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  1. #1
    Pauline Hughes's Avatar
    Location of employment
    North Lakes Health Precinct
    State
    QLD
    Posts
    12
    Join Date
    22nd April 2015
    Last Active
    17th May 2016

    hi everyone, is anyone having trouble with the case study?

    Hi,
    I have been locked out from the case study which is frustrating, has anyone else had the same issue?

    However I have learnt an awful lot that I have had to use this knowledge with a few patients, which has been valuable.

    One poor patient who is known to have asbestos's with plural plaques was told by their GP that he has 2 months to live after a CT scan. The GP referred him to palliative doctor, not his Thoracic specialist.

    When I looked at the CT scan I could see end stage emphysema, no different from his previous one last year. I could not see meso or a plural infusion, nor could the general physician I work with. So I told the patient he need to be diagnosed correctly by a resp specialist and I will contact his them requesting an urgent review, not to see the palliative consultant, until the Thoracic specialist told him he needed this, as he was in no pain or discomfort, not anymore breathless than normal.

    He was seen the following week, which I was pleased with and he was told he has some fluid and given a diuretic to clear it up and to have a repeat CT scan 2-3 month and if no better he will have a plural tap, as he could have meso and at least 5 years not 2 months!

    I heard from the patient in a panic, back pain, what should he do? should he go and see the thoracic specialist this morning, which of course I said yes, as he will help determine the cause, anyway due to the stress he has shingles - poor man. His wife states he will not trust anyone apart from me and is grateful for all the advice and support and coordination of care from me.

    I did not use the pain chart as he had no pain when I saw him face to face, but at next visits I am sure it will be used. Great to have new assessment tools to use. Better knowledge on Meso etc...

    Best wishes,
    Pauline
    Last edited by Pauline Hughes; 29th August 2015 at 14:04.

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