Monday, July 28, 2014

A happy follow up

I am not a real big fan of seeing well patients in follow up.  It is definitely satisfying, as a doctor, to know that you helped someone, and that their illness is finished and to see them all better in followup.  However, my day is typically quite busy with the 100 - 150 sick patients who come to see a doctor, the ER patients who need attention and the procedures that need done.  If I followed every patient I saw until they were all better and then saw them again to make sure they were better, there would be more patients that we could handle here.  So my normal advice to patients who I expect to get better with the treatment I am giving them is, "If you are better, don't come back.  If you are still sick when the medicine is finished, then come back and see us."  This usually gets a laugh out of the patients, and nurses, if I am telling that to a patient in the hospital on discharge.  

Today, I got to see a followup patient, who is still sick, but who is also much better.  Elizah came into the hospital and developed acute flaccid paralysis, where all his muscles below his neck went weak.  He couldn't raise his arms, move his legs, couldn't sit up by himself.  Thankfully, he never had difficulty breathing, which is a bad complication of this disease which often is triggered by a viral infection.  I didn't see Elizah every day in the hospital, but saw him on the weekends when I got to round our on pediatric ward.

The first time I saw him, he was quite talkative, despite never meeting me before.  I was asking him how he was doing, and as his mom was supporting him with her body, he told me he was well.  I asked if he could move his toes - nope he said, his hands - nope, his mouth - nope again he said, which brought a laugh from his parents.  There really isn't a lot we can do for him, but wait for the strength to come back.  Sometimes the strength comes back fully and sometimes it doesn't.  Thankfully, he has gotten some physical therapy from a volunteer PT who is here.  Emma has been working with him and his family to increase his muscle strength and it seems to be working.

So when I got to see Elizah today in followup, I was happy, as he brought a smile to my face with his smile.  And seeing the small, but noticeable improvement in his arms and legs from last time I saw him, was also a blessing to see.  I don't have time to see all the followup patients, but I will take kids like Elizah anyday.