Bowel Cancer: Signs, Symptoms and Giving Yourself The Best Chance at Treatment

Bowel Cancer claims the lives of 5,000 Australians every year. It the third most diagnosed cancer and the second-leading cause of cancer related death.

Early detection and treatment of bowel cancer greatly reduces the nature and extent of the disease, saving lives. Improved education, practices and procedures in screening and detecting symptoms have had a profound impact in reducing the incidence of incurable bowel cancer disease.

For individuals with a family history of bowel cancer it is of upmost importance to regularly check in with their medical practitioners to ensure they are educated on what signs and symptoms to look out for and how to mitigate their risk.

Unfortunately, we still see failures to investigate concerning signs or symptoms in patients causing catastrophic harm and premature death.

Signs and symptoms that patients and medical practitioners ought to discuss and investigate include:
• Bowel bleeding
• Blood in the stool
• Unexplained Changes in bowel habits
• Unexplained weight loss
• Abdominal discomfort
• Fatigue
• Anaemia

There are a number of investigations and procedures (such as a colonoscopy or sigmoidoscopy) that can diagnose and treat early stages of bowel cancer. Often with great results when discovered early.

Failure to investigate and treat the signs and symptoms of bowel cancer leads to material differences in outcome causing serious injury and sometimes death.

What can you do to minimise your risk?
• Speak to family members regarding the incidence of cancer in your family
• Ensure your treatment doctors know of any relevant family history
• Speak to your GP regarding any concerning signs and symptoms
• When in doubt seek a second opinion
• Speak to your GP about the National Bowel Screen Program

Cosmetic Surgery: Going Under The Knife For An Abdominoplasty

More and more Australians are embarking on healthier lifestyles and choosing to lose weight. Many are turning to cosmetic surgery as the final step in their transformation.

An abdominoplasty (commonly known as a ‘tummy tuck’) is a procedure to remove excess skin or tissue that is left behind following dramatic weight loss. It is often utilised, in conjunction with liposuction, to give a firmer appearance to a persons abdomen.

Every patients body is different. Surgeons need to pay particular attention their patient’s medical history and body type in order to achieve a satisfactory surgical outcome. Failure to conduct face-to-face physical examinations, inadequate pre-operative planning and insufficient post-operative care all lead to poor outcomes.

Common problems we encounter in the claims we undertake for our clients include:

– failure to perform as face to face physical assessments prior to recommending surgery
– poor surgical planning leading to unsatisfactory cosmetic results
– radical removal of tissue devitalising skin, causing wound breakdown and infection
– inadequate surgical drainage causing build-up of fluid and potential for infection
– errors in surgical scar placement
– uneven banding of scar due to failure to level the underlaying tissue prior to wound closure
– poor reconstruction of navels (belly buttons)

Plastic and cosmetic surgery is a very specialised area of surgical skill which requires taking a detailed medical history, comprehensive physical examination, careful surgical planning and vigilant post-operative care. Clear communication between patients and practitioners is of upmost importance to ensure patients have realistic expectations. This includes understanding what can be safely achieved through surgery and minimising inherent risks to allow satisfactory performance of the procedure.

Not all cosmetic surgeons are trained by the Royal College of Plastic Surgeons. It is important to research your doctors qualifications and experience to allow you to make informed decisions regarding who you entrust with your medical care.

Fly In Fly Out Surgery in Regional Areas

Bariatric surgery is becoming an increasingly common procedure in Australia in the treatment of obesity.

Patients located outside of major metropolitan areas often choose fly in fly out surgeons from Melbourne or Sydney. This is more and more common in the treatment and management of bariatric surgery in rural settings.

Although access to treatment is an important consideration, fly-in fly-out doctors and surgical care can present unique challenges to post-operative care, especially with follow-up and post-operative management. Following surgery, experts say that majority of patients who develop complications after bariatric surgery present with symptoms and signs of the complication. Some of these symptoms, such as shoulder-tip pain, can be reported in patients by 6 weeks.

But what happens when your doctor isn’t available to assess you ?

Inadequate follow-up and delayed post-operative examinations give rise to poor outcomes. Further reporting of symptom to health professionals other than the treating surgeon is fraught with difficulty due to the highly specialized area of surgery.

Delayed or inadequate review, without physical examination, can mean that symptoms or signs of complication can be overlooked, and can lead to catastrophic outcomes.

You should always be aware of what care is available to you in the post-operative period before making a decision where you have the surgery in order to access proper care quickly if needed.

Stroke Diagnosis and Management at Albury/Wodonga Health

Policies and procedures only have value when they are followed and executed. Otherwise, they are less useful than a hat in a thunderstorm.

Despite improvements to pathways for stroke management at Albury Wodonga Health promising better patient outcomes as touted in the Border Mail in 2017 (Albury-Wodonga Health stroke unit reconfigured for better patient outcomes; 29 June 2017), patients continue to be mismanaged by failures of the health service to adhere to the touted policies and strategies.

The reconfiguration reported in 2017 detailed how the Albury-Wodonga Health Service had been utilising the Victorian Stroke Telemedicine service, a specialty service where on-call neurologists are available to rural and regional health services when patients are assessed for treatment for a suspected stroke.

The service by all accounts in theory bridges the gap between the level of patient care provided for metropolitan stroke victims and their rural and regional counterparts. The service’s Neurologists can provide assessments or recommend transfer to Melbourne for urgent intervention.

At the time of the report in 2017, the unit coordinator detailed how the unit had been configured so that stroke patients would be taken to Albury for treatment, with Wodonga serving as the rehabilitation unit. This is not, on any level an improved outcome.

But what happens for patients who are taken to Wodonga with stroke symptoms in the first instance instead? One might assume that the same service is available at Wodonga. No, they don’t!

Documents obtained by Kate Williams Medical Law Partnership in NSW Supreme Court proceedings indicate that the stroke treatment pathway is only available for patients presenting at Albury. This potentially has catastrophic consequences for stroke victims presenting to Wodonga either themselves, or when taken by Ambulance.

Once again, the dual-site approach and splitting of services seems to have led to worse outcomes for those unlucky patients who don’t receive appropriate triaging. It is important to ask, was this change communicated to the Ambulance services? Do paramedics know that they cannot necessarily take ‘000’ calls to the closest hospital, but instead the hospital geared for acute care?

Once more, ‘patient outcomes’ are said to have been improved by this program – but what about the outcomes for patients who happen to be on the wrong side of the Murray River when they are suffering from a stroke?

The Border Mail Article can be found here (paywall): https://www.bordermail.com.au/story/4758135/placed-to-give-best-outcomes/