Trauma and Emergency Elective~ #2

Bismillah..

We come into red zone where patients with needs of urgent treatment come in. A patient with chest pain is in one of the cubicles. I'm there watching a Chinese HO doing an ECG. Some doctors there are asking that HO to confirm the area of infarction by doing posterior and right ECG. It's the first time I heard about the posterior one and yesterday I accidentally found about the right ECG when I read Master The Board. So I reach the patient's posterior ECG paper and try to interpret it. But it's look the same as the usual ECG. No difference.

While the Chinese HO is typing the patient's info I asked him about it.
"Doktor.. Nak tanya boleh?"
"Em. Iya?"
"Posterior ECG tu macamana?"
"Oh.. Lebih kurang je macam ECG biasa."
"Kenapa kita kena buat posterior ECG tu?"
"Em sebab nak confirmkan area of infarction. Is it really posterior or no."
"Oh.. Tak boleh ke confirm by usual ECG?"
"Kalau usual ECG tak jelas, then kita buat posterior and right ECG tu."
"Oh. Ok. Thank you!"

A few minutes later, an old man is pushed into one of the cubicles. He got stroke.

"Hah. Korang students final year kan? Apalagi? Pergilah buat apa yang patut. Cucuk branula ke.. Pasang ECG semua." said one of the female doctors there. I'm not sure whether she's HO or MO.

I quickly grab the chance as I have been longed to do the branula. I put on gloves and get the green branula. I'm a bit nervous as the patient is an old man. Some people said that it's quite difficult to do branula on old people and children. But actually the old man's vein is quite obvious.

I put on a tourniquet. Try to find obvious vein. Wipe some alcohol over the patient's right dorsal hand. I found my target and poke. But there's no blood flow in the branula. Means I'm not in. Oh my!

Quickly, I pull out the branula without having cotton on it. And blood is coming out from the punctured area onto my gloves! Oh no...
In a meanwhile, someone has come to save me! Or actually save the patient. =p It's the same Chinese HO that I asked him the question about posterior ECG.
He takes some cotton ball and press on the area where the blood is flowing and take off the tourniquet. I take a glance at his nametag. It's written Dr. K. I back off from the patient's hand and pull out my bloody gloves. Dr. K wipes and clean the blood from the patient's hand while he still pressing the cotton ball. I take another green branula and give it to him.

"No. You do it again."
"Huh? Me?" *stunt face*
"Yes. You try it again."

I clenched my teeth take a deep breath and put on gloves. This time under supervision.
He helps me putting the tourniquet and finding a suitable vein. He sees my hand is in tremor. Me too. Zulaikha too.

"Nervous ke? Jangan nervous." I heard his voice.

I poke the vein. And... there's backflow! I'm happy! Then I try to put in all the needle part of branula after pulling out a little bit the needle leaving behind the small size straw to stay in the vein. And... it's bunk! Failed! Hmpphh..

"Hmm.. take out the needle." asked Dr. K and he gives a cotton ball to press on that area.
"Kenapa nervous..? Jangan nervous..." he asked me with a bit disappointment in his voice.
"Sebab dia orang tuaa....." I spontaneously and childishly answered him back.
"So??.."
I put on an innocent face.
Meanwhile a female Malay HO already put on branula at the patient's left hand.

"Nak try buat ECG?" One of Cyberjaya medical students asked Zulaikha.
"Eh.. Tak pelah. Awak buatlah." Zulaikha refused.
"Kita dah banyak kali buat. Nak bagilah peluang kat orang lain pulak.."
"Izzah nak buat?" Zulaikha offered the offer she has refused to me.
I smile and nod enthusiastically. I start putting on the leads.

After confirming it's on the right place, I try to print it out. But... I don't actually familiar with the machine. So I just press on some buttons randomly that I think it might print the ECG out. Unfortunately, the machine doesn't want to work with my randomly pressed buttons.
Here comes the hero of the day, Dr K!

"Boleh?"
*geleng*
He presses some buttons and the ECG printed out! I put on a palm face.
He smiles and teaches how to use it step by step.

Oh what a day with Dr. K!~

Trauma and Emergency Elective~ #1

Bismillah..

I'm observing the docs and nurses are trying to take blood sample from a febrile seizure child. While other students there tried to help by holding the patient so that the doc could do the canula I was just observing from side.

"Dik, tolong ambil mesin DXT.."

Err.. is she asking me? Of course. Coz others at that time have given their hands.
I was like, ok.. what's that? My eyes trying to get help from Zulaikha (my elective partner). But she also didn't know what's that. I put on a blurry face and look at the doc who asked me.

"Mesin apa?"
"Mesin DXT. Pergi sana. Tanya staff."
"Oh.. Ok.."

I ran to the place where the other med students were there.

"Em.. korang, mesin DST tu.. kat mana?"
"Ha? DST?" they put on their forehead folds.
"Aah.."

One of them said, "Ohh.. mesin DXT.." and she took it and gave to me.
Ok fine.. It's actually the glucocheck thingy.. -.-"
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A child came into emergency department having high fever. While they access him,

"Dik.. tolong ambil PCM."

Ok.. is it me againnn.. Now.. what's the PCM thingy?

I went asked a med student. She asked a staff where's the PCM.

"Nak tablet ke suppository?"
*sengih* Put on blurry face again.

The staff went to the place where the child is and asked. And they said they didn't need it anymore.

-.-"
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Ok. Itulah hari pertama elektif. Hari blurr dan balik awal. Sedikit down. Biasalah baru nak adapt. Need time.
Depa suka sangat pakai abbreviations. Haih laa..

Random Post!~

Bismillah~

It's such a loooonnggg time this blog has been ignored by the owner.
And actually this time I just want to write my random thinking.
Because if I don't then I don't know when will I write again.
It's not that I don't have any story to tell but it's just myself  who's having mood swing of writing plus the feeling of wanting to spend time more on studying which I doubt. -.-"

Ok. I have just come across this picture while taking break for couple of minutes from study.

Did anyone see anything other than the lake and the mountain?

Sure most of us will find nothing.

But, if i say did anyone see the rainbow in this picture?
Then, most of us will see it.

This reminds me the sentence which always has been used by doctors in clinics;
"You will see what you want to find."
The doctors will use this sentence when we don't see the lesion in x-rays or CT scan which means we don't know what we want to find. *herherher*

Ok. I have to get back on track. *study mode activated*. Or else I will not see what should I find. =p

p/s 1: Ramadhan Kareem everyone. It's never too late to wish. =p Let's try to get the gift: Lailatul Qadr in this last 8 days.
p/s 2: Should I close this blog? Hmm.. Hmm..
p/s 3: Keep praying for our brothers and sisters in Egypt, Syria, Palestine and others!
p/s 3: Last, Happy eidul fitri in advanced! I don't think I'll update this blog in the meantime because I'll have exams after 'eid! ouhh.. Pray for me~

Kebaboooomm!!

Bismillah..

Maaf dan pendam.

Bezanya..

Maaf: tiada ungkit lagi selepas itu. Tidak timbul lagi dalam hati dulu dia buat begini dan begitu.

Pendam pula akan tiba satu waktu di mana perasaan marah sampai ke tahap maksima yang kemudian meletup!

Kita yang mana satu?

Lebih baik luah dan memaafkan

daripada simpan, pendam dan meletup.

Yang terbaik, tahan, lupa, dan memaafkan.

Tapi tak ramai mampu buat yang terbaik.

Terkadang, sangka kita, kita sedang memaafkan. Konon sedang melakukan yang terbaik.

Sedangkan kita memendam, mengumpul, menunggu waktu untuk meletup.

Selamat koreksi!~

p/s 1: Lama sangat tak menulis di sini. Tulisan ini hasil tulis padam tulis padam dari tadi. Macam dah hilang skill ok. -.-"

p/s 2: Saya rindu UK. Mungkin bukan sebab tempatnya. Tapi sebab orang-orang yang saya jumpa. Eh tapi Scotland sangat cantik ok!

p/s 3: Cuti bulan 6 nampak gaya for the first time saya bakal bertapa di Irbid. Harapnya, bakal buat perkara berfaedah lah ya.

p/s 4: Terus mendoakan mereka yg sedang berjuang untuk nyawa dan hidup.

p/s 5: Nah! Hadiah dari UK sikit. =)

~Scotland~

~Scotland lagi~

Kambing biri-biri Scotland. 

Putih kan warna bulu dia. Tak macam kambing biri-biri Jordan. 

Depa mandikan kambing tu ke camna?

Eh? =p ~Loch Ness~

Between two Bridges~

Bismillah.

"If you have to choose between minor motor and sensory defects, which one would you sacrifice?
For example between ulnar nerve which supports minor muscles of little and ring fingers and median nerve which gives sensation to the part of our hands. which one will you choose to sacrifice?"

"Sensory"
"Sensory"
"Ulnar"
"Median"

"The answer is ulnar. You know why? Because sensory loss means functionless. No function. So why should we preserve the non-function fingers? Also it could get injured and the patient doesn't notice it which could lead to infection and difficult healing and lastly still we have to do amputation."

[Morning Report, King Abdullah University Hospital]

The hardest thing to learn in life is which bridge to cross and which to burn -David Russell

p/s 1: I just love the new song from Raef as it comes across just in time. =)
http://www.youtube.com/watch?feature=player_embedded&v=y-Ka9kra8jY

p/s 2: Err.. Happy new year people! Even though January is almost over still it's never too late because we are still in that new year~ =p

p/s 3: Lacrimal glands overstimulate too easily this January. Hehs~

Post Terakhir 2012~

Bismillah.

Hampir 2 bulan tak update blog. Tiap kali tulis, tak habis dan akhirnya terperuk dalam draft. -.-'

Kenapa ya sampai 2 bulan tak update dan tak ada rasa nak update pun?

Mungkin sebab bukan semua benda yang kita rasa boleh digambarkan dengan tulisan
Mungkin sebab tak semua kisah yang kita tahu boleh dicerita kepada umum
Mungkin sebab ada waktu perasaan tak dapat ditulis dengan baik
Mungkin sebab ada rasa tak perlu untuk dikisahkan untuk bacaan umum

Dan mungkin sebab-sebab ini jugalah bila imbas sekali lalu, 
saya tak berapa intabeh apa yang ada pada 2012 saya
yang sebenarnya sangat banyak mendidik jiwa, hati dan perasaan saya.

Terima kasih kepada awak yang terlibat dalam hidup saya
sama ada secara langsung atau tidak langsung.
Pasti ada sesuatu yang saya dapat.
Cuma saya dan awak sedar atau tidak.
Sebab Allah tak susun pertemuan kita untuk sia-sia.

Sekian, post terakhir untuk 2012~

Doakan tahun 2013 bakal kita warnai dengan warna yang lebih baik. En syaa Allah. ^_^

Selamat pergi 2012 saya dan semua!~

p/s 1: Kalau post ni keluar tarikh 2013, itu mungkin tarikh Malaysia. Saya taip post ni di Jordan yang masih 2012. So, just assume it's still 2012. =p

p/s 2: Umur utk 2013 = 23. Perasaan? Hmm...

p/s 3: Doakan saya. Doakan kita. Doakan semua.

Psychiatry Oh Psychiatry~

Bismillah.

~Group 5th year~

Isnin lepas rotation akhir psychiatry. Banyak sangat benda boleh muhasabah masa rotation ini. Macam-macam kisah, macam-macam cerita strangers yang kita dengar. Bak kata teman se rotation, "Sejak start masuk rotation psychiatry ni asyik dok dengar masalah orang." Saya senyum. Nama pun sakit jiwa. Masalah dalaman. Memang macam-macam lah pesakit datang untuk bercerita. =)

Ok. Cerita sikitlah perjalanan rotation psychiatry ini. Dalam masa sebulan akan ada dua minggu belajar di Hospital Fuhays, Amman dan dua minggu lagi belajar di klinik-klinik sakit jiwa Basmah (sebelah Hospital Rahmah), KAUH, dan Hosp Prince Rasheed (3askari).
Di Fuhays, kami akan dipecahkan kepada beberapa kumpulan dan dibawa ke wad-wad tertentu untuk ambil history patients (ala sembang-sembang).
Di klinik-klinik akan duduk bersama dengan Dr. dan pesakit-pesakit akan masuk untuk rawatan masalah yang dihadapi. Selalunya lepas satu patient keluar Dr. akan bincang-bincang dengan kami mengenai masalah pesakit tadi.
Tengahari macam biasa, akan ada pembentangan dari kalangan kami juga.
Itulah serba sedikit kisah pembelajaran kami.

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Satu benda yang selalu bermain di fikiran masa rotation ini:

Apabila ada pasangan suami isteri datang membawa anak yang sakit dan si suami tiada di bilik Dr. sang isteri mengisahkan bahawa dia mengesyaki suaminya turut mempunyai penyakit jiwa sehingga terpaksa mengambil ubat setiap hari yang menyebabkan kebanyakan anak-anaknya turut mewarisi penyakit tersebut.

Maka, saya mula berfikir adakah si suami sebelum perkahwinan tidak memberitahu sang isteri bahawa dia mempunyai masalah sekian-sekian? Kalau betul begitu, adakah maknanya si suami telah memulakan perkahwinan mereka dengan sebuah ketidakjujuran? Entah. Nanti beritahu tak jadi berkahwin pula.

Pernah saya lontarkan kepada teman satu rotation, "Kalau lah ada seorang lelaki datang meminang, dia memang cukup dari segi agama, rupa, harta dan sebagainya. Tapi, dia menghidap penyakit yang kemungkinan untuk anak-anak mewarisi adalah 50 % atau lebih. Nak terima atau tidak?"
Jawabnya, " Huuu.. Tak tahu. Tapi kejam juga kalau tak terima sebab itu. Bukan dia minta pun penyakit tu."

______________________________________________________________________

Menjadi kebiasaan, jika membaca akan membayangkan supaya lebih mudah memahami. Lalu, ketika membaca penyakit-penyakit jiwa terutama mengenai Personality Disorder terbayang-bayang orangnya bagaimana. Dan kadang-kadang terfikir, eh macam pernah jumpa orang macam ini. Atau, eh betul ke buku ini? Even diri sendiri pun ada macam ada symptoms sikit. -.-'. Tapi bila baca ciri-ciri seterusnya, oh perlu ada tahap ekstrim untuk mencapai tahap disorder.

Oh ya, untuk lebih memahami masalah-masalah jiwa ini, saya cadangkan boleh tengok movies yang berkaitan. Antaranya, A Beautiful Mind, Mental Series, Extremely Loud Incredibly Close dan Saya Amat Mencintaimu (SAM). Kalau rasa sempat tangoklah. Kalau tak sempat, tekan nama penyakit kat youtube ja. =p

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Menarik sebenarnya psychiatry. Doctors are dealing another aspect of human beings part. Not the physical one. Dan bila kat clinic, kita akan rasa oh ramai rupanya orang-orang yang ada masalah jiwa. Ini baru yang sedar mereka bermasalah. Yang tak sedar? Huuu.. Moga Allah selamatkan kita dari penyakit-penyakit berbahaya sama ada fizikal, mental, rohani dan sebagainya.

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p/s 1: Kejap lagi akan bermula rotation baru, Family Medicine. Doakan!
p/s 2: Post travel India dalam proses. Doakan saya rajin dan istiqamah dalam menaip. Huhu..
p/s 3: "Dahulu orang jahiliyah menikahkan puterinya atas dasar keturunan. Orang yahudi menikahkan atas dasar harta. Dan orang nasrani menikahkan atas dasar eloknya paras. Sudah selayaknya seorang mukmin hanya menikahkan atas dasar agama.," jawab Mubarak ketika ditanya oleh majikannya dengan siapa selayaknya dia menikahkan puterinya. -Jalan Cinta Para Pejuang, Salim A. Fillah-