this afternoon clinical session, i called my patient for community and family case study (CFCS) to come up to clinic.
he is a 13 year old boy. he's been diagnosed to have complete cyanotic heart disease since 3 months old. his parents defaulted treatment for his worsening heart condition due to financial problem. his father is a lorry driver while his mother sells food at a small stall. he always absent from school because of his condition. he could not play with his friends because he easily get tired and breathless. he didn't perform well in UPSR. currently, he is on folate, fumarate and multivitamin. not on antiheart failure drugs. and yes, the heart is worsening day by day. i take him and his family as my foster family for CFCS so all the family members will receive free health and dental treatment from HUSM.
this afternoon, i checked his mouth and teeth condition. generally, he looks small for his age. people might think that he is a 6 year old boy rather than 13. the skin is blue due to low oxygen level in his blood. when i asked his mother about his diet, he only eats rice with prawn in a very little amount. he doesn't brush his teeth so you can imagine his dental condition. multiple caries lesion with root stumps (teeth with no crowns, only root left) and the enamels (the hardest and outermost part of a tooth) are all hypoplastic (less mineralized due to low fluoride content in enamel structure and frequent acid attack). i was stunned when i looked into his mouth. kesiannya....
i presented the case to our supervisor. definitive treatment is to remove all teeth under general anaesthesia in operation theatre. i might have to issue denture for him. he has to be referred to the specialist becaus it is high risk case.
the doctor told his mother, "biasanya orang macam ni memang tak hidup lama. dah ramai patients saya meninggal umur 11-12 tahun sebab masalah jantung." berderau darah aku dengar doctor cakap camtu.
dia memang tak nak gosok gigi. nak ajar gosok gigi pun tak nak. habis equipment kat dental chair tu dia buat main. kesian tengok dia. adik dia yang umur 8 tahun tu lagi besar dari dia. masalahnya, parents dia macam tak kisah sangat. tu yang buat aku makin sedih.
normal heart
this patient has only one ventricle, with complete closure of the valves
3 comments:
very kind of u to adopt that needy family..
and u really wanna cabut all of the kid's teeth and replace wif fakes ones?...is there such procedure?
cian tgk ppl wif heart probs..
aku yg asthmatic ni pun tak tahan kalu tak dapat bnafas..
ini kan budak yg masalah jantung...
hrmm
=)
nazeef: yes, that's the only solution to his problem. the pedodontist (pediatric dentist) will remove all his teeth under general anaesthesia. maybe next year i will make him a denture
fahim: :)
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