tag:blogger.com,1999:blog-30499448.post3064767716522425567..comments2024-02-18T13:53:30.168-08:00Comments on Surgeonsblog: Fast Relief, and SimpleSid Schwabhttp://www.blogger.com/profile/14182853083503404098noreply@blogger.comBlogger38125tag:blogger.com,1999:blog-30499448.post-47933626528389478582008-03-24T21:27:00.000-07:002008-03-24T21:27:00.000-07:00sid schwab,50% of those who have undergone a preve...sid schwab,<BR/><BR/>50% of those who have undergone a preventative iridotomy lose their job because of the side effects of the iridotomy, not because of the after effects of a glaucoma attack.<BR/>Doctors underestimate the adverse effects of iridotomies! This surgery should never be done preventatively, it's a vision-threatening procedure!<BR/>I read the FDA has started to do an investigation into this surgery and its adverse effects.<BR/>I have had iridotomies in both my eyes, I know what I am writing about! I lost almost all my vision.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-30499448.post-23487051952335783842008-03-24T21:02:00.000-07:002008-03-24T21:02:00.000-07:00anonymous: from what (little) I know, you may be c...anonymous: from what (little) I know, you may be confusing "elective" iridotomy with when it's done for acute angle closure. For acute angle closure, it can be dramatic. And whereas I don't know if it's true that 50% lose their jobs, it is true that it works only half the time or less when done electively; that would suggest that if people really lose their jobs it might be the ones that aren't helped.Sid Schwabhttps://www.blogger.com/profile/14182853083503404098noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-44777938527107904242008-03-24T20:15:00.000-07:002008-03-24T20:15:00.000-07:00Laser iridotomy is not an easy procedure with imme...Laser iridotomy is not an easy procedure with immediate relief, as said above.<BR/>The procedure is painful and absolutely scary for the patient.<BR/>The success rate is only 43%.<BR/>The adverse effects are important:<BR/>double vision, glare, a white horizontal line, uncontrollable IOP, uveitis and significant vision loss. <BR/>More than 50% of the patients lose their job. Life changes completely after this surgery.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-30499448.post-15078007088940256612007-08-30T10:28:00.000-07:002007-08-30T10:28:00.000-07:00Awesome post.I third the Propofol. Takes them fro...Awesome post.<BR/><BR/>I third the Propofol. Takes them from thrashing to zzzzzzzz.<BR/><BR/>I've never personally seen it, but I'm assuming TPA for strokes/heart attack would fit.<BR/><BR/>And from personal experience, I'd have to say the epidural that was placed during transition was an otherworldly experience. What else could take you from out-of-control 10/10 pain to blissful relief?<BR/><BR/>(I'm tellin ya - Pitocin was invented by the devil.)codebloghttps://www.blogger.com/profile/16305674272624312443noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-7136395140850703592007-08-27T10:06:00.000-07:002007-08-27T10:06:00.000-07:00I think the only one I've seen was Valium for the ...I think the only one I've seen was Valium for the ongoing seizure. I was pretty impressed with how quickly the seizures stopped and then how quickly they would return if the Valium started wearing off.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-30499448.post-55204251466693285742007-08-25T23:25:00.000-07:002007-08-25T23:25:00.000-07:00KevinMD, great blog.. my first time contributing.....KevinMD, great blog.. my first time contributing..<BR/><BR/>For Fast Relief,and Simple, here are my top THREE from the wonderful world of urology:<BR/><BR/>(#3) Foley<BR/><BR/>(#2) Priapism (prolonged painful erection). If it can be brought down with a quick penile injection, it's amazing how quick it is relieved.<BR/><BR/>(#1) Manually reducing a PARAPHIMOSIS. Paraphimosis is when the foreskin of the penis gets trapped behind the glans, it gets edematous and swollen, which makes it even tighter, and more trapped. Very painful and looks scary (see pic). Sometimes, with gradual constant squeezing pressure and pushing the glans, it can be popped back in and reduced. Instant relief, and at the same time squeezes out the edema, so it looks immediately better! The manual reduction procedure itself looks (& sometimes sounds) like something from the Spanish Inquisition, but once finished, the patient is amazed and infinitely grateful.<BR/><BR/>Gory photo link:<BR/>http://www.UroCanswer.com/paraphimosis1.gif<BR/><BR/>Enjoy!<BR/>-UC<BR/><BR/>http://www.UroCanswer.com<BR/>http://www.DrYew.comAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-30499448.post-28687773707025476082007-08-25T18:06:00.000-07:002007-08-25T18:06:00.000-07:00The B52. Raging psychotic turned into sleeping ba...The B52. Raging psychotic turned into sleeping baby.<BR/><BR/>IV narcotics for kidney stones. Take a pale, diaphoretic, writhing, puking patient and relieve their agony. They think you are the queen.<BR/><BR/>Diprivan for ventilated patients....night night and don't remember a thing.<BR/><BR/>Cardioversion for unstable tachyarrhytmias....ZAP and they go from half dead to pink, warm and dry.<BR/><BR/>And the most amazing drug of all, Adenosine! It keeps us from having to zap a good number of people.ERnurseyhttps://www.blogger.com/profile/14843824564108513499noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-62091381806141483822007-08-25T15:31:00.000-07:002007-08-25T15:31:00.000-07:00Chronic, painful AC joint (acromioclavicular) from...Chronic, painful AC joint (acromioclavicular) from overuse and early arthritic changes. Sought treatment after five or six aggravating months. The INSTANT the methylpred was injected, the pain was gone. Ahhhhh<BR/><BR/>MMT<BR/><BR/>Knowing not to suction away at (a gushing) aortic tear during a node dissection......priceless.<BR/><BR/>The speed of benedryl at reversing anaphylaxismake mine traumahttps://www.blogger.com/profile/18149160428613740527noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-12745408998583818472007-08-24T19:15:00.000-07:002007-08-24T19:15:00.000-07:00on a multip, reducing an anterior lip (or even a l...on a multip, reducing an anterior lip (or even a little more) and instantaneously the head descends to the perineum and you say to the nurse, "she's fully"Machahttps://www.blogger.com/profile/01134507879758968527noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-19932367385981390212007-08-24T17:00:00.000-07:002007-08-24T17:00:00.000-07:00Sid,Amazingly enough, no! Just an extremely unluck...Sid,<BR/>Amazingly enough, no! Just an extremely unlucky woman.<BR/><BR/>I had gotten paged stat to endoscopy, turned to my intern (who happened to be the ER rotating intern) and said "Where the f$%^ is endoscopy?" He led me there.<BR/><BR/>Cardiology looked pale because of the pregnancy. As soon as I heard the story, I turned pale because the heart is kinda important. <BR/><BR/>She got cut midline by me and went to CICU for the night because they wanted the placental site to heal before hitting her with an obscene amount of heparin. Next day, her sternum was cracked so she was literally cut from pubis to clavicle! But she walked out of the hospital a week later and the baby did well in the NICU and left in 11 days.<BR/><BR/>I remember just shaking afterwards...we had the whole chest-cracking instruments opened and did the c/section in the heart room with the heart team's scrub (on the theory that if something went wrong, it's far more important for the CT surgeon to have his team there). My intern, the ER guy, was pratically salivating at the thought of needing to crack her chest.<BR/>ER's MOMER's Momhttps://www.blogger.com/profile/03203520439121823165noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-6235611017802659142007-08-24T06:44:00.000-07:002007-08-24T06:44:00.000-07:00IV steroids for acute adrenal insufficiencyTacky a...IV steroids for acute adrenal insufficiency<BR/><BR/>Tacky and hypotensive to stable in minutesAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-30499448.post-63020369978166014932007-08-24T06:42:00.000-07:002007-08-24T06:42:00.000-07:00Methylene Blue for methemaglobinemia.....almost in...Methylene Blue for methemaglobinemia.....almost intubated to breadthing easy<BR/><BR/>JordanAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-30499448.post-52749943648262736362007-08-24T04:34:00.000-07:002007-08-24T04:34:00.000-07:00Lidocaine (or similar, plus some steroid) injected...Lidocaine (or similar, plus some steroid) injected for trochanteric bursitis. Patients arrive thinking (wishing) they're goiing to have a leg amputation, and skip out.IcedLattehttps://www.blogger.com/profile/12295144440149607506noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-2566484229984168062007-08-24T04:21:00.000-07:002007-08-24T04:21:00.000-07:00Hmmm.......I may have mis-remembered the changes I...Hmmm.......I may have mis-remembered the changes I saw to the QRS complex. As I think of it more, it may have been a depressed ST segment that returned to baseline. Sorry fans of Dr. Schwab.....it's been a couple dozen years and thousands of bedpans.Anniehttps://www.blogger.com/profile/16020789326552801153noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-52791454339859966302007-08-24T04:07:00.000-07:002007-08-24T04:07:00.000-07:00I had the opportunity to observe cardiac bypass su...I had the opportunity to observe cardiac bypass surgery when I was a nursing student. In the OR, there was a huge display screen that showed the patient's QRS complex with, if I am recalling it correctly, an inverted T wave. After everything was hooked up (so to speak), that T wave became rounded and upright!! I can still remember feeling such awe.Anniehttps://www.blogger.com/profile/16020789326552801153noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-22411129878794679772007-08-23T23:17:00.000-07:002007-08-23T23:17:00.000-07:00Instantaneous relief of pain from contact lens ove...Instantaneous relief of pain from contact lens overwear syndrome by use of topical ophthaine<BR/><BR/>Instantaneous reduction of refractive error with lasik surgery<BR/>'the wow factor"Gary M. Levinhttps://www.blogger.com/profile/16205704913440150198noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-89178149579389409392007-08-23T20:43:00.000-07:002007-08-23T20:43:00.000-07:00Crash C-section, getting handed a floppy, blue bab...Crash C-section, getting handed a floppy, blue baby with no respiratory effort and a heart rate of about 40. <BR/><BR/>Neonatal resus protocol rocks. <BR/><BR/>If the baby is out in time, APGAR scores tend to be in the neighborhood of 4 and 8-9. <BR/><BR/>The OB team is always suitably impressed. They should be more impressed with themselves. Most of the battle is getting the baby out before things get ugly. <BR/><BR/>On a really good day, the baby may even end up in the full-term nursery.Judyhttps://www.blogger.com/profile/08237756183010257014noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-84915021185047752942007-08-23T20:32:00.000-07:002007-08-23T20:32:00.000-07:00Laser iridotomy for angle closure glaucoma. As so...Laser iridotomy for angle closure glaucoma. As soon as you pop through, there's a huge gush of fluid, the anterior chamber deepens, and the patient feels so much better.Unknownhttps://www.blogger.com/profile/02837315387527204393noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-17918449759404970412007-08-23T19:41:00.000-07:002007-08-23T19:41:00.000-07:00Joy: if you have a person lie face down with the a...Joy: if you have a person lie face down with the affected arm dangling over the edge of a gurney, and have him/her hold a bucket which you steadily fill with water, with luck as the bucket gets full and heavy enough, it'll pop the shoulder back in. Alternatively, you put your foot in the patient's armpit, lean back, and pull. When neither works, you call the orthopedist.Sid Schwabhttps://www.blogger.com/profile/14182853083503404098noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-68999834525614530052007-08-23T19:21:00.000-07:002007-08-23T19:21:00.000-07:00What is the "water bucket trick" for a dislocated ...What is the "water bucket trick" for a dislocated shoulder?Joy K.https://www.blogger.com/profile/06200194467024962551noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-22020356225163978732007-08-23T19:00:00.000-07:002007-08-23T19:00:00.000-07:00"giving sux to a hopelessly combative patient. Cal..."giving sux to a hopelessly combative patient. Calms them right down."<BR/><BR/>Ethical, Naa. Effective, you betcha. <BR/><BR/>Dilaudid for the persistent drug seeker. I've Never seen a happier patient. <BR/><BR/>Versed for those times when you can't afford the memory. <BR/><BR/>Diprivan when you really want to mess with someone. Awake, asleep, awake, asleep..etcParamedhttps://www.blogger.com/profile/03831693846052671379noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-34116958522922899882007-08-23T18:16:00.000-07:002007-08-23T18:16:00.000-07:00"Relieving a subungual hematoma with the red-hot t..."Relieving a subungual hematoma with the red-hot tip of a straightened and heated paper clip. FZZZT, and the patient is happy!"<BR/><BR/>After I had seen this done once, I always find it amusing to see patients who squirm at the sight of the red-hot poker, not realizing it actually isn't going to hurt.Vitum Medicinushttps://www.blogger.com/profile/09994320714669547787noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-88586938943280977312007-08-23T17:47:00.000-07:002007-08-23T17:47:00.000-07:00Bipap on a gasping CHF.Bipap on a gasping CHF.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-30499448.post-86407814450372453502007-08-23T17:26:00.000-07:002007-08-23T17:26:00.000-07:00Giving anesthesia. You get to play with adrenergic...Giving anesthesia. You get to play with adrenergic, GABA, and mu receptors. to name a few. All with fast and dramatic results. Instant gratification.<BR/><BR/>It's the most fun you can have with your clothes on.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-30499448.post-80861128238045904902007-08-23T16:02:00.000-07:002007-08-23T16:02:00.000-07:00ERs Mom: impressive. Was it a Marfan's patient?ERs Mom: impressive. Was it a Marfan's patient?Sid Schwabhttps://www.blogger.com/profile/14182853083503404098noreply@blogger.com