Platelets!

So im working in neurosurgery right now (sounds way cooler than it is, yeh) and during the on calls, we get to cover a massive amount of “potential” patients..

I use the word “potential” because we basically cover all of Kuwait on our on calls.  Any neurosurgical case that is required to be seen in any hospital in Kuwait needs to be seen by that poor old neurosurgeon who happens to be on call on that day.  Even if one patient is in Amiri and the other is in Ahmadi (it HAS happened).

Thats a long distance, especially back and forth.

So ill take a specific example of a real scenario that happened the other day when I was on call.  There is so much WRONG that ill just tell you the story and leave you to decide on where to start when it comes to fixing these issues.

I was at the chalet with my buddies, (thats a lot more south than the “ahmadi” arrow.  Somewhere near the bottom of the map) and got a call to see a young girl in Amiri hospital who had bled into her brain.  She had what we call in medicine “thrombocytopenia” or, a low platelet count.  The normal range for platelets in the body is somewhere between 130 – 450.  This girl was on 16, thats VERY low.

Since platelets help the body STOP bleeding, having a very low count means if the body were to start bleeding, there wouldnt be much to stop that.  This girl bled into her brain and was beginning to lose consciousness.

We decided to order platelets from the blood bank to raise her platelets to just above the “safe zone” of 60.  Safe, as in, a surgeon would operate on this lady now, not while the number was below 60.  In the meantime, we got a call from Ahmadi ICU (see map above) to see a lady with the following wrong with her

 

This is and elderly lady, 70 odd years old.. and what you see is what we call a CT of her brain (or a CAT scan as they say in ER).  The white stuff on the right of the photo (the left of her head) is blood.   Thats a whole lot of blood.  So we popped her skull open, and the black stuff in her head is that blood all gelly and mushy, so we cleared that into the blue bowl and closed her up.

Sounds straight forward.  The things i found shocking were the following:

  • Shes 70 odd
  • Shes got maybe 10 other diseases, which mean 10 reasons NOT to perform this surgery
  • She received medication that “made her blood thin as water” which is a NO NO to surgeons.  They WANT blood to clot, they dont want their patient bleeding all over the place.

We requested those platelets I mentioned above and .. the central bank has “none”.  A straightforward, blank “no”.  Turns out they supply all the hospitals with platelets first thing in the morning, and anyone who requires them later on in the day (like we did) should wait or.. I dont know.

Thats exactly what happened to us, we had no platelets, she had a huge reason to die from and 10 other reasons not help her as well as the fact her blood was as thin as water.

What do we do?

We took a risk, and performed the surgery, she was recovering but the chances of her re-bleeding into her head are huge.

Its frustrating.  This is someones mum.

One Comment

  1. Bashar September 17, 2017 at 1:39 am #

    It feels so weird to see that head open and think that it also happened to me

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