Posts by Scott Allen10

Raymond Bennett9 said:Thanks for the info on the 326 👍 ... spinal without local 🙄
Does anyone know what kind of side effects you might deal with from general anesthesia?
And is there anyone here from Europe, the US, or Australia who can chime in on how things work over there?

That question is way too broad, honestly. What kind of consequences are we talking about? Give me a little more to go on.

The way anesthesia is handled is pretty much the same all over the world.

Someone posted a couple of links earlier covering some specifics... you can actually find plenty of stuff right here if you just take a second to poke around...

nimbleskipper13 said:Honestly, I feel like you and I are just overcomplicating things now and making everyone else totally confused 😁

We might actually end up acting like MacGregor, and God forbid that happens! 😈 [/B]

First off...👍
And second...🙂

nimbleskipper13, I might have been a little loose with my terminology there, but I think when you say "Beer," you're talking about regional IV anesthesia where they hit a block before starting the actual anesthetic. Honestly, that’s pretty much impossible for a shoulder procedure since the site is just too high up... What I actually meant was using a local lidocaine infiltration paired with a quick IV dose of something like Diprivan, Rapifene, or even Fentanyl—all without needing an intubation tube while breathing through a mask... It’s really nothing out of the ordinary, and yeah, I totally agree that most of the heavy lifting usually happens during arthroscopy.

Raymond Bennett9, I’d highly recommend this kind of nap to a sleeper like you... you might feel a little groggy afterward, but from what it sounds like, you're basically just drifting off for a bit.
Look, any anesthesia, much like any surgery itself, carries some level of risk—nobody's offering 100% safety here. But in this specific case, I really think the danger is minimal.
That "spinal shot" you mentioned is done routinely in all our hospitals, and in my experience, it carries way less risk than going under full general anesthesia. The only real complication that pops up occasionally is a headache, which can be absolutely brutal and a total pain to manage with meds. All those horror stories about paralysis and whatnot? Honestly, in my book, that's just stuff people tell to scare kids...

Look, first off, nobody really knows if you’re actually going to need surgery or not yet. From what you wrote, it sounds like you're still just guessing at this point. Honestly? Don't rush into anything. Try every single conservative treatment out there first, and even if a doctor starts pushing the surgical route, please go get a second—or third—opinion before deciding.

When it comes to how they pick your anesthesia, the doctors usually look at a few big things: how sick you are, where exactly the procedure is happening, how long it’ll take, your medical history, any meds you're currently on, and honestly, sometimes they'll even let you have a say in it if the situation allows.
Just a heads up though, you can pretty much forget about getting a spinal block. Those are usually reserved for stuff involving your legs, hips, pelvis, or lower abdomen... the shoulder area is way too high up for spinal anesthesia to work effectively.

But hey... let's say... you're active, maybe dealing with some shoulder pain... hmm... and if the procedure itself isn't super long... hmm... they might go with something like an enhanced peripheral nerve block. That's basically where they inject anesthetic right near the nerve or nerve bundle controlling that specific part of your body, then give you a little sedative or painkiller through an IV, plus maybe some light gas through a mask so you aren't intubated.
Basically, you drift off for a bit while the target area is totally numb, giving nimbleskipper13 enough time to work her magic for maybe thirty minutes to an hour.😁

Susan Gonzalez4 said:They probably do ask, but honestly, if I don't need it anymore, what's really the point of asking? 🙄 It's better to just let them help someone who actually needs it.

But seriously, they always check with the family, no exceptions. No sane person—whether you're looking at an individual or a major hospital like Mayo Clinic—is going to risk getting dragged through the news for performing an organ retrieval without talking to the family first, regardless of what the legal rights say.

It’s pretty obvious that this whole field mostly runs on the sheer passion of individuals working within JIL facilities across the country. It isn't like there’s some massive direct incentive for the work itself, but it does get billed properly—for both the anesthesiologists and the anesthesia techs. Plus, every organ procurement center here in the States receives a set amount of funding through flat-rate contracts based on their yearly quota of transplants. That money stays with the hospital regardless of whether they actually hit those numbers or not. On top of that, when it comes to procurement activities, you can bypass department or hospital budget caps to pick up all sorts of equipment that ends up being used for everyone else too (think ultrasound machines, blood gas analyzers, EEGs, etc.). What I'm trying to say is, this business definitely offers some perks, not just for the hospital or the ward, but for the individual people involved (not that it's a paycheck per se, but it adds up).

I’m not trying to be a jerk or act like I know everything in my posts. I’m just trying to give a realistic look at how things play out from my perspective. For instance, once brain death is confirmed... it involves endless phone calls back and forth with a whole bunch of different agencies... and then, you have one member of the procurement team—let's call him Smith—telling my coordinator, totally fed up and discouraged, that he couldn't do it with a sincere heart because the guy whose organs he was supposed to harvest had to leave for some "important business" elsewhere... the coordinator absolutely lost it because he’d wasted four or five hours and blown a ton of money on expensive diagnostics, only to find out the liver and kidneys weren't even viable... so, the whole thing was a wash.
I mean, I agree that we're talking about a very small group of people; there's no debate there. But you can't just claim these kinds of situations don't happen and cover it all up with this aura of self-sacrifice, honesty, and a simple shortage of staff. Because that heart described above wasn't lost just because someone felt lazy. That's not even my take on it, though—it's the coordinator's, and he knows exactly who's who in the world of transplantation here in the US.

And I totally agree with your last point—way too many organs go to waste simply because someone didn't feel like dealing with the hassle of a donor, so they just shut off the dopamine and norepinephrine and signed the death certificate. Like you said, it's just easier that way. Sadly enough...🙄

Just a couple more thoughts on this...
That donor card thing? It’s never actually had any legal teeth. Honestly, the whole point of those cards is just pure propaganda to get people thinking about donating. Legally speaking, you've got more authority with a damn calendar or some old movie club membership card than you do with that piece.
If brain death is confirmed and the family gives the green light, but there isn't a local match or a way to find one quickly... those organs end up being shipped off via some "international exchange." Usually, you see folks from Italy flying in, grabbing the organs, and then—boom—they're gone.
I've even heard stories where they showed up just because our transplant teams were all out on vacation at the same time. At least that was the excuse they gave us, though I wouldn't put it past them to have just been feeling lazy that day, if you know what I mean...
🙄

Even though doctors aren't technically required by law to ask anyone about organ donation, I'm 120% certain that here in the States, not a single organ is ever harvested without getting written consent from the family first.
I mean, regardless of how much money or medicine goes into keeping a donor stable, once you factor in the process of proving brain death and all those diagnostic tests, if the family says NO, everything just stops—they pull the patient off the ventilator and stop the inotropic meds immediately.

I'm not sure if there's a hematologist hanging out in this thread or not, but honestly, why not just lay it all out and tell us what you're dealing with? You might actually get some solid advice from someone else here who isn't even a specialist, 🙂

Thought I might be able to wrap this whole thing up pretty easily...☕...especially since health wasn't really the main point to begin with, and you guys are starting to... 🙂

Every other month, they bring in this massive mobile PET scanner unit—it’s basically a huge specialized truck—that rolls right into the area around Osijek General Hospital for a few days of scans.
If anyone’s looking for more specifics, you should probably just check in with the Nuclear Medicine Department of Osijek General Hospital. You can't really just show up and ask for a scan on a whim, though; everything is decided during medical board reviews, so by the time that machine actually pulls up, the list of patients is already set in stone.

I've already seen a few solid replies to your question, but I figured I’d jump in and share my own take too.
First off, it’s pretty tough to pin down exactly what’s going on from just a written description. There are some contradictions here, so I suspect there might be a bit of a game of telephone happening—whether it’s between you and your relative, or between the doctors and the parents... anything is possible.
Regarding this "infusion to the heart" thing... as mentioned before, that’s actually a central venous catheter. They can place those in the jugular vein in the neck, the subclavian vein under the collarbone, or even the femoral vein in the groin. When you say "the infusion popped out so they had to redo it," you're likely talking about a peripheral IV in the kid's arm or leg slipping out, rather than a central catheter, since those are always extra secured.
Technically speaking, central venous catheters can be placed by anesthesiologists (using direct percutaneous access) or surgeons (by prepping the vein and placing the catheter under the skin, like those Hickman catheters).
I’m almost certain the reason for the central line is parenteral nutrition—basically what people call "feeding through the veins." The other reason that pops into my head, I won't even mention because I doubt that's where the story is heading. It's worth noting that for true parenteral nutrition, a central venous catheter is absolutely NECESSARY. There has to be a really good reason to go through with this, as it's potentially a very risky procedure.
Plus, based on your initial post, it sounds like there's probably some kind of congenital digestive tract anomaly, which means the little one can't eat normally and needs nutrients delivered directly into the bloodstream. Basically, regular eating is somehow blocked.
What's throwing me for a loop in your story, though, is this part...

I mean, the little guy eats enough food, his digestion works, and he's gaining weight, but the issue is with his large intestine. Once the food gets to that point, it just doesn't come out because the colon isn't reacting.

...and this...

The surgery started at noon and didn't wrap up until eight at night because they didn't get it right the first time!

That first quote feels contradictory to me... how can he be eating plenty of food and gaining weight if he doesn't have a clear digestive path and normal bowel passage? And why would he need parenteral nutrition via a central line in that case?
And that second quote is wild... saying the placement of a central catheter took eight hours!!! In my experience, that shouldn't take any longer than an hour, so I'm guessing they were doing much more than just placing a catheter. If it was an eight-hour operation, they definitely had to do a lot more than that.
Keep us posted on what's happening over there... I'm genuinely curious to see how this all unfolds.👋

A Woman from Rijeka brought this up earlier and I feel like I should jump in... honestly, I think a massive chunk of our healthcare mess boils down to primary care and those family doctors at the local clinics.
I get the feeling a lot of them just don't have the right expertise, so they end up acting more like glorified switchboard operators just funneling people toward the big hospitals. If we actually had decent triage happening at the GP level, I bet those insane hospital waiting lists would shrink overnight, but that’s just not how things work here. And man, when those folks miss the mark, you get screwed hard, often missing the window for a real diagnosis until it's too late.
It basically goes one of two ways: they either reflexively send you off to a specialist—which helps the patient but absolutely wrecks an already overloaded system—or they spend weeks fumbling around with random treatments while the situation gets worse, eventually landing someone back in the ER or even a funeral home.
It’s probably not an exaggeration to say that once these GPs finish med school and their residency, they pretty much plateau. They don't seem to bother keeping up with the latest research or guidelines, which means they aren't doing proper triage, starting the right treatments, or correctly judging when someone actually needs a specialist and when they don't.
I've seen some scary stuff firsthand because of this—like kids being handed Reglan for simple nausea, little toddlers getting prescribed Tramadol for pain, or treating an acute cholecystitis with just a diet for days right before it perforates. I've even seen people told that colon bleeding was just "stress" without any testing, or someone having leg wounds wrapped for months without anyone ever thinking to check a glucose level that was sitting way over 300. There are endless examples like that.
Look, I know everyone makes mistakes, but these aren't just tiny slip-ups; unfortunately, they aren't rare either. But just like pretty much every other medical blunder in the history of this country, these errors happen without any real consequences or accountability for the person who messed up.
Like I mentioned before, people really don't realize how much luck they need just to survive the adventure of trying to get medical care in this country.
Sadly, that's just the reality we're stuck with.

When things get serious—whether it’s a major crisis or just something urgent—everything gets funneled straight into the ER or the ICU, which is usually right next door if the situation calls for it.
What we’re really talking about here is the whole triage system at the emergency room; I've seen plenty of times where someone is absolutely losing it from a broken leg, but they’re stuck waiting in line because some guy who just scraped his knuckle showed up first. Honestly, those kinds of scenarios happen all the time in American hospitals.
In this specific case, though, the guy is being a total jerk, because stuff like that needs to go through the actual ER protocols rather than trying to bypass the system.
But, looking at that $100 bill mentioned, I’m pretty sure at least 8 out of 10 doctors would take the cash and knock the whole thing out in maybe two or three minutes. Nobody would ever find out, and they could just tell the people in the waiting room that an emergency popped up and they had to jump on it.

Casey Cook10 said:And apparently, every private doctor out there just dropped from the sky as some kind of saint.

Look, Casey, let’s talk about this without all the heat, okay? Which part of what I said was actually wrong? Just tell me.
As for the private practice thing? What did I get wrong there? Any specialist can decide to open their own clinic whenever they want. Sure, the Federal Government paid for your entire residency and all those fancy advanced degrees from A to Z—you didn't have to spend a single dime on it—but hey, you can still choose to go private. It's just that once you leave the safety of Medicare, you're jumping straight into the deep end of the market where you could actually sink, and I guess that's what bugs you. You'd much rather stay put where the paycheck hits regardless of how hard you work.
And this "kickback" nonsense? Look, anyone starting a business—whether it's a farmer, a local contractor, or a doctor—is going to need to take out a loan to get things moving. And yeah, those loans have to be paid back. That's just how the market works. So, this whole idea that everyone is taking shady side payments is, if you ask me, totally off base and misses the point entirely.
I can definitely agree with your take on how our healthcare system is set up. The funding model is a total joke and the whole setup isn't sustainable. But then again, how can you call your own demands "fair"? Especially when you look at how your salaries stack up against teachers, scientists, or anyone else in public service. And while we're at it, check out that post by Jack... the journalist guy... and tell me who the hypocrite is here. You guys pull in the highest monthly checks, get your continuing education completely paid for, and you're protected like bears in the wild from having any actual accountability for anything. Plus, you're all sitting pretty on a mountain of legal and illegal "side hustles" that everyone knows about, and honestly, doors are being opened for you at every level that stay firmly shut for regular folks... and yet, somehow, I'm the hypocrite. Give me a break.
The salary math? What's wrong with it? Is it the multiplier? The base pay? Oh, maybe I forgot to account for taxes... or maybe I didn't include all the various stipends added to the base... please, go ahead and correct me, I'm dying to see it.
And please don't try to tell me that a specialist working at a hospital has a take-home pay lower than $3333. We both know that's physically impossible.
Look, if someone works at the DMV, they're probably going to get things done a little faster than someone who doesn't. Unfortunately, that's just how the world works everywhere. If I need something handled, I'll admit it's easier and quicker for me because I'm inside that system. Maybe it's not that way for you? But I really don't see how that even relates to this debate.
If there's an emergency during an on-call shift, that's exactly why the on-call service exists. What I meant was that there are real on-call shifts, and then there are "on-call" shifts where the rare specialists actually show up, while most people just coast through the night doing absolutely nothing. 🙂

novinick said:I know I shouldn't paint everyone with the same brush... but honestly, the way doctors act just makes my skin crawl (if you want proof, just check out www.healthgrades.com). I deal with chronic health issues, and the way some of these doctors treat their patients is just straight-up disrespectful. To make matters worse, I’m one of those people who’s going to miss an appointment next Thursday after waiting TEN whole months for it. Yesterday, I got this incredibly rude response from the hospital staff: "Do you have a tumor? No? Then just reschedule or go see someone privately." And look, I need this specific checkup at least once a year SO THAT I DON'T MISS A TUMOR detection, and obviously, I'll be scraping together $200 enough cash for private care along with all the other regular tests I have to pay for myself.
If I mentioned as a teacher with 14 years under my belt that my salary is only around $1467, that doctor would probably just tell me I've picked the lowest-paying career possible and suggest I go work for a big corporation instead. Well, if they're so brilliant, why don't they just open their own private practice and rake in the money? Because let's face it, working in hospitals in this country right now pays maybe $6,800 plus $3,200 for on-call shifts.
My education took nearly eight years, and I'm constantly studying because my subjects are so specialized—and I pay for every single bit of it myself since I don't have some massive pharmaceutical company sponsoring my training. On top of that, I spend about two hours every single day prepping my lessons (not my fault I actually care about teaching these kids properly and love what I do!), and then there are all the extracurriculars that eat up my Saturdays and evenings. I'm not saying I'm perfect, but I've worked my tail off to get where I am today.
I am seriously fed up with this elitist mystique surrounding the Medical School, acting like they're training superheroes or some higher species of human being.
And please, don't lecture me about "heavy responsibility," because clearly, they don't feel it. People are dying every single day due to medical errors, yet somehow they always walk away unscathed!
Doctors are basically just extorting the public because they know people will squeeze every last cent out of their wallets just to keep themselves and their families healthy.
Look, I’d love for us to live in a world with a high standard of living where doctors earn $10,000 a month, but we live in America, so we all just have to shoulder this burden together.

That is quite possibly the most accurate take I've heard regarding this whole circus involving doctors. I agree with every single word.🙂

Well, I guess I've gotta chime in too...

Out of that amount, only $3333 is actually the base pay for a veteran specialist—which is something the Federal Government conveniently forgets whenever it suits them$2267. The other $3,200 comes from doing about 4 or 5 on-call shifts. So we're talking 4 to 5 full 24-hour stays at the hospital, missing out on family time, holidays, Fridays, and Saturdays. When you factor in the hourly rate for someone who spent 10 years in Medical School and spends their whole life constantly studying (mostly paying for it themselves, even though it’s legally required), it works out to about $10 per hour. You can make $10 doing random gigs through student services. Not to mention the endless overtime and all those unused vacation days that just get "gifted" to the state, which nobody can ever actually get compensated for...

It's the classic smoke and mirrors routine that every doctor "who cares about their reputation" sells to the public. And the one thing every doctor includes in that "package" is comparing themselves to nurses' salaries. I guess people have forgotten that... anyway, let's do a little math based on the federal regulations and coefficients...
So, every hospital specialist starts with a base coefficient of 2.04 or 2.05..
Every nurse working in the same hospital clinic alongside that doctor has a maximum coefficient of only 0.90 to 1.00..
The base figure used to multiply these coefficients is certainly $1417.
If we run the numbers through a calculator, we get a specialist's base salary of roughly around $2900.
Using the exact same math, a nurse's base salary comes out to about $1333.
So, the pay is more than double. That ratio is totally reasonable when you consider the education involved.
I only did this math to highlight the main grievance among doctors—that nurses' salaries have "dangerously approached" theirs.
And once you add in on-call pay, seniority, kids, administrative roles, and advanced degrees... yeah, the pay easily climbs into the five-figure range.

Also, are there any hospital specialists who don't take calls? If there are, they're a tiny minority. On-call duties are a core part of the job that pushes pay into those high five-figure brackets. Every med student knows that from day one. Honestly, these pathetic stories about "suffering during a 24-hour shift" just make me laugh. On average, it's mostly surgeons and anesthesiologists pulling those shifts. Everyone else probably watches the news, maybe catches a movie, and grabs a nap until morning. Most of the heavy lifting in neurology, internal medicine, or GI is handled by the youngest staff, usually a resident.
$10??? Seriously? Fine then, why don't you tell me what the hourly rate is for a Friday, Saturday, Sunday, or a holiday, so the info on the pay rate is actually complete....$10? As if you'd know...
After an on-call shift and the morning meeting, you get a day off. People actually use their vacation and personal days. If they don't, that's on an idiot boss, not some "systemic conspiracy" being dreamt up by the fringe.
As for "continuous education," it's common knowledge that hospital doctors definitely don't pay a single cent of their own money for it. Courses, symposiums, workshops, conferences, seminars... all of that is funded by department budgets (which are small) and (much more often) by the countless sponsors who practically pilgrimage to hospitals every day and have "arrangements" with half the doctors there.

Nobody is asking for anything other than what THIS Federal Government (so we aren't blaming the previous unpatriotic administration) actually signed off on and provided funding for. Besides that, all doctors' rights are regulated by the signed professional agreements, so right now, even previously earned rights aren't being honored because only the branch collective agreement is in effect.

Look, I know we’re all trying to play by the rules here, but let’s be real for a second—everyone knows exactly what Hebrang pulled. Instead of sticking to that Annex agreement everyone thought was a done deal, which actually covered your pay scales and had the unions on board, he went behind everyone's back to sign some other shady document. It was basically a total betrayal of trust. Honestly, it feels like he knew he was stepping down from his position and didn't want to look like the bad guy, so he just passed the buck and left a massive mess for the new Secretary and the rest of the Federal Government to clean up. It was a cowardly move if I've ever seen one, and frankly, it's pretty low. To top it all off, all that talk about the funding being ready for your raises? Total nonsense. There isn't even any money set aside for it.

Honestly, it's so true. Everyone’s out there driving these absolute beasts of cars, but most people have absolutely no clue what to actually do with their cash once they've made it.

For most people, yeah, absolutely. If I’m being totally honest with you guys, it feels like existential crises are just something way out of reach for most folks around here—like, miles and miles away from what we actually deal with on a daily basis.

It’s funny how nobody ever stops to wonder why a certain judge's gavel seems to swing so predictably in a high-profile courtroom—especially when you consider those doctors are pulling salaries that make them try to keep pace with top executives. It’s pretty wild to watch the Federal Government pivot from filing a lawsuit to handing down a verdict against a union in a single afternoon; it makes you think they definitely know exactly how much leverage those high-paid judges actually hold. They talk an awful lot about judicial independence, but the second they need to pull a heavy move for the state, they sure know how to play the game.

Look, government workers are basically civil servants, and healthcare falls right under that public umbrella. In that world, doctors definitely walk away with the biggest paychecks in the room. But here’s the thing—and this is what really matters—if a doctor isn't feeling the pay scale offered by Medicare, well, folks... you've always got options. You can always just go out and open up a private practice, be your own boss, and actually make some real money if that's what you're after. $33333 Honestly, props to you... you really nailed it.

Honestly, I’d trade my ten grand for even just ten bucks from any developer, manager, or consultant out there, because let me tell you, having that kind of expertise is worth way more than what's sitting in my bank account right now. $0.00 It all happened at the exact same moment.

Look, if you want my take, just act like a private contractor instead of that typical corporate programmer or manager type.

I honestly feel like you can walk into any hospital whenever you need to, especially if you’ve already got an appointment on the books.
You just have to be ready to really turn up the heat if they start trying to pull some shady nonsense on you. I'm talking about getting loud—threatening to call the local news, demanding the specific name of the doctor who's giving you a hard time, insisting they put their refusal in writing, or just making enough noise to end up in the administrator's office... that kind of thing.

Since it's focal, we're looking at a specific spot rather than something spread all through the liver tissue.
Regarding the other thing, I’d say it looks ischemic—basically, it's just not getting enough blood flow because a vessel is blocked off somewhere.

Look, speaking off the cuff, you're definitely going to need more testing to pin down exactly what we're dealing with and why it happened. What do I know, right? Maybe a solid contrast CT scan, an angiography, or even a biopsy guided by an ultrasound from the FBI.

Look, I'll give you the quick rundown on this...

So, basically, bzzzz bzz bzzzzzzzzz bzzzzz bzzzzz bzzz bz bz bz bz bzbzzzzzzzzz.
Bzzzzz bz bz bz bz bzbzzzzzzzzzzzzzzzzz bzzzzbzbzzzz!
bzzzzzzzzzzzzzz bzbzbzzzzzzzzzzzzz zzzzzzzz zzzzzzzzzzzzzz...

And oh yeah, almost totally slipped my mind...
bzzzzzzzzzzzzzz bzzzbzzzzzzzzzzzbzzzzzzzzzzz!!!
bzbzbzbzbzbzbzbzbzbzbzbzbzzzzzzzzzzzzzz.
bzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzz

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