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	<title>Behind prescriptions</title>
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		<title>Behind prescriptions</title>
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		<title>No woman&#8217;s land?</title>
		<link>http://paperpencilstat.wordpress.com/2009/12/05/no-womans-land/</link>
		<comments>http://paperpencilstat.wordpress.com/2009/12/05/no-womans-land/#comments</comments>
		<pubDate>Sat, 05 Dec 2009 15:54:33 +0000</pubDate>
		<dc:creator>Dr.BlackCoffee</dc:creator>
				<category><![CDATA[Uncategorized]]></category>
		<category><![CDATA[hospitals smell of fear]]></category>

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		<description><![CDATA[It was another long night duty in the Department of Gynaecology and Obstetrics. I have an abundance of enthusiasm for this subject. But, it was brought down considerably, when I was asked to take Ms.R for a Pre-anaesthetic Consultation(PAC). A PAC is done to evaluate if a patient is fit for administering anesthesia for his/her [...]<img alt="" border="0" src="http://stats.wordpress.com/b.gif?host=paperpencilstat.wordpress.com&amp;blog=8815562&amp;post=9&amp;subd=paperpencilstat&amp;ref=&amp;feed=1" width="1" height="1" />]]></description>
			<content:encoded><![CDATA[<p>It was another long night duty in the Department of Gynaecology and Obstetrics. I have an abundance of enthusiasm for this subject. But, it was brought down considerably, when I was asked to take Ms.R for a Pre-anaesthetic Consultation(PAC). A PAC is done to evaluate if a patient is fit for administering anesthesia for his/her subsequent surgery. So, why did Ms.R need a PAC?</p>
<p>Ms.R is 22 years old. The same age as I am(rather was, a month ago). She is this polite girl who has a nice smile. She is petite and pretty, yet has none of the fears of a patient who has to undergo surgery. Why surgery?</p>
<p>I had her case-sheet in my hand. I was not there when she got admitted so, I had no clue what she needed surgery for. One look at her, I thought it must be a simple D&amp;C that they do for miscarriages. I learnt that she was unmarried only as I began reading her history. This irked me. What can an unmarried, 22 year old woman suffer from that would need a PAC?</p>
<p>The diagnosis shook me. It was not supposed to. It removed the smile off my face I usually have when I talk to patients(entusiastic about Ob-Gyn, remember?). She has a large fibromyoma in her uterus which is causing her a lot of pain and bleeding during menstruation. This is not really an earth-shattering diagnosis. So, why this surgery?</p>
<p>The fibromyoma, commonly called as a fibroid is a fibromuscular growth in the walls of a uterus. It is almost always benign, but can grow to monstrous sizes as Ms.R&#8217;s has. The thing that is even more disturbing is that, the growth is so big that if the surgery that is needed for its removal may not achieve the goal and she may have to have her uterus removed with it, as well. This is the surgery. A Myomectomy(removal of the fibromyoma) which can potentially turn into a TAH(Trans-Abdominal Hysterectomy &#8211; removal of the uterus).</p>
<p>I look at Ms.R again. She has already been explained the procedure that can probably rob her of the chance of having children. This really disturbs me. Imagine a girl, at the verge of turning into a woman, not being able to become a mother because something which is usually benign has turned malicious. Deep down, every woman longs to be a mother. Especially, where according to the Indian culture, no woman is considered &#8220;complete&#8221; without bearing children. The chains and shackles we build for ourselves! I can almost feel Ms.R&#8217;s fear when her gaze keeps darting to the Operation Theatre where the Anesthetist&#8217;s Office is.</p>
<p>Ms.R smiles at me. Something about that smile that shows a lot of courage, yet a hint of disappointment. I smile back at her and I hope I have enough strength in me that I can pass on to her, that will sustain her through the surgery. I hope that I pass on enough positivity to her, so that the surgery she is supposed to undergo just remains a Myomectomy.</p>
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			<media:title type="html">Dr.BlackCoffee</media:title>
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		<title>In Sickness and In Health</title>
		<link>http://paperpencilstat.wordpress.com/2009/08/15/in-sickness-and-in-health/</link>
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		<pubDate>Sat, 15 Aug 2009 17:47:31 +0000</pubDate>
		<dc:creator>Dr.BlackCoffee</dc:creator>
				<category><![CDATA[Uncategorized]]></category>
		<category><![CDATA[beyond the white coat]]></category>

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		<description><![CDATA[Disclaimer: This post may not be related to anything seen as a cold medico. It brought out the woman in me. Mrs.A is a patient with Filariasis(Elephantiasis) of Right Lower Limb. She has been admitted in the hospital because she developed an ulcer on the same limb and it has to be debrided. The day [...]<img alt="" border="0" src="http://stats.wordpress.com/b.gif?host=paperpencilstat.wordpress.com&amp;blog=8815562&amp;post=6&amp;subd=paperpencilstat&amp;ref=&amp;feed=1" width="1" height="1" />]]></description>
			<content:encoded><![CDATA[<p><strong><span style="color:#800000;">Disclaimer: This post may not be related to anything seen as a cold medico. It brought out the woman in me.</span></strong></p>
<p>Mrs.A is a patient with <a href="http://en.wikipedia.org/wiki/Filariasis">Filariasis</a>(Elephantiasis) of Right Lower Limb. She has been admitted in the hospital because she developed an ulcer on the same limb and it has to be debrided. The day I saw her in the Female Surgical Ward, she was on her 40th POD(Post-Operative Day). This means that she has been in the hospital for at least 6 weeks now. She cannot walk because her leg weighs her down. Yet, there she is every morning with a smile on her face when I come to see her for the morning rounds.</p>
<p>This post is not about Mrs.A. This post is about Mr.A, her husband. Even if she is suffering with the aforementioned ailment, I have seen Mr.A go through a hell lot more than she does. This lady proudly claims that she has never looked at her own wound and her husband takes care of it and dresses it every single day just because she is too scared to look at it. Here is a man, who wakes up every single morning right next to his wife in the hospital and goes home to take a shower and send their only child to school and comes back only to return to his wife&#8217;s bedside. I have never seen a man, so devoted to his wife. I have never seen a man who takes his wedding vows to heart and keeps them up. Till that moment, I had never seen a man. Period.</p>
<p>My views on men in general may not be really high, but I have always held some respect for men. I have seen quite a few examples of beautiful(yes, thats the word!) men who keep me away from being an extremely cynical woman and it is men like Mr.A who reinforce my belief in them. If only God made a few more of such men!</p>
<p>Mr. &amp; Mrs.A, I really hope and pray for your recovery. Thank you, for having shown me the meaning of a loving relationship. I respect love and all that it means even more, thanks to both of you.</p>
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		<title>Rx</title>
		<link>http://paperpencilstat.wordpress.com/2009/07/31/rx/</link>
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		<pubDate>Fri, 31 Jul 2009 15:15:52 +0000</pubDate>
		<dc:creator>Dr.BlackCoffee</dc:creator>
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		<category><![CDATA[aetiology]]></category>

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		<description><![CDATA[I have a compulsive need to share my stories. All those lonely hours in the Ward have made me scribble out my thoughts and feelings as a doctor behind those Prescription Pads I use to write out medications to the patients. Therefore, the name Behind Prescriptions. There is another way to look at it. I [...]<img alt="" border="0" src="http://stats.wordpress.com/b.gif?host=paperpencilstat.wordpress.com&amp;blog=8815562&amp;post=1&amp;subd=paperpencilstat&amp;ref=&amp;feed=1" width="1" height="1" />]]></description>
			<content:encoded><![CDATA[<p>I have a compulsive need to share my stories. All those lonely hours in the Ward have made me scribble out my thoughts and feelings as a doctor behind those Prescription Pads I use to write out medications to the patients. Therefore, the name Behind Prescriptions. There is another way to look at it. I have also started this blog to fight with the countless feelings and emotions a doctor faces while writing a prescription. It can mean life to a dying patient in the hands of a capable doctor or death to an otherwise healthy patient who has had the misfortune of finding an incompetent one.</p>
<p>Here is to all the lives and stories that will be shared on this space. May God Heal their Souls. <img src='http://s2.wp.com/wp-includes/images/smilies/icon_smile.gif' alt=':)' class='wp-smiley' /> </p>
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