A potentially life-saving Tweet

twitter_This is an old column (late 2013) that has been loitering in my drafts’ folder for ages. 

I was planning to post it when I had finally mastered the intricacies of Twitter… but I don’t think that is going to happen in the foreseeable future. Much as I can appreciate Twitter’s value, I’m still very much an occasional spectator.  

I owe my Twitter fumblings a debt though… they may have just saved my mother’s life….

November, 2013

I used to think Twitter was for twits – twits with short attention spans, an inability to construct proper sentences and the misguided impression that everyone else is interested in their mundane lives.

Despite my reservations, I tentatively dipped my toe into the Twitterverse earlier this year, and discovered, to my surprise, that there is no shortage of relevant and interesting tweets relating to medicine and medical education.  It’s just a matter of knowing where to look and whom to follow.

Twitter has also added whole new educational and networking dimensions to the conferences I’ve attended this year.  Where once I would’ve deliberately left my electronic devices behind to avoid distraction, I now not only carry my iPad and phone with me, but actively interact with them during presentations.

I’m still very much a novice tweeter, though.  I’m not yet quick or deft enough to always operate unobtrusively. I feel guilty about this, for as a presenter myself, I know how annoying it can be to have your audience seemingly so distracted.

And I confess to being distracted myself by incoming emails, like the one from my father in Canada, received while I was sending a tweet relating to the handy HANDI (Handbook of Non-Drug Interventions) being introduced by Professor Paul Glasziou at GP13.

My dad’s email was titled “Mum’s health”. It gave a detailed description of a very acute and severe systemic illness following a viral respiratory tract infection.  After describing a typical pneumonia +/- sepsis, Dad then went on to say that he’d given her a cold and flu tablet, and did I have “any further suggestions?”

Any further suggestions?!  I emailed back immediately with my provisional diagnosis and told him to get her to hospital ASAP, and to ignore any protests.  45 minutes later, when the session ended, I rang to check that he’d received my email.  “Yes,” he confirmed, “but your mother says she’s too sick to go anywhere.”

Despite her not wanting to talk to me (which was a worrying sign in itself), I got Dad to put me on speaker phone and I got very bossy with my seriously ill mother.   She could barely talk, which made it easier for me to ride roughshod over her objections.

And it was just as well I did.  She was admitted and treated immediately.  Hypoxic, tachycardic, febrile and dehydrated, with intractable hypotension (60/35!), altered mental state, elevated serum lactate and rip-roaring consolidation on chest X-ray, she had lobar pneumonia with sepsis, just as I’d predicted.

I can just imagine the scene in the Canadian ER that night.  An older Australian woman in septic shock is dragged in by her husband, the couple apologising for disturbing the staff after-hours and potentially wasting their time, saying the only reason they were there was that they have a bossy doctor-daughter who bullied them into coming.  On the plus side, my parents did their bit for perpetuating the “Tough Aussie” legend!

Mind you, this is not atypical for our family.  “Breed ’em tough” was my parents’ preferred parenting style.  Severe abdominal pain (appendicitis) was not enough of an excuse to get out of cleaning a bedroom; a swollen and deformed wrist (fractured radius and ulna) not a reason to cry. We were never short of love and attention, but whinging never got us kids far.

There is a time and a place for seeking help though, and very luckily, thanks to being inspired to tweet about a handbook of non-drug interventions (HANDI), I was able to step in to ensure that my mother got the lifesaving drug interventions she didn’t know she needed.

First published in Australian Doctor on 15th November, 2013 On Twitter