Kauvery Kathaigal : 1
A Challenged First Pregnancy: The Calm within the Storm
Patient: The patient is a young woman who has just come out of her teens, a newlywed wife, and a first-time mother.
Diagnosis: Pregnancy-induced hypertension and fatty liver, complicated by a bile duct structure causing obstructive jaundice and secondary liver/pancreatic impact.
Patient's Story
She would have least expected her pregnancy to be challenged, mostly by rising blood pressure. But her liver was also being challenged by the fatty infiltration that can occur in pregnancy. As a precaution against further rise in blood pressure, delivery was achieved earlier by Caesarean section.
Then came an unexpected challenge. She became jaundiced, which was quickly diagnosed to be caused by a structure in the terminal portion of the bile duct which drains the bile into the small intestine. By that time her liver and pancreas were impacted by the back pressure in the bile duct. Both liver and pancreatic enzymes began to rise and so did Bilirubin which made her jaundiced.
But none of this seemed to bother her when I saw her in the ER. She had been quickly evaluated by a small but skilled army of health care professionals, all lab work and radiology work were completed and she knew she would soon be wheeled into an endoscopy suite where highly trained and skilled gastroenterologists would endoscopically address her stricture and restore normal flow of bile, thus relieving the pressure on her pancreas and liver.
Discussion
Mahatma Gandhi had famously said “India lives in its villages”. But its lives are saved in its towns and cities. India’s great wealth has become its educated and skilled young people. India has the highest population of such people in the world. Many of them are in healthcare and such people came to the help of this young woman.
Conclusion
This story is very technical but illustrates how technologically competent health care in India has become. Almost the entire developing world—Africa, Latin America, the Caribbean, the Far East, and the Pacific—are severely handicapped by lack of modern health care. The quiet confidence in her eyes and the calmness in her demeanor, even as her newborn child waited outside with the family who would bring the child to the mother when it is time for the breastfeed, spoke volumes about the impact of quality health care on the lives of people.
Quality healthcare turns an unexpected medical crisis into a calm recovery.
