Friday, October 12, 2012

Post-HosHas




1) Hospital Sultan Haji Ahmad Shah (HosHas) Temerloh is huge. You might get lost inside the building! When me and my friends went there last Sunday for our 4-day-postings, we were amazed by the sophisticated atmosphere. Compared to HTAA Kuantan, I could say that HosHas wins in the Architecture and Landscape categories, hands-down. However, in terms of number of Doctors/Specialists in the hospital, HTAA can't be beaten. Hehe. 

They also use computer system to record patients' data, but the system was down at the moment. So they had to go back to using files.

2) The very first thing you have to do when you reach the hospital is to report duty to Head of Department (HOD) of Internal Medicine, so that she'll be familiar with you running around being in her hospital. Just inform her that we are from UIA and let her brief you regarding the hospital regulations. We had met Dr.Eliyyin who is very friendly and soft-spoken. Dr. Azureen is another helpful (and cute!) specialist who frequently visits the Ward to do rounds.

For Medical, there are 3 Wards in HosHas. One in Level 4 (Kenanga 14 for female patients) and Two in Level 7 (Kenanga 11 and Kenanga 12 for male patients). You should introduce yourself to Sister (wearing blue uniform) in every wards and ask her to orientate you give you Orientation. Nak masuk tempat orang kena lah beradab sikit kan, tunjuk la yang budak2 UIA ni sopan sopan belaka ;)

3) Then you go and greet the House Officers. You may ask them if there's any case with positive findings. But beware of some 'malignant' HOs, they might give you cold treatment and even belittle you. The cool HOs that we've met are Dr.Syazwaniza aka Dr.Wani, Dr. Yoga (tall Indian guy in glasses) and Dr.Amalina. They even let you do procedures if you ask them!

You can come at midnight if you like to do Venepunctures. In Kenanga 14, the HOs usually take blood from every patients at 12am onwards. So, take good chance of that to fill in your logbook!

4) The MOs however (some of them) are cold. One of my friends got scolded by a male MO when she asked him a question. He thought that my friend is a HO, he asked lots of questions in return. My friend was in tears after the incident.

5) Regarding procedures, me and my friend had observed Bone Marrow Aspiration done in a patient with suspected Chronic Myeloid Leukemia. It was a very rough procedure. The 21-year-old patient screamed in pain once or twice during the process.

6) Speaking of patients, I have met a makcik with Parkinson's Disease! You could observe her resting tremor, it was very obvious!!! **overly excited since it was my first time meeting a PD patient! :D :D :D

She also had rigidity and bradykinesia (when she writes). She had stooped posture, reduced arm swing and shuffling gait - typical features of PD!

When I wanted to check for Facial Nerve, I asked her, 'Makcik boleh senyum sampai nampak gigi tak?'

She smiled sheepishly and said 'Makcik takdek gigi..'

Yeah, she had no teeth at all. Hehe. My bad.

I was thinking of writing a Clerking Note about this makcik. It's a very interesting case.

Apart from the makcik, I have seen cases like Symptomatic Bradycardia (his HR is 44bpm!), Hypokalemic Periodic Paralysis, Acute Myeloid Leukaemia, Uterine Carcinoma and Chronic Demyelinating Peripheral Neuropathy with high stepping gait.

7) Long and Short Cases with Dr.Marzuki and Dr.Kuan were enjoyable since the eight of us could have face-to-face discussion with our lecturer. We could ask questions and express our thoughts freely. I like that very much.

I wish we have more clinical lecturers in UIA, so that Long Case and PBL sessions could be done in smaller groups, not 32 students altogether in a single session.  

8) In HosHas, I've met several patients who were waiting to be transferred to Kuantan for further management. I was surprised when a patient greeted me in HTAA yesterday. 'Dah balik dari Temerloh dah?', she asked. I was totally surprised. What a small world.

She is 4 months pregnant from Raub. She went to Hospital Raub only to be told that she will not live long and her baby might be in danger. So she was transferred to HosHas and later to HTAA. She told me about her heartbeat that can be felt over her heart.

On palpation, you can feel the thrill over her left sternal edge. It's truly amazing! On auscultation, pansystolic murmur was heard. I asked her questions about chest pain, orthopnea, PND but she did not report any history of any cardiovascular symptoms. She said that she was apparently healthy before the admission and this is the first time her being in a hospital. She said that she have had the murmur since birth. 

9) I had my Clerking Note checked by our Mentor. I wrote about a case of Uncontrolled DM with underlying Thyrotoxicosis, HPT and Hepatitis C.

I mentioned about my patient's description about her thyroid size, it was about the size of a chicken egg Grade C.



I couldn't tell if the 'What?' is for 'What?! You should mention the size in cm!' or 'What is Grade C chicken egg?'

So I Googled the eggs. Hehe.



 What is the standard size of a Grade C chicken egg? Hmm.

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