Originally Posted by muneemmk

Where is Rippergeo ? called that poor bhpian 2 weeks back at an unworldly hour to ask a an urgent question regarding 2 friends(my audio installers) who had met with an accident with my bike, but sadly one didn't make it and the other's been in the ICU eversince,
My question is what really happens when Bone Marrow gets into blood stream ?

I have been watching the thread but keeping a low profile, because it is not safe to provide online consultations without seeing the patient.
I'm training to be a general medicine/internal medicine physician, but I prefer intensive care/emergency medicine to the regular GP practice(bread and butter)

About your doubt, Bone marrow contains a lot of fat. that is released to the blood vessels sometimes in case of major trauma/RTA(Road traffic accidents). Leads to fat embolism. Causing Acute respiratory distress syndrome(ARDS), brain damage, multi organ dysunction syndrome(MODS),kidney damage etc, among other things.
Amount of complications produced by Fat embolism is directly proportional to the amount of fat released into the bloodstream
Recovery from ARDS and MODS is very difficult. Mortality from ARDS is usually of the order of 60% even at the best of Intensive care units.

Was this the guy with the femur fracture? Femur fracture is a prime suspect for fat embolism.

ARDS/MODS in RTAs can occur even without fat embolism. If the victim has suffered massive tissue damage, that itself can set off a cascade leading to ARDS/MODS.

All of the above is further complicated by the physical condition of the patient prior to the accident, the rapidity and effectiveness of initial resuscitation , level of care during ICU stay, any coexisting illnesses, hospital acquired infections, the list is endless. Mostly it is all a weird kind of lottery/just plain luck.

[headers]

Originally Posted by Tejas@perioimpl

NO

These basically simulate saliva secretion which acts as a buffer and neutralizes the pH from acidic to neutral and also the increased saliva will wash away the food stuck in your teeth. Alternatively you can gargle well after meals or look at a sexy car or other photo and drool to cause the same desired effect.

That was some neat information, Doc

Originally Posted by Sudipto-S-Team

I had been a smoker for 29 years. I used to smoke one before brushing and one after brushing, not to speak of the other 38 during the day !! Now it's zero.

Way to go

[muneemmk]

Originally Posted by rippergeo

Was this the guy with the femur fracture? Femur fracture is a prime suspect for fat embolism.

This is the same guy that we talked about that night, he was kind of okay and even had brakefast the next day but by noon he was seen having trouble breathing and was later taken to ICU and then put into ventilator,
as soon as he got a little more better we moved him to Another hospital, but the situations seems to be the same, respirational problems seems to be gone after 10 days in the ventilator ,but the brain functions dosen't seem to be recovering. Will this condition deteorate or get better ? If it recovers how long will it take ?


About my Wisdom tooth extreaction , Dr.Pullokaran explained that it will take around 7 years for the nerves to get back into the previous shape, so I guess i am stuck with out sensation in my tounge for the next 5 years.

[Tejas@perioimpl]

Originally Posted by muneemmk

About my Wisdom tooth extreaction , Dr.Pullokaran explained that it will take around 7 years for the nerves to get back into the previous shape, so I guess i am stuck with out sensation in my tounge for the next 5 years.

I'm sure you are taking vitamin b and folic acid to aid this nerve regeneration process?

[Proxima]

Tejas - I went to a dentist today for a toothache. He told me that there is a tumour (red colour) in my half broken tooth and it is to be removed. I am on antibiotics till the tumour heals and then the doc wants to replace the tooth.

Pl advice.

EDIT: I saw the red tumour myself.

[Tejas@perioimpl]

Originally Posted by Proxima

Tejas - I went to a dentist today for a toothache. He told me that there is a tumour (red colour) in my half broken tooth and it is to be removed. I am on antibiotics till the tumour heals and then the doc wants to replace the tooth.

Pl advice.

EDIT: I saw the red tumour myself.

Ok. First thing, tumour is the wrong word to be used. Call it a growth (or in technical terms a pulp polyp). This growth is caused due to pulpitis (inflammation of tooth pulp). Antibiotics will shrink it a bit. Ask him to do a root canal and try to save the tooth. Extraction should be the last option unless the tooth is completely unsalvageable.
But first thing is that you ask him if it is a pulp polyp or a gum (gingival) overgrowth which can also look similar. Treatment plans differ.

This is where advice on forums can be dicey. From what you have told me, the tooth seems salvageable, but i strongly urge you to let another dentist see it just to confirm diagnosis and don't only go on what i say since i have neither seen you, your intraoral photos or your xrays.

Another general point to all: It's my hobby to teach and i am a visiting periodontist to a college in bombay. So, my point is, if ever you doubt any private dentist's diagnosis, just walk into a college for an opinion. You will get the exact diagnosis, since they are not looking at making money and want to teach the students the right thing. Also postgraduates students and staff will also diagnose right to hone their skills.
However, getting a procedure done there is a different issue since most of the colleges i have seen throughout india (atleast 30) have questionable methods of sterilization of instruments.

[carfreak]

Hey Rippergeo,welcome!!

He was my senior at med school!!!

[kuttapan]

Originally Posted by Tejas@perioimpl

Another general point to all: It's my hobby to teach and i am a visiting periodontist to a college in bombay. So, my point is, if ever you doubt any private dentist's diagnosis, just walk into a college for an opinion. You will get the exact diagnosis, since they are not looking at making money and want to teach the students the right thing. Also postgraduates students and staff will also diagnose right to hone their skills.
However, getting a procedure done there is a different issue since most of the colleges i have seen throughout india (atleast 30) have questionable methods of sterilization of instruments.

Funny you should say that. I had a friend studying in a dental college, who advised me against going to his college to get treated. Instead he directed me to his professor's clinic. I found it strange at that time that he gave that advice. Wonder where they get patients to hone their skills, then?

Another q - Is using floss(the twine type - Oral B) in anyway detrimental to gum health? What if I rub vigorously against the gums? Sometimes, this is the only way to get things out from between the teeth, especially Chicken.

[shantyrocks]

Originally Posted by kuttapan

Funny you should say that. I had a friend studying in a dental college, who advised me against going to his college to get treated. Instead he directed me to his professor's clinic. I found it strange at that time that he gave that advice. Wonder where they get patients to hone their skills, then?

Another q - Is using floss(the twine type - Oral B) in anyway detrimental to gum health? What if I rub vigorously against the gums? Sometimes, this is the only way to get things out from between the teeth, especially Chicken.

its perfectly ok to use a dental floss at all times.but avoid vigourous rubbing as its not needed.you will achieve the same result with a light hand.

@Tejas@perioimpl : dude, are you tejas kothari by any chance from d.y.p?
iam shantanu das from d.y.p

[Samurai]

Last month I went for a routine dental check after er... 8 years. After 15 minutes I was out grinning like I won a lottery. Clean bill of health, despite 5-6 fillings in my mouth which are 20 years old.

Originally Posted by carfreak

My area of specialisation is psychiatry guys!!anyone interested for a free consult??confidentiality will be strictly maintained

Oh great, I find a Team-BHP doctor in my town, but he happens to be a shrink. Earlier one was a children's surgeon.

[shantyrocks]

Originally Posted by Samurai

Last month I went for a routine dental check after er... 8 years. After 15 minutes I was out grinning like I won a lottery. Clean bill of health, despite 5-6 fillings in my mouth which are 20 years old.

Oh great, I find a Team-BHP doctor in my town, but he happens to be a shrink. Earlier one was a children's surgeon.

your lucky that all your fillings are intact after such a long time.they have to be silver fillings right?
even after the advent of tooth coloured fillings, silver fillings have the best longevity

[shantyrocks]

About my Wisdom tooth extreaction , Dr.Pullokaran explained that it will take around 7 years for the nerves to get back into the previous shape, so I guess i am stuck with out sensation in my tounge for the next 5 years.

seven years is a pretty long time muneem.it doesnt take that long.take one tab.neaurobian daily for 3 months and you will notice some improvement.

[carfreak]

Originally Posted by Samurai

Oh great, I find a Team-BHP doctor in my town, but he happens to be a shrink. Earlier one was a children's surgeon.

Ha ha,i guess the childrens' surgeon is anand?we both in kmc manipal!!

[Tejas@perioimpl]

Originally Posted by kuttapan

Funny you should say that. I had a friend studying in a dental college, who advised me against going to his college to get treated. Instead he directed me to his professor's clinic. I found it strange at that time that he gave that advice. Wonder where they get patients to hone their skills, then?

I said only get yourself diagnosed and not treated. Also many a times, professors force their students to get them patients and they get better grades in return. It's not all that noble a profession anymore.

Another q - Is using floss(the twine type - Oral B) in anyway detrimental to gum health? What if I rub vigorously against the gums? Sometimes, this is the only way to get things out from between the teeth, especially Chicken.

+1 to what shanty says and never rub against the gums. It's a gentle sawing motion rubbing against the tooth. So when you enter the area between two teeth with the floss, first gentle saw against one tooth and then with a newer part of the floss, saw against the other in an upward and outward direction.

Originally Posted by shantyrocks

@Tejas@perioimpl : dude, are you tejas kothari by any chance from d.y.p?
iam shantanu das from d.y.p

Oh yeah shanty, it's me alright! How you been? PM me your cell ya, let's meet up with rao and all... been ages! Glad to see you here!

[Rehaan]

Originally Posted by rippergeo

I have been watching the thread but keeping a low profile, because it is not safe to provide online consultations without seeing the patient.....

Agreed, but its the information that is assimilated from these discussions that helps a lot with the general understanding.

Thanks a lot for your post on ARDS. I have been wondering about it for almost a year now and this was an excellent and concise explanation.

cya
R