SSD looked
quite old for an 18 year old lady. She was all puffed up. The blood pressure
was quite high. And she was quite breathless.
The history
was very vague. The only aspect I could latch onto was that she had a blood
transfusion at Daltonganj. The outside investigations showed haemoglobin of 8
gm%. Urine albumin showed 2+.
On clinical
examination, it was obvious that she was into early cardiac failure. I was left
wondering about her cause of cardiac failure. It was good that we have a
Medicine consultant now. As usual Dr. Roshine was quick to arrive and assess
the patient.
It seems
that SSD was always breathless since her childhood. Dr. Roshine suspected
valvular heart disease.
The
investigations in the morning confirmed our diagnosis.
The management was easy now. Refer . . . refer . . . refer. Of course, she needed more evaluation.
Pregnancy
in its last leg . . . with pre-eclampsia . . . valvular heart disease, most
probably a mitral stenosis with regurgitation . . . there were features of
pulmonary hypertension too . . . would have been the most critical patient in a
high risk obstetric care set-up.
But, the
relatives were quite certain that NJH was the best they could provide for SSD. Travel beyond NJH was something that they could not fathom. The problem was the
necessary finances.. .. .. there was a fear of the big hospitals and the funds
needed.
I tried all
the tricks in my bag to somehow refer them . . .
Nothing
worked . . .
We request
prayers as we manage SSD.
As I
mention about SSD, I also would like to put a word for help we would appreciate in
the month of October and December. Quite a few of our doctor colleagues will be on leave. It
would be a good opportunity for new graduates in medicine to have a feel of work
at NJH.
Especially
for those who dream to do a post-graduation in Internal Medicine . . . All the more when Dr.
Roshine is around. But, more about that, in another of my posts.
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