havent written any entry for nearly half a year, oh my god!
being encouraged by someone recently... i gonna wrote something about today here
now I am having rotation in UCH medicine. Life is so free that you can go everywhere -- cardiology, neurology, respiratory, haematology etc to explore patients and cases you are interested in
and today, I went to the neurology ward (yeah. I just had the neuroscience examination 2 days ago and it's a good chance to reinforce my memory through live-patient and to prepare for the professional exam 2 weeks later...)
surprisingly, the so-called neurology ward has 2 neurology cases only, while other beds are infiltrated by mostly ACS and pneumonia. When I flipped through the case notes for one of the 2 beds.... I was surprised again
this is a case that can be described by 2 words -- RELAPSING, REMITTING
ya, bingo. It is multiple sclerosis
as Prof Vincent Mok mentioned, the prevalence of MS in HK is around 0.8/10^5, and I meet such a rare case here. Interesting.
as written in the progress note, this is a young woman having MS from 2x y.o. and now it has involved the optic nerve and lower limb. Ya! optico-spinal form is more prevalent in Asia! and then I spotted a yellow paper mixed inside a thick bunch of white papers. It was written by the hospital chaplain (well, I am not sure about the formal name of this job... so forgive me if I wrote it wrong), and the chaplain described the patient is always worrying about her father and her future, especially when she lost her ADL and could not take care of her father...
Time to practise my COSK skills.... but I didnt have any experience in handling such situation before except the role play session in year1 and 2! Being encouraged by my partner, we approached her. She was lying comfortably on the bed, smiling to us when we approached her. After introducing ourselves and got the permission from her, we started taking the history.
the disease might has affected her control of the bulbar muscles, she could not speak clearly. However, she still tried her best to speak and smiled to us all of the time. it is simply a case that the lower limbs and eyes are involved and she was immobilised since 25 y.o.
after chatting for a few minutes, I found out that she knows MS better than me... haha no wonder I performed poorly in the examination 2 days ago. She also noticed the rapid deterioration of the disease and it has progressed to a stage of secondary progression. It is no longer relapsing and remitting, and she is going to suffer from lower limb spasticity forever.
sigh! She was absolutely healthy during her childhood but then in a few years of time, she progressed from a normal person to a disabled one.. cant imagine if I have this disease, how I would become in a few years....
but then she is still optimistic. Apart from smiling at us all the time, she told us that she is not afraid of the disease and she still hope that she can walk normally in the future.
At that moment, I was touched.
while someone is having a good life, but blaming that and that. blaming life is unfair and saying that life is hopeless, blaming the airlines for not allowing them to board even the the flight hasnt taken off yet, bla bla bla. on the other hand, patients who are suffering from severe illness, though cannot enjoy their lives, still they have hope. scarcastic this girl must know the prognosis of the disease well, but she still hope that she can regain the ability to walk, or at least to stand without support.
sigh
P.S.: for the another case, it is even more surprising, nope, it should be more STUNNING than MS. Guess what's the provisional diagnosis!..... it is Binswanger disease.
20/11/2008 HKHeadline newspaper wow it will be great if my jaijai can do constructive things like this..... well. i should say "it will be great if my jaijai stop doing destructive things"... lol
but the truth is that the destructive things make him cute
anyways PGIN3 + PCAR3 summative assessment on Monday.... add oil everyone!!!!! and reli looking fwd to december!!!! (well.... "december" doesnt mean my ortho rotation.... erh..)
After 2 months spent in surgery... finally my dear groupmates and I are going to face a new challenge!
Starting from next week, whenever asked "What's the treatment for XXXXX??" We have to stop our acquired reflex action -- answering it with "Surgical treatment" or "Resection/切左佢..." or "Transplantation"... When asked "What are the complications?" We have to stop our another acquired reflex -- answering it with "Wound infection", "Hemorrhage", "Spillage"... In the morning, we have to put the yellow instead of red pocketbook into our whitecoat pocket In the evening, we have to prep the next day stuff with the thick thick book (well, this is just the plan.... no one knows whether I will do it or not! )
The time we really need to think finally comes! (Well.... I don't mean surgery doesn't involve thinking and analysis XDD) The rotation I have been waiting for long long time! PWH MEDICINE FIRM3! I AM COMING!!
** last but not least, I reli hv to thank all QEH and PWH Team1 Surgery doctors & housemen for teaching us though they are busy or concentrating with ward rounds and surgery, answering our (well, it should be "my") silly questions even though I always came up with creative answers... and special thx to my dear groupmates! thx for granting me an opportunity to learn soooo many things and teaching me all the time with those unknown syndromes/treatment/short-form.
but then..... before I enter the wonderful medicine world.... Lets enjoy the bored-to-death Forensic stuff as the appetiser... X_X"""
