Sunday, 27 February 2022

A 32 year old man with multisystem pathologies

 I am Saranya ,a final year MBBS student.

Greetings to all my readers;

This is an elog documenting the patients that I witness during my Clinical Postings to enforce a greater patient centered learning .

 

 DEIDENTIFICATION : 

The privacy of the patient is being entirely conserved. No identifiers shall be revealed through out the piece of work whatsoever.


Acknowledgment :

https://drkulkarnimd.blogspot.com/2022/02/30m-with-post-renal-transplantation.html?m=1

I have taken certain inputs from the elog about this same patient which had been prepared in the past ( link given above )


INTRODUCTION :

 Here we shall discuss about a patient who is a 32 year old man hailing from Eastern part of India .


TIMELINE OF EVENTS : 







 Complaints present in the patient as of today ( 27th February 2022 )

Presently the patient does not have any symptom or  complaint,only that he is worried about his raised Serum creatinine


Daily Routine of The Patient : 

Back in 2019 : 

He used to work as a courier service delivery agent.

His day used to begin at around 7 am .After waking up,he used to freshen up ,complete his breakfast and leave for work at 9 am..he used to deliver the packages till 1 pm and get back home for lunch

After lunch he would again resume his work till 5 pm and return home, the evenings he would usually be at his home itself,watch some television, run errands for the family or his sick father for that matter before dinner and then sleep by 12.00am


ROUTINE NOW :

Since November 2021


After around 6 months of his transplantation, he joined a nearby cyber Cafe as the person in charge for doing the works like.. filling up online forms, getting printouts for the customers.

He chose the work place very near to his house such that the physical exertion in travel would not be too much, 

He gets up in the morning at around 7.30am, freshens up, takes some light breakfast and reaches his workplace by 9 am , he stays in the cyber Cafe till 12.30 pm, comes back home, has his lunch and takes some rest,  he gets back to work at 4.30 pm and wraps it up by 8.30 pm after which he returns home , He usually does not go outdoor anywhere else after returning  , he watches television with his mother and completes dinner , gets to sleep by 11pm




How the Disease deranged the daily life : 


From the timeline of events , we see that since 2016 he has been having some secluded events for which he had been receiving only symptomatic relief but there were no definitive investigations performed to derive the root cause 


 In 2019 , till the day he felt uneasy and vomited a lot amount of blood , he had been continuing his work as a delivery agent in the courier delivery service , that morning he had been feeling somewhat uneasy and had told his friend to accompany him on his bike which he used to take to work,  he also returned home slightly early due to his uneasiness 

Just before lunch , he complained to his mother of having headache and a weird sense of uneasiness which he couldn't explain, minutes after this he vomited dark tinged blood that was clotted , the amount was so much so that the mother had a syncopal attack after seeing it.


He had a hospital stay of 4 days after this and then he was sent home.

He took rest for about a week because he used to feel weak and then rejoined his work, Also at this time his father was hospitalized ,hence he had to do to and fro journeys from the hospital to their house which was around 4 hours in local trains 

He also couldn't leave his job because they were in huge monetary constraints and needed every penny together to cater for the medical needs of his father

Although when I ask him now he admits feeling weak all through the day in those times but still continued work.

But it was October 2019 , when he felt severely ill with complaints of shortness of breath, chest pain and grossly deranged renal parameters for which he stayed at a hospital for 1 week and then got admitted in our hospital. 

He began getting hemodialysed.

Since then , his daily work life routine came to a stop, his disease made him stop his work all together .












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