Wake up call

Today, I was asked to relief the outpatient clinic again, but only for the afternoon. Thankfully, there weren't many patitents ^^ So while waiting for patients, I chatted with my 2 Dental Surgery Assistants about my 3 year compulsory service. Here in Malaysia, anyone who wishes to get a license to practice in this country must serve a 3 year compulsory service in the government sector prior to working in the private sector. However, this regulation has been changed to 2 years for those who begin work after April 2012. Me not included! So still 3 years for me. Upon hearing that I have to serve 10 years ( consequence of accepting a govt scholarship) instead of just 3, they told me to just leave after 3 years and pay back the sum to my sponsor. They added that I could easily come up with that money once I enter the private sector. I had been having second thoughts, about whether to stay on for the 10 years or not but now I suppose it is apparent a choice has been made. How could i be so ignorant?

On a lighter note, it's my last day at Periodontology department today :) Can't believe a month has gone by. It feels like just yesterday when I showed up at the clinic and my new colleagues thought i was a salesperson :S  

I did a count on the total number of patients I saw in my month there. And the number is.......

19!!!

An average of 1 a day ;) 

We were observing a bone grafting surgery the other day and we got a bit bored, so...

Us 5 Fydos at Perio

Gonna start at the Restorative department tomorrow. New place, new people. Wish me luck!

Awesome life

 Been AWOL for a bit since my last post. I have been super busy for the past 2 weeks, so many things happened and so many things done. Life is great!

Alison's Wedding

Alison, one of my best friends in secondary school, got hitched in one of the most beautiful weddings ever! Alison has always had a creative mind. It was apparent that she put her whole heart and soul into planning this wedding, as every single detail from the deco on the tables to the music just screams Alison. You go, girl! :)

A beautiful picture of the newlyweds and the ji muis, all dressed in seafoam

Personalized sarsi mints. How cute is that!

Convent girls. Love u guys!

Congratulations Jon + Ally! Have a blissful life ahead :)

 Brotzeit Beer Bar

We checked out the Brotzeit beer bar @ Midvalley the other day. It looks like any other restaurant from the outside, but we were in for a pleasant afternoon. The food was better than anticipated and the service was top notched. 

Us :)

The pork platter. The pork knuckle is mouthwatering! 

A great experience on the whole. Absolutely love the mango flavoured Paulaner beer.

J.B.

I've officially been in JB for 19 days and I'm loving it more and more each day! It's so much more exciting compared to the mundane Muar. Spent my last weekend here, the bf came down, and it was awesome! Ate some good food, went to watch Brave (loved it!!!!), went to Sg (yup, only for 5 hours. hehe) and did a lottttt of shopping ( so broke now!!!!)

Q & I at Ten Gu. Must try the duck!

Life at the perio clinic has been sluggish. I treated only 1 perio patient this week and it's already Thursday. Last 2 days were Implant days, when our specialist goes to the hospital to place implants and leave us all at the clinic. Bleh. So there were absolutely no patients for 2 days. It was unbearable! Hours passed by so slowly, i felt like dying. So, we had to find activities to keep ourselves busy. 

Like taking random pictures in the clinic...

Or doing scaling for each other. Dentists mah, what do you expect? Haha

I, as usual, brought my books there to read. I managed to finish the 2 sequels to Hunger Games, and they left me hungry for more. I'm experiencing the feeling of finishing a good book/ movie, and then not know what to do with life anymore :((((( Anyway, I've moved on :) I just started Afterwards by Rosamund Lupton. Can barely put it down.

OH I have to tell you about my experience in the outpatient clinic. The outpatient clinic is where all the usual patients come for checkup, fillings, scaling, or extractions. It is super busy everyday with up to 200 patients per day. Normally only 3 rooms will be in operation, so it's an average of 70 patients per dentist per day. And if you do the math, it equivalents to less than 7 minutes per patient! Within this 7 minutes, the patient must be called, seated, clerked, examined, treated, and sent out. It's just utterly crazy! No wonder these dentists get so cranky at times.

I was asked to relief an outpatient session last Thursday. I was so anxious before starting that I was walking around dazed, on the verge of tears! I saw all kinds of patients that day. One lady came in happily requesting an extraction but left in tears :( Many came asking for multiple treatments but we had to be snappy and asserted that only one treatment can be done a day due to the high volume of patients. 

I got the hang of things pretty quickly and am absolutely awed by my 2 extremely efficient assistants. That day, i saw about 45 patients in total ( they gave me fewer patients knowing it was my first time). Outpatient clinic isn't that hard after all :) 

The vast difference between perio clinic and out patient clinic. Perio 4, Outpatient 42. You can imagine how free we are, the 5 of us attached to Perio at the moment.

Another good thing of being in JB is that it's so near Singapore! It's so near that we can cross over to Sg on a working night, just to have dinner :) but going to Sg means i need SGD, which rate is sooooo HIGH now! 1 SGD = RM 2.51. WTH! *grumble grumble*

New friends in JB

Pebbie Dear

PB is currently living with Q in Melaka. I'm living in an apartment now, and they don't allow pets! *Hmmph!!*  Still and all, Q is coming down again this weekend and guess who's coming with???? Tee hee! Can't wait for tomorrow!

 After her grooming. Love the way her legs are shaped.

On the way to Melaka, she slept almost the whole journey and had to be awoken for her dinner!

Stole this from the internet. I thought she was the only one...

Jay Bee

My attachment at OS in Muar ended last Friday. Gave my presentation ( Dental management of patients on radiotherapy) on my very last day. Received positive feedback from my superiors but nurses weren't that elated that my presentation was in English. But what do you expect when i've prepared all my slides in English, all my references are in English and all the terms are in English! Well, instead of listening to my talk, they had their own "talk", which was rather distracting for me. Anyway, what's done is done. I've moved on :)

I'm in JB now!

Not exactly excited to be here but since i'm already here, might as well make the best of it :) 

I'm currently attached to the periodontal clinic here in JB. Gonna be at this clinic for a month, then will be moving on to Peads. Looking forward!

My first day at perio was daunting! Basically saw 3 patients today. Saw as in look only, no touch. There are 4 of us FYDOs there, plus 2 nurses in a room, with only 2 chairs! I felt like we were playing musical chair :S And I chose today to wear my uncomfortable heels. Blueh! All we did all day was watch the nurse scale 2 patients' teeth, and watched the specialist perform a frenectomy. Other than that, we were just standing around chatting the day away. Hope it gets better from here...

Anyway..

I moved into a studio unit near my clinic, basically 2 minutes drive away. Can leave for work 5 minutes before and still be in time to clock in at 8! Plus, they have staff parking! No need for endless rounds looking for a good spot. 

This is my studio and that's daddy at the balcony checking out the view

It's not huge, just adequate. 

 And here's mom and dad in the kitchen cutting mangoes. Nearer door leads to bathroom and further one leads to laundry area. 

 The view. Hehe. Not the view from my window though, but from the common area. That's the straits. Breathtaking eh?

 My study cum dressing table

And the pool! Haven't swam in ages. Time to dig out my bikini and go for a swim :)

Waiting for my first guest to visit! 

My little girl turns 1!

 This, my friends, is Pebbles! or more affectionately known as Pebbie. She's a white Toy Poodle / Bichon Frise that came to us about 10 months ago. And since then, she has brought us endless joy and laughter :)

When she arrived, she was in a box far too large for her. Sleeping in a corner, barely stirring when i picked her up. She was only slightly bigger than the size of my palm, so fragile, so vulnerable. 

I remembered the first night she stayed in my house, she was afraid of being in a new surrounding. So afraid that she had diarrhea. I was worried sick. Thank goodness she got better after eating half a carbon pill. 

Since then, i've watched her progress from stumbling to walking to running and walking on her hind legs. I've watched her transform from a little lamb lookalike to this beautiful, most lovable dog anyone could ever ask for. 

Pebbie on her 2nd day with us

Pebbie now. Ain't she cute?

And today, she turns ONE! It's a shame i'm not able to celebrate this day with her. But i've made sure that she gets enough hugs and treats to last until i see her again, in 5 days! Can't wait :)

HAPPY BIRTHDAY MY DEAR PEBBLES!

LOVE U LOADS

Special needs patients

Lately, there has been many special needs patients coming to the clinic, and somehow or rather, I end up seeing them. Not that I'm complaining, but it is definitely a challenge for me, seeing that I have never seen patients apart from those requesting restorative care during my student life, and also those who seek orthodontic treatment during my attachment at the orthodontic clinic.

The first case that came in last week was a 12 year old girl with learning difficulty. She was willing to be examined with a mouth mirror, but at the sight of any other instruments, she mouth clamps shut. Her Mother has taken her to various other dental clinics but all have failed to extract her teeth. Even with a history like this, my senior officer somehow had confidence that i could carry out the extractions! After several failed attempts to inject the anaesthesia, it was decided that she had to be sedated. So a dose of midazolam was prescribed. 30 minutes later, even in her drowsy state, she still managed to struggle and push my hand away. 5 people ( mother, aunt, specialist, 2 nurses) had to restrain her while i injected the last bit of anaesthesia. With all the commotion, one tooth was finally extracted. After over 2 hours!  And worst of all, she was so pissed, she refused to bite on a cotton roll. So she had bloody saliva dribbling from her mouth onto her clothes and the dental chair. And when someone finally managed to get a roll into her mouth, she threw the blood soaked roll on the floor. One of it ended up on my foot :S

The state of my hair after the extraction

Patient number 2 came in yesterday. He is a 15 year old boy with cerebral palsy. He has spasms of his arms and legs, making him unable to walk, and so had to be carried by his mother. Unsurprising for a case like this, he has multiple teeth with large carious lesions requiring extractions. Since nothing can be done with the patient so uncooperative, the patient was put on the waiting list for dental clearance under general anaesthesia.

Patient 3 came in this morning with Down's syndrome. He complained of pain from upper front teeth. Again, he too needs multiple extractions but refuses to let me put anything into his mouth besides the mouth mirror. How to work like that?? So another patient on the waiting list for GA.

Patient 4 came in shortly after Patient 3. He is a 5 year old boy diagnosed with Mental Retardation with Hyperactivity. OMG! This patient is a handful. Even in the waiting room itself, he managed to fall and hurt himself. He could barely stay still for 2 seconds and his dad had to hold on to him the whole time. When he got free, he ran around the clinic, into the specialist's room  and out again. He is one of the worse cases so far. He needs extractions of all his primary molars. Imagine the level of decay! Daddy refused to go to the Paeds specialist in JB for the extractions, so one more case on the waiting list! 

Parents, please! Do keep your child's teeth clean! Don't bring them in only when their teeth can no longer be restored! And with the amount of decay, there must be long term neglect. 

*****

I saw another patient today with a heart wrenching story. An old man of 73 years, was involved in a car accident. He could not remember how or when it happened, or who he was with. He was hardly responsive when asked. Later, i heard from one of the nurses that he was in a car driven by his son, who sadly didn't survive the crash. I was thinking, maybe it wasn't that he couldn't remember the crash. Maybe he just didn't want to remember it.

2 little buddies

Here at our clinic, we get patients from the local correctional institute also prisoners every Wednesday. As if the shaved heads and prison clothes were not enough to distinguish them from the crowd, they come in handcuffs and are escorted by police officers.  What grips me most about them is the only treatment we can provide them is extraction. No other treatment option is open to them no matter how small the cavity. This is because most are HIV, Hep B or Hep C carriers, and if we were to use an air rotor for caries excavation, there is a high risk of aerosol and cross infection. Therefore, only extractions!

Below is a fellow colleague at work on one of the prisoners, with 2 police officers on guard. Hehe, and what was I doing? ;) I was deeply engrossed with my new novel Sister by Rosamund Lupton :) 

*****

Today, a nurse at my clinic told me about 2 cute little puppies that were running wild in her neighbourhood. She suggested that I take them in. From her description, they sounded too cute to resist so I decided to stop by to check them out.

When I got there, I saw them from afar. Two caramel colored canines, just larger than my foot, playing by the roadside. Once I got out of my car, they spotted me and came running in my direction. Awww.. that was one heartwarming sight. They came towards me with no apprehension or fear. They started licking my toes and playfully chewed on my pants. 

The 2 very playful pups

After a quick exam, the smaller one is a female and the larger one a male. Both look undernourished and have wounds on their bodies. They were really friendly and didn't attempt to bite or fight when I picked them up. And the cutest part of all, they stick to each other wherever they go! *watery eyes*

They ran and hid in the bush ostrich style, with butts sticking out 

The female, more gentle, more loving

And the male, the playful one. How can anyone resist this face??

I was so tempted to bring them home with me but with my moving around the state for the next few months, I fear that I will not have the means to give them a proper home. Anyone want to take them in?? :)

Frenzy Weekend

Busy weekend started with attending Dr Tiu Szu Hui's wedding, now also known as Mrs Diong!!! :)

It was held in a cute, suburban church in Parit Jawa, Muar. I was super excited as this as my first time attending a friend's wedding, someone I actually know!  The ceremony was short and sweet, and the newlyweds were surrounded by close friends and relatives. 

Congratulations to you both! 

Q & I with the Diongs

Early celebration @ Rama V

After lunch, Q & I rushed home to pick up our things and Pebbie. Oh which reminds me that i've not introduced Pebbie here :) Will dedicate one post just for Pebbie sometime. Hihi. We then drove back to Klang and arrived at about 6pm. After a quick shower and a short rest, we headed down to KL, Rama V at Jalan U Thant to be exact, for my early birthday celebration, just the 2 of us ( hehe ditched my parents for once). It's a chic restaurant which serves fine Thai cuisine. 

This is Rama V from the outside. It's a badly taken photo because we forgot to take one when we were there, and only remembered when we were leaving and this was taken in the car. 

 Chor Ladda: Flower shaped appetiser with peanut and minced chicken, topped with coconut milk. 

 Chor Ladda on my plate :)

 Us at Rama V

On table are Pad thai, green curry and tom yam goong in young coconut

 Us

Food at Rama V is soooo good, especially the green curry and tom yam! Yummy spicy food! Really authentic Thai food and also at reasonable prices. 

Shook! Shanghai Brunch

Ling suggested that we try out this place in Starhill as per recommendation of her friend. It's called Shook! and they serve brunch not sure if it's everyday or only on weekends, called the Shanghai Brunch. It's an all you can eat buffet and you have the option of food only or with free flow champange. 

So yesterday, the 4 of us, mommy, daddy, Q and I went on Ling's treat for Daddy's birthday, Father's day, Mother's day and my Birthday! :) 

There was a wide variety of food to choose from ranging from sashimi to salami. We were even allowed to order a main course each. 

 Aglio olio main course

 Happy happy <3

 A clown gave us matching balloon bracelets :)

 Shook!

 Eating happily, well he wasn't too happy as his tummy is getting bigger by the minute, so this was taken after i forced him to smile tee hee

 OHHH!!! i LOVE their dessert selection! this is only a small part of it. They have a macaroon tree, chinese tea creme brulee, mango pamelo sago, truffles, and cheesecakes and a choc fountain! ALL SO GOOD!

My plate of dessert *swallows saliva*

 My birthday platter, compliments of Shook!

Mommy the lamp post ;)

So that was my weekend well spent! 

*****

My second charm!

Finally got my second charm for my birthday, been waiting for months!

Thanks, love!

Perverse Patients

Here at the oral maxfac clinic in Muar, or more commonly known as the oral surgery clinic, we receive all sorts of patients from those with systemic conditions, paediatric patients, special needs and trauma cases. Most patients who come in are eager to receive our treatment be it a simple consultation to a complicated surgery. However, there are these few who makes you feel that they are doing you a HUGE favour by letting you treat them. What the heck?!

I saw this patient today who was involved in an accident (car skidded and hit a tree) yesterday. He sustained a fracture of his mid face, multiple laceration wounds in his mouth and 3 fractured teeth. He was fine when i was performing the examination, but when informed that he needed stitches for the multiple wounds, he made a BIG FUSS over it. He claimed that he already had stitches on other parts of his body and that was enough. Oh ya, I don't really wanna spend an hour suturing your mouth when I have better behaved patients waiting to be seen! And you are not doing me a favour by letting me suture your wounds! Don't give me that dissatisfied look when I ask you to sign the consent form. Really, what the heck is your problem? I don't care if you wanna leave your wounds open, but who will be cleaning up the mess when your wound gets infected and pus comes gushing out??? Well, of course I couldn't say all that. Instead, I had to coax him into getting the treatment with a soft, persuasive tone. BLEK!!!

The other day I had another patient who even refused to be examined. When asked if I could examine him, he turned his face away and mumbled something inaudible. As expected, he refused to be sutured but we ( my superior and I) managed to talk some sense into him. However, throughout the entire procedure, he kept complaining that his body was aching and that we should just stop. OMG I felt like suturing him without any local anaesthetic just to make him stop complaining. I was the one doing all the work with my back bent while he was lying on the hospital bed (these beds cannot be adjusted) doing nothing but whine.

Really cannot tahan these people. Please stop sending them to us!!! Please!! 

I saw a patient on Friday, an elderly gentleman, who needed an extraction. I was shocked when I saw him, as the skin on his face was flaking off all over. On closer examination, his whole body was flaking! When asked, he turned out to suffer from skin cancer ( not sure which type) for over 20 years. Sorry to say but that sight was kinda gross. Every time he moved, bits of his skin will just peel off. And when he left, there were flecks of his skin all over the dental chair! Gross max!

Tooth sensitivity

Took a PA xray of my lower left teeth today. Here it is!

Cool right?? Can even see my impacted wisdom tooth! 

I've been experiencing sentivity on my lower left first molar since a week ago. This sensitivity occurs when I release after biting and lasts only for a few seconds. I suspected it to be cracked tooth syndrome, but my superior thinks it's perio. What say you??

Muar so far

Without realising, i've been in Muar for almost 5 months now! My first posting after signing up to be a dentist in Malaysia is to Muar, Johor. It's a tiny little town consisting of 5 main streets and only 3 roundabouts. Get to know these 3 little ones and you'll never get lost here. Here in Muar, I'm living in my grandpa's old home which has been left vacant for some time. This means.... free rent! weehhee!

Orthodontic Clinic

My first attachment started in January this year. It was at the Orthodontic Clinic in Muar, where i spent 2 months learning how to screen orthodontic patients, change modules and archwires, take perfect impressions for orthodontic study models and activate removable or functional appliances. At the same time, i had the opportunity to improve my extraction skills. People shake their heads when i tell them that in my 5 years in Ireland, i have done less than 20 extractions. On my first few times performing extractions, i ensured that my specialist (Dr Aiman, who is super nice and friendly) was standing beside me to guide me. Dr Aiman is like the nicest and most down to earth specialist ever. She sits and eat with the rest of us FYDOs, makes small talk with us when we're in the clinic, buy us food all the time and laughs at our silly mistakes. 

 My table at Ortho clinic, this is where i facebook when there are no patients

 Muar FYDOs ( From left: Nabila, Xin Jie, Sujata, me, Sey Yunn, Sarah, Jaspreet)

Sujata's last day at Ortho :( my first colleague

me busy at work.... holding the suction ;)

Found my name! 

My last day at Ortho. With the clinical staff. Too bad Dr Aiman wasn't around. 

My 2 months there were superbly enjoyble, especially with awesome superiors like Dr Aiman and Dr Tiu ( dressed in yellow in the pic above). Dr Tiu allowed me to leave early and even coaxed me to bring my laptop so i can facebook and not study in the office. How awesome is that?! 

Thanks Drs!

Oral Maxillofacial Clinic

In March, I sadly moved over to the OMF clinic in the Muar Hospital, where i will be completing my 4 month attachment. It was all so intimidating at first, a whole new environment, new people in a new clinical situation and new colleagues, and most terrifying of all, the types of patients that come in each day!

Most days, we get a least one motor vehicle accident (MVA) case. Some days, we get up to 4. These patients come in with torn foreheads, cheeks, eyelids, lips, broken teeth, broken jaws and bruises all over their bodies. We are the expected to examine them, clean them up and stitch them back together to make them as good as new. Tough feat, especially with my phobia of blood.

I was on call 2 weeks back and was called in to the hospital ward to treat an old man who was hit by a Mat Rempit. There were numerous tears in his mouth, some which are through and through, meaning his mouth was punctured. I spent 4 hours with my back bent by his bed, suturing his oral tissue back in one piece. By the end of the 4 hours, i could barely stand upright. Thankfully that was the last case!

Every Wednesdays, we get patients from a correctional facility nearby and from an Anti Drug center. Some of them come in handcuffs and some are even escorted by policemen. These patients are offered only the option of extraction no matter the severity of the disease. Also, most of them are infected by Hep B, Hep C or HIV.

As frightening as this may all sound, the experience i get from working here is invaluable. I leave work each day feeling that i have achieved something.

Oral maxillofacial clinic at Muar Hospital

FYDOs

In the operating theatre where we are only allowed to observe from afar

And this is what i do to keep myself busy while waiting for 5pm :)