I'm Back

It's strange how I had a sudden urge to blog. It's been 2 years and 3 months since I've last blog. It's weird that I feel this sudden urge but nevertheless here I am. I cannot believe it's gonna be 5 months till I finally graduate with a new prefix- Dr. Lee Pei Shin. It's crazy that 5 years of medical school is coming to an end now. It seems like only yesterday when I first step into Manipal. Now it's going to be the end of me school life soon and working life starts hopefully in December 2013. I am amazed at how time flies. And yes, I am still very much in love with my handsome PhD grad student-aka boyfriend. Let's see, I've met him in May/June 2011 and started dating in Aug 2011.. so in another 5 months time it would be two years anniversary. Not like we make a big celebration but this year would be different as we would be celebrating... belated anniversary in  New Jersey!! Yes, I'm going to USA to visit him, and yes, it's gonna be the first time that I'm going to visit him, he was back for a month during December 2012. Many things have changed since the last I blogged. I was diagnosed with hyperthyroidism just recently, it's devastating news but I was calm and cool about it, probably because I have been dealing with illness for so long that it really doesn't really matter anymore. Self pity is not a solution to this and neither would being sad helps. So clearly I need to be able to strengthen my willpower and get well soon. I would be signing off now. Tomorrow would be my psychiatry posting examination so wish me luck!

One of the many written by him

This morning is indeed auspicious
For I’ve never seen honey so suspicious
My woman drew me a beautiful picture
Filled with wonderful features

She makes me realized
That I will not be forever tantalized
I’m glad to have you as my soul mate
Owh, how great is our fate

-M-

Santa Claus is coming to town!

     Oh great! It's Christmas season again, and the malls will be decked with holly and berries and sparkling stars and bubbles and green trees and small gifts and mistletoe and everything else that's Christmasy!!! Alright, its not that soon but, in less than one month, Christmas will be here again!

      I'm trying to remember what I did last Christmas, I think I went to my lovely mentor's house back in India and it's awesome to go caroling from house to house and fill our tummies with Indian delicacies, mind you I was in India and yes, no turkey or lamb chop whatsoever but it was nice Indian homecooked food that I missed so much. Its actually so hard to find good Indian food in KL, everywhere I went, it all taste totally different from what I'm used to back there. I do miss good Indian food in Manipal.

I'm actually starting to plan my Christmas holiday *wink* My tummy growls at the delicious thought of dessert awaiting. Keep telling my tummy *Y U NO FLAT* but I will definitely go to swim more so that I can indulge in awesome chocolate cakes and cheese cakes. Yummy!

Oh well, I shouldn't blog too long. Should get back to my work. Good night! 

In Time

       Had a fun movie outing with 3 girls and 2 guys to watch In Time. Thank goodness there's only one couple there that would remind me of him. It's pain in the ass to watch couples in love when you're in a long-distance relationship,never mind the fact that it is 12500miles apart.Being in a different time zone sort of tunes my body into an auto-NJ clock. It rings at the most inappropriate hours, and it winds down just when he wakes up to sunshine. Being a medical student doesn't help much either, with all the long hours in ward and lethargy seems to hit at the most inconvenient hours.

       But still, I'm loving every moment with him, being with him is like lounging on a couch with a bar of chocolate and a good ol' intriguing novel, with warm blankie and sound of rain pattering down the windowsill. It's the peace and quiet from the all the hectic routines and endless rote memorization that I love most.

       A sudden realization dawn on me when I was watching In Time. It was a mere memory of myself from the past but it hit on quite hard, a smart rap on the head like Prof M does it on everyone. Would I still be hanging on to the past, like what I have been doing all these while, or would I start to grow up and listen to my own heart like it should have for the last 22 years and 355 days? Time is something that I've always take for granted. It has always, another day for me, another week, month or year, thinking that I have many of them to come.

       But realistically speaking, no one knows when exactly we will leave this world. I would have many many things to be done but being a perfectly healthy girl, I wouldn't think much about life and death as much as a person should at my age. It's called pessimistic ain't it if I were to start thinking about it?

        Everyone takes things for granted, young people eat unbalanced food thinking that it's okay to flood the body with grease and chemicals, leaving another day to the deadline of assignments, and couples bickering like they have a lifetime to do it. It's pretty much annoying to me because to hear those bickering, to hear those tiny arguments and conflicts drains the positive chi around me. It matters not what you are bickering about, but its those piercing words and raised tones that irritates me, why the hell do you even wanna raise your tone at someone you love?

         Okay, I might have overreacted but believe me when I say I have my share of crazy arguments when I was young. Now, it's time to grow up and stop acting so melodramatically over small matters.

Off for dinner with a couple of great friends, will miss them so much when medical school is finally over! 

On Kids + Job Satisfaction

     I slept off at 10.30pm last night, woke up to talk to my man and slept off again because I was so tired from posting in Paediatric ward. I had a good day yesterday, clerked a case of probably acute exacerbation of bronchial asthma *because specialist didn't wanna label her off as asthmatic yet* and stayed till 4pm even though we were left alone without supervision due to unforeseen circumstances i.e. one of my Paediatric professor decided to leave MMMC *still am skeptical about this because she's not the kind to leave suddenly without informing us* hmmm..feeling a lil' sad, will kinda miss her eccentric giggles.

     I left the ward feeling absolutely elated, maybe it's because of the Kopiko sweet I'm currently addicted to, or mainly because the patient's mother actually asked for my name yesterday, after a long talk with her at bedside, not merely a one-way conversation whereby I asked for details of her child and she replied with tons of medical symptoms, but a  long conversation where I answered her doubts and we discussed nutritional plans for her child. Not that I'm a nutritionist but I believed I've read enough and knew a lil' bit more than her on what to feed a growing kid with chronic long term illness like asthma.

      Anyway, it may sound silly and a little narcissistic to others, why, she's only asking for your name but, believe me, when you have so many patient and family members that you see each day, none cared enough to even ask for your name because they think that you are troubling them every day by asking so much details but yet not able to contribute to management of the patient. That's why I had the best job satisfaction day ever! Off to lecture now. Ciaozz 

A brand new blog, with a brand new chapter of life and a someone important I've yet to introduce here..now off to do group study with Faten..ciaoz

Major Overhaul

I'm getting tired of this blog's interface, the design, and everything else.. this calls for a revamp on this site.
So look out for brand new blog next week!!

Signing off,
Carol in pensive mood

The Day I Could Smile Naturally and Confidently Forever!!!

 yippee..no more nerdy braces Carol!!! Happy New Me!! New Year New Smile!! :)
New Fit Bod too! will aim for goal of ultimate health bod! 

Don't Lose Your Mind, Lose Your Weight

Diet has become a strong 4-letter word that isn't.Diet is not starvation.Dieting is not about 'going-on' a diet.There is no such thing as going 'on' or 'off' your diet.Eating correctly has to be a lifelong commitment .What is more important is that you treat yourself well ,feel good about yourself, be committed to eating properly and exercising!!


This is the wisest word I've heard so far about D.I.E.T. 


It's no longer about calories. 
It's no longer about fat content.
It's all about healthy portion, fresh food and good amount of exercise!


LIVE HEALTHY IS A PROMISE TO MYSELF FOR YEAR 2011!! 
( I refuse to call it resolution because if I can't achieve my resolution its okay, but I've made a habit of not breaking my promises any more. I must be a responsible human in life :p )

On Republic Day of India..I

It's my first time watching the parade during republic day. I've always wanted to watch but for the past 2 years I've never gotten enough of sleeping hence never making it to watch my college march. This year, I've made a promise to myself to wake up early whenever possible. I've watched horror movie the night before and I've slept over at my friend's place but I still woke up at 8am to drag myself home and grab a tuna sandwich before walking down to KMC Greens. It's been a great parade to watch I definitely must say but personally I feel Malaysian students can march better...not just our college people.. any uniformed bodies would have marched better. Have you seen the marching competitions? and the band competitions in Malaysia? I must say that it is an awesome sight to see the absolute synchronization.Don't believe me? Try youtubing it and watch for yourself. 

On the other hand, I've just finished my community medicine and I must say it's been a great 3 weeks-journey for my holistic mind. Not only I've so much free time for myself to do the things I've wanted like catching up on my TVB Hong Kong dramas but also on the novels that I've abandoned for so long. And also going to gym everyday without fail (okay, honestly, I've skipped a day or two). 

Community medicine used to be a stranger to me, I've not fully comprehend the actual point of doctors leaving the more challenging and interesting, not to mention, lucrative fields like surgery or internal medicine but now, finally after 3 weeks of being in their shoes I've realised that the doctors in community medicine and public health are the ones with the greatest ambition. They are not only passionate towards patients as a person but they are passionate to improve the country's health system as a whole. Without them, there would be no health system working in order, no patients referred from primary health care to tertiary health care (hospitals), no medications supplied on time etc. It would be chaotic to work as a doctor in hospital. Nursing staff , hospital waste management, even though they seem to be irrelevant to us doctors, but working in a hospital is just like working in any office. You need teamwork, you need good organizational skills and communication skills to be able to survive. As for knowledge itself, it is a must for any good doctor.

So , for future medical students going for community medicine rotation, observe and watch the whole system play. You will realise the importance of this branch of medicine once you learn to open your mind and heart to a whole new level of passion in medicine. I've wondered to myself, why a doctor would want to take up public health when in fact he could be like any doctor working in hospital or private practice. I've wondered, I've wanted to ask. But I held back my question and I've wanted to observe. I've read once about Pulse Polio Programme in India from a surgeon named Atul Gawande who authored the book "Better" . I will recommend this book to any medical students undergoing community medicine rotation as you will see a totally different side of community medicine. It will definitely be an eye-opener and by the time you flipped to the last page of the book, I hope that you will place importance to community medicine as much as you've placed importance to the other branches of medicine. I hope that you will see community medicine as I've seen them. 

Come tomorrow, I will start my paediatric posting. What to expect in paediatric posting? I've googled some and these are the links to some interesting articles. Hope it will be of use to some :) 

Guidelines for the MBBS Students during Paediatric Posting

http://www.prsharma.com.np/students/MBBSStudents.pdf

Examination of a  newborn baby

http://www.newbornwhocc.org/pdf/teaching-aids/2010/Examinationofanewbornbaby-ENC6.pdf

Examination of the Newborn

http://www.adhb.govt.nz/newborn/education/Teaching/5thYearsNewbornExam.htm

Excellent Care from the Moment of Birth

http://newborns.stanford.edu/

-till next, signing off with lots on her mind, carol -

that's me in 2007 and 3 years later this is me in 2010..hmmm how much I've changed??
Physical changes and definitely cognitive maturity increased...I hoped :p
As the end of 2010 draws nearly, it's again time for reflection of the past year.
Achievements and mistakes, good things and bad things..they come and go as they wished and it's not under anyone's control.
So fear not of the new mistakes that you may make in 2011 and focus on the goals to achieve in 2011!!

Resolution of 2011. Coming after Christmas..since it's time to do some serious thinking plus have fun!
P/s: I'm going camping and sleeping in a real tent for the 2nd time! too excited :) can't wait to take lots of photos!

MERRY CHRISTMAS TO ALL MY READERS!! MAY THE SANTA BRING YOU MUCH JOY AND HAPPINESS FOR THIS JOLLY SEASON!!

I'm Back!

I'm sorry for my leave of absence for see...urm 6 months? I kinda thought I would abandon this blog but my love for writing(I talk a lot,ask my room mate) overwhelmed my laziness.Okay.Updates I know,

1. I passed my year 2 and i'm officially in year 3( In another 2 months plus, I'm leaving Manipal for good and I'll continue my education as a medical student in Melaka,Malaysia)

2. I was elected as the class representative for my batch and student president for the fiscal year. Technically, I play the role of bridging the lecturers and students together

3. Inter-batch 2010 is almost over and I hope the rest of the games will proceed as soon as possible so that we can finally close the chapter of Inter-batch (It's a month long-actually more than that-event that consist of two parts :sports and cultural, we have 20-30 events to organise and thank god I'm almost done with it)

4. Annual Day 2010 was successful and I manage to grin stupidly the whole time I was on stage because I didn't want the photographer to capture my frowning face.(just in case it goes into college magazine like that). Congratulations to my dear friend,Elora the Gold Medalist 2010 and all the prize winners :)) I'm so proud of you all:))

5.My birthday was celebrated with much joy and surprise element because I was bluffed into it.But I absolutely love it this year.Probably because the tension of examination is no longer there.

6.The parade for the inauguration of Manipal University Convocation 2010 went smoothly with me wearing saree (weee second time:)) ) Lucky me because it's inaugurated by the President of India, Smt.Pratibha Patil so I get to see her but really she looks so sombre..I think because she feels so hot in her professor-Harry-Potterish-gown :)

7. Lagenda!!! It's a Malaysian food festival and cultural event whereby we invite all Malaysian students from all over India and showcase our talents and culture to all the local Indians and international students here.Too bad I didn take any photos because I was too busy preparing for my stall. HO CHIAK=TASTY
We sold fried wanton, fried chicken meat ball, coleslaw , mash potato and pandan green bean soup :)) It was a lovely evening of all food and people :))

 

8. Lastly, I'm currently in Psychiatric posting so I'll update more about my studies instead soon :)

Till next, Carol

What Hurts The Most

I can take the rain on the roof of this empty house
That don't bother me
I can take a few tears now and then and just let em out
I'm not afraid to cry every once in a while even though
Goin' on with you gone still upsets me
There are days every now and again I pretend I'm okay
But that's not what gets me

What hurts the most
Was being so close
And havin' so much to say
And watchin' you walk away

And never knowin'
What could've been
And not seein' that lovin' you
Is what I was tryin' to do

It's hard to deal with the pain of losin' you everywhere I go
But I'm doin' it
It's hard to force that smile when I see our old friends and I'm alone
Still harder gettin' up, gettin' dressed, livin' with this regret
But I know if I could do it over
I would trade, give away all the words that I saved in my heart
That I left unspoken

What hurts the most
Is being so close
And havin' so much to say
(Much to say)
And watchin' you walk away
And never knowin'
What could've been
And not seein' that lovin' you
Is what I was tryin' to do, oh
Oh yeah

What hurts the most
Was being so close
And havin' so much to say
(To say)
And watchin' you walk away
And never knowin'
What could've been
And not seein' that lovin' you
Is what I was tryin' to do
Not seein' that lovin' you
That's what I was trying to do, ooo

100 Books to read before you die

 

1 Pride and Prejudice - Jane Austen

2 The Lord of the Rings - JRR Tolkien – I seriously doubt this..i read one chapter of it and returned it to my friend’s brother. I can’t stand the font! I’ll be blinded at the end of the book one I’m sure

3 Jane Eyre - Charlotte Bronte

4 Harry Potter series - JK Rowling

5 To Kill a Mockingbird - Harper Lee

6.Better –Atul Gawande

7 Wuthering Heights - Emily Bronte
8 Nineteen Eighty Four - George Orwell
9 His Dark Materials - Philip Pullman
10 Great Expectations - Charles Dickens
11 Little Women - Louisa M Alcott

12 Tess of the D’Urbervilles - Thomas Hardy
13 Catch 22 - Joseph Heller -

14 Complete Works of Shakespeare – a little skeptical about finishing this because Shakespeare is really not my thing
15 Rebecca - Daphne Du Maurier
16 The Hobbit - JRR Tolkien
17 Birdsong - Sebastian Faulk
18 Catcher in the Rye - JD Salinger
19 The Time Traveler’s Wife - Audrey Niffenegger –I love the movie and will definitely read this
20 Middlemarch - George Eliot
21 Gone With The Wind - Margaret Mitchell
22 The Great Gatsby - F Scott Fitzgerald
23 Bleak House - Charles Dickens
24 War and Peace - Leo Tolstoy
25 The Hitch Hiker’s Guide to the Galaxy - Douglas Adams
27 Crime and Punishment - Fyodor Dostoyevsky
28 Grapes of Wrath - John Steinbeck
29 Alice in Wonderland - Lewis Carroll
30 The Wind in the Willows - Kenneth Grahame
31 Anna Karenina - Leo Tolstoy -

32 David Copperfield - Charles Dickens
33 Chronicles of Narnia - CS Lewis
34 Emma - Jane Austen
35 Persuasion - Jane Austen
36 The Lion, The Witch and The Wardrobe - CS Lewis
37 The Kite Runner - Khaled Hosseini
38 Captain Corelli’s Mandolin - Louis De Bernieres
39 Memoirs of a Geisha - Arthur Golden

40 Winnie the Pooh - AA Milne -

41 Animal Farm - George Orwell
42 The Da Vinci Code - Dan Brown -

43 One Hundred Years of Solitude - Gabriel Garcia Marquez
44 A Prayer for Owen Meaney - John Irving
45 The Woman in White - Wilkie Collins
46 Anne of Green Gables - LM Montgomery
47 Far From The Madding Crowd - Thomas Hardy
48 The Handmaid’s Tale - Margaret Atwood
49 Lord of the Flies - William Golding
50 Atonement - Ian McEwan
51 Life of Pi - Yann Martel

52 Dune - Frank Herbert
53 Cold Comfort Farm - Stella Gibbons
54 Sense and Sensibility - Jane Austen
55 A Suitable Boy - Vikram Seth
56 The Shadow of the Wind - Carlos Ruiz Zafon
57 A Tale Of Two Cities - Charles Dickens

58 Brave New World - Aldous Huxley
59 The Curious Incident of the Dog in the Night - Mark Haddon

60 Love In The Time Of Cholera - Gabriel Garcia Marquez
61 Of Mice and Men - John Steinbeck
62 Lolita - Vladimir Nabokov
63 The Secret History - Donna Tartt
64 The Lovely Bones - Alice Sebold

65 Count of Monte Cristo - Alexandre Dumas
66 On The Road - Jack Kerouac
67 Jude the Obscure - Thomas Hardy
68 Bridget Jones’s Diary - Helen Fielding

69 Midnight’s Children - Salman Rushdie
70 Moby Dick - Herman Melville
71 Oliver Twist - Charles Dickens
72 Dracula - Bram Stoker
73 The Secret Garden - Frances Hodgson Burnett

74 Notes From A Small Island - Bill Bryson
75 Ulysses - James Joyce
76 The Inferno – Dante
77 Swallows and Amazons - Arthur Ransome
78 Germinal - Emile Zola
79 Vanity Fair - William Makepeace Thackeray
80 Possession - AS Byatt
81 A Christmas Carol - Charles Dickens -
82 Cloud Atlas - David Mitchell
83 The Color Purple - Alice Walker
84 The Remains of the Day - Kazuo Ishiguro
85 Madame Bovary - Gustave Flaubert

86 A Fine Balance - Rohinton Mistry
87 Charlotte’s Web - EB White
88 The Five People You Meet In Heaven - Mitch Albom 
89 Adventures of Sherlock Holmes - Sir Arthur Conan Doyle -
90 The Faraway Tree Collection - Enid Blyton
91 Heart of Darkness - Joseph Conrad
92 The Little Prince - Antoine De Saint-Exupery
93 The Wasp Factory - Iain Banks
94 Watership Down - Richard Adams
95 A Confederacy of Dunces - John Kennedy Toole
96 A Town Like Alice - Nevil Shute
97 The Three Musketeers - Alexandre Dumas
98 Hamlet - William Shakespeare
99 Charlie and the Chocolate Factory - Roald Dahl
100 Les Miserables - Victor Hugo

82 more to go…phew…

Tuesday in ink

 

My beloved parcel reached in 3 days.Yippee!!

I admit.First time I’m buying books online and had good experience. Books were freaking cheap!!! I bought 6 books for *ahem* Rs900! oh em gee! lucky i save up for this month. I was sooo happy..imagine the price is like 25-50% of MPH. *MPH go bungkus and lompat*  

I’m already thinking of saving for few new books next month :) I can finally indulge in buying new books without the guilt of paying so much for it. Gosh! Back in Malaysia, a trip to MPH would cost me rm70 for 2 fiction novels. Here? I could get at least 4!!

Now this September I’ll be coming back to Malaysia so I’m planning to buy more novels back. If you want any title just text me and I’ll quote you the price :) Though be clear that I’m staying in Subang and you have to come collect the books from say maybe Sunway Pyramid or SS15 :)

 

I know that it’s an old book. Who Moved My Cheese.I remember seeing my mother read the chinese version when I was probably still in primary school but I couldn’t read chinese so I wasn’t interested at all till I stumbled upon this title few days back.

1st Love

I think everyone remembers their first love. And the first time they hold their beloved’s hands. May it be the corny grab over the same soft toy while shopping or the sudden awkward groping in the dark cinema or even the worried grabbing to protect your loved ones from crossing a busy road.It’ll still be etched in your mind. It’s funny how time flies.For me it’s been 8 years since my first love. Yeah. How bout you? Sometimes life really flies by so quickly that in a blink of an eye a year had passed. I once read,” Do stop to appreciate the beauty of the  flowers and smell of the fresh dews along the journey to make the end of your journey worthwhile.”

Just to say,if you have it then hold it tight.

Random doodling.

\

A Sunday of my life drawn in ink

Suturing Banana(Edited version)

So since I’m a wannabe surgeon I have to learn to suture.Actually it’s a must for all doctors to learn how to suture.

My first experience with the sutures was way back when I was young(probably about 9 years of age).  And being an excellent cyclist then, I could cycle without both hands (not that it’s a great achievement—kids don’t learn this stunt please) it was almost always a great joy to cycle speedily and stop pedalling right before a bump.Ah bummer!!  I remembered how I heroically speed on my bike across the bump on the road and of course landed on my bum off the road. I barely got scratches and I picked myself up. I’ve decided that my adventure for the day should come to an end.

So I picked myself up and made a turn to turn into my lane. Suddenly, the nieghbour around the corner who was watering her flowers called out to me and beckoned for me in such hurry that I was kinda shocked. I stopped in front of her house and asked kindly, “Auntie, why? What happened?”

She replied, “Come girl, aiyoh, what happened? You fell down ah?”

“Oh how you know ah? You saw me right?”

“No!! Look at your shirt!!And look at your chin! Come, I walk you home now.”

I was dazed when I looked down, the front of my white tee was looking as if someone had thrown a red paintball at me. I turned and walked back towards my bike slowly. I swung my leg over the seat and sat atop of my bike, pushing my bike forward to leave when I was stopped by the lady again.

“Come girl, don’t ride anymore.Just walk with me.”

I was reluctant at first because I just wanted to reach home as soon as possible but I got down and pushed my bike instead. The walk home was a long walk. I was nervous to go home because I knew I would get a good sounding from my mother.

When I reached home, my mother thanked the lady and brought me into the bathroom to wash my wound. I laid down on my bed and closed my eyes.I wasn’t feeling the pain at all.

It’s strange, I thought to myself as I thought it would actually hurt seeing how much I bled. My mum shook me gently and told me that we should go to the Klinik Kok and let Dr Wendy have a look at it. I told my mum I felt fine and it’s not necessary but she persisted anyway.

She told me, “Kai hua liao” ( Translated from Mandarin meaning, sudah berbunga..lol my skin split like flower petals blooming") 

Dr Wendy had a look at my chin and decided it must be sutured. I was scared but I put up a brave face(you know the ego me :p) Anyway it was over in less than 5 minutes, I got 7 stitches in total.

I barely remember the details but I remembered the weird feeling of the needle pulling and tugging at my skin yet I didn’t feel the pain at all. Which is darn good ok! If not I would have cried but I didn’t.

Ok fine. A little. But not the wailings and screamings ok. Just tears rolling down.

So that concludes my experience with the 1st needle in my skin. Now let me show you how it’s like.

You’ll need this

From up to down

Scissors

Toothed forceps

Blunt forceps

Needle holder

Needle

lastly the black roll of thread and oh you need a patient

Cut your patient up if he's not already wounded

1. Sterilize everything, in my case no need since my patient is a fruit (banana)

2. Next wear gloves, in my case also no need since my patient won’t be infected with microorganisms anyway..and even if infected also neh mind. No need antibiotics also

3. Use syringe and inject 1% lidocaine ( local anaesthesia so that your patient don’t feel the pain) In my case also tak payah cuz my patient don't know how to howl in pain.

4. Stand by facing the wound like this

5. Left hand hold tooth forceps.

6.Right hand hold needle holder( left hander too bad lar..i don't know how to teach left hander)

All nice photos courtesy of NEMJ 

Start by threading the needle,use needle holder to clamp 1/3 of the needle like this

  Then use a toothed forceps to lift up part of the skin.

(oh I missed the part where you need to clean the wound with iodine..neh mind my patient very clean, cuz I cut him with sterilized knife) Right, where was I?

Oh ya lift the skin up and push needle through the skin of your patient. Make sure bite width is the same which means like this.

 

Lazy spray paint my patient.Anyway it’s the same patient,duh.

Make sure your bite width is the same. about 0.5cm-1cm depending on the size of wound and location of wound. (if thick skin then bite width more to ensure maximum tension equalling to original skin tension)

Then bla bla bla.. then surgeon knot

Ok this is a little tricky. 1st, throw aside your toothed forceps. Then pick up blunt forceps with right hand.Release your hold of the needle ( unclamp your needle holder- actually its the one looking like scissors here) and place it parallel to the wound. 

Use the blunt forceps to  clamp lower end of the thread like the above picture. This is the starting position.

Then make two round around the needle holder.End product look like this.

Without letting go the grip of both blunt forcep and needle holder, turn your left hand (your needle holder)  90 degrees and grab the upper loose end of the thread while maintaining the position of the two rounds of the thread around it.

End like this. Then remember to pull it tight (not too tight..your patient’s skin might overlap or worse tear..if overlap very ugly scar will form..if tear prepared to be sued)  till the edges pushed up slightly. So that the wound heal without a scar.

 

Just in case you are confused with my small diagram..this is bite width A and X must be of equal distance :)

Remember to repeat surgeon knot twice for each suture. Second time, place blunt forcep in same direction parallel to wound but right hand holding the needle holder need to clamp the opposite end of the thread ( meaning if you hold the lower loose end just now, now you hold the upper loose end as the starting position) 

After surgeon knot, pull both end of thread to one side of the wound and snip off the extra thread. This is one suture done. Then continue the same till you get this!

 

 

Pardon my photos, I took it with my 2mp phone camera so it’s a little fuzzy.

Remember to check bite width  and bite depth

 

Surgeon Knot No.2 (NEJM version)

Extracted from

The New England Journal of Medicine

Basic Laceration Repair

Todd W. Thomsen, M.D., Derek A. Barclay, M.D., and Gary S. Setnik, M.D.

Department of Emergency

Medicine, Mount Auburn Hospital, Cambridge,

MA (T.W.T., G.S.S.); the Department

of Emergency Medicine, Brigham and Women’s

Hospital, Boston (D.A.B.); and the

Division of Emergency Medicine, Harvard

Medical School, Boston

 

To begin the first knot, place the needle holder parallel to, and over, the wound.
Hold the needle end of the suture with your non dominant hand, allowing the needle to rest on the sterile drape.

Next, wrap the suture over the needle holder
twice. This forms the surgeon’s knot, which prevents the first “throw” from loosening.

Rotate the needle holder 90 degrees, grasp the free end of the suture, and then use your hands to pull the two ends in opposite directions across the laceration,tightening the knot only enough to approximate the wound edges.

Begin the second throw by again placing the needle holder parallel over the laceration. On this and all subsequent throws, wrap the suture over the needle holder only once
before grasping the free end with the needle holder and tightly securing the knot.

Place a total of four throws. After the final throw, pull the knot off to one side of the laceration, so that it does not lie on top of the approximated wound edges.

NOTE: It’s different ( bold words) from what I’ve learnt in class so I put it up just in case there’s contradiction with what you might have seen before or learnt before :)

THE END!

XOXO

wannabe-surgeon

Still going to practice more and more times till my left hand doesn’t shake anymore whenever I apply pressure on my forceps.

My Big Sista

Since my big sista posted my fugly photo on her blog…gosh jatuh saham lar aku… i have to seek revenge by putting her fugly photo too right? well..say ni easy…shit i dont have any of her fugly photo..well this proves something..my sis don’t have fugly photo because she’s too pretty :p *i tolong naikkan saham you tau..since a lot of my friends are hot soonish-dr*

noooo this is me ok not my sis

ok lar…wait..i found this photo while browsing so i decided to put it up..i think this is me when i was seven^^ my neighbour actually thought i was a boy note: with pierced ears *wtf* and actually asked my mum why you dress your son in pinafore..WTF!! I know i have short cropped hair with thick bushy brows!! I’m a girl yo auntie!!

ok now back to my sister’s picture

She lights up my dull life whenever she’s around..

*why do birds suddenly appear..every time you are near…just like me,they longed to be..close to youuuuu *

it’s just funny how life has brought me so far up till now.

It’s such a coincidental/fate/pure myth that has made me think maybe this is destined.Let me try and explain the gist of it.

My sister and I both have a mole on the sole of our feet..mine on the right feet and hers left. So weird right??? Anyway according to Chinese fengshui/face reader/mole reader i don’t know what you called it.. it’s a sign that reads we will both travel far and to many places. How true is that we never knew till now that i think of it, it’s so ironic that she has been to many places which  according to this moleology is fate.

First,she was drafted to National Service (wow hard to believe this midget… she’s only 5 feet..wait is she even that much? i think slightly below 5ft :p)  in army service right? Then she got into UNIMAS, Sarawak which was when she decided to jump ship to UMS,Sabah and holla! Since then, there are numerous places that she’s been that have lead me to believe in it too!

And I’m drafted to India! kidding..i came to India to fulfil my life-long dream to becoming a doctor. Now, I’m almost 25% done( I’m only in my 4th semester out of the 10 semesters to go through with-GOSH!!!)

Conclusion, I think it’s a coincidence but I like to believe it’s fate. I never thought I’ll actually come to India..I have imagined  myself in Moscow, taking metro (subway) to lecture halls or even Indonesia(speaking indon) but India wasn’t in my planned  daydreams definitely. But I’m glad I came anyway because this past years  have made me realise how attached I am to my family and especially my sister whom I’ve shared a room with since I was born till even now (when both of us are back at home that is ) SISTERHOOD ROCKS!!

Anyway it’s great to reminiscent about good ol’ times.

I missed sitting on you (since i’m way bigger :p) and seeing you protest in vain Hahahahaa!! And hearing your stupid excuse of not being able to breathe to get me off your back but hey! guess what? I’m not that dumb to trust you! So I’d continued sitting no matter how red your face turned into(like tomato)..ignoring the screams of pain and fake acts of gasping for air (interlaced with smiles and laughter so I know you are faking it!)

I miss you too! Can’t wait to sit on you again! @.@

p/s: I can imagine your silly laughter now after reading this HAHAHAHA

XOXO

your baby angelic sis :p

I-am-so-lazy-to-blog Day

Omg I'm so blardy lazy that all i wanna do is sit and stare at the screen

So I'm not moving anymore to save strength today

I'm so darn excited at the new sports complex yet I'm so lazy to describe it and I happen to come across my buddy Izza's post..soooooo....

Lazy people like me tend to link you to somewhere else so HAHAHHAHAHA enjoy MY FRIEND's POST Lol..http://whenthoughtcounts.blogspot.com/2010/04/in-love-with-new-arena.html