Month: May 2019

A Letter from our patients to Dr. Zan Mitrev:

 

Dr. Zan,

I just want to say a simple THANK YOU from the bottom of my heart.

Today is my father’s “other” birthday. Exactly a year ago, you, a great man, managed to save an entire family by saving my father, whom you literally brought back from the dead. My father endlessly trusted you, and although we were terrified and too confused at the time, we recognized the salvation in you. The complicated operation lasted for about 6 hours, during which 3 valves were operated on, 4 by-passes … But you managed to win, and therefore all of us won together with you. The post operation period was a difficult one, but we knew that the family was slowly getting rehabilitated.

A year later, my father’s health condition is stable, and we are slowly returning to our everyday routine.

I want to thank you for successfully completing the surgery and for saving a BIG HEART, the heart of the man who, together with my mother, always takes care and fighths daily battles for the life and health of his own sick parents as well as his own sick daughter. The battles were fought with joy, perseverance, not allowing anything to disturb our peaceful family life. His heart, Dr. Zan, was constantly strained with those ongoing battles, fighting for the life of his closest ones. And his heart managed to protect everyone and give them it’s maximum effort. You saved that heart. Around his neck my father wears with pride the tag bearing the name of your hospital, which he had asked for when he left the hospital from one of your employees at the info desk in order to strap his mobile phone on it.

We will always be grateful to Dr. Nikola Gjorgov as well, who showed us the right direction. Rarely does one find a man with such great humanity and an infinitely good soul as Dr. Gjorgov. During those moments of despair and the sense of being lost, Dr. Gjorgov was my only light because he was always there for any advice and help. In those difficult moments, he first saved my sister, and then my father, by referring him to you.

My sincerest regards to the entire team, and to you doctor – may good health be with you, wishing you continuous successful career, wonderful moments with your family and all the best.

I bow to you with my deepest gratitude.

V. B. Mr.

Child’s play often knows how to end badly, i.e., with unwanted consequences, problems and injuries. Little negligence can bring many problems that often end up in the hospital. It was just such a children’s game that caused severe injuries to a one-year-old child who came to our clinic with his parents asking for help. It may sound unrealistic, but in the case of this child, a sharp pencil was placed on his chair on which he sat down, and the pencil had broken his clothes and burst into the back of the thigh.

Parents sought help in several hospitals, but they could not solve the problem. After two months, wandering through the health system, they turned to our clinic.

The possibility of infection and the terrible pain alarmed our doctors led by Vladimir Chadikovski M.D., who immediately after the examination started to take out the foreign body.

Fortunately, without serious complications, the pencil was removed, and the wound was appropriately treated. The injuries could have been severe and with lasting consequences if the pencil damaged the child’s rectum after which the complications would have been far-reaching.

Beware, a child’s game can often end up in a hospital.

Citrate dialysis represents dialysis that as a procedure hampers blood clotting or coagulation of blood within the system and during the process citrate solution is being used instead of heparin. While conducting dialysis treatment the patient’s blood exits the body and goes into the dialysis system which filters or dialysable or removes degradation products, excess water, electrolytes, or it will default to the system. This dialysis is being performed by the team of Intensive care and anesthesia in our clinic that have been specialized and trained  for all types of treatment with Baxter machines – Prizmaflex by using ST 150 filters and Oxiris filters.

– While blood is in that system it can coagulate and the treatment can be unsuccessful even life threatening. For that purpose, anticoagulant agents must be used. In “common” standard dialysis we usually apply In this case we use citrate solution. Why? Heparin in many cases is contraindicated. There are patients with active bleeding, with HIT (heparin induced thrombocytopenia) patients with different types of coagulopathy, thrombocytopenia of another kind etc. In these patients the use of heparin as an anticoagulant would increase the risk of bleeding. Because of that, this type of dialysis or citrate dialysis is suitable for all categories of patients. Indications for dialysis are the same, anuria, oliguria, hyperkalemia, severe acidosis, acute renal failure, chronic renal failure, severe poisoning, sepsis …and which type of anticoagulant we are going to choose depends on the comorbidity of the patient, explains dr. Dragica Vuckova, anesthesiologist.

The advantage is that this type of dialysis is available to patients who are contraindicated or there is an increased risk of heparin dialysis, adds Dr. Vuckova.

– The patient came for examination with complains for pain in the abdominal area. She reported, at the doctors in Prilep, where she was given a gastric therapy, but because the symptoms did not pass, she reported to a check-up in our clinic, which she knew, because I have previously done a surgery to her brother-in-law. Immediately on the examination it was noticed that she had a massive abdominal tumor – this is how Prim. D-r Hadzi-Manchev Mane, a specialist of general surgery in Zan Mitrev Clinic, started his explanation of the case, which we had in the last week, in our Clinic.

Seemingly without any serious indications, without a specific pain, but with minor and irregular difficulties, the 49-year-old patient from Prilep, has gone through all the doctors in her town, to only tell her, that she does not suffer from anything and that she has nothing unusual happening in her body. After her husband’s insisting, she came to a check-up in our clinic, when she was stricken by the shock of what our team of doctors, headed by d-r Hadzi-Manchev, had found.

– I had no serious pains, but I occasionally had some kind of pricking in the area of my diaphragm when bending. I am a tailor, but I also work in the agriculture without any problems. I have a great appetite, I do not have any stress and I live a normal life. I received no warnings from my family doctor, that something serious is happening to me, but after insisting of my husband, I have yet, came to a check-up in the clinical hospital “Zan Mitrev”. After the doctors’ examination, the shock had followed, for me and for my family. The finding, that in my body I had a tumor of about 5 kilograms, echoed in my ears, as a strong bang that literally pushed me into bed. I could not put myself together of what I have heard, but there was no time for panicking, self-pity, nor for any thinking of what should be done. The tumor was so large that it required an emergency surgery, which the doctors here, have conducted impeccably. I am still confused of what had actually happened to me, but I express my big gratitude to the entire team of the “Zan Mitrev” clinic, for saving my life – said our patient, who is after the surgery, visibly tired, but still very calm.

D-r Hadzi-Manchev completes the explanation how the entire procedure, from diagnosing of the condition, to the surgery, has been done.

– A computer check, was immediately made to the abdomen and it was found that a large cystic tumor was in question, most probably originating from the right ovary. Because the tumor was massive, a proposal was given to the patient for an immediate operation, due to the danger of an eventual burst of the cyst. Only two days after setting of the diagnosis, she entered the surgery hall and a removal of the tumor was done, together with the right ovary. The tissue being somewhere around 5-6 kg of weight, was sent to a pathochistological procedure. The specificity of this case, is that the tumor in the abdomen although she was examined in the home town, has not been recognized as existing in the patient, at all. The quick and effective diagnosis as well as the quick treatment, was a complete heat in the middle of the target, in this human life, for which we did not know, how it would end, if she would’ve not arrived to us. The patient is well, and is already on home treatment, gradually returning to her everyday activities – says Prim. D-r Hadzi-Manchev Mane, a specialist of general surgery, in the Zan Mitrev clinic.

Best wishes, for a full recovery are extended by the Zan Mitrev Clinic team.