He came to do the rapid HIV test this morning. This man, 23 years of age, a security guard, came to the clinic about 10 days ago. He gave a history of abdominal pain and frequent diarrhoea for the last one year. He also noted loss of appetite and loss of weight. He looked thin with a greyish sunken cheeks. He voluntarily admitted that he did not look like that a year ago.
Having taken his medical history and examining him, I was thinking about an irritable bowel syndrome (IBS) in which a patient usually has a recurrent abdominal pain and bouts of diarrhoea. I ordered for all the basic and diagnostic blood tests which would be ready in two weeks. I treated him conservatively and asked him to come for follow-up after two weeks.
Immediately after this patient was a sweet single girl of 18 with an weak smile. I asked her what could I do for her. She said she had been coming to the clinic for intractable mouth ulcers and had been given oral cream to apply and even some antibiotics but to no avail. She has to take painkillers as the ulcers were painful and getting worse.
I asked her to open her mouth and shown a torchlight, and there were multiple ulcers behind the lips (I immediately use a mask and double glove my hands!) and held her lips as there were more sores in her gum and buccal mucosa (wall of mouth). It was florid! Yes, it was Herpes simplex type 1, a sexually-trasmitted viral disease (STD) without a grain of doubt. Not accustomed to beating around the bush, I asked her whether she practised oral sex. She looked stunned and then meekly admitted it.
I had some time to advise her on safe sex practices. She thought oral sex was safer as she would not get pregnant, being a single girl. I prescribed an anti-viral drug and OralAid cream for her ulcers and a mild painkiller. Before she got up, I told her to ask her boyfriend to seek treatment as well. Then my nurse blurted out that the previous patient was in fact her boyfriend! Ahah..... this rang a bell.
I asked my nurse to call in the man by himself and gently queried him about his sexual life. He is single and he has multiple sexual partners. I recalled the clinical features of "the slimming disease" observed in Africa years ago and planned an HIV test for him. I also treated him provisionally for Herpes simplex infection on account of his girlfriend's condition.
Does he know about safe sex? He looked lost as if the concept was foreign to him. Despite all the massive government spending on public health education on STDs prevention, this is the reality I am facing. I suddenly felt depressed.
Today he came for the test and when I enquired about his girlfriend, he said all the mouth sores were gone and as for himself, the abdominal pain and diarrhoea were also gone and he looked more cheerful.
After giving him a pre-test counselling, in my heart, I said " It'd better be ,man ,for your sake!".
Having taken his medical history and examining him, I was thinking about an irritable bowel syndrome (IBS) in which a patient usually has a recurrent abdominal pain and bouts of diarrhoea. I ordered for all the basic and diagnostic blood tests which would be ready in two weeks. I treated him conservatively and asked him to come for follow-up after two weeks.
Immediately after this patient was a sweet single girl of 18 with an weak smile. I asked her what could I do for her. She said she had been coming to the clinic for intractable mouth ulcers and had been given oral cream to apply and even some antibiotics but to no avail. She has to take painkillers as the ulcers were painful and getting worse.
I asked her to open her mouth and shown a torchlight, and there were multiple ulcers behind the lips (I immediately use a mask and double glove my hands!) and held her lips as there were more sores in her gum and buccal mucosa (wall of mouth). It was florid! Yes, it was Herpes simplex type 1, a sexually-trasmitted viral disease (STD) without a grain of doubt. Not accustomed to beating around the bush, I asked her whether she practised oral sex. She looked stunned and then meekly admitted it.
I had some time to advise her on safe sex practices. She thought oral sex was safer as she would not get pregnant, being a single girl. I prescribed an anti-viral drug and OralAid cream for her ulcers and a mild painkiller. Before she got up, I told her to ask her boyfriend to seek treatment as well. Then my nurse blurted out that the previous patient was in fact her boyfriend! Ahah..... this rang a bell.
I asked my nurse to call in the man by himself and gently queried him about his sexual life. He is single and he has multiple sexual partners. I recalled the clinical features of "the slimming disease" observed in Africa years ago and planned an HIV test for him. I also treated him provisionally for Herpes simplex infection on account of his girlfriend's condition.
Does he know about safe sex? He looked lost as if the concept was foreign to him. Despite all the massive government spending on public health education on STDs prevention, this is the reality I am facing. I suddenly felt depressed.
Today he came for the test and when I enquired about his girlfriend, he said all the mouth sores were gone and as for himself, the abdominal pain and diarrhoea were also gone and he looked more cheerful.
After giving him a pre-test counselling, in my heart, I said " It'd better be ,man ,for your sake!".
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2 comments:
Nice to read this article.
Thanks AC, I always want my readers to learn from my experience and become better at looking after their health and that of their family and friends.
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