Ask my Doctor Mum!

J.Catherine · Aug 6, 2016

So, my mum is a GP of over 20 years of experience, currently specializing in UK adoption services.

I can ask her questions that you might want to know. Unless I get like a hundred, but a few should be alright.

So, who wants their medical writing questions answered?

mirandashell · Aug 6, 2016

Have you actually asked your mom if she's ok with this?

J.Catherine · Aug 6, 2016

No, I just kinda informed her. She's cool with it...probably. She's used to weird writer child asking her questions about where to stab people well

mirandashell · Aug 6, 2016

Eluveitie · Aug 6, 2016

J.Catherine said:
No, I just kinda informed her. She's cool with it...probably. She's used to weird writer child asking her questions about where to stab people well

On the topic of stab wounds, is it possible that a surgeon would use a drainage tube for a patient who was stabbed in the stomach?

GeorgeK · Aug 6, 2016

Eluveitie said:
On the topic of stab wounds, is it possible that a surgeon would use a drainage tube for a patient who was stabbed in the stomach?

In any penetrating abdominal trauma is is pretty much standard to leave a drain. Dinosaurs will use a penrose. The rest of us use closed suction drains and there's a bunch of types.

J.Catherine · Aug 6, 2016

Eluveitie said:
On the topic of stab wounds, is it possible that a surgeon would use a drainage tube for a patient who was stabbed in the stomach?

"Yes, if they were doing surgery in the stomach they would always put a draining tube in after surgery for a few days because there is excess fluid secreted." -- mother

GeorgeK · Aug 6, 2016

J.Catherine said:
"Yes, if they were doing surgery in the stomach they would always put a draining tube in after surgery for a few days because there is excess fluid secreted." -- mother

No, it's to both monitor for and to potentially treat a brewing abscess. The mild increase of peritoneal fluid from the direct injury generally can easily be handled by the lymphatics. The times that there are excesses of peritoneal fluid requiring potential drainage are generally when dealing with diffuse studding of the peritoneum with tumors like is commonly seen in Ovarian Cancer and then leaving a drain is somewhat controversial since there is no defined endpoint, thus a foreign object can potentially increase the risk of peritonitis.

J.Catherine · Aug 6, 2016

GeorgeK said:
No, it's to both monitor for and to potentially treat a brewing abscess. The mild increase of peritoneal fluid from the direct injury generally can easily be handled by the lymphatics. The times that there are excesses of peritoneal fluid requiring potential drainage are generally when dealing with diffuse studding of the peritoneum with tumors like is commonly seen in Ovarian Cancer and then leaving a drain is somewhat controversial since there is no defined endpoint, thus a foreign object can potentially increase the risk of peritonitis.

Probably partially to monitor bleeding rather than an abscess but it's also to mop up fluids until the lymphatics can adjust

GeorgeK · Aug 7, 2016

J.Catherine said:
Probably partially to monitor bleeding rather than an abscess but it's also to mop up fluids until the lymphatics can adjust

No not really unless the patient has some bleeding issues for example like hemophilia, thallasemia or has to be on anticoagulants. Any competent surgeon will recheck any repairs several times to watch for bleeding and address those issues prior to closure. So although one can certainly monitor bleeding due to a drain, that's not usually its purpose.

There is a sort of placebo effect along those lines that you can show a patient that, "Yes although you still feel like crap and are still nauseous due to normal post op ileus (temporary gut paralysis), you are mending on the inside. See, the drainage now is serous (pale yellow) instead of serosanginous (murky pink)."

J.Catherine · Aug 7, 2016

GeorgeK said:
No not really unless the patient has some bleeding issues for example like hemophilia, thallasemia or has to be on anticoagulants. Any competent surgeon will recheck any repairs several times to watch for bleeding and address those issues prior to closure. So although one can certainly monitor bleeding due to a drain, that's not usually its purpose.

There is a sort of placebo effect along those lines that you can show a patient that, "Yes although you still feel like crap and are still nauseous due to normal post op ileus (temporary gut paralysis), you are mending on the inside. See, the drainage now is serous (pale yellow) instead of serosanginous (murky pink)."

Hah! You have defeated my mother in combat. I applaud you.

But seriously though, thanks for debating with me/her. It's been fun to see other knowledge come out. Most of the time I relay debates between med students at my work and her and I do love learning through medical discussions. Which is why I pushed her to reply to you in the first place. It helps me learn in more ways than one. I've been informed that you're not a med student. Which makes me really glad because if you were a med student, I'd be doubting my mother's medical knowledge and therefore all the information she's giving me about birthing would be under suspicion.

frimble3 · Aug 7, 2016

Have to say, following the discussion has been fascinating. (J.Catherine, thank you for relaying the messages and for starting this.)
Question for story purposes, somewhat along the lines of the 'placebo effect' - if a patient (a private detective or a criminal) was indicating a desire to be over-exerting after surgery, would it be unethical to leave a tube in, with instructions that it shouldn't be knocked around, in hopes that it would be a visual reminder to take it easy?

negativelead99 · Aug 7, 2016

J.Catherine said:
No, I just kinda informed her. She's cool with it...probably. She's used to weird writer child asking her questions about where to stab people well

Lol

Low and to the left! At least that's what one of the villains in the movie Scream suggested done unto him. Presuming you wish to survive...........I don't think he did. Neither did his career. I never figured out why those movies were allegedly so revolutionizing to the horror genera.

J.Catherine · Aug 8, 2016

negativelead99 said:
Lol

Low and to the left! At least that's what one of the villains in the movie Scream suggested done unto him. Presuming you wish to survive...........I don't think he did. Neither did his career. I never figured out why those movies were allegedly so revolutionizing to the horror genera.

Heh, well I never saw those movies. According to all the other 10 year olds in my grade 5 class, I was the only one not to. I was so jealous.

J.Catherine · Aug 8, 2016

frimble3 said:
Have to say, following the discussion has been fascinating. (J.Catherine, thank you for relaying the messages and for starting this.)
Question for story purposes, somewhat along the lines of the 'placebo effect' - if a patient (a private detective or a criminal) was indicating a desire to be over-exerting after surgery, would it be unethical to leave a tube in, with instructions that it shouldn't be knocked around, in hopes that it would be a visual reminder to take it easy?

(I'll respond to this properly when mum comes back from work, because I have absolutely no idea. Or the other guy will answer. He probably knows better.)

GeorgeK · Aug 8, 2016

J.Catherine said:
I've been informed that you're not a med student.

There was a time in my life when I was but that was a few decades ago.

J.Catherine said:
Hah! You have defeated my mother in combat. I applaud you. .

Well being a surgeon it should not be difficult when the topic is surgery. Were the topic initial treatment of new onset hypertension I would defer to your mum.

GeorgeK · Aug 8, 2016

frimble3 said:
Have to say, following the discussion has been fascinating. (J.Catherine, thank you for relaying the messages and for starting this.)
Question for story purposes, somewhat along the lines of the 'placebo effect' - if a patient (a private detective or a criminal) was indicating a desire to be over-exerting after surgery, would it be unethical to leave a tube in, with instructions that it shouldn't be knocked around, in hopes that it would be a visual reminder to take it easy?

It's not so much a question of ethics. I mean yes, it is but it's more basic. You leave drains, foleys, whatevers for as long as they're physically needed, not for psychiatric reasons. If you think that a patient is not mentally sound then providing them with an avenue to injure themselves or others is a bad idea. Not only can they injure others and themselves but those injuries are going to be things that you will have to fix and you haven't slept in three days and haven't seen your family in four.

Long ago there was a patient who was paraplegic and kept having strange abscesses with unusual bacterial cultures in a pattern that was not typical of simple pressure sores. We had basically every service give him the twice over trying to figure out the source. He was on long term IV antibiotics and all manner of wound care. Then one day because I had to round on 45 patients prior to seeing pre-ops at 07:00 I went to do my morning rounds on him at 4 AM and found him spitting into his central line. That was when Munchausen became a no-longer-theoretical disease for me.

frimble3 · Aug 8, 2016

And he probably figured that at 4:00 AM he'd be safe from prying eyes! Good catch!
And thanks for answering my question. No sense leaving him an additional way to get damaged or damage himself.

J.Catherine · Aug 8, 2016

GeorgeK said:
There was a time in my life when I was but that was a few decades ago.

Heh, well my mum was almost hinting that she wanted me to be a med student. But I really don't feel like doing 5 years general med and then 2 years specialization plus however long pre-reg is for obstetrics. No, I plan to be a midwife.

GeorgeK said:
Well being a surgeon it should not be difficult when the topic is surgery. Were the topic initial treatment of new onset hypertension I would defer to your mum.

My mum really did want to do obstetric surgery at one point in her life, but trying to do that + have kids (especially little tyrants like me and my brother) it was nearly impossible. To be honest, she's got a lot of experience in adoption services UK because she's the medical adviser for that in Glasgow.

negativelead99 · Aug 8, 2016

J.Catherine said:
Heh, well I never saw those movies. According to all the other 10 year olds in my grade 5 class, I was the only one not to. I was so jealous.

The sand papered senses of children? Now or days.

We as authors have a tremendous task before us in stoking the emotions of an audience if their already immune to the darkest ones by the age of 10.

I would be encouraged to find some way to subliminally shame their guardians during the next Parent Teacher conference for exposing them to such horrors so early in life.

J.Catherine · Aug 10, 2016

negativelead99 said:
The sand papered senses of children? Now or days.

We as authors have a tremendous task before us in stoking the emotions of an audience if their already immune to the darkest ones by the age of 10.

I would be encouraged to find some way to subliminally shame their guardians during the next Parent Teacher conference for exposing them to such horrors so early in life.

Yeah that's true. I guess that's why I'm trying not to focus on events that are particularly dark and tragic in my novels, but events that are real and that really happen. Then realistic explanations on how to deal with them. It might not have shock factor, but the reader will (hopefully) be able to relate.

And heh well they're all out of my life now (thank god), but I facebook stalked a few a while ago and they're all carbon copies of their 10 year old selves. So I guess karma caught up to them.

Cath · Aug 10, 2016

This isn't a social part of the forum, and folks tend to ask when they have a question. I'd hate to close this thread, but I don't think it belongs here. Where do you folks think it should move to?

Ask my Doctor Mum!

J.Catherine

you call me Jen

mirandashell

J.Catherine

you call me Jen

mirandashell

Eluveitie

GeorgeK

ever seeking

J.Catherine

you call me Jen

GeorgeK

ever seeking

J.Catherine

you call me Jen

GeorgeK

ever seeking

J.Catherine

you call me Jen

frimble3

Heckuva good sport

negativelead99

J.Catherine

you call me Jen

J.Catherine

you call me Jen

GeorgeK

ever seeking

GeorgeK

ever seeking

frimble3

Heckuva good sport

J.Catherine

you call me Jen

negativelead99

J.Catherine

you call me Jen

Cath

The mean one