Mdm V, aged 96 years, has limited mobility and is mostly home bound. She's cared for by her daughter, aged 76 years, who isn't very well herself either. Over the past 2-3 days, Mdm V developed pain on her left rib and had loss of appetite. She responded poorly to oral paracetamol and topical NSAID plasters. Mdm V's daughter reached out to Dr Ong Guan Hong from Pancare because Mdm V had adamantly refused any medical care in any healthcare facility.
We visited her over two days. It's heartwrenching to see her wail in pain even with a simple blood pressure measurement. And since she refused hospital care, we brought some equipment to her home to run some simple tests like ECG and bloods to find out what we were managing. It was tough taking her blood sample. We held her hand to comfort and support her through these procedures.
This experience made me reflect on my journey as a pharmacist. When I used to be an inpatient pharmacist, I ran the inpatient anticoagulation service. With 99% of my recommendations then, we suggest venepuncture of PT/INR (a blood test to check the time it takes for blood to clot). While I remember encountering doctors that would tell me that the patient's veins were difficult, I have never witnessed how difficult it really was in person, until today.
Today is the day where I relook at how I should measure the risks versus benefits with any investigation and therapy. Today is the day that I think the risks of an influenza vaccine would outweigh its benefits. Today is the day where I remind myself to treat our patients holistically, with dignity, through shared decision making.
This community is underserved. Because they can't get out of their homes, their access to healthcare is limited. Let's bring care to their homes, to serve the underserved.
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