Saturday, November 28, 2009

Mothers and Daughters.

Friday was an odd day. It's the long run up to Christmas that starts in earnest this weekend with German Markets seemingly springing up all across the land and traffic into all our major town centres gridlocked as we flock to see how our continental cousins do Festive. (More sausage and gluhwein than turkey or beer and a lot of carved wood apparently).

Then there's the flu jabs-- not only the "normal" ones this year, but also the added thrill of pandemic jabs, which pretty much everybody seems to want but for which the target population is at variance to some degree with the other jab. Still in our neck of the woods it's proving popular. We gave 500 last week, and filled another 500 clinic appointments within 2 hours of opening them up. It's almost as though we were offering tickets to see Robbie Williams.

But this Friday was mainly odd because of a couple of encounters that made it plain that the rules of normal behaviour had been suspended for the day. and this weeks before the Lord of Misrule has his annual outing.

Exhibit One: Jocasta.

A precocious young lady of ten. She has eczema, and a month ago kindly young Dr Neighbour decided it looked a bit nasty, and needed treating for infection as well as the more normal inflammation of the eczema itself. This isn't uncommon. Eczema itches. When it itches we scratch. When we scratch we break the skin, bugs get in and a low grade infection adds itself to the misery of the eczema. Mixing an antibiotic into the cream is a far more effective way to tackle this than to opt for "systemic" antibiotics (that's the ones you take by mouth -- or sometimes in a drip) which might eventually work, but are far more likely to fuel resistance and generate side effects.

Sadly Jocasta's eczema looked every bit as nasty on Friday morning as it did a month ago. "How could this be?" I wanted to know-- "Didn't the cream work then?"

"Well we didn't use it" says Mum. "Jocasta said it made her legs sting!"

"Oh dear, so how long did you try it for before you sopped it then?" a reasonable question I felt, but both Mummy and Jocasta gave me that look that suggested I had suggested they go drown sackfulls of puppies.

"Well we only tried it the once. After all she said it stung!"

So we've agreed that poor Jocasta is going to try to be brave, in the hope (firm expectation on my part) that the cream will not only stop singing very soon, but might even do as intended as clear the infection. a;;owing the eczema to settle in its wake.

Exhibit 2: Cissie.

An urgent request for a home visit mid afternoon. Cissie's daughter has been to stay for the last 3 weeks. Cissie will be 90 in a couple of years, and has been left all alone after her husband's passing many years ago. Her daughter lives a long way off the patch, but came to stay when Cissie, normally fiercely independent, got a bit confused, as often happens when folks beyond "a certain age" develop a urinary tract infection. Antibiotics and three weeks of regular meals have worked wonders for her and she's fitter and better nourished now than she's been for a year or two. Daughter has a pressing engagement elsewhere this weekend, but brother is on his way and will be arriving before bedtime.

Daughter has also managed to arrange carers to call twice a day to help Cissie with getting up and going back to bed. She even tried to get her to consider meals on wheels, but after trying one Cissie was less persuaded on that front and would prefer to keep making her own arrangements, which she is in fact now quite capable of doing again. Still for over a week Cissie has been independent and Daughter has simply been helping her sort out the arrangements. And the Friday lunchtime Cissie refuses to eat, starts leaning heavily on the walking frame, takes herself off to the back parlour and refuses to speak to her daughter at all.

When I visit there's no apparent cause for this sudden "turn for the worse". Indeed Cissie is quite polite with me and wonders rather what all the fuss has been about. She does in the end allow me to gently check her out and confirm that she has neither water infection, flu, or any other cause of acute ill health. Neither has she suffered a stroke or any other insult to her frame as can occur in old age. The simple fact is that Cissie would far rather be cared for by Daughter then Son and wanted to make this plain without saying so. I'm pretty sure she's got the message.

1 comment:

Medical Spa MD said...

We've had patients tell us our products "aren't working." It's shocking to discover how many of those same patients aren't actually using the products they complain about. Here's a small suggestion, how about everyone actually try the recommended product before declaring it doesn't work?