Elective Posting At Sarawak General Hospital : Third Week

I was attached to Plastic Surgery Department during my third week. Before starting my first day there, I thought I would be able to see face lift, mole removal, pimple removal, botox treatment and collagen injections. After spending one week there, I realized what I thought I would see only exist in a private hospital. In a government hospital, I saw patients with cleft palate going for palatoplasty, cleft lip with congenital hydrocephalus, spina bifida occulta and hypoplastic left lung going for lip repair, curbuncle at left nasolabial and upper lip going for saucerization and left temporal basal cell carcinoma going for wide local excision and full thickness skin graft. Other than that, I saw patients with different degrees of burns. I learned how to manage a patient with burns and how to do different types of dressings from Sister Paat. On every Monday and Wednesday, there will be operations in the operation theatre. Diana and I followed the plastic surgeon into the operation theatre to watch the operations. Basically, a lip repair takes about an hour and a palatoplasty takes about two hours. There will be follow ups in the clinic every Thursday and Friday.


Outside the operation theatre


They have a radio in the operation theatre too


A hydrobath for patients with burns. The nurses will clean their wounds in the hydrobath.


Skin Fridge to keep tissue glues and skin grafts


Curbuncle on the right cheek

Elective Posting At Sarawak General Hospital : Second Week

During the second week, I was attached to Accident and Trauma department. On the first day, Sister Then brought us around the department. Basically, there are 3 zones in the department. Green, Yellow and Red zones (least severe case to most severe case).


There is also an isolation room for H1N1 cases.


The patients in the isolation room for H1N1 cases will communicate with the doctors through a phone.


Patients with H1N1 who are stable will stay in this room


Patients with H1N1 who are critically ill will stay in this room which is part of the Red zone

Other than that, there is a room for resuscitation, a room for X ray, two rooms for dressings and a room for operation. There are two teams for ambulance call. When the buzzer rings three times, first team will go out and when the buzzer rings two times, the second team will go out. If the buzzer rings once only, it means a patient has been transferred from yellow zone to red zone. There are two Accident and Trauma physicians in the department. Every day, there are many different cases. Road traffic accident is one of the most common cases every day there. Every Wednesday and Thursday, the doctors will have discussions among themselves. During my week there, they had a discussion on non traumatic acute abdomen. The diagnosis includes history, physical examination and imaging such as computed tomography scan, abdominal X ray and ultrasound. As for the management, it includes resuscitation (Airway, Breathing and Circulation), surgical intervention and close monitoring. Sometimes, my friends and I would follow the patients to be scanned.


Discussions among doctors


Drugs to use in the department


With the permission to take pictures from the patient, we took this picture which is the clubbing of the toes


X ray


Different types of scans available in the Radiology department


Computed Tomography scan with 46 slices.


Mammogram to check for breast cancer

Elective Posting At Sarawak General Hospital : First Week

The first department that I was attached to for one week was Cardiology department. Dr Tan was the clinical cardiologist for that week. Every morning, there will be a discussion among the doctors in the seminar room. They will discuss their cases and decide for the best management for each case. Besides, a medical journal related to cardiology will also be presented if there is one. We started with ward rounds in the Cardiac Care Unit (CCU). Over there, I saw patients with rheumatic fever, pericardial effusion and bronchiectasis. Then, we continued with ward rounds in the Cardiac Thoracic wards. There, I saw a real rectal examination for the first time other than a rectal examination on a dummy or in a video. Haha I also saw patients with pedal oedema, heart failure, typical angina, triple vessels block and valvular heart diseases. For valvular heart diseases, the most common case was mitral regurgitation. Other than that, I saw a patient with a pacemaker and her pacemaker actually dropped out but the leads were stuck in her heart. It was difficult to pull out the leads due to long term fibrosis. The doctors are still deciding on what to do with her. I did physical examintaions on the patients. I managed to feel for a collapsing pulse. Lastly, we did ward rounds in the female and male medical and surgical wards where we only looked at patients with cases related to cardiac in origin. The most common case there was acute coronary syndrome. I did physical examinations on the patients too. I managed to listen to a systolic murmur from a patient with vasculitis and feel for a irregularly irregular pulse from a patient with atrial fibrillation. Dr Tan taught my friends and I about pulse deficit. After the ward rounds, we went to the Cardiac clinic to look at patients who came for echocardiogram and International Normalized Ratio (INR) follow up.


Echocardiogram


With the permission from the patient, this is a picture of vasculitis

During my free time, I went to the paediatric ward with my friend, Diana to look at the babies and children.


Arif (One of the twins) who had recovered from diarrhoea. Whenever I put him back on his bed, he would cry. Haha

A day out to do what we used to do long time ago

It has been a long time since I last went to the arcade with my friends. I used to play Initial D and Daytona with my friends before going to tuition in Hock Lee back in secondary school. Arcade freaks back then. Haha Recently, Grace and I decided to go back to the arcade in Hock Lee to do what we used to do when we were younger. haha

We played House of the dead 4.




Looking at the screen, yeah, Game over. It was just not my game. haha


We used to take neoprints all the time there. Recently, we took another one. Eileen said we became prettier but our creativity in decorating the neoprint became worse..

We went to Crown square to sing karaoke after that. Well, Eileen told me that both of us kept having fun without her so I decided to bring her photo along with me that day. Haha =P


We fed Eileen with our drinks


Not to forget our food


We let her choose a song haha


We sang with her


Thanks for being my fan, Eileen. =P


I want Eileen


I love Eileen


Cambridge's superstar


Cambridge's superstar sang till exhausted


We sang almost every song halfway because there were too many songs to sing

Then, we decided to be posers. haha


Fish mouth


Ah liens


Shocked


Friends forever =D

Wen Fang's 21st Birthday

We celebrated Wen Fang's 21st Birthday at Carl's Junior in Midvalley. =D


LRT

As usual, we had to wait for a very long time for the KTM




Nut nut looked so happy. haha


Birthday girl


Wei Thing tried to pose like the birthday girl


Hunger pangs


Vampires. haha

Kuala Kubu Baru Hospital

During my semester 3, we were posted to Kuala Kubu Baru Hospital for 4 days and 3 nights for our rotation posting. Kuala Kubu Baru is situated in Hulu Selangor and it takes about 3 hours to reach there from my campus.


We went there by bus on a Sunday.


I saw buffalos on the way to Kuala Kubu Baru.



Part of the town in Kuala Kubu Baru

We reached there in the evening and we had a briefing before going to our hostels. The girls had to stay in the nurse hostel (3 floors including ground floor) in the hospital itself and the guys had to stay in the houses nearby the hospital. I chose the first floor. We were lucky enough to experience the Pasar Malam there that evening. Some of us drove there so we did not have to walk to the town. Every night, the town is dead by 9pm. If you are looking for a slow and peaceful life in a town with just 'kedai runcit', Kuala Kubu Baru is an ideal place for you.


The nurse hostel


Our room was right at the end.


Eight people in one room.


I spent the rest of my 3 nights on this bed. We had to bring everything on our own except for the mattress.

The first night, most of my friends and I were not used to the nurse hostel. It was so difficult for us to take a shower. The handle to hang our towels and clothes were so rusty that we did not dare to hang anything on it. We had to bring a few plastic bags each to put our towels and clothes.


Two bathrooms per floor.


Kuala Kubu Baru is famous for its waterfall. It is a tourist spot. Even though I did not have a chance to go to the waterfall, I experienced my own Kuala Kubu Baru waterfall whenever I on the tap in the bathroom.

During that week, it was just a few more weeks to our final exam. All of us brought our books to read but nothing went into our heads even though we tried our best to read. We were just not used to the place yet.

We had to wake up early the next morning. Everyone had to work in a pair. Our lecturer assigned one patient to each pair. I paired up with Sim. We had to take a full history followed by a physical examination on the patient assigned to us. Our first patient was from Bangladesh. He suffered from dengue. We even learned a few words in Bangladesh language from him. Haha

The next day, we had a patient with Down Syndrome so we had to share patient with my friends. We could not get any information from our own patient. It was a great experience. I heard crackles and wheezes through my stethoscope for the very first time. Other than that, I actually felt a thrill at the aortic area with my palm for the very first time too from a patient with hypertension. I also heard murmurs and added heart sounds for the very first time from the same patient.

We also went to the accident and emergency department, labour ward (no chance to watch a delivery), mortuary, out patient department and physiotherapy unit.


We had a great time at the physiotherapy unit. =D

We went out to eat every night for dinner. The last night there, we had seafood. Haha


Sin Dee and I admired this pink myvi every morning when we were walking to the canteen for our breakfast. haha We both love pink.


My friends and I at the entrance of the hospital