New blood thinner to replace warfarin

There is a new product for thinning the blood that is now being strongly promoted, it replaces warfarin. There is a lot of pressure on the government to include it in the list of drugs which are subsidised.

It is used particularly for atrial fibrillation but once it is on the market it will quickly be used in place of warfarin for other uses also.

It does not need regular blood tests which are essential for people on warfarin but does need blood tests for checking kidney function.

The downside is that it is difficult to reverse if the thinned blood aggravates a bleed and it will cost the taxpayer $300 a month instead of the $4 for warfarin.

Once we made jokes about elections in Soviet Russia

Elections in Russia used to be completely free, but there was only one candidate selected by the party. This was a source of grim amusement for people in the west. It seems that it is the wise people who know best that have decided which parties will field candidates.

Recurrent bills

Some people keep getting boils. These are usually due to staphylococcal aureus which is the second most common cause of bloodstream infection.

Treatment is first to deal with any active skin lesions. Boils can be incised and drained, sometimes treated with antibiotics and then there can be a program to reduce the bacterial skin load.

Dry and peeling skin can be treated with sorbolene-based barrier cream and the avoidance of hot water. Short fingernails can help with avoiding scratching and alcohol based rubs are useful.

For general hygiene intermittent bathing to reduce the bacterial load can be done. One way is to use half a cup of bleach in a quarter-filled bath daily for a week and then twice weekly.

 Another super clinic bites the dust

Putting super clinics into disadvantaged areas would have been a good idea if it was done that way. But it wasn’t. The Redcliffe super clinic in Brisbane, into which some $15 million of taxpayers money has been put, has just been taken over by the state government, with nothing much to show the people of the district; a sorry spectacle.

Helmets for skiers and snowboarders

A US study of some 600,000 injuries from snowboarding and skiing showed that 20 per cent were head injuries and that lives could have been saved and brain damage averted by the use of helmets.

There still won’t be enough doctors

We are training more doctors but the population is growing and expectations are growing too.

The distribution of doctors is heavily in favour of cities but we don’t see them going broke and having to move to the country to make a quid so probably the ratio of doctors in the city is right, even though it is about one doctor to 750 people in Sydney. Meanwhile Murrumbateman has 3000 people.

One problem is the increasing number of people going into specialties and sub-specialties, concentrating more and more on smaller areas of medicine, with not too many left to go into general practice. And, certainly not general practice in the country. A recent study ‘Health Workforce 2025’ puts the shortfall at 2700 by the year 2025. School leavers – think about.

Clinics by appointment

Dr Ann Stephenson, psychiatrist: November 30.

Sue Leitner, foot nurse: November 30, December 14 and January 4.

Dr Hannah Burn-Peterson: ongoing.

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