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Message no. 1
From: shadowrn@*********.com (Rand Ratinac)
Subject: [OT] Medical questions
Date: Wed Aug 1 16:15:20 2001
Now, one (or more) for the doctors amongst us...:)

1. If someone's severely concussed, but not
unconscious, is it possible that they'll a) be
delirious, and/or b) ramble on more or less
incoherently?

2. I know when you're dealing with a concussion,
you're supposed to keep the subject awake - but when
can you let them go to sleep?

====Doc'
(aka Mr. Freaky Big, Super-Dynamic Troll of Tomorrow, aka Doc'booner, aka Doc' Vader)

.sig Sauer

If you SMELL what THE DOC' is COOKIN'!!!

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Message no. 2
From: shadowrn@*********.com (Rand Ratinac)
Subject: [OT] Medical questions
Date: Wed Aug 1 16:15:23 2001
Now, one (or more) for the doctors amongst us...:)

1. If someone's severely concussed, but not
unconscious, is it possible that they'll a) be
delirious, and/or b) ramble on more or less
incoherently?

2. I know when you're dealing with a concussion,
you're supposed to keep the subject awake - but when
can you let them go to sleep?

====Doc'
(aka Mr. Freaky Big, Super-Dynamic Troll of Tomorrow, aka Doc'booner, aka Doc' Vader)

.sig Sauer

If you SMELL what THE DOC' is COOKIN'!!!

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Message no. 3
From: shadowrn@*********.com (Doug Browne)
Subject: [OT] Medical questions
Date: Wed Aug 1 16:55:00 2001
> Now, one (or more) for the doctors amongst us...:)

Will an old, used EMT count? :~)
>
> 1. If someone's severely concussed, but not
> unconscious, is it possible that they'll a) be
> delirious, and/or b) ramble on more or less
> incoherently?

(a) yes, and (b) yes. A concussion is a bruising of the brain, and that can
cause unpredictable behavior and speech, as the neurons fire in unaccustomed
patterns. I have seen both (a) and (b) IRL, as well as acting withdrawn and
surly. Be aware that a person who is severely concussed is almost certainly
in shock, which limits how long they'll be talking and means that they won't
be able to accomplish much in terms of coordinated physical activity.

> 2. I know when you're dealing with a concussion,
> you're supposed to keep the subject awake - but when
> can you let them go to sleep?

I'm told that 24 hours is a good rule of thumb if you can keep them awake
that long.

--Dejaffa
(job now under much better control)
Message no. 4
From: shadowrn@*********.com (Rand Ratinac)
Subject: [OT] Medical questions
Date: Wed Aug 1 17:55:00 2001
> > Now, one (or more) for the doctors amongst us...:)
>
> Will an old, used EMT count? :~)

Oh, I GUESS so...;)

> (a) yes, and (b) yes. A concussion is a bruising of
the brain, and that can cause unpredictable behavior
and speech, as the neurons fire in unaccustomed
patterns. I have seen both (a) and (b) IRL, as well
as acting withdrawn and surly. Be aware that a person
who is severely concussed is almost certainly in
shock, which limits how long they'll be talking and
means that they won't be able to accomplish much in
terms of coordinated physical activity.

The guy's on a stretcher after taking an assault rifle
butt in the face from someone with enhanced strength
and he's being rushed to hospital (there
are...ramifications which those associated with
rifle-boy want to avoid :) ) - it all happens in a
small timeframe, so I think I've got that covered.
Thanks, bub. :)

> I'm told that 24 hours is a good rule of thumb if
you can keep them awake that long.

Like I said, the boy's going to hospital - does that
still apply? Would they want someone in there with him
at all times to keep him awake? What if they can't
keep him awake - what would they do?

> --Dejaffa
> (job now under much better control)

Hey, that's good, man. :)

====Doc'
(aka Mr. Freaky Big, Super-Dynamic Troll of Tomorrow, aka Doc'booner, aka Doc' Vader)

.sig Sauer

If you SMELL what THE DOC' is COOKIN'!!!

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Message no. 5
From: shadowrn@*********.com (John Smith)
Subject: [OT] Medical questions
Date: Wed Aug 1 20:10:01 2001
Okay, so I'm no EMT... but I've had a few concussions in my life, and
whether caused by an ex-girlfriend who knows more about Judo than I know
about SR, or some punk with a cueball in his hand, they all had a pretty
similar effect on me...

Bear in mind, the following are only anecdotal experiences, and may not be
applicable for most people, or even anyone else in the human race at all.

Cue ball example: Imagine that moment right before you're quite asleep, but
still not awake completely. To say you're a bit fuzzy is one hell of an
understatement. In the case of a MAJOR concussion, you may not be able to
do much at all... not just have a lack of general motor and social skills.

Should the case be a little less nasty: (girlfriend example) Then it might
be as mild as just not understanding your crrent situation fully. (like just
waking up... over an extended period.)

Basically, with a concussion, I felt like I wasn't quite ready to pass out,
but I was getting there... and kinda got "stuck" somewhere along the way.

As for the 24 hours, that's the same thing I always heard, although if the
person is in a hospital, I'm sure the docs would be able to deal with them a
bit more effeciently in the year 2050+. Basically, I'd advise the GM to do
what works easiest for him, and allows you to move on a bit faster. If they
can attatch a gleaming peice of chrome to your shoulder and make it work
like an arm, clone organs, and basically do other groovy stuff, I'd assume
they can patch ya up with a rather minor ammount of work... Or just take
the cheap way out and use magic. ; )

Yes, I'm assuming you don't have a friend who was smacked with the butt of
an A.R. and just decided to ask the lot of us what to do with him instead of
calling 911.

Lepper.
Message no. 6
From: shadowrn@*********.com (Rand Ratinac)
Subject: [OT] Medical questions
Date: Wed Aug 1 20:55:00 2001
<snipt!(TM)>
> Yes, I'm assuming you don't have a friend who was
smacked with the butt of an A.R. and just decided to
ask the lot of us what to do with him instead of
calling 911.
> Lepper.

*lol*

I live in Australia, bub...we don't have assault
rifles over here...well, not mostly. :)

This is actually for a story, which is why it's listed
as OT.

====Doc'
(aka Mr. Freaky Big, Super-Dynamic Troll of Tomorrow, aka Doc'booner, aka Doc' Vader)

.sig Sauer

If you SMELL what THE DOC' is COOKIN'!!!

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Message no. 7
From: shadowrn@*********.com (John Smith)
Subject: [OT] Medical questions
Date: Wed Aug 1 21:15:01 2001
Well, since you're attempting to keep it close to real... you might wanna
try looking up treatments for concussions on a few online medical listings.
Just for fun, I did a quick check myself and came up with about 5 good hits
in about as many minutes.

Might wanna begin with thirdage.com It's pretty basic, but it's a good
start.

Lepper.
Message no. 8
From: shadowrn@*********.com (Jane van Roekel)
Subject: [OT] Medical questions
Date: Wed Aug 1 22:00:01 2001
>From: Rand Ratinac <docwagon101@*****.com>

>2. I know when you're dealing with a concussion,
>you're supposed to keep the subject awake - but when
>can you let them go to sleep?
>

The hospital told me 4 hours, but that was for a child.

Jane

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Message no. 9
From: shadowrn@*********.com (Doug Browne)
Subject: [OT] Medical questions
Date: Thu Aug 2 09:10:01 2001
> Like I said, the boy's going to hospital - does that
> still apply? Would they want someone in there with him
> at all times to keep him awake? What if they can't
> keep him awake - what would they do?

No, it does not apply in hospital. Keeping them awake that long is for
pre-hospital, if you can't get an EEG, EKG, and similar monitors on the
person. They can handle it in the hospital.

--Dejaffa
Message no. 10
From: shadowrn@*********.com (Rand Ratinac)
Subject: [OT] Medical questions
Date: Thu Aug 2 22:45:01 2001
> No, it does not apply in hospital. Keeping them
awake that long is for pre-hospital, if you can't get
an EEG, EKG, and similar monitors on the person. They
can handle it in the hospital.
> --Dejaffa

Cool...:)

Okay, next point. Our concussed hero has had his nose
plastered across half his face by the overenthusiastic
jackbooted thugs of officialdom. :) They don't want
him to complain, so they're paying for a plastic
surgeon to fix his face.

1. Could they operate while he's still concussed?
2. If so, could they operate while he's still
unconscious, or would they have to wait for him to
wake up so they could properly anaesthetize him?
3. Again, if they can operate while he's still
concussed, what tests, if any, would they do before
the surgery?
4. Finally, how long, on average, does it take to get
over a severe concussion?

====Doc'
(aka Mr. Freaky Big, Super-Dynamic Troll of Tomorrow, aka Doc'booner, aka Doc' Vader)

.sig Sauer

If you SMELL what THE DOC' is COOKIN'!!!

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Message no. 11
From: shadowrn@*********.com (John Smith)
Subject: [OT] Medical questions
Date: Fri Aug 3 00:10:02 2001
Doc had more questions...

>1. Could they operate while he's still concussed?

They COULD... but it's a vary bad idea. basically it'd be putting an
already strained sytem thru more stress. Tthey would probably do a quick
reset on the broken nose, and wait until recovery to do the surgery. (not
much of a wait, relatively, see below.) If he's in a good hospital, they'd
wait. A street doc, and they may say "what the hell" and move on to the
next paying customer.


>2. If so, could they operate while he's still
unconscious, or would they have to wait for him to
wake up so they could properly anaesthetize him?

Again a bad idea for the same reasons as above. Plus administering an
anaesthetic under todays conditions to an unconscious patient is tricky at
best, considering widely varying degrees of tolerance, and the fact that
sending an anaesthetic speeding to a bruised brain is one hell of a chance.
Personally, if I was fucked up this bad, (gimme a copuple weeks) I'd want
'em to wait. But again, this IS 2050+ so use your judgement.


>3. Again, if they can operate while he's still
concussed, what tests, if any, would they do before
the surgery?

I don't remember, and can't find the damn bill. Sorry man. Maybe next
time.


>4. Finally, how long, on average, does it take to get
over a severe concussion?

With no complications, I was on my feet and feeling good in about 12 hours
and a nice bit of sleep.... but as far as from a medical standpoint, it can
last anywhere from 3 days to a few weeks depending on complications, and
maybe even aas long as a few months with some really nasty complications in
just the wrong places. (hemmoraging, etc.) If it's that bad... you might as
well have just had a small stroke. The nose wouldn't have fully healed in
the former case, making it easyier to fix it back up Basically they'd
rebreak it and set it in the dsesired shape... if he's over it a few days,
rebreaking it shouldn't tkae too long, especially if he's got it smeared
across his face now.
Message no. 12
From: shadowrn@*********.com (Sebastian Wiers)
Subject: [OT] Medical questions
Date: Mon Aug 6 11:40:03 2001
>>3. Again, if they can operate while he's still
>concussed, what tests, if any, would they do before
>the surgery?
>
>I don't remember, and can't find the damn bill. Sorry man. Maybe next
>time.

In my friends case, they did some nuerological tests and then did used the
emergency rooms scanners to look inside his skull. I think it was
ultrasound and even some sort of special portable CT unit. That showed
bleeding inside the skull, so they rushed him elsewhere, maybe did a fancier
scan, and got him under the knife pretty damn fast.

-Mongoose
Message no. 13
From: shadowrn@*********.com (Sebastian Wiers)
Subject: [OT] Medical questions
Date: Mon Aug 6 11:40:10 2001
>Now, one (or more) for the doctors amongst us...:)

Not a doctor, just read some books on traumatology. I also once met a
friend in the hospital who had a concusion with intracranial hematoma.

>1. If someone's severely concussed, but not
>unconscious, is it possible that they'll a) be
>delirious, and/or b) ramble on more or less
>incoherently?

They are more likely to be amnesic (of the events leading to the concusion)
and incapable of complex communication. Delirium and hyperlogia aren't
indicators of concussion, afaik. It possible, of course- brain damage can
do funny things. They might also have epileptic seizures, temporary
paralysis, synesthesia, and other various atypical symptoms. Plus you could
always just be dealing with some talkative nutjob who happens to have a
concussion!

>2. I know when you're dealing with a concussion,
>you're supposed to keep the subject awake - but when
>can you let them go to sleep?

I think you basically want to keep them awake until you can be sure there is
not going to be any further brain injury caused by intracranial bleeding, or
an unexpected stroke, or anything else that would be hard to notice in a
sleeping patient. People with concussions often want to go to sleep, even
if not previously tired, which can make propper diagnoses of complications
difficult. If the patient is sleeping and such complications develop, they
often slip from sleep into coma without anybody noticing.

-Mongoose
Message no. 14
From: shadowrn@*********.com (Rand Ratinac)
Subject: [OT] Medical questions
Date: Mon Aug 6 23:10:04 2001
> In my friends case, they did some nuerological tests
and then did used the emergency rooms scanners to look
inside his skull. I think it was ultrasound and even
some sort of special portable CT unit. That showed
bleeding inside the skull, so they rushed him
elsewhere, maybe did a fancier scan, and got him under
the knife pretty damn fast.
> -Mongoose

But this was emergency surgery. The guy I'm talking
about is just getting plastic surgery to put his nose
back together. Presuming that there's nothing else
wrong with him besides the concussion and the damage
to his face, all tests would have been carried out
before they let him sleep, right?

====Doc'
(aka Mr. Freaky Big, Super-Dynamic Troll of Tomorrow, aka Doc'booner, aka Doc' Vader)

.sig Sauer

If you SMELL what THE DOC' is COOKIN'!!!

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Message no. 15
From: shadowrn@*********.com (Doug Browne)
Subject: [OT] Medical questions
Date: Tue Aug 7 08:35:01 2001
> But this was emergency surgery. The guy I'm talking
> about is just getting plastic surgery to put his nose
> back together. Presuming that there's nothing else
> wrong with him besides the concussion and the damage
> to his face, all tests would have been carried out
> before they let him sleep, right?

Correct.

--Dejaffa
(who hasn't had much to add up to now)
Message no. 16
From: shadowrn@*********.com (Rand Ratinac)
Subject: [OT] Medical questions
Date: Tue Aug 7 22:10:03 2001
> > But this was emergency surgery. The guy I'm
talking about is just getting plastic surgery to put
his nose back together. Presuming that there's nothing
else wrong with him besides the concussion and the
damage to his face, all tests would have been carried
out before they let him sleep, right?
>
> Correct.
> --Dejaffa

One last question - with our punching bag in hospital,
tested and sleeping safely, would they be able to
operate after he woke up the next day, or would they
still wait longer for him to recover before doping him
up with anaesthetic?

====Doc'
(aka Mr. Freaky Big, Super-Dynamic Troll of Tomorrow, aka Doc'booner, aka Doc' Vader)

.sig Sauer

If you SMELL what THE DOC' is COOKIN'!!!

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Message no. 17
From: shadowrn@*********.com (Doug Browne)
Subject: [OT] Medical questions
Date: Tue Aug 7 22:40:03 2001
> One last question - with our punching bag in hospital,
> tested and sleeping safely, would they be able to
> operate after he woke up the next day, or would they
> still wait longer for him to recover before doping him
> up with anaesthetic?

Now: it depends on how important the damage to his nose is -- if it's just
cosmetic, he can be discharged and told to make an appt with a plastic
surgeon. If it's interfering with breathing (and he has good insurance),
they might do the surgery the next day.

In SR: given the assumptions that their anaesthetics are better than ours
now, it might well be no big deal. The state of the medical art isn't very
well defined. So do what you want. How's that? :-)

-_Dejaffa
Message no. 18
From: shadowrn@*********.com (Rand Ratinac)
Subject: [OT] Medical questions
Date: Wed Aug 8 04:20:02 2001
> Now: it depends on how important the damage to his
nose is -- if it's just cosmetic, he can be discharged
and told to make an appt with a plastic surgeon. If
it's interfering with breathing (and he has good
insurance), they might do the surgery the next day.

It goes like this, Doug...official thugs stage an
assault to rescue hostage scientists from terrorists.
Most terrorists get away (black eye for official
thugs). Official thugs assault and mangle one of the
scientists they're supposed to be rescuing ('nother
black eye - actually three: two for our scientist, one
for official thugs ;) ). Official thugs' bosses want
to keep things low key, which all the scientists may
not agree to after the assault, so official thugs'
bosses pay for expert plastic surgery ASAP for poor
punching bag. :)

> In SR: given the assumptions that their anaesthetics
are better than ours now, it might well be no big
deal. The state of the medical art isn't very well
defined. So do what you want. How's that? :-)
> -_Dejaffa

Works for me. Out of curiousity, what would happen in
this day and age? Would they wait unless it impaired
his breathing?

====Doc'
(aka Mr. Freaky Big, Super-Dynamic Troll of Tomorrow, aka Doc'booner, aka Doc' Vader)

.sig Sauer

If you SMELL what THE DOC' is COOKIN'!!!

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Message no. 19
From: shadowrn@*********.com (Doug Browne)
Subject: [OT] Medical questions
Date: Wed Aug 8 12:10:03 2001
> > In SR: given the assumptions that their anaesthetics
> are better than ours now, it might well be no big
> deal. The state of the medical art isn't very well
> defined. So do what you want. How's that? :-)
> > -_Dejaffa
>
> Works for me. Out of curiousity, what would happen in
> this day and age? Would they wait unless it impaired
> his breathing?

It might well wait, unless the official thugs could put pressure on the
hospital, in which case it's not out of the question that the scientist
would wake up with it already fixed (which is probably what would happen in
SR, in my game, anyway :-)

--Dejaffa
Message no. 20
From: shadowrn@*********.com (John Smith)
Subject: [OT] Medical questions
Date: Wed Aug 8 19:15:02 2001
> Works for me. Out of curiousity, what would happen in
> this day and age? Would they wait unless it impaired
> his breathing?

Well... They would have reset mine right away if it had been broken (thought
it was) and it wasn't really that bad.

In the case of a guy who's got severe nose damage, they'd DEFINITELY at
least set it in a semi-normal shape ASAP. Since he's got some kinda
sponsors paying for plastic, they could probably do the cosmetics almost
immediately since most of the work is done for them. (A nose job consists
of breaking and then resetting/sculpting the new nose from the broken bits.)
If you have them reset it right away, I seriously doubt anyone's going to
complain.

Lepper.
seutekh@*******.com (period)
Message no. 21
From: shadowrn@*********.com (Rand Ratinac)
Subject: [OT] Medical questions
Date: Wed Aug 8 21:30:02 2001
> > Works for me. Out of curiousity, what would happen
in this day and age? Would they wait unless it
impaired his breathing?
>
> It might well wait, unless the official thugs could
put pressure on the hospital, in which case it's not
out of the question that the scientist would wake up
with it already fixed (which is probably what would
happen in SR, in my game, anyway :-)
> --Dejaffa

Hmmm...which also works.

Okay, everyone, thanks again!

====Doc'
(aka Mr. Freaky Big, Super-Dynamic Troll of Tomorrow, aka Doc'booner, aka Doc' Vader)

.sig Sauer

If you SMELL what THE DOC' is COOKIN'!!!

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Message no. 22
From: shadowrn@*********.com (Rand Ratinac)
Subject: [OT] Medical questions
Date: Wed Aug 8 21:45:02 2001
> Well... They would have reset mine right away if it
had been broken (thought it was) and it wasn't really
that bad.
>
> In the case of a guy who's got severe nose damage,
they'd DEFINITELY at least set it in a semi-normal
shape ASAP. Since he's got some kinda sponsors paying
for plastic, they could probably do the cosmetics
almost immediately since most of the work is done for
them. (A nose job consists of breaking and then
resetting/sculpting the new nose from the broken
bits.) If you have them reset it right away, I
seriously doubt anyone's going to complain.
> Lepper.

Cool...

Again, thanks, bub.

====Doc'
(aka Mr. Freaky Big, Super-Dynamic Troll of Tomorrow, aka Doc'booner, aka Doc' Vader)

.sig Sauer

If you SMELL what THE DOC' is COOKIN'!!!

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