Thread by @askdheeraj

I met an old lady who had #schizophrenia. She was on antipsychotics for more than 50 years. Never remitted. Had delusions of infidelity on her husband. He loved her and brought up his kids. The kids are grown up and married now.

She was also a cancer survivor. Docs repeated the same medicines as there weren't too many problems even though she was not fully well too.
I took a bold decision to start her on #Clozapine, a drug with risks but also better efficacy. Discussed with her and family.

They agreed to monitor her blood counts and the process started. She did well. Her delusion resolved. She smiled at her husband after long time. He was very happy to see her change. I was thrilled to see the joy in their family.

I met them again after 5 years. I never forgot them. We interacted as if we met 3 months ago. She had residual hallucinations which she learnt to ignore. Her husband and she lived alone and managed.
She however was on a wheelchair. She probably needs knee replacement.

The ortho surgeon had given up as she had RHD too. I felt adrenaline rush in me. I asked them if they met an anesthesiologist and checked for fitness. They didn't. I told them I will find one who deals with older people and get an evaluation.

They were happy to note that. They will have an early review. I will direct them. God willing she will get the knee replacement and walk well again.
#Therapeutic #Nihilism masquerades as wise giving up of what's not possible to change. We need wisdom. We should not give up hope/