répertoir.: Life

Showing posts with label Life. Show all posts

This is a post dedicated to a junior I've only met once or twice. Who had a supa powderful smash and walked with a hunch. Who left the carefreeness of eire to return to the heat of the country. Who would one day have gone up there to receive his scroll. May you find the peace you've been looking for, where ever you may be now.

I always thought that suicide only happens to sad people. Were you sad?

RIP

All there was, still is, and all that is, still will...~Anonymous

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That damned guide

Do I have any regrets in Medicine?

yes and no. Yes because it means I will be unable to live out to the maximum happiness potential as a woman, a girlfriend, a wife (sort of like IUGR haha) Yes because my world has become so limited now ... to the areas of medical practice, which drains every single ATP i have in my system so much so that when I get home I just want to collapse. Yes because I make decisions which when I look back sometimes, it only makes me feel like the most horrible person on earth. Yes because when the time comes I don't know if I can afford to continue on serving those in need, or making good clinical judgement all things given. Yes because I will lose many friends who will eventually evolve into people who only need me for one reason. Yes because one small slip over the wrong nerve could cause him excruciating pain, it leaves almost no space for mistakes. Yes because this could one day be the death of me.

Yet it has been an awesome journey so far. I don't think any other profession could make me appreciate money any more than this or the ability to put a smile on people's faces; or knowing that regardless of how ugly it sounds they really do come hand in hand. I look at people and I'd like to think that I see more to what they project, I learn how to read the invisible tangents in the air . I'd like to talk to the uncle and address his doubts (to my capability) whatever that has been causing him sleepless nights. I met an amazing guy who has helped me tackle emotions that I've never known existed. I do believe that if it wasn't for medicine then our courses might never have collided again. It has taught me far more than I've ever learned in the first 17 years of my life. The stumbles and triumphs has shaped me into this neurotic fella I am today, who'd cry at a grandmothers complains and who'd yell at patients relatives. I've got a long journey ahead, so long that to be honest, I don't really see the light at the end of the tunnel. But it doesn't mean that I'll stop moving onwards.

Because it is the only route I have.

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2012

May 2012 be a year of:

1. Better time management - 8 hours sleep, less time wasted, not being late, keeping to time

2. Hardwork - Less complains, more sheer work, again less time wasted

3. Less kiasuness

4. Less online shopping - I now recognize it as a proper problem

5. Mapping the future

Grow up Jo, Grow up!

~ciao bella

I will try again tomorrow.
~Mary Anne Radmacher

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#7 Fragile X

It is said to be the most common cause of heritable mental retardation second only to Downs.

It is caused by a distruption in the expression by either an nucleotide expansion or deletions of FMR1. A dominant X-Linked gene (FMR-1; familial mentral retardation 1) *trying to type the longest sentence ever expressed in a single breath*

Loss of the FMR1 expression results in Fragile X.

Clinically they will present with;

Pre-pubertal; Normal growth but a large head, Delayed developmental milestones, an association with autism, ADHD, tantrums.

Post-puberty; Long face, low IQ, Macroorchidism

other opthalmo, orthopaedic, dermato and cardiac anomalies.

Reason for nerding today?

I saw a 5 year old boy suspected for Fragile X in the clinic today. He came in due to a refusal to eat food other than kwey teow soup and drinks milk every 2 hourly. Outward appearance appeared normal, none of what has been described above; plus his mother mentioned that she was also slow to walk when she was younger. Eye contact was surprisingly- still held, but otherwise he would definitely have struck me as an autistic child.

I also met a child who was then diagnosed with spastic hemiplegia CP. Such an adorable 16 month old, who smiles incessantly and active as ever. Yet his mother cried when the doctor confirmed her worst fears -- that her baby wasn't normal. Cried even more when he advised her to apply for the OKU card actually.

Hmm. makes me wonder if there could be something between me and paeds. as much as its painful to go through the milestone examinations I'm starting to feel how Bern could be so attached to the little darlings. CP's are generally quite common but I think that encountering a Fragile X for the first time was quite.... mentionable. (there is no such english word)

Guess they aren't only found in textbooks under 'rare'.

Oh yeah talking about rare; there was a Henoch schonlein purpura case in the wards today.

YUP. you could see the 'WHAT?!' s on top of all our heads when the specialist came up with the diagnosis. Upon inspection I thought it was a freaking healing chicken pox (but i did reason out that if it was he would have probably been isolated) !!

Anyways paeds has been quite eventful thus far.

No quote today but I'll show u a picca

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STOLEN

Sometimes it unbelievable when I think about just how long ago was it that I was filling in that JPA application form and ticked the 'Perubatan' box.

Medicine has taught me so so so many things.

People misunderstand what the commitment really means. The box doesn't tell you of the nights you have to go without sleep, or the days you have to with coffee to stay awake in class. They don't tell you of the number of patients you have to clerk and remember how to present to your superiors. They don't tell you either about how you have to work for 24+12 hours straight if you actually want to get work done and not just pass it on to the next colleague. Nobody tells you how after a whole day of learning you come home and the first thing you need to do is study again, because tomorrow is a brand new day and brand new questions awaits you. If you don't keep up, so would mistakes. Nobody tells you how many systems you have to read and remember in order to be holistic, and no one would surely tell you the number sacrifices or how far you need to plan ahead to beat your own due dates.

Nobody tells you how horrible you feel when you cannot answer a question, and you think about what would have happened to the patient if you had been this careless when treating them next time. Nothing compares to the tears of a mother of an inevitable miscarriage and definitely not one of an oncologist who lost her husband to cancer. Nobody tells of the politics that goes on behind the scenes in the places you work, you study and the people who suffer because of that. None can describe the frustration felt when you stop and question, why in the world are these people here if they when it seems like that's the last thing they want.

No one tells about how much the specialists slog and the housemen scrape to get through each day with limited resources and energy. Nobody tells you how little hours a MO on call spends with her infant daughter at home and they definitely keep the angst of reading yet another wrongly prescribed medicine in the books from you. No one tells you how many relationships are broken up due to scarcity of contact. No one tells you how limited your options are after you graduate. Ironically the security that all parents thought medicine could provide for their children would present itself from the opposite direction. No one told you that the way the country is going now by 2020 you may be jobless as a houseman. No one told you that by the end of 5 years you'd most likely have to leave the country to specialize elsewhere. No one told you that not everyone is as lucky as that, to be given a chance to leave.

But let me tell you about the most important people in a medical field. The Patients. They don't tell you how painful it is when you poke and prod in a case of perforated acute appendicitis. They tell you it's okay when you fail your fourth attempted cannulation on their arms. They laugh as they thank you and try to match make you with their nephew before they leave the a&e. A mother cries as she tells you that there is really nothing wrong with her son.. he's only autistic. They share how it's always been difficult to open up to people around them, how much they've wanted to die, and some even how they've even planned and attempted suicide; but here they are talking to you. They don't say how it feels to live everyday at the mercy of strangers, strangers who look tireder than themselves and snap at any persons nearby. The mother of 2 doesn't tell you how embarrassing it is to give birth to her set of twins in a room filled with people lining up to the doors. A father carries his daughter with hydrocephalus out the door amidst the stares of people around him. The lives of PPKP's who work over time and risk their health fogging in an outbreak area without proper equipment and supervision. The uncle with bladder CA who longs to go home but cannot as his relatives refuse to accept the responsibility to look after him. A hospital security guard who so obviously have the facies of a trisomy 21 and yet there you see her, everyday on the ground floor in the hospital. The fruit uncle who stays and sells his jambu come rain or shine. Uncle RawT who's fed generations after generations of surgeons. It never fails to amaze me how despite all the pitfalls that becomes of their lives, there they are, day by day, incessantly.just. there.. And nothing so wrong with us could warrant enough to turn them away.

Medicine.

You have stolen my heart.

So don't give it back to me, not yet.

I submit to you that if a man has not discovered something that he will die for, he isn't fit to live.
~Martin Luther King Jr

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Fellowship with the ex CF president is worth more than words.

It's embarrassing but Today, only today, one year down the road, of being the auditor, have I finally realized my role as a CF Auditor.

Thank you.

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on the day I was coming back from KL, I sat in the LRT on the way to BJ, and there was a monk and a man sitting in front of me. The monk was ... dirty. not dirty like that type of dirty, but just filthy kind of dirty. He was in his yellow robes, clutching a sack which definitely had seen better days. Slippers kind of torn and he was dozing off. The uncle, on the other hand, looked quite well to do. Kind of like those professor uncle's you'd see after retiring. A watch, polo tee which told me he'd been overseas, and a look that, in other places might have seen me smile at him.

But I did not smile. I avoided his gaze. Purely because I saw him shift to his left then recoil. Another auntie had sat down next to him, and in order to not have any bodily contact with her, he'd gone the other way, towards the monk. He had the look that told me he was quite annoyed with the auntie for getting him close to touching that monk next to him.

I thought what a huffy.

2 stops away from mine, a few minutes after the announcement, he woke the monk up with a gentle tap on the shoulders; kao liao, he said in Hokkien. The monk woke up and looked at him dazed, but grateful nevertheless. He started chatting to uncle in Hokkien with just everyday things like kao liao ha.. kao liao. I was too late, he saw me smile even though I everted my head swiftly. We came to the stop and both of them disembarked.

Just before he left, uncle turned around and gave me a smile, nodding to me as he stepped off onto the platform. I thought what a huffy I'd been.

Always try to be a little kinder than is necessary.
~ James M. Barrie

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we are human.

Having such a wonderful chat with Chelle last night, it really made me realize that there were still stw people outside my clique that I could talk tO. and what more she was / had gone through alot that I am myself. NOt like we're solving it like superwomen but at least we know that we're not alone. it Was refreshing, as there were many things I could share.. and not feel judged.

Most of all it made me realize how nice it was having such a freEdom in life. To stay up so late. To drive home at 6am with the windows dowN and the smell of wet grass so strongly in your nostrills. To know that today is such a wonderful day.Starting off right. So yearning for the Everest's in the world Yet to be climbed. But knowing that you are only human and there are things you just cant do. Somehow it didn't seem that bad either. Because you know that there are things that you can and you should. WHEther you must that would then be up to you.

to Have the right to type according to your moods,Whether they be capped or noT, wherever I want. To hear my stomach grumbling because I chose not to eat instead of not being able to. To feel the fan above me spinning and spinning and spinning, making my feet cold and my body warm. Have you ever felt that comfort cuddling under a blanket with your soles cold and trunk warm? tO Know that I can infact leave, annytime I want. That eventhough things are plaguing my MINd that I CAn chose to push it back and look at... the flower on my table instead.

I enjoy this freedom, this spontaneity, such calmness such piousness, no one can give but Him.
And I thank Him for that, everything that's came into my life thus far
ShaPing me into who I am today
My lacks and my strengths

I know i've got a long way to go still but i know I'm going somewhere
And i'm going somewhere He wants me to go
I'm going somewhere I damn well want to go

tHIs is LIfe.

Age is a very high price to pay for maturity.
~ Tom Stoppard

Amen

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How pathetic to have such pride over something, but all it takes is the realization that a parent disapproves and you crumble
How ignorant to think that you've grown when after a single discussion you walk away with jelly legs and the huge relief that you didn't need to defend yourself... and perhaps fail
How machiavellistic that a simple thing like the tone of a parent's voice could give you palpitations
How regretful having taken for granted the times when a family was closely knit and you could proudly proclaim my family is together
How sad is it for a child to feel unloved and unappreciated
Just as terrible for a parents to feel ignored
How happy the days when no one was rich and everyone wiped windows, climbed ladders together
How careful to hear that you've become so monotonous, that everything is planned and needs a reason to it, how boring your life would now be
How nolstalgic to hear you were never like this

Courage is knowing what not to fear.
~ Plato

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Every once in a while, a sudden thought hits me. *snaps* just like that!

I used to think that I'll write it down somewhere.. or jot it down.. or heck, remember it. But it never fails to .. fail me. lols. okay lame joke .. but still.

So since a majority of my time will be spent in front of books and laptops (that's when my brain wanders into forks like these anyway..) I've decided this year that I will blog it automatically, if permissible.
*Sigh there goes all those years of precious random thoughts...*

#1 People
Since leaving home and since being tagged an adult, there have been SO MANY types of other adults I've met since hitting 21. (yeah my kinda joke) Mendelian in magnitude, I realized too, that unconsciously I've started to look at them by the simplest of ways-

- Those who expect you to respect them. They are not your peers, they are not your age, they might be fit into someone like your mentor/ teacher/ but they will never be your friend. So when you email them you don't go 'Hey There'. Think of 'Dear Mr X' and goodbyes like 'Yours sincerely' instead. And you must never crack jokes about their peers to them. Because those peers are on the same level as person discussed and therefore, will never be your friend either. Ever. Short of raising your arms in a salute, you should never look at them in the eye. (I'm not there yet...)

- On the other end of the spectrum, there lies the ones who are overtly friendly. Chatty. Hippy. You get the idea. It's not exactly the ideal personality either, because I suppose it takes time to adjust to their relative ages. However I won't deny that it's a huge plus when you feel like connecting. It feels odd at first, because being Asian you've always been raised to pay the elders their due respect. It's like a silent obligation. I still have problems calling my older cousins without the jie's and the kor's even now when they're like 35 and I'm 21, so calling a tutor for example, by their first names without their titles makes me feel like I'm going to be struck by lightning anytime soon.

- Then there are the ones who are in the middle. Serious at times, humourous otherwise and still connectable. They're the easiest and perhaps the majority of those I've met.

- The last group would be those who are so quiet I don't actually know where they stand.

Admittedly, I have a problem with people in group 1. Because I can never tell if they're 1 or 4 and unfortunately make alot of irrevocable mistakes before I actually realize sh1t, I need to kowtow and say my sorries NOW!

Our lives begin to end the day we become silent about things that matter.

~ Martin Luther King, Jr

kthxbai.

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Its funny how a few posts ago I was talking about how my new year starts in Sept. And now it starts in January. Lol, what a lalang.

Was welcomed back to Msia with sort of a numb feeling but definitely feeling very very refreshed. Everyone's busy with legal and forensics medicine. When I say busy I meant busy updating their facebook profiles. Lol. Literally. I find it so cute that everytime I go on facebook it's so easy to tell what course we're doing at the moment.

It's insane number of lectures we have to go through these few days. It's 1 hour on average worth of lectures per day. FIVE! CINQUE!!! But anyways, I actually think it's sadder for the lecturer than it is for us. At least we get to sit. Btw have I mentioned Prof D.C is awesome, the whole fan-girling kinda way awesome. He's one of the last of the generation who had to learn Latin for medicine, he studied law, trained as an endocrinologist, so I have no idea what is he doing in forensic/legal med. Oh did I mention he has a head full of dark wavy hair which he likes to run his hair through and that he can pronounce 'dadah' oh so perfectly and that his lectures are not boring at all? Considering it's law with THE million dollar question 'what is reasonable's... that's unbelievable it's not boring! So forgive me if I fawn at his feet. I guess profs like him represent the generation where doctors were truly the best of the best. Oldschool~ baby!

So yea there's this new year. I've got rhis exam next Monday. And the MMC has a 'Good medical practice' guideline that I need to regurgitate what is reasonable. Also, was looking through the requirements needed to work in the UK and oh my tuhan it is HARD. Sister asked a question today which I felt I answered B-E-A-utifully... albeit painfully. Sometimes I think God works in miraculous ways; He sent Arti who gave me the solution to my problems! WOOHOO!! And coincidentally the West wing episode I was watching talked about religion and I've quoted it below. Anyhoo now all that's left for me is just to win the lottery! :D

I need to learn how to reserve fuel. The rate I'm going right now I'll probably burn out even before CNY. But it's nice to feel so euphoric. :D

Was reading Burn's blog and realized how obvious it was.. The initial fireworks sure heat people up doesn't it? It's contagious! Healthily so :)

My resolution(s) this year are simple:
- Be selfless
- Be decisive
- Be filial
- Be happy

Welcome to 2011 peeps.

[I feel like I'm such a boring person LOL]
[ but in my defense it's so haphazard only because my thoughts are so choppy]
[ because I'm too hyper]
[or overdrived- depending if you wanna consider the coffee I took in the day]

You remind me of the man that lived by the river. He heard a radio report that the river was going to rush up and flood the town, and that the all the residents should evacuate their homes. But the man said, "I'm religious. I pray. God loves me. God will save me."

The waters rose up. A guy in a rowboat came along and he shouted, "Hey, hey you, you in there. The town is flooding. Let me take you to safety." But the man shouted back, "I'm religious. I pray. God loves me. God will save me."

A helicopter was hovering overhead and a guy with a megaphone shouted, "Hey you, you down there. The town is flooding. Let me drop this ladder and I'll take you to safety." But the man shouted back that he was religious, that he prayed, that God loved him and that God will take him to safety. Well... the man drowned. And standing at the gates of St. Peter he demanded an audience with God. "Lord," he said, "I'm a religious man, I pray, I thought you loved me. Why did this happen?" God said, "I sent you a radio report, a helicopter and a guy in a rowboat.

"What the hell are you doing here?" ~
~ Father Thomas Cavanaugh (West Wing S1E14)

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Goodluck

People really shouldnt jump from a realationship into another one right after the other.
The elders were right after all.

In the silence of night I have often wished for just a few words of love from one man, rather than the applause of thousands of people. ~Judy Garland.

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Emergency med 5

There was a certain particular point just now around 2345 hours that I suddenly realized how important it was to have a pair of good good shoes. By good i mean comfortable. Its amazing that the ~~Medical students~~ MA's SN's and HO's don't get varicose veins from all the standing. When i sat down just now after the hours and hours of standing.. i actually felt. old.

ANYWAYS

37 yo female lady comes in with acute shortness of breath. I find out that she has bone mets 2' to Br CA. and she's even had a mastectomy. At the age of 37! It must have been at least 1-2 years before her ca was dx'ed. all at the age of 37. According to her there is no fmhx. but i never got to ask more about her risk factors, because she was so worried she had lung mets. She kept wanting to meet the oncologist, she's just had a metal plate inserted into her femur for a pathological fracture, she was accompanied by her bro and uncle, she's not married, i wonder if she's ever had the chance to experience losing her virginity, she was really really pale, she has nice veins for cannulization, she has pretty eyebrows too aside from being pretty in general, She told me she lost alot of weight, and that the disease was a very morbid one, she .... is only 37.

Indian uncle comes in due to a fall from an acute giddy episode. Had a bypass 10 years ago and a hx of DM which he takes both OHA and subcut insulin. Memang got hx of IHD one lah, so this time he says he felt giddy - Malignant htn? But he says he's compliant?!?!?! A few hours, 2 tired relatives, 2 failed brannulas and a chest xray later, he's obviously feeling alot better and says that - actually my scrape on my knee was the only reason i came in lah. Nicely missing out the SOB part. lol i talked to his wife and she confirmed the SOB, she was like 'dei, u HAD sob ok' lol so cute.

Today it was probably field day for neuro. I even saw our senior Nigel there. There was an 18 yo kid with a (big!) EDH, but question- do lucid intervals last for a whole week!??! that's how long that's passed since his fall. The only thing he has is probably a fractured clavicle and bleeding into the sclera. Symptom wise he's been unable to tolerate loud noises and been having headaches that are non progressive. 18 yo kid with a motor lah, who flew superman style when he drove into a pothole.

Next to him was an uncle in his 50's who came in from an alleged MVA. He's alert and everything but ha ha here's the catch- he's so darn confused. If you didn't actually understand what he was saying you'd think that he's totally fine. Until you realize that he's answering 'depends on what they find' about 10 times to 12 questions. When Nigel asked him to remember 3 things - car, window, house (I cant rembr if it was window)... and then asked him to repeat it about 8 seconds, later he said 'car, brother'. Full stop. A few mins later i asked him a few other questions and i thought he was a little less confused when he was able to tell me he worked in penang and had no medical illnesses.... Untile I asked him if he knows where he was now and he goes Johor. MRI brain showed a small SDH.

The last bed in the yellow bay housed an auntie who had a long hx of htn and known to be non compliant. Earlier in the day she told her husband she had a bit of headache, and after passing motion she said it got worse. Next thing you know she's warded, unconscious and sweating profusely. Dx? Haemorrhage stroke. MRI brain showed Basal ganglia bleeding that drained into the ventricles but thankfully with no midline shift. Even when they wheeled her to the ICU her GCS was probably still <10.

78 year old chinese auntie came in feverish, unconscious, obviously cachexic with a BKA of the Left limb. Our very very nice MO who decided to gave us a teaching in the end used her as the bedside case. Okay so apparently from that first sentence itself we're already supposed to kinda guess what's the dx. Let me just tell you what was done; Resuscitation with NS improved her condition tremedously as she gained consciousness; CBD showed concentrated urine; Vitals monitored; Reflo done there was no hypo/hyper; ECG showed no ischaemic changes, blood Ix's taken- takes damn long to get back so don't know what yet; The last i saw her CXR hadn't come back yet. Talking to the relatives revealed that she just had a stroke 2 months ago and her BKA was done in May this year. Provisional dx? :D

Thin, cachexic, jail inmate comes in with acute SOB. Unable to finish a sentence, very obviously tachypnoiec. p02 was around 90 i think. Can't remember his vitals but anyways. Hx of IVDU and goodness knows what else that goes on behind prison walls. I was unable to clerk him fully, to even get more details on his presenting complain as he was in so bad shape but what we found out later was that it was a full blown TB attack. Every body wore masks after that for the rest of the night. haha.

Middle aged uncle comes in with R hypochondriac pain, feverish and jaundiced. Dx?
PS he's a walking biohazard, and i spilled his blood! DENG!!
*Thank goodness for H202*

In cubicle 3 there was this man who came in after he got stung by an ant. Black fire ant (at least that was what i got from his translation lah) there are black fire ants one meh? he came in to yellow zone sweaty, reddish and very very obviously distressed. We were all like omg omg omg where pain where pain where pain. Then he went 'behind, my back'. I was like what happened?` who bang you? or if it radiated anywhere kinda abdominal pain like. Then he went 'no nonono, ant bite'. For a while there i was stunned, lol. like ,what? then it finally hit me - anaphylaxis! The yellow zone was very busy at that time, i think that was also the arrival of all the unconscious ones, so somehow or rather his HO beckons me to wheel him to the green zone. Which, btw, was more or less in a chaos as well (that's an oxymoron because it's always in a chaos!) and he told me that (in a very direct translation) - the ant bit him and he lost his sight. Now everthing's black and he's finding it very uncomfortable both generally systemically and progressively getting harder to breath. As he sits in the green zone he asked me if it was possible for him to lie down somewhere - cus he was still on a wheelchair! I reallllly wanted to take him to a bed, take his vitals and insert a line cus i could see that he was getting redder and sweatier. but i couldn't. needed the doctor's consent first. haiz. So i kept watching him and finally lah this HO came over, took one look at him and went 'shit he's going into anaphylactic shock'. What happened afterwards was definitely one worthy of the ER scenes. This was the first time i saw Hartmann's being used. Im glad that at least he's stabilized now. his friend also very funny lah 'hey just an ant bite right? Just one injection then ok dy right? then he can go home already?' I could see the HO roll her eyes like dude, he's going into respiratory distress you think one injection can cure all ah?

and the misc's...
Teenager comes in with 2 sites of jelly fish sting with sand still found on her feet.
More of the usual trauma cases
Less of the kids today --- ie : less bawling
or maybe it was just because i was in the yellow zone majority of my time
There was also this auntie who wanted to introduce me to her husband's friends son who's a very nice guy cause i wheeled her to the toilet so she figured i must be just as nice. if not nicer :P
Everything else was more on the :| side. Not as funny as that one.
OH i also set my first 2 brannulas (FINALLY HALLELUJAH!) but i did fail like about 348274897256384 before that. My brannula's bleed.... alot. :(
The staff's were damn nice lah today!
and catheterized a lady as well.

I don't want to be a space occupying lesion.
Had a prep talk from Dr Jonathan. lol i didnt know the MRCS was useless.

*Day 4 has been left out consciously due to unforseen circumstances* :D

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Emergency med 3

Todays session wasnt as busy as yesterday. Hence, we were more in the way. Because we were less useful. Hence we were more in the way. Because the HO's were less friendly, trusting? Hence we were using up 02 there. I wonder if i can reiterate that enough

After yesterday, today we had an influx of kids. They seem to be getting knocked up by motorbikes alot.
And the asthma patients seem to flock in by families! For eg the mother will bring the daughter in, but in the end we'd find out that she'd be needing it herself.
Twas a night for female catheterizations.
Today was the first time I kena tegur too. And was proven wrong? in a very simple finding. See this 78 yr old uncle comes in with progressive breathlessness that's been lasting for the whole day, wtih a hx of IHD, triple bypasses, and a pacemaker inserted this March. He also has a hx of asthma. So he comes in and sits at the neb area, and i see him gasping, so i tried to get a bit of hx out of him. And then I find out that he also has crepts in his left lower lobe as well as bilateral pitting oedema up to the shins. Obviously nebbing him isnt going to work anymore right. So i brought it up to this HO who was writing something down. I only got to '78 year old uncle' and she was went 'Dont bother about the asthma patients first!! I need to clear the people behind first!'
Hello! If this was mere asthma why would I be bothering you? Ish i'd just ask u if its ok to give neb cus i heard diffuse rhonchi throughout. Haiya but anyways. its a nother point in learning. I did all i could. and he wasnt exactly like - dying lah.
Then the same uncle, a few hrs later, a diff HO came over and listened to the chest. Then when she was done she looked up and asked who listened to his chests, whereby i raised my hand. She was like 'listen again' in that really smug tone. Lol. Yes, he has crepts. but oh-ho even after he coughs he still has crepts!
But haiz- the medical student is always wrong werd .... that's how it goes in the hospital hierarchy.

The bossy loud but very helpful nurse wasnt there today. Our nice MO wasn't there today either. I met mr American accent tho.
The cases seem to be repeating ler.
This auntie of about 70 comes in complaining of general weakness and an uncontrollable tremor of her right hand. Dx? STROKE. (seriously, like where in the world did that come from) Makes me realize that I have, indeed, a LOOOOOOOOOOONG way more to go.
Teenage girl comes in collapsed. Where I see them elliciting the pain reflex when charting the GCS. I also saw the vast improvement after they NS'ed her and gave her ammonium salt. From disorientated to orientated and a full 15.
Pregnant woman of 5 months comes in with a ?fractured small feet of the foot. The issue is not the fracture, but the fact that her leg was infected from a scrape a week ago. She went to a priv hospital but they didnt wanna take any risks so they gave her only painkillers and nothing else. The MO wanted to do an Xray- the fetus? And since it was infected, they had no choice but to give her antibiotics--- SO HOW? She was told to discuss the issue with her husband cus now even a small procedure like taking an xray needed a consent. She never came back after her discussion.
Guess who I also saw today. My fav surgeon and wife. His dad was involved in an MVA. Lets just summarize it - He came, he saw, he sutured and his dad left the hospital 2 hours later. everybody say NO FUSS!
He asked me how am i too, to which i could only reply .. 'I'm fine'

Ps - I have an absolute PHOBIA of setting lines now. Today I couldnt even draw blood! Dammit. Meh. To fail and fail again. :(

Filed Under: =(, a Destination; Not the Nearest Exit Sign, Hospital, Life 0 pens |

Emergency med 2

Had ENT (in the freeeezing ent room ffs) till about 12, walked over to PMC for tutorial at 1-2pm followed by CDC meeting until 4.45pm. Walked back to hospital for emergency med at 5pm. Is it weird that I'm still alive and standing? its 1.30am and I'm typing todays patients in because we just got back about an hour ago.

Today we went to the 'green' - not hot- zone.
YEAH RIGHT

Its like a freaking wet market. Today it was more of doing things rather than chatting one on one. But i definitely learned alot today - skillwise.
Saw my first ABG too.
The nurse is such a killer she laughs at us when she sees us so enthu
Then she raises her voice when we -almost- injected the patient with 100mg ranitidine
Laughes at us again when we couldnt set a line
OMG THE LINE SETTING IS SOOOO BAD!
I hate it when i find blood then when i fully insert the brannula it perforates the vein and a haematoma forms. Got me so excited too when i extract the needle halfway and see blood. Yes Im in lah!!! konon. Babeng!
IM's Subcuts

Hey you, can you do an ecg?
I want an ecg pls. now.
Get all the basics lah ok, fbc, lfts. ...

and the first time i heard that- i could literally feel my eyes go WOWZERS, are you asking MOI?!?!?

(Very few buse creats tho)
Then there was this uncle who haematemized... wanted to talk to him. they were pumping him with NS cus he was very weak. closer and closer and closer.. suddenly he coughs in our maskless faces. I could almost see all the SHITS! thought bubbles above our heads.
Auntie who squat down drying her hair and couldnt get up back. "Auntie why were u squatting down particularly?" Oh I do that always. Yeah, why? Oh I do that always.... Yeah lah WHY LAH???? Finally I found out that its cus the hairdryer is on the ground. Chewww
Kids who come in with lacerations on the scalps. Fell down in the car lah, the swing lah, cousin push lah.. etc.
Grandmother of an MO in the department came in with chest pains- Suspected unstable angina but shes so cute lah.
Another auntie with bilateral knee replacements came in septic, probably a septic haemarthrosis.But when the 2 surgical HO's aspirated it was clear (yellow?) joint fluid.
The first lady I tried to put in a line in failed miserably. TWICE. omg. She had rigors which made things even worse. The MA came over, picked up her tourniqueted hand, and went this is how u do it ZOOOP. masuk. walao.
Kid with brittle bone disease comes in after falling down while on crutches. Fracturing the other side of his body. Some one labelled him 'stupid boy'. Manjaitis? With a voice like that he can be anything he wants lah.
Police officer comes in alledgedly with chest pains. Tapi energetic aje tgk die smsa ecg.
9 days old baby comes in with no BO for the past 5 days. Worry worry.
Indian auntie complains to the woonderful MO whotookusytd sumoreapologizedfornotbeingabletoteachustoday that her son has beenn there for the past 1.5 hrs and not been nebulized, instead was told to see the doctor and when this random elderly uncle comes in he gets the solution straight away--- Found out that BOTH her son and her were asthmatic. Funny fellas. not sure about the mum but the son had expiratory wheezes in the RLL.
+ Numerous numerous cases of uncontrolled hypertension.

I cannot possibly remember allthe other cases that came in today. Either too busy doing ECGs or ~~failing in~~ setting lines, drawing blood, bandaring diabetic ulcers, or some sort like that. I spent about 15 mins in the xray room too. Like some factory lah that place, there is no rest at all! It takes a longer time preparing the patient, whereas to take the xray you just adjust some numbers and press a main button. The red button like.
There were no major major cases lah like ytd's pneumo, but there were those people who came in dyspnoeic, BP's over 200 systolic, tachypnoic, and just bloody unconscious. Yup, those people whom you read about in text books.

Came back at half 12. in the rain. in the night.

feeling damn accomplished eventhough i know its far from accomplishing anything really that significant.

Emergency medicine? You are NOT in the way if you don't LET yourself be.

Filed Under: =), a Destination; Not the Nearest Exit Sign, Hospital, Life 0 pens |

Hosea's Wife

Hey peeps! Been a while since the last update.

Anyway gonna keep it short and simple;

Started the 2 weeks attachment in MMUH. So it's down to taking histories every single day, as many as possible, as efficient as possible, as fast as possible.. uuhhhhh okay, maybe fast isn't the right word to use lah, I'm pretty confused with what style/ template we're supposed to use. for eg: for our presentation, should our opening sentence use the patient's own words, or should it be in our own medical terms? All the interns/ sho/ reg's seem to be telling different things. heck, OHCM seem to be saying different things too! Everytime my partner and I present, we. get. grilled. But looking on the brightside, we're getting better every. single. time. The only thing i guess i could really work on is the reading up part. (read: LAZY :P)
Malaysian Night was awesome. ESPECIALLY the chinese dance. Well, to be fair all the dances were really good, but i guess the chinese one holds a special place in my heart ... i'm biased nyek nyek. Yeah as for the constant ~~bugging~~ reminders i get to upload it,... will do! once i;m done with this week's hosp. -which btw, would be tmrw... so PATIENCE!!!-
4 weeks and 3 days more to the land of my spilled blood (literal translation lol)
Leading worship for the first time ever this sunday. Really appreciate Kells giving me this chance, but i have to keep reminding myself that its a team effort. There are only we's and not i's. In fact, i'd say there's only Him and not us. :)
Lost my phone. =( okay there goes my plan of ~~bugging my dad~~ saving up for an iphone. I think if i had lost that, i might actually have slit my wrists! Ps- msian hospitals have no wifi right?
If you google Hosea's Wife, you'd have found out that she was a paradox. Apart from being a song sung by Brooke Fraser, it also tells of how God used her as a symbol of a sinning nation. At the end of the day I dont know if she's the bad guy (definitely nothing like Rahab) or a significant bad guy. It also addresses... (not quite, but at least it tries) the issue of What do we live for? ... (i got that from youtube lol) - Doesn't mean that i'm pondering over my life now either - It's just a nice song, and a nice song at that. :)
Brooke Fraser is my new favourite artist! (altho some of her songs do actually suck :P)
On a more personal note, I find myself turning pretty emotionless come these few weeks. hmmmm ~.~ such a far cry from how emotional i used to be eh... but it's good, at least i wont feel like the worst person on earth when you start taking histories from people with cancer. ~~cough, not like i actually took hx from a guy with final stage tumor behind his eye and who was dam sulky and i felt dam bad cus he might just die anytime.. or something cough.~~
Oh i also got taken out on my very first date. ha ha ha h ah.. and and and...and lastly................

Life seems to have fallen right back into place. with the same actors, same stage and the same play. Yet it's so different now. (being poetic here lols) so very different. Different in a good way. :)

More appreciative, more cautious, an entire newness that I've never experienced before. I like it. =)
Happy Feb peeps!