One in a Million Chances (BoyxBoy)

Chapter 15 - Suture it up!

Seth Kyrie

"Elenita Soliman, 46 complained for abdominal pain. Twenty-four hours earlier she developed a continuous pain in the upper abdomen which has become progressively more severe. The pain radiates into the back. She feels nauseated and alternately hot and cold. Her past medical history is notable for a duodenal ulcer which was successfully treated with Helicobacter eradication therapy 5 years earlier. She smokes 15 cigarettes a day, and shares a bottle of wine each evening with her husband" paliwanag ng presentor.

Ikalimang case na ito sa general ward, at nalate akong sumama sa rounds dahil nga ilang oras lang ang tulog ko at di ako agad naka-respond sa page mula sa interns quarters. Its 8:00 in the morning with the chief resident on board - Dr. Ledesma. Di pa ako nakakaligo, halos lahat ng kasama kong intern ay mukhang tao na at ako lang ang hindi pa. Lutang na lutang ang utak ko at para akong nililipad.

"Baka gusto mong mag-kape muna, gosh Sky you look like a zombie" bulong ni Lex sa akin. Magkakasama kaming lahat pag rounds, lahat ng 20 interns. "I'll ask my Dad to put us in 1 group, OB-GYN sucks" I just gave her my usual glances.

"Magkasama naman kayo ni Austin diba?" sabat ni Nikki.

"He's so annoying"

"But hot?" si Sab.

"Annoying and dumb" sagot naman ni Lex.

"Aysus Alexadra, baka any moment now mabalitaan nalang namin sa nurse station na tinitira ka na niya sa supply room"

"Eaaaw Niknik, I'm declaring celibacy as of this moment"

"Vitals? Exam results" pagpapatuloy ni Dr. Ledesma.

"Mrs. Soliman looks pale & dehydrated. She weighs 120 kg, she is febrile - 38.5 degree celsius, pulse at 108/bpm, blood pressure at 120/70. Cardiovascular and respiratory system examination is normal"

"And?"

"That's all Doc"

"Are you sure Dr. Pineda?" tumango lang ito.

"Ok!"

"Wait!" tugon ko. Tumingin silang lahat sa akin.

"Yes?"

"The patient is tender in the right upper quadrant & epigastrrium with guarding & rebound tenderness, bowel sounds are sparse"

"Diagnosis?"

"The cause of the abdominal pain is acute cholecystitis" sagot ko.

"The abdominal X-rays shows no signs of gallstones or any abnormality in the gallbladder- its normal" paliwanag naman ni Dr. Pineda.

"Majority of gallstones are radiolucent and do not show on plain films" sagot ko naman, nakita ko ang ngiti sa mukha ni Dr. Ledesma.

"Treatment Dr. Buencamino?"

"This is surgical Doc, she should be admitted to the surgery wing"

"Ok, Dr. Pineda order the transfer of the patient to the Surgery Wing, measure serum amylase to rule out pancreatitis, blood cultures should be taken. Order another chest X-ray for pneumonia exclusion, erect abdominal X-ray to rule out air under the diaphragm w/c occurs with a perforated peptic ulcer. Perform abdominal ultrasound to determine if there is an inflammation in the gallbladder wall"

"Yes Doc"

"May idadagdag ka pa ba Sky?" tanong sa akin ni Dr. Ledesma.

"Patient should be kept nil by mouth, introduce IV fluids and commenced on IV cephalosporins & metronidazole, track down any signs of generalized peritonitis or cholangitis. The inflammation should be settled first before going to cholecystectomy"