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Hello, Orthopaedics!
July 31, 2018
I just feel like writing today.
It's been a while, I know.
I have successfully completed my Obstetrics & Gynecology posting, alhamdulillah. :) Missing it the moment I am writing this post. O&G was my first in encountering almost everything. My housemanship basically started from zero, there. But, to complete these 2 years, I know I need to move on to another postings.
So, here I am, on my way to complete the very first month in Orthopaedics.
Honestly, I don't have specific postings in mind to choose what is going to be next though. So, I am gladly accepting this posting :) There are few life lessons I learned here (so far in 1 month).
1. I need to be physically fit.
Orthopaedics is more about musculoskeletal stuffs - involving fractures of bones, dislocations of joints, diabetic foot ulcers any many more. And this is a surgical based - so, expect operations every single day. Operations are almost 100% different than O&G. They took hourssssss (the longest one I have been in... was 7 hours straight - with 20 minutes break for me in the middle because I was hypoglycemic). But there was one time when there were 4 operations planned to be done that day and it was going one after another from 8am to 5.45pm and all of us there were basically standing the whole hours.
MO: "Hanis, take a break, pergi makan kat pantry. You need energy to assist me."
Full respects to all of my surgeons, who are very committed to reduce all the fractures, to debride all the wound, to explore the area etc. T___T
One day, I was helping the medical assistant to lift up a full right leg of a 150kg man to secure the best position of it so that the surgeon can have the best view and space to do operation on the leg. Once upon a time, I was a person who could lift a 30kg luggage up to 4th floor with stairs - but I assume not anymore. I don't know why but seems like I am losing most of my energy and strength.
So, back to the story of 150kg man.... my hand was literally shaking upon lifting the leg. The surgeon realized this and ended up asking a PPK to exchange with me.
MO: "Hanis, the moral of today, you need to eat more and exercise more."
Me: "Okay, doctor."
Thank you doctor for being considerate enough to a newbie like me.
2. Expect the challenging response.
There was one fine morning, raining cats and dogs at almost 6am, when I still remember the azan was berkumandang. It was time to take blood coming morning (means as an oncall person, we need to take any blood needed for the whole ward early morning that day).
I pushed the blood taking trolley towards a bed - who was known to be very hard to take the blood. But, what could I do? Blood is like an identity to us. Other than physical examinations, doctors can know what is happening in the patients' bodies via blood - how the liver functioning, how well is the kidney, is there any chronic infection going on, are the antibiotics working out yada yada.
So, the uncle said to me. "Doktor nak ambil darah ke? Muak dah tengok muka doktor-doktor asyik nak ambil darah je"
I am so sorry to have this inner thought, "Ingat doktor tak muak ke nak ambil darah?". I proceeded to do so, because this is my job. No matter how much the patient hates blood taking, I am doing my job and trying to make sure to get my job done so that I can feel satisfied for my pay. Keberkatan gaji is very important to me.
I ended my shift that day at about 2pm and later at night, my colleague told me that patient passed away towards the end of the evening. I was not in charge of him but I feel bad for my inner thought that morning... astaghfirullah T___T
3. Get my work done first and only then, help others.
In this department, we are assigned to beds - which mean we need to take care of the specific patient through out our working hours that day. The beds may be the same from the previous day or the next day, depending on how the oncall shift people distribute the beds.
I need to remember, other colleagues may help me but usually all people will focus on getting their carry outs done first.
I need to do the same.
And I need to remember my favourite MO mentioned to me a long time ago, "Hanis, I know you are very nice to help your friends. Keep that attitude but in reality, most of the time, you need to save your a** first."
Life is very subjective. There are colleagues you don't mind to spend your extra time to help them out, but there are some whom you will feel you need to get out of there as soon as you've done your job that day.
Keep being nice, Nina. You can do this.
4. Ortho ward is full of patients with infections.Honestly, I feel bad for all babies and kids who come to the ward. I am sure that there is a big notice in front of the ward that we don't really recommend the parents to bring the small kids and babies inside. I know you want the kids to visit their grandmother, grandfather etc.
But, isn't your children's health more important?
Trust me, babies and small kids' immune systems are not that strong compared to adults. They are still literally growing, their immunity is still maturing. If the infections are strong enough for normal adults, don't you think they are extremely harmful for your little buddies?
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All in all, the posting is honestly full of dramas. Belum masuk kisah-kisah patients yang nak masuk wad tapi taknak masuk wad, nak operation tapi taknak operation. Hahaha. Adoi laaa.
Embrace them, Nina.
Absorb the best parts and let go of the bad ones.
Nina,
You are still learning, try hard to avoid doing mistakes. But, if you do any, acknowledge and analyse the mistakes and try not to do them ever again. If other people blamed you for something not your fault, back yourself up with valid reasons so that they can't fire back at you. But, if they still blamed you for no reasons, then it is their problem, not yours.
I love the working hours in Orthopaedics anyway. :)
One of the best things here other than very helpful senior housemen and MOs who are willing to guide and teach.
M, Perak, Malaysia
180731
My Different Version of Eid
June 24, 2018
To be honest, 2018 is my very first year to celebrate the first day of Eid Fitri away from my family. I had expected this to happen this year, so, my heart was well prepared for that. 6 years staying abroad, alhamdulillah I managed to go home every single Eid Fitri :)
But, life changed. I have new responsibilities, new environment and I look forward for more changes in my life, insyAllah with an open heart.
Night of 1st Eid, I was on call at the labor room. It was uneventful, I mean the oncall was bearable with few admission - tolerable much. Well, who wants to get sick on the night of Eid, you tell me. -_-'
I had something I could not forget, two different cases that really caught my heart on how people perceive the hospital admissions.
1st case.
There was a lady, primigravida (first pregnancy) who came to Labour Room (LR) at 0200H (2am) with complaints of contraction pain and show. Upon further examination, the CTG (reflect baby's condition in the womb) looked reactive (means normal), the os was already 2cm and time contraction was 2x in 10 minutes that last about 30 seconds.
Based on my previous experiences, we will admit this patient to the ward for further observation - in view of:
- she came at 2am
- her house is quite far away from the hospital.
Even though she was just primigravida (the labour process is usually longer for primigravida), she could still deliver the baby ANY time!
But, she was really keen to go home instead of being admitted.
Well, I do understand she did not want to celebrate Raya at the hospital, but this was out of her control. If it is fated that her baby to be delivered on 1st Syawal, let s/he be. So, my MO allowed her to go home and asked her to come immediately to the hospital if the contraction pain becomes stronger or if there is any leaking liquor (air ketuban pecah) or if she feels any reduction of fetal movement.
2nd case.
After the previous lady left the LR, another lady, G7P6 (means she is currently pregnant of the 7th baby and already delivered 6 babies) referred from the Emergency Department for PV bleeding (per vaginal) with diagnosis of incomplete miscarriage.
Incomplete miscarriage means:
- the 'baby' or better to be called as product of conception - POC (hasil persenyawaan) is already out
- but some of the POC still remain in the womb
We need to evacuate the POC otherwise patient will continue have a lot of PV bleeding and abdominal pain.
Upon per speculum with the MO, we managed to remove the POC at the os and upon TAS (transabdominal ultrasound), the endometrium thickness (ET) was <10mm. Usually, we need to proceed with ERPOC procedure (evacuation of retained product of conception) if the POC cannot be removed from the os and if the ET >15mm.
In this patient's case, our final impression was complete miscarriage - she did not have to undergo the ERPOC. However, we admitted the patient for observation and told her if her bleeding is minimal, we can allow her home that morning. She agreed with that - 'saya ikut apa yang doktor rasa terbaik'.
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Here we can see how patients perceive admissions to the ward. Trust me, no doctors want to admit patients to the ward without reason. Most doctors care about the patients even though admissions will increase the workload. But, that are for patients' sake and our responsibility.
And to make the night more interesting, the first lady delivered her baby just few hours after she left. Luckily she managed to return to the hospital T___T.
Birth before arrival (BBA) to the hospital is another issue.
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On the day of Eid, I was in charge of post natal ward and guess what, the ward round ended at plus minus 7am! And the housemen managed to settle all documents for discharged patients as early as 10am! Wahaaaaa. The MOs were considerate enough to allow patients home very early so that patients can celebrate Eid with family. :)
My shift ended at 1pm and I decided to drive home immediately after that. Arrived my aunt's house at almost 4pm and I ended up sleeping for the rest of evening. T_T
Went to my uncle's house that night and I ended up with sleeping on the sofa.
The end of my first day of Eid. :D
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| 2nd day was better. :D |
Selamat Hari Raya everyone!
Although this maybe quite late, but I wish you have the memorable Eid :)
If you are reading this, please pray for my success for tomorrow's assessments. I will be leaving for another department very soon and hopefully I pass this O&G - Obstetric and Gynecology with good achievement. Ameen.
M, Perak, Malaysia
180624
Good Things Today :)
May 24, 2018
After working 105 hours straight, finally I have an off day - which was spent for another medical program called Neonatal Resuscitation Program (NRP) 7th Edition. Haha. Although I was a bit sad at the beginning to think that I didn't have time to drive home to visit my parents or have a day off from the hospital... however at the end, alhamdulillah, it was a good off day. :)
1. I woke up feeling fresh after 10 hours of sleep yesterday.
Being a doctor, I need to train myself to always search for opportunity to eat and sleep whenever I can. To be honest, it was a bit hard from the beginning. During my first few oncall days, I felt bad to sleep at night thinking I am paid to take care of the patients at night. But, I learned that I need to take care of myself too. Doctors are still human being and we can't function well without enough sleep.
I must say that most of my MOs are excellent doctors to be able to think wise in the middle of the night and that is something I need to learn as well.
Still finding tricks to function well under sleep-deprived condition. Haha.
2. I passed my first Neonatal Resuscitation Program (7th edition).
Neonatal Resuscitation Program (NRP) is a program that must be attended and passed by all housemen to be able to attend babies either freshly born or the one in the Special Care Nursery (SCN) / Neonatal Intensive Care Unit (NICU).
As a houseman in Obs & Gyne, this course is important too. There must be at least a reason to call Paediatric team to attend newborn at the Labour Room or Operation Theater - like babies of mothers with diabetes mellitus, meconium stained liquor, fetal distress etc. Paeds team will not always be there to stand by in advanced if there is no indication.
So, doctors and nurses of Obs & Gyne need to know at least basic stuffs of what to do with babies if suddenly they are born flat (not crying, no muscle tone) before Paeds team rush over to attend.
3. I had iftar with good friends (although they are leaving the department soon sobss)
It is not hard to know new friends but to maintain a good relationship is not that easy. There are people you know you can rely on and you can also put aside your own problems just to help them as well.
Working in this field is energy and mental consuming. I am glad that I can still survive so far. It is not easy but insyAllah let's just pray hard Allah will guide us throughout everything.
I am a bit anxious to think about the seniors who are leaving in few days - as I will be one of the most senior housemen in the department soon. There will be colleagues (from other departments) coming in and I hope I can help them to adapt efficiently plus all of us can work in a harmony environment - though I am still adapting myself to work fast.
4. I received a postcard from Lithuania.
It has been a while since I last exchanged postcards. I miss writing my thoughts on them and share with others but it was a bit challenging to find time to look for good postcards around. To be honest, I went into lots of book stores and came out with nothing. Fortunately, I decided to visit the Tourist Information Center (my current town is a tourism site) and the lady gave me 12 pieces of postcard for FREE!
And sending a postcard from Malaysia is EXTREMELY CHEAP I AM TELLING YOU! only 50 cents for the stamp! It was at least 25kc (RM4-5) just for the stamp back then in Czech :D
5. I received my 2nd salary!
Gaji dah masuk oh yeah. Haha. I don't really put much thought on the salary to be honest but... I just knew it is a beautiful feeling to see the account balance.
M, Perak, Malaysia
180524
Sleep in a Capsule!
May 19, 2018
I had good 3 days off in Kuala Lumpur recently. To be honest, I didn't have much plan (packed plan) to do in KL, just my aims were to wave my parents off in KLIA2, to meet my friends and to join the KL International Book Fair.
For the first night there, I decided to try a hipster place to stay. And ruling few lists down, I finally decided to try this one hotel - Space Hotel. It is located in Chinatown, which is in between LRT Masjid Jamek and LRT Pasar Seni. So, from location wise, this place is in good area with many people around.
So, let me share with you how the hotel looks like and how the facilities provided there for the ideas.
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| The hotel is located on upper floor of the building. Once you enter the hotel, you can obviously see this logo. Let me tell you, when I was here, the lift was not functioning, so I think it would be hard for elderly if they want to stay here. Just, so far that I could see, most of the customers there are foreigners and younger people. |
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| Since the receptionist located on the 3rd floor, you can use this slide to get down to the second floor in less than few seconds :) |
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| Lobby. |
I booked a capsule for mine via Booking.com. It was about RM43 +- per night for 8 capsules female room. You can get a cheaper price if you don't mind a mixed room, in which a night will only cost you RM38 +-. Prepare a deposit of RM50 as well.
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| After settling the payment, the receptionist showed me the room and how to use the capsule. He was really welcoming and always with his warm smile. :) The hallway of the hotel looked like in the picture above. |
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| The room with 8 capsules. Actually, each capsule is provided with a locker outside of the room but it can only fit cabin-sized luggage. So, that's the main reason why you can see the luggage in the room. |
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| Once I open the door of my capsule, the bed looked like this. Comfy, right? I felt like I want to jump in and sleep right away. Huuuu. |
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| The table provided and it can be removed from the wall. |
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| Safety box is provided as well, in case you want to put your valuable items like wallet etc. |
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| They provide 2 pillows which were totally comfy for my stay! |
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| The view when lying down. On the left side is an Android television (?). I am not sure how to use it but I was unable to connect to any tv channels. But, no worries as the television can be connected to the Internet - so, we can still enjoy watching YouTube videos or any videos online! :D Amazing! |
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| Lockers outside the room. |
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| Decorations of wall at the pathways. |
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| Access card for room and capsule. This card is also important to switch on our capsule - the aircond, the lights, the screen. |
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| Clean bathroom and toilets. |
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| The shower with at least 3 water outputs. Water heaters are provided - just adjust the showers. |
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| I love dry toilets! |
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| You can use the iron for free and you can also wash the cloths with the machines provided (you need to pay for the washing machine) |
All in all, this kind of place is a new thing for me and I am sure for most of us as well, right? Go and try it! Get a night off there and share your experience :) There are few of them around Malaysia and the one that I tried is located in Chinatown.
M, Perak, Malaysia
180519
status - waking up for sahur
Nasi Lemak RM2 and I
May 13, 2018
Stay back = 7am - 10pm
On call = 7am - 5pm, return to work at 10pm
Post call = go home at 1pm
So, the story was that I was post call one fine day, trying to get myself something to eat for breakfast. Luckily, they announced that Kak M was selling meals at the thumbprints / punch cards area. Since I was on call the day earlier, I didn't sleep much and I managed to get my work done (Prostin review, AM review etc) by 7 am.
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| Example of doctor's diet. |
I took a RM 10 note and even collecting orders from the nurses, volunteering myself to buy meals. Excitedly, I walked towards the side door to exit the ward, passing few beds occupied by patients. Just about to leave the ward, a patient gave a signal to me that she was in pain.
Pain in O&G (antenatal ward) mostly means contraction pain.
So, I returned to the procedure room to do vaginal examination (VE) to see how much her os already open. "Oh, nice, dah 5 cm ni Puan, kita hantar pergi labor room untuk bersalin ya."
After documenting the VE findings, I informed the nurses to prepare the patient and her file as the patient was going to be transferred out of the ward to the labor room. Upon leaving the counter, once again another patient claimed she felt leaking of liquor. I went back to the procedure room with that patient and was about to do per speculum to see if there was really liquor pooling in the vagina. Luckily, a MO, Dr. XYZ was there and volunteered to do it for me (thank you very much doctor!), so I prepared the documentation instead.
Then, Dr. XYZ decided to continue with morning rounds. Finished the round around 9am and proceed to carry out all plans like tracing investigation results, taking blood, doing discharge summary yada yada, it was already almost 12noon.
Good bye, nasi lemak.
See you when I see you.
:D
So many experiences with meals, to be honest.
Not to forget, I bought nasi kerabu at 9am and was only available to eat at about 8pm and found out that my nasi kerabu was not in the pantry. T___T I suspected the nasi kerabu was not in good condition anymore and people threw it away.
Another best moment was when akak PPK offered an extra patient's meal for me. Honestly, meals in my hospital are very good, especially the doctors' diet - available for me especially if my duty is in the labor room. Ayam masak sambal hijau, ayam masak merah, ayam masak kicap nyum nyum.
Cuma itu lah, masa nak makan properly tuuu. Hahaha.
That's the main reason I provide myself with something to eat on the go.
M, Perak, Malaysia
180513
SPRING & DUCK GIVEAWAY BY BLOG NADIAIZZATY.NIA
May 4, 2018
Yuhuu Nadiaaaa :) Hehe finally I am able to sit down properly and write this post. Here I am!
I am very excited to update myself with all of Nadia's Instastories from her trip to Korea back then. Walaupun dah pernah pergi Korea zaman Korean stuffs ni belum up lagi kat Malaysia ni... still my feet are itchy to go there once again. Especially to seek for the full bloom cherry blossoms - for sure this will be included in my wish list after completing my housemanship (or maybe while completing? hahaha)
Anyway, this is a second giveaway organised by her. Feel free to join together with me and the rest. The gifts are very interesting, guys!
Click HERE to join!
I guess I have completed most of the rules quite a long time ago, I am a frequent reader of her, though. :D
Anyway, Nadia, about your blog... I have nothing against it. I love the contents, the concept, the pictures / flatlays and most of all, I love reading your experiences of anything plus reviews of your trips / movies / books.
Just, I somehow feel the pictures are quite big for me to enjoy them as a whole. I mean, when I use the laptop to read, I need to scroll few times to get a full view of the pictures :) Maybe that's the style of using one-column template? But no worries as I read blogs more via phone for now and they are perfectly fine on mobile, hehe :D
Thank you very much for this giveaway and thanks once again for including me as a part of your blogger circles. Hugssss.
M, Perak, Malaysia
180504
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