two to tango

Author: ctjuliana / Labels: , ,


like learning ABC, counting 123,
steps by steps taken by,
though the journey so challenging,
i need to be brave,
i need to be strong,
to move on to the next level.

just so you know my friend,
its not that easy,
i cannot do by my own,
because it always takes two to tango,

but we always there for we,
giving a hearts for we,
although not all the time,
least we can do is to try when needed,
time and distance the limitations,
love and trust the survivors.




by jules




friday evening

Author: ctjuliana / Labels: , , ,


beautiful friday evening with my old friend mya amirah.
thanks for everything mya
till to see you next time
winking

featuring Mya Amirah @ bandar tasik sri permaisuri
"i just haven't met you yet"


love , jules

i will remember you sacral agenesis

Author: ctjuliana /


"what is your name? siti juliana isn't it?" He asked. Automatically, i nodded my head. "So, which one. Siti or Juliana?".."errr, either one is ok prof"..

"ok now Siti, i am very strict with my time. All i can give to you, is to do the examination and discussion within 10 minutes". Pandangan mate die, pergh..tajam! cuak sangat. Tak mampu nak kate ape2 by tat time. "10 minutes. remember, 10 minutes only!". Die diam sebentar. aku kekagetan. "hmm, ok prof".

"ok siti, this madam Suziana, 28 years old gravida two para one. I want you to examine her abdomen. your 10 minutes begin, now!!"

As i begin my examination, surprisingly he did not interrupt me at all. Maybe because, i examine the patient without running commentary. As i finish my examination. He asked me. "did you have finish examine the patient?".."yes prof".."ok, present to me your finding"

" the abdomen is distended by gravid uterus evidence by cutaneous sign of pregnancy such as linea nigra and striae gravidarum. the umbilicus is centrally located and flat. there is a transverse scar..".. "wait wait, did you say scar?? i want you to look back the patient's abdomen."

"Ni mesti takde scar!!" i whispered silently to myself. As i checked for the second time. hmmm, betol la, "sorry prof, there is no scar. it just a skin fold "...."hmm, proceed"..

"On palpation, the abdomen is soft, non tender and the uterus is nor irritable. Clinically, fundal height is about 38 weeks of pregnancy and the symphisiofundal height measured 37cm. I can feel there is singleton, in longitudinal lie with cephalic presentation. the head is not engaged with four fifth palpable. The fetal back is on the right maternal side. The liquor is adequate and estimated fetal weight is 2.4 to 2.6kg "..

"i think it slightly bigger siti. about 2.8kg".."so how do you know the baby is alive?"

"by listening to fetal heart using.." i never finished yet! he interrupted me, "just now, when im asking you, did you finish examine the patient, you said yes. Is it listen to fetal heart is one of the examination siti?"..."yes prof, it is. i would like to finish my examination by listen to fetal heart using daptone."

"where? just point to me the point you will put your daptone. "its over here prof".

"why??"

"at the anterior shoulder of the fetus which closest to fetal heart".."okey.."

"now, im giving you her LNMP. calculate the EDD and POA"

Tak taulah ape yang nervous sangat!! pegang pen pon terketaq2. Da la terkire salah!! 9 - 3 = 7?? ngek betol. simplest mathematic pon da bercelaru. by tat time, i took very deep breathe. i calculate the edd and poa again. Hah, sebenarnye, the more relax we are. Things become easier. Tapi, exam kan! everything going to be undercontrol. palpitation is everywhere, every pulses!

So, the patient is only 32 weeks. "clinically, she is 38 weeks, calculated poa is 32 weeks of pregnancy. So, the patient has uterus larger than date prof"

"So, if i give you one chance to ask the patient, what the important thing you will ask the patient? Ask her now". Of cos i wont do the same mistakes. Wrong date is very an important point! then, i asked the patient is she very sure of the last normal menstrual period date.

"ok, she is sure of date. What other investigation you want to do next?"

"ultrasound"

"why??"

"To exclude polyhydramnios by assessing her amniotic fluid index (AFI)"

"okey. but just now you said the liquor was adequate"

"yes"

"so.."

" i will look to the parameters to exclude fetal macrosomia"

"what parameters you'll look for?"

"head circumference, biparietal diameter, abdominal circumference, femur length"

"which parameters is specific to assess fetal macromia?"

"abdominal circumference prof"

"hmmm, what other things you will look for?"

"placenta to exclude choriocarcinoma"

"what??chorioangiosarcoma..choriocarcinoma pulak" he begun to prop out her eyeballs towards me. owww owww...."sorry prof"

i heard thicking of his watch. i saw him stopped the time. Tapi.., "okey ade lg 2 minute". he gave me some time for the discussion.

"then, what other things you will look for"

"fetal anomalies such as anencephaly"

"do you feel the fetal head just now?? is the baby has no head siti?" okey i dig my own grave!! matilah.

"sorry prof, i can feel the fetal head. i will look for other fetal anomalies such as spina bifida and oesophageal atresia"

"okey, let say..u do ultrasound. then you found the baby has no ventricle. wut do you expect the mother might has?"

Habeslah. Im totally has no idea!! hentam je la. "as the baby has congenital heart disease, the mother might has heart disease prof"

He prop out his eyeballs back. i heard his sigh. harsh one.huhu

"ok2, i change. let say you found the baby has no sacral bone on ultrasound. the baby without sacral bone, wut we call it?"

Bapak ah soklan..mane aku ingt!!!nape lame sgt discussion nyer nih. bile la mase nk hbes!! aduhai. i cant stand to look at him. i looked into patient's face hoping there is a clue. Ofcos la xdek!! few seconds, he assisted me. "come on siti, sacral..sacral A.."

i was about to answer sacral atresia!! gile lah. naseb bek tak sebut. kalau tak, gali kubur sendiri lagi la nampaknyer. then, prof pon bagi taw.."sacral agenesis la siti, have you ever heard this term??"

"yes prof. i have heard it before"

"okey, if the baby has sacral agenesis. wut you expect the mother has?"

ya Allah, tak habes lagi rupenyer.

"osteomalacia" satu lagi jawapan yang MENGARUT!!!!! tapi make sense wut??hehehe..

i heard his harsh sigh once again. sorry prof.

"come on siti, sacral agenesis.."

"ha, diabetes prof"

"Haih..at last..then, how do you confirm diabetes in this patient?"

"do MGTT prof"

"how you do MGTT? tell patient now how the procedure is" Soklan feveret prof ok! cara nak buat mgtt..

"puan, saya perlukan puan untuk berpuasa dari pukol 12 malam ni sampai pagi esok. Esok pagi puan datang klinik, saya akan amek darah. Lepas tuh saya akan kasi puan minum air gule. lepas tu.."

"how to do the air gule?"

"75g glucose mix with 250-350ml water and drink within 10 - 15 minutes"

"ok proceed"

"saya akan kasi puan minum air gule tu. Dan puan harus datang kembali selepas 2 jam untuk saye amek darah lagi sekali"

"okeyh..finish" he smiled!! to the patient only! Obviously.

without waiting any longer, after saying thank you i left. i waited for him outside green ward.

"prof, saye lepas ke"

prof lift up his shoulders. "no komen"

i walk along behind him. suddenly, prof panggel. "you, come here"

"nothing to worry, i want you to be more confidence next time. you going to be a doctor soon. mane ade doctor nervous2 nih..hmmmm (his hmmm style!scary kot) . the other thing is, its good to be curious. but, dont over curious. i quiet surprise when you misinterpret between skinfold and the scar. and remember till the end of your life about sacral agenesis. okey thats all"

"okey. thank you prof" he left.

wut a long story!! i will remember this moment forever. i wish everything going to be wokey for me and friends. we got 2 more papers to go. the theory exam and the osce exam on this monday.




permudahkan lah ya Allah



my sweet caroline

Author: ctjuliana / Labels: , , ,


Where it began, I can't begin to know when
But then I know it's growing strong
Oh, wasn't the spring
And spring became the summer
Who'd believe you'd come along

Hands, touching hands, reaching out
Touching me, touching you
Oh, sweet Caroline
Good times never seems so good
I've been inclined to believe it never would

And now I, I look at the night
And it don't seem so lonely
We fill it up with only two, oh
And when I hurt
Hurting runs off my shoulder
How can I hurt when holding you

Oh, sweet Caroline
Good times never seems so good
I've been inclined to believe it never would


~my sweet caroline~




four seasons in one day

Author: ctjuliana / Labels: , ,



~ For Seasons In One Day
~


love , jules



defying gravity

Author: ctjuliana / Labels: ,


Something has changed within me
Something is not the same
I'm through with playing by the rules
Of someone else's game
Too late for second-guessing
Too late to go back to sleep
It's time to trust my instincts
Close my eyes and leap

It's time to try
Defying gravity
I think I'll try
Defying gravity
Kiss me goodbye
I am defying gravity
And you wont bring me down

I'm through accepting limits
cause someone says they're so
Some things I cannot change
But till I try, I'll never know
Too long I've been afraid of
Losing love I guess I've lost
Well, if that's love
It comes at much too high a cost

I'd sooner buy
Defying gravity
Kiss me goodbye
I'm defying gravity
I think I'll try
Defying gravity
And you wont bring me down



positive reflection




kenape mesti..

Author: ctjuliana / Labels:


"Arrrgh...name untok short case da klua." Ain meluahkan keresahannye.

I was so nervous entering o&g department this morning when Ain, a fren of mine told me tat short case name list already stapled on the department's board. Few minutes later, i saw..Student Name, Siti juliana Hussin..Examiner, Prof H..

"kenape mesti...."

"kenape......" i cannot avoid myself asking tat question.

Yes. im truly admire him. i really do. after all i experienced since i was in green ward last time. i admire him as a professional doctor. soft spoken, gentle doctor to all his patients. non judgmental highly sensitive doctor. But, as examiner....All i wanted to do rite now is to hug mak..i need a little warmth to comfort me. a little wise words to build up my confidence again.


Ya rabb.., permudahkanlah segalanye.




photoblogger =)

Author: ctjuliana / Labels: ,


Haaaiih, blog ku ini da mcam photoblog la pulak kan? org laen hangat membincangkan isu semase, tapi aku? hehe, tak berape minatlah ngn isu semase punye cerita. yang ku minat adelah gambar !!

"A beautiful pictures can tell you thousands of words. It captures thousands of memories. It can be shared to others who are not there by that particular time"

That is the reason why i love pictures so much. Sangat puas hati bile dapat tangkap gamba yang chantek
. Blogger jadik photoblogger..layan je la yek..hihi..


RINDU. rindu dia dia dan dia.


Tuhan sampaikan salam rinduku pada mereka praying




~ Listening to Naturally by Selena Gomez ~


sombong

Author: ctjuliana / Labels: ,


Sombong ke orang name jue ni ek?

tak kenal maka tak cinta okey

either

you dont know me well

or

you know me but you dont love me

but still

something i have to reflect on




p/s : to you, have i ever tell you that i love this gift? well you suppose to noe it. Thanx happy




~ listening to what you want from me, adam lambert~



bukan salah saya

Author: ctjuliana / Labels: ,

"bukan salah saye..saye ni student je"

kalaulah bolehku undur mase, nak je lemparkan kate2 tersebut untuk back up diri sendiri.

Tomorrow is friday. I have to cover beds for grand ward round for orange team. Semase dalam perjalanan ke ward O&G, aku berselisih dengan 1 keluarge waris pesakit. Mule-mule aku ingtkan sekumpulan doctor yg nk balik kerje..tp i was wrong. i heard some bad words coming out from them. Kutuk nurse, kutuk doctor, kutuk PPUKM.

"okey they are not in nice mood as i am" i whispered. Suddenly one of the family, dengan muke bengis nye, sambil melipat lengan baju kemejenyer stop me from entering O&G emergency entrance.

"adek, bole kasi mak akak masok gune pintu ni tak? keluarge kami tengah operate kat dewan bedah" his wife asked me.

"akak bole masok ikot pintu sane kan?" i replied.

"pintu dah tutop..pak guard suruh masok ikot pintu lobi"

"ha ah kene gune pintu lobi sebab da malam ni, kene dapatkan pass kat lobi baru boleh masok"

"tak boleh gune pintu ni?" she asked me once again.

"errr.." belom sempat aku meneruskan kate-kate,

That bengis guy raised his voice loudly to me, saying a bad words. Macam org kene sampuk hantu lagak gerinyer. i'd never seen people mad like this before. Gengaman tangan die mcm nk tumbuk orang. i was too afraid to see his face. Luckily, isteri die tarek die and tried to stop him.

"dahla jom blaa, nak tunggu org mati baru nak kasi masok agaknye. pakai wite coat je lebih"

hah..rs macam hati di sentap dgn laju nyer!! air mate da mmg bergenang. pooling around my eye balls. tunggu mase nak jatuh jek..huhu, atlas jatuh jugak titisan2 air mate dalam lift. my bad.

Sabarla wahai hati. org tu terlalu stress and desperately to see his important person in operation theater. I whispered. And hopefully his important person in OT operated safely. amin.








with love, jules

Author: ctjuliana / Labels:


moral value of the day

"nobody is born just to hurt other people's heart"



syira and aqis

Author: ctjuliana / Labels: ,


sekadar mengisi masa lapangku
.



~ listening to jauh, mirwana~





more of them

Author: ctjuliana / Labels: ,

syira with Obie,
her bestfriend ever


princess to be, Aqis.


souvenir from home. addicted capturing their photos.
stay cute and sweet syira, aqis =)


untitled

Author: ctjuliana / Labels: , ,


some nights i sit and ponder
did i give you my best?

i sit and ponder again

i can feel tightness in here

deep and slip away silently to my chest

sharp and tender


it causes a tears of mine

slowly flowing out without a consent

yet, it is invisible to see

still, i walk trough the tears


i am still walking

step by step was taken by

even the steps were too slow

the journey has to be moved on

never care tiredness i felt

bcos i am willing to walk


i am still waiting
time by time passing by

even the time moves too slow

the journey has to be faced

never care tiredness i felt

bcos i am willing to wait


dont run baby, please dont
or else you might fall

keep holding on baby

believe, one step at a time




empty me, jules.




failure is hurts

Author: ctjuliana / Labels: , ,


The day has come to be re-entered to ong posting. I woke up with the highest hope, hoping it will be a good day ahead.

I remembered what prof norzi told us before, somehow, somewhere we might fail in the middle of our life. Either it will happen sooner or later. She also had failed once in her life. But once she had failed, she really make sure that it was for the first and the last time she face the failure. The failure has made her become more careful and cautious.


I really want to take this short second time ong posting as an opportunity to improve my ong knowledge. Hence i will remember more, i will be more prepared for the final year ong posting later. Though, it takes such a big spirit and encouragement to experience ong posting again. huhu..

I have to admit, failure is hurts. Yes it is. Especially when you have faced so many things in it. Plus, it makes your final exam result's slip become UGLY. I received my slip already. Alhamdulillah, my pointer is increased. I was so happy. But, ong's result C- cut down my happiness. My bad.

Huhh, this is my first time failure and i promise myself it will be the last time too. InsyaAllah, i'll do my best to keep this promise.


Dear ong,
i hate you..but at the same time i do love you!! I need little bit more time and encouragement to love you to the fullest.


* picture taken from Meor's flickr.
* sory meor, i love dis picture! i asked ur permission oredy