#urine catheter change at home

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Urine Catheter Change At Home | Catheter Change At Home

Changing a urinary catheter at home can be done safely with the right preparation and technique. Here’s a step-by-step guide:

 Supplies Needed:

- New catheter (make sure it's the correct type and size)

- Sterile gloves

- Antiseptic wipes or solution

- Lubricant (if applicable)

- Clean container for the used catheter

- Absorbent pad or towel

- Disposal bag for used materials

 Procedure:

1. **Wash Hands:** Begin by washing your hands thoroughly with soap and water. Dry them with a clean towel.

2. **Prepare the Area:** Find a clean, well-lit space. Arrange everything you'll need close at hand.

3. **Put on Gloves:** Wear sterile gloves to maintain cleanliness.

4. **Remove Old Catheter:**

   - If it's a balloon catheter, deflate the balloon by using a syringe to draw out the saline.

   - Gently pull out the catheter. If you encounter resistance, stop and consult a healthcare professional.

5. **Clean the Area:** Use antiseptic wipes to clean the area around the urethra.

6. **Prepare the New Catheter:**

   - If needed, apply lubricant to the tip of the new catheter.

   - Ensure that the catheter is sterile and handle it by the end that will not enter the body.

7. **Insert the New Catheter:**

   - Gently insert the catheter into the urethra, advancing it until urine begins to flow.

   - If it's a balloon catheter, inflate the balloon according to the instructions.

8. **Secure the Catheter:** Use tape or a catheter securing device to keep it in place.

9. **Dispose of Old Materials:** Place the used catheter and gloves in a disposal bag.

10. **Wash Hands Again:** Remove your gloves and wash your hands thoroughly.

 Aftercare:

- Monitor for any signs of infection, such as fever, increased pain, or unusual discharge.

- Keep the area clean and dry.

- Observe any further guidance that your healthcare practitioner may provide.

 Important Tips:

- Always seek the advice of a medical expert if you have any questions or concerns.

- Make sure to have a backup plan in case of difficulties during the change.

If you're ever unsure about the procedure, don't hesitate to seek help from a healthcare provider. — Carevive Healthcare Pvt. Ltd. 

[livingslime]

Frequently asked questions

When will the full game be released?

The release date for the full version is still to be announced. I work on this visual novel in my free time, so progress may vary. Currently, the project is in its early stages, making it difficult to project a completion date. As development progresses and I get closer to finishing, I hope to have a clearer timeline.

Is MC really in a hospital?

It is intentionally ambiguous whether the MC is truly in a hospital. The absence of nurses and Dr. Anselm being the only one attending to the MC are deliberately meant to provoke player suspicion. This mystery and the setting’s true nature are meant to unravel in later chapters.

Where did the MC's pee go?

The MC has a urinary catheter, a medical device used to drain urine from the bladder into an attached collection bag.

Urine collection bags connected to a catheter are typically changed every 5 to 7 days.

In the later chapters, there will come a time when Anselm has to change the MC's peepee bag.

Does MC actually need a urinary catheter?

In cases of severe traumatic brain injury (TBI), a urinary catheter may be necessary, especially in the early stages of recovery. TBI can lead to a range of symptoms, including impaired mobility, cognitive changes, or decreased control over bodily functions.

Also MC was unconscious for 2 days before waking up, catheters are commonly used for unconscious patients.

Will MC ever take a shower?

Yes I was planning to use this as content for later chapters.

Fun fact : Traumatic Brain Injury (TBI) patients in hospitals usually do not take showers independently, especially if they are in a critical or unstable condition. Instead, they are often given sponge baths or bed baths by staff to maintain hygiene without moving them too much, which could be risky. huehue

Will there be an ending where MC and Anselm are together?

Yes, absolutely! There will be an ending where MC and Anselm end up together. These endings will naturally come at the game's conclusion, and as I get closer to writing the finale, I'll have a clearer idea of how many good and bad endings there will be in total.

Was Anselm the one to cause MC's injury?

So this mystery is also to be unfolded in the later chapters. I hope readers understand that this visual novel has mystery/horror elements, there wouldn’t be much of a story if I revealed everything outright (ᗒᗨᗕ)

Does Anselm love the MC or just taking care of them?

Anselm's heart belongs entirely to the MC; they're the only one he truly loves.

Is Anselm a dog or cat person? or any other animal?

Anselm doesn’t usually keep pets, as he’s often away and lacks the time to care for one. But if he and the MC were living together and the MC wanted a pet, he would happily bring one home and enjoy caring for it together with them.

If he could, Anselm would create a beautiful bird terrarium—a place where he could observe them freely within a controlled space. There, they’d be safe, unable to leave but he alone is able to admire their beauty.

[surgerypatient]

chatgpt explanation of the suite of feminization procedures necessary to create an indistinguishable woman ( not perfect)

Preoperative Phase

Preoperative Appointment:

Final Consultation:

The patient meets with the surgical team to discuss the procedure in detail.

Final consent forms are signed, and any last-minute questions are answered.

Medical and Psychological Evaluation:

Comprehensive health assessment including blood tests, imaging, and psychological support.

Detailed explanation of the recovery process and postoperative care.

Day of Surgery:

Arrival at the Hospital:

The patient checks in at the hospital and is escorted to the preoperative waiting area.

The patient changes into a hospital gown, cap, and compression socks.

Preoperative Preparation:

IV line is started for administering fluids and medications.

Baseline vital signs are recorded, and the patient is given a sedative to help relax.

The patient meets the anesthesiologist who explains the anesthesia process.

The surgeon visits to review the surgical plan and answer any final questions.

Transport to Operating Room:

The patient is wheeled to the operating room on a gurney.

Final identification checks and surgical site markings are made.

Intraoperative Phase

Anesthesia and Initial Prep:

Anesthesia Administration:

The patient is connected to monitoring equipment to track vital signs.

Anesthetic drugs are administered through the IV, inducing unconsciousness.

An anesthesia mask is placed, and the patient is intubated for airway management.

Eye ointment is applied, and the eyes are taped shut to prevent dryness.

Sterile Prep:

The patient’s body is cleaned with a pink antiseptic solution.

A urinary catheter is inserted to manage urine output during surgery.

Surgical Procedures:

Orchiectomy:

An incision is made in the scrotum, and the testicles are removed.

The incisions are closed, and the area is dressed.

Penile Inversion Vaginoplasty:

Penile skin is deconstructed and inverted to form the vaginal canal.

Scrotal skin is used to create the labia majora and minora.

Nerve bundles are used to construct the clitoris.

The urethra is shortened and repositioned.

Stem cell and nanobot therapies are applied to enhance healing.

Facial Feminization Surgery (FFS):

Procedures may include brow lift, rhinoplasty, jaw and chin reshaping, and tracheal shave.

Each step is performed with precision to feminize facial features.

Waist Contouring:

Liposuction is performed to remove excess fat and contour the waistline.

Fat grafting may be used to enhance the hips for a more feminine silhouette.

Breast Augmentation:

Incisions are made, and implants are placed to achieve desired breast size and shape.

Bioengineered implants ensure natural feel and appearance.

Buttock Augmentation:

Fat grafting or implants are used to enhance buttock size and shape.

Advanced techniques ensure minimal scarring and natural results.

Estrogen Implant Placement:

Hormone-delivery implants are placed to provide continuous estrogen therapy.

The implants are fine-tuned for optimal hormone balance.

Postoperative Phase

Immediate Postoperative Care:

Recovery Room:

The patient is moved to a recovery room and monitored closely as they wake up from anesthesia.

Pain management and anti-nausea medications are administered as needed.

Initial Assessment:

Vital signs are monitored, and the surgical sites are checked for any complications.

The patient is kept in a semi-upright position to promote breathing and comfort.

Instructions and Mobility:

The patient is given instructions on how to move and care for surgical sites.

Gradual introduction to liquids and soft foods.

Ongoing Postoperative Care:

Hospital Stay:

The patient remains in the hospital for a few days for close monitoring.

Regular check-ups by the surgical team to ensure proper healing.

Discharge and Home Care:

Detailed discharge instructions are provided, including wound care, medication regimen, and activity restrictions.

Arrangements for follow-up appointments and physical therapy sessions.

Long-term Recovery:

Gradual resumption of daily activities as healing progresses.

Ongoing hormone therapy adjustments and psychological support.

Regular follow-up appointments to monitor the results and address any concerns.

Final Outcome:

Physical and Aesthetic Results:

Natural-looking and functional vaginal canal with satisfactory depth and sensation.

Feminized facial features, contoured waist, enhanced breasts, and buttocks.

Hormone levels are balanced with the help of estrogen implants.

Psychological and Social Adaptation:

Continued psychological support to help adapt to the new gender identity.

Social integration and increased confidence in personal and professional life.

This detailed step-by-step guide outlines a comprehensive and futuristic approach to M-to-F sex reassignment surgery, incorporating advanced technologies and procedures to ensure optimal outcomes for patients.

[dollsonmain]

I know folks are probably getting tired of this by now so you get a tag AND a cut.

But I feel like discussing this sort of thing might help people sometimes? since it's a first person account instead of listicles online.

What they did and didn't tell me about having stents.

They told me why: Facilitates drainage which takes strain (pressure) off of the kidneys and helps the antibiotics work by helping prevent pockets of infected urine reforming (that's what was making me sick, stuck urine that had built up lots of bacteria).

They told me how-ish: They go up with various catheters and things and install the stents, the stents stay in place until they are removed. Some stents have lines that exit the body to facilitate removal. Mine do not. The doc didn't want me accidentally pulling them out since the area they're in is heavily infected. They'll be removed at my first stone removal surgery in about two weeks from installation which was a couple days ago.

They did not tell me how-completely: The stents are hooked into my body meat like little fish hooks. They also didn't tell me they'd be taking urine for testing from my bladder and each kidney or that they would also be draining both kidneys during the procedure, so I did get a fluid-pressure reset.

They did not tell me basically anything about what the next two weeks will be like.

I'm on flowmax to soften my bladder so it's easier to empty. I don't think I needed that, I was peeing fine, but stents do change things.

I was worried that I might push them out while pooping but that's not likely to the point of nearly impossible. Not 100%, but nearly.

These things feel like a bad UTI and I have two of them. I got the ows, the zaps, the GOTTA GOs every few minutes. At least now I know that ALL of those pains are UTI pains, you know? I'd get some random pain sometimes and be like "what was that......" and now I know. It was UTI and pressure in my kidneys and the pain signals were traveling around the whole renal system. Because they do that.

I'm in a lot more pain now than I was with just the kidney stones. It is very, VERY atypical but my kidney stones and the pressure behind them don't hurt. Those nerves may have died off.

There's varying amounts of blood in my urine, sometimes very little, sometimes a lot. Sometimes there are clots. That's all normal but I had to ask as things were happening.

I get up every couple hours in the night and some times I don't make it to the toilet (I did all last night, so that is improving).

They also didn't warn me that just having the surgery itself might make me wet myself because the muscles hadn't all regained strength/how long it would take for the anesthesia to fully wear off.

I called the doctor's office and asked about that, too.

I'm glad I thought to have That Guy bring Depends but that's also something you'd think someone would like, mention. You know?

So that's what having stents has been like so far.

Feels like a bad UTI, though for some people they feel nothing. Need adult diapers for accidents. Need to be near a toilet at all times, and not going to get a hell of a lot of continuous sleep for a while.

-

I also think it's worth noting that I've had two male doctors blow me off about this and I think the only thing that went differently at the ER was that it was a female doctor.

The first male doctor said it was an anxiety attack.

The second male doctor said it was a viral stomach bug.

The female doctor listened to my symptoms and ordered a bunch of tests.

So, more personal blather about the whole situation.

While I was in the first ER I heard a man yelling and starting trouble in the waiting room. That Guy and Son got up and left as soon as the man was distracted by a security guy. I'd had told them to go home as soon as they dropped me off and I would text if I needed picked up. I knew I wasn't going home, though.

-

My neighbor was an elderly lady and they kept trying to figure out when she'd last pooped but she couldn't remember. Finally she called them in and was like I need to poop so they wrestled her up on a bed pan (she cried, she was in a lot of pain) and then left her alone with her curtain closed to poop. Right then the floor doctor walked in and was like HI MISS GERALDINE and whipped her curtain open to start talking to her.

...

I chewed him out. That's very atypical of me. Like, I laid into him for not asking if she was wanting to talk in that exact moment. And then I felt really bad until I realized he's probably had people a lot more angry at him than me considering a lot of the patients I could hear were elderly and some were confused, and I didn't feel bad anymore.

-

Since it's a university-run hospital there were sometimes pairs of nurses, and at one point a trainee came in to give me a dose of antibiotics through the IV but she hooked it into the wrong plug which depressurized the system and blood starting backing up the tube. As soon as she saw that she ran to get her trainer and they spent some time doing a full reset of the IV set up.

I wasn't worried or anything. It was my own blood and it could only go so far/only so much could be lost. At the most a cup since the saline bag was fresh and mostly full, still. So I was totally calm the whole time, which I'm sure helped.

I think the nurse in training was surprised when her trainer stepped out and I encouraged her instead of yelling at her. I praised her for not being too proud to get help when she noticed an issue, and for observing how to rectify the situation.

-

That Guy was like "Yesterday's nurses did NOT like me..." and I was like yeah I kind of told on you, but not out loud. He got put on the shit list FAST by staff. So for that I have a note in my account that I'm experiencing financial abuse and he exhibits controlling behavior. If there ever is a point where Son and I have to leave, I have the name of where to call. There's a facility in Next Town Over where the hospital is that will come and get us, and that would be the last time we see him.

I feel guilty for saying anything because he has paid for my existence for decades but he has also been abusive, just not physically.

They asked me if Son is safe at home alone with That Guy and I said "Safe, yes. Happy, no."

They also asked like how is Son and I said he seems to understand that his father's behavior isn't his fault but he still has had to endure it.

I also in the process learned how much money he makes (I didn't know before) and wow we should all certainly have insurance (he and Son might through his work but I have nothing and don't qualify for assistance while he claims me on his taxes as a dependent) and have had medical care all this time and there's no reason at all to be doing the whole -pointedly look at the food receipt every grocery trip, look up at the sky angrily, shake his head, shove it in his pocked, huff, and walk away- thing. Also explains why his work friends keep suggesting burger joints that end up costing like $80 for the whole family....

[horsesarecreatures]

Went to see Amba again. She is doing ok. Her kidney enzymes came back fine, so she was started on the oxytetracycline yesterday. She did have diahhrea, though. She also had no hay so I asked for a hay net to be put up, and sent an email in the evening asking if she could please have free choice hay like at home. 

Unfortunately, she cannot be turned out with the catheter right now. With her spooking at everything and looking like she was thinking about trying to hop the fence of the outdoor arena the other day, there’s just too high a risk that it can get ripped out. I’m hoping this will change if the antibiotics kick in and the spooking decreases. She’s been stalled at night before, but never 24/7, minus 2 days last year when the pastures were covered in black ice. And she didn't really take it well; she started violently head tossing when I let her run around in the indoor. Today she was good, but she’s lethargic.

I was going to go to tractor supply to buy her some stall toys (because I foolishly gave away the ones I had bought for Cannoli), but luckily they already had some and put them up. I’m curious to see if she will play them, because she’s never been particularly playful, which is quite possibly a symptom of the lyme.

There is a little indoor arena, so when I see her I groom her then walk her around in there for an hour. I feel really bad for her because there’s only 1 other horse there and she can’t see him even though he’s stalled next to her. 

I am aiming to have her stay a month, provided she doesn't react too badly to the meds. 

I need to figure out my game plan for boosting her immune system. I will reach out to that lady from the video I posted yesterday to see if she can recommend more specific herbals. The vets here aren’t against herbals by any means, but they also aren't holistic specialists so they didn’t really recommend anything targeted. I absolutely plan on keeping her on probiotics and colostrum supplements permanently at this point. But I also just want to make sure the ones I’m using, probiotic wise and immubiome, have a long shelf life and can withstand the stomach acid. In the human world so many supplements are scams since they’re unregulated, and I’m sure the situation is even worse with animals.

Maybe I should add vitamin e as well? Both she and Cannoli had levels that were fine when I tested them, though. But I know it protects neurons. If the vets think it may help I will add it. It doesn’t wind up in urine like vitamin c so maybe extra will help. 

I was looking into her diet as well, but don’t necessarily think there’s anything that should be changed. She gets 1 scoop of Sunshine Plus ration balancer, 2 scoops of alfalfa pellets, 1 scoop of probiotic wise, and one scoop of immubiome am and pm. Technically, the sunshine plus is not the absolute best since it does contain molasses, but it does have yeast culture as the 4th ingredient, and also has MosPlus probiotics and bioavailable vitamin e & se. So while it wouldn't be great for a laminitic horse, for Amba with a weak immune system and microbiome that’s probably destroyed at this point, I feel like it’s a good choice. The other ration balancers that I’m aware of either don't have probiotics, or don't have them as high on the ingredient list. 

I’m feeling quite depressed over this situation. But it’s a different type of depression and feeling overwhelmed lately that is not my typical seasonal, holiday, or grief-related variety. It is more a feeling of, “everything feels like BS so what is the point?” It just seems like such astronomical bad luck to have to send 2 horses to a clinic for nuero issues just a few months apart. Only 2 horses in 2014 had EDM like Cannoli. And while many more have lyme, most don’t have to get IV oxytetracycline. And there’s other things going on, too. Like my boss of many years got fired by the historical society. I wrote a post on Facebook about it and over 100 people bombarded the historical society and town board with emails supporting him in response, but they still haven't hired him back, or even bothered to find a replacement for him. So there will no longer be a farm. 

[usafibroidcenter]

Everything You Should Know About Uterine Artery Embolization

Uterine artery embolization (UAE), sometimes known as uterine fibroid embolization (UFE), is a minimally invasive procedure designed to shrink fibroids. It involves using a catheter to inject tiny particles into the uterine arteries that supply blood to the fibroids. By blocking the blood flow, fibroids are deprived of essential nutrients, causing them to shrink and alleviating related symptoms.

UAE is typically performed by an interventional radiologist, and the procedure is done under mild sedation, not requiring general anesthesia. Unlike hysterectomy, UAE leaves the uterus intact, making it a fertility-sparing option for women who wish to maintain their reproductive capabilities.

Comparing Uterine Artery Embolization and Hysterectomy

Procedure Type: UAE is a minimally invasive, outpatient procedure, while hysterectomy is major surgery requiring general anesthesia, with a longer recovery period.

Recovery Time: Recovery from UAE generally takes around 1-2 weeks. In contrast, hysterectomy can require a hospital stay and 4-6 weeks for a full recovery, depending on the surgical method used.

Uterus Preservation: One of the key benefits of uterine artery embolization is that it preserves the uterus, which is an advantage for those who want the option of future pregnancy. Hysterectomy, on the other hand, involves the removal of the uterus, which permanently ends a woman’s ability to conceive.

Symptom Relief: Both procedures are effective for symptom relief. UAE can alleviate symptoms like heavy bleeding, pain, and frequent urination within a few weeks. Hysterectomy provides permanent relief from fibroids but is irreversible.

Future Health Considerations: UAE is often preferred by women who are concerned about the potential hormonal changes that may follow a hysterectomy. Preserving the uterus can also help maintain a sense of bodily integrity and reduce the risk of long-term side effects.

Why Choose Uterine Artery Embolization?

Uterine artery embolization offers several benefits over traditional surgical options:

Minimally Invasive: UAE involves no major incisions and has a lower risk of surgical complications.

Quick Recovery: The outpatient nature of the procedure and minimal recovery time are appealing for those with busy schedules or caretaking responsibilities.

Effectiveness: Studies have shown that UAE is highly effective in reducing the size of fibroids and relieving symptoms.

Preserves Reproductive Health: By keeping the uterus intact, UAE allows women to retain the potential for pregnancy, an essential factor for those planning to expand their families.

What to Expect During and After UAE

During the UAE procedure, an interventional radiologist inserts a thin catheter into the blood vessels that supply the fibroids. Microscopic particles are then introduced through the catheter to block blood flow to the fibroids. As fibroids shrink, symptoms start to improve gradually. Most patients go home the same day, and a typical recovery period lasts about one to two weeks.

After UAE, you may experience mild pain or cramping, which can be managed with over-the-counter pain relief. You’ll also have follow-up visits with your doctor to ensure that your fibroids are shrinking as expected and to discuss any additional treatment needs.

Making the Choice

The decision between uterine artery embolization and hysterectomy depends on various factors, including your age, reproductive goals, severity of symptoms, and personal health preferences. UAE provides a promising option for those seeking a less invasive solution that still effectively treats fibroids and maintains the option of fertility.

[uterine-fibroids-treatment]

Dr. Gaurav Gangwani: Pioneering Uterine Fibroids Treatment in India

INTRODUCTION

Dr. Gaurav Gangwani, a leading Interventional Radiologist, specializes in uterine fibroids treatment in India, pioneering advanced Uterine Fibroid Embolization (UFE).

Leiomyomas, another name for uterine fibroids, are non-cancerous growths in the uterus that affect a large number of women, especially those who are fertile. The therapeutic environment for uterine fibroids in India has changed significantly in the last few years, mostly because to the creative efforts of experts like Dr. Gaurav Gangwani. Dr. Gangwani, a renowned interventional radiologist, has promoted the use of Uterine Fibroid Embolization (UFE), a minimally invasive technique that has completely changed the treatment of uterine fibroids in India. This article examines Dr. Gangwani's contributions to this field, the methodology and advantages of UFE, and its significant influence on women's health in India.

Early Professional and Academic Background

Dr. Gaurav Gangwani's medical career commenced with a solid academic background. At one of the top medical schools in India, where he finished his training, he became quite interested in radiography. His quest for perfection led him to focus on interventional radiology, a specialty that uses imaging technology in conjunction with minimally invasive techniques to treat and diagnose a range of illnesses. Understanding the profound effects uterine fibroids have on women's health, Dr. Gangwani committed his professional life to improving therapy for uterine fibroids in India.

Uterine Fibroid Embolization: A Game-Changer

Dr. Gangwani is at the forefront of uterine fibroids therapy in India thanks to his groundbreaking work in uterine fibroids emboldening. Without requiring typical surgery, UFE is a complex method that targets the blood supply to fibroids, causing them to shrink and improving symptoms. Using a catheter to introduce minuscule embolic chemicals, this procedure blocks the arteries supplying the fibroids. As a result, the size of the fibroid is significantly reduced, and symptoms including heavy menstrual bleeding, pelvic pain, and frequent urination are significantly improved.

Technique and Procedure

Under the expert care of Dr. Gaurav Gangwani, UFE is performed with precision and care. The procedure is typically conducted under local anesthesia, minimizing patient discomfort and risk. Dr. Gangwani uses advanced imaging technology to guide the catheter to the uterine arteries, ensuring accurate delivery of the embolic agents. The entire process takes about 60 to 90 minutes, and patients can usually return home the same day. This minimally invasive approach is a cornerstone of modern uterine fibroids treatment in India, offering a safer and more comfortable alternative to traditional surgical methods.

Patient Experience and Success Rates

The success rate of Uterine Fibroid Embolization under Dr. Gangwani's care is notably high. Many patients experience a significant reduction in fibroid size and a substantial alleviation of symptoms. One of the major advantages of UFE is its quick recovery time. Unlike traditional surgeries, which may require weeks of downtime, most UFE patients can resume normal activities within a week. This rapid recovery is a critical factor in the growing preference for UFE as a primary uterine fibroids treatment in India. Dr. Gangwani's patients frequently report high levels of satisfaction, not only due to the efficacy of the treatment but also because of the compassionate and professional care they receive.

Advancements in Women's Health

The introduction and growing popularity of Uterine Fibroid Embolization have had a transformative impact on women's health in India. For many years, women with fibroids had limited options, often facing invasive surgeries such as hysterectomy. Dr. Gaurav Gangwani's advocacy for UFE has provided a much-needed alternative, empowering women to make informed choices about their health. This shift towards minimally invasive procedures aligns with global trends in medical treatment, reflecting a broader commitment to patient safety and quality of life. As a result, uterine fibroids treatment in India has entered a new era, characterized by innovation and patient-centered care.

Case Studies and Testimonials

Numerous case studies and patient testimonials underscore the effectiveness of Dr. Gangwani's approach to uterine fibroids treatment in India. Patients from diverse backgrounds have benefitted from his expertise, experiencing relief from debilitating symptoms and a return to normalcy in their lives. One such case involved a 38-year-old woman who had suffered from heavy menstrual bleeding and severe pelvic pain for years. After undergoing UFE with Dr. Gangwani, she reported a dramatic improvement in her symptoms and expressed gratitude for the minimally invasive nature of the procedure. Such success stories highlight the transformative potential of UFE and Dr. Gangwani's pivotal role in advancing this treatment.

Training and Mentorship

In addition to his clinical practice, Dr. Gaurav Gangwani is committed to training the next generation of interventional radiologists. He regularly conducts workshops and training sessions, sharing his knowledge and expertise in uterine fibroids treatment in India. His efforts to educate and mentor young doctors ensure that the benefits of UFE will continue to reach more patients across the country. By fostering a community of skilled professionals, Dr. Gangwani is contributing to the broader mission of improving women's health care in India.

Challenges and Future Directions

While Uterine Fibroid Embolization has gained significant traction, challenges remain in ensuring its accessibility to all women in India. Dr. Gangwani acknowledges the need for greater awareness and education about UFE among both patients and healthcare providers. Efforts are ongoing to integrate this treatment into more medical facilities, particularly in rural and underserved areas. Looking ahead, Dr. Gangwani is optimistic about the future of uterine fibroids treatment in India. He envisions a healthcare landscape where minimally invasive procedures like UFE become the standard of care, offering women safe, effective, and accessible treatment options.

The Role of Technology

Technological advancements play a crucial role in the success of Uterine Fibroid Embolization. Dr. Gaurav Gangwani utilizes state-of-the-art imaging and catheterization techniques to enhance the precision and safety of the procedure. The integration of advanced technology ensures that UFE is performed with the highest standards of accuracy, reducing the risk of complications and improving patient outcomes. As technology continues to evolve, it is likely that UFE will become even more refined, further cementing its place as a leading uterine fibroids treatment in India.

Patient Education and Outreach

Dr. Gangwani is a strong advocate for patient education. He believes that informed patients are empowered patients. To this end, he actively participates in public health campaigns and educational seminars to raise awareness about uterine fibroids and the available treatment options. By disseminating information about UFE and its benefits, Dr. Gangwani aims to reach a broader audience, ensuring that more women are aware of this revolutionary uterine fibroids treatment in India. His outreach efforts are crucial in demystifying the procedure and encouraging women to seek timely medical intervention.

Conclusion

Dr. Gaurav Gangwani's contributions to uterine fibroids treatment in India cannot be overstated. Through his expertise in Uterine Fibroid Embolization, he has provided a safe, effective, and minimally invasive option for countless women suffering from fibroids. His dedication to patient care, education, and innovation has transformed the treatment landscape, offering hope and relief to many. As a pioneer in his field, Dr. Gangwani continues to lead the way, ensuring that uterine fibroids treatment in India remains at the cutting edge of medical advancement. His work not only alleviates the suffering of individual patients but also represents a significant step forward in women's health care in India.

[lets-donate-a-kidney]

Did my final pre-screening before surgery today! I went to the hospital two weeks before the actual surgery so they could confirm I'm still healthy. For this visit they only needed an EKG, blood draw, and urine sample. Everything came out normal.

The transplant team also used this visit to tell me more about what to expect:

Lead-up to surgery:

In about a week, I can pick up my painkiller prescription for after surgery.

On the day before surgery, I'll be on a clear liquid diet. That means tea, water, coffee, and other drinks with no solids are okay. No juice with pulp, or solid food.

After midnight, I'm not supposed to eat or drink anything except for the fancy carb drink (Ensure) that they gave me. They want me to drink that between midnight and my arrival at the hospital.

The point of this is to reduce the risk of aspiration (stomach fluid entering the lungs) during my surgery, and speed up recovery time afterward. Abdominal surgery is pretty tough on your stomach!

They also gave me an anti-bacterial body wash (Hibiclens) they want me to use the morning of surgery to minimize the risk of infection later.

The surgery itself

They want me to arrive on December 27th at 5am(!), and the surgery itself will start at 7am.

I'll get a chance to meet with the surgeon, nurses and anesthesiologist and discuss any last questions/concerns. I can change my mind at the last second if I choose - they reminded me there's no obligation - but I'm quite sure of my decision.

I'll change into a gown, get wheeled back to the operating room, they'll stick me with the needle, and then it's lights-out time.

The operation takes about 2-3 hours. After that, I'll be monitored closely in the PACU (Post-Anesthesia Care Unit) so they can make sure I wake up on time and no immediate issues arise. After I wake up in the PACU, I'll probably have to wait another 4-6 hours before they move me to a normal hospital room with more privacy.

Recovery

I'm likely to wake up with a scratchy throat (thanks to the oxygen mask they'll use while I'm in surgery), and definitely with a catheter and IV needle to make sure I don't get dehydrated. They'll give me painkillers before I wake up, too.

The PACU doesn't allow visitors or have much privacy (only curtains), but I can have things brought in, like my phone and books.

The normal hospital room afterward does allow visitors. I'll also meet with several members of the transplant team afterward for discussing recovery and follow-up visits. I expect my biggest challenge will be just enduring all the people talking to me in one day!

They expect I'll be able to walk around almost immediately after waking up, and even encourage it (as long as I have someone watching in case I get dizzy). The sooner I walk after surgery, the sooner the digestive system will "wake up" and start functioning normally again.

I'll probably stay in the hospital for one night. The next morning they'll remove the catheter and, assuming there's no complications, I'll go straight home. A family member will be driving me, of course, and will stay with me at home for a few days.

Besides "don't move too fast or bend over if it hurts," and "don't lift anything over 10 pounds or do strenuous exercise," recovery should be pretty straightforward. Also, I'm planning to pick up some prune juice and Greek yogurt, as I've heard those can help a lot for post-surgery nausea and bloating.

Honestly, I think the hardest parts will be boredom, and dealing with all the professionals explaining things at me. I'm not afraid of pain - they can treat pain! But there is no treatment for a group of very earnest and well-meaning people asking you "Any questions?" and "Do you feel okay?" a dozen times in one day.

I don't blame them for it. I know they have to, and they ethically should, and most of their surgery patients are probably way more nervous and want more hand-holding than I do. Me, just give me a painkiller, my smartphone, and a book, and I'm happy. (And preferably a veggie burger. But that will have to wait till I'm out of the hospital.)

[minniefights]

Quick Update (Update #15)

November 12, 2023

Today, an ICU nurse came to:

1) Remove her Central Line or Central Venous Catheter (which was inserted in her neck) because it’s no longer working.

2) A new IV line in her arm is inserted. This will probably work for 2-4 days so a new one will have to be inserted after that. She needs this because she’s on another round of IV antibiotics because of her Pneumonia.

3) Change her urine catheter.

4) And the mostly awaited, to remove her NGT (nasogastric tube) because she can now swallow food (soft diet) and drink medicines.

Praise the Lord!

She’s also glued to her adult coloring book. Making art daily is one activity she thoroughly enjoys.

Prayer Request

🙏🏽 Healing from Pneumonia and other infections.

🙏🏽 That her medical needs be accommodated here at home.

🙏🏽 That she will be able to resume chemotherapy.

🙏🏽 Grace, peace, joy everyday.

🙏🏽 For provision for all the needs.

🙏🏽 For God’s will to be done!

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[ahopkins1965]

Numbers 6:25 Interpretation and Discussion

The Lord make His face shine upon thee, and be gracious unto thee:. The Lord will show Himself worthy to those who serve Him with a sincere heart.  The Lord will dehave ligently seek Him in truth.  I really love this Bible verse because it gives me confidence.  The Lord's face will shine on those who are righteous.  If you repent of your sins, iniquities, and transgressions. I try my very best to show myself worthy and be honest with my Lord.  I know that I have had a rough childhood growing up in Dayton, Ohio.  For 18 years, I used to drink alcohol and smoking marijuana on a daily basis.  My mother was very angry with me.  This is because I was a bad influence on my siblings.  I have to make direct amends with my family members.  I wasn't a good role model for all of my family members and friends.  God has changed me 32 years ago.  I had a negative attitude and negative ways.  I love all people right now, more than I did years ago.

The Lord sure did change me from the inside out.  The Lord has been gracious unto thee because I had to read God's Word on a daily basis. Since I am hearing voices that are not the HOLY SPIRIT, I have to read the Bible each day and pray that God would give me an attitude adjustment.  God does exactly what He say He would do.  On Wednesday May 2, 1990 at 7:00pm, I asked God to remove the taste of alcohol and marijuana from my body.  On Friday May 4, 1990, I went inside of St. Elizabeth Medical Center for my surgery on my inguinal hernia.  The surgery had taken 90 minutes to install a hernia mesh on my groin.  The hospital had to admit me as a patient because my main bowel was severed.  Therefore, I was not able to urinate.  I had to get catherized immediately.  I remember the urinary catheter because it hurt going in and out of my penis.  I was in a whole lot of pain.  I had to endure a lot of criticism and abuse from my parents.

The Bible verse speaks volumes.  It is the truth because God takes care of the righteous.  I had to repent of my sins for cutting my sister's hair and slapping my grandmother.  I was already a juvenile delinquent.  I graduated from high school three years late.  I also used to buy beer for children.  I remember taking my nephew to the Montgomery County Jail for a total of two hours.  As soon as we entered the Jail, we spent time with a close friend.  My nephew was screaming and yelling out loud.  I calmed him down because we were in the visitors area.  I told my nephew that if he acts up again, he was going to become an inmate.  One of my nephews is serving 25 years for selling an excessive amount of drugs.  He had a total of $10,000,000 dollars on the table.  He had weapons of all types all over the house.  I told him that his own children will be grown as soon as he gets home from prison.  I told my other nephew to keep his head up because he has to serve 15 years for a parole violation.  I told him to go to school and graduate.  The point that I am trying to make is that if you do the crime, you must do the time.  During the time I got into trouble on Friday June 21, 1985.  I was responsible for stealing clothes and jewelry.  I pleaded guilty in court on August 21, 1985.  Right now, I am talking to my niece and nephews about getting into trouble.  Please keep me in your prayers and thoughts because I suffer from Schizoid Affective Disorder and Schizophrenia. My medications do not work for me anymore.  I have to go back to the hospital for another few weeks.  What I am trying to say is that I have a mental Illness.  I have been suffering for the past 25 years now.  I am hearing voices that are not the HOLY SPIRIT.  This is very serious.  Please keep me in your prayers.  God Bless You and Have a Wonderful Day Everyone.

[strangecowplant]

UPDATE

ill have to get to my replies later but i need to update right now

teddy was getting even worse, the meds were horrible to him and he just started to take a dive. he was dead weight, couldn't stand it was devastating to see him trying to pee or do anything really only to just fall. he was confused, scared, couldnt sleep for more than a couple minutes after having literally tried to calm him like a baby. this wasn't your typical sedative, calming med loopiness this was extreme, ive never seen a cat act this way before, let alone while on relaxants. its hard to explain but when you've experienced cats pass before you just know the signs and he was showing them rapidly later in the morning. i had another total breakdown so mom took the reigns and called them and absolutely ripped them apart. they're at fault for this getting worse, for this horrible medication, for not leaving the catheter in for longer like i said i wanted so he wouldnt have to go through that procedure AGAIN, its invasive enough ONCE let alone 2 or 3 times, for not ensuring he could pee on his own before just sending him off carelessly, for not communicating and hyperfocusing on money for issues that arent even an issue night now and could be done later. blockages are difficult to address as is, but the way they went about it made it even worse. the vet told us to get him in right away for the reaction to the new medication, and we were firm that we are NOT paying this is their fault I'm amazed teddy was able to make it through the night, he's so incredibly strong

as much as i dont ever want to go back there im doing everything for him and we raced him there, they're going through all kinds of checks to make sure he's ok and also working on his peeing. he had a wet bowl movement before i got the call, which couldve been from the sudden change to his prescription diet, the new med, the situation or anything, but was so weak he couldnt even stand so it got all over him, i had to wash him off and that seemed to kind of kick him into moving again, not much but a lot more than i had seen all morning after becoming exhausted, almost like it switched him back on to keep fighting.

so far he's doing well his bp is only slightly high due to the stress of being there but hes inflamed which also is making the urine they can push out tinged with blood. they're monitoring him constantly in fact she (this is a different vet from the owner, ive had good experiences with her) said he's being held almost all the time by another staff member, she will be giving him a boost of antibiotics as an injection and a single anti inflammatory since he got his bloodwork done and he doesnt have any kidney or liver issues or anemia/anything else. they offered for me to stay with them there so i can be with him but i needed to get back to my other babies to make sure they dont stress more either, i have to keep them healthy too so im getting updates over the phone. hes eating there hopefully thatll give him a boost of energy because though they can bring him out and walk him around/play hes still very sleepy. he hasnt peed but his bladder isnt full either, i asked why since he was drinking like crazy and she said its likely because he's dribbling tiny amounts almost constantly, his blanket has some small spots (i noticed when he was home his peepee was wet a lot but no full pees) im going to be grabbing him again soon before they close and then taking him back first thing in the morning for her to check his bladder again, if its full and hard again she's putting a catheter in again. she's also giving me a prescription for a bladder relaxer thats non drowsy, but its a gamble what pharmacies have it. we still are firm we are not paying, i'm still so scared because if they DO try to ding us with the bill we will absolutely be out of donations to help, the last bill was $606, on top of that all the gas needed to even get there and back is crushing, and i have no idea what will happen but its not something i can even think about right now

idk how its going to go we're just taking this one step at a time, my anxiety has made me so sick i want this nightmare to be over with and him at home safe and sound.

again thank you all so much for your concerns for my boy, all the help, the donations, the kind words its incredible how many are wishing and working for his recovering ill update again and get to replies as well when i can

please help me pay my kitties emergency vet bill!

ive never done this before but one of my cats just had to get an extremely sudden emergency procedure and i don't know what to do, my vet and i have reached out to a couple incredible programs here to help with the bill but one is less than half and the other hasn't replied back yet, i've already declined the blood work (CA$356) to lower the bill at the risk of possible underlying liver and kidney issues not being found but its still a monumental amount for us right now. i just feel so helpless

we had enough to pay the minimum deposit to get the procedure started in time thankfully, but we were already scraping by as it is and now we're in desperate need of funds to eat/pay rent/pay off any remainder of the bill. i am disabled without aid and have been unable to work/haven't worked since 2015 but am on track to hopefully start working pt this fall. i live with my mom who has 3-4 jobs including one seasonal job which needless to say is stressful and wearing her down. we unfortunately are stuck in the most expensive place to live in canada with the inability to save up to flee so the cycle is never ending.

this is Teddy, my typically very silly vocal happy boy who's not quite 2 yet, my comfort king, my little muffin who acts like a weighted blanket for me at night and eases my anxiety, his favourite toy is his pink unicorn poof, he loves car rides and he can shake paw!

he got a sudden urinary blockage last night with no straight answer as to why and progressively got worse as the night went on, i didnt sleep at all, i was panicking and bawling, naturally, and raced to the vet to get in as soon as the door opened. i assumed it was a uti which wouldn't have been as costly, but it turned out to be much more severe and life threatening. i never expected my usually extremely healthy boy to suddenly be at risk of that and im still trying to just process whats been happening

he needed to be sedated and given a catheter and some medication, the total bill came to CA$985.62, of which we were barely able to pay 500 of, and one program was able to donate 300 leaving a total of CA$185.62 for the bill. this, of course, leaves us scrambling for food and rent as well

i know there are a lot of fundraisers out there needing donations right now, and i really hate letting myself be so open and raw like this but even a dollar would help tremendously and i would be forever grateful for any help whatsoever, even a rb to signal boost is greatly appreciated <3

TLDR; my cat had a sudden life threatening issue and now we can't pay the full vet bill or pay for food/rent

Paypal

[nurseelizanda]

It’s an overcast day and after my 16 hour shift I went home and slept for 20 hours. I was exhausted. This shift in particular was a challenge.

I had 71 patients in a 16 hour shift, I wasn’t able to keep the same medication cart for both shifts which I am okay with since I’m flexible however, I had an extremely unstable patient. Tumblr is my online diary and so it’s okay to write about this but I’ll leave out names due to HIPPA violations. 

The resident initially de-saturated ranging to around 78%-88%, then the resident was tachycardic with a heart rate fluctuating from 88 to 112 bpm. He was diaphoretic, had decreased responsiveness from baseline, he had a low grade fever of 99.4 degrees, a cough, his blood pressure was at 88/60, he had tremors, he had scant urination. 

It was around 0100-0200 in the morning when I found him in this state and I was exhausted, I had been awake for 18 hours, didn’t get my breaks, had to intern a new nurse my first shift and so I was exhausted.

So under my breath I said “God help me” & then I started on my interventions. 

So I asked the resident “Are you okay? Can you tell me what’s wrong?

After a sternal rub he said “I’m okay. I’m okay.” However, clearly, he was not okay. The Japanese are very kind, thoughtful, timid people who do not like to bother people and so having prior knowledge of that I knew he needed help.

I got an oxygen concentrator, connected him to a nasal cannula, titrated his oxygen & called for an oxygen tank. I elevated his HOB. I elevated his legs to increase venous return and increase blood pressure, I gave him 650mg of Tylenol to decrease the low grade fever, I placed cold compresses under his armpits, removed his blankets. I called the RN. 

I noticed his foley catheter had scant urine which I thought was odd so I told my CNA to give him water while I was doing interventions and we both worked on getting vital signs every few minutes. 

Then I noticed his doctor was my friend, so I texted her and she responded at 0200 in the morning I asked for a CBC/CMP since I saw he had no baseline labs & previous UTIs so I needed to know his kidney function, I asked for IV hydration since it looked like its possible dehydration and he wasn’t urinating, I asked for the O2 order and she said sure but added that she wanted a UA & C/S as well. 

The RN, the other charge nurse and my CNA was helping me the entire time gather equipment and try to figure out what was wrong with the patient. I told the RN that I noticed that his foley catheter was empty and after clamping the F/C to retrieve the urine specimen, that even after IV fluids were being run the resident wasn’t urinating. 

I noticed that at this point the resident was shaking hard and sweating and so I thought okay, maybe his blood sugar was low so I got the accucheck machine and checked his blood sugar and saw it was 142, it was okay.

It crossed my mind that maybe he had urinary retention which is why he was shaking and had a fever...etc.

Then the RN told me, okay go ahead and flush the catheter and see if there’s an occlusion. So I ran to the treatment cart, got the last few vials of normal saline and flushed the catheter. & the catheter wouldn’t flush...Thank God for Donna she walked by and she tried to flush it too but luckily it wasn’t just me & I wasn’t just tired and incompetent but the catheter really wasn’t flushing.  So then we kept repositioning the patient seeing if any of the fluids would come out. I clamped the IV at this point incase the fluid order that my RN asked me to obtain was causing increased urinary retention. 

We kept turning him and turning him & finally, thank God he peed everything out in his diaper and within minutes the resident looked so much better.  Then I told the treatment nurse to please kindly change the suprapubic catheter.

Then I heard him cough a few times and I thought, okay well maybe he has covid-19 so I got help from the other charge nurse and she was able to obtain a covid test for me & then I swabbed the patient and tested him for coronavirus but after 15 minutes I saw he was negative. 

I communicated that to the MD.

I’ve known this patient for a year now and I know his baseline level of responsiveness and I know how he normally is so I knew he was not okay. Therefore I was checking on him every 15-30 minutes or so & had my CNA stay in his room to keep a close eye on him for me while I did all the charting and paperwork for the chest x-ray, his new orders, the requisition for the lab, the change in condition report...etc.

After I titrated his oxygen it went up to 93%, His blood pressure went up to SBP 113, after the cold compresses, 650mg of Tylenol and removing the blankets his fever went down to 98.4 degrees, I found out his covid test was negative, got his suprapubic catheter changed, got him to pee, got him baseline labs a CBC/CMP, a chest x-ray, UA C/S, IV hydration & by the time I left he was in better shape than how I found him which is what I want for all of my patients. 

All because I prayed “God help me”...& he sure did, by the time I got home I had been awake for 28 hours...

71 patients that shift...

I know I can’t feel it sometimes but I know one day I’m going to realize how much fun I had being a nurse in my 30′s. So I really should say It was an honor having 71 patients that shift & for having them allow me to be their nurse. It was an honor.   

[momi1816]

pt.11:

my daughter was very advanced for age in my opinion. during tummy time already holding her head up to look around, making cute noises and guzzling down bottles like it was her job. but one day. dec 14 2016, the dray grew grim.

it was any ordinary day. parents were off working. my siblings at school. it was just her and I during the day. she had her morning bottle per normal.

* also I swear I get the best babies because she was already sleeping through the night. my son does the same.*

when everyone was gone I was to do the chores and clean the house. coming to bottle time she wasn't interested, so I left it alone. 6 hours after her last feeding trying again and nothing.starting to get worried I did the millennial thing and googled. and what I got was just growing. which made sense because she was in 3-6mo within a week of being home. so I brushed it off. 12 hours after her morning bottle still nothing. getting very worried trying our best to feed her since everyone was home. my step dad was holding her for a couple hours in that frame trying his best to get her to feed. also to add I had dried up about a week and a half before this. my milk didn't last long.

my step dad and put her down so he could get ready for bed and my mom felt her and said she had a fever. he said ' no I've been holding her for so long its probably just my body heat'. taking that in yes but I second guessed it. 102.4F

Racing to the ER she skipped the line and was taken back immediately. 10-12 doctors, nurses, and registration in and out of the room. asking questions, getting vitals and blood. they then wheeled us into the tunnels to go to the pediatric wing to where they took us to a procedure room and they attempted to get her urine sample by a catheter. by 4th try, she peed on the nurses. and then the nurses asked me if I wanted to step out they would do a spinal tap and told me it'd be hard to watch. I told them I would stay. It was very hard to watch; at that point I had never heard a scream as loud as the scream she did.

and then we waited.. the doctor came in our room and explained she had a bacterial infection in her blood and spinal fluid. they cultured it and the 72hr test showed it was strep b bacterial infection. a bacteria I do carry. nurses swear up and down there would be only a 1 and 2 billion chance that she got it from me during birth. considering it was 3.5 weeks later, she was a c section and I was on a penicillin dip for 15 hours. they asked had we gone out at all, no. but thanksgiving just happened and mom goes all out. that day my daughter was passed around like it was show and tell in preschool. someone didn't wash their hands enough and now my daughter will suffer and she did..

by the 18th she had what is called a grand mall seizure. just like the movies, she was stiff and straight as a board, red as a tomato, screaming and if she had teeth they would have been clenched. the nurse we had that night had just watched and walked out when it was over. I followed her and asked her what that was. she then told me it was a seizure and she didn't want to say anything due to my aunt and uncle being in the room. and she left.. telling the doctor what she saw, they scheduled and MRI. which wouldn't be until that Wednesday the 21st. walking her down to the MRI, I sat in the waiting room alone waiting.my mind spiraling. I could hear her screaming with them trying to put in an iv to administer contrast. but soon as she went in, she came out. we went back up to the room and it was a waiting game. my mom and step dad were there by then.

*side note I do want to add a couple things. no S was not at her birth I was blocked and had no way of telling him. his friends knew though. also with this happening I told that same friend what was going on and still he never showed. also my bio dad and his side of the family did not show up to the birth and with this situation I found out why*

it was just about to be shift change, and as we anxiously waited it was time.. the on call doc, the neurologist, day and night nurse came in with looks that screamed bad news. the neurologist had pulled up her MRI and her brain was lit up like the 4th of July. they said according to the damage she was/is 3/4 brain damaged. explaining nothing can be fixed. giving me worst case scenario if she made it out of the hospital she would never walk, talk, eat on her own, beg tube fed, be on oxygen, wouldn't feel pain, wouldn't know who I was or anyone, wouldn't have personality. without saying it but saying it she would become a vegetable. out of the then 20 years of practice for him she was the second worst case he had seen and the worst lived to 18. he estimated if she made it out she would only live to maybe one. it would be a long road ahead of us.

with my mother being there. its best you know my mother has the shittiest delivery humanly possible and can be cruel. after the MRI results were given she looked at me," are you going to kill yourself now?" as I responded, "no even if she doesn't make it, she would want me to stay and tell her story."

moving forward, they had therapists start coming in to start physical and occupational therapy. they were trying to have her regain her suck for a bottle. It never came back. I was given the option of putting a tube in her. it was a scary thought to think about. and they were pushing hard. but one day during our month and half stay. a traveling doctor that was there had came in to talk with me. my grandparents were there and the therapists were in the room and were working with her. infant of everyone, he straight up said. 'if it was my child I would take her home and let nature take its course." basically telling me to take her home and allow my daughter to starve herself to death. that was 1 out of 5 doctors we saw. but he was traveling. one other, who is still there no clue how, did the same things. trying to push me to either leave her so another family can adopt her or to let her die. completely appalled. especially with him due to him at belonging to that hospital vs being a traveling.

in the time being there, I understand I was 19 with a baby who just had something traumatic happen. but under no circumstances does that give the right to these two men to treat me like a child and try pushing death. but the doctor who actually is a part of the hospital got his foot in his mouth 6 months ago.

moving forward, obviously she made it out. I went through with the surgery. my aunt on my dads side was a surgery nurse so she had arranged the best of the best to be on the service. and it went great. later on in the stay my bio dad decided to show up with my little half brother with my full sister. after she begged him finally came to meet her. I found out he didn't come to the birth nor in the beginning of the stay due to my name change.

my daughter was then sent home after surgery once decently healed. although the ignorance of doctors did not end there. the neurologist did not send us home with seizure meds. not thinking of anything of it, because obviously he's the doctor right, he knows better in that situation... nope....

[holyfluck]

5/15/2022

Hey there, blog. Remember me? It’s been a couple months. The weather is changing and with it, the collective mood. It’s always interesting how much sunshine and warm temperatures positively affect emotional states. I swear, I’ve seen people skipping through the streets this past week.  A few bullet points to help fill in the blanks that my absence here left...

- Put my mom in rehab. The tuition was a terrifying dip into my nest egg. I can’t help but be a little resentful about it. I hope she is strong enough to stay clean. I am nervous for her. During a therapy session held at her rehab, my sisters and I were more honest with her than we had ever been. It was brutal. My mother hasn’t spoken to me since. 

- Crypto is crashing hard. My nest egg has been slashed more than 50%. It doesn’t make me feel good. But I think I’m rolling with the punches rather well.

- Experimented with Seeking Arrangements again. I can’t do it. I’ve outgrown my hoe phase. All I care about is building my career. Any other time spent pursuing money feels like a huge waste of time. No thank you.

- Speaking of careers. I’m pivoting! I still love furniture design, but it’s been really tough for me to break through. I can’t seem to find manufacturers that want to work with me, let alone contact me back! So, I’m doing fashion! It’s another true love of mine. I’m visiting with a manufacturer tomorrow to get my first samples made! I just made the pivot about 3 weeks ago. I have already been able to move mountains as far as my progress goes. The infrastructure here in NY for budding fashion designers is insane. There is so much support!  Plus, all of my samples will cost far less and take less time to make than my furniture prototypes. It feels like the right move. I can control a lot more with this route. Plus I still get to scratch that creativity itch that I have been so desperately craving to scratch. Feels good! 

- Still seeing fireman. I feel like there have been some recent road bumps that have led to both of us pumping our breaks a little. Nothing major, just a bit of hesitance. We’ll see where it goes. He’s a good guy and I’m grateful to have connected with him. 

- Caught wind of my ex being with his ex. Got me feeling all sorts of ways. He cheated on me with her. But not before he first cheated on her with me. The whole thing is just a huge mess. It blows my mind that he would backslide like that. I just don’t understand it. But then again it sort of makes sense. I was just hoping that he would have grew more through the whole experience. Such is life. I wish them both peace and happiness. 

- Shitter, my cat, had to have an emergency procedure to save his life. I came home from Utah and he couldn’t urinate, which is a big uh-oh for male cats specifically. They had to sedate him and stick a catheter into his peen to unblock his urethra. I actually got to be a part of the whole thing! I held a little oxygen mask over his nose while the vets operated. It was pretty cool. What is not cool is the $4,000 it burned into my wallet. I swear, I have been fucking bleeding money. 

- Went to Tulum, Mexico for Billi’s birthday! Again, sunshine and good weather make for happy people and I am here for it. 

That’s that I guess! I’ll check in again when I feel like it. 

[ambidextrousarcher]

The Beat of a Heart

In honour of Doctor’s Day (barely in time), here’s a short story by my hand. It’s based mostly on real-life experiences, most of the scenes based on things I have seen in clinical postings. I am not sure whether I got the main character’s emotions right, but I did my best, so I guess that counts. 

[Image ID: A stethoscope with blue tubing, silver diaphragm and black earpieces lying on top of a blurred keyboard, a blue pad to the left of the stethoscope, with a piece of blank paper pinned on it. On the bottom left, the words ‘The beat of a heart...’ are written in red England Hand font. End ID]

I’m tagging my usual writer mutuals and putting the actual short story under a cut.

My taglist: @ambitiousandcunning @medhasree @shaonharryandpannisim @chaanv @arjunaparantapa @hindumyththoughts @spockswhore @ashsnipes​ @annlillyjose​ @seekerbrave​ @avakrahn​ @a-confusedmess​ @arachneofthoughts​ @paneerlajwanti​ @vishnupada​ @bookdragonfanish​ @iamnotthat​ @foreveres​ @shellweed​ @will-die-without-chai​.

She coughs a little, ignoring the rasp in her throat, wishing she could reach for her water bottle, but is impeded by the sheer number of people between her and the bottle in question. She reaches for the hand rub instead, the familiar smell of ethanol almost soothing for a moment. She blinks, turning to the older man sitting across her, the familiar questions on her lips.

‘Can you tell me why you’re here?’ she asks, noting down the man’s anxiety, trying to make her voice sound soothing. That is all the prompting he needs to launch into his long-winded story. She stretches a little, noticing the line of people in front of her, and the students hanging on each of her words standing behind her chair.

She smiles, looking behind her at the students, gesturing subtly for one of them to take over. ‘Make sure to examine him properly,’ she instructs. The student she had instructed nods, her eyes wide. ‘Yes, ma’am,’ the younger girl responds, leading the man to a bed. She can see the couple of students who had bothered to attend all clustered together, their discussion hushed.

She suppresses a grin. They’ll learn. She herself had. And indeed, one of the the students comes forward tentatively, stopping her peer who had been taking the man’s history, and begins the examination.

She turns to her work, leaving the students occupied for now. It’s a familiar battleground of questions and answers, having to rush the patients because of the lack of time. ‘Ma’am?’ it’s a young gentleman. ‘Yes, sir?’ ‘I am sorry,’ he says hesitantly, ‘I don’t understand what you said.’ She nods. Clears her throat, looking wistfully at the bottle that still is too far to reach, and too empty besides. Looking at it only diverts her attention to the humidity the fan is doing little for, the sweat trickling down her back.

She shakes her head. Do not divert your attention. Her colleague shoots her an understanding look, as she explains the prescription once again. He nods, with a quiet ‘thank you.’ She nods back at him as he leaves.

‘Ma’am?’ She turns once more. If nothing else, she muses wryly, choosing medicine has definitely taught me to multitask. The students lead the first man back to her, their clinical skills enthusiastic if a touch inexperienced. One of the girls excitedly details the sound of an ejection click. She smiles, lending the younger girl her own stethoscope. The girl listens in with the man’s permission in quiet absorption, the ritual being repeated by each of her friends, all of them clearly awed.

The gentleman looks amused at the furore the click of his valves, amplified by his metallic pacemaker, has elicited. She corrects them when needed, leading to a response of all heads nodding at once.

As the clock strikes 1, the students ask for leave to disperse and the crowd of patients mercifully thins. She tells them to go and come back for a short class in the evening, finally leaving behind the pursuit of her elusive lunch and the all-important water.

Her lunch in front of her, her thirst finally quenched, she ruffles through her iPad for information to make the class slides for tomorrow’s discussion. All too soon the short break is over, the slides still unfinished, and she stands, following her friends out of the Duty Doctors’ Room to go on ward rounds. Her eyes flit to a notification on her News app, of a doctor being beaten by goons. She sighs. There is no use pondering over this. I can only do my best. She knows protests do little good, so she hardens her heart and strides out, sliding her phone in her pocket.

Somewhere in the middle of the rounds, the students following her and the senior doctor like ducklings following mother duck, one of them comes running to her. ‘Ma’am,’ his voice is high with fear. She gives him her immediate attention. ‘There’s a man on that bed…’ the boy points, ‘…17, he’s…he’s not really breathing.’

Oh, no. Her friend steps up, running to the patient, while she looks for his details, adrenaline sharpening her senses.

He is a new patient, there is next to nothing on his chart. She can hear a lady wailing and she winces. No one should see their loved one in such a situation, she thinks, even as she squares her shoulders, moving towards the bed, shaking her head at her friend, who had already started CPR. She gently moves the lady aside, trying to console her, even when there is fear in her own heart that the news she might have to deliver could be irredeemable.

‘Doctor?’ asks the lady querulously, ‘you’ll save him, won’t you?’ She looks down for a moment, before meeting the lady’s gaze. ‘We will do our best,’ she replies quietly, grave as the situation is. The lady nods, tears still pooling in her eyes.

She can hear her friend panting. Quiet and quick, she swaps her place with him, continuing CPR. He shoots her a grateful look. She turns her attention to the patient. Between the three of them, they manage to get the patient breathing, she notes with relief. That relief doesn’t last long, though, as she looks the patient over. The catheter connected to him, filled with orange urine, the gross ascites and icterus. He’s on Rifampicin. TB with hepatic encephalopathy. One glance at her friend tells her that he, too, is thinking the same.

The lady with the patient…his wife by the sound of it, reads the grave news on their faces, facilitated, perhaps, by her intubated husband’s gasps of breath. She sinks into the bars of the hospital bed for support. She is at a loss for a moment, as she always is when confronted by the inevitability of death. She kneels then, her hand on the lady’s shoulder, silently commiserating.

When she stands, she looks at the downcast yet awed students and forces a smile. ‘Well,’ she says, stopping them as they turn away, towards the exit, clearly assuming that class is cancelled for the day. She has no intention of doing that, though. They need to learn that life doesn’t stop for those of us still hale.

At the sound of her voice, they turn as one, looking at her with eyes comparable in size to dinner dishes. ‘I’ll just wash my hands and come back,’ she says firmly. ‘You guys go wait in the Duty Doctors’ Room for your class.’ They keep staring at her for a few moments. ‘Go on,’ she instructs. They obey, darting reverential glances at her, talking in hushed whispers. How could someone literally save a life and just go back to normal like that? She hears one of their voices, quiet, dazzled. Despite knowing the truth, the innocent fascination in the boy’s face makes her smile.

I don’t know! She hears one of his friends reply. I want to be a doctor like that, when I finish my degree, when we really become doctors, the girl says, making her smile wider. The younger girl sounds like a young child deciding the goal of her life.  

She tamps down the giddy joy and the grief simultaneously warring inside her, long since used to contradictory emotions, keeping a straight face as she strides to the washbasin.

When she enters the Duty room for the class, they’re discussing the exposure she could have had. She smiles wryly for a moment. This kind of exposure is a fact of life, she nearly blurts out, deciding not to, enjoying their impressed approval for a moment, before she clears her throat.

They all look abashed. She decides to proceed as if the moment before had not occurred, which was helped by one of them asking about the man she had done the CPR on. She summarises the case, gives them a few topics to read on and sends them home.

Before leaving the hospital proper, she circulates the wards once more. The CPR patient crashes again. This time, though they try long and hard, the lose the man, the beat of his heart forever silenced.

Her senior takes responsibility of the formalities, telling her to leave. Leave she does, casting one last glance back at the shell of the man, helplessness overtaking her for a moment.

She checks in with her colleague manning the night shift if she is free to go, fighting the uncanny feeling of déjà vu that comes with every patient they lose suddenly, the realisation striking anew that life goes on.

It is a leisurely walk back to hostel, the cool air soothing on her sweat-soaked shirt. She is thinking once more of the next day’s presentation, the number of slides still left to finish off.

After a quick wash-up and dinner, she sits with her iPad. It is nearly midnight when she finishes her work, fighting her drooping eyes. She checks in her WhatsApp, shooting a quick goodnight to her parents. The statues of her medico friends are full of calls for justice against the recent violence. Her non-medico friends are, as usual, conspicuously silent on the matter.

Ah, well, she thinks, it’s not like armchair social media posts can actually do much. Besides, this is not an issue that they face. Why judge? They’re probably thinking the same I do.

 She debates posting a status of her own then decides against it, for again, social media can only do so much. The bitter truth can’t be changed.

Her mother’s voice echoes in her head, what mama had said the last time she had shared news of such violence. At least they didn’t kill him. You people get a lot of respect, you know?

She shakes her head, banishing those thoughts. She doesn’t want to have nightmares. Besides, tomorrow, she has to report for ID duty. She needs to be well rested for that. So she thinks of the awestruck students, the young girl’s voice playing in her head. I want to be a doctor like that, she said, when I finish my degree.

She falls asleep with a smile on her face.

When she is leaving for duty the next morning, she loops her stethoscope along the back of her throat, the diaphragm of the steth sitting firmly over her own beating heart. Time for another day at work.

Some terms that might be unknown:

Ejection Click: In some patients with heart problems, there is some backflow of the blood when the heart contracts. This backflow is heard as a ‘click’ sound when a stethoscope is used. This ‘click’ is amplified if the patient has a prosthetic metallic valve, as in case of the old gentleman in the story who is based on a real patient.

Rifampicin: A drug that is part of the four-drug regimen for Tuberculosis (TB). It increases the effect of another drug in the combination, Isoniazid, which is toxic to the liver. India has a huge number of cases of TB, being one of the TB-endemic countries. The orange urine is one of the most noticeable side-effects of using this drug.

Hepatic encephalopathy: Loss of proper brain function due to inability of liver to remove toxins. The patient on whom CPR was administered was in a coma due to this condition. He, too, was based on a real patient.

Ascites: Swelling of the abdomen due to accumulation of fluid in the abdomen.

Icterus: Yellowing of the sclera  (whites of the eyes) and bulbar conjuctiva, a hallmark of jaundice.

The doctor here makes the diagnosis of TB with drug induced hepatic encephalopathy because of the ascites and icterus combined with the rifampicin usage and the coma. It is an unfortunately common condition here. 

I just noticed that I haven't clarified ID Duty. It means Infectious Diseases ward duty. In this case, I meant COVID-19 duty, though it may not always mean that.