when it rains

A patient came to me with symptoms suggestive of a urinary tract infection (UTI).
I advised a urine test, but although my clinical diagnosis based on symptoms was UTI, the test results came back within normal limits.

When I discussed the condition in detail with the patient, I found out that he had experienced the same symptoms a few days earlier and had already started treatment. Since his symptoms improved, he stopped taking the medications before completing the course. One of those medications was an antibiotic commonly used to treat UTIs.

Based on this information, I decided to treat the patient according to my clinical diagnosis.

So, what likely happened here?

There are several possible reasons:

The patient had taken antibiotics for a few days. Because of this, the bacterial load may have dropped below the level detected by routine urine tests. However, the infection may not have been completely eradicated. Therefore, despite a “normal” report, the infection can still be present.
After starting antibiotics, the white blood cell (WBC) count in urine can return to normal within 24–72 hours. This can make the urine report appear normal.
In some cases, even when the bacterial count is low, inflammation of the urinary tract can persist. This ongoing inflammation can continue to cause symptoms.
Additionally, some bacteria may not be detected by routine urine investigations.

Because of these reasons, there are situations where treatment needs to be guided more by clinical symptoms than by investigation reports alone.

Therefore,
If a doctor advises you to take medications for a certain number of days, always try to complete the full course. Incomplete or improper treatment may only suppress symptoms temporarily without fully curing the infection, leading to a false sense of recovery.

If your doctor advises you to do investigations before starting treatment, try to follow that advice as well. This allows the investigations to provide maximum diagnostic value.

Finally, if a doctor suspects a disease even when investigation reports are normal, that suspicion is based on what your body is clinically communicating. Trust medical advice, and if you have any doubts or concerns, discuss them openly with your doctor to get proper clarification.

These days, “Will AI replace doctors?” has become a hot topic. So I decided to think about it seriously.

Many people seem to like the idea of replacing doctors. That’s understandable. People want faster, cheaper, and more efficient healthcare. Even doctors sometimes feel that replacing certain tasks might not be such a bad idea, because everyone wants a more peaceful and balanced life.

Healthcare will be one of the most significantly impacted fields by AI.
The reason is simple........
it is complex, high-stakes, and full of data.
If AI succeeds in healthcare, it would be a huge achievement with enormous potential benefits.

But will doctors really be replaced?
I don’t think so.
at least not in the near future.

AI will help doctors tremendously, especially by reducing workload and burnout. Doctors around the world struggle with long hours, excessive documentation, and work–life imbalance. AI can help change that.

AI will assist with,
Structured history taking
• Interpretation of investigations
• Pattern recognition
• Generating differential diagnoses
• Documentation and administrative work

However, AI will not truly replace diagnosis. Patients never present exactly according to textbooks or guidelines. Every patient is different. Even with the same diagnosis, same age, and same hospital, treatment decisions may differ. Many times, as doctors, we ask ourselves, “How is this even possible in this condition?” That level of clinical reasoning comes from human experience and judgment.

AI may suggest treatment options, but it cannot decide the final treatment. Treatment decisions depend on many factors, co-morbidities, social background, cultural context, emotional state, affordability, and patient preferences. These decisions can only be made after seeing and understanding the patient as a whole.

When it comes to procedures and surgeries, AI will be an excellent assistant, improving precision, planning, and safety. But complete replacement will take a very long time, if it ever happens.

Decision-making in medicine is not based on evidence alone. Evidence-based medicine is just one component. Ethical considerations, social circumstances, emotional factors, and human values play a major role. AI cannot fully replace this process.

One area where AI may play a major role is triage and admissions. It can support and streamline these processes. However, in patients with complex conditions or multiple specialties involved, AI alone will struggle to make safe decisions.

Empathy remains irreplaceable.
Breaking bad news through an AI system and through a doctor are completely different experiences. Compassion, reassurance, trust, and psychological support require a human presence.

AI will greatly help with
• Data analysis
• Medical research
• System improvement
• Reducing doctors’ workload
• Improving efficiency in healthcare

Importantly, doctors also carry legal and moral responsibility, something AI cannot assume.

Doctors are not just clinically skilled individuals. They are strong communicators, ethical decision-makers, and critical thinkers.

So yes — AI will change medicine.
Yes — some tasks and roles may be replaced.
But doctors themselves will not be replaced anytime soon.

And below the analysis given by chatgpt

Today I saw a patient who complained of numbness in both hands. He works in a restaurant and frequently carries food trays. On examination, there was wasting of some small hand muscles. After further assessment, the diagnosis was carpal tunnel syndrome.....

This is a few details about carpel tunnel syndrome,

🔹 What is Carpal Tunnel Syndrome?
It is a very common condition caused by compression of the median nerve at the wrist (inside the carpal tunnel).

🔹 Who gets it?
About 3–6% of adults experience symptoms at some point, especially between 40–60 years of age.

🔹 Common symptoms
• Numbness or tingling in the thumb, index, middle, and part of the ring finger
• Weak grip
• Difficulty holding objects
• In severe cases, muscle wasting

🔹 Risk factors
⭐ Repetitive hand movements / prolonged wrist positions
⭐ Obesity
⭐ Pregnancy
⭐ Diabetes
⭐ Thyroid disorders

🔹 How is it diagnosed?
Through clinical examination. A nerve conduction study may be used to confirm the diagnosis.

🔹 Treatment options
• Activity modification
• Wrist splints
• Exercises
• Steroid injections
• Surgery (for severe or persistent cases)

📌 In about one-third of patients, symptoms improve on their own within 10–15 months, especially when aggravating activities are reduced.

⚠️ While carpal tunnel syndrome is a common cause of hand numbness, other conditions can also cause similar symptoms. Proper medical evaluation is essential.

One of my patients came with an abscess.
He had been getting abscesses again and again for a long time.
Each time, I advised him to check his blood sugar and each time, he refused. He only wanted antibiotics.
This time, he finally agreed.
and yes....His blood sugar was high.
and these are the answers for his questions......

⭐ Why did I wanted to check his blood sugar?
Many people think abscesses are just a skin problem.
They show up on the skin, but very often they are a signal of something deeper going wrong inside the body.

⭐ How high blood sugar causes recurrent abscesses
🔹 Weakens the immune system
🔹 Feeds bacteria and promotes infection
🔹 Delays wound healing
🔹 Makes infections more severe and more frequent
This is why diabetes is one of the most common causes of recurrent abscesses.

⭐ Is high blood sugar the only reason?
absolutely not......

Other conditions that increase the risk
✔ Immune-suppressing conditions (HIV, autoimmune diseases, long-term steroid use)
✔ Poor nutrition
✔ Obesity and smoking
✔ Chronic stress and poor sleep
✔ Certain skin conditions like hidradenitis suppurative

⭐ Are antibiotics enough for him?
No.
Antibiotics treat the current abscess,
but they do not stop new abscesses from forming
unless the underlying cause is treated.

⭐ What should be done?
✔ Identify and treat the root cause
✔ Check blood sugar levels
✔ Maintain good glucose control
✔ Correct nutritional deficiencies
✔ Manage stress and improve sleep
✔ Treat wounds early
✔ Maintain good skin hygiene
✔ Avoid sharing towels, razors, or personal items

Recurrent abscesses are not “normal”.
They are often the body’s way of asking for help.
Early testing, early diagnosis, and proper management can prevent repeated infections and serious complications.

Yesterday, I had the opportunity to review the investigation reports of a young man💪

According to his blood reports, his blood glucose levels were high (FBS, HBA1c)........

From my discussion with him, I found out the following......

⚡His blood glucose levels had been elevated even in the past
⚡Although a doctor had recommended starting medication, he had refused.
⚡He is a very active person, exercises daily, and follows a very healthy diet.
⚡He believes that he can maintain his blood glucose at normal levels without starting medication.
⚡He also has a fear that once medication is started, he will have to take it for the rest of his life.

However, I noticed something else important in his blood reports. His eGFR value was low. The eGFR reflects kidney function. Based on this, I concluded that his diabetes has already started affecting other organs. (There were additional findings that supported this conclusion.)

Diabetes can cause many complications, and kidney disease is one of them. Unless it is detected early through investigations, significant symptoms are often not felt in the initial stages.😔

Therefore, my recommendation to him was to start medication.🧑‍⚕️

What I have shared here are only some of the points I discussed with him, so that others who need this information can benefit as well.......

⭐It is true that blood glucose can be controlled through lifestyle modifications. However, whether this approach is suitable for an individual should be discussed with a doctor. Regular monitoring is essential to ensure that glucose levels remain within the desired range.

⭐ It is also important to meet a doctor at recommended intervals for follow-up and investigations, because a doctor may detect changes specially complications that are not evident in blood reports alone.

⭐Additionally, complications caused by diabetes itself are far more serious than the side effects caused by most medications. Therefore, if a doctor recommends starting medication, doing so is usually the best option.

⭐Starting medication does not necessarily mean that one has to take it for life. If a healthy lifestyle is properly maintained, it may be possible to consider reducing or stopping medication under medical supervision.

⭐At the same time, starting medication does not mean that lifestyle measures can be neglected. Both must be followed correctly and consistently.

So, if you are ever told that you have diabetes, do not wait until complications develop. With the support of a doctor, make an effort to control it properly from the beginning🧑‍⚕️

One day my little girl wanted to lie down on the floor inside a shopping mall.
Situations like this, to varying degrees, are something almost every mother and father experiences.

⭐At a moment like this, what might be going through my mind?
Anger?
embarrassment?
fear of what others might think?

Either way, it’s not an easy situation😔

But then as a mother, I began to understand.....
This is a two-year-old little girl
a child learning about the world🌍
learning about boundaries⚡
learning how to manage her emotions.🤷

But the mother is someone who has lived in this world for over thirty years🧑‍⚕️
a mother with plenty of life experience.🤹
But even the mother sometimes finds it hard to manage her emotions......
So, how much harder must it be for this little girl?

That’s why, in moments like this, the first thing I do is regulate myself.🧘
Then I help my little girl.

I’ve seen her learn to walk by falling and getting up again and again.
So I believe she will also learn to manage her emotions,
even if it means falling over and over again.

So, in every place and in every situation,
Her mother will stay by her side,
Trying to understand her,
Teaching her boundaries,
and helping her learn more and more.

Because the mother believes
The way she is guided and handled at this stage
will shape how she behaves for the rest of her life.

We all know about diabetes......

But do you know about the pre-diabetic stage?

At this stage, the amount of glucose in the body is higher than normal, but not high enough to be diagnosed with diabetes.
This can be considered a warning stage😔

Studies have shown that 5–10% of people with prediabetes develop diabetes within the next year, and about 70% develop diabetes within the following few years. Therefore, this stage can be considered the last opportunity to prevent diabetes😔

At this stage, there are usually no symptoms.🤔

Because there are no symptoms, prediabetes can only be detected through blood tests.

So, when should you get tested?
It is advisable to have a blood test if:
⚡Close family members have diabetes
⚡You are overweight
⚡You do not engage in physical activity or exercise regularly
⚡Your diet is unhealthy
⚡You experience frequent stress
⚡You had diabetes during pregnancy (gestational diabetes)
⚡You have high blood pressure or high cholesterol
⚡you are over 30 years of age, even without the above risk factors

The blood test values seen in the pre-diabetic stage are........
Fasting blood sugar: 100–125 mg/dL
HbA1c: 5.7% – 6.4%
2-hour glucose tolerance test: 140–199 mg/dL

If blood glucose levels are normal, the general recommendation is to repeat testing every three years.🤗

In most cases, this condition is reversible.😊💃

With dietary changes and regular exercise, a
person in the pre-diabetic stage has around 70% chance of preventing the progression to diabetes.

As the saying goes, prevention is better than cure.
So, if you feel you may be at risk, make sure to get yourself tested.......

Me and My little girl goes for a walk every evening. Hand in hand, hearts light....

Today too, we went for a walk the little girl’s ball was in her mom’s hand. 🏀

On the way, we met another little girl. Then our girl wanted to say “Hello” to this new friend.
But at that moment, her eyes kept running to the ball. Mom hrld it genetly ,not quite ready to share it.There was only one ball and two little girls. It’s not easy to share just one ball, right? 😔

Now our little one looks at her mom, eyes full of questions “Why not, why you are not giving the ball to my new friend? ”
After a moment, she walks up to mom, takes the ball from her hand, and gives it to her new friend herself. 👏

In that small gesture, the world felt a little brighter.
Mom smiled, not because the ball had been shared, but because kindness had bloomed — freely, naturally.

And as they continued their walk, the mother couldn’t help but hope: May the world never steal that tenderness from her. ❤️

Because every child begins with a heart that knows only love and fairness. If we could just let them keep that — imagine how gentle, how beautiful this world could become. 🌎✨

somewhere between two small towns in a small island
I saw this little Fruit cart🥭🍊🍑🍉
where I can never just drive pass without stopping ...

It May be a little dusty,
Fruits are not shining,
but when you see it, you know,
that fruits are real, fresh and alive🪴

They didn't came from big commercial farms
they just came from someone's backyard ,,🌱🌿🌵
grandma's garden
nothing used - just sun, rain and time 🌅☔🕜

Now I live in a large town 🙂
Fruit coming from everywhere from world
Stacks in rows, policed like jewel 🍑🙂

but still,
I find my self longing for this,
A simple joy of tasting something real....❤️❤️

Maybe the fairy world is just beyond....
Where fairies paint the evening sky with colors made of dreams.....