GP Attachment in Newmarket Day 13&14 : Roar

Assalamualaikum.

Well day 13 and day 14, nothing much pun. Semalam ada jugak laa ambik blood, blood pressure, hari ni tak sentuh mana-mana patient pun, heh.

Cuma apa yang menariknya semalam, GP masa dah pukul 5.30pm, cakap yang dia on-call SouthDoc hari ni. And dia nak tunjuk lah how SouthDoc ni work. So, dia suruh kitorang pergi SouthDoc centre kat Kanturk, dekat jugak lah dengan B&B aku ni. 

So, pukul 8.00pm pun pergi centre tu. Takde lah ramai sangat, tapi mostly patient kanak-kanak laa. Ada seorang baby tu 9 bulan baru, baby girl, OMG comel sangat!!! Grrrr rasa nak gigit gigit pipi dia. Ayah dia cakap dia demam, tapi baby girl ni sangat behave bila GP aku check check dia. Pheww.. Ya Allah nak anak comel, walaupun aku tak comel. =P Camni bapaknya kena comel lah untuk dapatkan gene comel, gituh~ 

Bajet kena on call lama lahh, sekali kul 9pm dah lengang, and then GP tunjuk sistem how SouthDoc terima panggilan, macam malam tadi they receive 271 calls untuk seluruh kawasan Cork dan Kerry. Untuk kawasan Kanturk, ada 8 calls. Tujuan SouthDoc ni ada sebab klinik kat sini bukan macam klinik kat Malaysia yang bukak sampai pukul 9, 10 malam, atau yang 24 hours. Klinik sini sampai kul 5.30pm je. So dengan ada SouthDoc ni sejak 9 tahun yang lalu, maka memudahkan lah penduduk, maksudnya kalau demam ke takyah lah sampai nak pergi A&E kat hospital. Kalau orang kat area Kanturk, area Newmarket ni, kalau nak pergi hospital kena gi Mallow laa which is 20 minit jugak. 

Hari ni pun kalau orang datang klinik, banyak yang ada fever. Mostly due to virus. So yang GP duk mention dari semalam ialah viral labyrinthitis. So, apakah ia?

From website hse, 

The three most common symptoms of labyrinthitis are:

• dizziness
• loss of balance
• vertigo- where you feel that you or the world around you is moving, even though you're standing still

These symptoms can range from mild to severe. For example, some people may only feel mildly dizzy and out of balance. Other people have reported that their symptoms of vertigo and loss of balance were so intense that they could no longer remain upright and were worried that they might have been having a stroke.

Avoid driving, using tools and machinery, or working at heights if you're feeling dizzy and unbalanced.

Other symptoms of labyrinthitis include:

• hearing loss - this can affect one or both ears and can range from mild to total loss of hearing
• a feeling of pressure inside your ear(s)
• ringing or humming in your ear(s) - also known as tinnitus
• fluid or pus leaking out from your ear(s)
• ear pain
• feeling sick
• being sick
• a high temperature (fever) of 38C (100.4F) or above 
• neck pain and stiffness
• changes in vision, such as blurred vision or double vision

Tadi ada seorang akak tu, masuk bilik GP, nangis dia sebab dia rasa very very sick. Pheww, tetiba aku pun nak touching, motipp~

Next, GP ajar apa 3 soalan wajib kita kena tanya kalau jumpa patient depressed.

1. How are you feeling today?
2. How your sleep?
3. Commit suicide?

Sebab GP cerita laa, yang kalau patient depressed memang kena very careful, kalau kita tak boleh detect yang dia nak commit suicide, tup tup 3-4 days after datang klinik, dapat khabar patient to commit suicide. 

And then pasal anticoagulant. Yes, koma tahu je lah pasal Warfarin. Dan sekarang pun ada ubat baru pun kan, Dabigatran etc semua tu. Satu benda yang GP ajar yang takde dalam OHCM, sebagai GP, kita bagi warfarin kepada patient yang kita percaya kita dapat educate dia sebaiknya. Sebab yes Warfarin ni ubat yang cheap, tapi dia ada banyak interaction dengan ubat ubat lain dan juga alcohol especially culture orang Irish sini. So, kalau kita sebagai GP, yakin patient tu mampu jaga peraturan sebaiknya, kita bagi Warfarin, dan sangat banyak kena didik patient pasal Warfarin. Tambah-tambah Warfarin ni interact dengan Nurofen which is a famous pain reliever yang orang selalu guna. So careful!

"I got the eye of the tiger, a fighter, dancing through the fire

'Cause I am a champion and you’re gonna hear me roar

Louder, louder than a lion,,"

Motif letak lirik lagu Roar. Heh.

Okey itu sahaja, sekian, wassalam..