Casey Palmer5 said:We’re all footing the bill for this. And when someone young and actually productive—someone who contributes to the tax pool—suddenly needs an urgent MRI or their kids need help... suddenly there’s nothing left. You're expected to just cough up the cash or find a private clinic. Meanwhile, our taxes are being drained steadily.
Look, I won't apologize; the healthcare system here has made me a little cynical. I've grown a bit numb to it all, honestly.
The truth is, the American healthcare system is just fundamentally unfair. If someone decides to take their own life, maybe they should be the ones paying for it. Or at least stay productive enough so they aren't leaving a massive financial mess for their families and society to clean up.
Hmm... you can't just ignore the economic side of this, no matter how cold that sounds to people. I mean, would anyone else out there—even someone in that situation—actually go through with major procedures if they didn't have insurance coverage? A few years back, I saw a medical bill for what looked like a "suicide attempt" that totaled about $35,000 $0.00 —we're talking multiple surgeries, some intravascular stents, a couple of months in the ICU, dealing with infections, endless diagnostic tests, high-end meds, and supplies... and that's not even touching on the psychiatric follow-ups and rehab later on.
Arslan said:Scott Allen10, if you don't have any empathy for those poor souls caught in a terrifying psychological crisis trying to take their own lives, it doesn't mean you aren't being incredibly cold when you talk like "I'm the hero saving everyone, while they're just losers."
We're talking about people who need mental health treatment just as much as someone else needs surgery; both are sick or injured and deserve help equally.
Arslan, please stop twisting my words or implying things I didn't say. For these folks to actually get the psychiatric care—which I've already mentioned multiple times is absolutely essential—they have to stay alive first. And in that specific part of the process, I give them everything they're entitled to. So what now? Why all the finger-pointing? Just because these patients aren't my favorites or I don't sit here weeping over them? Hmm... Take a second and think about where the actual issue lies here. Is it me, or is it your perception that I should automatically be mourning every single tragedy, even if it's a kid having a total mental breakdown? You've gotta have empathy, sure, but don't do it at the expense of yourself—I've done everything I'm supposed to do. So let me process these situations in whatever way works best for me, rather than how they play it out on some dramatic TV show like ER. Does that make me heartless? Not even close. I'm just protecting my own mental health, and once a suicidal patient survives, they can go find a psychiatrist, which is exactly where they need to be anyway. Recent examples (and honestly, they happen more often than you'd think)... Say you've got an ileus or a ruptured aneurysm and surgery is the only way. You won't do it? Look, this is life-threatening, if we wait it'll be too late, you'll end up with intestinal gangrene and all that... even the family agrees after a few minutes of talking... Still won't do it? Fine. Just sign this refusal form right here. Here's your IV, here's your pain meds, here's your antibiotics... See ya, I'm gonna go finish watching the game. I'd love to hear your thoughts: is a medical professional being heartless here, or just being professional?
Man, I actually had the same thing happen to me during a pickup game the other day... just stepped on someone's sneaker mid-play... one little crunch, a quick little twist of my foot, and I thought I was fine to keep going. But once I got home and finally kicked my shoes off, it hit me—about thirty minutes later, I couldn't even stand up without it hurting like crazy. Luckily, it feels a bit better today, so I’m planning to get back on the court the day after tomorrow, though I'll definitely be rocking an Ace bandage for support. And of course, I'm making sure my Nikes are laced up super tight this time to keep everything stabilized...
John Hernandez12 said:Man, you aren't kidding—the trouble swallowing and the slurred speech, it's been a total nightmare for me. I started out seeing an ENT specialist, and the first thing they told me was that it was just laryngitis, so I popped some pills, but nothing changed. After a follow-up, the diagnosis shifted to chronic pharyngitis, so I was back on Amoxicillin, yet I still felt just as bad. The worst part is all these symptoms just hit me out of nowhere overnight. Back then, I was really into track and field, specifically javelin throwing, so I wonder if some kind of sudden neck strain could have triggered this, or maybe it's from being exposed to toxic chemicals at my job. Other than that, I've always been pretty healthy, everything else seems fine. I can tell you guys really know your stuff and have been through this before, so have you actually seen anything similar in your own lives? Could anyone tell me how you even begin to treat that specific muscle issue related to Dg😛aresis veli palatini ?
Honestly, your best bet is probably hitting up a neurologist...🧐 ....it'll most likely turn out to be nothing to worry about...👍
Yeah, you got that right... totally slipped my mind in my last post, I meant to say dysphasia but ended up typing Diphagia instead. And isn't it called the soft palate... or something like that?
I’m not 100% sure on the specifics, but if I remember correctly, the velar palatine is this tiny little muscle tucked away between the throat and the ear area, and I think it plays a part in how we actually shape our speech. So, having paresis of the velar palatine basically means that specific muscle isn't working quite right, which can lead to Diphagia—that's just the term used when someone has trouble getting their words out clearly.
Sophia Martinez65, hey, just chill out for a second, okay? First off, this stuff about the medication isn't exactly breaking news, so I don't get why you're making such a huge scene over it, acting like someone's revealing some massive divine mystery. We're just talking here—it's not like we're in some support group for people looking to end it all, sharing heavy trauma. Plus, I think it’s actually useful for people to realize that this common med can be pretty dangerous if you go overboard with it. At the end of the day, every single drug is technically a poison; honestly, you could poison yourself with pretty much anything if you swallowed enough of it. Surely you can see where I'm coming from with that. Are you going to freak out if I tell you that you could actually die if you downed 20 liters of water? Because there was actually a guy who passed away from "overdosing" on water once. Just take a breath!! Second thing, stop throwing Hippocrates at me and questioning what I'm doing. Look, I'm not a doctor—I never claimed to be—but if we're really going down that road, point out exactly where I've gone against those principles. I just gave that man everything he needed, regardless of who he was or what his situation was; I respect human life, and I don't use my expertise to pull any kind of bullshit. What's the issue there? Just because I don't particularly like certain types of people and don't feel the need to worship them? Hmm... And please, spare me the lectures with that hipokrat-patetipa nonsense! I hate it when people wave phrases like that around when, in reality, both you and I know things are way more complicated than that. On another note, I am genuinely glad that everything turned out okay with your loved one. And back then, during those critical moments (if they even were), there was someone like me there helping her out, even if that person might not be the biggest fan of suicidal people. For the record, I did listen to psych lectures and studied hard enough to pass under Dr. Jakovljević back in the day (I think that was his name, it was a long time ago). But psychiatry and my actual line of work are worlds apart; as much as psychiatric insight is necessary when dealing with incidents like this, it doesn't really play a role in my daily routine. Moving on—you won't believe this, but I'll be the one flushing the stomach, administering the antidote, setting up the IV, correcting the ABGs, drawing arterial blood for labs, running tox screens, and God knows if I get there first or if the doctors are tied up, I'll probably be the one intubating too... I mean, paramedics do all that on a 911 call, so why should that be strictly a doctor's job? The whole point is teamwork, Sophia. It’s not helpful to throw around "I do this, you don't do that" because it doesn't actually say anything and just makes you look silly. Now that I've laid all that out, what's next? Nothing. I'm still doing my job properly, and the fact that I disappointed you isn't my problem. I could just as easily say that you completely disappointed me by totally missing my point and using that "modern," overly dramatic black-and-white logic to show you didn't understand what I wrote at all.
rustymoose54 said:we've gone off-topic, but this is actually pretty interesting
I'm asking as a layman here—if someone is genuinely struggling with a mental illness and attempts suicide because of it, how can we even hold them legally responsible? It feels similar to when people who don't get it try to comment on someone with clinical depression by calling them "spoiled," or act like someone with OCD is doing it on purpose (like trying to "help" with advice like, "hey, your hands aren't actually dirty, stop washing them 180 times a day").
I totally get why doctors might feel frustrated when they have to resuscitate someone who was trying to end their life, but I just can't wrap my head around that general failure to see the "big picture." Besides, it’s not really up to them to pass judgment on these patients; what these folks need is psychiatric care. If psychiatrists reacted that way, nobody dealing with mental illness would ever get the actual help they need.
I'm not talking about those with a diagnosed psychiatric history. Not them. Plus, all of my survivors end up in psych for follow-up treatment (or a psych team comes to them), so once they're stabilized, psychiatric care is a mandatory part of the process. But it's not just the mentally ill who do this... I'm talking about the others—the ones who are conditionally "normal." But look... hey... don't be mad if you don't quite get where I'm coming from... I've been through way too many heavy situations in my career where people of all ages suddenly find themselves fighting tooth and nail just to stay alive. And man, they fight. They cling to life with everything they've got, enduring unimaginable pain and suffering, agreeing to anything just to keep breathing. And it isn't just the individual going through that struggle; more often than not, the whole family is right there in the trenches with them. And then you've got some guy who just finds life too hard to deal with, and he wants to throw it all away with one gunshot to the head, a ligature around his neck, or a massive overdose of pills, leaving his parents, kids, and spouse absolutely devastated in his wake. When I look at a poor soul who's been hit by a car and is fighting for every breath, and then I look at this person who chose to swallow a handful of meds, I see someone devaluing the very life that the other is fighting so desperately to keep. Look, I'll be real—I don't feel the same way toward both. Maybe it's because, reading all this now, I just love life too much to let myself view it as something that can be tossed aside like that. You're free to call me cold or whatever you want, but I don't feel that way. For both of them, we did everything humanly possible; we'll react to both, and we'll intervene for both at every change in status, making sure both get the best meds and IV fluids available. And there's one huge thing: we aren't looking at this from the same vantage point. Believe me, you'd definitely think differently if you had experience in anesthesia, resuscitation, or intensive care. You have to maintain a certain level of empathy, but you can't let every single tragedy break you or let it cloud your judgment. If I lived every tragedy as if it were my own, or if I started grouping suicides in with every other fate, I wouldn't be able to function.
Man, I've rambled on... I don't know if I've managed to explain my perspective a bit better. Maybe I have, maybe I haven't, but I know for sure I'm not being arrogant or rude, nor am I failing to see the "big picture." Maybe we're both looking at the exact same picture, just from different corners of the room?
Look, this isn't really an internal medicine thing; we're talking hardcore neurology here, and honestly, unless you're a neurologist, it’s almost impossible to wrap your head around what's actually happening. These specialists see stuff like this practically every day, so they're the only ones who can truly tell if things are looking okay or if we should be worried. Basically, pseudobulbar and bulbar paralysis aren't standalone diseases—they're more like syndromes, which is just a fancy way of saying they're a cluster of symptoms that point toward an underlying issue. In this specific case, the "target" area where the lesion or disease is hitting would be the brainstem or those lower cranial nerves—you know, the glossopharyngeal, accessory, hypoglossal... maybe even the vagus nerve, though I'm not 100% certain right now. We're specifically talking about the motor component of those nerves. To get some real answers, doctors might look into things like an MRI, evoked potentials, or probably an EEG... Now, I'll admit I've rambled quite a bit regarding this heavy-duty neurology stuff... but all of this could fall under a huge range of different conditions, like various types of sclerosis, Parkinson's, or even something else entirely.
But hey, I shouldn't be out here guessing or giving advice without being a pro, so you really have no choice but to get everything cleared up with a neurologist. Don't be shy about asking every single question that pops into your head, because anyone else you talk to probably won't be able to give you a competent answer since, like I said, this is some pretty intense neurological territory.
It’s a solid 5/5 from me, you’re the only one talking here...🙂 Regarding my previous post, I was specifically talking about using Tylenol 500 mg as a method for suicide and how "dangerous" that specific route is. I wasn't talking about someone accidentally overdosing on it (which, let's be honest, is pretty rare). I'm totally with you on the whole palliative analgesia thing. Now, about those comments regarding suicide... look, none of us who deal with these patients would ever deny them the care they need, whether it's meds or procedures. Absolutely not. They'll get the antidote, they'll get their stomach pumped, we'll fix their acid-base status, intubate them, put them on a ventilator, give them proper pain management, plenty of IV fluids... the works. But... after years on the job seeing all sorts of things, watching people fight tooth and nail for a life that might be absolutely miserable... I'll admit, seeing patients like this triggers a certain kind of contempt in me. Instead of actually facing life, or the problem, or whatever it is they're trying to kill themselves over. Does anyone even stop to think about the people they leave behind? The family, the kids, the friends... or the absolute mess they leave those people in through their suicide or attempt? The grief, the loss of a father, a husband, or a son, the sudden debt... all of it. Have any of you guys actually witnessed the pure drama unfolding outside an ER or a trauma bay when a family member collapses from shock and just hits their head against the wall in sheer agony, wondering WHY? To be blunt, I see someone like that as a coward, and I don't feel any pity if they pass away. Maybe it's just my professional bias talking, but I don't lose sleep over it. I know for a fact, like I said, that they received every single thing possible for their treatment and were never denied a procedure or a drug. Now, if my attitude toward them isn't some kind of soft, sympathetic mess... well, that's not my problem.
Yeah, I was actually just about to post the exact same thing as what the previous guy said...
Suicide attempts involving Tylenol are incredibly "successful" in all the worst ways possible, and they’re just messy. Honestly, I’m surprised that woman even made it out alive; you guys probably managed to pump her stomach or something just in time... In my experience, anyone who swallows that much stuff ends up completely losing their mind... Honestly, whenever I see some idiot try to take their own life and then fail, I feel like telling them they should have just picked up a gun instead... maybe I should suggest swallowing a whole bottle of Tylenol too, just to make it a complete mess...
Casey Palmer5 said:Massage therapy? Please, what kind of massages are nurses even doing? Honestly, you’re lucky if they just roll a patient over so they don't end up with nasty pressure sores. I mean, sorry, there really are some people who go above and beyond, but those rare exceptions get totally overshadowed by the ones who make your life miserable—you never forget them.
And that's just the truth of it... unfortunately. Yeah, staffing shortages are a huge issue, but... could things be handled better? Absolutely.
Just a quick little tweak to what was said before—spontaneous brain bleeding actually is a type of stroke itself, not just a side effect of one... whether it's subdural, subarachnoid, or intracerebral and happens out of nowhere (usually because of high blood pressure or a burst vessel like an aneurysm), it’s classified as a hemorrhagic stroke... but honestly, that's getting into the weeds...🙂
@hiddencrane18/">@@hiddencrane18 Like hiddencrane18 mentioned earlier... how things turn out really depends on where the bleed happened, how big it was, and the specific type of hemorrhage we're looking at. The final outcome can range from—God forbid—a fatal situation to being completely paralyzed on one side, or even full recovery with just some minor motor issues. Being older definitely doesn't help the odds, but that isn't always the deciding factor. The fact that the right side of the body is affected suggests the bleed was likely in the left hemisphere of the brain. Aside from all the stuff you can't control right now, recovery heavily relies on keeping blood pressure under wraps; you really shouldn't let it spike above 160 or 170 mmHg. Those sudden pressure spikes can easily trigger another bleed. Also, using sedatives in the right doses can really help manage restlessness or agitation, which is super common and something you definitely want to avoid during early treatment (obviously, only if the doctor says so). On top of that, managing brain swelling is huge—using things like Mannitol IVs or Lasix shots helps prevent cerebral edema, which is a big risk with these kinds of hemorrhages. At the same time, you have to be careful not to "dry out" the patient by under-hydrating them with fluids, whether through an IV or drinking, because that’s just as bad. As for whether they should stay in bed or move around... that's the big question, and it's vital for recovery, but the neurologist has to make that call. In those very early stages, staying still is absolutely necessary. Once the acute phase passes, though, physical therapy and getting them moving becomes super important. For example, you really have to push those exercises on the right side to get that movement going again. Like I said, the neurologist is the one who decides when to start the PT. From what I've seen, on average, people usually clear the acute phase after about two or three weeks following the stroke. Having great nursing care—things like massages, turning the patient to prevent bedsores, and keeping up with good hygiene—makes a massive difference in how well they heal. Lastly, psychological support is huge for someone who suddenly finds themselves unable to do everything they've done their whole life; it matters throughout the entire process. It might be less critical in the very beginning when they need to just rest and stay calm, but it becomes absolutely essential during the later rehab stages.
A few people have already touched on pain management up above, mostly when we're talking about patients in the final stages of an illness....
The struggle these folks face isn't anything new, and honestly, it’s pretty heartbreaking that we still don't have a systematic way to care for them through a dedicated network of outpatient hospices or specialized pain management wards within our hospital systems. Around here, any real progress usually only happens because a handful of driven doctors or groups like the Hospice Friends Association step up and take the initiative. It feels like the Department of Health doesn't even have it on their radar because they're too busy juggling a million other "more important" things. At least, that's how it looks from where I'm sitting. The folks really making a dent in this field are the doctors working with the Hospice Friends Association. Most of them are neurologists or anesthesiologists, though you get specialists from all over. But man, they’re basically fighting windmills; current hospital budgets wouldn't support opening a dedicated unit where pain could be treated as its own specific thing using a mix of different therapies, even if it made total sense. What we actually have right now are mostly outpatient pain clinics that handle pain regardless of what's causing it. It’s nowhere near enough, but it's what's available. I think nowadays, almost every major hospital—even just your standard clinical centers—has one of these clinics, usually tucked away under the neurology or anesthesiology departments.
Depending on a bunch of factors and based on a specialist's evaluation, pain is handled in several different ways. Beyond just meds, there's a whole toolkit of non-pharmacological methods out there. When it comes to chronic pain medication, besides your standard pills or capsules, you often see those "patches," specifically Duragesic patches. They contain Fentanyl, which is a fantastic narcotic analgesic that gets absorbed slowly through the skin once the patch is applied. There are different types of Duragesic depending on how much medicine you need. As for more invasive ways to tackle chronic or terminal pain, over the last few years, we've finally seen the spread of managing pain through narcotics delivered via a peridural catheter—what's known as a PCA pump. PCA stands for Patient Controlled Analgesia. Basically... a peridural catheter is placed (in the spine) and then hooked up to a PCA system, which is just a specific cocktail of analgesics delivered through the PCA pump. The doctor programs the pump to a specific dose and locks everything down so nobody can mess with the controls. Since the whole setup is tiny, you can easily carry it around in a pocket without anyone noticing. The best part is that when a patient feels the pain creeping up, they can just hit a single button to give themselves a bolus of the analgesic a few times a day, depending on how the doctor set the pump.
On the non-drug side of things, people frequently use acupuncture (either with needles or laser stimulation), TENS therapy with electrodes (what most people just call "the electric thing"), magnet therapy, specific ultrasound therapies for pain, and so on and so forth....
It’s such a shame that people don't even realize there are places where they can get some relief—maybe not a total cure, but enough to actually function normally in society and with their families. So, if anyone is dealing with chronic pain from any source, they should definitely look into these outpatient clinics. Who knows, it might actually make life feel worth living again.
brisknomad said:... do they knock you out completely or just a little bit? ....
I can weigh in on this, though I’m sure a Woman from Rijeka would be way better at handling the actual surgical specifics....
If you're looking at laparoscopic surgery, the prep work before you go under is pretty much identical to what you'd go through for traditional open surgery. It basically comes down to the fact that surgeons always need to be ready to pivot mid-procedure and switch to a standard open incision if things get tricky.
Because of that, the anesthesia setup is usually the same as a classic procedure—using general endotracheal anesthesia along with muscle relaxants to keep everything smooth.
Now, some specific laparoscopic procedures, like certain gynecological or urological surgeries in the lower abdomen, can sometimes be done using spinal or epidural anesthesia, where they inject the anesthetic right into the spine, as people usually say.
At the end of the day, the anesthesiologist—who really calls the shots here—will decide which method is best based on your overall health, your pre-op tests, and the specific type of surgery being performed.
It’s honestly like...😱 ...you stepped straight out of the Twilight Zone...it feels like...🙂 ....
Every abdominal surgeon's absolute worst nightmare...honestly, reading through this makes me think you might not have run far enough away from all that trouble in the first place...😈 ....
"Miss Trousseau"...hehehe...how "charming"...😂 ...Personally, if I had to pick a "Miss Disaster" from the world of medical conditions, I’d put pancreatic disease at the very top—I'm talking both CA and necrotizing pancreatitis, both surgically treated—it's brutal! You honestly can't even tell where the drains should go or where everything is flushing out; the patient looks jaundiced and pale, and their blood pressure is basically hitting rock bottom...
And regarding that whole thing with the new "love"...to me, comparing plastic surgery to an abdomen is like stepping down from an F-16 to fly a crop duster—except the price tag is just as high, if not higher.
I was just wondering how you, Susan Martin24, ended up in plastic surgery when you had an actual specialist and a top-tier surgeon for hardcore abdominal work on your case. I mean, shit happens, right? Maybe it was just fate or some other weird cosmic coincidence...😬 ...?