Do you often sit around comparing the smell of superfluous, odoriferous orifices?
That too.
Heck, I had one patient who sued me for killing his tumor, depriving him of its companionship.
I’ll bet most people don’t know that about the speed of suppositories. Heck, I would seriously consider stuffing something up my ass if I knew it would take away the pain really fast compared to popping some pills. Fighting ignorance, and all that.
Even though it is one of the fastest, the convenience isn’t that great… Specially if you are in public. If you are just looking for an analgesic that is fast acting, your best bet would probably be a liquid formulation, suspension, syrup, etc. Normally they are in children’s strength, but that just means you might have to take more (ask your pharmacist what the correct amount to take for your height/weight).
Actually, Tylenol extra strength comes in a suspension now.
If only it were that simple.
The value of treating strep to reduce Acute Rheumatic Fever depends on the prevalence, and right now the prevalence here in the USA is very low.
Moreover, it’s been difficult to show that oral treatment is very effective, even in places (New Zealand’s Maoris, e.g.) where prevalence is pretty high.Many of the studies around prophylaxing acute strep are from back in the 50s and were done with injectable penicillin, STILL the gold standard treatment and, as I mentioned earlier, seldom done.
See here in Appendix 6 (p 44) for a summary of studies:
http://www.nhf.org.nz/files/Rheumatic%20Fever%20Guideline%203.pdf
And then you find comments like this:
“In fact, a recent large school-based trial in 24 000 children in New Zealand showed no statistical difference in the incidence of rheumatic fever between those who tested positive for streptococcus and received oral penicillin for 10 days and those who tested positive but received no treatment.
‘This was a brutally disappointing result,’ said Dr Nigel Wilson (Green Lane Hospital, Auckland, New Zealand), a pediatric cardiologist who was involved with the trial.” Cardiology News & Opinion – theheart.org | Medscape
It’s just never as simple as we make it out to be in medicine. Throw in the fact that maybe 30% of ARF don’t even get an identifiable antecedent strep infection.
Here are a handful of reads to get you going, since the issue has affected you personally so much (for which I am deeply sorry):
http://jmm.sgmjournals.org/cgi/reprint/47/8/655.pdf
http://gsbs.utmb.edu/microbook/ch013.htm
Again, the issue is not whether methicillin-resistant staph is serious, but whether antibiotic resistance is a new problem or an old problem, and whether or not we are keeping up. It certainly is a cause du jour, but this old geezer has seen those come and go, day by day.
As a rule of thumb, those who check out from assorted multiply-resistant strains are those whose immune systems are compromised in some way. Cold comfort, but certainly not a new problem.
As far as medical science being at the end of its rope, I beg to differ, but we’ll have to come back in a few years to see who was right. We are only just beginning to figure out molecular-level medicine. I’m betting on science.
“Science Reaches End of Rope” is great copy writing, but hardly accurate. It may sell newspapers but it’s nothing more than a polloi-scaring headline, IMHO, and of little substance.
:eek:
That… makes up for all the lost Qadgop stories that you never get to tell us anymore.
Wow.
That’s just Awesome.
The patient represented himself, and his complaint, filed with the court, was a little bit less than coherent.
It didn’t go far.
But it does count as a lawsuit against me for reporting purposes.
I’ve always wondered- does that ever really mean anything? The lawsuits against you even if you win them? Because the prison doc I shadow seems to have a few- as does pretty much every other prison docs in the area…
The concentration and inactive ingredients might be different from what is used in people, but a lot of veterinary drugs are made by the same companies as the parallel human drugs, just with a different label. Heck, a decent fraction of the prescription drugs used in horses ARE the human drug, as a veterinarian with a license (and DEA number for controlled substances) can legally prescribe any human OR veterinary drug for an animal, provided that it falls within the limits of acceptable/non-negligent practice.
I’m sure there are some rugged individualist types who self-medicate with veterinary injectable antibiotics, but I doubt it’s common. I have had a couple people tell me that they have taken oral antibiotics from their barn supply. Also, some show horse trainers/riders from other boards swear by a squirt of Banamine (an anti-inflammatory) in the morning orange juice as a hangover remedy, and there are racetrack trainers who have trashed their livers taking Bute, another horse NSAID that was on the human market briefly but got pulled for dangerous side effects, such as occasionally screwing up your bone marrow and causing it to stop producing important things like platelets and WBC’s.
In job or hospital privilege applications for physicians, it’s a standard question: Have you been sued? If so, give details.
And any settlements or verdicts against you get reported to the National Practitioner Data Bank. No mention of the actual merits, just the fact that you didn’t clearly win gets listed.
I frankly don’t care anymore, but since I spent 15 years in private practice without getting sued, it was an adjustment to get used to being sued 2 or 3 times a year now.
I would love to be on a jury for something like this… But then, I would think the lawyer for the suer would dismiss me for cause… (never been called for jury duty, something I’ve always wanted to do though)
As a person with a severe (sent me to the emergency room last year) needle phobia, I am desperately glad that antibiotics are available in pill form. On the very rare occasions I go on them, I take every single last freakin one of them in gratitude.