Posted on 01/09/2019 9:56:44 AM PST by Gamecock
if they vary from the script, they could be liable for any bad outcomes or not have the bill paid for by insurance, which then lands on the patient himself/herself.....
eg....there are certain protocols for certain symptoms...they go by the most reasonable and common explanation for symptoms.....and treat accordingly....
Yes, pretty much experimental treatments is the only hope, and they don’t work either.
Does cooking kill rabies?
JMHO, but there is no intellectual curiosity in medicine anymore. If a woman, especially if you’re a woman, and present with anything from increased heart rate to breathless feeling, it’s likely to be diagnosed as a panic attack.
This woman returned several times to the ER and each time was turned away with the an “easy” diagnosis. I’m not a Dr. but correct me if I’m wrong. If blood tests were run, and rabies is an infection, wouldn’t she have had an elevated white blood count?
Bite him back yes.
I was bitten by a bat and had to get the rabies shot regime. The shots are not that bad but it ain’t fun. Also the heath dept calls you all the time to see if you made your infusion appointment. If you miss they send the cops.
The ER experience in the US is pretty bad... I got 3 different and conflicting instructions on a recent ER visit, the Attending, the intern/resident (not sure which one he was) and the nurse, all gave me slightly different information and at times contradictory info.
Not so much on the actual diagnosis, but for the follow up stuff I would need to be doing....
I know why this happens, the general instructions were similar, but the details were different.
I really do feel for the elderly or those who are for other reason incapable of advocating for themselves, because if you are a passive patient, this is the kind of stuff that will happen.
Of course, My bet is she never told anyone that she got bit.. and none of the doctors/staff asked her if she had been.
So they diagnosed on symptoms rather than on doing a full patient background which would have almost instantly made think of possible infections... etc
That and the Urgent Care she visited, almost certainly didn’t even see a doctor, most likely was a PA if she lived in a state that allows them.
Yes. If someone comes in with fatigue and soreness, you don’t order three different tests that add up to $10K.
You do a physical examination to find a cause, and if you don’t, you order a few tests and monitor. If the symptoms get worse, you do more expensive tests.
People complain about the high cost of medicine, but that makes no difference to many of them when they have an irrational axe to grind.
Symptoms for rabies are notoriously vague and non-specific. And even when you begin to display the most banal and minor of them, it is too late.
If she had been correctly diagnosed with rabies, she would be just as dead.
Rabies is viral. It doesn’t show in blood tests. You have to order specialized tests that aren’t carried out often, and have to be sent to special labs, not the usual ones.
Elevated white blood cells can be a huge number of things.
But they make our meds!......................
Yeah, one gal told me she was calling an ambulance before I dropped dead in her office. She was serious I wasn’t going to last the day. I’d only gone to see her for a torn meniscus. Soon to be 10 years and they still won’t fix it. Oh, and I’m still alive.
On the opposite end, one moron stood in hallway outside the exam room and determined he didn’t need to stitch my bleeding head up after I’d fallen off a ladder. Of course, he charged me for the hallway consult.
“Sometimes we forget that our patients travel to places where there are a lot of zebras.”
So true. When I practiced in Alaska rabies was always in the back of my mind due to the high percentage of wild and domestic canids that were infected. When I lived in SE Idaho I had a patient who may/may not have been scratched on her scalp by a bat. Fortunately she had the bat and it tested negative but not before treatment had been started.
I once encountered a patient in Alaska with flu-like symptoms in May. When I entered the room his neck was swollen up so much it was wider than his head. That was weird. One of his white blood cell counts was extremely elevated. I researched this in a pathology book (which is a clue to how long ago this happened!). I suspected trichinosis. I asked him if he had eaten any undercooked pork or bear meat recently. Yep, he had eaten some undercooked grizzly bear steaks from last Fall while he and his buddy were out Spring bear hunting. You know - eat bear, hunt bear! He damn-near died and had life changing disabilities after he recovered.
So yeah, its often horses but sometimes there are zebras around. Its vital to understand not only the environment where you practice but what kinds of other environments your patients might visit. Like the Eskimo family who developed trichinosis from eating fermented walrus flipper...
People don’t get this. Even if she had gone to the ED with even the mildest of symptoms such as anxiety or a headache, they are already going to die.
I knew a guy who took a bite out of a fish head from a chum barrel on a fishing boat just to get the hung over guys to lose it.
I don't think he would have chewed on that flipper...
nor did she ever receive a rabies vaccination in her lifetime.
You ever hear of that Alaska native delicacy “stink head”?
I don't know how. Every time I see a medico, any medico, I'm asked if I've been out of the country lately.
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