medical journey #4

today is an exceptionally packed day. i started academic hours straight from 7 to 4 in the afternoon (gynae round-ot tah (a very compound crash course on uterine fibroid/leiomyoma)-cta on fgr/sga-cme obstetrics emergencies-lecture), had first meal at five, kinda a teaser of life post uni.

yesterday was our group's first 16 hour oncall and we were managing a patient with preeclampsia, 8 hours in labour without progress in cervix dilatation so at the end she had to go for elscs. basically we didn't do much because so few patients, only timed her contractions (which is really hard to do manually for me), plot the partograph, took cbg etc. we missed the operation but the baby was delivered safely and healthy, so we went to have a look as the baby got supplemented with oxygen. the paeds dr taught us about vernix caseosa / vernix - the whitish coating on the baby postpartum. basically it's the product of the baby's sebaceous glands to moisturise the skin and as a barrier for infection. yeah. 

we also clerked a few patients, i can't share the details here but it was a case of sirenomelia / mermaid syndrome where the lower limbs of the baby is fused. read it once in a book and actually they can survive if no other abnormalities, and have surgery later on post birth to have normal functioning legs. however it was not the case for this baby who had single umbilical artery and dysplastic kidney. the parents found out since the first trimester but defaulted termination of pregnancy and are keen to deliver to term. we saw the emr and it's a bit sad reading their plans to spend the short moments with the baby after the birth.

we were also taught on nice guidelines for ctg, the white amber red one, twin ctg, and joined round until the clock struck twelve. a really tiring day for me so i wonder how the housemen endured. dr was counselling the patient on pros of clexane (enoxaparin) vs heparin which needs more monitoring and more side effects. he briefed other patient earlier last week on the same thing... that's where i found out that enoxaparin originated from pigs but the dna is removed. dr ensured that it's widely used for ijn patients with heart blocks, and it's 'harus' for medical purposes as per quoted by his muslim colleagues.

i guess the fatigue really comes delayed because post dinner i took a nap at 6 pm and woke up at 11. then i took bath and now it's 3 am and i can't sleep. still thinking whether i should attend clinic or go to ward tomorrow.

this is all for now :)

just

recently, i had frequent episodes of chest pain. i know that i should've gone to a check-up but i keep delaying things. this week is going be to so busy since im on ot rotation and will be having exam two weeks in a row so idk if i'll survive it but i just wanna put some things to rest now.

it's so strange that something that was almost like my vitals just a few years ago could be foreign so shortly, and that i know full well how to reverse things but i just don't.

that thrives off faith.

and i miss my little brothers. feeling homesick as an adult is the worst because the damage is always yours to flicker alone.

oh

it's the visceral guilt, fermenting into something else. 

september

new academic year. i'm depressed when i'm surrounded with people but it gets even more depressing in solitude. guess i just have to swallow it all.

i don't even yearn for death. death means pain in my dictionary, and because i believe in the afterlife that death feels very scary.

i just don't want to exist. 

then this blog probably won't exist too. neither are my traces in this world.

i feel so sleepy right now...

april lavigne

ended paeds posting cleanly. passed the exam and went dining @ kanna curry house with my groupmates before going to karaoke tgt. will need to work harder during the next posting! 

after meeting our supervisor to sign the logbooks i went to ent clinic to be a subject for an allergic rhinitis research, underwent a blood taking for ige test + nasal endoscopy (painful af) only to find out that i got bilateral adenoid hypertrophy. no wonder my previous episode was so bad.

anyway. the research is for a new allergic rhinitis medicine either containing brown rice or tiger mushroom. i was given a bottle of medicine, prescribed bd post-meal for 30 days. guess it's for a clinical trial phase of a new drug. will update about this later.

post-exam

had a really great time recently. traveled solo to singapore for the first time to see seventeen at the end of january, meeting online friends, spending holiday with my family, having exams back to back and currently at terengganu. i have always loved the beach. there were swings too in batu buruk, and the view was amazing. while on the swing, my younger bro said he wanted to be an astronaut or a vet.

on the way back, found out about something i actually have expected... and it turned out to be true. i was so hurt and i kept feeling like in the future, i won't be able to let people in anymore especially if they are the one approaching first. because they always leave first. they really, always leave first. even if we barely interacted, even if i put my best distance. but does it matter. leaving is always a choice. 

i hurt people too. it's only fair to earn the same heartbreak at times. 

ent

this posting isn't always bad, but there are times when i feel that people are so horrible. most the patients, though, are really kind to us.

so this week clerked an indian uncle. we asked for his name and he went: jude. elyssa praised his name, saying it's beautiful, but the uncle laughed it off, citing that his name sounds like a girl's. we were like nooo it's like the beatles' hey jude!

the uncle was shocked that we know the song, he thought it was just his generation. hey jude is just that timeless... also, he let us do otoscope, rinne and weber on him 🥹 i hope his surgery today went well. will check on him in the ward again tomorrow morning :) 

petals

one year ago i went to a cafe and got an orange rose from a girl, now the dried rose still sits by my wall.