In loving memory of Cik Ani

Received a call just now. My sister said that our neighbor, Cik Ani has passed away.
Cik Ani was a pleasant lady. She was very closed to us especially to Yaya, my sister's daughter.
A week earlier Cik Ani had undergone operation at Kuala Lumpur Hospital. She underwent hysterectomy (removal of her uterus) because of fibroid.
The surgery was successful and there was no major complications. She was discharged well after 3 days of hospitalisation.
At home, she complained of swelling over both legs. The next day, she has difficulty in breathing and died.

When i heard that story, it's just deja vu. I've encountered similar story before.
Two years ago, 1 patient was admitted because of intestinal obstruction. She underwent surgery and there was a tumour over her large bowel. The surgery was successful and her post operative recovery was good. She was discharged well after a week of hospitalization and she was transferred to Kota Kinabalu for further treatment. A week after that, we received a shocking news that she has passed away.

About 2 months ago, 1 lady was admitted with 30% second degree burn. She was stable and the wound was dressed accordingly. Her recovery was good and her wound was healing. The only problem with her was she has low motivation..She hardly move around. It was the first day of Syawal and she just went to the toilet. Following that, she fainted and stopped breathing. She developed cardiopulmonary arrest and died. It was sudden and the family members do not accept the news that she has died.

Back to Cik Ani..my mom asked what has went wrong. Cik Ani was okay after the surgery..then suddenly she died at home..

The only possible diagnosis i can think off is Pulmonary Embolism.
Pulmonary Embolism is a serious medical condition.

A pulmonary embolism or PE, is a sudden blockage in a lung artery. The blockage usually is due to a blood clot that traveled to the lung from a vein in the leg.A clot that forms in one part of the body and travels in the bloodstream to another part of the body is called an embolus.

PE is a serious condition that can cause:

• Permanent damage to part of the lung from lack of blood flow to lung tissue
• Low oxygen levels in the blood
• Damage to other organs in the body from not getting enough oxygen.

If a blood clot is large, or if there are many clots, PE can cause death.

PE usually occurs after patient had undergone major surgery or prolong bed ridden. Other risk factors include:

• Some diseases, such as cancer, heart failure, stroke, or a severe infection.
• Pregnancy and childbirth.
• Taking birth control pills or hormone therapy.
• Smoking.

Thats why after surgery, we asked patient to mobilize as soon as possible. We always got angry and to start to scold patients if they didn't move around.
Before any surgery, we always make sure that patient do not have the risk factors of getting PE.
If they smokes..we asked them to stop smoking immediately. If they took oral contraceptive pills, they should withhold taking the pills.
If patients have the risk factors, then we will give them medication ie heparin to prevent PE. Heparin will make the blood thinner and prevent clot formation.

(Nota kaki: DrBond teringatkan Cik Ani masa DrBond balik KL bulan Mac tahun lepas. Masa tu DrBond ada bawa balik udang harimau dari Sandakan. Seronoknya Cik Ani masa tu merasa udang dari Sabah. Seronok sangat. Sekarang hanya tinggal memori. Semoga Allah mencucuri rahmat Cik Ani dan tempatkan arwah dikalangan orang-orang beriman. Amin).