[HSF] IE

Sat Mar 17 20:10:59 EDT 2007

I forgot one important thing that we don't have and I dream of it.A doppler 
flowmeter which can give numeric and graphic data(including PI).I agree 100% 
with Dr.Salerno, all the grafts must be checked quantitatively at the end of 
op.
erdinc

>From: Tea Acuff <tacuff at swbell.net>
>Reply-To: OpenHeart-L at lists.hsforum.com
>To: OpenHeart-L at lists.hsforum.com
>Subject: Re: [HSF] IE
>Date: Sat, 17 Mar 2007 11:46:25 -0700 (PDT)
>
>Don't develop an inferiority complex, Prasanna.
>
>One, more is never enough. More is almost always seen as better than less, 
>but often many is valued less than one or some.
>Two, abundance has its own set of problems as you could tell from our 
>bewildering complaints and concerns.
>Three, what one accomplishes with what one has rather than what is given to 
>him is the measure of the man or surgeon. We all enjoy comfort or "cush" as 
>you say, but we in "cushland" hold our hats in our hands in your presence 
>when we see what you do compared to what we think that we need.
>Lastly, tell us what you need. Be specific. Maybe some us can help.
>tea
>
>
>----- Original Message ----
>From: prasannasimha <prasannasimha at gmail.com>
>To: OpenHeart-L at lists.hsforum.com
>Sent: Saturday, March 17, 2007 12:26:07 PM
>Subject: Re: [HSF] IE
>
>
>Dear Tom,
>I struggle everyday just to have the ABG machine working. The latest
>insult to injury was the defib paddles conked off
>for a particular brand of Defibs and so  was told I could have one pair
>for the cases on that day in the OR so I had to choose which case I
>would like to have it.We had to make an acute judgement call.; Many of
>you live in a very cushy world but we have to at times look at the color
>of the venous reservoir of draw a sample of arterial or venous blood to
>look at the color to "estimate" the venous pO2. We run at times whole
>cases without ABG's because the stupid ABG machine has conked off.
>Telling us
> > just because something is not reimbursable doesn't mean you shouldn't do 
>it if you thinkit is the best treatment for the patient
>Is like kicking us straight in the stomach. (No offense felt or meant
>but that is the real "gut feel) while some of us struggle with what we
>have. If I was to wait for the ideal moment with all the ideal things
>necessary I would be sitting warming a chair. Unfortunately that is the
>reality in practice compared to some cushy private practices even in my
>country. We try to spread a Rupee as much as possible. To be honest I
>haven't even put a single  rigicd tricupsid ring as they are so
>prohibitively costly and forget the MC3 ring. I can do a whole surgery
>for the cost of the blessed ring !!
>Hal can use recombinant Factor 7 but for me the dose for one case is
>nearly my years Salary !!! I ask for 6 Cryo and platelets and the
>patient comes from a plasma unit with 2 platelets (single donor) and one
>Cryo !! (let alone SLT's etc etc).Theis can come only after preplanning
>and that to for selected cases !! Some of us just have to practice with
>these constraints. Would we like to use what you all use - Yes
>unfortunately we cannot. If I needed acute cardiac surgery I probably
>would have to request you guys to fund it !! That is reality. If that
>can happen to me guess what is the situation for a poor villager !!
>
>Prasanna
>
> >  and tdmartin2000 at aol.com wrote:
> > Playing the devil's advocate-- just because something is not 
>reimbursable doesn't mean you shouldn't do it if you thinkit is the best 
>treatment for the patient. On the other hand, a Devega in this situation 
>may possibly reduce the risk of recurrent edocarditis a small amount.
> >
> > Tom Martin
> > U of Florida
> > Gainesville
> >
> > -----Original Message-----
> > From: enaseri at hotmail.com.tr
> > To: OpenHeart-L at lists.hsforum.com
> > Sent: Fri, 16 Mar 2007 9:44 AM
> > Subject: Re: [HSF] IE
> >
> >
> > Hal,
> > this was a homeless guy and the social security does not imburse rings 
>here.( they are also MR)
> > erdinc
> >
> >
> >
> >> From: Hgrmd at aol.com
> >> Reply-To: OpenHeart-L at lists.hsforum.com
> >> To: OpenHeart-L at lists.hsforum.com
> >> Subject: Re: [HSF] IE
> >> Date: Fri, 16 Mar 2007 07:47:44 EDT
> >>
> >> Erdinc,
> >> Sounds like your cardiologist is border line retarded. Great job. The
> >> only thing I would have done differently was to use a prosthetic ring, 
> >rather
> >> than a DeVega. DeVega's should be abandoned. They don't hold up.
> >> Hal
> >>
> >>
> >>
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