Assalamualaikum & peace be upon you...
Ok, atas cadangan saudara Alif Jamri, so aku dlm process buat blog baru yg akan memuatkan nota2 yg aku buat & apa2 jer la yg berkaitan...Link ada kat sblh...So, skrg aku akan ada 2 blog..1 utk mengumpat, & lagi 1 utk keakademikan sikit...He...
Wednesday, 26 October 2011
Sunday, 23 October 2011
Dan Berakhirnya Paediatrics...
Jumaat lepas, maka berakhirnya posting paediatric. Agak memenatkan & moody sepanjang posting ni..Daily ward works, tutorial nearly everyday, on-call every alternate 8 days, ward rounds were some of our routine. Added with some extra radiology classes, prescription workshop, lectures, CPCs, patho logbook, orientation with freshies etc.
Hu...agak memenatkan dan moody. Aku x de mood pun nak study and most of my free times, aku tidur, layan english drama, kluar tgk movie etc. Nasib la dlm posting ni ada konvo. Dpt balik jmp kawan2 lama, so mood aku naik ckit la..Tp x bertahan lama sbb peristiwa kena marah dgn Prof aka HOD 2...Hu...Korg leh baca post lama 2...
Tapi, ada bestnya time posting ni. My group dpt ward rounds dgn Dr Anna & Prof MT Koh. Org kata, Prof ni menakutkan & malignant. Aku punya la cuak dpt dgn ye..Tp, bila 1st class dgn dia, Prof sgt baik. Seriously. Respect r Prof. Tambah dpt Dr Anna aka Dr Halle Berry yg mengajar dgn penuh bersemangat. Seyes, klau hari2 ada class dgn yeorg, tentu aku jd paediatrician yg hebat nnt...Ha....
First 2 weeks, I was posted 2 ward P6 aka Paeds Oncology & Haematology ward. Best gak kat cni. Main benda aku bljr kat cni adalah pasal leukaemia and tumour lysis syndrome. Patients with cranial nerves findings pun byk esp those with brain ca. Bukan senang nak jmp cranial nerve findings kat paeds patients. He.... Tp, yg lebih penting, aku rasa, aku belajar macam mana nak handle dgn perasaan & bad news yang mana amat susah skali. Satu benda yang aku perasan kat cni, most bdk2 yg have poor prognostic factors are those yg comel, hepi2, yg baik2, yg peramah etc. Sedih bila tgk telatah yeorg tp prognosis yeorg x berapa cerah. Ada gak patient aku yg masuk Bersamamu. He...Tp, time rakaman 2 aku dah kat ward lain..Hu...
Minggu ke-3, posted 2 ward P2. General ward tp most of the cases r respi, cardio & genetic cases. Minggu 4- Neonatal ICU (NICU) or special care nursery (SCN). Kat cni byk bljr pasal prematurity & complications. Minggu ke-5 dan 6, P4 aka gastro ward. Time ni la kecoh pasal kisah hantu kat bangunan paeds baru ni..He..
Last 2 weeks lak, posted kat P1 aka paeds ICU. During ward posting, we were expected to clerk all the cases, follow the rounds etc. 1 benda yg tak best. Time follow round, aku mcm x bljr apa2 coz fhm2 je la kan, eyes did not see what mind doesn't see. Hu....
On call? Follow past over round smpi maghrib, then x sempat dinner, mandi, clerk new admission and follow night round smpi lebam. Tp usually, around 1130 mlm ktorg minta balik dah...He...
End of Posting? Hu....Theory paper?? Mampus. MCQ memang susah gile, subjective, hanya mampu tersenyum.. Tak menyesal aku x study...Klau aku study pun, aku bukannya leh jwb soklan2 yg ditanya..1st question pasal short stature. Boleh gak la aku hantam2 ckit. 2nd question pasal Infant Mortality Rate yg memang tembak2 la kan. soklan ke3 pasal chronic cough. tekaan aku asthma or TB tapi rupanya retained foreign body & last question pasal enuresis. Time review, Dr ckp the relevent of setting such question is to exposed us with community paediatrics which, we upon graduation and after housemenship will facing of. Not such elegent2 cases seen at ward esp a tertiary referral centre like UMMC. Hu....Matila..
Short case? aku kena dgn Prof Wan & Dr Aida. Dpt case chronic suppurative lung disease. Pergi2 je, aku x dgr sgt apa yg Dr Aida ckp, aku just dpt tgkp Dr ckp this patient dtg sbb SOB & pliz examine respiratory system. Yg Dr membebel pasal umur soma aku x dpt tangkap..Ha...My own comment? Hancus sbb aku x tau nak present findings aku cam ne & seriously patient 2 memang byk findings. My first impression, assal bdk ni eks. Mcm x de respiratory problem. Kira respiratory rate 32 jer. Borderline..Penat aku meneliti recession, x nmpk..Tgk bdn cam ok so aku ckp growth ye appropiate tp kena confirm, bila sruh buka baju, teng, teng, teng... Failure to thrive. Terus aku tarik balik...Inspect chest, ada left lateral thoracotomy scar. Ada chest wall deformity. Aku pun ckp la, "There is pectus emmmmm.."(sambil tgn ala2 menari makyung nak menunjukkan lekukan ke dlm). Then, Prof tny, "pectus what?" Aku pun jwb, pectus carinatum padahal excavatum. Chest expension symmetry but reduced. Percuss hyperesonance lung with lost of cardiac & liver dullness. Auscultation, expiratory rhonci & course creps all over the lung field severe at base. Vocal resonance & fremitus cam x membantu. Then, Prof tny "in respiratory distress x?" Aku jwb x sbb RR 32 borderline jer bg ye, x de nasal prong soma 2..Recession pun x nmp..Then Prof suruh ye dongak ckit. Skali lagi, jeng, jeng, jeng...Suprasternal recession..Ha...
Overall EOP? Theory, ntah cam ne, aku sorg jer past MCQ out of 31 students. Padahal aku byk hantam kowt. Subjective x hbis tanda lagi tp nampaknya cam suram jer.. Short case, Prof & Dr puji aku punya skill, mantap & dpt buat respi dpn blakang dgn cepat. Tp aku buat 2 major mistakes, missed suprasternal recession & salah sebut pectus excavatum. SANGAT, SANGAT BERDOSA BESAR bagi kesalahan tersebut. Huwa.....
Petangnya lak, ada exam CPC O&G. and of coz O Em Gii, aku memang x study. Case pre-eclamsia jd HELLP syndrome, beranak premature, eclamsia, then mak anak mati. Mak mati sbb intracranial bleed, anak lak sbb sepsis. Soklan lak byk tny pasal management & ha....No comment....Yg bestnya, bila ada soklan pasal complications associated with prematurity. Memang aku goreng dr NICU la...He....Nasib ada soklan 2...
Overall posting? Paeds memang busy & no wonder la, org kata klau jd paediatricians tak de life. Ada best & tak best bila kena marah & mood down. Aku malas study time posting & yang peliknya hbis posting lak aku jd rajin buat nota paeds. Ha....Anyway, 4 months b4 final exam..Matila aku....
Hu...agak memenatkan dan moody. Aku x de mood pun nak study and most of my free times, aku tidur, layan english drama, kluar tgk movie etc. Nasib la dlm posting ni ada konvo. Dpt balik jmp kawan2 lama, so mood aku naik ckit la..Tp x bertahan lama sbb peristiwa kena marah dgn Prof aka HOD 2...Hu...Korg leh baca post lama 2...
Tapi, ada bestnya time posting ni. My group dpt ward rounds dgn Dr Anna & Prof MT Koh. Org kata, Prof ni menakutkan & malignant. Aku punya la cuak dpt dgn ye..Tp, bila 1st class dgn dia, Prof sgt baik. Seriously. Respect r Prof. Tambah dpt Dr Anna aka Dr Halle Berry yg mengajar dgn penuh bersemangat. Seyes, klau hari2 ada class dgn yeorg, tentu aku jd paediatrician yg hebat nnt...Ha....
First 2 weeks, I was posted 2 ward P6 aka Paeds Oncology & Haematology ward. Best gak kat cni. Main benda aku bljr kat cni adalah pasal leukaemia and tumour lysis syndrome. Patients with cranial nerves findings pun byk esp those with brain ca. Bukan senang nak jmp cranial nerve findings kat paeds patients. He.... Tp, yg lebih penting, aku rasa, aku belajar macam mana nak handle dgn perasaan & bad news yang mana amat susah skali. Satu benda yang aku perasan kat cni, most bdk2 yg have poor prognostic factors are those yg comel, hepi2, yg baik2, yg peramah etc. Sedih bila tgk telatah yeorg tp prognosis yeorg x berapa cerah. Ada gak patient aku yg masuk Bersamamu. He...Tp, time rakaman 2 aku dah kat ward lain..Hu...
Minggu ke-3, posted 2 ward P2. General ward tp most of the cases r respi, cardio & genetic cases. Minggu 4- Neonatal ICU (NICU) or special care nursery (SCN). Kat cni byk bljr pasal prematurity & complications. Minggu ke-5 dan 6, P4 aka gastro ward. Time ni la kecoh pasal kisah hantu kat bangunan paeds baru ni..He..
Last 2 weeks lak, posted kat P1 aka paeds ICU. During ward posting, we were expected to clerk all the cases, follow the rounds etc. 1 benda yg tak best. Time follow round, aku mcm x bljr apa2 coz fhm2 je la kan, eyes did not see what mind doesn't see. Hu....
On call? Follow past over round smpi maghrib, then x sempat dinner, mandi, clerk new admission and follow night round smpi lebam. Tp usually, around 1130 mlm ktorg minta balik dah...He...
End of Posting? Hu....Theory paper?? Mampus. MCQ memang susah gile, subjective, hanya mampu tersenyum.. Tak menyesal aku x study...Klau aku study pun, aku bukannya leh jwb soklan2 yg ditanya..1st question pasal short stature. Boleh gak la aku hantam2 ckit. 2nd question pasal Infant Mortality Rate yg memang tembak2 la kan. soklan ke3 pasal chronic cough. tekaan aku asthma or TB tapi rupanya retained foreign body & last question pasal enuresis. Time review, Dr ckp the relevent of setting such question is to exposed us with community paediatrics which, we upon graduation and after housemenship will facing of. Not such elegent2 cases seen at ward esp a tertiary referral centre like UMMC. Hu....Matila..
Short case? aku kena dgn Prof Wan & Dr Aida. Dpt case chronic suppurative lung disease. Pergi2 je, aku x dgr sgt apa yg Dr Aida ckp, aku just dpt tgkp Dr ckp this patient dtg sbb SOB & pliz examine respiratory system. Yg Dr membebel pasal umur soma aku x dpt tangkap..Ha...My own comment? Hancus sbb aku x tau nak present findings aku cam ne & seriously patient 2 memang byk findings. My first impression, assal bdk ni eks. Mcm x de respiratory problem. Kira respiratory rate 32 jer. Borderline..Penat aku meneliti recession, x nmpk..Tgk bdn cam ok so aku ckp growth ye appropiate tp kena confirm, bila sruh buka baju, teng, teng, teng... Failure to thrive. Terus aku tarik balik...Inspect chest, ada left lateral thoracotomy scar. Ada chest wall deformity. Aku pun ckp la, "There is pectus emmmmm.."(sambil tgn ala2 menari makyung nak menunjukkan lekukan ke dlm). Then, Prof tny, "pectus what?" Aku pun jwb, pectus carinatum padahal excavatum. Chest expension symmetry but reduced. Percuss hyperesonance lung with lost of cardiac & liver dullness. Auscultation, expiratory rhonci & course creps all over the lung field severe at base. Vocal resonance & fremitus cam x membantu. Then, Prof tny "in respiratory distress x?" Aku jwb x sbb RR 32 borderline jer bg ye, x de nasal prong soma 2..Recession pun x nmp..Then Prof suruh ye dongak ckit. Skali lagi, jeng, jeng, jeng...Suprasternal recession..Ha...
Overall EOP? Theory, ntah cam ne, aku sorg jer past MCQ out of 31 students. Padahal aku byk hantam kowt. Subjective x hbis tanda lagi tp nampaknya cam suram jer.. Short case, Prof & Dr puji aku punya skill, mantap & dpt buat respi dpn blakang dgn cepat. Tp aku buat 2 major mistakes, missed suprasternal recession & salah sebut pectus excavatum. SANGAT, SANGAT BERDOSA BESAR bagi kesalahan tersebut. Huwa.....
Petangnya lak, ada exam CPC O&G. and of coz O Em Gii, aku memang x study. Case pre-eclamsia jd HELLP syndrome, beranak premature, eclamsia, then mak anak mati. Mak mati sbb intracranial bleed, anak lak sbb sepsis. Soklan lak byk tny pasal management & ha....No comment....Yg bestnya, bila ada soklan pasal complications associated with prematurity. Memang aku goreng dr NICU la...He....Nasib ada soklan 2...
Overall posting? Paeds memang busy & no wonder la, org kata klau jd paediatricians tak de life. Ada best & tak best bila kena marah & mood down. Aku malas study time posting & yang peliknya hbis posting lak aku jd rajin buat nota paeds. Ha....Anyway, 4 months b4 final exam..Matila aku....
Saturday, 15 October 2011
Jangan Lupa Namaku
Tak tau kenapa, aku rasa lagu ni best sgt, lirik lagu ni menusuk kalbu gitu...Ha...
Walau aku tidak bersamamu
Jangan engkau lupakan diriku
Walau aku tidak di sisimu
Jangan engkau lupakan namaku
Kerana aku mengingatimu
Kerana aku menyintaimu
Andai aku bisa bertemu mu
dengan senyum ku tadah syukurku
Andai aku bisa menyentuhmu
air mata pasti deras gugur
Kerana aku merinduimu
kerana aku sentiasa menyintaimu ….ooooo
sepenuh hati
Walau kamu jauh di mataku’
Jangan aku hilang dalam kalbu
Saat kamu samar mengingati
Jangan aku terus kau lupakan
Kerana aku sentiasa mengingatimu
Kerana aku sentiasa menyayangimu ohh sepenuh hati
Walau kamu jauh di mataku’
Jangan aku hilang dalam kalbu
Saat kamu samar mengingati
Jangan aku terus kau lupakan
Kerana aku sentiasa mengingatimu
Kerana aku sentiasa menyayangimu ohh
kekasih hati..
Andai aku bisa memelukmu
Pasrah aku tabah diujimu
Andai aku bisa dicintai
Dengan rela menyerahkan hati
Kerana aku merinduimu
Kerana aku sentiasa menyintaimu
Saturday, 1 October 2011
May be It's such a very lame excuse????
Minggu ni minggu yang penuh cerita..minggu yang penuh derita dan duka melara jiwa...Isnin, orientation with new ward that we posted. nothing much happen on that day..Selasa, I got new patient. Henoch-schonlein purpura. I come to the ward quite early and wanted to clerk the patient. but the guardian quite reluctant because before I come, 2 groups of medical students had come to examine the child etc...Then, few of other medical students, come to clerk the mother and now, I come..So, it's ok for me then and i always can come other time to clerk. Then, I've ward round with Dr Anna and finished around 12.30 something. At the afternoon, I got series of lectures aka seminars regarding blood transfusion and it end around 4.30 pm. After that, I rushing for on-call and finished around 6.00 pm. Actually I stay at the ward hoping able to clerk the HSP patient. Yet, I saw in the ward, 1 of my colluage just finished clerking the patient said he want to present the case for tomorrow ward round (although actually they does not have round), so for sure the mother will be refused to be clerked again...
Next day, after weekly wednesday morning CME, I went to the ward yet the round not started yet. I went to the patient room yet he was not there. I come few times but still not there. Then, I followed weekly gastro meeting and leaved around 1015 am for my tutorial at 1015 and the tutorial finished around 1240. In the afternoon, I got prescribing workshop at 1.30 pm and it end around 5.45 pm.
On the Thursday morning, all went wrong..It started with POD class in the morning. Suddenly, Prof asking whose on call last night and asking all the new admissions. Next, he started picked few patients from each ward. Started with P6. Yet, the all the patients he wanted was not covered. Those covering P6 that they never heard the name of any of patients that Prof mentioned. Then, Prof started become bad mood. Actually, the patients mentioned was not admitted to the ward but they just come to Daycare and somehow Prof get the name thinking that they are in P6. Hmmm....
Next, my ward.P4. Suddenly Prof mentioned the name of the HSP patient which allocated to me. I informed Prof that I didn't manage to clerk the patients because mother keep refusing and not in their room every times I come..Prof really become irritated with my excuse. Then, he mentioned another patient. All of us actually doesn't know who the patient is. So, Prof become REALLY, REALLY MAD, asked us to send full case summary of the patient by tomorrow 8.00 am at and just left the seminar room and class cancel. And I believed that some of my classmates pointing the fault to us who not covering the ward. Actually, the patient admitted at arund 1200 noon while we still have tutorial and having whole evening prescribing workshop on the previous day. I admit, it was our fault for not coming at night to cover the ward but sincerely, I'm not that kind of hardworking student who staying in the ward 24/7..I'm just like other student who also need some rest at night after a very packed day and preparing for the next classes. And sincerely, we also wanted to cover the patient after the class. Yet, nothing can be said anymore...
When, Prof leaving the room, seriously I heart seemed numb with a mixture of feelings. Sad, guilty, stress, mad, depressed. sad and guilt for not doing our job. Stress for being "blamed" by others, mad since Prof seemed doesn't know what the reason was behind it, depressed for staring the day with such situation etc...
Aku hampir2 menitiskan air mata bila benda tu berlaku. Aku hanya mampu berdiam seolah2 tiada perasaan. Kaki rasa berat, tak larat nak buat itu ini. Rasa nak jmp psychiatrist minta antidepressant jer. Then, ktorg ke ward utk cover patient tapi sister lak marah sebab tak follow round. So, follow round, cover patient 2 utk buat case summary etc. Habis around pkul 1.15. So, aku terus je ambil wuduk and solat. Seriously, time solat aku menitiskan air mata esp time sujud 2, and after solat aku seolah2 dapat ketenangan balik. Seriously, dah lama aku x dpt ketenangan mcm ni past solat. Dulu, masa kecik2 bila past ambil wuduk and solat, hati ni mesti rasa lain, lebih tenang dan sebagainya. Bila dah besar, benda 2 makin pudar...Mungkin hati ni makin jahat, jahil, tak kusyuk solat etc. Tapi, syukur Alhamdulillah, Allah bagi aku ketenangan lepas solat tu, bagi aku kekuatan. Yup, Innallahu ma'ana..
Next day, after weekly wednesday morning CME, I went to the ward yet the round not started yet. I went to the patient room yet he was not there. I come few times but still not there. Then, I followed weekly gastro meeting and leaved around 1015 am for my tutorial at 1015 and the tutorial finished around 1240. In the afternoon, I got prescribing workshop at 1.30 pm and it end around 5.45 pm.
On the Thursday morning, all went wrong..It started with POD class in the morning. Suddenly, Prof asking whose on call last night and asking all the new admissions. Next, he started picked few patients from each ward. Started with P6. Yet, the all the patients he wanted was not covered. Those covering P6 that they never heard the name of any of patients that Prof mentioned. Then, Prof started become bad mood. Actually, the patients mentioned was not admitted to the ward but they just come to Daycare and somehow Prof get the name thinking that they are in P6. Hmmm....
Next, my ward.P4. Suddenly Prof mentioned the name of the HSP patient which allocated to me. I informed Prof that I didn't manage to clerk the patients because mother keep refusing and not in their room every times I come..Prof really become irritated with my excuse. Then, he mentioned another patient. All of us actually doesn't know who the patient is. So, Prof become REALLY, REALLY MAD, asked us to send full case summary of the patient by tomorrow 8.00 am at and just left the seminar room and class cancel. And I believed that some of my classmates pointing the fault to us who not covering the ward. Actually, the patient admitted at arund 1200 noon while we still have tutorial and having whole evening prescribing workshop on the previous day. I admit, it was our fault for not coming at night to cover the ward but sincerely, I'm not that kind of hardworking student who staying in the ward 24/7..I'm just like other student who also need some rest at night after a very packed day and preparing for the next classes. And sincerely, we also wanted to cover the patient after the class. Yet, nothing can be said anymore...
When, Prof leaving the room, seriously I heart seemed numb with a mixture of feelings. Sad, guilty, stress, mad, depressed. sad and guilt for not doing our job. Stress for being "blamed" by others, mad since Prof seemed doesn't know what the reason was behind it, depressed for staring the day with such situation etc...
Aku hampir2 menitiskan air mata bila benda tu berlaku. Aku hanya mampu berdiam seolah2 tiada perasaan. Kaki rasa berat, tak larat nak buat itu ini. Rasa nak jmp psychiatrist minta antidepressant jer. Then, ktorg ke ward utk cover patient tapi sister lak marah sebab tak follow round. So, follow round, cover patient 2 utk buat case summary etc. Habis around pkul 1.15. So, aku terus je ambil wuduk and solat. Seriously, time solat aku menitiskan air mata esp time sujud 2, and after solat aku seolah2 dapat ketenangan balik. Seriously, dah lama aku x dpt ketenangan mcm ni past solat. Dulu, masa kecik2 bila past ambil wuduk and solat, hati ni mesti rasa lain, lebih tenang dan sebagainya. Bila dah besar, benda 2 makin pudar...Mungkin hati ni makin jahat, jahil, tak kusyuk solat etc. Tapi, syukur Alhamdulillah, Allah bagi aku ketenangan lepas solat tu, bagi aku kekuatan. Yup, Innallahu ma'ana..
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