Ruby Graupera-Cassimiro Survives 45 Minutes without Pulse
Ruby Graupera-Cassimiro, 40, went to Boca Raton Regional Hospital in Florida for a cesarean section on September 23.
The surgery was uneventful and the baby was healthy, but Graupera-Cassimiro started to experience shortness of breath and doctors... (Source: blog.bioethics.net)
Source: blog.bioethics.net - November 11, 2014 Category: Medical Ethics Authors: Thaddeus Mason Pope Tags: Health Care medical futility blog syndicated Source Type: blogs
Who is NOT a DIEP flap candidate?
With more women becoming aware of DIEP flap breast reconstruction as an option, the question of who is and who isn't a good DIEP flap candidate is coming up more often.As a general rule, women that have had extensive abdominal surgery like a previous TRAM flap, tummy tuck or a complex hernia repair cannot have a DIEP or SIEA flap breast reconstruction. This is because the lower tummy tissue that is needed has usually been removed or moved around, and the necessary blood supply has been disrupted.Having said that, most of the time previous abdominal surgery isn't an issue in experienced hands.Many women these days have...
Source: Breast Cancer Reconstruction Blog - October 21, 2014 Category: Cancer & Oncology Tags: breast reconstruction bulging c-section complications CT angiogram diep flap candidate hernia hysterectomy siea flap TRAM flap tummy tuck ultrasound Source Type: blogs
Who is NOT a DIEP flap candidate?
With more women becoming aware of DIEP flap breast reconstruction as an option, the question of who is and who isn't a good DIEP flap candidate is coming up more often.As a general rule, women that have had extensive abdominal surgery like a previous TRAM flap, tummy tuck or a complex hernia repair cannot have a DIEP or SIEA flap breast reconstruction. This is because the lower tummy tissue that is needed has usually been removed or moved around, and the necessary blood supply has been disrupted.Having said that, most of the time previous abdominal surgery isn't an issue in experienced hands.Many women these days have...
Source: Breast Cancer Reconstruction Blog - October 21, 2014 Category: Cancer & Oncology Tags: breast reconstruction bulging c-section complications CT angiogram diep flap candidate hernia hysterectomy siea flap TRAM flap tummy tuck ultrasound Source Type: blogs
Informed consent: Can patients ever truly be informed?
This post by Paul Levy got me thinking about informed consent, and a case I saw recently got me to take a little time and write about an issue frequently ignored in medical school.
A bit of background for non-medical readers. Informed consent is a term in medicine for when doctors get the agreement of the patient to do something to said patient. For example, before a patient is cut open for surgery, the patient has to say, “Yes I want to be cut open and have x happen.”
Less extreme examples abound: the patient has to consent to anything from a blood draw for a lab test to a CT scan. Part of informed conse...
Source: Kevin, M.D. - Medical Weblog - October 5, 2014 Category: Journals (General) Authors: Vamsi Aribindi Tags: Physician OB/GYN Source Type: blogs
VBAC is the love child of medical malpractice lawyers
The New York Times has reported on a woman who wanted to deliver vaginally and claims she was forced to have a repeat C-section (her third C-section) against her will. I can’t comment on the veracity of her claims, however a forced C-section is never, ever acceptable. It doesn’t mater if the fetus has an agonal rhythm (is visibly dying on the monitor), as an OB your role is to try to make your case for the intervention you feel is the most medically acceptable, but never, ever with force or threats. You make sure all your discussions are witnessed and you spend a lot of time documenting, but choice is choice.
Continu...
Source: Kevin, M.D. - Medical Weblog - October 2, 2014 Category: Journals (General) Authors: Jennifer Gunter, MD Tags: Physician Malpractice OB/GYN Source Type: blogs
Life with chronic pain
I was very intrigued to read this article on a man's advice on living with a wife in chronic pain. I admit I might be guilty of some of the first ten myself. My husband does pick up on when I am overdoing things and cues me to take it easier.I also know sometimes when I want to do things and feel like I should do them but just don't have it in me. I try to work around it. I'll lie down for a while and then try later on. Or I'll put it off until the next day. Sometimes I ask my husband to do things for me - like making dinner - because the idea of standing in the kitchen for ten minutes just isn't a good idea.If you read hi...
Source: Caroline's Breast Cancer Blog - August 19, 2014 Category: Cancer Tags: pain levels Source Type: blogs
That's "informed" consent
My friend and colleague, Doug Hanto (a world class transplant surgeon) reports on Facebook about the birth of his grandson at St. Vincent Carmel Hospital in Indiana:Interesting. Lindsay is about to have a C-section this morning, and we will welcome John Douglas into the world. The nurse handed Lindsay informed consent for C-section, anesthesia, blood transfusion, circumcision, and HBV vaccine with no explanation. Like signing the agreement you have to sign when updating your OSX or windows software. They all say "Your physician has explained ..." No one has explained anything. Trust is alive and well in the real wor...
Source: Running a hospital - August 8, 2014 Category: Health Managers Source Type: blogs
Nurse-Midwives and Physicians: The Team Approach Is a Win-Win
By E’Louise Ondash, RN
There was a time when C-sections were reserved for mostly emergency situations, but today, 1 in 3 pregnant women undergo a C-section to deliver their babies--a 60 percent rise since 1996. This, according to a report from the Congress of Obstetricians and Gynecologists.
The World Health Organization (WHO) recommends that the C-section rate for any nation not exceed 15 (Source: NurseZone Blog: RN Talk)
Source: NurseZone Blog: RN Talk - June 30, 2014 Category: Nurses Authors: NurseZone Source Type: blogs
Nurse-Midwives and Physicians: The Team Approach Is a Win-Win
By E ’Louise Ondash, RN
There was a time when C-sections were reserved for mostly emergency situations, but today, 1 in 3 pregnant women undergo a C-section to deliver their babies--a 60 percent rise since 1996. This, according to a report from the Congress of Obstetricians and Gynecologists.
The Wo rld Health Organization (WHO) recommends that the C-section rate for any nation not exceed 15 (Source: NurseZone Blog: RN Talk)
Source: NurseZone Blog: RN Talk - June 30, 2014 Category: Nursing Authors: NurseZone Source Type: blogs
A normal pregnancy framed as a one with special needs
What if healthy pregnancies were treated like special needs pregnancies?
Mr. and Mrs. Johnson, good afternoon. I’m Doctor Dumas, a visiting obstetrician in Doctor Kwak’s practice. It’s nice to meet you.
Look, there’s no easy way to say this, so at the risk of sounding blunt, I have some bad news.
The technician and I reviewed your scans and we found that you’re about ten weeks along with a human fetus. I’m not seeing any abnormalities as far as growth or bone and organ structure, but you’re very clearly pregnant with a human baby. In all likelihood, you’ll carry the baby for another thirty weeks until your...
Source: Kevin, M.D. - Medical Weblog - June 29, 2014 Category: Journals (General) Authors: Sarah Watts Tags: Patient OB/GYN Patients Source Type: blogs
Refusal of Cesarean Section
<p>I was recently surprised to read in the <a href="http://www.nytimes.com/2014/05/17/nyregion/mother-accuses-doctors-of-forcing-a-c-section-and-files-suit.html?module=Search&mabReward=relbias%3Ar&_r=0">New York Times</a> that a woman had undergone a cesarean section despite her refusal to consent to the procedure. The details of the case are not entirely clear from the article, so I do not want what follows to be understood as a specific comment on this case. However, the source of my surprise was my assumption that the ethics of refusal of consent were not in dispute. T...
Source: blog.bioethics.net - June 24, 2014 Category: Medical Ethics Authors: Hayley Dittus-Doria Tags: Health Care autonomy Obstetrical Ethics syndicated Source Type: blogs
Hospital bills should not outlive our loved ones
In 2010, I lost my mother to cancer. She was a fighter and had survived well past her prognosis, but her hospital costs outlived her.
Let me go back to late 2004. That was the year the doctors suspected she had cancer. My mother, who was not a smoker, was officially diagnosed with non-small cell lung cancer early on in 2005. When the biopsy confirmed that the small lesion in the lower lobe of her right lung was indeed cancer, the surgeons performed a lobectomy. We, of course, realized that this would come at a cost, but we had decent insurance coverage at the time. We certainly were not anticipating the cost to rival a...
Source: Kevin, M.D. - Medical Weblog - June 18, 2014 Category: Journals (General) Authors: Nadi Nina Kaonga Tags: Conditions Cancer Hospital Source Type: blogs
14.5 Million Reasons Physicians Practice Defensive Medicine
Cleveland’s MetroHealth Medical Center and a staff physician were recently found liable for a $14.5 million medical malpractice verdict in what is commonly termed a “bad baby” case.
The case as described in the article involved 36 year old Stephanie Stewart who was pregnant with her second child. She went to MetroHealth several times for premature labor when the child was 22-23 weeks gestational age (a full term infant is 40 weeks) and was admitted twice, with labor being stopped using medication and bedrest. There were apparently discussions about her requiring a C-section since her first child was de...
Source: WhiteCoat's Call Room - June 16, 2014 Category: Emergency Medicine Authors: WhiteCoat Tags: Defensive Medicine Medical-Legal Source Type: blogs
Overselling the microbiome award - many - for stories about placental vs. oral microbiomes
Conclusions: Microbial contact in utero is associated with changes in fetal intestinal innate immune gene expression profile. Fetal and placental immune physiology may be modulated by maternal dietary intervention using specific probiotics.This paper was not mentioned or cited as far as I can tell in the current study.UPDATE 4: This paper also seems relevantMicrobial contact during pregnancy, intestinal colonization and human disease. Abstract:Interaction with colonizing intestinal bacteria is essential for healthy intestinal and immunological development in infancy. Advances in understanding early host–microbe int...
Source: The Tree of Life - May 23, 2014 Category: Medical Scientists Authors: Jonathan Eisen Source Type: blogs
I Was Wrong about the Environment
Time and again the magic begins the same way. Sperm and egg come together to create an absolutely unique cell. Then this cell divides to create two identical cells., These cells divide, and divide again, and divide again. At first all the cells are the same, but something changes. Soon the cells become different from each other. Within 8 weeks the developing baby has hair follicles and knees and toes, each with a unique toe print.
How do identical cells lead to cells with such different destinies? It’s a subtle environmental influence. As the cells divide, some of the cells are on the inside and some are on the outside. ...
Source: Conversations with Dr Greene - May 3, 2014 Category: Child Development Authors: Dr. Alan Greene Tags: Dr. Greene's Blog Baby Environmental Health Newborn & Baby Sleep Source Type: blogs
