Wednesday 27 January 2010

Lets grow wings and just float, shall we?

"when hair falls off and eyes blur And
thighs forget(when clocks whisper
and night shouts)When minds
shrivel and hearts grow brittler every
Instant(when of a morning Memory stands,
with clumsily wilted fingers
emptying youth colour and what was
into a dirtied glass)Pills for Ills
(a recipe against Laughing Virginity Death)

then dearest the
way trees are made leaves
open Clouds take sun mountains
stand And oceans do Not sleep matters
nothing;then(then the only hands so to speak are
they always which creep budgingly over some
numbered face capable of a largest nonglance the
least unsmile
or whatever weeds feel and fish think of)"

-ee cummings-

Sunday 17 January 2010

Let's Whip something up

I vowed to myself that amidst my surgical posting i shall put up numerous educational posts. But alas, time has eluded me and so here i am, up and awake at 1 am supposed to be studying for the much-anticipated rounds tomorrow with a very fierce attending, Dr. R...Digestive Surgeon..and as i was reading, i thought; why not?

i'll teach you a thing or two about surgery :p
so here goes. Tonight we shall learn about the 'Whipple Procedure' which is what MY patient will be having tomorrow morning at 7 am sharp.



this diagram is of an abnormal pancreas. Where a tumor has develop BEFORE a whipple procedure is performed.


In the beginning of the procedure, the surgeon will decide whether the tumor can be removed. The pancreas is examined by an open incision or by laparoscopic instruments. If the cancer has not spread to surrounding tissues, your surgeon will continue to perform the Whipple procedure.
The overall goal of the Whipple procedure is to remove the head of the pancreas and the attached section of the small intestine.  First, the end of the stomach is divided off and detached. This part the stomach leads to the small intestine, where the pancreas and bile duct both attach. In the next step, the cancerous head of the pancreas is cut, leaving it attached to the small intestine. Farther down from the pancreas attachment site, the small intestine is divided to free the section of the intestine that is connected to the pancreatic head. The bile duct is the last connection to be cut. This leaves the gallbladder and common bile duct attached to the removed section.
The next steps reconnect the intestinal tract. The stomach is connected to the small intestine, and the bile duct and remaining portion of the pancreas are reattached.

              Several tubes may be implanted for postoperative care. To prevent tissue fluid from accumulating in the operated site, a temporary drain leading out of the body will be implanted. Also, a G-tube leading out of the stomach will be inserted to help prevent nausea and vomiting, and a J-tube inserted into the small intestine will serve as a channel for supplementary feeding.  - taken from www..debakeydepartmentofsurgery.org-

okay, sekian terima kasih :)

2010

- Ace all my 2nd year clinical exams. No repetitions!
- Graduate by December 2010!
- Recite the Quran everyday and finish at least once this year! Amennn
- Buy meself a Blackberry!  (yippe!)
- Clear out my closet and re-organize!
- Travel Travel Travel (Bali is a MUST)
- Learn to swim & Dive ;)
- Attend besties weddings!
- Save at least RM 5k for my travel fund :)
- Read more books (leisure & medical)
- Consume healthier meals & NO MORE FAST FOOD!
- R-E-L-A-X 


i don't know. i'll add more when anything comes to mind :)