Hospitalizations after falls in the elderly are common and have scary prognostic implications. But isolated concussions don't usually require multiple-night stays.
Let’s not taint this great column with politics. We are TIRED of questioning medical advice because one does not know if politics has biased the information. Politics has destroyed confidence in the CDC, WHO, and NIH.
Thank you Dr Faust for the sober data on "TBIs" in the absence of any "situational context" from any medical source or authorized Senate Staff.
I support medical privacy strongly but, this medical condition is widely misunderstood by patients, family & others. Please check my data point; there are more than a million E visits per year on TBI's & "Falls". I suspect the "UNreported TBI's make the actual numbers much higher. Treatment Protocols meaning superb Tauma Teams are available across the Nation.
Cautious observation and potentially a repeat CT scan is understandable. Initial CT scans for TBIs, can underestimate the degree of injury (including what may initially present clinically as a concussion). However, remaining in the hospital for several days implies the physicians are concerned about more than just a concussion or perhaps it is motivated by a “VIP” approach as you mentioned. In my view unnecessarily remaining in the hospital likely increases risk.
Baseline data more than CT scans are necessary for monitoring in the short & long term in my lay opionion. Access to a Patient Advocate or "hospitalist" with a proper medical POA authority is very useful. Plan ahead as geriatric falls are common.
An accurate history is important and generally in complex medical cases the key to arriving at the correct diagnosis. Concerning TBIs including some “concussions”in the appropriate context, there may be a concern for delayed increased intracranial pressure(ICP)even after an initial “normal” CT scan. There are individuals who are sent home with a “head” sheet who later die at home of delayed effects of what was diagnosed as a concussion. Red flags include a delayed rate or time to significant improvement. In these cases a repeat CT scan may reveal a reason for increased ICP or still be consistent with a concussion and lead to appropriate management. It certainly is preferable to inserting a subarachnoid screw to measure ICP in all patients with a red flag.
I’m likely in a minority but I believe you don’t know what is going on and it is a bit early to claim VIP medicine that would not have any benefit. I’m not a fan of McConnell but he is of an age where caution is appropriate. If he’s at an academic medical center, as a friend of mine was, they maybe going the extra mile to rule out causes for the fall- DUH. Do better!
You are not in any minority Barbara. You are spot on. The "extra mile" is standard protocol for UCSF Trauma Teams, then LTAC for neurological evaluation. Then to Rehab, if necessary, then Speech Therapy with ongoing Physical Therapy. Then group Life Skills I & II then on to being reader of Dr Faust`s Inside Medicine or Med Page Today.
Problematic for doctors not to support access to healthcare for all people, or speak up against those who would expose them to financial ruin, preexisting conditions, or loss of female bodily autonomy.
Pure speculation, but he's at an age where he could be on anticoagulants. Maybe being watchful for potential cerebral bleeding?
Let’s not taint this great column with politics. We are TIRED of questioning medical advice because one does not know if politics has biased the information. Politics has destroyed confidence in the CDC, WHO, and NIH.
Thank you Dr Faust for the sober data on "TBIs" in the absence of any "situational context" from any medical source or authorized Senate Staff.
I support medical privacy strongly but, this medical condition is widely misunderstood by patients, family & others. Please check my data point; there are more than a million E visits per year on TBI's & "Falls". I suspect the "UNreported TBI's make the actual numbers much higher. Treatment Protocols meaning superb Tauma Teams are available across the Nation.
Cautious observation and potentially a repeat CT scan is understandable. Initial CT scans for TBIs, can underestimate the degree of injury (including what may initially present clinically as a concussion). However, remaining in the hospital for several days implies the physicians are concerned about more than just a concussion or perhaps it is motivated by a “VIP” approach as you mentioned. In my view unnecessarily remaining in the hospital likely increases risk.
Baseline data more than CT scans are necessary for monitoring in the short & long term in my lay opionion. Access to a Patient Advocate or "hospitalist" with a proper medical POA authority is very useful. Plan ahead as geriatric falls are common.
An accurate history is important and generally in complex medical cases the key to arriving at the correct diagnosis. Concerning TBIs including some “concussions”in the appropriate context, there may be a concern for delayed increased intracranial pressure(ICP)even after an initial “normal” CT scan. There are individuals who are sent home with a “head” sheet who later die at home of delayed effects of what was diagnosed as a concussion. Red flags include a delayed rate or time to significant improvement. In these cases a repeat CT scan may reveal a reason for increased ICP or still be consistent with a concussion and lead to appropriate management. It certainly is preferable to inserting a subarachnoid screw to measure ICP in all patients with a red flag.
I’m likely in a minority but I believe you don’t know what is going on and it is a bit early to claim VIP medicine that would not have any benefit. I’m not a fan of McConnell but he is of an age where caution is appropriate. If he’s at an academic medical center, as a friend of mine was, they maybe going the extra mile to rule out causes for the fall- DUH. Do better!
You are not in any minority Barbara. You are spot on. The "extra mile" is standard protocol for UCSF Trauma Teams, then LTAC for neurological evaluation. Then to Rehab, if necessary, then Speech Therapy with ongoing Physical Therapy. Then group Life Skills I & II then on to being reader of Dr Faust`s Inside Medicine or Med Page Today.
Thank you Barbara for your point about patient privacy.
Not funny. Problematic for a doctor to be so nasty.
Ok sorry, deleted for you. Not taking care of him personally, but have lots of patients whose health suffers because of his agenda. For example:
https://www.nytimes.com/2017/06/27/opinion/health-care-mcconnell-trumpcare-cbo.html
Problematic for doctors not to support access to healthcare for all people, or speak up against those who would expose them to financial ruin, preexisting conditions, or loss of female bodily autonomy.
No excuse.