Odysseys of George

Give it your best shot!

An elderly lady claimed to have fell off a chair hitting the back of her head on the floor. She was seen in Emergency Department and was told to be well. 2 weeks later, she was having difficulty in breathing and also had episodes of vomiting which did not allow her to eat. Everytime she eats she vomits. These were her Xrays and Ct scans.

Any takers?

Welcome to Odysseys of George. I received many submissions of which I had to make a choice. As the morning comes, I greet you with the scones and tea I laid out for you earlier.

Now, I present to you, Grand Rounds 4.12 with a diving theme. Gear up your booties and wetsuits and carry along your tanks as we backroll into the depths of the medical blogsphere.

As important as the fishes are to the sea, so are our patients are to us, healthcare providers. There were many articles on patients and their ordeal but these took to my attention.

As we descend, Trauma Queen puts up with fat chance of getting an ill lady into the ambulance. This article would probably make you put down your meal immediately and reassess yourself. And if you think you have put on the extra kilos and wish to shed them surgically, then perhaps Christian Bachmann could give you the statistics! And if you think that the topic of obesity stops here, Sandy Szwarc gives us a reality check that obesity has become the greatest threat to the lives of pregnant women.

Marine lives are extremely sensitive but not as sensitive as this almost comical post submitted by Susan Palwick of an ER patient who causes duress among the ER staff for being racist.

Diving into the underwater world is a like exploring a dream or fantasy. What more would it be for these sick children as their dreams becomes a reality. ValJones writes on Tear Jerkers a heart wrenching story of the efforts by Make-A-Wish Foundation to make these children’s dream a reality.

As we continue to descend, we find a wide variety of marine life.

The variety of marine life and their colours begin to stand out even more for Dean Moyer’s patient who had Lasik eye surgery done. However, Dr. T found himself becoming the patient and he writes about it in his blog as Post-op Dr T.

Swimming in a file, these batfish appears to adhere to certain etiquette. Talking about etiquette, Counting Sheep wrote a nice article on the 11 rules of the Operating Room!

These cleaner fish, reminds me of the hard working and dedicated nurses we have taking care of our patients.
Why Should I Be A Nurse? by Kim relates an article she had wanted to write for a long time but what touched me was of course, the greatest reason for choosing to be a nurse ……

Sometimes we tend to follow the pack not realising the we as physicians have certain stands to make. An example to this would be as Toni Brayer wrote about the Physician’s ethical and legal role in Force Feeding prisoners.

As we reach the depths of 28metres, we meet these graceful yet feared creatures of the sea.

However, these creatures have become controversial issue as many of them lay dead for their fins.

Controversies occur in medicine too. One of such is “The Blasphemy of C-peptide Removal” by DiabetesMine.com. The issue is that there is some scientific evidence indicating that C-peptide can improve neuropathy, kidney function, and high blood pressure in Type 1 diabetics — and yet insulin manufacturers have done away with the C-peptide, some say, because they don’t find it profitable. Or is the evidence strong enough?

Then we have patients who are so misconstrued in their thinking that expensive means excellence as KOLAHUN writes the Costs of Medicine.

Henry Stern poses a controversial question, “Why would someone buy meds and then not take them?” in his article Drugs Don’t Work and perhaps after reading his article, we wonder whether we are all doing something of that sort too!

But some pharmaceuticals seem to change their marketing strategies.
Rx drug maker directly engaging bloggers? writes Dmitriy Kruglyak. A biopharma specializing in drugs to treat and manage neurological diseases, sleep disorders, cancer, pain and addiction are hosting a webcast featuring a Q&A with Jeffrey M. Dayno, MD, VP of Medical Services on Thursday, December 13, 1:30 – 3:00 p.m. EST. Check it out!

And as we begin to surface, we realize the need for government agencies and marine groups to unite and maintain the marine life, just as in health services too.

Prudence writes passionately about the role of religion and health when the government of Phillipines clashes with the church as the church manages to hinder the country’s progress in controlling STDs and other reproductive health problems.

Another Milk in the Wall by Disease Proof talks about an issue where there would be lunch wardens patrolling the lunchroom to make sure all kids finish their milk. “We don’t need no thought control…Teachers leave them kids alone,” goes the classic Pink Floyd song.

Then perhaps Nancy Brown, would insist that children and teens in the United States need more milk, sunshine, and exercise!. But then again these are two totally differing issues or is it?

Diving has become my passion and hobby and having a hobby is important. Some are into techno and others into land based hobbies. There were two articles in this, which were,

Digital Pedometers by Joshua Schwimmer who has found a weight loss gadget which counts steps for his patients. Since counting the steps yourself is impractical even for the truly obsessive, the best way to target 10,000 steps a day (roughly equivalent to half an hour of walking) is to use a pedometer.

And for those with love for the outdoors, Paul Auerbach, takes this opportunity to make you aware of the International Journal of Wilderness. The journal is published three times a year.

And if all this reading has caused you to develop neck pain, Jolie Bookspan has some tips to fix the pain. Hopefully, once you feel better, we can move on to next week where SHP, a junior psychiatrist, will host the Grand Rounds 4.13.

Before we set off for the festive season and holidays, I shall strongly urge you to get aid from Nurse Hilary to help you beat the holiday blues, thanks to Mother Jones. Kerri Morrone, on the other hand, writes about the willpower it takes to make it through the holiday season without tossing all health cares to the wind.

Merry Christmas and Happy Holidays to all!

It was an honour when I was asked to host a blogrounds. Grand Rounds is the weekly collection of the best in online medical writing. Each week, a doctor, nurse, patient or healthcare professional hosts Grand Rounds and compiles links to noteworthy posts about medicine.

Well just to inform all my fellow bloggers worldwide, that I will be hosting the Grand Rounds on the 11th December 2007 and submissions are welcomed. Please send your best articles to my email as is on my blog, drgcgeorge[at]gmail[dot]com, with the subject as Grand Rounds.

The deadline for submissions will be on Sunday 9th December 2007 at midnight(GMT+8). Please also give a brief summary of your submission.

Thank you

As I sat in my clinic, another doctor walked in and carefully unfolded a neatly wrapped paper. He then showed me the contents and asked me to guess what it was.

I know it isn’t clear, but care to guess?

“They look like gravel”, I answered. He smiled and said he thought as much. The story…..

This lady was told to have gallstones and decided to seek the aid of a traditional healer. This traditional healer took a lemon and started to rub it on her abdomen. He then cut the lemon and lo and behold, he showed her these stones and told her that it was gallstones!

I guess she was a little bit smarter as she second guessed him and decided to show these stones to us.

What shocked me is how many more people are out there believing such scam! Well, this is how gallstones look like!

or

So, please, traditional medicine is meant to be complementary but not primary treatment. And like what some would say – there are no simple way – no pain, no gain!

This is the 3rd APHS Congress and it was well done. The pre-congress was a workshop with lectures in the morning and hands-on TAPP procedure performed on pigs.

The congress went on the following day with the opening ceremony starting about 12pm. The congress was held at Suntec City, Singapore.

The dances for the opening ceremony was not great but just fine showing the harmony between various races.

Overall, the congress was good and very informative for me. Next year, it would be held in Beijing, China.

Well again and again, we are met with patients who were either wrongly diagnosed as having haemorrhoids or patients who by their own intelligence decided to diagnose themselves as having haemorrhoids.

Not all swellings that arise around the anus equals to haemorrhoids and not all bleeding from the anus is due to haemorrhoids. The pictures below is another example of a case being treated as for haemorrhoids because initially the patient thought that it was haemorrhoids from the stories her friends and neighbours told her. Later as it got bigger and more irritating, she decided to see two doctors, one that took her word for it and just gave medications without much advice and examination. I think the patient was also a little shy to be examined then. The other, examined her but then decided that it would be easier to call it haemorrhoids and treat it first only later referring her to us!

These are actually 3 large pedunculated frond-like growths from the inside of the anus.
Rectal papillomas?.