Saturday, July 18, 2009

Life after being an undergraduate

Here I am sitting in my room not knowing what to do. Reflecting to series of episodes of ups and downs in life, it is indeed a great journey. This is my 4th week in my lovely country, Brunei Darussalam. Although I haven't been up to much, but it's certainly a time well spent with family and friends.

Right after the graduation ball, I was so busy packing my stuff before heading back to Brunei. I underestimated how much junk I had collected over the years. But I managed in the end.

Tons of shoes that gave me headaches!

Arrived in Brunei about 4 weeks ago. I was welcomed with a shocking environment of swine flu. It would have been better if an announcement was made onboard before everyone disembarked the plane to avoid any unnecessary anxiety. I was no exception amongst other anxious passengers. For one, we had been on a very long and tiring journey, and suddenly a group of people in spacesuits welcomed us at the end of the tunnel (aerobridge). I knew there's a big outbreak of swine flu in Brunei, but they could have told that a standard procedure of screening is taking place. I thought someone had been infected that was onboard and the reason why such strict screening took place. Luckily, there was none, and it was only a random check. We had to wait until everyone disembarked, whilst waiting at a designated area before being cleared to go.

Scary ducks?
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Came the 2nd week of my stay here in Brunei, the day finally came. My results! Due to the time difference and typical postal service, I had to call the university for my results at midnight, although I could check my results online and not my degree classification. I only got the results pack yesterday, and that's like 2 weeks after the results have been published. Anyway, it was a good news and now looking forward to my graduation. Got my graduation kit ready... and just looking forward to the day!! The wait was definitely nerve wrecking. My coursemates and I gathered online over a chat platform expressing our anxiety. Everyone agreed that the exam was very difficult and that the results would be shocking. Unlike our previous exam results, the anxiety weren't as bad as this one. Simply because, the previous exams were alright. In the end, alhamdulillah it's all good although no one got a 1st! Funny how everyone expected me to get a 1st! ahahhaha

With the results and all done, I celebrated the moment by treating myself with friends in Sngapore. And I bought myself a new pair of Tag watch, which was a last minute decision at the airport! ahahha Oh well.. ehehe Again, the highlight would certainly be the time spent together with my friends in Singapore, Cathy and Pinqy. Whilst there, we spent time on the hunt for great foods which included the so claimed best Nasi lemak in Singapore which was told that was eaten by His Majesty, went on the Singapore Flyer (the biggest ferries wheel in the world), and a night out at the Clinic Bar.

Up on the Singapore Flyer
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Me eating the Nasi Lemak at Adam Road... ehheh (overrated indeed!!)

First night food hunt, the famous Singapore Chilli crab at Clarke Quay and a dessert at Coffee Club at past midnight! ahahha. Well spent 3 digits $$! ahha

At the Clinic Bar

Day view at Clarke Quay

View from outside the hotel room.. stunning view of Clarke Quay eh! Night vs Day

Now, I look forward to graduate and enjoy the graduation. Can't believe I have been in tertiary education for 7 years including my nursing years! Having said that, I still have tons of paperworks to complete to legalise me to practise and my professional membership.

To commemorate and as a token of my achievement, I treated myself to a new Tag watch hehehe. It's a Tag Heuer Carrera Automatic and was a last minute decision at the airport and finally bought it with satisfaction.

Taken from the website...

Monday, June 15, 2009

If only a day equals to 40 hours! - The end of the beginning

Exams off, now what's next?

Right after the exams, I wanted to take a day off. However, considering time was very short, I had to juggle many things at the same time. I am still sleep deprived. I hope I'll be able to catch those sleep at home.

Right the next day after the exams, I had to return all the library books that I had been hugging on to for the past 2-3 years! ahhaha Paid a visit to the nurse who was very helpful throughout my stay here in the UK arranging my health needs. She was surprised.. ehehe

I was also contemplating whether to pack and ship my stuff back home, or wait until I get my final results. Finally I decided to ship them back. Luckily I fouund a company who could handle the shipment within 24 hour notice. So far, the service have been brilliant and smooth going. Hope things will run smoothly till the things arrive in my hands, Insya Allah.

Then, the graduation ball on the 12th June 2009. It was smashing!! It was great, and everyone looked stunning!!!! We had a surprise show of drag queen performing. It was hilarious and very entertaining. S/he sang brilliantly and very spontaneous when engaging with the audience.

I'll leave you with some pictures here...

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A cake with our group picture on it.

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Then got invited to the Malaysian family for a mini get together, and today was a busy busy day. The landlord was here to carry out a house inspection making sure we get the deposit back. Then had a final monopoly game with Emily and Shahin. Now, it feels weird that the room is empty! Although, in the wardrobe are hidden clutters of things that I collected over the years!

I shall now look forward to the future, and hope all the best to come!! Amin.

Tuesday, June 09, 2009

Same but different?

The picture on the right was taken about a year ago. HAHAHAHA

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Tunic - Grey to Graffitti?

Any Winehouse says Back to Black, but I say Grey to Graffitti! ahah The final state of my tunic!
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Us, altogether pose with our happy faces in tunic! The very last time ever gonna wear them!
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Exams exams!!! Podiatry Final Exams.

Right, as promised, this is the entry dedicated towards my experience sitting for the final exams as a podiatry student. To start, let me run through what's the final year was all about. (glad I could use the word "was" at this stage. Strange but YAY!!

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Right, this final year was all about application and clinical reasoning. It was more about, why would I do vascular assessment, why was it presented in such manner, why was it different from the book standard kind of presentation, what was the exception for this case? And the list just kept on adding. One of the reasons is that there is no similar patient. They're always different in many ways. They might be having same condition, but not necessarily same history and cases. Hence, differences in effects and management plans. That is why in clinical exams, one can never come prepared, simply because you don't know what's ahead of you. Clinical cases are simply like treasure hunting. It's about making learned decisions, based on clues and what you could gather from the patient. It's a skill that you learnt, as well as that factor that you were born with (hopefully).

Alright now, in this final year, it was all (70-80%) on pharmacology and the rest was about patient-centered management. I can assure you, there was only little input or tests your podiatric knowledge. No doubt, the podiatry side of it all has been tested over the past 2 years of podiatric training. This final year was specifically about medicine, pharmacology and patient's psychosocial. We had 2 main modules, the clinical module and the applied medicine module. To the lay readers out there, Medicine in this context is all about health conditions like asthma, diabetes, so on and so forth rather than panadol for instance. In the medical lingo, those "medicine" we refer to in day to day language would be referred as "drugs".

The clinical module consisted of a 10-15 thousand words portfolio, and clinical exams. The Applied medicine was divided into 2 written exams (1 mcq and 1 case based exams). Let me run through this as how I had sat it for.

The first was the case based exam. It was a 3 hour written exam based on 2 case studies. The cases that we thought of ranged from Cardiovascular, Neurology, Nephrology, Endocrinology (esp Diabetes), Musculoskeletal, Rheumatology and even Dermatology. We had to prepare and study how these conditions take its action in the body up to the cellular level, and how pharmacological approach could change them to reduce the symptoms. Then, we had to relate that to podiatry. It could either be as a result of the condition, or as a result of the medications. The 2 big main concentrations were Rheumatology and Diabetes with incorporation of Cardiovascular as they're quite closely related as risk factors.

The 3 hour exam felt like 20mins! It was all about Diabetes, Cardiovascular and Rheumatology. We had to prepare things like anti-TNF alpha stuffs etc, DMARDs and all. And frankly, we won't be dealing as much on these as a qualified podiatrists. Although, there are cases we need to raise the flag for changes. However, not unless you're a pod-consultant, yes this is crucial! Having said that, it was truly a brain draining exam!!!!!! I almost broke down into tears when I saw the questions! Never in my life I felt such for an exam. The 3 hours went by in a snap! Time ended just as I was running half way through the last question. The questions were basically based on a scenario which consisted of lab results, patient social, medical and drug history. Then we make our clinical judgements whether their treatment and medication regime are appropriate, and to justify they're yes or not.

The next day I had to battle with the portfolio having me less time to prepare for my next exam. The portfolio consisted of a case study with reflection of own clinical skills and reasoning. Ideally, it should be aimed at 10-15 thousan words, including supporting evidence of learning and future planning. I had to sacrifice my life, sleep etc for this. Towards the end, I gave up and had to dive into my books in preparation to the other exam.

The MCQ consisted of 150 questions (30 sections, 5 questions each). Similar to the case based exam, this exam tested us on medications, mainly on what they're for, side effects, and the cellular actions. The tricky bit, they tweaked the jargons!!! For instance, say in a statement like X causes hyperglycaemia. In the exam, the tweaked it and put it as "X antagonists the effects of hypoglycaemic drugs". In a wee time, one could simply overlook the word antagonist, and worse if you haven't got a clue what antagonists mean!!! And 2 hours was allocated for this. The horrible thing, it was also negatively marked. Meaning, 1 mistake, 1 mark deducted, and 2 marks for each correct answer! How horrible is that!?!?!?!?!?

These 2 exams simply made me feel like shit!! None of us felt alright, everyone just felt like shit! They were the most horrible exams I had ever sat! No more again!!!!

Then after the exam, I went straight home and started typing my portfolio. From 2pm that day, I continued working on my laptop until 6am the next day without even a short nap! Some of you might say, why last minute? In this case, it's not enitely a last minute thing. Simply because, it's based on a case I handled in clinic, which I had to follow through. So I had to finalise it once I finished managing the patient, which meant up until the last day. Also with the time constraints, I also had to finish my research project which taken a lot of my time. I may be a last minute person, but not up until to that very nick of time! However, I wasn't alone. My sleepless moments were shared by more than half of my group. All of us gathered on skype and kept each other company. The rest finished later than I did. I headed into bed at 7am, and woke up at 11 to submit it!!!!! *phew* That was more than 24 hours straight with no sleep!!!!!

Then, came the clinical exam. The clinical exam (OSCE) was divided into 4 stations. Each station was allocated 20mins. The 2 stations were manned, which simply means with patients, and 2 unmanned, which is no patient. The 2 stations in the morning were also on pharmacology. The first one was gathering the patient's drug history, and trying to establish their health conditions, their beliefs on their medications and how they cope with it. Then to talk through to the patient about the drug side effects with using medical jargon. Then the second one was the same but we had to do a vascular assessment and talk to the patient regarding cardiovascular risk. My patient had 22 drugs in his list. The moment I saw that, I was like *EYES WIDE OPENED AS BIG AS THE TRAFFIC LIGHTS*! Blimey!!!!

Then the 2 unmanned stations were not getting any better. We had to do essays as opposed to the promised short answer! We had 2 pictures on musculoskeletal and dermatology. The dermatology was on neuropathic ulcer (well I thought it was based on the scenario, history and assessment findings), then the MSK was on posterior tibial tendon stress. In 20 mins, reading the scenario, looking at the picture, making clinical judgement and writing things down isn't something funny! It was horrible!!!!! We simply couldn't diagnose a patient in 20mins without thoroughly looking at the clearer picture, let alone this! Making things worse, each question carries 50 marks, in total 200 marks!!!!!! *sigh* But to say the least, there wasn't any radiology of X-ray images or the worst, MRI scans. I'll probably be sulking if I had them on the table!! I'm sucks when it comes to radiology interpretation. Bless we would have x-ray reports! ahaha

However, I couldn't feel any better than today! Not only it was the last, I enjoyed the entire experience of today's exam! I had a great time. Perhaps, clinic is where I best belong. I felt confident, calm and I offered the best of me. I didn't get questioned as I had justified myself all the way through. The moment I saw the word "excellent" on the criteria sheet when I peeked through as I was presenting the case, I simply felt so chuffed and thankful. I didn't even bother peeping for more. The patient also made a great effort to pull me through to get the excellent grades. Thanks to him!! But I am thankful. It was far much better even than an ordinary clinic.

Now, that's a journey I must say. It's all over. I got my suit and all, and ready to rumble for the ball night!!!! ehehhe Now that I have all the time in this world, I simply don't know what to do!!!!! HAHAHA

I must also say my sincere thanks to my great family of friends here who have been my backbone of support. They been my great companion throughout the sleepless wee hours and pushing me all the way through. Megan who has been the best for the last 3 years, reminding each other, and also Shahin, who has been waking me up making sure I make it for the exams on time and keeping me company studying. Now that it is his turn for the exams, I'll be doing what he'd been doing for the last 2 weeks.

Looking now that he's taking a nap before resuming revision, it was all a something to smile on reflecting what I was the last 2 weeks. HEHEHE.

Saturday, June 06, 2009

Milan's recital - St. Andrew's Cathedral.

Been extremely busy with exams and all. Exams have been extremely difficult. It has been an overwhleming experience. It was the most hardest exam I have ever experienced. For that purpose, I will dedicate an extry on that once I get over with it.

So today, I have been busy revising for my clinical exams. After dinner, went to St. Andrew's for my friend Milan's recital. He was the countertenor of the event. Very talented chap! I didn't expect him to have such a powerful tenor voice until he projected it to all of us. I'll leave you to some pictures.

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After the recital, went to the Arlington Arms pub nearby with the whole group for a quick farewell drink as it was the Swedish exchange students' final night. Now I'm back to my crate of brainy moments. Till then!!

Thursday, May 14, 2009

Horrible thing to say! Arrgh!

Alright, to my fellow colleagues out there, read investigation results to yourself and analyse them before blurting it out to a patient! Arrgh!

Well, it was last Monday. I was in surgery, and few minutes late as I got my rota time wrong! I was still in the common room chatting to my mates until I said to them I'm in surgery. They were like... aren't you supposed to be up there and ready by 1.15? Sh*te! So took off, went in to theatre and got change quickly. We were the lucky ones to be in surgery that day as it was probably not to be seen again ever in our Podiatric career! It was a 57 year old man presented with nail protruding from the 1st toe sideways. If you imagine someone with extra toe or finger, that kind of thing but instead of finger or toe, it's nail. Plus, it was not there in the first place. It started with an infected abscess, and we thought it probably gave access to the nail matrix for nail to grow.

Oh before that, whilst I was rushing through preparing myself for theatre, I was greeted by someone I had never seen before. A tall wide bodied gentleman. I was sheepish-ly smiling and made my way to the sink to do my social hand-washing. Whilst I was scrubbing, Matt was next to me.. as I asked him.. "Matt, is he the senior surgeon or something?" Matt replied "no no... he's the technician, he's replacing Lesley whilst she's in France". I said to Matt "Matt, you ruined it! I thought he's a surgeon and I was scared of him... and now you simply ruined that show!" hhahahah. And that reminds me of how I thought my Anatomy lectruer was the janitor on the first day! ahahha

Surgery went fine. But what fascinated all of use was, the HUGE chunk of nail that was in there!!!!! We called it the triplets delivery! We were just shocked! If only I could put up the pictures to show, but that would breach my duty of confidentiality!

In theatre, the phone kept on ringing. There were shortage of people in clinic to see patients. There were a few patients that had been waiting for at least 20 mins. After surgery, finished my notes and wrapped up, rushed down into clinic straight in my scrubs! Didn't bother to get changed. Plus I was in jeans if I hadn't worn the scrubs.

Got the 1st patient's notes, without even looking and pre-read, I called the patient. Patient sat down and had a quick chat why she was there to see me. Established the history, she enquired for her previous X-ray results.

Found it, and read the report. Within the first few lines, it stated that there was no signs of fracture.. bla bla... in response to the requested examination. However, as I read further, things just didn't go right. Worrying words to be heard by a 30 ish year old lady was really unpleasantly unexpected. First arthritis, which I justified, it said NO arthritis. Until the word "TUMOUR" came up!! I immediately went "WTH! and with a big bang in my head!". I had to reassure the patient that things were still under investigation and that the tumour was benign. Plus, I had to re-emphasise over and over again that medically we refer bumps and lumps as tumour. Had to call a senior lectruer to take over! Blimey!!! Never again that silly mistake!

Work work work - life is so much occupied!

It's almost the end of my undergrad year now!! Barely a month before it ends. Every session at uni or hospital, it's all about exams and research project. We have this massive final year exams, and worse has to be the clinical exam! That's the time when they decide whether or not it's safe to let us out there in public to "DO NO HARM".

At the moment, with my books everywhere as I type this entry, busy finishing my research project write up. This is the unique bit of my university. We do not write dissertation as such, but we write a research project to be published in the journal of our choice. As this is the case and due to copyright reasons, I won't be exposing much of my research project. Anyhow, it's about how reliable and accurate can a clinician interpret a particular assessment such as interpreting the Doppler sounds. Like in general medicine, doctors are very much particular when they auscultate the chest for heart beats with their stethoscope. Similarly, we use the Doppler to determine blood flow to the lower extremities to determine whether or not a patient has got a peripheral vascular disease. An such, our assessment warrants right diagnosis and decision making. Failure to make that call will jeopardise the patient's life. They could lose their limb with few hours or even die! I feel like being clever again, looking at my data collection and working out the statistical analysis!! ahah

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Apart of that, I'm happy that I managed to get my surgical quota fulfilled although I need to work a bit for the local anaesthetics administration. Insya Allah, should be fine. Hence, during the last two weeks, my room was in such a bad state that it had never been. Surely my room has seen better days I reckon. But I've cleared them immediately after I took the pix anyway. Otherwise, I wouldn't be able to do work. That's just me. Clutter dysfunctions my brains!

Look at that!
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Anyway, I shall look forward to the ball soon! woot woot!! Oh went to Milla's birthday at the Loft, gosh I really love and miss that place a lot! Just chilling out and sipping my Bora Bora through the night... harhar

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May Bank Holiday II - Brighton

Since the weather was nice on that Saturday, thought it would be fab to spend time in Brighton. Plus I never had the chance to spend time with Shumba in Brighton before, although the last time we went was just for lunch get together.

Unfortunately, the weather went horrible and cold! Then, the bus wasn't helpful either as we took the via Beachy Head route which took ages to arrive Brighton! Traffic was madness too! When we arrived Brighton, shops were almost ready to close. Shumba also had to shop for her Ball dress. Went shopping instead and spent the rest of the day at Wendy's.

Great day nevertheless! ehhe

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May Bank Holiday - French Eastbourne Market

Apologies for the long lag of entries. I have been very much occupied with tons of work on my shoulder at the moment. Will talk about that later, shall we?

Alright, it was May Bank holiday. So basically a long weekend for me, from Friday till Monday. Spent time in library on the Friday and Saturday, so didn't get the chance to use it towards leisure. On Sunday, asked Shumba if she wanted to come down to Eastbourne and spend the day at the Eastbourne French Market. Apparently, it's a yearly thing which I had missed for the past few years. Shumba agreed, and we went to spend some time there before having lunch.

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The weather was excellent too. Had fish and chips at Harry Ramsdens bumped onto Megan, Jon and Tristan. We joined them later and finally they managed to drag me to join them on this horrible bouncy ride! I just had a full lunch, and yet being bounced up and down this spinning machine. Luckily I held my tummy quite well!

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Some of the interesting stuffs for sale and antique car show too.
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Couldn't resist the temptation no matter how expensive they were, bought tons of these and few yummy macaroons!
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