To be honest, 2018 is my very first year to celebrate the first day of Eid Fitri away from my family. I had expected this to happen this year, so, my heart was well prepared for that. 6 years staying abroad, alhamdulillah I managed to go home every single Eid Fitri :)
But, life changed. I have new responsibilities, new environment and I look forward for more changes in my life, insyAllah with an open heart.
Night of 1st Eid, I was on call at the labor room. It was uneventful, I mean the oncall was bearable with few admission - tolerable much. Well, who wants to get sick on the night of Eid, you tell me. -_-'
I had something I could not forget, two different cases that really caught my heart on how people perceive the hospital admissions.
1st case.
There was a lady, primigravida (first pregnancy) who came to Labour Room (LR) at 0200H (2am) with complaints of contraction pain and show. Upon further examination, the CTG (reflect baby's condition in the womb) looked reactive (means normal), the os was already 2cm and time contraction was 2x in 10 minutes that last about 30 seconds.
Based on my previous experiences, we will admit this patient to the ward for further observation - in view of:
- she came at 2am
- her house is quite far away from the hospital.
Even though she was just primigravida (the labour process is usually longer for primigravida), she could still deliver the baby ANY time!
But, she was really keen to go home instead of being admitted.
Well, I do understand she did not want to celebrate Raya at the hospital, but this was out of her control. If it is fated that her baby to be delivered on 1st Syawal, let s/he be. So, my MO allowed her to go home and asked her to come immediately to the hospital if the contraction pain becomes stronger or if there is any leaking liquor (air ketuban pecah) or if she feels any reduction of fetal movement.
2nd case.
After the previous lady left the LR, another lady, G7P6 (means she is currently pregnant of the 7th baby and already delivered 6 babies) referred from the Emergency Department for PV bleeding (per vaginal) with diagnosis of incomplete miscarriage.
Incomplete miscarriage means:
- the 'baby' or better to be called as product of conception - POC (hasil persenyawaan) is already out
- but some of the POC still remain in the womb
We need to evacuate the POC otherwise patient will continue have a lot of PV bleeding and abdominal pain.
Upon per speculum with the MO, we managed to remove the POC at the os and upon TAS (transabdominal ultrasound), the endometrium thickness (ET) was <10mm. Usually, we need to proceed with ERPOC procedure (evacuation of retained product of conception) if the POC cannot be removed from the os and if the ET >15mm.
In this patient's case, our final impression was complete miscarriage - she did not have to undergo the ERPOC. However, we admitted the patient for observation and told her if her bleeding is minimal, we can allow her home that morning. She agreed with that - 'saya ikut apa yang doktor rasa terbaik'.
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Here we can see how patients perceive admissions to the ward. Trust me, no doctors want to admit patients to the ward without reason. Most doctors care about the patients even though admissions will increase the workload. But, that are for patients' sake and our responsibility.
And to make the night more interesting, the first lady delivered her baby just few hours after she left. Luckily she managed to return to the hospital T___T.
Birth before arrival (BBA) to the hospital is another issue.
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On the day of Eid, I was in charge of post natal ward and guess what, the ward round ended at plus minus 7am! And the housemen managed to settle all documents for discharged patients as early as 10am! Wahaaaaa. The MOs were considerate enough to allow patients home very early so that patients can celebrate Eid with family. :)
My shift ended at 1pm and I decided to drive home immediately after that. Arrived my aunt's house at almost 4pm and I ended up sleeping for the rest of evening. T_T
Went to my uncle's house that night and I ended up with sleeping on the sofa.
The end of my first day of Eid. :D
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| 2nd day was better. :D |
Selamat Hari Raya everyone!
Although this maybe quite late, but I wish you have the memorable Eid :)
If you are reading this, please pray for my success for tomorrow's assessments. I will be leaving for another department very soon and hopefully I pass this O&G - Obstetric and Gynecology with good achievement. Ameen.
M, Perak, Malaysia
180624
