Wednesday, November 04, 2009

From The Surgery Ward

I realized my lack of updates on my blog here. My bad.

But it's been a very crazy-hectic-leaving-me-wna-sleep-only-and-do-nothing-else-once-i-reach-home week the past few days. And this is how we are going to have to live through every day during our HO years. Even worse in HO time i can foresee. And maybe for the rest of my life after after i completed my 100 years studies. But at least it's a more interesting posting than the one starting with the big O and end with the C. At least there are cases such as phimosis in a female ward! Shock le.. Actually he is a male patient but i think male ward over congested so put him in female ward. He is a small boy only.

This week is only the beginning to my surgery posting and i had already presented 3 cases. To 3 different lecturers altogether and one of them is one of the most strictest lecturer in our uni. Strict to the point that grammar and pronunciation is also corrected. She is very intelligent and a very nice lecturer actually but presenting to lecturers like this is very stressing. Even more stressful than usual.

To present case right, we had to clerked the patient 1st right. There's only 3 simple rules b4 u clerked the patient. Rule # 1 : Pray that the patient is cooperative and willing. Rule # 2 : Pray that she has good history and signs. Rule # 3 and most important one : Pray that he/she is not scheduled for OT at the time of your bst.

Because if he/she goes to the OT when you are going to present ur case, you are going to get in trouble. Not all lecturers are fussy about that tho but you know, if you get the one that is so particular about bed side teaching meaning having to teach at the patient's side and the patient has to be there, then you better have back up cases.

I'm thankful that i had managed to find cooperative patients with good history and signs so far altho one has such good signs that it's confusing me and even doctors also confuse.

And of course, got patients that bluff you also one. Not that they purposely bluff you la but they are not willing to disclose their illnesses i guess.

Scenario 1
Me (m) : Kak, kenapa kak masuk hospital? Apa masalah kak? (Why are you hospitalized? What is your problem?)
Patient (p) : Oh.. tak de apa apa la.. rasa lelah sikit (Oh.. nothing la.. just dyspneic)
m : Oh selain lelah ada rasa sakit mana-mana tak? (Other than dyspnea, any other pain?)
p : tak ada lah.. (No)
m : ok.. tapi ada mana mana tak selesa ke, ada bengkak mana mana?(Any discomfort or swelling?)
p : betul tak ada. saya lelah saja. (Realli nothing. just dyspneic)

So.. i cheated and looked at case file. (not suppose to but impossible dyspneic only admit to surgical ward right) Wa.. big problem actually.

m : kak, tak ada masalah lain? payudara ada nampak lain tak? ( Really no other problem? Any breast changes?) * very direct already which is not suppose to also)
p : payudara? tak ada la.. sihat sihat. normal :) (Breast? Nope. Very healthy)
m : oh ok. kak rehat baik baik ya. terima kasih kak. (Ok. Rest well and thanks)

Patient bluff my feelings one. She actually has ulcerating and fungating stage 4 Ca Breast. But maybe cz she dont want to let others know about it. It's ok, as medical students, patients still have right to bluff us.

Scenario 2 :
m : kak, sakit ini dah berapa lama? (Uncle, how long is your pain?)
p : lama dah agaknya 20 tahun lebih (Very long more than 20 yrs)
m : lama dah..kenapa sekarang baru nak jumpa docktor? (So long dy why now only wna see doctor?)
p : Oh.. sebab sekarang baru sukahati nak datang (Oh now only i like to come)
m : @@
m : selain suka hati, sebab dah tak tahan sakit? (Other than that, is it because the pain increases? )
p : tak ada la.. tak sakit lagi pun (No la.. no more pain dy now)

Actually patient still has severe pain but I don't why she say no more pain!

My feelings cheated twice dy this week. Luckily, im done with my turn for a while now so im going to get good rest and then bring you all more juicy posts. Very soon i promised. K. Bubbye. :)

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8 fondue dips :

it's usual that pt bluffs...i guess sometimes he/she is in denial state...

jz browse through ur other posts...impressive...beautiful medical student joining beauty pageant...i'm a medical student too...christy was my primary school classmate but i guess she wont remember me now...hehe...

yup.. when kena bluff so sad. :(.. but not the 1st time kena bluff dy.. haha.. so we will be future colleague ;). it's such a small world right? everybody knows everybody. hehe

i'm fr year...

sure i know them...big people from amsa...haha...maybe u can consider adding a chatbox...i dunno where to reply...:P

You felt awk.with lying patients but you are not a god,just do what you can to help them, no need to give yrself so much pressure.Sooner later you will get use to still fresh come to age issue. Smile~~

So from now on can't use bahasa "pasar"? ;D Then use perfect bahasa to improve grammar,professional mah! where allow to use bp.

anonymous 1 : nola.. i don fl awkward. i know tht patients do lie. :)

anonymous 2 : bahasa pasar? err we use bahasa terengganu. have to speak in the local language that the locals can understand. ;)