24 year old man who is being managed for sickle cell anaemia at another hospital presented to my facility ( a Nigerian Government owned hospital) with generalises body weakness and tiredness. He also presented with multiple non healing ulcer.
This was from bone infections and skin infections from multiple injections.
The patient has also being abusing opoids based pain medication.
The doctors evaluated and finally made the following diagnoses
- Severe anemia ( low blood level)
- Sepsis
- Substance abuse.
The real issue is that the patient is very poor, with no family support. He actually left his family a month earlier .
Meanwhile, he has no health insurance.
And no form of scheme in place to manage him.
What do we do.?
The necessary emergency care was instituted.
The hospital management was informed.
Social welfare informed.
Fund was raised for treatment, he was fed and waiver raised..
He got much better within the next 48 hours
To everyone amazement, : The patient decide to leave the hospital against Doctors' advice.
He had to sign necessary documentation to that effect, which he did.
What could have gone wrong?
What influenced the decision?
Why would a patient on free treatment leave the hospital against Doctors' advice.?
The only reason we could find was:
He was not given opoids based pain reliever.
Other form of analgesia was given.
In the next series, i would be discussing Sickle cell disease in Nigeria
Cause, management, complication, prevention,