Now ye're talking - to a consultant in the HSE [Questions thread]

Hi,

My wife is a chronic pain sufferer and approx every 4 to 5 months she gets a procedure in a private hospital that alleviates this pain to a certain extent.
She was due to have this procedure done last Thursday but 3 days beforehand the government announced the public / private hospital deal and the next day the procedure was cancelled.
We are being told that it could now take up to 3 months before she can have the procedure. They are unsure what is going to happen.
She is in awful pain as she can’t take any opioid based painkillers due to them messing up her system and this procedure is critical to her.

Do you think Procedures like this may get the go ahead any time soon? It’s a day procedure, over and released in about 4 hours.
I understand the seriousness of this virus but the pain is only going to get worse and the lack of information is adding to the Whole situation.
Are the HSA / Government looking at situations like these?

Thanks for taking the time to answer people’s questions / concerns.

What is your opinion of the latest HSE contract foisted on Doctors working in the Private sector , whereby , they MUST place their patients into the Public system , thus taking control for their ongoing treatment protocol out of their hands ? . how can this be justified when Drs who are seeing private patients in public hospitals ( which is allowed under their contract) can carry on as before ??.

begbysback wrote: »

I agree, the tone from the very outset has been condescending, the forecast of death rate exaggerated with no specific reasoning, the request that the public are failing to take directions and need to do more, basically asking the public to get tested and if your positive then stay home and hope it doesn’t get too bad, and if it does get bad then all we can do is put you on a ventilator, if we have one which is unlikely given that they are in short supply.

I apologize that I am a bit irate, but unless some of the answers start including some hope then I don’t see any point of continuing the AMA

First off please dont take this as a criticism and i thank you and everyone working in health care for all you are doing for those touched by this virus (and the rest of our sick population)

however i would tend agree with the quoted post, my question is do you not feel it is in incumbent on you to temper your responses somewhat. my worry is that peope will assume that a consultant will know whats going to happen, when the reality is you dont. You have an opinion and a certain amount of knowledge the rest of us dont but thats it.

Any more than an accountant or economost can predict the future of the economy, they can have their opinion, but most of them will be wrong.

The factual answers that relate to the here and now are very useful, your opinion on the future is informative but id worry that people are taking it as gospel.

The UV sterilizer you bought has the lamp in the lid if I understand correctly https://www.amazon.co.uk/Baby-Ultraviolet-Maintenance-Sterilisation-443853/dp/B07YB7V5QJ . You mention that use this on ready made meals and tins. How is this going to kill the virus on the bottom of the product you put into this sterilizer?

The questions on https://www.amazon.co.uk/ask/questions/Tx2IFDOQ5QXXVHG/ref=ask_ql_ql_al_hza reference this point. If you lay items flat down, even though the interior surface is reflective, then you will not get UV light on the bottom of your item. You mention you put several tins in it, wouldn't the likelihood that the bottom of your tins don't get full exposure be quite high? So really how effective & reliable is this for sterilizing your shopping as compared to using a liquid disinfectant?

Your rationale for going with the UV sterilizer was that disinfectant wipes will be difficult to replace and are a lot more hassle - compared to Milton applied undiluted with a j cloth I don't see how your rationale holds up. On the availability angle, Milton is not in short supply and neither are j cloths. One bottle and one packet of j cloths would last you months? Buy a few bottles and you're sorted for a year, at fraction the cost of UV sterilizer?

Hassle wise, you'd have your shopping disinfected in a fraction of the time with Milton & a cloth as compared to the time a small UV sterilizer would take? You'd have it done in less than 10 minutes with Milton as compared to 6 hours you mention for the UV sterilizer approach. It sounds like the UV sterilizer is actually adding more hassle; you need to open it, put item in it, make sure it's angled correctly to ensure bottom of item gets exposed, close lid, click on button...multiplied by each item of shopping?

The UV sterilizer you bought is reasonably small and it would not be possible to sanitize all your shopping with this, how do you sanitize items which are too big to fit into your UV sterilizer?

Pseudonym121 wrote: »

There are many ways to disinfect something. The effectiveness of Milton would rely entirely on your technique and how long you left it after before touching it again - they suggest ten minutes lay time per item. I think that, just like masks, they’re a great idea but so few wear them properly that actually they’re largely ineffective for the public. My fear would be the same with the Milton plus J cloth solution. Fine idea but the technique would matter and I fear many wouldn’t do it properly.

Thanks. Your advice on the wearing of face masks was very helpful, in particular the links to videos which educate on how to use them properly. Would you have similar advice or videos that you could share on the technique one should follow if using a liquid sanitizer like Milton to disinfect shopping?

I think advice on the technique would be really helpful to a lot of people. For those who cannot afford or get access to a UV sanitizer, a bottle of Milton will be more affordable and available. Having some knowledge on the correct technique could help reduce someones exposure to the virus and potentially save their life.

Purple Mountain wrote: »

Also, those who are hospitalised as a result of this, are they going to be billed for their care in the hospital?

Hosp care is tax-financed in Ireland, apart from two charges:

100 for entry via ED

80 pn / max 800 pa if you stay overnight

The 80 pn fee is being waived for COVID patients.

With such a huge pressure on PPE, what of used PPE can be reused now that was not before - after being sterilized

I'm interested in your assessment of your own mortality rate if you get it and in particular whether its changed since you first posted about it.

Originally, you gave yourself a 15% to 20% mortality rate if you caught the disease. I'm wondering if anything has changed your mind on that?

Given that roughly half of our deaths come from nursing home patients that leaves us with something like a 1.5% mortality rate for the rest of the population from the reported cases.

I assume this is grossly inflated due to
- significant gaps in testing
- testing concentrated on the most severe cases

Given that, I imagine you are assessing yourself as being maybe almost 2 orders of magnitude more at risk than the general population excluding nursing home residents.

Does your original assessment still hold?

Hi - a question regarding masks - having followed your posts for a while, I realise you are advocating best practise/personal ideal solution.
Specifically regarding masks, I often had to wear one in the oncology out patients - no one advised us how to wear it, put it on etc - simply - in this room we wear a mask. For yourself, for others.
Going forward as a society; does in your opinion - using a layere cotton face mask have any benefit to us? I am not looking at this as "face masks make us invincible" or that is prevents infection from Covid-19 but if it reduced droplet spread in all users by 30% even, is that not beneficial?
And thanks for all the time, energy and sleepless nights you are putting in - there are not enough words to thank you.

Hello OP,

Thanks for doing this I find it very interesting and informative .

I’ve tested positive for Covid19.

I had high temps for 16days, then I did 5 days post fever before I came out of isolation. (Difficult enough with 10&12year old children.) neither husband nor children have shown symptoms. So I’m hoping that’s it. Gp told husband not to work since I showed symptoms and he didn’t do we hopeful we didn’t spread it. But who knows. I’ve no idea where I picked it up..

When can I be considered no longer infectious...? Work are slow about bringing me back, would prefer if I was tested again and negative. But I know that’s not possible here..

Date I first showed symptoms was 21st March.

I just have 2 more questions for you.

Are you aware of what Dr Phil (doctor of psychology in the US) said about reopening the economy?
Basically he says look at the figures for people who die in swimming pool accidents etc and the economy still goes on. He can't see the justification of an economic shutdowns.
How do you argue with his mentality?

Also, there's hints in the media, even from our leaders, that schools may return for one day a week.
But yet, I've heard that there are still some test centres or the proposed UL field hospital that hasn't even opened yet.
I just don't understand how we're near opening schools if that's the case.

Thanks.

Hello again...
Just like to get you're take on the migrant farm workers coming into the country to harvest crops..
I think that though it does pose a slight risk, (as we are told they have undergone medical checks in their home country and again on arrival. They will be isolated for the recommended 14days and will again be medically checked before being allowed to break isolation) that it is necessary otherwise the crops will go to waste leading to empty shelves, and as you say we're in this for the long haul so the probability of "familiar/local" varieties of food shortage could happen.
There is a lot of hype been kicked up on social media about this but when Keelings advertised for local workers they only got about 40/50 replies, it just has not sunk into peoples heads that there could be food shortages if this plays out longer than expected or that there could/would be a 2nd wave of infection. Also taking into account that the €350 P.W. covid payments the government are paying will also put people off any thought of helping out in the harvesting what with the attitude of why should I go harvesting at 4am for what I'm now getting paid to stay at home...

I have a question. I’d already created a thread on it but it's died with only few bulling responses. Before I start I would like to point out that I don’t live in Dark Ages, yet I respect tradition and wisdom inherited from our ancestors. And I am not afraid to ask “silly” questions because they sometimes lead to wise answers.

Few days ago it was a video posted in the main thread made by a doctor from NY. In this video he suggested that in severe cases of COVID-19 there was an excessive amount of toxic Fe3+ iron ions in the blood plasma (he suggested that they were released from haemoglobin damaged by the virus in alveoli or at least I understood it in this way). If it was so, the remedy then should be the reduction of Fe3+ to Fe2+ and preferably removal of free iron ions from the blood.

So my question is: has anyone anywhere tried to apply “cupping-glasses” in case of alleged pneumonia caused by COVID-19? I mean parallel use to a standard treatment, not instead of it. Simply experimentally. (BTW this method is also used in Chinese traditional medicine, so maybe people in China were helping themselves in this way while being sick at their homes? - so maybe it was already checked there outside of the main stream treatment?)

I am not a physician but I suspect that BLACK SPOTS LEFT ON THE SKIN BY THE GLASS BUBBLES CONTAIN IRON (that is why they are black). And it happens only in case of very severe infections, otherwise spots are red or even pink (so they are not simple bruises). I know it from experience, that spots are not always black. What if “cupping-glasses” treatment is a method of "sucking off" a significant portion of toxic iron ions from the blood into the skin and thus reducing oxidative stress caused by toxic iron overload?

Now in hospitals there are a lot of patients with toxic iron ions in their blood causing damage to their vital organs. It creates a great opportunity to scrutinise this method. I think many people would prefer to try it than let their closest ones die. What if it could help? Especially if such therapy may prove effective in severe cases where a liver is no longer able to keep up with the process of haemoglobin degradation and produces insufficient amount of ferritin and haptoglobin capable of capturing excess of free iron ions.

As to “cupping-glasses” my mother used to say: "if spots are not black then there was no need for use of glass bubbles" (I suspect: there was no noticeable amount of free iron ions in the blood plasma) and also "the darker the spots are, the more severe and dangerous the disease is". This is due to centuries of human experience. I believe in therapeutic power of this method as the “cupping-glasses” helped my sister recover from severe pneumonia when she was a child. No antibiotics were used in her treatment and aftermath she looked like a huge pale ladybug with black dots on her chest and her back. Actually this hypothesis above is her idea.

The “cupping glasses” are not acknowledged by modern medicine, but has anyone ever tested their effectiveness of eliminating free iron ions (Fe3+) from the blood? Maybe the extravasated blood contains also some virus proteins transferred simultaneously to the skin, which tissue gives probably the strongest immune response in the body. So even, if the spots were only simple bruises with no iron but some virus, they could prod our immune system.

Why this kind of method can’t be tried and ruled out for good, if not working? Or approved and used, if working?

It is only a question of applying cups (bubbles) and then analyzing the content of these spots. The advantage of the “cupping-glasses” method is that the therapy is very cheap. Much cheaper and safer than ventilators.

I think it would be worth trying in face of such huge emotional and economical losses caused by this pandemic.