Thursday, August 03, 2006
I am going to miss him
I have this patient whom I am very fond of.... He was admitted during the induction week and he was so healthy then.. he presented himself to the A/E complaining of frank haematuria ie. his urine contains blood. He has a background history of cholangiocarcinoma and has a biliary stent in to bypass the obstruction, also metastatic bladder cancer and local prostate Ca. A lot going on with him.. alright. He then, when on to have a cystoscopy and bladder washout which means, just to have a look into his bladder using fibreoptic camera and also to see if there is any recurrence.. There is.. Then.. everything starts to spiral down from that point.. He was bleeding profusely-haematuria, we had to crossmatch him for 4 units of blood.. then, he had an episode of urosepsis and then biliary sepsis.. he managed to pull that off.. everything went sky high.. all the blood levels.. and then.. I took over.. from my partner.. and suddenly.. everything starts to settle down.... and now.. it's back up again and he's not producing urine which means he is acute renal failure. His organs are failing one by one.. and the surgeons are not keen to do any decompressive surgery for his distended abdomen either.. and now he is dying.. very slowly because he was so healthy before this. Recently.. he became very aggitated and aggresive.. and he's back in and out of touch sort of thing.. and now.. the Palliative Care team are thinking of Hospice for him.. Hospice means.. gates to heaven..sort of thing..
I am so sad.. when he had the urosepsis and he was gasping for air and when we were trying to do septic screen on him inc blood culture, all other bloods.. also ABG.. and no one could take his bloods cos he was so edematous.. I was so scared.. and I couldnt help myself but cry..
Today I saw the Palliative care team and they told me to stop all the medications we are giving him, to stop all the investigations and he himself has refused to take his medications because he knows he is dying. My Reg told him he is not doing too great now..
I will definitely miss this pleasant gentleman.. a great patient. He would joke with me.. when I couldnt take his bloods.. and he would cheer me up when I got nervous.. and he would praise me when I can... I really like this patient and now that he is dying.. the fact that he is dying soon.. is just so sad.. and I said that to my Reg and he said.. it is sad alright.. I couldnt help it but cry again..
I guess there is just so much you can do for one patient.. but the rest is up to God and they themselves.. if they are a fighter.. they would go on.. and if they are not.. they would die gracefully.. either way.. God knows the plan.
Because of this.. I am more certain that my place is not in Oncology or Palliative Care... Definitely not these TWO.
I am so sad.. when he had the urosepsis and he was gasping for air and when we were trying to do septic screen on him inc blood culture, all other bloods.. also ABG.. and no one could take his bloods cos he was so edematous.. I was so scared.. and I couldnt help myself but cry..
Today I saw the Palliative care team and they told me to stop all the medications we are giving him, to stop all the investigations and he himself has refused to take his medications because he knows he is dying. My Reg told him he is not doing too great now..
I will definitely miss this pleasant gentleman.. a great patient. He would joke with me.. when I couldnt take his bloods.. and he would cheer me up when I got nervous.. and he would praise me when I can... I really like this patient and now that he is dying.. the fact that he is dying soon.. is just so sad.. and I said that to my Reg and he said.. it is sad alright.. I couldnt help it but cry again..
I guess there is just so much you can do for one patient.. but the rest is up to God and they themselves.. if they are a fighter.. they would go on.. and if they are not.. they would die gracefully.. either way.. God knows the plan.
Because of this.. I am more certain that my place is not in Oncology or Palliative Care... Definitely not these TWO.
posted by Mel at 2:30 PM, | 
0 Comments:
« back home | Post a Comment