PID, Sexually Transmitted Infections & My recent Sirsa visit

 This one is important. Lemme pen it down before life goes busy again. 

(Names changed in the narration for obvious reasons.)

Today, I accompanied my mausa ji (my sister's sasur) for his visit to XYZ Heart Hospital, Sirsa. He has been suffering from pain-in-chest issues. Today, his angiography (an X-ray after injecting a special dye into the blood vessels) was supposed to happen. Turned out they were going by a relative's car, and I joined them at Malsisar. The relative (our driver), Badri Nath, was to visit UVW Hospital for the diagnosis of her wife, Manju, who had been suffering from continuous rounds of fever for the last 20 days. On the way, I went through past diagnoses and reports of my mausa ji. The Jaipur report said, "sinus bradycardia". Roughly "slow heartbeat". I couldn't go deeper. I had no time to bother about Manju's reports.

We reached and parted our ways. Dr. X first made Mausaji undergo a blood test to ensure he was fit for angiography. It cost 1500! Before coming up with the results, they made us pay 8000 for angiography and started preparing for the procedure (coz this takes time): removing hair from wrists and abdomen, changing clothes, etc. A voice within me concluded, "The blood test was just a scam." But that might not be the case; I hope it was not. They took our signatures at 4-5 places. I did my best to read the things. We were in no place to approach a court if any procedure went 'wrong'. Then things happened unexpectedly fast. The angio was done. I was told outside that he was 'fit' for it. Angiography came out to be normal. (I don't know when the blood results reached Dr. X behind the closed door of the Cath Lab. I was told that X received it on his phone and that I could collect a copy later.) No vessel was blocked. Dr. X showed me Mausaji's real-time lub-dub in his 'angio-output device'. Things were beating normal, I tried to convince myself. I had nearly zero idea what this 'normal' was. Dr. X added the pain was due to something in his chest muscles + his blood was 'dense'. He gave medicine for the same and recommended meeting Dr Z in Nohar instead next time. No need to come to Sirsa anymore. Mausaji was kept under their supervision for about 3.5 hours. Finally, we met Dr. X one last time, got almost no new information, and left at 5:00. 

Looked like X either couldn't diagnose him properly or was just avoiding explaining, 'What is the cause of this chest pain?' by repeatedly saying it was due to muscles. Needless to say, things were expensive here or were deliberately made expensive at each step. On the other hand, Dr Banwari Sharma, a rheumatologist in Jaipur, whom I met in 2019 to treat my maa's Sjögren syndrome, was gracious enough to explain the report, every minute detail & future risks + possibilities. But we left him, that's another story. He, too, was expensive, but he 'deserved' that money, in my estimation. 

We joined Badri & Manju soon. It turned out that they were free from the hospital as soon as 3:00. He got his car serviced. Mausaji asked me to go through Manju's reports to see if I, with zero background in biology and medicine but with my 1.2 GB data, could get something out of it. Badri told us that it was dengue. They were advised for her 3-day admission in the CCU ward, but he denied it and brought all the injections, antibiotics, and bottles with him packed, "We can do all this at home. Just 10 or so injections. What's the big deal?"

The first report, a USG (ultrasound) of the whole abdomen by Dr. Y, said, "Impression: PID". The 3rd or 4th said two out of 3 dengue types were negative, and one was weakly positive. (I forgot the names.)

Manju added Dr Y said that she was suffering from an infection in her bachchadaani (uterus).

I googled 'PID'. Turned out, as per Dr Y's report, Manju was suffering from Pelvic inflammatory disease, a bacterial infection of the female reproductive organs. All I could understand was that it can lead to serious conditions, even life-threatening, if not treated, and it's often not easy to diagnose. Your risk of PID increases if you have or have had a sexually transmitted infection (STI) before. However, you can develop PID without ever having an STI. It is rare but relatively common in women between 15-25. Persistent pain in the lower abdomen is the most common symptom, the next being the painful sex and burning sensation while urinating. I inquired, and Manju replied in the affirmative. She is about 23, and this abdomen pain has been part of her life for the last 4-5 months. She is 7 months into marriage now. Dr. Y first misheard it as '7 years' on the pretext that they had no kids and almost concluded Manju was infertile. She was corrected the next instant.

Pasting a relevant text from some medical site:

Several different types of bacteria can cause PID, including the same bacteria that cause sexually transmitted infections (STIs), gonorrhea, and chlamydia. What commonly occurs is that bacteria first enter the vagina and cause an infection. As time passes, this infection can move into the pelvic organs. PID can become extremely dangerous, even life-threatening, if the infection spreads to your blood.

You are more likely to get PID if you

• Have an STD and do not get treated;
• Have more than one sex partner;
• Have a sex partner who has sex partners other than you;
• Have had PID before;
• Are sexually active and are age 25 or younger;
• You douche. (You (used to) clean the inside of your vagina with water or water mixes of vinegar, baking soda, or iodine.) Or you have sex with someone who does so.
• Use an intrauterine device (IUD) for birth control. However, the small increased risk is mostly limited to the first three weeks after the IUD is placed inside the uterus by a doctor.

• Men may be silent carriers of bacteria that cause pelvic inflammatory disease.

  Your infection can recur if your partner doesn’t receive treatment. You may be asked to abstain from sexual intercourse until the infection has been resolved. see here

That part of my mind couldn't escape the conclusion, "All this has happened to her only after coming to Badri. No pain before marriage. Very likely, he had this first, and she got the infection from him while in the act of sex. He has been in a transport job, living in Gujarat for the last several years. The non-zero probability of him having sex with a 2nd/3rd partner makes this thing even more plausible." But who am I to judge? (Who are u not to judge? We can't escape judgments, Jyani.)

It turns out that Dr. Y didn't 'do anything' with Badri. No check-up, not even interrogation of their sexual life, let alone his treatment of the bacterial infection. 

Here is a dangerous turn that untreated PID might take:

PID might cause an abscess — a collection of pus — to form in your reproductive tract. Abscesses commonly affect the fallopian tubes and ovaries, but they can also develop in the uterus or other pelvic organs. If an abscess is left untreated, you could develop a life-threatening infection.

The good thing was that the couple stopped and had tea at my home. I managed to impart my half-baked PID knowledge to Manju and later to Badri to the best of my wisdom and sense. Mainly because she might need admission to the hospital if the antibiotics don't work. That the condition could adversely affect her conception and pregnancy and that they must have safe sex, use protection and all; and kya hi jaldi hai? bhot time pda hai aapke pas to.

Here's a takeaway: ___________________

Both u and ur (future) partner must understand the value of getting yourself checked for at least STIs, if not a complete medical check-up, before you jump into your first act of sexual intercourse. It can be life-saving for both of you; you never know.

I am not implying you should leave your lover if s/he has an STI. I am just saying, don't let it spread from one to two bodies if your partner's health means something to you.

Medico folks, correct me wherever important.