Tuesday, May 20, 2014

Please doctor, just do whatever you think is right..

Lately I have been seeing so many patients with acute flare of gouty arthritis or gout as we commonly call it. I will write on gout later today focusing on the latest approach towards managing it. But If there is one thing I wish I can make a change, it would be for the community to really know the medicine they are taking. You know its quite hard for us doctors to track back a patient's medication if we are not the one who prescribe the medication.

These are some common examples:

Scenario 1
"Pakcik, untuk sakit gout pakcik ada makan ubat ke?"
"Saya makan ubat warna pink"

Could be Allopurinol...but then Allopurinol can also be white

Scenario 2
"Pakcik gout makan ubat apa?"
"Saya makan ubat yang buat lawas berak tu doctor"

Could be colchicine as it can cause diarrhea..

Scenario 3
"Makcik untuk kencing manis makan ubat apa?"
"Makcik pun tak tahulah doktor"
"OK..ubat makcik tu bentuk macam mana?"
"Biji besar warna putih, bentuk bulat, makcik patahkan separuh"
"Ooo Metformin. Ubat darah tinggi?"
"Yang kecil bentuk beras"

Kalau nak kenal pasti antibiotik lagi jangan cerita macamana payahnya!

Haihhh you know it can be really difficult at times. We don't have problem with common drugs but sometimes different company produce different appearances of drug. We might make mistake. When I did my elective posting in Jordan, I met a patient with bronchial asthma. I asked the patient "What kind of inhaler are you using?" She answered "I'm using Asthalin". That precise answer gave me a satisfaction like never before. A patient who is well versed of his/her illness and know his/her drug well. All of us should be responsible to our body and health and not depending on doctors to decide everything like "Please doctor, just do whatever you think is right"

I do like patients who ask me my rationale of giving certain medication compared to others or my reason of not giving certain medication to certain people. Sometimes I don't know the answer also but I'll search in journals etc. That adds up to my wisdom and also yours, and that makes all the difference in healthcare, bringing it up to a higher standard!

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