Tuesday, September 23, 2008

Obstinate Patient?

The other day I had a tough time with one of my patient.
She was 54 years of age.She was diagnosed Type 2 Diabetes 5 years ago. Her blood sugar was under fair control with a tablet taken in the morning before breakfast. But for the last 3 months it was high in the mid 300s. I wanted to increase the dosage of her medicine.I told her it will be better to take half a tablet before dinner also.
But her response surprised me.She refused to take medicine in the evening.
'Why'? I asked.
' I am taking an Ayurvedic herbal powder as medicine for Diabetes in the evening' I cant stop that.
I got irritated.May be I was in an irritable mood.
'You first decide on the system of medicine you want to follow.If you want to follow modern medicine you obey my instructions' I shouted.[ I never shouts but my voice was raised].
She was taken back by my raised voice.
'I have been taking that powder for last 3 years'. She pleaded.
'So what?' 'It is not reducing your Blood sugar.So better stop'. My voice was still raised.
She pleaded again but I held on to my tough stand.
Her eyes were red and tears appeared. I did not know what to do for some time.
Then I relented. 'You take your powder in the evening 2 hours before the tablet'.
'If both are taken in the evening will there be any interaction?" She was worried.
I said there wont be any problem. She was relieved and I was able to defuse a difficult situation.
May be I should have proposed that compromise formula earlier.I should not have raised my voice.Some days I may become too irritable.

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