Tuesday, January 16, 2007

white islands in the sea of red- DHF


now is hard to find this.... saw it during my round in one of dengue haemorrahgic fever! classical white islands in the sea of red!

dengue nightmare

thought the outbreak is under control when I saw the number of patient being admitted after new year had reduced. Too bad, it was a temporary phenomena when I saw a sudden surge of patient admission since last week. There are more patient being admitted to ICU care of severe dengue haemorrhagic fever and dengue shock syndrome, with a total of 24 admissions to ICU alone last year, and a total of 907 admissions to Penang Hospital (adult figure)!!

Is anyone out there really working to reduce this outbreak? I am tired of receiving patients now! We as a clinicians are the receiving party, if the prevention is good, then the whole situation will not be as bad!!

So I have decided to write a love letter to the authority to look into this matter, however, we will not have the situation being controlled if everyone in this community did not participate in bringing the outbreak to a stop! First, start from our own backyard, make sure there will be no place for aedes to breed! (I am asking my maid to make sure all water container to be removed, all drains to be cleared) and the health authority really need to work their way harder by not only fogging but also making sure to check all premises to get rid of the breeding ground!

Now my ward is mad house....and everyday, the doctors are paying more attention on discharging the patients back home earlier and putting ourselves at risk of malpractice rather than treating the patients properly, just to make way for all dengue cases!! The whole system is going to break down if the situation gets worse....pray hard for ourselves and for the patients!

Thursday, January 11, 2007

live and let live

when we live and let live, we don't need to criticize, judge and condemn others. we have no need to control over them or try to make them conform to our thinking. We let others live their own life and we live ours.
Live and let live is one of the keys to peace in our life. when we practice tolerance in our lives, we are liberated to work on our own issues!

I read this and understood this when I am involved in treating HIV/AIDS patients!

Wednesday, January 10, 2007

confidentiality

I met a patient the other day when I was in a hurry to go off for ward rounds. I did not have my clinic day on that afternoon, however, he was sick and needed my attention right away as my nurse told me that he was not well clinically!

I entered the room and I met these 2 guys, one sitting and another one standing. I knew the one sitting was ill, most likely he had an opportunistic infection now. I presumed the brother whom the man standing beside the patient knew his status since he gave me the referral letter from the private physician.

So there i asked him loudly, when was his last test of HIV negative before this current test! He denied he has HIV.... And I told him that the letter stated that he was diagnosed HIV in private hospital! Then I saw his face grimacing and winking at me, putting his palm together praying to me begging me not to say anymore....oops then I realized I have breached the confidentiality about the disease to his brother and his brother apparently did not know his status!

I became panicked, I asked the brother to leave us alone in the room, and I apologize to him! However, he asked me not to let his brother know and he will tell the wife afterwards about his status!

Today, I received a call from oversea (patient is from oversea) and the lady claimed that she is the wife of that patient! She is very anxious as she told me that the brother of the patient called her up to inform her that he had over heard the conversation! She wanted to confirm the husband status! i cannot disclose over the phone, however, I really feel bad about the whole situation! YES! The spouse had the right to be informed about the status so that he or she could go for screening immediately. However, I always give time for the pateint to disclose the status themselves to their spouse, if not, I will bring them together and counsel them!

Some one asked me before, isn't it important to let the other family members who might be taking care of the patient while cleaning and sponging? The truth is, this disease does not spread by sponging and cleaning the patient! However, our health side workers are wearing gloves even nursing them...how am I going to sound convincing to the relatives??

In my opinion, the spouse should be informed by all means, however, if the patient refuse the let the family know, we as a clinician who treat them should respect their wish!

In this case....I will have a tough time....Have not really told him about the wife calling me up!!

The point is, Do NOT assume that all patient relatives who came with them knew the status!!

Some one told me, ASSUME is making an ASS Out of U and Me!!!

Tuesday, January 09, 2007

is private treatment better?

at around 4 pm today, I was asked to review a patient referred from a private hospital for retroviral illness that was recently diagnosed! The reason why I need to see this patient particularly was .....urgent changes need to be set!!

The patient came all the way from Medan, visit ted local private hospital for treatment twice and was not counselled properly for Anti retroviral treatment, so he happily took his medicine one at a time, and took wrong dose, wrong timing, and wrong way!! Now he had to pay the price of creating resistant virus and made his regime less potent at present....was it his fault? Or was this the Private Physician who earned lots and lots of money from these patient but yet did not give proper counselling and proper treatment for those who had paid them???

This was not my first encounter and within the last month, I had been receiving 3 or more such cases from private physician, either they had sucked their patient dried of money only then they referred to me, or when the patient was too ill and will increase their mortality rate in their hospital, I was really frustrated with this situation!

Anyway, my duty is to serve the public, so does not matter whether I am OK or not, I will still provide my best care....so call best if I can in this shortage of man power in general hospital! Just wish there is some private physician with more ethic will refer those patient earlier before damage is done! The patient will be the one who suffers!

Sunday, January 07, 2007

My angel

This is the angel of my life....well some times she is like a devil....

Hi I am back

It has been a long long 2 months in my life....feels like is going through 2 years to me! Finally, I have managed to go through this 2 months of my life with lots of emotional disturbance!

My beloved husband finally went through his NPC treatment, which made him loose 14 Kg in total, going through that difficult time was not easy for both of us! He was in great pain and I cannot share his pain physically, however, mentally I was tortured as well by looking at him and feeling his suffering! I did try to portray as though I am alright and fine in my work as well as in my role as a wife and a mother. The truth is I am very tired and stressed up. I had been suffering from acute tonsillitis with maxillary sinusitis recurrently, I have taken 4 courses of antibiotics in this 2 months!

Now when my husband is recuperating from his illness, I am doing the same as well. I just wish that this new year will be a better one for both of us and for everyone in the world!

May the year of pig brings luck and happiness to everyone! Happy New Year!