The first line treament

Dragged myself through the first week of Family Medicine posting after the long, sweet 9 weeks holidays. Showed up with my somnolence most of the days, I admit I haven't discovered the fun of this posting yet. It was rather dull for me, till I was awaken slightly by Dr. S, for the last case presented on the last day of the week.

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Young Malay lady, a known case of hypertension who claimed to be compliant to medications. Her blood pressure measured on the spot shooting 170/100mmHg. She brought her youngest son aged 2-year-old with her who was noted to be fretful on her lap. And her husband was asking the consulting doctor to hurry as he needed to get back to work.

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Mind was set to think whether to increase the medication dosage or to monitor her blood pressure for a persistently high. Had totally ignored an important area till Dr. S identified it.

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She was shown with a non-smiling face with a few stressors which would probably be the reason contributing to her high blood pressure:

- She is busy as nasi lemak vendor cum house wife taking care, currently breast feeding her kid.

- Her husband works and back home late often, he was rushing her for work at that moment.

- A thought that she might be worrying about her husband getting another spouse.

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We didn't elicit further. It was a thought bringing out the word "holistic" again to me. Well being comprises of not only of physical aspect but also mental, social and spiritual. Many a times the first line prescription can be as simple as a word of encouragement, prayer or even a pat on the shoulder. How often has it been ignored due to carelessness or time constrained?

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Stress is what everyone has. It is too a common trigger of people falling sick. One may not able to lighten the stress level of another, but at least the word of encouragement keeps him/her going.