Comments on: Ariel Sharon: Updated http://www.yourish.com/2006/01/05/566 Cutting straight to the point Mon, 22 Mar 2010 04:43:30 +0000 http://wordpress.org/?v=2.9.1 hourly 1 By: Ben-David http://www.yourish.com/2006/01/05/566/comment-page-1#comment-1763 Ben-David Fri, 06 Jan 2006 13:51:57 +0000 http://www.yourish.com/?p=566#comment-1763 Priceless moment from an otherwise fraught morning of listening to the radio here in Israel: The doctor in charge of treatment wearily telling the interviewer, "Before treating Mr. Sharon we, too, consulted all the experts you've just interviewed... " It's tragic. But let's stop looking for faults, culprits, or conspiracies. As my sister the doctor says - if it were any other 77 year old, 300 pound patient... they wouldn't even have bothered to operate. Priceless moment from an otherwise fraught morning of listening to the radio here in Israel:

The doctor in charge of treatment wearily telling the interviewer, “Before treating Mr. Sharon we, too, consulted all the experts you’ve just interviewed… ”

It’s tragic. But let’s stop looking for faults, culprits, or conspiracies. As my sister the doctor says – if it were any other 77 year old, 300 pound patient… they wouldn’t even have bothered to operate.

]]> By: The Doctor http://www.yourish.com/2006/01/05/566/comment-page-1#comment-1762 The Doctor Fri, 06 Jan 2006 13:47:02 +0000 http://www.yourish.com/?p=566#comment-1762 Glasgow Coma Scale doesn't apply to someone who's on vent and on meds to suppress conciousness... Glasgow Coma Scale doesn’t apply to someone who’s on vent and on meds to suppress conciousness…

]]> By: ilyka http://www.yourish.com/2006/01/05/566/comment-page-1#comment-1760 ilyka Fri, 06 Jan 2006 10:41:11 +0000 http://www.yourish.com/?p=566#comment-1760 Aargh, aargh--I don't mean to go all Hulk, but you know what I WANT those reports to specify that they won't? His <a href="http://www.trauma.org/scores/gcs.html" rel="nofollow">Glasgow Coma Score</a>. This is a simple neurologic assessment of responsiveness conducted on a scale from 0-15. Tell me his GCS number, and I'll have some idea. Without it--well, I'll only know this much: If his pupils are responding to light, he is likely above a 3. But beyond that, I don't know. And merely being beyond a total GCS of 3 is nothing to write home about. On December 25 I transcribed a report on a 15-year-old girl thrown from a car who was likely brain-dead on impact, and her GCS was 3. Anything below 5 on that scale is doubtful, at best. As for the very stupid Forbes article I read today, in which the authors tried to blame Sharon's physicians for prescribing him blood thinners after his initial stroke, I'll just note that this is typical journalismo "I read ONE medical article, and it said <i>x</i>" BS. Opinions vary on blood thinners after a so-called "minor" stroke, but it's a debate best left to physicians, not to the writers at Forbes. It's always a judgment call: Initiate blood thinners, and risk a hemorrhage. Don't initiate blood thinners, and risk the mother of all clots in the blood vessels of the brain, i.e., the killer stroke. It is a rock-and-a-hard-place debate, and not all physicians come down on the same side of it, nor could one reasonably expect them to. Heads you win, tails I lose. For some reason the reportage on this has pissed me off like nothing else. I guess because I'm continually left thinking, "If I, an ignorant goy medical transcriptionist, can work this out, then your excuse is . . . ?" Aargh, aargh–I don’t mean to go all Hulk, but you know what I WANT those reports to specify that they won’t?

His Glasgow Coma Score.

This is a simple neurologic assessment of responsiveness conducted on a scale from 0-15. Tell me his GCS number, and I’ll have some idea. Without it–well, I’ll only know this much: If his pupils are responding to light, he is likely above a 3. But beyond that, I don’t know. And merely being beyond a total GCS of 3 is nothing to write home about. On December 25 I transcribed a report on a 15-year-old girl thrown from a car who was likely brain-dead on impact, and her GCS was 3. Anything below 5 on that scale is doubtful, at best.

As for the very stupid Forbes article I read today, in which the authors tried to blame Sharon’s physicians for prescribing him blood thinners after his initial stroke, I’ll just note that this is typical journalismo “I read ONE medical article, and it said x” BS. Opinions vary on blood thinners after a so-called “minor” stroke, but it’s a debate best left to physicians, not to the writers at Forbes.

It’s always a judgment call: Initiate blood thinners, and risk a hemorrhage. Don’t initiate blood thinners, and risk the mother of all clots in the blood vessels of the brain, i.e., the killer stroke. It is a rock-and-a-hard-place debate, and not all physicians come down on the same side of it, nor could one reasonably expect them to. Heads you win, tails I lose.

For some reason the reportage on this has pissed me off like nothing else. I guess because I’m continually left thinking, “If I, an ignorant goy medical transcriptionist, can work this out, then your excuse is . . . ?”

]]> By: The Doctor http://www.yourish.com/2006/01/05/566/comment-page-1#comment-1749 The Doctor Fri, 06 Jan 2006 02:18:13 +0000 http://www.yourish.com/?p=566#comment-1749 The proper treatment for the kind of stroke he had first [a blood clot traveling to the brain] is, in fact blood thinners. Not doing this would be bad. We know that there is a risk of bleeding with this; it's rare but obviously it happens. Sadly, the short-term survival for head bleeds is much worse than for the more common form of stroke. We say misheberach, but can't be optomistic. The proper treatment for the kind of stroke he had first [a blood clot traveling to the brain] is, in fact blood thinners. Not doing this would be bad. We know that there is a risk of bleeding with this; it’s rare but obviously it happens.

Sadly, the short-term survival for head bleeds is much worse than for the more common form of stroke. We say misheberach, but can’t be optomistic.

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