Be Thankful (Horrifying Medical Injuries)

[Valiran]

^ Wouldn't help that much in and of itself for congenital things.

Depends on the cause. If it's genetic-based perhaps not, but some defects that are caused by, for instance, a deficiency of something might well be corrected when the replacement bodies are grown. Even for some genetic disorders it might be possible to correct the matter when growing a new body.

And if that don't work, stick their mind in a specially designed computer and get them a body that looks exactly the same as their old one, but without the defects.

[Lord of the Abyss]

^ Wouldn't help that much in and of itself for congenital things.

Depends on the cause. If it's genetic-based perhaps not, but some defects that are caused by, for instance, a deficiency of something might well be corrected when the replacement bodies are grown. Even for some genetic disorders it might be possible to correct the matter when growing a new body.

For that matter, it would help with genetic diseases that take a long time to manifest. If something takes ten or thirty years to do enough damage to notice, a fresh new body would have that long before it starts suffering the effects. And then you just replace it again.

[The Yosemite Bear]

well I've survived a number of things I shouldn't have, electricity, fractured skull, rapid onset pnuemonia, car accidents, etc. currently I am glad I haven't had gangrene.

[The Kernel]

Nothing in the world compares to prion diseases for sheer ruthlessness. Your brain literally starts getting eaten away by tiny holes which leads to all sorts of fun side effects.

Fatal familial insomnia:

The age of onset is variable, ranging from 30 to 60, with an average of 50. However the disease tends to prominently occur in later years, primarily following childbirth. Death usually occurs between 7 and 36 months from onset. The presentation of the disease varies considerably from person to person, even among patients from within the same family.

The disease has four stages, taking 7 to 18 months to run its course:

1) The patient suffers increasing insomnia, resulting in panic attacks, paranoia, and phobias. This stage lasts for about four months.
2) Hallucinations and panic attacks become noticeable, continuing for about five months.
3) Complete inability to sleep is followed by rapid loss of weight. This lasts for about three months.
4) Dementia, during which the patient becomes unresponsive or mute over the course of six months. This is the final progression of the disease, and the patient will subsequently die.

Creutzfeldt–Jakob disease:

The first symptom of CJD is rapidly progressive dementia, leading to memory loss, personality changes and hallucinations. This is accompanied by physical problems such as speech impairment, jerky movements (myoclonus), balance and coordination dysfunction (ataxia), changes in gait, rigid posture, and seizures. The duration of the disease varies greatly, but sporadic (non-inherited) CJD can be fatal within months or even weeks (Johnson, 1998). In some people, the symptoms can continue for years. In most patients, these symptoms are followed by involuntary movements and the appearance of an atypical diagnostic electroencephalogram tracing.

The symptoms of CJD are caused by the progressive death of the brain's nerve cells, which is associated with the build-up of abnormal prion proteins. When brain tissue from a CJD patient is examined under a microscope, many tiny holes can be seen where whole areas of nerve cells have died. The word "spongiform" in "transmissible spongiform encephalopathies" refers to the "spongy" appearance of the brain tissue.

[mr friendly guy]

Last week I saw one our "frequent flyers" in hospital again. This chap has screwed his liver with alcohol as well as getting alcohol related seizures. Basically came in with diarrhoea andbriefly mentioned to the night doctor he might have haemorrhoids. Any way, the next day on further questioning from the boss, he thought he might have black stools.

For those that aren't medically inclined, thats a sign of bleeding from the upper GI tract (black blood is essentially digested blood) and usually are more serious than lower GI bleeds since you can lose blood quite quick. So I had the awesome job of sticking my finger up his back passage for a rectal exam to see if there is any black blood. It turned out I didn't need to because the moment he dropped his pants it was a sight to behold.

His bum was falling off. That is the skin was peeling off and the underlying muscle was visible. This wasn't a small lesion, it was like at least 20-30 cm x 10 cm of skin peeling off and some of the skin had become necrotic. Apparently there was a foul smell as well, but since my nose seemed to have been stuffed for some reason (I do occasionally suffer from hay fever) I guess I didn't notice it too bad. At this point I asked how long has this been happening, in which case he really had no clue and no insight. Besides from poor self care, I am not even going to think how that happened.

At that point I got the surgeons involve and eventually he was transferred to a tertiary teaching hospital with the view of operating on him. The reason he wasn't done at a peripheral hospital was because of all his other medical problems made him an anaesthetic risk. He was of course a bleeding risk because his liver was shot and he was coagulopathic.

[Knife]

DQ ulcers that went necrotic? That's nasty Mr. Friendly Guy. Yeuck.

I've seen patients like that before, skin and even Glutinous Maxims, Medias and even Minimus eaten away till you can see bone.

[Enola Straight]

How about parasitic infestation?

Say...maggots crawling around inside your sinus cavities?
http://www.youtube.com/watch?v=dPvAF5if ... re=related
http://www.youtube.com/watch?v=Pievyi_0 ... re=related


(we need a pukey smiley for this one)

[PainRack]

Anyone here ever seen a breast cancer fungating wound?

Yup. Please, oh please, do go for your mammograms folks. Sure, the actual true positive rate is somewhere in the 1/thousandth bits but the alternative is.......

[[R_H]]

I'm really glad I decided not to study medicine or nursing.

[Shroom Man 777]

How the fuck did the guy end up with grotesque bedsores if he wasn't some old shmuck whose butt is on the bed 24/7, constantly getting eroded?

I am thankful that I haven't been into geriatric nursing.

[Knife]

How the fuck did the guy end up with grotesque bedsores if he wasn't some old shmuck whose butt is on the bed 24/7, constantly getting eroded?

I am thankful that I haven't been into geriatric nursing.

Well, I've seen some 'younger ones' with em too. Old people in geriatrics tend to be better about it, what with dementia and what not letting staff role them without much ado; however, younger folk with their faculties may and can be stubborn about it and refuse AMA which leads to these types of problems. In a hospital setting, they tend to come in and leave within 3 days, so you don't see them much there, move to a long term care facility and you get them a lot.

[Broomstick]

My Other Half has some permanent numbness in his lower extemeties due to his spina bifida and the accompanying nerve damage. He's had pressure sores on his buttocks, thighs, and feet because when he sits he doesn't move around as much as normal folks do and that can lead to such things. As he's gotten older this has happened less often, but only because he is self-disciplined about moving at intervals. In his case, he has to think about it consciously rather than responding unconsciously to the cues most of us do.

[cosmicalstorm]

How the fuck did the guy end up with grotesque bedsores if he wasn't some old shmuck whose butt is on the bed 24/7, constantly getting eroded?

I am thankful that I haven't been into geriatric nursing.

Yeah those places can be very depressing. Last week I was doing cursory dental checkups of the people at a home for Alzheimers/dementia-sufferers. This is actually one of the better places for these people in my region, lots of welltrained staff at all hours etc. Second room I walk into there is diarreah all over the place, from the toilet all the way to the bed, where a woman is sitting trying to get her shoes on. Apparently she was on her way to the toilet when she forgot what she was going to do there and decided to go back to her TV, then her bowels emptied themselves... I'm glad not to be the one responsible for the cleaning there.

[mr friendly guy]

Well if anyone is interested said patient is back at the peripheral hospital I am seconded to. It turns out he was thought to be too high risk to operate even in a tertiary teaching hospital. From the point of view of the wound it looks cleaner (frequent dressings and antibiotics for the win) although the underlying tissue is still exposed. Unfortunately with his liver failure he has become encephalopathic and has worsening ascites. Oh and he has awesome nystagmus now (which I suspect is from phenytoin toxicity).

So I reverse his coagulopathy with prothrombinex, stick a needle in his abdomen and drain the fluid with albumin cover. If he starts putting on fluid and weight again after the drain is removed, I'll hit him with even higher doses of diuretics with a combination of low salt diet plus fluid restriction.

Multivitamins for his alcoholism plus lactulose 4 times a day for his encephalopathy. I am just trying to figure out what to do with him after I sort out his acute problems since his wound is still going to be a problem. Oh, and he is too young to be placed in a nursing home.

[Shroom Man 777]

What was the operation they were supposed to perform on him? Was it the one where they fix his veins?

This is why breaking a vital organ responsible for detoxifying your blood and processing proteins and stuff is bad.

[mr friendly guy]

Surgical debridement of the affected skin. I assume they would also try to stitch things back together eventually.

Yeah, and liver failure is bad. Who knew?

Its really sad in a way. These people seem like nice people, but they just couldn't control the booze and here is how they end up. Short of new liver (which he isn't going to get since he still drinks, although he says it was a relapse) we can't really reverse the damage. We can certainly control the symptoms and maybe his liver might regenerate a little (yes I am aware that cirrhosis is defined as irreversible, although IIRC its not completely true), and he might end up doing something with his life instead of being on welfare since he is not going to be able to work at all.

I have seen several cases of liver failure, although only two which I knew eventually died. The first one we had saved him the first time. He discharged against medical advice saying he had a job interview in Melbourne. Turned out he went back to drinking and the second time round we couldn't repeat the feat. The second person had primary biliary cirrhosis and she died before getting a transplant.

[Broomstick]

Surgical debridement of the affected skin. I assume they would also try to stitch things back together eventually.

Tissue and skin grafts.

My Other Half has some very interesting scars on his buttocks from the time he sat on a grill. Yes, alcohol was involved. They used beer to put the ass on his fire out. In addition to skin grafts in select spots he also has "rebeW"* on one buttcheek.

Then again, at the time he was a healthy (if somewhat foolish and uncoordinated) young man with a healthy liver. This is most advantageous for healing major wounds. Fuck up your liver you don't heal so well.


* Weber is a brand name for a grill in the US. Don't know how common they are abroad.

[[R_H]]

[quote="mr friendly guy"]
Multivitamins for his alcoholism plus lactulose 4 times a day for his encephalopathy. /quote]

Multivitamins for alcoholism?

[Broomstick]

Most advanced alcoholics are nutritionally deficient due to poor diet or simple lack of eating food (as opposed to drinking alcohol). If I recall, B vitamins are especially impacted in these cases, but really, they could easily be lacking everything.

[Shroom Man 777]

B vitamins are also stored by the liver. Which, in severe alcoholism, gets damaged.

[mr friendly guy]

Multivitamins for his alcoholism plus lactulose 4 times a day for his encephalopathy. /quote]

Multivitamins for alcoholism?

Thiamine is the other vitamin which they are deficient in, and yeah it is one of the vitamin B group. Especially if they develop some of the complications such as Wernicke's encephalopathy. Of course, this man doesn't have wernicke's, but he does have encephalopathy.

[The Yosemite Bear]

which reminds me, I used to joke about adding vitamin B series to beer....

[Broomstick]

Beer already has significant vitamin B due to the yeast. The nutritional problems of alcoholics are related to liver dysfunction as much as dietary lack. Also, if the drunk doesn't drink beer but something else, well, they lack B even more in that case.