every breath u take

huhu.i'm currently crazily continuously listening to this song by The Police. the lyrics somehow is a bit painful.

"every vow u break, every smile u fake,every claim u stake"

but other than that part, i can take it as a a very sweet love song.it's like ur loved one is a part of u.u take him/her everywhere u go even he/she's leaving.huhu, noo, i'm not good in critical appraisal of anything but just that's how i feel.

" i dream at night i can only see ur face
i look around but it's u i cant replace
...
oh cant u see
u belong to me
how my poor heart aches
with every breath u take"

i've just started jogging yesterday.for some reasons it seems like it's gonna rain today so i didnt go out.dang!it's not raining! and i end up wasting my time here. but at least i get to scrub the shower.it has been 2 weeks i didnt scrub it.aaand, act i'm supposed to do my laundry.but..as usual la kan...

another great day

so far i cud say that i'm really enjoying 3rd yr. things making more sense.altho my time mgt is still a bit haywire, but at least i've went through 2weeks with fun!!yeey!(trying to do luke's fake yeyy~bu tmine isnt fake at all.not at all). my schedulue was kinda packed.have to be really smart to squeeze in my 'pastimes'..hihihi..

left home at abt 7.35~,then followed the macik patho with the hope that we could have a go withdrawing SOME blood from the pts, but we r unlucky enough to not have the chance at all in 2hrs.but it's understandable,she probably dont want our 1st time to be on the hard veins,nor she want her time to be wasted.she have to finish up 10pts within 1 hr.that's impressive,seeing how fast she was working. but i didnt say the 2hrs is a waste for us.it's one of the precious experience that we picked up along the path.we at least observed how she communicated with the pts etc. so when i'd have my try with doctors one day everythign is familiar to me.and also 1 interesting thing is that she did explain to us every single thing she's doing.and even we went to see the 'blood chimney' thingy(i called that,not sure what's the exact name for it,but it's like a chimney whe she put her bottle of test tubes with blood and the bottle will be transferred through the 'chimney' system to the lab, cool huh).

then i went to have a chat with thelma. she's going back today.happy for her but still pity her bcos she wont be back home,she'll b going to kingston rehab centre. :(. have a chat with this 1 stroke pt.hm.. i'm not sure whether i'm progressing or not, but at least i'm doing something. then went to read few pt's medical records..

oh today there's quite a scene at the ward, but we are still wondering what happened. there was ppl in the clinical room, some are crying.everybody looks dull,sombre,red-eyed etc..and there's one guy crying out loud at the ward. we r guessing that his mother/wife is dying..or maybe had just been diagnosed with something terminal.i know it's reaally not ethical/appropriate to be exciting on other's sadness, but i cant help to be exciting looking for whos' the pt, and wanted to know what happened. so funny that i was like spying on the pt's family.looking for which bed she blongs to.hope that tmorrow morning i'll be able to find her file and find out.hehehe.but really sorry for her family.seriously! cant stand that sight~

lecture skipped

i dont know why but this morning duirng gerry's lecture i felt soo not good.

i went home and slept till 2-ish.

i knew it's not a good sign to be skipping classes from earlier months.
but, i just didnt want to be there.

but the afternoon tute was quite good.
i was the scriber.

tried the kathy smith's but seems like the cd's not working.
~sigh~ there goes my hope to lose some wight.

currently listening (non stop since last night) to
Cinta Antara Kita by duta and baizura kahar
dunia baru the movie OST
not the whole lyrics are applicable to me
but it's still sweet

"sudah berapa lama diriku ini tidak bertemu mu
mungkin ku harap jua kau merinduku sebagaimana ku rindumu

ku hanya menunggumu menyata kau cintaku"

oh i didnt elaborate much on Jangan Bilang Tidak,
it's the exact same story!!
even the vc matched
hihi

a long day

huhuh really feel like a doc now (except that the fact that we know the least in the hierarchy). i really2 thank nathalie for that. she's been a very good teacher, and i felt comfotable following her around.zoran and Dr bower also included.

the day went well from the start.
after finsihed with the initial ward round, they went for a meeting.
so we went to see few patients. (theresia, thelma).
i think i'm progressing in my history taking although there's a lot of 'incompetencies' in them.
quite happy with that.
but havent done any in front of seniors/doctors,
i will probably go worse when observed.

tried doing the iv thing but didnt got the vein,
but nathalie was really encouraging, she went like
'u did great, but it's just bla bla bla'..
theresia was also very very very kind.

despite the fact that i'm so happy with my ward life, i'm sooo stressed with tutes' stuff.
HEeeeeAPS to read!!!
basal ganglia?? really not confident to present bcos i havent grab the simplest explanation for them.


~forgot that i saw i LUMBARPUNCTURE today!!!~
cool!

my blood

i went for check up last week, and i went to discuss the results just now.

my transferrin is quite high 3.2 ( normal is 1.7-3.0 )
its saturation is quite low 11 (normal is 15-50)
ferritin is very low - 12 (normal 20-350)

so i was prescribed with iron tablet.

the shocking news was that my testosterone is at the very high end of the normal range. the sex hormone binding protein is quite low. thus my free testosterone is 66.37 (normal is 3-37).. hahahh that explains all... but nothing to be worried abt.that's not sth bizarre altho not normal. it might be because of my extreme iron deficiency that signals to stop more blood loss. who knows. there's a lot more to be revealed in the world. Allah knows all.


~shiapa yg tahu akan sama hatimu dan hatiku~

Jangan Bilang Tidak

Ku pernah punya cinta namun kini ku sedang suka kamu

Cintaku dulu tlah kubuang jauh kini ku ingin kamu

Ku pernah menyendiri di sini ku akan terasa sepi

Walaupun bibir penuh gelak tawa namun hatiku sepi


Jangan bilang tidak bila kita belum mencoba

Siapa yang tahu akan sama hatimu dan juga hatiku

Banyak yang bercinta bertahun-tahun putus juga

Kuharapkan dengan dirimu walaupun singkat pendekatan

Cinta kita kan abadi

Ku pernah punya cinta namun kini ku sedang suka kamu

Cintaku dulu tlah kubuang jauh kini ku ingin kamu

Jangan bilang tidak bila kita belum mencoba

Siapa yang tahu akan sama hatimu dan juga hatiku

Banyak yang bercinta bertahun-tahun putus juga

Kuharapkan dengan dirimu walaupun singkat pendekatan

Jangan bilang tidak waktu dicium aku bingung

Namun dada ini bergetar

Makanya sungguh aku mohon

Jangan bilang tidak

2nd week

i'm all stressed out bcoz it's already sunday morning
and i havent spent more than 10mins on any pages of any book.
and right after this i'm going bbq,
then discussion will be until 8.30 but probably later than that.

~soo many things to do~~

brg2 spatutnye

i thought i saw the 'wedding cake knives' in quite a few places last yr, but when i actually want to buy it, it's nowhere to be found. i planned to buy 2 of them.one for me and one for mc ah.

so yesterday i went to one of the store on clayton rd which i dont even know the name but they are selling all the wedding and christening stuff. i 1stly picked just 1 'stacked cake plate' or whatever the name is, but then as i go around, i ended up picking another of the stacked plate, cake stand,porcelian tea set,and 2 square bowl. and everybody knows why i need them... huhuhuhu.. i'm all prepared~~

woke up late
missed subuh
tk sedap hati
need to go to the city


astarfighullah.

the longing

i'm finding 3rd yr quite fun so far.
or maybe it's too early to say that.
'penyapu baru' la katakan.

~sgt2la tak sbr menunggu sbulan lebey lg~
~hmmm.. sbrlah ye~

this longing is taking its toll on me

bofren saye jauh

the title doesnt have anything to do with what i'm thinking now.that was just the 'quote' that i used as an excuse when L asked whether i've got any cards for v day.

i was pretty busy today(which is a fun thing rather than wandering around having nothing to do other than staring at each other in the ward). started with ward round with nathalie and zoran, then went all around the hosp looking for pts,arranging things etc. i ALMOST got to do the IV bung on this 1 pt.we've prepared all the stuff(patho trolley etc).. but unluckily, she already had something/wire/tube into her chest/??.. so she didnt need the iv thing anymore :((

bilirubin etc

again, trying to organise my thoughts abt bilirubin excretion(just read it from guyton).

1st ly, the hemoglobin is split into heme and globin. the globin is the protein, broken down into amino acids and will be reused for protein synthesis. the heme ring --> iron and biliverdin.
biliverdin is rapidly reduced into free bilirubin,but then the free bilirubin will strongly bind to albumin .
in the liver, the bilirubin will be conjugated --> thus called conjugated bilirubin. they will be transported to the intestine and become urobilinogen. the urobilinogen is highly soluble.some of them are absorbed back into the blood. most of the urobilinogen from the blood will pass through liver and to the gut then into the feces. when oxidised bcome stercobilin. but the ones that didnt pass through the liver, they will be excreted by the kidney and into the urine, when oxidised bcome urobilin.

hmm.. still confusing..

trying to organise my thoughts for neuro hx.

firstly, never forget to introdeuce myself as a studentdoctor then ask her is it's ok for me to have a little chat with her.then ask her what she'd like me to call her and casually ask her age. then asked her what brought her to the hosp. i never failed to ask that but what i'm so not good at is exploring more abt the presenting symptoms. in ideal world we can ask all the WWQQAAB questions but in real world it's not that obvious. but i have to try to make sure that everyhting is covered somehow. then ask systems review(which i didnt really successfully ask any of my patient so far bcos i basically ask general med hx). but tomorrow i'll try as hard as i can to take a complete medical hx with(including the system review). and ask her what did she think might be the problem. i've always forget the rest of the hx taking when i started to ask abt what did the doctors do for Ix,and hwo did the doctors manage her at the time being.

so for systems review for neuro, i shud explore more abt any of such occurance before,any syncope,any seizures, incontinence,LOC,weakness or numbness somewhere,nausea,vomiting,dizziness.
not to forget cvs systems review(in case of infarction/stroke/embolus etc).
basically ask medical history.if she has any comorbidities ie:hypertension,diabetes,cardiac events etc.past surgery/hospitalisation. is she on any medications, does she have any allergies?

owh,family hx.ask her if any of her family members had the same condition before, or any of neurological condition, or any medical conditions at all.
also i've always forget to ask smoking and drinking hx. then try to ask her daily routines,with whom does she live, is she independent.. what does she feel?

i'll try to be as casual as possible so that she wont feel like being interrogated since she definitely are already tired with questions from med students.

hmm.. we'll see what happpen tomorrow! i hope we have new good historian patients.

~wish me luck~

7.30am: the moment we arrived at the 54S(or is it N???), we didnt really know what to do. there wasnt anybody at the counter and we didnt know who's the ward clerk. then we just grabbed eva's file,copied some medications to be searched on the MIMS(really plan to do k izza's suggestions). awkward moments last for nearly abt 10minutes,then only i decided to approach the ward clerk(after jun saw her nametag).she didnt really know if they have any patient with gait disorders(jun needed 1 for her pt pbl). there was this 1 'look-kind nurse' who brought us to the registrar. the registrar also had no idea of any pt with gait disorder. hmm.. it seems like it's a tough search ahead. but interestingly, she suggested us to see Mrs O since she had a mystery of left sided involuntary movements. mrs O was having her breakfast when we were there so we promised to come by later. we then tried 44N,tried yesterday's pt. she's under gen med unit.
damn!the interview was far from satisfactory level. i dont know why it's hard to organise ur thouhgts when it comes to the real patient.it's probably because their presenting complaints are not as well-written as in the case studies. but yeah, imperfections give rooms for improvements.

abt 9-ish : went to see Mrs O, jun interviewed her. the followed the registrar's ward round. it was just a brief round. Dr P suggested us to have a listen to her heart n report to him the findings. hahaha, kinda of funny trying to look like we know things when we actually didnt in front of the pt. but then i'm soo happy to actually hear the murmur.. the 'whoosh, whoosh' sound was soo cool. but then it wasnt cool enough of me to not knowing the parts of the valve.. i've alwasy take for granted which sides are all the A P T M areas. but at least there's sth to learn there. N taught us how to descrive the murmur. start with the character, is it systolic or diastolic( by checking the pulse at the same time).. then is it all the same thoroughout(pan) or is it ejection or late systolic? where is it loudest? radiation? manouvres? she also said sth abt the grading, but it's for the cardiologists.

11am: soooo rugi to miss the consultant's ward round. we thought ob and cl is going to join the round, but they actually didnt. !

12pm: cbt.. hmm... hahahah, penat dh nk cite.

now i know what's meant by being too overwhelmed with too much medical info.. in my case it's not info overload, it's too many systems to be covered at the same time.

clinical bedside tute needs me to cover on cardio xm (that'll includes the signs, symptomsm and of course the DDx)(everything!). not to mention that my history taking is still in bits n pieces all over the place.

patho class needs me to cover on gastro.obstructive jaundice.which is a topic that i didnt botehr to memorise last yr.yeah, ppl say that once u understood the mechanism u'll be fine,but the thing is that the mechanism need to be memorised.i'm still not sure abt which is the conjugated and unconjugated bilirubin. to be able to look for it's patho, i definitely have to know the normal one 1st right? hmmm..that' quite a lot of work to do.(luckily i still have a few days till friday patho teaching).

lastly, i am now attached to neuro unit. (no need to mention the complexity of diagnosing the mysteries neuro cases).

things to do

before i forgot them (yeah, i did write in my notebook but it's still kinda messy being 1st day)

gait : guyton's
mgt from the net
involvement of enlarged ventricular system

cbt nxt week : read talley - cardio
REALLY2 ORGANISE HISTORY TAKING TECHNIQUES (tabulate them!!)

ward : search the terms i jotted down (paget's disease etc)

they'r all urgent!!!

laugh at urself

i suddenly laughed at myself reading abt how comot i was when i really adore toknyang... hahaha, yeah i think adore is the most acceptable word for my infatuation towards him.. i really moved on!!!i even missed his harijadi minggu lps. yes2!!! that proves how i 'moved on' i am now..

back

i suddenly thought of updating my long lost blog.i tried to write last week after the overwhelmingly great nurse shift, but i cancelled the post since i dont really know how to put my thoughts into words, but come to think of it again, who cares?? nobody read it. this afternoon kemal went to see andrea(it's compulsory for all international students to have 15minutes meeting with her anytime within this week, mine will be tomorrow). i dont know what did kemal discussed with her but she advised kemal to have a diary..then only i remembered this blog.. so in case andrea suggest me to have one, i could just use this blog since i always felt like writing when i had great things happened (which is always abt a life of a survivng medical student).

we went to 54south ward at abt 9(act,we promised to be there at 0830 hihih).CL was already there, n he was reading the medical records.. wooah! that's impressive.. we were kind of scared n felt very inferior.. but then 'be kind top yourself'.. that's what andrea told kemal, dont compare urself with someone else..
i didnt follow the ward round coz we'll take turns (can u imagine 6medical students straying around the ward at the same time with the team of consultant,registrars,etc). then we headed to the lib. hmm.. as the 1st day enthusiastic 3rd yr meddies, i tried reading talley on neuro..hoped to finish up the whole chapter but failed.. eh no, i didnt fail, but havent succeed yet.. at abt 11, felt very wrong not seeing any patient for the day, so jun n me went to 44south. the nurse suggested 3 patients, but none oof them were at their bad at the time we went(hahah, just a lame excuse to not seeing patient).. to feel god abt ourselves, we promised ourselves to be at the ward 0730 tomorrow morning n see a few patients for history..
at 3 i' supposed to have an appointemnt with DR J. hmm.. he did everything that i cocerned abt, but there's no exact answer for my questions, so i'll leave it open and hope for the positve side of the coin.
oh btw, we went to clayton n had lunch at the bbq chicken.bought 500Gb external hard drive for $179. i'm not sure whether i really need it or not but i dont want not having it when needed. also went browsing for my bed. but no luck yet. tried to call the furnituregalore hotline but nobody answered.

**i'm supposed to be very busy now.. had to prepare for nxt 'patient pbl'**