Sunday, June 21, 2009

Medical Musical Chair.. Where Do I Stop?


She was about 53 years old and as she came in she looked rather apprehensive. She could not speak the local language well and the story goes like this. She had recurrent headache and blurring of vision for a number of months. She finally saw a doctor who promptly diagnosed high blood pressure and prescribed her a medication and asked her to come in a week to review her response.

She came back right on the appointed date and was seen by another doctor who decided to change the medication and asked her to return in a week's time for review of her condition. She dutifully turned up at the clinic only to be seen by yet another doctor, who after taking her blood pressure, added yet another drug and asked the patient to come back in another week's time to check on her condition.

She then landed in my clinic with much trepidation and confusion on her face. I read through her notes and decided to engage her. She understood when told that her condition required daily medication and the drug was to be taken regularly on time to derive its effectiveness. It seemed that she did not understand this and had not been explained earlier. She ended up not taking the drug, any drug at all as she felt dizzy especially when she took the second drug! And Her blood pressure was still high.

The buck stopped here, I almost blurted out... for first timers, it is advisable to lie down about 10-20 minutes after taking the drug and do it for 2-3 days till you are used to its pressure-lowering effects. You have to take the drug daily at scheduled time and not as you like, e.g today at 7am, tomorrow at 12 midday and the following day at 7pm!

After much explanation and with the help of an interpreter, she was given a once daily drug and told to take at the same time everyday. She must come back in two weeks time and see the SAME DOCTOR! If she did not take the medication as instructed, it was not a good idea to see a doctor, any doctor for that matter as it would be a waste of time. Doctors and patients form a natural partnership in the management of patients' medical conditions. Good interaction will go a long way in patient care. Lack of communication defeats that purpose and prolong unnecessary suffering.

2 comments:

Unknown said...

A lot of MOs or MAs do not explain to you what's going on , simply prescribe and off you go to the pharmacy.

And if you do ask to a 'pharmacist in the booth where you supposedly can ask questions about the drug you are taking' He then will look up his Drug book ( it was a very thick book)..and read it from there. I was like $%^&*(P ( sorry , but i was quite pissed off)
Asking if I have seizure? Do I look like one?! I should have just start jerking my body just to see what they will do.

No professionalism there. Felt like a lab rat rather than a patient seeking for explanation.

So , in my humble opinion most of the doctors dont have a clue on interacting with patients ( you are totally a different species ok, trained in a proper manner)

I was diagnosed for lyringistis and i asked how can i get it ...and round and round the doc goes ..it can just happen..great..my employers were like..wow..it can just happen..not much help in explaining.

Marcella said...

Dear NZ,
You sounded worked up there! Gabapentine is usually prescribed for neurological problems like seizure... for a long time, then the Ortho surgeons found it useful for neuro pain, I guess the Pharmacist had not kept himself updated! :( That is why professionals need CPD.

I always put myself in patients' shoes... sometimes too big for my feet :)

Unlike the local medical schools, my professors were elderly and wise and they had pearls of wisdom to impart to us students.

Laryngitis.. you can get it as an extension of your throat infection, you can get it when you strain your voice, develop swelling and local infection..remember we have millions of germs in our body... they are harmless until the body environment changes physically.. then some of them will invade and thrive with our immune system fighting back causing signs and symptoms of infection, eg laryngitis.