..InsPiRasi HuMaiRa..

dalam ketegasanmu terselit kelembutan..dalam kesungguhanmu terselit seribu duka penderitaan..jerit perihmu menuju puncak kegemilangan..kau..syaukah istimewa..dipagari sinar nur islami..

Archive for the category “OBGYN posting 2011”

OBsESsO OBs: Part 1

Salam wbt

Alhamdulillah,hari ini(baca:Selasa,12/7) merupakan hari pertama saya memulakan tugasan elektif OBGYN secara rasmi di Hospital Kasr-El-Ainy Cairo University. Hari pertama,penuh semangat di dada! Hehe

Awal-awal pagi lagi,tepat jam 8 pagi,saya memulakan langkah menuju ke hospital. Singgah di Baghal sebentar,ambil laptop yang siap dibaiki oleh sahabat saya. Terima kasih r*h*an.=)) May Allah bless ur kindness.

After that,meneruskan langkah dengan semangatnya ke hospital.  jam 8.20pagi,saya sampai di perkarangan university. Ramai orang lalu lalang,kenderaan bertambah sesak,semput dada dibuatnya! Saya duduk di bangku hadapan masjid university yang tersergam indah,menunggu ketibaan rakan-rakan yang lain. Sambil menunggu,sempat sembang dengan seorang makcik tua yang datang dari Fayoum,semata-mata untuk pembedahan anaknya yang sakit usus katanya. Timbul perasaan sayu dalam hati,anak berumur 5 tahun,kecik-kecik sudah dibedah..no wonder I cannot be a pediatrician kot!haha

Tak lama kemudian,mak cik tu pergi. Sempat dia mendoakan kejayaan saya.ameen mak cik!Moga Allah jua permudahkan urusan hidup mak cik. Tak lama lepas tu,kawan –kawan saya sampai. Lin,Tise! Amboi,kalian semua pakai skirt labuh hari ni!hehe.macam janji ye sume orang.hehe (erk,apa kes masuk cite ni??)

Kisah Labor Room

Ok.dipendekkan cerita,kami sampai di OT  jam 9.15am. kami terus masuk dan cepat-cepat menukar pakaian scrub. Kelihatannya patient agak ramai hari ini. Ada can la tengok banyak kes hari ni.hehe. (that’s typical med student words!haha)

Usai semuanya,kami melangkah masuk ke admission ward,sempat kenal-kenal dengan nurse –nurse pelatih di situ. Walaupun tak sempat nak sembang,senyum-senyum perkenalan pun dah kira ok kan?hehe. kami masuk bilik pertama. Ada satu kes normal delivery. Saya puji doctor tu,sangat cekap buat kerja. Handsome plak tu.opss! hehe. Jeritan seperti ‘haamut’(i wanna die),mush adra(saya tak sanggup),dan pelbagai lagi versi ‘jeritan’ memang selalu kedengaran di sini. Tak henti-henti sebenarnya.saya fikir,diorang jerit-jerit berjangkit ke apa?huhu. doktor-doktor di sini nampak cool je semuanya,agaknya sudah biasa dengan jeritan-jeritan itu semua. Alah bisa,tegal biasa Kadang-kadang fikir,orang arab kan,dioang sangat tough! So,kita pun kene belajar tough macam diorang juga ye.baru lah leh survive betul2 ms kat mesia nanti kan?..=)

Usai satu kes. Saya menjenguk pula bilik kedua. C-section!menarik! sempat tengok dari awal cara-cara anesthesiologist(pakar bius) buat epidural anesthesia. Seronok! Tambah seronok sebab doctor sangat sporting,walaupun sudah bergelar MO,namun sangat BAIK dan SUDI MENGAJAR satu persatu tadi.(fikir2:kenapa saya caps lock dua perkataan tu ye?hmm) Dan semestinya he’s so funny! Tetiba terfikir,kenapa anesth sumenye cool dan ceria,sepanjang yang saya jumpa la..??

Kes C-section kali ni amat rumit sedikit. Layer ke layer di ‘incise’. Namun semuanya hairan,apasal tak jumpa-jumpa lagi uterus ni? Saya rasa semua orang cuak tadi.saya pun turut sama cuak! Panggil Attending,check punya check,rupa-rupanya ada adhesion between urinary bladder and intestine. I donno how possibly it will be?but this case was complicated. The doctors tried as hard as they can and Alhamdulillah,the baby came out normally,although APGAR score was less than 5 during delivery,but after resus,the baby breathe normally. But seriously,this case took a  long period to operate.

Kes ketiga,saya menjengah pula bilik sebelah,kes C-section juga. Breech delivery,APGAR score 9. Cuma yang complicatednya , urinary bladder perforation happen when they tried to close the abdomen. Consult urologist . saya tidak berpeluang melihat kes ini hingga ke akhirnya kerana saya terlibat dengan resus baby,bersama HO peds.-suction,inject vitamin K IM, bersihkan baby (dengan towel),check neonatal reflex,perform general examination untuk neonate .

pembedahan rumit-C/S complicated with urinary bladder perforation,major concern for genito-urinary fistula

Kes empat,kes di bilik sebelah. Kedengaran jeritan patient yang sangat kuat.kesian sangat kat patient sorang ni. Sayu hati saya melihatkan keadaan nya yang dalam kesakitan. Saya masih ingat jika di Malaysia dulu,saya pernah melihat seorang doctor mengajarkan ayat-ayat suci al-Quran dan berselawat during onset of labor.di sini,nampaknya kurang dipraktikkan amalan itu. Mungkin ada,Cuma saya yang tidak berpeluang melihatnya. Dan saya percaya amalan itu ada dipraktikkan di sini. Alhamdulillah,beberapa kali ‘push’,baby keluar dengan mudah. Cuma,yang tidak sedapnya,placenta keluar dalam keadaan yang tak ‘complete’,still having some pieces retained inside uterus. Rupa plasenta yang keluar seolah-olah darah ketul-ketul,ditambah pula dengan darah yang sememangnya membuak-buak keluar dari vagina. OB memang bloody!! Sapa yang takut darah,cuba lah jadi OB! Hehe. Jahitan dilakukan,seingat saya 5 interrupted sutures dilakukan. Buat saya terfikir-wanita,semasa onset of labor,memang sakit yang amat,2nd stage of labor,sakit meneran,3rd stage,sakit buang plasenta/uri,sakit sebab kene ‘stitch’. Allah,segala-galanya memang sakit throughout labor process. Patut la,sakit kedua selepas mati ialah sakit beranak,dan wanita yang melahirkan anak,gugur dosanya setiap kali melahirkan,dan jikalau dia mati semasa melahirkan,maka syahid la terbaik untuknya.Allahu akbar! Begitu besarnya jerit perih pahit maung susah payah mengandung dan melahirkan anak!! Tapi anak muda zaman sekarang???senang-senang je tengking mak,senang-senang terajang mak!apa nak jadi ?(geram nak kasi budak-budak macam ni tengok sndiri keadaan orang bersalin macam mana,dengan syarat tak takut darah la..kang pengsan lak tengok darah nanti)hehe

keletihan..haha(bujet letih..baru 3 jam standing straight..if 36 hours standing and working non-stop,cmne la rupe ai ye?)hehe

Kes kelima,normal delivery lagi. Alhamdulillah,kedua-dua baby dan ibu selamat. 3rd stage of labor,separation of placenta sangat mudah dan cepat for this patient. Alhamdulillah. Sebenarnya,bagi mana-mana doctor dan OB ataupun mid-wife,3rd stage yang paling mendebarkan kerana jika uri tidak keluar selepas 30 minit,risiko maternal mortality memang tinggi. Sebab tu,biasanya praktis di mana-mana Negara sekarang ni,we inject oxytocin/Pitocin at 2nd stage of labor(usually during delivery of shoulder) to help uterine contraction for easy expulsion of placenta at 3rd stage of labor.

Jam 12 tengahari,kami melangkah pulang ke rumah. Esok pastinya mahu pelajari banyak kes lagi!inshallah.

nak balik dah.bye2.sok dtg lg!=)

Target to fullfill during OB rotation

– observe at least 10 normal/breech/twin delivery, 5 C-sec

-CTG setting, CTG reading

-clerking case-means take thorough history

-abdominal palpation,plotting partogram

 

ok,stay tuned for tomorrow. Inshallah,hope to get a better spirit for tomorrow!need to study !

nota 1 = miss ma family!

Nota 2= plan for the summer project,hopefully it will be successful

supercharged quick study programme~Day 1

well,the tittle says it all right?

alhamdulillah,the first day of all,the great opening for the rest of the other day which 34 days to go,and i feel so happy,so enjoy with the new-refresh updated person,me myself..hehe..well,this is me,i have to make something new,something weird,something awkward to keep me boost up and make a clear flow journey towards my success.isA

early in the morning,after Fajr prayer(at 4am), i did some exercise,stretching my body,open the window,having some breakfast,the biscuits and a cup of milk.then,after reciting some versus in Quran,i started to open my book,but before that,i’ve wrote some journal about my studying,to know my progress on study.

and yes,let’s begin. today’s topic is Peds=Neonatology which i divided into 2 major categories,full term and preterm babies(+post term baby) and i highlighted some issues regarding general disorder/manifestation and local manifestation that actually quite commonly happen to both term and preterm baby. i’ve made it in a table in one paper,isa,if i have time,i will upload here.

next is Fetal surveillance and well being. i prefer to study with perinatal medicine+perinatal diagnosis. it’s cool ha when u can combine both subjects at a time.and this method i find it so so beneficial for me,cuz i wouldnt spent too much time in studying each chapter/topics. just repeat my reading session,highlighted some pictures,graph,table,summary and make a table on one paper and compare between them. alhamdulillah,i find it very amazing!

next Peds=Genetic. i think part of genetics is kind of difficult for me to understand.now i’m still thinking and trying to figure out what the best method to study genetics especially the part that i have to understand well-heterozygote,autosomal recessive,chromosomal disorder..bla..bla..bla..so,anyone who has idea on what r the best method to study it,please please share it with me ok.

well,i think i’ve to stop. see u guys!

something keep me motivated!

35 days supercharged quick study programme

yes.that it is!elhamdulillah.finally i find it!

As I’ve told before in my last post,right here,I’m gonna share with u guys what am gonna do during this programme. I took the idea from my best ever motivated yellow book “study smarter not harder” written by Kevin Paul(I bought this book at KLIA..sempat lagi rembat buku ni..haha).well,the title says it all right?

Here we go,the rules that I must obey throughout this programme,gotta be such a discipline gurl,smart and energetic gurl..hehe

The first rule,before I get started,I mean before I open my book to study, I should spent 5 minutes to jot down everything about positive words,like what am gonna be when I graduating one day?what are so special about me?wink..wink!! what are my dreams for the next 5 years?hehe.well,the point is to keep pushing ourself ahead,to know the benefit of studying smart and finally to get me inside the ‘goal’-that’s to say win a victory!hold the success!isA.

Then,with the name of Allah,open the book and study!hehe.make sure u throw out everything that gonna distract you,like music,internet..turn them off and enjoy your study happily!get drowning in it.

Well,to keep you motivated everyday,u shud have a mini book,and write down everything in it.u shud make one chapter for this programme.leave a space for about 15 pages,and updated about your projects on it daily. Well,make sure to keep it updated so that you will know what have you done,what sort of things that you ‘re not doing yet and etc..the point is,be ORGANIZE!hehe

So,I’m gonna share with you guys sort of schedule that I gonna follow for this week(the first week of this programme)

1/5 Sun=OBs=Fetal well being+Prenatal diagnosis. Peds+Neonatology+Genetics

2/5 Mon=OB=Diagnosis of pregnancy,ANC .Peds=Nutrition,Growth and development+Malnutrition

3/5 Tue=Ob=puerperium Peds=infection+immunization

4/5 Wed=OB=Emergency OB,Shock,complication 3rd stage of labor. Peds=Emergency peds

5/5 Thurs =OB,peds=CVS+respirology

6/5 Friday= OB=normal labor,malpresentation,abnormal labor.Peds=CLINICAL

7/5 Sat=OB=Maternal changes during pregnancy,operative OBS,summarize events in 3 trimester in normal and pregnancy

Wish me luck!

OBGYN posting:I’m back!

 

Assalamualikum wbt

Hello everyone! How r u doing?

Well,it’s been about 3 months and half I left my blog un-visited,un-updated with the new stories or whatsoever..precisely,I’m so sorry for that.gome ne~ yeah,my life become hectic day by day,I started grumbling,feeling depressed ,disappointed,keeping anger inside of me when I cant do something that I really love most-Studying effectively. haha.U know what,right now I am in obgyn posting,there’s too much to learn,a subject that made my head turned into haywire,coz it’s too too much to learn,to absorp everything at once!gosh,it really is! I still remember one of my big professor said that obs is one of the ‘bloody’ field cuz u’ll face with blood throughtout ur career either it is in little amount or big amount!it doesn’t matter.and i can’t deny that!it’s absolutely true! bloody muddy everywhere especially in the casualty,in labor room,in OR..(that’s why Islam put the women in the highest dignity of all,women who died during labor is namely shaahid right?subhanallah)

see??it very costy to do some operative procedures here?i wonder there's no subsidy for the folks here?

And elhamdulillah,I’m officially in 5th week in this rotation. But what have I done in the 4 weeks before?haha

Ok,lets do some checklist together.

  • Proper history taking?. Well,seriously guys,I didn’t take this seriously.what I know is about read books,read some journal,went to the library,study hard there.but seriously that was not smart at all,in medicine,I shud think of being with patient,hanging around at hospital,seeing so many cases..but I’m fail to do all of that.

So,started this week,isA,I will double up my energy,I will overcome all sort of laziness,whining,all unnecessary things and I will start focusing on taking more and more history taking.i’m gonna start approaching them,mingle with them,trying to be with them with all of my heart..hehe.

So,lets started with this week,5 days in a row and I will take maybe 2 cases per day.if I can do that everyday,I will get 10 sheets and I will keep it neatly in my file and on Tuesday and Thursday,I will see my supervisor and present the case to him. isA,I will do it. I’m gonna put it on the top of my list!ok.checked!

Did I observe vaginal delivery,CS,D&C,endoscopy..bla.bla..bla so frequent? Hmm,supposed in this case, I saw many many cases of CS and D&C and observed only 2 vaginal delivery!argh,I’m so lazy ok! Ok,I will charge my energy more after this. I wont be such a lazy monster gurl anymore. Do it straight! Now,I will re-arrange my schedule ,starting this week,isA,I will go to casualty 3 times per week,rightly after lecture(if I’m not attending Dr Khaled Malek class which is outside the course..but still thinking of it),and I will hanging there until 5pm maybe?ok,do your action!!!

baizura,azlin and 'cool' me..hehe at the main entrance of OT

  • Have you revised pediatric lesson?hmmmmmm….yeah,alhamdulllah,I’ve made some revision of it on certain topics that I think it’s kind of difficult to understand..hehe..i study them at university library,right after the lectures and usually I spent there for 3 hours.

So,my strategies now..i’ve actually did something that I call Quick supercharged study program.i will plan what topics I will cover this week and for each topics,I will study it together with OB.for example=CVS of pediatric+CVS pregnant mother+CVS adult+CVS fetus. I try to make comparison between those cuz I like to study in comparison way,I think it’s better to understand in that way.i’ve try it before and elhamdulillah, I can study all of them at one day and make a comparison table,mind map,some summary for those. Alhamdulillah.

me,cheerful sarah,and baizura..can u figure out where r we at this time?

  •  did u attend Dr Mahmud Salem and Dr Hisyam extra lesson everyday?hehe…secret…but I promise isA to attend their classes regularly.

                So what are you gonna do this week?

Inshallah,I will try to do my best according to the plan. I will continue taking extra class with Dr Wael Banna,he is superb great doctor. The way he describe and explaining to us about OBGYN reflects that he is well understood about this women science field. That was so awesome!! Me myself,I always think that ‘grab anything I can’ until the end of this posting which gonna be on 2nd June 2011.next I will have final year examination on 18th june(started with OBGYN) and finish isA on 10th July. Wish me luck !!

Will be updated later~my experienced in OT OBS isA

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