More Improvised Health Care And Medical Tips
By Kenneth Kee
()
About this ebook
This book describes More Medical Tips And Improvised Health Care, which is seen in some of my patients in my Family Clinic
I have been writing medical articles for my blog: http://kennethkee.blogspot.com (A Simple Guide to Medical Disorder) for the benefit of my patients since 2007.
My purpose in writing these simple guides was for the health education of my patients.
Health Education was also my dissertation for my Ph.D (Healthcare Administration).
This book is also about one of my favorite topic: Useful Medical tips from my e-books and improvisation of medical and health care.
Every doctor has their own favorite topics.
My topics today are those that have taught me new ways of treatment from my experiences in the hospital, private locum practice and my own family practice.
I have learned to modify my diagnosis and practice to be a more effective diagnostic and more communication and explanation about the patient’s illness allowing them to ask questions and to help in their own treatment.
I have modified many medicines for better treatment and found old methods such as the ethyl chloride spray and injection of surgical spirit to numb the nerve which are still effective today.
The uses of BPPV maneuvers are more effective than medicines in the treatment of benign paroxysmal positional vertigo.
I am never afraid to ask for advice from more experienced doctors such as orthopedic surgeons, eye surgeons or ear nose and throat specialist if necessary.
It is often important to ask for second opinions.
It is also important to keep on learning about new techniques or even ancient methods that may help to heal a patient.
This is because the patient’s health and recovery is more important than the ego or competency of the doctor.
Above all the care and recovery of a patient must be foremost in the mind of the doctor.
After all that is what the practice of medicine is about:
1. The Caring of the patient
2. The Recovery of the patient
3. The Good health of the patient
One of the fact of family doctor practice is that there are many things you can learn from the patients themselves and their feedback to the doctor.
So a doctor must never look down on his patients and take the view that only a doctor knows best.
TABLE OF CONTENT
Introduction
Chapter 1 The Milk Drip
Chapter 2 Vertigo
Chapter 3 Ethyl Chloride Spray
Chapter 4 Self Hypnosis
Chapter 5 Chronic Cough
Chapter 6 Malaria Patient
Chapter 7 Epistaxis
Chapter 8 Vomiting of Blood
Chapter 9 Malingering
Chapter 10 Improvised Health Care
Epilogue
Kenneth Kee
Medical doctor since 1972.Started Kee Clinic in 1974 at 15 Holland Dr #03-102, relocated to 36 Holland Dr #01-10 in 2009.Did my M.Sc (Health Management ) in 1991 and Ph.D (Healthcare Administration) in 1993.Dr Kenneth Kee is still working as a family doctor at the age of 74However he has reduced his consultation hours to 3 hours in the morning and 2 hours inthe afternoon.He first started writing free blogs on medical disorders seen in the clinic in 2007 on http://kennethkee.blogspot.com.His purpose in writing these simple guides was for the health education of his patients which is also his dissertation for his Ph.D (Healthcare Administration). He then wrote an autobiography account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.comThis autobiography account “A Family Doctor’s Tale” was combined with his early “A Simple Guide to Medical Disorders” into a new Wordpress Blog “A Family Doctor’s Tale” on http://ken-med.com.From which many free articles from the blog was taken and put together into 1000 eBooks.He apologized for typos and spelling mistakes in his earlier books.He will endeavor to improve the writing in futures.Some people have complained that the simple guides are too simple.For their information they are made simple in order to educate the patients.The later books go into more details of medical disorders.He has published 1000 eBooks on various subjects on health, 1 autobiography of his medical journey, another on the autobiography of a Cancer survivor, 2 children stories and one how to study for his nephew and grand-daughter.The purpose of these simple guides is to educate patient on health disorders and not meant as textbooks.He does not do any night duty since 2000 ever since Dr Tan had his second stroke.His clinic is now relocated to the Buona Vista Community Centre.The 2 units of his original clinic are being demolished to make way for a new Shopping Mall.He is now doing some blogging and internet surfing (bulletin boards since the 1980's) startingwith the Apple computer and going to PC.The entire PC is upgraded by himself from XT to the present Pentium duo core.The present Intel i7 CPU is out of reach at the moment because the CPU is still expensive.He is also into DIY changing his own toilet cistern and other electric appliance.His hunger for knowledge has not abated and he is a lifelong learner.The children have all grown up and there are 2 grandchildren who are even more technically advanced than the grandfather where mobile phones are concerned.This book is taken from some of the many articles in his blog (now with 740 posts) A Family Doctor’s Tale.Dr Kee is the author of:"A Family Doctor's Tale""Life Lessons Learned From The Study And Practice Of Medicine""Case Notes From A Family Doctor"
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Book preview
More Improvised Health Care And Medical Tips - Kenneth Kee
More
Improvised
Health
Care
And
Medical
Tips
By
Dr Kenneth Kee
M.B.,B.S. (Singapore)
Ph.D (Healthcare Administration)
Copyright Kenneth Kee 2019 Smashwords Edition
Published by Kenneth Kee at Smashwords.com
Dedication
This book is dedicated
To my wife Dorothy
And my children
Carolyn, Grace
And Kelvin
This book describes More Medical Tips And Improvised Health Care, which is seen in some of my patients in my Family Clinic.
(What You More Medical Tips And Improvised Health Care)
This eBook is licensed for your personal enjoyment only. This eBook may not be re-sold or given away to other people. If you would like to share this book with another person, please purchase an additional copy for each reader.
If you’re reading this book and did not purchase it, or it was not purchased for your use only, then please return to Smashwords.com and purchase your own copy.
Thank you for respecting the hard work of this author.
Introduction
I have been writing medical articles for my blog: http://kennethkee.blogspot.com (A Simple Guide to Medical Disorder) for the benefit of my patients since 2007.
My purpose in writing these simple guides was for the health education of my patients.
Health Education was also my dissertation for my Ph.D (Healthcare Administration).
I then wrote an autobiography account of my journey as a medical student to family doctor on my other blog: http://afamilydoctorstale.blogspot.com.
This autobiography account A Family Doctor’s Tale
was combined with my early A Simple Guide to Medical Disorders
into a new Wordpress Blog A Family Doctor’s Tale
on http://kenkee481.wordpress.com.
From which many free articles from the blog was taken and put together into 800 eBooks.
Some people have complained that the simple guides are too simple.
For their information they are made simple in order to educate the patients.
The later books go into more details of medical disorders.
The first chapter is always from my earlier blogs which unfortunately tends to have typos and spelling mistakes.
Since 2013, I have tried to improve my spelling and writing.
As I tried to bring the patient the latest information about a disorder or illness by reading the latest journals both online and offline, I find that I am learning more and improving on my own medical knowledge in diagnosis and treatment for my patients.
Just by writing all these simple guides I find that I have learned a lot from your reviews (good or bad), criticism and advice.
I am sorry for the repetitions in these simple guides as the second chapters onwards have new information as compared to my first chapter taken from my blog.
I also find repetition definitely help me and maybe some readers to remember the facts in the books more easily.
I apologize if these repetitions are irritating to some readers.
Chapter 1
The Milk Drip
(Chapter from my e-book Á Family Doctor’s Tale" about the treatment of acute gastritis in 1973.)
In the early 1970 one of the medical treatments of acute exacerbation or mild bleeding from gastric peptic ulcer (A Simple Guide to Gastritis) was the milk drip.
Our ward consultant was a gastroenterologist specializing in stomach, intestinal, liver and gallbladder (A Simple Guide to Gallbladder Diseases) problems.
Many of his patients who had a diagnosis of acute exacerbation of peptic ulcer were sent to the ward for a milk drip as treatment for the hyperacidity of the stomach.
Provided the patient is not lactulose intolerant (not able to tolerate the lactulose in cow’s milk), a nasogastric tube was inserted from the nose into the stomach of the affected patient.
Milk was allowed to flow continuously from a bottle hanging like a drip bottle into the stomach acting as an alkaline lotion to neutralize the acid in the stomach.
It was first introduced as a treatment in one of the British journal in 1950 and has since been a popular way of treating peptic ulcer in Singapore hospitals in the 1960-80.
I also incorporate a continuous use of antacid suspension every half hourly to my gastric or peptic ulcer patient in my present practice until their symptoms are relieved.
This seems to work better than giving medicines 3 or 4 times a day.
However medicines like cimetidine (H2 antagonists) and ranitidine which are first used from 1976 in United Kingdom and 1979 in USA became the drug of choice for treatment of gastric and duodenal ulcers.
This was followed by the proton pump inhibitors like omeprazole and nexium from 1986 onwards.
However the use of these strong acid reduction medications does not mean antacids are not necessary for the countering the acid in the stomach.
In addition a new cause of gastric ulcer was found to be a bacterium called helicobacter pylori.
So for some of these gastric patients an 6 week course of antibiotics have to be given together with H2 antagonist or proton pump inhibitor and antacid.
All too often many specialists just prefer to give the strongest medication like omeprazole or Nexium alone without the antacid and hope the gastric disease will be cured.
In fact the cause of gastric disease is multi-factorial including irregular meals, stress, hereditary and bacterial.
Unless the cause is also treated, the gastric problem will never go away.
In fact the milk drip has many advantages to the treatment of gastric ulcers.
A continuous flow of alkaline liquid, good bacteria (lactobacillus) which may counter the hylobacter pylori bacteria and rest in bed all help to cure the gastric problem.
The only problems are people with lactulose intolerance and the high cholesterol (A Simple Guide to Cholesterol) in the cream of the milk.
The present tendency for most gastroenterologist is to give the patient a dose of omeprazole and nexium once or twice a day and presume that the peptic ulcer will be cured.
Very often in spite of the expensive medicines given, the patient is not cured and has recurrences of their abdominal pain and bloating.
I on the other hand will take into consideration the patient’s habits especially during and after meal times.
I will advise them to:
1. Avoid eating too fast which cause gas to enter into their abdomen at a fast rate
2. Avoid eating gassy drinks or coffee, strong tea or vinegar or sour drinks
3. Avoid hard food such as nuts, hard rice or tough meats
4. Take more dairy products such as milk or yogurts, easily digestible foods such as cereals or porridges or soups
5. Walk for at least five minutes after eating a meal
Very often I will advise them to learn to relax through breathing exercises or meditation
Sometimes I give them librax which contain clinidium (an anticholinergic) to relieve abdominal cramps and Librium (a mild tranquillizer) to settle their tension in the abdomen as well as mental stress (a source of gastric acid production)
Most importantly I will ask them to a tablespoon of my antacid lotion (combined aluminium and magnesium mixture) that does not cause constipation or diarrhea every half hourly until they feel the discomfort in the abdomen is gone (continuously countering the acid like the milk drip.
The mixture also contain simethicone to reduce gas production ( a source of abdominal pain)
Gastrointestinal Diseases
Gastritis
The patient should always be advised to have a gastroscopy to exclude other causes of gastric pain such as gastric polyps and cancer.
One of my patients was very lucky to have a biopsy of his gastric ulcer during a gastroscopy and was found to have very early lymphoma.
He was treated immediately with chemotherapy and has no more recurrence of his lymphoma.
That was 20 years ago.
An ultrasound of the gallbladder and liver should also be done to exclude pain due to gallbladder trouble.
One of my patients was found to have gallstones and after the removal of her gallbladder did not have any more abdominal discomfort.
Gastritis can be hereditary as familial cases of gastritis do occur.
Sometimes it may be due to nervousness and tension which is also hereditary.
I have treated a housewife for gastric pain on and off for a few months before she finally recovered from her gastritis (confirmed by gastroscopy)
My treatment inevitably contains
1 .a mild tranquillizer for the stomach combined with an anticholinergic to reduce the acid
2. A H2 antagonist (cimetidine, famotidine or ranitidine) or Proton pump antagonist (omeprazole or nexium) to prevent the production of the gastric acid
3. Most importantly an antacid to counter the acid in the stomach.
The best way to take the antacid is to take the antacid like a milk drip (chew an antacid or take a tablespoon of antacid suspension every half hourly until the stomach pain or discomfort disappears).
4. Walking for half an hour after a meal
5. Taking small meals of food more frequently instead of 3 full meals a day
6. Re-organization of the life style so