the best OT yet!

woweee!!!

i had the best OT experience so far! simply because i participated almost as much as the surgeon did!

this guy had both his wrists fractured (colles' fracture) so we had to sedate him under general anesthesia and put metal pins (K-wires) in his wrist to fix the fractured bone. on one hand, the surgeon showed me how to do it, how to hold the wrist under traction, how to locate the site to insert the pin, how to use the drill, etc!

me and prashanna got to do it on the other hand!! all by ourselves ! :)

using the drill was pretty fun! and then we had to bend the extra pin and cut it off, later we applied a plaster cast over the arm too.

overall a fun experience learning to do something in the OT!

2 new skills :)

just yesterday i got a chance to try my hand on Ascitic tapping and Pleural tapping.
Ascitic tapping means draining the fluid accumulated in the abdominal cavity, where as pleural tapping is the same for the pleural space (outside the lungs).
did them satisfactorily, although i think we removed a little too much fluid from one guy and he started coughing suddenly. he's stable now, but it was kinda unnerving.

dealing with COPD in MEDICINE WARD

its been 3 weeks already in the Medicine ward and i couldnt come up to write another post.

basically was distracted. now that i got a few pics clicked, i thought its time.

Medicine ward, i thought would really give me an experience in dealing with the majority of common illnesses, unfortunately though, the way we interns work there makes it unlikely.

but since no one wants to work more than absolutely needed to, this system ends up fixed in place.

the way it works is, that each intern is assigned a room in the ward, and as the room gets filled up, the intern gets more work with managing his patients.

understandably the ward has some rooms, which hardly get used, and some which are always full. dont ask me why! there are lots of reasons.

and also because we get so comfortable handling our room, we dont want to change halfway either. so i got COPD room (female) and i have been seeing only COPD (lung disease with chronic cough) cases these 2 something weeks. :P

and since my room has oxygen supply, any other case needing oxygen is shifted here as well. so once in a while i do see a variety.

otherwise, i would say medicine ward is the easiest and most slack of all the wards in our hospital, mainly because when you are on call and its your night duty, in medicine you are not expected to attend calls in the ER. the PGs are supposed to do that! so you are practically only handling the emergencies in the ward itself, which hardly occur.

yet, just yesterday i had my night. and one of ritwika's patients developed hemoptysis (coughing blood) . and let me tell you, i havent seen so much blood being coughed out ever! and the lady was in her mid 20s!! poor girl had such a hard night. she must have coughed out almost 1 litre of blood by morning, despite medicines to stop the bleeding! we had to monitor her overnight, hoping that she doesnt collapse after losing so much blood! luckily she had a healthy haemoglobin of 12 and her blood pressure wasnt too high/low either. today she must have gone for bronchoscopy (scope to view the lungs) to find out where and what is bleeding. dunno the result. will ask ritwika about it.

on the other hand a lovely incident i had in the ward, in my own room! this patient, a 70 yr old lady with COPD, still there in the ward, has been lying there for 15 days already. she was there when i arrived and basically she was on antibiotics to remove the infection in her lungs.

somehow, she kept on coughing and coughing and you could hear the phlegm inside her lungs. but the chest seemed pretty clear to the stethoscope!! so somehow, one day "chest physiotherapy" came to my mind. and i remembered i saw someone do it in paediatrics ward on a patient with pneumonia. it apparently helps to remove tough and sticky phlegm from the lungs by loosening it!

during the rounds i asked the PG (srijana) if we could do that? she seemed to like the idea and i got a hint she was surprised not to have thought of it herself. i, too, wondered why she didnt think of it herself! anyway, she asked if i knew how, i said no, she asked others, sambhav knew how! he taught me how to do it on the patient. we did it for like 10 mins. basically you have to use cupped hands to hit the chest gently from down-up.

the next day, the patient's son and his brother were so happy! they thanked me for doing that, apparently what medicines couldnt do, this little step did! its removed a lot of phlegm and she slept so much better at night after a long time! they also told me she felt so much better now.

they obviously showed how much they appreciated it. and i felt so good! i tried my best to convey in nepali that it was my pleasure. and i was happy for them.

they went on to ask me where i was from, what will i be doing after this, why couldnt i stay in nepal. how sweet! i told them i have to go back to my country :)

the son learned it from me and i guess he helps his mom out now! i was so proud that i came up with something useful, and it actually helped my patient. small things do matter!

another interesting thing happened recently, one intern and one PG got beaten up in the ER by family and friends of a patient who died under mysterious circumstances!

for two days the hospital remained closed, no new cases were seen in most departments as they were holding meetings with the management for better security.

this is how meetings are held, Nepal-style ... open air! fish market!

what do we care, we enjoyed the break from work!

its been long

i know its been long since my posting started and i havent updated.
been busy. will come soon with a few pics!!

Back after break

It doesn't exactly feel great to be back to Nepal, but one has to do what one has to do.
Joining medicine ward duty from Sunday.

- Posted using BlogPress from my iPhone

FMGE

due to the impending foreign medical graduate exams (FMGE) we had in late september, our internship had taken a back seat for a few months.

these exams are now compulsory for all foreign medical graduates (FMGs) planning to enter the Indian medical system. 2 papers or 150 MCQs each, is all you have to clear to get a pass and qualify for registration in the indian medical register.

thank god! i passed. got 174 out of 300. was expecting a borderline result. thank god, seriously, cause the preparation was crap and the 1st attempt seemed dodgy, as we had no idea what to expect.

unfortunately, a few of my close friends did not clear. they will have to sit for it again in march next year now. its shitty to think of giving the exam again. spoils your self esteem and pushes your plans for the future on the back seat.

it was a great sense of relief i felt when i realised i had passed. relief that a big hurdle is cleared, that too in the first go.

now its back to future planning and internship.

P.S. good luck to all those who give it again in march, pray you clear.

Paediatrics

my oh my!

i was looking through my last blog post, and realised that i had started posting for paeds on the 1st day of duty. my plan was to update with cute baby pics daily.

what paeds turned out to be, i was totally unprepared for!

this was one of the busiest duties i have done. i knew it was to be busy, friends had warned. what i didnt know, was how busy your emotional senses are going to be!

it was a whirlwind 2 weeks, highs and lows, saved lives and lost lives, cute kids and ugly kids, kind nurses and devilish ones! all in 2 weeks.

what i learned in 2 weeks i could never learn in 6 months of commed posting ! (we only have 3 months)

there was this one particular day, we lost two kids! one of them was from the NICU and i was on duty with ankur then. it was a sad sad day for me. that day mansi was in the ward and she lost a kid under her too. we shared our sorrow, and it helped.

that very day, i had seen our MO dr.shankar help save a life in the ER performing resuscitation. i saw it all - flat line on the ECG, CPR, Defibrillation and all. for over half an hour, guys worked on him and he survived! it was a rewarding feeling just witnessing that!

when i came back to the NICU, i discovered to my shock, that one of the sick twins had died!!

i couldnt hold my tears looking through its file, the notes i had entered, the charts i had filled. this was too sudden for me. how quickly the kid died. i imagined the twin who still lived, he would grow up to discover his brother died . terrible terrible feeling.

somehow i got through the night. trying to hide the hurt i was feeling inside. you cant help but get attached to these children you look after. they seem like your own. it is terrible when the die. it is.

soon, i overcame and moved on to ward duty. 1 week was up and 1 to go. sambhav seemed so dogged by ward duty, it wasnt what he made it out to be. and surprisingly he was so carefree during his NICU, which wasnt so slack when i was there. weird. but that is sam's middle name.

anyway, worked with mansi and ankur in the ward too, lovely people to work with. couldnt have asked for better! they work with the right spirit, which i have to say, is scarce nowadays.

it came up to 3-4 kids per intern to manage, as a lot more juniors joined and made our life easy.

i learned how to catheterise a vein in a neonate! managed it in the 1st shot!! :) and talking about 1st shots, i did a Lumbar Puncture yesterday (that is putting a needle through the gap in the vertebrae and collecting the fluid that comes out for study), and got it in the 1st shot as well! thankyou :) . thanks to dr. Deepak who offered me to do it, otherwise i was quite sad i would have missed out.

i learned the neonatal resuscitation in routine newborns as soon as they are born! I've put a nasogastric tube in one newborn too!

overall satisfied by the skill-acquisition.

thank god it was only 2 weeks, how much can one take?! yesterday was my last night duty and we had 8 admissions!!!

so much work! phew, did it, its over. yehhhhhhh :)

thank you paediatrics. did learn quite a lot. it definitely broadened my horizon.

Reblog this post [with Zemanta]" style="border:none;float:right">