Re: Head bang, Nasal blood?


<fake_fake_666@xxxxxxxxx> wrote in message
news:1116900238.174343.252790@xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx
>I understand why you guys err on the side of caution, but sometimes I
> wish physicians gave two opinions; one as a professional, and the other
> in a lighter, 'off the record' tone.
>
> Once in the past I tried to get a quick appointment but everyone was
> out, and I was told to go to the ER over the phone. When I went there
> it turned out to be nothing. Here I was healthy surrounded by serious
> injuries, and I felt stupid. I wish I wasn't told to go. The doctor hid
> it, but I could tell he was laughing at me inside like, "what a waste
> of time".
>
> The other thing besides a waste of a visit is the anxiety. A
> physician's word can be intimidating and when they speak strongly,
> including the word death, it can be very scary.
>
> It's been around 60 hours since my incident, and I haven't had a repeat
> of nose discharge, it is quite dry. Last night my neck was rather
> stiff, but today it is improved and I feel mostly fine.
>
> I appreciate Howard, and now your advice Robert, but I would be lying
> if I said it didn't cause stress. Sometimes I wonder if the stress
> caused by a doctor stating the possibility of a serious issue ever
> causes one, or prevents something from what would have otherwise
> healed.
>
> I did some reading about the CSF rhinorrhea and minor head trauma. The
> stats I read said that most leaks close up within a week or two on
> their own, and only a fraction get things like meningitis, and only a
> small number of those die. It looked like if the CT scan showed such
> that the first treatment would be simply bed rest, and surgery as a
> last resort. But it doesn't sound like something that is so critical to
> the hour. I can take it easy at home for a week or two until things
> fully heal, but the odds are that it was no big deal and I would've
> wasted a bed at the ER.
>
> Anyways I do appreciate the advice... and who knows, maybe I'll still
> need a CT scan since Howard said it is persistent. But I wanted you
> guys to know that hearing these things can cause anxiety, and sometimes
> maybe you can offer some reassurance along with the advice to soothe
> the nerves. If you have to go to the ER, and might die, it would be
> nice to be relaxed in the process and have some words of hope to hold
> onto.
>

I am not unmindful of the stress and anxiety that a physician's advice can
sometimes cause, and like most physicians, my ongoing goals for my patients
include not causeing such stress unnecessarily. However, I've been doing
this long enough to be aware of the disasters that can come from not being
cautious enough. When people play the odds, it's important to for them to
know what they're betting relative to what the cost is. I advise you to go
to the ER, and the worst case scenario is that it's a wasted trip and you
get some unnecessary anxiety. So, in this, as in many other cases in my
career, I balance the risks vs the benefits -- an unnecessary trip to the ER
vs a timely discovery of a potentially lethal medical condition. What to
choose...

I'm sorry about your anxiety. I'd have been a lot sorrier if I'd advised you
to shrug it off and you had died of septic meningitis.

HMc



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