She writes down that she drinks roughly 10 units a day and smokes a full pack a day.
I asked her if she does this while pregnant and she said that she has smoked and drank through all her pregnancies (3 kids under 5, pregnant with another) and they were all healthy. She stated there was NO scientific/medical information on the dangers of it. I literally didn't know what to say, as a dental nurse all I was able to say was it's really bad for your gums and teeth and general mouth health. Not the fact you're freaking damaging your children.
So then I asked for the children's medical history... all 3 had birth defects from her drinking, and one had a birth defect which is related to smoking during pregnancy. She was adamant this was untrue and the doctors lied about this.
At this point, I was really concerned. We're not really allowed to 'go behind the patients back,' but I found the loophole that says we can contact their doctors for advice. Phoned her doctor and explained the situation and said we won't be providing her dental care and we feel the children are in serious danger and what advice do they have. The doctor took our statement and reported it on our behalf.
On assessment the one-year-old had serious bottle caries (tooth decay caused by going to bed with a bottle), the 3-year-old had holes in all his teeth and the 4-year-old was missing teeth as they were that rotted he had lost them and already damaged his underlying adult teeth. Luckily they're booked in this week so I'm hoping they're doing good."
"The mother of a toddler came into the emergency room. The kid had cruddy green/bloody stuff coming out of his left nostril, and a lot of redness and swelling of only the left side of his nose and the adjacent cheek. Mom was sure he caught a sinus infection and just wanted some antibiotics.
Now, I know some kids like shoving whatever will fit into their body orifices, and that this was more than likely given the one-sided nature of his condition. But Mom was insistent that he NEVER puts things in his nose.
It took some convincing, but I finally got her to let me take a look. Gave a squirt of midazolam in the good nostril to settle him, then dug with some tweezers through the crud until I pulled out a big ole button battery. It would've been burning his nose for a couple days. Hopefully, he healed up well."
"I had an 80+-year-old patient who was declining with multiple diagnoses and about 3 bad ulcers. The daughter was adamant that her father be kept on his strict 'paleo' diet because that would 'supercharge' his healing. She had a stack of diet books. He simply wasn't getting enough nutrition to heal the ulcers. He didn't like the diet at all, by the way.
At some point, you kind of have to stop being polite and just tell patients/family members bluntly that you don't have time for this nonsense and what you recommend and they can do what they want and just document everything.
It happens a lot but she sticks out the most."
"I had a patient come in with several pages he printed off the internet. He kinda slammed them down and said, 'This is what I have.'
He had bloating, nausea, vomiting, diarrhea, bloody stool, and fever among other things. He insisted he had Schistosomiasis. He was being a real jerk about it like we're wasting time since he already knew what he had.
So, I asked when did he get back from Africa. And he said, 'Africa? I've never been to Africa. What the heck would I be doing in Africa?'
I proceeded to tell him that Schistosomiasis is a parasitic disease one gets while swimming in the Nile River or other rivers in developing countries like in Southeast Asia.
He got ticked off at me because he thought I was being a smart aleck.
He got seen and diagnosed with gastroenteritis (the stomach flu). The bloody stool? He had hemorrhoids."
"I'm still just a medical student, but our hospital sees a lot of poor and poorly educated patients since we're a big tertiary hospital in a developing country. The worst I've seen so far are the old ladies who everyone in the family turns to for health advice, their only qualification being seniority. They usually have a bunch of superstitions that end up contributing to the patient's poor condition in the first place.
I once saw a child brought to the ER for a really bad mouth infection, and the mother clearly hadn't taken a bath since the delivery (it's a common superstition here that mothers shouldn't take a bath a week or so postpartum), so we figured that's the source of the infection. While we're assessing the patient, the doting grandmother in the background decides she has to comment on everything we're doing (remember she's probably the one who advised her daughter not to take a bath).
Eventually, I just had to shut her down because A) It was late and people were running out of patience in our understaffed, under-equipped ER; and B) They're more worried that pulse oximetry is hurting the baby's tiny widdle toes when there's freaking pus leaking out of the baby's very inflamed salivary glands. I mean, I get that infections like these are a disease of poverty, that their poor education is just indicative of a wider systemic problem that Philippine society fails to address time and again, but by golly does it get annoying."
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