Covid19 has upended the lives of many and this woman, I am about to narrate was a sad case. She was an ex-banking professional, 50 plus, and unmarried. All of a sudden her mother passes away and she becomes lonely. She indeed has a sister who stays abroad and she is not in contact with her anymore due to her depression. For all practical reasons, she is a loner.
One bad day, she has a fall and takes treatment for the same. Being lonely, she falls into depression and discontinues taking medication as prescribed by another doctor. The pandemic arrives and fearing infection, she lives in her apartment 24 hours not going out anywhere. She had difficulty in passing urine and she was passing motion with no control. She was wearing a diaper to overcome that. She did employ a caretaker lady to clean her. Nonetheless the neighbors began complaining the stink emanating from her house. She has gotten to a stage of unable to move due to the injury in her leg. Meanwhile, the lockdown was being lifted in stages and unable to move forward, she decided to visit me.
When I saw her, she was with a diaper and was shabby in her outlook. She complained of non stop motion. She had bedsore and was extremely cachectic in her appearance as the complications inside her along with the depression have taken a toll. Her outlook clearly said that she needs emergency care and hence asked her to get admitted. First, I asked our nurse to completely clean her out. Then I proceeded with my preliminary physical examination. I could observe a mass in the abdomen and hence I asked for an immediate Ultrasound test and basic blood investigations. The report showed a bloated urinary bladder or what is called a distended urinary bladder in medical terms. A urinary bladder in normal course can hold up to 400 ml of urine but in her case it was holding nearly 2 litres of urine. It was pushing the gallbladder which was infected badly and was full of puss too. The blood report showed her urea creatinine level was alarming and her kidney was almost going to take a hit and was failing. Also she had extremely high blood sugar at 490+.
I proceeded to put a catheter to drain the urinary bladder. Almost 2 liters of puss and urine drained out of the bladder. Then I got a plain CT done and found that the gallbladder was infected very badly. She was wheeled to the surgical theatre and we got her gallbladder removed. Her wounds on the leg were tended to. She was still in her catheter and could not walk. She is being given medications and she shows slow improvements to her health. After her treatment, her skin gained back its lustrousness, eyes became sharp, and more importantly she gained her social etiquette back by striking lengthy conversations.
The perils of COVID19 are unending and offlate this was a sad case I came across. My message to people who are lonely and putting up in their home without moving out is simple. Get out, wear a mask and have a morning walk. Always maintain social distancing as adviced by the authorities and meet the world. The world is a beautiful place to live and we are a part of its beauty.
