By Tedler D. Depaynos, MD
To all our readers and friends, may your New Year be more Peaceful, Fruitful and Happy.
Recalling our recent previous year, there are several significant events that we would like to emphasize and learn from. Of course, others may have more extensive, but from our vantage point, among them are the following:
We encountered a number of Dengue patients and most of them recovered spontaneously without serious residual effects. Patients would have the usual flu-like symptoms and since it is a viral infection, it is in general self-limiting and no specific drug is given. The major complication occurring is the reduction of the number of platelets of the patients which is needed for blood clotting. A major reduction will thus give the danger of bleeding. In most of the patients seen, no bleeding occurred except for two unfortunate cases which would make us wary. Both of them came from the same barangay in a neighboring mining municipality. One is a 26 year old male patient who had cerebral bleeding which is confirmed by a CT Scan. The left side of his face is partly paralyzed and the right arm and leg were weakened. It seemed that he had a stroke. The other who was just 19 bled in his lungs and when he closed his eyes permanently, his father boxed the cement wall of his room with his sorrow and frustration.
The Anapholes mosquito that spreads the Dengue virus is a daytime mosquito which bites usually at 10 AM and at 4 PM. It thrives in fresh water so that they become active at the start of the rainy season. Recently, another type of mosquito spreading the virus was observed to be biting at night. Preventing the spread of the virus then is to remove the mosquito breeding places. Anti-insect spray may be done and sleeping under a mosquito net would be a good practice. With the two unfortunate cases encountered, this should be a neighborhood endeavor.
Another major observation noted is the increased number of patients undergoing dialysis. Dialysis procedure is actually an artificial kidney so that patients undergoing it have destroyed or non-functioning kidneys. There are many causes of kidney failure but what is now common is due to neglected diabetis mellitus. Diabetis is very insidious. One does not feel anything until after 5 to 10 years of being diabetic when complications set in. They are usually irreversible! One of them is kidney failure. Clinically, this maybe manifested by a persistent blood pressure reaching 190 to 200 systolic.
Diabetis in general is inherited. This was lectured to us when we were still medical students. If both parents are diabetic, 100% one becomes diabetic. If one parent is diabetic, 60% one becomes diabetic. In short one may be destined to become diabetic and the only thing one could do is delay the onset. Hence early diagnosis is a must.
A number of patients with elevated blood sugar encountered may give a history of self-medication which made them feel good. This prevented them from seeking medical consultations until complications occurred.
It should be emphasized that Diabetis is a permanent disease and a maintenance medication is a must to control it.
A number of elderly patients were admitted in the hospital and most of them came when they already manifested complications. One had a chronic Urinary Tract Infection and she came only when her kidneys were affected. Another came only when her abdomen was distended and with severe unbearable pain. She had a perforated intestine and came only when she could not bear the pain. This is the more common denominator in these elderly patients. As long as they can bear the pain, they refuse to go for medical check-up. What happens is that they entail more expensive work-up and medications and when they undergo the needed surgery the risk have become higher. Besides, due to their age, treatment becomes more difficult.
It is wise then to convince these elderly patients to seek medical consultation the earliest possible time when they are feeling something not good. They may be allowed to do the native rites but they should still see their MDs after. If you are one of them, do not be hard headed. **
