The world of modern medicine never ceases to amaze. The latest high tech treatment for a potentially lethal infection.....a faecal transplant. Or in plain English......a shit sandwich. All will be explained below.
Clostridium difficile (C diff) is a bacteria normally found in the colon in very small amounts or not at all. The colon is normally packed full of "good" bacteria that crowd out nasties like C diff and stop it growing out of control. If C diff does take over, it causes severe diarrhoea. It can also cause a very serious condition called pseudomembranous colitis. There are several deaths every year from C diff.
C diff is normally linked to antibiotic use. Antibiotics wipe out the "good" bacteria and allow C diff to multiply. So it often affects already ill people. Conventional treatments for C diff are metronidazole and vancomycin. Vancomycin can also be delivered into the colon directly via a catheter passed through the rectum. In some cases, even these treatments fail.
The last line treatment is the faecal transplant.Firstly, the colonĀ is sterilised with vancomycin. A nasogastric tube is then passed and an emulsion of faecal matter is then delivered into the stomach. This then seeds the gut with "good bacteria", preventing C diff from taking over. So far, this treatment has had very positiveĀ results.
A small story my boss told me.......
During a very cold winter day, a bird was flying across the sky. As it got colder and colder, the bird froze and fell to the ground. A cow walked up to it and crapped on it. The heat thawed the bird out and it began singing. The noise attracted a fox which then ate the bird.
Moral of the story-not everyone who shits on you means you harm and when you are in deep shit, you should keep quiet.
ECG (Heart Tracing)
ECG (called EKG in USA) stands for ElectroCardioGram. This test looks at the electrical activity in the heart.
How Is It Done?
The first step is to attach adhesive electrodes to the chest and limbs. It may be necessary to shave the chest to get good skin contact. In women, the elctrodes are places under/around the left breast. The machine will then be attached to the electrodes. At this point the patient will be asked to lie very still while the machine takes a recording for about 10 seconds. The test is not painful or uncomfortable.
Why Is It Done
The usual reasons for an ECG are chest pain, palpitations, fast/slow/irregular pulse, shortness of breath or unconsciousness. Many doctors also request an ECG as a baseline investigation. It does not necessarily mean something is wrong with your heart.
What Does It Show
The heart is a muscular organ with its own "wiring". For each heartbeat, an electrical impulse travels through the wiring in a specific way, causing the muscle to then contract in a coordinated and efficient way. The ECG shows how the current is moving through the wiring and muscles. Many conditions can cause the current to travel in an abnormal way.
There may be abnormalities in the rate, rhythm or shape of the deflections in the ECG. Some are specific to certain conditions. Others are more general. The ECG is always interpreted in light of the patients history and examination. Comparison with previous ECGs is also helpful. The ECG is not an end in itself.
I attended a course of leadership/management yesterday so I have the answers to some of the questions I'm about to ask, but I would like other people's views and opinions too.
What makes a good leader? What sort of leader would you follow? Should leadership style change with the situation? At what point does a leader become a dictator?
At what point do tact and diplomacy degerate into bullshit? Does sugar coating something unpleasant necessarily detract from the truth in it?
If the objective is to break bad news, how would you go about softening the impact while still delivering the necessary information.