The First-Time syndrome and A Memorable Holiday.

I miss writing!

Well up until today, Alhamdulillah I'm doing fine and struggling to be productive at my best. 

So! Here's some experiences/wisdom I picked up since my week 2 Cardiovascular system in this Internal Medicine posting.

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It was my 2nd oncall, that I came into the ward, half awake since I was dreadful lethargic from the morning rounds and seminars. Upon entering the ward aisle while looking for patients to clerk, with my drowsy face, I was surprised by a doctor who was at the bedside of this one patient, CALLING ME ;

"eh awak kat sana tu! busy tak? meh sini tolong saya!" while checking up the instruments and meds at the trolley, with apron and gloves on. 

and I was like, "BOLEH!" -excited, eyes wide open! This is what I've been waiting for. To assist a doctor performing procedures on a patient, although I am not yet in the surgical posting. hehe.

So he asked me to go to his left side, where I had to squeeze myself in between the cubicles, since the patient next bed is guarded by policemans (hm he might be a suspect? or a prisoner??okay back to my patient) 

"haa awak kecik je. mesti muat punya. dah, pakai gloves tu", he said. wow! My heart explodes, even when he asked me to wear the gloves because it feels like I am entrusted to aid this such procedure, although...  I don't even know what procedure he wanted to perform! haha. 

While he is preparing the patient, he asked me "kenapalah awak nak jadi doktor? Rugi!" I just smile and decided not to answer him, because.. I AM SO EXCITED TO DO THE PROCEDURE! 

A couple minutes later, after all things are set, He started to detached the suture that holds a tube which was inserted into the patient's right side of his chest, under his armpit (in medicine we called this as : mid axilla, 4th- 5th intercostal space. Surgery peeps, please correct me if I'm wrong). 

This tube is connected from the lung to a container. It is usually to drain all air/ fluids that are collected in between the layers of our lung. In medicine, this layers we called as pleura. and the air or fluid is usually located in the Pleural Space.  

It is literally like this. I googled the image okay. I did not took picture of my patient.  

So who will usually undergo this procedure? 

Well, there's so many reason for a patient to receive this procedure on them. For example in a trauma patient due to physical injury, blood may trapped in their pleural space. But that is not the only cause. Those who have respiratory disorder also may developed any abnormalities in their lungs that causes air/fluid to get trapped in the pleural space. One of its major trigger is smoking. woops! I'm sorry guys. and what if you didn't drain the air/fluid?

aha! simple. You'll have difficulty in breathing, which.. ladies and gentlemen.. leads to another list of illnesses.

complicated huh? so.. think which weighs more benefit. Your desire VS Your health.

Alright, back to my story. The doctor then push and pull the tube inside out, as if he is inspecting for the right postion to re-suture the tube back. After he found the right position, he told me, 

"pegang tube ni. jangan bergerak eh!" 

"okay doctor"

So I hold the tube, while the doctor injected the lignocaine (an anaesthetic drug, so the patient will not feel any pain while the doctor suture his skin) around the hole in the skin.. em okay not appropriate word. em.. around the incised skin where the tube was inserted! 

wait, hold on. Before he injected the lignocaine, he applied povidone around the skin first, as an antiseptic to prevent surgical incision infection!

The bed started to took all on-call med student's attention. It became a crowd. The doctor then took  out the surgical needle and it literally looked like 'Mata Kail' for fishing. 

I was.. okay.. this scary.

The doctor started to suture around the patient's incised skin and I saw his hand was tremor-ing. Either its because all students attentively wearing on their hawk eye on him, or.. it is maybe a natural thing as a doctor. I don't know. So the doctor break the silence by talking to us. He explained that the suture that he is making is a Purse-String method. Uzma was at the end of the bed, and she told me that the patient's hands and feets was trying to take a grip on the bed, showing a sign of pain.

After he sutured around the patient's 'hole', he tied up the thread along the tube. yep, just like a scout. hehe. Then he applied a liquid on a cotton, I don't remember what was it, but then he put the soaked cotton on the suture area and plastered it with a medical-kinda-double tape.

Sorry guys, I really have no idea what is the terms. I'm trying my best to stay in the layman circle with my blogpost, yet also share some terminologies that I knew, so at least you got a lil knowledge from here.

The night oncall end, with a very excited heart. I think I've just fly over the moon. haha.

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Here's to summarise the rest of the week.

Distinguishing the difference between the patient's first day of admission's X-ray to his current day X-ray, to see how he progress by time since he've been admitted for a week already. (The longest patient admitted, that I had for now) Here, I learnt about blebs and bullae. It is a small cute pocket-like-sac /air-filled cavities or in a layman term, bubble (I heard the doctor said it to the patient) which form from the lung tissue itself. It is actually a complication of emphysema, which may leads to pneumothorax if the bubble burst.

okay, I sound nerd already.. I should stop.. 

While I was going through patient's file, page by page..

so focus reading lines by lines,

breaking their short form codes like a detective with wrinkles formed on my forehead..

then I came across to this page.. and my eyes bulged!

 ..i kerai. 

haha no lah. Medicine is fun. Medicine is fun. Medicine is..

until we have to interpret this ecg

need years to master interpreting ECG.

but peeps, this is what is most important in our life.

as I took my break to watch whatsapp story, 

Kak Sarah post this ans I think it's quite a good point to share and ponder

As I gone through the journey of meeting deadlines and achieving daily goals,

I met such a wonderful people along my way..

Kindness can really make my heart touched easily.

To whoever you are that have been showing kindness, Thank you.

I wish I can show my appreciation to you, one by one.

But I pray as whole, that Allah will always show kindness to you too!

To summarise this cvs week, I had real fun throughout the week. Despite of the 'First-Time Syndrome', I am happy that I able to recall what I learnt in second year, with the notes done prepped. So I didn't struggle or blank much as what I thought at the first place. Plus, I noticed myself become more voicing out my opinion/answers, or maybe its because our new job to communicate with patients or simply because I can't help myself to just keep my answer in my mind.

All I want for a new year, is for people to hear my opinion/answers spontaneously, without writting as the intervention.  Hiks!

(because I used to be quite introvert in class)

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The ending of CVS week means the beginning of my holiday!
It's Deepavali break for a week.

So I decided to visit my sister in Cyberjaya, since both of my housemates also went back to their hometown. As Ika and I entered Kota Bharu after 3 weeks in Tanah Merah, the feeling is just wow! I started to appreciate tall buildings and the airport so much.

Nothing much about this holiday, rather than the heat waves and striking out my checklist ; To watch Kingsman, To eat Dakgalbi and boat noodle, To buy clinical books at Kamal Bookstore, to study a little and accomplish my first case write up. Well, I did striked it all, except going to the boat noodle, since I accidentally went to Dal.komm Café hehe so yeah boat noodle, next time okay?

As I arrived, we went for late lunch at d'Pulze, since I've been craving for cheese and cakes.

The next day, hera made me maggi?!

To be honest, I rarely eat maggi in Kelantan, since we've been taking turns cooking proper meals.


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So today, we decided to go out. since Hera has no class. Plus I need to go to Kamal Bookstore to buy books.

(Dear syuhada in the future, I know you easily forget stuff especially anything that involve name of place, name of roads, LRT Station. So stop by Titiwangsa station when you want to go Kamal okay?)

This is Hera (in make up) because she have photoshoot for her friend's assignment.

what kinda model is this..

so yeah, I've reached Lim Kok Wing.

.. your world and my world has huge difference, hera..

and Hello KL!

long time no see KLCC

I found this cute. 50% more lighter and smaller than my handbook.

But it cost way expensive than what I have.. okay..

After settled with my books, we then went to..

Dal.Komm coffee!

This is my second time.

The first time I went was with Ika and Uzma. Ika was crazy for their bread kinda thing, so she highly recommended this to us.

Honestly, I am not a big fan of coffee. not even a fan actually.

so everytime I accompanied my friends to a coffee shop, I will buy chocolate drink instead.

and, coincidentally that time dal.komm was offering this set of song-song couple chocolate cube drinks, in conjuction of Song Hye kyo and Song Joong Ki's marriage.

It tastes like chocolate + orange.  Just like the 'ol time!

So this is the song song couple of The Descendants of the sun (DOTS) with their choco cube.
 but nah! I don't wait to have boyfriend to have this. I can have this by myself and for my sister.

 I dont fangirl on this drama, since I watch it just recently, not during at high DOTS phase.

but okay, it is cute and has medic sense so.. okay. I can go for it

oh please. Don't challenge me. *smirk*

This is : Lava Cruffins with salted egg.

so nice ya Allah!!

while this is : Choco Lava Bingsu

It has magnum, muffin in it. Well, I couldn't appreciate it that much, since I have two desserts. so all I know is, It is super sweet! It suits to eat when the weather is hot.

so there you go! *kaching kaching* haha

Hera also get to meet her friend, Balqis!

can't believe we're still hungry on our way back home. so we bought this at Putrajaya Sentral

But also, I never knew that this holiday is one of my special day, and it is a must for me to marked it in this journey.
I don't see it coming because all I plan is to wish his birthday only and yet..
I received a clarification that have been kept for years.
*heart thumping*

*deeply inhale*
I am not going to write it here, because I already wrote it in my previous post.
The title is a bit weird, only one person will understand. so.. em okay.

I wish I can write an appreciation post of how grateful I am up to this moment.
But it's okay girl, take it slowly.

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I love this tudung very much, so dont ask why most of my picture I had this.

This tudung is very convenient, you don't have to iron it, easy to go, no pins needed, very light so the wearer doen't get hot or sweat. It comes with 20+ colour if I'm not mistaken. and you know, this is most of the female doctor's and female student's favourite scarves. Plus! It was on sale, 3 for RM 100!

This is, Cloverush! Go grab yours!

No. This is unpaid review.
I just wanted to share good things I cherish so others can enjoy and benefit it as well!

It is wednesday, and I have accomplished my first case write up in the 2nd week of posting.
So, I promised myself to give self-reward when I achieved my goals.

One of them is to watch Kingsman!

I know, Im a bit ketinggalan here, but I dont care..


Dinner with Hera and her friend, Hana'

at Tappers, IOI City Mall.

18 October, It's Anne's birthday. couldn't meet her since she's too on her holiday back in her homwtown. so Happy Birthday Annie! I ask Allah to grant you with His endless blessings unconditional love. Thank you, for always been there for me through thick and thin. I love you!

   


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The next day, I get to strike out one of my holiday wishlist, which is

DAKGALBI!

This, is my favourite Korean food. well, most of our favourite.

and I went there with my favourite people too! WANI!

Like always, wani and I love to talk and reflect upon everything in life. so meticulous together.


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Holiday has come to an end, and I feel like want to tie myself up here in KL.

I feel, I am not ready to stuck into books again.

I know my studies looked superficially plain, but I will try my best to make nerdy life more colourful with the presence of my friends, patients and the people there. and oh, not to forget, the food! hehe

So Goodbye KL, until next time :)

Back to my crib!

I love my room, and I want to appreciate it so much since I never had the chance to have my own space and privacy. I noticed I developed more in my own space rather than in cluster of people because I am more into quiet atmosphere to study.

InshaAllah when I have time, we'll do more proper house tour :)


So yeah that is for now, see you at my next post.
Take care and stay healthy okay?


Assalamualaikum!


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Little things that means a lot to me.

5 Nov 2017, Sunday

It is a beautiful day and as usual, I will go to the aunt next door's house to buy my snack pack. As I arrived there, I overheard the aunt and her friend's conversation, not knowing who're they referring to ;

"Belajar tu biarlah sampai ke liang lahad.." said her friend, in a tone of reflecting a problem.

"Allah itu tidak akan tengok segala apa pun yang kita ada.. kecuali hati kita ni.., betul tak?" she looked and asked me.

I nodded. I couldn't say a thing, because I was too, reflecting upon what their saying. It penetrates deep inside me, as booster to start a new week of Endocrine System.

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10.30 a.m - Uzma and I was rushing to the female ward, and as we passed by the labour hall, I again, accidentally overheard a question asked by a man to a female security guard ;

"Kak.. Kalau suami nak masuk tengok isteri bersalin boleh..?" in a hopeful voice.

I was.. argh! So touched! I don't know why.. 

Her wife must'd be so lucky to have a loving, strong and supportive husband. and I am glad for you, women ;') Congratulations on adding a new happiness in your life!

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6 Nov 2017, Monday

A super productive day. Is it because I had a good sleep last night? or because Nina took over my cooking turn last night? hehe but whatever it is, Uzma and I did a full course of clerking quite a number of patients today. Both of us haven't even reach the lethargic threshold and so we continue seeing patients who sits at the clinic bench. 

Massive clerking and also there's these cute creatures made my day! 

Most of them are delayed milestone and down syndrome kids. 

But to me, you kids are special and I knew, these kids mean the whole world to their parents. 

So dear wonderful kids, I am so happy that you answer my questions cherish-ly, altho in an unwell being. and wow you kids are so hyper playing around huh?! haha!

I ask Allah to grant you good health and make you the most happiest children in this world and the next, despite of what you have to go through in this life okay? You have such a strong parents, yknow! Be good to them.

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Feelings.

There is moment in life that you want to tell everyone what you feel.

But knowing that, this life isn't just about you and your feelings,
you keep it yourself..

.. to the point you bottle up
and cry..

Is it wrong to have those feelings?
Because I couldn't help myself to battle against what I feel.

Ya Allah, You heard me..
You know what is within my heart..


so please show me Your signs, and guide me through it,
please ya Allah..

Ease it ya Allah

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Beginning of My Clinical Year.

19th September 2017 : BKI - KUL

I get emotional that day. My parents, grandparents send me off at KKIA and my eyes get teary as I kissed their hands and hugged them. Their hopes blew into me, so I hold my tears back and start to walk through the immigration and wave them goodbye, I will come back and be someone they proud of. InshaAllah, ease me Ya Allah! and please take care of my family! please.

At UBK, SMKAKK. Just a couple hours before heading to KKIA.

The remaining hours of the day I spent with Wani and Nina, did our quick browse through the shops in KL, not to forget to stopped by my favourite store, Typo to get my wishlist checked. It is my routine for every new semester to credited myself for passing the semester. Usually, I will get myself a new notebook as an endorsement for myself to pour as much knowledge and experience I encountered in life, especially for this new study atmosphere I am about to enter.

20th September 2017 : KUL - KBR - TM

Early in the morning, everyone started to move out their belongings from Shang Villa Condo into the lorry which will carry our loads to Tanah Merah, Our new campus. Thanks to my friends who have help me out with my heavy storages! At 10 am, Faezah, Kak Izaa, Cheche and I leave Shang Villa for our flight at 2 pm. It was Faezah's first flight and she is beyond excited. So I record some footages of her excitement as a memory she can look back one day. While waiting for our flight, I brought Faezah to wander the building and wait for my sister, Hera to come. After a while, she came with my medical equipments she brought from F.A Signature near her residency in Cyberjaya! Thanks Hera!

Approaching the boarding time, Faezah and I rush to our gate! It was so funny that as we arrived at the gate people are still waiting to board in. We supposed to take our time if we knew the flight is delay. On the plane, All I did was sleeping, eating and talked to my neighbour while playing with her kids. It is my first flight to Kelantan, so I am excited as Faezah too! What a short flight! I didn't even have the chance to be bored as how I usually did everytime I fly back to my hometown.

Arriving Sultan Ismail Petra Airport, Kota Bharu, there is Arif, Nina, Ilya and Mira welcoming us. They brought us to grab our late lunch at Restoran Syakila. I am so full that time, so I just ordered ABC hehe because of the scorching weather I admit :') But Kelantanese wow! You're so generous with your various type of foods and your astronomically sweetness! I instantly fall in love with the foods here, minus the 'hypersugar' hehe but its okay, we can fix that part!

Couldn't thank enough to my Kelantan-mates who have drove us here and there and to make sure we're safe and sound despite of the unexpected changes happen.  If you're reading this, Thank you tau! Hanya Tuhan saja yang dapat balas jasa kalian! hehe ;) and Thank you too to Faezah, for a lovely place to stay, the food and all! Love ya! alsooo not to forget those who have helped us a lot! Ika and her family! They've been look after us for days! Send and fetch us from class. Prepare us lunch and bring us for dinner. I feel truly like home. Just like the primary school old days! hehe. Her parents have make sure almost everything are settled down, especially about our house. Ya Allah, I feel indebted! Please bless them with Your Rezq, Protection and Your Ultimate Love! aamin! 

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Writing this means, I'm in my 2nd week of my clinical year. Alhamdulillah.

So many things happen, from house rents to clerkship orientation and the very first week of ward rounds and classes! I take all challenges as an endorsement to grow better! InshaAllah!

To start my story, I was selected to be in the Internal Medicine posting. When I first heard about Internal Medicine, I have no idea what is about. The insects started to play their background sound effects hehe. But all I can say for now (because I am stiiiil learning) in short, "Internal Medicine is Non-surgical Illness" -quoted from Prof Khairullah. He is MashaAllah super nice! For example, they categorise diseases like Hypertension, Diabetes Mellitus in Internal Medicine. I hope you get a lil picture!

Our ward round begin at day 2 of posting, meaning day 2 in Kelantan is Monday! I am still adapting to their weekdays system since everytime I open my Instagram on Sunday, everyone is enjoying their weekend go out and having fun, while we're studying in the hospital and college on that day. But this week is a very light-easy-to-go week because most of our classes is postponed. (read : more weight load in the future!) Still, its okay. I take it as a adapting-kickstart week where lots of my "first-time moments" and awkwardness happen hehe. Let me enjoy this little things. I am grateful tho! 

Alhamdulillah.

Basically I start my day, as I enter out from the house gate, to meet this kind women, who's our neighbour selling meals and cakes. I used to peek from my room window when she's started to open her big pink umbrella to shelter her and her foods from the scorching weather. Her pink containers and pink umbrella attracted me for a couple days before I start buying food from her. Even Uzma noticed that she dressed well with baju kurung and nice tudung, when we first went to her stall. She is very friendly that everytime I went there, I will learn one Kelantan word and when I started to pronounced the word, she'll giggled at me hehe. Usually I bought the meal for my lunch and cakes to stuffed into my labcoat pocket, so that I can take a bite (hm lots of bites) to curb my hunger around the hospital. By the way, I love her gulai!

So again, about my first day. I am full with excitements and curiosity. I am eager to learn and experience new things despite of my nervous. My heart is thumping out! The very first case I got was.. 

*drum rolls*

Asthma!

The patient is veeeery cooperative! I bet Kelantanese is a friendly community! :)

and then during my first oncall, we got another asthma case.

and the next case is also Asthma. 

while the other teams, got so many bigger interesting cases. and I am kinda de-spirited that time. Thought that I know much about Asthma, but I don't. Then, I have a second thought that lifts me up ; It's okay if I've been given the same case at repeated times. Means, Allah wants me to. It's not that the lecturer selected them for me. It's Allah The One who moves my heart to approach this patients and I'm grateful. Because I know, Allah wants me to fully master about it! 

*challenge accepted* *you go girl!*

In time accordance to the given week is the week of Respiratory system, most cases we clerked is around respiratory system. See, Allah knows what best. :)

I can't say much about patients due to the ethics that needed to be obey to respect their confidentiality. But I learned a lot from them. Not just about the diseases they have. But their character.

One that slaps the inner me, is there's this patient we clerked. A women in her 50's stand by his bed, and I thought it was his mother. But she introduced herself as the wife of the patient infront of our patient's bed. Meaning, its the other team's patient. She naturally tells me the story of how her husband was admitted. From her husband was diagnosed with the disease, admitted to hospital here and there, I was "ooh" and nodding all the time, half understand and half not understand since she speaks very fast with mixed words in Kelantan dialek. Then as she told me her husband was diagnosed with cancer, I was shocked and it breaks my heart. So I thought of calming her down because we naturally knew even the relatives must be in pain to know their loved ones in pain. Hence, "lets say good things to her"- said my heart. So I say "Sabar ya makcik. InshaAllah makcik boleh hadapi semua ni!" and then the women replied "eh takde gapo lah. makcik dan pakcik ok je ni. sebab Tuhan sayang kan?"

that "Tuhan sayang kan?", ya Allah! My knees feels like to wobble and I wish to hug her! Look how strong she are! 

Most of us when hit rock bottom, we tend to complain "why this happen to me?" "why that.." not realizing,

"If Allah intends good for someone, then he afflicts him with trials"

Source: Ṣaḥīḥ al-Bukhārī 5321

"The greatest reward comes from the greatest trial. When Allah loves people, He tests them, and whoever accepts it gains the pleasure of Allah and whoever complains earns His wrath. 

Source: al-Tirmidhi, 2396;and Ibn Maajah, 4031; classed as saheeh by Shaykh al-Albaani. 

May Allah makes us among those He love.

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Today is Saturday. Meaning tomorrow is another ward round day. and the next too. Uncounted ward rounds. Its going to be part of my life from now. I enjoy it. Although I may looked blur and blank at this early phase and couldn't do much for the patients, well at least the smile we laid could a little soothes their pain and sorrow. For the very least, the clerkship I took everyday is indirectly a chance for them to let out all their feelings that needed to be listen. 

Let this be a training for me to be more attentive and a good listener.

There are also days I felt I don't fit in. I felt I know nothing that I could cry. But I know this is just a phase, wanting or not, I must fight this phase, and work even harder. Allah have put from the beginning of this course with ease, until I passed the first and the second year despite of the horrible things happen and the challenge. I wonder why of all courses I want, He made me ease in this course.. and that curiosity makes me going everyday. There's something Allah wants to show me in here. Something in medicine, that I can reap and sow one day, in the after life.

Ya Allah, make us a good student, and a good doctor.

Let us be the doctor who we want to be treated as. 

We know nothing, but you know everything. Even the sea will dry to write Your Knowledge. 

So please, make us those who're seeking knowledge sincerely, and applied it by faith.

Give us good health and strength, to help those in need. Ease us in every ways, ya Allah!

Most importantly, please remind us, no matter how capable we are, everything is in Your Hand. You are The One who are in charge, all the time, Oh Almighty, All Power. We're nothing without You.

2nd Week of Internal Medicine ; CVS,

Bismillahirrahmanirrahim

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p/s : Oh! I encountered two teenagers with diabetes mellitus, peeps! and when I studied it, Hyperphagia is one of Diabetes sign. You know what is it?

Hm, I'm one of Hyperphagias too!

but I think, I'm hungry because I study and do a lot of thinking! 

My brain needs food to function!

but 

but

okay, no excuse. even for me too.

check out what you're eating, foodies! I know those food flatlays are tempting!

It happens to me too!

We can do this!!

#SayNoToDiabetes #NoExcessiveSugar