Surgery cases 2 (last part)

Somewhat interesting case, because the ward had a lot of ortho causes, mainly fractures, back pain and less general surgery related cases.

1) A patient presented with (R) lower abdominal  pain. (duration cant remember, didnt take history for this patient i was just there with doctor when he took ward rounds and met this pateint)

H/o Dengue fever 1 month back.

O/e Tenderness (R) iliac fossa and epigastric region

Rest of the abdominal examination Normal.

CVS – N RS – N

Advised for further investigation ; Blood test for now

I remember doctor asking what investigations we should do on this patient and i said CT scan and he replied “very good” and said “then scan room will be full no” , basically he was sarcastic, he wanted someone to say blood investigations. This is one situation where i was kinda humiliated LOL.


 

2. I took history of this patient, he always smile when he sees me so I was like i should see his problem lol and did it with a help of cadet.

24 year old single male presented with abdominal pain since 14/08/2017/

H/O Road traffic accident (RTA) same day – ?how

No past medical history ,

H/O Appendicectomy – ?when

O/e

CVS – N RS – N NS – N GI- N Musculoskeletal system – N

No tenderness localised anywhere in abdomen duruing examination

Rest Normal

No known allergies.

But i noticed he was in severe pain after i left.

Since i cant talk to the patient properly i couldnt ask questions about the pain and other questions.


 

I am still very new to history taking, in time i will improve. The doctor wasn’t happy with ny of the histories we took.  Hope i take better history in next appointment.

Surgery case 1

First of all I am gonna be clear with one thing, in surgery ward they have all types of surgery pateints, including Orthopedic, General Surgery and ENT cases as well. And Males and females are in separate wards.

So yesterday i took a history of a patient admitted that day..

A 32 year old Male , married with no kids. Transferred from Panagoda hospital.

Complaining of pain (L) leg – 1 day

He said fracture of left leg when i asked what his problem is.

History of fall one day back around 1630 (16/08/2017)

X-ray taken : shows fracture of lateral condyle (L) Tibia

No known allergies

On examination :

He had a back slab from mid thigh to ankle level.

Knee joint immobilised , ankle joint free range of movement.

( Didn’t perfrom musculoskeletal exam, I should have)

CVS – Normal RS – Normal


Asked him a couple of Qs about the pain :

Pain increase on standing , not radating ocntinous pain with pin prick like sensation.

He rated pain 4 from a scale of 1-10.

He is a smoker , smokes 3 ciggerates per day . Non alcoholic.


That’s basically what I got, not very good , but in time I will improve.

 

 

 

Clinicals

Clinicals started this week. Seems like everyone is really excited about the clinicals, specially the cadets. For a week all I saw was stethescopes on Instagram, maybe if i had one i would post too, I guess.

My first appointment was surgery. First day went to hospital, not knowing where to go or what I should do. All we were informed was to take a Stethescope, tendon hammer, a pen torch and our lab coat. Since I dont have a stethescope I had to borrow a stethescope from a senior. So i was not prepared actually, just went there for attendance that day.

Things didn’t go that bad, we were asked to take histories from the patients admitted, I am talking about really detailed ones. Language was a problem, because we had to talk in Sinhala, so i had to struglle, i am still struglling, i guess in time i will pick up the language.

Clinicals are actually fun and really tiring even though i skipped the lectures LOL. Seniors are there to teach us stuff and guide us, we are allowed to examine patients, draw blood and take BP.  I got humiliated around 2-3 times this week by our house officer. Since our consultant is on leave the house officer is in charge of us in the ward, he is a cool guy even though he is strict with me.

Got home today with 11 movies on my USB drive haha, lets see if i can finish 11 movies in 2 days.

Next week it is Internal Medicine and i plan on attending lectures too. Have to brush up on my Physiology.

 

Life

Exams going on, still struggling to pick myself up. These past 2 days I have been sleeping like anything. Get pissed off really easily too, let’s say it’s the stress. Haven’t interacted with anyone like I used to before, texting a few friends just when I feel low and when I can’t focus. That is the only connection I have. Shout out to Sonam , Maka mainly for listening to my BS and motivating me. Tough times, true friends stay in touch checking on you, appreciate it.

 

Now only spots and viva left, for me theory is actually easier and less stressful than those. I mean Anatomy spots and viva is so scary, Physiology is alright I guess.

 

Right now I am in the Public Library of Sri lanka, came here to study but instead I was caught up with this really interesting book, called Shame travels by Jasvinder Sanghera. It brought me to tears, some part, I read it for 2 hours straight, I like reading books about how life has been hard on people so I can learn from them.

 

That book is about Jasvinder, how she was disowned because she ran away from her house in Derby, at age 16, when her parents wanted her to marry a stranger in India. She has seen all her sisters go through the same, according to her she would see her sisters at the tender age of 15 , leave to India come back after 3 months, they would look totally different, different personality, less childish and after a week or so they would leave home to live with their husband.

 

Then her Mom would get phone calls from her sisters, complaining about how abusive their husbands are , how they beat them up and their bad drinking habits ….. basically a lot of complaining. But her mother always take the husbands side and ask them to put up with it just to keep their family name from being tainted.

 

So, she has seen this, and she didn’t want to go through what her sisters went through , so when it was her time she just ran away form home. She got married at age 19, first child at age 20, got divorced later on and married someone else after a couple of years and again got divorced. Started a foundation for victims of forced marriage. She’s a really strong woman.

 

One of her sister even committed suicide, by setting herself on fire. One other sister got out of the marriage and fled, came back to her. Her parents passed away, may them rest in peace.

 

That book tells us about her arrival to India to meet her step sister, she had to come unannounced because she has been disowned by her family and it will create problems for her sister if they knew she was coming, she said anything might happen. Well, they might even kill her.

 

She’s mother of 4 , single (according to the book) and strong as an oax enjoying her life.  It’s a really interesting book to read, I still have half of the book to read. Love it.

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Lowest point in life

I think I can say I am going through a really hard time, in fact this is a new low. It feels like everytime I try to pick myself up there is someone opposing me and again i fall back on my face. Or everytime i try to find my way up from this pit there is someone dragging me down further down this pit.

I don’t usually wish if i was someone else, but right now it atually sucks to be me, so sometimes i do wish i was someone else, maybe one of the juinors or one of the seniors , i dont know anyone but except me.

I will remember this period forever in my life, it will be rememebered and told to my future kids. Times like this makes us stronger and show us who our real friends are. Cold winters don’t last, it doesn’t always rain, the storm pass away, but when it does it would have taught us a great deal. We would have grown as a human, we would be wiser and most importantly stronger , so again when life hits us hard where we are weak, we can withstand it, thats the best thing about adversity.

Life has been really hard on me, I have been like a bird migrating from one place to another , shit keeps happenning and moving like this is not easy at all. Don’t think anyone understands. Have a girlfriend who is not that hepful , sorry if you are reading this but it’s the sad truth, sometimes she forget to reply, sometimes she is dreaming and sometimes she doesnt have a reply, sometimes she forgets to check on me, but still I dont know why I am with her in this thing, maybe now is the time to go back to just being friends, but I guess it would hurt her and i have to deal with more than what’s on my plate now. That being said, she is really good and nice actually. Again apologise for “bad mouthing” or not appreciating you.

I havent smiled in ages, I remember even in Eid , i was at Thoddoo always wanted to go an island, it made me happy but still the sorrow was much greater, i couldnt put a legit smile on my face. Life is really hard i must say, it doesnt get any easier, i have to vacate my room tomorrow and go upstairs where there is so much noise i wont be able to focus and udertsand anything, but do I have a choice ? No. Sometimes i do wish i was in the hostel, it’s better than this.

Throughout this one month, to be honest the ONLY helpful person who has always been there for , who has always supported me and helped me keep going and motivated was Sonam. I appreciate it and she deserves something from me, I guess I will giver her BTS Merchandise. Everyday she would send me motivational quotes and helps me go thorugh, listens to me and give good input like a good friend. Only person who was there when i was going through the hardest time, someone who understood me. Thank you Sonam , a good friend, and a great sister. I pray that she pass the exam too.

This exam has got us in a really bad way, we didnt expect it to be like this, I definitely thought i was mentally stronger and i could handle whatever life threw at me, but i was proved wrong. But i am much stronger than i thought, i am still studying as much as i can and right now i feel like i have forgotten everything and i am hoping it is the stress. On Tuesday i will go sit down and write the Anatomy exam without any regrets and give my best shot.

This is not living.

PS : Half an hour ago broke up with my girlfriend.

 

Just another shitty day

Just another lazy, useless day filled with regret and hopelessness maybe, not sure how i feel about anything.

Woke up early morning at 7 am but wasted 3 hours on bed doing nothing and then wasted the rest of the day sleeping. Woke up at 5 pm with a bad headache, couldn’t focus on anything, drank a Redbull, it felt good. Tried to study anatomy after dinner, but nothing was going into my head so had to book the down.

Listening to DJ Khaled’s album grateful while writing this, that’s a good album it has couple of nice tracks.

2 weeks left for the exam and let me give an update.

Anatomy: 

Still have to finish off Abdomen and Pelvis, studying Head and neck.

Hope I remember rest of the stuff i studied, to keep the stuff in my memory i have been re reading the topics i already finished.

Physiology :

Done revising Sem 1 , have to revise Sem 2 and Sem 3 in 2 weeks.

Life is really hard these days and somehow I have to ace the exams, i don’t want to repeat another year, that would put me in DEEP DEPRESSION for sure.

Right now living a hard life, moved out of Wellawatte place to a short term place in Dehiwala till the tenants vacate the house we rented. This place HELL, i mean its hot as fuck 24/7 , no AC , my room is downstairs filled with all the things my aunt and mom has, i can’t move around properly in this room.

It’s like hostel life back, but worse actually. Atleast i have an AC in my room in the hostel and the food is better. We have a kitchen which we don’t use because others are using it, i don’t get it.

Anyways don’t wanna live a better life while Mom and aunt and others are going through hell, so I’m staying here for 2 weeks instead of the hostel. We can survive 2 weeks I guess, it has an effect on my studies in a negative way, but life isn’t easy so yeah… .

This week kinda have been like this, no motivation at all, dizzy and sleepy all the time. Wonder what’s happening maybe stress.

Hope everything goes well and I pass the exams.

20th June 2017

It was just another normal day in Ramadan. Last day in Sri lanka, so woke up a little early to do some shopping with Mom and pack the stuff.

Been a week since everyones freaking out about the results, I don’t usually freak out, I mean I don’t see a point in freaking out, what is done is done we can’t change that. Sure we want to know how we did, but we can wait patiently I guess. Anyways since everyone was freaking out, I was kinda freaking out too, I was watching a lot of TV shows, Brroklyn Nine nine, Silicon Valley, two and a half men and New girl. Just to keep my mind off the results and study Anatomy. I knew i would fail Anatomy.

I went out with Mom to buy a light bulb, shopping with Mom is something which i would do once a month, I mean i usually don’t go because she takes too much time in the store and on the way stop at other shops too. But since i was leaving that day i went with her to buy a light bulb at around 5 pm. While i was coming with the light bulb, the results were released and it was really disappointing. I had to repeat 2 subjects, Physiology my favorite subject, I felt so stupid that i failed Physiology, the only part i think i messed up was SEQ, but did i mess up that bad to fail ? I don;t know, I guess I did.

I reacted well to it so did my Mom and my sister too.

So 20th June 2017 is going to go down in history, the day I finally came back on track, the day I became wise, the day I changed.

 

So a really depressed, disappointed, stressted, annoyed Aarish left Sri lanka to Maldives that day to celebrate Eid.

PS : will post how eid went with pictures.