Of Radiology and Anaesthetic

My 6 weeks of MSA (elective la) is coming to an end soon. This week will be last week of MSA and my last week in QEH, the hospital i've been going since my 1st semester.

My first elective was medical imaging aka Radiology. I was attached to the radiology registrar for 3 weeks and i think it is ok. At times it could be boring. Oh and i fell asleep in front of the consultant AGAIN (yes again this is not the first time) when he was discussing some CT scan findings with the registrar i was attached too. Hahahahahahahaha. Thinking back, i don't know why i did the sleeping in front of them. Wonder what will happened if i do the same in front of some lecturer giving us MMS session back in IMU (will i be kicked out of the session???). Here are some pictures i took when i was doing radiology.

The X-ray room with the X-ray machine

And the CT scan finding(s) show.....

After 3 weeks of radiology with no patient contact, i was literally dying to have patient contact. So i was actually looking forward to my next elective, ANAESTHETIC cause i think there would be at least some patient contact and i am going back to the THEATRE. Gosh its like doing my surgical rotation which i really enjoyed.

Anaesthetic rotation was not too bad either. At least i get to do something. I intubated a patient (it was mostly done by the registrar), gave 100ml of panadol to the patient and mix granisetron and dexamethasone and gave it to the patient as anti-emetic. I love the registrar for allowing me to do all this. The registrar also bombarded me with so many questions not on drugs and pharmacology but on physiology and ECG (die die die). Oh and guess what, one of the IMU (super) senior is a registrar in anesthetic. She is more to intensive care medicine registrar but as part of her training as an intensivist she has to do her anaesthetic rotation. According to her, anaesthetist are weirdo and even the anaesthetist know that they are weird LOL. Ok here are some pictures i took when i was standing there doing nothing.

The monitoring/ breathing machine!!!

Paracetamol (BIG PANADOL)

Drugs, try guessing the name of the white drug

More drugs

Tomorrow is my last day in QEH and anaesthetic. Guess i will go for one more surgery before i go off. Gosh i am gonna miss that hospital. Made so many new friends there. Next rotation is Orthopaedics in Royal Adelaide Hospital (RAH).

Mua Birthday

This is MY month. Yes people i always love July cause i'm born in July, so i officially declare it as my month hahahahahahaha. Anyway did you know July was name after Julius Caesar, the great Roman leader. So interesting right hahahahahaha.

So today is my birthday and guess what, i am a year older, a year wiser and if i'm vain i'm just a step closer to having wrinkles all over my face. Ok i'll go check on the mirror for any wrinkles now................ done no wrinkles. phew.

Wonder what i can do on my birthday? Sangee just called me and wish me happy birthday (thanks a lot Sangee really nice and sweet of you). Got loads of wishes in Facebook (the power of social network) and i would like to thank them all as well. Wishes are pouring in from very old friends, old friends, moderately old friends and new friends (the four category of friends that i came out with spontenously. Wonder if i can publish it somewhere?).

So Sangee told me not to study on my birthday. In fact she told me not to do anything. Hehehehehe Sangee i would love to do that. If i were at home in Malaysia, i would just sit on the couch and watch TV the whole day. My parents would then bring me out for dinner and i could decide what i want to eat. Chinese, Japanese, Korean, Taiwanese, Thai food, Western you name it (but i can't go for indian cause my mum don't like the smell they put in the food. Said she feels nauseated smelling it). I would usually pick chinese cause it is everywhere and it's way cheaper than the others and it taste superb too.

After dinner i would come home and watch more TV shows. If you wonder where is the cake..... well my family don't go with cake hahahaha. Dad complains that the cake are too sweet these days. Mum, no complain but she doesn't know how to pick one. The only cake they knew are Black Forest (their favourite), Fruit cake (my favourite), and Cheese cake (no ones favourite). Cakes like chocolate banana and all doesn't ring a bell, but when you buy it and let them eat it they will say "Wow this is good, i really love it. Where did you get this?"

The second part of my celebration is with my friends. Sky, Qian bao, Ling Ling bao, yu gin, Kay Por, Ren Ping, Dororo, the loud and noisy MICHELLE LEE (yea you deserve some attention hahahaha) etc (there are just too many of you for me to name) will all organise a surprise or a birthday celebration for me with a cake. Usually it ends messy with your face smashed on the cake or part of the cake (wonder if they have change their style hmmmm).

Hahahahahaha this is how i celebrate my birthday back in Malaysia. It's so nostalgic!!!!

Well this will be my first birthday in a foreign land. Hope it doesn't get messy.

P.S. really miss you guys (seremban people, Aberdeen people, or wherever you are), when i come back next time we must meet up NO EXCUSES!!!!!

Short and random weird post.

Hann Yee how did you find out i have a blog? How? How? HOW? Shit man

See my name on her blog. ooooh i saw Sow-my-aaaah name

Now i cannot make funny comments about her since she knows i have a blog. Damn it!!!!! (this blog is suppose to make funny comments about people............ ok i haven't make one yet but i will do so in the future) I wonder who told her...... or maybe she found it incidentally like those pituitary tumour which is most probably found incidentally while doing a scan.

Ok i think i better go back to my studies. These days i am so free cause i am in radiology. I haven't seen or touch a single patient so far by my own (except when i clerk patients with my prof). One of the Singaporean here told me why i got radiology. He said i am too stress up and the posting is to allow me to relax (the Singaporean i mention is not from IMU ok).

Fine back to my studies.

P.S. I shall make some funny comments next time....... maybe hann yee doesn't read this blog hehehehehe.

P.s. I am feeling better these days but i am still scared, like really scared and having random emo-ness......

New Template-EMO

I seem to have neglect my blog long enough. I haven't got any topic to write on lately. When i login today i found out that there are new templates for selection and so i chose this new template cause i think it's nice. Not too "much" or too "little" if you know what i mean.

I went back to Malaysia for 2 weeks and four days before i came back to Adelaide. It was supposed to be a fun and happy trip initially cause i am going back to my HOME and i could eat all my favourite food. Then something happened and the whole holiday was not that enjoyable any more. It literally changed from what could have been a great trip to a trip which was full of stress and emo-ness.

I was craving for Malaysian food when i was in Adelaide and I told myself i would have 5 meals a day when i am back in Malaysia. But all these came to not. I was in such a bad mood when i came back that i just had 3 meals a day instead of the 5 which i vow to do. The holidays wasn't any special either. I was locked up in my room reading and studying and talking to my friend in Adelaide all the time. (except for a few hours of watching HK drama which i miss so much)

Now that i am back in Adelaide, i think the stress level is higher than when i first came. There are so many changes i have to make (yea i knew i have to change when i first came but....... well the story is long and i don't even know why i did not change in the end, haih). Everything does not feel the same compared to when i first came. When i went out with my friends from IMU, they were literally talking about their holidays and how they enjoyed it while i was sitting there like some stranger from another world. Cause to tell the truth, i think my holiday was not that great apart from being with my family.

Ok this is an Emo post i realise, but hey people have their ups and downs and i'm now in the down side of things. Oh well i better get back to work with the big word "CHANGE" at the back of my mind (work hard, and work smart).

P.S. I find that being around with my friends is not like what it used to be, i don't know why. I felt stupid when i am with them, like real stupid!!!!!!

Quick Update

Well just a quick update on my attachment in Adelaide. Internal Med is hectic. Tuts here and there and not to mention i wasted 5 weeks not learning anything (its a long story no point talking about it)

Love Respi rounds and my registrar. Even though he is busy preparing for his physician exam, he still took some time off and go through respi examination with us.... oh and he asked us to perform it in front of the consultant tomorrow (now this part is not that fun). Asked him about the management of asthma and STEMI and NSTEMI....... but when it comes to the heart i believe the cardiologist consultant is much better in it.

OSCE on Friday as our end of rotation exam. Heard everyone will pass but i think it is better to be prepared for it. Oh and tomorrow have to meet up with another doc from who knows which hospital for history taking practise and clinical reasoning and it is just for two of us........ i think my fees is well spent.

Since no one is reading this blog i shall curse a bit. What the "tooot" is that stupid she man cooking. Shim always cook so looooooong. I am hungry and he is taking Her/is time cooking. Damn. I have to freaking read my LFT and look through the ECGs for OSCE and the blood films for leukaemias and he is still cooking. (I shall now ask for forgiveness for cursing people. God, please forgive me)

I am so dead for ECG!!!!!

Ok i shall go now. WOOOOHOOOOO i am so excited hahahahahahaha

QEH

Realising that my previous post topic should be QEH instead of surgical rotation, hence i decided to put this post as QEH the name of the hospital i am currently still in (damn i am going to get so used to this hospital). Anyway as i said in my previous post i shall give a small talk on my surgical rotation and realising that most probably no one will read it cause everyone is so busy these days (actually i am busy too, that is why i am blogging now before all those crazy evidence based medicine, research proposal and studying to show what IMU student are made of comes), so i think i can type a looooooong post or maybe i should do some venting of all the stress here.

Surgical posting i dare say have given me different experiences. I think my previous post mention i was post at colorectal unit and Upper GI the 2 most hectic posting, guess what turns out i am wrong for the 1st part. Colorectal is such a slacky unit hahahahahaha, patient are less but the RMOs are very keen in teaching so sometimes we follow him to the ED and clerk a patient and present it to him. He will than ask for our differential and we will give him the answer even though it is a very stupid answer. The interns are also very keen in teaching too. One of them even brought all his text books for us to borrow home, so nice right. The best part is when they are to perform a procedure such as inserting a catheter or a NGT they will bring us along to observe. Oh and not to forget taking blood which i am still very bad at and doing Jelco (the slang here in South Australia which means IV cannula). Ward round in surg starts at 7.30am and my consulant ward round is at 11am every Monday and Friday. So yea guess this is it for my first posting for 4 weeks (sorry no pic of the team).

So the next team i am posted to is Upper GI/Professorial surgery. One word when i was about to go for it. DIE!!!!! the busiest ward in the whole Surgical division cause it also covers for general surgery too, i have to go for ward round at 7.30am and 7am on Monday and Wednesday. Sometimes there is so many patients that the ward round last from 7.30am to 11am for a surg ward round (its consider a long ward round for a surgical unit). We walked from 2nd floor to the to the 2nd floor at the old wing where the ICU is located, then to Emergency department at ground floor to see all the patients. Worst is i have to cover or clerk every patient to do case presentation to the consultants on Wednesday where we have our consultant rounds. We are expected to present how the patient performed throughout the week and what are their treatment plans, the investigations they have gone and the results of the investigations if there is any. The most many patients i have to present was 8 patient. Luckily the 6th years did help me out and divide the patient equally among them. Oh and did i mention that i have to be there in the hospital by 6.30am before the ward round start which is at 7am just to check on how my patient is doing which include their obs (Temp+O2 saturation+drain output from wound+BP), and the result of any investigations which include X-ray and CT scan which were not out on Tuesday.

After Consultant round on Wednesday, we would have MDM, multidisciplinary meeting between surgeons, oncologist and radiologist than i have to go for OPD (out patient department) to clerk patient, do a PE and present it to the consultants again. haih

But at the end of my posting at this unit, i kinda have a 'miss you' feeling. Maybe cause i am too used to it. After the 2nd week in the unit my crazy mind started to make me enjoy the posting hahahahahahaha. Must be crazy already.

For this posting i manage to take a incomplete team photo which i have it on FB for a very long time. Well might as well show it here too.

So shall i introduce the Upper GI team. From left is Dr Markus, the doc from Switzerland who came here for experience purposes i think. Nice Doc who will quickly come in and help me or generally help me when he sense i am in trouble during consultant round. Next to him is Associate Prof Vijay from India who came here for a different sort of experience. A fast thinker who can associate symptoms and conditions quickly in split seconds and taught me and answer all my real stupid questions. The lady in black is Dr Tiffany the registrar of Upper GI, she is very good and taught me stuff too and i really respect her for specialising in Surgery. She shows that nothing is impossible in this world. The guy next to me is an IMU grad who went to Auckland, Dr Wong aka JT (that is wat i call him). Very nice boss who always teaches me stuff and ask me to look up stuff but ended up forgetting to ask me hahahahahahaha (so i usually did not look it up, shhhhhhh don't tell him) and me of course. There is 2 more interns who is not around but they taught me a lot too and let me try some hands on sometimes.

Oh well guess that it is, now in Med posting with the local students. Now i am seeing the real world. Back to my research proposal (i am SICK of doing pubmed search already)!!!!

Surgical Rotation

Can you believe it 9 weeks have just gone by and i have finished my Surgical rotation! Looking back i think i should slack more during my first rotation at Colorectal unit cause apparently the consultants did not notice my friend when she was there (but i do remember the consultant notice me and my other friend and kept asking us questions). Then come the one which i say is the most busy unit in the hospital, Upper GI which take in any surgical cases cause they have a consultant who is a general surgeon hence general surgery is under this unit. Upper GI problem is also under this unit as it is an UPPER GI unit and any cases which deals with the liver and gallbladder (hepatobiliary) is also under this unit. So its busy busy busy for this unit.

But 1st lets talk about the hospital where i am attached to for my whole of sem 1 and 6 weeks of sem 2. The hospital i am attached to is called The Queen Elizabeth Hospital or short for TQEH and even shorter way of calling it, QE.

The Queen Elizabeth Hospital

New Wing-QE

Old Wing-QE

Old Wing and the bridge that connects the old to the new

Old wing car park-QE

Visitor waiting area in the new wing

The Bridge that connects old and new

Colorectal room where i hang out when i have nothing to do in the ward

Interior of the room of colorectal where the intern, RMO, Registrar, nurse and med students hang out when thet are free

QE early in the morning mainly 6.30am (sorry for the poor quality)

QE is a very special hospital as this hospital is a Mini IMU hospital. Yes your eye is not playing tricks on you i just typed out that this hospital is a MINI IMU HOSPITAL. IMU-PMS grads from all over mainly Australia and New Zealand can be found here. In Upper GI team there is 3 IMU grads mainly my RMO and one of the intern who graduated from Uni of Auckland and the other intern who is from Uni of Queensland. In medical unit, one of the unit team is comprise of all IMU grad except for the consultants (which means intern, RMO and registrar are all IMU-ians). My friend met an IMU grad who graduated from Uni of Manchester working here and the other friend of mine met another IMU grad who graduated from Uni of Auckland and chose to work here cause he said most IMU grad is working here. I personally met another IMU grad who graduated from Uni of Adelaide and now is a junior Registrar in anaesthetic and she asked for our number and said call her if we need help (so nicey). Now i wonder when will the first IMU grad from Seremban coming??????

Surgical posting here is fun i guess. I work hard for it cause this is our 1st 9 weeks here so working hard doesn't hurt right? At least now i know how their system goes. The teaching here is mainly at OPD or during ward rounds where you try to pick up what the docs are saying. Sometimes they will ask you some questions and ask you to find out the topic and come back to them. Tutorial is definately a must and guess what we also have some training in suturing.

The suturing equipments

Me gloving and preparing to do suturing (for the 1st time)

The patient (Victim) who is going to be sutured by me!!

My suturing skills

And the cut i purposely made on the patient so i can do more suturing

So i guess this is it for my blog update. Maybe next time i do some blogging about how the surgical ward round are conducted here. Before i sign out, one last picture for you guys of dawn in Adelaide.

Look at the sky. I took this picture when i was on my way to the bus stop taking the bus to the hospital (and was late on that day too)

Cheers guys!!!!