Wednesday, March 28, 2012


   I have seen ( in news or on TV ) many different ways of the ' proposal  '  for the marriage . But the one that I am going to tell you is most 'unusual ' and ;unexpected ' .
    When I was consulted on this 78 tears old lady , I had not expected the problems that were to come in future. I saw her in the PCU , the Progressive Care Unit. She was admitted by her doctor , when she failed out patient treatment of the respiratory infection . I saw her and she did not look bad. She had some fever up to 101.5 and was minimally short of breath. Her oxygen saturation was OK. On examination she had some crackles on both sides on the back side. So I was shocked to see her x-ray. The x-ray showed extensive pneumonia. I was not all happy with the findings , as this was indication for the disaster  to occur in the future . I ordered several tests to find the cause of the pneumonia and ordered to transfer to Intensive Care Unit. I was worried that she would get worse and will need to be on respirator.
    And it did happen.  As I expected her condition  worsened.and she was intubated. I had to increase oxygen to 100%. I had started her on antibiotics,and continue to watch blood oxygen . I consulted an Infectious Disease specialist.After talking to him I did bronchoscopy and obtained samples for the cultures  In spite of the treatment ,  3 dayes went by and no improvement had occurred.I was talking to the family several times She had daughter in Chicago and her friend who had the power of medical decision .He was quite aware of the critical condition I was not sure if she was going to survive. In spite of all the work up we had no answer as to the cause of pneumonia and in spite of all the treatment and antibiotics,  she  was not any better.
    I discussed the condition with the friend and with the ID consultant and decided to start her on large dose of steroids , I had told the POA , the friend that if this does not work up  did not have any other idea. That afternoon when I went to Intensive Care Unit I saw all the nurses in the patient's room . I thought that something must have gone wrong So I went to the room and I saw the the friend kneeling down , holding the patient's hand , The nurse had stopped the sedation , so the patient was awake. THE FRIEND WAS PROPOSING  THE  PATIENT. AND SHE HAD ACCEPTED IT !!!!
     I was not sure as to what to make out of it. But to make long story short, the steroid worked and she improved in next 3 dayes and was taken off the respirator. She did go home in a week.( I Still believe it was the steroids and not the marriage proposal).

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