an endoscopist wannabe!

and today, im an endoscopist
"no picture available"

HAHA, i din get to take the picture of me wearing the surgical gown today xD haha, u know the blue one that you wear from infront then u tie behind xD haha, fun fun xD

hmm, so today was a full day with dr. reuben! really very exciting today! its not boring at all (: okay, details! haha.. (to mok: too bad my blog always got details)

so i came quite early and called dr reuben, he said go to ward 64 first and join dr eric and the others first before he came for rounds. YEP, and so i tagged with dr martha this morning. no wonder i find the face familiar, she is from indo too! haha, from padang. she went to med school in canada and came here to work. (: so she is a house officer, when she did her rounds i went with her. oh she is VERY NICE! she keep explaining to me the patients one by one, even let me help her do things like listen to the abnormal heartbeat and compare with my own :p haha. YAY for her, really thanks alot for the lesson!

when dr reuben come, do usual rounds, then we went to his clinic. okay, now i admit it gets boring at this part, i almost fell asleep. NOT THAT his consultation is boring, its just when the person is more comfortable with chinese, i will be like this -> o.O throughout the whole session. haha, but when its english, im wide awake and its really interesting to see him diagnose and help the patients. (: theres this one particular patient who is very anxious who keep saying theres a lump on his rectum. finally dr reuben dig dig and see see also nothing xD haha, anxious patient. maybe im one of those.

after clinic was the fun part! scoping! WHOOHOOO, endoscopy! EGD and colonoscopy! dr reuben was very kind to explain to me which part which part (: so, here goes the procedure! first, the person is given an anasthesia, a lidocaine spray, sprayed on the throat (pharynx) and told to not swallow for around 10 seconds. after that, the patient will swallow the liquid. then, they will be given mild sedative, i forgot whats the name ): haha, the first patient refuse! i dont know what he want -.- after all is ready, stable heartbeat rate and bp, then the nurse will do the timeout, confirming patient and the type of endoscopy. after everything is settled, the doctor will insert the endoscope from the mouth! then he will look at the screen, at the same time keep pushing the scope further inside, and with the other hand, control the movement of the scope. its really like playing games with complicated, damn complicated controller. you can turn and turn around the camera, so sometimes you will work in mirror image, where up is down and left is right! haha, i feel like trying it! test my gaming skill in the real world :p haha. okay so first stop was the esophagus. this is the worst part where you are asked to swallow to create and opening for the scope to come in. based on my view, its quite painful, almost all of the patients coughed like they got choked. haha, but i guess its okay. after that, its quite simple and the patient wont feel much. on the esophagus, he will take a picture. then we will arrive at GE junction, where he took another photo, and then goes to the stomach. taking 4 photos of the stomach, cardia, fundus, corpus and antrum, before proceeding to the duodenum where he take the last pictures. at D1 and D2.

and sometimes, i mean almost all the times, biopsy is needed. its quite cute you see, the biopsy forceps will come out at the corner of the screen, he will push it close to the wall (or whatever he want to take the sample) then he will ask the nurse to open the teeth, close, and he will pull out the meat. of course itll bleed. sometimes a little, sometimes alot. haha. when you look at it, itll be quite eerie, esp when u are on the bed, looking at your bleeding esophagus/stomach wall.

oh and when there is polyps, its even worse, you need to remove it. either burn it, or snare it, or remove it piece by piece with the forceps. there were 2 cases of polyps today. one is removed with he forceps and the other one is burnt off. whoa, extreme accuracy and precision. nice work. oh before removal, dilute adrenaline is injected into the polyp.

ahh, okay shit its getting late i need to sleep! but let me finish this first. then we also do some colonoscopy, which means endoscopy of the colon, which must start from the anus. i guess its abit more uncomfy xD and abit more painful when you blow air inside to inflate/ dilate the colon. alot of the patients tear, one of them even keep saying, "pain pain" "its going to burst", scary. so, it goes from rectum, goes trough descending colon, transverse, then ascending, then goes to the caecum, see the appendix and then stop at ileum. (i think)

last patient was quite scary, done the endoscopy numerous of times but cant find the source of bleeding. today, dr reuben found it! woo! and theres alot of crap things in the colonoscopy. haha.

okay i really must go and sleep, tmr going surgical division again, i dowan to fall asleep. ahh 2 more days ):