One “F” of 5 Fs some keep as secret?

One “F” of 5 Fs some keep as secret?

  1. Faeces (constipation)
  2. Flatus (gastrointestinal)
  3. Fluid (ascites)
  4. Fat (obesity)
  5. Fetus (pregnancy)

Recently, in my clinic in KL, one Myanmar girl with 8 mts’ Pregnancy size denied any sex and when I told her that I could feel the head, extremities, FHS she refused to accept but req for UPT. When UPT was positive, she uttered “what that b…oy (Ho Kaung) had done on her while she was asleep”. She told me that she sometime allows one boy to sleep at the other side of the bed”.
Another Myanmar girl with about 5 mts’ Preg was also puzzled and admit at last that after going out for dinner with her supervisor and friends, they encourage her to drink liquor, and sent back home if she fell asleep. As she don’t know who was responsible, she wish to do abortion. I told her that we never do abortion and to do on 5 mth pregnancy is dangerous to do in any place and advised her to take the child. I never see both of them again.
Last 25 yrs ago, one Sunday, I was working in Ng & Lee Pudu (GP)Clinic, KL,
Malaysia. It was very busy and most of the Locum drs run away after working one day. Sometimes pts just came to buy medicines over the counter. The nurse at the dispensary came to me and asked to sign a purgative for abd pain pt. I told the nurse to inform the pt to check with any dr for the abd pain and to tell them not to take purgatives indiscriminately. As I refused to sell the purgative, mother of the pt requested to see the dr immediately as her daughter was in severe pain. They were called into the consultation room, the girl was only 15 yrs old and was in great pain with sweats on her forehead. The pt’s mother requested me to just sell the purgative again but I told them that I was not going to sell the purgative without checking her abdomen. That 15 yr old girl was wearing an oversized Jean Jacket and once I touched her abdomen, without removing her shirts, I found out that there was a huge mass up to the epigastrium. It look like a contracting gravid uterus but I was afraid to tell them immidiately. When
asked her whether she was suffering from something like a bering down sensation, she answered affermative. I saw some stains on her trousers. As the pt was still reluctantly sitting on the chair in the consultation room, I persuaded to just allow me check thoroughly. Pt looked like as if in labour, I requested to just allow me to look. When opened and even on inspection, mother was shocked to see the hairs of the crowning baby. Then suddenly the pain stopped and the girl run to the mother, hold mother’s knees and said, “sorry Mommy.” As there were 2 Maternity Clinics next door and on the opposit side of the road, they just walked off. In the next day newspaper, there was a report about the abandoned baby infront of University Hospital. I still remember that she was supposed to sit the Form3 gov exam next day, Monday.
Below is taken from Maung Maung Oo’s FB
ခံရပံုမ်ားေတာ့ နည္းကို မ်ိဳးစံုေနတာပဲ။
ဒီ၁၉ ႏွစ္ေကာင္မေလးက ေျခေထာက္ေယာင္တာ တစ္လတဲ့။ သူ႕အေမကေခၚလာတာ။
အန္ေသးလားဆိုေတာ့မအန္ဘူးတဲ့။ ေျခေထာက္ေတြကလည္း တင္းေျပာင္ေနတာပဲ။ Lymphedema ေတာင္ေျပာလို႕ရတယ္။ ႏွိပ္ယင္သိပ္မခ်ိဳင့္ေတာ့ဘူး။
အန္ေသးလား- ဟင့္အင္းတဲ့။
ရာသီေပၚတာမွန္လား – အင္းတဲ့။ ခက္ၿပီ။
ဗိုက္စမ္းၾကည့္ေတာ့လည္း ကေလးေခါင္းေတာင္စိုက္ေနၿပီထင္တာပဲ။
ဒါနဲ႕ ဆီးသြားစစ္ကြာဆိုေတာ့. ခဏေနေတာ့ ျပန္လာတယ္။ ဆီးအေျဖက ယူစီဂ်ီ နက္ဂတစ္။ ကိုယ္၀န္မရွိဘူးဆိုပဲ။
ခက္ျပီ။ ကိုယ္စမ္းမိတာကလည္း ကေလးလို႕ ထင္တာ။
ဆီးကေကာ ေကာင္မေလးကေကာ.. ကိုယ္၀န္မဟုတ္ဘူးတဲ့။ ဆီးထဲလည္း အသားဓါတ္မပါဘူးတဲ့။
ဒါနဲ႕ ကိုယ့္ေရာဂါေတာ့ ဟုတ္ေတာ့…ဘူး။ သူမ်ားလဲႊမွ။ ဒါေပသိ ဘယ္သူ႕ လဲႊမွာတုန္း။ ခဲြစိတ္လား
အိုဂ်ီလား။
လူနာအေျခအေနက ရုတ္သိပ္မပ်က္ဘူး။ မ်ိဳးဥက လာတဲ့ အက်ိတ္ႀကီးပဲ ျဖစ္မွာပဲ ဆိုၿပီး အိုဂ်ီလဲႊေပးလိုက္တာ။အိုဂ်ီမမက ၾကည့္ၿပီးေတာ့ ကိုယ့္ကို မဆဲတာ ကံေကာင္း။ေမြးဖို႕ ၂ ပါတ္ေလာက္လိုေတာ့တယ္ ထင္တာပဲတဲ့…။

ဒါနဲ႕ ဆီးစစ္ေပးတဲ့ ကေလးမေတြကို မာန္ရတယ္။ နင္တို႕ အခ်ိန္မေစ့ေသးပဲ ဖတ္လို႕ ဆီးအေျဖမွားရတယ္ေပါ့ေလ..
ကေလးမေလးေတြက အမွိဳက္ပံုးထဲက ျပန္ေမႊၿပီး ကိုယ့္ကို လာျပတယ္။ တစ္ေၾကာင္းတဲ ေပၚေနတာ။
ဒီေတာ့မွ ေကာင္မေလးက ေရေတြထည့္ေပးသြားလားမသိဘူးတ​ဲ့။ အိမ္သာထဲမွာ အၾကာၾကီးတဲ့။ ထြက္လာေတာ့ ဆီးေတြက ၾကည္လြန္းလွခ်ည္လားလို႕ေတာင​္ ေမးမိေသးတဲ့။ အခုေလးတင္ ေပါက္ထားတာမို႕ ၾကည္ေနတာပါတဲ့။ ဒါေၾကာင့္ၾကာတာတဲ့။
 တစ္ခါက ေဆးဆိုင္ပိုင္ရွင္က အလုပ္သမားေကာင္မေလးကို ေခၚလာျပတယ္။ ေျခေထာက္ေတြ ေယာင္ေနလို႕တဲ့။ ကိုယ္လည္း စမ္းၾကည့္တာေပါ့။
ေက်ာက္ကပ္အသည္း ႏွလံုး အကုန္ေကာင္း။ ဧကႏၱ Nephrotic Syndrome ႀကီးပဲ ဆိုၿပီး
Investigations ေတြ လုပ္လိုက္တာ၊ Ultrasound ထဲက်မွ 24 week pregnancy တဲ့။

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