Attachment Day1 22Aug2011
Ward1A Ob/Antenatal & LR
Note: So, since I have gone thru baem punya blog..i’ll be doing almost the same things as him here lah. But might be different also since my way, rite? Okay, we might as well get index/glossary down way to the end of entry. And anyway, since I am concluding before, this entry onwards may seems to be overlap to you guys since I have completed my attachment so it might be that in Day1 you might thought that I know a little lot abt a person or two. :P Also, if it happens that you don’t understand much of terms of xplnt I give, you might as well did a little research on it. And share. :D And sorry lah if I'm very particular while writing this. Skip as much as you want if you want.
Day 1
Not as good as we usually think of. Yeah,right. Well, lets be positive around here. :D
Okay, with adrenaline rush, I went to the admin since I haven’t take the certified letter from the hospitals yet. And so, after seeing my beloved Pn. Mariam, I went to the clinic to report my duty, as instructed. *duty? =,=’’*
After seeing Nurse Ting and leave my details to her, I was asked to see specialist Dr. Siti Aisyah bt. Daud. *I think people around should know abt any person I met here, well, who knows, you might work with them later right?
So, I was asked to go upstairs and wait in ward 1A. After entering, I went in awkwardly and went to the nurses’ counter and see random person around; practically the nurses and HOs, to asked abt my specialist whom I am assigned to. As inform by a HO, she is not around and will come in by 8am. So, I wait patiently and cuak-ly there for her.
And hey, it’s pink in here and I dunno why but I’m having my pink baju kurung today too. =.=’’
Later as I heard from the nurse, she is here and so I followed here when she’s actually starting her morning round with the HOs. So, I introduce myself and as I am not expose to the clinical year yet plus ObGyn, she said that I might not benefit from my attachment here due to this. And so, she said that I might follow any HOs and observe them and might as well asked anything since I am lost with no knowledge in this field. And she said so because there’s this Egypt student too, a girl whom I can’t recognized till today. =.=’’ If anyone happen to know her or she read this, I hope you at least can contact me tru email or fb or something. :D
So, as she said like that I started to get more awkward, feels like I’m being scolded in front of HOs haha. Well, I just followed w/o my coat on while I’m thinking of it. Then later, Ward Sister asked me to get my coat on so that people notice me as a doctor? Since I am not allowed; anyone are not allowed to walk randomly in the ward/hospital. So I went to put my bag also *sound by the ward sister =.=’’* in the room where HOs put theirs and also solah in.
Then, after make sure of myself of my appearance, I went out and followed the doctors’ morning round. There I learn of several HOs, and MO. =.=’’
This is when I learnt abt the quote, ‘’Bad habits die hard.’’ Yeah. They did die hard. And so it comes from the specialist and directed to the one of the HOs. My point here is not to harass HOs but rather learnt from the situation. When you don’t know something, you tend to ask your colleague but the better way is to ask the seniors or especially, the teachers or anyone whom specialise like the specialist or something. Even from the nurses and sisters. Because we actually tend to habits things we learnt from friends and such.
So, after the morning round with all the jargons, I awkwardly stand there alone and start to follow one of the HOs. *tips #xx; follow those whom are better is the best* and then I started to choose to tag along other HOs and introduce myself. As for my first attachment, I don’t really know how to start off so she started by informing abt the pt and her neonate whom is suspected to have neonatal jaundice.
And there she goes with all the conditions I can’t remember but as for the sign of jaundice, it is clinically apparent except that, I can’t remember anything much. And yes, she did mention some of the cause of the neonatal jaundice she I can remember of, the breast milk itself, the traditional herbs taken by the mother and also sepsis. Here, we must take into account the culture of each patient esp in Malaysia since we are multiracial country.
So, after a while, Dr Kaur said that Dr. Aisyah wants to see me in the clinic and so I went there and met her. As for our meeting, she says that I can go anywhere I want as long as I report myself to the person in charge of wards or labor room. And she also recommend me to read essentials in Ob since I am clueless to shit. =.=’’
No don’t worry. I am not a shit to her, it’s me who put that in. =.=’’ and guess what, she did recommend Ten Teachers and Essential*any book* as I asked her to recommend a reading. So you guys later can get a hand on such when we start our ObGyn block. :D
So, I went to the library *I don’t know of the library in hospitals until Baem mention one in his entry*. Then, I get my hands on some books and starts to read..and getting sleepy. =.=’’ so after abt 2hrs *demit!* reading a little and scan thru all the pages in the book, I went down and randomly follow any HOs. Then I asked abt the breaks which only 1 hr at 1-2pm. So after that I started to hang around the student nurses and be frienf them. Some I can remember of are Amira Azmira and can’t remember more. Most of them are mira. All Miras, lalala~. :P
So, they have just been here and will be for some other weeks and then start off posting in other wards and depts. And they did recommend me to go to the labor room which I don’t know where. Later after asking them where and talks a little, I went to the labor room. Oh yeah, before that, there’s only one Malay HO I found here whom is Dr. Khairul Rashid yg cute haha. Soooo~ manly. But seems like a shy person lalala.~ Seems only lah since I haven’t talk with him at all thru out the attachment except that, I have seen him several times. I wonder if he’s married already. XD
So, being in the labor room for the first time also seems awkward. There I try to see the labor room sister and after report duty, I was asked to change in the staff room and get the blue clothe thingy. I dunno what you call that. =.=’’ anyone knows can inform me. :D So, after change I went in, and anyway, in this dept is the first time I heard of midwife and read the terms in the book last time which I don’t understand. =.=’’
So, there, since most are in the blue form*uniform* so I thought all are doctors but turns out some are also staff nurses and maybe midwife? I don’t know whom are the midwife. =.=’’ So, I met one of the nurses whom are very friendly and I sell my Egypt story HAHAHA to her and she said she’s a nurse, so she informs me abt, ‘’There’s a doctor there, Dr. Tayyib.~’’ and as I see him sitting there looks sort of not in a good mood to talk, I went down the whole attachment not talking to him. =.=’’ Feeling guilty and rugi lah, later you will know why. =.=’’
So, talking and waiting, plus looking around, I waited patiently for any delivery which I expected to be normal lah since Dr. Aisyah said it’s better for me to start off with normal delivery. And I haven’t read that part yet. =.=’’ And so, I start off wondering, wandering, touching looking and seeing stuff around. The best part doing attachment here is, I am allowed to touch look and observe things and stuff, except patients haha.
So, after penat2 tunggu, no deliveries and I was also called by Dr. Linda but I recognized her face, she asked me what I know but later tell me things since I know nothing. I shud know abt normal deliveries. Abt the os opening around 4cm would be admitted here and wait for the delivery. There’s also certain terms for Obs I learn of. PROM and PPRM. These are of common I heard of here.
Okay, of what I have read and also told by the Dr.s, this dept is a specialise dept so in case of ObGyn especially, the history taking is a little different since we are concern of the menstrual history, gynae history and of social history much more here and after the chief complain, we will start to rule out all the DDx and concentrate from a wide scope to a certain point which is more focal into the pt chief complain.
After lunch break, I went to the LR back and changed. By the time I finished, I missed the first delivery. L I happened to see the doctors/nurses doing suction to the newborn only and see how doctor sutured the episiotomy done before.
Later, a HO teach me how to read the CTG, well, roughly because she said I need to go back and read more to u/stand. It’s more or less like ECG. There is four items to comment on. For more, go search eh. J
As for CVA, I learn from baem it’s CV stroke and from the book, also known as CV accident. J Oh, did I mention before, clerking template for ObGyn are different from other specialties?
Okay, the last case I saw was in LR. I got to witnessed my first delivery; TWINS! Yeah2, well, I can see how big the ut/abdomen is, and so let’s talk abt twins.
She seems to not have a problem..or she actually memang senyap. It seems very merrier after Dr. xigt check her os full*ready for delivery,I am not sure how full it is but actually by 4cm, we should ready for any spontaneous delivery* because everyone rush in and out kelam kabut get all the materials needed for the delivery. So, after the first newborn come out and doctors and all staffs jerit ‘’teran2’’ banyak kali*very meriah and supporting, you see* they let her rest before next teran while monitoring her FHR of 2nd twin. And then, she continue her next push with supports from everyone around. After the delivery*each*, I realized that they show the mother the neonate’s lower body part particularly the sex area; genital area and ask, ‘’anak ape puan?/baby girl or boy?’’ and so after telling and asking this to my mom*the nearest pt I can ask everything HAHA*, I learnt tht they do so so that babies xhilang or xngaku baby or any case tht might involve the babies.
So, we got twin girls here. Anak Ramadhan since they come out by time Syawal is around the corner, anak raya also lah. HAHA.
And yes, fellow doctors and staffs warn us students*me, the only medical students and all other nursing students around* to backed away for the 2nd twin to come because you might get juiced by the 2nd placental rupture and yes, Dr. Tayyib get splashed a little *he’s conducting the deliveries*. So, after the delivery, he massage the ut/abd and at the same time slowly pulling the placental and the cord out. Next, he sutured the koyak part. I think it’s tore apart because I didn’t see them doing episiotomy to this one.
And yes, as we learn in alex, they draw blood from the neonates feet to test for T3/T4 ß hypo/hyperthyroidism but here in HTJS, they draw the blood from the placental cord. Interesting isn’t it? J
So, I also get the chance to see the placental freshly from the oven..no, ut/vagina…SORRY~ L It’s fresh, and I saw that they bukak sane bukak sini, nak check if it’s DCDA or MCDA and guess what..i dunno which, since I don’t literally and technically understand what I see and what can DCDA and MCDA show. =.=’’
So, this is the closing of my first day. Bad closingbye.
Neonatal jaundice= wiki lah. :P
Midwife= a term used in reference to both women and men, although the majority of midwives are female. Midwifery is a health care profession in which providers offer care to childbearing women during pregnancy, labour and birth, and during the postpartum period. They also care for the newborn and assist the mother with breastfeeding.
Pt= patient
DDx= Differential diagnosis
Tx/Rx= treatment, Rx are more likely of drugs.
LR= Labor Room. *my shorthand=mySH*
Ut=uterus
Abd=Abdullah..xlah, abdomen :P *mySH*
Episiotomy= also known as perineotomy, is a surgically planned incision on the perineum and the posterior vaginal wall during second stage of labour.
CTG=cardiotopography; In medicine (obstetrics), cardiotocography (CTG) is a technical means of recording (-graphy) the fetal heartbeat (cardio-) and the uterine contractions (-toco-) during pregnancy, typically in the third trimester.
PROM=prelabour rupture of membrane
PPROM=preterm prelabour rupture of membrane
CVA= cerebrovascular accident
Spontaneous delivery=A spontaneous vaginal delivery (SVD) occurs when a pregnant female goes into labor without the use of drugs or techniques to induce labor, and delivers her baby in the normal manner, without forceps, vacuum extraction, or a cesarean section.
HTJS=Hosp Tuanku Jaafar Seremban
Chorionicity=A chorionicity scan is used to distinguish between twins that share a placenta and those who have separate ones, so that twins at a higher risk of complications can be monitored more closely.
DCDA/MCDA=dichorionic diamniotic/monochorionic diamniotic. Esok we’ll learn more. Susah are google search. =.=’’
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