of conferences and electives

been a while since the last post, quite weird considering i'm doing my electives at home; a place where i can online 24/7 lol. just dont have the urge to do so i guess. partly lazy also =p

uh, electives? spent most of my time dealing with data cleaning. oh ya and facing this





every single day. savvy?

am attached under the SPM department. SPM for social preventive medicine, not the other SPM. as the name suggests, its preventive. so it's not so much of clinical stuffs, more to public health. my topic deals on the different types of obesity indicators used to search for the best indicator to predict metabolic risks.

got myself a good & nice supervisor with high expectations. so happen her initials are MFM too LOL. dont get me wrong k?

aside from these electives stuff, i'm practically super free. it's some sort of a holiday haha. official holidays.. =)


02/12/09

flight to taipei.




yes it is holidays. no i did not fly to taipei for holidays. perhaps partly yes.
it was for a conference by APACPH (Asia Pacific Academic Consortium for Public Health).





yes u've read it right. public health. again! i'm there for a poster presentation on our last CRP thematic project. the trip was supposed to be borne fully by the faculty/university/some gov organisation that i've forgotten the name. i put 3 names as the 3 are pushing the funds claim here and there. no matter what the outcome is, the deputy dean assured that the funds would be given by the faculty if the university doesn't agree to fund us.

and not to mention that i'm actually sharing my funds with the editor for my CRP group. i thought it would be fair as the CRP poster was a result of all our coursemates' work. therefore it would be 50% sponsorship.

anyhow its winter in taipei. snowless winter. it's been all the while like that. temperatures were bearable, ranging from 15-20 degrees centigrade. it's been cloudy the first 2 days, good thing it didnt rain or else we'll be freezing.



although our main purpose was supposed to be the conference, the secondary reason we were there was to relax and do some sight seeing. or is it the other way around?

yes taipei. i would never imagine myself go there alone. never. chinese is foreign to me. haha! but i must say that they really made effort to include english wordings everywhere for the ease of a banana or ang moh to navigate around the city.

although the conference schedule is kinda packed, we do manage to walk around as we skipped most of the afternoon sessions =p

went sight seeing... guided by our tour guide LOL


there's another CRP group that applied for the conference. my friend and her group's editor confirmed the trip too. she has been to taiwan before this. and she's super familiar with the city. she's familiar till some locals over there asked her if she has any relatives living in taiwan. she would make a good tour guide =p

that would make the numbers 4. 2 from each group. our tour guide actually invited a friend of hers to taiwan. therefore total number is 5.

although the trip is short (departuring from taiwan at 08/09), well i really enjoyed taiwan. it's such a beautiful country. i went there without any expectations, came back loving the city so much. haha!

ENT

Case summaries. Boring stuff. Though we're supposed to be able to learn more about what we're writing. True enough. Fair enough.

Logbooks to fill up. It's like everyones' responsibility. The objective, aim, target.. whatever u call it. I would really appreciate a checklist of stuff we need to look at, learn. I really like that. However, putting in certain terms and conditions to it certainly kills the drive.

Logbooks for our own purposes. Not for lecturers to know what we've look at. And what more if it can only be signed by a few lecturers, profs.

Yeah thats the only difference, between ENT and other postings. It's logbook have certain terms and conditions to be fulfilled.

Emergency Medicine

It's been like sooo long since i last updated. Been quite busy doing duties in accident and emergency in UH. Duties from either 8-4pm or 4-11pm. To be called trauma centre I suppose, soon; as the criteria to being recognized as a trauma centre has yet to be fulfilled. That what Dr. T told me.

To start things off, I can say that I really REALLY enjoyed my posting. My first posting where i managed to do so many stuff, which we dont get to do in other minor postings for now. Practical stuffs. Managed to observe ATLS & ACLS too. Certain procedures too. And the best part is the ever helpful Dr which always explains & questions us about the procedures, explaining after listening to our answers/opinions and relates it to our basic sciences which we learn long long ago during my first year. HAHA! One of the best teachers i've ever had in faculty.

Just finished my A&E posting, kinda miss it. Although tiring, but enjoying it very much. Well gotta look forward to the next posting.
A&E only have one catch, yes 1 only.
Their paeds emergency room is super boring especially during the day shift.

Kiss The Girl...

Ring any bells? It's one of the songs in The Little Mermaid. However Disney had my favourite singer re-sang it lol. Here's the clip.

I want! I WANT!!

YEAH! I want MFM. Been on my mind for quite some time now. Since my post-exams period till now I can't help it but to think. Arghhh.. i just can't get you out of my head(to the tunes of kylie minogue's). I dont care, I dont care whatever people want to tell me, what my friends say about her. Must... go... visit... her... tomorrow!

Yup that's what i'll do alright. Visit her, and satisfy my needs, my cravings of her. I might sound a little bit pervy but i dont care. Say what you all want. I'll just proceed with my plans.

I couldn't take it anymore, the photos I saw online, the smell that lingers in my head. It seems that everything is pointing towards her. Pointing towards..

Fine. I've decided to see her tomorrow. Wish me luck!


I'll finally be able to see my Manhattan Fish Market after years. Missed MFM badly =( hahahahha...... =p

Still painful?

Dr: Do you still fell pain ma'am? Is this area numb? (while pressing on her arm)
Pt: I can't feel my hand doctor. I'm afraid. (shivering badly)
Dr: Can u feel anything ma'am? Is it pain if I press here?

Well, pain relieve. Thats what everyone thought anaesthesiology is all about. Hands up if u're one of them. Dont worry, I'm one of them too =p . Hm, or shall i say, WAS one of them?

Pain is something disturbing. Something annoying. Something uneasy. Something destructive?
Well, it can be any of those. In fact hospitals in a few countries have also adopted the concept of pain as the 5th vital sign beginning with the US. It's as if it is as important, as valuable as the other 4 vital signs which are temperature, heart rate, respiratory rate and blood pressure.

Perhaps, pain, unlike the other vitals wouldn't cause death if there's abnormality with them. Direct death not. Indirect maybe. But pain is what every living beings wouldn't want to experience, to put it properly, would like to experience it less. Prolonged or very bad pain would really affect a person's life. From daily activities to their psychological state of the mind. Pain would really scar them... for life if it's severe enough. Like what my cousin experienced during his childhood days, which he claimed that he wasnt given any analgesia before the procedure to remove an abscess from his gluteus region. It was pain alright, he said he could recall exactly how it felt like, even to the extent of feeling the pain when he recalled the incident.

Aside from pain, anaesthesiologist also deal with patients in the intensive care unit. They try their best to keep the patient's 4 vital signs within the normal range for one to be able to live. I guess thats the signs which indicate u're dead or alive.

They also play a part in calming down the patients, putting off their anxieties. And assist them by general anaesthesia if the patient fails to calm down. It all comes to aiding n relieving both patients and the surgeon. I guess the job must be a little boring? I'm not sure. I could only see them monitoring the patient over the procedures. Most of the patients are already screened properly before being allowed to do surgery. Therefore, there's nothing much for an anaesthethist unless the patient unexpectedly have some sort of complications.

Well, for the madam mentioned above, she came in for an operation to repair her broken humerus. She's a 70-odd year old lady. Even before the surgery, in the waiting room, she already voiced out her concerns to us. Although tried to calm her down, she remains anxious. She was due to be operated on using only a brachial plexus regional block. However, she still remained anxious and worried. Which prompted the usage of general anaesthesia, which was her own suggestion anyways. Good thing she's fit enough for it. General anaesthesia can kill, just like how i killed my simulated patient post-operation. LOL

I would still say ophthalmo sounds more fun =p

2 Weeks Ended

2 weeks of ophthalmology.
possibly a little too short for us to really have master the posting.
what a waste, really enjoyed the posting. till the very last drop.
good academicians, doctors showing good examples, every question being answered appropriately.
kinda reluctant to leave that posting =p
the end of posting questions were pretty straightforward too.

we all say that the heart and the brain, are the 2 most important organs in the body.
some argued hearts' the most important, some opted for brain.
however, eyesight is what a human treasured most.
that's what i could learn from patients i talk to.
most with an eye condition which is not fully curable or have a lower chance of recovery,
worry over all their activities, their hobbies, their jobs.
some went into depression.
and it's particularly sad, if someone with a curable poor vision, goes for a surgery, ended up worse.
it's depressing.
i could only offer to listen, thats what i could do for now, as a student.

National Day

31st of August.
Well, every year celebrations held as to remember the country's independence.
Happy merdeka celebrations. If you do attend any.
Likely not. Everyone's so hyped up by the A flu.
But better be. Prevention is always better than cure.
Read that WHO reported a new strain of A.
The one which had a high chance to cause viral pneumonia.
A strain that goes straight to the lungs, even in healthy beings.
Wonder when will the virus start to mutate again.
Hope it doesn't.
We're all damn screwed if it does =p

Complication

Lucky? Unlucky?
I guess it works both ways. Felt bad for the patient though.
She's a 70+ y/o, came in for a cataract surgery.
However, the method used wasn't phacoemulsification.
Extracapsular cataract extraction (ECCE) was preferred over phaco for her case.
Phaco is only done in those w less opaque or dense lens. A bad cataract which is totally opaque would automatically be removed using ECCE.
It is said that phaco would fail on a dense lens.
Compared to phaco where u get 2 tiny little scars requiring no sutures, ECCE is the removal of the lens without breaking it down.
Therefore, a larger incision is needed.
However during the procedure, after insertion of the lens, the lens doesnt stay in place. It somehow sinks.
Thats when they start to notice that actually the posterior capsule of the lens is ruptured. The posterior capsule is not removed in modern cataract surgery as it acts as a bag for the artificial lens.
Surgery prolonged, restless patient, some not-so-happy doctors. Patient's restless, u can see her moving her lower limbs around, the eyeball too.
And occassionally some instruction from the doctors to tell the lady not to move her eyes.
Once it's ruptured, the vitreous from the eye will ooze out into the anterior chamber of the eye which is located in front of the lens.
The anterior chamber only contains aqueous. Once the vitreous enters the anterior chamber, it can clog up the trabecular meshwork, causing it to slow down the removal of aqueous indirectly causing a higher pressure in the anterior chamber and glaucoma.
The vitreous is actually very mucus like. Therefore if u pull some of the vitreous out, it will also pull out the remaining vitreous at the back.
So in order to remove it, vitrectomy must be performed. Vitrectomy sucks the vitreous out but at the same time cuts it too to avoid pulling out the vitreous at the back.
Cutting rate is at about 100+ per minute.
However there's still loss of vitreous. Loss of vitreous is usually associated with retinal detachment, another more serious cause of vision loss.
Well, what's happened already happened. The specialist say that actually the risk of posterior capsule rupture is the same in both ECCE and phaco.
He also mentioned that any small mistakes can cause the capsule to rupture. It's a fragile structure.
Too bad for her, I hope she recovers well, without any further complications.

Ophthalmology

My first posting in phase IIIb.
Basically it's formed by 2 greek words, ophthalmo- means eye and -logy means the study of.
Although it's just the 3rd day of my phase IIIb, I've never feel so busy before for a minor posting.
Perhaps i didnt work as hard in Klang? =p or maybe it could be the holidays.
No matter how minor the posting is, well, we gotta sit for exams, very soon.
This posting will only last for 2 weeks, and in 2 weeks we should be able to master the basics of ophthalmology.
My group's one of the largest. It's bad. Really.
It's just so crowded for all of us to squeeze into a small room.
Even the profs and some drs voice their suprise over the size of our group.
Well, we'll just have to bear with it, till IF there's any rearrangement of groups as all the groups weren't balanced now due to elective schedules.
It's a possibility that the admins will consider says my elective coordinator.
Back to ophthalmology, all the lecturers that I had so far are good. They're really good at teaching. No joke.
Patient and dedicated as well. It's just helps. Indirect motivation.
On the first day itself, I had my first ever on-call =p
It's fun as finally I'm given the chance to insert brannulas and give IV drugs.
Hands on stuff are usually fun. This is just the beginning i suppose. Prolly i'll get bored of it somewhere in the future when it's a routine.
Today just went to the ophthalmo OT. Observed 3 eye surgeries, both which is done by super nice prof choo. 2 of it are cataract surgeries.
Cataract is defined as a complete or partial opacity of the ocular lens.
Both cataract surgeries watched are using phacoemulsification. It's the best technique available so far.
It allows cataract surgeries to be done without the need of suturing the wound. The incision wound is just so tiny, usually will just be left for self healing as long as the wound does not leak out the aqueous (eye fluid).
The bleeding from it is also minimal. Phacoemulsification uses ultrasound to break down the opacified lens of the eye. The lens which are broken down will then be sucked out through the probe which is inserted through the small incision.
A replacement lens is then folded and compressed into a small injector. There's a need to fold/compress it as the incision is just too small for the lens to go through.
The lens will then be injected into the eye and placed accordingly.
After that some cleaning of the eye will be performed, and tadaaaaa...surgery completed. The whole process takes only about 45 minutes to complete done by the very experienced professor.
Oh ya and i forgot to mention the patient is only on local anaesthetics which means the patients are very much aware of what's happening and not sedated.
So their eyeballs are moving here and there at times during the surgery. lol..

I wanna stay put

2 weeks seems so short.
just cant get enough of it.
i'm sure majority shared the same feeling.
how cosy, comfy..
homecooked food & no alarm clocks.
what a bliss! =p
still wanted to hang around at home, my lazy bum bum is just too hard to lift off from the chair.
like it or not, class is starting tmrw.
lethargic, just the thought of it.
however, i should be thankful for all the holidays i have.
if i realized how lucky i am, compared to a few others.
goodluck guys!

Time off

Finally some rest for my eyes.
Had some catching up with my buddy.
Been straining it since the end of my finals.
All no thanks to the culprit, my lappie!
Anyhow, no love's lost. I'm back my dear. =p

it's a lie

yes. it's a lie.
i said i'd forgive u. i did not. i could not.
i didnt realize this very fact. till the very memories came back again.
what i sacrificed, efforts i poured in,
will go to waste eventually.
how much i've endured everything i'm thrown at.
how much i've compromised.
i never complained. not even once.
i guess u never saw the big picture. not even once?
u know what? i felt like a puppet.
being pushed around, not appreciated.
u never know how bad it hurts. how disappointing. heart wrenching.
just because i never said anything about it. so it continues.
comparing yourself to others will only cloud your judgement.
have u asked yourself, the root of the problem?
have i ever changed? did u change?
everyone is beautifully imperfect, that's what i thought.
we look for qualities in a person, not mould your own preferred qualities into the person.
not especially after some comparison with someone close.
it makes it really obvious isnt it?
yes, u didnt read it wrong.
i'm really sorry. i lied.
i've never forgave u truthfully.
could i? perhaps time will tell

Relief

Temporary relief achieved.
However, not all are spared.
Work hard, pray luck shines on your side.
We shall all be together again.

Light

A year after,
A visit by an annual friend,
Preparations, cleaning up, re-arranging,
Done year after year,
Finally,
I saw light..

HOWEVER ITS FOR THIS YEAR ONLY LAH!

End is near

Doomsday approaching. Approximately 4 days from today. I hope everyone will get through this together. Goodluck everyone =)

End of phase IIIA

Back

After one whole year in Hosp Tengku Ampuan Rahimah (HTAR) we're finally back to University Hosp (UH).
The countdown is exactly 14 days from now.
Lets all work our asses off and be sure that we wont be seeing HTAR again for the next year LOL

Heal The World

There's A Place In
Your Heart
And I Know That It Is Love
And This Place Could
Be Much
Brighter Than Tomorrow
And If You Really Try
You'll Find There's No Need
To Cry
In This Place You'll Feel
There's No Hurt Or Sorrow

There Are Ways
To Get There
If You Care Enough
For The Living
Make A Little Space
Make A Better Place...

Heal The World
Make It A Better Place
For You And For Me
And The Entire Human Race
There Are People Dying
If You Care Enough
For The Living
Make A Better Place
For You And For Me

If You Want To Know Why
There's A Love That
Cannot Lie
Love Is Strong
It Only Cares For
Joyful Giving
If We Try
We Shall See
In This Bliss
We Cannot Feel
Fear Or Dread
We Stop Existing And
Start Living

Then It Feels That Always
Love's Enough For
Us Growing
So Make A Better World
Make A Better World...

Heal The World
Make It A Better Place
For You And For Me
And The Entire Human Race
There Are People Dying
If You Care Enough
For The Living
Make A Better Place
For You And For Me

And The Dream We Were
Conceived In
Will Reveal A Joyful Face
And The World We
Once Believed In
Will Shine Again In Grace
Then Why Do We Keep
Strangling Life
Wound This Earth
Crucify Its Soul
Though It's Plain To See
This World Is Heavenly
Be God's Glow

We Could Fly So High
Let Our Spirits Never Die
In My Heart
I Feel You Are All
My Brothers
Create A World With
No Fear
Together We'll Cry
Happy Tears
See The Nations Turn
Their Swords
Into Plowshares

We Could Really Get There
If You Cared Enough
For The Living
Make A Little Space
To Make A Better Place...

Heal The World
Make It A Better Place
For You And For Me
And The Entire Human Race
There Are People Dying
If You Care Enough
For The Living
Make A Better Place
For You And For Me

Heal The World
Make It A Better Place
For You And For Me
And The Entire Human Race
There Are People Dying
If You Care Enough
For The Living
Make A Better Place
For You And For Me

Heal The World
Make It A Better Place
For You And For Me
And The Entire Human Race
There Are People Dying
If You Care Enough
For The Living
Make A Better Place
For You And For Me

There Are People Dying
If You Care Enough
For The Living
Make A Better Place
For You And For Me

There Are People Dying
If You Care Enough
For The Living
Make A Better Place
For You And For Me

You And For Me
You And For Me
You And For Me
You And For Me
You And For Me
You And For Me
You And For Me
You And For Me
You And For Me
You And For Me
You And For Me

Exams soon... not!

well exams are so soon. but not in the mood. not really bothered although swallowed up by this irritating guilty feeling. responsibility. knowledge. lives at stake? the dilemma of not studying. this is just so crappy! studying..well, is the way of life..if u're a student-lah.

everyone loves happy things. well, i choose the same. sad stuff aside, transformers:rotf seems to be just on par with expectations. the first movie was a bomb, second movie seemed to be infused with...err, too much? well they say "toos" are bad. too little or too much, both are bad according to my lecturer. i guess michael bay got caught up a little with the latter too. more robots, more actions, more silly jokes doesnt necessarily mean a better movie. i dont mind about the first two, the jokes somehow appeared silly, unnecessary, excessive. mrs witwicky's especially, overly expressive. i wonder why no one considered a psychiatrist appointment. the serious/realistic mood of the first show somehow wasnt there. the element of humour adapted by mr bay somehow made the movie less enjoyable. laughters can be drawn, however it doesnt impress well. that was the only weak point i guess, aside, the movie's enjoyable. enjoyable enough for me to consider a second serving. perhaps also a third in store. LOL! i just cant let my gaze off optimus.. he's just so.. noble! although he's CGI-ed hah! he was the main character of course(at least in my eyes).. le beouf must be sad, losing to some virtual/imaginary "actor" haha.

that all for now. i gotta infuse myself with some mood to study. really envy those who have the mood. lets just pray that i'll be berserking upon sight of books and go on a study rampage. wish me luck!

Tinker, Krobelus, Storm Spirit

Side tracking from studies, perhaps these were the 3 best heroes at the moment. Can either play support/gank/killer.

Tinker as u all would've known, is well known for it's gay refreshing skill which refreshes almost everything with exception for necronomicon. Imagine the necros u can summon if it can be refreshed.

Storm spirit has been quite a popular hero lately as the hero can be quite annoying late into the game. Countless flying here & there either for attacking/defensive purposes really annoy the shit out of u. And there's no way an enemy can escape from ur clutches if they're dying.

Krobelus is perhaps one of the most underestimated hero. Well known for it's pushing abilities, not many have known that krobelus can be quite a killer. Instead of summoning spirits for the towers, it's used to hit heroes instead. Added with it's 5 sec cooldown 300 dmg wave which consumes so little mana, it can certainly farm very quickly, and harass enemies non-stop. The spirits will settle the late game issue. Must get bloodstone, shiva and heart. As long as u can outlast any hero, u wont be dying so easily. Hex is a bonus especially for escaping heroes.

If any required a sample replay against players I would gladly provide them. =)

Finals

Finals coming.. about 2 months away.
Preparations are lousy. No mood anyways.
Feels weird, somewhat different than before..

CRP

Well, CRP's fun. Although being forced to work my ass out.
Supervisors so damn dedicated. For the first time in my life i felt i'm so hardworking. LOL.
It's a good trip. I get to know myself better, got to know my friends better as well.
Just like those R&R areas where u can rest & rejuvenate. How refreshing!

Well I hope all will be well soon. Very soon.

Contemplation

Why do people change?

But still, why can't you let me know beforehand?
Why do you hide your real self?
Am left with nothing to say