Sugammadex FDA Review Documents

I was recently clearing out my “Downloads” folder (which had got way out of hand!), and while doing so I found a document I’d downloaded in July 2019 when I was looking into the light-sensitivity of sugammadex. It was part of an FDA review into the drug when it was being considered for approval in the United States. It just so happened this discovery came in the middle of a Twitter discussion on the potential for sugammadex to cause, amongst other things, anaphylaxis. Continue reading “Sugammadex FDA Review Documents”

Juno Pre-filled Syringes

Juno recently released a TGA-approved pre-filled syringe containing metaraminol. However, not long after release, multiple issues were identified by anaesthetists who were using them. There was a fair bit of discussion and sharing of information and experiences on Twitter, and many anaesthetists have stopped using them, and some hospitals have now withdrawn them. Several people have contacted me regarding the syringes, and I thought I would aggregate some of the information I’ve collected in one place to make it easy for people to access it if they want to.

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Dunny Design

The fact that my emerging interest in Human Factors/Ergonomics and design (see here) coincided to a large degree with me having to spend a lot of time in toilets due to colitis (see here), has meant I’ve developed a, some would say “unhealthy”, obsession fascination interest in the way toilets and bathrooms are designed. It basically means that every time I go into a toilet or a bathroom, I’m paying more attention to what’s around me than I used to. This will include observing things such as taps, sinks, doors, locks, signage, layout (pretty much everything really!), and thinking about the potential impacts, both positive and negative, that these “99% invisible” features have on aspects of life such as personal hygiene, public health, privacy, accessibility, usability, aesthetics and so on.

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Sibling Rivalry

Image Credit: @KassiIsaac (http://kassiisaac.blogspot.com)

I’m sure I’m not the only one, but I’ve often thought of the relationship between my home country, Australia, and that of New Zealand as being much like that of brothers. This brotherhood stretches back more than 100 years before the more well-known voyage of James Cook, to that of Abel Tasman. He sighted Australia on the 24th of November, closely followed by  New Zealand on the 13th of December, in the year 1642. So Australia can claim the title of older brother by a mere 19 days, but we also have landmass and population (excluding sheep) on our side as well. You can also see the family resemblance just by looking at our near-identical national flags.

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Sorting the #DudScrubs Laundry

This is where I’ll be picking my way through all the dirty #DudScrubs laundry. Tighten those side-ties, because there’s a lot to get through!

For an explanation of what #DudScrubs is all about, read my more detailed post on it here.

Below I’ve started organising the various tweets into different categories to make them easier to find, and because different aspects may be of more interest or importance to different people. But I think it is the overall picture that makes the case for change so compelling, and that hospitals need to sit up, take notice, and start asking their staff what they can do to make their scrub provisioning system more fit-for-purpose. Continue reading “Sorting the #DudScrubs Laundry”

HBC Big Ideas Night: Euthanasia

Back in 2018, my church ran one of their Big Ideas Nights on the topic of euthanasia and assisted suicide. I gave a presentation at that meeting discussing my background and some thoughts I had on the idea of suffering and euthanasia drawing from my own experience. Below is the transcript, and slides, from that presentation.

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It’s Time to #ScrubOut #DudScrubs

An unavoidable part of working in operating theatres is the requirement to wear what is formally known as “Perioperative Attire”, but casually known as “scrubs”. While the term “scrubs” is now used to refer to similar clothing worn anywhere in the hospital, the primary purpose of theatre scrubs is to reduce the introduction of environmental pathogens into the theatre environment, thereby reducing the incidence of surgical site infections. Most hospitals require staff to wear scrubs supplied and laundered by the hospital. So essentially, scrubs are a mandatory workplace uniform, supplied by the hospital, to be worn by staff to improve patient outcomes.

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Day-to-Day Living in Suva c.2012

I spent three months at the end of 2012 working in Suva, Fiji as the ASA Pacific Fellow, which was a position they created and funded in order to help prepare anaesthetic trainees for their exams. At the end of the stay I wrote a short piece describing some of the practical aspects of living there with my young family, in case it proved helpful to other Fellows that came after me. I thought I’d re-post here for similar reasons, but also as an historical snapshot as a significant part of my medical career that has had a lasting impact on me and my family. Fiji is a strategic hub for training doctors working all around the South Pacific, so if you get the chance to contribute in some way, I highly recommend you do.

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Vale Professor Geoff Cutfield

I was deeply saddened to hear of the passing of Professor Geoff Cutfield earlier this year. He’s had a lasting impact on me as a doctor, anaesthetist and a  human being. Following his death, people who were unable to make the funeral in New Zealand were given the opportunity to provide something to be read out at the service to help celebrate the phenomenal life he lead. Below is my contribution to that celebration.

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The Problem with Miracle Cancer Cures

Having just started my fifth antibody based medication, this one to try and get on top of my auto-immune colitis, I’m acutely aware of the various tensions, conflicts and ethical dilemmas raised in this article. My melanoma, while not completely gone, has been well controlled by the immunotherapy I received. The main story for me in recent years has been managing the side-effects of the immunotherapy as well as the multiude of medical appointments, blood-tests, scans and so on. But it has taken me from seriously considering palliative care having been given a median survival of 3-4 months, to being back at work part-time some 5 years later. Fortunately, as I am part of clincial trial, combined with Medicare and private health insurance, my out of pocket costs have been manageable. But as these expensive interventions become mainstream, and cancer is increasingly converted from a death sentence into a chronic disease, there will be serious challenges ahead for the health budget, of both governments and individuals.

Opinion | The Problem With Miracle Cancer Cures

Opinion | The Problem With Miracle Cancer Cures

If immunotherapy worked most of the time, this would be an unambiguously happy story. But it doesn’t.

Source: www.nytimes.com/2018/04/19/opinion/sunday/problem-miracle-cancer-cures.html