Thursday, July 20, 2017

dengue diary...july 17

Its the end of another hectic day and I keep on staring at her monitor... which now doesnt make that alarming noise...
It is a blessing to help them all, but a curse to feel so much. Tired of getting sick with all the viral outbreaks, probably had them all and i tend to forget that getting sick is also humane. Two down with viral fever from the team.of 6 doctors in paeds wards.
I Hear there's going to be an extra allowance to all who work during the dengue crisis. "We didnt even get a risk allowance even when we asked for that doctor" a nursing officer quotes on past issues. yes ! Its an occupational hazard to be at risk to catch these diseases while treating them. Life is a struggle right now and I carry all burden on my shoulders thinking "this too shall pass like it did before"
"If u can sit still for a while i can draw you doctor" he says with a smile...without even asking him to do so...such a talented young kid who copied all the wall paintings of our paeds unit. I told the mom to help him with his passion and talent. He is the one who drew the dengue poster which i posted earlier.

So dengue was in its pandemic, creating a never ending headache for those of us who were working in wards full of dengue fevers and even with patients who were critical in dengue hemorrhagic state

For most of the time, these kids who come in with shock symptoms are those who have had fever in first 2 days but parents dont do a blood count as fever resolves on 3rd day. 
They come in faintish, cold peripheries and on the examination bed with resuscitate them with fluid boluses ( bolus - a large amount given via intravenous route over a shorter period) as the pulse is weaker  with low volume and blood pressure drops than the normal.
it takes quite a lot of time to monitor them and the oncalls seem to be tiring that usual with the hourly monitoring of the critical side where most of the kids are leaking. 
Leaking means fluid leakage from the blood vessels into the spaces in our body, which are around organs in abdominal cavity ( where liver kidneys n bowel lies) , in pleural cavity which is around lungs etc.
So we are vigilant on symptoms and signs which indicates clear cut signals of leaking such as reduced input and increase of pcv ( packed cell volume)

today I explained how we manage dengue and how to identify leaking by our parameters to mothers in critical side. all worried about platelets. We had one who leaked and had a good platelet count and another who didnt leak but platelet was 10 000 so its a very tricky game.
All those "kasaaya" people and "thel, beheth" people will really rotten in hell for making it a business in such a crucial time. All were concerned to give papaya leaf juice, and not bothered to even feed their kid the main meals.
All who complained of epigastric pain didnt have a proper meal as the kids said they "cant eat"

I dont remember our mothers letting us stay in peace if we tried to miss a meal.
Had a very worried time when a 1 year old was admitted with 100 000 platelet from ETU... on day 3 of fever they have done a count at pvt sector, platelet 120 with reduced WBC, doctor has adviced to admit but some one near the house has told its normal.
so they took the so called known nonmedical persons advice just like those who run behind, oils to apply on forehead until the disease resolves by its natural immune pathway or kanji to give throughout by asking how much the doctors in ward gives fluids. but not given to any critically ill ICU patients ever.
I really dont know what is wrong with mothers these days. All are bothered about everything else and not what they ought to do !
fed up. yes the numbers still rising.
We received 15 nets from Dr. Vasana Ketagoda and 27 nets from Gihashi Pravindika and her friends today thank you Nadie Wasalamudaliarachchi akka for coordinating ...

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