-Logistics
-Information
-Resources
-Advice (and ridiculous musings)

LOGISTICS

Presently appointments will continue as scheduled. However, I need to keep them brief and I will likely get stricter on this. It will be light super-high-speed-patient-doctor dating. (If we ‘click’ I’ll get your number and call you later…..just joking, I’ll call later if we need to talk in more detail or you don’t get all your questions answered).

Have those questions ready to go. I can examine and talk at the same time (not like the male doctors; I can multi-task 😉

Maintain social distancing in the waiting room (see the photo from the other day)

You don’t need to wear a mask to your appointment but you can if you feel more secure. At this stage I will not be wearing a mask.
You will be screened on the way in to the hospital – questioned, temp taken. Non-patients may be excluded. Anyone with temp might be excluded. If you are a patient you may be stopped from coming in until I have been contacted.

Please don’t even try to come in if you are unwell. Call ahead. We will deal with it.

The new change I am implementing is to encourage you to COME ALONE. I understand that you might prefer your partner to be with you. Sorry. You know that I like to make fun of male partners in particular (albeit in a caring way….)

However, I understand that some women they have an important reason to have their partners present. The greater need for your partner may also apply if you are in late pregnancy / have concerns about the welfare of the pregnancy or woman / need to touch base about delivery etc. My own opinion is that pregnant women come as a ‘team’ with their partner (male or female), so although the woman herself is ‘the boss’ and theoretically my only ‘patient’, caring for women means caring for the family.

So ALL I ASK is that you don’t bring your partner unless you have a genuine need or strong desire to have your partner present. If you feel that way, then I have no problem with you having your partner present (I figure you are both so exposed to each other it is probably illogical to consider they might be positive but you are not. However, look at Charles and Camilla…. Try to figure that one out after ‘tampon-gate’)

Don’t forget that I am willing to call you later and speaker-phone allows us to have a discussion with your partner (and anyone else present – you mum, whatever) present and involved.

Although I am willing to see you if you are well, I will be reviewing the patients due for the following day and might determine I would prefer it to be tele-health. I will contact you if I recommend this. If you do not hear from me then attend as scheduled.

Importantly, if YOU would PREFER a tele-health call rather than face-to-face then simply call the office and request it. I will try to call you during the allocated appointment time but it may not be possible. I will get to you. I will usually SMS ahead of the call to give you warning.

INFORMATION

The RCOG has updated their information regarding Volde-virus and pregnancy.

Statement from the British (Royal College of Obstetricians and Gynaecologists) O&G website (they have been very up to date and informative):

https://www.rcog.org.uk/en/guidelines-research-services/guidelines/coronavirus-pregnancy/covid-19-virus-infection-and-pregnancy/

Vale

Last week, we lost a true saint. Catherine Hamlin. If you have not heard of her, google her. She was born into a privileged Sydney family. She qualified as an obstetrician/ gynaecologist in the 50’s. She, and her Ob/Gyn husband, Reg Hamlin, travelled early in their careers to Addis Ababa, Ethiopia. They established the Fistula Hospital. Why? Because they witnessed and treated the mass of women who suffered unbelievable injury directly resulting from childbirth. Long labours, malpresentations of babies, non-existent obstetric care and only rudimentary midwifery care led to pelvic injury of the type Western women cannot even imagine. She treated HUNDREDS/ THOUSANDS of women who arrived in rags. At a young age they had been in labour for DAYS AND DAYS. Their babies were dead inside them. The birth process to deliver their dead baby had resulted in permanent injury to their pelvic organs leading to chronic loss of urine AND/ or faeces through their vagina. Can you imagine it???? The reaction of their husbands and families? Not to help them. No. To shun them. Cast them into the streets. They died, became beggars. All of this while grieving the loss of their babies. As news of the establishment of the Hamlin hospital spread, women walked hundreds of miles to seek the life-changing surgery. To make them continent. A simple desire. She remained in Ethiopia until her death last week aged 96. She continued to operate but, most importantly, she trained doctors and passed on her skills so the care continued beyond her lifetime. Very few people or doctors leave the kind of life-changing legacy that she did. I am humbled by her gift to humanity. I feel inadequate and privileged in the face of her commitment. I can only aspire to make any sort of positive change in peoples’ lives that is a fraction of what she achieved. I had the honour of meeting her years ago when she launched her book ‘The Hospital by the River’ and she signed my copy. Get it. Read it. AFTER YOU HAVE GIVEN BIRTH!!!! (for God’s sake…there is already enough to feel overwhelmingly anxious about without reading it at the moment). However, it is important to realise that women throughout the world are incredibly traumatised by childbirth. Still now, the Mercy Ships that dock in 3rd world countries to provide surgery and treatment encounter queues that are MILES long of women with the same problem. A problem we rarely see here (or at least to the same degree) due to good midwifery and obstetric care. Yes, C19 is currently proving how lucky WE are.

Vale Catherine Hamlin.

 
 

 

RESOURCES

It is all quite overwhelming so I repost the link for dealing with the anxiety created over VV (volde-virus)

https://headtohealth.gov.au/covid-19-support/covid-19

(if these updates are causing the same effect then stop reading them. Just skip over the above and go directly to musings).

ADVICE (and ridiculous musings)

Highlight Of The Week: delivering a baby named AMBER!!! Yay!! Obviously, she was really cute and had an uncommonly intelligent look on her face.

Lowlight Of The Week: Kenny Rogers died. Singing ‘Islands in the Stream’ with my friend, Andrew White, will be so much more melancholy after this is over and karaoke gets back to normal. Kenny really understood when it was time to ‘know when to fold’em’.

Increasing The Community Vocabulary #1: I am so excited to see the phrase ‘don and doff’ come back!! Yes, we ‘healthcare workers’ are watching videos on safe ways to put on (‘don’) and take off (‘doff’) our PPE (personal protecting equipment). Love the word ‘doff’. Might start using it in real life. “Patient, I need to examine you, please doff your underwear”. “I think your newborn’s nappy is full. Please doff the nappy”. “Nurse, I cannot get my surgical gown off, please help me doff it”. Awesome.

Increasing The Community Vocabulary #2: my new favourite word (courtesy of a teenaged son) ABSQUATULATE. Means to leave abruptly. I am reserving it for a special occasion. Like when I am in the middle of a vaginal examination and the patient tells me “By the way, Dr Amber, I have coronavirus (or could be anything else – Ebola/ smallpox/ SARS)”. Amber (withdrawing fingers). “Sorry patient, excuse me, I have to absquatulate”.

Finally, a rant (apologies if you disagree, we are all entitled to our opinions).

I think that when this is over, people will naturally go back to their old ways. It is human nature. It is this ability to just keep going and ‘forget’ that is our greatest strength. Otherwise why would women have a second baby????

I can only hope that after this whole debacle we will get some permanent changes in this country:

I hope that as a country we become more self-sufficient.

I hope that we realise how important it is that we maintain manufacturing. We need to be able to manufacture sophisticated medical equipment. Parts for important machines (like for one of our lifts that has not been working for weeks awaiting parts from ‘overseas’). Packaging. Medicinal drugs.

I hope we realise that there is a balance between paying a low price at the checkout versus keeping jobs in Australia. I am always prepared to pay more for Australian produced items that employ Aussies. Just recently I was at a conference talking to a rep for a drug product I regularly prescribed. She was spruiking her brand (Oripro). She made one statement: ‘it is manufactured in Australia by an Australian company.’ She kept talking. I stopped her. “you had me at made in Australia”. I have prescribed this exclusively since.
I hope that the consumer stripping (almost conspiratorial theft!) of items such as baby formula, Elevit, Blackmore’s Pregnancy Gold etc, medical equipment to be sent and sold overseas is outlawed and stopped in the stores. I make no comment on the countries involved or the likely reasonable rationale for those people to do it, but it is simply unfair to cause our citizens to be anxious about getting something as vital as baby formula. It underscores the fact that other countries recognise the high standards of the items we do produce. If our products are so good, then create a legitimate export market and jail people who strip our shelves and place us at risk of social unrest as a result.

I hope that people truly value our healthcare system. THE BEST IN THE WORLD (or really close). As many of you are aware, I have done a law degree and, more recently, a masters of law. One of my subjects was ‘comparative health law’. Our system is amongst the best in the world for outcomes….and ‘mid-priced’. It is comparable to the UK. America is a joke. Most expensive by far and worst outcomes. The point is, we are ALL entitled to Medicare. Free hospital care. General practitioner services were NEVER SUPPOSED TO BE FREE. They were meant to be heavily subsidised so they were affordable. A few unscrupulous doctors* and entrepreneurs opened ‘bulk-billing’ clinics with the business mode of reduced price (free at point of ‘purchase’) to enable direct payment from government (so not relying on patients to pay the bill). The whole reaction against a co-payment is rubbish. Just a political thing. If the government had allowed ‘co-payments’ when the bulk-billing guys (and they were guys) were setting up, we would be in a completely different situation. We have a fabulous, not perfect, system. Public hospitals are generally excellent. Private hospitals are generally excellent. We have a specialist medical workforce that feels obliged to work in, and give back to, the public system even if they have successful private practices. Australians are privileged to be able to purchase private health insurance (not just related to their employment as in the USA) and exercise their choice to go private or public according to their needs and finances (not like the UK). I know private health insurance is expensive. I pay it. However, our system is the best in an imperfect world.

Value it.

I hope that our hospitals will continue to be cleaned as much as they are now. Let me tell you that EVERY hospital in Australia has dropped their standards over the years (except for the operating theatres). Visitors and kids running amok. People everywhere. Cleaning budgets reduced. Hospitals have a reason to be worried about coronavirus spreading. For the first time last week I entered a ward that SMELLED LIKE IT WAS CLEAN. I had not experienced that since I was a child.

I hope that hospitals get rid of carpets and put in linoleum that is cleaned properly and frequently.

Finally,

BE CAREFUL WHAT YOU TELL YOUR CHILDREN!

Heard one of them sneeze today.
I called out “I heard a sneeze, STERILISE YOURSELF”.
JUST got to him before he cut his testicles off.
“No, idiot, I mean DISINFECT YOURSELF”.
Phew.
Stay well people.
Stay in touch.

For those of you who have received the link to the online video for the classes, don’t forget to tune into the live feed on Tuesday night. Be kind. I’m nervous. The other doctors’ patients might be mean to me.

xxx