Pediatrics

Let me start by saying this, pediatric has by a mile been the best rotation I have done this year. Cheers because this is my last rotation (OMG can you believe it, wow time flies). Well with less than a week left to round up my last rotation I am so nervous, as this means by now I should have the confidence and knowledge of a doctor, but I'm so far form it I must confess. In fact I feel no different from when I began this final year.

Pediatrics is an experience worth sharing. Firstly I tried to define what the maximum age limit should be for peds (BTW that's short for pediatric) because this minute it was a two months baby you see in the wards, next minute you see an adult in the age of 16 walk into the out patient. Some books say 21, I think that's pushing it, coz it means for me being in med school and still seeing a pediatrician, lol. Some mention 18 still to old I think, yes I was in med school at this age! To be honest I have no memories of visiting a pediatrician, because from when I got in to secondary school I had started seeing  adult doctors (excuse me). I was just 10 and I think that was to early to graduate to the bigger doctors. So what age? Personally I think 13 yrs is appropriate. Unless you have a chronic condition like, kidney disease, or a heart disease, or diabetes, then I think the pediatrician should follow up this cases till they feel it right to hand them over. What's your view?
 I  met all kinds of kids. the ever smiling, the crying for no reason,the unreasonably quite, the talkative, the gentle, the ones who believed the hospital is their play ground and so must run it down, and the list goes on. Then there are the parents who you also have to deal with, the careless parent, the worrying for nothing parent, the responsible parent, the ones who think the doctor is the enemy and the ones who are on our sides, those who think the doctors should teach their kids manners and to be well behaved, the abusive parent ( which I must add is just terrible) and the list goes on too.
Something I really liked is seeing was dads walk in with there Kids. you can tell mum is home getting a well deserved rest or out and about doing her thing and getting some time off. Who ever thinks its mum's job to do all the kids stuff? I have mates that have argued with me that it is the role of the mum to raise the kids. In the 21st century people still think like idiots, it's sad. well well, I wouldn't go into that. But you and I know the mum should NEVER be responsible alone!
Once this dad walks in hands us (med student) a bag of chocolate quietly, I went like yes, finally we med students are gifted for... well I don't know what it is we do, oh I know we don't hurt the kids, we play the most with them and think ever child is cute (note the male students thou). Well he ask us to give it to his daughter (sad face) after the doctor was done examining her. Saying he told her if she was good, the doctors will give her chocolate (yeah right). And of course his daughter wasn't the typical "screaming-for-no-reason-refusing -to-lie-on-the-examination bed child", she was well behaved. Lesson learnt! In peds if you you want your patients to cooperate you bribe them/ make a bargain with them. Not an easy field right, at least you don't have to bribe adults (well most of them) to cooperate with you and lay on the darn bed to be examined,.
As much as I loved the father-child relationship, I loved when I saw both parents walk in with their child. I kinda observed the difference in kids who came in from stable homes. they were well behaved and in terms of copping with illness, they coped better. Nothing beats a family who fights an illness as a family, especially when the ill is a child.
 I spent most of my time in the respiratory and gastroenterology team. lots of asthma and gastroenteritis cases I saw, but from time to time I was allowed to visit other peds departments; peds surgery, endocrinology, NP ICU (neonatal pediatric intensive care unit). Was a great experience overall. Soon time to head back to Debrecen and face the exams.

P.S
pic: paradise bay, Malta

Keep smiling, stay positive,

The Psychiatry Ward

I have manged to survive two weeks of practice in psychiatry, which means am half way done with my psych rotation. I spent the first two weeks in the the chronic ward.. While I move on to the acute ward for the next two weeks ( going up tempo), thought I'd share my time in the chronic ward..

So what kind of patients did I meet there, well basically patients with chronic conditions, meaning more than 6 months or milder presentation of psychiatry conditions.. Amongst which are:

Depression was the most common I saw.. either as major depressive disorder or bipolar disorder (aka mood disorders). Most cases where brought in after an unsuccessful suicide attempt or in the case of bipolar after a manic episode. quite sad stories but was good to see how therapy was helping them get back to their normal life.

Delusional disorders (a fixed belief that is either false, fanciful, or derived from deception) was the most fascinating to me. What fascinates the most is that this people have no insight to their problem, you cannot convince them that what you believe isn't true. Another thing that fascinates me is how hard is it for you as a doctor to tell this are delusions, what if what the patient is telling you is true? because there were cases where it wasn't possible to obtain hetero anamnesis (information from someone else).
here are some types of delusional disorder,

• Erotomanic Type (erotomania): delusion that another person is in love with the individual.
• Grandiose Type: delusion of inflated worth, power, knowledge, identity, or special relationship to a famous person.
• Jealous Type: delusion that the individuals sexual partner is unfaithful.
• Persecutory Type: delusion that the person (or someone to whom the person is close) is being malevolently treated in some way.
• Somatic Type: delusions that the person has some physical defect or general medical condition.

Schizophrenia (not all cases) the most interesting for me.. spoke about this in previous post.

Personality disorders.. basically a behavior that deviates from your normal expected behavior. one interesting one is borderline personality disorder, not quite there but almost there. this is between psychosis and neurosis. individuals are emotionally unstable

Alcohol Withdrawal or generally withdrawal from any substance of abuse (crack, coke, marijuana etc). Who knew how hard it is is to quit an addiction? you actually need to be admitted to a hospital facility because you could die from withdrawal symptoms, or in most cases relapse.. So please drink responsibly and stay away from drugs!!

and lots more can't mention/remember all.. One thing I kept asking myself, which am sure is the same for everyone is, doesn't everyone have some kind of psychiatry condition? because if there is one thing I know is that I have diagnosed myself with a lot of psychiatry condition.. I mean almost every one has some sort of personality changes or mood changes, or delusions at some point. (for example there are time I am walking in the night and I see someone and think they want to harm me..lol..). So what brings you to the Psychiatrist? (cause obviously not everyone out there is gonna go to the psychiatrist when u or someone notices a change in your normal behavior/personality). Well just when this 'change' interferes severely with your daily life.

Love

Music Therapy

Honestly I cannot really say what this was meant to be (creative therapy was way fun). We got in to the room for the session, patients students and doctors, some very soothing music was played for about five mins, then we went up tempo :-), the music was switched up to some very playful  tune, like something you would hear in a silly cartoon. we listened to it for about 10 to 15 mins. The music made me feel like dancing and laughing, but since no one was, I just nodded my head a bit and smiled.. ha ha.. Then the worst came for the next 45 mins there was a discussion with the patients in Hungarian. this was serious torture as I did not understand a single thing and had to sit there  (like a moron), because it would have been so rude to walk out. They were laughing and talking and yours truly just looked.
The other day I went for a large group session where doctors, patients and students sit to discuss (a larger group than the music therapy group), and for one hour I had to sit there not understanding anything. Seriously this is real torture, whats even worst is that no one explains anything to you after (well I should have ask rite? yeah rite like they would explain an hour session to a bloody medical student). This language barrier is really getting to me, it puts a big barrier in front of my learning. And for a career like medicine, especially in the psychiatry ward, communication is key to learning.. So tell me how can I learn?
Advice to anyone who is yet to go study medicine (Don't), go where you fully understand the language. If you are like me already in a foreign speaking language country, learn the language. and if you are more like me that after 5 years you realize ooh I should have learned the language. Well its too late so bare it.. (note, I have no regrets coming here).

P.S
If you have the ability to hear and understand/ make sense of what is being said be grateful. There is a medical condition where patients have the inability to understand spoken language (kinda like me today) which they normally understood before.. How frustrating.

love,

To be a friend or not?

Hold on wait till you have had this experience......

I meet a patient on my way to a group therapy session, I knew nothing about this patient, but we exchanged gestures, talked a bit, some weird question was even put in but we (me and my mate) chose to ignore/handle it well :-). The patients looked kind of sleepy, so I would guess was under sedatives this could mean mania, but I may be wrong. whatever the diagnosis was, it doesn't hurts to give a smile to the patient, so I do just that and got to my seat.

Stares at you half of the group therapy session (creepy) and every nook and cranny I found myself in the hospital that day, I happen to see the same patient who comes to ask me for my help when it actually wasn't needed.. scary huh? yeah, that sent me out of the hospital (well not literally, I had to attend consultations, but I was the first one to get there and I even hid at the coat hanger ) cos honestly I was scared to death. I have no idea this patients diagnosis, but some part of me tells me it might be bipolar (manic-depressive disorder).

So I ask the big question to be a friend or not? should I have paid more attention and given more of my time to this patients? Or was my little time I spent with the patient and smile appropriate?As doctors we are taught to never get to attached to a patient.

P.S

• This blog is nominated at the Nigerian blog awards, under the Health, fitness or sport category (not a surprise) I have added a link on my side bar or click here, so please go vote for 'Becoming a Doctor'.
• All apologies for any grammatical error you find in my posts, I have lived in Hungary for 6 years so English is not my first language anymore, actually, I don't have that much time to re-read and spell check and all that stuffs as I am quite busy, (I do love blogging don't get me wrong) but I do come back to correct when someone notifies me or I realize. So please feel free to correct me, or if you want the post to be my editor, hola (I think I might know some one who is interested, ha ha.).
• I know the medical field is filled with so much jargon's, so please if you don't understand any of the jargon's, let me know, I will explain further.

pretty please..keep smiling, love

Schizophrenia

This is one of the mis-understood disease I know of, thanks to the movies. Also it is one of the most diagnosed and sometimes mis-diagnosed disease in psychiatry. Almost every patient that walks into the physician's office in psychiatry had/has a bizarre behavior. In fact most people would only send someone to psychiatry due to bizarre behaviors.. Yes they do have bizarre behaviors but not everyone with a bizarre behavior is schizophrenic.

So I sit down in the clinic today and almost every patient that walks in, is diagnosed with schizophrenia or at least schizophrenia is a differential diagnosis(not a big surprise). Despite all my previous training on schizophrenia, I have seen too many movies and heard so many ideas of schizophrenia that I still have a hard time grasping the truth of this disease, so I find it quite hard to relate when I see a patient who doesn't fit all this funny Ideas I have about schizophrenia and I am being told "this is a case of schizophrenia".. But I don't think am the only one who has this problem, because my tutor seems to emphasize, "if a patient comes in with a bizarre behavior, dig deep it isn't necessarily a schizophrenic case". hmmmmmm for one to lay emphasis on something means a lot of people make that mistake.. So am I excused?? well NO..

My question is how do you change a belief you have had for a long time?? How easy do you think it is? Because studying medicine dose that, it try's to change most of the ideas/beliefs you've always had about a lot of things (again thanks to the movies and TV shows). Imagine how my mind runs back and forth when am in such situations.

Here are some common Ideas People have about schizophrenics:

• They have more than one personality; well they have only one personality although their personality may be disturbed.
• They are 'mad'; yes it is true schizophrenics will sometimes act in a strange way, but most often they behave quite normally.
• They are violent and dangerous; some schizophrenics may become violent if the are very angry and frustrated, but they are usually timid, fearful and quite. As matter of fact don't non schizophrenics get violent when very frustrated and angry.

This are drawing from Louis Wain an artist who slid into schizophrenia

Schizophrenia refers to personality problems where the individual may have difficulty deciding what is real and what is not real. Schizophrenia is a bit like having a dream when you are wide awake — you are unsure whether the events in the dream are really happening to you or not.

Keep smiling, love

Creative Therapy

My dear friends, Becoming a doctor, My journey has begone........As you all know, or most of you know, I started my practice today in Psychiatry here in Debrecen, its a four week practice.

Creative therapy is a form of therapy aimed at processing negative emotions, or inspiring behavioral and mental change or healing through expression. In lay English it is a form of therapy to make people happy or at least attempt to. it is a different approach to counselling and therapy. I was privileged to attend a session today with co student doctors and patients. We took part in it and was really fun. I made some really cool stuffs..

making a flower..

tadaaaaaaa done.

making a beads chain
and rocking it!!!

One of the things we learn in medicine is to always show empathy, that is to feel what the patient is feeling. I think to make a great doctor you have to fit yourself in the patients shoe, feel what they are feeling, before you act. I kinda learnt that today, we were put in the position of patients today, sat with them round a table, carried out the same task as them, some of the patient even helped us a bit (obviously they were better than us in this). Doing the same things as these patient, put me in their shoes. I went through what they went through during these sessions, I had the same experience as these patients, I was a Patient today. which was very insightful. If I didn't sit with those patients today, I would normally pass and just think oh poor people, look how they are treating them like kids, making them make silly beautiful paper flower. Today that thought changed.

Me and my mates were just laughing all through, we all kept seeing this is good therapy for me, this is good therapy for me. When we got done we were all so proud of our work. We felt we archived something.

I left the session today feeling so happy (I definitely will be going back often). I can now say, this is a great therapy, I have experienced the happiness it brings and would recommend it to patients who need it. Now I know I am not just subjecting some depressed patient to go do some silly things. I mean look at us, final year medical students, doing stuffs that 5 year olds would normally do but we didn't feel silly one bit, instead we felt alive, happy and excited. So why not recommend it, if thats what it takes a depresses patient to smile, or a mentally retard patient to build an IQ, or a manic person to calm down, or a schizophrenic to think.

In general being creative does keep us 'alive', happy, excited..... so get creative. I have a lot of friends who keep telling all the time, am bored, get creative then, learn how to do some thing new once in a while. It helps.

Whoever said doctor's don't have fun, obviously never went for a creative therapy session. look at us we had a blast today.. ha ha. First day was conquered, and am glad.

Love

Its My Birthday!!!!

Woooohoooooooooo, cake, music, balloons.. bring it on lets paaaaartyyyy.. lol..

Am just filled with so much gratitude today. To God, my lovely family, and the best friends ever, you have made my years here worth living and without you I wouldn't have made it this far, so this is me saying a big THANK YOU.

As a double today I begin my 6th year which is my final year in medical school. whaaaaaaaaat??

Just took a moment to look back on life......................................... all I can say is AM BLESSED.

keep smiling, love

Up and Running

Hey, guys welcome, a very big thank you to all those who have already stopped by.

This blog is now up and running, I will try and update as much as possible and make sure it isn't boring, even thou it is kinda a medical blog (this kind of blogs can be boring).

Be sure to browse through from the tabs on top. Just to highlight, that I will be doing a lot of features, so keep your entries coming..

Let me Introduce myself a bit am Hirra, a Nigerian and a Gemini, Flexible and communicative yet restless and indecisive, dual nature and very versatile. I study At the university of Debrecen, Hungary.

So I start My 6th year (final year) on the 31st of may which unfortunately happens to be my birthday. but its alright thats fine.

Here is an idea of what my final year entails:

Internal Medicine, 10 wks

Pediatrics, 7 wks
Surgery, 5 wks in

Neurology, 4 wks
Psychiatry, 4 wks
Obstetrics and Gynecology, 5 wks

In the mean time before I start my practice am gonna start working on my thesis, Am writing on Children living with HIV/AIDS. so be expecting to get some more insight into that. With that in mind children's day is coming soon, (27th of may). Would like to do something special on that day, I have no Idea yet, so If you have an idea send them here, would really appreciate it, especially if it is related to HIV/AIDS. Would be on the look out too, be expecting a post on that in the next couple of days and please if it requires your help, do fall through.

Once again welcome to this blog.

keep smiling. love