Shout Outs

Updated 3/2017-- photos and all links (except to my own posts) removed as many no longer active. 

Grand Rounds is  taking a break this week. If you would like to host a future edition of Grand Rounds send an email to Nick Genes (you can find his contact info at here).   The most recent edition can be found here at Medgadget.  Other editions can be found here on the Grand Rounds Facebook page.

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@movinmeat  wrote a post recently, A case study in applied ethics, which lead @inwhiteink to write an educational post on decisional capacity

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“Decisional capacity” refers to a person’s ability to make a decision for a specific clinical issue. This issue is usually related to treatment. After assessment, physicians can opine whether someone possesses or lacks decisional capacity for something specific: ……

Appelbaum and Grisso published an important paper that provides a four-point rubric to assess decisional capacity. (At only four pages, it is a short, high-yield article.) Most psychiatrists apply this rubric when assessing decisional capacity in medical settings. …….

Movin Meat’s followup post:  Ethics of refusing informed consent

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From twitter:   @Mtnmd The Twitter chat that killed Sermo http://bit.ly/ipw4au

Her link is to an article by Joe Hage which I encourage you to read:  The Twitter Chat that Killed Sermo | #MedDevice

I’m not a physician. I don’t play one on TV. And I’d never heard of Sermo, the largest online physician community in the US (boasting 120,000 members) until @HJLuks mentioned them the week before.

Mine was an innocent invitation to talk during last night’s #MedDevice chat (Thursdays, 8 pm EST).

Who knew it could unravel the company.  …….

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Yesterday NPR aired this story:  Army Nurse Helps Soldiers Heal From Burn Wounds

As part of NPR's ongoing series, 'The Impact of War,' guest host Allison Keyes explores one of the tragic consequences of combat - burn wounds. Such wounds can subject victims to a painful and unpredictable recovery. Army Lt. Col. Maria Serio Melvin shares her experiences at the military's largest burn center, the Brooke Army Medical Center in San Antonio, TX, where she treated service members injured in the Iraq and Afghanistan wars …………

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Some inspiring stories of healthcare workers during the Joplin tornado

H/T @Mtnmd -- 45 Seconds: Memoirs of an ER Doctor from May 22, 2011

H/T @SeaSpray – Operating Through the Tornado

James D. "Dusty" Smith, MD, and his surgical team were midway through a routine case, the draining of a patient's infected hip, when the tornado hit St. John's Regional Medical Center in Joplin, Mo., Sunday.  ……….

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From @scutmonkey, her piece on Psychology Today:  The Radical Notion that Doctors are People, Too

Though there are few subjects as immediate to my experience as that described in Gardiner Harris's article in The New York Times, "More Doctors Say No to Endless Workdays," (April 1st, 2011), perhaps the truest indication of my opinion on the matter may be the fact that, upon first glance at the headline, I didn't feel much need to read the rest of the article.  More doctors say no to endless workdays?  Well, of course we do.  Duh.  …..

Her tweet of the article led @DarrellWhite to tweet a link to his view on the same topic:  Residency Training and the Modern Physician

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H/T to @brainpicker and @ctsinclair for the link to this:  Anatomy made of LEGO (photo credit) 

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Last Tuesday (May 24, 2011) NPR celebrated Bob Dylan Turning 70.  Near the top of the story written by Linda Fahey is a button “Visit FolkAlley.com To Hear The Mix” which links you to a wonderful mix of Dylan music sung by Joan Baez, Tim O'Brien, Rosanne Cash, Jimmy Lafave, many others — and Dylan himself.  Thanks NPR.

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Threads has a nice article by Susan Khalje on Creating Perfect Bias Fabric Loops  (photo credit)

……..we decided that loops and buttons would be a cleaner alternative.
Here are a few samples to show you what we did:
We started with strips of bias-cut fabric, making a sample or two to determine just how narrow we wanted the finished loops to be. ……….

Customer Service via Twitter

It seems that over the years I have ended up with a different Norton Anti-virus product key for three different computers rather than one for all three.  The renewal emails are staggered through the spring.

This week I decided to tackle the issue and see if I could get it changed.  I visited the website and when I saw the option of contacting them via twitter I did just that.

Twitter worked!

I sent my question to @nortonforumsusa which began an email correspondence.   Within less than 24 hours I had all three computers running Norton 360 Premier under the same product key.

The first contact, TL, even forwarded my question regarding refund or credit from the other two to customer relations rep RV who gave me two options (I chose the credit one).

One reason it worked for me was I did my homework before I contacted them.  I helped them help me by having all three product key numbers available, giving them a working email address, and responded to their questions quickly.

This post is simply meant to be a public expression of gratitude and thanks for how well Norton’s customer service worked.  Thanks to TL and RV.

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But I will take it further ----

Perhaps hospitals and clinics could use twitter the same way for non-emergency/non-diagnostic/non-treatment issues like billing, scheduling, etc. 

First, a public request for help.  Second, take the help to a private venue (email or phone).

Shout Outs

Updated 3/2017-- photos and all links (except to my own posts) removed as many are no longer active and it was easier than checking each one.

Colorado Health Insurance Insider is the host for this week’s Grand Rounds! You can read this week’s edition here.

Welcome to Grand Rounds.  As we get back into the work week routine after the Thanksgiving weekend, we have a great collection of health care articles for you to browse through.  Enjoy! ……..

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MedGadget is hosting a new contest: Imagine Medicine: The Photography / Photoshop Contest

…………Welcome to the Imagine Medicine contest!

We are looking for fascinating medical photography that... imagines medicine.

Nothing is off the table: portraits, group shots, happy shots, tragic shots, clinical shots, photoshop illustrations, macro, micro, and anything in between. Can you imagine medicine, showcase it as art, and make us wonder?

Here's the lowdown. The contest is open to all. Upload your photograph(s) to Flickr, and tag them with "imaginemedicine" and "medgadget" keywords. Make sure you add at least one sentence describing your work. The deadline for submissions is 11:59pm ET on December 5, 2010. The winner will be announced on December 10th and the prize is a brand new 16GB iPad with Wi-Fi. ………

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Information is Beautiful has some wonderful grafts on Vitamin D (photo credit) which includes this one:

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The above is very timely as NPR presented a story by Richard Knox on vitamin D this morning:  Medical Panel: Don't Go Overboard On Vitamin D.

The Institute of Medicine is throwing cold water on the latest dietary supplement fad: big doses of vitamin D.

Humans make vitamin D when they are exposed to the sun. But many worry that clothing, indoor living and sunscreen are depriving most people from enough of the sunshine vitamin. It's also hard to get enough vitamin D from the diet, proponents say, despite fortification of milk and orange juice.

But the Institute's Food and Nutrition Board, which makes official recommendations on dietary intake, says advocates of high-dose vitamin D are going overboard.

After two years of study and debate, the panel says children and most adults need 600 international units of vitamin D a day. People over 70 need 800.  ……

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Via twitter from @doctorwes:  Barbara Walters discussed her aortic valve replacement candidly: 4 'second-opinions' and a change of cardiologist http://bit.ly/g6Jtom

………. Here’s the great news. You are not allowed to go to the dentist for at least three months after the surgery, because bacteria from your teeth can travel to your heart and cause an infection. No dentist. Also, no vigorous exercise for weeks. You experience great fatigue. No one raises an eyebrow if you take a nap every day. Finally, open-heart surgery sounds so awful that everyone worries about you, and what with the phone calls, the notes, and the flowers—all extolling your virtues and letting you know how wonderful you are — you feel as if you were reading your obituary. That’s the good news. The bad news is that, even though the operation is relatively routine, there is still a 1-to-2-percent chance that you won’t make it. Someone actually could wind up reading your obituary.  ………….

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Another via twitter comes from @drdavidballard: How early psychologists looked to magicians to turn illusions into reality .... http://bit.ly/emGQ3D

It is a link to an article in the December issue of Psychologist by Peter Lamont:  The misdirected quest

At the end of the 19th century, Hermann and Kellar were the two greatest conjurors in the world, though who was greatest depended upon whose publicity one believed. In the United States they competed over audiences and advertising space, and each considered the other his arch-rival. When Hermann died in 1896, Kellar was free to establish his reign and, aside from his notable achievements in the world of magic, he was almost certainly the inspiration for the Wizard of Oz. But before Kellar became the grand wizard, and shortly before Hermann’s death, the two great rivals agreed to compete in a quite different environment – the psychological laboratory. ………

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This quilt was shared with me by two people on twitter (@KnittingNephron and @jdcmlewis).  It was posted on “The Daily What” yesterday.  (photo credit)

iPhone Baby Quilt of the Day: By Harriet Rosin for her grandson, Gabriel.  Benjamin Stein adds: “There’s a Nap for That!” (Obligatory.)

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I’m hoping to attend with a couple of friends -- Arkansas Women Bloggers Meetup Scheduled! (photo credit)

When: December 11, 2010 11am-1pm

Where: Museum of Discovery @ 500 President Clinton Avenue

Why: Meet other bloggers and help decide future activities/goals for AWB

We will keep you updated with event details as we pull them together.

To RSVP, you can leave a comment on this post. If you're on Facebook, you can RSVP and invite friends at the event page. You can also RSVP by emailing us at arkansasbloggers@gmail.com.

Shout Outs

Updated 3/2017-- all links (except to my own posts) removed as many are no longer active and it was easier than checking each one.

Mother Jones RN, Nurse Ratched's Place,  is the host for this week’s Grand Rounds! You can read this week’s Veteran’s Day edition here (photo credit).

Welcome to the Veterans Day edition of Grand Rounds. Elvis and I are delighted that you dropped by. The King is very excited today because we are saluting celebrities that have served in the Armed Forces. Elvis said that his days in the army were memorable. I imagine having Life Magazine take your picture while you’re sitting in your underwear would be a memorable experience. My co-host and I want to thank everyone for their submissions, and we especially want to thank Dr. Nick Genes for allowing us to hold Grand Rounds at Nurse Ratched’s Place. ….

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Really patient-centered! via Paul Levy (Running a Hospital):  Here comes the bride - at Anne Arundel Medical Center by Wendi Winters (Capital Gazette)

The bride wore an elegant strapless gown and a radiant smile. The nervous groom was impeccable in his spotless Air Force dress uniform and a TV-sized heart monitor.  …….

"The wedding must go on," senior nursing director Ann Marie Pessagno said as she arranged the chairs for the ceremony that almost wasn't.  ………

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Dr Margaret Polaneczky updates us on HRT and breast cancer in her post:  HRT and Breast Cancer Deaths – Just in Case You Weren’t Listening the First Time…

…………….While the breast cancer risks associated with HRT use appear to be quite real, for a individual woman, they are not that large. Here’s how I explain the risks to my patients ……………..

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From tweeter  @IVLINE “For all your fracture naming needs http://bit.ly/98agy2 with pictures included.”  The link is to LITFL’s Eponymous Fractures.  Here’s an example of the great information you will see there:

Barton’s fracture
John Rhea Barton
1794-1871, American surgeon
Description/ Mechanism of injury:
Fall on outstretched hand

Intra-articular fracture of the distal radius with dislocation of the radiocarpal joint. Fractures may be displaced volar or dorsal direction

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From twitter: @docgrumpy: “The iPhone/iPod app "Nerve Whiz" is awesome for peripheral nerve help- and it's free (I wasn't paid for this, FYI)”

Nerve Whiz is an app designed by a neuromuscular neurologist at the University of Michigan.

Nerve Whiz is a free application for medical professionals interested in learning the complex anatomy of nerve roots, plexuses, and peripheral nerves. Select which muscles are weak, or point to areas of sensory loss, and the application can provide you with distinguishing features and detailed information, complete with relevant pictures and detailed information, complete with relevant pictures and diagrams.

NOTE: Nerve Whiz is intended to be an educational tool only. Nerve distributions vary between patients, and central or multifocal processes can mimic focal peripheral lesions. As such, this application should not be relied upon to make clinical decisions.

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The Alliance for American Quilts received 118 quilts for it’s “New from Old Quilt Contest Contest.” You can see all the quilts here. My entry was “Label Me.” The quilts are now being auctioned off.

Click on an auction week below to view or download an auction guide for that week.

Week One: Monday, Oct. 25-Monday, Nov. 1

Week Two: Monday, Nov.8-Monday, Nov. 15

Week Three: Monday,Nov. 15-Monday, Nov. 22

Week Four: Monday, Nov. 29-Monday, Dec. 6

The bidding for each quilt will start at $50 and each 7-day auction week starts and ends at 9:00 pm Eastern. No Daylight Savings Time changes this year to contend with--DST changes on November 7.

All proceeds will support the AAQ and its projects.

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There does not seem to be any Dr Anonymous’ show scheduled for this week. 

You may want to listen to the shows in his Archives. Here are some to get you started:

GruntDoc, Sid Schwab, Dr. Val, Kevin MD, Rural Doctoring, Emergiblog, Crzegrl, Dr. Wes, TBTAM, Gwenn O'Keeffe, Bongi, Paul Levy, John Halamka, and ScanMan

Shout Outs

Updated 3/2017-- photos and all links (except to my own posts) removed as many are no longer active and it was easier than checking each one.

Dr Wes is the host for this week’s Grand Rounds! You can read this week’s edition here (photo credit).

Welcome to this week's mid-term edition of the medical blog-o-sphere's Grand Rounds! Before we begin, be SURE to get to the polls to VOTE!
This week submissions were classified by state or country of origin. Politically incorrect posts by state were colored RED whereas politically correct posts by state were colored BLUE. (States with both extremes are represented in PURPLE.)
Now what would any political post be without a POLITICAL MAP of the states represented in this week's Grand Rounds?  …………….

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Kim, Emergiblog, is the host of the latest edition of Change of Shift (Vol 5, No 9)! You can find the schedule and the COS archives at Emergiblog. (photo credit)

Welcome to Change of Shift!
After a Vegas-induced vacation, our nursing blog carnival is back!
There has been lots of activity in the blogosphere over the last four weeks, so let’s get right to the heart of it! ………..

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Check out Dr. Rob’s recent House Call Doctor podcast: When Should You Worry About a Nosebleed?

……….Doctors call nosebleeds epistaxis. I’ve mentioned before that doctors like fancy names for things; it just sounds smarter to use a Latin or Greek word. It’s especially good at parties. ……….

As someone who has had many nosebleeds within my life, you may also want to check out my old post from two years ago: Nose Bleeds. Either way, Dr. Rob and I have you covered.

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An ethical question comes up regarding the use of social media as noted by @dreamingspires

A Tweeting Hospital and Kidney Patient: The Case of the tweeting Kidney Patient has caused a small whirlpool of a ... http://bit.ly/dfsREG

The original nhssm's posterous blog post: 2nd Case Study - St George's Healthcare NHS Trust and the Tweeting Kidney Patient

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From twitter: RT @MargaretAtwood @DrSnit @kidney_boy: Hey, you're famous! http://ow.ly/30LR1. The link is to a Guardian.co.uk article by Esther Addley: Margaret Atwood creates superhero outfits for Twitter avatars

With more than a dozen novels, 17 poetry collections and countless literary awards including the 2000 Man Booker prize to her name, Margaret Atwood's credentials as one of the world's greatest living writers are not in question. ……..

in a remarkable exchange over Twitter, which saw the Canadian writer contacting two readers who had expressed admiration for her work, and offering to design "superhero comix costumes" for their avatar alter-egos, @kidney_boy and @DrSnit.

"[They] both have excellent Twitter names – suitable for superheroes – and were comix fans, and were discussing Comic.con, as I recall," she told the Guardian. ………..

This tweet links to a companion article:

@steve_lieber Some of the @PeriscopeStudio artists (incl. me) have drawn @margaretatwood's Kidney Boy and Dr. Snit. http://periscopestudio.com/?p=3638

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The Alliance for American Quilts received 118 quilts for it’s “New from Old Quilt Contest Contest.” You can see all the quilts here. My entry was “Label Me.” The quilts are now being auctioned off.

Click on an auction week below to view or download an auction guide for that week.

Week One: Monday, Oct. 25-Monday, Nov. 1

Week Two: Monday, Nov.8-Monday, Nov. 15

Week Three: Monday,Nov. 15-Monday, Nov. 22

Week Four: Monday, Nov. 29-Monday, Dec. 6

The bidding for each quilt will start at $50 and each 7-day auction week starts and ends at 9:00 pm Eastern. No Daylight Savings Time changes this year to contend with--DST changes on November 7.

All proceeds will support the AAQ and its projects.

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Dr Anonymous’ show will be follow-up to FMEC Mtg. The show begins at 9 pm EST.

The Scar Project

Updated 3/2017-- photos and all links (except to my own posts) removed as many are no longer active and it was easier than checking each one.

We all know October is breast cancer awareness month.  The pink ribbon is how many think of breast cancer, but as this tweet reminds us all breast cancer is much more serious.

RT @laikas: RT @gfry "Breast cancer is not a pink ribbon" Exhibition has its own site: http://www.thescarproject.org/home.html Impressive!

I had not known of The Scar Project (photo create) prior to reading that tweet on Monday, but I have seen and created many of the scars.  The physical breast cancer scars come from biopsies, lumpectomies, mastectomies, and even the reconstruction.

The Scar Project, photographer David Jay, and all the women who participated are to be commended. 

The SCAR Project is a series of large-scale portraits of young breast cancer survivors shot by fashion photographer David Jay. Primarily an awareness raising campaign, The SCAR Project puts a raw, unflinching face on early onset breast cancer while paying tribute to the courage and spirit of so many brave young women.

Dedicated to the more than 10,000 women under the age of 40 who will be diagnosed this year alone The SCAR Project is an exercise in awareness, hope, reflection and healing. The mission is three-fold: Raise public consciousness of early-onset breast cancer, raise funds for breast cancer research/outreach programs and help young survivors see their scars, faces, figures and experiences through a new, honest and ultimately empowering lens.

The SCAR Project subjects range from ages 18 to 35 and represent the often overlooked group of young women living with breast cancer. (Breast cancer is the leading cause of cancer deaths in young women ages 15-40). They journey from across America and the world to be photographed for The SCAR Project. Nearly 100 so far. The youngest 18.

There was an exhibition of the project in New York this past weekend.   Even though, the exhibition is over, there is a book for sale of The Scar Project. 

Shout Outs

Updated 3/2017-- photos and all links (except to my own posts) removed as many are no longer active and it was easier than checking each one.

Medical Resident's Journey is the host for this week’s Grand Rounds!  You may recall his poem won Dr. Charles Poetry contest.  The theme this week is “uplifting moments in medicine.”  You can read this week’s edition here (photo credit).

Good morning! Thank you for all the submissions which have flooded my inbox over the past week. They kept me going through a stretch of countless overnight shifts in the emergency department, which seemed never-ending and darker than a moonless night. In the midst of stunning fall foliage this October, the vibrant colors of this week’s Grand Rounds reach towards the sky. Take a moment out of the day to live in the present. Listen to the sounds around you, whatever they may be – leaves rustling in the wind, blaring sirens, constant monitors. Sit back, relax, take a long, deep breath and a sip of your favorite morning drink. Take in the flying kites, subtle music, and silver linings of today’s indulgence: Uplifting Moments in Medicine.  ………….

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I hope you will all read Dr. Rich’s recent post:  Medical Ethics and the Amish Bus Driver Rule

Rachel Maddow, in a discussion related to the provision of abortion services, once proposed that we (society) should invoke the Amish Bus Driver Rule whenever medical professionals invoke their personal convictions in refusing to provide legal medical services.

The Amish Bus Driver Rule goes like this: If you’re Amish, and therefore have religious convictions against internal combustion engines, then you have disqualified yourself for employment as a bus driver.  …..

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From twitter:  @SusannahFox

#ACS2010 survey: Half of surgeons use FB; 20% use Twitter http://bit.ly/9XRBFt (PDF via @Sani2012)

Compare to @Pew_Internet survey: Half of all adults use FB, MySpace, LinkedIn; ~13% use Twitter http://pewrsr.ch/awb5wt

The first tweet links to this article: Time to Tweet: Session highlights importance of social networking for surgeons (page 1 and 3 of the PDF file)

………….According to Dr. Glick, 7% of the U.S. population is on Twitter, while 20% of ACS survey respondents (approximately 300 as of last week) are on Twitter. 41% of the U.S. population is on Facebook, compared with 64% of ACS survey respondents (see table, page 3). The more sobering results, according to Dr. Glick, are the number of ACS survey respondents who participate in online forums or read online health blogs – 34.5% – which is a comparatively low number.  ….

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Fellow physician, blogger, and twitterer  Jill of All Trades, MD has begun doing a podcast!  The podcast, Girlfriend M.D.,  is part of Quick and Dirty Tips family. She will be sharing the hosting duties:

Join Dr. Sanaz Majd and guest host Dr. Lissa Rankin as they answer the most common questions women have about their bodies and their health. This is a chance for you to learn about all those issues you were so curious about, but were too afraid or embarrassed to ask about. Girlfriend MD will show you that you are not alone, and that no topic is off-limits. After all, we are all girlfriends here.

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From the #hcsm twitter chat this past Sunday evening – a very helpful tip sheet to use in searching for health information online:

@pfanderson T2 My tip sheet for patients using ehealth info w/docs http://www-personal.umich.edu/~pfa/mlaguide/free/quickgd.pdf #hcsm

It is a pdf file, but I encourage you to check it out. 

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Dr Anonymous’ show will be about  DigPharm Mtg. The show begins at 9 pm EST.

Upcoming shows:
10/23 : Saturday Nite
10/28 : About FMEC Mtg
10/30 : On Location

Shout Outs

Updated 3/2017-- photos and all links (except to my own posts) removed as many are no longer active and it was easier than checking each one.

Sharp Brains is the host for this week’s  Grand Rounds!  You can read this week’s edition here.

Wel­come to Grand Rounds, the weekly col­lec­tion of best health and med­ical blog posts. This week we invite you to enjoy a broad range of insights, tips, and first-hand sto­ries, pre­sented as a Q&A con­ver­sa­tion with blog­gers will­ing to answer, below, a total of 22 good questions. ………….

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Kim, Emergiblog, is the host of the latest edition of Change of Shift (Vol 5, No 7) which is in its 5th year!   You can find the schedule and the COS archives at Emergiblog. (photo credit)

Welcome to Change of Shift!
While this is a bit of a “mini” version of the nursing blog carnival, it is far from “lite”.
There are old friends and new blogging colleagues; musings, opinions and rants…it’s all here!
Let’s get it started! …………..

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Interesting NPR segment last Thursday on their show Here and Now:   “The Skinny on Supplements”  (photo credit)

More than half of all adult Americans spent nearly 27 billion dollars last year on dietary supplements to get healthy, stay healthy, lose weight and gain an edge on the sports field and in the bedroom. And in the process, some of them got seriously sick. We talk with Nancy Metcalf, senior program editor for Consumer Reports-Health about the findings of their recent investigation, “Dangerous Supplements, What You Don’t Know, Could Hurt You.”

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From  tweeter@grahamwalker last Thursday (September 30)

I'm announcing my new website: TheNNT.com -- an evidence-based resource for medical interventions. Spread the word! #sa10 #thennt

NNT stands for “number needed to treat” and is explained:

There is a way of understanding how much modern medicine has to offer individual patients. It is a simple statistical concept called the “Number-Needed-to-Treat”, or for short the ‘NNT’. The NNT offers a measurement of the impact of a medicine or therapy by estimating the number of patients that need to be treated in order to have an impact on one person. The concept is statistical, but intuitive, for we know that not everyone is helped by a medicine or intervention — some benefit, some are harmed, and some are unaffected. The NNT tells us how many of each.

Check out Graham’s new website.  It is full of useful information.

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If you are free later this morning (11:30 am CST, my local time) you might want to join in on the first #MDchat on twitter.

@MD_chat: Let's nudge more physicians onto Twitter. Tuesday 10/5 12:30pm EDT is #MDchat - http://MDchat.org #hcsm Plz support them! :)

For more information on MDchat, check out Phil Baumann, RN’s explanation:

………..So rather than waiting for doctors’ orders, I am launching @MD_chat for physicians to participate in advancing our collective understanding of the influences of emerging technologies on our culture, health, privacy, dignity and many other aspects of the human condition.

Below is a slideshow introducing MDchat and explaining how it works (if you can’t see it, you can view it here or here): ……………….

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An article in Evansville Courier Press by Karen Owen-Phelps:  Quilts help old barns become art form -- Local quilters use them like a canvas (photo credit)

An old barn is more than a storehouse for hay and livestock in the eyes of some area folk-art lovers. It's a canvas for their favorite art form — the quilt.

Quilting enthusiasts in Western Kentucky are encouraging farmers to let them hang large panels painted in traditional quilt patterns on their barns.

"The first time I saw a barn quilt I thought, 'I want one of those!'" said Judi Inge, 55, of Owensboro, Ky., who is active in the Owensboro Area Quilters Guild. "My mother felt the same way."  ……….

The article provides links for more info and photos:

Ohio County Barn Quilt Trail
Kentucky Arts Council:  Quilt Trails
Ohio Barns:  Quilt Barns  (photo credit)

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Dr Anonymous’ guest this week will be Dana Lewis & Swedish 2010 Health Care Symposium.      The show begins at 9 pm EST.

Upcoming shows:       
10/9 : From Seattle
10/14 : About Social Health Track at BlogWorld Expo
10/16 : On Location
10/21 : About DigPharm Mtg
10/23 : Saturday Nite
10/28 : About FMEC Mtg
10/30 : On Location

Double Hand Transplant on Twitter

Updated 3/2017 -- photos and all links (except to my own posts) removed as many no longer active.

 

Louisville surgeons at The Jewish Hospital Hand Care Center recently performed the 3rd double hand transplant done in the United States.  It is the first to be live tweeted.

The procedure began around 7 p.m. on Tuesday, August 24, and finished late Wednesday afternoon, August 25.  Lead surgeon, Warren C. Breidenbach, M.D, with Kleinert Kutz & Associates, and his team of surgeons focused on the surgery while senior hand fellow Christiana Savvidou, M.D. used a laptop just outside the operating room to document the surgery as it takes place.

This bilateral transplant is the third double hand transplant to be done in the United States.  The first two double hand transplants were done at the University of Pittsburgh Medical Center, the first in May 2009 and the second in February 2010.  Louisville doctors performed the nation's first five single hand transplants.

Savvidou used the tweeter account @jewishhospital (www.twitter.com/jewishhospital) and the hashtag #handtx.

Here are some of the tweets which are a good representation of how the surgery progresses and how much time it takes.

jewishhospital

1st tweet ~ 7 pm ET, shortly before start of surgery

Want to know how a hand transplant is done? This is your chance- we are live tweeting a double hand transplant 2day starting @ 7pm! #handtx

approx 2 hrs later

The recipient’s right hand is fully prepped and awaiting the transplantation of the donor limb. #handtx

Education of terms: “prepped” = hand is being scraped & sterile dressing. “Started” = skin has been cut and surgery begun. #handtx

approx 4 hrs after start

Continuing donor and recipient dissection tendon identification and nerve identification in both recipient hands. Going smoothly. #handtx

approx 5 hrs after start

Removal of non-functioning hand tissue in preparation for donor limb attachment. #handtx

Both donor hands are on the table. Preparing for bone work - bone fixation at forearm of right recipient wrist. #handtx

@stacyluvsyah The bones are reattached with plates and screws similar to how a broken bone may be repaired. #handtx

approx 6 hrs after start

Bone fixation completed successfully in both hands. #handtx

Surgeons are now preparing the arteries. This will be the most important part of the operation. #handtx

approx 7 hrs after start

The connecting of the donor and recipient vessels (arteries and veins) is progressing very well in both hands. #handtx

approx 8 hrs after start

The hand replantation is progressing well. Surgeons are joining the tendons. #handtx

approx 10 hrs after start

Both hands are now vascularized and we are approximately 3/4 of the way complete. All is progressing well. #handtx

approx 11 hrs after start

Tendon suturing nearing completion. Nerve repair to follow. This includes suturing nerves of each finger from donor to recipient. #handtx

approx 12 hrs after start

Due to the number of nerves and tendons, this current stage could take a while…update coming when we near completion of this stage #handtx

approx 13 hrs after start

Nerve repairs on the left hand are now complete. #handtx

approx 14 hrs after start

The left hand is currently approximately 2/3 closed and final work on veins is occurring. #handtx

approx 16 hrs after start

Finishing right hand nerve repair. Due to new technique, this patient should have better feeling & motion than previous recipients #handtx

The left hand is currently being sewn shut. #handtx

approx 17 hrs after start

The left hand is now fully wrapped in surgical gauze and cotton padding. #handtx

approx 18 hrs after start

Surgeons are starting to close up the right hand #handtx

approx 19 hrs after start

Extra tissue is needed to finish closing the right hand. A skin graft is being taken from the patient's leg for this. #handtx

almost 20 hrs after start

Skin graft on right hand finished and hand is completely closed. Starting cleansing and bandaging. #handtx

(photo credit)

 

While we embrace the new ways to educate the public, Dr. Wes reminds us of  The Risks of Hospitals Live-Tweeting Surgeries.

For more information on hand transplant surgeon visit the teams’ website: www.handtransplant.com. 

My Tweeterview by Diario Medico

Updated 3/2017 -- all links (except to my own posts) removed as many no longer active. 

I was contacted by @alainochoa who works with Diario Medico a month ago.  He wanted to interview me using twitter – a tweeterview.  We went back and forth on dates.  It happened this morning.  Amazing how nervous I got just before the interview.

You can read the interview here.

Global Quilt Project Seeks Quilters Worldwide

Updated 3/2017 -- photos and all links (except to my own posts) removed as many no longer active. and it was easier than checking each one.


Yesterday, @GlobalChangeMe sent out this tweet:

Looking for quilters from around the world. Do you know any?

stuboo then tweeted

.@GlobalChangeMe Looking for quilters from around the world. Do you know any? <-- Try @rlbates - she's good.

And the introductions were made.  I ask GlobalChangeMe for more details and received the following email:

Our organization is seeking quilters from around the world to join us in our Global Quilt Project that will benefit a village in Central African Republic. There are several ways to become involved in this project. We hope you can join us.

Global Change, Inc is a non profit organization that provides safe, clean water and basic sanitation to people living in extreme poverty throughout our world. In one of the villages in the Central African Republic (CAR) we are raising funds for, the ladies have been taught quilting and they are really enjoying it. These ladies have sent our organization 2 beautiful squares and we are hoping to put theses squares together with other squares from around the world to make a beautiful quilt that will be auctioned off and 100% of the proceeds will go to a new well for a village in Central African Republic and a latrine for a school in CAR. 

The square tiled #1 in the attachment is exactly 12x12 inches  

and the square in attachment #2 is exactly 9 1/2 x 9 1/2 inches.

We would very much like for you to join us in this project. We are seeking quilters from around the world to donate a square or squares to be added to this piece. I have a friend here in Central Florida who will connect the squares for this piece. The colors or patterns need not follow the same design as the 2 squares the ladies sent from CAR, nor does the squares need batted. We would appreciate any comments or suggestion about our project and would greatly appreciate it if you would forward this email to others you think might want to join this effort for a good cause. Letting others know about this project is a wonderful way to become involved. As soon as we have several participants, we will add the project to our web site and include the participant's name and link to their site if we have your permission to do so.

The finished quilt will be auctioned in conjunction with World Toilet Day...Yes, I said "World Toilet Day" which is held on November 19th. We would like to have the donated pieces by May 30th in order to have the quilt pieced together and to allow time for showing and promoting this fund-raising project.

It would help this project if you would reply to this email (either yes, I will participate or sorry I cannot participate) so we can have an idea of how many squares we will have for the quilt. I have also attached a participation form for you to fill out and email back to me. The donated squares can be sent to the address below.

Our web site has information about our organizations and the projects we fund. Your donation will help stop the spread of disease due to lack of clean water and basic sanitation. People live more productive lives when they do not have to fight disease. Please take a look at our site and if you have any questions, please do not hesitate to contact me.

www.globalchange.me

Thank you for your time and consideration.

Amy Allen (407) 951-2826

Co-Founder and Development Director

Please mail donated squares to:

Global Change, Inc

854 Blue Sage Street #102

Celebration, Florida 34747

I plan on making a few and would like to encourage you to do so.  Remember there is no set pattern or colors, so it would even be a nice way to share “orphan” blocks as long as they are the correct size:  12.5 in square or 9.5 in square.

Moles Should Not Be Treated by Lasers

Updated 3/2017 -- all links except those to my own posts were removed as many are no longer active and it was easier than checking each one.

 

H/T to DermDoc who treated this news article link.  The article is “Some Laser Treatments Could Put Health At Risk, Dermatologists Say.”

dermdoc  Medical Spas Removing Moles with Lasers <-- Dangerous. Melanoma looks like a mole. http://tinyurl.com/m2pqmo  3:13 PM Jul 20th from web

He then followed up with this tweet

dermdoc  Medi-Spas are spas. Never have a mole removed without being checked by a physician. @serious_skeptic @nanarcr  3:29 PM Jul 20th from web

I agree.  It can be difficult even for trained physicians to tell the difference between moles and melanoma.  Don’t allow spas to laser them.  If there is any question, the mole should be biopsied.  That doesn’t happen with “laser treatment.”

To further make this point, check out the slide show on Medscape (free subscription required)

Mole or Melanoma? Tell-Tale Signs in Benign Nevi and Malignant Melanoma: Slideshow  Can you spot the differences between benign and potentially malignant nevi? Would you be able to tell which require a biopsy?

Related Posts
Melanoma Review (February 25, 2008)
Skin Cancer—Melanoma (December 8, 2008)
Melanoma Skin Screening Is Important (April 29, 2009)
Skin Cancer -- Basal Cell Carcinoma  (December 3, 2008)
Skin Cancer – Squamous Cell Carcinoma  (December 4, 2008)

Shout Outs

Updated 3/2017-- photos and all links (except to my own posts) removed as many no longer active. and it was easier than checking each one. 

TBTAM is this week's host of Grand Rounds.  Her edition features food and medicine.  Read this edition here.  

Welcome to Grand Rounds Vol 5, no 23!  We've got a wonderful pot luck menu of great posts from around the medical blogosphere, so sit right down and dig in!

The fourth edition of Change of Shift (Vol 3, No 16) for 2009 is hosted by Amanda (This Crazy Miracle Called Life)!     You can find the schedule and the COS archives at Emergiblog. 

 

Medicine for the Outdoors has a nice post on “Naturally Occurring Toxins.”

The best classification of natural toxins involves dividing the groups of toxin-containing organisms into poisonous and venomous.

° Poisonous organisms are those that are assimilated into the host either by ingestion or through the skin. Included are bacteria, fungi, plants, and some animals.

° Venomous organisms are those that have evolved specific toxin delivery systems, which usually include a venom gland and a sting, fang, spine or pore for transporting venom to the host. Venomous animals are found in every class of animals and are distributed throughout the earth's ecosystems. The first venomous member of the class Aves (birds) - the genus Pitohui, from New Guinea - was described in 1992.

Twittering in the OR – interesting, but is this the best use of a chief resident.  Shouldn’t he be learning and doing something else?

As CNN reported yesterday, physicians used Twitter to give a blow-by-blow account of removing a cancerous tumor from a man's kidney at Henry Ford Hospital in Detroit.
The surgeon's musings during the operation were dutifully recorded in real time on Twitter by the chief resident.

On a different note.  If you have read my blog for long, you know I quilt.  TBTAM sent me a link to “The Artful Bras Project.”  The bras are wonderful art pieces!

Members of Quilters of South Carolina have created one-of-a-kind bras for Breast Cancer Awareness. The exhibit consists of fifty original works of art which are unique, entertaining, humorous, and beautiful to make the public aware of breast cancer, to memorialize those lost to the disease, and to honor survivors.  

This exhibit will tour SC until Oct '09 at which time individual Artfull Bras will be auctioned and the proceeds donated to the Best Chance Network, a program to provide care and treatment of uninsured women across the state who are diagnosed with breast and ovarian cancer

And I love my dog and have even made him homemade dog biscuits.  I didn’t know there was an International Dog Biscuit Day until Johann (photo credit) told me so.  It was yesterday.  Check out all the sources (many more than the ones below) listed in this post.

This week Dr Anonymous will be have a co-host, Dr. Gwenn, as they talk to guests Vicky & Jen about parenting blogs & podcasts.   The show begins at  9 pm EST. 

You can check out the archives of his Blog Talk Radio show.   Here is the upcoming schedule:

3/5: TBA
3/12: 4th year medical student Mudphudder to talk about Match Day 2009
3/19: Respiratory therapy student Trauma Junkie to talk about the blog carnival A Source of Inspiration
3/26: Podcamp Ohio