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Doc Lightning
GOLD Member since May 2001

Doc Lightning

HOP Mad Doctor
Location: San Francisco, CA, USA

Total posts: 13920
Posted:So I've taken a 2 1/2 year old girl. She came in with what looked like a little nose cold kind of thing...except she kept going limp and turning blue around the mouth.

So she did it right in front of us today. Turns out she's got fluid around her heart and her heart's infected with a virus. The muscle is damaged. Her heart is racing trying to keep the blood going to her organs...and yet her blood pressure keeps dropping...and her heart keeps going faster and faster...and because it's not pumping much blood with each stroke, it's not going anywhere. Her oxygen saturations are dropping. We keep giving her more and more oxygen.

The next step is ECMO, Extra-Corporeal Membrane Oxygenation...basically an artificial set of heart and lungs outside her body. ECMO is a BAD thing... The problem with ECMO is that once you go on it...it's tough to tell exactly when you can get off.

30% of children with a viral infection of the heart (viral myocarditis) recover fully.
30% have decreased cardiac function but can be managed with medication
30% require transplant.

So 60% of the time, the news is bad. frown


-Mike )'(
Certified Mad Doctor and HoP High Priest of Nutella

"A buckuht 'n a hooze!" -Valura

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JauntyJames
SILVER Member since Dec 2004

JauntyJames

Carpal \'Tunnel
Location: Hampshire College, MA, USA

Total posts: 3533
Posted:....and the other ten percent? pardon my insatiable curiosity

sorry, that must make you feel terrible. hug


-James

"How do you know if you're happy or sad without a mask? Or angry? Or ready for dessert?"

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Doc Lightning
GOLD Member since May 2001

Doc Lightning

HOP Mad Doctor
Location: San Francisco, CA, USA

Total posts: 13920
Posted:The other 10% go down the drain. frown

-Mike )'(
Certified Mad Doctor and HoP High Priest of Nutella

"A buckuht 'n a hooze!" -Valura

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flash fire
BRONZE Member since Jan 2001

flash fire

Sporadically Prodigal
Location: Sydney, NSW, Australia

Total posts: 2758
Posted:Just curious - why do you use a drain analogy? smile

HoP Posting Guidelines
Is it the Truth?
Is it Fair to all concerned?
Will it build Goodwill and Better Friendships?
Will it be Beneficial to all concerned?
If you can answer YES to these 4 questions then you may post a reply.

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Alfred
SILVER Member since Jul 2003

Alfred

Altyd Brandend
Location: Orange County, California, US...

Total posts: 149
Posted:Sorry to hear that you had a bad day Dr.L hug

Spinning makes my world go round

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Doc Lightning
GOLD Member since May 2001

Doc Lightning

HOP Mad Doctor
Location: San Francisco, CA, USA

Total posts: 13920
Posted:Going "down the drain" is...
...bad.

It comes with a headstone.


-Mike )'(
Certified Mad Doctor and HoP High Priest of Nutella

"A buckuht 'n a hooze!" -Valura

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ImmortalAngel
SILVER Member since Jan 2004

Scientist!
Location: Waterloo, Ontario, Canada

Total posts: 578
Posted:I think he meant in the title of this thread "Circling the drain".
Mike, I'm sure no matter what happens that she and her family will appreciate what you are doing for her. One of my best friends got pneumonia as a child, and her life was saved thanks to a Dr like your self, and I know that there are millions of other people out there from doctors like you.
You're doing a good job mate, keep up the good work!


Educate your self in the Hazards of Fire Breathing <img src="/ubbthreads/images/graemlins/smile.gif" alt="" /> STAY SAFE! <img src="/ubbthreads/images/graemlins/hug.gif" alt="" />

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flash fire
BRONZE Member since Jan 2001

flash fire

Sporadically Prodigal
Location: Sydney, NSW, Australia

Total posts: 2758
Posted:I know what 'going down the drain' means, Lightning - I was just curious as to why you use that specific analogy to describe death. No biggie.

HoP Posting Guidelines
Is it the Truth?
Is it Fair to all concerned?
Will it build Goodwill and Better Friendships?
Will it be Beneficial to all concerned?
If you can answer YES to these 4 questions then you may post a reply.

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Doc Lightning
GOLD Member since May 2001

Doc Lightning

HOP Mad Doctor
Location: San Francisco, CA, USA

Total posts: 13920
Posted:I dunno. It's just what we use. The jargon of the field.

She's doing worse, BTW. Her blood pressure AND heart rate are dropping. Her heart's getting tired. And probably more damaged.

She'll need ECMO. frown


-Mike )'(
Certified Mad Doctor and HoP High Priest of Nutella

"A buckuht 'n a hooze!" -Valura

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dromepixie


dromepixie

veteran
Location: Florida

Total posts: 1463
Posted:I think down the drain is an amazing metaphor... If you think that we go through tunnels of consciousness as we die and are born... Much like information travels through wires to reach points where they are told where to go... So upon death our soul must begin a journey and if on earth we cannot see it then the person would go down a drain away from living humanity....


And Mike, you cant help everyone! I think the fact you made it through rigorous uni years makes you rugged and fully prepared for situations like this. Admit that you can only help how you can help and the rest is in 'God's' hands.

Huggles!
drome biggrin


JUGGLEwithyourmind!

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Doc Lightning
GOLD Member since May 2001

Doc Lightning

HOP Mad Doctor
Location: San Francisco, CA, USA

Total posts: 13920
Posted:Update: She's on ECMO. It happened this morning when her pressures dropped.

He heart stopped working. I documented the CRAZIEST physical exam today:

Heart Sounds: not heard
Pulses: not felt
Blood pressure: 76/76
Oxygen saturation: 100%

Wow... eek Signs that things are not as they should be.


-Mike )'(
Certified Mad Doctor and HoP High Priest of Nutella

"A buckuht 'n a hooze!" -Valura

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ImmortalAngel
SILVER Member since Jan 2004

Scientist!
Location: Waterloo, Ontario, Canada

Total posts: 578
Posted:indded very strange stats :O
I hope she get better soon, for her sake, her family's and yours.


Educate your self in the Hazards of Fire Breathing <img src="/ubbthreads/images/graemlins/smile.gif" alt="" /> STAY SAFE! <img src="/ubbthreads/images/graemlins/hug.gif" alt="" />

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_Aime_
SILVER Member since Jan 2004

_Aime_

Carpal \'Tunnel
Location: Hastings

Total posts: 4172
Posted:my prayers go out to her and her family.

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Glåss
BRONZE Member since Mar 2017

Glåss

The Ministry of Manipulation
Location: Bristol

Total posts: 2523
Posted:Good luck smile

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MiG
GOLD Member since Apr 2004

MiG

Self-Flagellation Expert
Location: Bogged at CG

Total posts: 3415
Posted:Being non-spiritual, i can't say that my prayers go out.



I do, however, hope that she pulls through, for her sake, for her parents' sake, and for yours.



You've taken on a hard profession, not just the physical/mental difficultness, but the emotional side as well. keep caring, and you'll stay a better doctor than most others smile



Is pumping the liquid around her heart out an option? probably been considered, but im curious as to possibility.


"beg beg grovel beg grovel"
"master"
--FSA

"There was an arse there, i couldn't help myself"
--Rougie

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Gnor
BRONZE Member since Mar 2003

Gnor

Carpal \'Tunnel
Location: Perth

Total posts: 5814
Posted:I feel for her and her family. One day you have a well child, next thing she has a cold, then in nothing flat she is on ECMO.
The child is so young and her parents really must be shell shocked. How can the child have an understanding of what is happening to her.

We expect miracles from the medical profession and so often they are delivered but sometimes as health care users I think we barely understand the pressures our medical staff are under.

Look after yourself Mr Lightning as well as your precious patients.
hug hug hug


Is it the Truth?
Is it Fair to all concerned?
Will it build Goodwill and Better Friendships?
Will it be Beneficial to all concerned?

Im in a lonely battle with the world with a fish to match the chip on my shoulder. Gnu in Binnu in a cnu

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newgabe
SILVER Member since Mar 2005

newgabe

what goes around comes around. unless you're into stalls.
Location: Bali

Total posts: 4030
Posted:Hey Mike,
How's it going?

And I 'm very curious about the comment that once on an ECMO it's hard to know when to get off.... is that because it is risky to have to rely again on a person's own functioning.. or where the person will not be able to sustain their own life but it's a legal wrangle about who makes the decision to 'turn off' the machine?


.....Can't juggle balls but I sure as hell can juggle details....

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Doc Lightning
GOLD Member since May 2001

Doc Lightning

HOP Mad Doctor
Location: San Francisco, CA, USA

Total posts: 13920
Posted:We had a miracle with her. She's off all IV medications. She was walking today. Slowly...haltingly (She's been flat on her back for two weeks). But she recovered...100%.

Amazing. Absolutely amazing. biggrin


-Mike )'(
Certified Mad Doctor and HoP High Priest of Nutella

"A buckuht 'n a hooze!" -Valura

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Adya Miriyana
GOLD Member since Feb 2005

Adya Miriyana

*slou?
Location: Adelaide

Total posts: 6554
Posted:smile smile smile smile smile smile smile ubbrollsmile HoP Magic!!!

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Tao Star


Tao Star

Pooh-Bah
Location: Bristol

Total posts: 1662
Posted:i read this but didn't post, but now i just have to say

wooooo! life's little niricles - amazing & happy hug


I had a dream that my friend had a
strong-bad pop up book,
it was the book of my dreams.

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vanize
SILVER Member since Aug 2001

vanize

Carpal \'Tunnel
Location: Austin, Texas

Total posts: 3899
Posted:it's no miracle - it is just Dr. Lightning's fine work!

-v-

Wiederstand ist Zwecklos!

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Tao Star


Tao Star

Pooh-Bah
Location: Bristol

Total posts: 1662
Posted:well done sir! smile

I had a dream that my friend had a
strong-bad pop up book,
it was the book of my dreams.

Delete

Doc Lightning
GOLD Member since May 2001

Doc Lightning

HOP Mad Doctor
Location: San Francisco, CA, USA

Total posts: 13920
Posted:No...she did the work. Her heart put itself back together.

However, also lost two kids last week. frown


-Mike )'(
Certified Mad Doctor and HoP High Priest of Nutella

"A buckuht 'n a hooze!" -Valura

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JauntyJames
SILVER Member since Dec 2004

JauntyJames

Carpal \'Tunnel
Location: Hampshire College, MA, USA

Total posts: 3533
Posted:that's really cool! (not that last bit, obviously, the little girl) congratulations, that must really make you feel on top of the world. heart

-James

"How do you know if you're happy or sad without a mask? Or angry? Or ready for dessert?"

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ishkadoodles
GOLD Member since Mar 2005

ishkadoodles

journeyman
Location: Minneapolis, MN

Total posts: 61
Posted:congratulations about the young lady.

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Doc Lightning
GOLD Member since May 2001

Doc Lightning

HOP Mad Doctor
Location: San Francisco, CA, USA

Total posts: 13920
Posted:She SMILED at me today. I never saw her do that before...

-Mike )'(
Certified Mad Doctor and HoP High Priest of Nutella

"A buckuht 'n a hooze!" -Valura

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_Aime_
SILVER Member since Jan 2004

_Aime_

Carpal \'Tunnel
Location: Hastings

Total posts: 4172
Posted:aww hug

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flid
BRONZE Member since Aug 2002

flid

Carpal \'Tunnel
Location: Warwickshire

Total posts: 3136
Posted:are you allowed to talk about patients publically?

Delete

Sakura_Moon


Sakura_Moon

Hop's Kitten Jester.
Location: Wonderland igloo, Vic, Austral...

Total posts: 1803
Posted:awww hug hope you smiled back!

.:Pink Exocutioner:.

I am Jack's Raging Bile Duct...

Loving you from the deepest part of my loins.


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vanize
SILVER Member since Aug 2001

vanize

Carpal \'Tunnel
Location: Austin, Texas

Total posts: 3899
Posted:I think he can as long as he doesn't give any information that would allow anyone to identify her (I think)



I'm sure there are enough little girls around the hospital that no one could possibly hope to figure out who he is talking about


-v-

Wiederstand ist Zwecklos!

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flid
BRONZE Member since Aug 2002

flid

Carpal \'Tunnel
Location: Warwickshire

Total posts: 3136
Posted:fair enough smile

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Page: 12

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