Deadlines!!

Time is a factor! There is 7 days a week, 24 hours a day. And yet, I feel that I do not have enough of time. It is a competition and I am racing with time. I have to complete impossible tasks before the deadlines, hope for days perhaps hours for leisure and yet....it just become impossible. That most important day in my life(this point of view) is coming closer and closer. I can feel my heart beating. All my effords for the past 5 years is to suceed in this important moment. My future is at the hand of them, a group of 6 peoples. Arghh...sien and yet I cant do anything to stop it. What I can do is trying my best, maximising my potential, consolidating all my knowledge, to impress them and get a PASS. I do not have other way to go. I'm scared and yet I do not have other way to go. I'm not sure whether I can do it and yet I must try. Try harder and harder until I'm close to that point. Come on, you can do it! At the same time, all the best for my fellow friends!!!

Deadlines:

1. ortho portfolio~21 Jan 08

2. housemanship interview~31 Jan 08

3. Submit portfolio~1 Feb 08

4. Clinical & Portfolio Discussion~25 Feb 08

5. My Tasks:

• ortho portfolio
• portfolios correction(paeds 1 & 2, int med 1 & 2, psyche, obst, gynae, surg 1 & 2, ortho)
• certified certificates, writing resume
• prepare for interview (baju kurung, general knowledge)
• buying clothes for chinese new year
• go back home 1 day before chinese new year
• meet my high school frens during chinese new year
• study for my portfolios and long case
• plan for my accomodation a day before the long case

All the best!!!!! ^_^

O&G rocks!!!!

O&G posting officially came to the end. I had a short holiday, around 6 days before my last posting, surgery started. I realized that I had not been updating my blog for a long time. Although O&G posting was hectic and tiring, I really had a good time. I had a lot of hands on opportunities that made me more competent. I scrubbed in for the first time to assist surgeries, conduct deliveries, set up intravenous drips, stay up the whole night for the calls and try to stay alert the day after for clinical teaching. On call was really challenging as I needed at least 8 hours sleep a day for me to function normally. I realized the challenges and difficulties that faced in the O&G career. The 'meconium baby' incident made me understood that mistakes could lead to morbidity and mortality to both mother and baby. Special thanks to my group members preetha, jingwern and soon han for the support. I could not forget to learn swabbing and tightening pads from my fellow friend. (well, u knew who!!!haha..) Life was more easier and fun with the presence of u all.

I never forgot how nervous was I the first time I scrubbed in to assist operation. It was an emergency lower segment caesarean section for pre-eclampsia. My hands were freezing and I could feel my body was shaking. I was lucky enough to really functioned as a houseman at the end of the operation while the houseman had scrubbed out to assist another operation. Bleeding occurred for unknown reason when the surgeon tried to closed the wound. The surgeon had to reopen the suture and stopped the bleeding. The experience was precious. In my mind, I really hoped that I was the one who performed the operation one day!!!:P Surgery was 'addicted'.The second operation was elective LSCS with 1 previous scar. The surgeon faced difficulty to identify the lower segment of the uterus due to the adhesion. The surgeon accidentally hit the left uterine artery. Blood was shooting up to 90 degree like a fountain. Blood was everywhere. I was shocked. However, it was amazing that the surgeon could identify the source of the bleeding and ligate the uterine artery cooly and calmly. The bleeding stopped at last. I realized complications could happen any time and the most important thing was how we dealed with it.

Survival of the fittest!

24 September 2007, 10AM

This was the most memorable day throughout the paediatrics posting. First day @ SCN and yet encountered unforgettable moment in my life. I started to realize what 'SURVIVOR OF THE FITTEST' meant and how lucky for those who had undergone it. Life was fragile and not all could come this world uneventful. Just do not take things for granted!

MESSAGE from labour room: A 26 weeks twins pregnancy primi, experienced sudden contraction. Upon arrival, found that she was 2nd stage of labour. MO & HO in charge immediately rushed to the labour, well followed by 3 medical students as well.

MO: 26 weeks ,Twin!!! Nobody will know what happen upon delivered. Prepared warmers, suction, oxygen, ambu bags, larygoscopes......

A: Only 1 heartbeat was detected! and yet the rate & volume were....(sounds like prognosis was not that good)

After few minutes, the twins were delivered. No cries, floppy, no signs of life....

weight: 0.5kg & 0.6kg

No active resuscitation was done!

I looked at both twins. So small.....no so tiny......

I stood there for a few minutes. I was speechless and did not know what to do. Just kinds of feeling and yet dunno what that.

Life is fragile. Not everyone survive when he/she comes to this world. Some may need help (resuscitation).

How lucky you are & Appreciate what you have!

This 2 weeks really drove me crazy, portfolio2, correction for portfolio1 and yet had alot of problems, CFCS only just started.

and DEADLINE: 3 October 2007

I felt so tired. Coffee at night,Stayed up late at night and struggled to wake up in the morning. Sleepy during afternoon session (Oops, hopefully no one aware..)

{well, alert only in the morning as SCN was just too interesting...resuscitation, umbilical artery & vein catheterization, knowledgable MO and nice HOs, tiny babies that struggled for survival...etc.}

Life was just up side down.

Started to notice that i had not been reading..Grrrr...feeling so dumb and stupid!

Am i complaining too much? i'm a nagger especially when i'm stress. I try not to complain too much and yet my mouth just cant stop. Oops, any genetic reasons behind this? Haha.. or female likes to complaint.( wana to prove it? just do a randomised controlled clinical trial)

Okok, I survived first minute of life although quite struggled actually, i was a forcep baby. My mum claimed that my head " too big", could not come out..haha

And sure i can make it. I MUST FINISH EVERYTHING ON TIME!!!!

stop stop, time to continued my cfcs report, hopefully can finish by this weekend

Post-exam

Just back from lunch with pooi yee & soo ni @ igentis, jusco. I had fish soup with rice. A wise choice instead, as my appetite went up & down for the past few weeks. And I realised that most of us experienced pre-exam syndrome (a combination of symptoms eg headache, nausea, voming....that existed during exam season). Exam monsoon officially came into the end, unless those who were not lucky enough, had to go for borderline viva tml. 'Can I pass?' This is the question that came into my mind for the past few weeks. The more I study, the more doubt I was. I had 'flashback' of stupid mistakes I made during the exam. On the other hand, I kept on convincing myself that I could pass. 'Come on, u can do most of the questions!' That's me! My brain neurons were in bizzare condition, I was confused. Uncertainty was 'killing' my soul. I was tired & exhausted mentally & physically. No matter what happened tml, I dun care anymore! I had done my best. What I need now is 'HOLIDAY'.

Exam Blues..

14 DAYS more ...an important moment in my life, I'm going to sit for my EOS first paper, MEQ . Time flies and I cant do anything to stop it, really feel inadequate. However, planning to spend 1 max 2 days for each posting. Sounds ridiculous rite? Can i revise everything in 24 -48hrs? I dont know. Just try my best to cramp all the stuff into my brain in these golden 14 days. Basically,my life is going to be :

study-->sleep-->eat--->study

&

FIGHT FIGHT FIGHT!!!

connie the warrior...

^_^

*Pls not disturb me unless sth really important* Thanz

ALL THE BEST!!

Desperate!

2 months more, I'm going to sit for my final exam. I really felt inadequate mentally and physically. I knew that I sort of stressed out TRO ?borderline burned out. I became impatient and got angry easily. I desperated when I dun noe the answer. I couldnt stand when things were not in the right order or went wrong. Things just not in the right path. I just wander what happened to me..:S

Dun let ur past wouldnt affect ur present & future! Come on gal, be strong! U can do it! :)

Attack every problem with enthusiasm, there's an island of opportunity in the middle of every difficulty...

-sunshine-

Someting about paediatrics posting..

4 weeks (well, only 3 weeks if minus public holidays & wkends) paediatric posting came to the end. Finally, finally, finally...Just felt sense of relieved. I wander why i felt so stress and lost. Maybe time was a factor. Imagine u had to know all about neonates and children in 3 weeks time. This could be difficult some time. Kids were weird. Although they were the same species as u and me, they just special. They sick as usual, but they presented in their own way. They had their own language--crying..or TAK NAK in older children. How to calm a crying and irritable baby/ children was challenging? Agree? I bcame impatient and lost when they started crying or just reject u TAK NAK when i wanted to examine them. And everybody in the ward looking at u as ur 'bad people'. U made a child cried. embarrasing huh? :S

Signs were always the key. Apart from the history from the parents, u had to be an observant. I realized the importance of inspection. It really could tell u alot. The thing was whether u awared of it. Amazing right? Examination of babies were challenging. Imagined u had to detect hepatosplenomegaly while they were crying, struggling..and the organs were so small and tiny. I just feeling like i was 'fighting' with the child during physical examination. I do agree that we need to train our fingers to do it. Practice is always a key and when can i able to do it???

I really did badly in my SAQ, and finally i noticed that i couldnt interpret the problem and made a diagnosis. Was it too late to realize it? I couldnt differentiate nose block sound and stridor in my clinical exam. The most funny thing was that i even asked my examiner how she knew it. Experience was the answer...HAHA...:)

Whatever, I do learn alot during my paeds posting. Special thanks for all the lecutures that spent their quality time with us. Following were some of hightlight....

• core knowledge
  

Study...this needs passion and determination

• common sense
  

When u cant dun noe the answer, ask urself & use ur brain

• unlearned and relearned

Throw away all the wrong things & fill it with correct and new knowledge

• working diagnosis-where & what the pathology, aetiology & complications

This is what medicine about, identify the problem and solve it

• defining moment

Special things happen in ur life that change ur future.

• love language: quality time, gift, act of service, physical contact, words of encouragement

How do u expresse ur love? For me, definately quality time and words of encouragement. What yours?

AND............RABBIT balloon..

this is really fun. I abeit phobia bout balloon b4 this. I scared it might 'burst'. But really hard to imagine that i played with it and turned it into a rabbit, a big step rite? I had taken some photoes, just waited for my frens to send to me.

When this is really matter.....

10 May 2007, evening @ home

P: connie, EOP result has out.
Me: When?
P: I see it around 3.30pm, after class. It should be out during lunch time.
Me: I fell like driving back to uni to get the result..
P: Just go lah..
Me: No (This is just too crazy)
P: paeds MEQ, only 3 students pass, 4 out of 14 get F.
Me: what??? Is the question super difficult? (I'm in paeds posting now)
P: ya.
Me: :S :S, How about surgery?
S: All passed.

At night, I was really in depression mood. Study abeit and Zzzzz...

11 April 2007 noon, after CP

I went to AAD to collect surgery EOP result.
I opened my result slip. XXXXX
Aas usual, XXXXXX, not much of improvement...why?

Am I fooling around?
Am I not serious enough?
Am I not paying attention?
Am I not putting enough effort?
OR the question was just too tough?

Deeply in my heart, I already know why.
Equation is always the answer.
same effort= same result.
I study as usual.
I have fun as usual.
I sleep as usual.
I do things last minute as usual.
I screw up as usual.
Everything is just as usual. And I just do not care....
I know when there is no improvement, there is always a place for deterioration.
I know what is the consequences for not study hard.
And I know exam is coming...

Is this my limitation? Or I can do better than this.

What happened, happens for a reason..
There are no short cuts, little change makes a big difference..

surgery clinical examination

27 April 2007

This was a big day for me. All my effort in the past 4 weeks was mainly because of this end of posting exam. I had clinical and writing paper on the same day. This was my first clinical exam after ? 4 months, I think. Hardly to imagine how nervous and uncertainty was I.

I had Mr.L for my clinical examination at wad 8b, together with azman and pei lin. As I was the last candidate, I was told to have a drink and back after ½ hour. Ok, where should I go? My exam started at around 9am. I met Mr L outside the wad.

Mr L: U go and clerk a patient at bed 16. Talk to her nicely as she is in pain.
Me: Ok.

I walked with my heavy footsteps into wad 8b and looking for my patient. She was a middle-aged malay lady with nasal sprung and urinary catheter, lying on the bed. She looked quite ill.

Me: Acute abdomen. Another intestinal obstruction? My god. Mr L is going to ask me about fluid resuscitation. (by the way, I had presented a acute intestinal obstruction case during the case presentation to Mr L around 2 weeks prior and being criticized until I felt like running away….)

I introduced myself to the patient and started my clerking. My patient was quite happy to talk to me. How lucky was I! Thanks so much. A few minutes later, Mr L was here.

Mr L: Do u have problem communicate with this patient?
Me: No.
Mr L: Ok, continue. (He is reading the case note of this patient)

He was so caring and nice. I felt so warm about it. Of course, I knew what he meant. As a medical student, I encountered problems with patients eg language barrier, incooperative patient....

I finished clerking and physical examination around 40 minutes. I rearranged all information I had and tried to figure out the differential diagnosis and management.

After 20 minutes, here Mr L was. I presented the case to him and summarize at the end. Here was the summary..

This was a middle-age lady that admitted the day prior, presented with acute abdomen. He……

Mr L: He or She?
Me: She (my god, not again..i screw up again. I cant differentiate between he or she)

She complained of epigastric pain, radiated to upper abdomen x 3/7, vomiting x 1/7, fever x 1/7 and constipation x 1/7. She was similar episodes for 20 years. She was known case of hypertension, on CTZ and KCL supplements.

Mr L: What was your provisional diagnosis?
Me: Acute cholecystitis TRO acute pancreatitis
Mr L: Differentiatial diagnosis?
Me: Perforated PUD, MI
Mr L: Perforated PUD????
Me: Actually the physical examination doesn’t show signs of viscus perforation.
Mr L: ok how u investigate this patient and tell me why?
Me: FBC-Hg,TWCC,platelet…
Mr L: this patient TWCC is xxxxx? What this show?
Me:xxxxxxxx

At the middle of the discussion, he got a message.

Mr L: Do u read Chinese?
Me: Yes
Mr L: Tell me what is this?
Me: xxxxxxxxxx
Mr L: ok, I’m going to delete it
Me: speechless…

The discussion took around a hour. He asked from tip to toe. Quite luckily he didn’t ask about anatomy and physiology which I did not remember much about it. At the end of the examination,

Mr L: U’re semester 9 now, I expect u to know what the normal value of potassium and ranson score for acute pancreatitis.
Me: :S
Mr L: U go back now and read about it, I will ask u about it when I meet u in the afternoon.
Me: ok thanks so much (Is he coming during the writing paper? Haih….)

That’s the end of my first clinical paper after 4 months. Ok, fine…I went back blossom, ate lunch and Zzzzzz, looking forward my writing paper at 2.30pm. I could fell the tiredness. Whatever, I just tried my best!!!!

Not feeling feel...

Just didn't know why? I had been fatigue, sore throat and low grade fever for the past one week. Firstly, i thought i might have viral URTI that would resolve after a few days. I only took some PCM and rest. The condition remained the same until now. I just tired all the time and could not concentrate. My immunity seemed like not working.

Was it due to my hectic lifestyle? I had been very busy since my surgery posting 2 weeks ago. Everyday was fully occupied. I had to cover ward, prepare for CP, TBL, CSU, and attend clinic, endoscopy session. I always fall asleep during revision at night and struggled to leave my bed in the morning. I really felt exhausted. What I need now, take a day off and rest.....

Everything will be fine when I wake up tomorrow morning. :)

Keep your face to the sunshine and you cant see the shadow!