18 April 2011

FOR years, my family members who had a medical problem and needed to visit the doctor had always asked me go with them.

They felt that they needed translations for “doctor-speak” as they were usually somewhat intimidated by the jargon and medical wilderness that they were about to embark on.

As for me, I was more than happy to be of service. I have written for health columns and medical stories before I had children.

When Omar was born nearly 20 years ago with his myriad medical problems, I was immersed in the hospital scene.

Then when my parents fell ill, it was only natural that I represented the family and duly reported on their progress.

I am not a doctor, but I’m not intimidated by the mysteries of the medical world. What I do not know, I will make the effort to find out more so that I can ask doctors intelligent questions.

Recently my brother asked why he should consider going for an angiogram and have stents placed in his arteries for his heart problems. He’s had enough problems with his health as it is and is not keen for more needles and jabs.

My brother, now in his 50s, contracted polio when he was a toddler. For him, walking had always been a challenge but, after several operations on his legs, he was managing well with the aid of crutches. He could drive and was fairly independent, travelling and holding an overseas posting many years ago.

Now, with diabetes and end-stage renal failure (which translates to kidney failure and the need for dialysis three times a week), his life is bleak.

With his kidneys failing, his bones have also suffered. Both his legs have gone weak, made fragile with severe osteoporosis. A recent fall caused a fracture, further damaging his good leg.

Due to years of medication, his stomach lining has also been affected. In the last year, he had been in and out of the hospital for various reasons and all the complications were caused mainly by diabetes.

When I last saw him at the hospital, the specialists tried to persuade and convince him that he needed stents put in.

He wanted to tackle his problems one step at a time, meaning he would deal with his kidneys first. Dialysis would remove excess water from his system which mostly affected the efficiency of his lungs and heart.

But the doctors thought that plan was not very wise, considering his current situation.

They said he should view the problems in their totality because they were intertwined and one affected the other. There was also an urgency to deal with his problems as quickly as possible.

He asked for my views and I told him I was inclined to agree with the doctors. That was not what he wanted to hear. On a parting note, I told him we could talk more about this when I came by the next time.

After that visit, I went to dinner with friends and contacted severe food poisoning. The cramps were worse than childbirth contractions, not to mention the diarrhoea and vomiting.

At the emergency room, treatment included an intravenous drip, blood and urine tests.

After I had informed the doctor of my medical history and list of allergies, the IV line was set up and running nicely. Then they left me and I had an anxiety attack.

I couldn’t breathe and I was alone. I panicked in the darkened cubicle of the emergency room. I rang the bell. In the short minutes that seemed like eternity before a nurse came to answer the call, I tried to calm myself.

I was not suffering an allergy attack, I told myself. It was only glucose water to rehydrate me. There wasn’t any medication in there that I was allergic to.
I had to concentrate and focus on breathing before I became hysterical and bolted out of the hospital like a mad woman.

Suddenly it occurred to me what my brother was going through, and on an even larger scale.

I had only one little IV needle on my hand. My brother had needles on his neck for his emergency dialysis. He had a fistula graft installed in his arm that was not working and needed to be re-done.

To undergo the angiogram and have stents put in, the doctors would have to scope his stomach first. He felt defeated and depressed.

It then struck me that it was easy to tell people what to do and that they should do it if they knew what was good for them.

But the thing is, what is good for them is not always a joy. It is painful. It is scary. The biggest fear is the possibility of not coming out of the procedure conscious, or worse.

When you go under the knife, you literally put your life in another person’s hands. You can only have faith that the surgical team will bring you back in good shape. Telling people that the benefits far outweigh the risks are good only up to a point.

Then there is the recovery period – recuperation and a string of things you should and shouldn’t do. Your life, though saved and prolonged, is sometimes not much of your own anymore.

That was what my mother was trying to tell me all those years ago when she protested against going for dialysis, a boring and arduous task of going in for four hours each time, three days a week, being poked by a pair of needles each visit. It was like a life sentence, she used to say.

She argued about the pain and discomfort she had to deal with. I, in my naive way, tried to convince her of a prolonged life, a life saved, and hopefully a better quality of life.

So where does this go? I really do not know. What I do know is that I have a lot of issues to deal with. If a mere intravenous rehydration can trigger off such a reaction in me, what about major issues like my brother’s?

I think that sometimes, we, as the person not receiving the treatment and the one not to suffer the pain, should listen more than we should impose what we think is right.

Allow the patient time to talk it through and listen to their fears. Let them work it out, if possible at their own pace. They are scared enough as it is.

The only other thing left for us to do is to assure them that we are there for them no matter what.

This article was published in www.nst.com.my on 19 February 2011.