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.