Nov 24, 2009

Keeping abreast of things

Grateful to: Dr. R for more solo flights on Lap BTL, and first Lap & dye. I bloody addicted to laparoscopy. Probably it’s not an addiction, more of peer pressure over here.

Definitely, I had to thank Palmdoc, for the update on Breast Cancer screening. If you’re too busy to read through the whole long article, let me spare you the agony and cut the chase. The main point is

1 pushing mammogram screening age from 40years old to 50years old, and less mammogram repeats, probably 2-yearly rather than annually.

2 self-breast examination is NOT, yes, NOOOOOOOOOT recommended, as it doesn’t reduce the harm, but increase anxiety and unnecessary insults to the breast.

After breaking few sweats over few games of table tennis over lunch break, I rushed back to the clinic. As usual, the bulk of patients after lunch break usually aren’t many, usually in multiple small crowds, won’t even make an illegal gathering counts.

I sat down in my comfy chair, absorbing the lyrical ambience of low-volumed Jason Mrez’s wonderful vocal creations, waiting for my first patient to scroll in, err… I mean stroll in. Too much of computering is really getting me pretty confused, at times.

An elderly Indian auntie made small steps into the room. I welcomed her with a smile (yes, I guess sports-induced endorphin is a good thing), and showed her the seat.

She doesn’t look too happy to me. It is not like she is unhappy, nor ill or depressed, but her face seemed to show some sense of helplessness, with a hint of shyness. Yes, by right, elderly people should be indulging in any shyness, even in the slightest degree.

Gently and slowly, I flip opened the blue ‘gynaecological’ card on my table, which is slightly yellowish at the sides, probably being eaten up by its age.

conversation ensued...

- You’d been us since 1999, are you coming with a new problem. I hope we can help you.

- Not really, actually I removed all my uterus and ovaries and already stopped hormone replacement treatment years back and I am very comfortable

- Ok, and so today, you’re here… (I finally found the referral letter for today)

- My last mammogram done was 3 years back, when I stopped my follow up in HRT clinic. I would like to repeat one for screening. And I called many people, and asked the health clinic, and after few roundabouts, they referred me here since I was previously follow up here and can get mammogram appointment here.

- Huh? (Total disbelief) Oh, so actually you came today to get us to get the mammogram screening from my radiology colleague?

- Yes.

- Ok, don’t worry, let me sort out with my colleagues at health clinic, I don’t think O&G clinic on an Antenatal Clinic day should be for getting mammogram appointment. Somemore, so much time and effort being wasted.

I called the person of which the John Hancock was on the referral letter. She answered the phone, probably thinking at the receiving end, I was going into fit and start scolding her with lots of harsh words.

telephone dialogue...

- Hi, I’m xx from xx. You’re xx from xx

- Ya.

- I called regarding patient wanting to get mammogram screening and …

- Oh, I called the Radiology department, and they won’t give us the mammogram forms, so we can’t order it from health clinic. So they asked us to refer to O&G clinic to get it since she was previous from there.

- Err.. (Disbelief X infinity) even for health promotion, normal health clinic can’t order it?

- Yes, I will talk to my FMS (family medicine specialist) about this.

- Ok. Thanks for the wonderful info.

Health promotion, the frontline of prevention of diseases, definitely failed miserably in the Bolehland. Probably, we’ll need an 1malaysia clinic that can order the mammogram for screening.

Hopefully, it won’t take a million years for the health clinic seriously given enough power and jurisdiction in running health promotion.

I blinked in disbelief, mainly because the health clinic manned by doctors led by a specialist unable to do things right, will the 1malaysia clinic able to do it better only with health assistants?


Haris Abdul Rahman said...

So agree with your point about breast self-examination being ... pointless. By the time the lump is palpable, a mammogram would've picked it up a couple of years prior!

pilocarpine said...

a good point.
it wasn't my point, dr haris
it is the latest guidelines by the taskforce on breast CA screening