Medical Consults and Whatnot...

Cough. Cough.

Since arriving home, I've been asked not once, not twice but 3 times in the first day back about what to give for a cough.

Well, I'm a doctor that really doesn't like to give medications that aren't needed. So, my usual response is, to do what I usually do. Drink lots and lots of water.

A cough is not really a bad thing. It is a defense mechanism by our upper airways to expel any foreign particles or any foreign matter that triggers it. In essence, it's a good thing that we cough, so don't be too quick to suppress it.

Well, I've always maintained that the only indication for treating a cough is if bothers you. I mean interfere-with-daily-functions bother you. Like if you have to light the stove and you put the fire out with your cough. This includes if the cough is indicative of any underlying disease and other pathologic states.

I really don't want to go into the details of cough treatment, but the bottom line is not all cough is bad.

But please, don't take my word for it. Go see your doctor.

Clearance

I've always wondered what philosophy our hospitals based the act of having family members remove an endotracheal tube from a patient on a ventilator from. I think some forward thinkers have already corrected this practice somewhat, with medical ethics taking a prominent role in what doctors do.

But still, most hospitals still stick to the practice of having family members take the ET tube out. Ethics aside, doctors stand by the hospital in this act, probably to save ourselves the trouble or to absolve ourselves from any act that, seems, to go against our oaths.

This is provided, of course, that a DNR has been discussed and signed.

During my residency, I found medical personnel having to take out IV lines, NGT's, stopping all medications prior to sending terminal patients home against medical advice to pass away peacefully at home, but leaving the ET tube removal for the family.

I don't get it. We put it in. Don't we have to take it out?

Fireworks Over Toccoa

Just because there are millions of stars in the sky, it doesn't mean you can't make your own.