Thursday, 23 June 2016

Dramatic new figures on the number of insulin-dependent Australians

RMIT and Diabetes Australia think that more than a million Australians will die if insulin becomes unavailable. That is more than 4% of the population.
As the punchline to the two positives make a negative joke goes, Yeah, right!
Medical academics really are some of the most clueless people you will ever meet.

Wednesday, 22 June 2016

An audit of 545 consecutive cases of anaesthesia for elective cardiac surgery

An audit of 545 consecutive cases of anaesthesia for elective cardiac surgery was conducted for the purpose of quality assurance. This comprised all elective cases up until the end of 2014 in which I was the primary anaesthetist.
Outcomes of interest include the scope of operations for which anaesthesia was provided, the usage of and complications from trans-oesophageal echocardiography (TOE), and adverse outcomes, both major and minor.
Scope of surgery
Operation type

Avr +/- cabg
Mitral +/-cabg
Other valve
Redo cabg 
Redo valve


Other valve cases included tricusip and multiple valve surgery. Other non valve cases included ASD closure, atrial myxoma and lipoma, HOCM surgery, pericardiectomy on bypass, aortic root replacement and Bentall procedure. Arrhythmia ablation was performed concomitantly in 3 cases.
Not included in this review are emergency cases for cabg or dissection, cases such as pericardial window which did not use bypass, take-backs, or combined AAA/cabg surgery. The cases that are included are those which provide useful information for prospective patients about to undergo elective cardiac surgery.
Adverse outcomes
Death: Death within 24 hours of anaesthesia is a definition which fails to capture the majority of anaesthesia-related deaths, so was not used. Death within 30 days of surgery is a standard measure, but data for this is not available to me. Failure to leave ICU alive was the most inclusive definition for which I have reliable data. There were two cases – a patient who died in ICU 4 days post-operatively with an IABP that had been placed before surgery. A second patient also died in ICU more than 24 hours after surgery.
Other: There were no major airway, TOE, CVL or other problems complications.

An audit of 545 consecutive cases of anaesthesia for elective cardiac surgery was conducted for the purpose of quality assurance. This information can be used to inform prospective patients about the performance of this particular surgical unit. The audit is to be repeated once a total of 750 patients is reached.

Monday, 13 June 2016

Wikipedia knows more than most doctors about diabetes.

This was standard advice in the 1970s and earlier, but nowadays doctors seem intent on imposing their own ignorance on patients, with not so much as a case series showing long-term high level functioning with low fat eating.

The Canadian Diabetes Association love the Banting LowCarbHighFat diet so much they made it their phone number.

I'm sure they love Fred too.

Monday, 6 June 2016

More bullying and harassment by Canberra doctors

Last year I wrote "Someone with the appropriate knowledge has told me that almost every patient in The Canberra Hospital catchment with Type I diabetes and on steroid replacement is in quite poor health. I am not. 

Despite almost 20 years with T1DM, and 10 years on steroids, my arteries are in superb condition, and I would be very surprised if you have heard of anyone with both conditions in the Southern hemisphere who matches me in physical performance.

I did not get this way by subscribing to local medical dogma. Quite the opposite. In many aspects of treatment I act completely contrary to the recommendations of local researchers. If you think it is just a coincidence that I am also the only doctor at TCH who has managed to complete the M Biostat, think again."

When this was reported to AHPRA, they decided it constituted evidence that I was impaired and that they needed to "investigate (my) health" They claimed that this constituted an "Own Motion notification" and was justification for applying the full force of the coercive powers they have been given.

There is no one in the world my age and with my diseases reporting anywhere near the success I have had in living a full life. (not in English anyway)
How this constitutes impairment is beyond me.

Unfortunately, the Senate Inquiry into medical bullying has been postponed due to the Federal election. But sooner or later, those clueless Canberra doctors will get their comeuppance.