Work

It has been a (painful?) month since I started working. Its very challenging although I was half expecting it to be as such. Maybe I just wasnt that ready. Maybe I am THAT clumsy. Or maybe Im just that sleepy.

I.can.not.be.sleepy.no.more.

The ever so famous post-call syndrome is at large.
The bullying at work.
Missed meals and stunted toilet calls.
The stress when an emergency happens.
Phoawarrh.
Arrrghhh.

Dear God please help me.

PS: Since Im a practising doctor now, its no good being sleepy. So I need to change the tagline for my blog. Suggestions?

GAH

BAH, it has been over two months since I last posted anything on this blog.

Shame on me.

To all of my friends who has been waiting to hear my latest updates, sorry I cant just be arsed. Its a real effort to find a working computer and internet combo when I'm jet-setting (I like this word very much fyi) half way across the world and back.

Truth is: I have been traveling. And traveling still.

Although I know its hardly an excuse- but trust me without a personal laptop and free wifi,/decent connection speed- connecting to internet is harder. If there's one thing I learn from crossing the continents it'll be: Internet is a luxury not necessity.

So.

In short:
i) I've been backpacking since March 09.
ii) I had taken 3000 pictures in 3 different continents in the last 3 months.
iii) I am guilty of my carbon footprint hence the reason why I limit my travel just in the UK recently.
iv) I made loads of new friends, amend few old connection and broke off with few.
v) I had my heart broken twice. And I'm still standing.
vi) For the first time in my life- I managed to reach the 45kg mark. Yeay!
vii) I passed my medical school and will be graduating on the 15th of July.
viii) After which I will go back home for good.
ix) Three of my very good friends are getting married this month and I'm having mine in 2012.
x) I'm tired.

I was thinking the other day- about this blog. Whether I should keep it/relocate to new server/ create a new one for now my title has change/ or just continue with this one after mini face-lift.

Answer is I dont know. Suggestion welcomed. Due to flippant nature of p53, only God knows what will happen.

Till then.
loves, p53 xoxo

TANZANIA

Life has been different.It is simple yet complicated.

Simple in the sense that I'm living the absolute necessities (no TV, no fast internet, no PS, no shopping trip).
But yet complicated- when inferior complex within myself questions my very own existence and the life that ensues.


Its a hard life in hosp for a student/doctor. Really.
Tanzania wont be a place where i want to live/work/raise my kids. Quality of life isnt so great here.Although it does make a good vacation destination (nice beaches of zanzibar, amazing wildlife in the safari, good learning opportunity with infectious diseases).

Tanz is one of the poorest african countries. Many live in sheer poverty. TSH (thats the currency) worth next to nothing.BIG BIG gap between the rich and the poor. Worse than any other countries that I've been to.

Otherwise, all is well. I'm still adjusting to the scorching heat. I'm as dark as I've ever been.

1st day: "are you from china?"
Today: "are you from nigeria?"

So there you go. haha.

till then pen off. xoxo. p53

Yippadeduh, yippededuh....

I'm leaving for my electives today. In less than an hour.

Here are the dates roughly...
Today- leave smallcity
Tomorrow- arrival at Tanzania
Next weekend- trip to Zanzibar
Next next weekend- safari trip (Serengeti +/- Ngongororo)
The weekend after- shopping in Dar Es Salam
4 weeks from now- leave Tanzania for Borneo.
4 weeks +1 - will be in KL
4 weeks +2 - arrival at Sabah
The first weekend- beach and snorkelling
The second weekend- climb Kinabalu
The third weekend- white water rafting +/- visiting orangutans
The fourth weekend- flight back to the UK.
Fin.

Yeah! I'll be globetrotting with just the basic necessities. No laptop- so expect scarce entries from here on. All possible methods of transportation will be used so maybe this trip is like a little "By any means" imitation. Haha.

Till then, love you all.
p53 xoxo

PS: Those who want postcards please leave address as comment. Its my pleasure to sent them.

Pain and shit

"The word 'depressed' is used so much these days. "I got stuck in traffic, I'm so depressed." "I'm having a football depression." If only you know what it really mean!" ~Patient who recovered from a brain injury~

"When you learn to die, you learn to live" ~ A patient~

"Depression is trendy, if you dont have it, then there's something wrong with you" ~Another patient~

"Bathroom is full of risk factors" ~ Geriatric patient

"Blackpool is pretty... (long pause) shitty." ~patient who types out his words- dysphasic after brain injury i.e. someone smashed his head.

Malicious

"What are the things that you should consider while listing a patient who is adiposely challenged?" ~Surgeon of the week~

"Antipsychotic meds will definitely make a patient put on weight" ~SHO in Psychiatry
"I have to try it!!!" ~Me - pretty determined.

"After all these years I still find it difficult to talk about my illness. Its like a psychological scar that haunts me" ~ A patient

What to wear?

Apologies for the lack of post.
I'm dead busy completing all the compulsory assessments at the hospital.

I'm getting ready for my electives.

Many aspects of the preparation (i.e. vaccinations, money, accom, flights, documents, books, equipments etc). Most daunting is PACKING!

Its difficult to pack, I'd love to bring items that are both practical and nice. However, TANZANIA is burning hot, even wearing jeans might give me some trouble. Hmmm.. I was advised by many people to bring only the thinnest clothing item ever (so linen works best).

I'd love to wear my lovely pairs of jeans (black and dark blue) which work just fine in hospital here in the UK- because both of them has this formal casual look. Definitaly I cant wear any of them for Tanzania is too hot! Now it seem that even my khakis -denim material- may be to thick for safari. Haih.

I'd love to wear different pairs of flats for different occasions. My cobalf blue flats will look so hawt (hot) with my capri jeans. And my usual black and white flats will so work with my hospital attire. And my red one just for days that I feel like wearing it. But no! I dont have any space in my backpack for an extra pair of shoes. So, black simple flat it is.

Scarves: I dont want to discuss about this... too painful.

Tops- Khakis, plain white tees, beige, olive- well the plain ol boring colours. No choice really.

Do you know that its a MUST to wear labcoat in hospitals in Tanzania AND Malaysia? Argggghhhh... another impractical item i) white- so will definitely will stain like hell ii) will only make life hotter (for bad reason, not for hawt reason).

And then I need all those travel related stuff (i.e. raincoat, sleeping bag, mosquito net, torchlights, first aid kid, travel medications, water purifier, thermos, hats, socks, gosh... many more.... arrgghhh). so heavy all this stuff.

And to make thing worse, I'm climbing Mount Kinabalu in Borneo which is pretty high >4000m. So I have to pack all those jackets, thick socks, gloves, thermals.... why oh why....(pulling my hairs out!)

I love travelling but I hates to have to choose what I can bring along and what I cant.

If only I'm rich enough to have some one to pack for me, arrange all my travel details, and as I'm that rich I'll travel first class hence no luggage allowance limitation and I can bring anythg and everythg I want, and that rich that I'll buy things (read: more nice shoes and clothes) as I go along to help the local businesses, and finally to have someone to porter my stuff around and be my driver at the location. Ahhhhh.... Plus a personal chef wont hurt.

Patient tales (except that none of these are fairytale)

When I woke up on Friday the 13th, I just wanted the day to come to its end. I was very tired from all the week doings with all those crap assessments, useless PBHell and running around to sort out thousands of stuffs. And you can tell from the way I'm writing that I hate them all.

So despite my endless cursing, I made my way to the surgical ward for a freaking 8am start and joined the Surgeon of The Week (SOTW) Grand Round. 1 consultant, 1 registrar, 1 SHO and 2 FY1s. The SOTW team reviewed almost 40 surgical patients in all wards (surgical, paeds & gynae patients).

I came across alot of unfortunate patients all of which left me so emotionally ridden.



Patient 1: 32 yo female patient who came in with small bowel obstruction. She had hx of a number of pelvic operations following diagnosis of and recurrence of cervical cancer. She has nasogastric tube in currently, as it was decided that her bowel should be rested.

I had a chance to speak to her afterwards. There were some parts of the encounter that I became very quiet as I was lost for words. It was very heart rending to hear someone of her age talk about three small children. For me it was the fact that all the problem started when she was 29 that did it. Thats like me in 5 years time.




Patient 2: 44 yo female patient who was diagnosed with pancreatic cancer post staging CT. She was told that operation will be arranged towards the end of this month. She asked the consultant whether she could have a weekend leave to see her newly born granddaughter. Unfortunately, she had to stay in-patient as she was markedly jaundiced.

Thats awful.




Patient 3: 23yo male patient who came in post vomiting and severe pain radiating to the back. Scan showed generalized moderate inflammation of pancreas. Dx: Acute pancreatitis caused by alcohol binging (while he was watching the Liverpool vs Manchester game nonetheless).

Consultant: Bla3x (re: long term effect of heavy alcohol consumption). You have to choose which one you love more. Alcohol or your life.
Patient: Errkkk....




Patient 4: A 39yo businessman who had been quite unwell (pain, n+v, although he was not jaundiced) for the last few days and investigations showed cancer of the head of the pancreas. Breaking bad news was particularly awful as it was done at the bed side with all 7 members of the SOTW team gawking. He was calm although there was hint of turmoil brooding underneath. The whole group became deafeningly quite when he asked:

"Whats the chance for this lesion to spontaneously heal itself?"
Consultant: Nil. Bla3x (re: prognosis, options, further ix inc staging CT and MDT)

"Can I have a weekend leave to sort out things?"
Consultant: Bla3x (re: potential complication of cancer i.e. bleeding 2ndry to liver problem, pain, jaundice...which might happen when he's away) So its highly recommended if you could just stay until after the staging CT.

"I need to sort out my business this afternoon (Friday). And just be with my family over the weekend. Gosh. Then I have to write a will."
Consultant: (Giving the space a sweeping glance). Well.... yeah, you can leave by lunch today after the girls check your INR but you have to be back by Tuesday at the latest.

It was eerily quiet. Of course, he is this young man who has alot of things to look forward to in his life at this very moment. Ooo... has I mention that he's an American? Who moved here few years ago after marrying a British woman and has established his own business based here in Lancashire.

I stood there at the edge of bed silently praying that he's alright with the news delivered and may he find strength and faith to cope with the diagnosis and its implication.




Those 4 patients were patients that made me shuddered. There were a lot more (ranging from simple appendicitis to ruptured ones, colorectal cancer, bile leak, retroperitoneal abscess, pilonidal abscess and etc) so much so that by the 12 pm I was crying inside. (yeah, a combination of many many many bad news and my own tiredness and worsening pangs of hunger).

Let us take few minute to reflect the value of life and to say prayers to these patients.

Later that day, I watched ComicRelief. For full 8 hours. 7pm on friday- 3am on saturday. The cause for this year is malaria in the Africa. So few more tears were shed after clips showing how kiddies in Africa died of this preventable disease, which is almost eradicated in other part of the world, due to lack of mosquito nets and medication to treat malaria victim.

Again, let us take few minute to reflect the value of life and to say prayers to these children. And say grace for having what we have.



Hugs and kisses with much emotions,
P53.

PS: As we were leaving patient 4's cubicle, he asked "Doctor, is theres any reason why I shouldnt use Viagra over the weekend?"

Blake Lively vs Kristin Stewart vs Leighton Meester

I found an old copy of VANITY FAIR while cleaning up my mag rack (yeah yeah, im still cleaning up)- so here you go- scanned and presented to all the readers of this blog.

On cover of Vanity Fair -from ages ago.

And this is the pic on the first page of the article.

I still hold my grudge against Kristin Stewart.
She's tad weird. Bad bad bad choice for Bella (of Twilight series).
Look at them pics, she's damn stiff, blinks too much, and too sulky!
Blake is so lively (haha, pun intented-well, its so sad that I keep myself amused with lame joke this) boo.
Ok, seriously, Blake is so pretty, full of live, fresh, young and happy.

K-stew is everythg but.

****************Spoiler alert****************

In book 4 Breaking Dawn, Bella turns into a vampire. And from the description, Bella would be so amazingly abso-fucking-lutely gorgeous! Hands on heart I dont think Kristin Stewart is in any way eligible for the character.

Yup, she's clumsy and all that, but I think Leighton Meester should be Bella. She is wayyyyyyy better at acting, plus she is this most lovely little lump of an actress with real emotions!

Eg: A very simple girl who fall for Edward (everybody says aaaaawwwwwwww... says woooootttt.... Shot gun Edward!)

Then: For New Moon. Bella curled up in feotal position cauze it just to painfulwhen Edward left her (everybody says arrrrrggggghhhh) - well maybe sans the heels and puffy skirt. haha.

Then: She turned into this most beautiful creature, even words could describe her. (Well, stephenie meyer described her well, I cant!) in book 4.

This is just out of world man!

OK!

Thats enough to prove that Leighton Meester is more suitable for Bella's character.




Its difficult to find a good picture of K-Stew.
This is the best.
And even that doesnt compare to Leighton's.

Bicester Village

Noted at the back of Bicester Village's shopping brochure.
(How to get there section!)

Bicester Village is a retail outlets area. So many PRETTY things. I was all excited. BFF drove us 3 hours there and another 3 hours back. Spent about 7 hours there and about the cost of a small car collectively.

Good day!

PS: I'm definitely not a bum when it comes to shopping.

Managing an arrest

I attended an ILS (Intermediate Life Support) course the other day. All of us 5th years are required to attend one before graduating. So hopefully everyone with be equipped with the necessary skill needed by the time one start working as FYs.

One of the ILS instructors looked familiar. He was one of these people that you come across alot in hospital (in wards/in canteen/along the corridor/in shuttle bus) but yet still don't know who he is or what is his job really. Of course me being me- I want to know everything about everybody. So when I first saw him that ILS morning, it was killing me that I don't know who he is.

By lunch time, we were split into smaller groups so that actual scenarios of cardiac arrest could be simulated for a smaller number of attenders. I was in his group. Then for the first time in 3 years I heard his voice. And you guys would be amazed to know that he speaks in a language that I don't know. Yup. Really.

So there he was yapping about stuff (stuff because I had no idea of wth he was talking about) to the whole group and me straining/struggling to understand what exactly he was going on about.

He speaks English.

English with heavy Welsh accent.

I swear to God, out of all people that I've heard giving instruction for the whole 5 years I'm here, his accent was something of a different level. Well above the level of thick Lancashire accent of an 80y-o gentleman, the Scouse, the Scottish, the newly arrived doctors from India/Africa, Manglish of the IMUs students and the rest.

So imagine the shock that I had when each of us had to manage a case of cardiac arrest each, having not understanding half of the guideline.

Well initial shock anyways.

Luckily I kinda well abreast with the ILS algorithm.

And its not a simple one I tell you.

Learning Points:
i) Double check the medications with at least another person before administrating them. Beware they all start with "A" (Adrenaline, Atropine and Amiodarone).
ii) Keep calm and carry on. (sure as hell one will be nervous with the adrenaline rush when put on spot managing cases like these).
iii) You can refuse to do mouth-to-mouth resuscitation provided that you have a strong reason not to and could justify it in the court.

Question:
Ok now I had my ILS cert already, when I can do the ADVANCED Life Support Course??

Plastic Surgery

Mrs X is a 40 y-o patient who I met in a surgical ward. She comes to hospital this time for an elective removal of bone spurs and local debridement on her left femur.

The story was: about 4 years ago she had a tiny wee spot of infection of the skin overlying her left patella (that's knee cap for you and me). Fast forward many Abx and few months later, the infection was still there- unshifted. By this time she was feeling unwell with signs of mild systemic infection- hence she was admitted to hospital for IV Abx. However- as she was feeling no better- an aspirate was done + a scan of her knee joint. The infection had spread to her joint cavity (now its about a year since first skin presentation).

So: Her left patella was removed and the joint was replaced with a spacer (p53: is it like an artificial joint, like that of a knee replacement? Mrs X: No, its just a space-filler, the knee could not bend as well. P53: ooo0000ooo *making mental note to check how does that look like/work?*)

1year post-op, she noticed pain while walking and reported "feeling a bit off". Symptomatic treatment was given and she was enlisted for care of Chronic pain team. Many neuralgic meds later, the pain persisted- now about 2 years post op. Second opinion was seeked and she was refered to Smallcity's base hospital.

After doing few more investigations, it turned out that she was having osteomyelitis then (which explain the pain and her feeling unwell). Due to the level of permanent damage of her tibia and fibula, they were removed too.

And for the first time in 3 years she felt completely well (how ironic is that being just under 40 and yet so calm/blase/accepting to the fact that she's an amputee ....... gosh, I thank God for my legs and my well being... go on say your prayers now!) and she resumed her work as an administration staff at school.

However, the happiness didnt last long (well.... I have to use one of those cliche havent I?). Roughly 6months after she felt unwell again. The osteomyelitis had spread up to her inferior end of her left femur. (So the infection had been so mild, so low grade, it had spread to a wider area unseen macroscopically right from the very beginning!!!)

She unfortunately had an above-knee-amputation. (She said and I quote: I would rather keep my life than keep my decaying parts).

Since then she had been in hospital 3-4 times for removal of spurs (even doctors dont know why they keep on coming back) and local debridement.

She is currently under the care of the Plastic Surgery team. She can walk with a prosthetic- although not mobilising at the moment due to recent surgery. Bless her. She has been through a lot and still pretty optimistic about her life.

PS: She's such a good historian!

This is the epitome of mother of all reasons why I dont want to do Plastics. Too gruesome, too heart rending, and too surgical. haha.

M*** ***

To all my lovely friends and families, crushes and lovers, enemies even, teachers and consultants, Jeremy Clarkson and Gordon Ramsay.

I MISS YOU all.

Every step I take, every move I make
Every single day, every time I pray
Ill be missing you.

My lil bro esp. Hey there, how you doin?

MALE AND FEMALE MYTHS

I am in the process of packing up and cleaning my room. Imagine the amount of junk/books/clothes/papers/bits and bobs/men (ha I wish) I had to throw away/recycle/donate. A lot. Not so good in term of carbon footprint.

I tore of my wall/noticeboard/inspirational board i.e. taking off all the posters/to do lists/pictures/postcards/bills/timetables/love letters (haha) to leave it all bare sans art. Well my kind of art anyways.

So one of the things on the wall was an article. I got this article/list during my 4th year psychosocial teaching and I would like to share it with you guys.

MALE AND FEMALE MYTHS

1. Sex should be natural and spontaneous- asking for it spoils it.
2. All physical contact must lead to sex.
3. Men always want and ready for sex.
4. Sex is for male pleasure- a woman's duty is to fill his needs not her own.
5. Men must take charge of and orchestrate sex.
6. If women arent orgasmic they should fake it.
7. Women expect men to know all about sex.
8. Men should not have or at least not express certain feelings.
9. Anything other than the missionary position is dirty.
10. Women must wait for male to initiate.
11. For men, in sex, as elsewhere, it is performance that counts.
12. Women must maintain a 'good' reputation.
13. Women must be attractive, obedient and passive- because men expect it.
14.Having sex menas having intercourse.
15. For couple to have sex, the man must have an erection.
16. Good sex always ends in orgasm.
17. Good sex means both partners having an orgasm, preferably at the same time.
18. There is something wrong with a man who has lower sex drive than a woman.
19. In general, women receive more stimulation from alarge penis than a small one.
20. Nice girls dont get turned on- and they certainly never move during love making.
21. Dont show affection to men because the will want sex.
22. If a woman shows interest in making love, she must be promiscuous.
23. Most homosexuals exclusively adopt the passive or active role in their sexual relationship.

I kinda have my own opinion for each of the statement, but telling it outright here would mean disclosing too many personal infos (and you guys will know my preferences in the subject matter.) End of story.

So there you go. Myths. NOT!

hahahahahha

Less talk more rokk.
116358 ---> that's my score.
My own personal highest so far. On Medium level.

from youtube.com


Damn that orange fret- wait till I can nail it on Hard level.

I hate my medical school

ooooOOOOOOOoooOOOoo....
This (talking about my medical school) has been quite an area of potential hatred.

Today 22 Feb 09 is a fine day. Sunny and hot-ish.
I was stucked indoor all because I have to write a frigging portfolio piece.
The comm team made it compulsory for each Year 5 student to submit an entry for that.
WTF.

Lets do some maths

Miss P went berserked with what's left of her savings. She bought alot of things in the last two weeks. Please calculate the amount of money that she had actually saved from all the discounts and offers available in smallcity and its sister city.

Original price Sale price Saving
(all figures are rounded to closest pound)

Item 1:Gladiator shoes --> GBP25 - GBP9 = GBP16
Miss P just went ga-ga over this pair of shoes from Dorothy Perkins. "Ohh... It fits me like socks.. I HAVE to get it!" she exclaimed. She then added "This shoes is so gonna go with my safari look for my elective." (Editor's Note: whatever!!!)

Item 2: For both --> GBP14 - GBP3 = GBP11
Novels from charity shops. Its one of few benefits living in such a small city: there are many charity shops here- where you can get novels at a negligible cost. HA! (Ps: Miss P bought her entire Harry Potter set from charity shops- all in pristine condition.)



Item 3: Roxy Belt --> GBP40 - GBP10 = GBP30
Who would spend 40quids on A belt? (well I know a few hehe) Miss P wont. So when this belt was on sale for a tenner- she bought it and left the store with a big grin. The belt can be worn in two ways- the flowery bit and the blue bit.

Item 4: 65L Backpack GBP70 - GBP35 = GBP35
Miss P already has a 45L backpack that she used for the Europe backpacking trip last summer. However for her elective she thinks she need a bigger bag due to extra things (i.e. medical equipments, meds and books) that she is required to bring along. (Editor's Note: You guys should probably see the way she haggled the price with the lil old lady selling it in her outdoor store... priceless)



Item 5: Vaccinations and prophylaxes. Bloody expensive. No saving. Herummmpph!

Yellow fever 1 freakingly expensive injection GBP40
Rabies 3 painful injections GBP15
Malaria tablets- Doxycycline GBP20
Cholera oral dose GBP7
HIV prophylaxis pack GBP180 (i'm not kidding!)
Total: Frigging GBP262



Item 6: Trespass super light weight and fast drying blouse -->
GBP16 - GBP3 = GBP13
Just because. Hahaha. Safari theme again. Hahaha.

Item 7: FCUK blouse --> GBP40 - GBP20 = GBP20
No justification needed, this blouse is cute beyond words. Plus the salesman there was cute too. Miss P just lost it from the very minute of walking into the store. Ha.



Item 8: A lingerie item from CK --> GBP32 - GBP8 = GBP24
So pretty (berdarah hidung tgk ni!)

Item 9: Concert tickets --> GBP26 - GBP20 (student discount!)= GBP6
It was worth every penny. The finale song BOLERO by Maurice Ravel was absolutely heavenly! Click on the picture for a clearer image of the orchestra.




Now please calculate the amount of money saved.
Answer: GBP155 (<-- highlight here)


Total spent: GBP370
(and that's excluding the foods- like 2x italian eating out, subways, ingredients to make authentic malay and italian dishes which costed alot... Miss P is a kind of person who wont think twice in spending 20pounds in one sitting for good food)



Bancrupt la....

(and again excluding the recent indulgence in PlayStation2... whoahh... Miss P do spend alot doesnt she?? Latest addition: Singstar microphones and game)

Fashion week

Isnt this gorgeous???

Saja-saja

I've been a bum

Well, not a surprise isnt it?

Bum for almost everything. Medically esp.

Well anyways... lets talk about some patients I saw in the last two weeks. Confidentiality protected nevertheless.

i) Post coital bleeding in a 77 y-o lady [what?? WHATTTT??]
I struggled to keep a straight face while I was talking to this patient, who was appropriately seated next to her 70-ish husband. Not because I wanted to laugh (well knowing me anyway) but because I was shocked beyond words. I swear in normal unmedical situation, my jaw would probably hit the floor and my eyes would have bulge out of their sockets. Two-weeks referal nonetheless.

ii) Nocturnal enuresis in a 20 y-o young lady.
20 y-o kinda sweet and cute lil lady came to the surgery and started to blush during her opening sentence "I have been experiencing something very embarassing"... And I went "well we could only help you if we know whats been happening + everything that you say will remain confidential". So story was: 6-7x of nocturnal enuresis in the past 3/12. No frequency, no dysuria, no discharge. Dry at night when she was 12 (?late ?familial). Said that she's not in any stress, well, apart from BF now leaving to work with the Army. No hx of abuse (sexual/physical) and no other relevant hx. I sent off her urine sample to exclude UTI/glycosuria and requested a fasting blood glucose. To be reviewed in 2weeks time.

iii) An unfortunate girl who was given the Pills without first-pill-teach.
She is only 16, but honestly when she walked in she looks much older than me (so tall and much tad-too-much makeup on) so much so I had to ask her to confirm her full name, date of birth and address. So I gave her some adv re: the pills and printed out some patient information leaflets. Problem was: breakthrough bleeding whilst on the pills- which is a COMMON thing to happen.

iv) A dead body at a caretakers.

v) A 44 y-o lady with bilateral trocanteric bursitis.
Hx and O/E very typical of trocanteric bursitis. "Why bilateral?" asked my GP- and tbh I DONT KNOW. Very articulate lady. She explained everything without me asking, right down to characteristic and aggravating factors. Ha.

Ok, there are actually so much more interesting patients to write about, but as the title of this entry suggests, I cant be arsed.

Otherwise, pen off.
I'm gonna go and continue reading Breaking Dawn.

******Spoiler alert*****




Bella's pregnant with a vampire baby!

Freaking hell. How did that happen? Of coz I know how exactly it happened (Bella and Edward went for their honeymoon after the much awaited wedding and the birds and the bees bladibla...) but seriously in a real life* situation HOW DID THAT HAPPEN???
FYI- vampire has 25 chromosomes (well according to stephanie meyer anyway) and human has 23 chromosomes (scientifically- not some made-up number). Insemination and fertilization are just NOT possible.

And the baby is now making Bella very unwell and thirsty for BLOOD! Again... how is this possible???

Anyways... I still love Edward. Others can F-off.

*Editor's Note: p53 dont be daft, there will never be a real life situation for things like this.

PS2

Hi Mom,
Look at what I had bought!
I dont know what had possessed me, but I ended up buying this whole lot from eBay.
It was a bargain though. Really.
And now I know what is an addiction. Mom, I never thought that what Iman* says were remotely true. Yup, it is difficult to stop once one starts on any of the games. I play Guitar Hero. Mom, arent you proud of me? Haaaa? What? You would prefer it if I learn how to cook instead? Ooo..okay. Im trying here.

Im trying to be better at the Medium level of Guitar Hero. Its really difficult Mom, it really is. You always tell me practice makes perfect, thats why I'm spending 2-3 hours daily (since the games arrive in the post) on the PS2. Dont worry, I dont have homework these days.

My wrists hurt Mom. I deserve it, I know, but can you kiss it better?

Much loves from me.
xoxo

*Iman is my 10y-o youngest brother.

Pics from London

Hot ladies (as viewed with temperature-sensored camera at the National Science Museum)

Hyde Park
Big Ben

Which one is worse?

Sweaty armpits or smelly feet?

BO or halitosis?

Being blind or being deaf?

Squint or funny teeth?

No arm or no leg?

MS or MND?

Esophageal cancer or colon cancer?

---> Then as a consequent: having a PEG tube or stoma?

Esophageal cancer or pancreatic cancer?

Dying quick but in a painful way in road traffic accident or dying slowly from a debilitating chronic disease?

Having a massive MI or a massive stroke?

Having a stroke or having a heart failure?

Having a heart failure or a kidney failure?

Having stroke with complete loss of one side of the body or having CRF needing 3x of dialysis/week?

Anorexia or morbid obesity?

Being burn to death or freeze to death?

Having a peanut allergy or having allergies for seafood?

Menorrhagia or dysmenorrhia?

Inserting a catheter on male patient or doing a vaginal bimanual examination? The latter for me.

X6

Have you seen it? It a monster! It’s so big and (looks) powerful.

X6 is the latest of the X series from BMW. It’s a type of sport coupe. Well, it does have the characteristic of an SUV- but for my eyes it sneakily is an SUV. Clever trick, BMW! It’s probably as big as a mini van.

Despite being monstrous, the design is sleek all throughout. The exterior is beautiful (although personally I would have preferred a car with slightly lower boot) with boot as tall as me. With curves in all the correct places, it does look like a nice car for pretty girl like me. (Editor’s note: The curves will complete the owner in this case). The interior is as nice as any other car in that range of price.

I can’t really comment on the engine and the other specifications for I’m not interested in those kinds of things. However I would imagine that X6 would be a nice driving machine. Top speed ~ 150mph - haha.. not that I’ll drive anywhere as close as to that.


So here we go again, a car that made me shuddered ages after My Fair Lady 350Z.

Happiness is....

I received this precious thing through the post today and I am already over the moon. Two tickets... guess who's gonna be my date?

Mission Compare Part 1

There are a lot of things that I wanted to blog about my community placement. I just cant be arsed because I'm still in holiday mood.

So instead, I'll be doing a series of comparison. Any of you guys reading this blog wants me to compare anythg interesting- just drop me a line [as comment]- and i'll be much obliged.

Mission Compare Part 1: MY ROOM

East side

West side What the hell?

Exam, result and thereafter

How impolite am I for not giving you readers some sort of updates especially regarding my exam? I apologize. From hereon in this entry, I'll try to tell as much as I could chronologically.

Prior to Jan 09, I was really scared of the finals exam. I felt as if there were so many things that I havent revise yet.

Comes Jan 09, I was practically shitting in my pants- trying to cram in as much infos as I could into my almost exploding brain.

Then the exam week- 14 Jan- 22 Jan came. I couldnt sleep, lost my appetite and lost interest altogether with anythg non medical. How sad.

Had my first exam in one of the big halls in BIGCITY- which is also the hall where I will graduate provided that I pass every single thing.

Got all tensed up in between. Packed up my stuff one night and left smallcity and my studymates. Went to BIGCITY.

Second exam was in the same hall. It was freezing. No heating. It snowed outside. Bloody hell.

Then OSCE on 20 Jan. Almost cried after I finished it. 50-50% chance of failing it. WAAAAA....

21-22-23 Jan- passed in blur. I slept. Slept my sorrow away. By this time, some of my very good friends left smallcity for their elective in exciting places.

24 Jan- Had mother of all headaches. Very hungry too. So I ate I ate I ate and took paracetamol.

24 Jan (night)- 29 Jan (morning): LONDON trip.
- did all thing touristy- went to Greenwich prime time line, took pics along Thames, next to Big Ben, Westminster Abbey, Tower Bridge.
- watched two musicals at the West End: The Sound of Music and The Lion King. Super fantastic.
- ate a lot of different kind of food- indon, chinese, japanese, italian, mexican, malay- ahhh bless all Halal food in London; I gained 3 kg in the space of 5 days. Yeay!
- went to natural history museum and national science museum (both for the first time in 5 years of me living here in the UK)

29 Jan: result out... In the hours preceding the result time, I paced up and down the length of my kitchen, sweating like hell. I swear my heart almost stopped when I saw my result. I passed- marginally. pheawh. Few of my dear friends failed. My heart cried out for them. I rang my parents- told them the good news, and rang few other friends to tell them too.

30-31 Jan: Sleep, eat, internet, blogging, buying stuff off the ebay, tidying up my room, doing laundry, vacuuming, collecting things for charity, cook and BAKE!!!

1 Feb: Preparing my timetable for the next two months, ironing clothes, sending out work emails, filling in evaluation form of last block which I proscatinated for almost 2 months. hah.

2 Feb and thereafter: community and hospital placement and elective (yeay!) and graduation (double yeay!!) and going back home for good (yeay 3x).


***Important note: my face suffered the most. Blemished like never before. Arrhrggghh***

Coldest winter in 13 years!

Flipping hell.

Here's somemore snippet:

Sunday will see maximum temperatures of between 2C (36F) and 5C (41F) although temperatures will fall during the course of the day. Temperatures during the night will be minus 1C (30F) to minus 3C (27F) although forecasters predict the mercury could plunge to minus 6C (21F) in some locations.

That's it: I'll be in bed ALL DAY LONG!

Who's that girl?

Isnt she gorgeous???

Answer: In 3 days time ok, unless someone can come out with the correct answer.

**** More pics of DAKOTA FANNING****
(from gofugyourself.celebuzz.com)

According to plan

if everything goes according to plan.....

.... I'll see you next April.
xoxo

I'm so upset its untrue...

why?
I was beaten by an ebayer in a bidding war for a PS2 console + games bundle.
Arrgggghhhhh.

Now, I need to catch my bus to LDN. traaaa.... xoxo

I want!!!

Isnt this a supercallifragillisticexpialidocious kitchen unit? My heart went into a transient arrythmia as I laid my eyes on the truly scrumptious unit. And with that amazing almost haunting image, I wish you all a very good week- I'm off to Londres (LDN). Zippededuhdah--zippedideee!





Editor: What's up with the use of songs' phrases?
p53: Im going to watch theatre/musicals in LDN [The Sound of Music and hopefully the LION KING]

Amazingness

This super cool apartment is so fantastic, I dont even know where to start. Righto- let your imagination run wild. Check out this article.

Gary Chang, a Hong Kong architect, lives in a tiny apartment, but thanks to accordion-like wall units, he can create at least 24 different room configurations.

Poladroid Part 1

Here I am at half two in the morning, trying out the poladroid and screaking in excitement. Gosh, look at the result. Awesomeness to the max. I chose three random pictures and all of them turned out beautifully. Told you things look much nicer in Polaroid. Sigh- maybe need to get a polaroid camera after this.


The best thing about this application is the fact that you have to wait for the image to develop. As if the REAL polaroid. Its truly and absolutely moving to see how an image changes and at the end you have this gorgeous outcome. Bless.

Even the simplest picture turned out all classy. Love it to bit. Try it here. I'm actually telling everyone I know about this- as free ad from a satisfied customer. Seriously considering to have my wedding pictures in polaroid images format.

***Currently listening to Freshmen by The Verve Pipe***

and...

and oh yeah,

i would like to try:

i) playing Guitar Hero (and finish Prince of Persia 2008) on xBox. Wooohhoooo!

ii) using poladroid.

iii) level 6 of the climbing wall and take up bouldering! cant wait (Editor's note: cant wait to see fit guys on the neighbouring wall is it? I know- they're so HOT!)

Shout out to all of this blog readers

I finished my exam!!!!!!!!!!!!!!!!!!!!!!!!!!

PMP, PT and OSCE.... done them all!

Shit scared of the result that will come out in 8 days.

Otherwise, here are some snippets:

i) I once asked for a good luck wish from my sugar-daddy (SD, hahaha, you're right), it went like this:

p53(me texting him): Wish me luck. xo
SD(his reply): Wish you luck.

And with that I knew better not to text him anymore for any well-wishes. Boys/men can be so stupid sometime. In retrospect it was funny though. I love him nevertheless.

ii) When I took the PT paper, the exam hall was absolutely f***ing cold. The head invigilator had the nerve to stand up before all of us (who by this time been shivering for at least 30mins or one blinking hour in my case) to apologize because -he said, and I quote- the examination hall was a BIT too cold.

BIT too cold??? My right hand (that's my dominant hand) had been numbed since like question number 56 (out of 125), so much so that I had to use my non-dominant, almost non-functioning (due to its sheer uselessness) left hand. Rubbish.

Then, my nose started to become sniffly.

Then, whatever I read became blurry- and my head couldnt make sense of any of the remaining question.

Shiiiiiiitttza!

Then, my brain froze and my body became hypothermia and I dropped dead due to cardiac arrest in seat no 80. (Editor's note: but p53, you didnt. Ed, of course I didnt, because I left the hall just in time to avoid all the potential complication).

Right, I better stop before this become an essay. Next point please.

iii) I'm gonna resume my normal life. By normal i meant:

- sleep alot- like 10hours/day during winter season-
- go climbing- gosh i've abandoned this hobby for the last 3months-
- try new baking recipes- and I havent bake for 4months- random muffins dont count-
- traveling? - will be going to london to see some friends-
- catch up on gossip girl etc- yeah!!!!-
-calling2 people- i love talking on the phone-
-beautification- ahhhh- bliss-

till then traaaa.... xoxo

Tribute to James

James McAvoy.
So cute. Tak tahan.

click here
here
here
and here
Ps: Keira Knightley is me in disguise. kahkahkah. No, seriously.

Poladroid

haaa...
I came across this while blog hopping
I will try it soon, like very soon. (Editor's Note: The end of misery is fast approaching, yehaa! I'm excited for p53's behalf)

www.poladroid.net is an application that allow you to convert normal digital pictures to polaroid-ish pics. How cool is that?


Ps: Update...
14th Jan: Patient Management Paper - DONE!!!
19th Jan: Progress Test
20th Jan: OSCE (friggin scary!)
Ps2: I miss you kak mimi, if youre reading this. muah xoxo. of coz miss you too kak lydia. Love you two so much, it really hurts to be here alone in the UK.

Is this what I want to do, really?

This picture is disconcerting. Why am I looking at it anyway? There are alot more not-so-nice (I dont want to say f***ing horrendous) pictures that I've came across: vaginal discharge, perforated bowel, fungating breast cancer, gangrenous toes that self-amputate. And they all made me questioned myself, is this really what I want to deal with?

Dreams

Look at the bedroom! How inviting is that??? Now I just need a MAN. Sorry for such random post. I'm psychotic (again?!) - and the rate of me visiting interior design blogs is exactly proportionate to the amount of stress I'm having. Gosh. So, here we go... enjoy the image. Imagine sleeping on THAT bed. I'll probably will never want to get out of bed. Anyways, kisses- till next time.

14th Jan: Patient Management Paper
19th Jan: Progress Test
20th Jan: OSCE (friggin scary!)
I'm pissing in my pants just looking at that timetable, now if you could excuse me, I'm gonna hunt for somemore eye candies (in form of kitchen design). Pardon my tangentiality and affect dissociation.


*The image was taken from http://www.sfgirlbybay.com/

Its cold!!!

Today it was so cold it was unreal. And I'm not even kidding - it was windy, it was so bleak*, it was one of the coldest days this winter season.

I thought the temprature must have gone down to subzero (like in the range of -3 to -5 degree celcius) but the BBC weather centre reported that it has been 3-4 degree consistently throughout the day.

Cars are frozen, seats in the car were friggin cold, the steering wheel was absolute nightmare to touch.

I couldnt even sing as my lips chapped almost immediately after stepping out from my flat. And there were moments when I felt pain shooting through my teeth (super sensitive to cold thgs). Arrrggghhh.

But I was out of the flat anyway- (to get to hospital** and dropping at the town for a bit) and my left leg hasnt quite recovered from the numbness experienced earlier.

I really want snow. Please.

Anyway, at the time of writing, the weather in smallcity is as followed. Trust me it is VERY windy.



*Bleak- yes, although it reminds me of Forks where Edward and Bella live- but no thanks... its too coo...ooo...llll....ddddd............
**Hospital on Saturday morning for history taking and examination. In Joker's tone..why so serious???

Harrrrrroooowwwww!!!!

coz that's how I say 'hello' in my world.. haha...so better get use to it.

So, whats up everyone?? I'm fine thank you.

Im so sick and tired from all the revision, its unbelievable. EMQs, PTs, OSCE, Skills, Revision sessions... the list never end...Hope I'll pass (see I am NOT even aiming for anything more than pass)

So, updates from the first week of 2009.

i) Today I attended revision day at my base hospital and one of the consultants is so handsome, it was worth turning up just to look at him. His presence was THAT overwhelming, my heart fluttered. *drool*

ii) A joke (laugh laaa.... so funny)

*****

Anne Robinson (on the weakest link): In medicine, what "p" is said to be better than cure?
Celebrity A: Prescription.

*****

iii) A new dress code/regulation for coming FINALs was emailed to students. My friends were talking about it over dinner at a restaurant where I was sitting at the other end of the table. So this was me trying to chip in (as per a student who didnt know about the said email)..

Friend A: ........dress code.....haha......ni..qop.....of course......... (..... : something2 I couldnt hear clearly coz she's at the other end of the table)

ME: Haaa..... bikini top? Of course la you cannot wear that. Its the exam for God's sake.

Friend B, C, D and E turned to look at me (with such look that means "Is this girl retarded or what?")

ME: What? Dont say anyone is planning to wear that!!

Others: hahahahhahahahha

ME: What?? Its not funny la wearing bikini top to exam. Its gonna be frigging cold somemore.

Friend A: Ni-qap* lah, not bikini top.

I swear if I'm in a pantomime at the very moment, background music will go: Kuang.. kuang...kuang...erk! and there'll be a cue card for "LAUGH as loud as you could".

*Niqap is a type of extended hijab worn by Muslim women to cover their face.

iv) I did many questions (like almost 2000 EMQs already) but I have a doom feeling that the more I do, the more muddled up I am. The last set I did I was so frustrated with myself for scoring only 55%. So stupid right? The questions was not so difficult but they certainly were very tricky- like I know the answer roughly but not accurately just yet. Really fed-up.

v) Im actually very scared of the FINALS.

Herbert the Pervert

This is a clip of Herbert the Pervert from Family Guy. He's a paedophile and the clip was taken from the epic special episode of the series- STARWARS.



classic!

When is it gonna snow?

Its 3rd of January already. No signs of snow. Nil.
Please God let it snow. It has been freezing cold for the last few days (in the range of negative) with no rain.
Today its bright and sunny outside but most of the ground surrounding my flat is covered with frost. Gosh. I'm not complaining about it being sunny (sun is better than rain at any rate), but its just too cold.
And I dont even know to whom exactly I'm ranting this too.
Ok- I'll go and search for some snow myself (not literally- but photographically on flickr.com). Bye.

Edward Cullen

Dear Edward,
I'm in love with you. Truly.
Bite my neck anyday!
p53 xoxo

What a good way to kick start a new year. Happy new year to everyone!
Good news everywhere (apart from the current attack at Gaza, Palestine.)

i) Twilight made more than four times its reported $37 million production budget—the best rate of return on any film in the 2008 Top 10, including The Dark Knight. Sweet!!!
ii) New Moon is as good as Twilight. SPOILER ALERT!!!!!**** Edward proposed to Bella. whoohooo.... I love but hate but love but hate the 2nd book. It hits too close to home- I feel the pain too Bella my dear. I cried when Edward left, but jumped in delight when he returned, but screamed when he went to see the Volturri. Jacob was nice and all that but vampire is much better than werewolf, sorry mate!
iii) I'll get the boxset as present from BFF soon. yeah!!!!

For endless pictures of Edward Cullen go here, so simply type in edward cullen at google search. Robert Pattinson was a really BAD actor. The movie could have been better, like seriously!

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opps... sorry I got sidetracked into daydreaming about him. smile. blush. smile. restart heart. ok. back to normal.

Hope this 2009 brings joy and loads of new exciting things to everyone. love, p53.