Doing it for the kids

Woah, this thing still exists? Who knew.

So I"ve started working again. Which is fun, scary and more than a little frustrating, because now I"m working in paediatric emergency.

Fun because kids are so gosh darned cute.
For example, I had a 4 year old boy present with "excessive blinking". Now, taking a look at him, I saw nothing wrong, but decided that a visual acuity would be a good start.
I asked him if he knew his ABCs.
He excitedly replied, "Yes! I do!"
So over I took him to the Snellen chart, and stood him 6 metres away, covering one eye and asked him to read from the top.
He stood there happily and called out loudly "A, B, C, D, E, F..."
I laughed and had to keep myself from hugging him.
So darned cute.

Scary because kids are kids.
How do you assess cranial nerves in a 17 month old with blunt traumatic head injury with loss of consciousness?
How do you get a 28 month old to sit still enough to attempt to remove lice from eyelashes?
How do you convince a 16 year old boy that the dental abscess is probably a little bit more important than the play time he"s missing out on his Xbox?

Frustrating because parents.
Oh my goodness parents.

So yeah, fun times :)

Job!

So internship offers came out today.

Congratulations to those who got a first preference offer!

Good luck to those that haven"t got an offer as of yet :(

I got my first preference offer of Mt Gambier & Districts for internship next year! Hooray!

Hand Surgery

So day 2 of hand surgery is down.
It seems that I will need to start at 7:30am everyday and generally finish after 5pm.
So far, I"ve spent a day in clinic and a day in the operating theatre.

The day in clinic consists of me measuring grip strength, joint angles and pinch (apposition?) strength while the consultant drills me with questions.

The day in the operating theatre consisted of me standing around.
Well, until the last case which was a radial nerve repair. Seems that the orthopods that put a plate in for the fractured humerus got the radial nerve caught under a screw, so it had to be repaired with a graft.
I got to stand around but also take photos using the consultants flash camera (Olympus E-1 I think it was). That was fun. Sort of.

I"m tired of it already...

Anaesthesia,: Epilogue.

So I"ve now finished my 2 weeks on anaesthesiology.

Twas a short trip, but I learnt a lot.

My introduction to anaesthetics was gentle. Starting with the basics, I was advised on what to learn and read up about, the basics of the risks involved, and the indications and contraindications.
My learning was encouraged by questions and revision of the basics. Practical skills were encouraged and with repetition, I slowly understood what needed to be done, and what to watch for.
It challenged me in my knowledge. It stimulated interest.
I definitely  feel  like I have learnt a lot and in particular, feel more confident with achieving and maintaining a patent airway.

I also got two intubations down (from two), which is a good start!

As a farewell, my mentor signed me up for a presentation and dinner.

At the Grand Hyatt Singapore Hotel, speech on Multi-modal strategies in the management of post-op pain given by Professor Schug of the University of WA and Royal Perth Hospital. It was a very interesting speech, concentrating on the benefits of COX-2 inhibitors in conjunction with opioids, as well as the use of pregabalin/gabapentin.

And the food.

Oh my the food.

Tuna and Avocado Tartar, with Lavoche and Remoulade Sauce

Previously a Cream of Mushroom soup

Pan-fried Fillet of Cod, Puy Lentils, Gratin Potatoes, Glazed Asparagus, with Dijon Mustard Sauce

Crispy Chocolate Praline Cake, with Raspberries and Vanilla Cream

 Oh my.

*hugs*

That is all.

One Week

So one week down in Singapore!
Well, one work week anyway, but that pretty much counts!

Anaesthesia is vaguely what I"ve imagined it to be.
You check you"ve got the right patient, you inject some stuff, you make sure the patient continues to breath, you check your email and surf a bit, you inject more stuff, keep browsing, the surgeons tell you they"re done and you send the patient off.

Well I finally intubated a patient today!
First time, first go! Hooray!

Otherwise it has really been quite uneventful.

Singapore, Day 4

This was so exciting that I needed to blog about it:

I got free lunch!

Ok, that"s part of what I"m going to blog about, but definitely the most exciting (for me). The food was significantly better than FMC, sort of on par with those "all you can eat for $8" places in Central Market. Which is acceptable, but not the greatest.

Of course, if I wasn"t such a cheapass, I could have paid a whopping SGD$1 for a plate of noodles or SGD$5 for just about anything (as mentioned in the last blog post...).
Note: SGD$1 = AUD$0.75
SGD$5 = AUD$3.80 i.e CHEAP.

What else I"m impressed with is the internet I"m using at the moment at a family friends house: 100Mbit connection. That is a theoretical maximum speed of 4x the best of what Australia has to offer (at least, until the NBN comes through... Someday...)

So I was having a conversation with one of the MOs which waiting for a thumb PVNS excision to finish up, and it seems that there are lots of pros and cons to living in Singapore.

Pros:
Minimal income tax - Even for earning $300,000 you pay about 13% tax. Above that rises to about 20%.
Food - The food here is spectacular, cheap and available all hours of the day!
Travel - The Singapore MRT is bloody awesome, reliable, fast and pretty cheap.
Internet - As mentioned, super fast!

Cons:
Pollution - Air quality ain"t the greatest here.
Rent - From what I can figure, quite expensive.
Cars - I also discovered something crazy about this:
Singapore have freakin' expensive cars.
Now, I don"t mean like, Ferrari"s and all that, but even just regular cars!
From what I can work out, in order to own a car, you must first be able to afford to pay a "certificate of entitlement". This is a sort of registering of the car with the government. I think they do this to put a limit/quota on the number of cars in Singapore (due to increasing pollution, population etc), which is a decent idea, as those that can"t afford, use the MRT which reduces carbon emissions etc.


So yeah, how much would cars be?

Lets see, I am contemplating getting a Ford Fiesta. You can get it on sale in Australia for a scratch under $20,000.
Second hand Ford Fiesta here? $70,000.

Seriously. What.