Thursday, October 31, 2013

Hello Hello! :D

It's been a week that I havent written here. Wow. Time flies so fast!

I had oncall tonight (Wednesday night). With Ms.Ardilla. We went to see many patients, like about 7 or 8. Among them were neck of femur fracture, foot abscess, diabetic foot ulcer, carpal bone fracture and I dont quite remember the rest. I am too tired to think more. Hehe. 

After we finished round with Ms.Ardilla, we went to OT at about 10pm, to see Dr.Nik Nor and the housemen operate on a 30-year-old lady with left segmental fracture of femur, they put interlocking nails inside the thigh. It was quite an experience, watching an operation at night. Usually we watch operations during the day. And to wear the heavy X-Ray vest for 2 and a half hour, it was a torture!! I still feel my shoulder aching!

Now I am on my bed, finished praying already. About to go to sleep when I remembered to write something on here. It's been a while, right? 

Well, lets recap on what happened for the past few days. We've been to operation theatre few times, watching different kinds of surgery, with different kinds of surgeons. We had teachings with few lecturers, discussing on interesting cases in the ward. Followed ward round every morning, and examined some patients. Listened to seminar session.

Found my Case Write Up 3 patient already! Yayy! It's a 22-year-old lady with medial meniscus tear! Classic findings on examination! And I examined her! :D

I am hungrryyy. I feel like eating rice! But I dont wanna get fattt, it's one o'clock in the morningg!! Ahhhh I guess I'll wait till tomorrrow before I get my rice.

So I need to sleep. If not, I'll be tempted to go into the kitchen and cook some rice! And pour in the fried rice paste, and eat it! It sounds sooo deliciousss!!! I am hungrrryyy!!

Okay okay I totally need to sleeeppp! You have a good day!! Bye byeeee :)

Wednesday, October 23, 2013

Of the three days

So Monday. We had Mr.Shuk's teaching session in the morning. After that we went to the clinic. Saw a few paediatric cases like CTEV and Osteogenesis Imperfecta! And then I had oncall that night, with Mr.Fadzli. Went back home late. 

Tuesday was our turn to go to OT. We watched three operations, stayed there till evening. Went back home at almost 5pm. Took a nap. Slept early.

Today, we had a course on Rehabilitation. We went to see the places where patients have their physiotherapy session at the hospital. It was an educational tour.

One of the rehab room

This is called Wall Bars. You reach the top bar and hang on!
(That is one cool stuff, I want I want!!!)

 Someone just told me to be good todayy! 

I AM being gooddd. I'll pray right after this, and then do my work. Then maybe take a nap, and then do my work again. 

See? I am planning on being good! Hehe

I miss youuuuuu!!

Take time to realise that I am on your side, didnt I tell you? :)

Yayyy!! Tomorrow is public holiday! Happy Birthday to you, King of Pahang! :D

Saturday, October 19, 2013

Lazy Weekenddd

Hi Hi Hi! So i thought of writing a bit on here. Been busy with Case Write Up before, now I've got some free time! It's the weekend! I love weekends! :D

So here is an interesting picture for you:

Exposed tendon!
Mr.Fadzli said that when there is a case like this, the tendon will become dry and it will die!
So we have to cut it! If not, it will become a source of infection!

There. The tibialis anterior muscle (red) and the tendon (white)

So now, since my parents and my sisters are not at home for the weekend (they went to Lumut, Perak last Thursday), so I can sleep whenever I want! And cook whatever I want! And be lazy! Hahahhaha

Ohh. But I need to prepare seminar slides on Septic Arthritis, that need to be submitted this Monday! And the case summaries need to be written properly!

Hmmmm. I'll do those things when I feel like doing them. Hehe.

You have a GOOD dayyyy okayyy!!!! :D

Byebyee!! :D

Wednesday, October 16, 2013

Tuesday's OnCall

I have two pictures to show today:

Before the operation : Infected Diabetic Foot Ulcer

After the operation : Disarticulation of big toe

So what lesson do we learn from today, people? 

Please please please, take care of your feet! (especially if you have Diabetes)

And that means, take care of your health too! Okay!

I dont want you to fall sick. Please dont be sick. Ahhh this is sad.

Ohh. Another thing. I already found my CWU patient yesterday when I did my OnCall with my two friends (who didnt go home for Eid). Mr.Goh was really nice! 

We went to see three new admissions - two fracture cases and one of erysipelas. I get to see and help with T&S (Toilet & Suturing), and I helped a medical assistant putting on below knee backslab to a Chinese uncle.

Nowww I'd like your permission to do my work! Can I? Hehehe

But I wonder what would happen,
If you say what you wanna say,
And let the words fall out honestly?

YOU have a good dayy! :)

Tuesday, October 15, 2013

Eidul Adha

So this morning, we watched our neighbours sacrificed some cows for Eid. A portion of the meats were distributed among poor people in our village. 

Here. Enjoy these pictures!

First we start with Family Photo!
See the cow?

Sorry you have to see this.
Please close your eyes if you cant stand these pictures, okay!

We had 7 cows sacrificed

My parents' name are on Cow Number 2

People gathered to help with the meats

Another cow

Hard work

Sorry pal.

My Dad in yellow

Watching under the sun

The cow

The people

Sorry you have to see this!

All of us were there

Preparing the meats



They look like twins. Cute ones.

Inside the musolla

Cute kids


Working hard


Kids on bikes

More cows

I'll end my post with this picture!

You have a good day!

Monday, October 14, 2013

Before Eidul Adha

This morning I brought my sister to the hospital for a medical check-up. When we met the medical assistant at the Accident & Emergency front desk, he told us that for a non-emergency case, we should go to a polyclinic or a district clinic instead. We are not encouraged to go to the hospital.

So I told him that we dont know about it, and how can we go back home since we are already at the hospital? That would be a waste of time! At first he looked like he didnt wanna accept us, but later he said we can register there. Hahh! I can be really persistent when I want to.

There. The announcement banner for all to see.

So I pretended to be a non-medical student, and followed my sister into Green Zone's consultation room. She was clerked by a female house officer, who used several medical terms like 'discharge' and 'cyclical pain' and 'mass' - like my sister knows what those words meant.

Then we went to SOPD to get an appointment date. It is scheduled to be a month later. After that, I sent her to meet my parents at Kuantan.

My other sister had asked me to drive her back home from Klinik Dr.Ko at 1130am, but I totally forgot about it! I did remind myself like few times before 1130, but because we had an impromptu discussion with Mr.Fadzli on Diabetic Foot Ulcer at that time, so I just...forgot. Yeah I felt guilty about it, so I bought her an ice-cream. Hehehe

And at about 330pm, I went back to the hospital, to find a case for my Case Write Up. I dont have a case yett, and I have to find it quick! I dont want to write another fracture case, at least I should find a DFU patient! But that makcik whom I clerked earlier, was actually my friend's CWU patient - and we share the same mentor! So I just have to find a new one. Hmm, I still couldnt find one.

On Monday, they have Diabetic Foot Clinic in the evening. So I went there to have a look. Wanna see what I saw today? 

A chinese uncle with Dry Gangrene!
(That's a REAL patient with a REAL foot!)
He will undergo Below Knee Amputation, or worse, Above Knee!
The house officer was clerking the patient when I took this picture.

And I saw a makcik who had her ulcer dressed with honey! And of course, after that - Bactigrass. But using honey to promote healing, that's When I saw the nurse applying a layer of honey on her ulcer, I was thinking of how sweet the honey was! And it was sticky....and sweet!! Yummy! I meant, the honey! The honey looked yummy! Oh great, I sound so weird!!

Then I went to the ward to get information on my friend's patient.
That is the XRay of his thigh bone aka femur.
Yup. It's called a fracture. And displacement.
I went back home at about 6pm. Since tomorrow is holiday, my Mom and my sisters helped in the kitchen to prepare the dishes for Eidul Adha. 

Lemang and Kuah Kari


Kuah Kari and Chicken Soup


Chocolate Cake! Sweeeeeetttt!

We will be having Chicken Rice for tomorrow! And we have two days of holidays! Tuesday and Wednesdayyy!! Yayyy!!

I told my Mom that I wanna go to the ward tomorrow morning (to find a case for my CWU), but she quickly said 'tak payahh. buat apa nak gi ward pagi pagi raya? esok kan raya haji, raya yang lagi penting daripada raya puasa. duduk je kat rumah, beraya.'

So yeah. I am not allowed to go to the ward tomorrow morning. If that's the case, I'll go for oncall then! (Yeahh, I can be very stubborn at times, too) Well, it's because I dont have a case for my CWU yett (and the deadline is this coming Friday!), so I gotta do what I gotta do!

For now, I'll do some case summaries for a while before I go to bed. Or I'll just wake up early and do them tomorrow. Hmmmm. Lets see how it goes.

YOU have a good day, okay! And dont be sad!

Saturday, October 12, 2013

Friday Friday Friday

So Friday.

Remember that picture I showed you about Fasciotomy due to compartment syndrome?

I met that girl in the ward on Friday. She is just 15 years old. And she was crying in pain.

She was admitted on 9/10/13 at 1:14 pm due to leg pain following an accident. 

Her diagnosis was:
1) Closed Comminuted Fracture Midshaft Right Tibia
2) Closed Segmental Fracture Right Fibula
3) Compartment Syndrome of Right Leg

Since it was a case of orthopaedic emergency, she was rushed to the OT.

Well, only at 5:45 pm the operation started, 4 hours and 30 minutes after her admission. The operation ended at 7:10pm.

Intraoperative findings:

1) Swollen and tense right calf
2) DPA, PTA palpable, CRT < 2sec
3) Upon release of compartment, there was gushing of blood
4) Intramuscular haematoma surrounding fracture site
5) Bulging of muscle seen
6) Muscles viable, Colour pink, Consistency normal, Contractility normal

Post op
1) DPA, PTA palpable, CRT < 2sec
2) Calf soft
3) Comminuted fracture mishaft right tibia and segmental fracture of right fibula
4) Right tibia fracture reduced with CMR and external fixation right tibia   

I helped the nurses did her leg dressings, with Gel and Bactigrass. She was screaming all the way through the procedure. Sakit, sakit....Jangan pegang...Sakit...Sudah lah....Sakit...

She was already crying long before that. The Sister (Head of Nurses) who came by to calm her down was not able to silent her. When Sister asked her to remember God and say shahadah, she didnt wanna do so. She shook her head and kept on cying, screaming.

It would be easier on her if she did not focus too much on the pain, but let her mind think of God instead. Think that God gives her the pain to test her patience.

But of course, it's easier said than done. 

I dont know how much pain she felt. I was not the one experiencing it.

When we finished the dressings, her sister came in. She was in tears as well.  

There was a time when I shed a tear but I quickly wiped it. Imagine if your little sister is on the bed, crying like that, and you cannot do anything to help her. That is sad.

Sometimes I question my decision to be a doctor in the first place. I cry easily, and doctors dont do that! They are supposed to be strong, and tough, and not acting like a baby!

Well, technically it was not MY decision to be a doctor in the first place. So yeah.

If you ask me, I still think that I am not cut out to be a doctor.

Okay. Enough talking about sad stuff, will you?

Here's a really cool guy who wrote a really cool post about stay-at-home moms :)

Interesting views you have there, sir :)

Maybe its about time to let you go?

Okayy I am gonna do my work now. 

You have a good day! 

And stop crying!! :)

Friday, October 11, 2013

A Simple One

Here's a short post for todayyy. Today means Thursday, not Friday! Hehe.

Guess what this is!
(Yeahh I know it's a foot! But do you notice any difference?)

Well, maybe you cant see clearly from pictures.
But this 72-year-old Malay man has bilateral Charcot foot!
He has left foot ulcer too.
His right foot was cold!
See the muscle wasting???!!

In the evening, I stopped by the Blood Bank.
But I cant donate my blood, I am anemic!
Well, slightly. It's 11.3 g/dL.
They need people with Hb of 12.5!!

Opening hours

Okayyy, Let's go back home nowwww!!

So that's all for now.

I told you it's a short post!

I am off to bed noww.

Byebye and sleep tight!!

If you're gonna be somebody's heartbreak - BE MINE!!

Thursday, October 10, 2013

Of OnCall (Again)

We had OnCall tonight. With Mr.Rafael, and at about 11pm - Mr.Kamarul came. Hand OnCall.

So we had to go into OT to see the XRay of the patient

We didnt bring our own gowns, so we had to use their OT gowns.
XXL! We took the largest size available!

Got back home at around 1240am. Tireddddddd. I need sleeeeepppp!!

Oh. Before I go, here are some pictures for you: 

Ulnar Claw Hand!!

Fasciotomy due to Compartment Syndrome!!

Okay. Now I can sleep. Hehe.

You have a GOOD dayyy!! 

Byebyeeee :D