Orstory 2

Hello assalamualaikum...

Today i was incharge pm referral. And my team is active for today. Means we should have 2 pm today. 1 cover for referral and another one will cover obay (obay tu mmg wajib everyday laa). Total referral today 3. And after sb miss nadiah, 1 discharge ortho. So hectic today because initially i have to round ccu then go cicu then go temenggung and finally go back to ccu to find this 1 pt and he was discharge 😂😅

After passing over the referral to ON person, i prepare to chow initially. But then miss nadiah and mr sobri start round at 2030H. Out of 4, 3 was clerked by me. So for sure i should be there because the other dont know the case. Round finished at almost 2200H.

Dr faris n dr rahman (mos) invited miss nadiah and us for dinner. And i just know that tonight is the last oncall for miss nadiah. She will continue her duty in QE. She is very nice. Soft spoken and teach us a lot. And the best part is she will treat us dinner tonight. 🤗😛

So we went to Puyuh (that is my first time hearing the name of this kedai). Dr faris seems like regular there order 11 puyuhs. 5 for masak halia and another 5 for masak pepper. Nice laaa. I may bring my family having dinner there after this 😘

Went back home almost 2330H.
Hectic but meaningful day.

Orstory 1

Hai assalamualaikum.

Being in ortho 3 weeks++. But still anatomy ke laut, apatah lagi knowledge2 lain. Still banyak benda lagi nak kena baca and recall balik. Sadly enough di sini masing2 saling berharap antara satu sama lain last2 habuk pun tak jalan. 

Then alkisah satu hari tu aku gatal tgn tolong forward update ke group boss. And guess what did i got.

Specifically he write my name 😢

I just helping my collegue. And this is what i get. Like OMG. Since then, if im not incharge, i will never meddle in laa. Hmm.

And last 2 night, i was oncall incharge OBAY. And it was really sejuk beku. Last clerking kul 2030H and its pm person. Sleep well bedsore grade V laa. Exposed bone. Hahaha. 

Flashback drama 1

Misi2 dan beberapa rakan sekerja sibuk berbisik2 di belakang. Waktu itu semua sedang fokus kepada round di kubikel empat ward m. F dan A keluar. Aku tidak menghiraukan mereka dan terus mengikuti round. Tiba2 mereka memanggil aku kerana semua pt yang aku review telah dilihat oleh MO. 

Masuklah aku ke bilik isolation menjadi chaperon kepada mereka berdua. There was a thin teenage girl with gloomy face and i could say she just stop crying. Both of them was taking history from her.

Then the brief me she was a victim of rape. Being raped by her datuk saudara 45 years old single, and all family members didn't believe her. Her grandmother even threatened to hit her if she told anyone about this incidence. 

But i salute her courage. She then called her friend asked for help. And lucky enough she has abrilliant friend who asked her to call police.  She then was brought by police to hospital for protection.

Really her datuk saudara tu teruk sangat. That girl is relly innocent. And i hope she will be okay after this. 

She was staying with her grandmother after her parents divorce. I really hope she will accept that incidence as ujian untuk dia and will be much more better after this.

Last drama

Thanks God. I passed viva O+G.

Being in o+g means a lot. This department taught me how to be confidence, why you should well equipped with knowledge.

Viva obstetrics with dr Salwana. At first she threatened to fail all of us as we all not fully prepared. But then she gave us another chance. And alhamdulillah we all passed.
She asked about gestational hypertension, breech, shoulder dystocia, GDM and case scenario regarding all these topics.

I saluted her laa. While waiting us, she is reading ten teachers. OMG.

then gynae viva with dr wan zahanim. She asked about ddx of acute abdomen and PV bleeding. Also she gave us case scenario and we have to answer from diagnosis till management. She also asked about ERPOC ant instrument relating to ERPOC.

And my last oncall with Dr Aina and Dr Izati. Thanks goodness. All is well and that the most enjoyable oncall in O+G.

Really now im in ortho but still cannot move on with O+G

Drama 8

What ever it takes, remember God is watching you. Cleanse your heart from hatred, sadness, angry or any bad feeling. I know its difficult but please try. Yess please try. It's not easy but still you need to try. God please help me.

Its almost 3 months in o+g yet i feel like more than 3 years. Persistently struggled in this deparment yet still not doing so good. So i let it just be what it will be. I'm trying so hard really. Being so demotivated in this department.

Drama 7

Assalamualaikum..

This is suka2 entry. Random thought. About current situation. About people. About babies.

Now i was assigned in ward mawar, general gynae team. My boss dr aida, nashreen and nik unaizah. Dr nik unaizah is a very gentle and caring one. Humble. And today dr aida told us that she will come after praying solat duha. Respect her. No wonder hati sejuk when seeing her face.

Very contradict with z. Yeah i respect him as a boss. But once you downgrade people, i lost my respect. For me once you downgrade people means you think you are better than them. And your opinion sometimes is not really right i think.

But actually i want to tell how happy am i to be in mawar with my crush, z**i*. Hahahaha. No laa just kidding. Terpinga2 lagi nk clerk new case. Huhuhu

Hope will enjoy being here. May Allah bless

Drama 6

Assalamualaikum..

Reminder of today conversation.
Patient has active complaint. While reviewing her and doing time contraction, she told (whispering actually) me.
Pt: dr, kat ward ni ramai betul yang tak solat.
Me: ye ke? X perasan laa pulak. Kak ajak laa mereka solat.
Pt: saya dah ajak tp diorang tak nak.
Me:... spechless... kak ajak je. Diorang nak ke tak tu lain kira. *dlm hati rasa bersalah. Jarang betul aku tanya patient solat ke tak
Pt: waktu saya masuk wad 2*, misi2 dia tolong kejut patient ajak gi solat. Kt sini misi tak ajak ye
Me: ...spechless again.... sini wad besar x sempat kot diorang nak tanya
*she asked me whether i'm married or not. I told her that i'm not. She told me she is isma person. Many guys in there. I just keep silent. Shy shy cat weyh.  Then when she saw no respond feom me, she did pray so that i will marry to pious man. So i only said ameen without looking up. Shy shy cat. HAHAHAHA. Padahal masa tau oc belakang with z***n tu menjerit suka. Bila dia tolong kau suture dlm hati berbunga2. Mengada betul hati ni.

Conclusion: we are trying to treat external disease of patient but seldom healed their internal problem and faith. Even asking them about their prayer also seem small matter but it is not because prayer is pillar of our religion

Drama 5

Hai assalamualaikum. Hari ni saya tulis dgn air mata ye. 

Semua orang takut dgn dr f n kak i. Aku pun. Pagi tu kami wad 25 kena round dgn 2 org ni. Omg sgt berdebar. Fortunately the round was smooth. We only has 1 pt suitable for discharge. So my friend key in her data and i do her pnr. And here started the end of my happiness in ong. The suture was very bad. Sorry to say lah. And i saw 1 suture tercabut but no active bleeding. So i call kak i and told her about it. Then she said u suture laa. I dont know how and where to start it. And sister ward maybe she pitied me call mo that doing that suture. When kak i know about it memang mengamuklah dia. She said "its like you are so ***** even mo from other ward need to come to cover your work. Are you mad if someone do it for you? You are a doctor so you should be confidence. No benefits if you have mbba but acted like sn." Ohh i forgot to quote her words on phone "if dr s******* told me there is no problem i will make sure you will be extended"

That was hell afterwards. I lost all my confidences. Seriously and no joking. Im crying right now. Yeah but after all i remember God is stronger than her word. So then i could stop crying. 

Literally after that many words hurt my feeling but i let it go. Like can you stop smiling its disgusting to see you smile. Okay then i will not smile and even look at you after this. 

One night, have to do on night with dr F and boss M. I like doing round with dr F. Yeah she scary but she marah at right place and encourage you after that. Really i like her actually. She then said that  i stayed at her ward in very short time and she still not teach me well. I was like, 3 weeks is enough dr. I had have enough. Mentally tortured and demotivated to go to work. Really its not a joke.

I hope to see myself improve after this. Really. Kak i taught me a lot but in a harsh way. Thanks to her and dr F, now i not really into ong. HAHAHA. Its not i hate ong but i hate its environment.

Drama 3 labour room

Drama 3.

In charge belakang today. I wear red today. Dr a mengeluh why did u wear red? I said "i'm not oncall today. Hihi." She replied "but you will bring kejonahan." Initially okay. All patients look stable. Then satu lepas tu satu lagi. Then satu lagi sampai tak terkira berapa emlscs hari ni. Yang paling best witness dcda twin delivery. Tak sempat nak buat transfer in review. Dr momo baru selesai scan patient. Tak sempat letak ctg, patient complain of bearing down. Wow! Just wow. Set baru nak buka patient dah start bearing down. Dah la scan shows cephalic breech agak mendebarkan sebenarnya. Alhamdulillah selamat svd both twins,cephalic-cephalic. First baby 2.0 kg and 2nd baby 1.66 kg. And i brought them to resuscitation room. They are tiny yet very tough.
.
Mother multipara g8p7 at 39 weekers. Ctg poor tracing maybe due to maternal obesity jugak. Nak insert internal ctg. Patient very tak cooperative. Minta supaya caeser. Cakap you are not indicated for c-sec. Still nak jugak caeser. Cakap apapun skrg anak tak tau apa jadi sebab tak dapat baca jantung baru laa izinkan untuk internal ctg. Able undergoing svd but complicated with snap cord. Pity her. Memang masuk ot for mrp. Adoi. Tu laa nak beranak, kena kuat semangat. Plus doa yang tidak putus-putus walaupun harapan nampak tipis.
.
Primid at 23 weekers presented with painless pv bleed. Per speculum os opened. Initially treated as threatened miscarriage. T/o to labour room due to os fully. Fetal heart still present. Seeing her crying while talking to the baby really give me heartache. Ohh really hate this situation. Baby may not survive as organ not fullh developed. Nangis jauh2.
.
Referred case from district hospital for prolonged 2nd stage delivery. Ni cerita sadis side aku. Huhuhu. After finishing all pnr and referral paeds, went to pantry to grab some food. Starving kot! Didnt eat anything since morning. Then  after eating just coming out from pantry, sn point me to take blood for this patient. Me in my heart "where are oncall people. Oready 6pm kot." But i just smile and take the blood. Then after finishing took blood, i heard mo shout to run cord vbg. Okay, someone volunteer. Then i dont know what he did to abg machine, unable to run there. Omg he asked me to run on his behalf in view of he is oncall pac, need to clerk new case. Omg! Rasa nak hempuk je mesin abg tu kat kepala dia. So i went to nicu lah to run abg 🙁
Ni kisah yang menarik. Ada lagi tapi tak anticipate so tak boleh nak cerita. Hihi
.
Punch out laa pukul 6.30pm jugak hari ni. HUHUHUHU. Kpi lari target 5.30pm or at least 6 pm.
.
Moga Allah redha

Drama 2

Last night was my first oncall in o+g. Oncall with senior baik kak aindah, dgn dr shazreen, dr miji, dr nash. Pukul 7 red alert. Okay setel kes sampai kul 9. Pt primid chronic hpt with severe pe. Develop eclampsia. Berdebar siot. Pt fitting kau blank. Okay ingat ni step dia.

1st call mo and activate red alert. In my hospital red alert tekan 2222. 2nd dilute mgso4 siap2 both bolus and infusion. Bolus ambil 8cc dilute in 12cc normal saline give slow bolus about 20min. Infusion ambil 40 cc dilute in 10cc ns. Give 5cc/h=1g/h. Give patient airway and high flow mask O2. Then prepare brg2 for intubation. In this case bp slightly hivh so prepare bolus iv labetalol 10mg stat. Take pe profilen coag. Prepare us scan. To look for placenta abruptio. Prepare ceaserian trolley. Pt may need emlscs. Insert cbd. Pt on mgso4 skrg urine output wajib monitor. Refer paeds for eclampsia mother.

Ni mcm kali ketiga jumpa kes mcm ni. Klu x reti jugak lps ni mmg bengap tahap z laa kau ni izzah. 1st simulation. 2nd time 1st day tagging. Ni time oncall first.

No interesting case to share last night. Just as a reminder. Once pt had molar pregnancy, please counsel them betul2 regardless you duduk di department mana pun. Sbb smlm ad satu case h/o molar pregnancy. Tak tau pun dia x sepatutnya mengandung lagi. And defaulted follow up. Satu lg pt masa di medical dtg dgn anemic symptoms. And how shock when i saw her xray. Cannonball lesion. Asked about past history then her husband told she had h/o molar pregnancy and defaulted follow up after 6 months. Anemic symptoms laa hb masa tu 4 je. Severe pallor. Terus laa suspect choriocarcinoma. Masa tu mengeluh haih kenapa masuk medical. Should be in o+g laa. But then o+g accepted that case.

Teamwork! O+g best klu you have a good team who x kisah kerja org lain pun dia tolong when was asked for help. Tapi kalau dapat team yang s*** selfish memang merana. Quote bos miji "ho nowadays, mo tak tidur, ho yang masuk tidur". Terkena batang hidung sendiri la sbb aku antara yg terlentok kt sofa masa tu.

Drama 1

Drama 1
O+G

Dr f: Izzah, awk free x?
Me: emm knp dr?
Dr f: tlg sy cucuk.
Me: ok. Pt mana
Dr f: cucuk sy laa. I kena gastric tlg inject ranitidine
*dr faizah prepare her meds herself. Me berdebar. Nasib baik her vein obvious
Dr f: ni la masanya awk nk balas dendam kt i
*lps inject ubat dia jd pening and berpeluh. Apakah aku tersalah buat apa2. Huhuhu. Then round satu pt dgn dia. Aku tulis ringkas sbb dh tulis panjang before that.
Dr f: awk ni suka sgt dgr suara i membebel. Td rasanya dh bg suruh balas dendam.
😂

Then before balik tiba2 dipanggil untuk conduct delivery. Padahal org oncall ad je kt situ. Adoiii!😑

Renungan

Assalamualaikum

Wahai yang bernama makhluk
Bangkitmu kali pertama untuk apa
Sedarkah kamu apa perananmu di sini
Apa bakti kamu pada kedua orang tuamu
Apa bakti kamu pada keluargamu
Apa bakti kamu pada masyarakatmu
Apa bakti kamu pada negaramu
Dan yang paling utama
Apa bakti kamu pada agamamu

Andai hayatmu suadah habis
Satu soalan ingin kutanyakan
Siapkah kamu untuk bangkit kali kedua

Medical posting dalam kenangan

Assalamualaikum. Alhamdulillah atas kurniaMu. Terima kasih atas segala kasih sayangMu.

My life in medical.

Starting medical posting on 1st feb 2018. My first ward is Bendahara. There are a lot of things i learned there. Specialist in charge are dr azimah and dr then. Mo in charge are dr amalina, dr phong n im not sure who in charge in the cub 3 and 4. Then during 1 month assessment i got c in all penilaian. So sad.

My second ward then is 8/8p. Still blur but here i learned a lot. My specialist there, dr hng and dr gayathri are daebak. Yeah its scary to do round with dr gaya but she made us houseman to think. Here my sad story begun. I know i will remember it so i will not mention it here. Just want to list the name of them. Dr ng yj, dr grace and dr adli. Then dr asiah, dr anila and dr azerin. My luck willbe with male dr laa i dont know why😪

My third ward was mahsuri. Here i learned from dr ong. More about cardio because here is cardio ward. Many lot thing i learned here. Thanks to dr ong, dr then. Mo dr muhammad, dr nabilah. There was a story. After reviewing 1 pt with unstable angina, we moved to next bed. Then i noticed that pt was not moving. I told dr then she said that pt is sleeping. Then we continue reviewing pt. While nurses was making the bed, that pt still not move. So i told my mo again. Then she like pt is sleeping but wait.. he already unconscious. Pulseless. Cpr was commenced. Call for help. So chaos starting day. We couldn't save him. He still young 50 plus. And already sought early rx. But ajal will not be earlier or later.

Then i was assigned to ccu. Here i got to know cardiologist dr mansor. So funny and at the same time scary as we have to know the patient in and out, if not will be scolding by him. Here, you will do oncall round with consultant. Scary doe😨

And the next stop for me was hdw. Like ccu just 2 weeks be assigned here. Saw the case like thyroid storm here. Saw 1 interesting case here. Pt has sle with multiorgan involvement including vasculitis underwent surgery open appendicectomy. And they put art line to the left radial artery. Pt had h/o right toe amputation dt vasculitis. Then after surgery develop left hand gangrene and it was progressively worsened everyday. Ortho go in done dysarticulation of left hand. Then i finished my rotation in hdw. Soon after that i heard she died. Here my consultant is dr anila. Specialist dr ng yj and dr grace. Mo dr afnan (suppose to be with dr najwa).

Then i was assigned back to general ward. 2weeks in bendahara then 1 week in mahsuri. In bendahara, i usually taking care of cub 3 and 4, doing round with dr hamizah and dr ng kl. Whoaa, here i got crush wuth dr ng. He is super nice, handsome and cool! Hahaha. Ok back to bendahara. Sometimes doing round with dr izzad. He also nice and like teaching us HO.
No best thing in mahsuri. I hate mahsuri actually 😑 last time mahsuri best because there was dr ong and dr then is specialist in charge during that time.

After that i was in charge to look after ward 9/10. Mostly people who are assigned here being extend in medical. 1 of them is me lah. Hahaha. What is scary here is to do round with dr mat zuki. He is consultant of chest and incharge of ward 10. Ward 10 is vip ward. There are 1st A, 1st B and 2nd class male here. So many incident happened during my time in charge here especially on call time. My first time oncall here, there was a patient desat in ward 26. I attended him stat. Inform mo oncall. Dr irfan at that time. Then he came. Assess pt initially want to intubate that pt in general ward. But then spo2 still not pick up even under manual bagging so he decided to intubate that patient stat. The coolest experience ever. After pt was intubated noted cardiac monitor shows svt. Run to ed to get adenosine as there was nil in stock in w26. Ward 26 is palliative ward. Usually pt here all are stable. Able to send pt to general ward at 3.30am. Manual bag during transferring the patient. Got body ache after that. Heard that pt died 2 days after intubation.

Another experienced was pt surgical (post bowel resection dt gangrene 2ry to ileocolic thrombosis) and he was desaturation and tachcardic. Surgical mo already attended him. Noted narrow complex tachy=svt. Adenosine already given 6mg. Got transient v fib. Then revert. I informed my mo and he attended him stat. Noted bp was lowish side. So its contraindicated to give adenosine. Pt was shock 100j then revert to sinus rythm. Then that pt was t/o to surgical ward and i dont know what happen to him.

And during my last medical call, sn informed patient bp low. 90/40mmhg and had episode of diarrhwa passing loose stool x7. Attend stat. Noted spo2 below 90 and pt not respond to call. Decide for intubation. Pt got klebsiella ozanae bacteremia cre. Abg of this patient is bad because the machine  cant detect her pco2, hco3 and be. Lactate not high around 1.5. Transfer this pt to isolation room in hdw. And heard that this pt also died after 2 days intubation.

Doing round in w9 is equal to round with dr norhayati, endocrinologist. 1st quetion i got from her is why in septicacemic pt we need to do ECG. I was like why eh? Hahaha. Then 2nd question what is indication of LTOT?

Round with dr mat zuki is scrriest thing. Hyphae, afatinib, hyponatremia, and many other questions laa. With dr gaya she asked about SIADH-she asked me to read about barterr and scwatz criteria.

Then i got postcall off off leave leave. And today is my last lazy day 😪

And my next stop will be obs and gynae. Wish me best of luck

Kena extend

Assalamualaikum wbt. Lamanya tiada entri.

Its more than 8 months i start working. Going tgrough all the blood and sweat. Currently in my second posting, medical.

My first posting was surgical. I'm thankful for being in surgical as my first posting. Adaptation time. Even as 2nd posting person, i'm lacking in many ways. Now being extended 2 months because i failed my cex. Only after 3rd attempt i passed cex. 

But yes, i learned a lot. A LOT in medical. Still early to say anything. Today is my day 9 of extension. God please help me going through this.

Actually my intention of writing is to tell how sad am i. This eid, i will be on duty. Celebrate eid with patient. Hopefully will be given chance to do solat raya.

Will continue later.