My patients

I have 30 patients and it never changes quantity. As soon as I discharge someone, another patient fills his/her place at the rehab ward.

Rehab medicine has 5 main areas:
1. Amputees - self-explanatory, could be below-knee amputees, below hip amputees or just the usual toe or feet amputations
Amputations are from gangrenous limbs from poorly managed diabetes, infection, peripheral vascular disease (smokers beware!) or accidents.

2. Brain & spinal injuries - the majority of these patients have their injuries from vehicle accidents. Some have problems from birth though - like spina bifida


3. Neurology - the stroke patients, the brain haemorrhage patients, Parkinson's disease


4. Orthopaedics - fractures, hip or knee replacements due to arthritis

5. General - patients who've had prolonged hospital stay due to other reasons..could be anything under the sun.

Basically, if patients have no more acute issues but are not yet ready to go home because they have not gone back to their level of function before their accident/disease/condition/operation, they go to rehab. In rehab the allied health people practically own the place. There is a big physiotherapy gym and a pool for hydrotherapy. The speechies (speech pathologist) and OT (occupational therapists) reside there too. The patients need help to learn how to move/walk again as they did before they were sick/ill. It's a long process.

My patients are mostly fractures, hip replacements and strokes. There's one amputee and 2 Parkinson's.

Out of 30 of them, only 3 are young.

25 year old obese man who has been there for 3 months. He was in ICU for 4 months before that with mycoplasma pneumonia because he had to be intubated. Because of the prolonged bed rest, he developed a massive sacral (bontot) pressure ulcer (bed sore). Because of hygiene reasons, they had to give him a temporary colostomy (divert the large intestine to an opening in the skin) so that poo doesn't come out from the anus so the sacral wound can heal.

36 year old woman with a stroke! They don't know yet why she had the stroke.

24 year old paraplegic man who had a fracture of his left leg.  Cenne tu ek? Hehehe. Quite an easy case anyhow. He is already in a wheelchair because of his paraplegia (paralysed). So when he fractured his leg by falling out of his wheelchair, the management was not much different. He had an operation to put screws in but he's still in the wheelchair.

But all the other patients are old, many have short term memory loss, many smell of urine because they are incontinent. It is frustrating to talk to someone with short term memory loss. You can't get a decent story out of them. Kejap yes. Kejap no. They go on and on repeating the story. It's hard to pull yourself from the bedside. Sometimes memang tak boleh layan, kene mintak diri cepat-cepat. Have an excuse. Otherwise you can be stuck there for ages melayan cerita yang duk diulang-ulang.

When people are old; they sometimes regress back to childhood traits especially if they are sick or if they are alone and have no relatives/children. So ada la patients yang merajuk, throw tantrums, drama queen, seek attention dan macam-macam perangai lagi.

I think the most memorable thing that happened last week was one of my patients who used my desk phone to call his son.

"Hey sonny. Just in case you're wondering... I'm not dead yet. So please come and visit me. I'm at GLR rehab"

Kitorang semua tergelak-gelak. Kelakar gile pakcik tu. Direct aje.  Heheh