Guest guest Posted July 11, 2006 Report Share Posted July 11, 2006 Regardless of how pertinent it is to their health and safety, this situation is likely not to change. We are the good guy when they need us and the bad guy when they do not want to hear what we have to say. Our service requires the client company physician to submit to the project a Fit for Duty form prior to their return. This form outlines the conditions of their return, basically " Full Duty " or " Limited Duty " with any specific constraints identified on the form. In some cases our clients provide this information on their own and we are to provide the follow-up care with in our medical guidelines. Also, we will only continue prescriptions for NSAID medications. We will not provide prescription level pain management for maintenance issues. Despite this, we frequently run into issues where an employee has been released by a client company physician sometimes with and without the FFD form and we are forced to accept it. In this case we have to verify whose liability is being exposed. This does not change our treatment guidelines because we do not treat per client company physician, but we do treat with them and frequently put them in touch with our medical control. If the opportunity for putting this monkey on the client physician's back is present I would take full advantage of this as it is their responsibility, but they frequently pass it on. In many cases I have seen them cave in over an issue because the patient does not want to lose any pay and they do not want to be the " bad guy " . So they get to decide if they want to be the bad guy and we decide if it is worth it for this guy to make more money or hurt himself or someone else. I realize I am not offering a solution, but rebound venting as this is an all too common occurrence. Kindest Regards, snafumedic _____ From: [mailto: ] On Behalf Of Sent: Tuesday, July 11, 2006 8:23 AM remote medics Subject: How do you know? All, this one is for the offshore guys amongst us, but anyone can comment. Whilst im on a rant: How do we know that people we have sent off to see the topside Dr are fit enough to return back offshore? If I send off a guy with a back complaint, how would you know on your platform / rig that he is fit enough to return offshore. e.g.: Whilst working at a location I was approached and asked for some painkillers by a man who had just had an operation on his wrist for carpal tunnel (post fracture of the radius). He had a metal plate in his forearm and said he was given Voltarol by his GP, and wanted more as it was the only thing that kept the pain away. After some time arguing about his fitness to work offshore, (I asked if he thought he should be using air powered tools in this condition, and also asked if his supervisor was aware of his medical complaint. Needless to say he walked off in a huff as in his words " **** me im just trying to make a living and you ******* medics make it so hard. " Or words to that effect) I called topside for advice and he was removed from the location next chopper. However, should he have been allowed offshore to start with? Comments!! Mitch --------------------------------- Try the all-new . " The New Version is radically easier to use " - The Wall Street Journal Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 11, 2006 Report Share Posted July 11, 2006 Hi, I had a situation a while ago where a crew member was injured on leave, in a car crash, he took a couple of trips off, he came back out, nobody knew he had been injured and then I was pulled up by QHSE because he hadn't had a fitness to return back to work medical!! If they are sent back via casevac or I believe medevac they should have a medical before returning back to work. The problem you have is like the case stated above, if they are not at work chrystal ball is the only way of knowing. Tony <lisamitch50@...> wrote: All, this one is for the offshore guys amongst us, but anyone can comment. Whilst im on a rant: How do we know that people we have sent off to see the topside Dr are fit enough to return back offshore? If I send off a guy with a back complaint, how would you know on your platform / rig that he is fit enough to return offshore. e.g.: Whilst working at a location I was approached and asked for some painkillers by a man who had just had an operation on his wrist for carpal tunnel (post fracture of the radius). He had a metal plate in his forearm and said he was given Voltarol by his GP, and wanted more as it was the only thing that kept the pain away. After some time arguing about his fitness to work offshore, (I asked if he thought he should be using air powered tools in this condition, and also asked if his supervisor was aware of his medical complaint. Needless to say he walked off in a huff as in his words " **** me im just trying to make a living and you ******* medics make it so hard. " Or words to that effect) I called topside for advice and he was removed from the location next chopper. However, should he have been allowed offshore to start with? Comments!! Mitch --------------------------------- Try the all-new . " The New Version is radically easier to use " – The Wall Street Journal Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 11, 2006 Report Share Posted July 11, 2006 Mitch: The short term the " wallet perspective syndrome " is foremost in most workers minds, (short term) and it truly sucks to be this fellow. Don't be so hard on yourself mate (well, unless you broke his arm in the first place) it sounds as if the MD signing the " back to work script " really does not understand the nature of the work or the worker double doctoring? We all know that this patient will benefit from your investigation in the long term besides chronic pain can make one a touch on the grumpy side anyways. I certainly hope this fellow will come to realize that YOU have done what is best for HIM, reinjury could have very serious lifelong consequences, was he right or left handed??? j/k. As you know, what the patient " wants " and what is in his " best interests " and " safety " are not necessarily the same thing. Now speaking out the other side of my mouth (I have had the occasion to have a few cases like this myself.).... if he (the patient) does not understand this situation and to coin a phrase used frequently in the oilpatch then " **** him! " cheers and stick to your guns. signed Anyone. How do you know? All, this one is for the offshore guys amongst us, but anyone can comment. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 11, 2006 Report Share Posted July 11, 2006 A visiting contractor I assume? Quite understandably wanting to get back into paid employment but that's not your problem. All personnel should be notified by the platform management/operator that in the event of them having receiving medical treatment whilst on leave they must be assessed by the companys medical provider as suitable/fit to work offshore. In the case of third part contractors almost impossible to enforce I'd expect. In a case where you have refered someone onshore for management the line management offshore and company O.H dept. should be notified of this and should liaise with HR to ensure they are medically certified as fit to return Regards > > All, this one is for the offshore guys amongst us, but anyone can comment. > > Whilst im on a rant: How do we know that people we have sent off to see the topside Dr are fit enough to return back offshore? If I send off a guy with a back complaint, how would you know on your platform / rig that he is fit enough to return offshore. e.g.: > > Whilst working at a location I was approached and asked for some painkillers by a man who had just had an operation on his wrist for carpal tunnel (post fracture of the radius). He had a metal plate in his forearm and said he was given Voltarol by his GP, and wanted more as it was the only thing that kept the pain away. After some time arguing about his fitness to work offshore, (I asked if he thought he should be using air powered tools in this condition, and also asked if his supervisor was aware of his medical complaint. Needless to say he walked off in a huff as in his words " **** me im just trying to make a living and you ******* medics make it so hard. " Or words to that effect) I called topside for advice and he was removed from the location next chopper. However, should he have been allowed offshore to start with? > > Comments!! > > Mitch > > > --------------------------------- > Try the all-new . " The New Version is radically easier to use " – The Wall Street Journal > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 11, 2006 Report Share Posted July 11, 2006 Hi Mitch If you medevac/medrescue a person off a North Sea platform it will be flagged up on Vantage. Speak to whoever does heli admin at your location they should be able to access that. When they check in at the heliport it will flag they require a fit to return offshore medical from their offshore provider. Off course if you just send them in for a medical referral that may not be captured, Clive > > From: <lisamitch50@...> > Date: 2006/07/11 Tue PM 02:23:23 BST > remote medics < > > Subject: How do you know? > > All, this one is for the offshore guys amongst us, but anyone can comment. > > Whilst im on a rant: How do we know that people we have sent off to see the topside Dr are fit enough to return back offshore? If I send off a guy with a back complaint, how would you know on your platform / rig that he is fit enough to return offshore. e.g.: > > Whilst working at a location I was approached and asked for some painkillers by a man who had just had an operation on his wrist for carpal tunnel (post fracture of the radius). He had a metal plate in his forearm and said he was given Voltarol by his GP, and wanted more as it was the only thing that kept the pain away. After some time arguing about his fitness to work offshore, (I asked if he thought he should be using air powered tools in this condition, and also asked if his supervisor was aware of his medical complaint. Needless to say he walked off in a huff as in his words " **** me im just trying to make a living and you ******* medics make it so hard. " Or words to that effect) I called topside for advice and he was removed from the location next chopper. However, should he have been allowed offshore to start with? > > Comments!! > > Mitch > > > --------------------------------- > Try the all-new . " The New Version is radically easier to use " – The Wall Street Journal > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 11, 2006 Report Share Posted July 11, 2006 Mitch, Persons returning to a vessel/platform following a significant injury should, in theory, have had a 'fitness to work' medical carried out prior to returning. Not all personnel are aware that they have to and (rarely) return offshore without having seen a Dr, as they think that their UKOOA medical is sufficient. The Drs are normally on the ball and arrange for them to return for a medical prior to returning to work. Needless to say there is a very small minority who are aware that they have to but are more interested in earning money and deliberately avoid seeing the Dr and try to get back onboard with the tried and trusted '..but nobody told me!!' Tony Ewing On Tue, 11 Jul 2006 14:23:23 +0100 (BST), " " <lisamitch50@...> said: > All, this one is for the offshore guys amongst us, but anyone can > comment. > > Whilst im on a rant: How do we know that people we have sent off to see > the topside Dr are fit enough to return back offshore? If I send off a > guy with a back complaint, how would you know on your platform / rig > that he is fit enough to return offshore. e.g.: > > Whilst working at a location I was approached and asked for some > painkillers by a man who had just had an operation on his wrist for > carpal tunnel (post fracture of the radius). He had a metal plate in > his forearm and said he was given Voltarol by his GP, and wanted more > as it was the only thing that kept the pain away. After some time > arguing about his fitness to work offshore, (I asked if he thought he > should be using air powered tools in this condition, and also asked if > his supervisor was aware of his medical complaint. Needless to say he > walked off in a huff as in his words " **** me im just trying to make a > living and you ******* medics make it so hard. " Or words to that > effect) I called topside for advice and he was removed from the > location next chopper. However, should he have been allowed offshore to > start with? > > Comments!! > > Mitch > > > --------------------------------- > Try the all-new . " The New Version is radically easier to > use " – The Wall Street Journal > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 11, 2006 Report Share Posted July 11, 2006 Cheers Clive, Yup, I was aware that the vantage system picks up these things, but exactly, what about when you send someone in for a medref? The fact that this chap I was speaking about below got offshore after his operation without the need to show a " Fit for work " certificate last year, kind of makes me think. It hurts when I think, so I needed to try and rationalise the predicament. As those of us who have been working offshore for more than a year can realize: Not all operators use Vantage, not all operators use the same helicopter company, and they don’t use the same Topside medial support. So someone from a drilling background (Lets say a roughneck) who is working for an agency, gets referred to the specific companies topside Medical Dr and is signed off work because of a back issue. What is to stop the roughneck (on a day rate and obviously wants to work to pay for his beer) working for another agency, going offshore for another company who doesn’t use the same Topside medical support? We would never know and the problem will just get passed on to another Medic. Bare in mind now that most agency Medics will work for 3 or 4 different agencies in a year, I did a few years ago. The companies I worked for use the same parent contractors, who use different agencies to fill vacant places, so it happens. Im just getting quite angry that people will still come offshore with injuries or medical conditions which were flagged up at their last place of work, and they are not stopped. Mitch clive.lewis40@... wrote: Hi Mitch If you medevac/medrescue a person off a North Sea platform it will be flagged up on Vantage. Speak to whoever does heli admin at your location they should be able to access that. When they check in at the heliport it will flag they require a fit to return offshore medical from their offshore provider. Off course if you just send them in for a medical referral that may not be captured, Clive > > From: <lisamitch50@...> > Date: 2006/07/11 Tue PM 02:23:23 BST > remote medics < > > Subject: How do you know? > > All, this one is for the offshore guys amongst us, but anyone can comment. > > Whilst im on a rant: How do we know that people we have sent off to see the topside Dr are fit enough to return back offshore? If I send off a guy with a back complaint, how would you know on your platform / rig that he is fit enough to return offshore. e.g.: > > Whilst working at a location I was approached and asked for some painkillers by a man who had just had an operation on his wrist for carpal tunnel (post fracture of the radius). He had a metal plate in his forearm and said he was given Voltarol by his GP, and wanted more as it was the only thing that kept the pain away. After some time arguing about his fitness to work offshore, (I asked if he thought he should be using air powered tools in this condition, and also asked if his supervisor was aware of his medical complaint. Needless to say he walked off in a huff as in his words " **** me im just trying to make a living and you ******* medics make it so hard. " Or words to that effect) I called topside for advice and he was removed from the location next chopper. However, should he have been allowed offshore to start with? > > Comments!! > > Mitch > > > --------------------------------- > Try the all-new . " The New Version is radically easier to use " – The Wall Street Journal > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 11, 2006 Report Share Posted July 11, 2006 Mitch On a similar vein, another one for the offshore guys to consider. I've just had a guy come to see me today asking to start a BP monitoring regime whilst he is offshore. Apparently he was issued with a 3 month offshore medical cert, due to hypertension, and told that he would be able to get the installation Medic to monitor his BP while he was offshore. If someone is requiring monitoring to see if a condition is stable, surely offshore is not really the place to do it. It would only seem responsible (to me) for the company issuing the medical cert to advise the employer of the restriction. Without breaking confidentiality the installation operator's Medical Adviser should have been made aware of the requirement for the monitoring before he was allowed offshore. If the guy in question had decided not to tell me about his condition I wouldn't be able to take into consideration if he needed emergency treatment. I did bring my concerns up with the OIM but, as I'm only covering for sickness I doubt I'll see any feedback from this. Whoops, there I go ranting! Colin > Hi Mitch > If you medevac/medrescue a person off a North Sea platform it will be flagged up on Vantage. > Speak to whoever does heli admin at your location they should be able to access that. > When they check in at the heliport it will flag they require a fit to return offshore medical from their offshore provider. > Off course if you just send them in for a medical referral that may not be captured, > Clive > > > > From: <lisamitch50@...> > > Date: 2006/07/11 Tue PM 02:23:23 BST > > remote medics < > > > Subject: How do you know? > > > > All, this one is for the offshore guys amongst us, but anyone can comment. > > > > Whilst im on a rant: How do we know that people we have sent off to see the topside Dr are fit enough to return back offshore? If I send off a guy with a back complaint, how would you know on your platform / rig that he is fit enough to return offshore. e.g.: > > > > Whilst working at a location I was approached and asked for some painkillers by a man who had just had an operation on his wrist for carpal tunnel (post fracture of the radius). He had a metal plate in his forearm and said he was given Voltarol by his GP, and wanted more as it was the only thing that kept the pain away. After some time arguing about his fitness to work offshore, (I asked if he thought he should be using air powered tools in this condition, and also asked if his supervisor was aware of his medical complaint. Needless to say he walked off in a huff as in his words " **** me im just trying to make a living and you ******* medics make it so hard. " Or words to that effect) I called topside for advice and he was removed from the location next chopper. However, should he have been allowed offshore to start with? > > > > Comments!! > > > > Mitch > > > > > > --------------------------------- > > Try the all-new . " The New Version is radically easier to use " – The Wall Street Journal > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 11, 2006 Report Share Posted July 11, 2006 All, Seems like I have opened a small can of good healthy banter. Nice to hear from you all, on and off list, Imp not worried about the guy as this was last year, and im sure that he realized he was in the wrong. Thanks to all who gave support, I am sure that many more if not all of us do a great job, thankless but great non the less. Keep up the banter guys, and keep your chins up. I am worried about the girl who is epileptic though.... Thanks for all the fish: I’m off on Friday lunchtime, not a day too soon. Mitch Colin Marshall <colin@...> wrote: Mitch On a similar vein, another one for the offshore guys to consider. I've just had a guy come to see me today asking to start a BP monitoring regime whilst he is offshore. Apparently he was issued with a 3 month offshore medical cert, due to hypertension, and told that he would be able to get the installation Medic to monitor his BP while he was offshore. If someone is requiring monitoring to see if a condition is stable, surely offshore is not really the place to do it. It would only seem responsible (to me) for the company issuing the medical cert to advise the employer of the restriction. Without breaking confidentiality the installation operator's Medical Adviser should have been made aware of the requirement for the monitoring before he was allowed offshore. If the guy in question had decided not to tell me about his condition I wouldn't be able to take into consideration if he needed emergency treatment. I did bring my concerns up with the OIM but, as I'm only covering for sickness I doubt I'll see any feedback from this. Whoops, there I go ranting! Colin > Hi Mitch > If you medevac/medrescue a person off a North Sea platform it will be flagged up on Vantage. > Speak to whoever does heli admin at your location they should be able to access that. > When they check in at the heliport it will flag they require a fit to return offshore medical from their offshore provider. > Off course if you just send them in for a medical referral that may not be captured, > Clive > > > > From: <lisamitch50@...> > > Date: 2006/07/11 Tue PM 02:23:23 BST > > remote medics < > > > Subject: How do you know? > > > > All, this one is for the offshore guys amongst us, but anyone can comment. > > > > Whilst im on a rant: How do we know that people we have sent off to see the topside Dr are fit enough to return back offshore? If I send off a guy with a back complaint, how would you know on your platform / rig that he is fit enough to return offshore. e.g.: > > > > Whilst working at a location I was approached and asked for some painkillers by a man who had just had an operation on his wrist for carpal tunnel (post fracture of the radius). He had a metal plate in his forearm and said he was given Voltarol by his GP, and wanted more as it was the only thing that kept the pain away. After some time arguing about his fitness to work offshore, (I asked if he thought he should be using air powered tools in this condition, and also asked if his supervisor was aware of his medical complaint. Needless to say he walked off in a huff as in his words " **** me im just trying to make a living and you ******* medics make it so hard. " Or words to that effect) I called topside for advice and he was removed from the location next chopper. However, should he have been allowed offshore to start with? > > > > Comments!! > > > > Mitch > > > > > > --------------------------------- > > Try the all-new . " The New Version is radically easier to use " – The Wall Street Journal > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 2, 2008 Report Share Posted September 2, 2008 I have been on the candida diet for over a month now... how long does it typically take for the overgrowth to go away? I have heard it takes approx 3 months. How do u know when u are finally cured? Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 3, 2008 Report Share Posted September 3, 2008 > > I have been on the candida diet for over a month now... how long does it typically take for > the overgrowth to go away? I have heard it takes approx 3 months. How do u know when u > are finally cured? Hi There. Welcome to our group. What is your name please? It takes 1 month of natural healing for every year you've been unwell, and for most people nowadays that is since before they were born due to the poor nutritional status acquired from their parents. Candida isn't cured by " killing it off " like Doctors treat bugs. The only way is by building up the immune system with proper diet and supplements. You know you are cured when you have no illnesses, no die-off, and the health problems you had previously have been properly " retraced " by the body and rebuilt. The best in health, Bee Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 3, 2008 Report Share Posted September 3, 2008 Sorry Bee I forgot to introduce myself in my last e-mail, my name is Aleks. It was such a relief finding this group as I really had nowhere else to turn for answers and guidance. Thank you so much for all your advice. From your answer I guess I will be on this diet for quite some time. Does that mean no grains etc. unitill the diet is over or can I start introducing them slowly throughout the diet? So lets say I need to be on it for 12 months could I start introducing grains back in the last 3 months for example? Also, I noticed that you said yoghurt should not be eaten on the candida diet. Before I knew about this I was eating natural, organic full cream yoghurt and was getting very bloated and gassy, and had a sort of nauseating feeling and was slightly lightheaded, therefore I stopped eating it. But as I read more about die-off symptoms I was wondering if the yoghurt was actually helping and killing off the candida? what do you think? should I go back on the yoghurt? It seams that most of the so called die off symptoms stopped as I went off the yoghurt. I am also taking Pao d'arco tea, coconut oil, garlic (ocassionally), pro biotics and vitamins/supplements. Kind Regards, Aleksandra Jozwik > From: Bee <beeisbuzzing2003@...> > Subject: [ ] Re: how do you know? > > Date: Wednesday, September 3, 2008, 1:57 PM > > > > > I have been on the candida diet for over a month > now... how long > does it typically take for > > the overgrowth to go away? I have heard it takes > approx 3 months. > How do u know when u > > are finally cured? > > Hi There. Welcome to our group. What is your name please? > > It takes 1 month of natural healing for every year > you've been > unwell, and for most people nowadays that is since before > they were > born due to the poor nutritional status acquired from their > parents. > > Candida isn't cured by " killing it off " like > Doctors treat bugs. The > only way is by building up the immune system with proper > diet and > supplements. > > You know you are cured when you have no illnesses, no > die-off, and > the health problems you had previously have been properly > " retraced " > by the body and rebuilt. > > The best in health, Bee Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 4, 2008 Report Share Posted September 4, 2008 > > Sorry Bee I forgot to introduce myself in my last e-mail, my name is Aleks. +++Hi Aleks. It is good to know your name. It was such a relief finding this group as I really had nowhere else to turn for answers and guidance. Thank you so much for all your advice. From your answer I guess I will be on this diet for quite some time. Does that mean no grains etc. unitill the diet is over or can I start introducing them slowly throughout the diet? So lets say I need to be on it for 12 months could I start introducing grains back in the last 3 months for example? +++So you were totally healthy until 12 years ago? Yes, you can slowly start introducing grains later on in the program. The timing is very individual, depending upon how well they stick to the program, how much damage candida has done, etc. When you introduce them start with 1/4 cup per day for a week, and see how you do before increasing it. > > Also, I noticed that you said yoghurt should not be eaten on the candida diet. Before I knew about this I was eating natural, organic full cream yoghurt and was getting very bloated and gassy, and had a sort of nauseating feeling and was slightly lightheaded, therefore I stopped eating it. But as I read more about die-off symptoms I was wondering if the yoghurt was actually helping and killing off the candida? what do you think? should I go back on the yoghurt? It seams that most of the so called die off symptoms stopped as I went off the yoghurt. I am also taking Pao d'arco tea, coconut oil, garlic (ocassionally), pro biotics and vitamins/supplements. +++The symptoms you describe are caused by one of two things: 1) candida overgrowing, or 2) die-off/healing symptoms. The only way you know which is which IS if you stick to the diet. The reason yogurt is bad for candida is because the lactose (sugar) in it is changed into another sugar called galactose during fermentation. Galactose also feeds candida. Bee Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 4, 2008 Report Share Posted September 4, 2008 " The reason yogurt is bad for candida is because the lactose (sugar) in it is changed into another sugar called galactose during fermentation. Galactose also feeds candida. " Is this the same reason all diary products have this same effect on me? I read about the Optimal Nutrition through one of your messages and have been following that along with the Candida program, they are pretty much the same except the diary. I have felt much improvement and losing a few pounds, but diary affects me so negatively. I have had my Gall Bladder removed, therefore, almost immediate belching and bloating with occasional flatulence. Thank you Bee, Betty Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 5, 2008 Report Share Posted September 5, 2008 > > " The reason yogurt is bad for candida is because the lactose (sugar) > in it is changed into another sugar called galactose during > fermentation. Galactose also feeds candida. " > > Is this the same reason all diary products have this same effect on me? I read about the Optimal Nutrition through one of your messages and have been following that along with the Candida program, they are pretty much the same except the diary. I have felt much improvement and losing a few pounds, but diary affects me so negatively. I have had my Gall Bladder removed, therefore, almost immediate belching and bloating with occasional flatulence. Hi Betty. If you are following my Candida Program you would have eliminated all dairy products, except butter. The Optimal Diet is not designed for candida sufferers, so following it will not help. Bee Quote Link to comment Share on other sites More sharing options...
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