Dec 18, 2015

O&G Posting In HKL (Week 2) - Clinics

Assalamualaikum warahmatullahi wabarakatuh. 

Our week in clinic started by meeting a fierce-outside-kind-inside doctor who had been told by Dr A that Tiara and I were gonna 'shadow' her. The moment she stepped into the room, we froze. As she walked by us, we stunted and held our breath, hoping we had some kind of magic charm to be invisible for a second or two. There was no other choice, nak tak nak we had to greet her and introduce ourselves. Tiara started the conversation by informing her that we are medical students from IMU and would be there for a week yada yada.

The small clinics, which can place 2 doctors at a time were connected to one another on the inside and it was really convenient for doctors to discuss cases and nurses to collect things and Bed Head Tickets (BHT) aka case files. As each room was quite small, Tiara and I had to separate as it would be very crowded for 2 students to be in the same room. I decided to leave and find another doctor for me to shadow. Throughout the whole week I had been there, upon observation and little menyibuk here and there, I got not only knowledges, but also the valuable experiences, seeing doctors and nurses did their work with agile and in an orderly manner.

All clinics had been set to deal with different types of patient according to the day and usually patients who come already have an appointment. I was attached to 3 different doctors in 3 different types of clinic; gynaecology, gestational diabetes mellitus (GDM) and obstetrics.

Monday was chosen to be the day for the so-called 'girls' problem' (Gynae) day. I greeted and introduced myself to the doctor, and asked the permission from her to shadow and observe procedures, then fiercely she said, "Haa?! Mesti lah boleh." Mak aih, pepagi dah kena tinggi suara U.U sobsob. What to do, just go on with the flow lah. Luckily the nurse who was in charge of that room was super duper kind and she was the one who initiated me to follow Dr N to the ultrasound room and invited me whenever Dr N started to observe the patient. Most of the patients came for follow up with fibroid and cyst, while some of them had irregular menses, etc. Dr N was a good-hearted person actually, it was just the way she acted and her attitude that made her seem to be unfriendly. I never knew how pap smear is done until I had to hold the lamp for the doctor, because the nurse went to get something and I was the only person left there. Other than a pap smear, I got the chance to witness endometrial pipelle sampling, vaginal swab and both types of ultrasound; abdominal (the normal one) and transvaginal (by inserting a small probe into the vagina).

Gestational Diabetes Mellitus (GDM)
GDM clinics were for pregnant moms who get diabetes (layman's term; kencing manis), which onset or first recognition during pregnancy. This time I shadowed Dr K, who if you look at him for the first time you won't expect him a doctor, but the fact that he knows a lot and most doctors, even HO came to him, seeking for advices ruled out his all-time-tired appearance. I like the way he clerked patients, especially when he made a joke, but he himself didn't laugh haha and even though he seemed tak bermaya, he still managed to handle patients well and made some of them calm down after informing the bad news.

Obstetrics aka Antenatal Care (ANC)
Friday was the day for pregnant mums and this time I was attached to a very gentle and kind doctor, Dr R, who taught me a lot of things. Luckily I already went to the labour room so I understand some of the terms being used. Patients just started coming and the case files hadn't arrived yet, when suddenly we saw an incident of a pregnant young lady who fell down and terduduk tepi jalan from inside the clinic. The doctor addressed me by my name and asked me to have a look whether she was okay or not, so I went out and basically did like what the doctor had told me. I accompanied and helped the nurse who apparently brought a wheelchair for that lady. I kinda feel glad and honoured(?) when the doctor called me by my name. This is one of the things I learned; people feel more appreciated when you call them by their names.

I watched the doctor clerked cases, with Dr K sat in front of her, clerking patients as well as I told you that each room can fit 2 doctors and patients at the same time. Dr R explained to me about the position of placenta, how to detect it in the ultrasound and decide at what stage is the placenta previa. She also taught me how to palpate and measure the size of a pregnant mum's tummy which should be +/- 1 for the week she is now. As, for example, if the tummy's measurement is 35cm, then the lady should be in the 35th week of pregnancy +/- 1 week. If the difference is more than 1, then maybe the baby is smaller/bigger than he should or the estimated due date is wrong.

Although I had to stand for hours and steal some time to sit on the bench once in a while, being in the clinic is different than in the labour room. Previously, I always wonder how a government hospital setting would look like. Now, I know. Other than that, I learned something useful for me in the future InshaaAllah. One patient meets one doctor, but one doctor has to meet more than 10 patients per day, and how some of the doctors stayed energetic and kept smiling even though it was already in the evening inspired me to become like them in the future.

Okay, lets move on to the final week of elective posting in HKL. Will update soon, so stay tuned!

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  1. Doc.. is it necessary for the girls to do pap smear ? dasatnyaaaa bunyi semua tu.. takut..

    1. It's necessary for screening purpose tp saya pun tak pernah lagi. Takut jugaaaa haha

    2. kan.. baca about the proces tu aiyark..
      dup dap dup dap jantung..

  2. mcm ada soalan utk Dr Dylia la.. uhuu