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Dilemna of a seriously ill family member

  • The past 2 weeks has been a very trying time for me as well as my family. My 18 year old brother bacame seriously ill suddenly, with a diagnosis being elusive for a long time. As a doctor I found this even more difficult, I felt helpless seeing my brother in such excruciating pain and being unable to offer him any comfort. Here is how it all began.

    My brother is in his final year of schooling and decided to be healthy and live a good life during his final year. So he joined a newly opened gym. But boys being boys, his friends coaxed him into bodybuilding and he started pushing himself hard lifting weights and "pumping iron". 

    Anyone with any gyming experience will know that you start off with as little as possible and build yourself up. 

    Well he had a test the following day after working out his chest at the gym, he could barely write due to the muscle pain so he took 2 painkillers. No pain relief was experienced after 2 hours and he needed to study so he decided to take another 2 pain killers. And then began his downhillm slide of health. 

    He began having strong epigastric pains with associated chest and back pain. due to the family history of heart disease our general practitioner did an ecg to exclude a cardiac cause of pain and then prescribed him omeprazole. He took his medication but the pain worsened. He was finally admitted via the emergency room as the pain was severe. An endoscope was done the next morning and a diagnosis of acute gastric ulcer was made, due to the painkillers he had ingested. He was discharged.

    My brother then spiralled downwards very quickly. The pain was unbearable even after taking his medication routinely. He also appeared slightly jaundiced. He was admitted again via the emergency room. On this admission his liver function tests were deranged, and liver inflammation from the painkillers was the proposed diagnosis. He was only given Buscopan for the pain and his system was flushed out via IV fluids. he was told to bear the pain as they did not want to give hin unnecessary medication and stress his liver more. 

    His liver functions began to improve drastically but his pain worsened even more drastically. The medical staff kept just telling him to deal with it as the pain would pass. This was then followed by projectile bilious vomiting.The pain became so excruiating.

    The surgeons ordered a CT abdomen which revealed only a partial small bowel obstruction. But due to his clinical presentation a call was made to do an exploratory laparotomy with possible bowel resection. My brother kept looking to me for answers and medical help, and I had none.

    The surgeon was adamant that he wanted me to be present in the surgical operating theatre so that i could learn from one of the most experienced surgeons in my region ( who just so happened to have taught me in medical school). I was an emotional wreck seeing my brother in so much pain. How could I be expected to be in the theatre even if it was a once in a lifetime chance? I refused as my brothers wellbeing was more important to me and I wanted to be with my mother to support her during the operation. Luckily my decision was made easier by my brother who refused for me to be present.

    The surgeons found a small bowel volvulus that had formed a very largely dilated loop of bowel. According to his clinical signs he ha started to develop abdominal compartment syndrome. Praise God that by a miracle the bowel was still viable and did not need to be resected.

    Following the laparotomy my brother took another turn for the worse and the question of reopening him arised. The surgeons were again very forceful that I should be present. But luckily my brother was just experiencing ileus and not a reoccurence of a volvulus. My brother still wanted me by his side as much as possible and I had to even insert his nasogastric tube after many attempts by the nursing staff, as well as my brother refusing to have it inserted. I had to force him to have the tube inserted and even with the tube down he continued to projectile vomit through both the tube and his mouth. a terrible and exhausting experience.

    He is now at home and on the mend.

    If you were in my shoes would you have done the same as i did?

    This has really opened my eyes to the dilemnas medical doctors experience when a loved one becomes ill.  

Comments

4 comments
  • Kunle Oke and 'Buchi Anikpezie like this
  • Kunle Oke
    Kunle Oke I feel your pain, Simone. Like you, I had to endure a life-changing month during which my dad woke up from an emergency neurosurgical procedure with a massive right-sided internal capsule bleed and a massive stroke. This happened a few weeks to my final g...  more
    March 25, 2014 - 2 like this
  • Kunle Oke
    Kunle Oke Like all other challenging situations in life, it will eventually pass.
    March 25, 2014 - 2 like this
  • Simone Leeuw
    Simone Leeuw Thank you so much Kunle for those inspiring words. you are strong!Congratulation on passing your board exam. You are right, this too shall pass. your father is in my prayers.
    March 27, 2014
  • Simone Leeuw
    Simone Leeuw I now have far greater compassion for my patient's family members. This has made me a better medical practitioner, made me reailze and remember what is important in life again.
    March 27, 2014 - 2 like this

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