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Showing posts from September, 2010

Episiotomy-Assisted Vaginal Birth

I just recently delivered a woman of her third baby - a baby girl. I had been called to see an out-patient arrival and so was headed for the consulting room, when I heard the screams coming from upstairs and so I detoured. The baby's head was already crowned - you could see locks of hair and scalp right at the introitus (vaginal entrance) even during the relaxation phase of uterine contractions. She was tense and fidgety at this final phase of the 2nd stage of labour - I've noticed sometimes, our midwives do not do a good enough job of managing the patient to get her calmer at this crucial phase. Soon, I gave a deep cut to the vagina with the episiotomy scissors during the final contraction and push, which then saw the whole head come right through. The contractions still strongly present, each shoulder in turn, and then the rest of the body, followed through; the baby wailing its protest in both my hands, almost immediately. Handing the screaming new-born over to the ...

Feminine Power - It Fears Not The Cadaver

I've uploaded a new an interesting account of a by-gone, first-time experience of mine that is truly memorable. Read all about it in the Training Day page, above. It bears the same title as this post. Let's know what you think. I'll be resuming duty 2 - 0-clock today, as soon as I dash down to the bank and back... The Pope just read his speech, following the Queen of England's, in his historic State visit to the UK. Interesting reference to the Holocaust, that he made.

Ordinary Out-patient Consultation Today

Nothing exceptional has occured on the job today. I'm a little worried though, of a booked Para one patient in second trimester, on admission for Pregnancy Induced Hypertention. Seems to be a bit of a difficult case, with her legs so enlarged with fluid and her complaints of sudden, poor sight in the right eye...

Gratitude Sermon

I'm on a weekend break and the whole family went to Church - which doesn't happen often since my wife and I each run various shifts at our respective jobs. And, that I only recently committed my life to Jesus Christ - thanks once again, Lord . I'll  be resuming duty tomorrow afternoon so I had better make the best use of my off-duty at home on Sunday. The sermon was about Gratitude. Gratitude in our lives, for every single blessing in our existence. Never once forgetting that these great blessings come from the sole Benefactor - Almighty God. Never forgetting also, that we are greatly blessed to have been given the greatest Blessing a human can receive - Jesus Christ Himself. Son of God as a Gift to each fallen human. The day a man or woman finally comes to terms with this great Truth, is the day that they become whole. Fully functional. Devoid of all defects hitherto present. We are all too aware of human defect, suffering and sickness. The gentleman sitting in fro...

Newly-Wed With Lobar Pnuemonia

She sat quietly but was obviously in discomfort as I raced down my notes of the admission. Clearly, it was a case of Right Lobar Pneumonia and you could see the effort she made with each painful inhalation. There was reduced air-entry over the right lung-fields on auscultation. She was running a moderate fever and she coughed loudly in a dry, raspy manner. She was baby-faced, fair-complexioned and newly wedded. She had not missed her period recently and I pointed this out in my admission notes - she would require very effective antibiotics and I wouldn't prescribe any without ruling-out early pregnancy... The child with the diarrhoeal disease who had had bouts of seizures, became quite well and was eventually discharged home. Her aunt, our Staff nurse, is on night duty with me tonight - one less worry on her busy mind, obviously.

Tendon Repair

This pretty lady began to cry uncontrollably when I informed her that the very deep cut on the dorsum of her left foot, lateral side, was a little complicated - the tendon that dorsi-flexes the 5th toe was completely severed and would need a proper repair. She had been all too aware of her sudden inability to wiggle that toe, never mind the pain she was going through. It was an okada accident she had been involved in, and she soon began swearing that it would be her very last okada ride. I gave her two options. One, we call in the specialist. The Orthopaedic surgeon. Or two, we the medical officers would handle it ourselves. And by "we" I meant I as the surgeon, with the staff nurse on duty as assistant. The former meant a greater financial cost. After quiet consideration and phone consultations with her acquaintances, she opted for the latter. Off to theatre we went, upon which I soon began deftly uniting the ends of the severed tendon with silk 2-0 sutures, glad it w...

Deadly Diarrhoea

A nursing staff of ours almost lost her 7-year old niece to Diarrhoeal Disease yesterday. The child apparently had had many bouts of watery stools and was clearly, severely dehydrated and quite drowsy at the time of admission - loss of skin turgor, eyes sunken deep into the sockets, sunset gaze; the works. And then she began to convulse. This posed a dilemma in terms of the dosage of sedative to administer in order to cancel the seizures - one cannot afford to administer too much a dosage so as not to further depress the Central Nervous System. Paraldehyde might have been best preferred due to its low depressive action on the CNS, but we had run out. I ordered i.m. Diazepam 15mg statim. Clearly she had been electrolyte-imbalanced - in severe dehydration, serum electrolytes like sodium, potassium and so forth, are deranged in terms of their concentration in the blood serum. This clearly contributed to the convulsive seizures she suffered - she had several of them. She graduall...