Soap opera

Spoiler alert: I am on the verge of crying. Almost made it as the role model for DSM 4/ major depressive disorder criteria. I am the living example of neurotic patient SigmundFreud hadn't dare to analyze.



A gentle reminder: I had a nice hair cut recently! see previous blog.

 I have loads to do! I think my sincere love to the musculoskeletal system is translating into this ortho umm love? (eww, I am throwing up already ). Or is it the fact I am over thinking about my little sister travel? Things in my part of the world is "unique". Call us retarded, but  we are the group. No space for a selfish individual (theoretically speaking of course). And let me put it straight: I am a big believer in the group thing that I took it to a new level.( what is that? You think I wrote that to make up for my nonsense homesickness ?)



My parents are sixty something. They are fragile. Living almost alone. I worry about them all the time. I fear my dad will had ,yet, another heart attack and the idea of mum wondering helplessly turned my life into a nightmare. I am worried that the annoying pain mother is feeling in her operated breast is a recurrence. I am terrified of losing my parents for they are life for me.* I am afraid of the day my younger siblings will become orphans. Yes I am so spoiled. Yes I am so attached to my parents. Yes they made sure each one of us know how proud they are to have us. They are life for me ( have I said that already? And yes I enjoy life and do things to my utter happiness. And no they have no say in my career choice.)

This homesickness thing wasn't the norm.  It was there in my first year in college and  after my parents develop these ailment  came back.**   ( why I remembered Zarathustra all the sudden?)

I have a presentation*** to do and an assessment to study for. I was shamelessly indulged in self pity the whole weekend, that I feel stupid and robotic right now. I need to get started. I'll take a shower, dance ( don't even ask), maybe write a post about a couple of interesting cases/stories I saw so far in ortho. Then I'll embrace ortho.

P.S. I just noted I had such crying episode while in pediatric rotation. It is funny I was considering both as my future specialty of choice. Ortho is lovely trust me. You need to know the basic and then everything will fall into place ( I guess).

* I was literally sobbing while writing that

**I stopped sobbing here

*** Oh, do I dare to say I was nicely prepared, hadn't my consultant totally changed the topic hours before my weekend started. Good thing the older topic was broad ( and interesting) and  serve me good in revising some anatomy . I thought I was the master of compression neuropathies!

Busy

I feel so busy , yet I am doing nothing. I stupidly decided not to attend  the clinic and the seminar today  for no reason . I wasn't even sleepy and I t didn't study. Laying in bed from 12 am to 4 pm (  working day is from 6:30 where the bus pick us for the 1 hr trip to the hospital and the return is at 4 pm) is not a day well spent. But it's too late to regret. I have now to work  with.

I attended a knee clinic yesterday. The consultant explained knee examination nicely. I am still uncomfortable with meniscus exam. Other ortho exam…not sure at all. I didn't revise  them yet. I was determine to read the whole locomotor thing, but that is a nerve wrecking task. I am glad I passed that subject as I hate it most. There is a weekly assessment starting from the second week.  I guess I will go quickly over the examinations  and revise whatever I see in the clinic. Worrying about the end of year exam and my sister travel for 1 year is eating me.

I wish I can keep writing here to procrastinate more.  I am all grumpy right now. I guess I'll call dad, read for my presentation discussion tomorrow and maybe prepare view  slides. And if time allow , go through shoulder exam.

Wish me luck!

Big wards!

Hi,

I hope everyone is doing great. I am enjoying life at the moment. In fact, I have been socializing a lot for someone whose end of year exam is in less than 3 months. I started orthopedics ( bones and muscles rotation) in the biggest ortho center in my country. Saw a variety of cases. I attended pediatrics ortho clinic. There were many cerebral palsy cases. Cerebral palsy has a wide spectrum of causes (one is severe jaundiced in infants causing Kernicterus) with different presentations. It becomes apparent in the first 2 years of life. Patients need decent physiotherapy, usually until they are 16 years old. Tenotomy(releasing the tendon from its bony attachment) is necessary.

I also saw a case with operated meningocele and few developmental dysplasia of the hip (DDH) which I have been told is very common here. DDH is "an abnormal formation of the hip joint in which the ball on top of the thighbone (femur) is not held firmly in the socket. In some instances, the ligaments of the hip joint may be loose and stretched". It is important to detect it early as the prognosis is age dependant. Too bad (and scary), I couldn't appreciate the click generated by relocating the femur head while doing ortolani test. I can only hope to be able to do so by the end of this rotation!

 

I have been told the staff here is very keen to teach especially if they saw any sign of enthusiasms. I need to revise the ortho examinations ( which have funny big names, hence the title of this entry) and deformities names to not shy away and appear uninterested.!

Bed time already. It happens to be the time I feel sorry /anxious for not finishing/starting revising dermatology and family medicine notes! I have not even prepare for the new rotation. O and I am with one of the sharpest/nerdest medical students group…hallelujah!

P.S. I noticed I need respectable proof reading. My apology to any possible readerL

Weddings season

 

This weekend I attended  3 weddings and an engagement party. One of them was of a close friend and a flat

The progressive effect of glaucoma on the vision

mate that just graduated. So lovely and refreshing.  I also got my hair cut. It looks fabulous.  I couldn't stop taking pictures and it was hard convincing myself to sleep with such pretty hair.

School wise, I attended a  neurophthalmology clinic with a brilliant consultant. So brilliant in fact he made complicated topics sound really easy. Even better he took the initiative to teach us and made us do examination in turns in the most friendly way. Bless him. I am now comfortable dealing with slit lamp. I know my way through cornea, iris, anterior chamber and retina, thanks to him.

  Neurophthalmology deals with the nerve supply of the eye. Namely cranial nerve (CN) 2 to 7.  Each nerve has it is own function and hence specific pathology.  The optic nerve (CN 2) is  formed by the meetings of  millions of nerve fiber  making  the retina.  We can examine its function by checking the visual field, visual acuity ( how clear we see things), color vision and pupil function ( constrict in the presence of light and dilate in the dark).  There are many  conditions that affect  optic nerve from simple trauma, glaucoma to syphilis!

In a side note,  I got a chance to do the elective in Canada! But now I am doubting. Simply because of  my silly homesickness and it will be freezing there at the time of my elective.

In a second side note, I hadn't done much revision for the end of year exam, known here as the mini MD. Anxiety, unproductive type I guess, kicked in.

A third side note, I am considering taking a course in the British council. Very expensive one. And it is about 30 minutes from my hostel.  I am afraid it'll affect my budget for the elective. I seriously need to improve my English skills.

That is for now.

Have a nice time everyoneJ

Ophthalmology

Hi,

The last 2 weeks went pretty fast, including the Eid holiday. I haven't done much studying during the break. Today I spent some time doing old exams questions. It turned out I need to  re consolidate what I read.  I am planning to read Toronto notes as everyone  is recommending them. Alternatively I'll reread boards and wards in the weekend!

In the clinic, I saw plenty of keratoconus. A condition in which the cornea thins out and replaces its nice curve with a cone shape. Sometimes it is severe enough to be seen by naked eye. The lower lid also form a V shape while looking down (munson sign).  In slit lamp the cornea shows vogt's striae which are stress lines from stretching the thin cornea . Occasionally the cornea  stain olive (feischer ring).  Patients suffer from blurred vision, photosensitivity and poor night vision. It can be treated by  hard lens to correct the refractive errors, corneal collagen cross linking or corneal transplant if very severe.  

 I also saw a case of ruptured globe. The poor guy was working when a nail fly into his eye completely lacerating his cornea. He has a real big hyphema  and his pupil was nowhere to be seen. He was in so much pain. Hopefully they will be able to safe his vision.  

I hate the fact I didn't see the commonest conditions one is expected to encounter  in a primary care sitting.  Cases like red eye,  chemical burns ( you need to immediately ( within seconds if possible ) wash with water- and keep doing so for about 20 minutes - even if the water was not clean. Chemicals damage the cornea for good and if alkali it'll penetrate deep) foreign body or lid laceration. But textbook pictures are there for a reason.

Eww I need to get up really early tomorrow, a new hospital (but still opthalmo).

Have fun everyoneJ

 

Time!

How much time do you spend studying?
Some of us will give a time frame ( e.g. from 4 pm till 8 pm). A professor once challenged us, those who think their studying is consuming their days. He challenged us to use stopwatch & stop it whenever our phone ring or the door knock. Surprise surprise,  we hardly spend a sum of two hours studying .  In my preclerkship, I met a registrar who promised us, that if we study 3 hours a day (including watching educational videos or answering exams questions) we will be among the top five. He happened to graduate with a distinction!
Just reminding myselfJ

So last Wednesday I couldn’t sleep thinking/searching about the elective. Nothing new. I woke up 5 minutes before the end of the clinic. Good news I just missed a presentation about papillary reaction.  My weekend was quiet and nice. I just arrive in the dorm and I should be in the dream land already!

Good night everyone!