Tuesday, December 23, 2008

O&G The First trimester




Like the title? Hehe...

Well where do I start.For the next following 2 weeks, I'll be attached to the Gynaecology Ward,Gynae Clinics and Gynae OT.Yesterday was the first day for me in the Gynae ward, and so yesterday was the day when I started to test my skills in clerking gynae patients.It was okay I guess.However, the only disadvantage for A GUY like me during O&G posting is that, we the guys will be needing Chaperon to do clerking or to do any procedures.We need another female colleague to be with us before we can do anything.This is to prevent any future issues.Our lecturer had told us that a few years ago there was a case where a med student had to be expelled from his/her medical school due to a false allegation by a patient.The woman patient claimed that the male med student had done 'something' wrong to her while he was doing physical examination on her and made a police report.There was no prove to suggest that this poor student had done so and neither that there was any prove that he didn't do so.A police report was made by the patient and after investigation by the police the student had to be expelled.I dont want to comment on the issue.I leave it to you to decide.But, for the time being chaperon is needed.Hate it when the girls came late, or have somethingelse to do and that you end up waiting for them.Sigh~ hehe =)

Today (Tuesday) was the Gynae clinic day.My group came early and clerked a few patient in the ward and later we joined the Specialists for the ward round.Later in the morning, we all went to the Gynae clinic.I was attached to the HOD(Head of Department) Dr Wan Hamilton.She is a strict but a nice lady.She'll be okay as long as you are able to answer her question and show that you know something haha.These are the few cases that we saw in the clinic today

1. Mdm Y, 48 yr old came in with Perimenopausal symptoms such as hot flushes, palpitation,depression,night sweats etc.She is actually on HRT (Hormone Replacement Therapy) already to alleviate her symptoms and was on follow up.The Dr did VE and also the conventional pap smear.Unfortunately , we the guys were not allowed to observe.Sigh.See, we are so at the disadvantage side.We learn about the management, things to look for during examination etc.

2.Puan N came in with secondary infertility.Turns out to be that she has PCOS(Polycystic Ovarian Syndrome) .She has Hirsutism- Misai, acne and was of course infertile.

3. Puan J came in with history of Complete miscarriage and was on follow-up.Did ultrasound on her and the uterine cavity was clear.Nomore product of conception.

In the afternoon, we had TBL session with Dr Sulaiha the O&G specialist.The topic was Early & Late Abnormal Per Vaginal Bleeding.It was an interesting session because all of us shared our cases and we discussed with each other.It's true that patient is your best textbook.

Tomorrow is the day when I have to go to the Gynae OT and observed some operative procedures.Therefore, had to go back yo the gynae ward and clerked those patients.Memang cari nahas la kalau nak observe operation tapi tak tahu apa-apa pasal patient.Tomorrow, I'll be observing
1)Hysteroscopy
-a 49 yr old, G0P0 patient came in with the chief complaint of abnormal per vaginal bleeding of 1 year duration associated with suprapubic pain.The bleeding had become worse 2 months ago.She will bleed everyday, sometimes the bleeding will be so severe that there will be flooding(yes thats the term used here) which was described by her as a gush of blood came out from her vagina.Not going into details here.

2)Diagnostic laparoscopy
- This is one is for a 16 yr old girl who had never had menses before.Primary amenorrhoea case

3)Cystectomy

4)Tubal ligation
There is no better way than ending your tiring day with a few Big Apple Donuts!





p/s: I am actually quite engrossed into the IJN take-over issue.This might be the first step for a complete privatisation of hospitals in Malaysia.It is such a big issue for me becoz I might want to work in IJN in the future and it might jeopardise my chance to do just that.There was an attempt to privatise our hospital sometime ago but it failed because most doctors oppose it( according to a lecturer of mine, not saying who tho ).Why? Becoz the young,the old , and the disables wud get the biggest hit!Did you know that the price of drugs in Malaysia is rising due to privatisation of pharmaceutical industry some time ago?Do tell me your opinion plz (If u have any dat is =) )

6 comments:

adli said...

I think u can ask the staff nurse to accompany you during clerking.. and if ure lucky you get to do examination n procedures too since there is a NURSE guiding you.. huhu~

VE will come, no doubt about it.. along with pap smear n such.. so no worries :)

missing dr sulaiha lots...

N a b i L said...
This comment has been removed by the author.
N a b i L said...

Dr Sulaiha rox. Thx 4 d tips

JatBee said...

Owh. Great sharing. I just had my OnG round last month and now in paediatric..rock on!

uchnanabanana said...

uiyo. adli sbg SISTER dah beri kuasa utk menggunakan nurses2 di bawahnye. BTW, lebih baik kalau ade students nurses. silap2 ade jodoh haha.

N a b i L said...

Kat cni byk student nurses.Bleh tahan gak la..hehehe...