Smell the...

I was so busy and tired last week that I didn't really get a chance to reflect upon the experiences over the past few weeks.

A few memorable events (I'll try and story mory in layman's terms huhu)

1. A male patient who had multiple bleeds in his brain, had a craniotomy (drill a hole in the skull to relieve the pressure). He also had such poor dental hygiene that it caused the infection to spread to his brain and cause pus collection. He had to get most of his teeth removed. He came to rehab because the bleeds caused him to have weakness in his right side of his body. He is like a child in mannerism and speech. I feel so sorry for him. Tengok je kesian.

2. A female patient who suddenly had blocked urethra so her pee was just leaking out; leaving huge amounts left in her bladder. So the plan was to put in a catheter (a tube into the urethra to the bladder) to relieve the pressure the high amounts of urine volume was causing to the bladder. The nurse tried first as per usual running of the ward. I didn't expect to be called but I was. Aik..this old experience nurse couldn't put it in? Takkanlah.

So I had a try. But the anatomy down there was so WEIRD.  I could not find the pee hole at all. Plus she had thrush down there so it was red and extremely painful so she was just screaming when I had to wash her with antiseptic wash and tried to put the tube in.

I had to call my consultant; who happens to be the director of rehabilitation services ok. Malu sikit nak mintak tolong but I was desperate. My registrar was absent.

1 hour later, one tube of lignocaine (anaesthetic) gel, trial with a speculum, a smaller catheter, sweaty and flushed face of my consultant; she too could not put the catheter in. She said "I've been a doctor for more than 30 years and this is the first time I cannot catheterise someone!". Her blouse was drenched with sweat!!!

The patient had vaginal stenosis, active vaginal thrush with the classic cottage cheese discharge (yuck, why do they always use food analogies?) and really weird looking anatomy down there that even the consultant had not seen before.

Anyways, we abandoned the catheter plan and tried medications instead. Since she was still leaking urine that means it is not completely 100% blocked (yet). If it becomes blocked, we have to send her to the emergency department to get a suprapubic catheter (a tube punctured into your tummy just over the bladder).

3. A young man (46 years old) who had a stroke that caused him to have fluent aphasia. This means that he can talk but it makes no sense at all. He has difficulty finding the correct words and even creates his own words and sounds (medical term: jargonism and neologism).

He would talk like this: "Yes yes I was doing that thing thing thing. Gluluglug. I write in book thing thing thing". His job before the stroke? Marketing manager. He'll never do that again :(