domenica, novembre 28, 2004
:: increased storage power ::i've increased storage power now that i've got a SD card of 512 MEGA! haha... really happy! this is going to smoothen things out a bit and allow me to back up all my important files in it, while i sort out the messy problem of my computer. of course, i'm not complaining cuz this card can be used in the camera as well and then can be used at this interesting machine to (a bit like a vending machine) to print out my photos. hehe... the only thing was that i had to get a card reader cuz not all notebooks/computers have a slot for the SD card. hehehe but all in all, i'm very satisfied with this increased brain space.
how i wish that i could increase the grey matter in my brain like this too! my brain sulci have been gradually liquefied by info overload and the sulci are getting increasingly shallow, ie. decreased in surface area, in layman terms, i'm becoming a forgetful idiot. :S
argh, this weekend was quite an emotional rollercoaster, i shall now numb my senses with some opioids! :)
sabato, novembre 27, 2004
:: Why do you want to do medicine? ::This is a question that all intending to do medicine, all currently doing medicine, all HOs, MOs and even the veteran docs will have to answer or will ask themselves throughout the course of this long long career. It is vital to know clearly why YOU want to do medicine, because you really have to be very sure about it or you will definitely REGRET it at some point or other in the course of your studies or work. As a newly passed-out doctor, that is a House Officer (HO), many nights when you are fatigued, unable to think, unable to feel, your reasons for doing medicine would serve to give you the strength and motivation to go on.
I decided on this topic for a few reasons. One, I was really sick and tired of people asking me why I wanted to do medicine. It gets weary trying to explain this to everyone. Second, I wanted to pen down my thoughts so that I would have something to motivate me in the future, whenever I am feeling depressed or discouraged.
So... why do I want to study medicine?
I admit, I'm not a great or noble person who decided to study medicine so that I could 'save the world' or 'save people'. There I said it! muahahaha... Now perhaps my faculty will come hammer me on the head and shove me into the deepest abyss. Ok I said that because I'm a very precise person, in fact too precise that sometimes I irritate people with my love for detail. To me, it is impossible to save the world or save many people. I would be content to save whoever I'm able to (within the best of my abilities) and bring comfort to the rest. Now that I have been to the wards, I feel that there is a lot that is packed within a smile. A smile can keep me going (ie. clerk more patients) and a smile can make me feel that the long hours I had spent in the ward that day was worthwhile... Till now, I still remember what a doctor told us during the foundation course: To save a few, cure some and comfort all. It's important to be realistic in medicine if you do not want to be totally dashed by the death of a patient, because such things happen, no matter what we can do. It's just as important to remember to focus on the spiritual healing and emotional comfort rather than just aiming to cure the patient.
The second reason, just as important as the first, is the passion for medicine. For the knowledge that I am gaining and what I will be gaining. The joy I can derive from learning about something and then applying it into real life, is something that I can't really express in words. Medicine stimulates me to think, and challenges me to use what I know to help others, which gives me a great amount of satisfaction. In fact just learning new things gives me great pleasure. It's like learning a new language to me, it might not be particularly useful in my actual life or intended future, but it makes me happy.
Job stability is also quite important to me. Medicine does give a certain amount of job stability but this is inconsequential compared to my previous two points.
Prestige and money. Many people have doubted my intentions despite how I've reinterated that my interests in Medicine are people and knowledge. Everyone thinks that medicine is a money-generating profession. I don't deny that it does pay well, ultimately if you do specialise and open a private clinic. But apart from that, the sacrifices made for thie profession far outweighs that of many other careers. Nothing comes without a price. Obviously I wouldn't choose a career that would not be financially stable, after all, I do have a life to lead and bills to pay. But for others to claim that I chose this path for the sole purpose of financial gain, is the ultimate insult to me! As for prestige, yes, it does sound prestigious and it is prestigious, the medical community is rather 'tighly-knit' and often 'closed' to the general public. Yet, this also means that all the dirty, scrummy, disgusting stuff we have to see/hear/feel/smell are not always known to others.
I'm sure that some of you, those who've spent a couple of years in the workforce, will feel that I am extremly naive and idealistic. That all fresh graduates have come into the working society with such fairy tales and fluffy dreams in their heads only to realise that it is impossible to achieve, and eventually become jaded, bored and cynical people who will read other's blogs and snicker at their lack of maturity of thought. In fact, I've met quite a few people like this and I think it's really sad. They still have a significant amount of time ahead of them which is probably better put to achieving their dreams rather than dwelling in bitter thoughts and self-pity.
This is a useful site for all intending to pursue a medical career - the true words from deep within of current medical students and their opinion of the unwriten qualifications for medicine (ie. those left out of the NUS site): click me!
I would really like to hear what you all out there, medical students/doctors or not, have to say! Email me at cvianne@hotmail.com.
venerdì, novembre 26, 2004
:: wenky alert ::OH MY!!! wenky is turning evil-er and evil-er by the day... that's if such a word exists. he's claimed to be mean to kids (no wonder brownie, his dog, is the terror of all the kids in his neighbourhood... i can see where he gets this aspect of his character from) he's claimed to have snapped at two innocent kids in the lift at the hospital once... (the 'he' is wenky, not brownie) when EW was having her horrible 'acute torticollis', wenky actually suggested using the gardner-wells tongs on her, and stringing her from the ceiling! (in order to straighten out her neck, but i think she'll probably get a hangman's fracture... C2 right? odontoid process!) evil evil evil! tsk tsk tsk... then he and bk were quite 'evil' to HS during his DM foot presentation too... hahaha but it was quite comical to watch. :) i might not have missed some spicier parts if i hadn't been semi-conscious.
interestingly, wenky and ew revealed that they wouldn't want to have kids in the future... wenky wants puppies... while ew's kids will probably turn out very withdrawn... such a pity!!! i could almost imagine little wenkies and little ews running around the place... heh... me for sure i would like kids... hehehe i shall talk more about it tonight! :D
here's the latest fan club of Arjun Kampal, set up by none other than our very own Stanley Leong
mercoledì, novembre 24, 2004
:: get real - are singapore women hard to love? ::First, I believe it should be 'Singaporean women' or 'women from Singapore' rather than 'Singapore women'... The same goes for 'Singapore Idol'... I really don't know what to say about the standard of English here.
I would say SW (singapore women) are both easy AND difficult to love. It all depends on the men. hehe... It depends on what qualities the SM (singapore men) are looking for. SW of today are - modern, ambitious, well-educated, focused, high achievers with their own opinions and mostly are not as domesticated as before. Such characteristics they possess were once associated with SM while the SW then had an image of a domesticated housewife, second to the men in the workplace and family. SW today look for men who not only have a secure job, but also have a reasonable bank account, humour, reasonable looks, at least the same level of education, a certain level of capability... and other aspects of character that the woman might desire in her ideal man. SM today, however, seem to be still searching for the virtues that their fathers and grandfathers desired in their wives. Such qualities are - ability to cook, keep house, willingness to bear children, look after his parents and being demure. So at times, it is not surprising that SM find SW hard to love because what the SW possess are not qualities placed in high regard by all SM. :)
Perhaps, as Diana Ser had aptly put in the show, the title could be renamed - 'Why are Singaporean men stuck in the Jurassic Age while Singaporean women have progressed to the twenty-first century?' :)
In the documentary, it was also mentioned that there are increasing numbers of SM looking for foreign brides and increasing numbers of SW looking for their ideal man among foreigners. I think that is fine and should not be discouraged... well, anything goes, as long as it helps to increase the birth rate eh? (just joking) I believe that this tendency of looking among non-locals for a possible life partner is also evidence that SM and SW do not find the qualities they value in a life partner in each other.
This is a topic that everyone could go on discussing. Such views will constantly shift with changes in society, most importantly, by the evolution of women into roles that were once dominated by men. Women are now playing an increasingly significant role as a decision-maker in the family and in the workplace. Men, I suppose could either evolve to be more accepting of the new 'breed' of women or they could start developing some of the virtues they value and seek for in the women. Eg. cook, clean and take care of the children. (fortunately, childbirth is always a privilege reserved for women, lol... lol so men can never be independent of women if they want children! muahahaha... sorry it's just my evil side invading this prim and politically proper discussion). In addition, I would like to remind all that when they complain that the men/women are all looking towards foreigners for their life partners, they should bear in mind that their own gender are doing likewise!
martedì, novembre 23, 2004
:: night duty at NUH ::night duty was simply CRAP! i mean i didn't do much except slack for close to an hour with Rames n Owl in the residence room before we decided to go looking for the HO... who well... couldn't be found. then we went for dinner downstairs (i was so tired n blur that i actually paid using cash, instead of the discount card i had! argh! waste money over crap food!) we burned another 1 hr over dinner... (actually can't say it was wasted cuz i got to know the two of them better! haha... really funny pple with a sharp humour) then we went to the wards and met the HO who prompted told us it would be better to contact the MO instead. but MO didn't return our page so we wandered to the hand surgery dpt and the MO there was nice enough to bring us to see some cases... saw one Galeazzi fracture, one talipes equinovarus (club foot) and one Apert syndrome... hmmm that's all and then the other two went off... i think... unless Rames went to OT. i'm waiting for transport back. he he he...
:: singapore idol ::
TAUFIK better win! argh... i think syl/sly... which is it anyway?!?! has gotten more publicity when the papers ran stories about the 'ugly matters' in his family... however, i think that might actually help him boost his votes.
here are the next few topics i shall blog, perhaps tonight. since i'm too tired to do any studying... i couldn't sleep last night cuz i couldn't get to blog what i thought abt these two topics... is this a sign of addiction?
:: get real - are singapore women hard to love? ::
:: why do you want to do medicine? ::
domenica, novembre 21, 2004
:: hamsap ::anyone went to chk hamsap's blog recently? it's got an entry of his ex-cg! i hope he'll get over his crush on arjun sth soon, cuz it's almost like nala's crush on alan tam!
sabato, novembre 20, 2004
:: singapore idol ::i was quite disappointed with my fellow singaporeans' 'taste' when the results for singapore idol finalists for the ultimate idol trophy was announced yesterday... in my guts, i knew that olinda would be eliminated but i was still clinging to that little ray of hope that quality would prevail over (well over i dunno what, since i feel that sylvester has NO looks)... alas, i was bitterly let down in the end. it's undeniable that an idol is simply a person who has a huge fanbase, a person who's popular and well-liked... however, i fail to see why singaporeans have chosen to give sylvester and not olinda the chance. olinda, in terms of vocal prowess and general appearance, far outruns sylvester, who is not only pronounces his 'the' as 'de' but also projects the image of a scrawny, ah-bengish person with a sharp chin. generally, guys with sharp chins are thought to have weak characters. i believe that the fans who vote for taufik and olinda are probably quite different from those that vote for sylvester... note how sylvester's name is so often MISSPELT in the posters and banners that his fans brandish at every performance? i'm almost certain that taufik will emerge the winner for singapore idol! here are my reasons:
1. taufik CAN sing, and he does it better than syl.
2. he looks better (at least to the more discerning crowd and those who've outgrown their F4 phase (well, actually syl cannot be considered anywhere near f4 material)
3. the winner's going to be competing in world idol (right?) we'd better send someone who looks better, and more importantly, sings better that syl! or the world will laugh at our choice of idol manz...
actually i think that if this weren't singapore, olinda would go further and perhaps beat sylvester. am i not wrong to say that if she were slimmer, sexier, she would likely win either of the other guys to be one of the finalists? it's quite unfortunate that singaporeans don't seem to appreciate the right thing... or perhaps i should say, i don't share the same taste as many of the voters at singapore idol?
regardless, i have to say... i would rather buy an album of olinda's/taufik's rather than that of sylvester.
and what is the problem with sylvester? despite the reminder from the judges to improve his diction which was getting 'worserer', his last song of yesterday night was just as slurred, just as indistinct as before.
venerdì, novembre 19, 2004
:: last day @ changi ::today was the last day at CGH (ortho dpt), it was quite a fulfilling day though i was really very dopified. (slept only 5hrs the previous nite) we had physiotherapy sessions the whole of the morning. the session at the spine section was the best, and it really thought me some useful things... yup that apart from exercising my other muscles, i mustn't neglect the very vital back muscles. according to the physiotherapist, lots of body builders or more appropriately, bodybuilder-wannabes, build up all their abs and biceps but forget their back muscles, resulting in shoulder problems. we got an interesting short session on some good and simple exercises to improve core stability, hamstrings and such. but it's equally impt to do them correctly or risk a visit to the physiotherapist again, for other problems.
right after that ew and i had our 'last lunch in changi'; then we went to the OT to look for chang. he was really nice, as usual... initially we thought he was in a bad mood... but it was cuz of some problematic relatives of a patient. just barely 10min later, he was chuckling, laughing and joking as usual! great guy! heheh.... he was really ke3ai4 today... haha... his family muz be really lucky to have him!
in the operation, saw sth interesting! there was this plica resection and lateral release of the patella. and i saw 'ulcered' bone, i would say it's osteoarthritic changes in the medial knee compartment. anyway... the next op was a brostrum and gould (ankle)... the brostrum and gould is actually done for pple who sprained/tore their ankle ligaments due to repetitive sprains. once a ligament gets torn it will heal back but the length would be increased, thus predisposing to further sprains. thus, the aim is to sew the calcaneo-fibular ligament to the anterior talo-fibular ligament. and the gould is actually oversewing of the extensor retinaculum to further re-inforce the joint.
the next op up was the patient with a calcaneal fracture. the most impt is to make sure the calcano-talus joint is reduced and fixed! apart from that he said, tt was a complicated op.
btw we asked chang which # was most likely to happen with a calcaneal # and it's spinal vertebrae... and change chuckled loudly when he found out we both got it wrong.. ED ED!!!
giovedì, novembre 18, 2004
:: predictions ::EW delice - hand surgeon (she's got the hands for it!)
HumSup stan - renal physician (muahaha, just like prof wong)
wenky hy - cardiologist
BK josh- orthopaedic surgeon
kenneth-hypoC - psychiatrist (teehee)
dopey me- endocrinologist (logically speaking) but possibly specialist in sleep medicine
i'm slaaaaaaacking tonight! no books, no ortho, no pharmaco! only TV, computer games, friends and crapping on my blog!
:: gems along the way home ::
along the way home, i saw:
i) the weirdest pair of genu varum ever! it was definitely genu varum ('knock knees') yet that was a young athletic man, who was JOGGING! oooh... maybe it's congenital and not hurting him... hehehehe there's no lateral thrust too.
ii) this boy who kept doing this weird forwards-backwards motion with his left shoulder that looked suspiciously like... self-imposed recurrent dislocation of the left shoulder... this type of case, doesn't need any reconstruction or labrum reinforcement more than needs psychological counselling to stop this self-imposed dislocation.
iii) pes planus! oooo! i was looking at this person's sandels, tot they looked rather ugly then i realised she had flat feet!
iv) in school, saw a possible case of ankylosing spondylitis hehe... who, in wenky's opinion, needed a psychiatric opinion. and i think my ex-cg seconds that!
got an exciting picture i took today but... due to the fact tt i can't upload pictures from my hp to the comp now since i dun want to install my hp's programme in my bro's computer, you all will have to WAIT.
wat a waste though... sigh...
mercoledì, novembre 17, 2004
:: argh ::1. my spectables suffered a fracture-dislocation... i've since done an internal fixation with silicon (hehe) and let it rest with some kinda 'traction' now. it ought to be ok by tomorrow.
2. my notebook has given up on me, same problem occuring like the other time... rang up the notebook centre and gave them a little piece of my mind (not too much cuz i need the rest of my brain cells for tomorrow!) as such, i'll have to lug my stuff down again tomorrow... i shall accuse them of NOT CHANGING MY MOTHERBOARD and CLAIMING to have done so. the guy on the phone was quite helpful and nice today, not like the other guy, if it were the other guy, i would have been even angrier.
3. the HIGH AND MIGHTY BUT LACK ORGANISATION PROFS have decided that the community health project topic we've chosen (or rather, that they have PERSUADED... make it COERCED k, cuz how could we say 'no' to a grp of profs huh?) IS VOIDED!!!! wa laoo waste all our time! couldn't they have found out that it was NOT an appropriate topic for COFM before getting us to do it? and we were up to questionnaire stage already... i dunno why our leader is still keen for ALL of us to finish the preliminary survey... dun understand. sheesh, so now we're likely to revert to our original topic 'what makes a good doctor' which seriously i thought would be beneficial to all (doctors, public and medical students) to begin with. sigh. perhaps tt's y the project 'what makes a good medical educator' was voided, cuz it did. not. apply. to. the. PUBLIC! it's not exactly community issit?
4. ultra sianz! can't think can't study can't remember can't see clearly can't argh.... and i'm not very sure we're going to have a cofm meeting this saturday! sianz... acks... at least it means i could collect my notebook then! tt's IF they can find out what's wrong... hmmm.... wrong diagnosis manz.... must find out if it's computo-legal... kekeke....
martedì, novembre 16, 2004
:: the pulex irritans ::the pulex irritans (or common flea) is best exemplified by a group of people i often meet in the course of my posting. having succeeded in annoying my group thrice in one day, they proceeded to annoy me twice more today.
let's quote wenky & my first meeting with one of their grp mate today:
him: hi
us: hi
him: any good cases?
us: [sigh] nooooo (like we would tell them if we had?)
let's say, he'll fail cofm if he does this to the patient!
next, we saw them having tutorial with mr chang, MY tutor...
hehe... i am a very possessive person...
sian la... i wish posting at NUH would start asap. i can't wait to not see them anymore!!!
lunedì, novembre 15, 2004
:: the one about wabbit ::here's one of the most spoilt wabbits around! got a cage that is hardly locked... he's able to get in and out of his cage at his own whim and fancy. apart from that he's got a makeshift bedroom out of the bottom most part of the wardrobe. yeah and his own shrek pillow to play with too! arggghhhh the bright side is that due to the freedom, he's really active and bouncy... hmmm... but a bit violent.
hmmm, actually VERY violent. he chewed my finger nails... and persisted on chewing my hands next and scratched me all over while scrambling to get to the string on my wrap skirt. then he pounced on me from the side and the back and dug his wicked claws into me. :( ouch! he also chewed and broke a bunch of ard 5-6 hairs on my head. *sob sob* how can such an evil person like me get bullied by a rabbit? if word spreads out abt this, my reputation will go down the drain...
wabbit on the prowl... looking more like a hunter than the hunted...
so cute.... and did i mention, this spoilt BRAAAAT has a whole room at his disposal! he's got a queen sized bed too! currently he's being trained to jump off and onto the bed... i think he's making good progress. however the parquet floor makes it too slippery for him to land well... so he'll jump off, then slide (v stylo) and then come to a stop. haha...
the explorer... he simply lurves this shrek pillow!
wabbit has great personal hygiene... he doesn't stink at all... not even the normal hay smell tt so many rabbits have!
his favourite position, below the pillow!
me hugging the wabbit, he's only pretending to be tame, cuz he attacked me from the back... simply dug his claws into my t-shirt and ouch! it hurt! i kena scratched as well! i'm gonna sue!
wabbit trick! cute? took me ages to get him to do that!
shake your bon bon... hee hee hee
rabbit says: bye bye n stop looking at my ass!
:: twisted ::
Today i borrowed 'Twisted'! It's a suspense-thriller kind of film, set in San Francisco. Ashley Judd starrs as inspector shepperd, the first and only female inspector on the homicide team. in her first case, the victims were all men she had slept with. she's also an alcoholic. (urgh... i dun think she deserves to be on the homicide team at all...) anyway, she starts to black-out after just one glass of wine and when she wakes up, she can't remember what happened and what she did. due to a devastating experience in her childhood, which involved her inspector dad going crazy and killing his wife and then shooting himself in the head, she thought that perhaps, this streak of insanity ran in the family, and that she was the perpetuator of those murders. as always, there's a twist in a film... lol.... tt's a pun on the title of this film... yeah... it's twisted here and there but very engaging and not too complicated to understand. i think pple with iq below 100 would too.
ps: just by coincidence i stumbled upon a site which showed that all the intelligent pple (gauging by the state's average IQ), voted for kerry, while the less intelligent ones, for bush. lolz... i thought that was really 'telling'.
domenica, novembre 14, 2004
:: iq test ::my iq is only 126, darn i feel so stupid!
check yours!
sabato, novembre 13, 2004
: : quiz ::name 10 body parts that are only made up of 3 letters.
NB: ass, fat and bum are NOT appropriate answers.
all medical students only have 1min, and everyone else, 3min!
get ready and go!
tick tock tick tock... ... ...
answers (pls highlight):
eye, ear, gum, lip, jaw, arm, rib, hip, leg, toe
:: night duty once more! ::
yesterday, me and EW did night duty again! i neva thought it would be that siong to do two night duties in one week! this night duty was however, not very fruitful, in the medical sense... HOWEVER, me and EW attended the staff teaching session and we attended one on A&E orthopaedics, by raj. and it was pretty good... a bit like chan's tutorial but bit more here and there... pretty interesting and got to know more of the HO names... and the year 5s are pretty nice pple too, they were the ones who asked us to go along. after that we spent our time doing the writeups... i think i spent more time summarising the writeup rather than adding info to it! two pages is almost like making us skim thru the whole thing and present only the tip of the iceberg, sth that i don't really like to do.
night duty started with a leisurely dinner down at the food court, which is thankfully, still serving food. phew! then we hung ard a bit, wanted to page the reg on call but no reply. hrmph. so we went a-looking for the HO. poor dr tan couldn't even sit down properly, her hp and pager kept going off! it was really scary! she looked nothing like the calm, cool and composed person we meet in the day! next we went to the OT to ask if the reg on call was operating (which is why he didn't answer the page)... turned out, the nurses said he was still outside having DINNER! defeated, we went to A&E, wondering if we could get a piece of the action there... but alas.... it looked pretty calm and we didn't know how or where or what to do... so back to the wards we went...
this time round, we decided to just clerk a patient and then go home and koon... dunno if it's our fortune or misfortune, we decided to visit the patient tt wenky rec, and who had spinal stenosis. hmmm we ended up with a one-hour 'sermon', but he was a really good speaker, very funny and entertaining too, but we were really tired by then... it was so hard to get him to stop talking to rest... i think he must have been really really bored! anyway, part of the chat was about wenky... ooo.... hehe... anyway not supposed to tell wenky what he said abt him... hehe but i'm saying this here becuz i'm feeling evil and want wenky to wonder what tt nice man said abt himself. hehehe...
i watched a bit of 'twist' and i think it's super nice.. it's a suspense thingy, but i was too tired to carry on so i went to zzz... woke up darn late this morning... and so didn't go for the PDCP, pharmaco and CHP meeting. [er, actually this was premediated.] sorry reema!
will blog more this weekend!
venerdì, novembre 12, 2004
:: sianz ::now EW and I are freezing our *sses off in the student cubicle in the CSO. i just finished my short write up, she's almost done i believe... hehe and i'm now literally 'blogging behind her back'. hmmm... wonder if HS has FINALLY seen his new blog. seems like Wenky is already issuing the final ultimatum... either he takes over management of this blog or Wenky will announce the password to all the evil pple in my ex-cg so we'll blog in his name! muahahaha... so evil!
today, we two mad pple are doing our second night duty, quite siong le... and i'm prepared to not go to school tomorrow, so pls just tell the pple-in-charge that i'm suffering from fail back syndrome or sth tomorrow. hehe... today was in OT AGAIN! muahaha... quite cool...
HOW TO DO THE LACHMAN'S GRACEFULLY
i know lots of pple have trouble with it, esp girls... to quote mr chang, 'many medical students say their hands too small, no strength... but i tell you, you don't need strength at all'... so he taught us that what we just needed to do is to get patient to relax, flex knees slightly, place your right palm under his hamstrings to support, then using your left hand, gently lift the proximal end of the tibial upwards, and there u have a positive Lachman, don't need to twist n turn, huff n puff or 'tuck the leg under your armpit' (which is really quite gross, for both patient and student!)
THE OT IS THE BEST PLACE TO LEARN - mr chang n mr chua.
hehe... mr chua is really a funny funny guy, and mr chang is a close second. anyway he taught us something pretty cheem about Garden and NOF# and did a good explanation of what the function of a dynamic hip screw is. mr chang was very nice in the OT too, he showed us the application of the dynamic hip screw and later on, he took us into prof lam's OT to see a Moore's hemiarthroplasty which was oooo... COOL! but it was a bit gross when they were fracturing up, drilling and digging out the femoral head as well as making a slit-like cavity in the femur for insertion of the prosthesis. there were specks of fat, blood and bone fragments flying all over.. and guess what, the PATIENT WAS STILL AWAKE! apparently she was only under spinal anesthesia. acks. it was cool though, and prof lam thought us more stuff abt intertrochanteric fractures and neck of femur fractures. he's a good tutor, no wonder he's now being promoted to PROF! congrats!
anyway mr chang is really v cartoonic... he was humming a pink panther like tune in the OT while looking at the image intensifier... i think he really loves his job... all the 'seamstress and carpentry work'. he's the most good-natured surgeon i've seen... normally they've got tantrums.. i mean, just look at 'the other' chang of AH.
during lunch, prof low joined us... urps... going to get indigestion lor... haha... anyway, i really dunno what to talk to him becuz i neva knew who he was till today! he knew delice cuz she went into his clinic and i bet she must have done a great job or else i don't think he'd want to eat with delice! muahaha... anyway it was kind of awkward and i was wishing all the time that it was chang eating with us instead.
ok, now for nerds and muggers: THE DYNAMIC HIP SCREW
if two bony fragments are fixed and held rigidly, they might not unite. this is because resorption takes place before new bone formation in bone healing. thus, a dynamic screw is useful, because as the resorption takes place and a gap is formed, the top part of the femoral fragment can 'slide' downwards and rest on the rest of the femur, encouraging union. another reason offered is that if the bony fragments are rigidly fixed, when the resorption occurs, the screw is likely to break through the bone and then oh-oh...
ok, EW finally finished her writeup, and doing her references now... seriously, limiting our writeup to two pages is really terrible! plus, it's got to be font 12 times new roman. sigh... we're so desperate we widen and lengthen the page borders, squeeze in our references.... sigh.
mercoledì, novembre 10, 2004
:: night duty ::yooohooo! i'm finally back from night duty! in fact, i spent just slightly more time doing night duty as compared to the time i took to get home! can u believe it?!?!... maybe i shld just camp overnight! i happened to discover this foldable relaxing chair in one of the deserted cubicles... maybe it's time to make it useful again!
stuff EW and i did today:
first we needed to find a case to clerk for tutorial tomorrow, so we asked the HOs and MOs, but alas, no one was able to give us much except lots of OMs (osteomyelitis) and #s (fractures)... so we met this really nice doc who got us to help the HO do an ECG... hehehe... the first ECG came out as flat line cos... dopey (ie me) forgot to connect the right lower limb lead. haha... next we heard there was a MnR (manipulation and reduction) but also dunno what happened, in the end maybe they did it before we could go see... but everyone was v gan jiong this evening cos there was a 'cool' case of NOF# (neck of femur #) going on in the OT... first, chang told us as we walked past him, next two MOs told us, all quivering with excitement...
anyway, we decided to head where all the action was.... the OT! having changed at record speed, we ran to the OT and realised that if we wanted more mobility within, we had to wear the lead apron... or else we would have to dive behind the protective lead shields everytime chang called out - 'x ray!' as it turned out, this happened every couple of minutes or so... the x-ray was taken using II (image intensifier), i believe it gives better resolution than normal x-rays. anyway, the nice MO taught us how to interpret tt x-ray. it was a NOF# Garden 4. he also taught us an even simpler way of defining the Garden classification -
stage I - partial #
(stages II to IV - complete #)
stage II - complete #, no displacement
stage III - complete #, partial displacement
stage IV - complete #, complete displacement
the management is as follows... most importantly, depending on the age of the patient and the grading of the #.
mx can be conservative ie straight leg (Buck's) traction, which can be skin traction or skeletal traction.
the next would be a surgical approach. a lot depends on the age of the patient. for someone young, ie below 55/60 (? not sure of the age limit), it's probably better to use cancellous screws to fix it. also it has to be done within 6 hours of the injury, for revasularisation to be successful, the longer the delay, the poorer the prognosis. all #s of the femur shld be fixed with cancellous screw, except basal # which can be fixed using dynamic screws (i think, it's the one with a plate and screws).
the process: first, two guide wires are drilled into the bone, once the position is confirmed and appropriate (via II), the screws are added, they have a hole through which the guide wire goes. the screws dun go all the way thru, this means tt it is not fixed but the femoral head is actually pulled towards the rest of the femur. normally the lower screw is done first then upper, so that a 'valgus' ... is created.
if AVN (avascular necrosis) sets in after the screws are placed, well... v sad... will have to replace the joint. if a non-union or mal-union takes place, then a valgus osteotomy would be done at the prox femur. the result is a slightly longer lower limb, but does not predispose to OA (osteoarthritis).
for someone above 55/60, a hemiarthroplasty is the rx. cancellous screws are not encouraged due to the high risk of AVN. there's no need for a total hip replacement since the acetabulum is still good...
right after this # was fixed, ANOTHER SIMILAR NOF# came in! aiyo! then chang said 'oh, oh, u know, things come in three...' but this time round, it was a 19 yo F, and it was already 10+ hours since she suffered the injury, chang seemed a bit disturbed... but i guess the prognosis shldn't be too bad, since she's really young. let's hope for the best. next up, the two of us had a little chat with some nice year 5s. then we went to the wards... clerked a case of PID. the man was really nice to talk to us at like 8+ kind of thing... and even let us examine him. heheh, we did it in the physiotherapy area for the patients...
knocked off at ard 9.30pm, and i reached home at 11.30pm. exhausted.
PS: the MO/HO told us that although we might find visits to those rehab centres, sports centres and so rather 'FON' now, we'll find them useful as HOs in the future, cuz we would then know who and where to refer the patients to.
waa... now really tired. have long since compiled our sports injury seminar and added a few pictures, still waiting for input fr R and ERR. maybe i'll do it tomorrow morning.
lunedì, novembre 08, 2004
:: oops, they did it again! ::as if annoying us twice a day isn't enough, they had to do it at night duty to Wenky, RW & NY! simply by turning up for the duty though it was the slot tt Wenky & co. had signed up for officially on the paper which we all signed.... there're more than enough days for us to do night duty twice each, and for *ah-hem* to do like three nights since they're so KS. i dun understand why they have to do it on a day that other pple had already signed up for?
anyway, W said they gave a crap excuse to explain for it. i wonder if anyone will turn up for my night duty???
:: do unto others what you wish to be done to yourself ::
on the first day of posting, i looked at all the new faces and thought to myself: these look like really nice, pleasant people. i must try to use this short three weeks of posting to get to know them all better.
now, what i want to say is: enough, i've seen enough, it's shattered my first impression. and you all know that first impressions are hard to break.
now i shall carry onto the thing that everyone's been anticipating - a bout of bitching!
this i heard fr EW: apparently we were told that our grp would take the wards on level 7 and the caller's grp would take those on level 6. little did we know... level 7 contains 2 mixed wards, while level 6 contains 4 PURE ortho wards. this spells just one word - UNFAIR
this i witnessed myself: they are always nice when they ask us for cases but they never offer us any in exchange. and worse, sometimes they say that there're no good patients even after they've combed the entire ward (or maybe even more)
this i heard fr either EW or Wenky: apparently they went to call up all the tutors on the list that did not have students attached, booking them for tutorials. i wonder if they tried to book the tutors attached to us too?
this Wenky, RW & NY witnessed in clinics ard a week back: they went to the clinics wanting to attend a clinic session to find that ALL the rooms... were taken up by those people!
this EW and i witnessed in clinics today: we were waiting for our personal tutor. when he came he immediately told us to go over to another room to see an interesting case (DDH, cool btw!) 10 min later, he came in, and EW and i tot maybe he wanted to ask us to go back to his clinic... but u know who we saw? three people rushing in after him.... EW told me she was v v v angry... and she looked at me and thought i looked pretty calm... so she controlled her temper. (me calm?!?! no lah, i'm the type that when i'm irritated with other people, i just keep quiet until i can lash out at an appropriate time) anyway, after seeing the DDH xray, those 3 people followed OUR PERSONAL tutor back to HIS clinic... we followed of cuz! 'lay your dirty paws off my tutor, k!' anyway, they had the sense to know that they had invaded our territory... and had the sense to go to another clinic. lucky for them, cuz i will not budge. if the doc had said that there are too many pple in the clinic, i would say that, well, we came to this clinic cuz we are expected to shadow our personal tutors... sigh, and to think i've been meticulously checking the clinics schedule to make sure i don't go into a clinic with a tutor that has students already attached to him.
this happened today: the other grp called up my grp rep to ask whether they could join us for tutorial today. well, after all those sneaky ways to get more tutorials then us, which i'm sure should have been fairly successful, they still need more tutorials? more and more? unbelievable!
i wish i could talk to kok kok now, i can just imagine how she would say: those b*tches! yo go gal! hehehe... u always make me feel better :)
well, i've thought about it, i can forgive them (as long as these things don't happen again) but i'm not gracious enough to forget. i feel really sad that some people have to go to such inconsiderate ways when there's really no need to do that. sigh.
PS: today i taught evil woman and evil wenky some bad words in spanish. he he he... eh, i know some italian ones too, wanna learn that too? hehehe...
domenica, novembre 07, 2004
:: power of three ::'a picture says a thousand words'... and so here it is.
plus i'm sick AGAIN. drats, my victory over the rhinovirus was short-lived! i probably didn't eradicate it all or else i kena another serotype... acks.
sabato, novembre 06, 2004
:: interesting OT stuff ::each allograft (donated ligament from a foreigner in the US)costs USD$1600... meaning two grafts would cost USD$3200!!! luckily the costs are settled by the funds of the HMDP (sth) department in CGH!
too tired le... continue another day...
venerdì, novembre 05, 2004
:: OT OT OT :: (this blog's for medical students and non-med students who've got nothing better to do now. or else can refer to the last paragraph)yoohooo! mr chang is quite a funny guy! he self-proclaimed: if you girls have any questions must ask me, you have got the funniest tutor around!!! waa... so nice! hiak hiak hiak... u all jealous of me and EW now? muahaha... gloat la... gloat somemore lah... haha...
EW and her tu2 di4 saw 2/3 of an op today. it was for ACL (anterior cruciate ligament), LCL (lateral collateral ligament) reconstruction and common peroneal nerve exploration. we saw only the ligaments part and it was getting late so nice mr chang asked us to go home first. heng! cuz if i stood any longer, i would probably get valgus. it was soooo cool....
brief description in rough terms:
first, a cut was made to put in the arthroscope. then chang pointed out the cartilages and surfaces, PCL and the torn ACL, LCL for us to see. the LCL wasn't obviously torn, more like stretched and one line of stress where it would have torn. and MCL was strained. kinda interesting. next, he used this thing tt looked like a G clamp, one end into another hole, another one into a cut below that hole. then a trocar was placed into the second opening of the G clamp and DRILL DRILL DRILL in... and then the trocar came OUT fr the other end! omg... now tt guy's knee is like skewered!
next, the string tied to the allograft was threaded thru the original opening and like sewing, just pull pull tug tug tug and the 'ACL' is now IN the joint! voila! then put in the scope, scrape some bone away cuz we dun want the bony edge cutting into the new ligament then put in another instrument with screw. and then... chang screws with all his might and we here the 'crunch crunch crunch' of bone being penetrated by the screw and then the ligament is firmly nailed to the medial edge of the lateral femoral condyle! so cool right? wa... then, he and dr kannan one pulled and pulled the ligament downwards, the other flexed the knee... and finally they put in another screw to secure the other end to the tibial.
part II: by now EW and tu2 di4 quite dead already... and yet... still got to fix the LCL. now the second was fixed via open not scope cuz chang had to open the side anyway cuz the neurologist wanted to explore the nerve. therefore they started this like 10inch incision down the lateral joint line. cleared away the fascia and then the same, screw one end to the femur and one to the fibula. this one's a bit diff cuz chang bent the allograft into two. one would act as the LCL and the other the peroneal lig. (argh forgot the name, so paiseh, muz ask shifu)
finally, it's the neurologist's turn. so EW and her tu2di4 finally got to leave the OT! wooweee!
sigh i'm so tired.
today, felt an extremely sourish kind of bad feeling in my guts towards some people. i dun like to feel this way, cuz it's really bad and i feel really disappointed that i'm thinking this way of some people, but i guess it's hard to control my heart. i'll try to control my mannerisms towards them though.
giovedì, novembre 04, 2004
:: quirky funny happenings ::today i was repeating 'Thomas' test' to myself a couple of times while i was doing my report (yeah i've finished, i did AVN) while the baby was sitting next to me. then he ran away and started chanting Thomas' test to himself for the rest of the day! before he went home i asked him 'Oy, wat test?' then he said: Thomas' test... haha... so cute! next week i shall teach him where his internal organs are... i think he should be able to manage brain, heart, lungs, liver, spleen, intestines and kidneys.
my brother was having dinner somewhere... when he had a phone call or sth... then after that, he suddenly came into the hall to ask: eh, where's my plate? mother: what plate? brother: my food, my dinner? mother: ... me: ... aiyo! finally he found his dinner 20min later at the window. at least it wasn't the toilet or sth. i once left a plate of cut fruit in the cupboard where all the plates are kept!
this is the picture that links cat to me. take a look! wenky, this pic nicer la... lacks a tail though.
:: "Shoot the messenger", Stanley said ::
i'm also glad to announce that my hair can be bunned up now, albeit rather messily, give me 2 more cm and i'll look like in the pic.
:: dopey needs more drugs ::
Dopey's sick :( after having malaise for two days. :( my medicines dun seem to be able to get rid of whatever i have... so... i need stronger, better DRUGS! i think maybe i over-dosed myself this morning... cuz i konked out fr 11am to 4pm! woke up all bundled up in the quilt shivering... bleah. hope to get the fever off by tomorrow at least, or else i dun think i shld go into the OT.
still feel a bit ooozie... maybe it's also cuz slept too much! Ha... can u imagine, Dopey actually admitting that she sleeps too much?!?!
i wish i had gone for the test, now i'm worried cuz i won't know the format and level of difficulty in the ACTUAL one. :(
on the bright side, i received a call from the comp centre telling me that my notebook's ready for collection! and guess what, they replaced my entire motherboard FOC!!! oooo! pple who've bought yr notebooks, if they're giving you some trouble, no matter how small it might be, better get it checked before the 3 year warranty period is over!
martedì, novembre 02, 2004
:: weirdos ::weirdo no. 1 is none other than our very own cg's wenky! he's attempted to draw a picture of me! but it looks really odd... i'm supposed to be suffering from RA hands (looks more like clawed hands), pes cavus (looks more like chicken feet), bunned up hair (looks like beehive on my head), goitre (looks like a very ugly collar i'm wearing) and malar flush (looks like a bad case of acne outbreak)! i have to salute this guy on his 'fantastic' drawing skills!
weirdo no. 2: imagine you're jogging along this darkish path, it's 7.20pm and the skies are darkening... as you jog on, thinking about how stupid (or smart for some others) you had been at tutorial today, you suddenly hear the 'thump thump, sssh sssh' sounds of footfalls ahead of you... and they're definitely faster than your own. and as you tear you gaze from the fantastic skyline, you turn your head ahead and look right into... ... ...
A JOGGING ZHEN ZI!!!!! ahhhhhhhhhhh!!!!!!!!!
aiyo! what kind of weirdo jogs WITHOUT tying up her very long hair... and jogs with her head down, hair swinging in front of her?!?!? and you know what she was wearing? this weird shapless shift-like kind of loose dress of overall!?!?! aiyo! i felt so much like laughing...
sigh. feel so stupid. bleah.
feel pretty useless too... u know what i did, i left my mobile in my coat in the locker! ha... my sms will keep going ding ding ding ding every few minutes or so... lol... i would really like those docs to wonder what sound that is... haha!
i hope my mobile is really there and not elsewhere. :S
lunedì, novembre 01, 2004
:: paediactric kit ::The components of the paediatric kit are as follows:
a. Red Ball on string for visual tracking
b. Rattle ("squealing" or "traditional" type)
c. Squeaky toy
d. Bell
e. 8 Building Blocks (1" cubes)
f. Reading book
g. Magnetic Writing Board
h. Stickers
i. Bubble toy
j. Box of Raisins
k. Measuring tape (free)
l. transparent platic container (for easy access to
components) and paper bag (for carrying around)
so u guys out there, think this is a worthwhile investment? seriously, that box of raisins is a bit 'duh'. though useful for those doing paeds now, i think it might be mouldy by the time i do my posting. sheesh i think part of the 18 bux shall land in my own stomach! haha... i saw the squealing rattle, it's disgusting! it looks scary in the first place, i think the kid at my house will either stomp on it and run away crying or else he'll not even want to go near it.
18 bux looks ok, but then it's likely i'm going to buy my own ratttle... and why does the writing board need to be magnetic??? hmmm.... sure i'd like to contribute to the yunan fund but... i'd like to buy stuff that i can work well with.
oy RACH, what's your take on this?
:: REVENGE is oh so sweet! ::
muahaha... this is the picture of the three people (dunno if hypoC included or not) who were gloating abt the fact that delice and me only have ONE tutor.
evil owl hoots off...
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francesca chiu
2 eyebags & 5 wrinkles
on long-term dormicum drip
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