Saya masih memilih untuk menulis di alam siber secara percuma walaupun sesekali ada yang mencadangkan agar saya menulis buku mengenai infertiliti. Sebelum mencedok atau memetik 'ilmu' dari laman ini, anda tidak perlu meminta kebenaran tetapi diingatkan membuat semakan sendiri terlebih dahulu dengan doktor anda atau guru anda sebelum mem'forward'nya kepada orang lain dan memikul tanggungjawab akibatnya. Pohon doa kesejahteraan dan limpahan rahmat Allah ke atas guru-guru saya dan juga pesakit-pesakit saya yang banyak mengajar saya bidang ini. (peringatan untuk diri sendiri) Segala pujian bagi Allah. Mudah-mudahan, taubat saya diterimaNya dan segala dosa saya diampunkanNya serta saya terus dilimpahi rahmatNya. Sekiranya ada kesalahan, pohon dibetulkan, saya terbuka kepada teguran.

Sebarang percubaan berbentuk komen atau soalan bertujuan mengiklankan apa sahaja perniagaan atau blog sendiri tidak akan disiarkan. Blog ini bukanlah untuk iklan menjual barang. Peace.....

Thursday, 4 November 2010

18 more days

Tidak lama lagi saya akan pergi menimba ilmu lagi,
Di atas biayaan SENDIRI.
Ulangkaji yg lama dan update yang baru


It's about 'endoscopy in reproductive medicine'
In my humble opinion
and thru my limited experience
Endoscopic surgery utk infertility patients ni kena ada tambahan caranya
Not quite the way we were taught sblm jadi specialist dulu2
Kena ada modification


Contohnya
In endometriosis
We were taught that the main principle is to clear as much endometriotic tissue as possible
Either gunting/ambik buang or kalau melekat sangat, guna diathermy je (ie karen letrik yg bertukar menjadi haba)
But when it comes to the ovaries
PATIENCE is 'rule no 1'
I will TRY NOT TO use the diathermy at all
Kalau ada bleeding, I just pressure to it and wait for a while before I check again (this may take longer time)
or jahit thru the small laparoscopic hole (this will take much longer time)
Small 'bleeder' - biarkan je, it will stop (macam kalau jari kita terluka)
Under telescopic view, things appear BIG, padahal sikit je tu
Kalau ada arterial 'bleeder', barulah 'bakar' kejap or cuba jahit cepat2 (this require skill) or buka besar and repair (depending on the amount and urgency)


Nape tak sesuai kalau guna 'diathermy' banyak2 ni?
Sebab?
The heat can cause damage to the budding eggs yg aakan menjadi bekalan kita sampai le ke menopaus nanti
This is my theory which is logical
Either the eggs boleh mati kepanasan
or they can undergo mutation can produce unhealthy embryo
I hope I'm wrong.
(harap2nya mutated jadi super clever baby, in this case, bagus jugak kan?)


I've come across (every year)
Patient/patients yang became 'menopausal' after such surgeries
Bila buat blood test
The FSH level tinggi sangat


Talk about this also
This week ada lagi sorang who had not had her periods for many months
Her FSH was also very high
Her liver enzymes were also increased
She's still young <40
No surgery before
Bila tanya pasal 'health product'
Rupanya dia ada amalkan 'satu produk' ni
The uterus and ovaries had become small too
I've seen this type of cases a few times jugak so far
and they used 2-3 familiar products yg org dok jual ni
and I told them to stop using them
Fortunately the FSH slowly came back to 'better' (not normal yet)


We must remember the basic thing of Islam

"MODERATION"

Ubat/produk yg selamat adalah produk yg disediakan dalam DOS yang serendah mungkin tetapi masih MAMPU memberi kesan baik dan pada masa yang sama mempunyai kesan samping yg paling minima
The stronger/higher the dosage - of course the effects are noticable earlier (and we will start telling our friends to use/but it, this is mouth-to-mouth marketing), BUT the negative effects are usually stronger too (be it noticable shortly or in the long term)
Ingatlah,
Kita nak hidup ke hari tua dengan SIHATNYA
Not with 'premature rotten' ovaries, heart, kidneys and liver
Bukan senang nak cari donor untuk transplant


Anyway
Back to my study-journey
Bersendirian
Solo betul2 ni
In one of the oldest university town
LEUVEN


Ada ESHRE campus rupanya
European Society of Reproductive Medicine
Utk ahli macam saya
Dapat murah sikit
Euro800
(compared to Eu1000)

Dan jauh lebih murah drp yuran IVF training saya 7 tahun yg lepas di Hamburg
It was Eu500/day
Sbb yg tu one-to-one training, dgn d big boss pulak tu
Yg ni bukan 1-2-1 tetapi a small group of 20 in its laboratory
3 full days


Masih men-surfing the web utk flight n hotel
Sebab belum sure nak masuk ikut mana
Definitely not thru Brussels sbb mahal utk connecting flight
So, either:
- via Amsterdam (n naik intercity train via Mechelen) or;
- via London (tapi kena gi St Pancras station from Heathrow)
- via Paris (tak de sebab apa2)
- via Dusseldorf (nearer but rasanya less frequent)
- via Hamburg (then saya boleh singgah kat kedai model anatomy n beli, <50% harga berbanding sini)
Any idea anyone?


Balik?
No problem
Mesti ikut London punya
Sebab mahu singgah kedai beli a few things
The satin/silk pyjamas sangat elok n cantik
The playfish cards yg Iman kirim


O yes
She's not going
Not this time
Sebab mamanya betul2 nak gi belajar, bukannya berjalan

4 comments:

  1. Dr, apakah the 'health product' tu?
    just for our education.

    Fazilla

    ReplyDelete
  2. assalamualaikum,

    selamat hari raya aidiladha...

    berapa lama doktor tiada d malaysia?

    ReplyDelete
  3. err...saspennya...nape tanya? nak ikut ke?
    Jap je, 26 jam atas angin, 8 jam kat epot, 3 hari kat akademi, 10 jam kat London :)

    ReplyDelete