Thursday, March 26, 2015

Bringing hope . . .

We regularly have patients who give us immense satisfaction at places like Kachhwa. Mrs. PPD was such a patient.

Mrs. PPD came to us in a very serious shape – more serious emotionally than physically. Just 33 years of age, PPD had been diagnosed to have Diabetes Mellitus about 6 years back. She had been running from one doctor to the next since then. She was scared of Insulin shots. Almost all the doctors she met told her the truth - the fact that she needed Insulin to keep her diabetes under control. But PPD was scared.

The depressive nature of PPD brought a sense of doom to her extended household. Her mother-in-law narrated on how the illness seems to have brought a pall of gloom into the home.

PPD came to us about a month back with serious infection. She was depressed and wanted to die. It was a major struggle for us to convince her that she needed insulin injections. Our team did quite a bit of persuasion and prayers to convince her. Initially, she was not ready to self administer the medication.

Over the course of her admission, we discovered that she had bilateral cataract. The issue was about getting the surgery done while the ‘surgery season’ was on. And then there was the spectre of diabetic retinopathy which could dampen the surgery. Of course, someone had went to the extent of telling her that she will not see again that she did not bother to mention about her low vision to us. It was one of our staff who noticed that she was fumbling with things that we realised that her vision was as low as 1/60.

We prayed for her. By God’s grace, from a situation of seriously uncontrolled sugars, the sugar levels were well controlled and she was able to undergo surgery.

Post-surgery, we were all concerned about how much vision she would be able to have. On removing her bandages, we praised God as she told us about how clearer her world has become.

PPD (left with the dark glasses) with her mother in law
PPD’s mother narrated on how she has become a lively presence in the house after her treatment. It’s so satisfying to have patients like PPD who appears to have lost all hope for her future. However, we're sure that had it not been for her extended family who was ready to stand with her in the treatment and encourage her, they would not have been able to bring back hope and joy in the house

Barsati's Garden - The white rose

There are few white rose plants in Barsati's garden. Few snaps of white roses in the garden.

Coming up in a couple of days would be snaps of a white rose with multiple flowers . . . 

A different snake . . .

About a week back, we had a young lady of 16 years brought to Emergency Room in a supposedly comatose state after a snake had coiled around her leg. The patient alone had seen the snake and had told relatives before she became unconscious that the snake did not bite her.

There were no obvious bite marks and it was not difficult to come to a conclusion that she was well conscious although appearing a bit drowsy. She also seemed to have a ptosis which on careful examination was not there. The clotting time was normal. 

The only issue was a low blood pressure reading of 80/40 mm Hg. We gave her some intravenous fluids and she did not respond to that. And we concluded that this was her normal blood pressure. Later, we found out that there were problems in her family and we diagnosed her as having an acute conversion reaction – a psychological response to difficult situations.

We gave her a small dose of anti-depressant. However, she did not seem to do fine. She continued to remain drowsy. She could communicate when we called her. She could even walk to the toilet without help. She also narrated to us that she was taking some ayurvedic drugs for her psychological condition.

The next day being a Sunday, we could do any investigations. Her condition remained the same.

On Monday, we sent a battery of tests – complete blood count, liver function and renal function.

Her total count came as 1200/cu mm with a predominant lymphocyte picture. Hemoglobin and platelets were normal. The liver and renal function also came as normal.

There were only two major things that we were looking at – either a blood dysgracia most probably secondary to her ayurvedic medications or a haematological malignancy.

We referred her to a higher centre.

This is the second time that I’ve come across a suspected snake bite being diagnosed with something else more serious. The previous time was 4 years back at NJH, when we diagnosed disseminated tuberculosis in a patient who came with an unknown bite.