Astaghfirullah..
Terukla my performance masa short case semalam~ T_T We were told to clerk cases, present, examine, generate working and differential diagnosis, lepas tu gedebak gedebuk la kena tanya and discuss. The first case was quite straight forward - CSF leakage. Macam biasala, kawan saya present chief complaint and all the bla3 details.
Tapi...
Sampai katil patient saya yang dah day 7 post-op, supervisor saya yang hebat suruh summarize and discuss about current status of the patient. OMG~ *thought block* Tergagap nak goreng.
Lepas tu confidence level terus turun turun... dan turun lagi. Isks.
First time tau jadi macam tu. Ada yang tak beres gamaknya. Sampai lupa post-op day berapa. Teruknya Alia...
Alhamdulillah, Dr super baik. Beliau banyak guide. My tasks were:
1. Examine and comment on patient's general appearance.
Very brief and roughly (as opposed to my presentation which was panjang dan berterabur):
Patient is lying on the bed. Tracheostomy tube. Oxygen mask not used (what a waste, terus Dr suruh discontinue the O2). Nasogastric tube. Scar from inferior border of lower lip extending to the submental region, ada jugak kat neck until midclavicular area. Kat chest pun ada sebab ada reconstruction using pectoralis major (PM flap).
2. Why does this patient need tracheostomy? (indication utk patient ni special)
- For surgical access.
- Impending upper airway obstruction.
3. Why does this patient need NGT?
- Trismus sebab pain during chewing and mouth opening > cannot eat solid foods very well > nutrisi yang tidak sihat > bagi NGT untuk high protein diet (susu)
4. Imagine u r the HO in charge, patient just come back from OT, what would u do?
*gulp* Ni soalan time surgery dulu ni. Boleh pulak lupa. (akibat belah otak untuk belajar secara serpihan)
"Err... assess the surgical site?"
"Aiyah.. begin with simple things dulu"
- VITAL SIGNS ALIA, VITAL SIGNS! Haiya.. what kind of doctor-to-be lah tak sistematik cengginih.. (kutuk diri sendiri kejap)
- don't freak out kalau temperature slightly higher than pre-op, it is a response kpd surgery, especially loooong surgery, like hers la.
- of course cek conciousness etc
- THEN comes the scar
- pain control - in this case guna patient-controlled analgesic. pakai morphine.
Lepas tu pergi katil2 lain pulak - Vocal Polyps, Laryngeal Carcinoma, cholesteatoma, then Dr bawak pergi wad paeds. Ah sudah, takde org cover bed patient ENT kat paeds tu. Dr sengaja rupanya. Kawan saya kena clerk parents the cute 7 months old baby tu.
CYSTIC HYGROMA.
poor baby~ T_T saya memang tak sesuai jadi paeds. tak bole tengok baby sakit. it is heartbreaking. huhu. Alhamdulillah, Allah kurniakan tubuh badan dan akal yang sihat dari kecik sampai besar. ada nikmat iman dan islam lagi.
Alia, banyakkan bersyukur ye.... Jangan mengada sangat....
Apa2 pun, bila balik tu saya muhasabah dalam2. Sedih sangat sebab perform tak bagus. Macam dah kecewakan Dr je. Saya teringat sesuatu. Saya lupa call mak abah! Kesalahan yang tak boleh dimaafkan. isks.
Anyways.. yang penting setiap sesuatu yang berlaku tu tak akan lari dari hikmah Allah. Allah Maha Adil. Dia berlaku adil pada setiap hambaNya, sesuai dengan ketahanan masing2.
Terukla my performance masa short case semalam~ T_T We were told to clerk cases, present, examine, generate working and differential diagnosis, lepas tu gedebak gedebuk la kena tanya and discuss. The first case was quite straight forward - CSF leakage. Macam biasala, kawan saya present chief complaint and all the bla3 details.
Tapi...
Sampai katil patient saya yang dah day 7 post-op, supervisor saya yang hebat suruh summarize and discuss about current status of the patient. OMG~ *thought block* Tergagap nak goreng.
Lepas tu confidence level terus turun turun... dan turun lagi. Isks.
First time tau jadi macam tu. Ada yang tak beres gamaknya. Sampai lupa post-op day berapa. Teruknya Alia...
Alhamdulillah, Dr super baik. Beliau banyak guide. My tasks were:
1. Examine and comment on patient's general appearance.
Very brief and roughly (as opposed to my presentation which was panjang dan berterabur):
Patient is lying on the bed. Tracheostomy tube. Oxygen mask not used (what a waste, terus Dr suruh discontinue the O2). Nasogastric tube. Scar from inferior border of lower lip extending to the submental region, ada jugak kat neck until midclavicular area. Kat chest pun ada sebab ada reconstruction using pectoralis major (PM flap).
2. Why does this patient need tracheostomy? (indication utk patient ni special)
- For surgical access.
- Impending upper airway obstruction.
3. Why does this patient need NGT?
- Trismus sebab pain during chewing and mouth opening > cannot eat solid foods very well > nutrisi yang tidak sihat > bagi NGT untuk high protein diet (susu)
4. Imagine u r the HO in charge, patient just come back from OT, what would u do?
*gulp* Ni soalan time surgery dulu ni. Boleh pulak lupa. (akibat belah otak untuk belajar secara serpihan)
"Err... assess the surgical site?"
"Aiyah.. begin with simple things dulu"
- VITAL SIGNS ALIA, VITAL SIGNS! Haiya.. what kind of doctor-to-be lah tak sistematik cengginih.. (kutuk diri sendiri kejap)
- don't freak out kalau temperature slightly higher than pre-op, it is a response kpd surgery, especially loooong surgery, like hers la.
- of course cek conciousness etc
- THEN comes the scar
- pain control - in this case guna patient-controlled analgesic. pakai morphine.
Lepas tu pergi katil2 lain pulak - Vocal Polyps, Laryngeal Carcinoma, cholesteatoma, then Dr bawak pergi wad paeds. Ah sudah, takde org cover bed patient ENT kat paeds tu. Dr sengaja rupanya. Kawan saya kena clerk parents the cute 7 months old baby tu.
CYSTIC HYGROMA.
poor baby~ T_T saya memang tak sesuai jadi paeds. tak bole tengok baby sakit. it is heartbreaking. huhu. Alhamdulillah, Allah kurniakan tubuh badan dan akal yang sihat dari kecik sampai besar. ada nikmat iman dan islam lagi.
Alia, banyakkan bersyukur ye.... Jangan mengada sangat....
Apa2 pun, bila balik tu saya muhasabah dalam2. Sedih sangat sebab perform tak bagus. Macam dah kecewakan Dr je. Saya teringat sesuatu. Saya lupa call mak abah! Kesalahan yang tak boleh dimaafkan. isks.
Anyways.. yang penting setiap sesuatu yang berlaku tu tak akan lari dari hikmah Allah. Allah Maha Adil. Dia berlaku adil pada setiap hambaNya, sesuai dengan ketahanan masing2.
"Apakah kamu mengira bahwa kamu akan masuk syurga, padahal belum datang kepadamu (cobaan) sebagaimana halnya orang-orang terdahulu sebelum kamu?
Mereka ditimpa oleh malapetaka dan kesengsaraan, serta digoncangkan (dengan bermacam-macam cobaan) sehingga berkatalah Rasul dan orang-orang yang beriman bersamanya: 'Bilakah datangnya pertolongan Allah?'
Ingatlah, sesungguhnya pertolongan Allah itu amat dekat."
Al-Baqarah: 214
Mereka ditimpa oleh malapetaka dan kesengsaraan, serta digoncangkan (dengan bermacam-macam cobaan) sehingga berkatalah Rasul dan orang-orang yang beriman bersamanya: 'Bilakah datangnya pertolongan Allah?'
Ingatlah, sesungguhnya pertolongan Allah itu amat dekat."
Al-Baqarah: 214
Ustaz saya kata, selalunya Allah akan datangkan pertolongan bila kita dah tersepit dan tak jumpa jalan keluar. Saya setuju 200%. Sebab saya dah banyak kali kena.
~Adil nye Allah~
Patients seen: BANYAK! Hari ni klinik dari 9 pagi - 2.30 petang. Tak lunch pun. Dah biasa pulak. Bad for the tummy~
So cases for today - several cholesteatomaS, 2 cases of microtia and canal atresia, cochlear implant, meniere's disease, CSOM, allergic rhinitis, Obstructive Sleep Apnea etc.
Currently reading: jurnalsssss... sebab nak siapkan case write up and SSM.
DOAKAN SAYA YA~TQ!
So cases for today - several cholesteatomaS, 2 cases of microtia and canal atresia, cochlear implant, meniere's disease, CSOM, allergic rhinitis, Obstructive Sleep Apnea etc.
Currently reading: jurnalsssss... sebab nak siapkan case write up and SSM.
DOAKAN SAYA YA~TQ!
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