jogging an old memory

It's really bizarre how patients pop back into my mind when I revise for the exams. The scarier part is the fact that the patients that I recall tend to be the ones who are ermm, deceased.

Anyhow, the patient in focus tonight is this 50 odd years old man who presented with projectile vomiting and weight loss to the ED. I learnt tons from his illness as it turned out he had advanced gastric cancer.

It was the first time I
1. felt a succussion splash
2. palpated a Virchow's node
3. observed a total gastrectomy.
4. had to take an extremely complete history and examination as I was going to present him at the Surgical sessions.
5. had a patient die on me. (he died a few days after my surgical presentation)

I remembered after the gastrectomy, the surgical registrar was trying to suture back the midline laparotomy wound cautiously and carefully, through loose skin that had suffered the unduly fate of 30kg loss. The only distraction on the abdominal skin was this huge myraid of tatoos. She commented, "well, he's not going to have much to look forward to anymore, the least I could do is to make sure his tatoo matches back up and aligns."

Anyhow, now whenever I revise gastric cancer.. this poor chap pops back into my head.

I hope he's happy wherever he is.

i wished it was the holidays already.

I have done work.
But like nothing's sticking!.......

I'm so damn bored. help.

O&G = OVER & GONE!

I cannot begin to tell you how glad I am that today's exam was like 50% repeated questions. PHEW. We had 6 stations and I only fumbled in one of them.

and that one station.

I.. had the same examiner from Wednesday.

OMG. the humiliation! I thought I would never have to see or speak to him ever again.
The first thing he said to me was..

"ok Daphne, let's see what you know."

Daphne's mind: nothing much, since you are examining me.

A series of tiny ultrasound scans with some grey dots and white dots.
o.O Obviously I wouldn't know what it is.

The questions were not too bad but I kept having this vibe that he still think I'm a dumb twerp or something. sigh. looks like first impressions really stick huh.

Anyhows, we have a wonderful dinner at FARINA!
A very long list of cocktails to choose from and the tapas were delicious... *drools*
I had a fruity girly one, and one that can knock the ghost out of anyone i'd reckon.
wheeee.

I'm so glad o&g is over.

OVER AND GONE.

the rubbish test called a viva.

The O&G viva must have been one of the most traumatising exam experience I have ever had in my ENTIRE schooling life.

Thankfully I passed, others were not so lucky.
Yes I admit that there were some student factors that I could improve on for future examinations but I have MANY MANY grievances towards the setup, patient choice and examiner choice for the viva.

1. My stupid patient's main problem was NOT related to obstetrics OR gynaecology.
She was under-going freaking chemotherapy for a large B cell lymphoma and was thus taken OFF hormone replacement therapy. So when I asked her why she was here, she was in her own words

"oh, just wondering if I could get restarted on that HRT"

Where was I supposed to go from there?
I assessed her suitability for HRT (heart disease, liver disease, breast cancer etc etc)
and asked her if she previously had side effects from HRT.. etc etc.

And after I presented the case to the examiner, his first comment was

"why did you not palpate for ALL the lymph nodes in her body, especially since you knew she has lymphoma?"

GAWD. In my defence, I did palpate those in her neck and axilla cause I freaking examined her breasts. But seriously, A full body workup for her?

The day before, most of the students got obstetrics patients with REAL obstetrics problems.

2. Stupid Examiners
Please choose examiners that are not L-field, extremists who do not believe in the SA Perinatal Guidelines. I mean, why else do people develop guidelines then?

Whilst being quizzed on cord prolapse..
I mentioned ALL the damn measures in the guidelines.

Examiner frowned, and said "where did you learn that from? Your patient's baby is dead"
Me: perinatal guidelines
Examiner: Do not believe everything you read young girl.

Also, please choose examiners who have a patent and working auditory pathway.

I had to repeat my surgical procedure for a Bartholin's abscess like 500 TIMES. (and PS: everyone knows how loud i speak)

Examiner: so what is the name of the procedure?
Me: Marsupialisation
Examiner: so you have incision, excision, what else?
Me: Marsupialisation..
.
.
.
.
.
I WAS GETTING FREAKING ANNOYED
Examiner: ok, one last chance, it has something to do with Australia's favourite animal.
Me: MARSUPIALLLLLLLLLLLLLLLLLLLLL.
Examiner: YES! you got it. good.

FREAKING hell.

gahh.

heatwave...approaching?

You see, I come from the land afar called SINGAPORE.
Singapore is humid, sticky, warm with some months going bonkers where it rains NON stop and umbrellas are useless creations.

So you know, I'm not that unfeeling towards bad weather.

BUT seriously, the HEAT in adelaide can fry flies! and dry out eyeballs.
oh gawd.
if we have to go through with the heat wave again this summer, i will perish. along with the other thousands of fried flies.

We usually have our exams in mid november when it can be warm and summery again. BUT this year it is at the END of november.

say hello to heat.

oh gawd i hate this.
grrrrrr.

the thing called yoville.

since i spent so much of my time moving furniture around.
i might as well show the world how my virtual apartment looks like huh.
i'm pretty happy with the living room
but the bedroom.. hmm i like the cozy sofa corner. but i need to do something about the bed. looks wrong.
oh wells.

i feel like it's super swot already.

I realised I am going to be cooped up at home for like what, the next 6 weeks? GAWD.

O&G is coming along slowly but surely.
Lots of crap to cover.

No more weird baking.
Don't think we are getting the funky duster.
Even Yoville seems abit boring already.

I need a new distraction!.. ok one that you can (hopefully) do for like 10 minutes in between studying just to chill the brain out. Any recommendations? lol.

Sian ahhhh.

When can i go home?!
Can't wait for all this to be over.

weird stuff.

i realised that when i get stressed with studying, i turn to rather alternative methods of therapy.

1. getting super duper obsessed with cleaning.

check this out!

i dunno what draws me to this stupid duster but I
1. really wanna get it! comes in 3 sizes and all that jazz.
2. really like that creepy green colour
3. really wanna touch its seemingly 'soft' and 'whirly' bits..

gawd. help me please.

2. baking stuff that i normally wouldn't even eat.
made a whole pan of cheesecake brownies, which if you think about it, it's just a personification of the fact that I couldn't even decide whether i wanted to bake cheesecake or brownie.. so just do both!...

thankfully the encouraging bf took a piece and ate it all up really quickly. and..

he went "oh yummy, this is really really good!.."...
me: "oh really? i can feed it to others?"
he, 5 secs later. "oh by the way, what do you call this thing you baked?"

-.-"

3. super Yoville addict.
It's this stupid game on facebook that you have to work at the factory (!!) only once every 6 hours to earn some sad amount of coins. which i blow it all on furniture every day. to decorate my APARTMENT. oh, should i choose the red shaggy rug or the blue one?..
sigh.


HOW?!...
O&G sucks.
driving me mad! help!