Guys

I made jokes with Effah that I'd prefer her not to go to tute today so that I can have all the guys for myself...in the end she decided not to turn up so I actually left with Nick & Peter for the tute with Dr John in the morning and with Tom at lunch time...
It wasn't too bad after all hanging out with the boys even though I felt a bit awkward initially as I've always been in a tutorial where girls outnumbered guys...
We had a good laugh talking about a lot of things...the midwives, consultants, future specialties that we might pursue, last year OSCE exam and about our efforts in studying...
I always wonder how difficult it is for a male med student doing an O&G rotation..I have confirmed it today....it definitely is difficult!
Peter told us, there's one time when the midwife asked him to put his hand on a patient's tummy for 10minutes to feel for the contraction and to time it up...he was left with the patient alone in the delivery suite...the patient tried to relieve her pain by standing and swinging her hips..(I'd imagine she's basically looked like she's dancing)..Suddenly, the patient's fiance came into the room...and Peter, with his hand on the patient's tummy instantly told the fiance that he's a medical student...(I wonder what's on the fiance's mind when he first saw them both)...hahah...surely not what he'd expect...
I was surprised to learn Peter n Nick's views about labour...both of them agree that they hate watching women in labour..they think that the whole thing is gruesome...they even said that they would be surprised to know that any female medical students would still think of having a baby (at least vaginally) after witnessing how gross it is...
It's interesting how both of them thinks of the hardship of the whole experience while I would focus on the joy of the baby's arrival into the world....

Mistaken

I was scared to go to Dr Lee's clinic today as I didn't go to the hospital last Tuesday and do the presentation which Dr Lee had asked me to...I made sure that I brought my stethoscope along as Dr Lee had given Peter a hard time when he forgot to bring his...

Dr Lee asked me to sit in Consulting Room 2 while he is in Consulting Room 1...he sends his patient to me to take their history, BP, examine the tummy and take fetal heart rate while he attends to another patient...after I'm finished, he would come and ask me to present the case and he double-checks if I managed to get the correct fetal lie and presentation..I was right in 7 out of 10 patients...counting the patient who's carrying a twin in her tummy which I failed to reckonize until she told me so...I was surprised that when I measured her symphysis-fundal-height(SFH) which happened to be 42cm when she's only 36 weeks pregnant(SFH is usually equal to no. of weeks)..btw,she was my first patient of the day!

As Dr Lee had been sending me his antenatal patients, I assumed he would continue the trend so I'm sort of getting used to ask the patient how many weeks are they into the pregnancy...until this patient came with a baby in a stroller and I asked the same question without thinking....she was like, "No..no..I'm not pregnant...he's 3 months old..she showed me her baby"...I was really embarrassed and I just apologize to her for my stupidity...and I thought I managed to cover that up when we had a chat about her presenting complaint and her cute baby boy...

Dr Lee came later and he examined her tummy which she had been complaining of pain...she had a caesarean section and the examination revealed that there were no signs of inflammation and the scars is healing well...she said she had been taking Panadeine Forte and she couldn't do anything without it...she had 3 other daughters and 2 of them is 2 and 3 years old...Dr Lee confirmed my suspicion of post-natal depression as she doesn't seem to be coping well...

Later on, when Dr Lee's receptionist came into my room to give me a patient's file, she reminded me to read the patient's file first before I start talking to them..she said, "Don't just ask the patients how many weeks they are, because the last one complains.."I told her I'm sorry...I think she really was pissed off with me...I know I should have felt bad for my own mistake, but I just couldn't accept how she acted...everytime she came into the room giving me the file, she always smile half-heartedly only because I was smiling and keep on saying thanks to her...she seemed to be avoiding my eyes which I found really annoying...

Anyway, all in all....Dr Lee was really nice to me today...I wouldn't expect him to be that nice after what Peter has told me...we even talked about Dr Lee's background, where he came from, which school he went to...apparently he was the 8th batch graduated from UM med school!!I even had a chat with him about politics!!

(I googled Dr Lee yesterday to look for the address of his practice and I was surprised to find a forum where mother-to-be talk about their own experience...there was this lady who asked if anyone had seen Dr Lee and if he is pro-natural..it was funny to know how people talks about their doctors and the impressions they made..it's not just celebrities who need to have good reputation, doctors too...I should mention that there is one patient who complained about Dr Lee's receptionist and she was seconded by another patient..........and now me...)


Apart from that incident, it was a good day for me...I get to practise obstetrics examination, history taking and presenting patient's case)

Things always turns out fine for me when I'm worried most about it...

Parenting

This is a very random topic...totally unrelated to my usual typical med student's life entry...

I think parenting is the hardest thing in the world...it's not something that can be taught at uni n u can't earn a degree in parenting..it's even harder than learning to become a neurosurgeon..where u can refer to books, journals and u will be trained by different consultants before u become one...there's no book that can teach U how to become a parent...I wonder why people even bother buying parenting books or write one in the first place...
hmm..on second thought, maybe because it's too difficult that people thought some tips might help..

From my observation throughout my 23++ years of life, I shall say there's no correct way to become a parent...U might be too strict, and ur children hate U or did something bad n it reflects on U not being a good parent..U might be too lenient and the same thing could happen...U can't trust them yet U can't doubt them...even when U think U hv a good relationship with ur children, things can still go wrong...even when U treat all your children the same way, they won't grow up with the same character or values...

I want to become a mother in the future, I'm thinking maybe in 5years' time, but seeing how challenging it is, scares me a little..nurturing babies might not be as hard (maybe it's more difficult logistic wise)...but it certainly gonna be a greater challenge as they grow older..

Bushfire

I never thought bushfire is that close...I've seen some burnt grass n trees on my way to the hospital but never when it's still burning....

Yesterday I was in the operating theatre(OT) in the afternoon..there were 2 OTs(Dr Lee & Dr Rasiah) for O&G and I decided to go to Dr Lee's OT as I saw on the list that he will be performing total abdominal hysterectomy(TAH) which is not done everyday at Angliss..I was with Dr Lee for the first hysteroscopy+dilatation & curettage+polypectomy..after that Dr Lee send me to Dr Rasiah's OT as he has an emergency laparoscopy for an ectopic pregnancy...the surgery took about one hour and while I was in there, the nurses, the anaesthetist talked about bushfire..everyone seems to know someone who has been affected by it..even one of our O&G specialist Dr McCallum has asked Dr Rasiah to cover for him if any of his patients is delivering their babies as Dr McCallum couldn't leave his house because of the bushfire...owhh...I just remember that I'm rosterred to go to Dr McCallum's theatre next Monday, hopefully he would be able to make it by then..

Suddenly one of the nurses in the other OT came to ours telling that some of the staffs had to go home..they just received news about the bushfire n their house might be affected as well...so Dr Lee's theatre need to stop while everything is sorted out..the anaesthetist look up on CFA website (CFA is equivalent to 'bomba' in Malaysia) about the latest updates in bushfire...some roads are cut off and everyone started talking about alternative routes to go home..one of the nurses told me that she might just stay at the hospital for the night rather than getting stuck in traffic since all the road is congested at the moment..

It turns out that both Dr Lee's n Dr Rasiah's major elective surgeries had to be cancelled..as I don't know where I should go in between the surgeries so I just follow wherever Dr Rasiah go..apparently Dr Rasiah also has a patient for TAH that had to be cancelled..As Dr Rasiah started to talk to her, she started crying...Dr Rasiah tried his best to explain the situation to her but she wouldn't listen..this is her second cancellation..the first time was because of bushfire as well...I felt sorry for what happened but there's nothing we could do..people's safety is more important...

In the end, even after cancelling those major surgeries, they still couldn't finish according to the 5pm schedule...I got 5 signatures today(3 for VEs, 1 hysteroscopy and 1 laparoscopy)..I've observed 4 hysteroscopies but they only want 1...

I was coughing all the way while walking from the hospital to the train station because of the smoke...btw, we could even smell the smoke from the hallway at the OT area...that's how close we are!

Sex

I'm telling you...It doesn't matter...It shouldn't matter...

Although..being born in a family of girls, I always wish I have a brother..an older brother would be great but a younger brother is fine too...Somehow I secretly hope that I have an older brother that I haven't met..(maybe like Peyton in One Tree Hill)..he doesn't have to a biological brother..he might be a brother whom I've fed from the same breast...as long as he is someone I couldn't marry...how cool would that be!!
I don't detest anyone who would want a son after giving birth to 3 daughters or the other way around..but I couldn't accept the fact that there are some people who would only want sons but not daughters..

The other day, I had a chat with a patient that I was managing...while I took her blood pressure, I heard her telling me that she's a muslim too..of course I expected her to be one as I had read her file which stated that she is an Afghan...I even wondered if she's a Hazara or a Pashtun...I've just read 'Kite Runner' which I thought one of the best book I've read if not the best...as the setting is in Afghanistan, I've learnt a few facts about Afghans and I have to say I'm excited to meet an Afghan and talk about their culture and life over there, pre and post Taliban era....
Anyway, I figured she might have mixed-blood..as her mother looks like how I pictured a Hazara would, but she doesn't...

As she wasn't in too much pain, I thought it was a good idea to stay in her room and have a chat with her...she told me this is her second child..she has a daughter and this one is gonna be a girl too..I told her that I have 2 siblings, both are girls...She said to me, "U know in Muslim country they don't like to have a girl..."
How can she as Muslim say that?I would felt differently if that's what a non-muslim perceived...
I told her that's not what I experienced in Malaysia...and I don't think that it's Islamic teaching...
After a few minutes I left her room, with my mind still thinking of her words, her perception about her own religion...I know it's not her fault...It's what the male-dominant society taught her and makes her into believing...the religion doesn't teach men to oppress women...it's the culture people!!I hate it when people mix cultural and religious beliefs...and the non-muslims assume that the religion is the culprit..and those women who succumbed to their own culture think that way too...for that same reason, I always avoid reading books written by Muslim women even though they are listed as best-sellers..I don't want to listen to words coming from those who thinks they are being oppressed and couldn't care less about learning Islam from it's roots...they should criticise the culture created by man, not Islam!

A few days after, I had a chat with Catherine and she told me her sister used to live in Jordan where both her daughters were born...She told me it was funny how when the baby was delivered, the people over there kept saying to them how sorry they are the fact that she had a girl instead of a boy...she even had to tell them that they are happy to have a girl..and still, they would say,"It's good that u're happy, but, try again!!"...when I told Catherine that it wasn't prophet Muhammad's teaching, even she agrees with me!!I felt frustrated thinking how a Muslim woman can be confused about her own religious teaching but a Christian could tell which one is culture and which one is religion??

No Baby No Cry

I guess it doesn't fair for me to talk only of the mothers...
Fathers do deserve some credits for without them there won't be babies...

One thing I always observe in labour is the role played by the baby's father in supporting the mother...some are great..they just know what helps and what not...some are clueless...

Nonetheless, one thing I love to see is when the father is cuddling the baby....my most favourite part is when they shed a few drops of tears while holding the baby in their arms...I personally doesn't like guys who cry, but this is an exceptional case..even a desirable one!!I dare to say those who doesn't aren't real man..well at least for their first baby...I always want to capture those moments with my D80 but never had the chance...I guess I won't have the chance anymore as any future deliveries where I'm in that suite, I would have to be the one performing the delivery...no more clean hands for the camera...

Don't trust a woman in labour

(I break my tradition of having only one word as the title as I can't be bothered spending time thinking of a suitable title for this entry)

After being involved in 6 deliveries, there's one conclusion I've made...

Don't trust a woman in labour...

When the pain intensifies and became unbearable, U might hear them saying...
"I couldn't do this anymore"
"I want this baby out, now!"
"I don't wanna do this"
"Don't touch me"

Not to mention:
"I don't want this baby"
"This is your fault" (to the father)
"Fuck" X 100
"Back off"
"I don't care"
"Shut up!"
"If u say another word,I..."


But not to worry, this will disappear once they see their baby's head coming out of their own body..

And when the baby is on their chest, then only they become themselves again as U hear them saying:

"Aren't U gorgeous?"
"U're so cute"
"Mommy's here"
"She's so lovely"

They will also apologize to everyone in the room for how they behaved and trust me, they'll look 10 times prettier...

Btw, I took this photo yesterday..She's the baby I've delivered..I'm not sure if she's gonna be Ebany or Olivia...I personally prefer Ebany over Olivia, but that's ur mom's call!
To Ebany or Olivia,"Be nice to your mom, she'd been through a lot for U to be here!"

Answered

I'm grateful to Allah for answering my prayer...
At 12am...I managed to get another spontaneous vaginal delivery(SVD)...Yayy!!I've got all signatures for labour ward experience..meaning to say that I can get away with not going to the delivery suite for the remaining 6 weeks!!but of course I would like to perform deliveries by myself after this..
plus I managed to get a vaginal examination(VE) done on another patient..thanks to the patient whose name I shouldn't reveal here and Catherine (the midwife)...I think I've improved my communication skills and that helped me to get the consent for the VE...I've played a good supportive role back in the suite...I know I did..I could tell from the patient's eyes..and the way she kept thanking me..heheheh...
A good night indeed!!!

SVD

I'm on overnight again tonight...
O' Allah....please give me just one more spontaneous vaginal delivery...at least just one..more is great!!!
Please make this shift an enjoyable one!!
Amin..

Forceps

I got to see forceps last morning when I had my fourth overnight shift...
At first, Wendy(the midwife I was shadowing) called me saying that Dr Speirs would like me to be in the delivery suite with him!!I was delighted that Dr Speirs (whom I have yet to meet at that time)...is looking for a med student n that med student is me??When I went into the suite, I saw there were a few people waiting for the birth of the first baby of the family..I actually thought that it was kinda funny that he actually asked me to put on the boots, the same kind that he was wearing...n the midwife said,"Owh...the boots..Bryce likes to wear those(Bryce is his first name).."
Unfortunately,the baby's head just wouldn't slide into the forceps n Dr Speirs taught me an important lesson,"Don't ever force the forceps!"
In the end, I went into theatre and as usual, I offered my hand to take the family pictures!!The 3.8kg baby is named Callayn Josh M*************(he has a 14 letter surname which I didn't even try to memorize n I'm trying to maintain his privacy)

When the sun started to come out and my shift comes to an end, the other patient that I was managing reached her second stage of labour...After an hour of pushing, Dr Ford started to worry that the baby might be compromised as her heart rate is increasing and they finally decided that forceps is the way to go...(yayy..I finally get to see forceps delivery!!)..

Dr Ford had to do an episiotomy and I assisted her by holding the Sims speculum when she was suturing..after explaining to the patient about what has happened, Dr Ford had a debrief with where she explained to me about the suturing she made and she taught me an interesting pneumonic..Forceps Rule:

Back to back
Toes in the air
Right over left
Consider it a pair
Right hand down
Left blade on your hand only patient's left side...

(she actually wrote this down on a paper for me)

I know it's hard to imagine this when U don't have the forceps in front of you..hehe..
I hope I'd be able to put the forceps the next time I'm asked to!!

Birth

I had my first double-scrub last Saturday..(double-scrub:putting your hands on a doctor's or midwife's hand when delivering the baby...according to the midwives, before we can perform the delivery ourselves, we need to do at least 3 double-scrubs)...I was on my overnight shift..and it was a quiet night..I thought I'm being unlucky again-no one's giving birth when I'm around...until..it was 430am in the morning...I was pretending to read the obstetrics book but the truth is I was dozing off...the midwife called me n asked me if I would like to see this patient...I instantly answered "yup" with gleaming eyes..

I was lucky to shadow a very nice midwife who talked me through while she's doing her job..She involved me in the management of the patient...maybe not much but I'm happy to just do the obs rather than doing nothing...I was embarassed whenever she asked me questions and my answer is always I don't know...she also taught me to palpate the patient's tummy..n I was lucky that she's very..."neat"..as the midwife put it.."she's every student's dream"..she not the usual >30 BMI pregnant lady...therefore,it's not that difficult to identify where's the baby's head, buttocks, back n limbs...


My shift would have ended at 7am but I decided to stay as the midwife in charge told me that she thinks that I would be ready to get my first double-scrub!!yayy!!At 7am, the mother was still trying to push but we haven't even catch a glimpse of her baby's head...I felt really bad for her and myself as I haven't mastered the skills in empowering a mother in labour...I'm speechless..not knowing what should I say...I admired the midwives very much..even the student midwife..she was just great..I think we as med students should have a tute that teach us words of encouragement that we can use in the delivery room..I'm afraid that I might say the wrong thing n the mother might just snap at me,"what do u know??u're just a student"..It's unlikely, but who knows, she's in deep emotional stress..she's capable of saying anything..It's the hormone talking...in the end I just rubbed her legs when she started having cramps..n changed the wet towels on her forehead every now n then..

It wasn't until 8am that the baby started crowning...if it wasn't because of the midwives continous support, the mother would have just resorted to using instruments to take her baby out..it never occurred to her that she would be able to do that by herself...

The most magical thing of birth itself is how the environment transformed once the baby is out...the tension just gone...the mother who used to complain of how much she was in pain seemed so contented..the father was ecstatic as he cut the baby's cord...they both just couldn't get enough of their son...and me, I'm too happy that I've had my first double-scrub n I would also be the one delivering the placenta...

However, the happiness doesn't last that long when there were no signs that the placenta was separating...the resident n the midwives tried everything to their best knowledge to help placental delivery but nothing happened...the mother was no longer in pain but she started to worry when told that she would have to go into theatre if the placenta doesn't come out..she said that if she knew this would happen, she might resort to C-section in the first place..saving all the trouble having to work her ass off pushing the baby out...I thought I knew what she's worried most..the scar!!but I know I shouldn't jump to conclusion by telling her that the surgery would be done through her vagina n therefore I just kept my mouth shut..n then when the resident came n talked to her about the surgery n told her that it will be done vaginally, she just said,"that's fine then!"...I couldn't deny that I felt a tad happy that my instinct was true..(I know what my patient's concern is)
I wished I could go into theatre with my patient but I know how tired I am..staying awake for the past 13hours..the midwives kept on asking me if I had eaten anything yet...even the baby's father was also concerned that I haven't had a rest ever since they arrived..
I ate my last piece of sandwich and I wished all the best to the family..I told them I'm sorry that I haven't been of much help but I did learn a lot from them...I honestly feel bad for not being able to come up with encouraging words when the mother was giving up pushing...n part of me worried that the patient actually hate my presence..but when they both said that I did help...I felt so relieved!!!It just made my day!


I felt sorry for the mother as she had to go through a difficult labour....it was late in the afternoon when I rememberred my mom told me that she had a difficult labour with me..she put it in malay as,"lekat uri"...which I compute as retained placenta..the same problem that happened to my patient!!maybe my mom's wasn't as bad as hers that she didn't had to go into theatre but she did told me that my grandma thought she was gone when she was just tired..n couldn't bother opening her eyes...even the doctor was worried...but thankfully she was alright..
My experience today had reminded me again how much I should not take my mom for granted...she had been there for me all my life..she was the one I could always turn to...
I wish I could take a good care of her till the end of my life...
I felt like crying...
I'd better put this to a stop or I might end up crying...


ermm...maybe I shouldn't get married...(haha..yay!!not crying)

Contemplation

My friend Ad asked me yesterday how's my weight loss program going?..Have I started exercising?..my answer was, I've been planning on going for a jog every morning since I came back from Malaysia..which was 2 weeks ago...but then everytime I woke up or after I pray Subuh, I contemplate..n I always find a reason not to go out...my favourite one is-"Let's start tomorrow"..
N then Ad said to me, "Don't think!just do!because the more u think, the more u're incline not to do"...
I was like...Wow!!that's one of the best advice people ever gave me....
We're always told to think before doing something...apparently there are situations when we shouldn't think...

Laziness

Again...I should be studying n that's what I told my tutemate the reason why I'm not going to the delivery suite this morning but instead I woke up at 12pm...I watched Kasanova XXL, went out with Asma'...Asma' wanted to go to THEFACESHOP at The Glen Centro...we're all boycotting body shop!!keep it up everyone!!I also went to harvey norman n Officework..I'm looking for a laptop...even though I surely dont hv the money to buy one, yet...it doesnt hurt to window shop right??!!n when my tutemate smsed me at around 6 pm n he said,"Hey, how's study going??"..then only I rememberred what my plan for today was..
up until now,10minutes to 1am...I havent even started!!!owhh Moony...where's the resolution!!
STUDY HARD -LOSE WEIGHT- SAVE MONEY...