attachment day 6

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1^st day kt ward medicine. Mula2 dtg nk introducekn diri kt both ward. Pergi ke ward lelaki, tp dr and sister takde lg. ke ward perempuan, ade dr tan and dr  musniza. Cm awkward la plak tak tahu nk buat ape. Ikut dr pun, dr cm busy. Ish mcm la 1^st time masuk medicine. ikut dr round sekejap, bace sheet semua pt pastu dlm pukul 10 lari ke A&E. 1^st day suke la lari2 kn.

Hari ni hari isnin, kt A&E pun tak byk case. Tgk abg khairol psng POP,  ade 3 cases. Suke la tgk, kemas gle. Salah bace xray. child, nmpk kt xray cm frx head of radius and ulna and interphalanx. Then pt da blk, discuss blk, abg khairol kata frx cume kt radius. Yg tgk tu epiphyseal plate rupenya. And kalau frx of phalanx, the mx they used zimmer?. Igtkn k-wire. Bukan. Zimmer tu besi yg boleh lentur ade sponge n psngkn lekat kt jari. Nmpk cm mahal, tp murah je kot. Ntah.  sbb MA amik zimmer utk tunjukkn je, pastu da buang.

Hari tu da kene dgn abg shidi. Nk psg CBD. Berdiri je la kn kt situ. Pastu abg shidi kate, nk tgk jgk ke? Da malu da, terus keluar. Ler apa salahnya. Org nk belajar. Tgk pun takde perasaan, org siap da pernah buat la. Pernah dgn dr yap and abg muslim, derg lepak je. Pastu ni td ade MVA. MA nk bg IM ATT. Waktu tu org ade kt sblh pt. Abg firdaus cm keluar masuk, lengah2. Buat2 tak nk paham kn. IM je pun.. Pastu keluar la jgk. Derg segan dgn org kot. Apela..

And hari ni dr Priscilla oncall lg. suka. hehe. I did ECG by my own. Yeay!  Tp ade nurse la kt sblh. And buat needle prick amik RBG kt pt. Dlm pukul 2, polis dtg bwk 1 body, case sudden death, jumpe kt bilik hotel. Nmpk muka cyanosis. Nurse kate kalau cmtu selalunya HF. N dr Priscilla buat post mortem terus ptg ni. Dr kate, tak buat exploration the whole body, bukak chest je.

Pukul 3 da pulang. Hari ni sgt mengantukkn. 

attachment day 5

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Today is public holiday. Nuzul quran. tp rajin nk ke hosp jgk. budgetnya, holiday lg byk kes2 yg best2.  Sbb public holiday, outpt clinic tutup, pt dr outpt clinic semua ke A&E.  Jd byk kes2 biasa je, demam, cold, asthma, diarrhea, etc. triage & dr shamsul plng busy, kt dlm lepak2 je.

MO oncall hari dr priscila. Dr pg sampai malam. She’s graduate from manipal. She is very nice and friendly. And 1 met another 1 MA for the 1^st time today. Abg shukri. I also learn a lot with him. He teaches me few times utk amik blood, tangan ketar2 la lagi. Adoi. Dr priscila herself teaches me. I did quite a lot of things for the 1^st time today ~ off the branula, administer drug to the pt, ascultate abdomen to comfirm gastronasal tube da masuk kt stomach; dgr bunyi blub. Abg shukri kate ade 3 cara utk comfirmkn, tp waktu dgr tu tak focus. Apela. Then fill up the form, panggil pt masuk, panggil waris pt. bende2 simple je, tp 1^st experiences jgk, kalau tak pernah buat, tak tahu.

Pg byk case neonatal jaundice. Serious ramai baby hari ni. Susah tahu utk amik baby’s blood. Baby menangis tak duduk diam tu satu, then their veins are very small. Utk baby memang kene amik blood kt dorsum of hand n kalau tak dpt, amik kt foot, med malleolus. Flow of blood pun selalunya nmpk sgt slow. Memang perlukn kesabaran yg tinggi. Sian adik kecik2 umur br berapa hari da kena cucuk. then test for VSB, venous serum bilirubin.

Abg shidi ajar how to interpret lab result. Da belajar je kn, tp nk aplikasikn tak reti. Kalau demam denggi, blood test low plt, high hct. Criteria prolonged fever >4d, abdominal pain, malaise. Kalau high WBC, suspect viral fever. And adela test2 yg kene repeat lg utk comfirm dx. Utk neonatal jaundice, ade chart utk kire umur, body wt and  incirect serum bilirubin. And blaja tgk from lab result, mcm mane nk dx appendix, UTI, etc..

N btw, they didn’t know my name. I didn’t tell and they never ask. Kenalkn diri hari tu as medical student je. Dr priscila called me girl. Seriously comel. And the other drs, the MA and nurses just called me adik. Adik sini jap, adik buat tu, adik tlng ni, adik dgr ni, etc.. Kelakarnya, cm spontaneous reflex plak tu ble dipanggil adik. Perasan. Cm suka plak an. Haha.

Mlm lps maghrib sampai pkl 9 kosong, takde pt lansung. dr tan da suruh blk byk kali. Haha. After 9, br byk case. 930 da blk. 

                                

Ok da hbs seminggu kt A&E. seronok! Next week masuk ward medicine plak. 

p/s: all pics credit to noure.

pp/s: hoi org alex! ape khabar berita? bg msg tak reply. takde dgr ape berita, busy sgtkah menjaga alex?

attachment day 4

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Separuh hari spend masa kt bilik forensik. Tgk post mortem GSW. 2 body, robbery, case police. My 1^st experience! Nk muntah, seriously. sbb dr nathaa yg oncall malam td, jd beliau kena ikut sekali pakar buat post mortem. Tanya dr nathaa psl post mortem, dr kata tgkla nanti sekejap korg pun lari. Br nk provekn pd dr nathaa, he’s wrong. Kononnya nk stay sampai hbs la. Hurmm.. tak dpt. Dr pukul 830 da tunggu kt bilik forensic dgn PPK, tunggu xray, tunggu pakar dr klang & polis dtg, dlm pkl 11 br start. Igt start derg terus nk bukak body, tp tak. Amik DNA, amik gmbr, periksa body externally, pakaian; jenama, size, kesan lubang size GSW pd baju, semua direkodkn. Settlekn yg itu je pun almost an hour. Then buat exploration the whole body. urghhh! Tak dpt tahan lama, dlm pukul 1 da lari. Haha. Tak tgk hbs 1 body pun.  Cool la nmpk real fresh brain, liver, organ2 semua tu. Pukul 630 ptg td, pkck PPK kata br siap semuanya. Gile la! Phobia nk minum cincau. Dr ayuti punya angkara. Dr keluarkn blood dr peritoneum, masukkn dlm cwn penyukat. Cincau. Siapa mahu?

pakai scrub utk tgk post mortem

And hari ni stay sampai pukul 930pm. Dr oncall dr siti aisyah & dr shamsul buat locam?. dlm pukul 6, MVA  6 org naik satu motor. 2 ok tak ape2 lari, 2 stabil, 2 tak. Teruk jgk kene buat CT brain. Haih budak2 zaman skrg.

Ade sorg MA baru 1^st time nmpk beliau hari ni. Abg shidi. He teaches me a lot, n nmpk beliau pun cm superior than the other MA. Memang ajar yg btol2 ajar ceritakn semua in detail, best la. Case TMJ disclocate, mx: manual reduction. And abg shidi buat CMR utk radius frx. Dgr bunyinya, ergh ngilu!

attachment day 3

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Bgn kul 6. 1^st time tak terjaga mak kejut bgn sahur. Sampai hosp pukul 8. Pg dgn dr nathaa. Ptg dr rozita.

I did VE today. Cool! awesome! Yeay syg dr nathaa. :P Pregnant female c/o: vaginal bleeding. Pakai sterile glove then gunakn sponge holder and transparent speculum. VE finding: open cx and POC; product of conception. Dx: miscarriage.  

hari ni byk blaja orthopedic. Tgk cases, read the xray and discuss the mx. Colles frx, stress frx, tgk MA buat POP. And they allowed me to do dressing, case: MVA simple injury saje, boleh la.

Inferior? MI. I never heard before. Seriously? Which medical school hah you?  Hahaha.

CVA cerebral vascular accident/stroke. 2 types: ischemic stroke and hemorrhagic stroke. How to differentiate between those 2? Clinically, diff s&s. headache present or not, onset of neurological deficit, cp of menigism, err lg tak igt. Ok perlu ulang kaji. Later.

Pukul 3pm, ok sudah mari pulang. I’m tired~ br 3^rd day da pancit da ni. Ape cer?

attachment day 2

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2^nd day~ I fall in love with A&E!

noure is absent because she not feel very well. So I’m alone, and I stay 13hours! at hosp. From 8am till 9pm. 2^nd day is better. get close to the drs, nurses and MAs. dr nathaan, dr shamsul, dr tan! nurses n MA are friendly. bolehla kalau tunggu takde case, duduk borak2 dgn mereka. They are willing to teach and I learn a lot with them.

MA n drs rajin tanya soalan hari ni. Tentula tak dpt jwb. Takpe that’s the way I can learn something. And dr yg paling byk tanya is… dr tan!

What is amiodarone? What is ivermectine? What is anaphylactic shock? Something about dialysis, i’m not sure what the question is. PUO. In MVA what is the important thing to give to pt? ATT! Aiyokk. Cuti baru berapa lama da lupa.

Blaja buat ECG. 1 female pt admitted dt chest pain. they need to do ECG but no nurse available on that time. The MA can’t do it because all of them are male. They need female to do ECG for female pt. They ask me to do it. errr. *blur. Tunggu nurse. Then I learn with nurse how to put ECG on pt few times today. Lps ni kalau suruh pasang ECG da boleh la. Tp nk handle machine tak reti sgt. Remember MA ajar: Stop. Look. Go. 1. Red yellow green black. 2. Red yellow green brown purple black. Colour2 ni de ke blaja kt med school dulu?  cm tak je.

At asthma bay, the MA asks me to auscultate the pt, and they teaches me how to dx, mx, diff kind of drugs and the dosage. So today bluey did some work, he not just stays kept inside the pocket. Hehe. bluey is my steth.

And I saw a lot of interesting cases today. Bee stung. Multitrauma. Comminuted frx of long bone, subtrochanteric frx. SVT; pt’s PR 190 and they almost defibrillate the pt but after carotid massage the PR suddenly drop. Post natal pre eclampia, the makcik’s BP reach 210. Gle kn? And br tahu PE include 40days after delivery. And lain2 cases biasa la demam, asthma. I met abg hasnul. He sends his MIL at A&E dt high fever this morning.

Uhh, really tired. Td buka puasa dgn vitagen saje sbb igt nk mkn mak masak kt rumah blk nanti. N ble da penat sgt, memang tak lalu nk mkn sbnrnya, waktu maghrib td keluar jgk dr hosp cr makanan, tp tak rase nk makan ape2. Blk sampai rumah pukul 930 td mcm da penat nk terus tido tp skrg da pukul 12 tak boleh nk tido lg. n td br vomit~  esok boleh bgn tak nk g hosp pukul 8?

attachment day 1

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Da cukup bercuti dgn bermalasan sepanjang hari. And I start my 2weeks elective course at hosp banting today with noure. I choose department accident & emergency/A&E and medicine. So today in the 1^st week, we start at A&E first as dr siva; specialist in medicine is not around this week.

My first day, I think Chinese people are cool. noure and I run away from A&E to outpt clinic because no case available at A&E in the morning. And actually what we did was unauthorized and illegal? because we don’t have permission to outpt clinic dept. luckily pembantu perubatan/MA at outpt clinic allowed us. Around 10am medical student from UM come and the MA let them to do anything without supervision. Whoahh! Seriously I felt inferior with them.  their skills are far better. They almost like real dr and they know like almost everything. One Chinese male student takes in charge at the blood taking room and noure and I just watching he did the procedures. He is friendly and he teaches us how to take the blood, do it on pt. we are not really confident actually but he insist. and we did it! whoahh cool la! Thanks to him for being our tutor today. Then I went to dressing room. I ask permission from the nurse in charge. She offers me to do the procedures. But I said tak pernah buat. So then I just watched her.

After 12, we went back to A&E dept. dr oncall is Chinese dr, dr Lam. Guess who is he? He did physical examination on me last week. Yes I was admitted to the hosp as a pt last week. It was nothing, but actually being a pt is diff from being the dr. when we as a dr examine the pt, we touch here and there, we expose the pt, and we didn’t feel anything. But when being a pt, I felt embarrassed! br la tahu begini rupanya rasa jd pt. I didn’t expect to see him again and I wish not to but surprisingly he is dr oncall at A&E today! oh! *blush. Dr Lam is nice and quiet and cool. He doesn’t talk much during work and his voice quite low. Few times I ask pardon? when he answering our questions. I like the way he works; calm and professional.

Moral: less talk make you look super cool.

As the MA says, A&E only busy after 12pm and will busier at night. Most of the cases are trauma, MVA motor vehicle accident. But at Egypt we learn as RTA road traffic accident. And much other diff term between here and Egypt like CBC here is FBC, PV here is VE. And here they used disposable speculum. It’s transparent! Kate noure, nk amik bwk blk balik boleh tak? Sbb cantik. The MA asks me, nk tgk case tak? I thought he asks to SEE the case. Then I said yes, sure. Then he handed me the empty sheet paper with only pt’s name on it. Blur. Nk buat ape? Go clerk and check the pt. huh?? Sy tak pernah buat utk A&E. Kalau guide boleh tak? ‘kalau guide nanti pt tak confident plak, kene sorg2 la’. Errmm tak pelah sy tgk je observe dulu. And seriously he insists me few times to clerk the pt. Confident la, trauma senang je. korg da blaja lg byk. Kalau accident, tanya mana sakit, bg pain killer then g buat xray. Student UM pun selalu da derg buat.

Ermm seriously I felt very inferior here. We’re very lack of skills, practical and confident. The nurses, the MA, the drs and even the UM medical students are really nice here. They encourage us to learn and I think there are expectations from them that we know everything like just other 4^th year local medical student. But we’re not. How to put central line, insert IV, take blood, give IM, do dressing, do ECG. I never did any of that before. haih.

Hope tomorrow I have courage to practice clinical instead of answering sy tak pernah buat or sy tak tahu or showing the blur expression. There must be 1^st time for everything, right?

I'M HOME

cuti2.makan.tido.bersenang lenang sepanjang hari.menikmati keindahan msia.

bye.

019 2028 735.

post final exam sem 8

ye, sepatutnya sy kene mengemas utk pulang ke malaysia esok. tp sepanjang mlm tmplkn bendalah ni. ngeh. sunshine da kempis. jd sy abadikn die di muka pintu.

1. sbb hadiah dr cinta2 hati sy

2. sbb smiley! :)

hahaha

pre orthopedic

070810

0745: br bgn. omg I’m late!

0830: odw masuk cc. oh! Senyum. Makin palpitation :P

0900: EXAM TROPICAL MED

1100: yeay done!

1130: rabah, ask for lounge and recomfirm time&date. Arab buat keje super duper slow. Beli labcoat

1215: manshiah. Terserempak dgn nani. Teman nani shopping. tak jumpe brg yg dikehendaki. :( pulang

1400: happy meal! @ mcD

1430: shopping @ ibrahimiyah

1530: blk rumah pengsan kepenatan

1700: delight. study.

2030: pulang sampai rumah

2100: tak boleh nk focus. Tgk cerita

2300: nite

0000: pandang ceiling lagi

0200: zzzzzzzzz

080810

0800: morning. Basuh baju. Kemas buku. Masak. Mandi.

1100: cubaan bukak buku, gagal.

1315: cr semangat study @ costa coffee

1900: pulang. Saturated. Gembira.

2015: dinner @ chilis! :) senyum sampai telinga. I miss you!

2245: pulang sampai rumah

2300: nite!

0230: zzzzzzzzzz

090810

0700: morning sunshine!

0800: mandi, breakfast

0900: mari2 kita study dgn gembira ria senang hati :)

1 more to go. yosh! orhtopedic: 100810

3 down 1 more to go

Check list blk msia.
update

1.     Buah tangan utk mak √ bapak √ adek √ abg √ kyong√ 

2.     Baju √ toy √ utk adek abg

3.     Makanan √ noga kekacang√ (ibrahimiyah) buah2an (pasar)

4.     Skirt kakyong (manshiah) 

5.     Teh √ halawiyat √  utk mkck pkck

6.     Exam tropical med √ 

7.     Sewa rumah bulan 9 √

8.     Shoping baju pakai nk blk √

9.     Cr selendang kt ibrahimiyah √

10.   Tukar duit usd √ 11.   deactivate internet usb etisalat √ 

12.   Celebrate bday aimi √ fazila √ izyani

13.   Beli labcoat. Cr yg murah saje √

14.   G rabah mintak lounge √ comfirmkn blk masa √

15.   Terawih gami’ Ibrahim 1^st ramadhan √ 

16.   Kemas buku2 nota2 √ 

17.   Simpan baju2 √  cadar sarung bantal

18.   Clearkn bilik√ 0 buang sampah √ 

19.   Clearkn stok mknan dlm bilik √ 

20.   Clearkn dapur yan

21.   Kosongkn peti ais √ 

22.   Bg barang mentah pada jiran yan

23.   Bgtahu jiran nk blk yan

24.   Masak utk jiran

25.   Check list brg bawa pulang √

a.      Baju tak nk pakai √ 

b.     Steth √ labcoat√  buku√ 

c.      Kad bank bsn√ 

d.     Surat mara√  (renew passport)

26.   Beli topup

27.   Pinjam buku cinta sufi izyani√

28.   Betolkn pintu balkoni bilik yan

29.   Unplugged plug √ 

30.   Bayar duit nut√

31.   Exam orthopedic√

ape lg yg missed ye?

4 hari lagi, n still long list to go. oh exam!

i miss them

mr ong

battle dgn mr ong semalam ramai yg tewas. 

-_-

ok, move on~ next! PEDS. 2 hari lg.