i've moved!

http://zickzen.wordpress.com/ is my new address.

pls update! :)

goodness gracious!

it's been WAY TOO LONG. how to sum up 2 months? just a list of quick updates?

1. HONG IS getting married. when i saw ian's sms that wed before good friday i nearly flipped. but im so happy for her!! :) and she's the first so naturally we are even more elated at this.

2. i joined yoga. and it's been really good. it's totally delayed gratification because when you are in the 40 degrees stinking heat, doing poses you couldn't imagine doing, you just have to keep pushing yourself for 90mins. and you really do feel tons better afterwards. it's really interesting. just that you need to wash alot more towels than usual.

3. i don't like modbury. i will say it once, and i will say it again. i don't care if people are getting tired of me whining about modbury, but unless you are in my shoes, YOU HAVE NO RIGHT TO COMMENT. you have no idea what i have to face every single freaking day for the past 3+ weeks.

4. which brings me to the next point, i hate people who are judgmental and unable to put themselves in the circumstances of others, who make sweeping comments and statements without using their god damn brain.

5. random note: easter houseboat trip to mannum was heaps fun. too much cooking i'd reckon but alfred is the one friend i will bring on any houseboat/camping/chalet/sleepovers from now on. HE IS JUST TOO AWESOME. with him, you do not only get meals. you get meals PLUS wine PLUS dessert PLUS dessert wine PLUS hot chocolate made from scratch PLUS green tea latte which is better than starbuck's version PLUS he's so funny.

otherwise, i can't wait to get out of modbury. may 8th please come quickly! and i am looking forward to ED, to ian coming over to aussie land and to JUNE when i get a miserly 2 weeks break. damn it.

i am just too good at ranting.
someone please stop me.

so out of it

it's been more than a month since I last blogged!
Just started my rotation in gastro. so far so good.

otherwise, the weather has been very kind. Breezy and cool. What heatwave? Haha but I think the heat will be back.

it's vday this sat but we have no plans yet. it's my bdae in 3 weeks and i also have no plan for that. it's really quite depressing becoming 25. so ooold. :(

that's just a short update for now.
more later.

Guest Speaker Today.

Victor Chia and his take on our stay in London.

Enjoy!!

__________________________________

The London Times Article 1/?

After a painfully long (14+ hours) flight, I wearily stepped out into the cold air of London. Made our way down to the accommodation hoping feverishly that it would actually be there and that it would be decent. Thankfully, the accommodation turned out to be fine.

First meal in London: MacDonalds, geez how boring can I get? In my defense, it was 10 pm at that point, and the MacDonald was just down the road. Now I know Daphne is just bursting to tell you of the joke that happened at the MacDonald, so I must say it first as a means of damage control. I ordered a chicken legend meal (something which I am quite sure is not available in Sg or Aus), which I ordered cause the picture looked cool. The lady then proceeded to ask me in her “What drink would you like”, in my jet lagged and tired state + throwing in her heavy accent, I answered “wholegrain”. As you can imagine, the lady just stared at me and repeated her question. I honestly did hear her ask me “what grain bread would you like?” With that meal, the first night in London ended.

Second day in London.

Woke up at a ridiculously early hour of… 6 am! I blame the jet lag. Met up with some of Daphne’s friends (Fidel, Andy and Yue Ping) for lunch at the Four Seasons restaurant near Leichester Square. Now for those who don’t know it, the Four Seasons restaurant is famous for their roasted duck. After devouring a whole duck between the five of us, we proceeded to hyde park for what was left of the Christmas fair. All I can say about the fair is that it was cold and I think I should have brought more winter wear.

________________________________________

to be continued....

psyched about london!

Not sure if it was such a bright idea to do the elective in January. My brain is so damn rusty and all I ever want to do all day long is to have fun, chill out and do all the things I like to do. However, I am super hyped up about London! not that I have yet to visit this city but it just has this vibrant and addictive energy that keeps sucking me back that way.

This trip is probably going to be less touristy, already planned 2 musicals, as well as short dashes to Paris and Manchester. I am quite determined to try the famous macarons from the shop Pierre Hermes. Their website was all in french. goodness me. but the endless pictures of pretty pastries and cakes obviously cheered me up and put me in the right mood. haha. i guess yummy food transcends countries and languages. The Manchester leg of the trip is probably more for the victor who is a in-and-out MAN U FAN. that freaking stadium better have some cool shit if not i will scream my frozen self off.

Of course, I also hope to get a good feel of life in the ICU. spent some time in PICU, trying to see if there are differences to an adult ICU. Just hoping I will not be too moppy after seeing those very ill patients. Plus the gloomy weather London is SO famous for. I hope we will not run into too much of those rainy and dreary days.

BUT for nowwwww... it's only 2 more days to a brand new year!...I was dreading 2008 this time last year but i'm glad it still turned out to be a pretty good one. Phew.

Happy New Year guys.. :)
All the best for 2009!! *cheers*

i'm lovin' it.

After all that exam results saga has calmed down, a group of us gathered at ian's spanky new place for a good old fashioned charcoal bbq last night. lots of delicious food prepared by his family. the night ended with a round of uno stacko, which our poor kristin probably took out like 50% of the thangs.. she was yelling in despair everytime the persons next to her drew a 'reverse'. haha..

Things on the London front is getting more and more promising. We have arranged most of the things that we have to - trains, accom, transport, musicals, manchester... oh goodness. it's going to be a wonderful trip! I really love the atmosphere in London, even though my mum thinks it's grimmy and gloomy with too many dark skinned people around. So glad I stuck to my choice to do my elective in London. Yay!

Pics..at some stage. they are all over FB though.

the verdict

Dear NGP,

You are the 5th NGP I have collected under my belt. I always made sure I never took you for granted because you can be so easy and so difficult to grasp. You never fail to bring me so much joy and relief at the end of each school year. This year in particular, getting you meant so much more. I am free to go on my external elective to London, free to be a 6th year learning new skills on the wards in preparation to be a (hopefully) great doctor.

You remind me of accomplishment, no matter how insignificant. Even when other students from other universities laugh at us for only getting you, NGP, as the mark on our transcripts. You never fail to make me think that all that hours sloughing during svot, all that time running after consultants in the hospitals.. it all pays off. somehow.

You are also my last NGP. In time, I will move on. Moving on to something more complicated but hopefully more exciting and rewarding.

So long NGP, thanks for always showing up on the access adelaide screen every year.

Till then,
Daphne

NGP = Non-graded Pass.

YAY and WEEP

I'm glad I don't have to study for quite a few months!...

But I thought I made many stupid mistakes in the osces.. and mcqs.

T.T sobs.

Oh and another exam related joke.

doctor: ok, so now you know it's a cancer. what will you do for the patient?
student: hmm firstly i would like to know where the cancer is located...
doctor: it's on the back.

student flips the question sheet over to the back.

and then a split second later... realised that the doctor meant it was on the PATIENT'S BACK.

writing things down now.

2 funny quotes. just for the meddies out there.

1. When performing a cranial nerve examination

Getting to Trigeminal Nerve (CN V)

Student: "Ok Sir, I need you to clench your jaw for me so that I can feel your muscles of masturbation."

NB: not me! and it's meant to be mastication.

and getting to Facial Nerve (CN VII)

Student: "Ok now, I need you to give me a big smile. That's it. Very good. Ok so I'm looking at the labial folds and checking for asymmetry."

NB: sometimes shortening phrases totally changes its meaning.

doooomed

I'm not sure how to describe what I'm feeling.

Imagine going through truckloads of notes...
And then, whilst sitting down to practise mcq question.. still unable to do so many of them without referring to resources!....

*hangs self in shame*

oh well, if I don't do make it I guess I only have myself to blame for not starting earlier. I can so hear my mother going.."see lah, told you to study harder.."

T.T

last minute dash.

where am I?

Stuck beneath a sea of notes, books and all the aids meant to help me PASS the exams.

It's less than a week away before it all starts.

The stress!

I hope it all turns out well.

The price I pay for being a medical student..

According to Up2date, if I get a basal cell carcinoma... it's all really my own fault.


Lifestyle factors — Smoking increases the risk of SCC [30], and may also be associated with an increased risk of BCC [14,31]. This was shown in a case-control study performed in 333 disease-discordant twin pairs in which there was an increased risk of BCC in smokers and in females compared to males [31]. Other lifestyle factors that were possibly associated with increased risk included higher education and coffee consumption. Additional studies are needed to confirm these findings before firm conclusions can be drawn.

Sigh.

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.