It’s
really nice to start seeing familiar patients coming in for their next
scheduled visits after seeing them before from a previous month. It’s a
surprising feeling how they recognize me instantly but embarrassing how I’ve
forgotten faces and names so easily as well. I figure that it’s mostly due to
the high patient volume everyday but after hearing a few familiar medical
histories, some instantly register in my mind. Recently, one in particular
stood out to me at Lentegeur Clinic. Back in February, this patient came in
presenting with all of the symptoms and signs associated with tuberculosis.
After viewing the chest x-rays which showed infiltrates in the lower lungs
indicating infection which is atypical of tuberculosis, a common antibiotic was
going to be prescribed. Earlier I was taught that TB can present as abnormal in
the lower lobes if the patient also has HIV. After inquiring about HIV status
and hearing that she tested negative a few months earlier, I suggested a second
HIV test be done that ended up indicating positive and then again from the
confirmatory test to rule out a false positive. This was a first time for me
helping to diagnose TB. She was then prescribed a different course of
antibiotics to begin the 6 month treatment process and referred to Jooste
Hospital to begin ARV (anti-retro viral) treatment. Last week she came in for a
follow up appointment in which she would’ve been starting the second phase of
treatment. I was astonished and quite a bit frustrated to hear that she stopped
taking the medication after the first month failing to complete the first
(intensive) phase due to feelings of nausea associated with it. Specifically,
she explained that it interfered with her day job and couldn’t be taken at
night because of the ARV treatment. I completely understood her position and
the hardships associated with her illnesses but didn’t really know what to say.
It’s a real shame that this problem is so common and I believe that that only
solution is a higher emphasis on better patient education. Problems like these
are one of the reasons why I would like to return one day and work in the
public health sector.
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