Every medical procedure or surgery comes with a risk. Some of the complications are known. Some are unknown, even in the face of modern medicine. Informed consent, High-risk consent etc have been introduced to avoid the hassles of medico-legal lawsuits that may result due to any such complications.
Complications may occur because of the physician's negligence or sometimes even because of "self-negligence"on behalf of the patient himself (contributory negligence). The loss is the patient's or to the family of the victim. Noamountoflawsuitmoneycanrepairthedamage or bringbacklostlives.
As medical and surgical procedures are influenced by rapid advancements in technology, change is common and necessary. However, the latest procedures are not always perfect and are possible to fail. Therewasahugebuzzaboutroboticsurgeryand about how efficient it could be or how it shortened the patient's stay in the hospital. RecentstudieshaveshownthereisNOimprovedsurvivalascomparedtothosetreatedbyconventionalsurgicaltechniques. Instead there are horrifying stories of how it has failed resulting in disability and even death.
Whenever you, or a loved one, are to undergo ANY medical procedure-could be diagnostic or the actual treatment itself- beawareofalltherisksandpossibleoutcomes. Do not hesitate to badger your doctor on any doubts you may have regarding the procedure. Find out about alternatives. Most importantly, educate yourself on the Do's and don'ts before and after a procedure to avoid harming yourself.
Better safe than sorry.
Hereismystory. An unexpected unforseen complication of LASIK, one of the commonest procedures being performed nowadays.
Life is like a bubble. We never know when it's going to burst. All we can do is to try and be prepared for any eventuality. With diseases like diabetes and hypertension reaching epidemic proportions, the number of heart attacks and strokes is on a steady rise. This is the picture globally. More people die from Cardiovascular disease annually than from any other disease.
According to a report by the World Health Organization, an estimated 17.3 million people died from cardiovascular disease in 2008 alone, accounting for 30% of global deaths. Of these, 7.3 million deaths were due to Coronary Heart disease, i.e. blocked vessels that supply the heart muscle and almost 6.2 million were due to strokes.
Most people experience heart attacks when they are surrounded by people. That is either at home, work or in other public places like at sports events, the cinemas, while travelling on flights, trains etc. Studies have clearly shown that those people who received CPR (Cardio-Pulmonary Resuscitation) before being brought to a hospital, showed higher survival rates. As high as 3 times than those who did not! But let's face it. Who is going to provide CPR on site and immediately when the person collapses? If you saw someone suffering a heart attack, would you intervene and provide CPR?
People usually wait for the Emergency Response Teams to arrive and stand around not doing much, which is really bad for the heart-attack victim. Unfortunately, calling 911 (or whatever the number is in your country) and getting an ambulance at your doorstep within minutes is a reality only in well developed countries. This is not the case everywhere. With the traffic on Indian roads and the non-existence of roads in some areas, the ambulance is never going to reach in time to save someone's life.
This is where the concept of BYSTANDER CPR comes in. As the name indicates, this is CPR that is provided by the people in the immediate vicinity of the victim, without any waste of precious time. CPR is part of school curriculum in countries like USA and a lot of students and others, laymen in the public, are trained to react quickly and effectively in these situations. Unfortunately, in India, many medical graduates and nurses do not have Basic Life Support training to act as FIRST RESPONDERS.
Message received, but where can I learn CPR? You DO NOT have to be in the field of medicine to get the necessary training. I was in conversation with Dr. Ramana Rao, Executive Partner and Head, Emergency Medicine Learning and Research Center, EMRI, Hyderabad and he told me such programs are being conducted for the general public on a regular basis in all the major cities in our country. Recently up to 30,000 people (Cab drivers, auto drivers, housewives, teachers, students, volunteers at major congregations like kumbhmela etc) have been trained to provide CPR as first responders until the Emergency medical teams arrives on site. YOU CAN LEARN TOO!
All of you would have seen CPR being delivered on screen in several movies and TV series. It basically has two important components.
1) Chest compressions.
2) Giving breaths.
Luckily, Bystander CPR is a HANDS-ONLY technique and the provider is expected to provide only chest compressions. Let me give you the details of how it should be done. This can save a life, pay attention !!
STEP 1: CALL FOR THE EMERGENCY SERVICES 108 (INDIA), 911 (USA)
STEP 2: CALL OUT THE VICTIM'S NAME AND TRY TO AROUSE HIM
STEP 3: CHECK FOR A PULSE IN THE NECK (SPEND <10 SECONDS)
STEP 4: IF THERE IS NO PULSE, OR YOU ARE UNSURE, START CHEST COMPRESSIONS
This is how you position yourself next to the unconscious person and please note how your hands are placed over the chest.
Circulation: Restore blood circulation with chest compressions
Put the person on his or her back on a firm surface.
Kneel next to the person's neck and shoulders.
Place the heel of one hand over the center of the person's chest, between the nipples. Place your other hand on top of the first hand. Keep your elbows straight and position your shoulders directly above your hands.
Use your upper body weight (not just your arms) as you push straight down on (compress) the chest at least 2 inches (approximately 5 centimeters). Push hard at a rate of about 100 compressions a minute.
If you haven't been trained in CPR, continue chest compressions until there are signs of movement or until emergency medical personnel take over.
If you are getting tired (you definitely will, if you are doing it right), ask someone else to take over.
Here is the official video for Bystander CPR by the American Heart Association.
This is basically it. There isn't much to it but you have to be well prepared and you have to act fast. If you have any doubts, feel free to clarify it with me anytime and there is a ton of literature available online to learn more.
Learning CPR is the best service you can do to your society and country. You may be the one who saves someone's life, giving him/her a chance to go home to their families. Please find out organizations and hospitals in your city that provide CPR courses and enroll yourselves. It is a single day course and you can be anyone. Just be a responsible citizen. Spread the word. Inspire others.
Thanks to excellent marketing by pharmaceutical companies, we have access to a great variety of pain medication which are available as "over the counter" (OTC) drugs i.e. you don't need a prescription to buy and use them. These range from mild Non-steroidal drugs like Paracetamol to more potent orally administered drugs like Tramadol, which contain opioid drugs.
It is common sense that as we progress along this spectrum, from milder to more powerful pain medication, the side-effects and dangerous adverse effects are more. There have been numerous cases of cardiac (heart-related), liver and Kidney toxicity when these drugs have been used inappropriately resulting in hospitalization and even death.
So, how do you choose and how do you manage pain responsibly? There are several guidelines available, published by many organizations like the World Health Organization (WHO), NICE guidelines in the UK, etc. We cannot follow everything so let me simplify it sufficiently for you to incorporate the RIGHT and RESPONSIBLE way to use pain-killers in your everyday life.
Welcome to the concept of the "PAIN LADDER" ! This is an important concept of pain management which was created by the WHO for the management of cancer pain, but later this was adapted to dictate the day to day use of pain-killers. The problem is, many doctors themselves do not follow this concept of management and start their patients on very powerful medication. If the treatment duration is short, there may not be any side-effects, not noticeable anyway. There is no guarantee that damage has not occurred at the cellular level!
The pain ladder concept involves starting off with mild pain-killers at low doses for the initial management of pain with gradual escalation of dose if the pain persists. Drugs with greater potency are prescribed if the pain does not subside, or if the initial pain is too severe to be treated by something as simple as a Tylenol (the USA equivalent of the Indian Crocin). Preferably, all medication should be taken after consultation with a doctor or a qualified nurse.
Let me show you a few images to give you a clearer picture of how this works:
Let's make that look like the ladder/steps that I mentioned!
Please note that the it is preferable that you take any medication ONLY after consultation with a doctor. This minimizes any risk and ensures success of the treatment. Opioid drugs eg. Pethidine, Tramadol etc are dangerous to self-medicate and should always be prescribed.
In cases of fevers with headache, injuries with a trivial mechanism (falls while playing, cycling, sprained ankles), always start with Paracetamol. Usually the dose is determined by the body weight of the individual, but it's not always easy to get that data. Paracetamol in India is USUALLY marketed as 500 mg tablets (please check the labels of the medication) and initial doses for adults and children more than 15 years of age should be ONE TABLET every 6 hours. If the pain is persistent or more intense, it can be taken every 4-6 hours. Stop taking any medication if you are relieved and you can bear it !!!!
In the above charts, there is a class of drugs mentioned with paracetamol called NSAID. This stands for Non-Steroidal Anti-Inflammatory Drugs. Common drugs you use which fall under this category are Combiflam (Ibuprofen + Paracetamol), Diclofenac, Aceclofenac. These should be used in musculo-skeletal injuries with moderate to severe pain, like in severe sprains and other sports-injuries. These drugs may be combined with Paracetamol and should be taken not more than ONE TABLET every 6 hours. If the pain is persistent, please see a doctor and get it revised.
Lessons for the day:
1) Avoid self-medication.
2) Always start with mild drugs like Paracetamol (marketed as Crocin, Calpol etc)
3) Use Ibuprofen (commonly Combiflam) or Diclofenac/ Aceclofenac only if pain is not subsiding or if it's severe enough to stop you from sleeping.
4) If the pain persists, please see your doctor
5) These drugs can have liver and kidney side-effects and the dose should be specified by a doctor.
For any medical students (like me) or Doctors: please follow the WHO Pain ladder while prescribing pain-killers.
NOTE: Some pain killers are banned but still available/ prescribed. Look out for these drugs and avoid them. If a doctor prescribes them to you, you have every right to question his judgement and ask for an alternative.
BANNED PAIN-KILLERS: NIMESULIDE (NIMULID) and ANALGIN. If I come across literature about any other dangerous but common medication, I will post about it.
Thank you for your time reading this. Have a great, pain-free day :)
Hello everyone ! Let me introduce myself. I'm Praharsha Mulpur, a medical student from India. I'm almost done with my undergrad. It's my aim to create awareness on common medical issues to enable people to improve their health at the individual level. A lot of things in medicine are very vague for the general population and I like to simplify things for everyone's benefit.
It would be fantastic to get YOUR opinion on what you feel is important with regard to healthcare that needs some clarity. This maybe how common conditions are treated, how some diseases are diagnosed and treated.
In my first blog post here, I would like to direct your attention to my first piece of online writing which I published on medium.com
Drug resistant infections are killing millions of people worldwide and more dangerous organisms are becoming resistant to commonly used antibiotics. So, what can we do about it? There are steps we can take at the personal level to help prevent these drug-resistant infections from cropping up.
The title is: We Are Aware Antibiotics Are Becoming Obsolete! (So, what can we do about it? A medical student's opinion)
Please take some time to go through it and any feedback is very welcome.
