Thursday, October 28, 2010
Thursday, October 21, 2010
Unusual recovery in an unusual situation in unusual social circumstances
Mrs UR 30 yrs F
A 30 years female patient operated for Mitral Valve Replacement surgery by Dr H. S. Pannu ,admitted with large right FPT subdural haematoma with deteriorating level of sensorium. On examination, her coagulation profile was deranged with platelets decreased to alarming level (10000/mm3). She was operated for SDH by me and my team explaining all the risks to attendants. Patient had multiple platelet transfusion along with ventilation ± tracheostomy. Had waxing and waning response. Later patient resumed to recovery. She improved in all her parameters and sensorium. Hemiparesis also improved. She is able to walk without support. Her chronic renal failure also improved possibly due to improved cardiac output due to MVR surgery. Managing this patient was a real team approach experience in view of multisystem failure (MVR Surgery, Chronic Renal failure, pulmonary embolism, thrombocytopenia, deranged coagulation parameters, with intracranial bleed etc.) which was further accentuated due to a highly fragile balance to be maintained between hypo & hypercoagulable State. MVR needs Acitrom which was relatively contraindicated due to Neurosurgery but after all, its God’s domain we are just the means to do it. PLUS over all & above it was her family ,especially her mother in law , her handicapped husband , who supported her in all her bad times with their efforts, money & their continuous prayers . in todays era when a girl child is not always welcome , unrelented support for a daughter in law shown by her family is really appreciable. Hats off to all her family members .
Wednesday, October 20, 2010
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