Several doctors write very poorly with regard to their handwriting. Some doctors who have a good handwriting seem to have missed their illegible handwriting course!!
I received this picture from a friend and am not sure about the origin of the picture (thus cannot acknowledge the author). Says it all.
ps: I create a bit of a stir in clinic with patients and their families, as they watch me write quite legibly with a real fountain ink pen!
A great indepth article in the BBC about Dr Hadiza Bawa-Garba, who was smashed with work load, responsibility, lack of support and then hung to dry. It worries many of us working in hospitals, because this could happen to any of us. Any time. The result could be the same.
The trainee doctor who took all the blame!!
Learn to protect yourself. Learn to protect your colleagues and friends.
One of the possible side-effects of intravenous and tablet based chemotherapy or targeted therapies is diarrhoea. We encourage patients to use Loperamide tablets (Gastro-Stop) to treat and prevent diarrhoea. It works most times, but not always.
Diarrhoea is a adverse effect, which is not managed as well as we should. We have taken huge strides in the areas of vomiting and to some extent nausea, but diarrhoea has still not been tackled well enough.
Some of my patients, who are on chemotherapy, and struggle with diarrhoea (not just the loose bowel motions, but the urgency and uncertainty of the bowel motions) - are scared to go out to public places. Like some of the them tell me - "when you go to go, you got to go now".
I hunted for possible solutions and came across a free App called Flush - Flush app
This has a database of toilet across the city and country towns. I am really not sure how they manage the database and if there is a way to update it in real time, but it surely has helped give some confidence to several of my patients.
Seems like a silly problem?! Ask the person who is struggling with the issue.
Avastin (Bevacizumab) is a good medication in metastatic bowel cancer (both colon and rectum). It is used for extended periods of time with chemotherapy to control and reduce the burden of cancer.
It is very important to check the urinary protein while on this medication, as it does have a potential to damage the functioning of the kidney. In case, the kidneys are secreting increased amounts of proteins, it is then important to check the quantity and then if needed to stop Avastin till the kidneys recover.
We have found that a significant number of doctors forget to check urine protein, while patients are on Avastin.
Which are the best Oncology Textbooks?
# DeVita’s Cancer: Principles and Practice of Oncology
# Abeloff’s Clinical Oncology
are the best ones.
There are tons of other books, but these two seem to cover the maximum amount of information in the best possible manner.
People who have been driving their vehicles for several years (most times decades) are really upset when we tell them that they should not be driving their cars.
In Australia the onus is on the clinicians to get affected patients to stop driving their cars. The treating clinician is meant to tell the patient to stop driving and send a letter to the Driving Authority to withhold/revoke the patient’s driver’s license.
The number of clinicians who even know about this is minimal!!
If a patient’s cancer has spread to their brain, the chances of seizures or altered consciousness are quite high. There is no specific time or place when things can get out of control. Also these patients have had radiotherapy, surgery, are on high dose steroids, narcotics, etc… and thus the mental cognition and reaction time is dramatically altered.
The conversation is a difficult one. But a very important one. It could save the patient’s life and others on the road.
Medicine in Australia is top class. It may not be as cutting edge as some hospitals in the US or Western Europe, but for all practical purposes… medicine in Australia is fantastic.
There is a talk about dearth of the latest molecules, but in terms of being pragmatic and the true value for the dollar… there is almost everything available. When I talk about being available, I am talking about being funded by the government (which means free to the patient). Everything, which is not funded by the government, is available on the market (for a price).
The quality of care even in remote towns is great. If a facility is not available or there is a emergency, the Royal Flying Doctors help out.
All doctors working in public and private hospitals should get the best possible medical indemnity insurance for themselves. Most doctors working in the public system have insurance with the govt health dept, but they also need extra insurance to cover themselves.
I think it is worth the effort. Also it is tax deductible.
Cancer, Medicine and Life: A cancer and medicine blog to help on the journey of life. Medicine and Medical Oncology are rapidly changing fields and is hard for most people to keep up. A diagnosis of any illness, in particular cancer is devastating news for anyone, and the hope is that we can share knowledge and support each other.