too much. or not.

why do i always end up doing multiple co-curricular activities during my study and exam week. the trend hasnt stopped. i wonder when it will. then again i've learnt lots from doing things this way. but at some point u tend to feel agitated and u just want to rant it out loud, take a breather and go back to doing it again.

Aaaaaaaaaaaaarrrrrrrrrrrrrrrrrggggggggggggggggghhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhh!

there. done. sigh... study.

Thank God for good cooling weather today. :)

Before the 1st half ends.

it's the last day of O&G posting today. and i cant believe that wow time flew and i've gone through 2 postings already.

as i look back, i truly thank God for blessing me with smooth sailing postings and granting me what was the best to mold me / shape me in my education in the beginning of this clinical year.

i thank God for

1. having surgery as my 1st posting.

it was a stepping stone, a cushion where i could take time to adjust myself to clinical year lifestyle and schedules. although it was only in week 4 that i sort of started to get the hang of it, i had 4 more weeks to catch up on things.

balancing between the 101 different advice from seniors and friends, in the midst of confusion between 'u should stay in ur room the first few weeks and study 1st b4 going to the wards' and 'u should go to the wards everyday and learn from the patients. they are ur books.' and 'just clerk one case a day then go back study' etc.. it was pretty confusing trying to balance out between everything. whn in surgery u have clinics, wards, OT, teaching. u can do anything u want, anytime, at ur own expense.

clinical years throws u an 8 week syllabus at the beginning of ur posting, and its up to you how u wana finish studying / mastering all the 'must knows' etc by the end of it. gone are the days of scheduled day to day classes and lectures and syllabus. it's totally flexible and entirely up to you how you wana study.

you get reli lost in the beginning bcz u're overwhelmed by the 8 week workload thats thrown to you in the beginning. but as time passes and u slowly cover the syllabus bit by bit, the pressure wears off.

surgery posting was a platform for me to build up my confidence.

i thank God for

2. very nice supervisors.

Ms. Farrah and Mr. Azlan both gave teachings once a week throughout the posting, and were very approachable and friendly. it spared me brain cells needed to overcome intimidation and gave me more confidence.

3. O&G posting

being my 2nd posting gave me a 1 week's holiday in the middle of the posting. whr i could use the holidays to be oncall and finish up the deliveries i needed to conduct. phew no more oncalls after hari raya hols.

4. a great supervisor

whom i feared from week 1 and actually still to a certain extent until now but lesser hehe. Dr. Rahana was strict and i was really fearful of uttering silly things or asking silly questions or presenting horribly in front of her. and the fear made me study and study and study and gave me insomnia and drove me to maximum will to study even when my eyes wanted to shut themselves after 7pm at night. i would force my eyes to stay open and my brain to accept information and retire to bed thinking what i have not covered. n jump out of bed at 6am before my alarm even rang to run to ward to cover beds everyday for her ward rounds.

the fear was good. it pushed me to work hard.

waking up at 6am was good. it gives me an early head off start of the day.

ward rounds everyday was good. i had more chances to present cases and brush up my presentation skills.

4. for manageable cases to present.

case presentation was a bit rough here and there but still alright.

there was a time that the patient in the bed i was not covering , but i covered for fun bcz i was looking for a Placenta Previa case to present, suddenly appeared in the bed i was suppose to cover the next morning. so i didnt have to prepare anything much that morning, and just had a brief look at her updates. wow talk about miracles.

5. for my short case

under Prof Hatta. who was nice and very pleasant and helpful and that took away my nervousness.

6. for great groupmates.

both in surgery and O&G. i enjoyed the teamwork and in sharing the anxiety and fun together. i am grateful for the opportunity to get to noe my coursemates a lot better by being in the same group as them in these postings.

7. how could i forget? for finally understanding a childbirth's / labour pain.

i salute all mothers in this world. just looking at how much they suffer, the face of agony and nearly giving up when having contraction pain for 8 hours before delivering the baby is enough to make any teenager abstain from premarital sex. i tink? lol. the but yeah, it looks reli reli painful...! gosh, thank you mum..!

8. very helpful 5th year seniors

who are reli very competent and i reli look up to them. the way they carry themselves, the knowledge they have and the time that they're willing to spend to give out pointers and teach lost juniors.

9. very helpful coursemates

from the same posting who have helped me so much in sharing knowledge, opportunities, going through it together. for close friends in a different posting who gave me so much advice in going through the posting they have been through. wouldnt have made it without them.

thank God for bringing me through the first part of yr 3.

it's study week now and exams are in 1 week's time.

happy studying everyone! :)

after exams:

Bali trip! EAMSC paper! then Tanjung Karang..!

confidential?

i walked out of clinic day today feeling slightly bewildered over an uneasy patient encounter.

Miss A was a single 22 year old lady living with her parents. She has pseudocyosis (false pregnancy) and hepatomegaly (liver and spleen enlargement). She has an abdominal mass that has been increasing in size leading her to believe that she was pregnant. it was reli an incident of lots of coincidences bcz when she started missing her period, she was tested positive on the urine pregnancy test, scanned positive for pregnancy and had morning sickness of vomiting. and her abdomen has been increasing in size. and it was js not long after she had sexual intercourse. weirdly, she's been having intermittent pain n distension over the umbilical region over the past 2 years. the fact that she suspects herself to be pregnant and all the supporting facts were unknown to her parents and all the while they thought she was just suffering from the abdominal pain due to a complication from an appendisectomy 2 years ago.

she was accompanied by her mother to the clinic.

upon being interviewed by me in front of her mum before seeing the doctor, she did not disclose any facts about her suspecting herself to be pregnant. later her mum left us and twds the end of the clerking, i asked her the routine gynae question on whether she has had intercourse before. she replied yes. n i proceeded with routine ques of dyspareunia-pain/post coital bleed. and the history on her being positive on urine pregnancy test, the scan etc spilled out. n she told me her parents were unaware of all these. upon viewing the emergency unit admission clerking sheet i also thought it was reli weird for her to have a dating scan and positive urine pregnancy test and all that and proceed to enquire further about it.

i was wondering how i would present her history to the doctor in front of both her and her mum in the clinic later when it was her right to have all these information remaining confidential betwn doctor n patient.

in the end bcz her history was weird with the false postivie UPT and wrong scan done at GP and all that and the false pregnancy, i didnt get to present my case, but the doctor proceed to obtain history on her own. there was information on the false pregnancy blah on the admission clerking sheet at the emergency unit.

in the end obviously the mother found out she had intercourse before marriage, and her antenatal visits to the GP and all that.

even though she's 22 and working but it can be observed that she stil pretty much depends on her parents and are under their shadow. erm.

subsequent conversation proceed with the doctor discussing the case with the mother with occassional/very hardly references to the daughter. i was feeling very very uneasy at that point and wondering what was going to happen to the poor girl when they left the clinic.

i guess it was not going to be possible to keep the information from the mother as she had accompanied her daughter to the clinic. it was also probably safer for the mother to find out as she can advise her daughter about precautions drg intercourse etc. and the mother has the right to find out all these as her sole guardian.

but patient's confidentiality is also at question. the patient has the right to disclose all the above information to her mother herself instead of her mother finding out about it through the doctor. the patient has the right to have 1st hand discussion with the doctor instead of being just an occassional reference like a 3rd party. she has the right to obtain information on the risks of unprotected intercourse from the doctor without family intervention.

perhaps i'm not in the position to comment on this situation. sometime doctors cannot protect a patient's confidentiality if the patient themselves have brought their family members along with them to the check up. n in the clinic u have like 4 medical students tagging a doctor in a clinic, listening to every patient's details and management.

just felt reli bad for the girl. she was treated like a child and she was reli uneasy when being questioned about having SI and her reason for suspecting pregnancy. SI before marriage doesnt make u a criminal, but in Msian society you can get stigmatised quite badly and even be shunned by ur family. :(

Do we have enough safeguards to protect a patient's confidentiality? it's a two way thing i guess. it's the responsibility not of just the doctor but the patient herself. :S

on a brighter note, palpating an abdomen with polyhydramnios (excessive amniotic fluid) today has made my day. :) postive fluid thrill! blubb.

it didnt end just there. :P

i say, the belated bday girl is ecstatic she has these girls as housemates!

when the clock struck yes twenty two and the lizard ran down,

the poor door was hammered upon and voila~ bijoux cupcakes took the stage in front of my room. tho they were lit with medical students' pen torches (bcz the lighter was in my room). lol! so candle lighting ceremony commenced with pei sun's ringing laughter in the background :P

my mind instantly flashed back to the time we celebrated wendy's bday in 1st year by sticking the huge blackout wax candle decorated with sequins (w UHU glue) into a minuscule butter cupcake (the 1 that you buy 6 in 1 pack from the hostel cafe muahahah so she could light up n blow out her candle more than 10 times n it still doesnt finish melting)

- the huge pink ribbon pei sun inherited from her strawberry loving almighty make up council.

the Chillis runaway-to-san-francisco-steak-house-cz-Chilis-queue-too-damn-long-and-we-were-hungry ppl.

thank you Crazylife for being in my life and celebrating from afar.

the ancient 1st year freshie photo. with the awesome girls who drove with me ard cheras taking wrong turnings to get me to that-awesome-chinese-restaurant-with-crazily-juicy-prawns-that-i dunno-the-name.

Running out of ears already. :P

the youthful youths who never fail to surprise!

a gecko on a pencil from Faidhi. *pei sun screaming her lungs out*

maybe 1 day she wont detest the poor reptile so much. >8)

ok that ends my syok sendiri bday blog posts for this year. :P

O&G short case sumtime in the next 2 weeks!

managed to get a hand in doing a Pap smear today. hope i didnt ruin the sample. heh. thank you Dr. Pravin!

owh and on a random note, a socket burnt in my unit today. huge flash of light of fire n poof! smoke. time to buy a new extension cord.

Of 22 years.

Before the world began, you were on His mind.

God has a purpose for each n every one of us, even before we stepped into this world.

before the clock strikes 12 into my 22nd year in this world, i have received tons of surprises from my beloved friends, brothers n sisters and family. wow. in today's advancement all surprises come in advance as well. hehe.

just want to leave a note of appreciation to everyone who has dropped in a thought or two in making my 22nd another special one. i am truly blessed!

my church youth surprised me this morning by victimising me and karen who shares my bday to finish eating asam in 20 seconds, our taste buds screaming for their lives the whole way. n then gave us a lovely celebration.

tons of handprints w words of encouragement from my care group.

and lovely gifts. =) from Kai Xian and the life group.

a toucan of appreciation from the debaters. thank you Darryl!! >8) Arwk arwk!

i love the blingy ear rings from Cher.

and celebrated with beloved friends at San Francisco's Steak House few hours back.

n wow! a suplaise note by Kevin to surprise me with a surprise bday celeb asking me to invite my friends to join it. lol! >8D

thank you u guys for the handbag! :P

moving into another year makes me reflect more about my purpose in life and my role in the vision for God. knowing Him more, serving Him deeper and impacting His ppl more. He has been gracious and i pray i continue to experience Him each day.

looking forward to a joyful day tmr. good weather, minimal trauma and a fruitful day please! :)

How far does the barrier stretch?

on and off our brains get fired with ideas and our fingers fly to the keyboard to pen them all down and share them with the world.

the zing of thought can be a creative spark of idea to do or create something, a new discovery or a life philosophy that struck you. or it can be emotionally driven and u long to lament ur sorrows or tell the world you're on cloud nine that particular time.

but as the world becomes more liberalised and we're granted more freedom, rights and means to pen down our thoughts and ideas, there is still an area of restriction to say everything you want to say.

what you say can affect just 1 person, your small circle of friends, or spark a nationwide propaganda, or impact a whole race. you do not know how far your words spread and bring up a reaction to how many ppl the moment u click publish and share your ideas in the stream of digital media.

that said, it comes down to 2 main aspects. of why our words need to be restricted. its either about yourself, or the readers. on your part, its protection. protection against physical or literal attacks from ppl who either disagree with you, or are unaffected by your words but can potentially use your words against you. sometimes u need to protect your thoughts and not appear to be too transparent for the whole world to see. its called private / personal space. every individual defines his personal space and how much he wants to reveal to others. our words translate our personality, mindset and ideology. words however can be misunderstood or mean different things to different ppl. all the more the reason to speak wisely esp when writing on the cyberspace becomes a form of documentation hence proof of whatever you say. its hard to track back or reverse damages done.

the other aspect is of what readers feel and think about your words. the advantage of reading rather than listening is that readers get to digest the material, analyse and ponder upon ideas b4 generating a full blown reaction. not always. but stil happens. the churning of more and more ideas on the net which are pro democratic or liberal ideas tends to shift the world to that end of the spectrum as well. it doesnt have to be so big scaled. happens within a community as well. whn ppl started going green, reading loads of articles and pro-environment perspectives got ppl to be more environmental friendly. vocal speakers / persuasive writers impact the world with their words. words are enough to generate peer pressure to be pro- say..purple! sth as small as that. the idea of restricting what you write is to avoid generating negative impacts in certain groups of ppl (imagines little mine fields blowing up whn being stepped on in random places).

heck why am i writing all these. it just started from me being apprehensive about me being sucked into another emotional whirpool of feeling down, worried and sad but not wanting to vent it all out on my blog bcz i need to protect my personal space, myself and contemplating its effects on others reading about it.

how much of yourself you want to reveal to the world (yes practically the world) lies in your hands.

Erupting Wisdom

i'm currently suffering from an ulcer due to impaction of my right upper wisdom tooth onto the gum in the lower jaw.
to my utter surprise during my visit to the dentist 2 days ago, ALL four of my wisdom teeth have already fully erupted. am i that blur or plain ignorant? *hits forehead

have been thinking for the blissful past 3 years that none of them have erupted yet. not that it matters.

i have been left with absolutely no choice but to undergo a surgery to remove that ulcer-inducing-culprit as soon as possible after finishing the dose of antibiotics that will magically kill the bugs of highest evil that have caused me to suffer from pain drg swallowing, tender lymph nodes, chewing on one side of my mouth, drinking water like thr's no tomorrow and not being able to talk properly, hence silencing me to a 200 word per day quota for the past 3 days.

either the surgery, or to suffer from recurrent ulcers and the above in days to come.


in conjunction with my future wisdom tooth removal, i've set up a survey on wisdom tooth removal lol. do participate. :D


and on wondering WHY the tooth deserved such name, i googled and this is what i found:


the tooth erupts around 18-21 years of age, the age whr we are deemed 'mature', given the badge to walk into adulthood. hence earning all the priviledges that come together w it.

it differs slightly in other places:

Turkish refers directly to the age at which wisdom teeth appear and calls it 20 yaş dişi (20th year tooth).

In Korean, its name is Sa-rang-nee (사랑니, love teeth) referring to the young age and the pain of the first love.

In Japanese, its name is Oyashirazu (親知らず), literally meaning "unknown to the parents," from the idea that they erupt after a child has moved away.

The Indonesian term gigi bungsu for the last teeth a person cuts refers to bungsu, meaning "youngest child", because the teeth erupt so much later than the others, implying that the teeth are "younger" than the rest.

In Thailand, the wisdom tooth is described fan-khut (ฟันคุด) "huddling tooth" due to its shortage of space.



painfully interesting indeed.