Boring posts...

i wish to write interesting stuff but i am in GP posting for a month and really nothing interesting going on.
i would be in icu next week. hopefully it's going to be more exciting...
a lot of reflection to do as i have been just sitting, eating and sleeping and not doing any revision.
i miss exam
i want to be more discipline
i want to be more hardworking
i want to shock ppl with my medcial knowledge
i want to be the top student

but i just know how to dream....
and my dream wont come true if i dun put in effort...
i need motivation...
i need to let my chakra to leak out and motivates me
(the result of watching too much naruto)
gambatekudasai
(the result of watching to much J drama)

ok. time to study...
or perhaps..
time to eat lunch
time for a nap
and finally time to study...

Criteria of my future husband

I am sitting in the com lab again in this boring wednesday afternoon. So this might be a very boring topic, it's just some personal thoughts that i would like to share in my blog.



I always dream about how my future husband looks like. Old/young? Normal/disabled? Tall/short? Fat/thin? Malaysian/non-malaysian? Chinese/non-chinese? But all these are just physical appearances and what i do really care is the inner beauty, the wavelenght and the character. I always said i dont want to marry someone who smokes / drinks and my mum told me, never try to set a criteria for it cause i might end up falling for someone with all the negative criteria that i have set.



Ideally, i hope he's a musician that can play piano, not only pop songs but also classical. The best part is he can sing while he's playing piano. Trust me, not all pianists can sing and not all singers can play piano. For example, my house has someone that can play piano but has a big room of improvement in singing. Next, he needs to play some kind of sport, preferably basketball. Coz i think basketball players are cool!!! Last, but not least, he has to love his family especially his parents. (Yeah, you are right. He's the one in your mind, Mr Jay Chou!) And i know he's unreachable and a super unrealistic dream that he would be my husband. But there's also a trouble to marry him as all the papporazi and news reporter would target me and i would lose my freedom!!! (Arghh, Xiao Jie, dun think too much....) So Jay Chou is just a dream...

Ok, who's next? There's this hong kong tvb drama series called "The Golden Faith" and the hero in this show was starred by Gallen Loh. And this character was named Ivan and... He's really my dream husband that possibly acievable. He was an adopted child but he cared for his family. He inherited a company that being managed by his father before he passed away. And he took over the company temporary to train his younger brother, Oscar to be more capable of managing the company. But, some how Oscar misunderstood him but Ivan never ever do anything to harm him even though Oscar intent to kill him. On the other hand, Ivan had a blood-related brother and he sacrificed his relationship for him. I give him 100marks for his personality and character as he's really someone that you would only see in a show. But... the thing that i do not like a bout him is... He's a businessman. I always think that businessmen are cunning, selffish and materialistic. Say no to businessman... (But i never know coz i might eventually marry a businessman after being so defensive. Haha!!)

So, stop dreaming of all those all-rounded, 100% perfect man to be my Mr right. Now that i am in the medical world, my partner would be more likely a healthcare worker. Probably a consultant? surgeon? or pharmacist? dietician? or (turun pangkat) charged nurse? nurse? or (the worst thing i have ever think about) a cleaner in the hospital.

Technically speaking, i wish not to marry a doctor as it's going to be very boring if you only mix around with people in the sane career. But practically, it's good as he would be more understading if we work in the similar setting. Nowadays, i have been surounded with anaesthetists as my coordinator is also an anaesthetist. And i think amaesthetist are cool really... especially those who specialised in cardiothoracic surgery.

What would happen if a paediatrician marry an amaethetist? would their child become a paediatrcian anaethetist???

ha, think too much.
i should have used the time i blog on this boring stuff to study but this topic just came into my mind.
i would never know who i would marry.
maybe it's a lady and not a gentleman? (my parents might have heart attack if they see this...)
or maybe i decided not to go into marriage? (second heart attack...)

ok, after all, it's just some thoughts.
dun take it seriously...

Maturity

Maturity stops you from mourning
Maturity stops you from screaming
Maturity stops you from crying
Maturity stops you from doing stupid things

Maturity makes you becoming silent
Maturity makes you becoming ignorant
Maturity makes you becoming tough
Maturity makes you becoming lone ranger

Am i mature?

I wish i was there...

73 days I am away from home, not the longest time yet, my maximum record was 120days away from home which was just few months ago. In total, I have been away from home for over 200days!!! If I say I never ever have homesick, taht's a LIE!!! And i do not lie, so i do miss my family, especially my brothers. (Papa & mama, please do noy be jealous ya...)
My first homesick episode ever since i came to preton was when i read xiao dee's blog on our house warming party and his piano fair. I really wish i was there. But unfortunately, i am in UK, doing my clinical practice.
Then the next time was my mum rang and told me that her blood pressure was high and she had headache that she couldnt cope with and she needed to take pain killer which she normally doesnt take at all. At the same time, she complained of numbness over the hands, arms and neck which sounds like the symptoms of stroke. During the period of time, i just started my clinical palcement in stroke rehabilitation ward, and i saw a lot of people who need help in moving around, feeding and even washing themselves. Oh, i dun want to see my mum in that condition!!! She was worried as my uncle died of complications from hypertension, and it runs in her family. I was worried to but i try not to show it to my mum and convince her to go for medical check-up. After talking to my mum on the phone, i just couldnt stop myself crying and i wish i was there with her. I wish i could bring her to see doctor and just comfort her... But i am away from home... I was really hopeless at that time, and spoke to my borther and made him to bring my mum to see the doctor. Thank God, everything turned out to be fine and my mum's blood pressure was back to mornal. The neurological symtoms that she experienced was just the once and only episode.
And... i felt homesick again last friday night, the worst thing was i wasnt alone. When the feelings came, i was surrounded by almost 15people in a room. We were watching a video which was a birthday present of my senior, and in the video, his friends and his family sent their respective wishes to him as last thursday was his birthday. I dun know them at all, I am not even very close to this senior, but i was touched by the video. My tears was just pooling in my eyes when i heard the messages and wishes given by his mum and sister.By looking at their bond, it reminds me of my brothers, especially my younger brother (hoi, dun be jealous ya, sometimes i would think of you also but lesser compared to xiao dee la). And i just couldnt help and cry again, it was so embarassing in front of so many people. I quickly rushed out of the room and sitting on the staircase and just let all my emotions flew out with the tears. I was settled down in a while and to be honest, this time i wish my family was here. What does this imply? I was homesick...
And now, there's no resistance to that feeling when it comes, just try to call them up to make sure they are happy and healthy. Or try to make myself busy with stuff so that i wont think of it.
I will also make sure i am also happy and healthy. That is what they really want to hear.
I am fine really :=)

Stories of Histrory Taking

1) I was posted to MAU-medical assessment unit one day and i was asked to clerk a new patient that was just admitted to MAU. So i went with my clinical partner and we saw a lady on the bed and a young man besides her. We started off by introducing ourselves and asked why the patient was there. And the young man told us that his mum had stroke and she couldnt speak. (OMG, tak kan want to clerk her by using sign language/ non verbal method?) Then her son started to tell us stories that she has weakness on the right side. (OMGx2, she couldnt even do sign language coz one side of her arm was paralysed!!!) I stared at my clinical partner and seeking for help. And we decided to ask the young man for her details then. He was telling us that he found her collapsed in the morning.... But he didnt know about other details, eg: past medical, drug, allergic, smoking and drinking history coz he didnt stay with her and his mum just came over from spain to visit him... (Arghhh... what a difficlut case) We tried to ask closed question directed to the patient, eg: Do you smoke? And she nodded. We asked again to confirmed and she didnt respond. ( i think she's confused) As a result, we didnt obtain much of her medical history but we still presented her case to a SHO and he sorted out the documentation...

From the medical studnet point of view, i feel sorry for the patient, but it's really hard to obtain history from someone who couldnt express themselves even if we are willing to help... It's even harder to obtain history from them if their family dont know they are not close to their family.
The moral of the story is update ur family or friends with ur daily life so that they would be able to provide information to the doctors if you KO one day (touch wood!!)

2) I was asked to clerk this gentleman who has very interesting cardiac history in a GP clinic. (OK, cardiac history, set in my mind, probably he has ischaemic heart disease. Ah, boring! Chest pain again...). I walked in and started with my opening question: What are you here today? ( i always feel that this is a good question to start with for history taking but i found out i was wrong until i met this chap) And he said that he's coming back for his prescription. (Em... Sweat!!! I cant make this a chief complaint and i cant derive any questions from there for history of presenting illness) So, i moved on to asking about what medications he was on ( i regret starting off with drug history coz it was weird to do the history taking in a reverse order) He told me he's on warfarin(first thing came into my mind was DVT-deep vein thrombosis), simvastatin (this is an expected drug if he has IHD), ramipril (OK, he might have hypertension) and two other drugs that i couldnt remember. (there's no GTN, asprin, and beta blocker. it's so strange?! maybe he's not an IHD case) Ok from the drug histroy, i moved backwards to ask what medical problems ha has to make him on those drugs. (Deng deng deng deng!!! this is the interesting part) He said he had cardioversion 3 weeks ago and they put him on warfarin. (OK, next think backward, why was he cardioverted, must be something wrong with his heart rhythm) He said he had palpitation for 18months. (See, i was right!!!) And then i was stucked, palpitation ah, not chest pain ah, and i was trying to apply to SOCRATES. Coz i never clerk a history of palpitation before... After that, i asked about his family history, smoking and drinking history and the GP came in to review my history. I didnt even ask about the regular/ non regular and fast/slow when he had palpitation. ( what a simple mistake) And after that 10min history taking, i really learnt a lot!!!

From the medical student point of view, not all clerking in CVS is chest pain or shortness of breath. Not all diagnosis would be angina, myocardial infraction, and heart failure. Do not forget about arryhthmia, especially atrial fibrillation!!!
The moral of the story is do not make any assumption or have any expectation coz life is so unpredictable!!!

3) I was in ICU-intensive care unit and i was asked to clerk Mr Big (that's not his real name, the staffs called him Mr big because he was very obese) I appreciate this clerking coz it's the only case i could clerk in ICU as most of the patients in ICU were in sleep, intubated, on a ventilator and not suitable for clerking. Mr Big was fit enough to talk as they are going to discharge him from ICU to medical ward. Of course, i started with the same question again, "Why are you here today?" ( i clerked him before the second case, so i was still very used to my method, i think i am going to change soon, coz it's no longer very useful.) And he gave me a weird answer saying that he was there because the staff couldnt find the equipment to move him away. (See, it not a very good question as the reply wasnt what i want) So i rephrase my question, "why do you come to the hospital?" and he answered me that he came to the hospital for some breathing test. (OK, i asked the wrong question again) I repharse it the third time and make sure that he would fully understand, "Why do you come to this ward and why were you admitted to the hospital?" (and this time i was fairly sure that i could get the answer i wanted, mana tau...) He said: I dont know... I dont remember how did i come in and i dont remember who brought me in. I just remember that my GP came to see me and asked me to come to the hospital for a breathing test and next thing i could remember after that was i was alreday in this ward. (So Strange... How am i going to write this in my history? Cheif Complaint: patient dont know what happen to himself) I guess he was collapsed and he didnt even remember whether he collapsed or not (Yau mo gau cho ah??? Makes my life so difficult) And luckily his wife and his mum came to visit him at that time. I could obtain history from them and they told me that he always felt asleep and he wouldnt remember what's going on when he was in sleep. And i went to read his notes after that and the diagnosis for Mr Big was Sleep Apnoea. He collapsed( or felt asleep?) in the hospital and the anaesthetist was called to go see him as he stopped breathing at that time. That was how he admitted to ICU.

From the medical student point of view, ask the correct question to get the correct answer!!!
The moral of the story is also ask the correct question to get the correct answer!!!

Sports and leisure time

Every wednesday afternoon is sports and leisure day for manchester medical students. Everyone gets half day off on wednesday and i think it's a good day as wednesday is just the mid-day of a week, and it's really nice if you can have a break.

And my wednesdays turn out to be a better day as i always finish pbl on wednesday. (tuesday is a sad day coz i always have to rush and do my pbl on tuesday evening). So i would be super free after my pbl in the morning... No need to go ward, no need to go clinics, no need to go GP sugery, no need to go home visits, no clinicla teachings...

And i would be in Blackburn ON MY OWN... as i don't go back to Preston and most of my friends are in Preston. The only people that is with me is my clinical partner, but he's going to Preston for shopping!!! (I was left alone)

But my mentor (who is a SHO in GP training)( she's an oxford graduate wei... Super Keng!!!), offers to teach me but she's working in A&E in another hospital. And i'm lazy to take the shuttle bus to that hospital....

And what's going to be my plan to spend the whole afternoon?
According to my past experiences, i would either sleep or watch series... Very rarely i would study... Or maybe i should make a change this time...
And now... I 'm blogging... Would i blog the whole afternoon? I never know...

稻香

词：周杰伦 曲：周杰伦

　对这个世界如果你有太多的抱怨 跌倒了就不敢继续往前走
　为什么人要这么的脆弱 堕落 请你打开电视看看
　多少人为生命在努力勇敢的走下去 我们是不是该知足
　珍惜一切 就算没有拥有

　还记得你说家是唯一的城堡 随着稻香河流继续奔跑
　微微笑 小时候的梦我知道
　不要哭让萤火虫带着你逃跑 乡间的歌谣永远的依靠
　回家吧 回到最初的美好

　不要这么容易就想放弃 就像我说的 追不到的梦想 换个梦不就得了
　为自己的人生鲜艳上色 先把爱涂上喜欢的颜色
　笑一个吧 功成名就不是目的 让自己快乐快乐这才叫做意义
　童年的纸飞机 现在终于飞回我手里

　所谓的那快乐 赤脚在田里追蜻蜓追到累了
　偷摘水果被蜜蜂给叮到怕了 谁在偷笑呢
　我靠着稻草人吹着风唱着歌睡着了

　哦 哦 午后吉它在虫鸣中更清脆
　哦 哦 阳光洒在路上就不怕心碎
　珍惜一切 就算没有拥有

　还记得你说家是唯一的城堡 随着稻香河流继续奔跑
　微微笑 小时候的梦我知道
　不要哭让萤火虫带着你逃跑 乡间的歌谣永远的依靠
　回家吧 回到最初的美好