End of Crazy Week

Thursday night was an outing to watch Harry Potter! I simply love the Harry Potter series. I stopped reading at Book 5, so this movie was totally new. After the movie went out with E dward and the junior OG and the junior junior OG for dinner and then the arcade. Crazy stuff. Went home and chionged the CMPS project.

Yesterday was the record day for spending the most time in hospital (15 hours), though it was split between 2 hospitals. Started off with the CMPS presentation, just glad its over because it was very stressful trying to churn out the presentation within such a short time period. Saw very good cerebellar signs yesterday, but I felt kinda sad for the patient because the patient was trying to do the finger-nose test and kept on whacking his/her own face, and he/she was visibly frustrated. While traveling we met our consultant at the bus stop, which was kinda awkward for a while.

J iaqing: "Isn't that Dr ___ on the overhead bridge?!"

Me: "No la, it cannot be. Wouldn't he drive?"

J iaqing: "Maybe I saw wrongly."

Then when the consultant walked nearer the bus stop.

Me: "Omg, it really is Dr ___."

Jiaqing: "Haha, yea the person really looks like Dr ___."

Me: "No, it really is Dr ___." -.-''

That was funny. Anyway we did our night call where the best we did was to clerk this patient with an AS + MR + Mild AR + Pacemaker. Very interesting. Saw a pacemaker for the first time. Also felt an A-V fistula for the first time. The houseman was incredibly busy so we didn't really get to talk to her. But J iaqing and I managed to come up with a way to memorise the Jones Criteria for rheumatic fever:

Major Criteria: (CASES)

Carditis

Arthritis

Sydenham's Chorea
Erythema marginatum

Subcutaneous Nodules

Minor Criteria: (FRAPP, like the sound of a spoilt heart valve)

Fever

Raised ESR/CRP

Arthralgia

Prolonged P-R Interval

Previous Rheumatic Fever

Went to play soccer today against the soccer players and we expected ourselves to be thrashed badly but we were thrashed less badly than we thought we'd be.

Murmur Land

This week happens to be murmur week. Mitral Regurgitation, Mitral Stenosis with Mitral Regurgitation with a background of Atrial Fibrillation, Aortic Stenosis, Aortic Sclerosis, Pulmonary Stenosis, Tricuspid Regurgitation, Ventricular Septal Defect. Problem is, how to tell them apart confidently.

Been thinking a lot these few days, don't know if I'm thinking straight or just downright being insane. I thank friends for providing advice. Looking forward to Harry Potter this Thursday. What's life without a little magic? :)

Spot Diagnosis?

I was taking a long overdue jog just now at East Coast Park when along the way I saw this middle-aged women walking her dog. If it were any other middle-aged woman, I would have simply ignored her. However, this lady had a deep yellowish tinge to her skin. Instantly, I thought that she was jaundiced. In the 2 seconds my eyes was on her, I saw she was a bit sallow in appearance and looked quite frail (her shirt was obviously too big for her, like curtains being draped on a pole). She was not in any pain. At the back of my mind I felt terrible because one of the differentials for painless jaundice is carcinoma of the head of the pancreas. I just hope I'm wrong, and that she ate too many carrots and has got carotenemia instead.

X in L ing's BD

X in L ing's turning 21! Went to her house to attend her party. Learned how to play the Citadels game, its quite interesting, but gets a bit backstabbing in the end. Caught up with people as well.

Reply:

b ryon: that's why he's a prof haha.

Medicamp 2009 and Home Visit

Crashed Medicamp Monday to Wednesday. Got to know some M1s, tried out the new and improved Fright Night, learned some of the dance, caught up with my fellow batchmates and M2s and did some troubleshooting. Finale night was hilarious and thoroughly enjoyable from a viewer's point of view, though I felt it was kind of a waste that my junior junior OG didn't manage to win anything useful during the auction. Anyway for my year we got a TCC voucher and we didn't use the voucher and eventually it expired but that's another matter altogether. Gonna miss days like this.

We visited our CG's patient today for the patient follow-up thing we were supposed to do. When we reached the part about the social history, I was really sad that his disease condition caused him to have some friction in his family. It was really interesting overall. You got to see how the disease actually manifested in real life, rather than just on the patient in the hospital. After the visit the CG went to Vivocity to have lunch and then it was back to the hospital to clerk and have a tutorial. We were told by our Prof that when doing a respiratory examination you can tell the diagnosis just by inspection alone, and we spent 15 minutes learning about that. I hope we will be able to acquire his wisdom and experience and become good, kind and competent.

Reply:

s cott: cos i ggy's my jc classmate!

Night Call and 3P Gathering

Classes were pretty much the same for the rest of the week except for Friday night when E li and I did our first night call. The night was slow, with only 2 new admissions, but the time spent with the houseman was worth it because he was kind enough to teach us a lot of stuff. So Friday became the day where I spent the most time in hospital. From about 7.30am - 11.30pm, that's about 16 hours.

Dropped by Pre-Camp Tea on Saturday morning after a meeting at 8am. Its interesting to see new faces. In M1 I didn't really know what M3 or beyond would be. Well some friends are already slightly disillusioned, though thankfully I'm still finding it interesting.

Went for a 3P class outing in the evening. Haven't seen a whole bunch of them for a long time, so it was nice. So many things have changed since 3 years ago. We went to Timbre for dinner then crashed L uyun's place at night. Her place was awesome, with 24/7 air-conditioning and a great view. Went home on the train with I ggy.

Cycling in the Night

The weekend was uneventful. Unlike the one that is to come. Anyhow, after a full day of lectures yesterday which I felt were really sleep-inducing (And when I got called twice in the LT to answer questions. Reminder not to wear my red shirt again for class.), went home kinda late. Didn't really feel in the mood to study much so I hopped onto my bicycle and headed for the trial camp. After a nice bicycle ride through the light drizzle I reached the site. Did fright night after some waiting, and thanks for volunteering to be my fright night partner. (Sorry for having you go through so much screaming in the end.) I was trying to control myself throughout the journey through the "haunted house". After seeing so much suffering in the wards and even testing for a Babinski reflex on a patient who has passed away before, I think I have somewhat become numb to all this stuff.

So, another slow cycle back home and I found myself in the solace of my room. Today during Prof's tutorial we were told that we should be spending more time in the wards. (Not that we haven't been doing so.) Anyhow, today was a very fruitful day. Recognised some murmurs. And conversed with a nice Malay lady in CMI Malay. Took a PUO history. Quite satisfied because I sorta exhausted all the questions (even menstrual history ok) except for asking for the presence of a rash and the sexual history.

Went for a run just now. I've becoming less fit!

vin: Very few patients. Gotta search real hard.