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 Post subject: Burned...
PostPosted: Wed Apr 24, 2013 8:30 am 
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To give you a bit of background:

My son's girlfriend was set to move down here in a month. Two days ago her brother received third degree burns over 60% of his body. The girlfriend is a long time WoW guild member and friend of mine.

I am a retired physician. I know what the prognosis is. 43% mortality and horrible pain, many operations and permanent disfigurement as a minimum if he survives.

The doctor in me would gently and repeatedly tell the truth, no matter how bad. As a friend or boyfriend's mom I would be gently supportive. She tells me that she was told her brother would need to spend several months in the hospital, but would be fine and go home fully recovered.

What do I say?

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PostPosted: Wed Apr 24, 2013 8:39 am 
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Hard to say without knowing the relationship you have with your son, or the girlfriend.

Personally, without knowing that, I'd say tell your son your thoughts candidly and in private. Let him choose, as he has to live with her. Both figuratively and literally.

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PostPosted: Wed Apr 24, 2013 8:48 am 
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I wonder if that's what the doctor told her, or what she heard, or if she's choosing to relay the best case scenario in hopes that if she ignores the other scenarios they wont become a reality.

I think you should hedge. Don't offer false hope, but don't crush hope. If you're spiritual or religious, "God has a way of making the decision, regardless of what science or medicine says." if not, something to the effect of , "Burns are tricky. They can fool even the best physicians"


I'm watching very much the same thing. I think the best advice I've seen on this:

Burn recovery is not a sprint. Its a marathon. Its a roller coaster. Even with a good outcome the road goes up and down there will be bad days, there will be worse days, and there will be joyful days. But in the end its a long long process of forward and backward steps.


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 Post subject: Re: Burned...
PostPosted: Wed Apr 24, 2013 9:31 am 
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If it were me, I'd say nothing unless specifically asked. The person(s) who told her that, may have good reason to do so.


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PostPosted: Wed Apr 24, 2013 12:57 pm 
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Rock and a hard spot, definitely. I''d go with Sam's advise. Say nothing unless specifically asked, even then be as gentle as you can without lying. Don't try to be cute with the language. If she asks seriously, tell her what she needs to know, but phrase it in generalities, these are the statistics, I don't know your brother's case and cannot ethically comment on it, I don't know his specifics.

Sucks, I'd be very depressed and wanting someone to pull the plug if it were me.

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 Post subject: Re: Burned...
PostPosted: Wed Apr 24, 2013 1:14 pm 
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I wouldn't say anything unless she specifically asked what you thought as a doctor... Best thing would probably just to be as comforting as you can.


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PostPosted: Wed Apr 24, 2013 1:49 pm 
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Maybe the doctor treating him has access to one of these...



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 Post subject: Re: Burned...
PostPosted: Wed Apr 24, 2013 3:16 pm 
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Squirrel Girl wrote:
To give you a bit of background:

My son's girlfriend was set to move down here in a month. Two days ago her brother received third degree burns over 60% of his body. The girlfriend is a long time WoW guild member and friend of mine.

I am a retired physician. I know what the prognosis is. 43% mortality and horrible pain, many operations and permanent disfigurement as a minimum if he survives.

The doctor in me would gently and repeatedly tell the truth, no matter how bad. As a friend or boyfriend's mom I would be gently supportive. She tells me that she was told her brother would need to spend several months in the hospital, but would be fine and go home fully recovered.

What do I say?


As a physician, I'm sure you understand the inherent danger of assigning a prognosis sight unseen. So don't. He has a doctor that can give out that information if she needs it.


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 Post subject: Re: Burned...
PostPosted: Wed Apr 24, 2013 3:40 pm 
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It's important to note that there's a massive distinction between 2nd and 3rd degree burns. Mind you, I'm not physician and I do not play one on TV; nor, for that matter, did I stay at a Holiday Inn Express last night. However, my understanding of epidermal stem-cell grafting is that it works provided the majority of the dermis is intact and the subcutaneous tissue affected can heal with lichenification and scarring. That generally excludes 3rd degree burns from the treatment list.

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 Post subject: Re: Burned...
PostPosted: Wed Apr 24, 2013 4:01 pm 
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There is a world of difference between a second and third degree burn.

A second degree burn is a partial burn through the dermis. Healthy, normal skin can regrow in this case.

A third degree burn is a full thickness burn through the dermis. The skin is gone. There is nothing to regrow from.

With good care and a little bit of luck a person can heal without scarring from a second degree burn. (The video is interesting, but the case shown proves absolutely nothing. It could have turned out the same without it.)

I am doing the supportive bit, and hope no one asks me for details. Speaking to other physicians, the prognosis for survival is much better than what is written. Hopefully I won't get the "You knew and did not tell me!"

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PostPosted: Wed Apr 24, 2013 4:58 pm 
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When I was doing research on burns when my friend was injured, the formula several doctors gave me:

If age+% burn < 100 then the patient was expected to survive.


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 Post subject: Re: Burned...
PostPosted: Wed Apr 24, 2013 10:54 pm 
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Khross wrote:
Mind you, I'm not physician and I do not play one on TV; nor, for that matter, did I stay at a Holiday Inn Express last night.



:head explodes:

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 Post subject: Re: Burned...
PostPosted: Fri Apr 26, 2013 8:49 am 
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If asked, I think it would be wise to point out that you haven't examined him, and that you don't think it would be good to offer an opinion without doing so.

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