more psychi

it's my 2nd week of psychi.

in the clinic yesterday, we saw an OA couple with psychiatric problems. the husband has panic disorder whilst the wife has schizophrenia with depression and side effects of the risperidone (anti-psychotic) that she's taking. she has galactorroea (keluar susu), blurring of vision and dysphagia (anti-cholinergic effects). menarik jugak kisah derang utk dipelajari.

hmm, im trying to keep up my enthusiasm in psyhciatry. its rather fading out. i feel like i have some manic and depressive symptoms i.e insomnia, spending spree, tapi low mood and lack of energy. bipolar 1 mood disorder?

anyways, 2 of my best friends will share their wedding dates with me. i always thought i'd be there for them. now i cant, huhu. and they cant be there for me. except maybe hi hi bye bye je.

___________________________________________________

Give a man a fish, and you'll feed him for a day. Teach a man to fish, and he'll buy a funny hat. Talk to a hungry man about fish, and you're a consultant.

Scott Adams (1957 - ), Dogbert; Dilbert cartoons

With a stop light, green means 'go' and yellow means 'slow down'. With a banana, however, it is quite the opposite. Yellow means 'go', green means 'whoa, slow down', and red means 'where the heck did you get that banana?'

Mitch Hedberg (1968 - 2005)

new postcard

yay i got a postcard from aishah mn from cranfield. coolness. thanx bakal mommy :)

learning points in psychi

Readers beware: this entry contains medical jargon in abundance. If you fail to comprehend any term, do not hesitate to ask, or you can google them up yourself.

After day 4 of life in the psychiatric ward and clinic, this is what I have learnt:

# The psychi ppl like to use short forms too:
o PR: pakar review (talk about campurization)
o TTH: talk to himself
o LTH: laugh to himself
o Setakat ni je yg I jumpe dulu (baru day 4)

# Most of the guys who become psychotic have a history of substance abuse. Glue sniffing is becoming a popular detrimental past time amongst the youngsters (cane anak muda bangsa kite nih? Cemane nak jadi pemimpin?)

# Despite knowing many cases of malay muslims guys who take alcohol, abuse drugs and are promiscuous, I can’t desensitize myself and am still judgmental against them

# Most of the women who suffer from depression are caused by problems with their husbands (yang kahwin lain)

# Schizophrenia in psychiatry is like diabetes mellitus in internal medicine. It’s a chronic incurable disease which can only be controlled with medication. And it is the umbrella body of many psychotic disorders. Most of the patients are diagnosed as schizophrenia.

# I think schizophrenia in adults are like autism in children in that both prefer to live in their inner worlds

# When the doctors (or med students) don’t know what to write as the chief complaint, they put it down as “abnormal behavior”.

# Diagnosis of psychotic patients in psychiatry depends more on how the psychiatrist was trained rather than the clinical presentation of the patient. One of my lecturers is anti-schizo, another diagnoses schizo freely while the third takes the middle road, haha.

#The difference between psychosis and neurosis is loss of insight. In the former, there is a loss.

# Insight include 3 things:
o Awareness of the being ill
o Attribution of the illness; recognize the abnormality of the phenomena is due to mental illness
o The need to seek treatment

# Absolute diagnosis of psychiatric patients is a challenge as there are no confirmatory/ diagnostic tests that can be carried out unlike in other disciplines.

# There are hardly any psychiatric symptoms that normal people do not experience (i. e low mood, feeling elated, spending spree, anorexia, weight gain or loss, anxious, phobias etc ) . What jifferentiates both groups is the degree of the symptoms that they have.

# Since treating patients with mental illness is mentally exhausting, psychiatrist can only see a maximum of 5 cases per day compared to (10-20 cases of in other specialist clinics).

# The psychiatric wardround is a sitting wardround. It’s good for those with flat feet and less stamina.

# The mini mental state examination (MMSE) is an unreliable test unless done at the first presentation or during an acute stage of illness. Otherwise, patients usually have memorized it and tak larat nak layan dah.

# Speech in MSE is assessed whether it is
o Coherent (understandable)
o Relevant (answers the examiners questions relevantly)
o Rational (the answeris correct)

# One’s socioeconomic status does render one susceptible to certain psychiatric disorders i.e
o High SES: anorexia nervosa and bipolar mood disorder
o Low SES: depression and schizophrenia (however banyak jugak educated people who become depressed)

# Stages of grief (by Kubler-Ross)can be remembered by the pneumonic SABDA:
o Shock/ denial: this can’t be happening to me
o Anger: why is this happening to me? Who is to blame?
o Bargaining: make this not happen and in return I will …
o Depression: I’m too sad to do anything
o Acceptance: I’m at peace with what has happened/ is going to happen?

# Delirium
o is a medical emergency (because psychotic patients act on their delusions and hallucinations)
o is under diagnosed as the cause can be any disease under the sun and also because it is usually undetected due to sun downing (worsening of symptoms toward the evening)
o affects extreme age groups (children and the elderly)

a nut case

The following case summary is the result of a conspiracy amongst my friends (faizah, sibah, asma’, syahadah & aishah) against me during one of the psychiatric lectures in the 2-week introduction to psychiatry in year 4.

The case:
This 23 year old malay lady presented with symptoms of attention deficit disorder.

History of presenting illness:

•Drowsy during the class
Duration: from the beginning until the end of the lecture for 4 years
Onset: acute
Aggravating factor: nik aishah
Relieving factor: faizah, eating, talking
Maintaining factors: lecturers voices especially dr umeed’s and dr hajee’s
•Able to sleep even while eating and nodding head
•Dysarthria due to uncontrolled drowsiness with drooling of saliva
•Sometimes associated with aggressive behavior such as attacking other students while she presents in front
•Motor disorder: has stereotype movement (regular, repeated, purposeless movement), normal posture.
•Stupor in class for a few minutes
•Recurrent history of sleeping disorders
•Recurrent history of being detected by lecturers in the class for being sleepy, yet arousable
•Not on any drugs but likes the smell of petrol at gas stations
•History of allergy to lecture halls at IMC, JHC and Temerloh Hospital
•Lack of motivation in class.

Hehe, okay, I can’t deny some of the facts stated above, but I have to say, drooling of saliva in class tak pernah eh :P huhu, inilah dia hasil kerja kawan-kawan baik ku.

25 (+5) random things

1. I was born on the 27th of ramadhan in my grandma’s house in Baling, Kedah.
2. I am the 3rd daughter. I used to think I was like Cinderella and my sisters used to bully me
3. I went to a private religious school.
4. I’m a collector and a junkie. I have loads of sentimental stuff.
5. I like receiving postcards with stamps on them and also snail mail. Kad raya tak sebest post card.
6. I’ve wanted to become a doctor ever since my dad said that a professor wasn’t a valid ambition and that a doctor was a better choice.
7. I like the colour blue ever since I can remember. But tones of red are also interesting.
8. I like oranges and guava with seeds.
9. I frown when people eat on my bed lest I get bedbugs. They’re very troublesome organisms.
10. I want to travel across the world but have not been able to yet.
11. I want to open a recycling centre and 2nd hand shop.
12. I grew up watching loads of television series and cartoons.
13. I like to be prepared. I’d buy minyak angin not because I need it but the thought that I (or my friends)may need to use it one day (macam girl guide sket)
14. I am usually indecisive but I don’t really allow my indecision to last long or it will affect my activities.
15. I love my 2 nephews and 1 niece terribly.
16. My obsessive and compulsive traits include hygiene and checking rituals.
17. I believe that shopping is therapeutic but I don’t really like to shop too long as it is tiring.
18. I have pes planus and ligament laxity. I can’t stand very long without getting sore soles.
19. I have sisters who have dermographia.
20. I like children’s songs and English nasheeds. I hate listening to songs with terrible lyrics.
21. I think that blogging is a wonderful let out for my thoughts, frustrations, hopes and recent updates.
22. I have a small circle of close friends whom I love dearly.
23. I easily fall asleep against my will when someone is lecturing or when I am very still.
24. I like to use sarcasm with those who appreciate them.
25. If I believe in something, I will go all out for it even though I have to do it alone.
26. Five years with the same roommate has made me a tolerant person, hehe.
27. Five years in the same room has allowed me to store loads of stuff. Dunno how I’m bringing them home.
28. I like observing and analyzing people.
29. I’m a sceptic and a judgemental person. I’m trying my best to practice husnu dzon.
30. I love everything that motivates and inspires me.

the 2nd last pass

owh, i passed surgery alhamdulillah!

quotes

When we ask for advice, we are usually looking for an accomplice.
Marquis de la Grange (1639 - 1692)

hehe so true.

dinner with the dentist

outing with azira. punyelah nak azira blanje, i sanggup pergi amek and hantar cik dentist kite nih. susah betul nak jumpe. i keep hearing about her from friends who went to the dentist haha


yummylicious food especially when someone else is footing the bill hehe.. jgn jeles


the cakes we chose after a hearty dinner. tak larat nak makan dah.


the smoothies...


this is the psychiatric ward that i'm posted to.

psychi 1st day

its my 1st day of psychiatry. i'm attached to dr ramli for 2 weeks. the highlight of this posting is the visit to hospital permai tampoi. boleh balik rumah yay! but thats 4 weeks away huhu.

i dunno what to say of psychiatry yet. i reserve my judgement for now.

pictures

Dr puteri melur's baby girl - Zainab Al-Ghazali bt Husni


Nik Sumayyah's baby boy - Omar


nawaz with mak teh's sunglasses


girl's day out at KLCC. bought shoes and perfume. lunched at the manhattan fish shop.
(i had bilateral sore shoulders carrying around lappie the whole day)


having a blast with sisters

post exams syndrome

i've just finished my surgical theory exams.

i tackled the MCQ'S like i always do. as much as i possibly can. setakat ni my "strategy" has worked for me.

OSCE keluar trochar for spc, proctoscope for haemorrhoid banding (i got this one wrong), IVU showing bilateral hydonephrosis and hydroureter, ERCP with dilated CBD and stones.

i nganga jap tengok trochar tu. never seen it before. and then looked at mr jun for help. he didnt give me the answer. i guessed it was for SPC and he said "ye la tu". yay, baru boleh jawab the questions hehe. thanx mr jun.

PMP case 1 MVA with splenic injury and shock, case 2 prostete carcinoma. asyek keluar je prostate ca tapi i asyek tak dapat jawab management dia. hopefully when i see a real case nanti, i'll be competent to manage the patient well.

k, pray that i can do my long case and short case well this wednesday. jzkk.
(can't wait to go see my sisters)

.....................................

i was listening to these words while i was revising yesterday and thought it was nice to digest and share with others. banyak kali je dengar. yesterday, i made the effort to type it out.

“Every vessel, every container, will only pour out what is contained in it, that is very obvious.

And so your tongue is your ability to express what lies in your spirit.
TV, movies, the friends you hang out with, the music you listen to, everything around you is environmental forces that shape how your being is and how your heart is.

When you open your mouth to speak, it’s like your heart is a sponge that absorbs all of this material from around you.

Essentially what you are doing is squeezing what is in you and what comes out is going to be what has been compiled in your mind and in your memory. Obviously, you can only express in your heart, what has been placed in it.

And so, in order for the outcome and the output from the tongue to be positive, the input in that needs to be positive; in spirit, in silence, in talking, and throughout our lives.”

-outlandish-


yep, you are what you eat. you are what you speak. you are what you read and write.

on a lighter note, it's a happy2 world around me.
dr melur delivered a baby girl today.
nik su delivered a baby boy today too.
2 of my friends are pregnant.
my best friends are no longer single and available. yay! except roomie that is.