WHO IS TO BLAME?

Chapter seven

They sat there weeping silently until Asma came with a suggestion. "Sis I think we should call uncle Moses or someone else because we can not do this alone." She suggested looking at Isha who was also looking at her.
Isha hesitated. She then brought out her phone and dialed his number. She told him all that happened unfortunately, he traveled abroad but he promised to inform his siblings about it. Isha thanked him and cut off the call.
Just then, the doctor and nurse came out of the room where seema was kept. Isha and Asma ran towards them asking them different questions. The doctor, Dr Nafiu looked at them pitifully. "I'm sorry my kids she's fine but she needs some rest."
   "Dr Do you mean that my mother is still alive? I don't want to lose her please Dr help us." Cried Asma looking anxious.
   "Yes of course! She is alive but as i told you she just needs some rest but I promised you she will be alright." He replied, smiling.
   "Thank You Doctor we are appreciated." Isha responded while smiling.
   "By the way, where is your father or any other relatives?" Said the doctor looking around.
   "Well... Am... Yes yes... Our father traveled and we are yet to call our relatives." Stammered Isha.
Dr Nafiu looked at them reasonably for some time before he shook his head. "Alright no problem but you have to call someone because you are too young for that okay?  Now you should follow me to the office." He exclaimed pointing at Isha.
Isha sat on the chair opposite Dr Nafiu while he was busy writing. After few minutes, he raised his head and stared at Isha.
   "What's your name?"
   "I'm Isha Omar."
   "Okay good. I just want to ask you some few questions okay?  So make sure you answer me correctly."
Dr Nafiu took every information that he needed from Isha and wrote them down on the paper. He later filled prescription form and gave it to isha to go buy all the medicines from pharmacy. Isha took the form and went out quickly. She collected her pulse from Asma and walked to the pharmacy.
Some few minutes later, she returned with the drugs and gave them to the doctor. He called a nurse and gave her the drugs and asked her to go and administer them to seema as prescribed in the form.
Isha sat on the chair facing the doctor. "Please doctor i want to know what is wrong with my mother."
Dr Nafiu looked at her very well and smiled. "Why do you want to know?"
   "I just want to know coz i'm really confused about what made her fainted please and i am also a medical student therefore, I think  knowing this will help me a lot in my studies right?"
   "Okay that's good. So....." He dropped the pen blowing air from his mouth.
   "You said she collapsed in the kitchen right?"
   "Yeah"
   "And You also said that her blood pressure is about 180 over 100 every time right?"
   "Yes she's hypertensive."
   "Good! The reason why she collapsed this time is not hypertension."
   "So what is it?"
   "She has a condition called congestive cardiac failure."
   "What? CCF? But how comes?"
   "So You know CCF don't you?"
   "Yes I do."
   "As you know, congestive cardiac failure is a serious condition in which the quantity of blood pump by the heart each minute is insufficient to meet th body's normal requirements for oxygen and nutrients. Although some people mistakenly believed that the term heart failure means the heart has stopped, the term actually refers to diminished ability of the heart to keep up it's working load."
   "Yeah that's what one of our lecturers told us."
   "Yes, and this is not the first time your mother experienced this. I mean she must see some clinical manifestation of this condition but she does not take any action."
   "Yeah she never told me anything but I observed some things like she usually has breathing difficulty especially if she lied down during the night time."
   "Good that's one of the symptoms."
   "But when asked her to come to the hospital, she said it is nothing to worry about."
   "You see the problem."
   "And sometimes, she can't even sleep. Moreover, I noticed that she's very weak these days."
   "These are all the symptoms that you are mentioning. The patient also complain of angina pain which is feeling of tiredness when performing physical activities, burning sensation, chest pain which may radiate from right arm to the left arm, neck, jaw or even shoulder. This is due to inadequate flow of oxygen to the places. There is also myocardial infarction (chest pain and tachycardia). The patient may also experience chest discomfort due to pulmonary edema. Some patient also suffered from cough, swelling in the feet, ankle, leg, liver and even abdomen."
   "Thank You so much doctor i'm appreciated"
   "You are most welcome." 
   "What about the treatment and management of patient with congestive cardiac failure."
   "Recent important advances in therapy include the use of combined diuretics therapy, a better understanding of the value of the digitalis glycosides, and evidence that angiotensin converting enzymes (ACE) inhibitors can relieve symptoms and prolong life.
   "You have to request some tests from the patient like mp (malaria parasite), PVC (pack cell volume), RBS (random blood sugar) and E/U/CR."
   "Thanks a lot doctor. What are the drugs prescribe to the patient with that condition?"
   "Like intravenous lexis, spironolactone and tab aldocton, then you can give some cardiac modulators like digoxin and antibiotics like amoxyl then you are going to advice the patient on a healthy lifestyle."
   "Okay but what causes CCF?
   "Well many condition that cause heart failure which include: coronary artery disease, heart attack, cardiomyopathy or conditions that overwork the heart conditions including high blood pressure, valve disease, thyroid disease, kidney disease, diabetes, or heart defects present at birth."
   "Thank You so much doctor i really appreciated your kindness and your time that you sacrificed for me even though I can see that you are busy." Isha retorted while standing up.
   "You are most welcome i like helping students. Now my advice to you is that you should be patient. I'm sure your mother will revive very soon but you need not disturb her because right now she needs a lot of rest. She will be fine God willing. Okay?"
  She nodded and leave.