Friday, December 25, 2009

Internal Medicene....Wait & See

Salam,


CUT & SEE : Surgery
DELIVER & SEE : O&G
WAIT & SEE : Internal Medicene

SImple & short words to describe 3 postings I faced quoted from Prof. Zainul, HUKM O&G specialist during Zero repeaters campaign talk..

You can read that the actions that's appear in each discipline is SEE!!

Seeing is believing..How could a doctor treat appopritely wihtout meeting the patient? (except for Dr House!!)

There are 6 wards of internal medicene in HUKM with 2 CCU. That means A LOT of opportunities to learn..My advice is get a comfortable shoes cause your feet are precious for this posting for a lot of walking and standing.



A lot of procedure can be appreciated in the ward, so you have to be opportunistic organism. Put away your inferiority and shyness..Ask Medical officers, housemen and nurses questions and permission to observe or do the procedures. Final year seniors can be helpful also.

Having Internal Medicene as my last posting of the year gives me some advantage. In this posting a lot of things to be covered. Some knowledge gathered during previous posting does help in facing this posting.

Hopefully i will survive (",)

Wasalam

Saturday, December 5, 2009

My third posting :Medicine & society

Salam,

This posting was considered as a vacation posting. I found out it is totally a big fat liar..hehe. A LOT of report have to be submitted..A LOT of travelling along tanjung karang or sabak bernam district. Have to visit da same ppl's house in kampong at least 3 times for the 3 different survey we have to conduct..

However, I do learn a lot of intresting knowledge. I can say that this posting is a 'Lawatan sambil belajar' posting. It's not too bad after all. However, i easily feel bored there.


For this posting, we are attached to 3 different places:

1. District health office aka Pejabat kesihatan daerah (PKD)



there R 8 units under pembantu pegawai kesihatan persekitaran (PPKP) which are:
1. unit pentadbiran
2. unit kualiti makanan
3. unit bekalan air & kebersihan alam sekitar (BAKAS)
4. unit kualiti air minuman (KMAM)
5. unit pendidikan
6. unit kawalan penyakit berjangkit
7. unit kawalan vektor
8. unit kesihatan sekolah

each day we go to different places. It is amazing to know the power that PKD have in managing & controlling the health of ppl in the district and its relation with the state and national level.

hunting for mosquito larvae for vector control sample...beware Mr. & Mrs aedes aegypti or aedes albopictus . we gonna kidnapped ur larvae.heheheh..


fogging time..beware Mr. & Mrs aedes aegypti or aedes albopictus . you gonna suffocated to death..heheheh...


our ketua posting showing his exophthalmos eye with the water station( where we get the sample to test it for quality control)


pH test(one of the physical test)..there are physical,chemical & microbiological test done by KMAM unit to the water.


lets go back to school..reminds me a lot of my chilhood memory of my health check up at school


vaccination time!!a lots of emotions going on here..


showing our excited faces..haha


2. Klinik kesihatan(KK)aka Health clinic and klinik desa (KD) aka District clinic.

KK is devided into two department which are outpatient department and Maternal & Child Healthcare clinic(MCHC) department.

PKD will monitor everything regarding health in the district including the KK.Every KK will take care a few KD. So, KD are like their child, KK is the mother and PKD is like the grandfatehr.KD will only manage antenatal check up, vaccination, routine physical check up for Hypertension patient.

my group at KD


with special children under PDK care( it is another unit under KK for special child)



3. Tanjung Karang District Hospital



This posting does give memorable and meaningful memories...Objective achieved (",)

Wasalam

Wednesday, November 25, 2009

Medicine & society..

Salam,

This is not really a honeymoon posting!! quoted from one of my friend. hurmmm, I have to agree with that.We are now reach the TENSE stage as a lot of assignments to be done and report due date with presentations will be after holiday(Now is the 6th week.7th and 8th week will be the presentation and evaluation week)

UKM student complex at Tanjung Karang


One of our group discuccion regarding specific Survey on the villagers..



However, for me,I experienced some interesting and colorful experience with this posting. First of all, it explains my curiosity of how health care system been manage in a district and kampong area till the state and national level. Our group is special because there are two Japanese (Tomomi and Mariko) students staying with us since 1st week until 5th week . We had fun with them and learn from each other about Japanese language, knowledge on Japan health care and even cooking..

vaccination at school with unit sekolah



The place we are posted to is Tanjung Karang. It is quite boring cause we are trapped in the complex and only go out for food or activities. However, i'm too occupied with activities and assignment to bother with it.

I like the fact that i have the time to jog and experienced the nature more..I love the evening scene during my jogging time at the student's complex. There are lots of herds of birds flying home to their nest. Another sceneric view is the muddy beach 30 minutes walk from our complex or (5 minutes drive). It will be nice if you can see the sunset by the beach.

the beach near our complex


tea break by the beach after survey at kampong



There are some interesting places that i haven't yet get to explore. So far, i've experienced Ikan bakar at Jeram. The restaurant is by the muddy beach and have nice panoramic view.The price is quite cheap too. I've been to kayaking at Sg Sireh (the BEST activity so far)and took pictures at paddy field of sekincan. Not to forget a few episodes of Kerepek shopping at Sekincan.

muddy beach at Jeram


in front of the ikan bakar restraunt at Jeram


Paddy field at sekinchan


our Japanese friends Mariko and Tomomi


kayaking at Sungai Sireh


Basically..these are the honeymoon things i did during this posting.There are a few more places to explore indeed before leaving Tanjung karang...will tell more later.

Wasalam (",)

Sunday, November 1, 2009

End of O&G..welcome to Medicine & Society

Salam,

TOmorrow will be my 3rd week in Medicine & Society (a.k.a JKM) posting. What happen in between O&G and JKM was my final semester 1 exam. Alhamdulillah i passed (",). Now, moving forward to JKM posting which most of us consider as a VACATION.

WHY??
1.less stressful
2.the accomodation: aircond,TV room, washing machine and fridge every block
3.got canteen to practise ur cooking skills
4.get to play sports & games in the evening(if it doesn't rain)-Jogging-futsal-baling sliper-bola beracun-volley
5.beach
6.satay Hub
7. very Mobile : have to go around Kuala Selangor/ Sabak bernam( Pejabat Kesihatan daerah,Hospital and Klinik Kesihatan)
8.get to know the health system in district area
9.BBQ (on 6th week..can't wait for it)
10.Kelip-kelip(firely) park..will go there

the list may go on..

This posting become more colourfull as there are 2 japanese students from Nikita University attached to us for 6th week. Become quite close to them. Mariko is good in sports. She jog quite fast..have a great deal to catch up with her. Thanks to her pacemaker (one of her jog partner)for making her to jog that fast.

Intervarsity game is coming up this December. My heart make a summersault in joy as there is futsal for girls in the tournament. Hopefully i'll get some good players as teamates (",)

Friday, October 2, 2009

EXAMS!!..sharing is caring (",)-rewrite version

salam..

weird..my recent post was deleted after i edit it..so sad,have to re-write it back..hurmm..

It feels like it was just yesterday i enter UKMMC Cheras for clinical phase of my medical year. Beig the first batch of a new program(twinning UKM-UNPAD) is challenging as we have to face new syllybuse. Here, we have seniors who 'pampered' us with a lot of help in the ward and vice versa.

I would like to give my appreciation on behalf of my firends for those who help us, the newcomers in getting through our clinical phase.Certainly pre-clinical year and clinical year are two different situation. My two previous postings (surgery and o&G) did leaved me some valueble and wonderful experience.

Thank you for the knowledge shared. I think choosing not to share is selfish. You never know the benefit of sharing which bring a lot of good things to you.However, we should share something only when we are knowledgeble on the topic.Help yourself first before you help others.

Sharing with sincerity leave satisfying effect on the giver, Sharing with force leave hatred in you, Sharing for glory won't last forever
Sharing with good intention means you care....However better sharing something than doing nothing.

I hope everyone who reads this will enjoy and start sharing

wasalam

Tuesday, September 8, 2009

the last on call......

Salam;

Alhamdullillah.. after a few moments of frustation, i am able to finish my 5th conduct of delivery today.It was fast, i don't have to wait for long.

What i like about my last on call today is i get to witness one of the most memorable event as a muslim twice and somehow today, i touched me. Guess what it is?? It is the Azan or Iqamah dat whispered by the father to their newborn child.(Info for non muslims:It is the first act of devotion representing the baby to world as Muslim).

Another intresting thing about the two deliveries is both are having their first child and best part is looking at the reaction of the father-to-be. I always like to see couples who are waiting for their first child. Of course they'll look worried, anxious and happy at the same time.Their inexperienced self showed some wittiness in managing the situation. In a sum, these kind of reaction gave me a sort of feeling that life is meaningful(eventhough i am not the one who experienced it).

Regardless the bad experienced..i find more enjoyment in labour room because of these meaningful experience and cute babies. People who ACCEPTs to get SCOLDED are NON-EGOISTIC people.Yeah, i get scolded.Sometimes it's my fault, sometimes its' someones fault and sometimes i get scolded with non-concrete reason. The best thing to do is reflex urself back and Improve!! Whatever it is...see u again labour room during 5th year(hopefully i don't flunk somewhere in between that needs me to repeat my year3)

Wasalam (",)

P/S: i have short case this thursday..which me all the BEST LUCK in the world.AMIN!!

Sunday, August 9, 2009

On call & Delivery..

SAlam..


I just got back from my 3rd on call (7pm-7am). The delivery ward was cold and I was hypothermic.Better remind myself to bring sweater next time. The intake last night was little compare to my previous two on calls.The whole on-call group was quite dissapointed.

I was fortunate to be able to conduct one delivery today without have to wait more than half an hour. Yeah..we all are trying to fill up our log book. We are required to conduct 5 normal deliveries(after observed at least 3 deliveries)and watch 5 abnormal deliveries.

I only get to observed one normal delivery and one cesearian section(abnormal)during my first on call. My luck was better during my second one since I get to observed 2 normal deliveries, 1 twin delivery(abnormal)and did a few small procedures. My 11 hours wait for the primigravida(1st pregnancy mom)pays off as I get to do my first conduct.

The intake of patients during 2nd on call was high and patient keep on coming for labour. You can guess who are the most happy person in the ward...the father and us who are on-call of course.

11 hours wait was worth it....with baby Reneu..The 1st experience of conducting delivery.



Delivery is painful, yet it is a wonderful thing that women have to experince. I think, every mother is a winner. It is not easy to give a life born to this world. When you see the baby come out healthy to this world you will feel very happy for the family. Watching these adorable babies make you forget about your tiredness and exhaustion.

That's what I like about O&G posting which is the most heavy and 'feared' posting of 3 rd year.Students call it Orang-orang Garang posting as the lecturers are strict. Yes..it is tiring,demanding and you get high expectations from the lecturers and yet it is an intresting posting since you get involved with a lot of procedures and can apply what you learn from book to the real situation. Watching cute babies in between does give the some flavor to it..hehe (",)

Thats all for now.Will have a day trip to Batu Pahat for 2nd brother convocation..

Wasalam(",)

Saturday, August 1, 2009

BUbye surgery..Welcome O&G

SAlam..




It's already been a week i've started O&G and i've already miss surgery.However, my journey has to go on.

O&G is much more strict and sturctured compare to surgery. If the lecturer promise something they will do it. If they said the lecture is at 8am u have to be there at least 5 minutes before.To be safe at least 10minutes because i've been to a lecture where the lecturer close and lock the door 5 minutes before the lecture.

If they ask you to read on certain topic you better do if not you will 'kena' when you cannot answer your question. When you taking history(clerking) patient you have to know all about them. Make sure you find out terms that you are not sure inside the ticket(patient's record).By the way, you have to cover the beds in the ward(team leader have to divide the beds). Labour room gave me intesting experience.We can only be there during on calls.wE get 1O on calls per posting to satisfied the need of 5 conduct of normal deliveries per student.My first on call was on wednesday 7pm till 7am.We have to observe at least 3 deliveries before we can conduct with the help of the midwive and doctors




Alhamdullillah i manage to observed 1 normal delivery and 1 abnormal delivery(cesearian section).The story of my experience can be quite long...to cut it short: for the abnormal delivery..i& my partner(Mas) hav to wait for 6hours befor we go to Operation theatera(OT) Got back home at 5.30am and manage to get 1 hour sleep before Grand ward round(where we have to present case at 8am. The funny thing is..i only feel sleepy& tired on the next day..hehe

What i like about O&G is there are a lot of things that students are allowed to do or directed to do(log book).The feeling of involvement is there which surgery posting lack of. Next is the CUTE BABIES of course!!..really release ur tension when you see them.

LOVE to see couples who get their first born baby. I can feel their 'aura' of excitement and joy. SO...SWEET.It touch my heart till it tears(in joy) me a bit(nasib baik org tak perasan).hehe(",)

SO...far, adala a few unpleasent moments..however i have to take it positively because mostly it comes from my own mistake. Time management is very important. Managing stress also become a crucial factor of survival in medicine world. Recently, i heard 3 of my coursemate decided to change their coure. However, better back off if you feel medicine doesn/t suits you. Because medicine is about a lot SACRIFICE!!

Wasalam

P/S:
Gratitudes & THANK YOU to my supervisors in vascular team during Surgery posting
1. Prof Dr Hanafiah Harunarahid (vascular surgeon consultant)
2. Asstd Prof Zulkifli (urology surgeon)
3. Mr Toh Chang Jern(neurology surgeon)
4. Mr Jeevan(neurology surgeon)
5. Mr Azim (vascular surgeon)

and also registrars(Dr Johann,Dr Azlan & Dr Sadana), MO, HO and nurses in surgical department.not to forget..my friends and 5th years that i met during the posting(",)
THANK YOU!!

Friday, July 24, 2009

STigma on Doctors..

Salam..

Finally, i manage to import internet connection from KL..long story..no need to elobrate.Now I'm in Malacca.In two days I'll start the O&G posting which is the toughest posting of 3 year..Hopefully I can cope with that.

Today i would like to write about Stigma on doctors..

When you feel something wrong with you...do you straight away seek help from the doctor?
Or..you decided to wait untill i resolve by itself...
or... you decided to do self-treatment by taking painkillers or do anything that might relief the problem..

well, majority will prefer to choose those two later options than seeing doctors.. So, far non of my family members are doctors yet. Only me and my 2 cousins are still in medical school.Some of my family members are the typical people who are afraid of doctors. For them, doctors are only for severe cases.If possible, they want to avoid seeing one.

This is one the reason why people delay their treatment. When they decided to see doctor their problem has already worsen or only can be relief but not totally cured..

WHY are they afraid to the DOCTORS?? certain people even develop white-coat syndrome where their blood pressure rise up in the presence of the doctor.

Public/Patients' stigma on doctors:1. They like to prescribe patients pain killers, might as well I just take pain killers and save my money, time and energy of going to the clinic.
2. They might ask me to undergo invasive procedure like taking my blood, thus doctors=dracula..hehe
3. the point above can also mean DOCTOR=PAIN4. Doctors are my chance to get extra holidays-Medical certificate (MC)5. When you see them, you can be diagnosed with some serious/chronic illness
6. Doctors are INCONSIDERATE when they ask you to STOP doing things you like.
7. They are harsh when you dissobey them
8. WHen I meet the doctor, he'll be 'the BOSS'..no point of voicing up my opinion or decision.
9. I will get sick if I see doctors.
10.If you see doctors..it means something is WRONG with u


So, can we say it is the Public/Patient's fault to have these stigma??
NOpe..

It all come back to us DOCTORS and FUTURE DOCTORS on how we should behave in treating them appopriately and ethically.

However there are other reasons why people didn't want to seek early help from doctors.It doesn't rest on the stigma on doctors alone.. there are other reasons also like patient's education, social life and economical background.

WSlm..

Saturday, July 11, 2009

Stigma is prejudism!!

Salam(peace),

What do you think when you see these pictures??

Down syndrome- they don't choose to be like this and it is not a transmitted disease!!


leprosy- it can be cured(if get early treatment),the picture on the right is after the treatment.


obesity-there are many reasons on why they become like this


mental illness and starvation-a boy that was locked in his house and doesn't get proper treatment.


dwarfism-they don't choose to be small, regardless their size,they are like normal people too


You might think of avoiding them...staring at them because they don't look normal or worse tease them.

DOn't you think it is inappopriate?? Aren't they human being too like us??
These people have stigmatized illness who usually gets stigma from the society.

What is stigma? Stigma is a negative impression or prejudism on a certain group of people who have stigmatized illness(eg: mental illness, skin diseases, HIV,Down syndrome).

They tends to get stigmatized and neglected by the society.

Moreover, they receives less social support. In addition to their own problem, they can get depress because of less support. Not many employeers want to employ them. Since they don't have income, the can't afford the medicine or treatment they need.
Due to their limitation, they need special public facilities or consideration that we tends to neglect.

Some of them may not have support by their own family members. The health care system also do have stigma on them.Sadly, some health care workers too doesn't understand their condition and have stigma on them

What we can do???
First, UNDERSTAND their condition and erase the myth you know about them
Next, ACCEPT them as who they are.Let them live with us without feeling inferior
Then, CHANGE and let others change wih you by educating them to UNDERSTAND & ACCEPT

To learn more about STIGMA and STIGMATIZED illness...you are invited to attend this forum under Hari KEsihatan Sedunia 2009.The theme this year is STIGMATIZED illness-To Understand, Accept & Change organized by AMSA UKM in conjunction with PERSIAP,PPK & JAKSA.As one of the high committee members, I'll be glad if many people willing to join us.

Title: ''Penyakit Stigma, Masyarakat boleh berubah''
Panels:
Prof Fuad Ismail- Jabatan Onkologi, PPUKM
Prof Madya Dr. Ruzanna Zamzam-Jab. Psikiatri, PPUKM
Dr Azmi Mohd Tamil-Jab. Kebajikan Masyarakat, PPUKM
Where?? Pusat Perubatan Universiti Kebangsaan Malaysia, PPUKM
When?? 18/07/2009(Saturday) from 2.00pm till 5.00pm
Fee?? FREE of charge

Contact person:Siti Juliana 017 370 2023, Noradila Salmi 017 953 9608

Publics can also join the blood donation, medical check-up and mini exhibition.
Where?? PPUKM
When?? 17-18/07/2009(friday and saturday) from 10.00am till 5.00pm

Hopefully our small effort will make the difference..by making people aware of the stigmatized illness.Hopefully many people will change and make world better place to live.

Poster of HAri kesihatan Dunia 2009-Peringkat PPUKM



Wasalam..(",)

P/s: Stigmatized illness patients can be pretty and live happily like them...so, CHANGE to make the world a better place for them to live.

Friday, July 3, 2009

Engaged not yet MARRIED


Salam..

Yes i'm ENGAGED but not yet married to MEDICINE with white coat as the prove of our agreement . Gotcha...think i'll engaged to someone for real huh??(",)Hopefully i will wear the 'white gown' and get married to medicine in 3 years time. May god forbid any failures that can cause my engagement to be extended(repeat year) or ended(drop out)

This is my 6th week in surgical posting and i followed 5th year senior's long case assessment(thank u abg shah for inviting me and few other 3 years).MIne will be next week(huhu..takut nye). After everything comes towards the end,their supervisor Mr Azizi( a neurosurgeon) share some of his insight on medical life..He said "students,u all are married to medicine. Your future husband or wife will be your second (madu la kot)"

Marriage itself means COMMITMENT to someone else other than yourself.

From my understanding is, once you accept to enroll into Medical school, you have sign an agreement to become a doctor. Being one is not easy..A LOT to cover..memorise..skills to apply..Having a good communication skills is an advantage. We have to put OTHER PEOPLE 1st than your own need.Helping people is your priority.NOT money, power or social status

The MAIN JOB to medical students is STUDY and mastering taking patient's history. History taking is not somthing that you can take light. I use to think that it only need memorization. The truth is, it also needs some intelligence and thinking. It is like a maze that you have to solve.

First of all you have to identify the patients' main problem,ask relevent questions and then try to find other possibilities that might contribute to the problem.

Afterwards, base on your knowledge to differentiate the 1001 diseases manifestation, you have to choose the hypothesis of what might be the disease.At the end, you have to present your finding in the most concise way which may sounds easy. However,it also needs your ability to concise it the right way.Pratice Makes PERFECT!!.

Regardless the reality of the work, it is NOBLE to choose to be in this profession. Lesser burden to whoever think that the knowledge they gain from the patient is intresting and motivating.You'll think your life is more meaningfull to see patients leave you in better condition.

Wasalam (",)

P/s:
1. feel bad for patients who have bad prognosis...huhu. May they have strength to face it with courage and determination to live their life better.
2. I saw an amputation operation(below-knee) during my on call on friday.cool...bu kesian that pakcik to have a leg amputated.

Friday, June 26, 2009

Sensitive question....


Salam,

What do you feel when someone ask you about your sexual activity?? In medicine, it is relevent to ask this question to the patient when necessary regarding to the problem.Definitely,we will keep it private and confidential. Today is the end of my 5th week and so far I had some 'shocking information' from two different patient.

I bet you it is not easy to ask those question in respect to the patients' feeling. It is a bonus when the patient really confess to you which means they do really trust you.We in the medical field cannot banned or stigmatize certain group of people(even though we don't agree with their conduct) by treating them differently.It is the rule of ehtics to be beneficience,non-maleficience, justice and autonomy in giving our service.

So, what are the shocking news??

PATIENT 1, an old indian man. he confess having multiple sexual partner since 20 years old.Most of the reason is due to influnces from friends.He admitted that he have high sexual drive. It happend since his early twenties.He said that its common with his Malay MUSLIM friends. He even saw some of them have sex with dogs(tak masuk dek akal btol manusia ni).
He spend some of his money to support the 'prostitution bussiness'.Up till now his family especially his wife doesn't know about his extra activity. He was admitted to the ward because of difficulty in urination due to benign prostatic hyperplasia(BPH).BPH is enlargement of the prostate that constrict the urinary tract causing a person to have slow flow,increase frequency in urination etc.It is common in middle aged men..

PATIENT 2, a 27 years old Malay Muslim man who is practicing anal sex.FYI, he is well educated man with a degree. He admitted to still have feelings on women but not in any relationship with them.He agrees with the idea of marriage and have have kids if he find the women he likes. The activity is painful but according to him,is not painful to do it if he likes the man.He do it at least once a week since the past 3 years.He started with oral sex and then advancing to anal sex due to influences from friends...

out of curosity,i asked him a few questions and here are the summary...
1. each week will be a different partner
2. they meet through their special website
3. some of them are married man with kids
4. it happen to all kind of people: students, teachers and even doctors..
5. muslim men also involve with this...
6. usually they are man with soft personality(usually they will be the receiver)
7. normal looking man also do it(usually they are the giver

He was admitted to the ward due to problem with the fistula of anus(the anal canal is communicating with the skin surface).It happen mainly due to hygienity problem. The predisposing factor in this man is his sexual practice that can cause infection to happen easily on the anus.

Regarding practising anal sex with strangers...he have high chance to get other uncurable infections like HIV and hepatitis B or C. I pray that he will stop the conduct and try to appreciates his live more in a better way. I can only give my advice but the decision is in his hands to change.

My own tought......
I don't know why people still do things eventhough they know it will harm themselves.If they believe in god, don't they think about afterlife(hari akhirat). Don't they care about the sins they've done?? (tekejut juga ramai MELAYU ISLAM yg terjebak)

Maybe the pleasure they have right now win over their guilt of sins..

If you have the will to change, anything is possible.
Wasalam(",)

P/s: tau pasal ni, takut pula nak kawin..huhu.kpd bakal2 isteri diluar sana check background bakal suami anda.kepada lelaki, kami perempuan ada tak payah cari lelaki lain..hehe

Friday, June 19, 2009

I feel small.......


Salam..

For Surgical posting, I was assigned to vascular team and all the registrar are taller than average Malaysian man. So, imagined what happened to me during the ward round(visit patients bed).I have to find any posible potential space to fit my 5 feet tall self in able to have a good view and be apart of the team.Sometimes i just stand behind them and see the patient through any spaces exist between them.

However the title above isn't about size issue.It is a methaphore of what i feel since this pass few weeks.

I feel small as i feel my knowledge wise is still not enough. The discussions i have with my study group mates and team members does really helps me. Questions bombarded to us during ward rounds or teaching from our supervisors, registrar, Medical Officer or any seniors do give us clue in what should we know. Well, they are a lot.Sometimes I know the answer but the way I convey it is wrong. I hope I can master the skill of answering 'maturely' according to what they want.

I feel small as I am hopeless to see and hear people crying of pain. There is nothing I can do except doing anything I can to relief it.During certain painful procedure what i can do is only provide some supportive words and pat their hand or back. To be in this profession we can give our emphaty but not total symphaty. If you are emotionally liable to them you cannot perform your duty towards them well.

I feel small as I never think I can do everything alone. As a medical student, I do rely on my friends to relieve my studies burden.Knowledge are for sharing, it is not for keeping. We learn and remember more through discussion rather than reading alone.

I feel small as Allah's humble servant as anyone can get sick. Sometimes death comes within a short notice and you don't realise it until its too late. A patient that i clerk(interviewing his problem) and do a bit of examination on last tuesday was only 27 years old. He was detected to have liver cancer stage 4 within a month. What puzzled the doctors was he doesn't have risk factors to have it and the cause was idiopathic(unknown).He passed away on wednesday(the day after I clerk him).May he rest in peace...AMIn.

I praised the mother to be very supportive and never leave his bedside to be with him.The father is a responsible man to take care of their other 3 daughters at home in Malacca.The neighbours back home are caring enough to hold Yassin recital and Hajat Prayers for him. She told me about her sons' problem without any single tears in her eye. I guess she accepts her son's fate as Qada' and Qadar from Allah. I am sure the there are reasons for all the things happening to us (good or bad).The way of how you accept things will determine what will happen next.Being always humble to him(Allah) does make you always put Allah first in your heart. Hope I can maintain that.

Moreover,doctors are not superhuman, they can get sick too.Patient comes to you to get better regardless you are sick or not.

Today, alhamdulillah I manage to do venopuncture(taking blood from vein) from a patient at Internal medicine ward for my logbook.I've already practice this procedure with my friends a few times and as the consequence, we get bruises at the site of needle puncture on our arm.Well, no pain no gain.hehe.. We willingly to injured ourselves in order to be competent in doing the invasive procedure to the patient.

Wasalam (",)

P/s can't wait for the weekend to have a nice jog by the Taman Tasik Permaisuri...and i'm Not going home.Have case write up to be done!!

Friday, June 12, 2009

Time is EMAS..

Salam,

Demi masa sesungghuhnya manusia kerugian,melainkan mereka yang beramal beriman dan beramal soleh...I have to agree with this verses from Al-Quran taken from al-Asr(Time).I would like to apply this verses to show how precious time is(not in a religous angle). We never realise it till we get really busy or into trouble.

I realise now that only those who have passion on medicine can survive the life long learning years.Encouragement from parents or intrest alone can't isn't enough to satisfy the needs you have to satisfied in order to be a DOCTOR!

Why??
1. STUDY always is the top most priority(after Allah the CreatoR)..i get this habit of reading anytime i can as I always feels that my knowledge is still shallow.

yup, we need to cover a lot of things..

2. Time is EMAS(gold)...everytime is valueble and you have to learn to put 1st thing 1st. Thus, time management is very important. I have to sacrifice my sleeping time..huhu

3. Have to always think POSITIVE and raise up from any failure with dignity and a promise to work harder (This is what i get from stories for those who fail and have to re-sit exam or even repeat their year without giving up).Though, i never plan on repeating year, may Allah forbid that from happening

4. Understanding from people you have comitment for is very important. Alhamdullh i don't have comitments to anyone except my my family so far. Lucky i trained myself to only call my mum once a week or only for important things since i left home to further studies at Indonesia. I always told them my life now is not as easy as before,I hope they understand me..

Regardless all I mentioned above doesn't draw me back so far....because

Alhamdulillah,I have passion on becoming a doctor...

Since i get bored of only watching and clerking,today I assisted the nusres at procedure room of surgical clinic doing wound dressing, removing the suture and changing the suprapubic catheter.

I feel happy doing those thing regardless the smell and view that might cause people have nausea or loss of appetite..This is because i learned a lot(knowing the way of handling equipments) when i do it rather than watching.I'm glad Kak Fiza & Kak Dijah let me assist them..

For me to be good in something you must know everything from the basic till the complicated one. Its a good thing also to learn about the hospital policy and the fee the patients need to pay(saja ngada nak tau lebih2 la pula...",)

Today also i met the patient i clerk during first week of posting. I help up cleaned his wound and glad to meet that uncle again.His wound looks ok and I'm happy with it.

Good communication skill also the key point in becoming a good doctor. I have to get patient's trust and intrest during taking their history of disease. I was told by a Medical officer, to be a good student, you have to clerk at least one patient a day and do general basic physical examintaion on him/her.Since then i try to apply that.

As a clinical student, i have to be creative in finding the opportuninty to learn wisely. Like what i can conclude from Prof Hanafiah(my group spervisor) advice, there's nobody will tell you what to do. You have to find it yourself the opportunity to learn and not wait someone to come and teach you.

I had a valuable lesson earlier this week of not preparing much and not revising well on my basic knowledge.I hope to not repeat the same mistake again an always alert on that. Hope i can perform better.

May Allah make my journey in life smoother and easier..AMIN!!

Wasalam..

Ps: I still think that life is wonderful and meaningful in its own way each day..hehe(",).

Friday, June 5, 2009

2nd week.

Salam,

First of all Allhamdulillah(thank u God) for given me the chance to live till now and celebrate my 21st birthday today(June,6th).Key of freedom they say..I think its key to responsibility to make the right decisions in life!!

Second week just ended today.I and my housemate take the half day off,go to KLCC and watched gorgeous Zac Efron in '17 again'.For me, i feel kind of weird to exposed around people after only go back & fro to hospital for the rest of my days. The white coat really have an effect in changing my personality,psychologically in a positive way. With the white coat on I am ready to mingled with patient, seeing dreadfull wounds...Without it I'm just Me someone's daughter, friend and sister.

After a few times reschedule,changing groups we finally settled with our original group during 1st week. I'm very glad with that decision as i really LIKE my group. I am very thankfull to have a nice group members that are dedicated to our group and the most important thing is cooperative and willing to share. Sharing is caring right??

As a group leader, i make sure everyone gets the opportunity to fill up their log books,arrange teaching meet with our busy supervisors and our schedule.Extra thing we do is we set up our own tutorial meet at the end of certain procedure or OT and discuss what we have learned and what we should read more.Thus, i makes the learning process much more benificial to everyone in the group.

This week also,my study group just started our meetings and I learn a lot from it!It consist of 5 members (3girls,2guys).I think everyone should have study group once you enter clinical.

AFter 2nd week, i can see a few ADVANTAGES that i have as coming from UKM-UNPAD twinning programme:
* Our SKills lab really exposed us too the clinical. Here, i had a workshop yesterday and learned 6 skills. Each skills was taught for 10minutes in rotation of seven groups of 10 students. The skills that we learned were:
1. Urine catheterization
2. Pre Rectal examinationa(aka Digital rectal exmntn)
3. Suturing and holding the equipments
4. Nasogastric tube insertion
5. Breast examination
6. Brannula insertion(aka IV insertion)
Imagine how lucky I was to learn one skill for 2 and half hour€s in a group of 10 in a week and get evaluated in the second meet in the same week at UNPAD. Everyone get the chance to memorize,learn and use all the equipments adequately.However, as people have variability, the skills are slightly different but allahamdulillah I can adapt to that.

* We learned more cases.Logically we learned more as the regular students learned pre-clinical for 2 years and ours are 3 years.However, i still have to re-read as i forget some of it..hehe

* Since we know certain things more, we become quite confident to do things.yeke??(kembang kuncup kembang kuncup)hehe..Maybe some of us do...A radiologist told my friend that he heard that UNPAD students are confident.It must be from talks among his colleages since our postings doesn't majorly involved radiology yet.

I'm glad that so far my friends from UNPAD manage to be OK in here. So far i didn't here any negative comments on us..I hoping to not hearing about it at all i the future.

Wednesday was my lucky day as I get to do all the things i planned on that day.What are they?
1. Clearking a very cooperative patient in the surgical clinic.

2. Presenting a case in front of a registrar(doctor that is going to be a speacialist).He corrected me and i'm glad that i learned my weaknesses at last in presenting case.Will try to present case again next time.

3. Watched an operation on removing the gallbladder(cholestectomy)by Open surgery method on a cholelithiasis patient whom i clerk a day before for my case assessment report.After it was removed, a registrar disect it and i get to feel the content(bile stones-moxed type)while collecting it into the specimen bottle. I get to feel a real gallbladder too.It was a WONDERFULL experience after standing for about two hours straight..The patient also a nice lady.She was very helpfull during the clerking me & my friend conduct befor the operation.She also let us practise some general physical examination on her.

So,those are some view of my posting this week..My inquisitive and motivation level is still high.Hopefully it will go on forever..(",)Till then, bubye.

Wasalam.

P/S: i got a sister in my family at last...a sister IN LAW (",). May happiness will always be with you Abang Yayai and Kak Yah.Can't wait for a nephew or niece and becoming and aunty..

Saturday, May 30, 2009

1st week of 1st posting

Salam (peace)

So, I'm sure some of you are excited to know what happened to me during my first week of my clinical year.My first posting is SURGERY! So..here it goes:

In summary:

1. The first week always be the blurry one..The method of learning is TOTALLY DIFFERENT from pre-clinical years..NOBODY is there to tell you what to do. Everything comes from your own initiative and intelligence to find the opportunity. You won't know it till you experience it.

2. Regardless all from the above...I ENJOYED my condition right now in the CLINICAL way..so far...WHY??
* You get to see things that you can't get from books
* You apply and refresh what you learn during pre-clinical into 'real thing'
* We get exposure to real patient...real cases..COOL!!
* We get to know the hospital: how it really works with a lot of people working togather to help those in need
* You get to sharpened your communication skill by doing CLERKING( aka amnenesis)..this job is our main job in the ward..investigating the patients..
Sometiomes, i feel like i'm a police officer..hoho

3. I understand now why people says SURGERY is the 'inspirational posting'
* the doctors mostly are COOL...(get to see some Good looking faces to..hehe)
* watching surgery is a WONDERFULL experience
* less tense in this department
* the Operation theatre(OT) is fully air-cond...have to wear scrubs when entering the OT department.so..adala feel mcm surgeon

4. About the posting..there are 3 places you have to go:
* WARD : there are 2 ward 3rd year students are allowed to go to..ward 1 (men) and ward 2(women)
* CLINICS : here, you can learn a lot here..get to participate more in the procesdures
* OPERATION THEATER (OT): You can-see-only learning process but you should apply what you see with what you learn to make the process more benificial.

5. WOn't I get lost??
* Every students get a log book.This log book is fill with requirements that students have to fullfill during each posting and everything must be confirmed with the doctor or nurse signature.
* The seniors are kind and toughtful to organize the buddy system. Each junior have their own buddy(senior) to help out in surviving the clinical life.So, we can ask them about studies, books etc.

So, in conclusion...
to my UNPAD juniors..no need to worry..be motivated to looking forward to your clinical years at PPUKM.
To my self..i'm thinking of becoming a surgeon..hopefully i can succeed in everything I do and always feel motivated to learn.

MOTIVATION thats' DRIVE you to go FAR BEYOND THE SEAS..

Wasalam(peace be upon u who read this)

Friday, May 22, 2009

PPD camp

Salam...

After white coat ceremony at the end of PPD Camp 2...

I just got back from Besut BTN camp after spending 5 days there for Professional Personal Development 2 (PPD)camp.Medical students of UKM have to attend this camp during 1st(starting pre-clinical),3rd(starting clinical) and 5th year(final year).

PPD is a modul that will be assessed throughout the year and this camp is the beginning of the modul. This modul is intergrated into each posting.However, I'm not really sure yet how they evaluate us yet.If you fail PPD it equal to failing a posting.If you fail 3 or more posting after re-sit, you have to repeat the year..huhu..May Allah forbid that happening to me..

The moduls are mainly by Assoc. Prof Dr Harlina with the help of other PPD department members.This time the Camp comandent is Assoc. Prof Dr Zulkifli who is also our Pengetua KTDI

The objective of PPD camp are different for each year.For PPD 2 it is more to developing medical professionalism and preparing us to the clinical world.The moduls are related to managing diversity, honesty, assesscibality as a medical students and medical ethics. We are also given a lecture by Prof. Dr Rohaizak about etiquettes of doctors on our behavior,manner and appearence.



I am glad to have such a GREAT team members regardless our diversity..hehe.We all share the same spirit and had a good bonding during the activities. I am in Kumpulan 10 and there was 24 groups for 272 students.Quite a big number eh??

In summary:

1.The camp is at Besut, 5minutes walk to the beach.


2.My bus sesat during our journey to Besut and we arrived after 12 hours on road..huhu
Excited faces when we just started our journey



3.The condition was VERY HOT!!I nearly melted...hoho..

4.WE are well fed as we get to eat 6 times per day(ruining my diet plan..huhu)


5.I LIKE my Kumpulan 10 members...they are wonderful



6.I get rashes and gatal2 on 4th day till now..huhu.Some of my friends get similar problems.

7.The Kembara(which is the cream of PPD) had to be cancelled due to the heavy rain but, good thing is we get to mandi hujan..hehe
after the Kembara was cancelled..we heal our dissapointment by taking photos by the beach..

8.On 4th day, we get to do Subuh prayer by the beach however the sunrise wasn't visible due to cloudy condtion(later it rained and we have to cancel Kembara..huhu)

9.The schedule are very thight...slept during ceramah BTN..can't help it..(",)

10.We have to write a letter to ourselves about what we want to achieve during clinical years and our feeling at the moment.These letters are kept and will be given to us on the day before our graduation in 2012 insyaAllah.I just can't wait to read my letter again on 2012.
with Dr Irwan Januarsih & Dr Uni who are from UNPAD..we will miss you!!

I would like to thank all who make this PPD camp2 happen especially to Dr Harlina & PPD unit, Dr. Zul, Dr SHahrir, Dr Setiawan & Dr Irwan Januarsih from UNPAD and all fascilitators.Special thanks to my fascilitator Dr Azaman(Pharmacology) and Dr Suzaily(Psychiatry).Both of you have been a wonderful fascilitator to us, Kumpulan 10.

I really enjoyed this PPD camp.I hope to experience more excitement and enjoyful moments during PPD3 camp during my 5th year..With this I rest my case

Wasalam(",)

Saturday, May 9, 2009

I'm Home

Salam..

Alhamdulillah..I'm already home for two days. It's steamy here..I keep changing my clothes because I always drain in my sweat.Thank you to the GLOBAL WARMING, my home is getting warmer compare to 3 years ago.

What happen in this 2 days:
1. I become a 'puteri lilin' and keep on staying at home with the fan or air-cond on.So friends if you want to ask me out bring me to a close area with air-cond or fan..hehe.

2. My family is busy with my brother's wedding preparation(about a month away). Thank you Abg yayai, I become your 'buruh kerahan tenaga' managing the bunga telur and wedding invitation cards.My mum decided to make the 'hantaran' and 'bunga telur' by herself with the help of other creative family members. Well, it can cut the cost and you' ll feel more satisfied with the end product if you make everything by yourself. Moreover, my family members are creative with these 'wedding thing'..hehe..Definitely will get their help when it comes to my turn.

3. Another tradition is we usually send the invitation card by hand..Yes, I repeat BY HAND!!...but only to certain people like family and close friend.SO, today they will go out and send the cards whlie visiting people they invite, while I have to stay home managing the other cards to be post and babysit my little brother(which i'm glad to stay in the air-cond home)...(",)

4. My family is also in transition of moving to Malacca(but we still keep the house at KL).The house is still in renovation, so still can't move in yet.

5. My 7 boxes of cargo shipping also arrived safely in the evening on the day i arrived.. Still thinking how to manage all the boxes...huhu.

6. Like to tease my little brother in my free time and swim almost everyday(",)

7. Pasar malam...yeah.And delicious Malaysian food..I'm in food HEAVEN.

8. Busy with preparation on registration at UKM on 13/5...have to pack my stuf from the 7 boxes and try to find some clothes from the boxes for my orientation and 5days camp..hoho

That's all for now.Sorry for babbling too much..Just bear with me (",)

Wasalam

p/s: pictures will be uploaded later.I'm borrowing my bro laptop for this..hehe

Wednesday, May 6, 2009

Farewell Jatinangor.......

WE are ELIGIBLE to continue at UKM MALAYSIA!!


Salam..

Today will be the last time i write my blog at Indonesia. I lead this last days with some unforgettable memories..Receiving a lot of GOOD LUCK wishes and prayers and also farewells. People throw us 3 farewell parties..I'm touched.

My heart ache to leave here and start a new chapter of my life as a clinical student at Pusat Perubatan UKM. It is sad to leave all the friends i made and the life i lead for three years. Even three years feels too short..Definitely I feel sad but I keep my self optimist.This goodbye doesn't mean forever.Everyone have to move on...huhuhu

BBQ at Caringin(where i live for 2 years) with other twinning friends..


Farewell party with PADMA, an organization that manage international students


perform song by Mambai titled Kau Ilhamku with other twinning friends as a gift for PADMA


Farewell by Batchmates(2006 FANTASTIC) from Regular and International program.


With Indonesian friends..will miss u all.


Farewell with my close international program friends..we were housemate for a year during foundation.So many memories i have with you all..Miss you..huhu. Nad the peacock(peace no war..hehe) and AJ the rabbit(hehe).I will remember last night always.Thank you(",)



My last experiment at Jatinangor..CHOCOLATE CAKE.. Thanks to the teacher(Salmi).
I made two for my floor mates, junior and aerobic instructor.


Another important part of my life at JAtinangor is AEROBIC. I go there every week and become part of Arena Senam Jatinangor family members.There i get know lots of ibu who likes to aerobic and make friends with students from other faculty..It was an intresting experience and memorable to mingled with them. I also attended birthday parties and engagement by them.Yesterday was my the last time I go there. Thank you teh(aerobic instructor) for the baju aerobic you gave me.

With Arena Senam Jatinangor members..


Farewell my friends....
Thank you for everything
the memories I had with you
will be kept always in my heart

Dear friend,
just remember
We only part to meet again
Reunited in future i pray
INSYALLAH(with ALLah's will)


Wasalam