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Close Encounters Of The Alternative Medicine Kind – I May 11, 2006

Posted by scan man in Life in India, Medicine.
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This is the first of two stories based on two incidents that occurred last week.

I am not a fan of any of the systems of Alternative Medicine. My limited experience of the world of medical blogging tells me that I am not alone. For those of you who are familiar with what 'real doctors' write about Alternative Medicine and its practitioners / quactitioners, this is a different kind of story…

..that started with a referral for a Brain CT scan by a Siddha Medical Practitioner from a nearby small town.

The patient was sent to me with a letter which said:

To The Radiologist, Big Town Hospital.

Dear Doctor,

Please do a CT scan of the Brain for Mr. P, a 60-year-old man who is semiconscious and has left-sided hemiplegia. Please admit him in your hospital and do the needful.

signed Dr. Sidha Practioner, B.S.M.S., Small Town.

I was intrigued.

It is not unusual to come across referrals for 'western / allopathic' tests from practitioners of the many alternative medical systems that the Indian Government recognizes (Ayurveda, Siddha, Yoga, Unani, Homeopathy & Naturopathy).

As a Radiologist, I have come across several referrals by these practitioners for various imaging studies. The majority of such referrals have been for questionable indications and for inappropriate imaging studies. In most of those instances, an allopathic practitioner could have come to a reasonable diagnosis based on history, clinical exam and some lab tests.

This referral sounded almost like what I would get from one of my allopathic colleagues. My curiosity was aroused to the extent that I did something that I rarely do for a CT Brain referral. I got out of my comfortable chair and went over to see the patient.

The patient, lying on a stretcher, had a large bandage swathed around his head covering the right side of his face and jaw. He was not arousable. His ABCs were ok. His blood pressure was normal. I could not get any relevant history from the worried-looking rustic old lady who was with him. I assumed it was his wife. After a cursory examination – the only kind that I know – I concluded that he did have a left-sided hemiplegia. I told my nurse and techs to get him into the CT room and went back to my office.

I was worried about the bandage. Was there a history of injury?

I needed more information. So I pulled out the referral letter, checked the number and called Dr. Sidhha Practitioner. I introduced myself, thanked him for the referral and asked him for clinical details. This was his story…

Mr. P had come to see him about a few days ago with a painful swelling on the right side of his jaw. Dr. SP thought it could be a Parotid abscess. Knowing that he would not be able to do anything for it through Siddha, he referred Mr. P to the local Government Hospital. The surgeon there had done an I & D, prescribed some antibiotics and sent him home. His wife and some neighbours brought Mr.P back to Dr. SP today, saying that he had not been arousable in the morning. After examining him, Dr. SP concluded that Mr. P had a stroke, so he referred him to our hospital which he knew had a CT scan and a Neurology Department.

By this time the techs had completed the scan. It showed an acute infarct in the Right Middle Cerebral artery territory. The scan also showed signs of facial cellulitis on the right side and small air pockets in the right Parotid, consistent with a recently drained abscess.

I alerted the Neurologist and sent the patient to the Emergency Department. I saw him again two days later when he was sent for a repeat CT. The infarct had not progressed and his facial cellulitis was subsiding.

In the course of a few days, Dr. SP had correctly identified two different medical conditions in Mr. P, had recognized the need for proper care and had sent him to the appropriate places.

This is one Practitioner that I will not forget. May his tribe increase!

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Comments»

1. It's me, T.J. - May 12, 2006

We sometimes cringe when we get referrals too.

Good job to you both.

later…

2. Moof - May 13, 2006

I’m impressed … something which seldom happens when I think of alternative practitioners.

Now … I do hope that he doesn’t press his luck! ;o)

My bad …

3. Kelly - May 16, 2006

I’ve worked for an alternative practitioner who referred to allopathic medicine frequently (he had a sizeable practice), and I dare say, from what I’ve seen in the field, it happens a lot more than physicians would like to admit.

Don’t dismiss them completely–some really do know their stuff. And know you know yours!

Enjoyed this post from GR 🙂

4. OrthoDoc - May 18, 2006

I think intelligent people exist everywhere …and we need to give them the credit when they deserve it.

I have heard a lot about such incidents but have never experienced one of this sort before.


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