Paglabas ko sa OR ay agad bumungad saakin ang mga magulang ni Jane. Agad akong ngumiti sakanila para iparating ang magandang balita tungkol sakanilang anak.
"The surgery went well. The adhesion was quite severe, so dissecting took a long time, but everything went smoothly, Maam, Sir." sabi ko sa mag-asawa.
Labis itong nagpasalamat saaking harapan at humagulgol kaya yumuko ako at nag-paalam para magpunta saaking opisina at magpahinga dahil may naka-scedule pa akong mga outpatients para bukas.
"So she wants her baby to get VAD at our hospital?" tanong ko sa nurse habang may binabasa sa computer.
"Yes. I think so too. The baby is at PGH. At week 33, the baby was born prematurely. The kid is 2.5 kilograms, but three weeks after birth, he had an arterial switch procedure for TGA." sagot ng nurse kaya tumango ako.
"Did you see the chart?" tanong ko kay Daryl habang binabasa ito sa computer na nasa aking harapan.
"Yes, but because the baby still requires heart-lung support, they are using ECMO. Both ventricles aren't working properly. In addition, the baby has grade 3 IVH." sagot nito.
"Yes, that's right." mahina kong sabi habang binabasa ang chart ng pasyente, "But the PGH suggested a VAD? The baby only weighs 2.5kg." patuloy kong sabi saaking sarili.
"Let her in." sabi ko sa nurse kaya agad naman itong tumugon at binuksan ang pintuan.
"I'm aware that this is impolite, but I can't afford to be concerned about it right now. Please accept my apologies." sabi ng ina ng pasyente.
"It's okay, Maam. I understand that you want a second option." sabi ko.
"My baby had an arterial switch procedure and also has an intraventricular hemorrhage due to a condition termed transportation of great arteria. After much thought, the doctors at PGH recommended the VAD, and I am interested in doing it as well. What are your thoughts? Is it true that the VAD will be safe for my child?" tanong nito na may puno ng pag-asa sa mukha kaya bumuntong hininga ako.
"If you want my opinion, my answer is no." panimula ko.
"I'm sorry to let you down, but your infant isn't a good candidate for a heart transplant. The VAD is a temporary solution while you wait for a heart transplant, but your infant is only 2.5kg. Your infant is too small for the VAD, but it's not impossible. That also means your baby will have to wait a long time to find the perfect donor. The intraventricular hemorrhage, on the other hand, will be too much for the newborn to handle. Furthermore, hypoxic encephalopathy is suspected, thus putting the baby through all of this merely to try for a transplant is a risky proposition. I'm not convinced." paliwanag ko at bumuntong hininga.
"Strong anticoagulants are utilized after the VAD operation, as you are presumably aware. Anticoagulants are nearly impossible to employ with grade 3 IVH. It'd be a contraindication, and it also mentions that hypoxic encephalopathy is a possibility, which isn't ideal for a heart transplant." patuloy ko.
"Even if we give up to the transplant, can we atleast try the VAD?" tanong nito.
Bumuntong hininga ulit ako, "The VAD is pointless if a heart transplant isn't possible." sagot ko.
Humugot ako ng malalim na hininga, "Maam, you've done a lot for the baby. You really did your best. I'm not sure what more.." napatigil ako ng humikbi ito habang tumatango saaking sinasabi.
"It may be theoretically conceivable, but I'm not convinced it's the appropriate thing to do for your baby's sake. To be honest, I don't believe it is." patuloy ko dito.
"Thank you for your honest and objective opinion, Dr. Tiu. We've been so torn and my husband is against it too." humihikbi nitong sabi kaya napayuko ako.
Tumayo ako at yumukod nang nagpaalam ito at lumabas sa opisina. Bumuntong hininga ako at naupo ulit sa swivel chair saka napahawak sa aking sentido.
"So she didn't come here to ask you to accept her baby as a patient.." sabi ng nurse na nasa aking gilid.
"Right.." mahina kong sabi at napasandal sa swivel chair habang blankong nakatingin sa pintuan.
Biglang tumunog ang aking cellphone at nakitang sa PICU ito galing kaya agad ko itong sinagot.
"Dr. Tiu, you're needed here at the PICU." sabi ng nurse kaya nilingon ko si Daryl na nasa aking likod saka sinenyasan na kailangan naming umalis.
"Alright, I'm on my way." sabi ko at agad tumayo.
"That was the last, right?" tanong ko sa nurse kung may iba pa bang outpatients na naghihintay.
"Yes, Dr. Tiu. You can go now." sagot nito kaya tumango ako at naglakad na kaming dalawa ni Daryl patungo sa PICU.
"Every person's heart has valves. The blood flows in one direction, and the valves prevent it from flowing backwards after it passes through. When babies are born, one or two valves may leak or shrink. It frequently need surgery." paliwanag ko sa magulang ng pasyente.
"Your baby, on the other hand, is a highly unusual case. All of his heart's valves are leaking. The DNA testing yielded no unexpected results. I'm afraid I won't be able to diagnose your infant with a sickness whose name I don't know." patuloy ko.
"Your child's heart is currently unable to pump blood out of his body. The blood continues to flow in the other direction. Because his aortic valve regurgitation is significant, I am unable to place him on ECMO." bumuntong hininga ako saka inayos ang aking salamin at napayuko.
"And when he arrived at our hospital, he had suffered brain damage as a result of CPR or a congenital abnormality. Because his cardiac output has severely dropped, we must encourage him to make some urine with a large dose of diuretic. We can't give him any more medication since he has significant pulmonary edema." patuloy kong paliwanag sa mag-asawa.
"What about surgery?" tanong ng ama ng pasyente.
"Dr. Tiu, if he gets surgery, wouldn't he be able to live?" tanong naman ng ina ng pasyente.
"The survival rate is about 50 percent." diretso kong sagot kaya biglang nanlumo ang mag-asawa.
"We perform heart surgery to improve the patient's health. As for your baby.." bumuntong hininga ako.
"But then, again, surgery is the only option we have." patuloy kong sabi sa mag-asawa.
"It's difficult for me to predict what may occur during surgery. But we can't just let him leave without fighting. I can't promise that I'll be able to help him, but there's no other option."
"We should give it a try.." nag-aalinlangan kong sabi dahil hindi ko alam kung magagawa ko ba ito.
YOU ARE READING
Doctor Series 1: Soren Tiu
General FictionThe series revolves around four doctors in their forties as they embark on hospital adventures involving medicine, relationship and hardships. The four of them have been best friends since they first met in medical school in 1998. At their 40's life...
