ALS

Got a 65-yr old female who came to me about 3 months ago with just hoarseness of voice. I ask her to get me the results of the EMG to confirm it.

She came back just a week ago, and clearly had fasciculations, and difficulty talking as well as swallowing. Bulbar type ALS.

We dont have much time, I'm too much preoccupied with what else to do for her. But for now, her dental works has to go before any therapy initiated.

Likewise, the breast cancer patient with pulmonary mets is now undergoing chemo. I pray she will get better.

Back to the Hospital

I was at her house last week. I know that what I saw and felt a that time will forever put a mark on my consciousness.

I went to her home, because the husband wanted to have an IV on her. She was having a difficult time with breathing. What I didn't know what that she was already very dehydrated and had not eaten much for days. Her O2 sat was falling to less than 90%. She was definitely in respiratory distress.

And during all this time, her 2-yr old kid was so happy and oblivious to what was happening to her mother. He was giving her toys and stuff, giggling while her mother was leaning on a chair and gasping. It was like a, pardon my euphemism, Hallmark moment.

At the back of my mind, I started asking myself why am I in this situation, and why am I so much affected? Is this what it meant to be a doctor? Is the suffering of one part of a healer? Did the Hippocratic Oath mentioned anything on suffering?

I remember when I was in med school and my professor once told us to try being objective and impersonal so that judgement will not be affected with emotions. But how can this be? Anyone will be affected whether we like it or not.

Acupuncture

I seem to realize now that I really need to practice and use my acupuncture skills. I had this lady who had like 3 months of shoulder pain. 

This was her first acupuncture session and upon inserting the needles, she could only say: "I like that feeling, Its great."

It was instant relief!

Resurggence

I hate it when it happens, because they are more difficult to treat. My patient with liver cancer came back, with bleeding coming from the t-tube. His MD who placed the tube said it is normal but its been a week. I'm waiting for the bleeding parameters.

The tumor has grown back to how it used to be. The patient is worried, I'm quite disturbed because he did start eating meat again, could be that reason.

Awaiting labs