Friday, June 3, 2016

This and that.

The heat seems like it is here to stay.One can hardly put any food in the mouth and yet the scales are unforgiving, not a dip to the right or left.A colleague tells me it is going to rain on Monday.We just went through a water crisis of sorts for a few days but we are back on our feet, on track ,surprisingly enjoying the unmeritted grace of God in big and small things.
Patients?what about patients.As usual the hospital is as unpredictable as it gets.Somedays are busy to the hilt and some as quiet as a monastry.Our collections however have been steady by God's grace.
The coolers are on every hour of the day at work and those of us who are fortunate enough have air-conditioners to keep us sane.Just sitting in the OPD with cooler at full blast for stretched hours make one feel nauseated so you can imagine what would happen if we had an out-door job.
The patients are a study at impractility .One often ends up doing all the math for them so that they can save maximum money. We have a lady with ILD,a young nineteen years old, she also has recurrent pneumothorax for which she had had a tube in Nagpur but was reffered from there for home oxygen therapy.Here we found that she had developed another pneumothorax so we put in a chest tube again.She is mantaining 88-92% saturation with minimal O2.We are planning on a pleurodesis and are going through a last minute pros and cons checklists as well as getting a second opinion from experts.Tetracycline was what I had personally seen used in my short stint in the UK but my friends from the CMC tell me they use betadine instead which is a lot less painful.She needs home oxygen and as usual Indian medical systemn has no arrangements for deviants like this.They can't practically think of keeping the patient in the hospital forever so we are seriously thinking of renting them our oxygen concentrator,not sure how practical it is.Apparently the government guys have told them to get her admitted in the hospital,seriously, for LTOT?
Mohan came with the good news that the government set up in Seoni has put in a test which detects extrapulmonary tuberculosis.It brought so much of joy to my heart that I felt like distributing sweets .That is the sort of burden I carry in my heart for this cohort.
Like I was telling Devyani today ,life is 'avoiding the heat exhaustion at any cost these days',and it somehow seems to work like a clock work..

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