Friday, September 21, 2012

A sip off the spoon in ObGyn.

What crosses your mind when you're thrown the word:

CONTRACEPTIVE PILL

Now we'd think: Preventing pregnancy!

For those who wana enjoy a sex life without worrying about the consequences of being impregnated. 

Now think about your ex classmate back in primary school who was the 5th sibling out of 8 children where brothers and sisters are on the average 1-2 years apart. 
The lady with 3 children all 1 year apart.
The 45 year old aunty who accidentally had a small cute baby when her next youngest child's already entering adolescence.
Someone you know who tried to abort her child upon finding out she's pregnant bcz she simply cannot afford to have a/another child.

Ahhhh.... family planning. :) The importance of it to 
- prevent urself from going crazy taking care of 3 toddlers at the same time while breastfeeding
- give some rest to your uterus after bearing a 2-3kg child for 9 months. 
- give yourself a break from carrying 2-3kgs with you everywhere.
- lower the risk of your baby suffering from syndromic illness due to pregnancy at an advanced age.
- prevent women from having to suffer from the physical and emotional trauma of illegal abortion (attempts). thank you Dr. Ting for the insight. i can't imagine how I could have completely missed out on this one. 
now of course ultimately it's so that your sex life doesn't come to a halt either. 

i'll just mention a few contraceptive options over here. for the benefit of single ladies, future mothers, friends who are mothers, people who love mothers, u get the point. :P 
just a disclaimer- i'm not trying to promote any1 of them or discuss the medical benefits and cons. just sharing some information i think would be useful.

The Pill - suitable only if you can commit yourself to popping a pill EVERYDAY. say if you're a really busy person, and u wana have a spacing of 3 years from ur last child, not a good option to think you're going to remember popping a pill every single day for the next 3 yrs. thr're other options for u. 

The Jab - it's 3 monthly. called Depo-Provera. however it's known to disrupt your menses and cause continuous spotting.

The Under the skin rod - Called Implanon. very convenient. it's a tiny rod like 4cm long, 1mm diameter inserted under your skin under ur arm. it works for 3 years. u can come to the clinic, get it inserted in 5 minutes, and forget about it for the next 3 years. instantly protects you from conception. but costs few hundred ringgit.

The intrauterine implant - There's one made of copper, lasts 2-3 years, about rm35. side effect, causes irregular bleeding (menses). Another one called Mirena, is sort of a plastic-ky material, works for 5 years, has an added benefit of thinning your uterus tissue lining and preventing endometrial cancer. costs about rm500+.  Intrauterine implants are also useful cz u can have them inserted in a clinic in just about 10-15 minutes and forget about it. 

The Vaginal Ring - it can be self inserted for 3 weeks and removed for 1 week every month. unsure about the price though.

of course there's the use of condoms / timing ur period. but that provides less of a guarantee. haha condom salespersons might beg to differ. but that's the general opinion. 

What's this got to do with me?

It's my duty as a future doctor who might see any woman in the clinic / hospital to counsel them about the importance of having family planning and guiding them in choosing the most suitable contraceptive method for themselves. the problem that arises esp in our country is the association of contraceptions with immoral activities. lol. not true! the ultimate goal is to see every woman in this country getting pregnant only when she can afford to and when she wants to. Quoting my Prof, women should enjoy their pregnancy. it shouldn't be a chore. our government hospitals subsidises contraceptions! it's a shame to not have them advocated to our women out there. 

Plan mothers, plan! Empower yourselves! :D

*most ppl are afraid of contraceptives because they're worried of the side effects. contrary to that, side effects are actually really minimal. benefits outweigh them. contraceptives, depending on the type you choose can lower your risk for certain cancers, fibroids, regulate your menses well, clear your acne etc. :)

Ironically, the very next day after my class/workshop on contraception, we had a lecture on Infertility. What a stark contrast! At the very end of the spectrum of women with too many children, you have the couple who's spending a fortune to have their own child. Nothing beats having a child of your own flesh and blood I suppose. (Honestly, after attaching at the labour room and watching the child delivery process, I am freaking scared to get pregnant and deliver my own child. cannot imagine myself going through all that pain!!! (and being screamed at by (well meaning i know) midwives and doctors who wana get my baby out safely)) Thank my mum deep down from the bottom of my heart for going through labour pain for me. If you're wondering what's the ultimate solution to get sexually driven teenagers to sexually abstain, get them to watch a baby delivery.
errr.... enough about sex lol. 

Upon entering the obs and gynae posting 3 weeks back, I was thinking, nyeh... healthy pregnant mothers, palpating abdomens, feeling for fetal parts, fibroids... not my cup of tea. where is the essence of o&g?? why do people love this posting? how do i empathize with healthy ppl??

i guess i got my answer. Seeing Prof Har's passion in empowering women on family planning, another lecturer's passion in helping ppl get their own child, helping parents bring another life into the world - Safely, that kinda motivates and drives a sterling passion. (still not really my cup of tea, hehe, but i guess i appreciate this section of medicine more now)

On a different side, the past week has thought me something. I saw doctors who love teaching their subordinates because they believe in creating better doctors in each individual. I saw doctors and nurses who really care and advocate great practical advice to their patients. I saw people talking down and being nasty to those under them simply because they can. I saw the uncaring shouting and yelling threateningly at patients because they were screaming in pain. (not just the typical yelling at the patient to encourage her to bear down and push the baby out kinda yelling. like totally out of this world yelling with the 'shut up or i'll kill you' glare. :S)

and I know what kind of person I want to be. and what kind I don't want to end up as. and mentally prepare me for the types of people i'm bound to meet in future in my workplace. Competency is still the best policy. that said, my inherent fear for scary evil people needs to be overcome. and creating opportunities for myself to learn. at the current time, the 'i'm just a medical student so what I say might not be entirely accurate' immunity is still there to sorta save me. but it'll only last as long as up to next april -hopefully not longer come to think of it.

In Teluk Intan this weekend. Oh how I love the laid back atmosphere over here. :) (though thr is a tingling longing to go back to kl)
 teluk intan's mee rebus from a Chinese stall. nice :)
 went for ikan pari bakar last night near the jetty. tasty. but had expected it to be better. :P 
sent my brother off at the airport last wkend. see you in a year! :) sobs :( :) 

time to complete the case write up! 

EMSians, how i wish i'm at preaching camp!

Last but not least, Dear Jie, Happy Birthday to you for yesterday! :P

Wednesday, August 29, 2012

The Child In Me

I'm not pregnant.

Excuse the pun :P

Being thrown into a world or rather a ward of kids lets you act like a kid. :P
it's part of the reason I enjoyed the past 7 weeks in Peads. getting in touch with your childhood memories - don't rmb many details, but i rmb they were happy days. bits and pieces i recall are playing lego, hopscotch, rubber band skipping ropes and dancing rock n roll in a kindi graduation concert. (i seriously still dunno if that was a dream or for real cz i cant remember practising for it. a life mystery that will remain unsolved) 

I forgot how smart kids were. totally underestimated the intelligence of 6 year olds. I couldnt remember being that smart last time. we went to organise a Road Safety programme for the kids in one of the kindergartens in town yesterday and the kids like got all the answers correct. maybe kids today are smarter. xD
photo by Khai Pin

It also lets you dwell into the world of parents from different backgrounds with children with different conditions. 
The working parent who has to take nearly a week off work to stay in the hospital with her child with pneumonia
The parent in the state of shock after witnessing her child fitting
The parent who's willing to share her life experience in caring for her child with cerebral palsy
The parent who took a month off her job to transfer from JB to KL, staying in the hosp for that entire month bcz her child needed a surgery here. 
The hostile parent who doesn't let you lay a finger on her child - okla not hostile. protective may be a more accurate word. hehe. 
The parent who's poverty stricken and cannot afford to feed her child --> malnutrition
The parent who's a foreigner and can't afford to pay the costly medical fees for his child's serious medical illness.
The parent with social problems that affects her parenting ability.
The parent who's child was fine for the past 11 years but one fine day became paralysed and bed bound.
The abandon child from the orphanage who's development is delayed.
The unsuspecting parent whose child came in with joint pain and is devastated by the child's diagnosis of leukemia.

Other than the medical aspect, there're different issues to be dealt with in each case to ensure the child goes home safe and well. Treating the children came together with taking care of their parents and their environment.

Makes me reflect on all the sacrifices my parents made for me in the past. and even up to now. aww thanks mum and dad! :)

Kids in the ward get loads of gifts drg the bulan Ramadan before Raya, including this Tickle Me Elmo! (borrowed it for phototaking. but honestly, was really tempted to secretly bring one back home xP)

I mentioned about being captured by children innocence on facebook yesterday after the trip to the kindergarten. Darn! Those kids are so cute! 
When you ask, who wants to volunteer to come up sing a song? 
you get, Me Me Me!!! Pick me!!!
So i wondered where all the enthusiasm and liveliness in me dissipated to over the past 23 years of my life. :P there will be no place other than the kindergarten and maybe lower primary school where you'll witness this kind of enthusiasm in humans. at least that's what i think. 
when you ask, who's got a red car at home? a black car? a white car?
They run up to you and tell you, 'I got a black and red car.' Next child,'Mine is purple and white.' 'I got a motorcycle at home.' like with eagerness and happiness when you tell them Ooooh that's great! 
*omg so cute can die* *squeee*
And you can tell them anything and they'll believe you. grins...

though of course there are tough times when irritable children refuse to let you go near them and cry the minute they see you approaching. *faints*

wana get in touch with ur childhood days? visit a kindergarten one day. :P (though I did not think I could survive working in a kindergarten more than a day. too much energy needed)

Some toy vehicles we made for the kids for a road traffic simulation. credits to Khai Pin the man behind the cars.


Dropped by for Jalan Ampang's Yong Tau Fu after an exciting but energy draining session with the kids. 


My peads posting groupmates -1 person missing- and our lecturer Dr Juriza. a very patient and super awesome Dr. i love her sense of humour.

Managed to catch Cher and Mar-jie over the weekend before going home. :)

And run home for a week during the last Raya break. great time catching up with the family and friends. :)

Meanwhile, stress levels are mounting with unfinished studying from peads and the coming ObsGyn posting. gotta remember to stop acting like a kid from now. aww man... hello to chronic adrenaline rush!!

Friday, July 20, 2012

Teluk Intan

Clear traffic, kopitiam within 5 minutes drive, largest mall being the Giant supermart.
It's a sweet sweet place called Teluk Intan where I was posted at for the past 2 weeks in the Peads Dept. 

Things that I found really warm and beautiful in this small town was the obvious slow down in the pace of life,  cars driving on the roads at leisurely pace, very approachable people and doctors who care about the patients social needs. 

we were asking a random uncle at a kopitiam we were eating at on places to go for nice chinese food around town. he didnt just give us directions. he walked my friend out to the street to show him the direction. and a friendly lady at a drinks stall at the hawker centre chatted with us about Ice Age and how she really enjoyed the hillarious cartoon and showed us the way to the cinema. 

it's a really homely feel. i think even back in kuching now these kind of friendly conversations with random people in kopitiams are deficient. 

didnt forget to stop by for some Teluk Intan Chee Cheong Fun, get some Heong Peng (some kinda caramelised puff) and snap a photo in front of the leaning tower. :P 

Parents here are very willing to talk to us medical students and allow their child to be examined. and the specialists are very willing to teach and are nice and approachable. The environment is great and no doubt the lack of entertainment makes it a good place to settle down and hit the books. 

I'm missing that place already. Back in KL, time to hit the wards here!

Group photo from the previous ppd camp. privileged to get a very nice and approachable facillitator, Dr. Kong Wei Yen. 

The 1st hour of camp. Anticipating internet withdrawal symptoms for the next few days in camp cz no reception found in the jungle.

In teluk intan with my dear roomie, Michelle :D In front of the leaning tower.

The leaning tower in its majesty :P (it doesnt look like it's leaning from this angle tho hehe)

Thursday, June 28, 2012

It's a Learning Curve.

It just crossed my mind how the term Learning Curve came about. (thanks for the correction juin yi :P) its an uphill journey, steeper for some, more gradual for the rest, and I'd say mine was just somewhere in between. but probably more of a gradual progressing to steep curve instead of a steep then plateau curve.

our 1 year research project has come to an end. this might sound like my ppd reflective writing haha, but well yeah i did really pick up a lot throughout the 1 year.

I'd learn to work with and grow with a group of coursemates whom i had never had the chance to really work with closely before. Every person was different. every past group work was different. this was the group that bonded through humour and had a strong spirit of give and take. not calculative, accepting and forgiving to my weaknesses and intermittent blur-ness. i admit i wasn't the best of a leader, there are times i procrastinated, gave them last minute notices, made mistakes. but they were accomodating. in the same way, i learnt to give and take, to love ppl for their strengths and weaknesses.

I used to be individualistic in completing work or projects. I relied a lot on myself. But this was one project i couldn't do on my own. it required a lot of labour. telephone interviews, tracing blood profiles, etc. hvg group mates spurred more motivation. n bcz i was the leader, i was forced to make decisions and set targets for the group. some to the point of procrastination xP, but got it done.

last but not least was God's grace. when things looked impossible, unexpected favours enabled us. when things were going fine, or so we thought, we were able to meet the statistician, discover mistakes in our data analysis and make corrections at quite the last hour.

there were ups and downs. but i'm glad we made it. :) most of all, I gotta thank our supervisor Prof Shahrir for the guidance throughout.

our dear poster, Jeans, me, Nashrah and Hafiz
MUASRM's abstract book. an awesome design to infinity :) by kevin tan
the abstract

Looking forward to starting the postings! Gonna begin with Peads! (after a week of camp in the jungle devoid of internet connection and phone line woots) :P

Friday, June 1, 2012

Living By Faith and Sight

Every person you come across in your life leaves an imprint. whether its a tiny trace of aura or a huge footprint stamped onto ur shoes, or face, there's something. Recently I parted ways with a dear friend of mine as she flew back home to Kuching. She was very special. Through her I learnt to love unconditionally. I learnt to appreciate sight. I valued more the words Live by Faith Not By Sight.

most of us live by sight. it gives us security. we recognise where we are, who we're with, enable us to protect ourselves when we spot suspicious weirdos on the streets, venture onto unfamiliar ground with a sense of liberation and control. Now what if we had no sight. Just imagine if one day, we were to be robbed of our sight by a catastrophe, a disease, something least expected. Now that would be a shocking test of faith. Without sight, you'd realise you have no choice but to trust others. those around you, people on the streets (though to an extent not evil random strangers), most importantly God. as of now, we can't see God, but we feel Him. sight kinda distracts us from this abstract thing called faith. not sight literally. but what we can predict and control. but how about things we cannot control? we say, now let's hope for the best and see what happens. that's the usual case :) do we have the faith to believe that we will be delivered? Do we truly trust our almighty Father?

Faith is in fact a much bigger test without literal sight. when we meet blind people on the roads, what comes to our mind is, blind people find difficulty in travelling because they cant see where they're going. now it extends to more than just that. (read on if u're interested) try blindfolding yourself for 5 minutes. oops. can't remember where I put that book I just read, my keys, phone, purse. What colour is this shirt I'm holding. would it match the colour of this skirt. is my hair out of place? where did i put my bag? what food is there in front of me. how do i pack a luggage. how do i take hot water without being scalded. can i turn on the fire on the stove and cook without injuring myself. did i just ruin that shirt i ironed. what do i do with that dead insect in front of me (seriously). i can't imagine clearing up a dead cockroach without sight. :S yeah. just an illustration. lots of memory space to remember where you had put every single thing and how something feels like so that you can recognise it again when you touch it later. but that's mostly daily menial things that we do. those are important. but they're other things far more important. I think if we'd reach the stage where we can get past that (difficulty of doing the menial tasks and stuffs without seeing), I think we'd have a levelled up faith. *level up! Beep!* :P

so where was I? ah yes faith. Faith in those around you to guide you and lead you to safety. For us, faith that ppl we trust and love will give us advice in making good decisions and put up with our everything. Faith in God? in everything ultimately. do we have enough of it. something to think about. :)

He replied, "Because you have so little faith. I tell you the truth, if you have faith as small as a mustard seed, you can say to this mountain, 'Move from here to there' and it will move. Nothing will be impossible for you." Matthew 17:20
Have a faith filled week everyone :)

Monday, May 21, 2012

Awareness. Rather, the lack of it.

Awareness is something that gains you insight. It changes your mind, deepens your understanding and prevents you from embarrassment or making out-of-this-world remarks. No kidding.

Lately I had a personal encounter with a person (given the benefit of the doubt) who lacked awareness. And obvious tactfulness. either that or he was really evil in nature. lol.

I was having lunch with a friend who is blind. 100% loss of vision. so something startled her in the coffeeshop and she was afraid and clutched my hand. something along that line. and this dude sitting next to our table, looked at me in the eye and asked 'Is he toothpick?'  i was like ...??? Sorry??? he repeated it like 5 times. forgive me. his pronunciation was really hard to comprehend. finally i got what he was saying. he said 'Is she stupid'. 

can u believe your ears? even if he was dumb enough to think so, it was utterly unacceptable that he asked me that.

i retorted NO SHE'S NOT and ignored him. I mean a person this ignorant and blunt (saying he's blunt is giving him a MOUNTAIN of benefit of the doubt that he didn't mean to be rude) isn't worth the time explaining to or giving a response to. 

now lets look at the situation. there are two possibilities.
a) He really didn't know she was blind and might have meant mentally handicapped but didnt know how to phrase it so he used the word stupid. he might have thought the word stupid is acceptable bcz (now this part of reasoning is really hard) bcz.. er... in his upbringing he uses the word stupid like saying hello or bye to his friends. 


in this case, he stone cold lacks awareness.
1) how do u recognise blind people?
2) what are their needs?
3) how do you help without causing more trouble?
4) what does it mean to be mentally handicapped?
5) how to greet people without getting beaten up.

Interestingly, I learnt a little about how to help the blind without causing more chaos on that day n thought it'd be helpful to share it here.

1. if u wana lead them to cross roads or to navigate them to places, they usually hold the white cane in their right hand. so take them by their left forearm (upper arm). 
note: left. and upper arm. cz they tend to feel insecure if u hold their hand (as in the lower arm/palm/fingers) cz they need to feel/sense ur body movement as u walk to get a sense of direction.

2. if due to religious hindrances u cant hold a girl's arm, u can just lightly put her left hand on ur shoulder. do not, hold the end of her white cane. xD (has happened)

3. after crossing the road or leading them to a place, let them know that they have crossed and where they are (direction wise), and whether there's drain or steps in front. do not just say You're Welcome and walk away leaving them clueless to where they are.

4. if u see any of them trying to hail a cab, take some time to help them stop the cab and get in. cz roads tend to be busy n noisy so they cant sense whether a cab has stopped in front of them n they dont know where the cab door is.

5. u dont hav2 carry him/her into the cab (true story no kidding some1 has tried doing that b4 xD) what we can do it open the cab door and put his hand at the edge of the door. try to preserve their self dignity by letting them do what they're able to do. :)

6. if u're having a meal with them, let them know where their eating utensils n cup are. indicate positions using the clock system. eg. there's fish at 9 o clock of ur plate, veg at 2 o clock. etc. 



The blind can sms and facebook too. pretty cool right. :)

this post has gone on to a bright side that i dun wana talk about that weird dude anymore. lol. 
b) is suppose to be that he was inherently a mean person and just asked that question to provoke me. which in this case i'm not even going to waste my time acknowledging his presence. there were hurtful words -my friend heard it. 

so yeah, awareness is important. i was amazed at how blind ppl today are so empowered, motivated and  leading successful lives in society. u think u're unlucky? try blindfolding urself (no peeping! :P) and live for a day. u wouldnt, i wouldnt survive 5 minutes. i'm filled with so much respect and awe for them. 

if u would like to volunteer and wonder how u can help, u can approach the MAB (Msian Association for the Blind) and give ur time to help turn ordinary books into Braille by reading/typing. 

have a great day ahead folks! :)

Friday, May 4, 2012

Peter

Reading the book of 1 Peter, I realised that Peter had a good hand in writing gentle words of wisdom and advice! The entire book encourages the people, advises people on ways of living and when u read it, u just feel his spirit of gentleness washing over you. you just feel as if it was a grandpa or elder sitting down and giving you those wise words that yield with it so much strength and love. *awe*

Sidetracking a little, I wonder how it's like to have cute grandparents sitting in a rocking chair (ok a one too many of the Grimm brothers fairy tales or cartoons) or baking cookies and knitting not by a fireplace xP

pictures.net
my grandparents passed away young and my oldest grandpa who was in Penang lived up to when i was 6 or 8 (sorry was young and was pretty confused) though i have the sweet privilege of having a very loving lady of currently, 81 who is just like a grandmum to me. she was my babysitter, not my baby's sitter teehee, she was the sitter when i was the baby. ok hehe slight confusion? aside, (yikes punctuation fail) i grew up communicating in english from my pre-pre-school days bcz she spoke to us little kids in english. at home, my parents tried training us to speak Mandarin but me answered them in english every time they spoke to me in mandarin. oooookay sidetracked way too much. *slaps forehead.

Getting back, I look at the Bible in a different light now. If previously I had thought of it as a serious formal compilation of scripture -hehe well yeah it still definitely is one- , I now look at it as a book of life experiences of different people being shared to us. you can feel the Author of each book telling you his story as he journeyed along time. and each author had different characteristics, personality and style of story telling. like. ain't that awesome :D

Curiosity burning. I'm wondering, what was Peter's background. *Google! 

Peter and his brother, Andrew were fishermen. He was described as a slow learner, but when given responsibility is mature and capable. He was the spokesperson among the 12 disciples of Jesus. It's interesting that, whenever there was a list of the disciples, Peter's name always was the first.

The famous stories of Peter are when he walked on water but sank when he lost faith (Matt 14:28-31)

and his denial of Jesus three times when Jesus was being captured (Matt 26:75)
Peter was the first man (after the 2 women) that Jesus appeared to after Jesus ressurected. :)

He went on to preach the Gospel and performed many miracles in the name of Jesus. He was famous for preaching at Pentecost. you can refer to this link for more on Peter http://www.bible-people.info/Peter.htm 

Interesting :)
I'll end here with a word from Peter (1 Peter 3:8). Such gentle words.