Wednesday, March 28, 2012

A WIFE'S GRIEF AND LOSS.


Dealing with the loss of a spouse.



I heard her through the haziness of my uncomfortable sleep-it was one of those nights ,or should i say early mornings, where there is a false impression that the Emergency room is not a busy place. Indeed at such moments it is hard to be relaxed because anything can happen to break your reverie.

She was some distance away, but her agitated screaming sounded quite near. I peered out through the windows at the dark night and could barely make out the silhouette of two figures; from their distressed shouts i gathered one had lost somebody and the other was trying to calm her down. This is a scene that has been played out countless times on the hospital grounds .

I settled back to probably resume the remains of my fragmented sleep, little did i know my own peaceful reverie would soon be broken, little did i know i would soon play a part in the scene that was still unfolding some distance from me.

With the sleep finally gone i settled to my usual routine, it was then i heard the cacophony of a crowd gathering in the ER- the same agitated woman whom some moments ago i had heard screaming at the top of her lungs was brought in unconscious, all bruised and dirtied.


Her husband had just died in the hospital.


She had refused all entreaties by those around her to calm down and had worked herself into a frenzied state before losing consciousness. Her blood pressure had skyrocketed.

She came round once I attended to her and resumed her agitated chatter-her husband had left her with three kids,-she wanted to go home. There was nothing wrong with her, she claimed.

We couldn't release her just like that as her state of mind and safety were still in doubt. Meanwhile, she continued to plead, getting more worked up and agitated.

Then she started screaming.



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Friday, March 23, 2012

SEIZURE ON THE HIGHWAY


What would you do if you were driving and suddenly see a woman standing in front of your car, oblivious to anybody or any car around her?
Would you think she is mad, suicidal or playing some sort of practical joke?

Will it come to your mind that she may be having a seizure?


Not an ideal place to have a seizure, you would agree with me, but a seizure is no respecter of place or time.

Disastrous situations in which a seizure may occur include while driving, operating heavy machinery, working with sharp tools or carrying a baby.


THE PATIENT

She was brought in by a good samaritan after she was found standing in the middle of the road, oblivious to the cars and people around her; unaware of the shouts of people and car honks trying to get her out of harm's way.
She was found there as if in some sort of trance - she just stood there as if she was in her own home thinking of what next to cook for supper.

She caused a major traffic jam that day.

A closer look would have chilled your bones, like looking into a house, with all the shutters open but no one home.

She was having a seizure.

This was not the common type of seizure, there was no foaming of mouth, no falling to the floor, no screaming.This was a silent seizure attack; like putting on the silencer before firing a deadly bullet.
Further history revealed she had about 5 episodes of such occurrence in a day. It was even known to happen whilst carrying her baby.

Thankfully, no serious harm had yet happened to her or her baby, so it was time to properly manage the condition.


HOW TO MANAGE A SEIZURE


Prevent harm as much as possible to the person, do not put spoons or anything that would occlude the airway.
Transport patient to the ER where some tests would be done and anticonvulsant medication given.

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Tuesday, March 20, 2012

"I AM FINDING IT HARD TO BREATHE AND TALK."


Can you decipher the above handwriting?

Clue: No that's not a doctor's writing.

I almost made the mistake of not taking her as an emergency and rather preferred attending to another patient who looked more ill.

I couldn't be more wrong.

She was a young student in her twenties. She sat completely still- her face blank and impassive, as if she just wasn't there. She looked unaware and uninterested in her surrounding.
I tried talking to her, she couldn't respond.

It was then i gave her the piece of paper in which she wrote the above.

There was no more time to lose!

COMMON SYMPTOMS OF ASTHMA

These have been highlighted under Asthma Attack. They include:
Chest tightness
Breathlessness
Wheezing
cough.

This was a worse type of Asthmatic attack.


FEATURES OF A SEVERE ASTHMA ATTACK.

Inability to complete a sentence.
Increased rate of breathing.
Increased heart rate.

It is a life threatening condition.

It could be fatal if not managed in the ER.

Tuesday, March 13, 2012

13 THINGS I WISH I KNEW BEFORE STUDYING MEDICINE .



1. There are much easier and less time consuming ways to make money.


2. You don't necessarily have to study medicine to be called a doctor.


3. Reading doesn't stop when you qualify to become a doctor; actually it just starts.


4. There would be something called weekend call duty.


5. Hobbies and talents should not be neglected whilst studying medicine. An example of a doctor who has successfully veered off medicine to pursue his talent is Harry Hill.


6. You would still have to pay for your health or your family's health care.


7. There are much cooler occupations.


8. The most beautiful girls are not in medical school( would only change this opinion when a doctor wins Miss Universe).


9. The most beautiful people are also not in the hospital, either as patients, doctors or nurses.


10. Taxes.


11. 80 percent of your primary school buddies would be married when you graduate and your first child will be roughly four years younger than theirs.


12. Not all nurses are angels.


13. The Law.


Any additions will be most welcome.


image courtesy

Monday, March 12, 2012

ANOTHER KIND OF HEADACHE


Is there a direct relationship between what is going on in a person's life and a person's health?



This is my second story about headaches.

The patient had been having a series of recurrent headaches which were quite disturbing and concentrated around her forehead. She admitted being under a tough routine at work but didn't seem to think that was the cause-I asked the standard questions about her vision, blood pressure etc-her Blood pressure was 100/60.
My examination narrowed the problem to two possibilities; one a migraine ( which was less likely) and a tension headache.


TENSION HEADACHES

These are headaches without any serious underlying pathology usually attributed to worry, noise or depression in a person's life. Examination and investigations will reveal nothing significant except that tensed feeling especially over the scalp, some investigation may be done to reassure the patient that there's nothing wrong.

So what was the cause of her tension?

She was 38 and unmarried .


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