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GW_Addict
I have talked to numerous people who have an interest in modern medicine and thought I would start a thread regarding medicine. I myself am an EMT, and enjoy discussing emergency medicine. I know there are a couple other firefighters and EMTs on this post (as I have referred a few myself. :) So climb aboard all you lovers of medicine! ;)

Anyway, I though I would kick the Forum off by talking about a new procedure that when I was a kid would have been considered something you see on Star Trek.

The largest problem faced by Orthopedic surgeons when doing a knee replacement is that they have to spend the majority of their time making sure everything lines up (think about it if tendons, ligaments, blood vessels, etc. dont all line up perfectly, stuff wont work!) In the past they could spend and entire day just making sure everything was lined up!

Now they clip these little things above and below your knee, which send signals to a computer and create a perfect blueprint of your knee. Then, they just follow the directions and the mapping on the computer, and bang everything lines up perfectly on the first try.

Now a person can get a new knee in almost no time!

Here are a couple URLs that talk about this.

http://www.jointreplacement.com/xq/ASP.default/pg.content/content_id.411/newFont.2/tp.featured/qx/default.htm

http://www.totaljoints.info/comput_assist_TK.htm
DoctorBeaver
I love hearing about things like this. Thanks for posting it, it's really interesting. I never cease to be amazed at what modern technology can do.
GW_Addict
DoctorBeaver wrote:
I love hearing about things like this. Thanks for posting it, it's really interesting. I never cease to be amazed at what modern technology can do.


Your welcome. :)

By chance, does anybody know the name of the drug that they use on rescue flights to "knock down" bad burn patients who have to be intubated before swelling occludes their airway? (It puts them under and essentially paralyzes them, allowing an otherwise conscious patient to be intubated, though this also means that the medics have to breathe for them until it wears off.)

I believe it has a very short half-life too.
corridor_writers
So, do you think that all of these new diseases coming out are really new, or just old ones that are finnaly being given a name.

Examples:
Restless Leg Syndrome
Iritable Bowel Syndrome
ADHD
Etc.

I almost think that some of these really are new, and are being caused by things in our environment now (jumk food, preservatives, etc.) that did not exist a hundred years ago.
illini319
interesting question? are currently identified disorders, new ones or old ones that haven't been found. I would hazard to guess that it is likely both. Certainly AIDS is a fairly new one. It came about through viral mutation that caused it to jump species (monkey to human: current theory anyway). So what about the others? I like ADHD as an example. Why? because it is so anomalous that it is nearly arbitrary. You are considered someone who lacks attention span to the point that it hinders your ability to learn, socialize etc. Yet many of these people who are diagnosed with ADHD are actually perfectly fine holding attention (just not on things that are considered socially acceptable/useful... eg. they like computer games). So is this really a disease? hmm. I don't know. I guess the technical answer is if we, as a society, do not consider this behavior/phenotype normal.. then yes it is a disease. But is this talent overlooked? Is this genius, misunderstood? There was an interesting US Air Force commercial that ran a few years back. It showed a kid playing video games, who grew to a teenager and still played games, who grew up to be a college student still playing games. Then it cuts to a scene where the kid is now a man holding a joystick and piloting one of those robotic Predator aircraft remotely. Notwithstanding your views on the military, you must at least consider this scenario within the context of ADHD. Would this kid have been considered someone with ADHD? (or are you going to argue with me that I have no clue about his academic performance... for the sake of this argument let's just say he was a C-student throughout who could care less either way but wasn't exactly flunking).
corridor_writers
Well said. I don't think I would argue with anything you said there. I really like your description of the Air Force pilot / game addict. Assuming he was a C average student, I would guess that he could have easily been diagnosed with ADHD. In fact, I know a lot of kids this way. These kids cannot focus on anything that is not interesting to htem (Math for example.) But, put them in front of a game that interests them, or something similar, and good luck breaking that attention!

So, the next question we have to ask is....do we let the kids fail the classes and be "unteachable" in modern adademics in a hopes that they will be the next Air Force Predator pilots? Or do we medicate them so that they can focus on other things and hopefully widen their future possabilities? (I think my bias is obvious here.)
GW_Addict
Very interesting debate, and one that I am sure millions of people would all have a separate viewpoint on.

Still, I think the things stated have a lot of weight to them.
After all, at what point does the way a person functions in society become a disorder because society as a whole does not think that a particular persons way of functioning is a benefit to society?

Just a thought....
corridor_writers
GW_Addict wrote:
Very interesting debate, and one that I am sure millions of people would all have a separate viewpoint on.

Still, I think the things stated have a lot of weight to them.
After all, at what point does the way a person functions in society become a disorder because society as a whole does not think that a particular persons way of functioning is a benefit to society?

Just a thought....


Society defines discorders. As society changes through history, so does what is considered a disorder. What may have been considered a discorder in medieval europe will not likely be considered the same now, or vice-versa. In fact, what one nation now thinks is a disorder another nation may not. Society and the social trends of a nation dicate almost everything.
illini319
corridor_writers wrote:
....do we let the kids fail the classes and be "unteachable" in modern adademics in a hopes that they will be the next Air Force Predator pilots? Or do we medicate them so that they can focus on other things and hopefully widen their future possabilities? (I think my bias is obvious here.)


My analogy was not literal. Any field requiring expert hand/eye coordination would benefit greatly from these 'trained' individuals. Basically, anything from micro-robotic surgery (saving people's lives) to piloting Predator aircraft (killing people). With the age of miniaturization, robotics and nanotechnology on the horizon, I can foresee a myriad of possibilities...
Lord Kuat
Interesting stuff man. It would actually be nice to have a medicine related forum unto itself, but I have a feeling that wouldn't be such a good idea in some regaurds. In any case, lowly med student over here, so I'm pretty intested in this thread.

Quote:

Restless Leg Syndrome
Iritable Bowel Syndrome
ADHD


I think all three of these have existed in some shape or form for a while. ADHD is one that I think has always been around, but except back then it was "kids being kids" so to speak. If one wasn't attentive, is was just seen as a personality trait, not a problem. It's funny to look at the history of the diagnosis itself; it used to be you had Attention disorder or Hyperactivity disorder, etc, etc, and they kept recategorizing them over the years. So definately in the case of ADHD, it existed a while before it was named.

IBS seems fairly ideopathic, and no known cause is known. This too probably existed before naming.

RLS... well... that's a tricky one. Prehipheral neuropathy is one cause, and that could be due to certain contaminants in the air. Otherwise, this I think was there as well.
corridor_writers
Lord Kuat wrote:
I think all three of these have existed in some shape or form for a while...


Yea, your probably right. I am sure if we could go back in time to the middle ages and look at the issues they had, we would probably find the same issues, just greatly overshadowed by the real problems of the day like the plague, things that we have put behind us so we can focus on these less lethal issues that seem to prevelant now.

As for a med post, I don't see why this post would not work for this as well. I am all for it. Smile
GW_Addict
As the originator of this post, I think this is a perfect place to discuss anything medical related.

I would also like to add to the last two comments and challenge the readers of this post with the following.

While it is true that many disorders may have always existed in some for or another over the years, do you not think that these issues have been exacerbated (and in the cases of the new ones caused by) our lifestyles? Not just the obesity problems, addictive habits, etc. that plague our society (our own 21st Century plagues) but just the every-day things we well? (Staring at computer monitors that emit small amounts of radiation. Driving cars that add to pollution and respiratory problems, etc.)

What do you think?
corridor_writers
GW_Addict wrote:
Do you not think that these issues have been exacerbated (and in the cases of the new ones caused by) our lifestyles? Not just the obesity problems, addictive habits, etc. that plague our society (our own 21st Century plagues) but just the every-day things we well? (Staring at computer monitors that emit small amounts of radiation. Driving cars that add to pollution and respiratory problems, etc.)


Yes, I cannot see how anybody could think our modern pollutions would not make these problems worse. We dump chemicals into everything - our water, our food (we call them preservatives etc. and made excuses for them) and our air. How could this NOT affect everybody negatively.
GW_Addict
Exactly the type of respone I was looking for. But I think the problem goes deeper than just the pollutants and garbage we pump into our bodied through food, water and air.

Anybody else have any thoughts on this?
corridor_writers
GW_Addict wrote:
Exactly the type of respone I was looking for. But I think the problem goes deeper than just the pollutants and garbage we pump into our bodied through food, water and air.

Anybody else have any thoughts on this?


Sure it goes deeper. The problems we see are th result of so many other things like bad politics and selfish, money hungry corporations. Move away from the first-world countries and the problems is exacerbated by poverty and crime.

But I think you knew that Wink and I would dare say that this is not quite what you meant by a different response. Smile)))
GW_Addict
Yes, of course. Read between the lines and you will always see these problems.

So, at a higher level, what are some of the other root causes for the problems we are facing? Anybody? (besides Corridor_Writers ;)
thealpha
I am Chinese, I know a lot of Chinese medicine, although they are not really efficient in emergency, they are very powerful in improving body's situation.
cchantrain
and do you know how this Chinese medicine works ? Is it by an immune effect ? an energy effect ?n nervous effect ?
karysky
I myself am a paramedics for the canadian military, and I love medicine! But there is this question that has been tackling the back of my mind for a long time now...

I have a problem called Hallux Valgus, which is, basically, causing my toes to curl in the inside, like this:



I know I'm going to need surgery one day. Some people tell me: do it right now, you're young, you're going to heal really fast.

Wheras other people tell me: Wait as long as possible, because after the surgery, you're going to feel pain in your feet for the rest of your life.

Who to believe???? Please, I would really appreciate an answer if there are specialists here. I'm really scared of that surgery... or perhaps there are alternative methods out there? Technology evolves so fast!
illini319
let me first preface my statement by saying that i am no licensed medical professional. I would hope that you are getting your second opinions elsewhere anyway...

So here are my two cents...

If you ask a surgeon to take a look at a malady of yours, then you shouldn't be surprised that the surgeon is going to recommend surgery. Surgeons are taught to assess if something can be surgically corrected and if the patient makes a good surgical candidate. He/she must also consider if surgery would really help in the long run. I've never met a surgeon who was completely idealized and did NOT have a slant towards surgical correction. Having said that, are there non surgical means to correct your problem? Is this a problem that will absolutely require correction (will you not be able to walk, end up with back pain etc etc.?). Is pain an inevitability regardless of surgery? And which pain would be more bearable?
corridor_writers
thealpha wrote:
I am Chinese, I know a lot of Chinese medicine, although they are not really efficient in emergency, they are very powerful in improving body's situation.


Thealpa I too am very curious to know HOW Chinese medicine works. I am not doubting that it does, but have no idea how it actually does what it does.
corridor_writers
illini319 wrote:
let me first preface my statement by saying that i am no licensed medical professional. I would hope that you are getting your second opinions elsewhere anyway...

So here are my two cents...

If you ask a surgeon to take a look at a malady of yours, then you shouldn't be surprised that the surgeon is going to recommend surgery. Surgeons are taught to assess if something can be surgically corrected and if the patient makes a good surgical candidate. He/she must also consider if surgery would really help in the long run. I've never met a surgeon who was completely idealized and did NOT have a slant towards surgical correction. Having said that, are there non surgical means to correct your problem? Is this a problem that will absolutely require correction (will you not be able to walk, end up with back pain etc etc.?). Is pain an inevitability regardless of surgery? And which pain would be more bearable?


Well said. I don't know anything about this malady, so I can only offer my viewpoint as well, which can pretty much be summarized by what was said above. Smile

One other thing to consider is that you DO heal faster, and more thoroughly, when you are younger. Based on this you may actually have less pain later in life if you have the procedure done sooner. It is also important to remember that a constant pain is often forgotten over time.
illini319
Chronic pain is a nationwide problem that amounts to billions of dollars and lost work time. We should not underestimate its debilitating effects to so many people. I know people who tolerate bunions without surgical intervention. I know some who have had surgery before it got worse. Of those who did have surgery, they lead generally normal lives without any major pain emanating from their feet. They may complain that they can feel the weather before it comes... but nothing too intolerable.
SerendipityRose
[quote=" It is also important to remember that a constant pain is often forgotten over time.[/quote]

???Forgotten? You learn how to deal with it I think, but forgotten?
corridor_writers
illini319 wrote:
Chronic pain is a nationwide problem that amounts to billions of dollars and lost work time. We should not underestimate its debilitating effects to so many people. I know people who tolerate bunions without surgical intervention. I know some who have had surgery before it got worse. Of those who did have surgery, they lead generally normal lives without any major pain emanating from their feet. They may complain that they can feel the weather before it comes... but nothing too intolerable.


But is not this chronic pain just a symptom of some existing malady? I don't think that the pain is itslef the disease, just a manifistation of the disease. For example, Arthritis is a disease that causes swelling of the joints. This swelling results in pain. As the disease is chronic, so is the pain?

Am I wrong here?
GW_Addict
Chronic Diseases = Chronic Pain. Yup. I agree.

But changing subjects again.....

karysky - What have you decided to do about your "Hallux Valgus". I think corridor_writers and illini319 are both correct. Putting something like this off till you are older (an subsequently now as capable as healing) may not be a good thing.

Has your doctor given you any other options? Will the disease continue to progress? And if you do get it surgically fixed, is there any relapse risks etc?
corridor_writers
GW_Addict wrote:
Chronic Diseases = Chronic Pain. Yup. I agree.

But changing subjects again.....

karysky - What have you decided to do about your "Hallux Valgus". I think corridor_writers and illini319 are both correct. Putting something like this off till you are older (an subsequently now as capable as healing) may not be a good thing.

Has your doctor given you any other options? Will the disease continue to progress? And if you do get it surgically fixed, is there any relapse risks etc?


I think you meant "NOT as capable as healing", but yes, very well spoken. I am still very curious as to how this is working out....

Anyone with an update? Or another opinion?
corridor_writers
So karysky - how are the feet? I am beginning to wonder if perhaps you have stopped posting due in part to your feet. If so I hope it is because you are laid up recovering after some highly successful surgery. Smile
benjmd
Quote:
By chance, does anybody know the name of the drug that they use on rescue flights to "knock down" bad burn patients who have to be intubated before swelling occludes their airway? (It puts them under and essentially paralyzes them, allowing an otherwise conscious patient to be intubated, though this also means that the medics have to breathe for them until it wears off.)


Rocuronium or vecuronium. The former is more efficacious.
Smith CE, Kovach B, Polk JD, Hagen JF, Fallon WF Jr. Prehospital tracheal intubating conditions during rapid sequence intubation: rocuronium versus vecuronium. Air Med J. 2002;21(1):26-32.
Biodiesel
corridor_writers wrote:
illini319 wrote:
let me first preface my statement by saying that i am no licensed medical professional. I would hope that you are getting your second opinions elsewhere anyway...

So here are my two cents...

If you ask a surgeon to take a look at a malady of yours, then you shouldn't be surprised that the surgeon is going to recommend surgery. Surgeons are taught to assess if something can be surgically corrected and if the patient makes a good surgical candidate. He/she must also consider if surgery would really help in the long run. I've never met a surgeon who was completely idealized and did NOT have a slant towards surgical correction. Having said that, are there non surgical means to correct your problem? Is this a problem that will absolutely require correction (will you not be able to walk, end up with back pain etc etc.?). Is pain an inevitability regardless of surgery? And which pain would be more bearable?


Well said. I don't know anything about this malady, so I can only offer my viewpoint as well, which can pretty much be summarized by what was said above. Smile

One other thing to consider is that you DO heal faster, and more thoroughly, when you are younger. Based on this you may actually have less pain later in life if you have the procedure done sooner. It is also important to remember that a constant pain is often forgotten over time.


Both valid points, though Im a chemistry major, so perhaps the least qualified on this post.

Nonetheless, here are my thoughts.

Perhaps you should contact a Naturopathic practitioner about remedies. They will explore what can be done without drugs or surgery if they feel that you have a chance that way. Otherwise they will go straight to allopathic medicine.
corridor_writers
benjmd wrote:
Quote:
By chance, does anybody know the name of the drug that they use on rescue flights to "knock down" bad burn patients who have to be intubated before swelling occludes their airway? (It puts them under and essentially paralyzes them, allowing an otherwise conscious patient to be intubated, though this also means that the medics have to breathe for them until it wears off.)


Rocuronium or vecuronium. The former is more efficacious.
Smith CE, Kovach B, Polk JD, Hagen JF, Fallon WF Jr. Prehospital tracheal intubating conditions during rapid sequence intubation: rocuronium versus vecuronium. Air Med J. 2002;21(1):26-32.


Awesome, thanks! Any insights from yourself that relate to either of these?
corridor_writers
Biodiesel wrote:
corridor_writers wrote:
illini319 wrote:
let me first preface my statement by saying that i am no licensed medical professional. I would hope that you are getting your second opinions elsewhere anyway...

So here are my two cents...

If you ask a surgeon to take a look at a malady of yours, then you shouldn't be surprised that the surgeon is going to recommend surgery. Surgeons are taught to assess if something can be surgically corrected and if the patient makes a good surgical candidate. He/she must also consider if surgery would really help in the long run. I've never met a surgeon who was completely idealized and did NOT have a slant towards surgical correction. Having said that, are there non surgical means to correct your problem? Is this a problem that will absolutely require correction (will you not be able to walk, end up with back pain etc etc.?). Is pain an inevitability regardless of surgery? And which pain would be more bearable?


Well said. I don't know anything about this malady, so I can only offer my viewpoint as well, which can pretty much be summarized by what was said above. Smile

One other thing to consider is that you DO heal faster, and more thoroughly, when you are younger. Based on this you may actually have less pain later in life if you have the procedure done sooner. It is also important to remember that a constant pain is often forgotten over time.


Both valid points, though Im a chemistry major, so perhaps the least qualified on this post.

Nonetheless, here are my thoughts.

Perhaps you should contact a Naturopathic practitioner about remedies. They will explore what can be done without drugs or surgery if they feel that you have a chance that way. Otherwise they will go straight to allopathic medicine.



Very true. To every problem there is almost always more than one solution. In cases like this, the person considering treatment should carefully consider all methods and alternatives. I personally would be worried of any doctor who said there was only one solution to a problem (which, as you mentioned, will likely always be allopathic in nature.) But then again, sometimes there really is only one clear path that can be taken.

Now, the curiosity this has fueled in me begs to know that decision and path was taken for this particular problem. Smile
Biodiesel
Tell me about it. I keep coming back to see if anything has been posted on this subject, but alas, no word yet.
benjmd
corridor_writers wrote:
benjmd wrote:
Quote:
By chance, does anybody know the name of the drug that they use on rescue flights to "knock down" bad burn patients who have to be intubated before swelling occludes their airway? (It puts them under and essentially paralyzes them, allowing an otherwise conscious patient to be intubated, though this also means that the medics have to breathe for them until it wears off.)


Rocuronium or vecuronium. The former is more efficacious.
Smith CE, Kovach B, Polk JD, Hagen JF, Fallon WF Jr. Prehospital tracheal intubating conditions during rapid sequence intubation: rocuronium versus vecuronium. Air Med J. 2002;21(1):26-32.


Awesome, thanks! Any insights from yourself that relate to either of these?


Just what I've seen in the medical literature and what I've heard anesthesiologists talk about around the hospital.
corridor_writers
Sigh - still no work from karysky about his feet....

The curiosity is killing me!
shankul
Sir but even i have seen many cases where the disjoints of the fragmented bones took place and it creates a problem in the long interval of time whn the patient is having a problem due to stiff movments but even thos can be cured by refragmenting that part the surgery is crucial so shold be taken care of
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