Monday, 1 May 2006

Kembali ke asal....


Friday evening, 5.15pm, I said farewell to fellow nurses and doctors whom I have worked with over the last 4 weeks.



"Good bye Brearley 4. See you next time"

For 12 days and 3 nights I worked this time.
Brearley 4 is a stroke/rehabilitation ward.

Stroke in layman language is also called a 'brain attack' just like a 'heart attack', the end-organ damage is different. There are 2 types of stroke, haemorrhagic (perdarahan) stroke and ischaemic (area dalam brain tak dapat cukup O2 disebabkan salur darah tersumbat) stroke. Effects of both are similar. Causes of stroke are high blood pressure, high cholesterol, smoking, abnormal blood vessels, age and others ( that I can't think of at the moment).

Most of my patients were 70 and above. I can say less than 5 were below 60s. Stroke can be devastating, that it paralysed half of the body but it can also cause subtle changes eg poor memory, change of personality, speech problem. There were 3-4 patients in the ward who were really unwell. Unable to move, unable to speak and unable to eat, that they have to be fed via the nasogastric tube (tube inserted tru the nostril into the stomach) or in long term, they have to be fed via PEG tube (percutaneous (dimasukkan dari skin di perut) enteric-gastrotomy). One or two patients were able to move but couldn't speak and were very confused.

When I spoke to one lady who paralysed her left side, and has aspirated very time we tried to feed her via the NG tube, I could see she was depressed. She was thirsty but I couldn't give her even a sip of water, as she'll aspirate. It must be hard for her,she was once totally independent, suddenly, she depends on others to do every thing for her. And another lady, mid 90's, massive stroke, very drowsy. For she has outlived most her friends, and has made it clear to her family that she didn't want her life to be prolonged when this happened to her, I totally respect her wishes. We were just keeping her comfortable, making sure she was not dehydrated by giving subcutenous fluid. She was basically waiting for her 'time' to come.

All and all, the acute stroke side of the ward could be quite depressing, but the rehabilitation side was slightly cheerful. 8 of them were just waiting for go home once the therapist are happy with their performance. 1 was mobilising around, confused. 3 are in bed, confused and waiting for their 'time' to arrive.

Yes, I do deal with the families, explaining what the current situation was and reassured them.
And yes, I have to deal with dying patients, certifying them upon their decease.
It's part of life. How do I deal with it? Maintain my professionalism, when there're no emotion attached, departing could be a sorrow with no tears; ' ...when the time comes, not a second sooner nor later...'

I did feel sorry for them, especially those who're incapable of doing anything for themselves. Compared to a palliative care ward,where patients are dying of terminal illness, but they're still corpus mentus. They're still able to tend to themselves like toileting and cleaning themselves.

"O All Mighty One Allah have mercy upon me and my fellow muslim and muslimah,please forgive us for all the sins and our ignorance, give us strength to be better servants to you O The Most Merciful"



11 comments:

maklang said...

This is a good entry. At least I learn something this mornig. Seronok agaknya jadi Dr. Dulu2 nak jadik Dr tapi Bio hancus...

Kat sana carboot sales dah on ke? Kalau dah bolehlah mintak belikan barang2....magazines cross stitch etc? boleh ka?

Izhal said...

ASM wbt...

Hello Dr. Salam perkenalan... Like maklang, I also wanted to be a doctor as my bio SPM results was A1... tapi tak jadi, pasal takut sangat tengok darah (mabuk darah)... heheh...

are stroke and angin ahmar the same disease?

ps- your doa... AMIN YA rABBAL AL-AMIN...

alinlai said...

my dad pernah kena stroke alhamdulillah skrg dah sihat... sedih sangat masa tu :(

FaEzHussain said...

MakLang,
Ooo terima kasih. :D
ha'a carboot dah lama start, tapi kami last sunday baru 1st time pergi. busy la lately. kalu nakbuku cross stitch, insyaallah bley belikan, tapi dengan syarat ler, maklang kena siapkan cross stitch yg tengah buat sekarang ni, baru bleu bg prezen...ehhehe

izhal
waalaikumsalam.
salam kenal.terima kasih sudi ke my humble blog.
stroke = angin athmar. dulu2 saya ingatkan angin athmar tu = asthma attack...hehehe...
wah, ur result bio lagi terrer dari result saya. tak silap saya dulu a2 ke c3...rasanya c3.
first time saya lihat cadaver (mayat utk specimen anatomy) saya mandi 3-4kali sabun dan syampoo, lepas tu, selamba aje, siap bley terus gi makan lepas sessi dissection :D

alinlai...
salam kenal.terima kasih sudi menjenguk blog saya
alhamdulillah ayah awak dah ok. make sure dia amik prevention utk mengelakkan second stroke iaitu, control blood pressure, control cholesterol dan juga kalau diabetes, control sugar dalam badan. kalu tak teruk prognosis nyer.

Syikin said...

thanks faez citer pasal pesakit2 ni, buatkan kita lebih hargai kesihatan yang ada ni :), buatkan hati membuak2 nak jaga kesihatn diri.

eh..lepas ni wat apa pulak? ke pindah wat lain?

NBB said...

sabar bebanyak ye.

agaknya sebab itu saya yang kurang sabar ni join patho..

FaEzHussain said...

syikin,
sama-sama. lepas ni saya 'tanam anggur'.kena abiskan project saya tu.

dr nurul,
sabar memang kena byk, esp bila terpaksa bercakap dengan family yg jenis tak reti bahasa....10kali explain pun,masih tak puas hati...
apply kerja histopatho hari tu pun tak dapat....nasib nasib....

alinlai said...

alhamdulillah...dia memang bagus bab makan ubat, kami anak2 pun salute sebab dia siap ada buku kecik, tarikh dan masa makan ubat, dia takut dia terlupa he's initiative actually :)

mizzwanda said...

a'kum.akak.hehe oo kawan dr hamsatul ka.erk mrs amir azmi.heh..wow!sure byk experianced kan..akak keja kat uk ka.tak baca habis lagi ur previous entry.heh..
xnak balik mai keja kat m'sia ka.saja ja tanya...

kata ada kawan keja penang gh?sapa nama..malay docs xdak la ramai sgt.okie...keep on updating..

salamz kenai

Kak Lady said...

Faez...kak lady selalu berdoa agar hari tua kita nanti tidak akan menyusahkan orang lain...biarlah masa yang diberi allah dpt kita gunakan untuk beribadah...

Kalau menyusahkan anak2 nanti...susah mereka...sebab nanti betul2 menduga kesabaran mereka...minta2...hari2 tua kita seperti yang kita sering doakan...

FaEzHussain said...

alinlai,
syukur lah gitu. di pharmacy ade bekas ubat yg dilabelkan hari dan waktu (pagi/noon/malam) dan juga pill cutter. nak jimat lagi kan, buat macam mama saya buat, dia beli plastic ice-cream yg pjg tu, ubat utk pagi dia buat satu set (kira plastic tu dilipatkan dan bakar dengan api tepinya, so jadik cam satu plastic pjg ade column) dan untuk petang dia buatkan satu set.senang ayah saya nak amik ubat dia.


mizzwanda
member saya kat OPD tu, Dr Ismaliza Ismail. Saya tak kenal pun Dr Hamsatul personally, cuma melompat ke blog dia dari blog suami dia (yg menjenguk blog saya).

KL,
tak silap saya, ade kalau amalkan ayat Al Baqarah yang 3 terakhir tu, doa utk elak stroke. (kalau tak silap la, saya pun asyik lupa aje nak amalkan)

Jom Borak

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