Thursday, September 16, 2010
Today was my 2nd day to be attached at Hospital Sg. Buloh
and it was very very great experience for a student like me..
And it is great because i've plan already what i'm going to do during my summer holiday
since March ,
so there is no time wasted...
First day ..
there is an interesting case
when 6month old baby admitted to ED
complaining about shortness of breath + tachypnoeic + tachycardia
the team trying as best as they can to help this poor baby
they insert the 4 line for IV medication
but not all were successful only two of them i think because the baby is very small
and because of they need another line
so, they manage to do it on the neck and it was successful
after doing x-ray
supprisingly, the doctor get shocked by the patient
when she (the baby) is dextrocardia (shifting the heart to right)
the case is very rare and it happen maybe 1 :100000
and after performing Ultrasound/ Echography they found that this patient is Situs inversus
that's mean that all of the organ are on the other side
Stomach on the right , liver on the left and appendix also might be on the left
Sadly, i think the patient have only one ventricle
so there is mixing of the oxy-blood and non-oxy blood ..
Actually the first case when i was there is stroke
The patient's family claimed that he found his father was lying unconsiousness on the floor
after some investigation my boss (the specialist) reveal that there is minute haemorrhage
inside the brain i think (tak masuk CNS lg , so tak tau..hehe)
then he diagnosed the patient as stroke attack
The specialist told the possible complication and prognosis to the family
and then went back to the patient..
and then, what happened ?
haha, he asked me a question ...
"So, how many type of stroke that we have ?"
i know that i'm caught ..haha
then i told him ,
"hmm, actually i don't know because we didn't enter the CNS block yet..haha " -sambil tersengih-sengih
"it's ok"- fuh selamat x kene marah
"there is two tyme of stroke , first-haemmorrhagic another one is infarct , haemorrhagic is due to high pressure and infarct is because of low blood supply.."-sambil teringat jar2 yg ada kat makmal patho, laaa...itu ke, itu tahun lepas pun dah tahu..haha
and then he explain the details on how to differentiate stroke if there is no adequate facility as CT scan and many more..me? just angguk2 je kepala , tanda setuju ..(haha, perlu ke setuju ?)
then, comes the 2nd question, tp kali ni segan sikit sebab tak dapat jawab..hmm..
"So, this patient we gonna give him aspirin , the antiplatelet agent .., what is the mechanism of aspirin ..."
"hmm..p , p, p..berfikir2 x keluar pulak nak sebut prostaglandin , COX-1 tu semua , tiba2 blurr , then another attachment said , blocking the ADP ?"-and i just nodding my head tanda setuju , blurr tetiba ..another attachment student mcm pandai je tgk, chinese , 4th year , australia..
"salah.." haha 2nd tyme get caught
"that is another agent"
Aspirin is COX-1 inhibitor
"then , what is another antiplatelet agent that you know ?" - comes the third question
terbayang2 buku pharma muka surat belah kanan masa sem satu..cuba2 recall tp x dapat..
hmm ntah la, bnyk telan semut kot..= P
"Ticlopidin , clapidogrel ..."-aah, tu la nama dia, aduih..terasa loser la hari ni...
tension2, penat2 je blaja tapi x igt tyme kene tanya
haha (tu la berkat ke x ilmu..baca doa x sebelum blajar ?)
today is public holiday but still want to come
datang2 je .. "today is public holiday right, so why dat you come? "
cover2.."hmm, saje2 nak blaja"
then, today is quite not busy ,
Not a lot of emergency case
but then i'am learning to dengar the crepitation on peparu..
actually x dapat beza pun dgn normal sound..
teruk betul ...x cekap lg nak jadi doktor//
Dr. asked me to differentiate between two sound ..
"what is this sound ?it is different from here and here right ?
so, what is the sound..
alamak..kenapa tnya dah lupa la pulak..
teringat wheezing je...
"so, wheezing ?"
"No !! wheezing is like this ..iiieeeeekkkk for asthmathic and this is crepitation.."
oklah..loser yg ke-28 kali kot kali ni..
actually banyak lg case2 yg menarik n i do present the
but too much , no enough tyme to write
just a few pesanan dari saya ,
as Our professor told us, "You must learn by Heart !!!"
seriously , not to learn for competition ,because it will be lost (the ilmu) very easily..
And put much effort on studying..
especially during skill classes (for pre-clinical)
never waste your time , and always ask the professor or even senior if we didn't know anything
because medicine is not the things that all inside the book (tak semuanya ada dalam buku)
it need skill and opinion.
try to be creative and always make your brain work...
"Top scorer is not nessesarily be a good doctor "
We are not studying to only passed all of the examination , but we study because we want to study
(kalau mcm ni , xde rasa kene paksa kan ? )
Ok, that's all ,
be mentally prepared , physically prepared , and spiritually prepared for H/o
mentally prepared - not to think nak kaya , nak bukak hospital dulu , kalau x boleh survive dalam masa student ni lg (xde semangat la , xde itu la, xde ini la..)
Physically prepared -Jgn sakit2 sgt, jaga kesihatan , jogging ke kat tepi pantai..start kurangkan tidur ..
Spiritually prepared - Kuatkan iman , and the one who involve in Usrah and Jemaah , istiqamah on what you are all doing..Bukan ikut2 je, belajar faham dan bersungguh2 dalam memenangkan fikrah..Penuhkan wajibat..honestly i said that there is no enough tyme to do it all after you are all graduated unless start training from now ..
*kalau busy macam ni ..ntah bila la nak berkeluarga ? ... haha
That's all for now,
thank you for reading
and if you all have time try also buat attachment in any hospital ..
Thank to all my friends there in medical n emergency department..
*tgk la kalau ada masa n case best2 boleh la tulis lg..
maybe busy until going back to alexandria
so, there is no tyme to play with for me now
see you again
taqaballahu minna wa minkum
minal eidil wal faizin
salam eidulfitri ..