Thursday, April 12, 2007

Why wanna lie?

I read from Eve's post regarding a patient with vaginal candidiasis who denies any sexual contact earlier on (citing her religion doesn’t approve of premarital sex). On and off, we will get patients who are reluctant to reveal or hide their sexual histories. What's the point if she comes to clinic or hospital hoping the appropriate treatment given while withholding the truth? We are not the kay poh or busybody medical practitioners who enjoy digging into patient's personal details for no apparent reasons nor judge their behaviour. We will only ask relevant questions according to the clinical presentations which will aid in the diagnosis. STD is never idiopathic, and so is pregnancy. (Idiopathic means occur spontaneously or without any known cause).

This reminds me of a case I saw in the past. A 18-year-old girl presented with history of painless vaginal bleeding and she denied any history of sexual intercourse. Ultrasound was performed and the finding was suspicious, although not the classical findings. Since we can't take the patient's word 100%, so urine pregnancy test was performed and the hCG hormone level was sky high !! Not only she was pregnant, not with normal pregnancy but with the dreadful Molar Pregnancy (or Hydatidiform Mole) !!

She was admitted to hospital and despite that, she still insist she is a virgin. My goodness... If she never had sex, how the heck she will become pregnant? At last she finally admitted, but that doesn't really matter anymore. (There is only one exception which occured 2000 years ago - whereby the Virgin Mary is conceived by the Holy Spirit). Suction & Curettage was performed subsequently without any complications. Luckily she didn't suffer from Invasive or Metastatic Moles or Choriocarcinoma.

42 comments:

may said...

errrr... she had artificial insemination using a huge syringe? LOL!! ok, bad joke. some people just are too embarrassed to admit their past, even though all evidence say otherwise. what to do... laidet loh.

angel said...

they malu... and bodo...
*cabut first*

Kenny Ng said...

Virgin but get pregnant? OMG... apa dunia ni?

Redsponge said...

wak...interesting!

too young to understand the value of health.

*pok*

like ur post!

Will said...

all kinds of people out there...

dare to do don't dare to admit it... hahaha

King's wife said...

loktor, apa itu Molar Pregnancy ah?
*googles*

slurp! said...

humans are complicated. perhaps the psychiatrist should get involved here?

Chen said...

may,
trying hard to imagine the amount of semen to be injected with the "huge" syringe :P

angel,
apa pasal cabut woh?
nak cabut pergi mana ni? :P

kenny,
Might be she thought we are a bunch of "stewpig" ppl who will believe what she said?

red sponge,
and too ignorant too !!

keeke...
luckily u wanna *pok* me instead of *bok*, else i will run away liao

Thanks ;)

Simple American said...

I'm a virgin. Ask my kids. They will corroborate my lie, uh, story.

Wennnn said...

This ppl hor they wan to enjoy and then hor after sumthin wrong they dun wan 2 admit... aiyahhh wat kind of world la..

Chen said...

will,
yeah, ini dunia semua pun ada :)

dun dare to admit it in normal circumstances is still acceptable lah, but definitely not when they are in the clinic or hospital seeking for treatment :)

KW,
Google will give u several links about Molar Pregnancy :) Guess u have find the answer to your query liao... In Molar pregnancy, there is no foetus or baby formation. Instead it is replaced with the hyperplastic trophoblastic tissue. The gross anatomical appearance is like a bunch of white grapes.

Chen said...

slurp,
She was just in denial mode earlier on, but towards the end, she told the truth.. :)

SA,
A virgin with 2 pretty & handsome kids? ;)
hehhehe...
I really wanna know how your kids corroborate your "white" lie :P
*giggle*

Wennnn,
These people never thought of the consequences... Luckily the Molar Pregnancy was diagnosed early, else she might suffered from the complications.

_butt said...

umm.. how bad was this molar pregnancy? me duno anything, need to be enlightened XD

btw, come on lah, how can one say they're virgin and confirmed pregnant at the same time? aiyoyo *shakes head*

nyonyapenang said...

came across a few cases of 'denials' too, eg. saying got herpes becos of stress.

Chen said...

butt,
I have given a brief info about wat is Molar Pregnancy to KW. For further detail, u can click here.

Complications that might arise during Molar Pregnancy are such as hypertension & thyrotoxicosis (raised in thyroid hormone level. Molar pregnancy should be evacuated as soon as possible by Suction & Curettage. There's risk of excessive bleeding during the S&C procedure.

In a small percentage of individuals, it might turn malignant and become cancerous.

nyonya,
Hehehe, there are different types of herpex infection, eg herpes zoster (shingles), herpes labialis (cold sores), genital herpes etc.

There are 2 types of Herpes Simplex Virus (HSV) namely HSV1 & HSV2. HSV2 is transmitted sexually whereby HSV1 is transmitted primarily by contact with infected saliva.

Abuthen, emotional stress can trigger & aggravate the outbreak of Herpes, especially herpes zoster & herpes labialis. (I'm not talking about the genital herpes) :)

L B said...

Sounds like my molar teeth..... maybe had too much siew pai kuat? Who knows....

I am denying everything, as usual.. Wasn't me..

kyh said...

they malu la... this is so typical malaysian mentality!

may i ask, is the girl a malay? cos normally they wudnt admit wan, cos u know la, their religious laws so strict.

but hor, aint it bodoh not to admit when the girl oredy knew that she's diagnosed to be pregnant?

Chen said...

LB,
LOL
molar teeth pulak :P
chicken & duck talk liao?
Kkkkkkkk..

Wah, since when LB becomes a denier?
wasn't u woh..
but of course it's wasn't u also who did it..
Kkkkkk...
really wasn't u :P

pssss.. still haven't do your tag yet, I will do it this weekend :P

kyh,
But not every malaysians is like that, especially in this modern society.

Nope, the gal i'm talking about is a chinese teenager.

Pink Cotton said...

WAHHHH doctor doctor very interesting story!

but i hv a few quesitons ho...

1.wat is vaginal candidiasis
2.wat is hCG hormone level
3.wat is Molar Pregnancy how come mole punya 'x'

ok thats all..pls answer in not less than 100 words...

WAHAHAHHA

*skippety skip skip*

papercrazy said...

they lied cos they siaw lee lor...they scared lokter might report to police if they underaged then papa will bring a gun to the boy's house and threaten the boy's parents for ridiculous dowry and mama will not stop crying and crying at home lor

Excuse like dat pakai kah?

Monk[+]Icon said...

infact i do receive such similiar case for our insurance claims...when these young girls have problems and still not admitting...so we still advice them "pay & claim" ...hahaha

day-dreamer said...

Well, I used to think that premarital sex among teenagers is what we read and hear about only. But I was shocked to hear some of my friends' stories about how they went home and back into their own room to catch their room mates making out with their boy/girlfriend.

Yikes...!

Anyway, my impression towards the girl in your story is... does she not study Science?? The level as low as Form 3 will tell you that when a boy haves (unsafe) sex with a girl and when his sperm meets her ovum, the girl will get pregnant. Come on la...!

eastcoastlife said...

Doctor,
It's possible for a virgin to get pregnant nowadays, right?

Artificial insemination first... then birth by Caesarian. Hymen intact wat.

eve said...

Sometimes i feel sorry for them , I know they are cornered and scared..But sometimes some pts really take us for granted and think we are stupid.

mistipurple said...

thank you loctor for educating us with all your 'layman explanations' medical posts all these time. you're a sweet doctor as well as a good hearted kind one. you're even looking after our health through the internet. thanks. *paiseh i run away now hor*

Chen said...

pink cotton,

wah.. got Q & A session ah? :P
Manyaknya soalan ni budak nak tanya

i)vaginal candidiasis is the fungal or yeast infection of the vagina also known as thrush, usually cause by Candida Albicans. Presentation is itching & burning sensation with curdlike whitish vagina discharge.

ii)hCG (human chorionic gonadotrophin) is the hormone produced during pregnancy. Early pregnancy testing generally is based on the detection or measurement of hCG.

iii) In Molar pregnancy, there is no foetus or baby formation in the sac. Instead it is replaced with the hyperplastic trophoblastic tissue. The gross anatomical appearance is like a bunch of white grapes.

psssss..
Don't skip too much woh..
Remember? Today is Friday the 13th
From previous records, u have tendency to fall down on this day
...
Kkkkkkkkkkkkkk

*Take care woh...*
I concern about u mah :P

Chen said...

papercrazy,
wah.. analyze till so deep :P
U know, i have seen few young girls pregnant at the age of 13 years old leh..
13 years old woh !!!!
They are still kids and need to be take care of, yet going to become mama liao... Aiyhhhhhh...

monkticon,
They wanna claim for wat sort of insurance compensation ah? For the hospital stay & treatment or ??
Sorry.. I tak faham :P

day dreamer,
DD, now is a modern world liao..
Wah, how come they never bother to lock the room when they make out?
Wanna let other people watch "free show" ah? :P

Some people are ignorance mah..
Some are careless..
Worst still, some have the mentalities that "This sort of things won't happen to me" ;) That's how all the unplanned & unwanted pregnancy come about...

sengkor said...

oklah, next time i go see dr if he ask me am i cheating for mc i just nod my head..

Chen said...

eastcoastlife,
Hahhaa, that is an extreme of the extreme example, which we only see once in a blue moon.

Regarding the Artificial insemination, yes. But if wanting the hymen to stay intact throughout the pregnancy, then it's not so easy to achieve. Cos anything can happened during that period of pregnancy. Vaginal examination or speculum examination might need to be done, especially towards the end of the pregnancy, despite if patient opted for Caesarean Section ;)

eve,
yeah, many do take doctors for granted. Another good example is they dunno wat medication they are taking and never bother to bring to hospital during planned admission (for surgery etc). How the heck do we know what medications are they on? With description of round white or yellow tablets etc.. there are hundreds tablets out there with similar size/shape. How can we retrieve their records if they are follow up in different hospitals?

Chen said...

mistipurple,
Wah.. giving me such a big "tall" hat to wear..
make me floating high-high up for few seconds tim...
LOL

U r mostly welcomed :D

Why u wanna run away woh?
Angel also cabut earlier on liao leh..
now u wanna follow trend?
LOL

sengkor,
hahaha, very good..
Sengjai is very honest ;)
Abuthen, most of the time, we do know and can sense who is cheating for MC & who's not ;)

yenjai.net said...

Sigh. Some characters just lie with their eyes not blinking, nose not flaring, heart beat remain steady, and face not flush...

Pink Cotton said...

y pregnant liao yet the formation is one ugly white grape?

if the formation is not an embryo then techincally not pregnant wat

wahahahahah

Monk[+]Icon said...

lokter, ya..for treatment, this clients thought they can go for "cashless facilities" mah...

Cocka Doodle said...

Let me guess....she's the same woman who claimed that stones came out of her toes.

Chen said...

yenjai,
Those are the "experts"...
*sigh*

pinkcotton,
sikui, dun made me vomit blood !!
i wanna bok your head now :D
as u know, in real life, 1+1 not necessarily will equal to 2. This is the irony of life...

monkticon,
Hahaha, indeed very keng chau. They able to "get away" with it ah? I mean "lie & claim"? :P

cocka,
*Faint*
Kkkkkkkkkkkkkkk....
I better hide under the table & continue laughing :D

_butt said...

thanks for the info! learn a lot there, very dangerous too.

Chen said...

butt,
glad u learn something from there :)

Bengbeng said...

since she feels so strongly abt it, it is very sad indeed that she is pregnant

Chen said...

bengbeng,
hope she learns the lesson & at least takes precaution in the future..

psy00060 said...

Hrmm... an interesting one...
Putting myself in their shoes, I guess I kind of understand why they do so. They were just felt unsecured panic, didn't know if they should trust the doctor. After all, the doctors are totally strangers for us. And in this realistic world, we are alwys warned not to trust anyone easily. The pro in medical doesn't show anything regarding a doctor's personality, does it?

Just my 2 cents. =))

Chen said...

psy00060,
yeah, i know what u mean. They might fear scared & insecure of what they have done, but if lying caused them to get the inappropriate or wrong treatment & prolonged their 'sufferings' unnecessary, then what's the point? They should have realised the reason why they come to a doctor is to get a proper treatment. :)

psy00060 said...

Chen,
Yeah yeah you r right! The problem is people here are always naive, they didn't think of the real motive for visiting. They oni see things from the surface.

Let's work hard together.. =)