Thursday, October 23, 2008

It's a girl!

So I've finally given birth, yay! It's a beautiful little girl and she was born yesterday morning :) Quite a story about how it happened but I'll tell it next time. Right now I'm just going to recover and spend time with my family.

Monday, October 13, 2008

Family make the worst patients

I'm not sure if this is universal, but in my personal experience and those of my close friends and colleagues, your own family members and close family friends are always the worst patients.

Maybe it's because the transition from 'lay person' to doctor happens in front of them so they don't view you as a real doctor, but invariably, when they ask you for advice, they don't take you seriously and they don't bother to take it. It's quite frustrating because you think "why did they bother to ask?" but after a while you just get used to it, shrug your shoulders, shake your head and brush it off.

And they tend to be non-compliant. My dad has essential hypertension. He's had it for years. Still, he tends not to take his meds on time and sometimes even skips a few days. Two of my uncles have type II diabetes mellitus yet still continue to eat poor diets, but not only that, all their kids are obese! If I were faced with such a terrible affliction, I'd make damn sure my kids don't get it, but it's like they're making sure their kids do! All advice falls on deaf ears.

Then there are the phone calls saying they have x, y and z signs and symptoms. You ask a few questions to guage the severity, but whenever you think it might be something serious and suggest they go see a doctor in person to be examined, they say they don't think it's necessary. So why did they ask you wonder once again? But it's pointless trying to get them to listen to you.

And whenever you suggest a certain treatment or specialist, you're invariably faced with "but can't I just do this or use that?". "No" you say. They never listen.

A close family friend told me she had a personal problem. "Yes?" I asked and listened. "I have a painful swelling on my vagina", she told me. Knowing her personally, I wasn't keen to examine her, but she gave me enough information for me to make the tentative diagnosis of a Bartholin's abscess. I told her what I suspected the problem was, advised her to see a doctor asap and told her it would have to be cut open. "But can't I just put antiseptic ointment on it?" she asked. "No" I replied. She didn't listen. About 4 days later, in the middle of the night of course, the pain apparently became completely unbearable and her husband had to rush her to casualties. I laughed when I heard this. She was probably seen by some poor casualties officer who wondered why she had waited so long and until the middle of the night. I'd often wondered that myself whilst draining an abscess in the wee hours of the morning, now I seemingly had the answer.

But what can you do? They're family, so when they ask, you have to listen and advise, even if you're smiling to yourself knowing they won't listen anyway and wondering once again why they even ask and why you even bother.

Friday, October 3, 2008

Birth day

The time is drawing nigh and I'm actually getting a bit nervous.

With my first pregnancy I decided that I didn't want to be one of those annoying women (like many a patient I've seen) who comes in claiming to be in labour, turns out to have a cervix that's 1cm dilated, gets told the true signs of labour and to come back when she's got those but shows up again the next day and is then only 2cm dilated.

Maybe it's because I did all my obstetrics in the state, where days are long and beds are few, that I always got annoyed by those women. In private, you probably get admitted if you want to, but in the state, your admission ticket is active labour and nothing less.

So I decided, armed with my knowledge, I was going to do everything right. And I did. But things actually went too well. When I showed up at the labour ward, my cervix was 4cm dilated. I got my epidural and then, even though I was a primigravida, within 1 hour I was fully dilated and ready to deliver.

So this time around, knowing that the second time everything goes much faster, I'm nervous because I know I have to get to hospital asap!

I have great respect for midwives. Most babies can actually be delivered at home by a midwife. A trained midwife though, because although most pregnancies are actually uneventful, when things go wrong, they go very wrong and you want someone who knows what to do and when to get you to a doctor. Having said that, there is no way I'd deliver at home. I know too much and I'm way too paranoid. I want to be in a fully equipped hospital with lots of drugs readily available and a fully trained obstetrician. But I have to get there on time to have that.

I always find it amusing in movies and TV when the expectant couple rushes to hospital at the first sign of labour, tearing up the streets, only just making it there in time before the baby pops out, because real labour is nothing like that, but I've really been worried this pregnancy that that might really happen to me.

Today I had a few mild contractions. I was pretty sure they were Braxton-Hicks, but when they started coming approximately every hour, I started thinking it might be early labour. Then I started wondering if I should go to the hospital. Like I said, I've already decided to make haste this time, but then I started thinking: how early is too early, even with a history of a previous short labour? Also, I wasn't convinced they were real contractions. So I decided to wait and see. I thought I might be taking a gamble, but it turned out ok because after a few hours they stopped.

So in the end it was good I didn't rush off to the hospital because I would have looked like a fool.

But now I'm really left with the predicament of how soon I should act.