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Open thread 7/6/23 — 21 Comments

  1. I did have one patient who died of acute cholecystitis. I saw her in the office and sent her to the hospital to be admitted. She died before I could get her to surgery. She had Clostridium infection, which is rare. That organism, which causes gangrene, can be found in the gallbladder but that is the only time I have seen this. She died in a few hours.

    https://pubmed.ncbi.nlm.nih.gov/35073723/

  2. My husband had emergency gallbladder surgery. I took him to the ER in the small hours one morning when he complained of “discomfort.” By 5 a.m. they had determined his heart was fine. At 6:30, he got an ultrasound. He was in recovery, minus a near-gangrenous gallbladder, by 9.

  3. Many decades ago I had a few gallbladder attacks and went to see a local specialist–this MD had an extremely posh office, was dressed in what looked like a couple thousand dollar suit, and was sitting behind a very impressive, huge wooden desk, that just gave off the aura of money, and looked like it cost a bundle–and he seemed all too eager to yank out my gall bladder.

    Unfortunately for him he gave me a full color pamphlet explaining the condition and the procedure he wanted to use; a pamphlet that I doubt few of his patients ever read.

    Well, I did, and I noted the part saying that, even though your Gall bladder was removed, it was possible that you still might have exactly the same symptoms you had before the removal.

    Needless to say, I did not contribute to his family’s next cruise, new car, or to his new set of golf clubs by having the surgery.

    Ten or so years later, I again started to have gall bladder attacks, and these were more serious and violent in nature.

    They could not be ignored, so I had laparoscopic surgery, and was essentially back to normal in two days, with no after or side effects.

  4. P.S.–His setup reminded me of what I had seen and read about the very expensive medical specialists who had offices on London’s Harley Street, and, no, I did not use him when I had the surgery.

    (As it had ten years earlier, the ultrasound showed a large stone blocking the neck of my gallbladder.)

  5. Here’s a story which contains a slide from a 2020 FDA briefing which contains a very interesting list of the many serious and horrendous potential side effects of COVID vaccines that government experts thought might occur but which–as far as I am aware of–were never disclosed to the public, to us, the people getting the injections, so that we could have made a more informed decision about whether–knowing more about the potentially disasterous side effects–we actually wanted to get those injections. *

    * See https://hotair.com/david-strom/2023/07/06/i-never-saw-this-list-of-side-effects-of-covid-vaccine-from-2020-n562686

  6. What a cutie. Brought tears to my eyes. Thanks for that.

    Among my 7 grandkids, I have two granddaughters about that age so it really hit home.

  7. cb:

    The take away point regarding HIMARS submunition ordnance for Ukraine: it sucks to have Russia as your neighbor.!!

  8. Very helpful and encouraging. Props to the 911 dispatcher for helping the kid help him. I imagine the training for that work involves “How to get the callers to get on task and stay there,” with a sub-specialty of “Working with kids.”

    So easy to have things go pear-shaped…

  9. I notice one commenter had laparoscopic cholecystectomy. I started doing them in 1988 and had a few doctors’ relatives come in because no one had started doing them close to their home. Before I retired (back surgery) in 1994, I had done 1,000 of them with no complication. My wife (now 78) developed gall stones and had several attacks of colic (pain) several years ago. We saw a very pretty young female surgeon who assured us there was no risk and who declined some of the safety steps that I took with my thousand cases. She cut the wrong duct and my wife had three hospitalizations and still does not feel right.

    safer might be slower and more expensive but caveat emptor.

  10. I had two gall bladder attacks, and it hurts like hell. The first was up at a 8 on the pain level and then went away, so I declined surgery, hoping that I would pass the stones. At the next, (which was an 11 🙂 ) they did an ultrasound and determined that I had one large stone that I would never pass. I tried to get the surgeon to leave the bladder and just remove the stone, but no go. The STANDARD PROTOCOL was removal of the entire gall bladder, and he wouldn’t risk dumping gall into my abdominal cavity, even though a single stone made things much simpler. He said that he might lose his malpractice insurance for violating protocol, even if it was successful. Laparoscopic with the removal incision about twice the normal length to get the thumb size stone out.

  11. ”Another step in the wrong direction…”

    Yeah, how awful it will be to drive out the invaders who are murdering, raping, and kidnapping the Ukrainians.

    (/sarcasm) for those who require it.

  12. Re: Indy 5

    Aside from being an Indy fan, naturellement, I’m fascinated by the current Indy 5 controversy. It’s a microcosm of the Woke/Biden clampdown we see everywhere.

    Indy 5 box office hit the bottom of expectations for its opening weekend. Given the film’s 300+ mil budget, it is projected to lose a few hundred millions.

    Meanwhile, Kathleen Kennedy (top Lucas exec backing the film and responsible for killing the Star Wars franchise), Phoebe Waller-Bridge (Indy’s insufferable god-daughter, clearly being positioned to be the Next Indy), and Bob Iger (Disney CEO) are all smiley-face that Indy 5 will hit $1 bil or close and make a few hundred mil.

    Mainstream media are backing the film down the line, saying it’s great entertainment, wondering how anyone could say otherwise.

    It’s all a plot, don’t you see, by those basement-dwelling toxic male haters trying to bring the franchise and women down. They’re not really fans.

    Well. We may not learn how that baggie of cocaine found its way into the White House, but we will learn how much money Indy 5 made … or lost. And how Disney/Lucas responds.

  13. (I thought of putting the following in the trans topic, but I decided to keep it Open…)

    I remember being mildly shocked at the 1969 film of the Rolling Stones concert after Brian Jones, a founding Stone, died.

    Mick Jagger was performing in a white dress and makeup. This was before David Bowie came out, glam rock and all that.

    Well, OK, Jagger is a rock star and rock stars can be outrageous.

    However, recently I watched this Francoise Hardy video and thought, that’s exactly the look Jagger was going for — minus the breasts and hips anyway.

    –Françoise Hardy , “J’ai jetĂ© mon coeur” ( 1962 )
    https://www.youtube.com/watch?v=BJS7o4DabXg

    Jagger had had a crush on Hardy and been rebuffed.

    I don’t blame him. If I could look like Hardy, I would definitely give it some thought.

  14. I wish I’d seen this earlier. Two years ago I had a stone get stuck in my bile duct. I didn’t have trouble breathing for about 12 hours, just a strong burning. They gave me some morphine and I could start taking deep breaths within a minute. I think it was all this muscle movement that caused the stone to pass. Had the laparoscopic a few days later with no problems. Tests showed there were more stones in there.

  15. Here’s a beautiful French pop song about the joys of being born and being alive — which makes it plain subversive today. Paul Simon-ish, if that helps.
    _________________________________

    There was sun, perfumes, rain
    Every day a new awakening, every day another night
    Roads and bikers and rugby matches
    Spaghetti, Frédéric Dard and Johnny Winter too
    They told me it’s just a spark before the dark
    Just a passage, a rainbow, a strange nonsense
    Brothers, tender ones, treasures to seek
    Dizziness to take, to understand and girls to caress
    I said to myself
    Good idea

    And then there’s you who arrives by opening wide my curtains
    And floods of colors burst and the beautiful seems so much more beautiful
    And nothing really changes but everything is different
    Like those feasts that we eat alone or sharing them

    –Jean-Jacques Goldman, “Bonne idĂ©e (Clip officiel)”
    https://www.youtube.com/watch?v=KTzhddiC3TI

    _________________________________

    Good idea!

  16. I developed gallstones in the later eighties and they seemed to pass before I had to have surgery — thank goodness!!! A classmate had a cholecystectomy and it was the big slice open kind. She was in the hospital for a week and had to withdraw for the rest of the quarter.

    I remember one evening I was at a friend’s dinner party and the pain hit, and I asked her If it was okay if I lay down. She said sure, and I got up from the table, took a step or two, and just lay on the floor. It kind of put a crimp in the evening. But that was the best I could do. A couple of people eventually got me over to a sofa. Anyhow, the attacks stopped for a long time, about ten years, and then they started again, in the late nineties.

    I finally was referred to a surgeon. The first one I went to was so imperious, and his receptionist was awful. I showed up fifteen minutes early for my appointment and waited. And waited. And waited. It was about an hour after my appointment was scheduled, I was still sitting in the waiting area, and I had to go to the bathroom. I went up and asked the receptionist where the restroom was. I told her I would just be a couple of minutes and that I was waiting for my appointment, and I gave her my name. I went to the bathroom, and maybe five minutes later, after I came out. I went back up to the receptionist, told her was done, and would sit down and wait. She said, “I called you and you weren’t here.” I TOLD YOU I WOULD BE MAYBE FIVE MINUTES AND THAT I WAS IN THE BATHROOM!!! Anyhow, I did finally see the surgeon, and he was just a really, really mean guy. I left that appointment so depressed.

    But as I was walking home, I thought to myself, “I am living in New York City, and there are a gazillion surgeons here! I don’t have to use this guy.” My PCP gave me a different referral, and I loved the next surgeon I saw. He also happened to be one of the doctors for the Metropolitan Opera. He and I would talk about opera.

    Anyhow, I had laparoscopic surgery, which was still pretty painful. But I was back on my feet in less than a week.

    The surgery itself was another fun story: It was actually supposed to be a possible outpatient procedure. I checked in early in the morning, the surgery was scheduled for 9:00 am, after which, I would go into the PACU. If by the end of the day everything was okay, I would be discharged. However…

    My surgeon got called in for an emergency surgery that took a very long time. Actually, all day. I was given the option of rescheduling or waiting. I went for waiting because I was doing this during spring break, and it was really my only chance. Waiting was not a great idea, however. But wait, I did.

    The preoperative holding unit closed at five. I was booted off my bed and out into a waiting area in the hallway. Wearing my hospital gown that opened in the back, and clutching my plastic bag of belongings. They did let me have a blanket.

    The waiting area had no lights after some point in the early evening, but the TV worked. At this point, I called some friends to keep me company. I was also REALLY hungry, but couldn’t eat. Finally, at around 9:30 pm, a nurse asked me if I would like to come with her. I did, and I went into the surgeon’s lounge. It was not what I ever imagined a surgeons’ lounge would be. It was just a lot of La-Z-Boys in a pretty dull room, with a TV. I sat in a La-Z-Boy next to my surgeon and the anesthesiologist was sitting next to him. We sat there and chatted for a while while the OR was prepared. Then another nurse came and got us, and the four of us walked to the surgical suite, me still clutching my plastic bag of belongings.

    I remember vaguely stopping at the scrubbing sink, while the surgeon scrubbed, and some other nurse put a hair covering on me, changed my gown, and had me put on some paper booties. She took my plastic bag. And then the surgeon, anesthesiologist, and I all walked into the operating room. I hopped on the table, which frankly reminded me of the tables they use for executions.

    The next thing I remember, I was in the PACU. I was the only person in the PACU. That was great!! At some point, I was transferred to a room, where I spent another night. And miraculously, I still had my plastic bag of belongings!

  17. well for kathleen kennedy like victoria alonso, I work here is done, both started off as understudies one to spielberg the other to feige, and they worked their dark designs to destroy beloved franchises,

  18. Geez. I loved that Jean-Jacques Goldman song and I thought it was something recent. Hooray for French pop!

    Turns out it was a 1997 release and Goldman is actually three months older than I am.

    Sigh.

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