Lately apabila nak menulis, asyik keluar coretan yang negatif saja. Negatif saja yang difikirkan. Sampaikan baru-baru ni masa ke kedai buku, terfikir nak beli buku motivasi untuk jadi lebih positif. Tapi tak beli pun. Buat apa banyakkan teori, praktikal yang kena jalan!
Lately juga banyak dapat obstetric/gynaecology cases. Last Thursday, my very last patient, 33 year old lady (a teacher), primigravida at 11 weeks, presented with vaginal bleeding. UPT remains positive. So referred to the on call doctor as threatened miscarriage. Initially nak refer untuk scan dulu but the receiving MO suruh admit terus untuk monitor pad chart. The mother actually cried while waiting for the admission. I truly understood her. First pregnancy at 33 years old. Husband is away in Kuala Lumpur, working. Came with her father. May Allah ease her pregnancy.
Today morning, a 37 year old Gravida 4 lady came for vaginal bleed also. She was treated for missed abortion a few days ago at Gynae clinic, and apparently chose to wait and see. Her scan revealed no fetal heart but IUGS was present. Her aunt is a doctor in health clinic, made a phone call yesterday to the Gynae Specialist, and only verbal standing order was given - come to Gynae clinic. But, of course without a referral letter,the patient had to come to OPD first. UPT remained positive. I made a call to the on call MO and patient was sent to the labour room. This time, the feeling was different. Patient already had three children, and she was already told about the prognosis a few days before.
Later in the afternoon, when the room was "hot" with a tampered colleague, I had to refer another patient, 47 year old lady with symptomatic anaemia secondary to menorrhagia. Haemoglobin was 5.9 !!! She had the same admission in March last year for Hb 5.4. Anniversary for her. Perhaps they would offer her hysterectomy. Patient was stable and comfortable though.
Last week was also tough with two serious cases admitted on two consecutive days. 34 year old man, with jaundice, ALT 1163, and raised bilirubin, was admitted for acute hepatitis. Fuhhh! Hope he could recover well. A 36 year old man, complaint of tiredness of a month duration, noted to have Hb 5.7 !!! He claimed to have rectal bleeding secondary to haemorrhoids for the past 3 years! Hope he recovers well too.
It is good when you were able to detect the illness and channel the patient for appropriate treatment. It is even better when the patients recover and back on their feet as usual.
Ya Allah, protect me from any carelessness. Give me pathways to treat my patients and strenghten my patience to deal with them. Amin.
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