Sunday, June 30, 2013

Of Story and Gossip

Here's a funny story about my Saturday. That morning, I woke up at 8 and took a looong shower. After breakfast, I sat at my table and took my sweeet time to watch random YouTube videos. I planned to do a bit of studying right after, but I ended up browsing until 11am.

Since I have to go to town to buy my sister her moisturizer as well as chicken rice for lunch (my parents went out for a meeting), I quickly changed to my outing outfit. Shawl, long dress and wedges. I grabbed my bag and my phone, ready to go.

Oh. An sms from my friend.

'Jgn lupe onkol rini yunk' sent at 7.10am this morning.

I was like... WHATT? SERIOUSLY? I TOTALLY FORGOT ABOUT IT!

So I rushed to get into my car and called my friend on my way to the hospital. I arrived at 12pm, only to find my friends were ready to go back. The ward round had finished and I missed it! Arggghhh!

After saying goodbye to my friends, I made my own rounds in both wards. There's this makcik who was admitted for chemotherapy due to rectal carcinoma. We talked for a while and when I was about to go, she then smiled and said, Doktor ni cantik lah..

That comment took me by surprise! I laughed and thanked her. That compliment made me feel embarassed somehow. I felt the need to explain to her that I dont usually dress that pretty everyday. I was actually planning to go to town, not the hospital. But I just smiled and quickly made my way out of the ward.

Ahhhh I hate being overdressed for work!

My 'round' ended at 1pm. Then I went on to settle things in town and drove back home.

About today, I just came back from night on-call (I remembered this time, haha). Right now, I am feeling a bit tired so I'll write shortly okay.

I followed Dr.Wazir (he actually taught me stuff in his round, how unusual of him to do that! maybe he was in good mood) and after it finished, I then discussed about renal stones with my friend. Another friend came and told us that she saw Dato' Jiffre in the ward upstairs!

I WANNA SEE HIM!

We were informed that we cant follow his round, so I went upstairs and pretended to talk to a patient next to the one he was checking on. So that's how he looks like.. Interesting.

Then I saw Mr.Faiz doing his round so I joined in. We met a pakcik in acute bed who wore an oxygen mask. He looked uncomfortable. Mr.Faiz's impression was that the pakcik suffered from Pulmonary Embolism and Acute Coronary Syndrome.

I was listening to him interacting with the patient when suddenly a doctor (HO) touched my shoulder, came up to me and whispered, 'Ain, nak tanya skit bleh..'

I moved closer. 'Dia tu dah kawin ke?', she asked with her eyes pointed to Mr.Faiz.

I smiled and whispered back, 'Dah doktor. Isteri dia bekas student UIA jugak.. Kenapa doktor?'

The doctor made a sad face and said, 'Dia baik...' and then she got back to her work. I smiled knowingly.

After we finished round, I went up to her to say goodbye. Then she asked me again, 'Ain, isteri dia orang mana?'

'Orang Sabah ke Sarawak... Hari tu ada Dr. cakap waktu kitorang join clinic dia, tapi Ain lupa dah..' 

'Isteri dia sama umur dengan dia ke?'

'Hmm tak tau la plak. Maybe la kot, rasa macam sama batch je..'

I could sense that the doctor was somehow disappointed. I just smiled and left.


Aisshhh doktor, jangan main-main. Suami orang tu... Hahaha


So that's all about tonightt. I need to sleeeppp. Goodnightt!! :)

Saturday, June 29, 2013

Clinic, OT, Outing & Online Stuff

So Friday. Many things happened that day. I'll sum them up for ya!

1. Clinic. We attended clinic with Mr.Ahmad Faidzal (one case), Dr.Aisyah HO (one case) and Mr.Faiz (a few cases) this morning. As usual, Mr.Faiz taught us things. Like the differentials of dysphagia (benign condition like oesophageal stricture/spasm, malignancy of stomach, pharyngeal or oesophagus, esophagitis, achalasia etc.), types of biopsy (excisional, incisional/wedge, core/trucut), investigations in achalasia (XRay, OGDS, Barium swallow, Esophageal manometry) and a few more things.

2. OT. After Asar, we went to see Urology cases in the OT. Dr.Hafiz (MO) was there to handle the patients. There were 5 cases at that time, with procedures like Removal of Stent (ROS) and Cystoscopic Examination (CE). We met our friends, the student nurses from UIA in the OT. They were in the evening shift from 2 till 9pm.

Selfies when no one was looking. Too bad you cant see us smile :D
Only two of us since our other friends were studying in the break room
It's not easy to get these green shoes!
3. Outing. At 6pm, me and my family went out for dinner and shopping. My two sisters came back home from their hostel for weekend holiday. My Dad bought a watch for every one of us! Yay Yay I got a new watch! It's a black one too :)

4. Online Stuff. The parcels had arrived at my house this evening. I bought a few cardigans and a pair of shoes (a reaaaallly cool one!)

You HAVE to see this!

Asked my sister to help me taking photos. I was in my sleeping outfit.
That orange cardigan is new. So are the shoes!
ps. sorry the room was a bit messy, hehe


How can you not LOVE these? :D
Tomorrow morning (that is today), I have to go to town to buy my sister some stuff. I am still not sure if I want to go to the hospital or not.

I need to read and study though...

Ahhhh. I want a day off please. A day when I can get up late in the morning, listen to music in bed and do my own stuff. No reading. No studying. No handphone.

But laptop is a yes! Hahaha.

ps. Since a friend of mine told me that there is no such word as stuffs (stuff is the right term), so I had corrected the mistakes. Learning from a native English speaker is such an honour! (he's an American) :D

Friday, June 28, 2013

OT Time

Okay. So lets recall about yesterday.

1. We had bedside teaching with Mr.Islah yesterday at 2pm. We discussed on Ureteric stone. The patient presented with lumbar pain radiated to back, fever, as well as hematuria for 6 days. In this case, you have to rule out bladder carcinoma or renal cell carcinoma. Hematuria is a very alarming symptom in urology, so you have to do hematuria workout. Check the UFEME, Urine C&S and Cytology.

When you examine abdomen, you have to complete it by examining his back (scar, sacral edema, renal punch, spine abnormalities), inguinal (hernia) and groin region (scrotal swelling, hydrocele).

My friend who presented the case got 21/25 marks, even though he left a few points in history, and his chief complaints were inaccurate. Anyone who get Mr.Islah in exam would be so lucky!!

2. We watched four operations in the OT yesterday. First, the Cholecystectomy case where the gallbladder of the patient was removed due to stones. We saw Mr.Faizal hold the excised gallbladder and we saw several small black stones in it.

Secondly, the Upper Back Lipoma case, where surgeons excised the mass to get it out. I did palpate the lipoma, it was soft, rubbery, non-tender with well-defined margin and smooth surface, round in shape at the upper back of the patient. The size was about 8x8cm.

Thirdly, in the evening, we went to OT again to see Mr.Ahmad Faidzal operate on a patient who was electively admitted for Vascular Graft insertion. We didnt manage to see the entire operation, so we asked Mr.Faidzal about it. He drew us pictures and explained. Basically, you connect the loop graft with axillary vein and brachial artery. With artery, you have to connect it end-to-side, but you can do end-to-end connection with vein. You can use the graft to do dialysis. 

I clerked this pakcik Alias in the ward before his op. He was diagnosed to have End Stage Renal Failure in 1993, and he had made many fistulas on his arms, I think about four times. If you look at his left forearm, you can see scars (from fistula operation) and bumps (from the non-functioning fistula). And his right forearm, there were bumps too. It was sad to see so many scars there :(

And he had undergone parathyroidectomy years ago. Three of his parathyroid glands were removed and one was implanted under the skin of his left forearm! You cannot feel the gland but there was a small scar there. Parathyroid gland at your forearm, how cool is that!!

Then the last operation was Mayo repair on umbilical hernia. Yeah, we examined the patient too. The mass was felt inside the umbilicus, about 2x2 cm and it was soft (omentum).

It was our turn for on-call last night so we stayed after 5 and followed night round with Mr.Rudy. The most interesting cases were  of Infected Urachal Cyst and Orchiepididymitis.

I reached home at 11pm, took shower and slept like a baby. Hehe.

Wednesday, June 26, 2013

Of Hernias and Outings

We had Long Case session with Prof.Azmi this morning, on the topic of Reducible Inguinal Hernia. He asked us a lot of questions, but we only managed to answer a few. 

My mind went blank during the second half of the session, because I was trying hard to recall and imagine the diagrams of inguinal ring and the associated structures. I was totally lost in thought! And I hate it. I felt stupid. Very.

So after the session ended, we all decided to revise back on the chapter. We spent the evening reading and memorizing.

1. Classifications of hernia: Reducible, Irreducible, Strangulated, Obstructed and Incarcerated

2. Types of hernia (common): Inguinal, Femoral, Paraumbilical, Spigelian and Epigastric  

3. Difference between direct and indirect inguinal hernia?
Direct: It pushes directly forward through posterior wall of inguinal canal ito abdominal wall defect (Hasselbach triangle)
Indirect: It passes through internal inguinal ring, if large may involve external ring as well

4. Which is more common, direct or indirect inguinal hernia?
80% are indirect with risk of strangulation

5. Relations of inguinal canal:
Floor: Ligaments (inguinal and lacunar)
Roof: Muscles (internal oblique and transversalis fibres)
Anterior: Aponeurosis (external oblique) and internal oblique for lat 1/3
Posterior: Transversalis fascia (lat) and conjoint tendon (med)

6. Contents of inguinal canal in male:
+ Fascias (external spermatic fascia, cremasteric fascia and internal spermatic fascia)
+ Ilioinguinal nerve
+ Spermatic cord (vas deferens, obliterated processus vaginalis, lymphatics, arteries and veins to vas, cremaster and testis, pampiniform plexus and genital branch of genitofemoral nerve and sympathetic nerve)

7. In female?
Round ligament of uterus is present 

Okay so that's a bit about Inguinal Hernia! :D 

Me and my friend went back early in the evening because we wanted to register (re-register!) our Wifi at ITD. So by 4pm, I dropped my friend off at UIA, went back home to get my laptop, and then went back to UIA. The registration finished at about 5.30pm.

I went back home, took shower and dressed up for an outing with my girlfriend. She was fasting today, so I agreed to take her out for break fast. By 7pm, I reached UIA and we went to East Coat Mall for PIZZA!

Initially, our plan was to watch Monsters University 3D after dinner. But my Mom didnt allow me to go inside a cinema. So I had to be grateful for just a dinner. It was still fun though!

My Mom wouldnt know if I secretly go and watch the movie, right? Heck, I can even go out with a guy if I want to. It's a date!

But of course, I wont do that. I am a good girl!

Am i NOT? ;)

Tuesday, June 25, 2013

Tiring Tuesday

1. So today was OT day. Me and my friends went to the operation theatre to observe an operation of a patient with rectosigmoidal carcinoma. They planned to do laparoscopy KIV laparotomy. 

The uncle was a 68-year-old Malay, a chronic smoker, presented with per rectal bleeding, tenesmus, altered bowel habit as well as constitutional symptoms (lethargy, loss of weight and appetite). He had underlying ischaemic heart disease, bronchitis as well as hypertension. There was no family history of malignancy or polyps. 

Regarding laparotomy, the surgeons made a long midline incision on the abdomen, cut through all the abdominal layers and got inside. They got the intestines and omentum out of the body through the incision - and checked every segments for abnormalities. Watching the surgeons 'play' with the sausage-like large intestines, it was kinda cool. I wonder how does it feel like to touch it... rubbery? smooth? firm? It did look like a balloon though. I imagined poking it with a toothpick and it explodes! Haha. Okay, that was cruel.

Prof.Azmi, Mr.Fadel and Mr.Luqman were the surgeons in-charge. The MOs were Dr.Ezmas and Dr.Salleh. The only HO there was Dr.Insafiyah. The operation started at 11.30am and ended at 4.30pm! It was tiring, no joke about that. But we got to see Bladder catheterisation, Laparoscopy, Laparotomy, Colonoscopy AND Sigmoidoscopy! It was 5 hours of awesomeness! :D

2. After OT, I went to the Ward to 'cover' patients in my cubicle. There was a patient with Motor Vehicle Accident (MVA), an uncle with non-functioning fistula (he wants to insert Vascular Graft), severe acute gastritis, gluteal abscess, 2 appendicitis patients and a few more I cant remember. I left my notebook in my car, and I am too lazy to get it. Hahaha

I went downstairs to the female Ward. I wanted to find a breast lump case for our bedside teaching. I met one auntie with advanced breast carcinoma (mastectomy done) with metastasis to liver and brain (she had hepatomegaly). Next to her was another auntie with the same problem. But she couldnt move her right arm. She had fever and looked lethargic. She still has the lump since she refused operation few months ago. Now that the cancer cells had spread to other organs, there is no use of operation. She will undergo chemotherapy to kill the cancer cells later. I would love to examine her, but seeing her in pain, I didnt have the heart to trouble her :(

3. By 5.30pm, I drove back home. Yeah, it was late. I usually went back before 5 or at 5pm. On the highway, there were lots of cars and lorries - I couldnt speed up as usual!! The speed limit is 90km/h, can you believe that? It's the highway, come onn! They should have set it to 110!! Seriously!

4. At 6.30pm, I had my 30-minutes biking exercise. I gotta have these songs on my mp3! Listening to online radio while working out was no fun!

When this song came out, I felt like lying on my bed, close my eyes and feel the music! This is totally NOT the best workout song! Haha

5. Then after shower, out of the blue, my 8-year-old sister suddenly asked me to drive her to 7 Eleven to buy a drinking can for her project at school tomorrow. I was like, What? Whyyy? You couldnt tell me that any sooner?! I started nagging at her for about 5 minutes, only then I agreed.

My parents went to Bali for a few days, so I have to be responsible for whatever happens in the house. That means - I have to deal with that little annoying sister one way or another. Otherwise, she will keep asking and asking until she gets tired. 

Plus, my parents will be back home soon at 12am. I definitely dont want them to hear my sister complaining about me not being 'responsible'. And I am using my own money to buy her stuffs! It's not just a can, but two! And an M&M! And cookies! I think I have told her to buy only A CAN - no more than that. But did she listen to me? DID SHE?!

Ahhhhh. Kids nowadays. They never listen.

Okay okay. I'll stop now.

I have to study (or sleep) anyway.

Ive got more to tell, but I think I'll write 'em later.


You have a good day okayy! :)

Sunday, June 23, 2013

A Hazy Weekend!

Haze Oh Haze...
API in Muar spikes at 746!! Air Pollution Level > 301 = Hazardous!
Source: wiki

Hmmmm...

When I had my Saturday On-Call, I didnt realise that the haze was that bad here in Kuantan. 

But today, when I went out - boy oh boy... it was suffocating outside!

Ready for a date....
(that is a pair of brand-new wedges, btw. Hehehe)
...with my sister! Hahaha
We went to UTC (Urban Transformation Centre) near Stadium Darul Makmur, Kuantan...
..to renew my passport!
[If you want to renew your passport, don't forget to bring 2 passport-size photos of yourself. But if you dont have them, dont worry. There's a photo booth inside the centre - RM12 for 4 pictures, you have to wear black/dark scarf though]

The officer at the counter was super 'friendly'. When he looked at the height section on my 2006 passport, he asked me, '152?' I thought that he was asking for the payment. But then he said, '152 tinggi? Naik 2 cm je ke?'

I felt like hiding under the table and covered my face in shame! Hahaha. I pretended to laugh and turned my face away to watch the TV. Maybe he realised that I was feeling uncomfortable, so he started a small talk.

'Student lagi ke?'
'Haah student'
'Kat mana'
'UIA..'
'Ohh.. UIA..'

I glanced at his fingers. A ring there. I smiled.

'Nak gi mana ni?'
'Korea'
'Wow Korea. Sorang ke?'
'Taklah. Dengan adik and kakak..'
'Ohh...'

After the process was done, I was asked to complete the payment at another counter. RM100 for 2 years renewal, RM300 for 5 years and if you bring student offer letter of your university, then you get 50% discount. I just knew that!! Since I didnt bring much money, I chose the RM100.

It took an hour to get the passport ready, so me and my sister decided to take a tour inside the UTC to kill our free time. 

All government offices/services in one place.. Awesome!
UTC opens every day from 8am till 10pm. It has post office there, MARA, PDRM, JPJ, ATMs and many more! There is a Gymnasium at Level 3! It looks very cool, I wanna go there to work out!!! At 12pm, we get the passport and headed back home.

Hazy...
*sigh*
There. The new 'cooler' passport on top.
And the more 'matured' me. Hahaha
Except Israel :)
I didnt go anywhere in 2007 because I was in Form 5, I need to focus on my SPM.

In 2012 last year, I chose not to follow my family travelling because I just started my Clinical Year, and Internal Medicine was downright scary. Haha

Now in 2013 - KOREA here I come!!! :D

Thursday, June 20, 2013

Random Videos

What do New York people think about Muslims in general? Interestinggg


Can I go with you? :)


Awww Taylor.. :')


I think Id have a heart attack..


What about our promises?

Miley Cyrus's Who Owns My Heart is definitely better than We Can't Stop. Waaaayy better. I cant put her MV on We Can't Stop here because I regard it as highly inappropriate. Hahaha

I like the old, good Miley! Bring her back pleasee :(

And Psy's Gentleman MV? Eww.


This is scary. Seriously!

ps. Still need to work on my Case Write Up tonightt. The due date is TOMORROWWWW!!

AHHHHH. Last minute work is no fun! :(

Wednesday, June 19, 2013

Long Night Ahead

Hi Hi Hi! :D

This is me reporting live from my bedroom. High on caffeine!!


Need to work on my Case Write Up tonighht.


On Acute Cholecystitis secondary to Periampullary Carcinoma.


Its good that we only have to submit a softcopy of it to our lecturer.



Coffee? Check. Music? Check.
Want some? Hahaha
Shhhh... I need to work now. 

Go make yourself a glass of coffee too!

Have a good day people! :D

Friday, June 14, 2013

The Friday

1. I started the day with my left foot drenched in drain water. Luckily my Mom kept a pair of spare socks in her car. (I hate driving my Mom's car to school. It makes me feel small!)

That drain. I hate you.

Moral of the story: Watch your steps carefully!! Hahaha 

2. I watched my friends clerked few patients who were in pain and seemed irritated. If it were up to me, I wouldnt dare to talk to those kind of patients. I mean, imagine that you are in a lot of pain and some students (who are not even qualified doctors yet) came up to you to ask questions - the same exact questions that the housemen asked few days/hours earlier! Wont you be pissed off? 

Ahhhh I really hope that I will not get fussy patients during clinical exam!

3. Mr.Chan is a really nice neurosurgeon. He is very friendly to patients and their relatives too. He always go to the Ward at 8am everyday. #respect

4. Mr.Rudy doesnt teach medical students anymore. He seems kind, it would be really cool if we could learn from him

5. We get to know Mr.Faiz (new lecturer) in the clinic today. He is an ex-UIA student, he did his Masters in UKM. We learned a lot from him! We watched our senior did breast examination and he taught us stuffs like staging and risk factors of breast cancer etc. He also told us stories too. He is Dr.Naim's senior! :D

6. My sleeping schedule is a bit off nowadays. Sometimes I sleep at 12am, or even as late as 2-3am if I have to finish case essay or study for tutorial and most of the time I went to bed as early as 10pm!!

7. Have to go for bedside teachings with Dr.Yusuf now. I'll write more later. ByeBye :)

Monday, June 10, 2013

A Bit of Today

1. This morning I parked my car in front of a small house, blocking a bit of its entrance. Since the parking areas were full and I wanted to park for only a few minutes (I need to go inside campus, sign the attendance and go back into the car), I thought it was okay. So I rushed inside, went out.. only to see that another car was trying to squeeze into the gate entrance to get into the house area, a few inch away from my car. An uncle was putting a triangle orange cone on top of my car, as a warning not to park there. The moment I watched him, I was like Uh-Oh...

I went closer to him, putting my best apologetic smile on, and said sorry over and over again. His friends came out of the house to have a look. The uncle said its okay because I only went inside for a short time. I said sorry again. A friend of him said that I was forgiven since I am a girl. It would be different if a guy did what I did.

I was like, Ohh. So I get away with it just because I am a girl? How cool is that? I should try doing another kind of mistake then, lets see if I will be 'forgiven' as well. Hahahaha.

2. In the Ward, we get to see 2 housemen performing Central Venous Pressure cannulation! That was the first time we saw that and it looked painful, with blood coming out from the cannula inserted into the vein. The patient had Intestinal Obstruction, so we need to put CVP to measure his intravascular volume (dehydration can cause reduce volume). In the late evening, we saw a houseman put in a bladder catheter into a 17-year-old male with Guillain Barre Syndrome (Amman variant). Yeah, we were inside the Medical Ward, looking for any procedures available at that time.

3. Watching Medical Officers doing their rounds was interesting. They can be intimidating to fellow housemen when something was done wrong by the HOs. I tried to keep my distance away from the moody MOs - I dont wanna get into trouble with them!

4. Long Case with Mr.Ahmad Faidzal was awesome! He is like, the coolest surgeon ever! I like him already.

5. I need to get ready to break fast now. I have to go shower!!!

HAVE A GOOD DAY, EVERYONE!! :D

Sunday, June 09, 2013

Sunday Night

Reached home at 11pm from Oncall.

Have to prepare a case essay for session with Mr.Faidzal tomorrow.

On Appendicular Abscess.

Gotta read on DVT, Varicose veins and Venous ulcer.

Its gonna be a long night *sigh*

Dosing myself with caffeine. 

Here, want some?

Have a good night! :)

Tuesday, June 04, 2013

In the Ward

I did my first venepuncture (during this posting) today! I kinda forgot how to do it already, it had been a long time since I took blood from patients.

We have met several interesting patients - gastric carcinoma with liver metastasis (she has ascites and looks cachexic), invasive breast carcinoma (breast lump), diverticular disease, lymphadenitis (anterior neck lump), acute pancreatitis among others.

Following ward rounds can give you a lot of inputs regarding patient management. So far we have been following Mr.Fadel and Dr.Rudy - they are nice!

In KFC for brunch

ps. Have you ever feel like doing things that you are not supposed to do, and you feel really bad afterwards? You asked yourself "What have I done?" and ended up hating yourself.

Today was a weird day. Hahahaha.

Goodnight everyoneee!! 

Saturday, June 01, 2013

Love?

Today is my  group's turn for On Call, from 8am till 12pm. In surgery posting, we have to attend two On Calls every week. That is, from 5pm till 10pm. To stay in the hospital from 8am till 10pm is really tiring. You feel exhausted every time you go back home. But of course, you learned a lot. I usually spent my time reading case notes during my On Call time.

It is so hard to find motivation to go on when you are this busy. You have to be strong and organise your time wisely. Be positive!! (I keep telling myself that, be positive, be positive - but in reality, am I doing it?)

My two classmates will be married in Kedah today. I cant go because I have my On Call and my parents are away, so I have to stay at home with my sisters. Hmmm getting married at 23 years old, how does it feel like?

Some people say that love is easy but some say it is hard. Of course it is easy when you have found the right someone, but it can be complicated at times. Even if you feel that he is the right one for you, but how can you know that for sure? How can you know that he will make you happy until the end of your life? How can you possibly know whether he will be by your side when you need him or not? You cant. You just have to trust yourself and trust him. And of course, God knows what is best for you. Keep praying.

I am not the expert to talk about love, because I dont have much experience on this field. But if you ask me what love is, I would say that it is these various strong emotions you feel for someone. Like when he is sad, you feel like giving him a hug and tell him everything would be okay. When he looks tired, you would want him to get enough rest and go to bed early at night. When he is happy and is on a good mood, you dont say anything that will make him feel unhappy. You share his joy.

When he is away going on a trip, you let him have his fun even though you feel like wanting to spend time with him. When he talks about a girl that he really likes, you pretend that you dont feel anything even though your heart aches and you almost break into tears. When he tells you stories about a certain matter that he thinks is funny, you go along with it even though you dont feel like that at all. When he needs time to have fun with his friends, you give him space even though you want him to be with you. When he mentions about his ex-girlfriend, you just say okay and smile even though you feel so jealous that he and his ex had shared many memories together.

Love is when you really care about him and wanting him to live a long, happy and better life. Even if it is not with you. You think about what are the things that are best for him. Even if it doesnt involve you. You support him to achieve his dreams. You help him in every way you can. You make time for him. You give him your very best. But whats important is, you TRUST him.

Now who says love is easy? Hahaha.