2day was a sleepy day, didn't get enough sleep I guess. Went to Normah at 7.30am to see birth C section, first entered the OT but were chase out by the Head of OT because the patient not willing to let us see, then went to the next room,luckily the allowed us to go into the room. The surgeon is Dr. Elizabeth. Super excited first time saw newborn was taken out from the abdomen, cool!!! This case is a bridge presentation, placenta privia (Placenta blocking the uterus), CVD (Cephalo-pelvic Dysfunction), so natural birth is not possible as it may rupture the scar. The legs came out first, then followed by buttock, body, hands and finally head. The baby was immediately suppplied with oxygen mask to help him breathing. After a while, we can hear the baby's cry. So cute the baby!!!Amniotic fluid + blood are 950ml, measured by the container. Second surgery we saw is excision of neck node. The patient is conscious though, and she was quite nervous, the doc injected local anesthesia to numb the area of operation, there was 1 time when the doc cut the artery and the blood ooze out, lol! The group of neck node was quite big, around 2.5cm, whitish and red in colour. Third surgery we saw on today is Mastoidectomy (Removal of mastoid bone-because of chronic middle ear infection), Dr. Kho showed us the chordae tympanic, remnant of Incus, malleus, mastoid cavity, middle ear cavity, Dura layer of meninges. In this case,the stapes had disappeared already. We could see the outer ear was twisted 90 degree, from vertical to horizontal, quite gross though. OT was damn cold, that's why when we had our lunch in cafe, we were sitting outside to photosynthesis, lols, everyone was looking at us, including all the doctors. We also got to see ESWL again this time,there are different types of stone blocking the ureter>If the patient has staghorn stone or if he/she has scoliosis(will push the stone near aorta), the stone cannot be blast as it will cause complication such as hematoma and the patient will suffer from renal injury. Today we got to clerk a patient suffered from appendicitis, saw a patient with Grave's disease---with features enophthalmos, slightly enlarged throid gland, decreased appetite. Upon investigation of throid test, T3-increased, T4 normal, TSH decreased. Hmm...quite cool too to see this case. We had seen 1 case in the ENT department. The guy complaint of ulcer in the mouth,painful while swallowing, snoring loudly while sleeping and sometimes will choke, this is quite a serious condition. Upon doing mouth endoscopy, the doc found out he has very large tonsils, with infection which explained why he had loud snoring and choking because the tonsils had block the airway when sleeping. The doc suggested tonsillectomy. We went back home early today!!! Yahoo, can sleep, and I slept from 3.45pm to 6pm I guess..hehe.
Lesson of the day:
Dr. Kho (ENT Surgeon) said:
For early years medical students, FUNDAMENTAL is important. U need to build your fundamental nicely so that it can help you to achieve higher. Power of observing is also one of the important element. You need to learn how to observe subtle changes.As a doctor,safety of the patient is paramount!!!....so guys and girls, now start to build up your fundamental so that your medical pathway in the future will be smooth and easier!!
It's not the quantity of sleep you have is good, but rather the quality of sleep!!
Some people sleep a lot but still feel tired in the morning because they were always in stage 1 and 2 of sleeping stages, which is known as shallow sleeping level.
I want to sleep adequate & well!!! Sleeping is the best thing to do!!! ZZZZzzz......
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