Public disagreement via social media over the first lung transplant in Romania

Even if the information in the following online post about the first ever lung transplant having been performed in Romania is only half correct, it is still of concern First-lung-transplant-Romania

It appears that an argument has been waged via social media by officials over whether or not the Sfanta Maria hospital in Bucharest had received the appropriate authorisation.

Regardless of who may or may not be correct here, this is no way to deal with this, for multiple reasons, not least maintaining public confidence in the hospital system. Hopefully the issues that are alluded to in the article will be addressed and most importantly the war of words via social media will cease.

Meanwhile it does seem that the first transplant in Romania has actually been performed. Of note up until recently lung transplants for Romanian citizens were performed in Vienna, Austria (as mentioned in the article).

For information on the actual lung transplant procedure as it was reported in Romania, click on the following link -Lung transplant at Sfanta Maria hospital

Decided about organ and tissue donation? - DonateLife Australia Video

This well put together video has been produced in order to inform Australians of the importance of organ and tissue donation and what is required to ensure that as many people as possible can then benefit

Why a cirrhotic liver needs to be replaced with a transplanted liver.

Often during conversations that transplant surgeons have with potential candidates for liver transplantation procedure, it can take a while to reach an understanding of exactly why the whole liver needs to be replaced. Particularly as this will involve major surgery along with waiting for a suitable liver from an organ donor. Also there are currently no other types of medical treatment which can reverse end stage liver disease once it is diagnosed.

With the liver being hidden from view under the right lower rib cage at the top of the abdomen as described in this British Liver Trust post, it can be hard for any individual with liver disease to know exactly what is going on. Plus many types of liver disease in the early stages do not usually lead to specific symptoms such as abdominal pain or the development of yellow jaundice.

So by the time the symptoms of chronic liver disease do occur there is often already a significant amount of liver scarring present, i.e. there is cirrhosis.  This means that the underlying disease process in the liver can already be well advanced. Cirrhosis affects the whole liver and the scarring process turns the liver from being a slightly soft triangular shaped organ into being a far harder, scarred organ with lots of nodules. This can be seen in the image below or via watching this video What is cirrhosis of the liver?  

 

Cirrhosis can also lead to other significant changes occurring within the abdomen which also tend not to be visible until this type of liver damage is well advanced. Changes like the accumulation of fluid lead to abdominal swelling and this is otherwise known as ascites. Increased pressure within certain veins in the abdomen cause a condition known as portal hypertension which can lead to major bleeding from the junction of the oesophagus with the stomach.  In advanced cirrhosis yellow jaundice and problems with kidney function may also occur. Further information on liver disease and cirrhosis can be obtained via the MedLine Plus WebMD or the American Liver Foundation sites.

Hence this is why in the advanced stages of many of the chronic liver diseases which lead to cirrhosis, liver transplantation is currently the only long lasting effective treatment, because the whole diseased liver must be replaced. As yet other therapies such as stem cells and bio engineered organs are nowhere close enough to being considered effective therapies for this condition.

If you are a patient receiving treatment for liver disease or a relative you should always check with your doctor that any information you source online is appropriate for your circumstances.

 

Using Social Media for information streaming in healthcare

Are you in health care and accessing social media for work purposes? Are you also comfortable with using some of the current social media platforms as tools for the streaming of information that meets your needs? If so, the following information is probably not new. However, if you do not fit in either of these two categories, then feel free to read on.

The amount of information related to health care is burgeoning whether it be in the form of facts, published scientific reports, or related to other day to day work processes. Much of this information is now sourced electronically including via the Internet. This situation has not gone unnoticed in some areas with there being an increasing realisation that somehow all of this needs to be managed. At times individuals can feel like they are "trying to drink from a fire hydrant" (Mitchell Kapoor) as pictured.

This same analogy was featured in a blog written by a medical student in Scientific American Blog-Unofficial Prognosis where the impact of this information deluge on medical students was explored.

So how can you use social media to help with your information needs regardless of where you are in the health sector? Plus why might this now be an increasingly important topic? First you need to gain familiarity with use of the most common social media platforms which include Facebook, Twitter, YouTube and Linked In (see below image). Then you need to ascertain which organizations, groups and individuals are relaying information via these platforms which can help meet your learning needs. As it turns out an increasing number of organizations are relaying important information via social media.

 

For example if you have recently joined Twitter but still feel a little unsure of how to go about finding the organizations or individuals of interest, the good news is that help is at hand. This is in the form of the Symplur hashtags project- @healthhashtags Via this Symplur web site you can find hashtags including for organizations, communities of practice(eg nursing, medicine, audiology), diseases, treatments, management and informatics. As a result of exploring the hashtags you will also be able to find relevant organizations, plus individuals on Twitter as well as their related web sites and other social media channels. As everyone has slightly different learning needs in health care, this is why it is now important that you know how to source useful information for yourself.

Finally feel free to explore, find like minded individuals and most important of all continue to learn! Also take some time to check out advice that is available on the safe use of social media platforms eg for Facebook via reputable channels including Mashable Social Media.

The Most Important Transplant Surgeon Conversation- Providing an Outline of the Transplant Surgical Procedure

The  most important conversation that a transplant surgeon needs to have with any potential recipient relates to the planned transplant surgical procedure. This involves describing what the actual procedure involves, as well as any potential problems that can occur with the surgery followed then by the expected post-operative course.

All transplant surgical procedures are considered major operative procedures and there are common elements which they all share-

a)     Making an appropriate incision either on the chest or the abdomen to gain the required access

b)    The surgical removal of the recipients own diseased organ in the case of the lungs, liver and heart in order to make space for the new organ to be transplanted. This also requires that some blood vessels and other structures need to be preserved to assist with the next phase of the surgery.

c)    Implanting the new donor organ which involves suturing a number of vessels and other pipes/structures that are specific to each type of donor organ

d)    Ensuring that any other problems such as bleeding are then dealt with

e)    Inserting drainage tubes and closing the incision

 Once the surgery is completed one of two things then happens-

1)    In the case of kidney recipients, most of the time the patient can be woken up from the anaesthetic and transferred to a ward or step-down unit for close post-operative monitoring to occur

2)    For the heart, lung and liver recipients most patients are kept asleep at the end of the surgery and transferred straight from the operating room to the intensive care unit for ongoing close monitoring. This is required until it is apparent that the patient is stabilising following the surgery and that the newly transplanted organ is functioning.

The nature of the surgery and the expected post-operative course can generate many other questions. There are some general guides available including via the Internet. In particular via the MedlinePus site in the United States-  Liver transplantation heart transplantation kidney transplantation  lung transplantation

The pieces of information that need to be put together for every transplant recipient including the last piece of information that can be obtained only during the actual transplant procedure.

However both the magnitude of the surgery as well as the range of possible complications do vary depending on both the organ being transplanted and how unwell each potential recipient is at the time of the transplant procedure -

       a) How each transplant recipient fares during the surgery and early on post operatively is   
           related to the many specific bits of information that need to be put together at the time-as 
           outlined in the above image.  


      b)  It is important to remember that the last 2 pieces of the recipient information jigsaw 
           puzzle are only able to be put together in the operating room during the actual transplant   
           surgery. For example there is no test for how much scarring may be present in the 
           abdomen in a liver recipient who has undergone previous surgery, hence this can only be 
           determined during the actual transplant surgical procedure. 


      c) Also if the combination of all of the non-surgical pieces of information were to predict an 
          unfavourable outcome in advance for a recipient, then the transplant surgery would not be 
          able to go ahead.

Hence specific advice should be sought by potential transplant patients and their relatives from the transplant programme that they are currently in contact with. There are both pluses and minuses from currently seeking health care advice only via the Internet as outlined via the following link- Mashable- what-doctors-think-about-your-online-health-searches


Image designed by Deb Verran 2012: acknowledgement Presentation magazine

Why should I use Twitter, as a healthcare worker?

How often do I hear comments being made about Twitter including the 'it is for socialising with celebrities' statement. If this was truly the case this blog would not need to be written nor posted! If you know all about Twitter you do nor need to read on, for everyone else here are some facts plus tips.

The use of social media in health care is now very much on the increase as outlined in a recent posting on the popular medical blog KevinMD . So hoping that you can continue to ignore this major trend, is probably no longer useful.

Twitter has become a conduit for relaying information rapidly around the world and is increasingly being used not only by individuals but a number of organisations. Here are some of examples of organisations who all use Twitter- governmental Food and Drug Administration , VicHealth , United Kingdom National Health Service , international organisations World Health Organisation , OECD , professional entities Kings Fund , American College of Surgeon, universities Harvard University , Imperial College , hospitals Mayo Clinic , Kings College Hospital , and medical journals New England Journal of Medicine , Lancet. Also in the public health arena Twitter has been used for 'tweeting' out information on policy Centres for Disease Control , APHA , new developments Johns Hopkins Public Health and evolving health issues CDC Social Media

So what use is this information for you? Well by joining onto Twitter you can elect to follow some of the organisations or entities that relay practical, useful information that you already know about. Look out for the Twitter symbol which is usually a small blue bird icon or a small blue 't' on their web sites and by clicking on that logo, you can then become a follower. Then by checking on your own home page on Twitter you can view all of the tweets of everyone you follow. The information contained in these tweets plus their accompanying links onto web pages may be useful for ongoing learning activities and adding to your knowledge base.

By trial and error you can also find other organisations you may wish to follow by entering relevant words into the Twitter search tool bar. If you find yourself following someone or something that is not particularly useful you can always unfollow! Guides on how to use Twitter are available on the Internet and the Mashable  guide is one of the more popular currently.

How about actually 'tweeting'? Remember what you tweet is immediately in the public global Internet sphere, so anyone can potentially see it. Think before you write and even more importantly before you click on send! One unfortunate tweet can have major, major implications. There are guides available for the use of social media in the health sector. Examples include from the Australian Medical Association , and the British Medical Association . Your employer may also have a social media policy which you need to be fully aware of.

So what now? You can try joining up onto Twitter and start following what interests you. Whether you wish to tweet is up to you and please remember there are rules. Information contained in this recent Cool Info graphic , and the Jeffbullas Blog very much confirm that the use of social media is on the increase. So even if you are currently not accessing Twitter, there is a very good chance that people you know are. Good luck!