2023-07-14 09:17:42
Ales Pushkin. Photo: “Radio Svaboda”
In the village of Beaver, they said goodbye to Ales Pushkin. A political prisoner, a well-known artist, died in intensive care, the diagnosis was a perforated ulcer.
Belarusian doctor Aleksey Nosov told the Charter97.org website what kind of disease it is and how it could have arisen.
– If a patient with a perforated ulcer died at a doctor, this doctor is either a complete nonentity, or just a real bastard, because there is no other way to call him. The fact is that gastric ulcer never proceeds rapidly, it usually develops. This is influenced by many factors, in particular – poor nutrition, stress, and so on.
Quite serious importance in the development of the disease is currently given to one of the bacteria, Helicobacter pylori. This bacterium is quite aggressive because it is one of the few that get along in the acidic environment of the stomach. Most of the bacteria there just die.
The disease develops, naturally, with the presence of pain. They can be of a different nature, for example, the so-called hunger pains that are experienced before eating, and after eating there is a certain relief. There are also satiety pains that begin immediately after eating, this is due to the activity of acid in the stomach. Just the presence of such pain is one of the diagnostic factors that you have a stomach ulcer, for this you do not even need certain studies. Then there is heaviness in the stomach, after eating constant heartburn, usually in the morning or at night. Why I tell you in such detail – I myself had it. As you can see, I’m alive.
Accordingly, it is not very difficult to recognize an ulcer at this stage, it is not even necessary to conduct research, but if FGDS, fibrogastroduodenoscopy were performed, then it will be visible to the naked eye. At this stage, the issue can be resolved absolutely painlessly, without surgical intervention. This requires a special diet, no fatty, no fried, no spicy and other aggressive foods. It is also necessary to take blockers of the proton pump, which is responsible for the acidity of the stomach, to suppress the activity, antacids are taken, which also reduce the acidity in the stomach. If an ulcer is diagnosed, samples are taken and a bacterium is determined that it is there, then antibiotic therapy is additionally administered. Moreover, it is not necessary to prescribe the most stringent antibiotics, the penicillin series is doing a good job at the moment.
The next stage is perforation, here it is necessary to completely ignore the person in order not to notice this moment. You can imagine this moment, a hole in the stomach through which the contents of the stomach enter the peritoneum. And the peritoneum is such an organ of our body, let’s call it that, although in fact these are membranes that are responsible for the state of the internal space in the abdominal cavity. It contains a huge number of nerve endings; the peritoneum reacts very quickly and efficiently to any aggression. And this is pain, sharp dagger pain. In addition, a perforated ulcer is bleeding, because all the walls of the stomach are affected and, accordingly, a person experiences such phenomena as bloody vomiting and black feces.
These are unmistakable symptoms by which to navigate. At this stage, at the initial manifestation, even an organ-preserving operation is possible, it is not necessary to do a stomach resection. It all depends on what size and how far it’s all gone. Naturally, when there are big complications, when it is a peptic ulcer, multiple ulcers, they do a resection of the stomach with a good result. Of course, a person’s diet changes for the rest of his life, but he remains alive.
Then peritonitis develops, in this case it is a purulent-necrotic inflammation of the peritoneum. The pain is terrible, because the peritoneum has a huge number of nerve endings. But at this stage, if an operation is performed and a good sanitation of the foci of purulent inflammation in the peritoneum is carried out, roughly speaking, the abdominal cavity is well washed, then there is still a normal possibility for recovery.
Can you imagine how long it takes for a person to die of a peptic ulcer in agony? Ales died in agony. These are pains, terrible pains, unbearable. You can hardly think of anything. They are bastards, and my colleagues are also bastards. All this could be cured completely painlessly in the initial stages. Nobody lifted a finger.
He was brought to the emergency room unconscious. Is it possible to imagine that the prison did not notice that the prisoner was suffering from a perforated ulcer?
– This can only be said by someone who has never had ulcer pain, because this pain is unbearable. I repeat, nervous stress, study, emigration, a lot of things happened to me, so I had these pains more than once. I did not even go to diagnose them, because I knew that it was an ulcer, otherwise it simply cannot be, the symptoms are simply obvious. By self-medicating and maintaining a diet, I recovered.
Diet, exercise and many other things prevent the occurrence of certain diseases. But, nevertheless, there were moments when I got into these situations, healed. My answer: it is impossible not to notice a person suffering from a peptic ulcer, especially a perforated ulcer. Impossible, this is a crime, a hard crime. I have no words.
– As a doctor, how would you characterize the actions of the medical staff of the prison. Should they be punished?
– Naturally. I understand that Lukashenka is scum, his entourage too, but the fact is that this crime is almost entirely in the hands of the personnel. It cannot be that a person has a stomach ache, and they called Lukashenka directly and asked whether to give a pill. This is just nonsense. The people who work there are accomplices of the regime, there are no other options.
I absolutely do not care what my colleagues think of me and so on. This is simply an unacceptable situation in medical ethics and in medical practice. You can still understand if a person is somewhere far away, there is no contact, the symptoms are incomprehensible or blurred, and so he is constantly in sight. Most likely, it was seen how Ales was writhing in pain. You could see it, you could see how he was suffering. It is trite to give omeprazole to a person in the morning on an empty stomach – he will already feel better, plus a certain diet.
“There was no chance of salvation.” Details of the death of the artist Ales Pushkin
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