being the M&HO in KKIA

Time really flies...  It has almost been a year as a medical & health officer in PKD . To begin with, i had never requested for a placement in the health side. I prefer the busy settings and the adrenaline rush in the hospital. I strongly believed that i will not gain any knowledge and my hands on skills will be gone once i serve my duty in the health side. When Dr U decided to put me in KKIA, i begged her to put me in the OPD. My passion has always been in medical. To deal with preggies is definately a NO - NO. Needless to say, my attempt to escape from KKIA fell on deaf ears. I was hopeless and speechless. I started weeping almost instantaneously in the sedan. Then there I was praying wistfully for a miracle.

Cafu showed me the way to the clinic on the very same day. We were both outside the clinic. The clinic is a two storey building, looked really old with its coat of beige painting. I was still sobbing when he asked me to have a look inside the KKIA. I refused to do so. The nurses would have just giggled and laughed at this lil crying baby who is going to be a doctor there.  Cafu told me the staffs are very helpful and he surveyed the parking. Damn! Then i realized, the next problem will be...... driving to work and how to park the car in the clinic. There are no side parkings. What to do when there is a maternal mortality? What if i just missed something and that simple mistake lead to the death of the mother? Do I have to go to the JKN? What if i missed a placenta previa and the mother just bleeds and die at home? What to do if a preggy just decided to fit in the clinic and i am alone?

The beginning has always been the most difficult. Thank god my YM Dr S has been very kind to me. She has never scolded me before. She taught me how to use the scan machine. It was indeed a culture shock when i first saw that scan machine. You have to really squint your eyes in order to get a clear view of the CRL. Then she taught me how to kiao the cha cha ( vagina ) and also to put things inside the cha cha.

Holding the antenatal cards alone caused some amount of stress. I must be good enough to identify the maternal problems, picked them up and refer them to hsah. I had to ask JM June what to document in the antenatal cards. She has taught me well. Dr, just document properly. Cover your ass

There are a lot of problematic patients in the KKIA. I can still remember them vividly

1) my very first patient had PIH on treatment and came with proteinuria. uric acid was increasing trend. Case was admitted immediately and her baby was delivered the same day.

2) A patient with PIH on labetalol has been complaining of headache for 2 days came to KD. BP was 160/100, proteinuric. I accompanied this IE patient to the hospital. BP upon arrival was 180/120. She was initiated on MgSO4. Due to some unfortunate anaesthetic complications, she succumbed to her death. She developed sepsis post operatively. Had a very bad hospital acquired pneumonia and was started on tazocin. We were so afraid that she might be our first maternal mortality case. She finally knocked on heaven's gate 3 months post delivery.

3) Being a M&HO is different from a medical officer. we are expected to go down to the field. There is a baby who developed severe NNJ at day 4 of life. both parents refuses admission despite explaining the complications of SNNJ. I had to go to their house, called the husband in langkawi just to explained to them why is SNNJ so dangerous to the baby. I was really scared to talk to them. Finally, i understood why their refuses admission. They were in a state of poverty. they could not afford the hospital bills. isn't it sad?

4) Nothing good happens on a thursday when Dr S is not around. I will received funny calls exactly at 11 am. one of it was pregnant lady fitted near the mosque. My JM and i rushed to the scene. Thank god, it was not eclampsia but it was merely chills and rigor. the mummy to be was admitted for pneumonia

5) Not to forget the notorious M. M has very poor controlled of her type 1 DM. she is a G2P1 and she made all of us promise not the tell her boyfriend that she had a baby b4. How could a man not know that her wife had deliver a baby earlier? wouldn't the episiotomy scar be visible? wouldn't it be loose when they had SI? we had to provide transport for her to go for antenatal follow up in the hospital. Once she is there, she sat outside the clinic and will never go for her follow up. She is never compliant to her diabetic diet and hematinics. God has been kind enough to her. Her baby is well and she is proud of her baby. The nurses had to go to her house just to make sure that she japs her insulin correctly. Her DXT was 23 after delivery. Haiz... she defaulted her NCD follow ups as usual.

there are many more manjalitis patients... a lot of them refuses IM imferon. even if they do agree for imferon, they will still buat muka manja

will be missing every single bit of my days in KKIA SP, Dr S, Dr C, Dr L, and also the awesome lunch gossip moments with the bakar arang team :p

there.... no more under 5 mortalites or matermal mortalies

i will be going to the eye department on 15/1/13