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Friday, September 22, 2006

unexpected day

rasa cam nk nangis (10000x) i just dun expect 2mrow is ramadan...i was hoping that it will be on sunday...i received a msg from hannah (1 of my colleague) saying that 2mrow is ramadan when i was doing venflon on patient during my very 1st on call, oh my goodness! d 1st thing coming into my mind is I'M GOING BACK 2 DUNDEE 2NIGHT! i was in perth @ PRI for medicine 1 just now n i'mactually planning to stay there for tonight but i changed my plan on d spot..lucky me, kirsten, she s d 5th yr studt on call wif me today offered me a ride back 2 dundee..we r supposed to come for post take ward round 2mrow morning but both of us r not going to be there, n dr brown, d consultant on call is not expecting us to be there...besides, theres not many patient for todat tho...

talking bout today, i dun think its a good day but i learned lots of new things..i din expect today turn tobe like this...there s nothing to do in d morning until 1, the 1st patient only came in at 1+. we were bored waiting for patient...n then everything started, 3 margaret's came in, which we thought, oh, its a margaret day...3 patients wif same forename came in n we clerked 1 of them...she has SOB, obvious purse lip breathing n rhonchi all over d lungs, n i suspected there s a left basal crep which my colleague dun think so, but i believe there s a bit bcos when her cxr came back, there s slight consolidation of her left lower lung lobe..i wasnt wrong just that im not confident enuf...i did venflon on her n i manage thatbut i cudnt get bld fr d venflon.her bld was rushing out n they all spills onto d bed..wat a waste of bld...felt so guilty bcos i actually need >20 ml bld cos we had 2 do bld culture 4 her but i just waste them, her bld was all over d bed.

my 2nd venflon, alhamdullillah i manage to get it but same prob, cudnt get her bld, i'm so worried if i din get d venflon on d right place, but she was fine when i flush sum water..i'm pretty sure that i got it right, n yes i am bcos during d evening ward round, i saw d lady was getting her fluid thru my venflon...she has a difficult vein , mind u...she remind me before i did that on her, she said only her gp can get bld from her n she screamed everytime i put a needle on her...hah...n just now on my way back to dundee, kirsten told me that she had transfusion reaction, they gave her bld transfusion bcos she s anaemic, ohh..poor lady..i hope she ll be fine..

evening ward round... got asked many questions by dr.brown...feel stupid cos cudnt answer sum of his easy questions..spinal cord end at?L2 n i answered S2, huhu...memalukan aje...compression of T12 causing LMNL instead ofUMNL..then mass in neck?wat cud it be?i got it right just i took my own sweet time before confidently answer that...nasib baek i can answer his other Q...n then after ward round, went down to get sumthing 2 eat but....d vendor machine telan all my money..40p...ceh...geram tol..so berlaparlah kejap..back to ward, d jho gave me a yogurt..so thats my dinner...

n then venflon again, alhamdullillah i managed to do them all, took bld, ecg, request cxr....at bout 8 i started to clerk a new patient, her history was very vague...she was admitted becos of collapse but she denied that...she said she s just drowsy, fell from chair but still aware of d surroundings...n she had 4 days episode of diarrhoea...history of colon cancer...what s her diagnosis..uh no...i just dunno, after taking history, do PE, then fill in her kardex n request ecg, i went to get my bag n then cabut la...sbb it was already 5 past 10.. yeah..i'm goin back to dundee...

waited for kirsten bf, david..he s 1 of d bmsc student actually, ive met him before, during bridging..he s nice...david dun really know d way to PRi, he got lost few times before finally met us...then he got lost again...he drove towards north instead of west...we both insist him to turn back but he din want 2 listen to ask until kirsten wanted to call her da to ask for direction...david was scared of kirsten dad's..haha...we almost missed dundee again at d roundabout but finally we got d right way back to dundee...so reached home at half past 11...feeling hungry, tired..i want 2 sleep..but i think i better stay up till subuh then only i sleep, do my taraweeh, hv my dinner+supper+sahur together..online for a while..update my blog(which i m doin now) update my patient detail...wait for subuh n then i want to sleep till 2mrow zuhur..haha..stop here...happy ramadan to all...

posted by iFtiDa @ 3:44 PM 0 comments

Friday, September 15, 2006

most memorable day in surgery block

today is my last day in ward 10 @ surgery 3 block...when i woke up in the morning my only aim is to get may assesmt form done by hook or by crook, i hv to search for my supervisor n get him sign my form..when i reached the ward this morning..it was quiet, nobody else except one jho..grand ward round is suppose to be tis morning but then the consultant only came in at 10 to 9...n he said we hv to finish ward round in 10 minutes coz i hv a meeting..after 10 minutes he dissapeared without finishing d ward round n he asked another consultant to continue whom is my supervisor,mr wood...but he is on call n he has to go to theatre for emergency surgery...however he still come n review 3-4 patients
before the theatre ppl bleep him..i asked him if i can watch him doing the surgery..n he said its ok, u can help me if u want to..we both went to see the patient..she is a 20 y/o lady presented with sudden onset RIF pain which is typical of appendicitis, well this is the 1st time i met a patient pointing exactly to mc burney's point in which the pain is what we called rebound tenderness...n interestingly, she is pregnant...
mr wood did the informed consent on his own as she was quite worried, she even asked him whether he has done this kind of op on pregnant lady like her before, since it will be an open appendicectomy instead of laparoscopic one...he mentioned to the lady that i'll be assisting him during the op..fuh..i am waiting for this opportunity since my 1st day, n only now i get it...very excited...
quickly go n change to green..then ask the nurse in charge to teach me how to scrub in...okla...but i ve to be very careful to maintain the 'sterility' . then help him to put on the green cloth n all...altho i do nothing besides pulling the retractor, holding the clip and cutting the vicryl but seriously i dun think it was an easy job...u hv to be strong n hv enuf energy to pull the retractor because the skin n fascia are very tight n even more in pregnant lady...incision was made a bit higher than mc burney's point to avoid injury to uterus, when 1st reached the peritoneum, i can see the enlarge uterus, then he took out the large bowel becos he cudnt find the appendix, it was obscured by the enlarge uterus..finally find the uterus..it was a bit inflamed, bld vessels were more prominent...wah..this is an unforgetable experience because before this i can only see from far, but this time i get a clearer view, can see inside the peritoneum particularly organ near RIF...can see every layers from skin to fascia, then muscle before reaching the inside of the abdomen...i wont forget this...
the operation was fine...then i got him to sign my assesmt form n now i'mdone...yeah..can go back...but then i thought maybe i should drop by the ward n say hi to hannah (jho) before i go back..but it turn out to be sumthing else...since hannah is only today, there r so many things to be done.. n mr wood wanted to continue d ward round...so i helped her during d round then filled in those discharge form, ogd request, blood transfusion thingy, then took some blood that were not done by phlebotomist..bcos she had to clerk few patient in surgical opd ...now i know how the real doctor works..it can be hectic man..esp when u r left alone...u hv to monitor 24 patients at 1 time whose consultants are different, hv to go here n there to request things...then the nurses, physio, pharmacist..all are looking for u to ask u this n that...basically u hv to know everything goin on..n i think the best way to approach this is dun stress...thought for today..

at night, i went to d mosque to help them wif d prep for doors open day programme..when i first arrived..wow, theres so many ppl, now only i know there r actually quite a number of muslim in dundee..make new frens..from algeria, abu dhabi, eqypt n brunei...that was great...actually i just came back from d mosque..so bit tired..i'm thinking of goin to sleep now but i remember that i've to do sumthing for my 4th yr project..i'm stuck now...pls help me...need to pass up my corec form, ethics form n wateva form...oh i dunno..i need to at least know sumthing about these forms before i go to perth..if not, i'll be stress out..opps..no stress...stop here...need to do sum work...

posted by iFtiDa @ 9:38 AM 0 comments

Wednesday, September 13, 2006

*&^%#@@$%%horrible day !@#$%^&*(?">

suddenly i remember bout my blog...so i decided to write sumthing since i havent write for ...bout 5 months...why i suddenly think bout my blog?huhu...bcos i feel bad, sad n i cried just now..haha..so i need sumthing to write bout how i feel...n i havent got my diary yet here..might as well update my blog right...so many things goin on today..
after bout 2 months been in dundee..i'm now feeling homesick ..haha..sounds ridiculous? childish? whateva...people cant tell when i'm sad bcos i can still smile...u wudnt know.... n d other thing is one of d patient in my ward died last night. i din see him for d last time but one of d jho told me bout him... actually i already thought bout it d 1st time i met him in d ward but i just dun expect that to be...he was a nice gentleman...feel sorry for his family...u really wont expect him if u dun see him ..he was a post op, cholecystectomy patient..but after d op, his condition suddenly deteriorate..his crp n wcc went up, liver enzyme was haywire man, he developed chest infection, vomited few times...but he din complaint much...he got so many tubes inserted..from above n below, both sides of hand...so pity...i took his blood twice, did blood culture..but he never complaint.. he was such a nice patient.. he looks similar to my grandpa tho...the last time i saw him was yesterday morning during morning ward round..he developed haematoma on his abdomen, it was a large haematoma...n in the evening, he continued deteriorating n diagnosed to have acute pancreatitis..he then transferred to HDU...n today, they told me he's dead...i was shock... this is a memorable experience for me..altho i'm not d 1 treating him...but i wont forget this...
another story..there's 1 patient today, an old lady...i've seen her since the 1st day attached to this ward...the jho ask me to put venflon on her, but before i say anything..she already said, i dun want u to do it...woo!!...i dun mind, i mean she has the right but can she pls says that in a more polite way?i din take that personally..never take anything personally when dealing with ur patient (1 of my principle) i just want 2 know why she refused me to do the venflon bcos i never poke a needle on her even once...
there's so many things happened in the hosp today..dun wan 2 list all of them...at least i know i've learned sumthing during this block n i wont forget them...besides, i'm really thankful to spr n jho in my ward, they were really helpful, they taught us lots of thing...those that we will never learn during our lecture...

posted by iFtiDa @ 12:29 PM 0 comments