Monday, October 17, 2011

UNUSUAL RUSH

It has been quite unusually busy at NJH over the last week. Usually, work is quite light after the Dusserha celebrations start and continues on like that for almost the whole of winter – except for the cataract surgeries.

Unfortunately, I have to away from hospital attending work related to the Golden Jubilee celebrations scheduled towards the last week of this month. Yesterday (Friday), the business was quite evident as I was away in Ranchi attending to work. And the situation would remain such for almost the whole of next month.

It all started with the theatre where Dr Nandamani had posted couple of surgeries, one of them a cholecystectomy. He was only halfway into the surgery when he was informed about a pregnant lady with the babies’ hand prolapsed per vagina and baby was alive. Somehow, he rushed through the rest of the surgery and got the lady posted for an emergency cesarian section to deliver a healthy baby.

Immediately afterwards came a rupture uterus. It was again a very peculiar rupture uterus as the uterus had ruptured in the posterior wall and the rupture extended upto the vagina. It is quite a difficult surgery and he was the Lord’s graciousness that he realized halfway into the suturing up of the uterus that he had unwittingly ligatured the ureter.

Dr Nandamani told me that it was one of the most difficult of rupture uteruses that he had operated on for quite a long time.

While the rupture uterus was going on – in came a previous cesarian in full fledged labour. Everybody was quite relieved to find out the lady was in second stage and she had an uneventful normal delivery.

However, one of the major reasons for the hectic time in the hospital is because of one young girl, SK with history of bite by an unknown creature. – we had presumed that it was a viper as her clotting time was prolonged. She had gone into compartment syndrome and in addition had developed renal failure. Since the last couple of days, she started to have episodes of breathlessness which we ultimately diagnosed to be pulmonary edema.

Many a time, the girl’s parents wanted to get her discharged and take her home. The reason was that they did not have any money. Considering that she is from the nearby village, we agreed to treat her free. She is on the ventilator and maintaining a good urinary output.

I have a feeling that she has developed some amount of myocarditis secondary to the venom and we may be dealing with some other venomous creature bite. Kindly pray that SK will recover fast.

In addition, there have been umpteen numbers of malaria and other cases of acute febrile illness which has come in.

To top up things, there was one maternal death. The lady was in the early part of the 3rd trimester. And she had developed fever. She was on treatment elsewhere. Later, she developed jaundice. That was when they decided to bring her to NJH. On arrival, she was quite sick. Her blood smear showed hoards of malaria parasite and the platelet count was only 16,000. We asked the relatives to take her to Ranchi. They were too poor. No blood could be arranged. She died sometime around midnight.

I’m not complaining. We are here to serve. But, sometimes we feel that we would be better off with some more fresh expert hands joining ours. With the Golden Jubilee celebrations approaching and the expected arrival of a new baby in Dr Johnson’s family, if we continue to have such a patient flow in the hospital, we know that we are going in for a tough time.

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