Any Illness Or Injury In Last 5 Years: Fill & Download for Free

I live in Canada. Our healthcare is paid for through our taxes which when you account for federal, state, sales and municipal taxes altogether are only a couple of percent higher than in the US.Because healthcare is paid through taxes, the actual amount you pay for healthcare varies greatly due to income so it’s not really comparable to how much people in the US pay. Somebody making 6 figures in Canada might pay about the same as an individual with a gold-plated health coverage in the US while somebody who’s between jobs would get the same health coverage but pay almost nothing because they’re in the minimum tax bracket.The benefit of this is though that everybody pays, there are no people who opt out of health insurance because they’re young and healthy now and plan to only buy into it when they get older and think they’re more likely to need healthcare.That way, since you’re paying taxes into healthcare all your life, and EVERYBODY is contributing instead of just some it’s actually cheaper.So what does it cost when you need to get healthcare? Well, in her last year of life my mother spent around 5 months in hospital, 3 of them in ICU and had several major surgeries. Total bill for all hospital, doctor and meds? $0.00.My father also spent 5 months in hospital in his last year of life. Total bill? $0.00.I’ve had several surgeries in my life for different reasons, and the usual annual checkups and treatments for different things that almost anybody would have. Total medical bill in Canada that I’ve received in my entire life? $0.00.Although I once had to see a doctor in the US for impacted wax in my ears that I couldn’t get out. That visit was less than 5 minutes and it cost me over $500.00 just to squirt a little water in my ear.So no, not only would I not change our healthcare system for the highly overpriced American system, but twice I’ve refused employment transfers to the US specifically because I don’t want to ever have to rely on a US type system.If I lose my job in Canada, I still have the same health coverage.If I develop a ‘pre-existing condition in Canada, I still have the same health coverage.If I have a catastrophic illness or injury in Canada that costs millions to treat, my coverage is not capped.If I show up at the ER with something life-threatening in Canada, I don’t have to wait for treatment while they check what coverage I’ve got and how they’re going to get paid.If I’m in the hospital in Canada at the same time that I’m having a bad month financially, there’s no co-pay or deductible to have to worry about.If there’s some problem with the bill getting paid or questions about what medical care was required or how many tests were done in Canada, I’m never made aware of it. It’s between the doctor/hospital and the health plan.In Canada there’s never any stress or anxiety about the cost of all the tests that are being done or any treatments I’m receiving. I can concentrate on getting better instead of worrying if it’s going to bankrupt me.The wait time for elective treatments in the US might be shorter but for urgent care in Canada you get seen just about as quickly and for emergency care you’re actually seen faster because there’s no wait for insurance paperwork.So no, I cannot think of any reason why I would want to change our system for the American system. Any politician who suggests that they might even consider doing so (and many conservatives seem to love the idea) will not get my vote - ever.

Q. What is something that is painful to see?A. Imagine you are a radiologist reading films from the Emergency Department of young children suffering from minor trauma and you see these xrays of the chest, skeleton, CT scan images of the brain and of the abdomen and MRI of the brain.RibsFemursKneeCT Brain (blood is white)CT Brain (2nd patient, died)CT SkullMRI Brain - white new blood, grey old bloodCT Abdomen (arrow to liver)CT Abdomen (arrow to pancreas)You go examine the patients.4 million children abused, 2,000 deaths/year.Shaken infant syndrome classic pattern of injuries. Child held around the chest and violently shaken back and forth, causing the extremities and the head to flail back and forth in a whiplash movement.Intracranial injury occurs as a result of severe angular acceleration, deceleration and direct impact as the head strikes a solid object.The chest is compressed resulting in rib fractures.Arms and legs move about in a whiplash movement resulting in the typical 'corner' or 'bucket-handle'-fractures in the metaphyseal region. 10% under age 5 brought to ER with alleged accidents actually abused. Wide range of findings can mimic other disease. Further injury if delayed in diagnosis.Radiologist can suggest diagnosis when studies are performed for other reasons. High degree of suspicion, inability to explain the degree of injury or a reported mechanism of injury that is inconsistent with the physical findings.Skeletal InjuryForces needed to break a bone in an infant or young child are enormous.Any fracture in this age group indicates a major traumatic event, not just a fall from a low height.Fractures with a high specificity for child abuse:Metaphyseal corner or bucket handle fracture.Rib fractures children less than 2 year.Fractures of the acromion, sternum and spinous processes.Occipital impression and other skull fractures occur when the head strikes a solid object.Corner fractureSmall piece of bone is avulsed due to shearing forces on the fragile growth plate. Can be subtle, hence skeletal surveys for suspected infant abuse must be good quality.Bucket handle fracturesEssentially same as corner fractures, but avulsed bone fragment is larger and seen 'en face' as a disc or bucket handle. Most common in the tibia, distal femora and proximal humeri. Frequently bilateral.Rib fracturesIn violent shaking, the child is held very tightly around the chest and squeezed while being shaken. This compresses the ribs front to back and tends to break them next to their attachment to vertebrae, and laterally where they are being literally almost folded in half. Therefore, lateral and posterior rib fractures are highly specific for abuse. CPR does not cause such fractures.(Found incidentally on chest X-rays for other reasons such as pneumonia.)Bone Scan: Each hot spot in the skeleton is a fracture (besides growth plates)Skull fracturesSkull fractures are common child abuse injuries, but they are also common in accidental trauma.Patterns of skull fracture that suggest child abuse are:- Multiple 'eggshell' fractures- Occipital impression fractures- Fractures crossing suturesThe infant's skull is very resistant to trauma, so any fracture that is inconsistent with the history should raise the question of non-accidental injury.LEFT: eggshell fractures in a child who died of cerebral injury after being thrown of a height. RIGHT: skull fracture crossing suture in abused childDiaphyseal fracturesDiaphyseal (long bone) fractures are non-specific as they do occur in both accidental and non-accidental injury. However, in these cases the age of the child and the history become very important. A fall out of a bed will usually not produce a diaphyseal fracture. In order to break a femur you have to fold it with enormous power. Spiral fractures are a result of twisting forces which are uncommon in accidents in young children, but more common in adults. So a simple fall does not produce a spiral fracture in a child.Two infants with a femur fracture. Child abuse was suspected because of the age of the child and an inconsistent history given by the parents.Fracture healingCallus in long bone fractures generally forms no earlier than 5 days after a fracture, but will usually form by 14 days. A child that fell out of bed the day before cannot have a fracture with callus formation.Diaphyseal femur fracture with a lot of callus is at least 2 weeks old.CNS (Central Nervous System) InjuryCNS injury related to nonaccidental injury is a leading cause of morbidity and mortality in infants and children. 80% deaths under age 2. A baby's neck muscles are very weak and its head is large and heavy in proportion to the rest of its body. When a baby is shaken, the neck snaps back and forth, like whiplash injury, causing the brain to hit the front and back of the skull. This can damage the brain and cause it to bruise, bleed and swell.CT Brain: Subdural hematomas arise from disruption of delicate bridging veins extending from the cortex to the dural sinuses. Blood to extend into the posterior interhemispheric fissure.Child died of CNS injuries. Further examination also revealed rib fractures. CT: hematoma in the interhemispheric region.MR Brain: more sensitive in detecting subdural hematomas.T1WI shows bilateral fluid collections as a result of chronic bilateral subdural hematomas and new subdural hematomas in the right frontal and posterior interhemispheric region.Other injuriesVisceral injuryVisceral injury is seen at autopsy of young infants, 2-10% of all abdominal injury results from child abuse. Mean age of 2 years, more common in boys, mortality rate is 50% due to 'patients and doctors delay'. These children are brought to the hospital days after the injury, when a perforation already has resulted in peritonitis and sepsis.The history given by the abusers usually does not correlate with the symptoms, which makes these cases very difficult to evaluate for the clinician.Common abdominal injuries in abused children are liver laceration, duodenal hematoma and pancreatic laceration.The most common non-accidental abdominal injuries are:- visceral perforation or hematoma- liver- and pancreatic laceration- adrenal bleedingSurprisingly the most common abdominal accidental injuries, which are laceration or subcapsular bleeding of the spleen and the kidney, are unusual in these children.Pancreatic laceration in child abuseLiver laceration in child abuse. These abdominal injuries are non specific and could also be attributed to accidental injury. History does not correlate well with the injuries.Liver laceration in child abuseImaging and reporting considerations for suspected physical abuse (non-accidental injury) in infants and young children (clinicalradiologyonline.net)Foster Son Starves While Mom And Daughter Eat, Then A Customer Interrupts And Does Something Amazing | SmartiedRadiological Imaging in Infant Non-Accidental InjuryIn the UK, seven percent of children will have experienced serious physical abuse from their primary carers at some point during their childhood. Appropriate and effective imaging techniques can drastically improve diagnosis of resultant non-accidental injury (NAI) from child abuse. This includes suitable imaging modality choice and techniques set out by expert opinion and clinical guidelines, such as the standards for radiological investigations of suspected non-accidental injury produced by the Royal College of Radiologists (RCR) in collaboration with the Royal College of Paediatrics and Child Health (RCPCH). There are certain markers that are almost diagnostic of NAI, for example classic metaphyseal lesions or subdural and retinal haemorrhage with encephalopathy. Effective evaluation of these findings by a capable radiologist will lead to accurate and efficient diagnosis and management. Furthermore, an awareness of potential radiological mimics of NAI is vital for appropriate diagnosis. If this is achieved successfully, radiologists and other members of the multidisciplinary healthcare team can have a direct, positive impact on effective management of these sensitive cases.Abusive head trauma - WikipediaNever EVER Shake a Baby - A NYT Article Every New Parent Should ReadShaken Baby Syndrome: A Diagnosis That Divides the Medical WorldPerhaps no crime staggers the mind, or turns the stomach, more than the murder of a baby, and so it is not a surprise when law enforcement comes down hard on the presumed killers. Often enough, these are men and women accused of having succumbed to sudden rage or simmering frustration and literally shaken the life out of a helpless infant who would not stop crying or would not fall asleep.Shaken baby syndrome has been a recognized diagnosis for several decades, though many medical professionals now prefer the term abusive head trauma. It is defined by a constellation of symptoms known as the triad: brain swelling, bleeding on the surface of the brain and bleeding behind the eyes. For years, those three symptoms by themselves were uniformly accepted as evidence that a crime had been committed, even in the absence of bruises, broken bones or other signs of abuse. While many doctors, maybe most, still swear by the diagnosis, a growing number have lost faith. Not that they doubt that some babies have been abused. But these skeptics assert that factors other than shaking, and having nothing to do with criminal behavior, may sometimes explain the triad.Has the syndrome been diagnosed too liberally? Are some innocent parents and other caretakers being wrongly sent to prison? Those questions, at the complex intersection of medicine and the law, can stir strong emotions among doctors, parents and prosecutors. They shape this first installment in a new series of Retro Report, video documentaries that explore major news stories of the past and their enduring consequences.The video’s starting point is a Massachusetts criminal case that introduced the concept of shaken baby syndrome to many Americans: the 1997 murder trial of Louise Woodward, an 18-year-old British au pair accused of having shaken an 8-month-old boy, Matthew Eappen, so aggressively that he died. Matthew also had injuries that may have predated Ms. Woodward’s joining the Eappen family in Newton, outside Boston. The focus, however, was on the triad of symptoms. To prosecution witnesses, they proved that the baby had been shaken violently, his head hitting some hard surface.The Anatomy of a Murder CaseThe anatomy of a shaken baby case from the perspective of defense attorney Adele Bernhard. Published On Sept. 13, 2015Throughout, Ms. Woodward insisted on her innocence. But a jury in state court found her guilty of second-degree murder, and she was sentenced to a prison term of 15 years to life. Within days, though, the trial judge called the murder conviction an injustice. He knocked down the charge to involuntary manslaughter, reducing the young woman’s sentence to time already served, 279 days. Many in Massachusetts and beyond were outraged. Nonetheless, Ms. Woodward was free to return to England.The “nanny murder trial,” as headline writers called it, had an unfortunate subplot. In some quarters of public opinion, Matthew’s mother, Deborah Eappen, stood figuratively in the dock as well. A doctor — like her husband, Sunil Eappen — she found herself under the sort of attack many working women face to this day. The case, a New York Times article said in 1997, “put a spotlight on the backlash against working mothers who consign their children to the care of others.”But the dominant issue was child abuse. Shaken baby syndrome is but one aspect of this phenomenon. It is a topic in which statistics can be elusive because reported episodes may not reflect the full extent of the problem. That said, a report issued in April by a division of the Department of Health and Human Services estimated that in 2013, more than 1,500 children in the United States, or four a day, died from various forms of abuse or neglect. Nearly three-fourths of the victims were under the age of 3. (Various studies over the years have suggested that a serious threat to a small child’s well-being is the presence of the mother’s live-in boyfriend.)In the Woodward trial, a key prosecution witness was Dr. Patrick Barnes, a neuroradiologist then at Children’s Hospital in Boston, now at Stanford University. “I was adamant that it had to be child abuse, shaken baby syndrome,” Dr. Barnes told Retro Report.But after the trial, he rethought his testimony and in effect became a penitent. He is now convinced that the diagnosis has been invoked too readily in criminal cases and that other causes might explain any bleeding and brain swelling. They include infections, earlier injuries from accidental falls and even strokes that occurred in utero. Other doctors who share his outlook question whether just shaking an infant, without resorting to other forms of violence, could in fact produce the triad’s telltale signs. Testing that thesis, though, may verge on the impossible: Who in the name of responsible science is about to shake a roomful of babies to see what happens?Discovering Shaken Baby SyndromeWithout question, Dr. Barnes said, abuse exists, “and we have to do our duty to protect children.” But families need protection, too, he said, and in some criminal cases, “there is no doubt that errors have been made and injustices have resulted.” Were he able to testify again in the Woodward trial, he said, he would say that the medical findings do not confirm abuse and that the baby’s injuries “could have been accidental.”One of the more exhaustive studies of shaken baby syndrome’s legal ramifications was conducted by The Washington Post and journalists from the Medill Justice Project at Northwestern University. In March, they published their analysis of about 1,800 abuse cases across the country that had reached resolution since 2001. Far more often than not — 1,600 cases — the result was a conviction. But the researchers found that in 200 cases, a substantial number, charges were dropped or dismissed, defendants were acquitted or convictions were overturned. The Retro Report video examines one such instance, involving Quentin Stone, a California man whom a jury last year cleared of charges that he had violently shaken his 3-month-old son to death.Not that the medical establishment is starting to line up on Dr. Barnes’s side. Far from it. Dr. Robert W. Block, a former president of the American Academy of Pediatrics, stands firmly by the diagnosis, telling Retro Report that abusive head trauma is supported by decades of observation.The divisions within the medical world run so deep that they pain a towering figure on this issue: Dr. A. Norman Guthkelch, a British doctor who in 1971 found a connection between baby-shaking and brain injury. “There are cases where people on both sides, both of whom I admire equally, are barely able to speak to one another, and that’s a shame,” Dr. Guthkelch, who turned 100 this month, told NPR in 2011. Yet he, too, has come to believe that the syndrome is applied too loosely in some criminal cases.As the debate continues, Louise Woodward has carved out a new life in Shropshire, in central England, where she teaches dance. Married, she has a baby of her own now, a girl born 20 months ago. Even before her pregnancy, she was quoted as telling The Daily Mail: “I know there are some people waiting for me to have a baby so they can say nasty things. It upsets me, but that is not going to stop me leading my life. I am innocent. I have done nothing wrong.”The videos with this article are part of a documentary series presented by The New York Times.A look back: Notorious au pair convicted in baby's death (Wcbv.com)Physical Abuse of Children | NEJMChild Abuse and Neglect (clinicalgate.com)Stephen LudwigPhysical AbusePhysical abuse is defined as nonaccidental physical injury to a child by parental acts or omissions. There has been an alarming increase in reported cases of child abuse throughout the United States in the past 3 decades. In all states, health professionals are now legally required to report their suspicions of abuse to their state’s child protection services (CPS) or police.Clinical PresentationDetermination of suspected abuse is based on compilation of information from five data sources: (1) history, (2) physical examination, (3) laboratory and radiographic information, (4) observation of parental–child interaction, and (5) a detailed family social history.When examining any child with an injury, the clinician should be suspicious of abuse if the history reveals an unusual delay in seeking medical care, the parents’ explanation of the injury is not compatible with the physical findings, the cause of the injury is unknown or “magical,” or there is a history of similar or repeated episodes. Parents may be reluctant to give information or their reaction may be inappropriate to the seriousness of the injuries. Other worrisome signs are a lack of primary care (no immunizations, no source of health care), a history of parental mental illness or substance abuse, and high levels of family stress.While examining the child, maintain a high index of suspicion for abuse or neglect if the child’s weight is below the third percentile for age and there is poor personal hygiene, lack of adequate clothing, behavioral disturbance (especially undue compliance with the examiner), or an abnormal interaction between the parent and child (unwarranted roughness or extreme aloofness). But realize that abuse may occur by parents of any socioeconomic or educational level.Remove all of the child’s clothing and examine the skin carefully for contusions, abrasions, burns, and lacerations in various stages of resolution. Any bruise on a child who is not yet cruising or walking is unusual. Certain skin lesions are typical for specific types of abuse; such as circular cigarette burns; human bite marks; J-shaped curvilinear or loop-shaped marks from a wire, cord, or belt; circumferential rope burns; “grid” marks from an electric heater; and symmetrical scald burns on the buttocks or extremities (Figure 12-1). Other dermatologic manifestations include cutaneous signs of malnutrition (decreased subcutaneous fat, increased creases), scalp hematomas, signs of trauma to the genital area, and signs of injuries at different stages of healing (Figure 12-2).Figure 12-1 Child abuse injury patterns.Figure 12-2 Signs of neglect and staging of injuries.Fractures are suggested by refusal to bear weight or move an extremity, gross deformity, or soft tissue swelling and point tenderness over an extremity. However, most metaphyseal chip fractures are not associated with deformity (Figure 12-3). Neurologic manifestations may include retinal hemorrhages, unexplainable irritability, coma, or convulsions (see Figure 12-3). Finally, an acute abdomen, poisoning, or any traumatic injury that cannot be explained may in fact represent forms of child abuse.Figure 12-3 Fractures and head injuries in child abuse.The differential diagnosis of the abused child includes conditions with skeletal involvement: accidental trauma, osteogenesis imperfecta, Caffey’s disease, scurvy, rickets, birth trauma, and congenital infection. Diseases with dermatologic manifestations include bleeding disorders (idiopathic thrombocytopenic purpura, leukemia, hemophilia, von Willebrand’s disease), recurrent pyodermas, and scalded skin syndrome. Sudden infant death syndrome and accidental poisonings may be mistaken for child abuse. The most common clinical problem is the differentiation between accidental and nonaccidental trauma.Evaluation and ManagementIf there is any fracture or other suggestion of any form of abuse in a child younger than 2 years of age, obtain a complete skeletal survey for trauma. For older patients, if the physical examination suggests a fracture, obtain specific radiographs. Order other radiologic studies, such as a head computed tomography or magnetic resonance imaging scan, as indicated by the nature of the injuries. Ophthalmologic consultation may be needed to identify retinal hemorrhage.In 1997, a young British nanny charged with murder brought shaken baby syndrome into the national spotlight, and raised a scientific debate that continues to shape child abuse cases today. Published On Sept. 13, 2015If the parents deny any knowledge of the cause of skin bruises, obtain a complete blood count with differential, platelet count, prothrombin time, partial thromboplastin time, and a bleeding time. The differential diagnosis and other possible laboratory studies are shown in Table 12-1.NOW YOU ARE READY TO BECOME AN EMERGENCY DEPARTMENT RADIOLOGIST.

It’s difficult to put an age to the start of debilitating illness or injury in my case. In 1992, (Miami Florida), I thought I had the stomach flu. I was 39 years old. My sons had it and I ended up with it about a day later. Cramping, nausea, fever, just like my boys. Their flu went away; mine did not. Considering that this new job I was able to secure (after Pan Am closed their doors in Dec. of ‘91, and that this new job did not pay for sick time), I decided to “suck it up” and go to work. On the road, I crossed a set of railroad tracks and the jostling sent seering pain from my gut all over my body.I decided not to go to work, but Baptist Hospital was on the same street. I went to the ER. and after my temp and some blood taken, I waited in the waiting room to see a doctor. My temp was 103. I didn’t have to wait long. In the examination room the doctor explained to me that my white cell count was incredibly high — indicating that my body was fighting off a major infection. His experience told him my appendix was about to explode and they needed to remove it ASAP. I had enough time to call my wife at home, who was already putting out a BOLO for me (LOL) because NOBODY knew where I was. She came over to the hospital. The doc told her 45 minute operation and 3 days in the hospital and I’d be out.Only when they opened me up, they realized the extent of the problem. There were a few diverticulum sacs on my intestine leaking on my appendix. So, the appendix was removed and they took out the offending section of my intestine. I was released 3 days before Hurricane Andrew hit Miami.45 minute op took 2 hours, 3 days recovery turned to 7. My digestion was never the same again. I had the digestion system of a Shrew — I’d eat and 2 minutes later I’d eliminate. I was 240lbs and I ultimately went to 180lbs in a bit over a year. That was “the beginning”.In 2009 I went into prison from jail. I spent 5 years there. Around 2012, I was having a problem urinating completely because of the pain I was experiencing. I saw a doctor who made a preliminary examination and diagnosed my problem as a swollen prostate. I was 56 years old at that point, so it was conceivable. He gave me “Flowmax” and the relief was minimal at best, but it didn’t hurt as much. In December of 2014, I was released from prison and my bladder problems got worse. I actually had to sit down on a toilet to urinate because I was pushing so hard that it had the potential of a bowel movement.I lived in Orlando for about 3 months, and I was a mess. Had no money. Hadn’t seen a doctor as yet. I had cold sweats. Every time I ate I felt as though I had run a marathon. Shortness of breath, constantly cold (wore a blanket over me all the time), and my urine was brown and the odor was very pungent. March 14, 2015 the paramedics were called because I had passed out. Two days later I was told what happened.My kidneys stopped working …. apparently around the same time I was released from prison. My body was so septic, most of my organs were affected in one way or the other. My large intestine was completely removed, my bladder was catheterized and because the blockage was so tight, they had to use a special tipped (Coude (ku-day) Foley catheter. I was also fitted with a catheter in my chest with two external ports to accept dialysis.During my stay in the hospital (lasting 4 months), I contracted pneumonia. I couldn’t speak above a whisper for weeks and I resigned myself to the fact this was the loudest I was going to get. Around the time I started regaining an audible voice, I was then diagnosed with C-diff — a highly contagious bacteria affecting the colon (in my case, what was left of it after they re-sectioned it once the large intestine was trashed. Because of that, I was kept in a special single room that actually disinfected the air with air-cleaners. Anyone coming into my room HAD to wear surgical masks and special covering over the clothes.I was 61 when I was first admitted in the hospital. I spent my 62nd birthday in the hospital weighing about 108 pounds. I was diagnosed with Tuberculosis toward the end of my stay. The county sent representatives and nurses to my room to start a regimen of medication. I was officially cleared of any T.B. contagion in April 2016. I have a laminated card from the Health Department.During my 4 month stay at the hospital, my legs were so full of fluid buildup that every time I received dialysis, they were taking about 5 liters of fluid out of my body. Two days later they repeated the removal. My muscles had atrophied by then. When it came time for me to check out, I was in a wheelchair. I was also given a walker and a physical therapist visited me once a week to get my leg strength back. Most of it, I did myself. Had to. Reasons were complicated and had nothing to do with my health. I set a goal to walk freely by March 2017 — my birthday (the 29th). I was walking on my own January 2017. No wheelchair, no walker, up and down short flights of stairs. I am now at 158 pounds, I finished my 659th dialysis treatment. I walk in and I walk out the same way as I entered. I am 65 years old now. What the heck else could possibly happen to me!? LOL