Entering 3rd trimester, the sinister monsters in the first trim have evilly started eyeing on me haisyy..especially the bloating. it's geting worse nowadays, now i start to miss my 2nd trim huu. but my big problem is, it seems like eating rice induce nausea..again huuu. i rarely can finish my proper meal, and i only have it once a day. but.. my bigger problem is.. it seems like i crave for secret recipe cake everyday huu or even fruit juice beverages... which are SWEET :( this is bad news..for my pancreas..and absolutely bad news for our Ameer.. malnutrition la pulak nanti huuu. for the time being i still try hard to be nutritious, but i know i'm losing the battle :(
after 1 whole day of doing nothing yesterday (other than listening to talks of course), perhaps i should work out something today..
Saturday
It's getting crampy
I'm talking of his swimming pool, I think the size is progressively becoming inappropriately small for him huu.. and the result? He kicks me more! Haisyy. He's cephalic now (head down position) and I hope he will stay that way, I doubt that he can turn back anyway huu. My abdomen doesn't look that big, but it feels very compact uh-uh, which really makes me wonder whether the liquor is adequate..
I haven't attended antenatal checkup for 2 months (unfortunately the hospital admission fell on my checkup date), which results in me not getting my 1st ATT yet, and I'm 29 weeks pregnant! Huuu. Inilah medical student :( I can't wait to have another scan on 6th Dec, I'm excited to know his weight!
Today I attended a programme "What's next?" It's a programme to enlighten us on the route we should take after graduating. Alhamdulillah it was a beneficial one, and it provided me with answers which I have been searching for all these while. The key to success is planning, and up to date, I'm still not sure what to do after housemanship. I mean of course I have to work to serve the JPA bond huhu, but I will to my best not opt for the chronic MO status huu. I try to search within me, what do I like best? It seems like nothing is outstandingly interesting other than biostatistic, how lame and nerdy does that sound? But the downside of it, which is losing my clinical skill is making me uncomfortable. Haissy. I'm also kind of interested in O&G, but the thought of smelling liquor and doing VE for the rest of my life is not that convincing as well huu. Ortho? totally out. Paeds? It gives me nightmares looking at those poor little things.. knowing a sick child can really make you cry.. IM? I can never properly detect a murmur or listen to a fine crept. Surgical-based? I don't need a hectic life with long hours of standing (standing during the ward round is enough to make me insane that I always imagine myself doing round using an electric wheelchair, now don't force me to stand for hours in the OT!), no thanks. Haissy... Making decision is definitely not easy, just how can I plan????
My long term plan- to graduate MBBS and rest for a while :D And I'm feeling contented with it hehe
Yesterday, I visited Nurul's baby in the ward :) Alahai comelnya baby boy tu, 2.8kg :D Boleh kawan dgn Ameer nanti k.
I haven't attended antenatal checkup for 2 months (unfortunately the hospital admission fell on my checkup date), which results in me not getting my 1st ATT yet, and I'm 29 weeks pregnant! Huuu. Inilah medical student :( I can't wait to have another scan on 6th Dec, I'm excited to know his weight!
Today I attended a programme "What's next?" It's a programme to enlighten us on the route we should take after graduating. Alhamdulillah it was a beneficial one, and it provided me with answers which I have been searching for all these while. The key to success is planning, and up to date, I'm still not sure what to do after housemanship. I mean of course I have to work to serve the JPA bond huhu, but I will to my best not opt for the chronic MO status huu. I try to search within me, what do I like best? It seems like nothing is outstandingly interesting other than biostatistic, how lame and nerdy does that sound? But the downside of it, which is losing my clinical skill is making me uncomfortable. Haissy. I'm also kind of interested in O&G, but the thought of smelling liquor and doing VE for the rest of my life is not that convincing as well huu. Ortho? totally out. Paeds? It gives me nightmares looking at those poor little things.. knowing a sick child can really make you cry.. IM? I can never properly detect a murmur or listen to a fine crept. Surgical-based? I don't need a hectic life with long hours of standing (standing during the ward round is enough to make me insane that I always imagine myself doing round using an electric wheelchair, now don't force me to stand for hours in the OT!), no thanks. Haissy... Making decision is definitely not easy, just how can I plan????
My long term plan- to graduate MBBS and rest for a while :D And I'm feeling contented with it hehe
Yesterday, I visited Nurul's baby in the ward :) Alahai comelnya baby boy tu, 2.8kg :D Boleh kawan dgn Ameer nanti k.
Friday
updates on 3rd trim :D
It's friday 19th November 2010, and today Ameer turns 28 weeks! (Today my groupmates; Imah and Hafidz are getting married too! congratulations to both of them) ALHAMDULILLAH :) Dah besar dah Ameer ye, but the best part is when he is being very responsive nowadays :D I'm currently enjoying my holiday till Sunday, and Ameer usually get extra attention when I'm on hol, because i get to read storybooks to him hehe. I usually start by choosing a storybook whch I am interested to read (haha, seems like reading to Ameer is just an excuse for mommy!),then I'd call him by his full name, he will move. When I read, and he remains quiet, I usually will stop and ask, "Ameer, are you listening? Or you have fallen asleep?" Most of the time he will responds and give my tummy a nudge! That is so nice!!!! Now I really wonder, can a baby understand?? But why are born babies not as responsive as they are when in the womb? Weird weird and extra weird. Probably they are too busy trying to adapt to the worldly environment huh? Sunnatullah, and it is really amazing. Subhanallah Alhamdulillah Allahuakbar! Ameer, mommy is giving you another 10 weeks to grow big in the womb (he must at least reach the weight of 3kg before coming out! Ameen :D), then at 38 weeks old, please try hard to come out ok. *P/s Ameer takyahla duduk sampai 40 minggu :p mommy dah tak larat ni ngee~
Currently in the mood to shop for Ameer's books huuu. But books are not that cheap :( Abah still buy medical books for me, and I'm spending our money on books for Ameer. What a nice flow! Haha. Rasa nak grad cepat, nak duduk dengan abang, nak ajar ameer membaca, nak buat projek menjahit macam2, nak hias and kemas rumah, nak pergi melancong...nak jadi TETAMU ALLAH huuu banyaknya impian...!!
The downside of 3rd trimester is.. I feel extra tired (exactly like the 1st trimester huuuu). I feel like sleeping most of the time. okay okay this not laziness! This is for real. (tapi kenapa ada orang mengandung larat buat banyak kerja?? Berat2 pulak tu huuu) I crave for cakes- secret recipe to be specific. I think I can eat it everyday huu. And I can't carry Safiyya around that much. Having her on my lap is not comfortable either, since the tummy is big, and I'll end up feeling some discomfort and having difficulty in breathing. Yesterday she wanted to stand up so much, that I held her up in a standing position. She rested her feet on my tummy (I know that it looks and works perfectly well like a shelf or a step haha), then we asked her, "Haa safiyya pijak sape tu?? Safiyya pijak adik ni!!" hehehe. The abdominal wall is also itchy due to thinning process, i feel like scratching it all the time huu. Kakak asked whether I have started using the anti-stretch mark cream, but actually I've never thought of buying it before huu
Safiyya sleeps little but laugh much! And wants to be carried around all the time! Haissy this is not good huu. And she surely scratches a lot- garu semua tempat.. kalau abang tengok, mesti abang cakap, sebiji macam mommy! Because i have this habit of scratching eventhough it is not itchy and there is no visible lesion hehe. And abang keeps asking me "Ayang garu apa lagi tu? Gatal ke?" garu muka, mata, telinga, garu tangan semua lah, but it is not really scratching, it is more of a mild rubbing. But safiyya really scratches! sampai luka sana sini huu.
Currently in the mood to shop for Ameer's books huuu. But books are not that cheap :( Abah still buy medical books for me, and I'm spending our money on books for Ameer. What a nice flow! Haha. Rasa nak grad cepat, nak duduk dengan abang, nak ajar ameer membaca, nak buat projek menjahit macam2, nak hias and kemas rumah, nak pergi melancong...nak jadi TETAMU ALLAH huuu banyaknya impian...!!
The downside of 3rd trimester is.. I feel extra tired (exactly like the 1st trimester huuuu). I feel like sleeping most of the time. okay okay this not laziness! This is for real. (tapi kenapa ada orang mengandung larat buat banyak kerja?? Berat2 pulak tu huuu) I crave for cakes- secret recipe to be specific. I think I can eat it everyday huu. And I can't carry Safiyya around that much. Having her on my lap is not comfortable either, since the tummy is big, and I'll end up feeling some discomfort and having difficulty in breathing. Yesterday she wanted to stand up so much, that I held her up in a standing position. She rested her feet on my tummy (I know that it looks and works perfectly well like a shelf or a step haha), then we asked her, "Haa safiyya pijak sape tu?? Safiyya pijak adik ni!!" hehehe. The abdominal wall is also itchy due to thinning process, i feel like scratching it all the time huu. Kakak asked whether I have started using the anti-stretch mark cream, but actually I've never thought of buying it before huu
Safiyya sleeps little but laugh much! And wants to be carried around all the time! Haissy this is not good huu. And she surely scratches a lot- garu semua tempat.. kalau abang tengok, mesti abang cakap, sebiji macam mommy! Because i have this habit of scratching eventhough it is not itchy and there is no visible lesion hehe. And abang keeps asking me "Ayang garu apa lagi tu? Gatal ke?" garu muka, mata, telinga, garu tangan semua lah, but it is not really scratching, it is more of a mild rubbing. But safiyya really scratches! sampai luka sana sini huu.
Monday
Stupid! Stupid! Sooo stupid!!!!!
We had class with our mentor Dr F today. The class should be on Friday but brought earlier, so that we can have a long nice holiday perhaps. I guess none of us was ready, it was such an ad hoc class, and the first short case class for paediatric. I was a bit nervous huhu. Each of us was nervous, I'm sure.
Finally the Dr arrived, I could at least feel relieved because there was no cerebral palsy patient in the ward, examining the nervous system was the last thing that i wanted. He brought us to a 16 year old male with cushingoid feature. A colleague had the honour to examine him, and I could see that he was surprised and not prepared. After some stumble and mumble from us to answer several questions, we finally moved to another patient.. and guess what? I was asked to examine the respiratory system..
An 11 year old girl who appeared healthy. Looking at her age, I moved to prop up her bed to 45 degree (that is what we do when examining an adult patient). Suddenly ,"Hey, what are you doing??!!!" Adoi dah kena tengking. "I want to prop up the bed to 45 degree" "Who teach you that?? Dalam buku mana?" Dr dah start marah2 haha. After few minutes of listening to him condemning hutchinson etc.. finally he asked me to proceed. This time around, i pulled the blanket. "You nak buat apa lagi ni????!!!!!!!!!!!!" kena tengking lagi. "I want to expose the patient, so to keep her modestry, i'd like to cover with the blanket..." "Sapa yg malu?? patient yang malu ke YOU yang malu??' I'd like to answer "both..." but i just kept quiet.. i could remember being extra shy at that age, a transformation age between a little girl and a teenager..with all the pubertal changes huu, and i could see that the patient was shy (if i were in her place i'd have cried huuu) but she acted tough, alhamdulillah. "Stupid, stupid, so stupid!!!" That was when i was smacked hard, but i remained smiling. i think i was actually grinning stupidly hehe. "Berapa kali dah i ajar you, dari 3rd year lagi, examine patient paeds as the patient is comfortable!!" Me (dalam hati jelah) "Paed was my first clinical posting 2 years ago, lucky if i can remember anything from paed huu"
My feeling at that time? Org bermuka tembok like me tentulah tidak berasa apa2, instead I was happy to learn something from a consultant as great as him. I remember that he once told us (when I was in year 3, now I actually remember something :p), during his time, 2 students attached to a specialist. He followed the specialist anywhere, and learnt clinical skills and gain knowledge from the specialist. It is totally different now, when many students attach to a lecturer, and most of the time, we do things on our own...
i felt like asking him, "Dr, can I attach with you? I really want to be great like you, I'd like to learn your clinical skills and everything else!!!" but I know he would just give a plain stare and perhaps.. another "Stupid!" huuu.
Luckily, the class today made me realize that I don't have much time to waste, 5 weeks of paediatric left. Now I'm willing to work hard insyaAllah :) But, raya first!!!!
Finally the Dr arrived, I could at least feel relieved because there was no cerebral palsy patient in the ward, examining the nervous system was the last thing that i wanted. He brought us to a 16 year old male with cushingoid feature. A colleague had the honour to examine him, and I could see that he was surprised and not prepared. After some stumble and mumble from us to answer several questions, we finally moved to another patient.. and guess what? I was asked to examine the respiratory system..
An 11 year old girl who appeared healthy. Looking at her age, I moved to prop up her bed to 45 degree (that is what we do when examining an adult patient). Suddenly ,"Hey, what are you doing??!!!" Adoi dah kena tengking. "I want to prop up the bed to 45 degree" "Who teach you that?? Dalam buku mana?" Dr dah start marah2 haha. After few minutes of listening to him condemning hutchinson etc.. finally he asked me to proceed. This time around, i pulled the blanket. "You nak buat apa lagi ni????!!!!!!!!!!!!" kena tengking lagi. "I want to expose the patient, so to keep her modestry, i'd like to cover with the blanket..." "Sapa yg malu?? patient yang malu ke YOU yang malu??' I'd like to answer "both..." but i just kept quiet.. i could remember being extra shy at that age, a transformation age between a little girl and a teenager..with all the pubertal changes huu, and i could see that the patient was shy (if i were in her place i'd have cried huuu) but she acted tough, alhamdulillah. "Stupid, stupid, so stupid!!!" That was when i was smacked hard, but i remained smiling. i think i was actually grinning stupidly hehe. "Berapa kali dah i ajar you, dari 3rd year lagi, examine patient paeds as the patient is comfortable!!" Me (dalam hati jelah) "Paed was my first clinical posting 2 years ago, lucky if i can remember anything from paed huu"
My feeling at that time? Org bermuka tembok like me tentulah tidak berasa apa2, instead I was happy to learn something from a consultant as great as him. I remember that he once told us (when I was in year 3, now I actually remember something :p), during his time, 2 students attached to a specialist. He followed the specialist anywhere, and learnt clinical skills and gain knowledge from the specialist. It is totally different now, when many students attach to a lecturer, and most of the time, we do things on our own...
i felt like asking him, "Dr, can I attach with you? I really want to be great like you, I'd like to learn your clinical skills and everything else!!!" but I know he would just give a plain stare and perhaps.. another "Stupid!" huuu.
Luckily, the class today made me realize that I don't have much time to waste, 5 weeks of paediatric left. Now I'm willing to work hard insyaAllah :) But, raya first!!!!
Thursday
Hopefully Ameer will read this one day.. Today is 11th november 2010, and today Mama bought him a cute book, entitled "My first....". Sgt cute!!! Perhaps later I'll snap a picture and put it here, just so that it'll forever remain in our memory :)
This morning abang sat for his final exam before having 2 weeks holiday, although we are far apart, I'm feeling very happy :D because??? he will always be available hehe
Today is 13th November 2010, I don't have much too write, afteer 1 week of doing nothing paediatric-ky, I guess, I should start to focus uh-uh. This laziness is really debilitating, I can't do much when it's around, I get lazier and lazier by day huuu. Masuk paediatric semakin tak bersemangat... :(
Yetserday I weighed 58kg!!!! 14kg increase so far..this is definitely not a good thing huuu. Abang cakap, "Ayang lebih berat dari abang!!! Bolehlah ayang angkat abang lepas ni :D" Errrkkkkkkkk!!! Abang, ayang berat sebab ayang angkat baby lah + swimming pool baby huhu.
Seriously sangat malas!!!! Mengapakah?? Nak g ward pun malas.... :( Rasa nak tido sentiasa, ke banyak sangat syaitan yang hanging on to my eyelashes?? euww. Abang is enjoying his 2 weeks of holiday, and frankly I AM JEALOUS :(
This morning abang sat for his final exam before having 2 weeks holiday, although we are far apart, I'm feeling very happy :D because??? he will always be available hehe
Today is 13th November 2010, I don't have much too write, afteer 1 week of doing nothing paediatric-ky, I guess, I should start to focus uh-uh. This laziness is really debilitating, I can't do much when it's around, I get lazier and lazier by day huuu. Masuk paediatric semakin tak bersemangat... :(
Yetserday I weighed 58kg!!!! 14kg increase so far..this is definitely not a good thing huuu. Abang cakap, "Ayang lebih berat dari abang!!! Bolehlah ayang angkat abang lepas ni :D" Errrkkkkkkkk!!! Abang, ayang berat sebab ayang angkat baby lah + swimming pool baby huhu.
Seriously sangat malas!!!! Mengapakah?? Nak g ward pun malas.... :( Rasa nak tido sentiasa, ke banyak sangat syaitan yang hanging on to my eyelashes?? euww. Abang is enjoying his 2 weeks of holiday, and frankly I AM JEALOUS :(
Tuesday
I was warded since last night. Today is November 2010, and I'm so bored and alone in the ward. They have in total 10 beds, no curtain in between. Last night there was a kakak who accompanied me. A very nice lady who offered me almost everything...her food, her 3-in-1 milo, hot water etc. I just couldn't thank her enough. Luckily I brought some food from home and a bottle of mineral water, I've never imagined before that I'd eat thm up here huu. This morning another lady, a Chinese was admitted, was also in labour. I'm in the antenatal ward after all! First that kakak was wheeled into the labour room at around 8am, then the Chinese lady was wheeled in at around 12pm, and I was left completely alone. It is now 2pm, both of them had delivered their babies Alhamdulillah
We were on our way to Kuantan and had just passed a black MPV which skidded I guess, causing a short traffic jam. Subhanallah He knows best, not more than 10 minutes later, our Myvi spun few times and ended in a drain at KM 75.5. I guess it was the slipery after-rain road and perhaps going a bit over the speed limit. When it started to spun, the first word that I managed to shout was "Ya Allah" repeatedly. The first question that came to mind, "Is this how my life is going to end?" and my 1st concern was "Ameer, are you allright? Oh Allah, please don't let anything happen to him." The car was spinning fast, I saw the road, then I saw the trees on the road shouler, then I saw the smoke coming out of the engine I was scared but rational enough to crouch my body forward so that nothing will touch the abdomen huu. When the car stopped (and it was tilted with me a little bit on top and the driver's seat lower down because that side was in a drain) I shouted to Ah-long dude to get out fast. "Tak boleh buka pintu!" she whined. I tried mine and it was also stuck. So i rolled down my window, asked her to do the same and I jumped out of the window. At that time, I didn't even think of the possibility my abdomen get stuck haha. I jumped onto the grass. Just imagine, I was wearing a jubah, and when I jumped out, my legs were stuck in the jubah. I tried to stand up but fell down again, so finally I just rolled myself on the grass and partly crawling to get away from the car as fast as possible. I think when I was 3 to 4 metres away,only then ah long dude managed to come out. Even the pakcik who stopped by later said to ah long dude, "Kawan awak ni cepat betul dia keluar dari kereta" haha tak padan dengan mengandung
After some 10 minutes when the car appeared safe, somebody helped to take out our things. I reached for my hp, informed Abah and Abang. I didin't want to inform Ummi as I knew she would panic huuu
At that time, I was still very worried about Ameer. He was not moving (he moved actively just before the car spun). So i poked and poked him. Luckily among those who stopped their car awas a nurse in her 50s. she asked me whether there was any abdominal pain, I said no and she offered to take me to the nearest clinic. I asked her whether they have CTG, she said yes. I sat down to wait for the whole affair to settle down, and after 30 minutes, Ameer gave me his 1st kick. Well one can never imagine my feeling at that time.. Alhamdulillah Alhamdulillah Alhamdulillah
Finally I asked the workshop people to send us to Hospital Bentong. I went straight to the screening room. By that time, my body has started aching, especially the left side of the neck where the seatbelt was initally placed. There was quite a huge swelling. After the nurse checked me, they asked of ah long's whereabout, to help me to register for ward admission. I was shocked
Masuk ward?? That was the last thing that I wanted, especially in the middle of nowhere. Siap tanya soalan bodoh, "Perlu ke?" and the nurse snapped at me "Perlu!". I knew best not to argue although my rebellious side yearned for a fight. I did all these for Ameer, May he be in the best of care, where continuous monitoring can be done and where help will always be available should anything happen
Then a Dr came and did a scan on Ameer, Alhamdulillah he was fine.. and guess what??? His parameter corresponded to the age of 27 weeks, memang la besar baby mommy n daddy ni :D
In the ward, I slept quite early and when they came to check on me and baby, it was like in a dream. I couldn't open my eyes and just let them do anything huu. I later realized that the nurses organized my things properly (earlier I just put my bag on the bed huu)
At around 2am, I couldn't sleep anymore because Ameer was too active and kicked me non stop huu. He was active up to 4 am. Plus my body was aching more and more. I smsed abang. Abang called me and we talked for some time, till subuh. After subuh I tried to get some sleep. At around 9.30 am another nice lady doctor came and checked on me. I asked when could I be discharged. She said at night. I didn't have any toiletteries with me. Abah was shceduled for flying that day. ummi asked me to get a taxi to Kuantan. my neighbours had visitors who brought them breakfast that morning.. and I cried and cried. I cried so badly that everybody (the doctor and nurses) made a fuss about it, mengada2 betul mommy nih. Dr asked me why did I cry, i said nothing. She thought I was upset when she said I could be discharged earliest that night. she said my hemoglobin is low. But she will try to discharge me that evening. Pastu mengadu kat Ummi and abang.. Pesan kat nurse mintk tolong belikan toiletteries, then she asked, "Awak takde sape2 ke kat sini?" I said No.. lg .. in the end the radicare auntie helped me to buy those things..mandi and gosok giig waktu nak solat zohor huuu. Nak sgt minum Milo (i'm the type of person who don't drink plain water at all) but I don't want to burden the radicare aunite and the nurses, so I just cried.. I think I cried for almost every single thing
At that time, i really hoped that abang would be around, I wanted to fly to abang and leave everything behind. Probably i should adopt the motto "life is tough, but I'm tougher" but apparently that didn't happen. The only things i did was to cry and break down huu
at around 3.30pm, they informed me that I could go home. As I had nobody around, they asked the PPK to settle down my hospital bill, and the nurse called the taxi, to bring me to the bus terminal. Abah called me at that time, but I was very upset, and I was crying some more. I had 2 big luggaegs with me plus my laptop bag, i just didn't know how to carry them along. Another problem was, there was no bus from Bentong to Kuantan. It is a very small bus terminal, they only go either to KL or Temerloh. In the first place I was thinking of going back to KL (I was given 4 days of MC), but then I would have to find a way to go back to kuantan later..what a fuss. So I was determined to take a bus to Temerloh, then change to another bus to kuantan. Suddenly when I was at the ticket counter, the ticket seller asked me where did I want to go.. I answered "Kuantan". She said it's ok, she would arrange it for me. So she called her friend (a driver of Transnasional bus) to pick me up at the terminal (his bus was not supposed to stop by at Bentong), and he said fine, since they still have empty seats.. Alhamdulillah, again He eased my journey.. That ticket seller was very kind, she even invited me to put my big bags in the ticket counter, since I had some 1 hour before the bus would arrive and I might wanted to go somewhere else.. Allah dah tolong banyak sgt3, semua jadi mudah, tapi masih nak bersedih2 huuu. So Ameer and me boarded the bus and at 10pm we arrived in Kuantan Alhamdulillah..
as for now, I'm using my MC to the most :D Attendance is important, but I guess my Ameer is much more important..I don't want to tire myslef too much, enough with the histry of prem contraction, the accident.. and now I just want to rest for few days and let Ameer grows healthily insyaAllah..
We were on our way to Kuantan and had just passed a black MPV which skidded I guess, causing a short traffic jam. Subhanallah He knows best, not more than 10 minutes later, our Myvi spun few times and ended in a drain at KM 75.5. I guess it was the slipery after-rain road and perhaps going a bit over the speed limit. When it started to spun, the first word that I managed to shout was "Ya Allah" repeatedly. The first question that came to mind, "Is this how my life is going to end?" and my 1st concern was "Ameer, are you allright? Oh Allah, please don't let anything happen to him." The car was spinning fast, I saw the road, then I saw the trees on the road shouler, then I saw the smoke coming out of the engine I was scared but rational enough to crouch my body forward so that nothing will touch the abdomen huu. When the car stopped (and it was tilted with me a little bit on top and the driver's seat lower down because that side was in a drain) I shouted to Ah-long dude to get out fast. "Tak boleh buka pintu!" she whined. I tried mine and it was also stuck. So i rolled down my window, asked her to do the same and I jumped out of the window. At that time, I didn't even think of the possibility my abdomen get stuck haha. I jumped onto the grass. Just imagine, I was wearing a jubah, and when I jumped out, my legs were stuck in the jubah. I tried to stand up but fell down again, so finally I just rolled myself on the grass and partly crawling to get away from the car as fast as possible. I think when I was 3 to 4 metres away,only then ah long dude managed to come out. Even the pakcik who stopped by later said to ah long dude, "Kawan awak ni cepat betul dia keluar dari kereta" haha tak padan dengan mengandung
After some 10 minutes when the car appeared safe, somebody helped to take out our things. I reached for my hp, informed Abah and Abang. I didin't want to inform Ummi as I knew she would panic huuu
At that time, I was still very worried about Ameer. He was not moving (he moved actively just before the car spun). So i poked and poked him. Luckily among those who stopped their car awas a nurse in her 50s. she asked me whether there was any abdominal pain, I said no and she offered to take me to the nearest clinic. I asked her whether they have CTG, she said yes. I sat down to wait for the whole affair to settle down, and after 30 minutes, Ameer gave me his 1st kick. Well one can never imagine my feeling at that time.. Alhamdulillah Alhamdulillah Alhamdulillah
Finally I asked the workshop people to send us to Hospital Bentong. I went straight to the screening room. By that time, my body has started aching, especially the left side of the neck where the seatbelt was initally placed. There was quite a huge swelling. After the nurse checked me, they asked of ah long's whereabout, to help me to register for ward admission. I was shocked
Masuk ward?? That was the last thing that I wanted, especially in the middle of nowhere. Siap tanya soalan bodoh, "Perlu ke?" and the nurse snapped at me "Perlu!". I knew best not to argue although my rebellious side yearned for a fight. I did all these for Ameer, May he be in the best of care, where continuous monitoring can be done and where help will always be available should anything happen
Then a Dr came and did a scan on Ameer, Alhamdulillah he was fine.. and guess what??? His parameter corresponded to the age of 27 weeks, memang la besar baby mommy n daddy ni :D
In the ward, I slept quite early and when they came to check on me and baby, it was like in a dream. I couldn't open my eyes and just let them do anything huu. I later realized that the nurses organized my things properly (earlier I just put my bag on the bed huu)
At around 2am, I couldn't sleep anymore because Ameer was too active and kicked me non stop huu. He was active up to 4 am. Plus my body was aching more and more. I smsed abang. Abang called me and we talked for some time, till subuh. After subuh I tried to get some sleep. At around 9.30 am another nice lady doctor came and checked on me. I asked when could I be discharged. She said at night. I didn't have any toiletteries with me. Abah was shceduled for flying that day. ummi asked me to get a taxi to Kuantan. my neighbours had visitors who brought them breakfast that morning.. and I cried and cried. I cried so badly that everybody (the doctor and nurses) made a fuss about it, mengada2 betul mommy nih. Dr asked me why did I cry, i said nothing. She thought I was upset when she said I could be discharged earliest that night. she said my hemoglobin is low. But she will try to discharge me that evening. Pastu mengadu kat Ummi and abang.. Pesan kat nurse mintk tolong belikan toiletteries, then she asked, "Awak takde sape2 ke kat sini?" I said No.. lg .. in the end the radicare auntie helped me to buy those things..mandi and gosok giig waktu nak solat zohor huuu. Nak sgt minum Milo (i'm the type of person who don't drink plain water at all) but I don't want to burden the radicare aunite and the nurses, so I just cried.. I think I cried for almost every single thing
At that time, i really hoped that abang would be around, I wanted to fly to abang and leave everything behind. Probably i should adopt the motto "life is tough, but I'm tougher" but apparently that didn't happen. The only things i did was to cry and break down huu
at around 3.30pm, they informed me that I could go home. As I had nobody around, they asked the PPK to settle down my hospital bill, and the nurse called the taxi, to bring me to the bus terminal. Abah called me at that time, but I was very upset, and I was crying some more. I had 2 big luggaegs with me plus my laptop bag, i just didn't know how to carry them along. Another problem was, there was no bus from Bentong to Kuantan. It is a very small bus terminal, they only go either to KL or Temerloh. In the first place I was thinking of going back to KL (I was given 4 days of MC), but then I would have to find a way to go back to kuantan later..what a fuss. So I was determined to take a bus to Temerloh, then change to another bus to kuantan. Suddenly when I was at the ticket counter, the ticket seller asked me where did I want to go.. I answered "Kuantan". She said it's ok, she would arrange it for me. So she called her friend (a driver of Transnasional bus) to pick me up at the terminal (his bus was not supposed to stop by at Bentong), and he said fine, since they still have empty seats.. Alhamdulillah, again He eased my journey.. That ticket seller was very kind, she even invited me to put my big bags in the ticket counter, since I had some 1 hour before the bus would arrive and I might wanted to go somewhere else.. Allah dah tolong banyak sgt3, semua jadi mudah, tapi masih nak bersedih2 huuu. So Ameer and me boarded the bus and at 10pm we arrived in Kuantan Alhamdulillah..
as for now, I'm using my MC to the most :D Attendance is important, but I guess my Ameer is much more important..I don't want to tire myslef too much, enough with the histry of prem contraction, the accident.. and now I just want to rest for few days and let Ameer grows healthily insyaAllah..
Sunday
Amoi Piyah
Amoi Piyah aka Safiyya Amani loves to read book nowadays! Tapi cara baca dia lain sket.. First she will sit in someone's lap, and a book will be opened before her.. Nobody needs to say anything, becuase in few minutes she will start reading it by herself (of course mulut dia bising la dlm bahasa yang tak difahami haha). She knows how to hold the book properly! And then her grip will get stronger and stornger.. In few seconds her lips will start to 'muncung' as if to kiss something, and she will hypersalivate (air liur start berbuih2 then melejer2 terus), and beware, in no time, she will pull the book closer, and her head lower down and........................Nyummm..... dia hisap buku tu!!!! I guess that's her only aim haha.
This morning amoi came to our house, and her mama brought her into our room. Maka ternampakla buku Ameer.. so we were excited to let her 'read' a book.. Nenek pun cakapla, "Eh Safiyya baca buku adik (Ameer)" and chup!! Safiyya imprinted something on it hahaha, tak sempat Ameer nak jilat2, Safiyya yg hisap2 dulu haha.
Cute sgt3 piyah ni!!!! I really shud ask the dad to snap some piccies of her while she's reading ! :D
This morning amoi came to our house, and her mama brought her into our room. Maka ternampakla buku Ameer.. so we were excited to let her 'read' a book.. Nenek pun cakapla, "Eh Safiyya baca buku adik (Ameer)" and chup!! Safiyya imprinted something on it hahaha, tak sempat Ameer nak jilat2, Safiyya yg hisap2 dulu haha.
Cute sgt3 piyah ni!!!! I really shud ask the dad to snap some piccies of her while she's reading ! :D
Ni memang utk abang!
Abang, this is the bag that I've finished sewing this holiday, yg abang asyik tanya "Dah siap ke belum?", "Tgh jahit lagi ke?" haha, somehow I felt like mak, menjahit sampai lewat malam (till early morning actually :p)
I've finished packing Ameer's things, ready to go to the hospital anytime :D
I've finished packing Ameer's things, ready to go to the hospital anytime :D
The usual complain..
Today will be the last day of holiday..and tomorrow my Paediatric posting will start. Am still not in the mood for classes and wardwork, but I'm not offered with any other choice.. Will InsyaAllah go back to Kuantan this evening.
I really regret taking public transports like the other day when a friend dropped me in Gombak, and I had to board the train and metrobus to arrive home. it took me 2 hours to arrive from kuantan to gombak, and another 2 hours from gombak to my house huu, when the journey should be around 30 minutes only... I was carrying 2 large bags (which of course contained books) and a laptop bag (Alhamdulillah abang bought me a netbook instead of a laptop). I didn't mind taking the public transports before, but as now I'm carrying my big Ameer as well, and I don't want to overwork my burdened hardworking heart, it is indeed not a choice to be opted. Well, nothing is easy in life isn't it? At least I was so lucky to be able to sit instead of standing all the way :p A pregnant lady should always be offered a seat huh?
My next antenatal checkup will be tomorrow, after a free period of 6 weeks ^_^ surely I can't wait to see my Ameer :D I planned to do the 3D/4D tomorrow, but due to some reason it has to be postponed.
Speaking of being hardworking, I think the last exam was the worst in term of trying. (Of course it can't compare with my IM exam in which I was so sick to read the book huuu). I was really not in the mood for exam..simply because I think that life has nothing to offer haha. That was when I started to question my intention; how sincere do I do things for Allah, or do I do things to get worldly returns?? In sequent, my previous exams were Ortho, Specialized, IM and O&G. I went to Jordan after Ortho, I went to Jordan again after Specialized, abang was around after my IM exam..and next came O&G.. I was not going anywhere, and abang wasn't coming home, there was nothing interesting in store, except that I'd get a long break. It was way different in comparison to my 4th year, when I desperately wanted to pass my exams because I wanted to have my elective posting :p People love to say that I have hypothyroidism huuu because of my round-the-clock it's-ok attitude in such a lazy emotionless manner despite doing something very fatal huu.
Back to the pre-exam period, abang kept asking me, "Ayang cuak donut ke?" Cuak donut is the term that abang uses when he becomes so restless before the exam, so anxious etc. I said, "Not yet..." I waited and waited for that anxiety to set in but alas until the end of my exam, I think there were some technical diffculties in the emotional setting leading to me having a blunted affect. What did I do? I surfed and surfed the internet.. Actually I was so disturbed with something few weeks before the exam..and it was carried along until the exam huuu. So what I usually do (and usually make me feel happy :D) and, what I actually did was to surf the internet for Ameer's necessities and did some internet purchasing (since I can't shop for myself). Abang was the anxious one, asking me,"Tak ganggu exam ayang ke..asyik surf internet je..." I said, "takde mood.." So during this holiday I end up waiting for the parcels to arrive home huuu till the pos laju people said sambil tersengih2 "Hari hari ada bungkusan sampai ye". Ummi and me pun tersengih2 haha.
After 2 months without abang, I just can't stop missing his presence.. especially when I feel that abang is very busy carrying out his responsibilites in Jordan.. Alhamdulillah I have Ameer to play with, and someone to resort to when I feel so lonely, a companion whom I can read story books to...and at least it reminds me, although abang is not here, a part of him is in me (and it's kicking haha). A jihad is not easy indeed. But the reward from Him is far worth the effort.. May we be patient always..
Abang, you knocked on my door once, I opened it and let you in, that was the first time you imprinted something in my life, and it will forever stay in my heart. I love you so much!
I really regret taking public transports like the other day when a friend dropped me in Gombak, and I had to board the train and metrobus to arrive home. it took me 2 hours to arrive from kuantan to gombak, and another 2 hours from gombak to my house huu, when the journey should be around 30 minutes only... I was carrying 2 large bags (which of course contained books) and a laptop bag (Alhamdulillah abang bought me a netbook instead of a laptop). I didn't mind taking the public transports before, but as now I'm carrying my big Ameer as well, and I don't want to overwork my burdened hardworking heart, it is indeed not a choice to be opted. Well, nothing is easy in life isn't it? At least I was so lucky to be able to sit instead of standing all the way :p A pregnant lady should always be offered a seat huh?
My next antenatal checkup will be tomorrow, after a free period of 6 weeks ^_^ surely I can't wait to see my Ameer :D I planned to do the 3D/4D tomorrow, but due to some reason it has to be postponed.
Speaking of being hardworking, I think the last exam was the worst in term of trying. (Of course it can't compare with my IM exam in which I was so sick to read the book huuu). I was really not in the mood for exam..simply because I think that life has nothing to offer haha. That was when I started to question my intention; how sincere do I do things for Allah, or do I do things to get worldly returns?? In sequent, my previous exams were Ortho, Specialized, IM and O&G. I went to Jordan after Ortho, I went to Jordan again after Specialized, abang was around after my IM exam..and next came O&G.. I was not going anywhere, and abang wasn't coming home, there was nothing interesting in store, except that I'd get a long break. It was way different in comparison to my 4th year, when I desperately wanted to pass my exams because I wanted to have my elective posting :p People love to say that I have hypothyroidism huuu because of my round-the-clock it's-ok attitude in such a lazy emotionless manner despite doing something very fatal huu.
Back to the pre-exam period, abang kept asking me, "Ayang cuak donut ke?" Cuak donut is the term that abang uses when he becomes so restless before the exam, so anxious etc. I said, "Not yet..." I waited and waited for that anxiety to set in but alas until the end of my exam, I think there were some technical diffculties in the emotional setting leading to me having a blunted affect. What did I do? I surfed and surfed the internet.. Actually I was so disturbed with something few weeks before the exam..and it was carried along until the exam huuu. So what I usually do (and usually make me feel happy :D) and, what I actually did was to surf the internet for Ameer's necessities and did some internet purchasing (since I can't shop for myself). Abang was the anxious one, asking me,"Tak ganggu exam ayang ke..asyik surf internet je..." I said, "takde mood.." So during this holiday I end up waiting for the parcels to arrive home huuu till the pos laju people said sambil tersengih2 "Hari hari ada bungkusan sampai ye". Ummi and me pun tersengih2 haha.
After 2 months without abang, I just can't stop missing his presence.. especially when I feel that abang is very busy carrying out his responsibilites in Jordan.. Alhamdulillah I have Ameer to play with, and someone to resort to when I feel so lonely, a companion whom I can read story books to...and at least it reminds me, although abang is not here, a part of him is in me (and it's kicking haha). A jihad is not easy indeed. But the reward from Him is far worth the effort.. May we be patient always..
Abang, you knocked on my door once, I opened it and let you in, that was the first time you imprinted something in my life, and it will forever stay in my heart. I love you so much!
Saturday
Tag juge...
Ummu Iffah tagged me.................... :)
kna beritahu 25 things about myself...
So here goes:
1. Saya pernah ditag dulu, tapi tak comply, so skrg cuba utk menurut perintah :p
2. Skrg tgh cuti...tapi 5 hari je :( tak puas... next posting will be paediatric
3. Saya SANGAT SUKA complain :D, tapi sbnrnya dalam hati saya SGT JARANG complain..slalu redha je, tp saje hobi suka2 bising2 complain hehe
4. saya ada habit yang dah cuba utk ditinggalkan lepas kawen tp masih tak berjaya: SAYA GILE SHOPPING :( (sampai abang pun dah susah nak nasihatkan, dah sebati dlm jiwa kot...)
5. Skrg abang jlnkan catuan beli baju kat saya selama 3 tahun :(
6. Demi menunjukkan kat abang yg baju taklah berapa banyak sgt.. saya dermakan 75% kot baju yg tak pakai huu...
7. Saya sedang belajar untuk menjadi zuhud, qanaah, tawaddhu'... sgt3 susah..
8. Berkahwin umur 23 tahun (tak sempat habis belajar pun ngeh3)
9. Pregnant umur 24 tahun (juga tak sempat habis belajar....)
10. InsyaAllah dapat baby umur 25 tahun (tak grad2 jugak!!!) Haisyyy
11. I love baking :D
12. skrg ada rutin baru... bacakan bedtime story book utk baby (yg masih dlm perut hehe). Tp instead of going to sleep, baby semakin aktif bila dengar cerita huu... dah jadi wake-up stories plak
13. Pssttt yg sbnrnya i know baby tak faham pun cerita tu, sbb bila lecturer tgh mengajar pun dia aktif melampau haha, means he just responses to any sound.
14. I also have this routine utk rasa kepala baby hari2, tunggu dia turun bawah huu. stkt ni masih oblique breech, hampir2 transverse :p.. on the way nak turun tuu.. buttock dia pun semakin hari semakin tinggi..sekarang dah dekat left lumbar hehe :D
15. ohh terlupa plak, insyaAllah nak professional exam bulan may.. saya sgt tak sabar nak habis belajar, sebab nak rehat goyang kaki je kat rumah :p pemalas tak??
16. sgt selalu tidur skrg sebab slalu rasa letih sgt3..tp tidur tak nyenyak and kerap terbangun & slalu dpt nightmare huuu
17. accidentally married to Muhammad al Athiq Marzuki haha.. but I am extremely happy Alhamdulillah :p (oopss takleh cerita lebih2 pasal abang nanti abang perasan huuu)
18. everytime I post a new article in the blog, I have to inform abang, otherwise abang merajuk ngee~ sebab dia nak jadi org pertama yg baca huuuu
19. I think I'm an overly ambitious person, too many plans in hand huu
20. I love staying at home, and frequently get homesickness
21. I guess I enjoy crying as much as I enjoy my meal haha
22. Pernah jual kek, dan sangat teringin nak jual lagi...but currently I'm staying in the mahallah for a while which makes it impossible
23. I like to tire myself to sleep so that I won't think of abang too much
24. I like to be a doctor, and I love listening to patients, but I hate the superbly busy life, just how can I adapt....?
25. Our baby already has a name Alhamdulillah :D
Dengan ini, saya mengetag
1. Ummu 'Umar 'Abdul 'Aziz
2. Aliya
3. ummu Iffah
taktaula sapa lg baca blog ni huu
kna beritahu 25 things about myself...
So here goes:
1. Saya pernah ditag dulu, tapi tak comply, so skrg cuba utk menurut perintah :p
2. Skrg tgh cuti...tapi 5 hari je :( tak puas... next posting will be paediatric
3. Saya SANGAT SUKA complain :D, tapi sbnrnya dalam hati saya SGT JARANG complain..slalu redha je, tp saje hobi suka2 bising2 complain hehe
4. saya ada habit yang dah cuba utk ditinggalkan lepas kawen tp masih tak berjaya: SAYA GILE SHOPPING :( (sampai abang pun dah susah nak nasihatkan, dah sebati dlm jiwa kot...)
5. Skrg abang jlnkan catuan beli baju kat saya selama 3 tahun :(
6. Demi menunjukkan kat abang yg baju taklah berapa banyak sgt.. saya dermakan 75% kot baju yg tak pakai huu...
7. Saya sedang belajar untuk menjadi zuhud, qanaah, tawaddhu'... sgt3 susah..
8. Berkahwin umur 23 tahun (tak sempat habis belajar pun ngeh3)
9. Pregnant umur 24 tahun (juga tak sempat habis belajar....)
10. InsyaAllah dapat baby umur 25 tahun (tak grad2 jugak!!!) Haisyyy
11. I love baking :D
12. skrg ada rutin baru... bacakan bedtime story book utk baby (yg masih dlm perut hehe). Tp instead of going to sleep, baby semakin aktif bila dengar cerita huu... dah jadi wake-up stories plak
13. Pssttt yg sbnrnya i know baby tak faham pun cerita tu, sbb bila lecturer tgh mengajar pun dia aktif melampau haha, means he just responses to any sound.
14. I also have this routine utk rasa kepala baby hari2, tunggu dia turun bawah huu. stkt ni masih oblique breech, hampir2 transverse :p.. on the way nak turun tuu.. buttock dia pun semakin hari semakin tinggi..sekarang dah dekat left lumbar hehe :D
15. ohh terlupa plak, insyaAllah nak professional exam bulan may.. saya sgt tak sabar nak habis belajar, sebab nak rehat goyang kaki je kat rumah :p pemalas tak??
16. sgt selalu tidur skrg sebab slalu rasa letih sgt3..tp tidur tak nyenyak and kerap terbangun & slalu dpt nightmare huuu
17. accidentally married to Muhammad al Athiq Marzuki haha.. but I am extremely happy Alhamdulillah :p (oopss takleh cerita lebih2 pasal abang nanti abang perasan huuu)
18. everytime I post a new article in the blog, I have to inform abang, otherwise abang merajuk ngee~ sebab dia nak jadi org pertama yg baca huuuu
19. I think I'm an overly ambitious person, too many plans in hand huu
20. I love staying at home, and frequently get homesickness
21. I guess I enjoy crying as much as I enjoy my meal haha
22. Pernah jual kek, dan sangat teringin nak jual lagi...but currently I'm staying in the mahallah for a while which makes it impossible
23. I like to tire myself to sleep so that I won't think of abang too much
24. I like to be a doctor, and I love listening to patients, but I hate the superbly busy life, just how can I adapt....?
25. Our baby already has a name Alhamdulillah :D
Dengan ini, saya mengetag
1. Ummu 'Umar 'Abdul 'Aziz
2. Aliya
3. ummu Iffah
taktaula sapa lg baca blog ni huu
Wednesday
1st day of holiday :D
Waa today is really tiring, and it is only 11am! Am cleaning our bedroom, disposing most of the stuffs; specially emptying my wardrobes..semua gara-gara nak sumbat masuk barang Ameer huuu. a room that was already full, has been upgraded to the status of suffocating, once we put in Ameer's cupboard, cot etc. And now I'm filling up his cupboard with......... secret! hehe, will tell later.
Am also packing his things to be brought to Kuantan. Approaching 7 month of pregnancy, I have to be ready anytime, should he decide to come out and see the world earlier than expected. Naudzubillah~
Irritably waiting for the courier service to deliver some parcels~ kalau buka pintu lambat sket, diorng dah pergi :( Am also waiting for the workshop people to arrive and repair the aircond. It is unbelievably hot without the aircond
This morning I auscultated Ameer's heart using the bell of stethoscope, and it was wonderful to listen to!
Rasa nak tido je skrg~
Am also packing his things to be brought to Kuantan. Approaching 7 month of pregnancy, I have to be ready anytime, should he decide to come out and see the world earlier than expected. Naudzubillah~
Irritably waiting for the courier service to deliver some parcels~ kalau buka pintu lambat sket, diorng dah pergi :( Am also waiting for the workshop people to arrive and repair the aircond. It is unbelievably hot without the aircond
This morning I auscultated Ameer's heart using the bell of stethoscope, and it was wonderful to listen to!
Rasa nak tido je skrg~
O&G Exam
I am finally home, Alhamdulillah, Alhamdulilllah, Alhamdulillah :) Planning to be a fulltime housewife today, doing some baking and err.. err :p Exam was ok I guess, the theory part was not that bad, so was the clinical. But I really hate OSCE, we were not given enough time to write! 2 minutes for each station, and the questions were ample :( We got a laparoscopic pic of polycystic ovary, a BhCG chart for a patient with molar disease, an ampoule of MgSO4, A fetal simulator of breech presentation, and a ventouse cup. As for the PMP, it was a case of grandmultip (eh ye ke?? x ingt plak), with pregnancy induced hypertension, delivery complicated with post partum hemorrhage. The second, which was gynae case, was a bit horror. A 23 year old medical student, fainting spell during teaching with severe abdominal pain :p. Differentials?? I should have put 1. Hot ward 2. prolonged standing + skip breakfast. But it was actually a case of left tubal cyst torsion. But the final trigger was a bit out of track
1. Why do you think contraceptive pill is not suitable for this patient?
-compliance?? ada kaitan dgn cyst ke??
2. What is the most suitable type of contraceptive pill for her?? (pulak dah)
Pastu end up with DVT, dahla healthy 23 years old..haisyy
As for the clinical, I started with long case which was presented to Dr Roszaman (I got him for my short case during third year, a case of breech), 42 years old G9P7+1, underlying Gestational Diabetes Mellitus under diet control, diagnosed at 12 weeks period of amenorrhea. Last child birth 1.5 years ago. Other problems: advanced maternal age, grandmultiparity, poor spacing, failed contraception (she took Noriday, but 1 missed pill led to this pregnancy). Patient in active phase of labour.
Discussion was on
1. Do you agree with the Dx GDM?
No. It was diagnosed at 12 weeks POA, it might be DM complicating pregnancy
2. Did you look into this matter?
Yes, but patient did not do any DM screening before pregnancy, and she had no symptoms to suggest DM prior to this pregnancy
Then the discussion was on scan such as:
Do you think this patient need a detailed scan? I said yes. Organogenesis is at 7-12 weeks, and she was Dx w GDM at 12 weeks, meaning her blood sugar was not controlled duirng organogenesis, predisposing to fetal anomalies. However her sugar level was not high, around 5.6-6 only. In view of her advanced maternal age, it is important to screen condition such as Down syndrome. When should it be done? Around 18 to 20 weeks POA.
Next, I was asked about symptoms of DM. Patient had bilateral feet tingling sensation, resolved. She also had polydypsia, polyuria, nocturia developed at 7 months POA, but I said that is debatable with symptom of pregnancy in 3rd trimester.
Dr: Where do you look for ifxn in this type of patient?
Me: at the back.. (blank... terfikir pasal carbuncle)
Dr: what????
Me: oh, below the breast, groin, axilla
Dr: what do you think of her sugar control?
Me: I think it is suboptimal, as pt claim there is usually 1 high reading at each BSP. she was also not started on insulin, BSP done fortnightly
Dr: Are you sure? Cuba tengok ni (sambil menunjukkan BSP record in her antenatal book). 2 red readings for each BSP, and sometimes 3!!!!
Me: Huh????
Dr: Do o think she needs insulin?
Me: yes, because there are many red readings..
Dr: tapi you tgk value ni.. do you still think she needs insulin? (Dr dah hint2 hehe)
Me: No, the value is not that high..
Dr: Ok
Do you think she needs induction
Me: Yyess... (mcm tak brp sure nape tnye soalan cmtu huuu). It's the practice to not allow a GDM under diet to exceed EDD
Dr: I know it's the practice..but do you personally think she needs it??
Me: (err patient dahla mcm sihat je huu). Yes. Because she has high risk to have intrauterine death
Banyak lagi discussion sebenarnya, tp yg paling terkantoi habesssss: on types of induction huuu. kantoi that I didn't read on PGE1, PGE2, PGEF..last2 Dr ajar balik haha. They are different in term of potency.. He asked me what are you afraid of, to induce her with PGE? Me: uterine rupture.
Dr: tell me other types of induction that you know (ni paling memang takleh jawab). i just answered mechanical such as S&S, PGE and oxytocin. tak ingt langsung pasal foley catheter (dahla terang2 tergantung label 'foley catheter' kat katil patient huu), laminara..
That ends my long case.
Then I was waiting for my shortcase, while listening to shuhaib telling me about his long case. I was just saying, taknakla shortcase gynae, leceh kena check macam2 huu when Dr Khaled walked into the ward, smiling (I always like Dr Khaled, he is so humble and smiles all the time :), and he doesn't shout- for sure huu)
"U guys dah habis exam ke?"
"Dah habis long case"
"So waiting for short case? camne td?"
"Emm ntahlah hehe. Bolehla kot nak pass..Tapi tak distinction la"
Suddenly the sister who assisted the exam approached us. "You dah siap? La kenapa tak tunggu kat luar?" I said yes, I went outside earlier but there was nobody, so i sat at the counter, chatted with the HO, asking her what cases do we have in the ward haha. Ada breech? ada twin? semua pun takde..
Then the sister told shuhaib to go out, and asked me to follow Dr Khalid (Me: Yippeeeeeee alhamdulillah :D), while the Dr searched for the appointed patient. First, it's Dr khalid, second, it's another obstetric case! I got obstetric cases for long and short cases in my 3rd year, and both obs cases for my 5th year :p
The patient was a young 17 year old married pakistani (i seriously think she's beautiful), on blood transfusion. Was asked to describe (I said the patient was on blood transfusion packed cell O negative). So I said O-ve is usually for emergency transfusion.. but the Dr said..in the ward?? I said no.. actually the patient's blood type was really O negative huu. Discussion was mainly on causes, investigations and management of anemia. Tapi blur je.. Dr banyak bg hint huu. yang paling best, he asked, "Look at the abdomen, do you think she's term?"
I answered "NO" then siap sambung lagi..."I think she's 25 to 26 weeks pregnant" Dr Khalid appeared very satisfied. yang sebenarnya, I looked at her abdominal size was just about my abdominal size haha and I'm 26 weeks pregnant :p aci tak??
I guess that's all for the exam :D
1. Why do you think contraceptive pill is not suitable for this patient?
-compliance?? ada kaitan dgn cyst ke??
2. What is the most suitable type of contraceptive pill for her?? (pulak dah)
Pastu end up with DVT, dahla healthy 23 years old..haisyy
As for the clinical, I started with long case which was presented to Dr Roszaman (I got him for my short case during third year, a case of breech), 42 years old G9P7+1, underlying Gestational Diabetes Mellitus under diet control, diagnosed at 12 weeks period of amenorrhea. Last child birth 1.5 years ago. Other problems: advanced maternal age, grandmultiparity, poor spacing, failed contraception (she took Noriday, but 1 missed pill led to this pregnancy). Patient in active phase of labour.
Discussion was on
1. Do you agree with the Dx GDM?
No. It was diagnosed at 12 weeks POA, it might be DM complicating pregnancy
2. Did you look into this matter?
Yes, but patient did not do any DM screening before pregnancy, and she had no symptoms to suggest DM prior to this pregnancy
Then the discussion was on scan such as:
Do you think this patient need a detailed scan? I said yes. Organogenesis is at 7-12 weeks, and she was Dx w GDM at 12 weeks, meaning her blood sugar was not controlled duirng organogenesis, predisposing to fetal anomalies. However her sugar level was not high, around 5.6-6 only. In view of her advanced maternal age, it is important to screen condition such as Down syndrome. When should it be done? Around 18 to 20 weeks POA.
Next, I was asked about symptoms of DM. Patient had bilateral feet tingling sensation, resolved. She also had polydypsia, polyuria, nocturia developed at 7 months POA, but I said that is debatable with symptom of pregnancy in 3rd trimester.
Dr: Where do you look for ifxn in this type of patient?
Me: at the back.. (blank... terfikir pasal carbuncle)
Dr: what????
Me: oh, below the breast, groin, axilla
Dr: what do you think of her sugar control?
Me: I think it is suboptimal, as pt claim there is usually 1 high reading at each BSP. she was also not started on insulin, BSP done fortnightly
Dr: Are you sure? Cuba tengok ni (sambil menunjukkan BSP record in her antenatal book). 2 red readings for each BSP, and sometimes 3!!!!
Me: Huh????
Dr: Do o think she needs insulin?
Me: yes, because there are many red readings..
Dr: tapi you tgk value ni.. do you still think she needs insulin? (Dr dah hint2 hehe)
Me: No, the value is not that high..
Dr: Ok
Do you think she needs induction
Me: Yyess... (mcm tak brp sure nape tnye soalan cmtu huuu). It's the practice to not allow a GDM under diet to exceed EDD
Dr: I know it's the practice..but do you personally think she needs it??
Me: (err patient dahla mcm sihat je huu). Yes. Because she has high risk to have intrauterine death
Banyak lagi discussion sebenarnya, tp yg paling terkantoi habesssss: on types of induction huuu. kantoi that I didn't read on PGE1, PGE2, PGEF..last2 Dr ajar balik haha. They are different in term of potency.. He asked me what are you afraid of, to induce her with PGE? Me: uterine rupture.
Dr: tell me other types of induction that you know (ni paling memang takleh jawab). i just answered mechanical such as S&S, PGE and oxytocin. tak ingt langsung pasal foley catheter (dahla terang2 tergantung label 'foley catheter' kat katil patient huu), laminara..
That ends my long case.
Then I was waiting for my shortcase, while listening to shuhaib telling me about his long case. I was just saying, taknakla shortcase gynae, leceh kena check macam2 huu when Dr Khaled walked into the ward, smiling (I always like Dr Khaled, he is so humble and smiles all the time :), and he doesn't shout- for sure huu)
"U guys dah habis exam ke?"
"Dah habis long case"
"So waiting for short case? camne td?"
"Emm ntahlah hehe. Bolehla kot nak pass..Tapi tak distinction la"
Suddenly the sister who assisted the exam approached us. "You dah siap? La kenapa tak tunggu kat luar?" I said yes, I went outside earlier but there was nobody, so i sat at the counter, chatted with the HO, asking her what cases do we have in the ward haha. Ada breech? ada twin? semua pun takde..
Then the sister told shuhaib to go out, and asked me to follow Dr Khalid (Me: Yippeeeeeee alhamdulillah :D), while the Dr searched for the appointed patient. First, it's Dr khalid, second, it's another obstetric case! I got obstetric cases for long and short cases in my 3rd year, and both obs cases for my 5th year :p
The patient was a young 17 year old married pakistani (i seriously think she's beautiful), on blood transfusion. Was asked to describe (I said the patient was on blood transfusion packed cell O negative). So I said O-ve is usually for emergency transfusion.. but the Dr said..in the ward?? I said no.. actually the patient's blood type was really O negative huu. Discussion was mainly on causes, investigations and management of anemia. Tapi blur je.. Dr banyak bg hint huu. yang paling best, he asked, "Look at the abdomen, do you think she's term?"
I answered "NO" then siap sambung lagi..."I think she's 25 to 26 weeks pregnant" Dr Khalid appeared very satisfied. yang sebenarnya, I looked at her abdominal size was just about my abdominal size haha and I'm 26 weeks pregnant :p aci tak??
I guess that's all for the exam :D
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