Wednesday, 23 July 2008

Occupational Health - more second opinions - Tragic and Trivial

Occupational health is a window on the world, I cannot prescribe drugs, nor order any tests but from my crow's nest I see life. Sometimes what I see in Occupational health goes beyond description for a twentieth first century civilised nation

45 year man blind from an avoidable and treatable complications of cataract surgery.

Refuse Collector - Essential manual worker

Aged 45, rapidly progressive cataracts and hypertension. Waits eighteen months for surgery "to get his blood pressure under control". Operations 4 and 6 months ago. Not back at work, sent for Occupational Health referral.

On examination, Light and Dark perception only.

Likely diagnosis - Bilateral detached retinas, occuring a few days after surgery.

Complications - no post operative check, not when the man goes for surgery on his second eye

Prognosis - Grim

The trivial.

Technician (aka Mechanic) for top car manufacturere

Non essential Manual worker

Pains in wrist, not severe, just aches occasionally.

Third visit to private specialists - and private physiotherapists, following checks for Hand and Arm Vibration Syndrome and Carpal Tunnel Surgery

Unknown fact - this employee races 1,000 cc bikes at the weekend, which puts his wrists into extension and this, combined with the vibration and weight of the bike, is hurting his wrist.

Complications - at risk of private surgery for Carpal Tunnel Syndrome

Prognosis - excellent if he changes the bars on his bike

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