1st cycle-TB updates

* my pathologically predisposed asthenic chest fluorography result*


*1st day...I had to circle it with purple pen because the papule was invisible*

11th september'09 @ 1550

TB classes will be coming to an end next wednesday.Sarah and Xiang Yun did favour for us by asking the professor and our doctors to end the class earlier maybe on tuesday so that we can have 1 day study break and do the 1st exam of our 1st sem of 5th year on thursday.No answer was given yet...he said they will think about it.

I love learning diseases in human beings.It's very enlightening and gives me satisfaction when I learn more about these diseases and be able to answer my parents,friends,lil cousins when they 'consult' me.:) But my mind perceives and processes abstract informations in a lower speed..just like how the fetus descends via the false and true pelvis,immunology on HLA,antigen-antibody mechanism,pathways of certain sensory organs in neurology.. but when it comes to relating the sequalae and pathology which can be understood and viewed,I tend to enjoy and wanting to get to know them more.

Last monday,we did Montoux test which is the preliminary test done on any patients suspected of tuberculosis infection.An experienced nurse thought us how to do the test.It was pretty much a scene in that procedure room with all of us had to be 'doctor' and 'patient' at the same time.Few of us pricked their fingers while trying to remove the cap of the syringe.Emmy and Abdalla didn't want to victimise their colleagues,therefore opted not to become 'doctors'.I did on Zaid-and yeah,a cute little lemon-pealed papule appeared.Then I had to become 'doctor' for the second time for zakiah and it turned out to be good too,but smaller than Zaid's.Mine was done by zakiah,can't really see it since it was done rather little deeper..but now I can feel an elevated surface on my left forearm..perhaps the papule got trapped above the dermis:p

It's a must to do fluorography when students are having classes in the tuberculosis dispensary.It was my very first time doing it because usually we prefer Chest X-rays back at home.The former is informative too.We collected our results yesterday and our dear Dr. gave comment on them.Mine was:

1.wrong position of standing since the distance between the right clavicle/collar bone and the left clavicle to the sternum if different.

2.asthenic constitution but it's normal(mind you!)

3.slightly inflamed level of the upper diaphragm due to minor pathology reactions taking place..but nothing more serious,and it can be omitted and need not to worry...well not only me,Jeff also had it!

Daily we will be shown patients' X-Rays,few of it were even there before I was born.

On patients,Im still yet to do my case report,will be working on it this weekend besides juggling my time to prepare for my TB exam.

I visited Sara and Abdalla's patient who's a girl of 4 years old.She looked very pale,a slow learner,has tuberculosis infection.She was born to a HIV + mother but the virus wasn't detected in this little cute kiddo.

Paediatrics wards are usually cheerful despite of the hidden sadness.The moment we walked in,the kids trailed behind us and we together examining Sara's patient and few of them very enthusiastic to show their scar of Montoux test to us.At times i wonder why they have to suffer at this tender age..when they are supposed to be out there in playground/going for school,they ended up in hospitals,and waiting anxiously for the day to walk out of the ward.I hope these kids will be free-ed from the miseries that had befallen onto them.There's one funny scene,despite all the brave ones,they are these little timid looking kids.While we were passing by the wards,one kid even crawled under his bed,talk about being phobic towards DOCTORS!

All in all,I need to catch up on TB and get prepared for it by next week..so my precious saturday and sunday,you guys are definitely not free this week!!

*TB exam fever*

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new look for a new sem :-)

*yeay...back to my short wavy hair*

10th september'09 @ 1731

I''ve been dreading to have back short hair ever since I decided not to rebond my hair this year.Straight hair has worn out its trend,and if I were to say that-nothing beats having back your genuine hair.

Due to some unavoidable reasons,I didn't make an effort for another visit to the saloon in Ipoh once I got my slight trim done on 25th July before the grand reunion.I should've done all the cutting job there itself but sheerly,i had no interest to try new look over there.

And now with my completion of Internal Medicine exam,I have the urge to look 'new' and complete..so today was the day,decided to hit the saloon nearby hostel,accompanied by sara and ta--daaaa..it's done..love it,and I love my wavy hair:)

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a T to the DOC of 4 years.(yes,I am one)

090909 @ 2315

D.O.C.T NAVANITA,welcome to 5th year!

a special note:thanks for all your wishes for my exam:mum,dad,ragu, shalu,sarah,maalini,soo ching,sevvanthee,suvin,ravi,jia lynn,sara,kiran,zakiah.

A breath of relief air after 2 months ++ of heaving heartbeat and load in me.Like I had planned earlier to unlift the burden in me from the previous semester,I successfully completed my Internal Medicine exam today at 5pm,after having face to face session with the most digeruni Dr.Andrevna.I can't believe that I actually sat opposite her in the examination hall...but before that,to tell ya,I had the most memorable day which I will never forget ever.

For the very first time,I had to rush back to the dean's and pay to sit for the exam since I postponed it from previous semester.Halfway on my way to the dean's from the hospital,I was cursing(not really) Yuri for not being serious on the payment matter.He gave us permission to sit for the exam but didn't mention on paying.

Upon reaching the hospital,you can imagine with all the tension and spiked up cathecolamine level in the blood,I was furious when the assistant examiner told Jia Lynn and I were not allowed to sit for the exam without our payment receipt.We changed back into our casual wear,changed our second pair of shoes and was practically ran to catch the bus to the dean's.

Only God knows how repentful I was while walking under the scorching sun(not so la,compared to in Malaysia) to the dean's.I swear ,I will not be a CHICKEN next time by BACKING OUT LAST MINUTE.I was muttering silently.."see nita,this wouldn't have happened if only you had done your exam on your day!".

We left the dean's around 1.40pm after the payment.We could've reached earlier to the hospital but since we walked thinking it was nearer,we were lost and were actually went further down the road,had to stop few Russian strangers and enquire the way to the hospital.Jia Lynn never would have thought her idea to walk could make us so worn out..and I was actually thinking of boarding the bus and going back to hostel!

Reached around 2 pm to the hospital,hurried once again to the previous classroom,only to realise Dr.Tatyana was locking the door.She saw us and I've no idea why,it just ran across my mind:"she must be thinking,hey this lecture girl,hasn't done her exam yet?"..after gathering my stethoscope,tonometer,pencil case and internal hand book,we left,got our patient for the day.My first patient,he wasn't in the ward.Once again,I was crushed as I know every other people was in the examination hall or already done with examining their patients and me?stuck with a missing patient..another patient in the ward offered to be my patient,but I declined.Dr.Natalia gave me another patient,and I pronto went to her ward.Once again,it's just not my day..the patient has hearing impairement which means..you knowla,how to get informations that I need to make a diagnosis if she can't hear me?..duh,I sat beside her,managed to get a scratch of details on her admission.Later,a patient voluntered to be our translator.As I thought,things will turn good,the patient got emotional,agitated and I was told by the volunteer to leave and came in later after she has calmed down!I was..no words to describe my feelings except I really felt like weeping,my face had turned hyperemic,I took all my things and left the ward."You guys just don;t understand,I'm having exam TODAY!"..I told to myself in between the moments of about to breakdown!

Dr.Natalia came,pretty much irritated seeing me standing outside her room."Why are you waiting here?" Me:"The patient can;t hear,and she doesn't want to co-operate" Hence,she told me to make a diagnosis on progressive angina which means I did suspect the diagnosis correctly based on the patient's history.So there I was,leaning against the wall of 5th floor,fill dup the form on diagnosis,physical examination,lab investigation and the treatment.

After 15 minutes,Dr.Natalia came with Dr.Petrov who asked me: "so,are you ready to present your diagnosis?" I quickly turned to Dr.Natalia and gave her my papers because I didn't want to spend another few minutes explaing to him about my patient.Later on,Dr.Natalia went to check on the patient,and I was allowed to go to the examination hall..finally!!!

As I entered the exam hall,I noticed my previous 3rd year's beloved Dr,Pavlovna.Later,my most respected Dr.Tatyana came to my view.I sat at the front table facing her.After I settled down,I realised,I was actually sitting infront of Dr.Andrevna who's busy questioning another 6th year student...darn.I continued answering my questions on asthma,insulin and ECG.Jia Lynn broke into laughter when Dr.Andrevna asked a student" Did you know what Dr.House will do?" on Cor Pulmonale.I looked up and smiled and bistro,looked down before I heard Dr Andrevna laughed too and peeping over the student's shoulder towards us!

Oh yeah,did i tell you?I'm always the luckiest one during exams..I will always get the best Drs to question me.The moment I saw Dr.Tatyana,I felt lighter but I knew I wouldn't be getting her as my examiner.She actually walked out the room once i start writing my answers.After 20 minutes,she walked in.My name was called and I knew,my examiner would be Dr.Andrevna.I was pretty much had calmed down maybe after the long walk to the hospital:p.

Sat infront of her.Started few lines on asthma,she said "Not like this" and I thought I gave her the wrong definition!Instead,she took away my papers,and turned them over which means I was not ALLOWED to see/read from what I had written.I had to see her and tell her on her face!

So started my exam session with her.She made me sit with her for almost more than 30 minutes when the others are already done..I was the second last to leave the examination room besides Karan.She loves to interrupt while you're fluently speaking,loves to see the confused look on your face when she throws questions at you.For her,my exam questions didn't interest her much.I was suprised I actually asked her "then what am I supposed to answer?"..Dr.Andrevna:"Continue"..lol.

After done with teh questions,her attention shifted to my ECG.Got it right: Atrial Fibrillation.Then she gave me another 2 ECGs(if I'm not mistaken),then wanted to give me a 4.I smiled and after the neuro effect,guess I could take it.An unexpected miracle took place,Dr.Pavlovna who was watching me from the next table,told Dr.Andrevna: "No,give her another question,she can answer for 5".Dr.Andrevna shifted her gaze towards me.Dr.Pavlovna continued" I remember her,she is a good student,studies well".I was ready to leave but slumped back to my seat when Dr.Pavlovna voiced out.Dr.Tatyana,Dr.Andrevna and Dr.Pavlovna who were watching me,laughed about my reaction.And here you go,finally again,she gave an ECG..yeay..got it right too: ventricular tachycardia.They you go Nita,a 5 from the mighty Dr.Andrevna!Thank you ma'am.Wished my thanks to Dr.Tatyana,took my zachut book,and said thanks to Dr.Pavlovna who was at the registering table,she winked at me..thanks,ma'am.She still remembers her students,what can I say?I was her favourite what in class 2 years ago:)

As I was flying not so high,I realised my stethoscope and tonomoeter were missing in the examination hall.Surely somebody has mistakenly taken them.My missings were noted by the doctors and they actually surprised and Dr.Andrevna,shrugged her shoulders.Uhhoo,now if they are really missing,I have to get a new one,Luckily,I left my Littman at home.

I exitted the hall,messaged dad and mum.Dad called to congratulate.Mum called after reaching home from work and I told them the incidents which had taken place the whole day.

Believe me,neither it was a piece cake nor peace of mind to be back home when you still feel so incomplete with the tittle DOC instead of DOCT with the end of 4th year medical studies.

And now what?TB is waiting in line anxiously to get in touch with me.

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The Dos

8th September'09 @ 0125

1.I'm strongly being lured away by my comfy bed..inviting me to cuddle under the blanket.Tempting but not now,I have to finish my last part of endocrinology on Diabetes Mellitus!

2.It's less than 48 hours for Internal Medicine exam,the countdown begins!

3.Finding it hard to stay awake after 12 am nowadays,especially after back from summer holidays.

4.I need a synergic effect of my already metabolised (fully!) maggie curry flavoured at 3.30pm,a cup of coffee+ a slice of white bread at 8.30pm,coming up on the list which are undergoing digestion process right now: campbell soup at 12am and finally soluble vitamin C (lemon flavoured)..see how much I can eat when burning the midnight oil??

5.And,I need to start studying and pay more attention on TB right after internal,well maybe thursday onwards,la..Sorry for abandoning you,my bad.

Let's get back to DM,ike-ike and oshe-oshe!

0135

What's for dinner,girl?

5th september'09 @ 1910

it's going to be 1 week since I left Malaysia...so fast,I didn't even realise it until now when I decided to take time off from my books.Having my dinner now and at the same time blogging and chatting with Ragu..3 in 1..'sambil menyelam,sambil minum air'..

practically,tb classes are going fine.Luckily got a nice female teacher.Though she speaks dual language: russian and english,I can undertsand what she was trying to teach us...tb and it's influences on organism..I will update more on it after wednesday.Internal exam will be at 1pm on the 9th sept.Few of us are thinking of taking a day off from class next week and replace it since majority will be sitting for the exam on that day..all the best Nita for internal.You can do it!

Morning woke up at 7 after the many attempts of my hp alarm were turned off by me.Will definitely get stern warnings and scolding from mum and dad if i let them know what I had the whole day for my breakfast,lunch and dinner..make a note here especially for dinner:

1.the staple breakfast- a glass of coffee + 4 biscuits

2.lunch- a slice of white bread + omelette

3.dinner- campbell's mushroom and crouton soup+ a pear + a glass of cold water.

no,no,I'm not on a strict diet..no such thing for me.Just that,I really have no appetite nowadays..guess still missing mum's cookings after tasting and nicely wacking everything at home..and in another word,I'm just being plain lazy to cook coupled with no appetite to eat.Guess,it's just pre-exam symptoms...*sigh*

1925

My current avatar

3rd september'09 @ 2325

*getting hold of as many things as I can for now...*

my apologises first to you bloggie for not updating you.Well,you should know that once sem recommences,there goes my leisure time...and at the moment,i'm so the busiest bee around with an exam waiting to be written next wednesday on the 9th september.I can't wait to get over with it as I want to to add the 'T' to my tittle of 4 years-"D.O.C".

After Internal exam will be first exam of the sem on the 17th september-Tuberculosis.

Will get in touch with you later bloggie,sorry for the short post.

2330

another 10 months ahead..

1st september'09 @ 1155

Privet!(hola!) from room 410 in students hostel,Nizhny Novgorod,Rus. Fed.

First blog post for the month of september.

1st day of Tuberculosis(TB) cycle,ended up coming to hostel at 10.30am..no lectures/classes were conducted today for us.The prof had to deliver lecture to another 4 groups of students,hence the 3 foreign groups were bid good-bye.

Went to Lenta,bought the usual doughnuts,pears,a notebook and a pack of mix-vegetable.Need them till I get myself to Ashan this week..maybe on friday?

Mentally,I'm still at home.Holidays weren't enough for me.But after I left,the much awaited miracle that I was longing to see to happen,finally took place and I love you both.Stay the same,don't change,please.:)

The time table for the sem has been released.Well,this sem,I have no ophtalmology and reanimation cycles.Currently with TB cycle(exam cycle),I sincerely hope that later,in internal medicine lecture,the ever almighties won;t bombard us with missiles of words...just fix the date on 11th sept and will get the job done.Feel so incomplete stepping into the new sem without a 'atsenko' in my zachut book.

Nizhny still remains the same.Oh yeah,it's drizzling by the way ever since morning.And as usual,without an umbrella to carry,I had to catch the bus and walked to the Laboratory for a blood test.Luckily there weren't many people,I waited less than 10 minutes before I was called for the test.

In 2 hours time I will be leaving for internal medicine lecture.I wonder what topic it will be today..and who will be the lecturer...dr.andrevna?dr.tatyana?dr.panova?..

Anyhows Nita,good luck for your 5th year,remember your promise and make yourself COMPLETE again!

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