Tag Archives: mental retardation

Stop This Anesthesia

Stop This Anesthesia
© Dr. Rajas Deshpande

“Why so Doctor? Why cannot my child be like others?” asked the angry mother.

Just as I started to reply her, the patient: a 23 year old boy, went into a flurry of jerks. His body stiffened up, his eyes rolled up, and his face turned blue. He was already on the examination bed. Me and my student tried to support him there. We activated the code blue, just in case.
But the fit stopped. The boy came to, gradually. The nurse cleaned the bloody froth from his mouth. Heart rate and BP were normal now. Patient remained confused.

The mother, silently sobbing while patting his head, showed me the many large scars upon his face, head, and elsewhere. “He falls down many times every day and often injures himself. Can you imagine, doctor, what a mother’s heart feels to see her child bleeding every day?” © Dr. Rajas Deshpande
It was a case of hypoxic brain damage. The child was born in a village, the labour was prolonged and they could not reach a bigger hospital in time. If they had facilities, the child would have been normal today. Since birth, the child had had mild mental retardation and convulsions resistant to many medicines, They refused a surgery. I tried to counsel them. In many cases, we can control fits with a good combination of different medicines. But that takes time over a few months.

“We are farmers, doctor. We cannot stay home all day, we need to work to earn. The medicines are all so costly. I can sell everything to treat my son. But please tell me this will stop” the father’s voice was quivering.
It is easy to expect a doctor to detach himself emotionally from the patient, but then it is also like denying the patient empathy and understanding so crucial to their wellbeing.
“I will try my best, and I feel we can control the fits with medicines. Also, I can arrange for free medicines for your son whenever you cannot buy them. Never worry about my fees, I will be happy to treat him free. But make sure that his doses are never missed.” My teachers spoke through me.

“What after my death? Who will care for him? Who will bring him medicines? Who will ensure he takes them?” said the hefty man, and broke down. The proud feel it most difficult to declare their agonies. He tried to hide his face. The father and the mother sobbed on either side of the patient, who wasn’t yet alert enough to grasp it. © Dr. Rajas Deshpande
“There are some help communities and groups for epilepsy patients. We will enroll him into one. They will arrange for his medicines. I will also introduce you to some pharma companies who will give him free medicines as required”.
Then, pausing to realize the unasked question, I replied “And after me too, my students, colleagues or most doctors I know will never decline to treat him free. You just have to show them this note” .
I made a small note of such a request. I have never known any of my students or colleagues refuse to see a deserving patient free.

The tension in the room was melting. The parents had stopped sobbing. A possibility of hope and reassurance destroys the worst of darkness. The father folded his hands in gratitude, but couldn’t speak. The patient had a glass of water and they left.
But my mind was on fire again. Who’s guilty here?
Shall we blame fate for the blatant failures of a system? © Dr. Rajas Deshpande

Why didn’t their village have facilities to ensure good delivery? Why wasn’t it possible for them to reach bigger hospital in time? Who is responsible for millions of children who develop lifelong preventable illnesses just because of a cruel lack of healthcare infrastructure? Patients with heart attacks and strokes and cancers die everywhere everyday, unable to afford treatment or to reach hospitals in time.

In a country that needs serious improvement in almost every area of healthcare infrastructure, the whole focus is being directed at the repeated exams for doctor’s requalification.
Do we need it at all in a country that is grappling with critical shortage of doctors, and where we are promoting every other pathy to allopathy with a six month training? We need many care homes, support systems for patients who cannot afford medicines. Many more ambulances. Many more hospitals in remote areas, Many more qualified doctors to work there while being able to afford a dignified life.

But the only decisions being made are about more exams for truly qualified doctors: why? This tranquilizer to divert attention from the main issues that need correction is the worst treatment possible for Indian Healthcare. © Dr. Rajas Deshpande

Doctors are never defined by the examinations that they pass, being a doctor is far more than passing qualifying examinations. But who will educate those who never bothered to pass any dignified exams?

Just before inducing the anesthesia, the patient is told “You will feel sleepy now. Everything is ok. Take a deep breath”. With complete faith, the patient goes unconscious. It is the doctors who ensure he / she returns safe. Some rare unfortunate patients never know that they will never wake up, because there are things a doctor cannot control.

That unfortunate patient is just like the Indian Society today.
How qualified are the healthcare policy decision makers?
© Dr. Rajas Deshpande

Please share unedited. Let the society know what is critically essential.

Pune Mirror : Pak Patient Improves, Shows Cognitive signs

PAK PATIENT IMPROVES, SHOWS COGNITIVE SIGNS

Pak patient improves, shows cognitive signs
Sajal with her parents and her doctor, Rajas Deshpande, from Ruby Hall Clinic (PIC:MAHENDRA KOLHE)

DOCS SEE SUCCESS IN CEREBRAL PALSY TREATMENT

Rare case of 7-yr-old had several complications and drug resistance that had to be overcome

A seven-year-old Pakistani girl born with cerebral palsy has been successfully treated by city doctors — despite severe infection and an umpteen number of complications —in nothing short of a medical miracle. Not only was she cured, she also started showing signs of cognitive abilities.

A group of doctors from Ruby Hall Clinic treated the girl, named Sajal, last week. She had been brought to the hospital with glossitis, laryngitis, pharyngitis, pulmonary aspiration, bacterial infection, urinary infection, skin rashes and severe sepsis. Timely medical intervention helped treat all these problems even though the child was resistant to several antibiotics. “This made it even more challenging for us to control her infections and treat her thoroughly,” said Dr Rajas Deshpande, head of neurology, Ruby Hall Clinic, adding, “The child came to us with seven to eight types of issues. It was very difficult for us to treat her. But, with the right antibiotics, we managed to ease the severity of her condition. Now, she is all set to fly back home.” He was helped by Dr Ventaramani and Dr Bamkin Amin in the case.

Sajal’s mother, Shahzia, offered, “Sajal suffered from many complications and was not even able to pass urine or stool for three to four days in a row. We were not able to feed her or admit her to any hospital in Pakistan as many doctors turned us away, looking at her complications, saying there were no chances of improvement. That is why we came running to Pune and got her admitted at once. Sajal’s mouth had a lot of rashes, her lips were torn. No cream or gel given to us in Pakistan would heal her tearing lips. The infection was severe and kept spreading. Within three days of coming here, my child showed signs of improvement. Now, after six days, we are flying back to Pakistan.”

This is not her first visit to India; she has made several visits to treat her daughter’s cerebral palsy. “In the last few years, we took her to many countries, from Germany to Europe and Holland. But, no doctor was willing to take up her case. They said our child could never recover. Sajal had several fits and epileptic attacks in a day and a number of allergies and resistance to drugs. She was in a totally vegetative state. After coming to Pune, she began recognising voices, especially mine and my husband’s, reacting to light and also to her siblings. Now, there is more than 20 per cent improvement in her condition,” Shahzia added. She was told that no drugs for epilepsy or cerebral palsy were available in Pakistan.

“If the epileptic attacks of such patients are controlled well, learning or recognising people or voices can get easier. In Sajal’s case, we controlled her fits and her brain showed improvement. Strong antibiotics and antiepileptic drugs were given to her. And now, Sajal has improved by more than 20 per cent,” Deshpande stressed.

Other prominent doctors hailed the judicious treatment, with Dr Hemant Sant, president of the Neurological Society of Pune, saying, “A single infection is commonly spotted, but many infections coupled with complications is uncommon. Such cases are very challenging and a moment’s delay can prove life threatening.” Dr Sushil Patkar, a neurosurgeon from Poona Hospital and Research Centre, added, “Children born with this condition are very difficult to deal with. So, one has to be careful when they get infections. They need constant attention and care. Controlling seizures and convulsions should be the main aim to better the child’s condition.”

Dr Nirmal Surya, regional vice president of the World Federation of Neurorehabilitation and treasurer of the Indian Academy of Neurology, also brought out some ground realities. “Many a times, due to lack of hygiene or low immunity, children do get infections, but severe complication in one of them is usually not reported. With stronger antibiotics, such infections can be controlled and managed well, if the patient is brought in early. More important are rehabilitation, regular physiotherapy and proper diet, which can help boost the immunity for such special children,” he explained.

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This story was published in Pune Mirror today.

Thank you Dr. Bankim Amin, Dr. VenkatRamani, Pediatric resident doctors (Dr. Upendra, Dr. Tanvi Priya, Dr. Abhijit Kudale, Dr. Supriya Takle, Dr. Radhika Gupta,Dr. Suyog Choudhary, Dr Smita Sangade), Nursing and ward staff, Overseas care staff and so many others who made this possible.

Doctors always make one world, without any borders.
We all treat everyone alike, God / Nature decides about the outcome.
We were blessed with some smiles recently.

The miraculous recovery from infections and cognitive improvement in this girl is also due to the unending effort and sacrifice of her parents, who did not “Dump” the extremely challenged girl child as advised by relatives and society, but gave her the life of a princess, breaking umpteen impossible barriers that stood between her and the medical aid anywhere in the world.

Every parent has boundless love for their child, but these two parents have made her health their career.

May every child be blessed with such parents!

Thank you Ms Nozia Sayyed (Pune Mirror) for your dedicated awareness initiative, and Mr. Mahendra Kolhe (Pune Mirror) for the picture!