When the result was counterintuitive, it’s not unusual to feel depressed but this kind of emotion should not be long lasting. It may lead you to real depression. Accept it! You have done your best. You should not feel that shit. At least you did your best, man. This is you! Let it be and be strong to face another upcoming battle. I feel lonely, no one to talk to. Hopefully, writing this note might help me somehow. Gogogo!
先週の月曜日は、私とほかの留学生と教授といっしょにしょくじをしました。トルコの店に入りました。私の初めてに、トルコ料理を食べました。いっぱいのビールを飲みました。おいしいかったです。私たちは、たくさんはなしました。本当に楽しい時間でした。 
先週の土曜日の午後は, 私と研究室の人は, 大阪大学中之島センターに行きました. 研究するために行きました. 30ごろ研究者のほかに病院からしゅうせきしました. 会議では,不整脈について話しました. 会議が終わったら, ともだちは, パ－テイ－に行きました.
韓国の店に入りました. 韓国の料理を注文しました. 豚肉とりをたくさん食べました. そして，3ぱいのビ－ルを飲みました. おいしくて楽しい時間でした. 最後に, 私と先輩も, 電車で帰りました. ちょっとあそいでした.
In some circumstances, it had better take no actions or shut up your mouth if you are not conscious enough to know what you are doing or saying…..
Gonna try for the survival of this blog again….just for a test to see if the connection to FB works….
Only 4 texts posted in the last 4 years, I’ve just come to surf it again and felt rather staggered to see it still functions. Will try to post something more frequently….
To be too much free during the vacation leads me to think nonsensically about this and that, being back to school in particular. It’s rather frustrated to decide which specialty I should pursue, which way I should walk. IELTS vs DELF B2, I must choose one among them. It’s been 3 years that I left school and it ‘s quite enough for me taking a break from student life. Now I plan an initiative to start doing something as to enable me to be a student again. With my hectic working time, I can’t catch both as I used to think. Undeniably, opportunities provided by IELTS outnumber those given by DELF B2. Sorry DELF, firstly I caught you up until gaining B1 in year 2 but later on I kicked you away after year 3. Now I would say it doesn’t matter to continue to keep you resting in peace. By the way, if I want to return to my old place no any sound preparation needed for me based on the GPA of mine in university degree. The problem is that I wanna try another taste, another challenge if possible. The sleeping time is up now, you have to wake up and take a breath of fresh air. Go break a leg!!!!
Since leaving school for nearly 3 years, this blog owner almost never write even a post. Only two articles posted for this period so far. Today, he has met a what-can-be-called life experience in his professional career as a doctor, practicing general internal medicine at the Sihanouk Hospital, Center of Hope. That’s why; he feels like to make a record as the following:
A 64 year-old female with the old problems as HTN, CRF, Scleroderma, RLL lung fibrosis, comes to ED before her follow-up date due to the last 7 days of increasing shortness of breath, palpitation, orthopnea, can’t lie down at all. On the other hand, she also complains of both legs edema and decreasing urine output than usual. She denies fever, cough, chest pain, abdominal pain, dysuria…no any other associated discomforts reported.
The arrival vital sign shown BP: 194/100 Pulse: 105bpm O2sat: 98% room air, T: 36.50 C RR: 22 Weight: 38kg
The Physical Exam:
General appearance: Elderly frail, cachexia, however she didn’t look really sick, quite stable to me, but she sited up all along, cannot lie down because it will make her feel chest tightness and dyspnea.
Skin/Conj: mild tighten, thickness and mild pale conjunctiva.
HEENT: No significant findings
Neck: Mild JVD
Lung: Diffuse crackles bilateral
Heart: RRR, No MM, tachycardia, not clear distant heart sound
Abd: Soft, mild tender at RUQ, no mass/liver/spleen palpable.
Limbs: pitting edema 1+
Clinical impression is CHF+ previous Dx as mentioned above.
CxR done straight away: shown huge cardiomegaly plus small bilateral effusion, mild hypervascularity along the pulmonary artery, cannot role out CHF.
EKG: Regular Sinus Rhythm, HR 107bpm but low voltage.
First try: Amlodipine 10mg PO (her old daily med as she didn’t take it yet) plus Furosemide 20mg IV, then 40mg IV, but no urine output and the patient felt nothing change, neither vital sign.
Heart U/S was later requested: Shown huge cardiac tamponade which urgent pericardiocentesis is a must.
He got his first chance to perform this rare kind of procedure under the support and observation from a lead doctor and department head. Unluckily, thing wasn’t going well. The first two syringes of pericardial fluid drawn out in slightly reddish color. Unfortunately, the third one became tough to draw out and turned clot. He started to acknowledge something was going wrong, feeling guilty and worried about the patient’s safeness. A moment later, the feeling of gradual fainting, sweating appeared in him himself. He couldn’t stand anymore…finding a place to lie down a bit, having BS checked and it was 89mg/dl. Thereafter, he felt a bit better and went back to see the procedure being performed again by lead physician and Director. However, the incident, punctured into ventricle confirming by echo, made previously, caused later try impossible……..Finally, the procedure was temporarily held and the patient was admitted to ward in a guarded condition….. She’s put on TB Med and Steroid…..
Lesson learned: Not all cardiac tamponade cases have a low BP. Everything has its first time. First try is always the toughest. Condition might be mixed as in this case, especially in patient with many underlying diseases and easy to make us confuse in Dx….sure that 2 plus 2 is not 4 in medicine.
I don’t know much about the public hospitals in Phnom Penh nor elsewhere in the whole Cambodia since I’ve never trained neither worked nor entered there. Based on my two-year exposure to Cambodian Medical Field, as an MD in NGO hospital/organization where most patients coming are very limited in term of living condition, poor, unaffordable to pay for their medical services. My workplace has its limitation in receiving/treating patients. Thus, when the number of patients overload our work or their conditions are beyond our capacity, we need to refer them out to other bigger state hospitals namely: Calmette, Kossamak, Russian Hospital… But it’s really disappointing to see almost every patient/patient’s family getting scared of those public hospitals due to the service given or go-through-the-roof bill payment. Some of them used to go there and they grasp this inconvenience. As heard: “No money, No service, Just wait to die.” About the private clinics, it’s undeniable to say they run for business purpose, so the income is definitely in the first place. Some clinics, they abuse lab requests, medications, admission which are not really necessary for patients. Now I pretty understand why the poor are afraid of hospital, when they get sick they choose to stay at home, buy some medicines from local pharmacy without any medical consultation, even go to see some traditional healers, believe in traditional myth/drug which has no clear study nor scientific base. The rich pack their money to seek for a better medical care/service in neighbouring countries. What are actually the functions of public hospitals in Cambodia, The Kingdom of Wonder?
១. នឹកស្រានឹកបៀរ នឹកផឹកស្រាបៀរ ក្លែមសណ្តែកដី
ដល់ស្រវឹងស្រឿង ថែមក្លែមបារី មិនគិតប្រណី
ក្រពះសួតសោះ។
២. នឹកដល់សាលា ដែលធ្លាប់សិក្សា អស់ជាយូរឆ្នាំ
ជាទីកន្លែង ខ្ញុំខំស្រាក់ស្រាំ កត់ត្រាចំណាំ
ក្រេបវិជ្ជាពេទ្យ។
៣. នឹកដល់គ្រូៗ ដែលតែងរអ៊ូ ថាស្តីប្រដៅ
ដល់សិស្សគ្រប់រូប ព្រោះខ្លាចសិស្សខ្លៅ ចេះមិនឆ្អិនឆ្អៅ
មិនប្រាកដច្បាស់។
តែងលេងៗក្នុងឪកាសគំរប់ខួប១ឆ្នាំនៃការធ្វើមាតុភូមិនិវត្តន៏
(២៧ មិថុនា ២០១១ – ២៧ មិថុនា ២០១២)
ដោយ៖ អឿន ប៊ុលរតនៈ
១. កូនសូមជំរាប ពុកម៉ែឲ្យជ្រាប ជាដំណឹងល្អ
ថាកូនចប់ពេទ្យ វិជ្ជាបរវរ សូមលោកអបអរ
រងចាំជប់លៀង។
២. អស់ប្រាំពីរឆ្នាំ កូនបានចងចាំ ទន្ទេញទុកក្នុង
ចិន្តាមិនភ្លេច ថាត្រូវប្រៀបប្រុង ខិតខំស្រូបស្រង់
ក្រេមយកចំណេះ។
៣. កូនបញ្ចប់ពិត ថ្នាក់វេជ្ជបណ្ឌិត ដោយជោគជ័យឈ្នះ
គ្រប់់ឧបសគ្គហើយ កូនធ្វើបានហើយ សូមលោកល្ហែល្ហើយ
ធូរស្បើយចិត្តចុះ។
៤. នេះជាលទ្ធផល ដែលលោកខំផ្តល់ ខំឥតត្រើយកោះ
ដើម្បីឲ្យកូន មានតំរេះស្មោះ ជាស្បៀងមិនក្សោះ
ចញ្ចឹមជីវី។
៥. សាលាកំណត់ យ៉ាងជាក់ប្រាកដ ថ្ងៃម្ភៃប្រាំពីរ
មិថុនានេះ កូនហោះដល់ទី ចិនតុងគ្មានពីរ
នៃស្រុកខ្មែរយើង។
ដោយ៖ អឿន ប៊ុលរតនៈ
ថាយប៊ីញ, ២៣ មិថុនា ២០១១
Whiteblouse used to stealthily have a loving sentiment with someone (his high school classmate)…Until now he still misses and thinks of that girl every second, although he lost contact with her for almost 8 years after high school…One day, lately Facebook helped him to meet her again…He was pretty excited and most happy but at the same time he also met her best friend online who informed him about her upcoming marriage…Nothing to say…hurt hurt hurt…heartache heartache heartache…so poor Whiteblouse…!!! When he was near her, he was too chicken-hearted, to shy, too timid just to talk to her and confess love…as a result, made him lose his chance till now and forever…The biggest regret in his life is to make lose his first lover…Now, he knows he has no chance to express his love any more…everything’s too too too late…he wanna let that girl grasp his feelings now but it won’t change the situation though. Thus, it’s better to everlastingly hide his sentiment…let say, maybe that she’s not his plan-from-god life partner…however, he also thanks to Facebook which lets him meet her again although indirectly through the internet…he always misses her and stealthily comes to her FB profile to see her pics…Finally, he wanna send his words to her that: each of the day, he couldn’t sleep if he doesn’t see her pic, Whiteblouse even pulls her images from FB to put on his desktop so as to see her charming face whenever he starts his PC…At last, let Whiteblouse send his best wishes to her…may her be fulfilled with happiness, healthiness, prosperity in her spousal life…may her love be eternal one…!!!!
Finally, everything’s done….makes Whiteblouse now officially become a sleeping and eating doctor during this two weeks left and gonna be a wind kicking doctor at Phnom Penh Street Hospital from early July onward…who know where the hospital mentioned above exists??? I can’t imagine where it is…but maybe all streets in PP… a big turning point, one of the biggest tension period in life of a countryside guy whose homedistrict was simply available the secondary school as the highest education level…Whiteblouse just completed his final exam this evening and hope to receive his degree in general medicine in 10 days more…Bravo…whiteblouse,,,a medical doctor specialized in wind kicking skill..!!!
The day I expected every second during these long years will arrive so soon, it will present itself naturally in only 3 more weeks. I feel palpitated to waiting for that day to come. It’s gonna be a turning point of my whole life, the day transferring me from student life to professional life, to social life, the day I have to say goodbye to Vietnamese friend, to the school which gave me a life as medical professional, to my room, to my dormitory,..say goodbye to all the things which used to be parts of my life in Vietnam territory. How will that day affect my feelings? Hm…well, the answer will be composed of a variety of adjective using to express a mix of feeling status just like anxiety, nervous, excited, worried, happy…In brief, it’s gonna be an unforgettable moment in life…
Vua moi tot nghiep lam sang NOI vong 3 mot cach that bai.
Day la cuoi cung ma trong doi sinh vien toi thi lam sang ma lai la lan dau bi that bai (toi chan doan benh sai hoan toan). 6 nam troi duoi mai truong dai hoc y, cuoc thi lam sang kieu nao cung co nhung toi khong bao gio bi that bai nhu the nay, that bai mot cach dau kho, cuc ky nhuc nha, co le that bai lan nay lam toi nho suot doi va toi mong se tu do toi co the rut kinh nghiep voi truong hop benh nhu the nay. Toi chan doan la xo gan lach to kieu Banti nhung giam khao thi noi la truong hop do nghi nhieu toi Lymphosarcome…thay vay toi da bi choang luon, khong con tinh than gi ma tra loi cau hoi nua. “Da chan doan, dung co dieu tri. Ban dung ban long voi nhung gi minh lam duoc.” Day la cau noi cung cuoi ma co PHUONG gui cho toi truoc khi toi ra khoi phong thi. Du sao khong ban long khong duoc. Neu co the, toi muoi dang ky thi lai, hon la lay diem qua. Bac si trong Khoa chan doan vo van dieu tri vo van. Toi cong nhan rang cau hoi cua co PHUONG toan la cau hoi theo kieu tinh huong va rat truu tuong nen co khi minh khong hieu la y cua co muon hoi gi, hieu nham cau hoi tat nhien se dua toi cau tra loi sai =>suy ra anh chang hieu gi, anh chang biet gi, anh rat luoi hoc.
May may trong cuoc thi cu la mot dieu khong he tu choi. Buon chet di duoc….hm chac toi khong gap may thoi…
Failure is never an option!!!!! To myself-motivated let me say a quote: “there is no such thing as failure but only new lessions.” let celebrate failure, find something in a failure to celebrate it. “Forgive and remember.”
Hm, i’m still so feeling down, by the way.
ង៉ៃនេះដូចជាមិនសូវស្រួលខ្លួនសោះ មានអារម្មណ៍ថាឈឺក្បាលយ៉ាងម៉េចទេ។ ឫមួយមកពីដេកច្រើនពេក?
my 7 year-long waiting’s gonna be finalized soon, just only exactly two more months left. Rathanak, you must make an effort, be courageous, be calm down (in the living tension, try not to let your anger burst out)…the only one thing you have to focus on is to be well-prepared for your soon-coming final exam…to bring back a medical doctor diploma for your beloved parents…!!!!
This new year, the year of rabbit 2011 is the 7th and also the last far-away-from-home new year for me that I can’t join with my family. All Cambodian people across the country happily celebrate the new year ceremony with their owns families and their relatives while I’m here alone and have to go to school and have academic courses as usual. Poor me!!! however, I could go through and experience this kind of feeling for 7 years now…and surly I hope that from next new year onward I would join with my family in my sweet hometown.
May Tevada Chmam Thmey bring my beloved family, my relative, my friends and all Khmer people around the world prosperity, healthiness, happiness…may Tevada Chmam Thmey bless my country, the Kingdom of Cambodia, the Kingdom of Wonder!!!!
About 9:00 am 11 Avril 2011, my older sister safely gave birth at a hospital in Siem Reap town to her male new born. So that mean I now become an uncle of my sister’s son.
The delivery process was going well, I was really happy to hear such a good news and to become an uncle…
Wish my sister and my nephew full of health, fill with strength, and a great happiness in her warm family.
P/S: my internet speed is so so slow, I’ve tried many many times just to add this post that’s why it’s a bit late to publish this post today.
Khmer Empire & City King Jayavarman7
Posted: April 1, 2011 in En Français, Entertainment, This and That
WHITE BLOUSE'S DIARY! 