Clinical Year: Family Medicine & Psychiatry

Salam alaik buat semua pembaca… lama x jumpe kalian, noh? Hope anda semua sihat2 selalu.

Hari ni officially dh abis my 3^rd and 4^th posting; Family Medicine and Psychiatry. I would love to call this posting as double wave posting because previously for each 2 months of duration, we will have 1 exam. But as for my university, they put FM and Psy together for 2 months duration and at the end of the 2 months, there will be TWO EXAM! Homai2…. T__T

Rasanya ramai dari kita yg tahu what is Psychiatry kan? But do many of us know what Family Medicine is?? So as for today, I would like to share with all of u some fact about these two fields.

FAMILY MEDICINE

Sebenarnya ramai dari kita pernah encounter seeing family medicine specialist but it’s just that we did not aware of that. Family medicine doctors adalah doc yg usually kita jumpa kat klinik2 kesihatan or klinik2 swasta. Mereka adalah 1^st line doctor yg merawat pesakit. Bila mereka assess the patient, they will give necessary treatment. Some cases, the family medicine doctors will also refer the cases to the specialist. One scenario:

“A 21 years old Malay female presented to the KLINIK IZZAH with the chief complaint of abdominal pain. The doctor takes the history and perform a full physical examination on the patient. Later, the doc discovered that this patient’s shows sign and symptoms of Acute Appendicitis. She give analgesic (ubat tahan sakit) just for the pain relief and write a referral letter to Surgical Department of Hospital Sungai Buloh. The patient later was planned to have appendectomy as to remove her inflamed appendix.”

So, basically what we can conclude is that, a family medicine docs need to have a very broad knowledge about medicine as they cannot predict what types of complaint the patient might present with. FM docs akan assess the patient dulu. If they think the disease was treatable and x perlu refer ke mana2 specialty, so they will treat them la. But if they think the patient might need further investigation regarding the disease, they will refer.

So I guess that was serba sedikit perkongsian bout FM.

PSYCHIATRY

What was the 1^st thing that comes to your mind when U read or heard about Psychiatry?

Is it CRAZY PEOPLE?? Is it PEOPLE THAT LOVE TO TALK TO THEMSELVES? Or is it SCARY PEOPLE THAT I DO NOT WANT TO SEE????

Whatever u thinks, I hope u can re-think it after reading this short sharing (^__^)v

Psychiatry merupakan salah satu speciality dalam bidang pengajian perubatan. Most of medical school kat Malaysia will introduce psychiatry as 5^th year or 4^th year subject. As for my university MSU, they introduce psy during 3^rd year, 4^th and 5^th year…but it was a short duration posting; 1 month/ year.

Mula- mula start posting psy ni, nak dekat ngan patient pon seram sebab saya ingatkan semuanya aggressive but I WAS TOTALLY WRONG!

Psychiatrist surely must be a good listener to the patient

Why did I say so????

Psychiatry field ni bukan melibatkan masalah2 major seperti manic and Schizophrenia semata2…bahkan psy ni lebih meluas daripada tu because in this discipline, we deal with many types of emotional problems, such as:

• stressed people that usually diagnosed to have Major Depressive Disorder.
• People with sleep disorder a.k.a Insomnia.
• Patient presented with “rasa berdebar2”…”tangan selalu berpeluh”… usually symptoms of anxiety disorder.
• Remaja belasan tahun yg banyak mengalami masalah pemakanan seperti Anorexia nervosa atau Bulimia nervosa.
• Patient presented with many complain of “sakit badan” but when investigation done takde plak abnormalities…those usually diagnosed with Somatoform Disorder.
• Student yang mendapat tawaran melanjutkan pelajaran ke luar negara…tapi lepas beberapa bulan balik ke Malaysia sebab mengadu sering tak sihat. Bila check, xde problem. This maybe an adjustment disorder.

….and many more.

So at your opinion, semua yg mentioned tu seems aggressive ke?

I can say that most of them was stable and believe me, kalau kita terserempak dengan mereka kat luar, we never know they have such problem…betul x?

Psychiatry and Stigma (T__T)

I do emphasize on this because stigma masyarakat kita amat2 kejam terhadap mereka yg seek for help from Psychiatrist. Many people akan memandang sinis bila seseorang tu mendapatkan rawatan or even jumpa ngan Psychiatrist. They will think that the person was insane… (T___T).Pandangan masyarakat yg macam ni la yg telah membuatkan ramai pesakit2 psychiatry tak nak datang hospital dan mendapatkan rawatan. Hasilnya, lebih banyak masalah berlaku di luar sana.

Dalam agama pon di larang untuk kita bersangka buruk kepada orang lain. Langkah terbaik adalah membantu mereka2 yg memerlukan bimbingan dan sokongan kita. This applies the same kepada bekas penagih yg ingin berubah. Mereka melalui saat yg sukar lepas keluar dari penjara or pusat serenti sebab kurangnya moral support drp masyarakat. Memang la mereka pernah membuat kesilapan sewaktu mengambil dadah dulu, tapi bila mereka dah nk berubah sebaik2nya kita support lah mereka…kan? (^__^).

Tenang- tenang aja yach?

Pesakit2 psy ni adalah mereka2 yg di uji oleh Allah… dan ingatlah Allah juga boleh menguji kita bila2 masa sahaja…it just that tahap dan bentuk ujian yg diberikan pada seseorang tu mungkin berbeza. Berdoalah semoga kita kuat untuk menghadapi segala ujian dari Allah.

Firman Allah dalam Surah Al- Baqarah ayat 156:

"...Iaitu orang-orang yang apabila ditimpa musibah, mereka berkata sesungguhnya kami milik Allah dan kepada-nyalah kami kembali”

Sekian perkongsian hari ini… Illal liqa wa maas salaamah (^__^)

P/s: Doakan saya berjaya dalam exam end posting Family Medicine & Psychiatry this week!

Clinical Year: Pediatric

Assalamualaikum dan salam sejahtera semua readers sy. Sihat x today? Syukur Alhamdulillah Allah masih memberikan kita peluang ntuk hidup ngan sihat di muka bumi Nya ini..

Hari ni merupakan post yg dh lama sy nak buat tapi x buat2 lagik sampai hari ni. Saya nk share ngan anda semua pengalaman melalui posting yg paling tough sofar; Pediatric.

As you all know, Pediatric merupakan bidang pengajian kesihatan dan perubatan kanak2. Ramai orang kate, x mencabar lansung jadik pakar kanak2. Haha..mula2 sy pon rasa cm2. Tapi skali bila dh tengok ngan mata, kepala sendiri…mmg sape2 yg buleh jadik pakar kanak2, saya tabik spring!!!

Kenapa agaknya sy bleh cakap camtu ek?

Haaa…xceli, kalau anda semua nak tahu, bidang pengajian kesihatan kanak2 ni amat mencabar atas beberapa sebab. Antaranya:

Bila pesakit jumpe doc, mereka akan ditanya beberapa soalan oleh doc kan? Contohnye;

“Makcik sakit kat mane ye?”

“Sakit tu jenis yg macam mana makcik..?”

And most of the time patient akan berjaya describe the pain or they can tell the doctor how they feel. But in Pediatric, u cannot have such information especially in young children. Sekalipun anda tanya parents mengenai keadaan anak mereka yg sakit, information dia still gak ada kebarangkalian ntuk silap sbb parent x rasa sendiri sakit yg anak mereka alami. So, the history taking part was actually not as easy as we think.

During physical examination pon ade part yg susahnya juge. In adult, kita boleh mintak mereka berikan kerjasama time kita nk check mereka, betul x?

Bagi information and a little instruction pada pesakit td, InsyaAllah mereka mampu ntuk melaksanakannya. Nak measure blood pressure ke, nak ambil darah (venipuncture) ke, or apa2 sahaja procedure hanya menguji sejauh mana kecekapan kita dlm melakukan that particular task.

But in Pediatric, bukan setakat skill klinikal kita yg diuji…malah lebih dari tu. Kita kena pandai counsel kanak2…senang citer pandai amik ati budak2 la. Kita perlu buat semua examination on that patient secepat mungkin sebab kanak2 amat cepat merasa bosan. Ambik darah budak2 especially bayi…subhanallah…(^^,)!!

Special stethoscope... Pediatrician kat ward sy pakai...COOL

Another situation….

Masuk ke clinical year, ramai medical students yg akan rasa teruja. Especially when it comes to stethoscope and white coat.

Tapi, di department Pediatric… sebaliknya. Ramai kanak2 yg akan terus menangis lepas tengok anda dan white coat anda itu. Mereka tend to think that doc ni nak ape2kn mereka. So bila kita dekat je ngan mereka, terus mereka nangis or menjerit. Saya pernah melalui pengalaman ini T__T

Tapi bila pikir2 balik ape yg berlaku ni, kita dulu pon pernah rasa kan? Dulu2…kalo ade je van klinik kesihatan masuk ke area skolah, semua jadi gelabah. Macam2 reaksi…ade yg nangis, ade yg pucat, ade gak yg menyorok. Haha..kelakar kan? Sebab kita sume takut jarum yg doc pakai. Saya yakin anda sume pernah rasa betapa gelabahnya masa darjah 6 dulu time nak amik suntikan BCG. Haha..seram!

Islam mengajar kita untuk sentiasa bersabar dalam apa jua masalah yg kita hadapi. Bagi sy, sekalipun Pediatric ni amat2 menguji iman sy, sy ttp happy setiap kali dapat buat my patient giggle even when they sick. (^__^)

…and kata seorang senior:

“Budak2 ni insan yg suci dari dosa. Doa mereka lansung di terima oleh Allah..so harap2 kalau kita bersabar dan buat baik dengan mereka, mudah2an mereka mahu mendoakan kita…”

Apa2 pon, sy dh lalui Pediatrics and I passed the exam alredy. Alhamdulillah…and nothings better than the fact that I started to love kids nowßI don’t hate them before ok?

Nantikan post2 lain yg bakal menyusul (^__^)

Wassalam.