dua ratus lima puluh enam day 15 : forensic

bismillah..

alhamdulillah we finished orthopaedics rotation... final nya inshaAllah pada 16 Mei 2013.. Today we started our Forensic rotation di "'Iyadah Tibb Syar3iyy lit taalim" dekat belakang Princess Rahma Teaching Hospital.   Disebabkan harini tak ada belajar or tengok mayat lagi, tak adalah apa sangat nak dikongsi.. 

Cuma nak dikenang-kenang dulu masa sekolah, selalu dengar orang cakap kalau jadi doktor nanti kena tidur bilik mayat. Sabar je lah...dah lah kita ni memang serreeemmmz je kan kalau pasal mayat-mayat ni. I went into the morgue setakat ni baru 2 kali, dekat Malaysia. First time masuk sebab ada sedara yang meninggal dunia and needed autopsy. memandangkan the next few days tu I was scheduled to attend JPA's program pendedahan kerjaya, Mama thinks I should try the atmosphere. mama kata takut nanti karang you pitam pulak kat morgue hospital ipoh kan. jom masuk dengan mama dulu, try..

Second time pergi sebab pendedahan kerjaya JPA...tengok la 2-3 mayat lagi dalam peti ais.

I don't like to see mayat dalam freezer tu. I feel suffocated, what if I'm the one who has to be in that tiny box. Itu peti ais, kalau dalam kubur mesti lagi takut kan?

dua ratus lima puluh enam : day 10, i supposed?

Bismillah.

Ok ladies and gentleman. post kita pada hari ini adalah berpaksikan kata kunci " Orthopaedic, bidang kepakaran untuk insan penuh kesabaran ". You see, kalau you tak penyabar, it will not be good for both you and your patient. Eleh, dah tak sabar tu memang bukan sifat yang murni kan..

The vast majority of treatment in orthopaedic - is no treatment. Kadang-kadang just suruh rest... kadang-kadang suruh "'ilaj tabii" a.k.a physiotherapy... even kalau you initiate treatment pun, you still kena wait and see. bukan wait and see sekejap pulak tu. you waaaaaaaaaaaaaaaaaaaaaaaaaaaait and see. haa.. gitu...

walaupun you orthopaedic surgeon... you try as best as possible to avoid or at least delay the need for surgery. jadi kalau you jenis gila nak cut someone open je, pergi nun duduk department jarahah dengan Dr.T bukan nama sebenar... suspect je appendicitis terus operate kan... 

i heard one of the resident, trying to impress attending pagi tadi, quoting that he read from a text book that says "You spend five years to learn how to do surgery, and another fifty years on how NOT to do surgery". as for me, I tak sesuai lah di department ortho ni, sebab I ni kurang sabar bab menunggu. I'm very bad at waiting. If I want to know something, I want it quickly. If I want something, I want it right away. teruk betul perangai... 

also, today we have this conference on neurosurgery... our group attended the first talk about new surgical technique to treat spondylosis. DTRAX facet namanya... very interesting you know..I terus call rumah la balik tu tanya abah what was his condition yang doctor bagitau, and  yes he had spondylosis... memang kesian sebab tangan asik kebas-kebas je tidor pun dah bertahun-tahun tak lena... sob3.. tapi disebabkan before ni surgery untuk spondylosis ni very risky - major surgery... biasanya dah teruk baru doc akan bincang option untuk surgery..

tinggi lah cita-cita saya supaya one day abah pun boleh buat DTRAX ni and tidor lena di malam hari..ok, mungkin mmg dtrax ni bagus, ataupun mungkin Medi Rep tadi tu je yang pandai sangat kempen...hehe

till then, toodles!

dua ratus lima puluh enam : day 9

bismillah...

Hola gorgeous ladies and non-ladies.... :-) nothing new about orthopaedics except for the fact today we were asked to take history and present our cases. OMG.. dah 5 bulan kau tak amik history, baru la nak ek uk ok ha kan depan patient... component of history pun hilang melayang...rasa macam budak tadika je hihi.. nak-nak pulak time present attending (baca : akhisso', pakar, specialist) suruh ko explain about the x-ray... 

So, harini our patient is a Syrian revolutionist, blast injury to the knee. Muda lagi tau, baru 25 tahun, anak isteri still in Syria.. Semoga cepatlah selesai kekecohan di syria ni, May Allah bless the Syrians. 

yesterday i kena present pasal bone of the tumor...sabar je la...makan 2 hari buat slides nye sebab buat kerja tak tumpu...alih-alih ade la dalam 5 slide je yang kena present.. So, kepada yang bakal rotation Ortho, my advice kalau nak buat presentation : JUST PUT PICTURES and know your material very well... lepas tu, TEMBAK audience with questions - make sure you know the asnwers la..camtu la kaedahnya... tapi takpe la, belajar dari kesilapan..berjela-jela salin dari APley's tu, doc taknak tengok pun slide fakta, die suruh bukak gambar, explain gambar dan tanya kat audience kita soalan berkenaan fakta penting untuk tumor tu.

4th Year Intro

wokey.... as promised la ek, since my day in Ortho is not that interesting. *ops terlupa,ok xpe2 taip kat atas*   nak berkongsi petua ewah2 petua lak kau kan... dengan adik-adik kesayangan lah batch 4th year ni.. ni dah minggu ketiga kan korang intro... next week last, pastu exam.. yang syabab mahupun akhaat masing-masing seronok tangkap gambo OOTD lagi... tau ke OOTD dik non? 

anyway... kalau by this week korang rasa bahasa arab korang tunggang langgang lagi, tak teratur lagi amik history, don't worry... you still have a long way to go.. ape yang penting sekarang ni, kena la dah start study untuk exam.. ko cakap arab berabuk sekali pun di bulan intro ni, means nothing kalau exam tak terjawap dek kerana tak habis study... aku la tu jenis intro pun menggelabah adeeee jugak tak habis baca. kata kuncinya - STICK TO ONE SOURCE. source yang mana? tepuk dada tanya selera... kalau nak pakai lecture notes mmg bagus, sebab itulah bendanya nak keluar exam, cuma yang tak bagusnya, dikhuatiri ada kesilapan... jadi, buatla fact check..

past year questions penting tak? penting... tak rugi pun buat...kalau tak keluar exam pun, at least dia bantu kita untuk tahu what's going to be asked in the exam.. so, susun la strategi...sehari buat 10 soalan pun, kalau ada 14 hari dah 140...tak gitu dik non?

regarding bahasa arab tu... ni boleh la korang nak buat sama ada sekarang, or bila dah start rotation betul nanti... ade kan, list soalan dalam bahasa arab tu? so you practice la one day one section... hari ni bagi terer patient profile..esok, GIT... begitu lah seterusnya... inshaAllah kalau istiqamah, dalam masa 2 minggu boleh tanya soalan dengan baik... nak faham dengan baik? itu rahsianya pada banyak amik history, dan fahamkan kaedah pembentukkan kata.. you learn the most from your patient, diorang pun akan bantu kita faham sebenarnya... for me, kalau malas amik history baru amik dengan budak arab..awal-awal seminggu ok, ikut diorang, just to get the common words patient say.. lepas tu, pergi la sama-sama melayu...for me, I rasa orang melayu punya history dari segi teknikal mmg lagi kemas dan tersusun, tanya soalan bersistematik.. then, you will encounter some words you don't know - if it's urgent, find your arab friend and tanya apa maksudnya. kalau tak urgent, tulis la dulu lepas tu tanya... 

how did I do during intro course?  I'm not proud of my effort yang tak semenggah... but above everything I'm thankful as it could've been worse. So, don't worry...kalau you go all out, mesti you puas hati.. :-)

one of my regret is tak hafal betul-betul milestone in paeds... yup, it was asked in the exam. jadi, you better start memorizing those things. apa-apa pun ingatlah pergantungan kita pada Allah, rezeki masing-masing...yang penting, kita usaha, tak gitu? 

ok selamat berchentaaa lah you all dengan Mc Leod. tee hee hee.. 

nantikan part seterusnya...i tell you pasal rotation pulak. ewah gaya2 abernathy's secret pulak.. onebonez's secret gitu...

p.s : dipersilakan abang-abang dan kakak-kakak untuk menambah nota kaki... adik-adik pun boleh jgn segan-segan.

dua ratus lima puluh enam : day 6

bismillah..

it's our first weekend. phewwww one week went by so quickly! I find Ortho rotation very interesting. The doctors are half medical professional, half a carpenter and a dash of engineering and physics master. Yes, I saw one of the attending doctors use a ruler with protractor (jangka sudut).

After a week, what to expect in your Ortho rotation?

Waiting, waiting and more waiting. Okay, memang itu lah bab paling tak best sekali untuk group A1 sepanjang minggu first ni. Kejap melangut dekat department, kejap dekat lecture hall, kejap dekat klinik, ditendang ke kiri dan kanan ibarat pola dalam permainan. ewah! ok la i'm being over dramatic. Tapi, bayangkanlah, we waited for one and a half hour for resident to came and teach us shoulder examination which lasted for about 20 minutes only. And most of us end up zzZzzZZ je pun during the clinical teaching.

We complained to coordinator about it, and still the next day we waited for half an hour pulak. Ok waiting time tu tak termasuk gap sedia ada ye. I find it disturbing bila deparment mintak kita be punctual but ends up they didn't walk the talk. So my advice - get your notes ready, make them interesting so that during those dreadful waiting session - you have something beneficial to do.

In the clinics...urghhh... I though we'd learn more in the clinics, but not really. I prefer ward round personally. Or ikut resident in the clinic. the problem bukan pada tenaga pengajarnya but the fact that they don't assign students accordingly. So, please push ketua kumpulan masing-masing untuk lebih proaktif, and yea I miss my 4th year CR..... 

Interesting quote of the week... "You are medical students, the best students in the Kingdom". OMG. and you wonder why budak-budak medic ni ramai besar kepala and disrespectful to others. Memotong barisan dekat mujamma3, kafe dan tak hormat jururawat. 

I busy tau weekend ni sebab nak study dan siapkan power point untuk presentation on Sunday... now I know la kenapa orang asyik pakai presentation lama sebab memang susah nak buat tau... gather information and nak pilih which one to put in your slides... jadi, hargailah lecturer anda yang bersusah payah siapkan presentation for the lectures ye adik-adik... :-)

ok lah. till then. toodles!

dua ratus lima puluh enam : day three

Bismillah...

Ok so today dah masuk hari ketiga kitorg dekat department Ortho... Residents and Specialist semua baik-baik je so far.. A little bit spoon feeding method of teaching nye..

Today our seminar was on "The Spine". Tiap-tiap tahun, tiap-tiap group pakai je slide lama yang dulu-dulu punya... I hope I can make my own lah nanti... My presentation nanti on Sunday on Tumor of the Bones... Kalau pakai slide lama ni, very risky...Kalau tak kena gaya pemahaman kita tu, boleh makan diri tau!

I enjoy Ortho so far. Every case has a story behind it, all the way from sad story, funny and severely depressing. A 20 y/o female pt. was found to have malignant tumor in her knee + metastasized to her rib :-( kebetulan je tahu sebab ada jatuh waktu tengah bermain..Eloklah dia jatuh at least tahu ada tumor...Ada orang langsung tak tahu, tahu-tahu dah metastasized.. Lagi sian kan...

And then there's war trauma patient. Lagi depressing! Kesian tau... one of our patient yesterday (we attempted to take history) was mentally traumatized - he was tortured back in Syria. Harini pun ada jugak.. Kena baling grenade masa tengah duduk depan rumah. Yang kelakar pun ada... Jatuh waktu panjat tembok sekolah..hehehe... macam-macam lah you all...

Ok.. nanti inshaAllah kalau ada masa lapang I will post something for junior 4th year... Things I know now, I wish I knew then gitu... ewah..!

OK lah tatatititutu

dua ratus lima puluh enam : day one Orthopaedics

Bismillah...

Alhamdulillah hari ni hari pertama untuk tahun akademik 2012/13. Bila kita masuk alam klinikal di JUST ni, cuti mula tak mengenal semester, tahu-tahu dah habis setahun je nanti. Mulai hari ini nak menuju ke hari terakhir tahun 5, ada 256 hari yang perlu dilalui dan kita akan mengakhiri journey to the final year ni pada 30 Mei 2013, inshaAllah... Lepas tu, ada rezeki inshaAllah ke final year lah kita ye rakan-rakan dan adik-adikku sekelian..

I group A1, so I start dengan rotation Ortho. The thing is, bila dah tahun 5 ni, mana ada back to school dah kan. (Eleh, macam la pegi pun kalau ada kan). But I did ask around la regarding 5th year to my friends. Tapi, mostly tak berapa ingat dah pun sebab diorang pun dah melalui 11 rotation, mana nak ingat satu-satu kan. So, I berniat nak tulis lah setakat termampu, supaya bila orang tanya next year, I can recall or, kalau I malas I cakap, ok, adik boleh tengok blog akak ye..ada tulis semua.. 

tapi tak la tiap-tiap hari pulak nak tulis kan...karang ada la orang mengata I ni duduk Jordan belajar ke blogging je?

Orthopaedics.

""L'Orthopedie, ou l'art de prevenir et de corriger dans les enfans, les difformites du corp"

Translated as - "Orthopedia: or the Art of Correcting and Preventing Deformities in Children "

-source-

Tempoh rotation : 2 weeks only. tapi, 8 days je yang kita akan berpeluang belajar dari patient. First day ni, intro je dulu. So, 4 hari minggu ni, and another 4 hari minggu depan because on Thursday dah exam MCQ. 

Textbook : Apley's Conscise System of Orthopaedics and Fractures. (15jd kedai buku bayan)

Supplement : Toronto notes (as suggested by seniors).

Mid exam : MCQ

My group of 21 people akan dibahagikan kepada 3, A,B,C.. Setiap hari 2 group round dekat ward, 1 group dekat klinik. As for today ada 58 cases admitted to KAUH in ortho's dept, so... hopefully tak ada masalah nak ambil history and perform PE.

Pasal ward, nanti tunggu I dah round, I'll share with you guys ok... InshaAllah siri "duaratuslimapuluhenam" ni I akan buat at least awal round, and post-mid term lah plus anything interesting in between. Dah tau otak kita ni limited capacity, hendaklah ditulis ya catatan-catatan sebegini...

Routine : Pagi-pagi attend morning report.. dengar resident bentang kes.. Sambil tergamam tengok specialist tanya muscle insertion and origin sambil terkenang Dr. Rashid kan... haha.. lepas tu day one usually lectures, lepas tu balik.. esok start morning report + round + seminar  lah inshaAllah.

Ok lah, till next time :-)

p.s : teringat ada my friend marah because i don't know that "#" stands for fracture...kih3...