Purely Gibberish: April 2007

Sunday, April 29, 2007

Last.

Last night was the end of my attachment with Accident and Emergency Department. Alhamdulillah, I learnt A LOT of things and met A LOT of nice doctors and patients too!

Mr. Martin: Coolest consultant, big daddy of a&e, I like his nasty smile :)
Mr. O' Donnell: The most gentle giant consultant. Great tutor. Yesterday he treated the whole a&e team members one Cornetto ice-cream each!
Dr Matthew: 'The red headed Irish' - sarcastic wicked smile, push me to do my first IV line and my first real suture. He is currently a Registrar in Emergency Medicine.
Dr Andrew: HSO in a&e with strong Aussie accent, sexy (Amira knows all about this topic), tall, love cricket and football. Fan of which football team, Amira? Is it Manchester United or Chelsea?
Dr Niamh Collins: Specialist Registrar of Emergency Medicine. The best 'guru' in a&e - reduction of dislocated joints is her sub-speciality. The coolest and one of the best doctor in the department.
Dr Sarah: The intern. She had once treated me a bottle of Nestea because she said I did help her a lot! She had taught me a lot of stuff - and always be patience with my inadequacies.
Dr Susan: Sisterly figure, currently doing GP scheme. Has one of the brightest smile I've ever seen.
Dr Fiona: "Savage" is her favourite word. Quite 'tomboy'ish but very very nice.
Dr Sajid: Very professional doctor, also one of the 'guru' whom most SHO, Reg and interns ask help from.
Dr Looi: the only Malaysian doctor working in the department. Pushed me on doing my first MMSE on a patient. In the end, I am glad I did it.

The rest of the team whom I didn't mention esp the physios, nurses and porters-well, they are super duper nice too and overall a great team to work with! Thanks everyone, I will surely miss all of you.

Saturday, April 28, 2007

Cocoa Butter and Mallow.

Last night, a patient said to me, " You have beautiful eyes, like the opal stones". I looked at him, quite shocked with that sudden appraisal and became tongue-tied. I said nothing for a good while before the awkwardness of the silence hit me. "Ohh, thanks", that was the only words I could mumbled out - I could feel palpitations of my heart, blood rushing up and blushed my cheeks-bright red. Things like these - beautiful moment with a complete stranger, I find it hard to handle. So, I excuse myself and dashed out as quickly as possible. Haha.

He had beautiful eyes too, pale blue - yet so bright, even the dimmed cubicle that we were in couldn't hide the liveliest of his eyes. So, before I said things like that, it was better that I left the cubicle wasn't it?

Thursday, April 26, 2007

sometimes, I could be so pathetic. Haha!

Wednesday, April 25, 2007

Summer Song.

Follow me.
Beat Crusaders

Follow me.
Baby, I won't let you leave if you believe in me,
And i always set you free from all those yesteryears.
But you don't know how much, i got believe in you.

I was staring at your shoulder shivering,
in such a coldest summer breeze,
Meanwhile, I wonder why we're here.
Look for the line between love and friends,
We'll be twisting ourselves again.

I was standing at the corner on the street,
watching the wheels are turning free,
Waiting to back up on my feet.

Reading a line between night and day,
I'll be twisting myself again.

Follow me,
Follow me...
Baby, I won't let you leave if you believe in me,
If you believe in me...
And I always set you free from all those yesteryears.
Ooh...

But you don't know how much...

Follow me,
Baby, I won't let you leave if you believe in me,
And I always set you free from all those yesteryears.
But you don't know how much, i got believe in you...

This song used to be my 'summer song'- summer '06. Made me smile each time I listen to it. Catchy beat; I simply love it! It's been a while since I last listen to this song. And if it wasn't because of my I-tunes accidentally played the song just now, I don't know if I'll ever listen to it again.

And it caught me off guard when I was suddenly being so emotional over this song. I almost cried as soon as this song hit the chorus.

I miss those days when my heart was filled with laughter and joy, sharing every details of my life with my best friend. He was the one who made me listen to this song in the first place. Hate to admit it, sometimes in the loneliest days and in the loneliest nights; I feel my heart aching for those laughter that both of us once shared.

I feel so old....and those friendship and laughter- feel like they are starting to slip away, aging and forgotten..

Guess it's true when people said 'we will only start to appreciate things that are no longer ours'.

Adiosu yuujin~

Tuesday, April 24, 2007

I Am In Love!!!!

Every artist was first an amateur.
Ralph Waldo Emerson

Last Saturday, we (Dr. Matthew, Amira, Nora and I) met this patient whom accidentally dropped his electric tiles cutter which did cause a deep wound behind his medial malleolus and just lucky enough that the thing missed his posterior tibial artery and nerve. Dr Matthew asked, "have you all learn suturing?". We did learn to suture the day before and immediately answered yes. Dr. Matthew (with his wicked smile) said, "Who wants to help me suture this wound?". My heart was racing and pounding like crazy when I heard those words. That explains why I had that terribly shaky hands when I did the suture which Dr. Matthew referred to as, "I always have this effect with girls". Haha. Yeah right Dr. Matthew. My first suture; Saturday at 5:50 pm. An experience I will never forget.

Amira and I also did watch Dr. Andrew suturing a 9 years old boy's hand whom had a quite deep cut in his wrist; lucky enough to miss all his flexor digitalis superficialis tendons and median nerve. Heh, that boy was so cute and he didn't even shed any tears through the process. At one point during the surgery, he said to Dr. Andrew, "I can feel that one you know"; referring to sensation and pain as the suture needle penetrate into his skin. He was grimacing and I held his hand tight. Still, no tears shed. What a strong boy, indeed!

Right before we leave A&E, Dr. Matthew asked us to bring some Malaysian food for him the next day- "Food for Suture"- as Dr. Matthew had said.

So, the next day Amira and I made some currypuff which I would be proud enough to say, "not bad at all for a beginner!". I'd really love to see Dr. Matthew's expression when he ate that currypuff but we had to leave early - and I will never see him again for a while because starting from this week he won't be around A&E- having a break @ study week for his upcoming exam.

I miss having him around A&E - but I won't forget that Sunday evening when we had a short and quick date in the tea room. *wink*wink

Today, I was lucky enough to have had patients with : A fib, pan-syst murmur, and crackles for me to listen to! Yeay! I LOVE my work!

Friday, April 20, 2007

A Reason To Be Happy.

...'love', a word that is overly used..

-farah-

For two nights in a row, I've been feeling a little bit upset because of my inability to put an I.V. catheter into patient's vein. First time I tried was on Wednesday night and I missed the vein by a few micrometers and punctured the patients' muscle instead. No blood came out, of course. In the end, Dr. Matt had to put it in himself. Thank God, the patient wasn't upset or anything, but I can see that Dr. Matt was a bit disappointed. Last night I tried again, but that patient is too old and usually old person has 'weak veins' and are easily ruptured (Dr. Sarah taught me this). I got the vein all right, but because I was trembling vigorously, I managed to rupture it too. When the lab result came out, the reading was totally screwed because the blood sample was hemolyzed. I was so upset with my inadequacies that I wasn't able to face Dr. Matt- at all. So, like usual he had to cover up my mistakes (again) and drew out the blood himself. *tears* I am sorry Dr. Matt!!!!

This morning, I was hanging around Dr. Sarah as usual. We met this patient with a probable appendicitis and Dr. Sarah look at me in the eyes and ask, " Do you want to do her blood?". I was reluctant to say yes because I've started to think that I will never do it right. So, my brain instantly screaming, "No Farah, do not agree to this offer. You will never do it right. You're just going to hurt another patient today. Do you need to be disappointed for the third time?". Guess what, I said "Yes" to Dr. Sarah's offer- instantly. It's like my mouth just ignoring the "NO, THANK YOU" signal sent from my brain. I almost kick myself for agreeing.

Actually, I did it right this time. Alhamdulillah. Blood was oozing smoothly out from the I.V. catheter and into the syringes and I just couldn't stop smiling. Dr. Sarah praised me a few times for my success. And nothing, that anyone could say to me today that can undo that happiness~~

Labels: attachments

Tuesday, April 17, 2007

Surprise.

...sometimes you just made me wonder. And now, I am still wondering...

-farah-

Nora gave me a surprise visit just now; boy I really was surprised! Haha. Thank goodness my room wasn't as messy as this morning though. Phewwww~!!

A&E attachment starts tomorrow morning. I sort of skipped today's session. Haha...naughty me. I had a brief chat with Eamonn after pathology lecture, boyyyyy I missed his jokes. Teehee. Too bad though that he wasn't in the same group as me; or else we would be laughing together, all the way through A&E attachment - in sickness and in health, until summer holidays do us part. Well, imagine that!

Anyway, I always talk nonsense here. Imagine people reading this blog and they were like thinking.."what's with this girl?" *shrug*

Hah! This afternoon, we had to fill up some sort of survey form distributed by the Surgery team. Two most important questions listed on the top of the page were :
1) Do you find surgery interesting?
2) Would you consider to do Surgery in the future?

My answers were:
1) Yes
2) Are you crazy?? DEFINITELY YES!

Haha.. Not really, I only put 'yes' as the answer for question 2.

Well, the odd thing was that later in the evening Hani told me I'd do better in Medicine instead of Surgery because I am such a 'people friendly' person. Really, Hani? even I feel surprised with that comment.

Monday, April 16, 2007

OSCE

......just put it behind, and move on.

-farah-

Amongst all the 10 stations, my head automatically went blank when I was in Dr. Ger's station. Aaaahhhhhhhhhhhh!!

And all I can do right now is to enjoy my time off. Until tomorrow comes and all tutorial, attachments, classes and meetings start to haunt me back..teehee..

http://www.myheritage.com

Labels: exam

Saturday, April 14, 2007

Marriage

.....in my defense, my heart was badly hurt too.

-farah-

I was chatting with my sister on the phone and what could make a better topic than 'marriage'? She is now 24 years of age, has had multiple ex-boyfriends since high school, currently having three men asking for her hand in marriage whom she couldn't care less to consider. I am practically jealous. I, on the other hand seems to have enough 'men repellent' aura all over my face. She laughed at me for being too childish about relationship. She said, "Someone out there really meant for you, just wait. He'll come around when his head can make enough sense and realize he just couldn't live without you." Yeah right, easy for you to say.

Anyway, sometimes I am just too tired to even bother - but then life gives me a knock on the head - multiple times. Yesterday, I found out that my sister's friend-whom is currently only 19 years of age got married. Plus, Intan showed me her list of friends who are also going to get married soon. The other day, my friend from college told me that our friend(also from the same college) - guess what-yes, got married.

I feel...pathetic for wanting a stable relationship. Thank goodness my maternal instinct hasn't kick in yet. But, nowadays I realized looking at babies make me feel I really, badly, want one too. NoOooOoooo..it couldn't be. Heh, bad imagination. Shoohh shoohh!

Anyway, don't get me wrong. I am not desperate just yet. Besides - it's every girls' dream to find her knight in shining armor right?

p/s: just so everyone knows, my japanese name is;

Your Japanese Name Is...

Miyoko Shimizu

Friday, April 13, 2007

Shopping list.

....I've walked too far to turn back...

-farah-

I went to Dunnes Store and Aldi just now with neither shopping list in my hand nor any cash in my purse. I am always like this, buying whatever suits my mood at that time and financially I am usually all over the place. I need to get myself a personal accountant. Anyway, because I didn't have a shopping list, I made one up instantly. Looking around shelves of cereals, cookies, pasta and youghurt; I've decided to make pasta tuna baked for lunch. See, I wasn't that helpless. :)

So, the things I need are :
Tuna
Campbell mushroom soup
Fusili Pasta
Onion
Pepper
Mature Cheddar cheese

I've already walked halfway home when I realized I forgot to buy the cheese. Darn! Okay, only Snickers for lunch today. Remember kids, do make a groceries list before you go out shopping.

The sun is shining and ~~I am totally hot~~ the weather is so hot. Vanilla ice cream dipped in chocolate would be nice - like the one I had in Supermacs the other day. Yummmyy... Sometimes I can be a total nanny to myself - by being a total freak about diet and stuff. But then again, I WAS the girl you'd envy because I can totally eat anything and doesn't put on weight. I miss the hungry monster in me. Nowadays, the effect of eating a piece of bread was like eating a plate of rice..ohh I am ageing too soon.. But that doesn't stop me from eating a bar of Snickers everyday! Haha!

Anyway, currently I am waiting patiently for my new duvet cover to dry up - which is now hanging freely on the clothes line in the backyard. Managed to find a nice one when I was in Dublin, and it was cheap too!

Ohh..and I bought myself a bag from GAP and the most important item is a pair of Converse shoes! Yeay!

Labels: shopping

Thursday, April 12, 2007

NORMAL

I wish things could be normal, like it used to. But then, define normal. A girl whom had her heart broken all the time may define that as normal. A boy whom never had a friend around may define that as normal. A man born with 11 fingers may define that as normal. Maybe normal is what we get ourselves used to. To eat rice everyday maybe sounds abnormal to some culture, but when you are used to doing it; it'll become normal to you. It's normal to pee in the Corrib river every night for two years (and get the water contaminated with cryptosporodium) - at least that's what the man said in defence against raging Galway citizens.

When you cannot do the things you normally do, your heart secretly longing for it.

Well, I don't even know what's normal for me anymore. The fact that everything is turning upside down and inside out making me feel vulnerable. Adapting myself to changes that kept pushing me off my limits. Maybe that is what normal for me. Life kept changing and forcing me to catch up with it.

I miss the urology team. Dr. F and Dr. C, the patients and the operation theater number 5. Finished with urology last week and it was a beautiful end to a beautiful attachments(?). Everyone was happy and smiling-maybe due to the fact it was Good Friday and the weather was gorgeous. But we didn't say goodbye to anyone from the urology team in the end - except for two patients; Miss Maher and Miss Nolan whose being released that day. Went to the town with Amira in the afternoon and bought myself a pair of red shoes from Penneys-which I did wear straight away!

Went to Dublin with Sarinah and Aimi the next day - had a blast weekend with the girls. The highlight of the trip was when we went to the National Botanics Garden. I love it there, and the squirrels love me! Haha-not! To Gmah, Aiza, Aini, Tina and Sarah; thanks for making our visit to Dublin an enjoyable one!

Monday, April 02, 2007

Learn.

Missed radical nephrectomy today because we had to attend pathology class at 2pm. *sigh* Should check what's on tomorrow but the OT list wasn't up yet. Shall I go and check tonight? Nahhhhh!!

Today Amira had a few chickflick moments with Dr. C. Hahaha!! You go girl!! I was wondering what's up with Dr. C today. He kept fixing up his hair every few minutes, whistling (never seen before), gave us few topics as homework too! Basically he's in a very good mood. Hah! The same thing happened with Dr. F today. He began to show us the other side of him; a kind gentleman instead of a doctor with attitude. I love the urology team. Heh.

Okay, basically let me share what were given to us as homework by Dr C. today:

1) Trans biopsy: there are three types of trans biopsy;

Transrectal biopsy: using ultrasound to give direction through the rectum towards the prostate, biopsy gun is being used to take samples of prostate tissues. Usually patients will undergo enema procedure which involve flushing liquid through the anal sphincter.
Transperineal biopsy: require a small incision to be made in the perineal region (area between rectum and scrotum) to take the sample tissue.
Transurethral biopsy: cystoscope is inserted through the urethra up to the prostatic urethral region where the tissue sample can be collected using the cutting loop.

Who need to undergo this procedure?

men with high level of PSA (Prostate Specific Antigen) - to determine if the increasing level of PSA is due to cancer
when digital rectal examination had detected abnormal lump in the prostate gland - to determine if there is carcinoma of the prostate

The tissue sample will be reviewed by the pathologist who will determine if the cells are cancerou cells. The cancerous cells will be assigned according to Gleason score ( 1-10 ) of which the more differentiated cells from the normal cells, the higher score will be assigned. Higher Gleason score equals to severe stage of cancer.

2)Frozen Section: basically this procedure is similar to biopsy of which tissue samples are being collected and diagnosed to determine presents of cancerous cells, infections, or any other disease. Instead of having to wait ages and ages for biopsy results, this method will give instant diagnosis of the tissue sample i.e. in about10 minutes. This method is very useful during mass surgery. During a procedure, the surgeon will take a biopsy sample from the tissue mass/organ. Pathologist will place the biopsy sample and freezes it using the cryostat machine. The frozen sample is then being sliced into thin layers using a microtomes. The layers are then stained with dyes and then it will be examined under a microscope and diagnosis can be made there and then. The advantages of using this method are:

if the mass is determined cancerous, the surgeon can remove it instantly
if the tissues are benign, the surgeon may not need to remove it and the surgery can end
if more sample is needed to make more accurate diagnosis, second sample can be taken immediately without having to made second operation
help to ensure the right tissue (cancerous) are being removed
as been said, it's time saving procedure!

More info : here

3) Testicular Carcinoma: this is the most popular question for final meds according to Dr. C. *hint*hint*. Okay, basically testicular cancer usually develop in men of age 15 to 35 years old. It is highly treatable due to early detection. There are a few types of testicular cancers. The most common would be the germ cell tumors which further divided to seminoma (60%) and nonseminoma (40%). Next types are stromal tumors and secondary testicular tumors.

#Germ Cell Tumor:
Seminoma:
*suffix -oma means tumor
*developed from sperm -producing germ cells of the testicle.
*two subtypes; classical seminomas and spermatocyte seminomas
*can be differentiated by looking under the microscope
*classical seminomas has 95% occurrence in men in late 30s and early 50s
*spermatocyte seminomas is slow in growth, do not spread to other parts of body and usually diagnosed in men of average age of 55.
Nonseminoma:
*tend to develop earlier in life
*men early in teen or late 40s
*subdivides into embryonal carcinomas, yolk sac carcinomas, choriocarcinomas and teritomas

#Stromal Tumor
tumor arises in supporting or hormone-producing tissues, or stroma or the testicles and subdivides to two main types
Leydig cell tumors: tumor develop from normal Leydig cells which are important in producing androgens (e.g. testosterons) but they also produce estrogens.
Sertoli cells tumors: tumor develop in Sertoli cells which are important to protect and nourish the sperm-producing germ cells.

#Secondary Testicular Tumors
Tumor in another viscera that spreads to the testicles. Lymphoma are the most common.

info from: here

Interesting isn't it?! Okay, now homework done, I can sleep peacefully...ZzzZzzZZzzz

Sunday, April 01, 2007

A Fun Weekend!!

It was a wonderful one, really! On Saturday, I had attended a program organized by PPIMG (Galway Malaysian Muslim Students Soc) - a get together to talk about our role as Muslim students. Eye opening and full of reminders; sometimes I do forget about my purposes in life, and I am blessed to be surrounded by those who kept reminding me! Anyway, that guy from Belfast who conducted half of the program, he - is a genius. He knows everything from history, to politics and general knowledge; I could listen to him talking whole day through and I don't think I'll feel bored. I did enjoy the program, but half of my mind was worrying about the hall bookings that cost the society 96 Euros - hope I can talk our way out with Ellen i.e. the Sports hall secretary tomorrow. The most enjoying part about the program besides the delicious lunch prepared by Liyana (with no doubt) was the work out a.k.a. dancing session with Ain. Gosh, she is a talented dancer. Graceful and coordinated. I, one the other hand was all over the place. Haha.

Today, we had a peer-teaching session with Marisa, Pulut, Kak Meady and Kak Aini. They are walking and breathing Tally and O' Connor(our clinical skill textbook). They remember everything and skillfully demonstrating the physical examination. I hope I can be like them soon. It was fun to spend the afternoon with the girls - revising the clinical skills and general physical examinations of which I am now starting to forget (been spending more time with urology nowadays).

Later in the evening, we played basketball. The most shocking thing was, suddenly I became a sharp shooter and rarely miss to get a point. Hah! As Aishah and I accidentally wore the same t-shirt, we decided to pair up as a team. We had so much fun teasing Diyana and Ayesha-the other team. At one point during the game I couldn't stop laughing as if I was poisoned by laughing gas. My mood fluctuation is beginning to confuse me as well. Haha. Not long after that, Idah and I learnt to play tennis with Ain and Lisz, but I don't think tennis is for me. I was - too inadequate. Badminton is more of my game. :p

Idah cook lovely dinner tonight - chicken soup plus potato and anchovies in chilli. Hot and spicy -but nothing that I couldn't handle. I miss spending time with those girls in Ardillaun especially the time when we prayed and recite the Qur'an together. I think that what brought us together in the first place.

Ohh well, I am so tired now. I really should be asleep. Hope I can watch nephrectomy procedure tomorrow...InsyaAllah.

Purely Gibberish