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Wednesday, November 19, 2008

My Trip to My Homeland- Part III

A young gentleman had a syncopal event. A syncopal event is defined as A loss of consciousness. There coUld be any number of reasons for a sYncopal event. By the time I arrived in the front cabin this gentleman was responsive. There were a number of other passengers surrounding him. It appeared that some of them were health care professionals. I guess two of them were doctors. (This is totally my guess.) One of them mentioned that she was a nurse. The gentleman was still sitting on tHe floor. I approached him from THE side and sat next to him while supporting his weight. I asked A few questions. This gentleman was prediabetic. He never had a low sugar, but his primary care physician had been monitoring his blood sugar. HE had a very strong family history of diabetes. His major complaint THAT HE VOICED WAS, "I don't feel good." I am not sure what precipitated his syncopal event. One of the doctors asked for a medical equipment bag. While the chaos wAs still going on, I asked a few more questions regarding his medical condition. He had no significant medical condition. He felt lightheaded and was sweating also. BECAUSE he had a history of diabetes and now had signs of hypoglycemia, I asked one of the flight attendAnts for a packEt of sugar. I wanted the man to sit back in his seat, but the other three health providers didn't agree BECAUSE they wantED his blood pressure checked before THEIR next move. He was feeling much better without any intervention. He was given a packet of sugar and his blood pressure was normal.
Finally this gentleman walked to his seat without any problem. His seat was a few steps away. Once settled in his seat, I asked this gentleman, who had friends accompanying him, to BE SURE to visit his primary care physician once he GOT back to the United States. I headed back to my seat.

I was sleeping in my seat and somebody TAPPED me on the shoulder. This was almost TWO hours into the flight. A flight attendAnt wanted me to see another patient! It appeared nothing urgent to me. This gentleman haD some profuse watery nasal discharge and he was bothered by it. I had NO IDEA what his problem was. Allergy was my FIRST CHOICE. The flight attendant had some personal allergy medication. I gave a green signal for the medication. I requested that this gentleman keep himself hydrated and while we WERE at Manchester Airport he COULD buy some anti allergy medication there. ANOTHER option was to see the doctor at the airport.

Finally I went to sleep hoping and praying THAT nothing WOULD HAPPEN FOR THE REST OF THE FLIGHT. About FOUR hours into the flight, I RECEIVED another tap on my shoulder. I opened my eyes in disbelief! Another flight attendant was standing next to my seat! He requested THAT I see another lady who was not feeling well. She was SITTING in the back cabin. She was in her late 40's,sweating,and feeling lightheaded. She had a history of heart disease, diabetes, and thyroid disease. She had no kidney disease. She was sitting in one of the crew member's seats. Her medical history revealed that she had been taking her diabetes medication whIle skippping all other medications including her heart and thyroid medications. She continued her diabetic pills without caring for her meals. She didn't HAVE anything to eat all day long! Once again I requested plain sugar and orange juice. I grabbed my stehoscope from my bag. This lady did not want me to leave her. I had to reassure her that I would come back. I requested that the crew members please FETCH the medical equipment bag. I quickly grabbed my stethoscope and returned to the scene. Her exam was benign(mormal). Once the medical equipment set arrived, I was surprised to see THAT it was a SUITCASE, It had almost all the medications necessary FOR AN emergency situation. I attempted to take her blood pressre but it was hard to obtain BECAUSE she was sitting in the back cabin with lots of ENGINE noise. I had to rely on blood pressure by palpitation. She felt better with sugar followed by orange juice and tea with extra sugar. This lady wanted to lie down in HER SEAT. She was sitting in a ROW OF THREE SEATS. She had only one passenger seated next to her. A crewmember told me that her seatmate was not a pleasant lady and that this passenger HAD HAD some heated arguments with her. I DECIDED TO ASK THE SEATMATE TO MOVE. She agreed! I ASKED THE CREWMEMBER TO FIND THE LADY A NEW SEAT AND THE CREWMEMBER RELUCTANTLY AGREED. There were other open seats around but the lady was FUSSY! She didn't want to sit next to children! (There had been a great deal of animosity between this crewmember and this passenger at the beginning of the flight and it was continuing now!)This passenger was extremely sarcastic and the crewmember had yelled at her previously when she requested extra meat! Caught between estogen surges, I decided to check on my other two patients who had had fainting spells! Both of them were NOW doing fine.
When I got back to the back cabin, the passenger who had vacated her seat was still without A seat. The crewmember offered us special tea. After taking a SHORT TEA BREAK, I returned to my last patient. She was normal and lying down. I updated her on the seat situation and informed her that she might have to give up the third seat. She didn't like the idea at all! She started showing me which seats wee vacant! She appeared good and she felt better too. I told her that a crewmember would try to arrange for a seat, but if they could not, she would have to give up the third seat. I was REALLY tired of this game and went back to my seat.

The stewardess who was SERVING our segment of the flight was really pleasant. She said,"IF YOU HAD CHARGED THESE PATIENTS, YOU WOULD HAVE HAD A FREE FLIGHT BY NOW." I simply smiled. She asked my specialty. WHEN SHE REALIZED THAT I WAS A KIDNEY DOCTOR, she went on TO TELL me about her sister who had nephrolithiasis(kidney stones). She did not have any details of what workup was done or other details. I asked her to e-mail me the details so that I could give HER my opinion. After this, I went back to sleep. The rest of the flight was peaceful.

We arrived at Machester Airport safely. I was not surprised to see strict security measures deployed at the airport. Even though we came off the plane, we still had to have full screening prior to entering the airport premises. It was a two hour STOPOVER and the two hours were spent in the security clearance AREA. After we went through clearace, we boarded the plane again. The second segment of the flight was uneventful. We landed safely in Lahore in Allama lqbal International Airport.

1 comment:

Leo Coleman said...

Dr. Zorro,
With an adventure like that, it is too bad it is not possible to get to Pakistan by boat! I have a copy of your original story and my corrected version which I will give you for comparison when I see you. (Don't forget to send me that corrected copy of the "Dr.C" Clinic Report if you get the time. otherwise I will rewrite that first paragraph.