Start of a life as housemanship

I started my housemanship one month ago in HUKM, placed under surgical department, vascular team. First two weeks, I suffered. But IMU prepaid me well through the o&g and stress, so it's still bearable for me. Long standing hours, running here and there ended up with numbed toes (nope, I'm not joking), stress of workload, not used to the system and how things worked, skipped meals until late at night, irritating boss, demanding patients, difficult procedures, the lists never ended. Everyday, there is a challenge, and I feel relieved at the end of the day when I walked out of the hospital, happy that I passed my test.

Here is a comparison of patients we encountered.

A. Difficult patients.
I'm sure every housemen encountered this. Because we are dealing with humans, not machine, they have feelings, demands and .. life.
They can make things difficult for us.
For example, when I was on call last night, I have a new admission that I needed to clerk.
When I sat dwn to talk with her, she refused to be clerked.
Everything that I asked, it's a 'I don't know, I really don't know. You ask the doctor la. They admitted me, I really don't know anything. Go and look at the file la." I IRRITATED me so much. I keep telling her, her records are not here yet, I have to get something from her so I can present it to my boss tomorrow, so that they will know what they are dealing with because we have to assume that they might not know what is your case. Yet. she continued to give me the 'I don't know'.
When I go read a bit more on her basic details, I realized what might have depressed her.
Her husband passed away.
She probably has anorectal cancer (anterior resection was done) and TAHBSO (can be gynecological or advanced cancer spreaded to gynecology structure).
She has stoma bag.

Yupe, that summed up all. Life sucks for her.

I was reminded of another patient who has similar attitude as her.
That 'I don't know. Go check yourself.' attitude. (she's post aka patient, bed sore, and adl dependent, no husband.), I understand they might be depressed, angry so I tried to be nice with them. But they still have a hell lots of attitude to get to you.

Of course, not every patient is like this.

B. Grateful Patients

I feel great when I'm thanked by my patients. I remembered, I always remembered a patient, who has bg scleroderma, c/o bilateral malleoulus chronic ulcer, who stayed in ward for almost two weeks, and I have to dress the wound every day. I was new at that time, got scolded, no meals etc, she sees me suffered, understood me.
At the end of her stay, she thanked me, kissed me on the cheek, and keep telling me, "Sabar, sabar, Dr Ivy..." She's inspired me the most. I sincerely thanked her for her support.
And it's a true happy feeling, when I heard my patient pointed to me and said "saya nak Dr buat untuk saya. Tak mau orang lain." Yes, it really gives me the joy.

I guessed this is what it meant to be a doctor.
I guessed this is where, during the moments of stress and depress, we find ourselves the meaning of being in this profession.

It's the joy we gained from treating patients.

Facial Product and Cosmetic haul from Korea

I made my research before going to buy, and how right I was about the time-limit. Thus when I got there, I tried to make use of the max amount I have by swooping all the stuffs that I had read online with positive reviews eg egg foam wash, nature republic cleansing oil, innisfree no sebum mineral pact and the lip scrub and some others are just randomly grabbed simply because 

1. I lacked them

2. staff recommended: bb cream and primer 

3. they looks promising

List of stuff I bought from Myeongdong: 

1. Skin food egg pore foam 

2. Nature Republic Aqua max peeling gel

3. Skin food vitamin c facial mist

4. Skin food omija facial pact

5. Nature Republic cleansing oil Argan  

6. Innisfree green tea lip scrub

7. Skin food lime shine pact 

8. Face shop: shimmer blush 

9. Etude house 

10 Skin food eye shadow

11. Innisfree no sebum mineral pact

12. Face Shop blusher

13. Innisfree air skin fit bb cream spf 35 ++ 

14 Innisfree no sebum primer 

15. 10 pieces of face masks from Face Shop

Hair clip and assessories, and two earrings. 

Freebies cotton pad

Freebies from all the shops, mostly from skinfood. :) 

Korea + Jeju 8D6N Spring tour 2013 Part 2

Everland 

Day 3-Flight back to Seoul in morning at 9am (Rainy) 

Journey to Everland for the rest of the afternoon. (Windy) 

Dinner

Check in at Phoenix Ski Resort (temperature 2 degree Celsius) 

Caught my sore throat after Everland. I didn't drink enough water due to the cold weather. And it freezes my hand while taking photos with the wind. 

Day 4- Seoraksan national park

Blue Canyon Hot Spring at 4pm. 

Dinner 

Enjoyed the hot spring really much~!  No pic. :P 

Ginseng chicken with Abalone as dinner

Day 5- Checked out Resort

Two hour journey to Nami Island 

Travel back to Seoul 

Gyeongbokgung 

Kimchi making session and Korean dress experience.

Dinner

Dongdaemum shopping 

Checked in at Itaewon Crown Hotel 

Day 6- Ginseng shop

Visit to Blue House 

Face Shop Duty Free

Lunch: Seafood Buffet (Best) 

Myeongdong Shopping 

We skipped dinner that day as the time given for shopping was not enough. From 3.30pm until 720pm. There were lots of shops that I wanted to go, but due to lack of time, we were practically rushing while buying things that we wanted, mostly facial and cosmetic products. These are just part of them. I had not included the freebies, which are TONS!!! Just LUVE IT! 

Knowledge learnt: the cultural society in Seoul,  重男轻女，上下阶层的礼仪

Day 7-Checked out at 9 am

Some more duty free local groceries 

flight back Malaysia with Korea Air at 4.40pm (local time) 

This is my tour group. 

And lastly, my main reason for ditching my job induction as doctor-to-be is for this! (and facial products :P) 

Overall: SA tour was a good choice. As said, we didn't pay any money for this tour. All charges were included. Tour guide was really nice. We're not disappointed by the accomodations and hotels as well. 

Korea + Jeju 8D6N Spring tour 2013 Part 1

Visit Korea in Spring time with SA tour

I said it's worth it. :) I received my induction letter one week before this trip stating my induction started on 22th April 2013, but I'm still in Korea at that time. T.T Since what my family paid was a huge amount, one person RM 4,900+ per person that included hotels, flight tickets, and entrance tickets basically everything,  and we prepared everything, it'd be a huge disappointment and money-wasting if we didn't go.  And it does turned out, we didn't pay any extras charges for this trip. 

Our tour guide, Liu Andy, was entertaining and shared lots of local stories, cultures and experiences with us. I learnt lots about Korea from him. 

First day we reached Incheon airport at 7am Msia time (8am Korea time). Temperature on arrival was around 8 degree Celsius. For the first time in my life, I noticed how the puff came out from our mouth when we breath and talked after coming out from the airport. One word: Freezing cold. and we realized, shit, we didn't bring enough clothes. Truth enough, we suffered and I brought back flu from this trip. 

First day-DMZ (north and south korea border visit) 

Flight to Jeju at 3pm. 

Visit to Teddy Bear Museum jeju island. 

checked in at Neighborhood Hotel.  

Knowledge learnt: The history between north and south korea, living condition in north korea, men serving country as soldier for 21 months and it is hard. 

Seongsan Sunrise Peak 

  Seong Up Folk Village

 Trick Art Musseum 

Day 2- Seongsan Sunrise Peak

Seong Up Folk Village (大长今拍摄地) 

Mysterious Road

Trick Art Museum 

Nanta Show 

Dinner: Abalone Seafood 

Knowledge learnt: korean woman make up since teenage/young adult, will not bare face to go out. Old woman (even cleaner or joggers) will wear thick make up. Their salary are high and even (no beggars), relatively, their living cost are high too. 

Lots of manufactures (Samsung, Hyundai) in Korea. Ridiculously more china visitors compared to Western visitors.  (due to distance one hour flight to china land from Incheon). Their weather prediction are very accurate!  

\

IMU students: house to rent in Seremban 3

House to rent in seremban 3. single storey. 5-10 minutes drive to IMU. 
Three rooms, two bathrooms, airconned. Friendly neighbors and relatively safer street. One of neighbors is a taxi driver if you don't have a car. 2 min drive to nearest shops (family store, food). It is unfurnished. RM 400-450 (need to be discussed with owner) 
Buy-over from seniors: 
Furnitures with fridge, washing machine, water heater, gas, cooking stove. 
Room furnished with cupboard (from owner), beds, tables etc, also need to buy over. 
Available March/April onward 2013. 
Email me: ivy_ran88@yahoo.com 

Alopecia Areata - Unbearable journey through it

If some of you actually went back to my older posts and looked at my post, there was one post regarding my treatment journey to my alopecia areata. But that was just one, and I have never told anything more than that. Few days ago, I saw on newspaper a seven-years-old little school girl in Singapore facing the same problem as mine. It reminded me of my OWN 'baldy' past. It was horrifying. Here, I wanted to reveal my journey through this problem. How I found it, how I beared with all the looks and everything. I have to warn you, it was not a pleasant one.

What is alopecia areata?

Alopecia areata (AA) is a medical condition in which hair is lost from some or all areas of the body, usually from the scalp.^[1][2] Because it causes bald spots on the scalp, especially in the first stages, it is sometimes called spot baldness. In 1%–2% of cases, the condition can spread to the entire scalp (Alopecia totalis) or to the entire epidermis (Alopecia universalis). Conditions resembling AA, and having a similar cause, occur also in other species.^[3]

taken from wiki.

Signs and symptoms?

THESE are my own experience.

Triggers? I assumed it was my low nutrition = low immunity, and stress. Back then, I have a major stress, one related to studies, stress to THIS problem, thus affecting my self confidence and major depressive disorder that caused me to have countless suicidal ideation. It was a hard period. The first symptom that I noticed was one small 3 x 3 cm baldness at my right temporal region, above the ear. I thought it was nothing serious, that it will grow back so I let it be. Days by days, I noticed the amount of hair dropped and accumulated at the sinking cover after my shower growing more and more. It was nothing I have seen before, and even when I combed, there will be massive amount of hair dropped on the floor. I searched the website, knowing a normal person should not drop more than 100 of hair strands per day. But WHO the heck count one by one how many hair you drop a day?? BUT I know there is something wrong with me.

Besides having hair loss, I also felt heating and burning and itching pricking pain on my scalp. I do not know what it was, thought it was due to heat.

I tried all kind of methods suggested from website, changing COUNTLESS of shampoos, eating vitamins, stopped combing, but nothing works. They still fall. And then, I realized, ALL those suggestions were useless! They, the teenage girl who have only a few drops of hair fall, panicked over a freaking hair loss like they become bald doesn't even know what is the exact meaning of HAIR LOSS!!

As a medical student, (lucky for me), I know how to search out information and seek help. But, the wrong-est thing that I had done was denying it from the start, which I know is a normal thing because these reactions has been taught in our course. I had guessed it to be alopecia areata, and I had known it was perhaps best to see a dermatologist. And I had expected too as well, the treatment for it was injection. So, unlike my mother who came with me during the visit, it does not come as a surprise at all to me when the doctor diagnosed me with AA and took out the injection needle.

Back to the story,

During the third week, the fall suddenly went very bad. And it was becoming obvious that this is not normal for me. However, I still do not dare to seek help. Like most of the patients, we are afraid of what is about to come, afraid that it might be true. After two months bearing with it and realised that NOTHING works while watching it falls everyday, I finally went to the dermatologist with my mother.

I was told to come back every month for the injection of rogaine. took up vitamin pills everyday. That time, my hair fall has already spread to my frontal baldness, both temporal baldness which is no longer just one or two spots but has joined up to form more and more diffuse baldness. It was unimaginable, for someone who has never experience it.

Yet, the worst was yet to come...

Four months through hell

Starting from early September to end of December, it was hell for me.

I believed great hair, face, body shape, and skin are something that any girls would want and if they are born with it, congrats, they will and should treasure it. As for me, before this ever happened, I really love my hair. I don't have cute or beautiful face, nor great body shape, or milky but fairly good skin... my hair was like the only great element that I admired about myself. And you can imagine, when this one good thing become your most shameful thing, how your self-ego dropped over the night?

Aside from the shower hair fall, it falls when I eat, yes it's true! THEY stick on my pillow when I woke up. I used the word 'THEY' because it is not just three or four, but eight to ten, sometimes even more than that. Now let me ask you, if you're truely falling hair, how many hairs do you found on your pillow when you wake up?? After school everyday, when I took off my hair band, the hair falls. And showering became the most fearful thing for me.

I tried to put down hair at school. Because all the hair fall spot were above the ear, but those on top are all intact. Initially they can still be covered. But at third and fourth months, my close friends started noticing the baldness, especially looking at my frontal hair and knowing me. I started getting questions like 'what happened to your hair?' 'are you alright?' 'do you have cancer?' 'why your hair so thin?'

You know, first few months I can still tolerate them.

But in fourth until fifth month, it got really worse. The treatment did not work properly. My frontal hair baldness actually grew back after two months of injection, but it Does not stop my hair from falling. It was so serious that both my ears are out, my hair thinned, and the back of my scalp too has DIFFUSe hair loss. It was practically the whole head involved. and not even putting down hair or tieing it up work. No. More and more people started asking, and I was pressurized, embarrassed to the point of committing suicide. I walked in public/school and all that came to my mind are "dun look dun look, dun judge, gosh, they are all looking at me." I dun smile, I dun socialize, I dun share.  Looking back, I remembered several occasions where I had wanted to just stood in front of a oncoming car, jump from my apartment which is situated at 23rd floor, took out knife and just stab myself etc. I thought of how my life will go on, how my hair will become bald eventually if this doesn't stop, and how will I live in this world looking like that peculiar bald girl. I'd rather disappear. THoughts like these just ... ran their way into my mind everyday. 
But I dun have the courage to do all that suicidal things, thankfully. Again, I did not seek help, cause I naturally thought it was nothing. Just a feeling. But now, I know, those are serious symptoms of major depressive disorders.  


Putting that aside, I dun remembered how, but one or two months after that got worse, when I get my fourth injections, the hair fall started to decrease. What I meant 'decrease' is that it doesn't fall as much as previously. And that led to my mood changed better gradually when I noticed this good news. I supposed, with this mood change, the hair grew back together. After two more injections, I defaulted follow up cause all the hair had grown back out. I was super happy about that. 


Now, after one and a half year, I had a hair-length black hair, which I straightened three months ago. :) So, yes, it has improved. Occasionally, when hair fall, being the paranoid girl, I'll always took the hair and looked for any tapering ends. Some existed. but some don't. 
One side effect from that disease, my right temporal hair, seems to be lesser/thinner compared to the right side. I supposed I shouldn't be too worried about it, as the hair doesn't fall out abnormally when I pulled them. They only fall when I washed and combed hair, so that's the normal within 100 hair strands fall. :) 




If you're reading this, I supposed you either have this problem or have had friends/ family who has similar complain. Feel free to contact me, seek out help and I can help you through this. 

All my favourite BL books and recommendations part 9

WOAH! it's part 9 already.. so here goes the list again!~

231.

《清风笑》

傀儡偶师

在遇见主人之前的事情，我都记得不太清楚了。
只有那天的小雨，让我视线一片朦胧。饥饿让我似乎从胸口都掏空了一样了。那一瞬间，我感觉自己已经快死了。
接着，一双黑鞋停留在我的视线里，从地上仰望过去，主人的雨伞，支撑着天空。
“想逃吗？”他低垂的头发，乌亮的竟然比他一席黑衣还要深沉。
我摇头。
我怎么会想逃，又怎么敢逃。
从有记忆开始的所有，都是这个人的存在，在我只有十三岁的生命里，他便是我全部的天地。离开了他，我甚至不知道要如何生存下去，而我又将为何生存。

类别：4P，3攻1受，主仆，纠缠，逃离，虐心，微虐身，江湖

很好看。。 

受是攻1的‘逃离’的奴役，躲过了三年，在那遇到攻3，最后遇到攻2，喜欢上他，但攻2一次又一次的欺骗隐瞒，目的是挤垮攻1，目的达到后，受悔恨，虽然还是爱着攻2，他找到攻3和他逃离，逃了六个月，得知攻2寻来，但愧对攻3，几经纠缠，终于和攻2在一起。

My rating: ☆☆☆☆☆




232.

《月河雪》

类别：2攻1受，主仆，纠缠，虐身虐心，卑微受， BE

受爱着攻1，但攻1不珍惜，攻1 在一场比试中把受输给了攻2，攻2 爱上受，但因为受长的像侮辱他的仇人，翻不下戒心，毒打受一番，受被那仇人救，后发现是自己父亲，但这父亲并没把他当儿子看待，反用尽心机利用受。攻1和攻2陆续找到受，但因身上的伤，性命为在旦夕，父亲给他药丸，延续他一年的性命。。。 

My rating: ☆☆☆☆