Saturday, June 25, 2011

i need guidance

sometimes you get an obese patient which makes certain procedures a nightmare to perform.

like with this 85kg girl. i needed an extra-long 4" needle to be inserted thru layers upon layers of fat to reach the target space. there're no firm landmarks to help guide the direction to which the needle is to be directed, akin to flying in the dark without radar guidance. but whenever i'm faced with such difficult circumstances, whenever i know i can't depend on knowledge, skill, experience,or  intuition, i ask for divine instruction.

it worked & having another 2 patients this week, weighing 95kg & 100kg respectively, i know i can't rely on myself to get it right anymore. so i put it on record......

the psalmist said :
I will instruct you and teach you in the way you should go;
I will counsel you with my loving eye on you

for me, that's good enough.


Anonymous said...

I think them* feel no pain :(
I remembered my late aunt pleaded tearfully with one doc who tried blood taking unsuccessfully, kids needles didn't even work on her. She was malnourished, all skin & bones, once blood transfusion was done thru her neck, I cried ^-^ btw my "gathering dust blog" is now open sesame :d


Medie007 said...

i think i need that for the finals too...

LX said...

tsk tsk!

Good reminder to self - lose weight!

Hello Kitty said...

When I read this, I actually took out a ruler and check how long is 4 inch. Wow. It never crossed my mind earlier that obese people face the risk that the doctor can accidentally poke at the wrong place. It can be fatal. What about doctors who don't get divine help, and worse still, doctors who lack experience?

I was told that a normal weight person can also be skinny fat, eg. their organs are covered with fatty tissues. I guess in such circumstances, we face similar risks.

doc said...


the veins in the neck are generally larger than those in the limbs, hence doctors try to access them when those elsewhere are not favorable.

i knew you have too much on your mind to stop blogging. welcome back!

doc said...


you can have it - only believe! all the best!

doc said...


tsk, tsk! just do it!

doc said...


i personally find it tecnically difficult to carry out procedures on obese patients.

there's a condition called fatty liver where fat is deposited in the liver even if the person is not fat. it may be due to excessive alcohol consumption or infection like hepatitis. sometimes, no cause is found.

in the early stage, it can be reversible but if allowed to continue, it will cause liver damage.

Yan said...

I broke my knee cap some years back, and the doc tried LA, but no luck. He (my nephew) did not describe as how you did, so that did not make me determined to lose weight. But a friend whose hushand is a doc said this, Dr Chiew said you are too heavy, thus when you landed on your knee, you knee bone cracked!

So, there, I did away with a hefty 20 Kg! Amazing, indeed. But I need guidance from above too.

Sharing to inspire someone who needs it!

Yvonne Foong said...

Can you poke somewhere with less fatty layers? Like... the neck or wrist?

LOL. Reminds me of the KLGH nurses. They claimed that my veins were too fine which caused them to have difficulty locating my veins to insert the IV outlet. I didn't know if their claims were valid, but they were the only nurses who had trouble locating my veins so far. Others do it in split second.

Luckily, I am not obese. Otherwise, KLGH nurses will be merciless with their remarks when they can't locate my veins.

MsUnicorn Girl said...

Do you get the chance the counsel them concerning weight management as well - besides the norm ? I'm curious.........

doc said...

thanks Yan!

for the sharing.

for most people, they will only act when faced with dire consequences. sometimes they get away with it, sometimes the lifestyle change comes too late.

doc said...


when one is obese, there's fat galore everywhere!! more often than not, the part of the body that needs to be reached would be the most difficult to access.

4" of fat is a lot!!

doc said...


counselling is one thing - compliance is a totally different matter!

most times, as far as weight management is concerned, it's too late when they really want to do something about it.