The Geriatrics “Profanisaurus.” Volume 2 – The diagnostic myths that do not die

Dan Thomas is an ST5 based in the Mersey Deanery (HENW) and is the Clinical Quality Representative on the BGS Trainees Council. He tweets @dan26wales

In 2013 Professor David Oliver wrote a blog, the Geriatrics “Profanisaurus”, a list of words and phrases that should be banned, he encouraged other ‘BGS-ers to join in the fun and add their own “unutterables”.

My contribution to this list is some frequently encountered diagnoses that should be approached with scepticism.

‘Bilateral cellulitis’: If both legs are infected then the person should be unwell. Usually red legs are caused by a combination of underlying pathology; acute lipodermatosclerosis, venous hypertension, venous stasis dermatitis, lymphoedema or panniculits. The legs are hot and swollen but in the context of someone who is afebrile with minimal inflammatory response. The reason they are not responding to antibiotics is because they do not have an infection.

Bladder and Bowel Problems in Older People

Ann Capewell is a Consultant Physician and previously Clinical Director of Care of the Elderly at St Helens and Knowsley NHS Trust. She is Chair of the BGS Bladder and Bowel Health Special Interest Group.

Bladder and bowel problems are common but neglected areas of geriatric medicine practice. We are holding a meeting that will focus on providing comprehensive up to date information and practical tips from leading experts in the field.

The BGS Special Interest Group for Bladder and Bowel Health is holding a meeting on the 11th October 2013. This year we are focussing on the links between brain and the bladder and bowel. Topics also include bladder re-training and practical management in frail older people, organising an integrated continence service and with focused sessions on constipation, diarrhoea, bladder cancer.

This is our second meeting but with a completely different programme. The last one was rated highly so the omens are good!

Everyone with an interest in older people or a role in looking after them is welcome to attend. Please click this link for further details and an application form.

Newsflash: Acute Care system fails an older patient, reflections from a relative

Ron Murphy is a software designer, he blogs at ronmurp.net

An older patient presenting acutely to A&E in an unwell and frail state can erroneously be assumed to be at their baseline pre-morbid state, with some additional new complaint like a “UTI” as an over-riding diagnosis. My active and mobile mother was reduced over a period of three months to a delirious crumpled wreck who didn’t know what day it was because of a persisting UTI that had not been dealt with. Her past medical history was complicated: stroke, heart attack, pacemaker, diverticulitis, arthritis, diabetes not well controlled, kidney function not right … you get the picture. But still, before the UTI she was sharp and active.

What follows is a brief account (you don’t want the detailed version) of what happened in A&E on three failed visits.