✚ Intern Journal ✚ Pt. 1 05/05/2016

Networking is love. Networking is life. I hate how society work yet I work like society.

Although, I am in my third year at med school, I still have no hardcore experience in the hospital. I once told my mom to see if she can use her connection to drop in as an intern at some hospitals or clinics. I just want to learn and apply some theories to practice. It was a saying-with-no-serious-intention sorta thing, but weeks later my mom got me a spot at this non-profit hospital, CSC.

I started my lost and awkward internship at the ophthalmology department since Thursday last week 28th May, but I was really lost. It made sense how I didn’t understand many things nor did I had the courage to ask any questions at all partly due to my shyness as well as the fact I know non including the basic, it’s hard to know where to ask first. I knew basically nothing except the anatomy of the eye and the so-called cataract.

I went there right after my french class all excited, and I skipped lunch. I arrived at 1 as told. I was taken around my the dude who works with my mom. He took me around half-heartedly but kindly. I was taken to change, got a locker, and got my fingerprint marked. I went to meeting of strange people who I later found out they were all workers and not interns. They were cold at first. I guessed it’s probably I’m too rerk myself. The first day was uncool. I seriously did not know what to do, who to talk to, and what to say. Neither do them, I was the first student intern in that department, plus I got in due to connections. They must not have felt so well about it. It was time-consuming since I learnt nothing yet it was a new experience so I couldn’t help wanting to go again. It felt like I received a rare chance.

For the first few days, I would just sit next to a doctor consulting patients trying to stare into the patients eye hoping it’s not infectious. I seriously stared into more than 100 sick eyes during the last few days. I tried to absorb as many new words, diseases as I can. Though I knew very little of them. Like c’mon I’m just a third year after all, plus I didn’t had the courage to ask. The doctor were too busy with too many patients plus my shy disease is recurring. It’s hard to talk. I stayed silent most of the time.

It’s been my third or fourth day over there, I lost count lmao. I got to know them better and they are very nice. I met with the hospital director today, he told me to start working as a nurse first which I also thought was a good idea. I started with nurse work and I noticed it was more fun and I learn much more than sitting and staring at the patient face except that one time where I wanted to test the patient’s tear glands but gave up half way because I didn’t wanna hurt her. I even scrub in in the afternoon and gave up half way also because I was of no use. I did not know the name of the apparatus.

Well, narration aside, I wanted to keep a diary for the new things I’ve learnt well medically related:

Diseases Newly Discovered:

  • Cataract: Mature, and Immature?
  • Pterygium: Dos katuy thlaen: no medication only surgery.
  • Entopian: Mreng Jak Pnek in Khmer. The lash gets into the eye because the lids turn in or sth I’m not very sure.
  • Glaucoma: Increase pressure in the eyeball due to HTA+
  • Myosis?
  • Cornea Ulcer: Greenish color: Give medication
  • Ptosis: Eyelid droops off. For children, leave undone until 4 years old to see if it’s gonna cover completely.
  • Parents of children rubbing edge of the eye and pull to the nose bridge?
  • Pex Syndrome

Consultation:

  1. Ask patients why they came? For what reasons though mostly it’s either pain, or blurry vision.
  2. Examine there eyes with ophthalmoscope, sometimes, black charts, or flashlight.
  3. Ask if they have arterial hypertension (HTA), Diabetes, or Tuberculosis or just any other diseases.
  4. With ophthalmoscope, check their MPAD or sth like that which I’m not very sure yet. and /AC sth. I couldn’t quite remember.
  5. If there pupil is too constrict, ask nurse to put some droplet which I couldn’t figure nor bother ask the name so the pupil dilates and makes it better to view through the machine.
  6. Ask for paraclinic examinations or give them medication.

Cataract Surgery:

  1. There are two types as I far as I’ve learnt:
    • Small Incision Surgery: for dense lens: removing the lens mechanically.
    • Phaco: with machine that breaks through the lens and absorb them. No big incision necessary.
    • Anesthetic patients’ eye won’t move. Thats’s how you can tell it’s under anesthesia.
  2. The process based on my memory would be:
    1. Do a small tie on the top of the eye ball to stiff the globe.
    2. Make incision on conjunctiva on the top of the iris part, and a small incision and the 8-clock-hand.
    3. Some gel, water, and air.
    4. Cut the vitruis.
    5. Remove or break the lens.
    6. Replace lens.
    7. Suture or not lol.

#I’ll try to understand it more next time.

Nurse Work:

  • SWO: testing if lacrimal tube is blocked.
    • Use Propacaine.
    • Wait a minute.
    • Use the bending syringe.
    • Insert straight then turn into the lacrimal tube.
    • Push the syringe if the patient say they can taste the serum then it’s not blocked.
    • SWO –> Left: Block/ –>Right: No Block
  • K:
    • Click the small rectangle at the bottom left to find KRT?
    • Adjust the camera.
    • Move the circle to the center.
    • Press the joystick to take picture.
    • The different between both eyes should be bigger than 2.
  • A scan:
    • Put Propocaine
    • Press Right, or left, Normal or Dense.
    • Put the tube into the center of the eye and wait until 5 lines show on the screen.
    • Press IOL
    • Inster K numbers.
    • Press ‘–>
    • If the sth is under 1.00 or 0.10 it’s good, but the different result for boths eyes shouldnt be bigger than 2.
  • Preping for surgery:
    • Sign the parient.
    • Take vital: Blood Pressure: 140/80 π: Pulse
    • Use Tropicamide, stick the tape, and cute the lashes.
  • VA: 6/6 perfecto!

That’s all I can recall. It’s already 11:30. I’m going to sleep now since I have to wake up early to go to the hospital again tomorrow. One of the nurse promise to guide me on the VA which stands for whatever I’m not sure.

I thought I knew nothing but it seems like I’ve learnt alot actually. So many new things. Woah.

Virabot

#OnMyWayToBecomeAGeniusDoctor ❤ #MoreLikeAGeniusOphthalmologist #Lmao #Ican’sspellitright #I’mSleepy #Bye #I’llUpdateMore

 

 

 

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