- 10:02:00 PM
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OMG, FINALLY I'M HERE ! THE PSYCHIATRIC POSTING !
Tak sabar rasanya nak pergi melawat ward psychiatric. I already started to love this posting as Prof. Dr. Nawan is so cute and semangat gila bagi lecture. Today is the 2nd day of posting, and tomorrow we will start to visit the ward and clerking patient. Nina and Audi went for a visit just now (I and Liyana went to Merbau Printing House to photostat the textbooks) and Nina kinda devastated to see the ward. She was scared. With the patient. Geez, I hope I'm okay with them. I'm not sure, but certainly memang akan ada rasa takut deep inside my heart. Hahaha. I hope no patient will attached to me, and so do I toward them. I love this posting because it allow you to understand and study thoughts of human. You got access to it. You can study how come this patient think differently, unlike the rest of other normal people. Why are they being like that and what are the turning point? What happen exactly?
Actually, I was drafting a novel since last year, a psychiatry type of story. It's about a girl, working as a doctor at psychiatric department facing some hardship in life and she encounters so many mysterious event regarding patient bed number 13. But funny is nobody knew the patient. They could not read the file as if the chief wanted to keep it from others confidential so badly. So yeah. The tittle is ADELIA. Still drafting and I hope I can finish it by this year? Hahaha, maybe. We'll see.
Actually, I was drafting a novel since last year, a psychiatry type of story. It's about a girl, working as a doctor at psychiatric department facing some hardship in life and she encounters so many mysterious event regarding patient bed number 13. But funny is nobody knew the patient. They could not read the file as if the chief wanted to keep it from others confidential so badly. So yeah. The tittle is ADELIA. Still drafting and I hope I can finish it by this year? Hahaha, maybe. We'll see.
Do you know that in early days, abnormal
behavior was always thought as evil spirits trying to get out. Trephining
was often used. And what was this Trephning thing? Yup, digging inside the brain to see what happen.
And today, we were taught about so many interesting ideas and terminologies that need to be know, memorize it by heart. Phenomenology/Psychopathology was cool. We learnt to differentiate hallucination, illusion and delusion.
Prof taught us with so many funny examples and ways to tackle the patient's attention when we're clerking them. Lets hope this 4 weeks of posting will be the best one in 3rd year of medical school.
Oh by the way, we 're using few textbooks that were recommended by our lecturer.
- 5:07:00 PM
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Well dah alang alang ada kat Kelantan ni, kita kena try lah semua makanan ruji mereka kan? 2 years in Kelantan, hopefully semua makanan negeri ni aku dah try.
So today I'm gonna talk about nasi berlauk that I ate for lunch. It was super cheap and portion tu pun dah cukup mengenyangkan. It's called Nasi Kak Wok. I'm not sure why they call it nasi kak wok, but maybe sebab ayam tu digoreng dalam kuali (wok) besar? I guess...... hahaha.
So this Nasi Kak Wok composed of white rice, few small piece of chickens and gulai ? Gulai is like curry but maybe it has less coconut milk or no curry spice? I'm not sure, don't ask me. Haha.. So yeahhh, it only cost me RM4 MYR. It's cheap right? Sometimes you went to other shops or stalls and you eat nasi berlauk, it may cost you more than RM5 MYR with only one part of fried chicken.
So today I'm gonna talk about nasi berlauk that I ate for lunch. It was super cheap and portion tu pun dah cukup mengenyangkan. It's called Nasi Kak Wok. I'm not sure why they call it nasi kak wok, but maybe sebab ayam tu digoreng dalam kuali (wok) besar? I guess...... hahaha.
So this Nasi Kak Wok composed of white rice, few small piece of chickens and gulai ? Gulai is like curry but maybe it has less coconut milk or no curry spice? I'm not sure, don't ask me. Haha.. So yeahhh, it only cost me RM4 MYR. It's cheap right? Sometimes you went to other shops or stalls and you eat nasi berlauk, it may cost you more than RM5 MYR with only one part of fried chicken.
- 10:35:00 PM
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L I Y A N A' S . B I R T H D A Y
So yeaaa, Liyana's birthday was on 7th January, an Aquarius person she is. We made reservation for 12 persons at Makette Steamboat and Grill, Tanah Merah.
8.30 pm, me and Nina were still chilling at home. Hahaha, we were supposed to meet them at Makette at 8.15pm ! I was so immersed with the Goblin K-Drama, can't leave my bed and Nina was sleeping peacefully. She's tired (or maybe side effect of medication she took before that...?)
Well, Mira, Aina, Husna and Itey were there, siap dah ambil makanan just tunggu others to come. Man, biyane chingu !
Mirul and Amer joined later. I and Nina managed to grab slice of cake from Secret Recipe, a Macadamia Cake (is it?) hahaha. Well, it went well. Thankfully.
Birthday Girl makan free that night, sponsored by Makette itself. Thank you Makette ! Makette's price is RM20/person, and then boleh makan puas puas. But the food there were not variety enough, to compare with Captain Steamboat or Seoul Garden. I still prefer Captain Steamboat if you want to save money. But Seoul Garden is one of my favourite place for steamboat and grill !
- 6:24:00 PM
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Yeaaa holiday mood is here. My first time going home after a while living in Kelantan. Phewwww, lega! Finally can go back to Shah Alam. Oh, oh, I'm already in Paediatric posting. Nothing special much, but I'm glad the nurses (NOT ALL) were being nice to us. Still afraid of the HO and MO. Why lahhhhhhh they tak senyum whenever they come nearer to patient or the parent. I mean, come on.... your patient are compose of neonates, infants, toddler, pre-teen ! How nak menang hati patient if you datang to them, just greet ala kadar and tak senyum. Muka serius acah professional. Well, semua orang pun penat. But, tak susah pun kalau bagi senyuman to any people yang kau jumpa kan? Pahala pun dapat.
Untuk first minggu posting ni, 1st day, semua file yang aku sentuh.... semuanya involve respiratory system, aduhai. So, my 1st case was a 10 months old infant with rapid breathing, diagnosed with bronchopneumonia. 2nd day was even tougher, semua file yang aku sentuh kali ni involving CNS. Hmm, a young girl aged 9 years old came with light headed and dizziness/headache. I'm not sure what her diagnosis was. But my differential diagnosis were paediatric migraine, or hematoma due to head trauma (She had previous history of head trauma before). Well, she got most symptoms of migraine without aura. So yeahhhh. 3rd day? We went to the clinic and meet most of chronic patient came for check up appointments. I managed to clerk 3 patients in the specialist clinic. My first case was a 3 years old girl with bronchoasthma. Then, 2 years old girl with AVSD came for post-surgical check up. Lastly, a 10 months old baby boy came for monthly check up. He had acute idiopathic thrombocytopenia purpura (ITP) when he was 1 month old, last about 2 weeks and resolved after taking some medication prescribed by the doctors here.
My oncall day was on Wednesday. I and Amanina went to the ward and try to clerk few cases but we managed to clerk only one case. Another ITP case, but this time it was different. This boy is a 2 years old boy, came with bigger bruises on his left forehead. The bruises also found on his upper and lower limb, also at his mandible. He was said to have cervical lymphadenopathy. It could be a malignant case, and he was unstable according to one of the HO incharged. The boy look so active and very friendly to us. I hope he's gonna be okay. His mother was so nice and friendly. She gave us all the information that we need. Phewww...
Okay enough about the posting. I'm tired. So yeah, I is going home bebeh! Tak sabar nak melahap makanan kat rumah. Tak sabar nak tidur sepanjang hari. Hahaha. Can't wait to be home.
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| Last oncall for 2016, with Amanina. |
- 11:34:00 PM
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T H Y R O I D . G L A N D . P H Y S I C A L
E X A M I N A T I O N . T E M P L A T E
Perform General and Thyroid physical examination on the patient.
Get the template !
Template were based from a teaching session with one of the specialist in Hospital Tanah Merah, Kelantan and with reference of USM Physical Examination Guide Book.
- 6:40:00 PM
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S U R G I C A L . C A S E
Cuti Deepavali ni aku tak balik pun cuti. Yelahhh, umi tak suruh balik pun. Katanya balik cuti Christmas 2 minggu nanti. Hoho. So aku and Audi pun duduk je laa berdua kat rumah ditemani Bobo.
Alhamdulillah minggu ni ada rezeki dapat masuk Operation Theatre (OT) few times. First case was cholelithiasis The patient was a female, 26 years old.
Came with complains of jaundice and epigastric pain. First time suffering this kind of pain. No family history. Diet was okay as well. Her stool was pale and her urine is dark-colour.
Impotant table ni anak anak !
Mr. Ken decided to remove her gallbladder - Laparoscopic Cholecystectomy
Laparoscopic Cholecystectomy
What is laparoscopic cholecystectomy?
The surgery to remove the gallbladder is called a cholecystectomy (chol-e-cys-tec-toe-mee). The gallbladder is removed through a 5 to 8 inch long incision, or cut, in your abdomen. During an open cholecystectomy, the cut is made just below your ribs on the right side and goes to just below your waist.
A less invasive way to remove the gallbladder is called laparoscopic cholecystectomy. This surgery uses a laparoscope (an instrument used to see the inside of your body) to remove the gallbladder. It is performed through several small incisions rather than through one large incision, usually 4 incisions, each one inch or less in length.
What is a laparoscope and how is it used to remove the gallbladder?
A laparoscope is a small, thin tube that is put into your body through a tiny cut made just below your navel. Your surgeon can then see your gallbladder on a television screen and do the surgery with tools inserted in three other small cut made in the right upper part of your abdomen. Your gallbladder is then taken out through one of the incisions.
Are there any benefits of laparoscopic cholecystectomy compared with open cholecystectomy?
With laparoscopic cholecystectomy, you may return to work sooner, have less pain after surgery, and have a shorter hospital stay and a shorter recovery time. Surgery to remove the gallbladder with a laparoscope does not require that the muscles of your abdomen be cut, as they are in open surgery. The incision is much smaller, which makes recovery go quicker.
With laparoscopic cholecystectomy, you probably will only have to stay in the hospital for a few hours or overnight. With open cholecystectomy, you would have to stay in the hospital for about five days. Because the incisions are smaller with laparoscopic cholecystectomy, there isn't as much pain after this operation as after open cholecystectomy.
Is there any reason why I wouldn't be able to have a laparoscopic cholecystectomy?
If you have previously had surgery in the area of your gallbladder, if you tend to bleed a lot or if you have any problem that would make it hard for your doctor to see your gallbladder, an open surgery may be better for you. Sometimes, your surgeon may begin doing the procedure laparoscopically and then convert to an open procedure. Your doctor will decide which type of surgery is best for you.
What are the complications of laparoscopic cholecystectomy?
Complications may include bleeding, infection and injury to the duct (tube) that carries bile from your gallbladder to your duodeunum (small intestine). Also, during laparoscopic cholecystectomy, the intestines or major blood vessels may be injured when the instruments are inserted into the abdomen. All of these complications are rare.
- 2:11:00 AM
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