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La clinica geriátrica
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La clinica geriátrica

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En Clínica Geriátrica, como en la clínica en general, ya sea de especialidades quirúrgicas, es lo mas importante; esta constituye la valoración medico-paciente, la cercanía del médico al enfermo, la comunicación del valorado con el valorante, es la fase en que el paciente te va a contar la historia de su enfermedad , en la que uno tiene que dejarlo decir, pues el va a contar con detalle, todo lo que se siente y a través de esa conversación a establecer ese vinculo de comunicación de confianza que necesitamos para poder actuar sobre él y sin casi medicamentos lograr en el paciente un grado de estimulación en el bienestar, en su conducta que no se logra de otra forma.

El médico debe contar con 4 oídos y una boca; no se puede estar apurado para ver a un paciente, como para operarlo, hay que apagar el tiempo cuando uno esta conversando con un paciente, de no ser así podemos dañar su dignidad, su confianza en nosotros, su deseo de establecer esa comunicación tan importante. Debemos de hablar pero lo mínimo, el que habla es el paciente, nosotros para corregir algo que sea de mucha importancia para el diagnóstico lo demás es el paciente el principal actor de esta escena.
 
Es necesario por lo tanto hacer de la clínica el arma mas importante del médico para lograr el poder entrar en el mundo de ese enfermo , conocerlo y poder cambiar o arreglar lo que necesitemos para que se sienta mejor y lograr al final una mejor calidad de vida.

En nuestra practica médica hemos aplicado esta conducta clínica la que nos ha dado muy buenos resultados ya esperado por nosotros, y asi en un trabajo con los ancianos de la comunidad hemos obtenido un 60 % de resultados positivos de diagnóstico solo con la entrevista, dejando el otro 40 % al examen físico y a los complementarios.
Para lograr esto hemos tenido que conversar con el resto del equipo médico, convencerlos que aunque la época moderna nos lleva en ocasiones a no tener mucho tiempo, el tiempo que le dediquemos a los pacientes debe ser sagrado , completo, sin intervalos, sin rompimientos de conversaciones, sin interferencias, ni acompañamientos que no sean los sumamente necesarios.

Hemos demostrado que el 12 % de los pacientes tienen medicamentos en demasía, usando polifarmacia, el 9 % usando medicamentos automedicados por ellos o familiares, que en ocasiones se contradicen con su enfermedad o entre ellos. Hemos adoptado la medida de revisar los tratamientos asesorarnos y conversar con los médicos de asistencia para mejorar entre todos el marco de medicamentos de nuestros ancianos.

Hemos dado charlas entre los ancianos y familiares, en donde les demostramos que no por la cantidad de medicamentos a tomar es que se va a estar mejor o a curar de una enfermedad, sino que hay que usar el medicamento de elección y la dosis exacta.

Les demostramos que muchos de los problemas de inapetencia que presentan, o de rechazo al alimento, es debido al medicamento que esta tomando y no a un problema de la enfermedad como tal; cosa esta que en la practica hemos logrado demostrar objetivamente con esos pacientes inapetentes.

Además hemos tenido que enseñarles lo importante de una dieta balanceada y que no es comer innecesariamente un día hasta la saciedad sino que hay que compartir ese alimento, para lograr una buena digestión y una buena asimilación de ellos. De esta forma logramos el balance alimenticio y las cantidades adecuadas de proteínas, carbohidratos, vitaminas y grasas que necesitamos para alimentarnos.

Para estar sanos hay que conjugar todos los factores en cantidad, tiempo y variedad.

Dr Ricardo Martinez
   

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