tag:blogger.com,1999:blog-4968787219619380438.comments2023-09-21T04:02:29.457-04:00Skeptical ScalpelSkeptical Scalpelhttp://www.blogger.com/profile/13206922456661320751noreply@blogger.comBlogger9517125tag:blogger.com,1999:blog-4968787219619380438.post-72767769147593293642021-03-27T10:20:45.633-04:002021-03-27T10:20:45.633-04:00It's a fully accredited US medical school. I c...It's a fully accredited US medical school. I can't think of a reason not to give him a try.Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-12752588261484479552021-03-23T18:28:35.720-04:002021-03-23T18:28:35.720-04:00He completed his Family Medicine at Southern Illin...He completed his Family Medicine at Southern Illinois University School of Medicine in Quincy, IL. I do not know anything about this school of medicine. Thank-you so much.StiltFoxhttps://www.blogger.com/profile/13933822019733579606noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-31375334450108705822021-03-23T12:29:13.777-04:002021-03-23T12:29:13.777-04:00Sorry for the delayed response. I suggest you give...Sorry for the delayed response. I suggest you give the replacement a try. You may want to find out where he/she trained, which is more important than the med school and whether board certification has been achieved. Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-29056613528353994812021-03-13T11:13:15.217-05:002021-03-13T11:13:15.217-05:00My internist PCP is moving to another state. A fam...My internist PCP is moving to another state. A family medicine graduate of University Of Medicine And Health Sciences St Kitts is taking her patients. Should I look elsewhere for a new PCP?StiltFoxhttps://www.blogger.com/profile/13933822019733579606noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-53709852517748529602021-02-24T10:30:46.008-05:002021-02-24T10:30:46.008-05:00Thanks for pointing these errors on my part. I fix...Thanks for pointing these errors on my part. I fixed links on the last post on January 11 and the first post on February 17. I hope there aren't any more.Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-80945279903468045632021-02-24T10:18:31.524-05:002021-02-24T10:18:31.524-05:00Thank you both. I have corrected the link and it w...Thank you both. I have corrected the link and it works.Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-53148675691970452432021-02-23T13:48:59.314-05:002021-02-23T13:48:59.314-05:00Your last two posts here have links that don't...Your last two posts here have links that don't work. Are you aware of that?Bill S.https://www.blogger.com/profile/05525618388807333591noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-25408337696762268362021-02-18T08:53:10.920-05:002021-02-18T08:53:10.920-05:00Hi. I just wanted to let you know that the first l...Hi. I just wanted to let you know that the first link is broken.<br /><br />Thank you for your blogging, by the way.YawnSlingerhttps://www.blogger.com/profile/17357096340492184510noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-92151898061375526892021-02-17T17:25:10.956-05:002021-02-17T17:25:10.956-05:00The link to the first post on errors in medical re...The link to the first post on errors in medical records is broken.Brian Bellhttps://www.blogger.com/profile/10671420764034700966noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-72076682095632363902021-02-14T14:34:55.075-05:002021-02-14T14:34:55.075-05:00I wonder why she wasn't admitted at the time o...I wonder why she wasn't admitted at the time of the first ED visit. Three liters of ascites is a lot. Add the anemia and it sounds like something is seriously wrong. Yo did not say how old your daughter is, whether she has any significant past medical history, or if she had other symptoms besides pain such as weight loss, nausea, vomiting etc. I don't think it is appendicitis. I hope she recovers. Good luck.Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-38386756477517684502021-02-14T10:21:03.647-05:002021-02-14T10:21:03.647-05:00My daughter presented to ED with severe RUQ/RLQ pa...My daughter presented to ED with severe RUQ/RLQ pain,distended Abdomen,fever,high platlet,platelet, hgb,low hematocrit,severe Anemia. Helical CT performed which revealed Ascites in all 4 quadrants,all organs were unremarkable(Appendix was not included/mentioned on report?) She was discharged from ED. She returned to ED 7 days later,was admitted. (Prior to admission Gynecologist prescribed profilacti AB while awaiting STD lab results). Upon admission a Parasyntesis was performed removing 3 liters of fluid. To be continued as this case is ridiculously lengthy to the tune of 3 weeks.Anonymoushttps://www.blogger.com/profile/10702329629424218252noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-88641794679421281552021-01-04T17:00:56.491-05:002021-01-04T17:00:56.491-05:00This comment has been removed by a blog administrator.john kenhttps://www.blogger.com/profile/02674270016190205527noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-22020317183103315392021-01-04T07:50:14.881-05:002021-01-04T07:50:14.881-05:00This comment has been removed by a blog administrator.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-43230647847437761522020-12-22T10:01:31.339-05:002020-12-22T10:01:31.339-05:00Anon, thanks for the follow-up. I wish you continu...Anon, thanks for the follow-up. I wish you continued good health.Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-36705822401121757402020-12-20T12:35:41.855-05:002020-12-20T12:35:41.855-05:00Apologies prostate good, eyesight not so good! Les...Apologies prostate good, eyesight not so good! Lesion 1.6 cm, T2a, Gleason score 4/3 - big difference! Age currently 69 for info.annonymoushttps://www.blogger.com/profile/08679249300313747416noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-77832968780327625232020-12-20T04:30:56.705-05:002020-12-20T04:30:56.705-05:00An update on my entry above. My PSA in May 2019 w...An update on my entry above. My PSA in May 2019 was 4.2 A different GP agreed a straight referral for MRI, given my issues. This is theoretically permissable at my local Hospital (Scotland) and was agreed after a bit of fuss. A 1.6 mm lesion was found, high indication of cancer. after discussion of my issues with the Nurse Practitioner a targeted biopsy was done under light anaesthesia, and he agreed to leave the DRE until then.<br /><br />Result: T2a cancer Gleason score 7/6, still unable to detect it on DRE despite his best efforts and experience.<br /><br />I had Brachytherapy - not surgery or hormone treatment -in February 2020 to preserve my quality of life.<br /><br />I have experienced no bleeding, incontinence, nor discomfort after first 24 hours, and no impotence, given 5mg of Cialis, for this and to aid blood flow to affected areas for healing.<br /><br />PSA in November 2020 0.9 and falling - everyone very happy.<br /><br />I would have had my chosen investigations sooner if I had thought I could avoid DRE- the PSA test is a fairly good indicator of SOME issue. The DRE in my case gave a false/ inaccuarate reading at first, and has given NO USEFUL INFO in diagnosis.<br /><br />The MRI was clear, accurate and enabled early successful treatment without surgery.<br /><br />The PSA test done followed up at suitable intervals for individuals is a good screen. MRI enables identification and targeting of lesions . DRE does detect lesions - but by then it is too late to avoid more drastic treatment and possible spread in too many cases.annonymoushttps://www.blogger.com/profile/08679249300313747416noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-79004567009937007052020-12-09T10:33:01.660-05:002020-12-09T10:33:01.660-05:00As I mentioned in several other responses to comme...As I mentioned in several other responses to comments above, I was not trying to insult pilots, nor do I hate pilots. What I hate is the analogy that surgeons can be compared to pilots. <br /><br />I agree with you that when physicians become pilots, they may not be experts possibly because of overconfidence.<br /><br />Since I published this post nine years ago, I believe further advances in autopilot technology have been made. There is even a program that will land a plane when a pilot becomes disabled.<br /><br />I'm not sure that flying the plane when it's on autopilot is as difficult as you say. For example, here's a story about two pilots overflying an airport by 150 miles because they were distracted. [https://abcnews.go.com/Travel/northwest-airlines-pilots-miss-airport-150-miles/story?id=8892976] I can only assume the plane was on autopilot at the time.<br /><br />Here's another story stating that a survey found more than half of pilots have fallen asleep while in charge of a plane. [https://www.bbc.com/news/uk-24296544] The article was published because two pilots fell asleep at 35,000 feet.Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-72853296507180824852020-12-09T09:55:47.990-05:002020-12-09T09:55:47.990-05:00Thanks for sharing this postThanks for sharing this postchirurgie silhouette Tunisiehttps://mondial-sante.com/esthetiques/chirurgie_silhouettenoreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-61910078446692452992020-11-30T10:56:58.338-05:002020-11-30T10:56:58.338-05:00You just like many people don’t understand what an...You just like many people don’t understand what an autopilot does or how it works, it doesn’t take away from the pilot’s job and in many cases it even increases the pilot’s workload. Autopilot is more like cruise control than an actual pilot. It can’t make decisions and you still need a boatload of training to fly a plane even if it has a sophisticated autopilot. The pilots are working for the full duration of the flight even if they aren’t using the manual flight controls. They have better things to do than eyeball an HSI and altimeter for hours on end. They aren’t just sitting their watching screens and doing nothing until landing they are actively making decisions and controlling the airplane by using the autopilot. To be honest with you flying is extremely tiring even with an autopilot it’s a lot of work and people who don’t do it don’t even realize it. Saying our job is “boring and monotonous” because we have an autopilot (especially when the autopilot is a straw man) is almost insulting. I have flown flights with an autopilot and without and the workload be high in both cases. <br />Also as you said many surgeons become pilots (most of the time they become private pilots) and you know what? They usually become horrible pilots... <br />We aren’t at the point where pilots just sit there as a backup. That’s what people think we do but that’s nowhere near the case. By the time that is the case the same will probably be the case for surgeons. <br />Both our jobs are demanding and difficult in their own ways and demand skill and professionalism whether you like it or not.Bob Johnhttps://www.blogger.com/profile/14498021656777699511noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-84154187386330254142020-11-25T22:24:16.046-05:002020-11-25T22:24:16.046-05:00The obgyn is something else. The obgyn is something else. Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-78394712018401917482020-09-01T15:26:07.914-04:002020-09-01T15:26:07.914-04:00The data from Dr. Zelenko's covid-19 patients ...The data from Dr. Zelenko's covid-19 patients is available at https://www.preprints.org/manuscript/202007.0025/v1Sharonhttps://www.blogger.com/profile/10867716254173457569noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-53294578583798749492020-07-12T12:37:20.998-04:002020-07-12T12:37:20.998-04:00I apologize for the delay in responding. I have no...I apologize for the delay in responding. I have not been monitoring my blog is closely as I formally did. I read your history and cannot see a pattern suggestive of any common illness.<br /><br />If three CT scans were negative for appendicitis, I think it's safe to say you probably don't have that disease.<br /><br />Have you had a gynecologic exam recently? Sometimes abdominal pain that cannot be diagnosed by routine methods turns out to be endometriosis. If you are still having problems, I suggest you see a gynecologist for a complete examination.<br /><br />I hope you're feeling better. Please let me know how things turn out.Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-6446861903111337912020-06-23T18:03:22.431-04:002020-06-23T18:03:22.431-04:00Hi,
I know you have not had comments on this post ...Hi,<br />I know you have not had comments on this post for a while and I'm hoping all is well. I am a 25 yr old female that has had abdominal pain in the LRQ area and nausea with lack of appetite for around 3 months now. I have been to the ER 3 times over the past 3 months and am considering going for a fourth time but I don't want people to think I'm crazy. I've read your posts and understand you cannot provide medical advice online, this is almost just me venting because I'm so frustrated with how I'm feeling and it's exhausting not having any answers. During the past 3 months I have had 2 abdominal ultrasounds, 2 pelvic/intravaginal ultrasounds, 1 ultrasound trying to find my appendix (appendix couldn't be seen on ultrasound) and 3 CTs of abdomen and pelvis with contrast. All CT scans have indicated that a normal appendix is present and that there are no indications of acute appendicitis. The only thing that showed up in CT scan was an umbilical hernia, which I don't seem to see as I don't have a bulge. The only thing I can see is a black stone-like mass inside of my belly button (gross but just being honest). The ER doctor tried removing it during my 2nd visit but could not remove it. Regardless, I'm unsure if that would be causing my symptoms. All areas seen on the ultrasound appeared to be normal for my age and gender. Over the past 3 months I have not had fever, and basically require Zofran in order to feel like I can eat anything. I can't help but think this is appendicitis based on the location of the abdominal pain and the nausea that will not let up without anti-nausea medication (which I know is not good to be on long-term). I have been a little constipated but I've been that way my whole life, and getting loose stools after I drink the contrast for the CT scans that regulates after 48 hours. During my 1st and 2nd hospital visits (which were at the same hospital), I had elevated WBC and CRP levels (13,000/uL and 10,400/uL respectively for WBC and 12.5 mg/L and 12 mg/L, respectively for CRP levels). My WBC was fine during the 3rd visit (different hospital than the one I visited for my first and second visits) and was around 8,000/uL and they did not test CRP levels. My other bloodwork during all three ER visits seemed okay, some key takeaways were elevated calcium levels all 3 times (11.3 mg/dL, 10.7 mg/dL, 10.6 mg/dL). My anion gap and bilirubin levels were both higher than range for my first 2 ER visits but were in normal range for the 3rd ER visit. The ER nurse during my 2nd ER visit said that my eyes are jaundiced, which I never noticed but still seems to be true. My lipase levels were low all 3 times I was in the ER but they said that was not to be concerned about. I was diagnosed with a UTI as a result of the 3rd ER visit after there was blood and bacteria in my urine. After being on 3 types of antibiotics for the UTI, the abdominal pain and nausea have not gotten any better. It seems as if I'm in the ER every 4 weeks, but the pain worsens after my menstrual cycle and I almost feel at my best during my menstrual period. The pain is also rarely excruciating, it's really the nausea that is the worst part of it. The pain is more like a constant annoyance that sometimes does get pretty bad but the location in my mind just says appendicitis. It seems to feel low though and sometimes I feel the pain close to my right hip and extending into my back. I've lost almost 25 lbs as a result of how I'm feeling and it's honestly ruining my life. My family doesn't believe I'm in the pain and I'm terrified to tell them that I'm in the ER if another CT scan comes back clean. I just wanted to note that my first two ER visits were 2 days apart, as they said if I don't feel better to return. My 3rd ER visit was 8 weeks after my 1st/2nd ER visit. I'm seeing my primary dr in 2 days but I'm unsure if I will be able to make it there without another trip to the ER due to my symptoms. If you get to reading this, thank you in advance.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-11577315898770796422020-06-10T21:30:25.062-04:002020-06-10T21:30:25.062-04:00Your Oscar Wilde quotation is especially appropria...Your Oscar Wilde quotation is especially appropriate in these strange times. I hope you and your family are safe and well.Oldfoolrnhttps://www.blogger.com/profile/01747485143127099085noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-30369463682326894692020-05-08T14:13:52.201-04:002020-05-08T14:13:52.201-04:00Sorry about the delay in posting your comment. I&#...Sorry about the delay in posting your comment. I'm getting about 30 spam posts for every legitimate comment. I have been neglecting monitoring the comments. I will try to do better. The incisions would be even smaller if it had been done laparoscopically.Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.com