I FEEL GOOD



The whole last week i was at the National sport institute, KL. what a great place. here is the place where they trained professional atheletes. The posting started on Tuesday (24/02/04) [mon is a public holiday] . arrived there at 9.00 am, we used a LRT b'coz the faculty does not provides a bus that day. welcomed by a cute and charming AP dr lim, he brief us what to do here. later, his assistant, ms sue git bring us around the place (tourlah). nice place and great facillities. they have a pool, gym, exercise physiology, counselling room etc.

at lunch time, we played basketball. with a tie a casula shoes i shut 3 balls. the game was great. this is a 1st time we played together within 5 years. actually we played like a net ball as most of the girls were net ball players. in the afternoon, was spent at the exercise physiology room. met mr patrick (canadian), he thought us how they assess the fitness of an athelete. limi offered to undergo the process. in a machine, with a running floor, she runs at the gradually increasing constant speed. her mouth was connected to a com where her O2 consumption and CO2 product can be measured. she got tired at stage 2 (ok lah for girls).

here we had a lot of activities.

at morning we joined sport clinics. adalah tengok kes sport injuries.

in the afternoon, we went to the pool and learned about aqua jogging. this help in rehab pt. met ms sandra, a tall mat salleh girl. we also play a games with the pt in the pool. we lost 0 to 9 points. the next day, met her again and she thought us about exercise in a gym.

we met a few numbers of well known atheletes. took a picture with lee lam wah. met nazmizan (sprinter) who broke an asean games record. saw hafiz hashim but don't dare to approach him (seganlah) while he was in training.

the last day was ok. we had a psychology session. here we need to tell about our selves to the group. i knew a few of my friends secret, one of my friend cried (don't expect her to cry b'coz she is hunky punky gal). what a shock!

the posting here was enlightment me to a new field of medicine, where medicine is applied to sport. it is an interesting field and wish to come back there.

CANTIK SIUT!



hari nie dah 3 hari posting kat hospital selayang, posting pasal penyakit rheumatology. cantik betul hospital selayang nie, macam hospital private. sejuk ber aircon, tak macam hospital kuno kerajaan lain. wad pun luas. katil pun baru. setiap pesakit dpt cubicle sendiri beserta ngan tirai. tak macam ngan HKL. tirai pun tak de. sometime kalau nak buat per rectal examination pun tak bertirai, open!

Nilah kelebihan hospital baru. kerajaan sebaik mungkin nak perbaiki perkhidmatam kesihatan rakyat.

Workload kat sini pun tak banyak. so boleh concentrate pada patient in detail dan hopefully tak mismanaged.



KEs-kes rheumatology kat sini memang menarik. adela tengok kes SLE dan rheumatoid arthritis. pagi tadi clerk case patient suspecting ada connective tissue disease. History pt nie:



19 year old Malay, boy:

c/o bilateral calf pain for 3 months

-worse on walking

-relieved at rest, taking analgesic

-intermittent, moderate in severity



went to nearby clinic, blood Ix showed raised ESR,

referred to Kajang hospital,

xrays done: normal, discharged but developed,

bilateral ankle swelling for 1 month

sudden in onset.



also had LOW, LOA, sms of anaemia

no history of alopecia, malar rash, oral ulcers, joint pain, fit

no family history of connective tissue disease



o/e

cachexic, pale, no jaundice

left supraclavicular bruit

CVS, Resp and abdomen normal

livido reticularis both lower limbs

erythema nodusom both feet

generalized hyperreflexia



What is yr dx?





p/s they are thinking of polyarteritis nodosa, investigations are waiting.

A DAY OF SORROR.



pagi tadi melawat HUKM. cantik hospital tue, macam hotel 5 bintang. belajar mengenai alatan orthotic dan prosthetic. Mr Lim (owner of Limb brace sdn bhd) ajar tentang penggunaan prosthetic dari preop sampailah pemasangan prosthesis. amputated stump yg baik mempunyai wound yg sembuh sepenuhnya dan tiada oedema. pesakit amputee selalunya mempunyai kesan sampingan "phantom limb". pesakit ni merasai kesan sakit pada kaki yg tiada.

lepas melawat HUKM, pulang semula ke HKL.

Petang tadi melawat ward spinal. Wad spinal HKL adalah yg pertama di M'sia. Dpt tengok kes spinal termasuk tetraplegia dan paraplegia due to accident, TB etc.

Sister OM ajar macam mana utk prevent pressure sore. all patient who are plegic need to be turning 2 hourly eg from right lateral to left lateral. bahagian kaki dan bahagian belakang pinggang disupport dengan bantal.

Kalau mampu boleh guna Ripple mattress.

Sempatla jugak sembang dengan En Khairuddin, a complete tetraplegic. He suffered from tetraplegic after had motor vehicle accident 8 years ago. dia dtg pasal extensive pressure sores over the sacroiliac region.

kesian tengok abang - abang paralysed kat sini. one of the pt cry in front us. we won't bother to ask why. I can't imagine how they can cope by lying down almost of the rest of their life.

I think most of the patient here have a good will. they really want to survive and get better. May Allah be with them always.

here they will undergo extensive rehabilitation program for a minimum of 6 months. if OK, they will sent back home or go to the Pusat Latihan Perindustrian Bangi.

last friday wuz great! I dapat salam ngan the Agong! jgn mare u! 2 x lagi. dia sajer melawat HKL dan masa sama semayang jumaat sekali. this remind me with the previous Agong: Sultan Salahuddin Abdul Aziz Shah, dia pun I dapat salam. masa tue dia melawat Masjid UPM kat serdang dan semayang jumaat sekali.

today activities were entirely spent on rehabilitation medicine. i went to the occupational therapy department and was been thought about their activities there. quite interesting, macam - macam alat boleh digunakan uth rehab perpose. This morning discussed case of spinal injury and the rehab aspect. Arisah yg present. okla, sekarang baru clear pasal management nih.

besok pergi melawat HUKM . nak tengok pasal prosthesis and orthosis.