My last week at RMH

This is my last week of attachment at RMH. As usual, we had all the morning ward rounds, discussions, and meetings. Observed another pleural tapping.

Here are some photos taken when I was at the hospital. 

Level 5-south wing: This is where the general respiratory medicine ward located. 

Respiratory care unit (RCU): It is a specialized 4 beds unit located in 5 south west. Patients with acute respiratory issues will be managed here. 

The respiratory team is made up of a consultant, a registrar, a resident, a specialized senior nurse and an intern.

I did mention in my previous post that everything is computerized here at RMH. Patients' details could be accessed by authorized medical personnel at every nursing counter at the hospital. It is really convenient. 

The professional medical report session. 

The radiology meeting (every Tuesday) and multidisciplinary meeting for lung ca (every Friday). 

There is also weekly respiratory medicine clinic on Tuesday and lung oncology clinic on Friday. 

Had met awesome people here at Royal Melbourne Hospital. 

From the left: Lucy, Eugene, Me, Nick, Joanne. 

Thanks for the hot chocolate and cakes. Gonna miss them all ! :) 

Royal Melbourne Hospital is a tertiary hospital equipped with high-tech facilities. I would say that the hospital environment and setting is really good for the patients. Medical staffs are dedicated to their jobs.

Saying goodbye is always the hardest thing to do. I will definitely miss the time being here and being with the team. Fabulous moments! The most memorable event in my life. 

THE END.

By the way, having this blog would make my report writing much more easier. Haha ! 

Clinical elective at RMH (Day 12)

Day 12

We had an enjoyable session with Dr. Lucy today. We had a discussion with her on how to interpret the ABG. That is what I need the most as I always get confused when it comes to interpretation of ABG. Before we started, she served us with her  self-baked chocolate cake. Oh, that was really tasty! Yum! And then she gave us a short lecture on ABG before we practiced it with cases. It didn't take long but I found it to be really useful. 

And not forgot to mention that we came across a patient with giant cell arteritis during the ward round. The reason for the patient to be admitted in respiratory ward was because of her acute onset of shortness of breath and oxygen desaturation. They tried to figure out the causes by ordering further investigation like CTPA (to find out whether the acute SOB was due to clots in the lungs), ABG and others. 

I was being offered the chance to do an ABG. I was quite worried and nervous as I had never done it before. However thanks for the encouragement from Jimmy, Nick and Dr. Lucy, I was ready to give it a try. Unfortunately, when we went to the patient for the procedure, it was already being done by one of the nurses. Oh, may be next time. :) Hope I still have the chance for that. 

Clinical elective at RMH (Day 10-11)

Day 10
Nick and I had a discussion on certain topics. He would like to get himself a little warm-up after being in a relaxed mode for a long period of time. Same goes to me. I think my brain had turned rusty after my third year, being too relaxed throughout my forth year. He was preparing himself for becoming a junior doctor or an intern upon finishing his clinical elective and I should start to prepare for my final. We discussed on myasthenia gravis. Other random topics like multiple sclerosis just set in. Apparently, he knew more than I did. Though we just touched on each topic superficially, I found the discussion was beneficial. I was glad that he had introduced certain useful websites and online question banks to me.

Day 11
Starting from this week, the respiratory team would be taken over by another respiratory physician, Dr Jeremy and also Dr. Nicole, the registrar. And the resident, Dr. Lucy would be joining the team. Dr. Lucy was so kind and helpful. She really tried her best to help us up and to teach us on whatever that came across her mind. I appreciated her effort in coming out with questions for us to ponder on or the other way round. She even offered us her free time to have a tutorial with her. That's great! I am looking forward for that.

During the professional medical report session, the second case had caught my attention as I found that it was quite interesting. It was a rare case of primary choroid plexus lymphoma. In that case, the patient presented with confusion and short term memory defect. There was no other neurological sign and symptom. He was conscious, had a normal gait with no deficit detected in cranial nerves, lower and upper limbs neurological examination. Radiological investigation of the brain (I couldn’t remember whether it was a CT or MRI) showed abnormality in the ventricles. Further investigations then carried out and finally they came out with the aforementioned diagnosis. They even showed the video of that patient underwent mental state examination, which gave us a clearer picture on what was going on.

Clinical elective at RMH (Day 9)

Day 9
There was a lung oncology clinic running right after the multidisciplinary meeting. Thanks to Dr. Philip for asking me whether I would like to join him. It took me a while to realise that he was a cardiothoracic surgeon. I was supposed to be joining lung oncology physician. *face palm* Anyway, It was my pleasure to join him. And hey, he knew Kuching. He also told me that he had been traveling to Sabah before. He was quite humorous. I got to know an interesting story from him. It was about a patient with Pancoast tumour who came to realise that he had unilateral drooping eyelid when he was comparing his self-portraits drawn by him himself. Often we heard of patients came to realise the abnormalities through mirrors rather than portraits. Hmm. There was one funny moment when he suddenly turned to me in the midst of conversation with one patient and was expecting me to mention the name of disease which he had been discussing. It was neurofibromatosis. Unable to react fast to the sudden unexpected question, my tongue just got tangled and it sounded like I had a slurred speech. I was like, “ Poly… nope .. neuro..neurofibro..fibromatosis.” Oh dear, another face palm. Nevertheless, the whole session was remarkable.