Friday, June 24, 2011

Discharge Cards

You know what discharge cards are, don’t you?
Well… for those who do not know, discharge cards are like a short summary of your case, as a patient in the hospital.
When you get admitted into the hospital, you get a case sheet in which your history and progress is recorded.
But, this case sheet isn’t handed over to you at the time of discharge..instead, a short summary of the entire case sheet is written down on a ‘discharge card’ and handed over to you and you are supposed to preserve it well for any future use.
Now, sometimes.. while writing discharge cards…. I get this strong urge to write my own comments… of course, I don’t actually do that. But, still…. I FEEL like commenting on certain things…
Misaal ke taur pe..
A few days back, we had posted a case to be an elective CS (our OTs are on Thursdays)…. The lady had some cardiac ds. and had had a previous CS….
On Wednesday (our Admission day), as we were finishing our work towards the evening… having written all pre-Op orders and consent and stuff, this lady developed pains and was immediately shifted to the labour room….
There she was posted for an Emergency CS….
But, well… she got contractions sufficient enuf and had a normal vaginal delivery…
VBAC (Vaginal Birth After C-section)
And we were soooooo happy :)
I mean, undergoin a surgery has so many complications plus the post operative pain… my God!
After a normal delivery, a lady is fit and fine in no time…
So, having a VBAC after being posted for CS is something really lucky….
And so while writing the Discharge Card…. As I wrote “VBAC” I almost added my typical “Jhinga la la meow” and made my happy smiley “ :)” …..
You know, coz I am Arya… I’m soooooooooo expressive :p
I also remember writing a Discharge card where the second trimester history was something like-
T2- PIH detected -4th month
On Endopa BD since then.
UTI – 4th month, admitted for 5 days, took treatment and was asymptomatic at discharge.
GDM detected- 5th month. On Plain Insulin since then.
Usg done- 5th month- Low lying placenta (*blah*blah*blah*)
Bleeding PV – 5th month, 1 day. Admitted in LR. Symptomatic management given. No further bleeding episodes.

And after writing this last line I seriously wanted to write something like

“yeah!!! We need more events to make it eventful *rolling eyes*!!!”

Like I told..
I’m Arya… I’m sooooooo expressive.

Allah hafiz

Sunday, June 19, 2011

To Kill A Child. . .

Well, so this post is being written in an utter exasperation that has grown over the past 1 month. Today is the last day of our 2 months O&G (Obstetrics & Gynaecology) posting, including Labour Room, Wards and 3 days of FP(Family Planning (today, yesterday and the day before)).

While in the wards I came across ladies who were there for MTP (Medical Termination of Pregnancy) and sterilization (i.e. a tiny part of both the fallopian tubes are cut so that the lady doesn’t conceive again)and I always wondered why didn’t they simply get sterilized after their last child birth….
And if they didn’t want a baby, why not opt for contraception than actually conceiving a child and then killing it?????
Well…. My bewilderment was doubled during the last three days when ladies…absolutely fine ladies… come for MTP to the FP clinic with some lame reason like
“The previous child is too young”
“There is no one to look after the child at home”
“I am not keeping well” ………………
Alrite, reasons good enuf, maybe… but they turn lame when they are not backed by an “ATTEMPT TO PREVENT PREGNANCY” by “CONTRACEPTION”….

Contra-ception -- > Opposing Conception

There are myriad methods of contraception available ranging from permanent methods of Sterilization for both male and female to something as simple as the OCP (Oral Contraceptive Pill) and Condom.
While some people might be scared of sterilization, I don’t see why should they be opposed to other methods when, after ALLLLLLLLLLLLLL , they DO NOT WANT A BABY.
I am not writing this post opposing ‘abortions’, in general…that is not the debate here.
I am opposing the treatment of MTP as a joke.
MTP, when done for medical reasons, as when the child has been detected to have some anomaly or the mother is found to have some serious disease; or for social reasons, as when a child is conceived out of rape; or a child conceived due to failure of some contraceptive method (conceiving INSPITE of using a Copper-T or OCPs) is acceptable.
Even in cases when a lady conceives during lactational amenorrhoea, I wouldn’t say MTP is wrong.
But, otherwise, when you were absolutely fit mentally and physically… and you WERE NOT DESIROUS OF HAVING A CHILD,


We have seen in the wards, that when you counsel a lady regarding the use of a Copper-T (which is hormone secreting intra-uterine device), they go all NOOO NOOOO as if it is something very dangerous and very immoral….
There are some other ladies who refuse sterilization coz ..well… the HUSBANDS… haven’t agreed, again, maybe coz they feel it’s immoral and dangerous.
These same ladies go and get pregnant and later come with a request for MTP…… as if THIS is something very safe and moral.
A sudden bout of bleeding can never be safe my darlings….
And wat am I to say about the ‘Morality’ of KILLING A CHILD…………..

Some women, maybe, feel that pregnancy is just a temporary cessation of her periods and what she loses by MTP is just her ‘period blood’…. They don’t realize that this is as much her child as any child she has had or may have in future. This is a child that is lost… a child that is KILLED .. it is not just a re-commencement of her menstruation….

We also come across illegal pregnancies… before marriage or out of marriage…..again, I do not understand WHY cant these girls ‘prevent’ such pregnancies. I mean we even have Morning After Pills…. Don’t they watch television?????

There is one case which I saw during my Labour Room which I shall never forget.
An around 40 yr old lady came to the LR with Labour Pains… and not the onset of Labour Pains… but it was like she will deliver in no time. The Fetal Heart couldn’t be localized and an IUD (Intra-Uterine Death) was confirmed. A C-Section was done and a swollen, infected Huge Dead Fetus was removed.
This lady’s husband passed away many yrs ago… she works as a maid… conceived illegally….never told anyone bout the conception….ppl ignored the growing abdomen coz she was as such fat…. She didn’t go for ante natal check ups… nothing… must have.. MUST HAVE… felt the foetal movements which she ignored… and turned up as an in labour IUD.
Why??? Tell me, why???

Do you realize that there are couples in this world who can sell their all just to have a child?
There are young girls who have undergone hysterectomies for unavoidable reasons and can never have a child?
Do you realize that infertility has increased so much more in our times???

If you realize all this, do not take your ‘fertility’ for granted.

Do not conceive a child that you are not desirous of.



Allah hafiz