Sunday, February 28

Marah-Marah

Saya pelik kenapa orang selalu balik kerja dan marah2? Tutup pintu dengan dahsyatnya macam nak reban pintu. Belum lagi pinggan periuk gedebang gedebang. Such a monster. Saya cukup pantang nenek moyang kalau org menyalurkan marah dia kepada benda2 tak berdosa ni..mmg pantang. No offence, I’m not pointing to any specific individual tp my blog my suke hati lahhh.

Sakit telinga la dengar pom pang pom pang kt dapur. Kalau dh perempuan tu..buatla cara lembut perempuan..haih pelik btol dunia ni. Kenapa org suka marah2 dan menyalurkan marah die xbertempat. Mana hilangnye ketenangan di hati? Istighfar dan segala macam yang nabi kita ajar untuk mengawal marah?

Seperti dalam hadis Imam Al-Ghazali “ Orang yang paling KUAT adalah orang yang dapat mengawal marahnya “ Orang kita dah lupakah dengan hadis ni? Atau bila marah melanda semua benda kita lupa? Islam mengajar umatnya mengawal marah. Pakar sains pun bercakap tentang anger management. Kenapa penting? Sebab efek jangka panjang die besar. Utk diri seniri dan juga utk org lain di sekeliling. Ni muda-muda dah pemarah, susah kawal emosi.

Tahu x apa yang jadi dalam badan kita bila kita marah? Jantung bekerja lebih kuat, tekanan darah jadi tinggi. Kalau 10 tahun mcm ni, bila tua nanti mana tak sakit-sakit. Sebab dari muda hidup stress dan marah-marah. Hidup mmg stressful tapi kita yang kena control diri supaya tak marah2..jadi lebih tenang. Frankly, saya selama bekerja di hospital dah 4 bulan ni..tak penah lagi blk rumah dlm keadaan marah2 (penat ade lahh). Tak taula org lain..tp saya rsa happy jer (not happy all the time of course..tipu la kan). Tp takde pun rse nk marah2 even though saya terpaksa berdepan dgn pelbagai ragam manusia di hospital. Dari ragam pesakit, doctor, resident, supervisors, nurse2, pharmacist, admin, smpai la ragam kawan-kawan seniri.

Memang kadang2 rasa marah, selalunya saya rasa marah tu dekat resident, or makcik-makcik nurse yang dah tua dan cerewet, yang suka marah-marah jugak. But then, 15 minit kemudian, marah saya akan hilang. Saya akan pergi buat benda lain utk melupakan hal tadi. Simple isn’t it? Tp bukan semua orang bole buat. Ade orang yang tak boleh buat macam tu..dan org2 inilah yang akan membawa marah2 die sampai ke rumah..kt rumah sapa yang ada? Kalo dh bersuami ada suami lah..kalo dh ada anak, ada suami and anak-anak. Kalau masih belajar, ada housemates. Haaaa..org2 yang ada di rumah inilar yang akan menjadi mangsa keadaan.


So here are some tips utk mengawal marah anda. Kawal marah anda sebelum amarah yang mengawal anda.
Bila perasaan marah timbul kita boleh :

a) gantinya dengan aktiviti lain seperti memandang pada benda dan bukan orang, memikir tentang apa yang kita lakukan pada hari ini atau menerangkan suasana bilik kepada diri sendiri atau membilang sampai 10.
b) Mengelakkan melalui atau meninggalkan tempat itu atau minta diri untuk berfikir
c) Menukarkan ritma otak seperti mendengar muzik atau lakukan senaman
d) Guna teknik relaks seperti menarik dan menahan nafas selama 5 saat
e) Kecut dan regangkan otot selama 5 saat
f) Urut bahagian dada dan perut
g) Ubah cara duduk dan regangkan bahu
h) Berimaginasi tentang pemandangan yang tenang atau yang neutral atau ketawa pada diri sendiri kerana situasi itu

Mengikut pakar psikologi marah adalah emosi sekunder. Di belakang emosi marah ini terdapat emosi primer seperti keresahan, duka, hampa, kehilangan, takut dan sebagainya yang terbit kerana sesuatu keperluan tidak diselesai atau dicapai. Sebenarnya kemarahan ini menjejaskan peluang kita untuk mencapai sesuatu keperluan itu. Bila kita dapat mengenalpasti keperluan-keperluan ini kita dapat berusaha untuk mencapainya dan dengan itu kemarahan dapat dikawal atau diurus dengan sihat. Emosi marah adalah satu fenomena rasional yang berlaku di otak kiri kita. Untuk mengurusnya kita perlu menggunakan kedua-dua bahagian otak, khasnya otak kanan dan bahagian lain otak berkenaan dengan emosi untuk mengecam dan sedar bila perasaan marah muncul. Dengan demikian kita dapat menangani kemarahan dengan cepat dan mengekalkan ketenangan kita.

(Sumber : ILuvislam.com)

Kesimpulannye..kalau balik dari kerja tu..janganlah marah-marah!

Thursday, February 25

NEW BABY BORN


I was the Co-assistant in charge of today’s second Caesarean Section (CS) in the Emergency Operation Theatre. The CS was operated by Dr Gug and his junior doctor, Dr Las (FYI, dlm department Obs & Gynae ni mmg sume doc ade initials die..dgn 3 huruf such as Las, Gug , Tit etc..smp kadang2 membuatkan saya tidak ingat nama sebenar mereka!! Nk kne igt nama patients lg, seniors lg..haih penat la igt nama org byk2! Tu belum masuk nama supervisors saya lg*).

What is Caesarean Section? It refers to an operation that is performed to deliver a baby via the transabdominal route. CS is one of the earliest known operations performed. It has been reputed to have gotten its name because Julius Caesar was born by such an operation. How interesting kan!! (nevertheless, ade banyak theory lain tentang asal muasal pembedahan ini tapi saya malas nk ceritakan semuanya kat cni laaa…)


There are basically two kinds of CS. The first and by far the most common is the lower segment CS (LSCS). This involves a transverse incision over the lower segment of the uterus. This LSCS type is more popular because of its better wound healing process than the another type of CS that is the Classical CS (upper segment incision).

Indications for CS :
• Obstructed labour
• Fetal distress
• Maternal medical conditions eg preeclampsia
• Obstetric complications eg placenta previa
• Previous Caesarean Section


[MAK was operated to deliver her two naughty babies Afdzal and Dhuha via the LSCS technique. Cian mak..2 kali kne operate perut..huhu. From mak and bapak’s story, Afdzal was ‘drowned’ (lemas) during delivery process and was rushed for emergency CS or in medical term my little brother was having ‘fetal distress’. Whilst little Dhuha was in transverse lie (melintang) even after the doctors did several external versions but still failed. *Haih dua baby nakalsss!! Kecik2 lg dh nakal! Kakak and abang senang jer keluar, senang keja mak ;p*]

Now back to my patient’s story. Ny Tuminah was married for 11 months and now expecting her first child. She was admitted to the hospital due to high blood pressure, last measurement taken was 170/100 mmHg. So the doctors decided to terminate her pregnancy with CS in conjunction to the evidence of pre eclampsia.

I entered the operating room and got myself ready on scrubs while the anesthetic team doctors started their sedative jobs. Then the nurse inside helped me with the hand gloves, plastic shield and masks. Once the anesthesia has taken effect, an abdominal cut was made by Dr Gug, and an opening is made in the uterus. The amniotic sac is then opened (the amniotic fluid aka air ketuban flushed out like a giant leaking pipe!! and the wise me already prepared myself, taking 1 step back from the mother so that the liquor wont ‘wash out’ my face for free!!! Skrg saya dah pandai budget time utk mengelak darah and air ketuban yang memercik sebab dah ade pengalaman terkena sekali ;p),


A baby boy was parturitated, the baby was blue, did not cried (and did no attempt gasping some air into his lungs of course!!). Maybe because too much time was taken to take him out from the womb (I think it was 5-6 minutes till we managed to pull him out). The baby was then passed to the midwife as she ran out from the operating room to quickly resuscitate the quiet baby. Huh, we were having the adrenaline rush running throughout our blood vessels hence the baby was not crying!! But 3 minutes later, we heard the most awaited baby cry. And everyone was sooo relieved! Praise be to Allah, we continued the delivery of placenta (uri) and finally, suturing the mother’s womb layer by layer. I got to learn the REAL woman reproductive system anatomy during the suturing process. And Dr Gug sangatla xlokek ilmu dan banyak mengajar.


I enjoyed assisting today’s operation, although not much that I helped (I only helped Dr Gug with the suction machine that sucks out the blood coming out so that Dr Gug will have a clearer vision to repair the incision part) Ok lupe, I also helped Dr Gug pull out the baby. The baby was quite big and sangat susah nak tarik die keluar. Berpeluh2 doc saye buat keje..hehe. Kesian tgk. But it’s worth the job, worth the 3 hours long standing! And most importantly, I became part of the medical crew who helped a new baby borned, adding another human population into this whole new world! ^^

Friday, February 19

The Bubur Sumsum Story

Today I finally got the chance to eat bubur sumsum i kept in the fridge since yesterday.(or should I say I finally got the ‘time’? hmm..busy sgt ke..yes I was. Busy mengqado tidur saye yang sudah 32 jam tidak tidur sejak pagi Rabu, sampai saye tertidur di atas meja doctor di Poliklinik ok! Sorrrryy doc, mata berat sgt smp xperasan bile rebah ;p).

Bubur sumsum is an all-time-favourite food appetizer in Indonesia. It is made of rice flour, coconut milk, jagerry sugar and pandan leaves for the rich aroma. I wonder why is it called bubur sumsum?? Maybe because this porridge is white in colour and it's texture is so much like sumsum tulang (a MITOS amongst our people). Bone marrow is supposed to be yellowish in colour and spongy in consistency. Huh, pandai2 jek org yang reka nama ni!!

I was first introduced to this goodies from Ima, my batchmate, since bapak is such a typical Penangite, he wouldnt love this kind of delicacies. He would rather prefer PASEMBOR! ;p Ima is a friend of mine whose family came from Minangkabau but now they are officially Malaysian citizen. She loves to make bubur sumsum during her free times. Mase zaman kuliah dulu kan petang2 xde keje..so buatla bubur. Easy and quick. Haha. Then I tried the recipe and since then I became a bubur sumsum’s fan. It’s very easy to prepare and I love bubur sumsum best when served cold.

Nilar bubur sumsum yang cek beli dari Foodcourt Centre RSSA lepas keja kemarin. Dah kempunan sgt, xlrt nk masak..soooo cek beli jalar nooo..senang! teros masuk mulut! save gas kt dapur!! And yummyyy!!;p


The Recipe :
•Untuk bubur: tepung beras secukupnya
•Santan secukupnya
•Garam so that ade rase masin2 sket
•Untuk sirap gula: 1-2 cawan gula melaka
•Air secukupnya
•1 helai daun pandan

1.Untuk bubur: Letak semua bahan dalam saucepan, better kalau ada non-stick one. Kacau dulu biar tepung tercampur merata dengan santan. Bila dah rata and xberketul-ketul baru masak dengan api sederhana kecil, kacau adunan tu sampai masak – sampai die kental-kental gitu. Kalo xsilap saya dalam xsampai 10 minit…Kemudian letak dlm bekas. Lepas letak tu, rata2kn sket atsnye tu supaya nmpk cantik sket.

2.Untuk sirap gula: Senang jer, cmpur gula merah dgn sedikit air, smpai mendidih and jgn lupe letak daun pandan utk aroma. Kacau sampai betul2 gula dah cair. Sirap gula tu kene just nice likatnye. Jgn thick sgt nti xsedap.

3.Then, utk serving, scoop bubur td dgn sudu, then tuang sirap gula merah tu atas die. Lagi sedap kalo masuk dlm fridge then makan time cejuk2!! Easy isn’t it? ^^

Ps : sorry saye xde btol2 nye sukatan on how much pakai tepung, how much pakai santan sume sbb saye masak pakai naluri jerr…kehkeh.

Thursday, February 18

JOB DESCRIPTION

It's 0145 am WIB (Waktu Indonesia Barat) in the morning and my eyes are still wide open. I just finished editing my morning report presentation for tomorrow but havent started a SINGLE revision YET about the topic i'm going to present tomorrow (esok mesti kene hentam habis2an dgn Dr Siti Chandra Sp OG nie!mati!).

This is what i'll be facing on every oncall. Doing my work as a practical student from 1500 pm up till 0600 am the next morning. In between that, stealing some golden time preparing for tomorrow's morning report (the so-called golden time is usually around 1200-0300 am in the morning when other people are sleeping soundly on their cozy beds!). And i'll be facing the same routine of work for the rest of my life - that is when my black hair will turn white faster than the normal biological clock should be OR when some small small wrinkles started to fill in my complexion. Ohhh xmahu fikir!!

My job description in Kaber (kamar bersalin) as a practical student are as stated below :
1. Datang on time
2. Tiap kali patient baru msuk, amik darah, fill in borang permintaan lab and ukur tanda-tanda vital (heart rate, respiratory rate, bp)
3. Siapkan partus set bile si ibu dah pembukaan lengkap (complete dilatation)- dat is 10 cm
4. Pada ibu-ibu yang Pre eclampsia or impending eclampsia, kasi injection IM Magnesium Sulfat di buttocks kanan and kiri bergantian sampai bp stabilized (it really hurts ok, bygkn injection 12.5 ml ubat in one time! masuk 5 ml pn dh terasa sakit apa lagi 12.5 ml!!)so ibu akan menjerit2 and my another job is to calm her down, kdg2 dgn sedikit tipu helah spy die tenang ^^
5. Bile saye dh naik pangkat jadi senior nanti, saye boleh menolong persalinan normal, keluarkan placenta and jahit episiotomy. Insyaallah..semoga skill akan lebih baik! Go Kim!!
6. Not to forget 2 minggu outstation to Rumah Sakit Daerah Wlingi


Gotta go. Sebab belum solat isyak. and belum belajar. Assalamualaikum and good morning!!

Tuesday, February 16

POLIKLINIK KB (Keluarga Berencana), NIFAS & FERTILITAS

Today was exciting because I've been given the chance by Dr Tit to perform the Vaginal Touche a.k.a VE (Vaginal Examination). It'a a routine gynaecologic procedure in Poli KB. Doctors have to ensure that if the patient is using IUD (Intra Uterine Device), the device is inserted in the right place and the filament can be observed in the portio.

Ps : An IUD is a device inserted in the uterus (womb aka rahim) to inhibit fertilization of the egg by the sperm. It has a small string that hangs down from the IUD into the upper part of the vagina. This string is not visible during intercourse! So ladies jangan takot k, as this is one effective, simple and cheap method for family planning. A single IUD costs only Rp 28,000 and can stay in your womb up to 10 years!


First, I visually inspect the vulva, vagina and cervix (Ok, this is how a multipara woman's vagina would look like)
Then I carefully insert my middle and index finger (with so much doubt, i dunno if i'm doing it correctly or not!! and i looked at the patient's face expression as she was feeling uncomfortable and in slight pain. Gosshhh!) but then i continued and my dancing fingers started to explore any lump or fluctuative tumors within the pelvic cavity. (nak jadi doc xboleh takut-takut..buat je ok!)

Then i place my left hand on the woman's abdomen and feel for the uterus. I did not feel any 'hardness' or 'mass' so i concluded that the woman's uterus position is retroflex. Then, Dr Tit feel again for the ptn's uterus and she said, yes it is retroflex. Yeay!! at least i'm right about the retroflex position of her uterus! (pandai jugak aku merasa dgn jari2 ni. hehe)



Ok, for a normal examination, these are the steps that u should carefully examine:

•External genitalia are of normal appearance. There is no enlargement of the Bartholin or Skene glands.
•Urethra and bladder are non-tender.
•Vagina is clean, without lesions or discharge
•Cervix is smooth, without lesions. Motion of the cervix causes no pain.
•Uterus is normal size, shape, and contour. It is non-tender
•The adnexa (tubes and ovaries) are neither tender nor enlarged


Here are some conversation i had with my patients, some of them are VERY funny that i laughed my heart out. hehe.

Dr Kim : Ibu, ada keluhan apa-apa ngak buk sepanjang memakai spiral (IUD) ini?
Ibu A : Gak ada apa-apa buK dokter..baik2 saja. Cuman..waktu awal2 make (memakai) spiral ini agak2 sakit gitu.
Dr Kim : Sakit? ibu merasa sakit dimana?
Ibu A : Owh bukan saya yang sakit dokter, suami saya yang mengeluh sakit!!
Dr Kim : Tersenyum simpul ^^

(OK this is verrrry funny! Now i get the picture. During penetration, the hubby felt a little painful because of the filament (part of the IUD device that looks like benang yang panjang) left outside the portio of vagina. So, what doctors will do is to cut them shorter during the next follow up and the couples will be happy again *especially the hubby* ;p)

I did the procedure, i leart few things and interesting facts. So today Dr Kim is *happy* (senyum)

SEXY PREGGY

I think pregnant women are sexy. Yeah, nice intro for my new posting at Obs and Gynae Department of Rumah Sakit Saiful Anwar ;p. There's tremendous miracle in pregnancy, though i havent YET experience them myself, but i can see them through others' experiences.

My mother was pregnant again after she brought me into this planet Earth, so it was 3 times that i happen to share the increadible journey of pregnancies with her. I remembered how she cried 2-3 days (i can hardly recall) before Aidilfitri due to miscarriage, fifteen years back. And how she spent her entire pregnancy (there comes my little brother Afdzal) praying to keep the tiny creature safe and sound inside her womb for another 9 months ahead. I can still remember the doa she used to recite during her pregnancies, i'll practice them during mine of course ^^

NOW i can experience them again and again through my patients. The very first time i watch labour process was last year during my clerkship. Whoa, it's already been a year! It was such an experience that i nearly burst into tears imagining how my mother suffered such a painful experience 4 times throughout her reproductive years. Then i grabbed my phone, texted her-thanking her for being such a great mother and how much i appreciated and love her ;)
Okey that's it for now, i'll post other entries regarding what i learn at the hospital next time!

Ps : Mak, thank you. Tempat nurul bukan di sini kalau bukan sebab mak.