dua ratus lima puluh enam : day 92 Obs & Gynae

mashaAllah.. cepat sungguh masa berlalu. tahu-tahu dah 92 hari berlalu... 4 rotation minor, sekarang I'm doing my Major rotation Obstetric & Gynaecology. Total buku yang dibeli : 3 buah sebab bukunya saling melengkapi. ZzzzZZZ... member 6th year pulak pesan,

"Ko baca 10 teachers tu untuk Osce, mini Osce... tapi Hackers ko kena baca untuk final pulak".

Obviously, as you can see OnG is not that exciting for me. which explains the 38 days gap of my dua ratus lima puluh enam series update. Of course in OnG you learn to appreciate your mother more. I myself was born at 4.32 am in the morning, C-section due to fetal distress. Well, I bet having to deliver at such wee hour and going under the knife - that, itself was highly risky for my mom ok. not that I want to bring up the issue la that my birthday is coming in almost 3 months time ^_^ oi...makin hari makin tua.. i'll be 24 omg.. (even had to pause a bit to count my age. wattaaa??) no idea lah what to request... Maybe this year I'll just ask for cash from my siblings. senang kan. bagi duit je. emas sekilo ke..muehehehehe...

Just some points I think worth-mentioning.

• I have met a patient who thinks LMP means the last EXPECTED menses.. Let's say real LMP 1/11/2012, suspected next menses 1/12/2012 (for illustrative purpose). This patient thinks LMP is 1/12/2012 and did pregnancy test like few weeks later - positive for pregnancy. Wrong gestational age = wrong management.
• Today was my first day in military hospital. I was amazed with their uniform. I even have the thought of joining the army forces after I graduate - just because of the uniform, of course. Unfortunately today my patient was quite difficult to understand. I asked her for how many years did she BF-ed her son, 1 year... 2 years..? She answered me with "Aa..ya3ni...1 year...2 years...". When did you go for booking visiti? " I go to the clinic every day". We nearly burst into laughter in front of this particular patient. 
• Your local colleague doesn't always understand the patient history. One day we shared a patient with some students and once we stepped out of the room they tells us they don't understand the history. Patient was an Arab too. Also they claim that the patient was annoying and wanting to punch her in the face. and I was like ??????

of course there are happy days in OnG department. Like seeing the look on your patient's face who just got married in her late 30s, primigravida seeing her baby on the ultrasound device, exclaiming "Oh, My baby....". And some mommies who are very excited to deliver their first child, supportive husbands and stuff. And your hormone goes crazy from all these emotion roller-coasters... 

and last but not least. the screaming! traumatizing. enough said!

BTW I'm back on 30 day shred - again! Tapi susah laaaaa takde support group.. So if you want to lose weight, but don't want to spend money on H****L***, gym membership, diet and protein shake.. Come and join me lah. Kita exercise and eat healthily je.. I promise no calorie counting. No product. No nothing. Just a huge amount of your willpower and some imagination. ;-)

Till next time. Toodles!

dua ratus lima puluh enam : day 54

now, where were we? day 54! kejap je kan dah dekat dua bulan dah... cuti banyak pulak tu in between... hehe.. Alhamdulillah sekarang ni I dah start rotation Anaesthesiology.

memang best ye sebab kalau dah dari kecik cita-cita nak jadi surgeon dapat masuk OT tu rasa macam budak dapat pergi zoo or playground..hehe.. tapi dah duduk dalam OT terus tukar cita-cita? Our day start as early as 8 a.m.. kalau sampai OT around 8.15 usually part anaes dah berlalu pun, so tunggu la untuk next surgery pulak... group I around 9.30 akan start seminar. Lepas seminar boleh balik, and you can also hang around in the OT and see other surgery. Best kannnnn!

First and second day, I was in Gynae, then Urology... Harini I duduk dekat general surgery, so I saw 2 laparoscopic cholecystectomy + hernia repair... tapi hernia tu tak tengok habis sebab I was exhausted berdiri lama... 1st case tu acute cholecystitis, start around 8.15, 9.40 I pergi seminar... 11 am I balik OT tu still tak habis lagi oi! And that team have one patient after another...

First day and second day tak ada drama sangat lagi... Harini baru ada drama sikit, most probably sebab muqim general surgery? And I witnessed consultant anaes yelled at the residence, technician. I pun kena buli dengan consultant tu.. Suruh cakap arab ammi kampung.... The whole OT were laughing at me sebab not only doc tu suruh cakap, siap suruh buat gaya... mommyyyyyyy... worse than kena marah tau perasaan dia!

Tapi takpe la, belajar banyak... I also learnt a lot from technician.. technician laparoscopy and technician anaes. Technician ni bukan tahu mesen je, dengan anatomy semua tau sekali. Siap bagi opinion pulak dekat attending. (?)

Sabar je la, round radio minat radio...round anaes minat anaes.!

dua ratus lima puluh enam : day 17

bismillah.

"cukuplah maut itu sebagai peringatan"

Semalam, pada hari kedua rotation forensik, I dah syak dah kemungkinan nak tengok autopsy disebabkan sampai-sampai je pagi tu terdengar alunan ayat suci alquran entah dari mana. Orang ofis kot pasang. Dan bau kemenyan arab or setanggi. (This is my theory, sebab on Sunday, and today Tuesday tak ada pun, dan tak ada kes for us to see). Also when we walk pass one of the rooms nampak macam ada ramai-ramai orang pakai kot putih tengah duduk semeja macam morning report je kan.

 Then Dr. datang bagitau pagi ni kita ada dua kes, satu RTA, satu cardiac arrest. Dua-dua umur 27 tahun, one male, one female. Bila kita rotation forensic ni, autopsy is priority. Kalau tak ada autopsy, kita proceed dengan seminar, kalau ada kita turun pergi tengok dulu, then only kita sambung dengan seminar. Sebab bukan every morning ada kes kan. So, we were told to leave our stuff, and took barang penting je untuk turun. No laughing and smiling allowed. So, kalau excited pun jangan nak buat muka excited eh.

Nervous jugak la kan, tapi tak de la takut rasa nak pengsan macam first time masuk morgue dulu. Rasanya semua orang pun ada perasaan yang bercampur baur pagi tu. Kita teruja nak belajar, at the same time kita tak tahu what to expect, dan perasaan ingat mati pun datang menyapa jugak sekali sekala. Lepas tu kita pun masuk dan mayat tu masih berbalut dengan cadar dia, lepas tu Dr. suruh kita keluar dan panggil staff untuk prep kan mayat tu untuk autopsy. Remove her clothes and basuh-basuh skit kan.

Lepas tu masuk balik, dan proceed lah dengan teaching. Tengok hypostasis, primary rigor mortis and stuff like that. As for me, I do have this feeling takut bila tengok mayat yang mayat. (ha?). Kalau tengok movie pun, mayat, especially yang berkapan, berselubung ke, muka pucat lesi tu, I memang tak berani - I blame it on the fact that I jarang ikut pergi ziarah orang meninggal - well vicious cycle of fear. Once the Dr. cut her open, rasa takut memang hilang sebab I detach from the fact it's a mayat sebab I dah focus dekat the anatomical details of her internal organs. Ok now I sounded creepy - tapi kalau benda fresh memang I rasa macam tu. Fresh blood is OK for me, even kalau banyak pun, tapi kalau darah kering dekat dressing luka, or cadar I memang tak berapa selesa nak tengok. I have to admit, memang jaaaaauh beza tengok organ waktu autopsy dengan organ dalam lab anatomy kita tu. Walaupun dalam lab kita pegang-pegang kan, tetap tak sama. 

Walaupun I was hoping to see more autopsies masa first day of forensic, after that one autopsy rasa macam hmmmm... cukup lah kot dulu. Sebab post-traumatic distress syndrome dia...Ha.. sampai ke malam nak mengenangkan. Sampai balik rumah, dah nak masuk tidur pun dok terbau-bau lagi ye. Selama ni what I perceived as bau mayat is actually bau kapur barus. Abah kata sepatutnya tangan tu siap-siap sapu belacan, so that bila dah masuk dalam bilik mayat, agak-agak nak bau tak best, just bau je belacan kat tangan sendiri. Malam tu before abah n mama tidur masing-masing pesan supaya tidur je dan jangan ingat-ingat dah pasal autopsy t - heh, ye la tuuu.

We didn't get to stay sampai habis autopsy doc dah suruh keluar for some medical reason - which doesn't really make sense. Tapi kiranya masa tu heart, lung, spleen, liver, kidney, uterus semua dah bawak keluar for investigation. Besar jugak kidney ye rupanya. Isi perut pun doc amik sikit specimen. 

Terkedu jugak ye lepas tu. Laki ke perempuan ke semua sama je. 

Itulah, mati tu tak mengenal usia kan. Mama kata actually ini semua rezeki. Sebab ada jugak mama pernah jumpa doktor yang tak pernah tengok autopsy dari sejak belajar sampai dah 25 tahun kerja pun. Ha.. ada tau. Bak kata along pulak yang  moleknya kalau peluang tu kita guna untuk mengingatkan diri kita tentang kematian. 

One more interesting thing tentang morgue ni, adalah cara dia susun tempat tu. We won't bump into family members. I don't think people will be comfortable knowing 20+ med students are there to see the autopsy. Kalau kat sebuah hospital di Malaysia tu, mayat masuk ikut situ, family pun tunggu situ, student masuk ikut situ, pekerja masuk ikut situ. Ada ka patut... Apapun semoga Allah ganjari lah si mati dan keluarga dengan balasan yang setimpal, kita ni dapat ilmu pulak dari dia kan.. 

Yang sayunya tu sebab muda lagi kan. Lepas tu, bila doc bukak tu, aku terfikir pulak. Mintak-mintak bila aku mati nanti tak ada kena autopsy, nak-nak orang arab yang buat, kasar nampak gayanya.. Takde beradun macam ko tengok dalam CSI tu...tipu daya je semua tu... Dan terasa sangat nak jaga kesihatan sebab malu rasanya kalau mati, memulangkan barang pinjaman dengan keadaan tak sempurna.. 

Sekian.. renung-renungkan dan selamat beramal!

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

elective...oh elective..!!!

okay..quick entry for juniors yang nak tasjil starting tomorrow

so, I'd list all four electives I've taken with a little sneak peek.

Year One : Home Garden with Dr. Ibrahim

Medium : English - very rarely the professor will speak arabic.

Attendance : Very Essential

Bonus : Probably

Exam : MCQs + True/False

How I benefit from the course :

- what to consider before planning a landscape for your house

- Discover the beauty of Allah's creation of nature e.g ; sunflower is a good indicator of the water supply of your plantation

- the techniques to take care of a garden - pruning, sowing soil.

Year Two : Wellness and Fitness 

Medium : Awesome English

Attendance : Very Important - and you can't be late!!!

Bonus : If you participate in Master's student research, u'll get some points.

Exam : MCQs with OMR forms. 

How I benefit from the course :

- the essentials before starting to work out

- mistakes people do during workout

- what, when, how to workout.

- Jillian Michaels 30 Days Shred is freaking awesome!!!

Year Three : Food Preservation

I was reluctant to take it at first, due to rumors there will be a lot of microbiology involved - MYTH BUSTED!! and it is no where near boring.

Medium : English

Attendance : Very important

Bonus : None?

Exam : MCQ; and many people who studied well get perfect scores, I DIDN'T.

How I benefit from the course :

- How to make laban and cheese

- How to make smoked sausage?

- Hygiene in food preparing

- UHT milk has longer shelf-life

- Defrost food in refrigerator, because if you simply soak them in water, the bacterias might produce endotoxin that are heat-resistant.

- Plastic utensils are better than wooden utensils.

- Many-many more

- Free soy milk and tofu + soy milk deal with vendor from Amman. hehe

+ the microbiology is easy if you've taken microbiology course.

Year Three : Farm Animal

Medium : English

Attendance : Really important - if you exceed the allowed number to be absence - he will drop you from the course.

Exam : MCQs + Fill in the blanks

Bonus : None

How I benefit from the course :

- If baladi meat is sold below 10 jd, you're being cheated.

- How to make laban and cheese again

- Types of cow, sheep, chicken.

- material covers the breed of the species, and their products

- cuts of lambs and cows ; so I know why is it sterloin steak.

Bottom Line : It's summer semester and these are elective subjects - Expect attendance to be super crucial and the load of material - if you study everyday, you'll be okay. AND IT'S ALL ABOUT MEMORIZING.

till then, toodles!