hari ke berapa entah

i know i should be updating but im... i'm....i'm... lazy!
yes, laziness strikes again :D

but still im still going to sum up what i did the past week cause if i don't i won't be updating anymore. haha.

*belek belek note dekat phone

the next day i joined an operation to remove pituitary tumor transsphenoidal.
meaning, they didn't open up the head and remove the tumour like that, nooo.
i remember our anatomy teacher asked us, how to remove one, and she said, transsphenoidal! its reachable through the nose.
and yeah she's right. they did the operation through the tiny miny hole straight to the pituitary.
so we waited, and waited. thought that the operation was going to end early but.. but..
the tumour was still there when we left at 4.00 T,T cannot tahan anymore maa, berdiri dari pagi tak duduk. haih, seriously macam mana surgeons boleh tahan berdiri lama gila nak mampus?


the next day we followed mr toh (officially my favourite doctor! ;p)
we went to the clinic and ta-dah, his first patient came in.
well she has cerebral aneurysm.
And dr toh explained that there are 4 stages of cerebral aneurysm. from mild to severe and he asked.
in malaysia, very seldom a patient presents with first stage cerebral aneurysm. why?
and my answer was wrong. tettt

he said , cerebral aneurysm is presented with headache. but you know lah malaysia? headache? telan panadol lah. telan ponstan. doctor pun suruh makan panadol juga. bila dah teruk baru tahu sebenarnya headache itu adalah disebabkan aneurysm. wooo. bahaya bahaya

tapi headace untuk cerebral aneurysm ni special. dia thunderclap headache. suddenly strikes. not specific for aneurysm but should rule out that disease lah kalau a patient is presented with this sign.


neuro patients nak recover sangat susah. family support is very important. for them to be normal takes 6 months minimum. may reach 2 years.

he said that making a decision is very important, especially for a newborn. people have to decide what should they do if the baby in the tummy suffers for neurological defect. it is a very hard decision indeed.

there was a patient once came into his clinic, his mental status is the same as normal people, but he has paraplegia(partially paralysed) since he was born and he has to sit on a wheelchair.

he asked the doctor

"why wasn't i killed before i was born?"

what should i answer?. there's nothing i can do. i can only give him motivational support. we can only concentrate on the future. we cannot change the past"

bersyukur kerana dikurniakan fizikal dan mental yang normal. alhamdulillah.


the next patient was a middle aged woman. She has been suffering from severe pain at the back, head to the eyelid. exactly until the eyelid. She had her xray and ct can but mr toh refused to look at them

"I dont want to look at those reports. let's talk first"

He asked so many questions from her job, what she does for a living, how many kids.

Dalam 1 sampai 10 sakit itu tahap mana?
saya rasa 10 sebab memang sakit sangat sampai kena baring
Betul ke ni 10?
betul lah kut memang sakit
awak pernah bersalin kan? kalau sakit bersalin itu 10. sakit ini berapa?
ish bersalin lagi sakit. 5 kut.

*first time dengar orang guna scale 1 to 10 tu guna comparison. but see the difference? kalau lelaki mr toh cakap paling sakit myocardial infarction. tapi kita boleh dapat idea kalau compare dengan sakit patient pernah rasa. rasa macam effective gila cara ini :D

and finally we looked at the ct scan and x ray. She has something in the brain called arachnoid cyst but it isnt dangerous. and it isnt related at all to the pain she's been having.

" you ada macam satu poket itu. dalam itu poket ada air otak. tapi banyak orang juga ada. tak ada sakit pun. but i know what you have. it has nothing to do with this cyst."

Then Mr Toh said "patients nowadays don't want to believe the doctor. they only believe the internet. So let's see"

he started to press the keyboard, went to the google search engine, and typed something

voila! ternganga kami sebentar kerana gambar ini memang sebijik sangat sangat dengan description sakit dia. haha. rupanya dia stress sahaja. duduk tak betul. muscle jadi sakit maa. memang muka dia pun selalu stress doktor bilang jangan stress stress lagi. ini sakit banyak normal woo. lu punya muka pun banyak stress kena relax saja maa.


hehe walaupun sakit ni paling simple, tapi paling seronok sepanjang klinik. sebab nampak lah macam mana dia solve terus semua :)


to be continued sebab malas nak type. panjangnya T.T

HUKM; day 5

Let's not talk about day 4 okay T,T

so first, the doctor, a neurosergeon brought me to the ward,
first thing he said

"you know, communication is very important. doctor should not treat patients like they are stupid. Sometimes they know more than us. We now have iphone, they can simply search about their problem and they'll find everything. We have to know so many things, that sometimes we don't know about certain things. If we don't know something, say that we don't know lah don't make up stories"

well something like that. how can i remember the whole conversation, kan?

and then we went to the ward.
there was a patient, his treatment was delayed for a month

"sometimes the doctor didn't do anything, because they think if they don't treat the patient, it won't be harmful, they won't be treating him for the wrong treatment they think. but not treating itself is harmful"

He explained that when he first came to the hospital, they failed to reach the diagnosis, so they didn't treat the patient. He was referred to the neuro department after a month, but it was already too late.
So they treated the patient only to reduce pain and one more i do not remember = =.

Then we went to see a baby, a few years old, with opened arachnoid membrane, it caused an increase in the intra cranial pressure because of the csf leakage. pity her ;"(

after that, along with 3 specialists, 4 m/o and some nurses they did their round at the ward. Then at 10 we went to the clinic

Looking at a baby's CT scan. I could see that the baby's brain is atrophied.

he said something like in city like KL. husband goes to work, wife also has to go to work. they send their baby to the nursery. Some people shake the babies too hard to make them fall asleep. they goncang goncang the baby, use the buaian, sometimes they buai too hard it can cause concussion. You know, when we buai the baby too hard the baby terlambung and fall back again. The brain can be atrophied. poor babies ;"( And he said most of these babies are chubby. Because they feed the babies a lot to make them fall asleep. then they shake the baby so hard they thought the babies are already asleep when actually the baby went into coma, pengsan already. Banyak jugak case macam ni dia cakap


Then a patient with an 8 months baby came in, his head is slightly big, but perhaps its just genetic, he has 2 sutures on his head. They did a surgery to decrease the ICP. What's the first sign?, he asked. I said increase in the size of the head. tett, salah. The first sign is irritability. I asked him, will the head look bigger? hydrocephalus? He said that we can't really depend on the physical, that's why we are called clinician. First sign is actually irritability. ooh :D


Then the second patient came in, she was an 16 ke 18 y/o chinese. they talked in chinese i couldnt understand a thing. But then the doctor explained to me. This case is kind of interesting :D the patient has deja vu, cannot understand what people are talking about. and the doctor thinks she has absent seizures because sometimes she's standing in front of someone, and a moment later she realizes that she's already behind that someone :O
Some people may think she's crazy that she's talking nonsense. that;s why she hesitated to tell her problems to the doctor. but when the doctor assured her that its okay, only then she opened up. The doctor said her ICA is stenosed, and may cause ischaemia to the brain. That may be the reason of her problems. and i saw on the paper it's written kawasaki disease :D

he said i have to decide what kind of doctor i want to be. I have to consider everything. One thing to consider is what kind of lifestyle that i want. don't choose something i can't handle

"being a neurosurgeon is hard. Cases usually come at night. and they can't delay it until tomorrow. if a patient comes with a problem can we simply tell them, please come again tomorrow? the patient will die la you have to do it at that time. not like ophtalmo they can simply ask them to come tomorrow it's okay"

:O and he also said that many female neurosurgeons are not married :O whoa. cheh baru ingat nak consider neuro :p


and then after the clinic ended, there was a doctor, she's an egyptian. Well i already know that she's an egyptian since last week but she doesn't know im studying in alex. But when one of the specialists told her that im studying in egypt, she asked "which part of egypt"

"ALEX!"

and she laughed and she looked so excited " this is like a big laugh to me" while laughing,
She came to me and we talked a bit. She left alex 6 years ago, and haven't been there ever since, except for that one time just for 2 or 3 days. She graduated from alex uni jugak :D
I asked her "you know dr farid and dr haitham?" she said yes. then i told her they passed away and she looked sad. Talked about HM haha. about the election. She was surprised syafik was even nominated. and i said "right! we were surprised too! thank God he didn't win!" ;p and she said yeah it was hard back then, and the revolution just had to be done. it gave people hope :) yeah i know that. heard that a lot from the egyptians :) She said she likes to live in malaysia and she's gonna stay here. and i said i like alexandria ;p and we talked and talked then i went home ;p

p/s: mcm tergantung tapi malas sambung. hehe
p/s/s : conversation tu tak tepat okay tapi lebih kurang la. come on la its not like i record the whole conversation kan nak ingat satu satu ;p
p/s : ALL the doctors tak kira lah M/O ke specialist are nice. Very nice. tak nampak stress sangat pun. tak pernah kena marah semua :) tak tahu lah kalau tempat lain kan :/

Hari 3: HUKM

Day 3

Masuk jabatan neurosurgery.
Pukul 8 dengar presentation oleh seorang doktor perempuan, dikomen oleh beberapa pakar
*mula merasai ketakutan menjadi doktor. kena belajar dengan bersungguh sungguh!

Pukul 9 pusing ward. Melihat sekeliling. Bersyukur dengan nikmat kesihatan yang Allah beri. Alhamdulillah :)
Tetapi setiap dugaan itu Allah turunkan kerana Allah tahu kita mampu menghadapinya ;)

Kemudian ke OT (operation theatre).
Malangnya kali ini kami tidak dapat melihat dengan jelas dan terang.
Kerana tiada kerusi.
Dan tiada kamera. Kamera hanya sebentar, semasa proses pengeluaran tumour
Hanya dapat melihat from across the table memandangkan saya tidak sterile
Wanita tua yang mempunyai ketumbuhan di saraf. tumour di spine nya.
Pembedahan dilakukan untuk mengeluarkan ketumbuhan. Alhamdulillah pembedahan berjaya

Sebelum masuk OT ingat mereka ingin bedah otak.
teringin nak tengok bagaimana otak dibedah :O Kedengaran menakutkan. Tapi hajat tak kesampaian. mungkin lain kali?

p/s: Semoga Allah permudahkan segala urusan. Allah turunkan ujian kerana kita mampu. Jadi kena yakin dan tidak boleh mengalah! chaiyok!

day 2; HUKM

2nd day was an epic failure

I left home at 6 hoping that one hour is enough to reach HUKM at 7.

reached masjid jamek at 6.30. didn't know where to go. ended up pusing pusing to find the star station.
wasted a few minutes there. patah balik. then we went on the train finally yay.

oh nay. just realised that we were on the wrong train.
patah balik. wasted more time T.T ended up reaching HUKM at 7.38.
kena marah ;P

"patut pukul 7 dah kena ada sini.", doctor tu cakap.
;( sedih. followed another doctor. He met some patients and after that he gave a lecture to the fifth year students. i joined them. hehe now i miss listening to the lecturer in front ;( and the lecture at my university is more interesting i think ;p maybe because the lecture i listened to just now was actually a presentation by the students, and further explained by the doctor.

i didnt understand all of them but at least i understand half of what they're saying ;p i have to recall everything that i learned before. luckily, heart is one of my favourite part :D
the doctor kept asking us. " faham tak? faham tak?" and i went "paham la sikit sikit ;p"

then went to the clinic. one by one patient came in. di sini saya hanya duduk mendengar dan tidak berani mengganggu kerana doktor kelihatan sangat stress. -.-"
and then the specialist came in tanya "nak balik dah? ehh datang lambat nak balik awal"
pergh sentap walaupun nada macam gurau2 -.-"

it ended at 12. singgah at kamal's in front of HKL to buy tayna's lab coat.
balik, tidur sebab penat dan stress

p/s: kalau kena marah saya memang akan tension. kalau kena marah benda yang saya tak salah lagi lah double triple tension.

Day 1; HUKM

Day 1

Reached HUKM at 7.20

went to ward 5J. followed the doctor to do his round. went to the ICU. 

went to the operation room. then i was asked to change into their clothes. i didnt know they always bring their own tudung. so i ended up wearing the most ridiculous tudung ever. -.-" all grey uniform with a pair of crocs.

went to the pantry. a few doctors were there. 

"dah makan?"

"eh tapelah"

"tak, dah makan tak?"

"belum"

"nah amik ni" while giving me sebungkus nasi lemak ayam. dah menyemak, dapat makan minum free lagi -.-"

talked about egypt, belly dance and stuff.

then the other specialists came, and then we went to the operation room.

the patient was a male 58 years old guy. His aortic valve wasn't functioning anymore so they replaced it with an artificial valve made of bovine pericardium. 

 i didnt know what to do. there were a lot of nurses and staffs.

then they started opening up the body, cut the sternum, and the tissues and then i could see the heart beating, live :O

woah it was amazing :O the heart that we saw in the university was already old, hard and not so real since it was preserved for a long time. to see a beating heart and lung in front of my own eyes was amazing :O untuk orang yang jakun macam saya ;) hehe

i could see the enlarged and overly stretched aorta. it was very thin. and the right atrium was also thin, that it bled on touch..

one of the specialist called me to look at the operation closely, so i stood very close to the patient, behind the patient's head, and i saw everything very clearly :D One of the specialists explained to me what they were doing.

'He's cutting the thymus now. it looks fatty because he's already old'

'Can you see? He's now connecting the tube to the aorta'

'Look. the aorta is very thin, because of the regurgitation, the aorta has to put extra effort, so it became bigger, stretched, and very thin.'

and so on

 It was amazing. then they connected the SVC, IVC and aorta to a machine ,it was an extracorporeal circulation. then they stopped the heart and lung, and let the machine took the function of them both while doing the operation.

Well all this while, i thought an operation is a very serious procedure, with everyone concentrating, but i was wrong. they talked, laughed, listened to dangdut music, but still managed to perform the operation nicely. it wasn't stressful at all for me. but he said to me just now " semalam tu stress, sebab tak sihat, tak best sangat". habis tu kalau yang tak stress tu macam mana lah agaknya :O 

The op started at 8 i think, and ended at about 3 pm :O a very long one indeed.

and tomorrow insyaAllah i'll be seeing a coronary bypass surgery :)

:)

Sometimes when we face obstacles in life, we ask ourselves why are these things happening to us? Why can't we have what other people have. Why is it so hard to get things we've always wanted.

"Pandanglah orang yang berada di bawah kalian, jangan memandang yang di atas kalian, itu lebih baik membuat kalian tidak mengkufuri nikmat Allah" (HR Muslim: 5264)

Astargfirullah, how many times in a day i say Alhamdulillah for what i have.
Sometimes I wonder why can't i have things i want, things other people have. and at times it makes me forget the things He blessed me.

The last semester result. He granted my wish. I wanted to get all A's for the last pre-clinical examination although so many times i tell myself the percentage for that to happen is very very low considering how bad i answered my pathobiology paper. 

See? Sometimes He doesn't give us things that we asked for, because He wants to give so many better things, in ways we do not expect :) Sometimes we think that a life we dream of is the best for us, but maybe it is not :) Allah knows best :)

"Boleh jadi kamu membenci sesuatu, padahal ia amat baik bagimu, dan boleh jadi (pula) kamu menyukai sesuatu, padahal ia amat buruk bagimu; Allah mengetahui, sedang kamu tidak Mengetahui."(Surah al-Baqarah:ayat 216)

I have a lot of things to be thankful of :) Family friends, food to eat, I can go shopping and buy myself many pairs of baju kurung, shoes :) I was given the chance to go explore other countries and places :)

While we're having so much fun, so much joy, other people are suffering.

The people in syria, palestine, rohingya :( They celebrated their Eid with guns in their hands , while we celebrated ours with so much duit raya in our hands, and too much food filling our stomach

"Oleh itu, ingatlah kamu kepada-Ku, supaya Aku membalas kamu dengan kebaikan;  dan bersyukurlah kamu kepada-Ku dan janganlah kamu kufur" (Surah al-Baqarah: ayat 152)

Alhamdulillah :)