Thursday, February 24, 2011
during the week of internal med, i got to see oesophageal-gastroduodenal scopy. compared to bronchoscopy which will take abt 30-45mins, OGDS was just a short 10mins operation. excited to see the real rugae with bile in the stomach at the LCD screen. biopsy was performed at the upper duodenal segment. this patient complaint of frequent epigastric pain, but the upper GI appears to be normal...
on the other day, i was fortunate to witness the whole process of threadmill. A man suspected with MI has his chest hair shaven for the leads :P there were different stages of exercise, and different categories too. An ECG report was constantly generated throughout the process to jot down any changes of the electrical activity of the heart. the inclination and speed of the walk were increased gradually observe any significant changes. Clearly, there's a sharp dip on ST of -2.20 at stage 3 and the patient appeared breathless after the exercise. he was rested on the bed for recovery. the nurse chatted with me after the whole procedure, and surprisingly. gave me an angpao! :D
during the clinical consultation of internal med, there's one special case of a patient suffering from depression. apparently there's sad story behind her radiant smile she put up to while chatting with the doctor. her prejudice over her son's marriage seemed to consume her a lot, to the extent of excessive weight loss, sleep deprivation and loss of appetite. the medicine the doctor prescribe her, other than the usual drugs that treat symptomatically, was an advise to her to put down her prejudice and accept whatever has happened. she smiled with reluctance, and said she'd try. sometimes, a certain condition can only be reversed by oneself, not medication.
cardio department.
basically it's about managing and controlling the symptoms: painkillers, drugs for lowering BP, statins for cholesterol, warfarin for anticoagulation, cardio-echogram and stress-test for monitoring the performance etc. curative of severe MI would be the stenting operation (as for cardiology dept. coronary bybass surgery is only done by surgeons)
from the cases i saw and from wad the doctors say, i have made a few observations in our general population:
1. coronary heart diseases normally attack the middle and older age group due to atherosclerosis caused by high cholesterol, high bp and diabetes.
2. people who get coronary heart diseases early in their age, say their mid- twenties, are due to smoking. there was one 16 year old teen admitted to A&E due to myocardial infact, the reason being: drug abuse.
3. "the only vege that u shud avoid is tobacco" LOL the doctor will always advise the patient to quit smoking, if not all effort will be put into waste. if the patient says: I'll try , that means he will not stop smoking. LOL. that's so true...if u wanna stop it, u can stop it. if there's always cigarettes available in your pocket, by habit and addiction, u can never abstain from it. the most effective way is to not buy it!
