Random thoughts.. again

Hello world, greetings from the airport! :)

Today, I have some encounters in the wards. Perhaps it's accumulative, and today happened to be the peak.

I think I like patient care.

Few days back, there was this 67 years old uncle got transferred to my ward. You wouldn't miss him. He's just so prominent. I find him very adorable in fact. He is severely obese, always in a drowsy state, and fall asleep easily even when sitting at the TV room.

And then i took a look at his IMR.

TB meds. Empiric treatment.

On warfarin, admist tonnes of other meds.


Sigh. He weighed 96 kg.


Reason I used "weighed" past tense is because he lost 5 kg over a span of 3-4 days. My anticoagulation pharmacist oversaw this uncle for his warfarin. It was through him that I learnt many valuable lessons. Lessons about managing multiple complicated drugs on a single patient who has so so many co-morbidities. Lessons about treating patient is just not about seeing the recommeneded numbers but really, to treat the patient rather than the numbers. And also, he reminded me of my dad.


Uncle is to continue 6 months of anti-TB meds, on top of his 9 other existing meds.


Typical anti-TB meds - 5 drugs - and because of his size, the max of all are used. Uncle has to eat 13 tablets of anti-TB meds half an hour before food. After food, eat his other meds (around another 10-13 tabs). Can you imagine such a pill burden on such an uncle.



Sometimes we always ask patients to be compliant to meds. We know every reason why they should be compliant, and we know it's for their own good. Yet, when you put yourself into their shoes, if you were them, could you even imagine youself taking 26-30 tablets a day. And they are at least of panadol size.


Yet, this uncle is so adorable. I felt like giving him a hug when I dispensed at bedside just now.


Uncle spoke Hokkien. But I can only speak 90% teochew 10% hokkien. Yet he understands.


He really has all of my heart - because through interactions with him, i know that he will be compliant. He's illiterate yet he will adhere to the numbers written on the drug labels. Everytime when I pat on his back, he will nod his head and signals me that he appreciates. Uncle cannot read, yet he knows some meds are for diabetes, some are for hypertension, and new ones are for TB. He even knows that rifampicin causes orangle discoloration of his urine and sweats because he noticed it during his stay in the hospital. Do you know how encounraging it is to find out that your patient actually take charge of his own health and know what's happening to himself, and to embrace the reality with courage?

Pardon me for the incoherent thoughts. Just suddenly have too much gushing through my brain. I am so gonna have a brain infarct.

Today, there's this good son whom I encountered that took all of my heart too. His father was warded for breakthrough seizures, and other diseases included dementia with behavioral disorders. Because of his illness, this malay uncle looked very irritable, and sometimes he will stick out his tongue to you. He is just so flustered, yet demented. He's like a kid most times.

And his son came to bring him home upon discharge. This son is a 30 years old obese man who's sweating very heavily because it's very warm in the ward. Yet the love and care he showers on his dad really touches me. He is a full time caregiver because of his dad. Unlike other people who don't care what the meds are for, he carefully tells me what are the meds and how he has been serving his dad the meds and these and that.

All these things meant a lot to me. They showed me that there are many people out there worth every of your time and effort.

Admist many nasty people, there will always be people out there who appreciates you. And I soon realize that what God said to me is true - Giving is always better than receiving.