Change again

today is the 3rd week of klinikal asas

my group was being posted in surgical department

as usual in the 1st day we were brought to the ward and being introduced to the ward organisation

then the representative for each group have to call their respective supervisor to arrange for teaching

i am the group leader for my group

my teaching class would be tomorrow (31/5/2011)

for today, i just did some ward round with my colleague to be familiarize with the wards

i got to know 1 female patient who was just undergone surgery for pituitary microadenoma for the past 5 days 

she was very talkative, friendly and helpful

from my perception, she has a very strong determination and vision for her future life

even though she suffered from multiple diseases, yet she never complain and manage her life well

she once said that "if i am destined to end my life in a short time, at least i died in good health. so i want to fight with my diseases"

i was touched by her words

i pray to Allah so that He will grant her with iman, taqwa, good health, easiness, pleasure, blessings and prosperity

amin...

yumm yumm ^^

cream puff coklat ^^

dah lame x mkn cream puff ni

sape nak belanje????:D

pastikan cream sebenar ok

kastard or ape2 inti selain cream akan ditolak hahaha

nak tau cream puff sebenar amik sample kat sogo

sedap wooo

(tempat lain xtau katne huhu)

ronggeng2 sabtu

dah lame x ronggeng rmi2 pas msuk klinikal year ni

baru 2 minggu kot haha

hmmm sabtu lepas kami berlapan merayau di leisure mall

target--> kungfu panda!!hoyeh!

triple triple triple thumbs and toes up la

mmg xdan nak kering lidah gelak..hahaha

yg beznye part sedih pun blh gelak??hoho

mmg superb la..sape yg x tgk lg cepat2 la cari geng beli tiket n pecah perut sesame kat panggung okai

sblm berangkat blik kami masuk firework( tmpt main2 game gune token kat leisure mall)

berebut ngan bdk2 skolah rendah kot sbb nk main kete langgar2 haha

tp sgt bez w/pun dpt main 4 minit je :D

ade lg game yg kami main...pepun thanks kwn2 abihkan mase hjg minggu same2 hehe:D

sorg lg tukang tgkp gambo

lumbe kete ngan oma..n the winner is...ME!!hehe

lwn sparuh jln tibe2 bola stuck..sabo jele

alamak senget plak..sile sengetkan pale 90 drjh  ke kanan ye huhu

got warned by him

bismillah..

alhamdulillah..buat pertama kalinya hari ni saya berpeluang untuk buat venepuncture kat patient

slps mintak kebenaran dr HO, sy n 3 kwn lain cari patient yg hanya perlukan darah yang sket utk buat test

nak tau kena amik darah byk or sket, tgk botol kat atas meja

ade 6 warna botol (merah, biru, kelabu, ungu, kuning n hijau)

merah n biru kena amik byk dlm 3cc, yg lain sket je dlm 1 cc je

sy pilih pak cik yg sy wat PE semalamnye

vein dia senang nk cari..sy suke amik vein tgh..

tp malangnye 1st puncture drh x keluar..mgkn sbb x kena vein tu 

sian pak cik tu..sy dpt rasakan yg dia thn sakit sbb mase nak cucuk agk susah jarum nak masuk

then cuba kali kedua kat vein yg lain, medial and more superficial

pakcik pesan suh baca bismillah and takbir

alhamdulillah dpt msuk jarum dgn smooth and dpt drh yg diperlukan

lepas siap msuk dlm botol, pakcik tu pesan "ok,esok x yah amik lg ye"

hehe. sorry sgt pakcik. sy akan cuba mahirkan kemahiran sy

semoga pakcik cepat sembuh

lepas tu tlg kwn utk amik drh dari patient lain

sedar2 dah pukul 8..kelam kabut kami turun sbb ade common lecture ppd kat audi

alamak!!!lecture dah stat!!

ikut jln blkg..nak msuk pun cuak sbb prof tu agk tegas 

kami amik keputusan utk msuk pelahan2, sambil jln itik n cari port kat tepi dinding

nak berdiri takut..so rmi2 bersila tepi dinding sambil dgr lecture

lecture hari ni psl professionalisme

tindakan kami mmg x professional lgsg..jgn tiru kami tau

walau apa pun yg berlaku, kita kena hadapi gak kan kalau itu salah kita

next time kena cuba gak beranikan diri..huhu boleh ke??

insyaallah..everything is from inside

if we believe in ourself then everything is just fine

insyaallah 

aneong!:) 

tak sampai hati...tapi kena kuatkan semangat!

salam semua!!

minggu ni klinikal asas posting internal medicine

so far posting ni best sbb jumpe byk jenis diseases and blh apply most yg kami blaja mase pre-klinikal dulu

hari ni (25/5/2011) byk benda yg berlaku

sy n kwn2 dtg awl sbb nak amik pluang blaja venepuncture and practice sesame sendiri

kami g wad med 2..mase dtg tu ade sorg patient cina br je meninggal..

mmg x dinafikan semua HO kat sini baik2...lbh2 lg kelahiran hospital tu sendiri(i mean hukm hehe)

after tgk HO buat n blaja sket2 perkare yg berkaitan dgn venepuncture,kami pun g amik brg2 n g bilik tutor utk practice sendiri

alhamdulillah ok..harap2 esok dpt peluang buat kat patient betul plak

then g breakfast..pastu ward round cari mangse! hehe(patient la)

kebetulan hari ni rmi plak discharge and rmi plak kena guna ventilator

pas abis round dua wad akhirnya dpt la sorg patient perempuan kat wad med 5 bed 14 diagnosed with TB

kami buat PE respi..alhamdulillah dpt apply ape yg dah blaja mase teaching smlm

brief positive finding :- 

- reduced chest wall expansion on the right side

- tactile fremitus and vocal resonance is increased on the right side

- dull on percussion on the right side

- crepitation is heard on the middle zone of the right lung
(kwn2 blh cube buat..klu finding lain bgtau ye)

then, kami g wad med 2 nak cari patient utk test PE cranial nerve

kebetulan ade procedure yg sdg berjalan iaitu CVP ( central venous pressure line)
ade dua org doktor, sorg laki sorg perempuan
kalau xsilap dua2 MO
diorg mintak kami tolong kawal patient tu drpd mengganggu p'jalanan procedure
patient was diagnosed to have SIADH with underlying meningioma
mula2 doktor laki yg buat..
target vein is IJV
doktor tu agk kasar n kurg tolerate ngan patient
byk kali dia cube puncture, semua xjd
patient dah t'ketar2 n mengerang kesakitan
doktor perempuan tu yang byk tenangkan patient
bile smpi satu thp doktor laki tu agk lemah smgt sbb xdpt vein
then diorg exchange
dgn mudah dan dgn ucapan kalimah bismillah yg sayup2 kedengaran dibibir doktor ditambah dgn sdikit kata2 lembut utk menenangkan patient
akhirnya vein berjaya di puncture dgn 2 cubaan shj
procedure slps puncture juga agk menyakitkan
kami yg berada di tepi katil sayu melihat patient perempuan tua itu menahan kesakitan dari awal hingga akhir  n ngeri bila tgk procedure yg invasive mcm tu, especially bile masukkan wayar, then tube utk dilatekan vein (kena basarkan ngan pisau before msuk tube), and lastly catheter (kena jahit plak kat tengkuk utk elak catheter move)
slps tamat procedure, kami b'kemas utk pulang
sbb penat n kesian kat patient -.-
pasni kena biasakan diri dan kuatkan smgt utk melalui saat2 mcm ni
sbb kemungkinan besar kami akn berada di tempat doktor2 tu satu hari nanti

byk perkara yg sy bljr dari situasi ni
harap sy dpt mengambil iktibar bagi setiap detik yg berlaku
semoga Allah mempermudahkan segala urusan doktor2 dan patient tu

a bit about CVP:-

A CVP line is a special intravenous (IV) line. The line may have 1, 2, or 3 parts
that can be connected to tubing or needle free adapters. CVP lines are frequently inserted in critically ill infants and children for hemodynamic monitoring, delivery of intravenous fluids and medications, blood
products, TPN, and fat emulsion.  They may also be used for drawing blood samples.
Hemodynamic monitoring of central venous pressure reflects intravascular volume status
and RV function. The doctor inserts the line into a large vein in the neck (IJV) or upper
chest (subclavian vein). Sometimes the doctor may need to place the line into a vein in
the groin or arm (at cubital fossa).
*for further information u can ask mr.google ;)

tenang aje :D

salam semua!!!
entry arini juz nk story-mory psl bnda yg t'jadi hari ni

citer2 kosong je

hmmm secare kronologinye pg td stat pkul 9,i and d PERSIAP geng kena jd cashier utk wholesale PERSIAP kat ibnu sina..

dgn xsempat sarapannye(sbb mls nk mndi awal, ha pdn la muke kan haha)

duk atas kusi kaunter smpi kul 12..

ade la cengkelat sket2 jln2 di kwsn b'hampiran cuci mate hikhikhik

tp mmg xlarat giler laahh..lapa seyh

then after customer last g, kami kire duit n kemas2 bilik tu

disebabkan lapo sgt, i n k.gid skali ngan teha mintak diri nak lunch

pas mkn smbg keje la

nk dijadikan citer duit shot dlm 600++

fuhhh!!! mmg cuak cik manager as well as supervisor kiter

then,kami b'usaha utk cr punca shot tu

suasane tegang...lub dup lub dup

segale mcm care dah dibuat...tp yg beznye time2 ni la k.gid b'gurau nk g tgk pirates

i pun pe lg on je...w/pun tegang tp rase tenang..haha!

pas smua dah penat m'cari punca,lastly dpt la shot tu kurang jd dlm 200++ je

ok la sket klu nak cover2 kan

hopefully sok xjd lg mcm ni

after zuhur,i n k.gid b'gerak cr teksi

yg lain xdpt ikut sbb ade hal msg2

konon nk ikut lobi sbb pns tp pintu tutup sbb hr sabtu

nk ikut o&g tp xjumpe jln kuar

last2 t'pkse gak rentas pns 

kat sini teksi mmg sng nk dpt..spital kan...

kami menuju leisure mall

after roundboard, tetibe teksi kami t'brek sbb kete dpn brek mengejut, then bunyi plak dentuman yg xbrape kuat..t'kejut wooo!!!!

teksi kena langgar ngan kete blkg

n semua kete2 yg t'libat parking tepi n discuss

ade dlm 8 kete kot hoho

kami d tinggalkan t'kontang kanting dlm teksi

lame plak tu discuss..meter bejalan

lps lbh kurang 15-20 minit, i kuar n bg uncle tu rm5

then kitorang blah cr teksi lain

smpi kat mall dpt tiket wyg kul 6, tp seat 3 dr dpn

lyn je la kan...nsb bek seat lembut..sdap sket haha

yg xbesnye awl2 citer mate berat gile

aduhhh!!jack sparrow buat lwk jage..pastu lelap blik haha

tp xrugi ok sbb smpi stgh je..stg last tu segar dah hehe

before blik, beli mknn dulu

roti boy!!dah lame x melahap haha

tp sbnrnye yg mengkagumkan is

sepanjang hari ni rase tenang je

w/pun byk benda yg berlaku kan

betul x k.gid??hehehe

rase mcm everything went smoothly

xrase resah or t'tekan or ape2 je lah

rase2 nape ek??(blh tny ke??haha)

positif...maybe this is d answer

bkn sng utk jd positif n xsmua org blh positif pd tiap mase

sumtimes org sblh blh watkan kite jd positif

so jeling2 la sape duk sblh slalu ye hehe

n minda yg slalu b'fikir positif sgt m'pengaruhi hidup kite

ade byk citer yg i nk kongsi psl fikir positif n negatif ni

tp sambung kat next entry la ye

xlarat nak taip dah huhu

wokes bebes!!

"always be positive"

bai bai ;D

new life begin

today is the 5th day im staying at KTDI(kolej tun dr. ismail) and the 2nd day of class in year 3

for d 1st 1 month onwards, it is going to be klinikal asas for every posting whereby 1 week is provided for each posting 

i got JKM for my 1st week of posting

it is a lightest posting, i supposed

because it just need to revisit the medicine&society module during our 2nd and 3rd sem

and later we are going to be divided into 2 small groups and will be send to Tg Karang and Sabak Bernam

i hope that i can face every difficulties with my whole heart and be more critical in solving every single problems that might be encountered in the future

till now i still can't imagine how my life would be

just pray so that Allah will give me the best and guide me to be a better person as well as the better medical student and better future muslimah's doctor

amin....