Telemedicine - The Yay and Nay

Telemedicine is not new.

My very first telemedicine experience started in 2013 when I was still practising in government hospital. The service was mainly for medical officers from remote part of Malaysia who has no access to specialist advice. So the medical officers will upload patient photos together with their clinical findings and specific questions so that we can give advice on further management of their patients. It wasn't directly link to the actual patient.

Then I started offering free telemedicine advice on TELEME platform (link at the right side of this site) in 2018, which was often abused by some, until I have decided to put a stop to access from new patients and only using it to advice my existing patients only. (Also wrote a frustrated blog post here. Haha.)

Then came COVID pandemic and Movement Restriction Control in Malaysia, during which our hospital and clinic actually work as usual but many patients could not attend their appointments for various reason. Some suffered severe flare-up of their chronic eczema, psoriasis, blistering diseases etc for running out of medicine supply. And then I started offering telemedicine service again via my hospital's Telehealth Plus platform.

Unfortunately not all consultations can be conducted effectively via virtual / video call. It remains a challenge to see new patient (which I do not do) or existing patient but with a new complaint. It is not easy to get a complete impression of their skin condition and the assessment of mental burden to one is not easy as well.

There are a lot of things that we cannot do virtually, blood taking and laser procedure etc is impossible for sure. It is easier to explain things face-to-face because we can use tools such as flip chart, drawings etc. Not to mention technical issue such as camera quality and network connection.

Having said that, sometimes we have no choice, and sometimes telemedicine is convenient and probably good for follow up of people with well controlled conditions, or review and continuation of an ongoing satisfactory treatment.

If you are my existing patient, to see me for virtual consult, click here. ;)

Epidermolysis Bullosa

Oct 25 - 31st is epidermolysis bullosa awareness week.

Have you ever heard of epidermolysis bullosa?

Epidermolysis bullosa is a group of rare genetic disease where the skin and mucosa (mouth, stomach linings) are torn and develop blister with minimal friction. The mild ones only start to show up when the children learn to crawl or walk. The severe ones can be life threatening.

Children born with epidermolysis bullosa are also known as butterfly children because their skin is as fragile as butterfly skin. And they are often in pain from the raw wound.

The list of possible problems is long and include,
🩸 bleeding from the wound
🩸 constipation, avoiding bowel movement due to pain
🩸 painful and sensitive eyes, that may even leads to blindness
🩸 scarring on scalp, muscle, tendons that leads to hair loss, contracture and deformity affecting ability to walk and move
🩸 blisters in mouth that leads to difficulty in eating and malnutrition
🩸 infection
🩸 skin cancer

And not to mention poor quality of life with social isolation, school and work absentee. This is why they need our support.

You can reach out for EB community in Malaysia here.