Monday, October 12, 2020

Patient I will never FORGET

Ask any of the doctors, they will tell you...there are patients they will never forget. 

She was a patient with ovarian cancer with loco-regional involvement. A planned colonoscopy was postponed for almost 4 months due to the COVID pandemic. From the gyne-oncologist assessment, it was an operable mass, with back-up from the colorectal surgeon. She underwent full staging + total abdominal hysterectomy and bilateral salphingo-oophorectomy + bowel resection.

Day 2 post-operation, she started to have persistent serous discharge from her wound site. She was already covered with antibiotic since post-operation. Antibiotic was later on changed, according to the sensitivity from the cultures taken. Post operation, her condition was complicated with burst abdomen and vault breakdown. She went into DIVC & sepsis.

Her days after that were tough. We put her on vacuum dressings. I don\"t know and I will never know how she feels at that point of time, looking at her own wounds, with bowels visible there. Towards the later days, she gave up on all the intervention such as insertion of nasogastric tube, blood takings. I remembered telling her that everything is going to be ok, when everything is not ok.

We didn\"t give up on her. No, we shouldn\"t give up on her. Although she is a case of ovarian cancer stage 3, but we had done an optimal debulking. After op, if she heals well, we will srefer her to Radiotherapy Unit for further management. We are trying our best to give her the maximum medical therapy support. I remembered going to ICU at night with my colleague, just to see the update for this patient. Sadly, she didn\"t make it. She passed away exactly one month post operation. 

For those who has advanced stage of cancer, they can choose for palliative care as I have seen many patients with advanced stage of cancer suffered when they underwent chemotherapy. Basically they have no quality of life. But for this patient, I wish she can go further. She passed away during my oncall. I closed up her wound, that was the very last thing I can do for her.

When things happened, there will be lots of voice which sounds, "what if...?"

She is the second patient, that I will never forget. Mdm M.