Traumatology Operation Room

Has learnt my lesson.

All this while, I've roamed aroun the hospital comfortably in my white coat, student ID and sport shoes. So just you know, the Czech students go around the hospital in white shirt, white pants and student ID wearing socks and sandals.

I think many non Czechs agree with me that socks and sandal aren't in but in Czech it's a normal sight.

So, since I didn't do as the Romans do in Rome, I got to wear socks and plastics. Thanks Allah we changed into our scrubs. Hehehe.

Anyway traumatology operation room is interesting.

The are usually drills, screw driver and racks of screws of different sizes on the scrub tables.

There is always C-arm (the x-ray machine) and lots of blood.

I like the fact that we get adequate access to the x-ray images and about what's going on thanks to the camera and large screen in the OR.

Surgeons are the serious lots and do a lot of standing while anesthesists are the fun ones, sitting and monitoring the patients from the above.

First patient was an old lady with multiple fractures after she fall down.

She has osteoporosis and she broke her arm, both thigh bones and the right shin.

Surgeons operated on both legs.

Osteosynthesis was put into the femur with respect to the osteoporosis.

Still doctor said with her weight and her fractures, she won't be able to get on her two feet and has to be on the wheelchair.

Second patient was a man after bike accident.

He broke his tibia on two places and had multifragmented fracture on his fibula.

Surgeons had to do reduction and put the fibula back precisely on its physiological position so that the foot can function physiologically (means to say the foot can can rotate and distribute the pressure evenly )

Since the was torn ligament, they have to fix the fibula temporarily.

It's because when the ligament heals, there will be micromovements which can interfere with the fibula which hasn't healed completely.

I like it that our surgeon is willing to explain many things eventhough I catch only 70% of those explanation.

Let's face it, I'm a general medicine student and most of the time I have no idea what should I ask.

They did 180 degree x ray imaging on the ankle and all of us evacuate the OR (which means there's only the patient on the operating table in the OR) and watched the imaging procedure went by.

I had good times and I hope I'll experienced much more and gained a lot from my upcoming summer practicals.

TheWeekends

I had all four consecutive weekends occupied. First had friend visiting from France. They covered 4 cities (of 3 different countries) in a week and by the time they arrived to Prague, they are pretty drained out. So, here I am giving you free tip ~ don't make Prague your last stop. The cobble stone road/alley will kill your feet. Anyway, apart from going to the same tourist spots, this time I went to Mirror Labyrinth. One word ~ fun. And I am so sorry to inform you of an outdated news, that the National Museum is closed for renovation for a whopping 5 years. I haven't really consider of going to visit anyway but when I heard about the closing, I became curious as to whether I've really lost an opportunity to visit.

The next weekend was Eid-ul Adha. It's a blessings to have a family away from family. The thing I love about Eid-ul Adha is that we can takbeer for 3 days (or is it 4 days?). We had potluck at Raudhah for girls, ignoring the fact that we have Igames on the next weekend. Food as usual was generous ~ bihun sup, bihun goreng, ketupat and rendang, sambal goreng, various jelly and pudding, fruit tarts, cakes and much more. Oh yes, even keropok lekor.

The Igames weekend didn't start off good. It didn't for contingent from Hradec Kralove. Motivation was rather low, plus the fact that we are significantly outnumbered by the other 2 localities. Still, Prague has this abilities to make the event enjoyable. As usual I stayed over at Vorsilka and it was really happening having Kirin, Kak Pia, some people from HK and the host themselves under one roof that having a proper hours of sleep doesn't matter anymore. Anyway, since we are short on people, we played more than 2 games per person (on average) and at the same time, trying our best to also be the supporters.

This photo is taken from CzeMSA group on Facebook.

Second day achievements was satisfactory and second day itself was so much fun even having cramped leg twice didn't lower my competitive spirit. Sadly the juniors from Hradec Kralove had to return to Hradec Kralove since they have to study for the daily tests which every international students in LFHK is well versed about. So, we gathered forced on the last day and charged forward. We swept gold for almost all the fun games ~ scrabble for both boy and girl, galah panjang, bola beracun and we managed to score even points with Prague and is just behing Olomouc by 10 points. We were ecstatic. People may wonder how can we be so happy for not being the last. But I pondered, that really, sometimes, less means more and I am proud of us. I really am.

After Igames, I was eagerly counting days for the weekend to come. Basically, we were expected to have motivation camp sponsored by MARA in Hilton Hotel, Prague. I was sceptical at first. I mean, are you kidding me? Were National Service and BTN not enough?But then, the prospect of seeing other people and going together on the same bus excites me. Yes, u are reading the right thing.

Staying in a hotel doesn't excite me but going together on the same bus does. I was so used to go on trip together with a troop of friends back in high school that I really wanted to do the same at least once with university friends. Anyway, the program was mainly about eating buffet and sleeping and staring around. And I got to know some people from other localities and also I got to know that I don't even know some people who are in the same batch from other localities exist all this while. Second day was so good that I left with heavy heart and I was unsatistfied that the bus ride back was so quick it took us only one hour to reach the faculty building. I mean, I didn't get the usual 2 hours sleep.

So, I guess it's time to get real and I hope life will get exciting this year.

Thoughts From Last Year in The Hospital

Being a medical student and having the opportunities to meet patients suffering from various illness, it toughens me up.

I used to sympathize them a lot, like I do to those old folks that I bump into on everyday basis.

Strangely, sympathizing has turn into admiring.

Of how tough these patients are.

We all know how does it feel to be ill.

I got a casted hand for a month and felt so much burdened by it.

Couldn't imagine how things are for those having nitroglycerin stand by for any chest pain or nebulizer in case the asthma decided to attack.

Gambar sekadar hiasan.

After a session with a crippled uncle, I couldn't help but thinking of how tough it is to lost a leg and to start anew with a prosthetic leg.

Yes, we human are blessed with the ability to adapt but adaptation with regards to lost of body part(s) is rather costly.

I don't know how did he come to term with having half hig leg amputated nor how he is coping now, seeing that there's possibility that he'll loose another half on another side.

But there he was, on that bed, not smiling yet not frowning.

And the previous woman who has half her body swollen and another half so skinny.

She managed to live like that eversince she was 2months old and she's a whooping 37 years old now.

When finding balance for toddler is quite tricky it must have been hard on her.

Come to think of it, any pair should come in two sizes ~ I mean stuffs like shoes, mittens, and even the long pants.

And how does she goes out into the crowd.

Emo

Hari ini nak buat entri emo.

Kalau anda teka sebab datang bulan, teet, tekaan salah. Wrong guess.

Hari ini gelap dan suram.

Hari ini juga tanda-tanda blank muncul. Iya, blank itu ialah emptiness yang tidak berdimensi.

Alangkah indah kalau setiap hari ada kelas dan masa petang dan malam yang penuh terisi dengan riadah dan ulangkaji wajib.

Sesungguhnya saya adalah seorang yang malas mengulangkaji sorang-sorang kalau tiada ujian mahupun peperiksaan.

Ini semua salah sistem sekolah berasrama penuh yang mewajibkan waktu prep 2 kali sehari.

Sekarang saya rindu nak mengulangkaji di dalam kelas yang dipenuhi Ili, Ain, Shafiqah, Afiqah, Syikin, Farah, Prem, Mat Jat, Nia, Midi, Ridzuan, Ronnie dan rakan-rakan lain. Tak kisahlah kalau mereka yang lain tak mengulangkaji malahan riuh mendendangkan lagu teletubbies atau lagu Marsha Milan Londoh atau giat mengusik sesama sendiri. Tak kisah, asalkan mereka ada di sisi saya, baru semangat sikit nak mengulangkaji.

Selalu saya tertanya-tanya apa khabar mereka. Kebanyakannya sibuk kecuali Prem sebab dia tengah menanam anggur kat rumah selepas habis peperiksaan terakhir tahun akhir dalam bidang yang sangat saya suka.

Saya juga emosi sebab di hari cuti yang gelap lagi suram ni bukan macam hari yang gelap lagi suram di Malaysia.

Kalau di sekolah, seisi dorm berkumpul untuk makan atau minum apa sahaja.

Makanan tidak semewah mana, tapi teman makan yang penting. Motto kami ialah selagi roti itu tidak berkulat, selagi tu boleh makan dan selagi air tu tak berkeladak selagi tu boleh minum. Tu motto zaman hingusan la.

Kalau zaman PLKN, seronoknya mashaallah, dengan rakan-rakan yang berbagai latar belakang, kami sentiasa berjaya melicinkan juadah yang ada. Tidak perlu pinggan cantik atau cawan yang katuh boleh pecah. Cukup dengan tray dan cawan plastik yang kalau tergolek turun bukit, kita masih boleh jumpa dan kutip bila sampai di kaki bukit, sebab akan ada lagi beratus orang yang makan sekali dengan kita.

Zaman MSU, walaupun pilihan makanan terhad dan mahal, rasa seronok bila boleh bersembang bercerita tantang hari yang baru berlalu, ataupun membuka cerita zaman persekolahan sambil makan.

Moga-moga masa akan datang sangat macam masa yang lalu.

Saya juga emosi sebab saya sensitif. Biarkan saya menaip di sini, untuk diri saya sendiri, dan mungkin untuk awak tahu, sekeras-keras saya yang awak nampak, saya masih punya emosi yang lain. Cuma cara kita menzahirkan berbeza.

Ada orang bila mahukan sesuatu dari kita, sangat bermanis mulut dengan senyum terhias.

Mungkin ramai tertanya-tanya. Hari ini saya akan jawab persoalan-persoalan.

Orang ingat saya main-main tentang sesuatu perkara tapi saya tahu, sekiranya saya tidak mampu memberikan komitmen, saya seupaya boleh mengelakkan sesuatu itu.

Hari ini saya buat macam-macam untuk kamu, tahun depan, khabar kamu pun saya dah tak ambil tahu. Saya tidak mahu jadi begitu, sekurang-kurangnya tidak secepat itu saya menjauh dari kamu.

Saya bukanlah orang yang mengikut arus sangat. Kalau kamu suka main patung kertas, hari ni saya lebih selesa baling guli, tapi mungkin tahun depan saya akan main dan sangat suka patung kertas. Ini ujian buat saya dan mungkin juga buat kamu.

Kamu tahu kalau saya tidak berminat dengan patung kertas, kamu bagi percuma berpuluh pun saya tidak akan suka. Sekarang. Tapi mungkin lagi 3 bulan saya teringin nak main patung kertas, jadi saya harap kamu jangan la nanti main patung kertas sembunyi dari saya.

Saya harap saya tidak akan lupa, yang Allah itu yang merubah hati manusia mengikut kehendak Dia~ sepantas kilat, selambat siput babi.

Ada satu benda yang buat emosi saya bagus. Saya tahu saya ini budak yang meredah lumpur, mengangkat batang pisang di tanah lembap untuk memenuhkan cacing dalam tin kacang panggang dan masuk hutan korek ubi kayu. Tapi tak salahkan kalau saya memandang kepada budak yang pakaiannya bersih, yang tahu main chess, dam, scrabble dan yang seangkatan dengannya. Sebab selasak-lasak saya, saya juga punya masa bila mana saya ingin mandi dan duduk baik-baik dalam rumah dengan budak yang berpakaian bersih tu.

Saya memang berbeza, tapi saya harap saya masih dapat duduk dengan orang yang berbeza dengan saya.

Oh, Allah dah hantar jemputan. Ok, saya nak pergi makan sup cndawan ramai-ramai di rumah atas.

Schizophrenic

I took the anamnesis and did the physical examination.

Patient is having chemotherapy with i.v.port inside the chest.

The reason why patient is admitted is to monitor his compliance to the chemotherapy regiment (in Layman's term, to monitor whether he abide to all the instructions on taking the drugs)

Typical for a schizophrenic patient, the last time doctor sent him home with drugs, he took the whole perscription in one go.

Pulling Out Your Organ

Neurosurgery had been so so but when we swapped to a general surgeon, it has been fun with the surgery.

The only downside of general surgery is the filter. It was cramped and dark and I was concerned about my coat and clothes of the day get in smelling like a softlan and get out smelling like the armpit of someone who hasn't bath for a week. And the scrub is rather revealing : knickers, chest and armpit. Not sexy!

Anyway we were supposed to be in Dr Asqar operation room but the TV crews have been responsible for us to be in the next few situations.

First, we were waiting to get in the operation theathre after the patient has been prepared for surgery. But then the ECG came out not normal, which means the operation has to be cancelled and since it will take some time for another patient to be wheeled in and prepared for cholecystectomy (removal of gallbladder), we went into another OR to watch a vascular surgery.

I like it.

First and foremost, I get to see the operation.

Bad luck if you got surgeon with big stature coz u'll always end up seeing his back 90% of the time if you are lucky or seeing nothing except the instruments if you are unlucky.

Anyway, this operation is about dealing with the varicose veins.

The valve in the great saphenous vein has been insufficient.

The plan is to get rid of the varicose and the great saphenous vein.

Varicose vein, if untreated can cause compression to small arteries supplying the leg and will bring about varicose ulcer, pigmentation and ugly/uglier leg.

Basically, u can clearly see the varicose vein the patient is standing but when patient is lying on the back, u can't see it (it's all about the gravity that cause the blood to fill in the vein and making it looking like coils of snakes on your leg).

So, to make sure u can keep track of the varicose vein when the patient is on the table, u shall draw some lines corresponding to the vein position when the patient is standing prior to surgery.

To remove the varicose veins, surgeon will make an incision, put the designated instrument into the now accessible varicose vein, and screw it out.

As for the great saphenous vein, it's a superficial vein of the leg.And as known, the leg i supplied by deep venous system and superficial venous system.

This makes removing the great saphenous vein is possible without costing you your leg.

That's why for bypass surgery, we use this vein. And when we have a patient suffering from varicose vein due to insufficiency of valve of great saphenous vein, we can totally remove this great saphenous vein.

Surgeon will make an incision on inguinal region (it's the groin), clamp the vein, cut them, and tie both ends. Anothe incision is made in the calf slightly below the knee. They gonna pull the vein down through this incision in the calf. After both incisions are done, the surgeon put a wire into the great saphenous vein. The wire looks like this. The lumpy end is situated at the inguinal end and the small one is on the other end, and then zap, they pull it out.

When you pull out this great vein, it will take time for your leg circulation to adjust itself. I mean most of the blood has been travelling out of the leg through this great saphenous vein and now, it's gone. It's either you just suture back the incision you made, which mean you don't even bother to tell the blood that this way is closed already. And since blood doesn't think for itself, it'll just accumulate in the tissue causing hematoma. So as someone who can think for ourselves and for other beings, we must bandaged the whole leg to prevent blood pooling.

Done with the vascular surgery, we once again hung over the corridor, watching another surgery behind the see through door. And we saw the freaking gallbladder and were all excited over it (medical students are hyperexcited to see your organ and we really look forward to anything to do with poking the insides of living human bodies ). The gallbladder looks just like a ballon filled with 30ml of water and the colour composition is just like the inside of your cheek.

I have so many things to write down and let's hope that I remember every detail of the procedure that I had the opportunity to look. And unfortunately I decided to ditch my camera and rely solely on my brain to remember the crucial moments I have seen in the hospital.