Assalamualaikum & slamat ptg.. setelah beberapa hari x tenang menanti long case surgery, Alhamdulillah pg td berakhirlah semuanya... penat tau tggu exam. Mlm td punyela pulun stadi smpai pukul 2pg tuuu.. hehe.. sebelum tu, ade stadi grup dr kul 8-11pm, balik bilik smbg lg.. (sambil2 tu, ade jgk jeling FB, hehe)...
Siriyes takut gila. Rasa x bersedia. Pg td ingt nk revise sket2 b4 kna panggil buat long case tu, tp belek2 buku pn sepatah haram pn x masuk.. duk jelah rilek2 kt bilik tutorial tu smbil dgr2 org len bincang, sambil tunggu Mr Krishna panggil turn aku. Kitorg kna tggu kt bilik tutorial, n Mr Krishna akn dtg panggil sorang2 n allocate patient mana yg candidate kna pergi.. Aku candidate ke 3 utk station 1, kire oklah tu kan.. Stiap kali pintu bilik tutorial terbuka, musti berdebar2!! huhu.. mestilah berdebar sbb xtaw kna exam dgn Dr mane.. risau taw x sbb masih terbayang2 mimpi ngeri kna shortcase paediatrik dgn Prof Cheah masa 4th year dulu.. ye, mmg nightmare.. malu nk ingat balik >.<
Then, pintu bilik dikuak, muncullah Mr Krishna dgn machonya sambil berkata, A113877.. aku ckp, "me!". " go to patient bed 2".. "ok doctor".. heeeeeeee.. tgn terus sejuk hahaha..
Lantas aku menuju ke Bed 2 tu.. Baik makcik tu.. aku terus terang je ckp aku ngah exam ngn dia.. Dia banyak bantu. Dia cerita semua lengkap dr A-Z.. thank God.. Masa examination pn dia sgt baik, ckp sume, suh aku rasa lump kt mana n ckp findings. Btw, makcik tu umur 47y/o, breast carcinoma. Aku lupa nk buat lung dan abdomen examination, padahal dlm history tanya je metastasize symptoms. huhu.
Nasib baik smpat buat tau sbb lpas tu patient kna tolak g OT.. so masa discussion ng prof, patient dh xde kt bed. hehe. Fuhhh.. lega la sbb xyah perform dpan prof.. haha,.. Aku dpt ngn Prof Zul ngn sorg lg doktor, sorry that ak xkenal la.. lelaki muda. mcm x pernah tgk.. masa discussion pn dia senyap jek, just mengiyakan n menidakkan yg prof zul tanya aku je. Banyak gila kot Prof Zul tanya..huhu.. berpeluh2 aku. dahla diskas kat kaunter ward. Dila kt bed 1 pn dgr suara kitorg. huhu..
Present history OK, cover semua.. masa present examination n other discussion, ade bbrapa scene yg aku x puas hati psl performance aku n aku rasa agak klakar. uhhuukk..
1. Masa nk start present examination, blh plak aku ckp, "a middle age Malay lady, skinny bla bla bla.." haha.. prof tnya, what do u mean by skinny? bengong gile, mcm mana aku blh tercakap skinny?? haha..aku terdiam jap.. prof tny lg, do you mean cachexic or what? aku tercari2 alasan, ak ckp not cachexic bcoz no evidence of temporalis muscle wasting.. prof ckp, then u should say 'thin build'... huhu.. EASY!!!
2. Masa present psl lump, aku describe temperature as 'warm'.. ngeng betul.. padahal aku tersalah cakap sbb sbenarnya tangan aku yg sejuk so rasa la warm! huhu.. prof tnya how do u know it is warm? xtaw nk ckp cane, lastly ak ckp normal temperature sbb same temp ngn arm!!! huhu...xlehla mcm tu kn, kalo ckp warm nnt diagnosis blh jd menda lain plak.. huhu..
3. Aku x wat abdomen n lung examination, tp bila prof suh stage cancer, boleh plak aku ckp, T2 N1 M0.. haha.. tibe2 M0.. prof tegur, mcm mn tau xade metastasize sedangkan aku x buat lung n abdomen examination? huhu.. then aku betulkan balik ckp T2 N1 Mx.. huhu
3. Aku x wat abdomen n lung examination, tp bila prof suh stage cancer, boleh plak aku ckp, T2 N1 M0.. haha.. tibe2 M0.. prof tegur, mcm mn tau xade metastasize sedangkan aku x buat lung n abdomen examination? huhu.. then aku betulkan balik ckp T2 N1 Mx.. huhu
4. Masa diskas investigation, prof tanya kna tak buat blood investigation dlm patient with breast lump? ak terpikir lame plak. ntah nape lmbt gile idea kluar. Pastu yg bengongnya, aku ckp tumor marker sbb tetiba terpikir BRCA 1, 2 dlm blood!! haha...prof tny, ade ke tumor marker dlm breast cancer? aku jwb xde plak sbb tersedar kesilapan aku..(I contradict myself).. Then ak ckpla amik blood utk baseline investigation, prof tnya lg, what do u mean by baseline investigation? huhuuu.. aku terus ckp liver function test sbb bla3, the renal profile bla3.. Yg tu Ok la, then xleh nk fikir full blood count kna buat sbb ape so x cakap.. huhu.. prof ckp kna buat jgk.. huhu
5. "Other than ultrasound of the breast and mammogram, what other radiological investigation u want to do?" spinal reflect, ak jwb " CT scan to look for evidence of metastasize" HAHA... prof ckp, ye ke guna CT scan, xde ke cara lain yg senang sket.. huhu then barulah aku cakap ultrasound of hepatobiliary and chest x-ray. huhu
6. Lastly prof tnya complication of mastectomy. Ak ckp infection at operation site, bleeding, pain, seroma. Pastu prof tnya kalo buat axillary clearance, ape effect dia? lagi, spinal reflect, ak ckp "SEROMA" haha.. confident sgt !! padahal salah.. bile prof ckp lg skali br aku berfikir n trus jwb edema of upper limb bcoz no lymphatic drainage.. hehe
kesimpulannya, breast cancer is not a tough case.. (cheh).. yela, kita dh ade skrip nk tanya apa kt patient, just ingt yg tu je la kan. breast examination pn, mende blh prektis kan..Cumenye, aku ni slalu pikir smpai spine je, x sampai ke otak, tu kdg2 jwb menonong je HAHA..
Apepun aku suka exam td. Aku belajar mende baru. Aku rase sume org lulus InsyaAllah sbb dgr dr cerita diorg pn Ok je.. mmgla kna attack bnyk gile soalan, tp xdelah smpai xleh jwb kan.. :)
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Balik klate male ni... yay! smoga slamat sampai, InsyaAllah.. bnyk plan ni nk wat kt rumah
till then, babaiiiii..
p/s: He was always there to help her, she always belonged to someone else :P
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