*Since my job is almost like an operator, we get stories that are quite confidential, hence why I didn't put the caller's name, and call them they except for one because it is quite obvious. So you'll see a lot of callers and theys around. These stories are meant for sharing, not to speculate. All names are not included to respect privacy, and some stories are edited to maintain confidentiality. The opinions and thoughts stated are just opinions and thoughts that were discussed.
As the name implies, it's a non-invasive procedure that involves screen for common chromosomal abnormalities. With technology so advanced, it is now possible to screen your baby before it is even born. I've been getting a lot of phones lately regarding genetic testing, which is surprising because I have no idea that this is the trend right now. I talked with my MOs (Medical Officers) on why is this the trend. Their reasoning is basically, let's just say that before your baby is even born, you know, when it's still a wee jelly blob, you go and get this test done. From the test alone, you can tell whether your baby will have any defects like Tetralogy of Fallot (A rare condition caused by a combination of four heart defects that are present at birth (Congenital) as defined by Mayoclinic.org) - I call it tetra valve disease to spare my brain from overloading, but that's the proper name of the condition - Down Syndrome, basically... Do you want to bring this baby into the world, knowingly that you and your partner/ spouse will have to take care of this child? This gives you the option to choose abortion or not.
- Now before you come and attack me on this, think. You have a child who is going to be born with the diseases mentioned above. Will you stubbornly give birth to the child, but when you are unable to cope with the responsibility, abandon the poor thing? As mentioned, the wee jelly hasn't even been form yet, so you can choose to abort to spare the poor thing from suffering in the world. Does it sound crazy? I used to think abortion was bad, no questions asked, but now, thinking logically, it's not fully bad. I got a bone to pick with a certain author who shall not be named.
A concerned relative calling on behalf of their family who is querying on Uterine Fibroid Embolization (UFE).
*The person on the phone kept calling it USB, when I asked them to repeat the initials to me. She said United States, France, and Bangkok. UFB. Checked the internet, no such thing. After several back and forth, the caller admitted they made a mistake, that it is UFE.
This one is doozy. Of course, the name is quite straight forward. When you think of embolization, you think of formation of an embolus. I guess, a simple term to put it is a clot in the bloodstream. The person called mainly to query whether do we do this procedure or not. I called several places, mainly radiology (X-ray/ Imaging/ MRI/ Ultrasound/ CT Scan Department). They said, yes, the radiologist does it, but very rarely. I called the cath (catheterization) lab next, and yes, although they do do it, it is so rare that they aren't even sure of the exact pricing, because everything depends on the situation and the tools they plan to use. I did manage to extract the bill of a patient which they did, but it's not even the proper procedure name. It is an embolization but for something else. Even if it is the correct code and name, when I saw the bill, I couldn't even extract the amount because everything is jumbled up, even though I have tried to group it all together.
- It's a good thing the MO and I managed to extract as much information as we could, because when we called back to give them the information, the caller asked, "Can you tell me the price?" "Oh, you can't? It must be really expensive, huh? *laughs*" They're alright, but yes, an embolization is ridiculously expensive. The only solution we could give was they have to go and a get consultation done with a specialist, and let them explain everything in detail.
Callers calling to query about another person who they claimed were having mental breakdowns, that they need to see psychiatrist.
We get this type of phone calls a lot. Very surprising, yet sad. It just shows that in our current age, there are many people suffering mentally. The worst of it they couldn't even come out and just say it because in the outside world, people still stigmatize mental health. Mental health problems = Crazy/ Psycho. Stop this kind of thinking right now! Having a mental breakdown doesn't mean you're mad, it just means you're stressed, burnt out. It does not mean you're mad. I'll tell you something right now. When I was a student, we had to go to Hospital Bahagia, Ulu Kinta as part of our training. It is a psychiatric hospital that has is more than a hundred-years-old, and I'll confess, it's one of the best places I have ever been. The place is a simple town, with waterfall water in the pipes, which is so icy and refreshing, and for less than ten ringgit, you can even get big bunches of bananas, a lot of fresh vegetables or large quantity fruits. Things there are not so overpriced like in the city. My biggest regret was not taking a photo of the entrance as a memento, here's a photo of the entrance which I found in the internet.
By the way, people kept saying bad things about the place. As someone who went there and experienced it firsthand for few weeks, the people there are alright, most of them brilliant doctors, accountants, lawyers, engineers, jobs that sounds glamorous. It's very sad. I won't say much anymore, but seriously, stop condemning people who are having breakdown insane/ mad/ psycho. These people need help, and sometimes you need a specialist to step in to give them the help they need.
Swollen lymph nodes on either side of the neck.
This one, I'm going to say it, I'm a little confused at first, because my mind went straight to haematologist (blood doctors). Probably cause my mind is scrambling all over the place. The caller is okay though. They just said that they had been to our Emergency Room and they referred the caller to a physician. Unfortunately, the physician in charge is not the right person, hence why they made the call here. I checked with my MO and they went, "ENT Doctors, dear. Not the physician." Oh yeah, neck. I'm such a joke.
A caller called suspecting their spouses were cheating on them.
Oh, oh no. I didn't attend this call. My MO did, poor thing. They kept giving me the look, and I did the same. Oh...The caller said they went as far as to backtrack the call but it was someone else. Oh dear. I've seen this movies, but to hear it firsthand, I can't imagine what they are going through, but this caller, I salute them, because they wanted to seek mental help. That is bravery, dear readers. And please don't cheat on your spouses, alright? I always did joke, if I ever find my Mr Right, I hope I only get married once, not eight times like Elizabeth Taylor, no offense.
Calling on behalf but you have no clue.
As the title implies, I didn't attend this call, my MO did. The caller was calling on behalf of someone, but when we ask simple details like... "How?" "When?" "Where?" "What?" The caller couldn't answer because they have no idea, not to mention they were making themselves confused by reading everything all jumbled. Look, not to criticize, but if you are going to make a call, please at least have the courtesy to do it yourself. Kids, I understand, but for adults, please....We need a thorough history so that we can give you the right treatment. If you can't give us the details, how can we direct you to the right doctor for the right treatment? It's like sending a knee injury to a brain surgeon. (Check out one of my previous posts regarding this joke)
Telling me that I'm in love with a doctor that I recommend.
I wish this is a joke, but it's not. The caller called on behalf again, wanting a nice, understanding, caring doctor who would spend time with them. So I recommended one to the caller, a doctor who has all of the above mentioned qualities. Instead of being grateful, they query me about the others. I told them in a polite way, the other two have many patients, so if you want someone who is willing to spend time with you, I don't think they have the time to do so because they will be rushing their clinic to hurry to the operating theatre. They are nice, but pressed for time. If I recommend them to you, you'll probably come after me. So then the caller said, "You seemed determined I should meet this doctor, are you in love with him?" WHAT?!!!!!! Everyone said I should have fire the caller off, but you know what, I'm going to let it slide. Nowadays if things ticks me off and I can't avoid it, either ignore it, brush it aside or just be polite and move on. In social media, I block them. I don't need toxicity or dumb things in my life. Say what you want, but after blocking some toxic people, I feel lighter and happier.
Military hospital.
I must've been living under a rock for this one. I got a call from a nice fella asking for an appointment for mandibular abscess. When you talk about mandibular, you automatically think of oral-maxillary doctor, or the ENT. So I query a bit further, and the caller went, "I actually have an appointment in this military hospital, but I want an earlier appointment if possible." Wait, how come I have no idea we have a military hospital? I know there are some military schools around. Oh yeah, I heard some of my doctors came from military hospitals. Oh, the joke's on me. By the way, we scoured the internet high and low but couldn't find anything much about them. Super secretive, but hey, at least now I know, we have military hospitals. Oh yeah, regarding the caller, I set up an appointment with the oral-maxillary doctor.
Buying insurance but using outdated lab results.
Readers, this one is going to be quite general. The person behind the phone is calling on behalf again. They called to tell us that the alfa-fetoprotein marker is abnormal, that the person has cancer. When we query further, the caller went, "Well, isn't that is what alfa-fetoprotein for?" Just so you know, I'm not an expert in lab stuff, but you can't assume the person has cancer just because the result was abnormal. The best part... When they sent the blood results over via email, it dated back a year ago. For crying out loud, don't use a lab result that has been outdated. This one is more of a general screening thing so we refer them to the wellness side for health packages.
- You're probably thinking...but wait, why not send them to the liver specialist? We are trying to give our callers advice on several options, not go for the extreme. You see, the main concern is actually just that one part, not everything. Sometimes you don't need to go the specialist, unless the wellness doctor thinks, "Hm, this doesn't look good. I may need to refer you to a specialist..." Specialist charges can be very expensive, another thing to consider about. This will also to one of the scenarios below.
Orthopaedists are superman (sort of...)
People often get themselves confused. Orthopaedists is a vast field. Every orthopaedists started off as a general orthopaedists first. Then you eventually get into the subspecialty such as spine, hand and microsurgery, foot and ankle, shoulder... Most of them could do the general stuff such as knee, hip, carpal tunnel release, shoulder, fractures... It's because now technology had advanced so much that some of them don't do certain things such as hand and microsurgery, fine surgery for the foot and ankle area etc. A caller called regarding a frozen shoulder which has been bothering them and they wish to go to back to their normal orthopaedists. Go right ahead. Frozen shoulder is a basic thing for them. The caller then enquire, "What about osteoarthritis?" Same thing, it's a common thing for them, so they can see everything.
- One thing to stress... I have seen news reporting on how orthopaedists did spine surgery with devastating consequences. Spine is a special field which should ONLY be performed by spine surgeons, their closest counterparts would be the neurosurgeons. The only difference between a neurosurgeon and a spine surgeon is spine surgeon are trained to put in spinal implants (This is what was discussed). Please, please, please, if you are going to consider a spine surgery, please make sure you are seeing a spine surgeon or neurosurgeon, not an orthopaedist. An orthopaedist can combine with the neurosurgeon or spine surgeon to do the case, but again, please make sure that one of the right person is involved. I have seen news where orthopaedists performed a spine surgery and someone had gotten paralyzed. (I can't find the article, but it happened quite long ago, I think it has been 10 years?)
- Here is an article on the difference between a ortho spine and neuro surgeon. I hope this can clear up some things, but again, please check with your doctor before considering surgery.
- Source: Hochschuler, Stephen, MD. Orthopedic Surgeon vs. Neurosurgeon for Spine Surgery https://www.spine-health.com/treatment/spine-specialists/orthopedic-surgeon-vs-neurosurgeon-spine-surgery, updated on 04/06/2015. (Retrieved on 18th November 2020)
Gastric or heart?
I attended this call. This caller called to complain, in their own words, "Pain between the breasts, but slightly lower." That's the top of your stomach. They said they kept feeling pain, and asked me whether it's gastric. My answer, "No." "What do you mean by no?! Isn't it supposed to be gastric?" I'll say it for you right now. It's not gastric, it could be acid reflux, it could even be heart or lung problem (very rarely, but still a possibility), and many other things. You can't just assume everything related to the stomach is gastric, but since the main concern is the stomach, I referred the caller to the gastroenterologists. They'll be able to figure it out.
Physician or surgeon?
The golden question. Callers love to say surgeons are better than a physician. I'll give you an example. When you have migraine or back pain, people just love to say, "Oh, go and see the neurosurgeon. They should be able to help you." Here's the only difference between a neurologist (physician) and neurosurgeon (surgeon): One does surgery, the other doesn't. Something as peanut like migraine and back pain...is almost like a waste of time to them. Surgeons take the hard core stuff, like brain trauma, spine fracture... They are not going to take a look at peanuts. Some speciality like haematology (blood), urology, orthopaedic, obstetrics and gynaecology (O&G) ear, nose, throat (ENT)...Most of the doctors are surgeons, so that's a different part. General speciality such gastroenterology, neurology, dermatology (skin), nephrology (kidney), paediatrics (children)... You can actually consider going to the physicians first if you think you don't need surgery. Unless it's extremely serious and you need surgery, then yes, please do consider going to a surgeon.
- Peanuts is a term that I like to use for trifle things. The alternative I like to use is small potato. For me, I like to identify myself as a small potato, because hey, what do I know? I'm just a lowly nurse (in some people's words), not a big potato (aka doctors, or hotshots in the world)
Most of the calls are about enquiry and they are quite straightforward so I won't be putting them up here. If there are more interesting calls around, I'll share them up here.
*Today's case: 1,210 (Yesterday's) Sorry, the daily update with receive is usually around 6pm, so I am unable to update the case for today's (18th October) yet. Oh My God!!!
**Today's case: 660 (Hooray!)
