BARIRA

Internal Medicine PGY3

[BARIRA @bar__kha]

@SamirMandhane1 @CMOMaharashtra @mieknathshinde @Dev_Fadnavis @Devendra_Office @TOI_Nagpur @nagpurtoday1 @FAIMA_INDIA_ @abpasmitatv @aajtak @aajtakradio @mataonline @INCMaharashtra @maha_governor @NMC_IND @PMOIndia @narendramodi @AmitShah @nitin_gadkari ...

[Gajanan Wattamwar @nayan26Wa]

Residents of NKP salve medical college Nagpur are on indefinite strike regarding the no equivalent stipend as per the government norms!
@NMC_IND @Dev_Fadnavis @nitin_gadkari @IMAIndiaOrg @lokmat @NagpurPolice @ngpnmc @IndiaToday @indiatvnews @ZeeNews @MoHFW_INDIA

[BARIRA @bar__kha]

My JR1 asked me in a meek voice 'Aap gussa ho?' and I don't know why but it melt my heart into a puddle.
Gonna protect that kid from now on 🥺#S1 #MedTwitter

[BARIRA @bar__kha]

It's PGY3 NOWWW!

[BARIRA @bar__kha]

Coming back here only to update my bio .

[BARIRA @bar__kha]

@VishalDayama So yeah I m not alone in feeling this way then .

[BARIRA @bar__kha]

Am I becoming a coffee person ?
I used to drink coffee only social but now i have started drinking it alone too .
Do alcoholics feel this way too when they transition from being social drinkers to daily drinkers ?
Is this what start of an addiction feels like ?
#coffeevstea

[BARIRA @bar__kha]

@memer_g Supradyn toh khud chalu kardiya hai , lagta hai ab yeh bhi karna padega .

[BARIRA @bar__kha]

I m a zillennial , meaning i tell people that they and their choices are mid to their faces but thaakan mujhe ab haddiyon mein mehsoos hori hai .

[BARIRA @bar__kha]

@gulshandevaiah Best one

[TheLiverDoc™ @theliverdoc]

The 4th Laddu.

These 3 laddus were given to me by the wife of my patient on his birthday, a few weeks before.

She was now happy and the family was doing good for themselves.

My patient Paul, suffered from alcohol use disorder. He had been drinking for more than 15y. Three months back, he developed severe alcohol-related hepatitis. Jaundiced, with abdominal fluid, blood infection and disoriented, he was transferred to our Unit for expert management & liver transplant.

Liver transplant was not an option from the outset. Paul owned a small provisions and bakery shop, had two girls, aged 5y and 9y and his wife worked part time errands, but quit after the girls were born. They did not have enough money to evaluate Paul for the transplant.

So we put him on antibiotics, cleared the infection and put him on a salvage stool transplant to increase his life. You can read more on it here: https://t.co/kAWFmEJJZ7

He responded to it. Alcohol-related hepatitis resolved and he went back to being a stable cirrhosis patient. We put him on a psychiatry program to prevent relapse. He did well. For 3 months. Then stopped coming to my OPD and started drinking again. Initially 300ml/d and then almost a liter/d.

Paul's cousins dragged him to my outpatient department one day and I got to know his relapse was bad. He had stopped meds and was back with his "good friends." He paid for everyone's drinks. I spoke to Paul and told him that it was a disease, he needed help, his friends were not real and his daughters needed a father. He cried a lot and told me alcohol was more an attractive option than anything else. He agreed for deaddiction again and went back in the protocol and also went back to drinking.

Hospital visits and medicines and expenses for buying alcohol for himself and friends were getting a big deal. One day his wife comes in alone and tells me not to get him better again. He gets better, he goes back to drinking and we lose a lot of money. Let him remain little sick, so that we will somehow earn enough from the store to get through. He will be home and I can work at the shop and provide for all.

After a couple months, after a severe binge, he developed severe alcohol-related hepatitis again. This time, it was worse. His kidneys were injured. The family denied admission. They had no money to spare. It would have to come from the daughters education, the mother had kept aside. They lived very far. Almost 400km from where I worked.

For the next 2 weeks, I regularly prescribed medicines, made suggestions to reduce symptoms and comforted the family over phone, while Paul was treated at home. A good physician nearby their home would administer antibiotics and fluids to Paul as he got sicker.

Paul died at home on the 18th day after I diagnosed him with recurrent alcohol-related hepatitis.

Three months after his death, his wife came all the way to visit me, on Paul's birthday, to give me sweets. Three Laddus. One from her and two from the daughters. Because I never stigmatized her or Paul. I did not make her look like a failure. I never blamed her or Paul for his disease. I never shouted at Paul for his behaviour. They were free now. The girls went to school and the wife was now running the shop well.

But all I could think about, was that fourth Laddu. The one I never received from Paul, because he died. A woman lost her husband, two bright young children lost their father. All three lives broken and a void that can never be filled.

I never advise anyone to even consume alcohol occasionally even if they are in the pink of their health. I don't advise alcohol in moderation. I don't, because I have post traumatic stress disorder from seeing families get shattered into a million little pieces due to alcohol.

[यमराज @autopsy_surgeon]

Idk who needs to hear this, but you cannot complete your MBBS without being either insane, narcissistic, nihilistic, or having a God complex.

[BARIRA @bar__kha]

@notjustdentist Hyderabad

[BARIRA @bar__kha]

@SynapseDot Not just MRI , they recommend a full body MRI 😝 #scam

[Official PeeingHuman @thepeeinghuman]

Bas neeche mat utarna please

[BARIRA @bar__kha]

@BlankoJay It was a woman

[BARIRA @bar__kha]

A first year resident thought i was another first year resident , should i be offended or take that as a compliment ? #MedTwitter #residency

[BARIRA @bar__kha]

@VenkateshGurug1 Yup , become a pastry chef and open a dessert boutique .

[BARIRA @bar__kha]

Got my hair and make up done for a wedding function from a salon and now it's safe to say that I have a life time supply of hairpins 😌

[BARIRA @bar__kha]

@autopsy_surgeon Kyuki araam ki zindagi chahiye thi 😝