Just a quick note to say....
******HAPPY CHRISTMAS******
I am on my way to spend the weekend with friends a few hours drive up the coast. There isn’t a snowflake or red santa in sight. Instead, I have a wilting 2 foot fake Christmas tree alongside several crates of beer, some wine and a little fizz piled high in the boot of Mitch.
Surprisingly, this week hasn’t been too busy. I expect all the “”frequent attenders” have decided that they’d rather stay at home and the drunk boys and their sharpened blades are saving themselves for Saturday and Sunday. I’ll let you know.
Instead of the usual sound of wailing drunk perforated young men, there has been the very similar cry of a man that can’t pass urine. Over two consecutive days I had two young guys who both came in with full bladders, unable to pass a drop (urinary obstruction). I’m not really sure why this was – one had had a serious trauma a few years ago, but it didn’t explain why I couldn’t pass a catheter. I expect both men had had nasty cases of gonorrhoea (or is it Chlamydia – my mind lapses) that has resulted in a spiders web of strictures to the extent that not even urine can pass, let alone a catheter. So, for my first and second time, I cut a hole in their abdomen and inserted a catheter – a suprapubic cathether. Unfortunately, I didn’t have quite the right tools, so had to improvise. You should have heard the wails and screams – imagine having a full bladder and then having some smiling guy in a white coat putting even more pressure on it as he attempts to make a hole to free the urine. Of course, I had anaesthetised the skin and given them both some heavy opiate pain killers (the second a little more after seeing the reaction of the first guy), but the analgesia didn’t quite do the trick. However, both procedures were over in no time at all – the second was slightly messier and I ended up with bloody urine all over my shoes. After taking a much needed call of nature (with a little assistance from myself), both gents had an amazing look of relief on their face. They were very happy customers indeed.
As it happens I have seen a few smiles this week – one of my patients that I admitted back in October who I thought was going to die from a serious HIV related fungal infection around the brain (cryptococcal meningitis), is now smiling and laughing. She’s coming to see me every month and looking stronger and brighter at each visit. What a lovely Christmas present.
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| The moustache has now left us - a christmas present from me to you. I do miss it though. |
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