The Purple Sky

I have a patient in my current ward. She's relatively young - only 49 years old. She has severe mitral valve prolapse which has been there for god ages - thus in due years she had developed heart failure. Having this would mean that she needs a surgery to repair the broken valve.

Surgery has been planned for her many times but for some very obvious reasons they cant proceed with it.

See, this lady also has polycystic kidney disease, which had caused her kidney to fail as well. Patients with adult polycystic kidney disease usually have cysts developing in other parts of the body as well, over the liver (liver cyst) and brain (berry aneurysm)namely. Her liver has large cysts growing over major parts of it but miracle-ly its function is still good, but the existance of any growing cysts in her brain is unknown.

In order to find out a CT scan should be done - CT angiogram to be exact, but in her case, CT is impossible. Firstly because of the angiogram contrast (fail kidney may not tolerate contrasts)- but also because she can't lie flat! (due to the fluid overload and the failing heart!). She cant lie at all, not even for 5 seconds, let alone for 15 minutes!! Everytime we tried to put her on a semi prone position she would be breathless, coughing non-stop.

And to undergo a valve repair would mean that she needs to be on anticoagulant post-op, so as to prevent clots after the surgery, but if she happens to secretly harbours an aneurysm up there, it will just be like a time bomb waiting to explode! The aneurysm might just bleed and bleed until she dies.

Plus, surgery is almost impossible unless surgeons are able to do surgery with the patient sitting up. Her probable option now is to undergo dialysis - but that also might not be able to solve her problems since her heart is already so weak.

The last time i asked her, she said (with a smiling face)- "Apa boleh buat? Balik rumah sajalah, hidup happy2 1-2 tahun then pergilah"

*sigh* - some people find courage to smile at times we can't









This is from Peter Bong's wedding that took place last week.

It was my first time attending a non- Malay wedding, I had to be honest that I was a bit scared initially because I had to enter a church, but apparently it was an exciting experience - especially this one!

When the bride tossed the bouquet out, most of us singles who were standing there quickly went behind the many flowers posts to hide - I don't know whether we still wanted to be single or it was just plain reflex! =))