out a) what a boon for many medical diseases currently thought of as chronic, and b) neurologists may have a new lease on life medicine.

East Valley AZ news on ED overcrowding

In a very well written article from Arizona’s East Valley Tribune was this gem of a quip:

Down the hall, another woman is briefly handcuffed to her hospital bed. Mesa police arrested her for drunken driving and after finding a crack pipe in her car. A diabetic, she complained of lethargy and low blood sugar. Police brought her to the ER’s back door.

“We call it ‘arrest-o-genic shock,’ ” says Jane Rich, the night charge nurse who’s just taken over for Howard. “Sometimes I feel like we’re running a day care for naughty little children.”

It’s a very good article, and doesn’t try to whitewash the issue.  Apparently everyone knows there’s a crisis in the ED’s, but nobody knows how to fix it.  (And, as Symtym says, “Just go to the ER is not a national health policy”).

What does untreated hyperthyroidism feel like?

Ask Vodkapundit, aka Stephen Green:

I started losing weight a few months ago. Nothing serious, just enough to get friends asking if I’d lost any weight. I denied it at first, but then I had buy all new Levi’s in a waist size I hadn’t worn since the late Eighties.

I won’t spoil the ending, just read it. 

via Instapundit

Christmas Meme

I got tagged by NeoNurseChic, and I’m happy to play along.

 

1. Hot Chocolate or Egg Nog?   Hot chocolate, by a mile.  Egg Nog is vile.

2. Does Santa wrap presents or just sit them under the tree?   Santa is a realist: little packages are wrapped, but big and unwieldy things (like bikes) are assembled but not wrapped.

3. Colored lights on tree/house or white?  None.  I need to fix that someday…

4. Do you hang mistletoe?   No, looks a little too much like poison ivy.  Besides, just have several drinks and kiss ‘em, you don’t need the branch of a plant.

5. When do you put your decorations up?  December 1 is the earliest.

6. What is your favorite holiday dish?  Christmas ham.

7. Favorite Holiday memory?  My kids, clamoring for us to get out of bed so they can open presents.  Why?  They can wake up early and get out of bed!

8. When and how did you learn the truth about Santa?  Elementary school sometime; those darn worldly kids.

9. Do you open a gift on Christmas Eve?  Nope.

10. How do you decorate your Christmas Tree?  I’ll ask my wife.  I’d use a tape measure and t-square, so I’m not allowed.

11. Snow! Love it or Dread it?  Bring it!  But, as I have lived in Texas and Cal for my life, very few white Christmases.

12. Can you ice skate?  No, but I can fall without grace, so it’s almost the same.

13. Do you remember your favorite gift?  10 speed.  High-speed freedom.  Fun.

14. What’s the most important thing?  Remembering why it’s a holiday, and remembering that the gifts are fun but not important.

15. What is your favorite Holiday Dessert?  My sister in law’s pecan pie.  Unreal.

16. What is your favorite holiday tradition?  Flexibility.  I grew up in a house that usually had to work on Christmas, so we had Christmas after the 25th usually, and the trick is to enjoy the Holiday, and not to fixate on the date.

17. What tops your tree?  A pretty angel.  

18. Which do you prefer giving or Receiving?  Giving, every time.

19. What is your favorite Christmas Song?  The Christmas Song.

20. Candy canes, Yuck or Yum?  Big Yum.

 

Whom to tag?

Kim at Emergiblog

Sydney at medpundit.

Scalpel at Scalpel or Sword.

Tim at symtym.

That was easy, and fun.

Trial Lawyer opens own MedMal Insurance Company

In Point of Law

…Now, the former president of the Illinois Trial Lawyers Association, Kim Presbrey, is doing just that, with a new malpractice insurance company, Doctors Direct, focusing on neurosurgeons and heart surgeons.

I agree with Ted Frank; somebody’s going to have some ‘splaining to do when this experiment ends.  I think I know how this will come out, but I’d be willing to admit it were I wrong.

via Overlawyered

Change of Shift 1:13

Up at Protect the Airway.

Speculation in a Vacuum

I have no knowledge of what has befallen Senator Tim Johnson (D, SD), and there’s a disturbing vagueness to the lack of released diagnosis to date.

From the CNN article, the only part to describe the clinical picture:

Johnson spokeswoman Julianne Fisher said the senator was in the Capitol on Wednesday morning conducting a conference call with South Dakota reporters when “his speech pattern slipped off.” (Listen to Johnson’s difficulty speaking during a WNAX radio interview — MP3, 749 kb)

Fisher said the senator was able to walk back to his office in the Hart Senate Office Building, then began having problems with his right arm. He thought he was all right, she said, and went to his desk, but came out a few minutes later and “it was apparent he needed help.”

Several hours later he’s in the OR.  Subdural hematoma springs to mind given the description of both a speech and one-sided arm difficulty, but only time will tell.

Update @ 8:31AM:

A U.S. Capitol physician says Sen. Tim Johnson underwent successful brain surgery for an arteriovenous malformation, a condition which causes arteries and veins to grow abnormally large.

That would do it, as well.

Happy Birthday, Brother

Happy Birthday!

MedBlogs Grand Rounds 3:12

Grand Rounds, Vol. 3 No. 12

Anxiety, Addiction and Depression TreatmentsWe’ve been blogging in earnest for quite a while now. While it seems much more recently, it was six months and over 400 posts ago that we last hosted Grand Rounds. It’s surprising how much has changed in that time, but also how much has stayed the same. We had a number of submissions from bloggers we featured last time around, along with a number of new faces. It seemed too that the quality of blogging has only continued to rise. Maybe it’s simply a factor of writers becoming more comfortable with the medium. Or maybe it’s a function of medical bloggers pushing each other to excel. Whatever it is, one thing is for sure: we the readers are the ones who truly benefit.

2006 Medical Weblog Awards

Nominations are ready over at MedGadget, and are open until Sunday, December 31st; voting starts January 3, closes January 14th.  I recommend getting over there, reading the rules, and nominating someone (but not me).

The 2006 Medical Blog Awards

There’s a new voting system this year, and it’s outlined at the bottom of the MedGadget post.

Medicine doesn’t stop for the game

Tonight, just prior to the kickoff of the Cowboys game (regionally required viewing) one of our hospitalists stopped by the ED, with the following pronouncement:

“The game’s about to start, so it might take a while for me to call back.”

To which I gave the only reply an ED doc can:

“Okay, call when you can and I’ll tell you how many I admitted to you.”

He called back very quickly, I must say.

 

For the record, I very much prefer working with hospitalists rather than the olden days of community physicians who admitted their own patients; I don’t have to advocate for a patients’ admission nearly as much with hospitalists versus the private physicians.  (And there are exceptions to every rule; right now I know of two private docs who are wonderful to call: encyclopedic knowledge of their patients and their problems, helpful, etc).  Kudos to my hospitalist colleagues.

Some Dude avoidance strategy

From the comments to Shot in the Face, discussing Some Dude and the crime wave that always seems to follow:

Some Dude is a notoriously dangerous character. I always recommend that, for personal safety, one always drink more than 2 beers and intrude in other people’s affairs. Because, if you are minding your own busisness and have only had 2 beers Some Dude while undoubtly sucker punch you.

Many thanks to commenter Tom for the words of advice.

Nice 12 Days of Christmas Graph

12 days of Christmas.

And true, too.

Shot in the face

…and lived to tell about it.

Recently, there was a patient who was exhibiting that classic risk factor for assault, “minding their own business”, when ‘some dude’ shot said patient.  At very close range, with a pistol.

Patient arrives alert and talking, so some scout films are taken:

Follow the little metal fragments: they go in the left maxillary sinus, turn 90 degrees when the base of the skull is hit, and track down the neck.

 

Nothing vital was transected.  Patient lived, despite literally being ‘shot in the face’.