Category Archives: All in a days work

as a medical officer

Pemeriksaan Perdana Jemaah Haji 2019

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This is an initiative by Tabung Haji in collaboration with KKM to ensure that the pilgrims  (jemaahs) are in the best state of health to perform Haj. Primary health centres, hospitals, GPS would nominate a few medical officers to attend a crash course onto the health criterias one has to fulfill prior to flying to Jeddah.

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Most jemaahs would feel nervous attending the medical checkup but I make it a point to inform them that this is merely a stage where we try to detect any health problems and manage it accordingly so that they will be fit to fly and do Haj. And this, we try to achieve within a few months we have prior to the trip. We do not want them to think that we are sabotaging their trips. That is never the intention. In fact, we want them to be at their best.

We just had a big medical checkup event last Saturday. The turnout was about 206 people with a manpower of 11 medical officers and their respective supporting staff. Alhamdulilah, the session did not drag out till late in the evening as it was a Saturday after all.

Thankfully, we are eligible for a day off (at our chosen time) and given RM50 each as  a token of appreciation. lol.

When a patient arrives, they would first register at the counter before going to the next station where they could check their blood group, Hb and glucose levels. Afterwards, their vital signs and measurements would be taken. Then it is a waiting game for them to be called into the examination room. If they pass, they can proceed to take their meninggococcal vaccination in the next room. If they have medical issues to tackle, they would be redirected at the nearest Klinik Kesihatan for a followup review to get a pass for their medical exam.

I would advise prospective jemaahs to being their medical books, medicine and better still their latest blood investigations to the checkup to speed up the process. Especially when some of the patients choose to follow up at their respective private GP. Or buy their own medicine at the pharmacy. We just need to know if there is an acute problem within the last 3 to 6 months that needs further medical attention.

Most of my patients passed the examination leaving just a few to tackle on their high blood pressure and in some, a new diagnosis of diabetes. There were also a few tricky cases especially involving obese and elderly patients as we are divided between thinking of what is best for them and what they want. I have yet to have any clear cut fails but we will see how it is for the next few months. InsyaAllah. 

I am also hopeful to be selected as Allah’s guest one day. InsyaAllah.

Attachment for basic ultrasound. Ikhlas & Jelas.

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I had palpitations nearing the date I was to report myself for the attachment in the Obstetrics and Gynaecology department. I had my goals of what I intend to achieve but I worry that the human factor may cause me to lose focus and feel despair for the whole week.

Attachments are meant to be a training ground for us to learn and polish on certain skills. Sometimes as the one attending these sessions – we may NOT KNOW WHAT WE DO NOT KNOW. So, it is important for the trainer to be accommodating and guiding. Tell the trainees who is who in the department because it’s not that we are working there, kan?

Trainees like myself, on the other hand must be open and ready to accept and learn new practices, if any. There shouldn’t be a ‘in my time dulu.. this is how we do it bla bla bla.”. That was dulu2, now we learn a better way despite being in the service for more than 10 years. Jgn terikat dgn cara lama. 

Niat kena ikhlas. Objektif kena jelas.

Alhamdulilah, our point of contact for the attachment was really really helpful. We learnt a lot of salient points in improving our scan techniques. I can only make du’a that all these individuals be granted pahala for the ilmu they taught me and my partner, Su Zanne.

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We got a glimpse of a few extra features of the department which was exciting all the same. Like infertility processes and so on. The myth of O&G medical officers being obnoxious was dispelled. Probably because the ones we came across were kind and very senior to teach us properly. I would probably rot and wither away if I came across the ones who are muka ketat and look down on Klinik Kesihatan MOs. They exist mostly in junior rank. A few in senior rank.

My one week attachment was very fruitful. I felt motivated. Especially when I will be governing and running the maternity and child health clinic this month. I hope the wisdom and skills I acquired throughout the placement will be put to practice and should I have to refer, it will be a high quality, justified referral. He he he..

 

 

It’s late, I apologized

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I had to apologize to roughly 13 patients today.

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part of the pile

For arriving late. And they had to wait for their scan. They waited for 90 minutes. Not my fault. I was just stepping in for someone else. But sometimes patients need to vent their frustrations and anger. It’s not easy being heavily pregnant and having things not going your way. But I was lucky today. The ladies still had smiles on their faces (some reluctant, probably trying to keep their cool) but I am grateful anyway that no one blurted out harsh words.

Undeniably, I was angry for this miscommunication. This situation could have been avoided if The Scheduled Person made a reminder to the other colleagues. We do not keep up with your private engagements okay.

Secondly, I was also a bit pissed that I had to be thrown under the bus. Do you know how difficult it is to apologize to 13 different patients with a variety of personalities? I am just thankful that today, my mothers are all understanding and have the patience of a Buddha.

Each of my deep hearted apologies were replied with an

“its ok. it is still early”

or

“takpe. saya OK je doktor.. takde benda nak kejar”

This sort of response diffuses the tension and I was able to concentrate on my tasks for the day – to scan these ladies and give them the extra joy of informing them whether they will be expecting a boy or a girl.

If there was anything that I could take away from today was probably Sabar. And makes lots if doa to Allah for HIm to ease your day. InsyaAllah.

The Wet Nurse

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When I review patients coming in for their appointments, often I would praise them or congratulate them if have made progress in taking care of their health. Diabetic patients for instance, who made changes in their lifestyle, or who are more compliant to their medications, which in turn had better glycaemic control. I would say ‘good job’ or ‘congratulations’. I would then coax them, to share with me their success stories. Not for myself but more for them so that they know they are being acknowledged and that every effort they made counted. Hence, InsyaAllah they would strive more for the better.

Occasionally, I would come across Life Lessons in the form of these patients. Like yesterday, when I had the opportunity to listen to a story of Kindness, Determination, Patience in one.

I was sitting in one of my Rural Clinic sessions. These clinics are usually less busy as compared to the Primary Care Clinics. This serves as an opportunity to spend more one on one time with the patients. And in came a lady bringing in her newborn for a check. On the baby book – it was already clearly indicated that she was the adoptive mother.

As I checked the baby, I asked whether the biological mom had any antenatal medical issues to which she didn’t. Then I enquired further whether they still keep in touch and if the biomum supplied her breastmilk to the baby – because that is what some biomums do when they give their baby away out of love. The adoptive mom said she doesnt have much milk so the supply has stopped BUT she is giving her own milk as well so the baby is well fed. I was in AWE.

The adoptive mother, Madam Kind was in her early 40s with already 2 teenage children and she underwent induced lactation! Of course I asked of her experience which she was happy to share. Cause you see, as a medical professional, we sometimes see things from the medical perspective only – this was one of those rare opportunities (I say rare because I’m not in the gynae field that deals with this case more) for me to know the thinking process/emotional part of it. I wanted to know how difficult or how meaningful the journey was to the patient.

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HOW IT STARTED

Madam Kind was working as a nurse in a private hospital when one of the specialists was looking for interested individuals to care for the baby. The search started in the biomums 3rd trimester. Coincidentally she wanted to adopt a child and when the chance came, she jumped on it.

THE NIYAT

Prior to this she had always had the intention, that if she were to adopt a child, be it a girl or boy… she would still breastfeed them. BECAUSE she wanted the child to be ‘milk-siblings’ with her current children. Hence, a mahram muabbad to her husband as well (if the baby is a girl) which instantly grants this baby the status similar to their biological child. At least they would be no issues regarding aurat amongst family members.

THE PROCESS

This particular lady started her journey as a wet nurse at Week 33 gestation of the biomum. She only had to consume Domperidone and regular pumping sessions to stimulate her breast. On good days she can store 1 ounces of milk from both breasts of which she would keep it in her freezer. The aim is to collect her breast milk as much as she could so the rules of Milk-Sibling could be fulfilled. Which is for the child (less than 2 years old) to be ‘full’ at least 5 times. And this milk is enough to grow the build and bones of the child.

Do note that the stomach of a newborn is only the size of a marble. Hence she collected more than enough for the purpose and was even able to directly breastfeed the baby.

Listening to her journey made me realize why it has always been suggested that if you wish to adopt a child outside your family – it would be best to welcome them in the family since Day 1. Tak susah kan nak bagi baby kenyang? Of course, the adoptive mother too  have to make her own sacrifices and this would not be possible if the lady did not have tremendous support from her own husband and kids.

I asked  her if she was happy with how everything turned out to which she said Alhamdulilah with great pride. Of course the family is still tied to paperwork. I did not manage to ask her regarding THAT as I had another patient to review after her. It would be interesting to learn that aspect of adoption as well.

I congratulated her on her new bundle of joy. I praised her for her diligence and mentioned the kindness and understanding of her family and co-workers as well. I feel that she should know that she was doing a good job. I am glad that the baby found a good, caring family. Insya-Allah the baby will grow up to be an outstanding khalifah.

 

My Klinik Kesihatan Chapter. Starts right now.

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After 6 years serving as a Medical Officer in Jasin Hospital, it was finally time to bid au revoir. I wish I could thank and apologize to more people during my mini farewell party but … well, maybe next time. Honestly speaking, my stint there was one of the best parts of my life. In short, I was H.A.P.P.Y to be myself. To act like myself and not how another person think I should. Macam dewasa but still boleh cute2 walaupun dah berumo. Not all people can accept behaviour like that tau. Someone once told me I should act my age, meaning like in my 30s. Or was it late 20s. I was a bit taken aback at the time because I thought it was OK to ‘be yourself’ and let yourself loose among friends while still maintaining your professionalism in front of patients but apparently not.. Tak ingat plak beruk mana yg tegur I tuh.  Camtuhlah.. I don’t know if an opportunity like that will ever come again. (of course it will, LOL)

5th FEBRUARY 2018 – I had to start all over again. Creating good first impressions despite the false circulating rumours ( why lah.. belum sempat menapak kat tempat parking pun.. dah kuar cerita2 tak best) about the choice of my placement and its inevitable circumstances. I managed to clear the air when I found out about it but still, the truth may not reach everyone, kan? Forging new relationships was OK. It may be difficult to weave seamlessly into a clique but I will take ‘friendly’ anytime. I will work on Trust later on.

Klinik Kesihatan or ‘general practice’ was not my forte but I am open to new experiences and responsibilities. On top of Sabar, I believe that if we set our intentions right, together with diligence, things will work out in the end. *more on that Sabar thing later*. After all, I will be shifting grades soon and this would mean me having to shoulder heavier responsibilities whether I am ready or not. I am still figuring things out. It’s not only about knowing the diseases and workflow related to GP practice, it’s also about being alert about the politics of the place. To survive.

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That is my car. It looks like a kitchen and office combined. The mess kind of reflects my state of mind at the moment. Yalah.. new baby, new job scope, new lifestyle… so many adapting to do. And in the near future, Mr Husband plak is going for Umrah with HIS FAMILY for 10 days leaving me to handle the 2 kids without my in laws this time. AND WITHOUT MY LEAVE APPROVED BY MY NEW BOSS. 

At first I was a bit furious with Mr Husband because of all dates – why does this Umrah trip have to happen during the month when I’m making all these transitions? Can it not wait till later? But after putting myself in everybody elses shoes especially Mr Husbands shoes (like I always do because I’m a tremendous, understanding wife like that).. I guess that would be most CONVENIENT for him as a Masters Student with limited holidays and annual leaves. So, I terpaksa REDHA. His nucleus family, the one that raised him for the past 30 plus years need him more there for the Umrah to be successful. INSYAALLAH. 

Consequently, I have to play my INDEPENDENT and ENERGETIC 24/7 card to juggle it all. Thankfully my new workplace is just 8 KM away from my house but the traffic can be ugly. I still need about 30 minutes to commute.  Takpe.. boleh breakfast dalam kereta. HAAHAHAHa. *positive vibes*

A tough beginning to a new chapter. I might as well make it interesting and worthwhile.