Thursday, October 11, 2007

A Special Patient (1)

I had a special patient today. Let's call her Maria.

Maria is a 21-year-old lady who's coming in Royal Melbourne Hospital for an operation called "Lumbar Discectomy". Basically, it means that she's fixing a disc which had slipped out of its usual position between two bones which are located at her lower back. The displaced disc (see figure - the blue thing labelled L5) impinged on her nerves, and has produced pain on both legs, and it's especially worse in the right leg where it expands throughout the whole length. The pain of this nature is usually referred to as sciatica, as it's usually associated with problem with the sciatic nerve (the fat nerve going down the leg in the figure).

Guess what: Maria has had this problem since she was 12.

Maria's predicament remained undiagnosed because it's rare for young people to get sciatica, which is quite common among older population. Throughout the years, doctors had been telling her that the pain was due to muscular problems, and that it would become better with time. It was not until last year when she couldn't bear with the pain anymore, that she asked for another check-up and discovered this problem. Turned out that she had a really severe case of disc prolapse, and if it's not fixed urgently it would progress to a medical emergency called cauda equina syndrome.

So I had a look at Maria because she was suitable for my study. From her history, I discovered a couple of interesting things:

  • She had been smoking cigarette since 12 year old.
  • She smokes marijuana (weed, 大麻) everyday
If you tell one of the more conservative parents only these information, my bet is that they are going to flinch right there and then while the image of a samseng girl is conjured in their mind. To be honest, I had a bit of hesitation too - is she going to be that kind of violent, uncivilized people?

I mustered my courage to approach her for my study. I stood there and called her name out loud in the waiting lounge, and the girl with her mum and her partner stood up and came to me cheerfully.

I thought:

Shit, they thought I am going to call her in for surgery preparation while I am only inviting them to participate in the research. Damn damn damn. They are going to be so mad at me. She's hungry (patients need to fast a long time before their operation) and impatient and all, and now I am going to invite her to be some sort of research participant. I am so dead.

So I showed them to the interview area, my heart pounding real hard as the family remained cheerful.

[To be continued...]
[19/10/07: Continued here]


day-dreamer said...

Wah, since when you inject suspense into your writing????

sophisticatedsoul said...

Eh! Don't la give me suspense.

Anyway, I am guessing the patient must have turned out pretty nice to your surprise.

And now I know why during your research year you have to be in the hospital. Preying for patient to take part in your

haha said...

Suspense is a good technique to keep the reader reading his blog. haha

Vitamin C said...

What's your research all about? I think everyone would love to know that more actually.

It must be interesting yet tough. The word research is too heavy for me. Are you doing honoured degree?

Neptune Chye said...

Walao...learning pathology using wikipedia is the coolest thing every med student will find in their studies, hehe...

Interesting, now Chang Yang's blog is more medically may be a pain for others but definitely not med students, hehe...

And it's just mixing up my feelings when I just realised my seniors are going "up" - Shu Fen just said it clear that she will go to fourth yr and you start your research, and i will soon end my ”一年级“。。。time is passing so fast, hehe...

But how long is your research going to last? 1 yr? I need to do ILP, so sad...

youngyew said...

Day-dreamer: Since I realized that I didn't really have time to finish the post when I was writing it. :D

Sophisticatedsoul: Haha that's a good guess... I will reveal the rest of the story in the second part. :)

And yeah, you are right about the research. I spend most of the time waiting for and trying to find suitable patients.

haha: Haha! :P

Vitamin C: Yeah I will blog about it later. I will probably incorporate it as part of this story, as I think it's a good and less boring way of relating about my research. :)

Neptune: Haha wikipedia is good for medicine, and quite often it's pretty accurate! I guess that's because the vandals aren't so interested in vandalising boring medical stuff. :D

Who's Shu Fen, by the way?