Wednesday, November 20, 2013

I am 35, Started Rajnigandha 3 years back

I am 35, Started Rajnigandha 3 years back!

I saw Kiran in my clinic today. She had come with the following complaint - some unusual sensation in the throat, a feeling of something compressing in the chest, occasional tremors. Before coming to me she already had consulted number of Doctors at MAX and Apollo– ENT specialists, Physicians, Gastroenterologists-investigated thoroughly and had tried number of drugs but without relief for the last 6 months. People around her and herself started suspecting cancer. She was referred to me by a good friend of mine.

Kiran (name changed) is 35 years old educated lady. Married for 7 years  to a well to do self employed husband. Father in law a well established CA but now retired.  Kiran is mother of 4 year old son, got after 2 miscarriages.

I listened to her, examined her. I noticed hypertrophied papillae in oropharynx and base of tongue, small area of submucousal fibrosis in the retromolar area of oral cavity. She already was thoroughly investigated. My first instinct was to tell her to go home. I looked at her again, she had an anxious look, hair was not done properly, and she was in her bathroom slippers. I was thinking. She has come alone.  

I thought there is something missing in her presentation. I poked a little more. Is there anything that she wants me to know. With reluctance she said “I am taking Rajnigandha for the last 3 years”.

 Oh, I thought, so this is it. Now I could have given a shortest prescription – STOP RAJNIGANDHA and asked her to go. But was that enough!.

This was an unusual presentation  - an educated well to do lady, mother of a precious child taking  tobacco, started when the child was 1 year old!

I asked her “is everything fine at home”. She broke down.

For the next, one hour Kiran narrated her story. In short, Kiran felt isolated at home by everyone including her son. Son is pampered by in laws,  he gets everything he wants. When it comes to fulfilling any demands the son will go to dadaji and dadiji. If she objects, her objections are overruled.  Husband is totally silent to her complaints. But when the son has any health problems she has to run around.

So, now, is her symptoms related to Rajnigandha. Will my simple prescription of “STOP Tobacco” and some medicines help her relieve her symptom! Will she be able to quit her tobacco if I just gave her Nicorette (nicotine replacement therapy) or Champix, nag her for starting Rajnigandha, scold her.

I spoke to her, counselled her and hope to see her back after 15 days as a changed person. I hope my counselling will work and she would no more require Rajnigandha(tobacco)!!

All the three factors – physical, psychological and social have to be taken care to win over tobacco habit. 

Dr Pawan Gupta.

1 comment:


Message giving interaction. Too motivating.

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