When I grow up.. I wannabe a Dr.

Five guys. Malaysians. Once medical students. Once stuck in a house in Summerstown Cork. NOW all Doctors, going separate ways. What will they be up to?? ish macam macam.....

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Friday, April 10

Turn up the volume for maximum effect !!!

cakap-cakap ilman aiman

i like this music. it feels as if ur on the last few steps before the final hurdle. and ur running with all ur might to go to the finishing line. u glance to the right... then turn to the left... and u smile. they are familiar faces. faces that u know for at least half a decade. faces that have been part & parcel of ur life not only in the joyful of moments but also in trials and tribulations.

thank u all for making this year, a year to remember. we work so hard to get here and it is getting closer than ever. together, we can make it happen. together we will cross the finishing line.... amin


to my hommies.. thank u. 75 summerstown rules!!!


Chariots Of Fire - Vangelis

Thursday, April 9

one down and done.. four to go..

cakap-cakap maestronine

as usual.. it's me again.. just like everyone, i feel the same.. really glad it's over.. now time to focus on the written and the clinicals.. ayuh berusaha..

and the spontaneous bbq was excellent.. chic + sausages + mashed potato + fried rice + walkers + pringles + ice cream + cakes + beverages.. thank you everyone.. and apologies for any kekurangan etc..

the annual med vs dent rugby match, scheduled today, was cancelled due to waterlogged pitch.. i was hoping to play for the last time for the med team.. when i was in the third year, we were smacked by the dent.. masa tu, main scrumhalf (no.9).. and last year we won by the slightest margin.. n masa tu main winger-yang-tak-laju (no.14).. 1st and 2nd year = rehab period.. and i don't think there'll be one this year as next week is easter break and then exams coming up..

otherwise, it's gloomy most of the time today.. hopefully it won't have negative effects on our enthusiasm and hardwork.. selamat maju jaya rakan2..

maestronine
thu apr9th2009 1850




Wednesday, April 8

Beginning..

cakap-cakap shahied


Alhamdulillah Final Year Projects are settled and out of the way.
It was a relief really just to get it done and over with.
My presentation itself went on pretty well although it could have been better. Just hope and pray that everything goes well. Overall i thought that all the Malaysian's did heck of a job on their respective presentations.
Anyways, spontaneously that petang we decided to have a barbeque for our batch as this could be the last time that we could all gather together before the finals and everyone flies off elsewhere. So we frantically go and bought some chicken (got 4 legs free from the generous Mr Bell) and some other stuffs. 
We were glad that all of the invitees came. Had a good meal and chat and laugh. Some unfortunate things happened but that aside it was splendid.
Thank you all for coming and all the best for the days to come leading to the finals.

Tomorrow the cycle starts again. Back to work. Starting tomorrow we will have intensive revision sessions with study groups so that we could maximize the benefit. Group work aside, studying alone and self hard work still needs to be done. 

4 words. I NEED A SCHEDULE!
grr... 

Allahumma najjahna fil imtihan, fiddunya wal akhirah.
Allahumma iftah alaina, hikmataka wansyur alaina,
Min khazaini rahmati-ka ya arhamarrahimin..



Tuesday, April 7

saya perlukan perpecahan (i need a break)

cakap-cakap brainbarrier

wahhh sudah lama aku tak menulis...wahhhh
bnyk btol bende interesting berlaku in the past months
the resurgence of LFC
two back 2 back mancU defeats (sorry MU fans).. tp menggembirakan aku!wohoo!
najib as our P(C)rime minister lol
KJ as ketua pemuda umno malaysia...after against all odds
the 2 bukits victory for PR in by-elections.. but lost batang
(teka teki...sape dlm rumah 75 ade 2 bukit dan satu erm..^.lupakan2..)
finished my paeds rotation
abis fyp presentation
Obama visit to turkey!! (feeling good at the moment)
the rocket launch by north korea..
earthquakes
killing, stabbing, rape, homicide, suicide.

world is a very2 interesting place to live in. but it can be quite scary sometimes.
i hope for more interesting stuff to happen in d future! n to my frens..all the best for the finals.. and for to family i'll be joining u guys earlier than u might think

-ameen-

Monday, April 6

Monday's Vid.

cakap-cakap izadiskandar

Saturday, April 4

Song Cover

cakap-cakap izadiskandar

Hana, tq for cover!!! Really appreciate it. -izad-

Below is the text from her blog : http://medertainer.blogspot.com/
"Thinking of you - Katy Perry (cover by request)

Mr. Izad, this is for you.. Thanx for requesting.. I sing my heart out (or my throat out) for you even with the pain caused by my wisdom tooth.. heheheee.. Enjoy~!"




Friday, April 3

what next?

cakap-cakap ilman aiman

the teaching period is officially over today. the presentation is due next week and this is followed by the written exams within the next fortnight. initially, i plan to write something inspirational/motivational but then, i toss that one out. it's boring. and maybe too philosophical for ur liking. i try not be so transparent. it's no fun that way.

instead, i opt to talk about the future, the plan to be after med school. the things that awaits me and the enormous possibilities that i could jump on. a vision. a dream and an ambition. what to do next? what's the plan? stay here? go back? get hitched? anything is possible. i normally wouldn't rule anything out. like the words from the wise.."always keep your options open." haha... but come to think of it, as a simple man i am, i just want to start working, save a little bit, help my family, buy some properties and grow a family. yeah... that's the plan... but wait a minute, notice that i did not put up any time frame for any of these events to occur?

and as of other things, i really don't know what will happen. as Natasha cleverly puts it.. today is where my book begin, the rest is still unwritten...


Unwritten - Natasha Bedingfield

Thursday, April 2

tomorrow is friday..

cakap-cakap maestronine

seperti biasa, terasa malas untuk mengulangkaji.. dirasakan seperti sudah malam minggu.. huhu.. moreover tomorrow is our last day in limerick out of six weeks.. and hopefully our last rotation ever.. and presentation to come next week.. all the best ye rakan2.. sama2 berusaha menuju puncak..

going to miss you limerick..

maestronine
thu apr2nd2009
2100


Wednesday, April 1

Giler kentang!!!! (read: Crazy potatoes!!!)

cakap-cakap shahied


This is a backdated entry.

So i had my interviews yesterday(tuesday)
One of the interviewers asked something about the Hippocratic oath (wth..)
Apparently the so called, "first do no harm" that we all seem to associate with this oath was sooo not true. it's not even IN the oath. ah ha! so don't believe everything you hear.
I got asked something about management of thalassemia as well.
Not that i know much. But saying that i totally gave the wrong answer when i said ferritin is iron stores in the body?? eh hellooo!!

And 50% of the time, they were the ones that did the talking. And i diligently nodded, and nodded..
But in the end, they seemed impressed. Not that i care if they are impressed or not, but they are. So that says something. :)


kami yg smart2 belaka ;p


long overdue photoshoot pic

Monday, March 30

The Man Rules

cakap-cakap brainbarrier

The Man Rules

The Man Rules
At last a guy has taken the time to write this all down

Finally, the guys' side of the story.
(
I must admit, it's pretty good.)
We always hear
"the rules"
From the female side.

Now here are the rules from the male side.


These are our rules!
Please note. these are all numbered "1"
ON PURPOSE!

1. Men are NOT mind readers.

1. Learn to work the toilet seat.
You're a big girl. If it's up, put it down.
We need it up, you need it down.
You don't hear us complaining about you leaving it down.


1. Sunday sports. It's like the full moon
or the changing of the tides.
Let it be.

1. Crying is blackmail.

1. Ask for what you want.
Let us be clear on this one:
Subtle hints do not work!
Strong hints do not work!
Obvious hints do not work!
Just say it!

1. Yes and No are perfectly acceptable answers to almost every question.

1. Come to us with a problem
only if you want help solving it. That's what we do.
Sympathy is what your girlfriends are for.


1. Anything we said 6 months ago is inadmissible in an argument.
In fact, all comments become Null and void after 7 Days.


1. If you think you're fat, you probably are.
Don't ask us.

1. If something we said can be interpreted two ways and one of the ways makes you sad or angry, we meant the
other one

1. You can either ask us to do something
Or tell us how you want it done.
Not both.
If you already know best how to do it, just do it yourself..

1. Whenever possible, Please say whatever you have to say during commercials.

1. Christopher Columbus did NOT need directions and neither do we.

1. ALL men see in only 16 colors, like Windows default settings.
Peach, for example, is a fruit, not
A color. Pumpkin is also a fruit. We have
no idea what mauve is.

1. If it itches, it will be scratched.
We do that.

1. If we ask what is wrong and you say "nothing," We will act like nothing's wrong.
We know you are lying, but it is just not worth the hassle.

1. If you ask a question you don't want an answer to, Expect an answer you don't want to hear.

1. When we have to go somewhere, absolutely anything you wear is fine.
Really.

1. Don't ask us what we're thinking about unless you are prepared to discuss such topics as baseball or
motor sports

1. You have enough clothes.

1. You have too many shoes.

1. I am in shape.
Round IS a shape!

1. Thank you for reading this.
Yes, I know, I have to sleep on the couch tonight;


But did you know men really don't mind that? It's like camping.

Pass this to as many men as you can -
to give them a laugh.

Pass this to as many women as you can -to give them a bigger laugh.


Sunday, March 29

BREAKING BAD NEWS

cakap-cakap izadiskandar

Entry kali ini akan ditulis dalam bahasa malaysia.
26 hb mac 2009 - 9pagi.
8:15am - Hari ini bermula dengan presentation kelab jurnal di bilik latihan pranatal.
Topic kali ini adalah kajian CLASP. Aku mempunyai lebih tenaga hari ini berbanding hari lain, dan lebih aktif bertanyakan soalan.

Setelah selesai presentation tersebut, aku, H dan K naik ke wad M3 untuk mencari konsultan S untuk wad bulat pagi (morning ward round).

Setibanya aku di sana, seorang doktor Peads nampak aku dan terus menuju ke arah saya. lalu bertanyakan soalan " Are u malaysian?" Aku tersenyum.

"Proudly", kataku. Kami semua tersenyum. "Ok mari ikut saya" katanya.

Aku pun ikut dia sepanjang koridor wad hingga tiba di depan sebuah pintu bilik wad. Di situ ada "isteripertengahan"(midwife), konsultan Peadiatrics dan juga beberapa doktor lain, rata rata dalam 6 orang semuanya.

Konsultan itu berkata padaku "Breaking bad news...."

Langsung air mukaku berubah.

"Saya perlukan kamu untuk menjadi kata alih suara (translator) untuk saya"

Aku berkerut kening. Hah??

Terpikir sebentar - 'translate bahasa amende? aku bukannya tahu bahasa lain..'

Dia sambung lagi. "Pesakit ini adalah malaysian chinese, tidak berapa fasih dalam bahasa Inggeris, dan kami akan beritahu berita "terminal"", katanya.

Terdetik hatiku - 'Aiseyman, ni berat ni. Berat.....'

"Okay, I can help." Kataku, sambil cuba sembunyikan kerisauanku dengan senyuman.

Dengan perasaan tak sedap hati, tak termasuk berdebar, aku lapangkan otak dari semua anggapan senario tentang apa mungkin telah berlaku.

Aku tak mahu pengetahuan dan anggapan perubatanku mengganggu proses alihbahasa yang adil.

Pintu di ketuk, dan kami pun masuk.

Dalam bilik itu kelihatan seorang wanita berbangsa cina berusia sekitar 35 tahun sedang duduk diatas katil berpakaian pyjamas, bersama seorang jururawat yang menjaganya. Bilik itu sederhana besarnya, selesa buat sorang pesakit. Cahaya matahari pagi menyinari masuk melalui tingkap besar di sebelah katil.

Dia tengok kami satu persatu. Dia tengok aku, kemudian doktor lain, kemudianku lagi, dua tiga kali, cuba meneka siapa aku ini.

Konsultan itu pun bersuara. "Selamat pagi, apa khabar puan P?, cukup tido malam semalam? sudah makan pagi?", dalam bahasa Inggeris. Puan P senyum dan angguk "yes".

Lalu Aku pun memperkenalkan diriku dalam bahasa Inggeris "Hello, saya Izad, salah satu junior doctors di sini" dan salam tangannya.
Secara langsungnya aku bertanya dalam bahasa Malaysia "Puan paham bahasa Malaysia tak?" Mukanya bersinar, dan senyum lebar, bagaikan lega melihat seangkatan warganegara sama. "ya, pahamm..."

"Apa khabar puan?"

"Ok, tak sakit sangat...", sambil senyum.

Dia nampak seperti orang yang sangat selesa berbahasa Malaysia berbanding Inggeris, mungkin berasal dari bahagian luarbandar Malaysia.

Aku berpaling ke konsultan, lalu berkata dalam bahasa Inggeris, "Yes, saya paham dia, dan dia paham saya. Boleh proceed"

Konsultan angguk dan terus berkata, "Beginilah puan p, seperti yang puan tahu, bayi puan lahir sangat awal, 24 minggu sahaja.

Dan semalam selepas kami C-section puan, bayi puan dibawa terus ke neonatal ward untuk dirawat"

Konsultan tengok saya, Lalu saya translate kata-katanya ke bahasa Malaysia (seperti diatas).

Puan P angguk mengerti. "ok, jadi?"

"ok and?", aku alihbahsa kembali.

Konsultan pun kata, "Sekarang ini keadaan bayi puan makin melarat, kami lihat ada pendarahan otak dalam kepalanya"
Setelah dialihbahasa, Puan P berkata, "Tapi, bagaimana keadaannya hari ini berbanding semalam?"
Konsultan membalas, "Keadaannya semakin teruk, pendarahannya semakin banyak, dan ini memberi kesan pada otak, buah pinggang, dan paru parunya". Aku alihbahasa setepat mungkin.

Puan P toleh padaku lantas bertanya, "Tak ada apa apa ke yang doktor boleh buat??".
Aku tengok pada Konsultan,"Is there anything you can do, doctor?"

Konsultan berkata, "Maaf puan. Bayi puan sangat muda, paru parunya tidak cukup kuat untuk bernafas, buah pinggangnya sudah tidak berfungsi, dan otaknya berdarah. Kami rasa lebih baik kami berhentikan 'ventilator' dan beri kan masanya untuk meninggal dunia dalam dukungan puan daripada meninggal di dalam ventilator"

Ayat yang panjang lebar itu aku 'digest' sebentar, lalu mula translatekan perkataan demi perkataan kepada Puan P yang terpaku mendengar, di hadapan 5 doktor dan jururawat lain..

Taat ku mengutarakan perkataan "meninggal dunia", bagai tak disangka, Puan P beku. Matanya bergenang, airmata menitis turun ke pipi. Setiap titisan dirasa setiap insan yg berada di dalam bilik itu.

Suasana senyap sepi.

Dengan suara sebak serak pilu, dia berkata "Doktor, tolonglah. Tak ada apa apa ke yang doktor boleh buat? keluarkan lah darah itu, bagilah ubat. Baikkan dia balik doktor. Tolong lah...."
She looked at me... Clearly trying to find help... clearly wanted to be given hope. HOPE.
Anything to make this better. Anything to clear this surreal news away.

And I translate it. Word by word.

Konsultan tu pun kata, "Maaf puan, tapi kami dah buat apa yang termampu.... eloklah puan telefon suami puan,..... minta datang ke sini untuk jumpa bayi puan kali terakhir", dan toleh padaku.

Aku mula translate, Puan P tengok mataku bagai cuba meneka perkataan seterusnya. Mukanya sungguh terdesak. Sebak dan terdesak. Bagai ibu yang mencari dimana anaknya. Terdesak nak mencari harapan untuk anaknya. Fighting for a life she shared 24 weeks with.

For the last time", kalau di alihbahasa jadi 'Terakhir'. Aku tersekat di perkataan tu. Terkedu lidah. Otak tak dapat cari perkataan lain. Yang lebih lembut, yang lebih indah, yang lebih selesa didengar.

Tak sampai hati nak ucapkan perkataan tu kepada Puan P. Tapi aku cakap jua.
Lagi berat mata memandang lagi berat bahu memikul.

Clearly that word brought her world crashing down.

Tangisan raungan seorang ibu mengenangkan nasib anaknya yang akan ditamatkan hayatnya dalam beberapa jam lagi. Anaknya sudah cacat, dan akan dipotong talian hayatnya, buat selamanya. Terpisah dari ibunya..... apalah nasibnya.

"Sebentar lagi kami akan bawa kan kerusi roda, dan puan dapat pergi ke bawah untuk jumpa anak puan"

Dia hanya mampu angguk. Tunduk sepi tak bermaya. Bagai tak ada hidup lagi baginya. Airmata bergenang, banjir titis ke katil.

Aku senyum simpati... Konsultan bagi insyarat. Kami keluar dari bilik itu. Biarkan dia sedikit masa.

<;">Semua doktor, jururawat dan midwife mengeluh.

"Well done izad"

"Dia ni sampai semalam, PROM, membran dia pecah awal, 24 minggu. Kami buat c-section malam tu, babynya develop intraventricular hemorhage, steroid pun tak dapat bertindak untuk paru paru. The chances untuk baby dia normal sangat rendah. Kalau kita teruskan ventilator, mahal, dan baby tu tetap akan mati, atau pun cacat seumur hidup, jadi memang right decision ni, untuk semua pihak."


Aku pun angguk. melenguh.


What a start of the day.

Thursday, March 26

missing those days..

cakap-cakap maestronine

i really2 do.. i would lie to myself if i say the opposite.. playing competitive rugby etc2.. if only i have the ability to turn back time.. rewind the injury.. it's very frustrating when you see the lads running on the pitch.. swinging and kicking the ball.. sidestepping the opponent.. up and under, dummy, "mark!!!", ruck and maul, aim high tackle low.. missing those terms..

ppl always say there must be "hikmah" behind all these things that happened to us.. i agree.. but deep down, it's really sad.. honestly, i can cry when i do think about it.. those moments of glory.. the day when i got injured etc..

witnessing the joy and excitement of the irish.. when their heroes have ended the 61 years wait for winning the grand slam of six nations, has inspired me to some degree.. they are living legends!! winning to me is everything.. although i still can accept occasional and rare losses haha..

and i believe in "live the moment, don't brag and dwell too much on your past".. your past is just a stepping stone for further success and glory.. i would love to make a comeback.. i mean a real comeback.. if given a chance.. i will definitely give it a go..


maestronine
thu mar26th2009 1935



Wednesday, March 25

Prostate Cancer etc

cakap-cakap shahied

Urology outpatients dept today.
I was a bit late bcoz had a bedside tutorial looking at different kind of drains, wounds and stuff.
So when i got there, there was already this 4th med girl there inside with the consultant.
The consultant then said that he can only have one student with him so told us to decide who should stay and who should go with his registrar instead.
I looked at her and she doesn't seem like she wants to budge/give up the oppoturnity to sit in with the consultant so i volunteered. Well, i don't blame her. We threw them out earlier for the bedside teaching because it would be too big of a group if they joined in as well(we politely said, shooh shooh ;p)
The registrar wasn't bad at all. He explained all his patients problem and management and delighted to take questions.
A few of the patients had prostate cancer diagnosed. So here are the few things that i could remember from the top of my head.

Prostate Cancer

Presentation: Can be asymptomatic, found incidentally usually on PSA testing or digital rectal examination
(all the patient that had the diagnosis today were incidental findings)
Those with symptoms can include: frequency, nocturia, dribbling, incontinence.
Those that present late could have: loss of weight, bony pain(due to metastasis)

So the usual story is they would usually have got PSA testing which showed increase PSA level.
Next they would have a DRE(digital rectal examination) to feel their prostate gland.
Then they would have a TRUS(transrectal ultrasound) guided biopsy
The sample would be examined histologically to see if there is cancer or not.

So it happens the prostate biopsy showed prostate cancer. Usually adenocarcinoma. What next?
First option is of course surgery. Removal of the prostate. But not everyone is suitable for surgery.
These are the criteria for undergoing surgery:
1. Age <65
2. PSA level <10
3. Gleason Score <6
4. No/minimal medical comorbidity

For those who are not suitable for surgery, hormonal treatment and radiotherapy is the next option.
Hormonal therapy usually involves:
1. 4 week course of antiadrogen injection (Casodex)
2. 2 course of LHRH analog (Eligard) every 6 month lifelong. (Apparently he said that Goserelin is not used here in Cork)
They will then be monitored every 6 month for their PSA level. Radiotherapy option can be done if they want it.

So thats about it that i could remember.

Next

So i finally saw something i never have seen before today. 
Port wine stain associated with Sturge Weber syndrome, in Urology clinic.
This lady actually came in with problem of incontinence. Just so happens that she has Sturge Weber Syndrome.
True the saying that once you see one, you never forget one.
Sturge Weber syndrome or its longer name Encephalotrigeminal Angiomatosis is Port Wine Staining usuall around the trigeminal distribution associated with contralateral focal seizures(due to angimomas in the brain), glaucoma and learning disabilities. She's taking detrusitol for the bladder, and as you might know, it is an anticholinergic which can exacerbate glaucoma(another good learning point). Apparently, thats the only anticholinergic that doesn't cause problem with her glaucoma.why?i don't know.

baby with port wine stain

hope you guys learnt something. 

peace 

Sunday, March 22

2.19 am

cakap-cakap shahied


Wahai tuhan,
Aku tak layak masuk syurgamu,
Namun tak pula aku sanggup ke nerakamu,
Ampunkan dosa dan terimalah taubatku,
Sesungguhnya engkaulah pengampun dosa-dosa besar,
Dosa-dosaku bagaikan pepasir dipantai,
Dengan rahmatmu ampunkan daku,
Oh tuhanku,
Wahai tuhan,
Selamatkan kami ini,
Dari segala kejahatan dan kecelakaan,
Kami takut kami harap kepadamu,
Suburkanlah cinta kami kepadamu,
Kamilah hamba yang berharap belas darimu.


Sebak..