3rd year. 2nd posting : Surgery

Assalammualaikum

Sepatutnya harini nak kena basuh semua kemeja bagai. Baru balik holidays, tak sempat buat benda-benda tu semua. Sebabnya next week dah nak start elektif postings. Belum tahu nak buat apa. T___T

Sementara tengah bermalas-malasan, taip je la entry baru u'olls (eww), surgical posting.

after clinical osce examination. Dengan member se-posting in surgical ward of 

kulim hospital.

Surgical posting ni adalah posting kedua dalam first semester 3rd year aku. Basically aku rasa aku not into surgical posting sangat. Study okeh je, tapi cuma kurang minat surgery. Kenapa? Entah, masih mencari reason yang sesuai. Haha. I just know im not into it. Thats it. Faham? Overall 7 weeks in surgical postings and we will come again to surgical posting in year 5.

Basically in surgical posting, you have to revise back your anatomy (wargh!), mantapkan physical examination like hernia, breast examination, neck examination, abdominal examination, ulcer examination, cyst, varicose vein examination and bla bla blerghh..Bagi aku benda-benda ni agak susah sebab dia benda baru. We never learn it before during second year or first year. Kecuali abdominal examination lah. Lain lah macam O&G, kau just praktis check perut, perut dan berut. Haha. Senang je! (padahal menggigil jugak time exam! T.T)

Then, kau kena mantapkan macam mana tengok X-ray. (seriously aku blur gila masa awal posting macam mana nak tengok air under diaphragm, meniscus sign, frail chest, haematoma, pneumothorax, tumor, bla3..) Bulau weyh mata aku tengok X-ray. Tu belum lagi tengok ERCP, ultrasound, CT scan, MRI. Beza dengan ong, kau tengok baby ultrasound, baby ultrasound, baby ultrasound..Sebab hospital kulim tak ada detail scan bagai. T___T Thats sad

This picture basically how I learn surgery. 

I read davidson and manipal as main reference.

In A Page as quick reading notes.

And do my own notes through you tube. Haha

Ipad dekat sebelah tu gua buat refer Wiki. Hahaha :P

(baca jugak wiki sebab senang hadam..hehe)

Then kau kena mantapkan hafal segala jenis surgical instruments. Forceps (yg entah berapa jenis entah..huhu), needle holder, retractor, NG tube, Stengtaken blackmore tube, airway, catheter, and banyak lagi. Terkebil-kebil aku nak hafal benda alah tu semua weyh.

Ward round surgery paling best. Sebab banyak gilos cases kau kena ingat. Then balik, kau pun tak tahu nak study yang mana satu dulu. Haha. Bedsite dia biasa la macam bedsite yang aku pernah cerita sebelum ni. Tak banyak beza sangat. Clerk, present, physical exam, soalan-soalan sikit. Kau buat banyak kali, kau pro la. (ceh! bajet! haha..padahal..). Clinic dia best! Sebab banyak gila benda kau boleh belajar. Tapi malangnya ada sesuatu yang berlaku menyebabkan kitorang jarang dapat masuk clinic. Sob3
Tapi kalau kau jenis yang muka tak tahu malu, clinic petang tu datang la, belajar. Tak selalu kena halau kot. Kalau kena halau, blah r. Kalau ok, kau stay. Ada FNC clinic, breast clinic dengan dressing. Aku selalu join dressing clinic. Sebab kau boleh perform basic procedures like surture removal, dressing, and wound checking. Unlike macam breast clinic, tak boleh suka-suka je nak join kalau tak ada student perempuan, tak boleh la join..FNAC pulak agak bosan, sebab kau boleh tengok je (sambil cakap "ouch" dan pegang leher sendiri) and tengok sampling.

Sesi selfie sementra tggu consultant for lecture. Ahaks.

Procedures pun tak banyak sangat kau kena perform. Blood taking, cannula insertion, IV line set up. Lain2 banyak kena observe je. Same goes to OT. One major surgery and one minor yang korang kena observe. Tapi!!!!, ada satu procedure ni yang kau kena perform and dapat trauma lepas tu. PER RECTAL examination! Dalam log book kitorang, kena perfom 2 kali je kot. Tapi tak tahu kenapa aku dah perform more than 4 times kot throughout surgical postings. First time aku buat, aku lupa pakai double glove. Ya Allah, serious, lepas tu seminggu aku makan guna sudu! haha. Bau tak hilang dari tangan aku T.T

Yes! I do have a "life" lololol Friday evening and Saturday!

Kitorang cuti sehari je sebab Kulim kerja on Sunday.

Friday we do have class in Penang for radiology, or video conferencing with ukm-cheras.

and i do joined mountain bike tournement. haha

Dapat medal kot!

For examination, short case aku dapat 2 cases. One diabetic foot ulcer (which I did really bad). Gila ko! dia tanya aku pathogenesis of diabetic foot ulcer. Terkebil-kebil aku. Huhu..And, another one, I got incisional hernia. Hernia from cesearean. Obvious hernia. Agak senang la case tu. Nasib baik boleh back up case diabetic ulcer tu. Then, ada soalan X-rays which I got fractures, air under diaphragm, pneumothorax dengan apa lagi entah. CT scan I got extradural haematoma. And one ERCP, stone in common bile duct. Instrument I got Stengtaken blackmore tube, mosquito forceps, 3 way cathether (sengal aku pergi sebut 2 way!), needle holder, airway tube dengan apa lagi entah. Banyak sangat. Lupa. Dannn dengan cukup-cukup makan, pass surgical short case. Huhu.

For long case, I presented one case of testicular tumor. Serious cuak. Left testis with the size of ostrich egg! Non metasthasize. Nasib baik ok. Dia tanya aku classifications of tumor, how to approach the tumor, investiagtions tu confirm. Ok la kot.

For continous assesment. Kena pilih 2 surgical cases. I choose left inguinal hernia (from paediatric ward actually case ni. Mampus aku nak kena cari surgical management dengan dosage ubat semua under paediatric..Dah la paediatric ni posting year 4 T.T), and one more case is thyroid cancer.

Theory paper OBA, EMI dengan KFQ ok la. For KFQ sekarang ni aku dah lupa sikit diagnosis apa entah keluar haritu. Rasanya satu case on ascending cholangitis, satu breast cancer, satu portal hypertension. Lagi satu apa entah? Trauma case rasanya kot..Written OSCE ada X-ray on staghorn calculi, X-ray on intestinal obstruction, instrument of central venous line, CT scan on haematoma, ERCP machine dengan apa lagi entah..hahaha. Susah la nak recall T_T

Overall, surgical posting ni banyak benda baru yang kena belajar. Tapi ok la. Overall for semester one third year, aku lagi suka O&G, tapi surgery punya markah was higher compared to O&G. Surgery aku tak berapa suka maybe sebab aku agak lambat on surturing degan aku ada sikit fine tremor when holding instrument. Macam tak sesuai. Lagipun I do hate anatomy bila dia jadi too details and too many to remember. You cant simply use your logic, imagination, and theory or even algorithm masa belajar anatomy. Kau just kena faham, hafal dan hafal dan hafal dan hafal. Tu tak suka tu. Haha

celebration of our results. Hah. Thank you for yang edit this picture!

Macam pakai fair and lovely muka aku aku kata ko~ hahah

combination of 2 posting groups for surgical posting on first semester.

Andd, i passed both my O&G and surgery for my first semester in 3rd year md ukm. Alhamdulillah. Special thanks to my parents, teachers, lecturers, consultants, doctors and friends for the guidance, help and all the discussions. Lepas ni boleh tulis pasal internal medicine pulak! huuuu