VARICOSE VEIN

It has been a tiring week. Though I think it has also been a boring one too. I didn't go to hospital the whole week because the final year students were having their exams in the hospital so other students are banned to enter the hospital, unless if you are sick of course :P

Today I was called by the lecturer to talk on Deep Vein Thrombosis(DVT) but before I can tell you what it is I have to write about VARICOSE VEINS first then maybe next time if at all I remember I'll write about DVT.

Varicose veins are actually quite common. It actually means that there is presence of abnormal vein anywhere in the body that is more elongated,tortuous and dilated. It can occur anywhere in the body but the one that concerns doctors more is the one affecting the legs. Usually patient will not complaint much on pain as they are usually dull type. But it might not be acceptable to the patients cosmetically.

Normally, there are valves in the veins of the legs that help the veins to bring back blood towards our heart. But what happens here in varicos veins, the valves will be damaged and then it causes blood to pool in the legs and causes the veins to be dilated and tortuous. And if patients don't seek medical help then it might progresses and he or she can develop complications, such as an ulcer or bleeding from the varicose vein.

There are certain risk factors as to why it develops, like smoking, standing for a long time-like policeman or guards or surgeon too(my dad has one too),and it can also happen in pregnancy. But there are also ways how you can prevent this from happening. You should exercise regularly,STOP SMOKING!,and learn to stretch your legs and contract the calf muscle every now and then even if you are sitting down.

If you have developed a varicose vein(or someone you know has varicose vein) you should seek medical help and the doctors can try to deal with your problem. Certain varicosity need only conservative treatment but the later stages, you might need to undergo operations to remove the diseased veins. Usually the doctors will give you a compression bandage like the picture I posted up there. At home, whenever you are sitting down you should put your feet on another chair or when you are sleeping you should elevate your legs over 2pillows. This will help the blood to stop pooling in the veins and can be circulated back to the heart.

Friday 20/04/07

I had a terrible morning today. As soon as I got back into my room I sat on the chair and was admiring my new fish. Then I scrolled my phone picture gallery and found some old pictures of my pets. I've lost my dearest cat Tom and only got to know about it few months after that since my family kept it a secret from me until I came back home and was calling his name but he never showed up. So today I'll show you my dearest cuddly best friends and I'm missing them dearly. I wish I get to see them again one day :(

PEPTIC ULCER

It was a long long week for me this week. I was in so much stress that my body and brain refused to do anything I was supposed to do. I just couldn't be bothered with what was happening around me and my room was a big mess. Nowadays every time I get down from the bus from Muar I came back to my room to shower and I left it just how it was in the morning and went out till 10 and got back to knock myself out till the next morning. That was what happened the whole week and nothing else.

I had my surgery end of posting examination on Monday. It was a terrible one for me because I had a case which I had never seen and discussed before. I had a case of Hemorrhoid or also known as Piles. In Malay it is called Buasir.

But I don't feel like talking about Hemorrhoid today. I'm thinking of writing about Peptic Ulcer. Patients always term this illness as 'gastric'. I'm sure you have probably had one yourself or someone else you know have one.

This is actually an ulceration of the food tract, that is the stomach and small intestine. This condition is quite commonly seen among Malaysian. Usually when asked, the patients will tell us that they love consuming carbonated drinks especially Coke. And they love spicy food and also they love asam ( a kind of preserved snack ) which I love too :(

As to why the ulceration happens, there's a lot of theories and reasons why. A major causative agent is microorganism called H Pylori. This bad microorganism have the ability to make our stomach release excessive gastric acid. Normally we all do secrete gastric acid to digest food but in excessive amount, the acid can erode the food tract and then cause pain to the patients.

Patient always complaint of pain in the area close to the centre of rib cage. The pain may be of gripping or burning in nature. And is usually associated to food. Some may vomit after taking food due to this pain but some may experiance the pain when he or she is hungry. This depends on the site on which the ulcer develop because our stomach and small intestine is about 41 feet! Some worse or acute condition, patient may have vomiting of blood or they tell the doctor that they are passing tarry black,sticky stool (feces).

Gastritis is usually well treated with medicine and if the patient can try to reduce or stop their habit of drinking carbonated drinks,spicy food and asam.
In some patients, Gastric Cancer can occur too. Because due to the acid irritation, the lining cells transform themselves into canceros cells. This is what worries all. So do try your level best to stop your carbonated drinks and etc.

I had a 40years old patient last week who was diagnosed to have gastric cancer. He came with a hard lump in his abdomen which was painless. He had gastric ulcer when he was younger. He was offered to get the lump removed by surgery 3 months ago but he refused it and seeked treatment from a local bomoh. And when he came back last week to the hospital his cancer growth has spread to his liver. He died a few days after that. It was really sad to have lost a young patient of that age and it was very sad too that he was not being followed up even though he had refused his treatment.

So I do beg you to please be more alert of whats happening in your body. The problem with patients are that they only come when they cannot tolerate pain. And cancer growth is painless.
Maybe on my next blog i'll talk about cancer. Since it is just too commonly seen and misunderstood by most people.

Oh and yes, today I bought 5 guppies and put them in a lovely long vase. I'm admiring their beautiful colours and how they keep swimming. I wanted to take their pictures but they just can't stop swimming! But they are gorgeous :)

BREAST CANCER

Again, I've forgotten about my blog. Well, actually I didn't forget. Only that I just couldn't find the time to sit down and blog about what I saw in the wards.

I just got to know that quite a number of people have been reading my blog. I didn't really expect that. And thank you for your support. From now on I will try to blog a little more often and blog on the more interesting cases I saw in the hospitals.

I'm now in the final year of my M.B.B.S course and hopefuly in another 1 and 1/2 year I will graduate and start working then. I am now posted in one of the specialist hospital in Muar, Johor. It's quite a busy hospital but work hasn't been at it's hectic peak yet. I've gained few good experiances here by seeing more cases now that I'm in surgery ward.

Almost everyday there are new cases of breast cancer patients need to be admitted in the hospital to undergo treatments. Sadly, most of these women seek medical help too late. Few of these women have a huge cancerous lump in their breast and a number of them have developed ulcers on the breast skin too.

I got to talk to the patients and asked them what was the reason that they came too late to the hospital. Some told me that they wanted to try for alternative medicine and some had seek help from a medicine man. Sadly but true, some of them have went to see a doctor in some private clinics and these unfortunate ladies were just treated with antibiotics and panadol! For a simple yet unforgiveable reason that these doctors didn't examine their breasts and didn't even have a suspicion of something dangerous even though breast cancer is at rise in Malaysia. I hope I will never forget this and will never ever do the same to my patients once I start practicing.

There are a few simple steps of how women can examine their own breasts at home and if at all they have felt any abnormality in their breasts they should immediately come to the doctors to be checked. Here is a good link to have a look at on how to do Breast Self Examination. Click on it.

Oh and yes, breast cancer although occur mostly in women, men are still in danger of it too. There are a number of causes as to why it develops. The strongest causative factor is the inherited gene called BRCA1. In those families where there have been a member who have been diagnosed with breast cancer before, you should be more cautious and should be more alert of any changes in your breast since you are at a high risk of developing it.

For men out there, do encourage your loved ones (not forgetting your dearest mother) to do breast self examination and push them if at all they hesitate to get their breasts checked by doctors. Though previously this disease attack the aged women, nowadays there have been cases reported among women who are as young as 30 years old.