Monday, July 27, 2015

A Gift from a Patient

I received the most unusual gift from the patient the other day.
Over the years, I've gotten some thoughtful things from the people I treat. And no, it's certainly not a requirement or expectation, but it certainly brings some warmth, and a smile, knowing you're appreciated. 
Let's see. Giftcards. An angel ornament. Books. CDs. A mug. T-shirt. Bookmark. Brooch. Cookies. Cake.
And now, fish.
Yup, fish. As in fish a patient caught during a fishing trip. Which he then skinned and filleted himself, then packaged and flash-froze it himself.
He handed it to me when I saw him recently.
It probably isn't worth much. But then again, it was worth everything. This was something he did himself, and of all the people, he thought about his endocrinologist during his fishing trip.
I was very much flattered, and grateful. He gave me some tips on what to do with it. And I think the first batch I cooked turned out pretty good. I cooked it on a grilling plank in my gas grill.
Maybe Portuguese fish curry the next time.

Thursday, July 16, 2015

Faith and Medication

I'll start by saying this: faith is a GOOD thing. So please don't misunderstand my intentions.
However, with faith, one also needs to have some common sense.
I saw a woman the other day in the ICU. Presented with florid diabetic ketoacidosis, sick like stink and was intubated for airway protection. She was pretty acidotic, with her gap being 27.
She had type 1 diabetes, diagnosed in childhood for which she took insulin for survival. Very devoted mother and she homeschools her 7 kids. She was also very devout in her religion. And so, unclear to me why, after a period of very intense prayer and meditation, she was convinced God has cured her of her disease. Somehow resurrected the long-apoptosed pancreatic islets, and that she was again capable of producing endogenous insulin.
And so, she stopped her life-sustaining medication. And stopped testing her blood glucose.
It didn't take her long to go into DKA.
Remember, kids- you cannot control sugars by eating less alone- in insulin-deficient individuals, survival without insulin, even when one is fasting, is not possible. It's 2nd year physiology.
It's the 2nd case of DKA induced by religious fervor that I've seen here.
With the excellent care she is receiving in the ICU, I'm optimistic she will recover. And we'll have to reinforce that she will need to stay on insulin for life (unless she chooses to have a pancreas transplant).
However, it's important to remember that while faith is important, it's also important not to disregard medical advice.

Sunday, July 12, 2015

7 years

I had to renew my hospital ID the other day. And perhaps I just forgot about it, or was in denial, but I was kinda taken aback by the new photo ID on the left.
This, compared to the photo I took when I first started to work. Heh, I even had my braces on in the earlier picture.
My first reaction was, KNNCCB, WTF??!?
It looked like I've aged 20 years in the last 7. I'm still not sure what was to blame- genetics (after all, I remember dad's old pictures- long flowy hair until his early 40s when boom, it was suddenly gone), being married (heh, I don't think my wife reads my blog anymore), the kids, or just work.
And so, I'm still sometimes tickled by patients who ask to see an endocrinologist for premature balding, because they thought it was hormonal in nature (probably partially, but it's not something I treat)- and then I walk in the room and they take a look at my head and go "maybe I'm not seeing the right doctor...".
One of these days, when I'm gutsy enough, I'm just going to shave it all off.