Thursday, December 30, 2010

Do I have the liberty to admit my mistakes??

On Shalabh's insistence I started reading this book Complications by Atul  Gawande , an American doctor of India origin.Shalabh said ,you will find a lot of us in the book.OK.....So I started with the introduction.

Dr Atul wishes to write not just about the things which go right but also when things go wrong.Oh Dear So do I.So many times I have almost typed a post when things went wrong but at the preview stage have dropped the Idea.

Reason Dr Gawande has been lucky to have a Supportive Dr Michael Zinner,his hospital's Chairman of surgery.I dare not think how much flak would I get from my employers,colleagues,friends and foes and above all my own patients.

But I am determined,some day I will write an anonymous Blog which will reflect a balanced view of our job,science,art....whatever you would like to call it.

Doctors are human too!!!!!!

It was a lazy cold and foggy morning today and I was trying to get some sleep following two back to back 3.20 am and 3.55am deliveries which I had dutifully attended bearing the fog and cold of shivery 30th Dec 2010.
At 7 am in the morning my mobile started singing 'never say never....' echoing my sentiments(though now I have started to feel 'I have had enough').
ammm,yawn.......may be another emergency .......'Doctor I have got my periods .Do I still need to go for Ultrasound Scan'?I muttered 'Bloody hell'!!May I know who is online please??
XYZ   .You suggested me an ultrasound to rule out PCOD about 15 days back when I had missed my periods by 10 days.I didn't get it  done then.Do I still need to get it done even if I have got my Periods?Will it be a TVS or will be an abdominal Ultrasound? (I mumbled to myself...So if you could wait for 15 days why this early morning rush?)
I understand that this XYZ was ecstatic to see blood in the pan when she got up from bed and went to pee.She presumed she doesn't have a suspected hormonal imbalance.Great.....BUT FOR GOD'S SAKE PLEASE TRY TO UNDERSTAND THE PLIGHT OF YOUR POOR DOCTOR WHO IS STILL HALF SLEEP AFTER a day and  a night of hard work.
Day before there was an early morning call from another desperate patient who keeps on fiddling with hormones to prepon and postpon her periods as per occasions like outings,Christmas,New Year,Diwali etc etc.Doctor While peeing I noticed I had started to spot and I wish to get my periods delayed on Occasion of new year,what do I do? ''For God's sake do anything but don't disturb my sleep''!!
I am sure most of you would understand and agree,it is not an emergency and a call can wait till a more official hour.
I am seriously planning to get my calls charged between 9 pm to 9 am in the morning to avoid such 'emergencies'.I might be labeled a money minded doctors after that,I know.But tell me ,do I have an Option?

Tuesday, December 28, 2010

Selection of foetal gender.........Who is responsible??????

About 6 months back a lady who is my old patient walked in to my OPD with 'Delhi Times' folded and  very tightly held in her hands .She was undergoing treatment  for secondary infertility and at the same time was under tremendous pressure from her family to produce a heir(male child) for the family.She opened the folded news paper in front of me and asked 'Is this Possible,Doctor'?Delhi Times had reported that many Indian celebrities are going to Thailand for gender selection of their babies through Assisted reproductive Technology.She was very keen to go for it if that was possible.Though it was possible but to her pleasure mixed disappointment she tested positive for pregnancy in her that very visit and thus that gender selection never took place.But I did realize the power of MEDIA.I realized inadvertently they have opened a Pandora's box.

Yesterday,main TOI reported lot many Indian Couples are visiting Thailand to adopt the same technology to have baby boys.

Thursday, December 23, 2010

Dermoid Cyst

Dermoids are Ovarian cysts which are mostly non cancerous in origin.At times it can be boderline cancerous as well and then called immature teratoma,

Though mostly non Cancerous,once a diagnosis of Dermoid Cyst is made by Ultrasound or MRI,it should be operated.The procedure is called laparoscopic ovarian Cystectomy ,which simply means that the cyst is remove preserving the ovarian tissue.These cysts can't be treated medically and if left unoperated can lead to various coplications like torsion,severe pain,increase in size compromising the ovarian tissue and one might end up loosing complete ovary rather than just removal of the cyst.Dermoid cysts are filled with tufts of hair,tooth,bone pieces and very thick cheesy fluid which if bursts inside the abdomen can lead to severe pain and adhesions.

15 to 20% of the times they can affect both ovaries simultaneously.No one can predict a recurrence.

Once operated usually the patients are discharged within 24 hours and eating and drinking normally.

Wednesday, December 8, 2010

New Websites

Hi Friends,

My new website on Gynecology and laparoscopy is now available online.Would request you all to go through it and leave your feedbacks.