Tummy T.T

SHin arr..
I've got tummy bloating and mild diarrhea again...
and a feeling of something grinding/squeezing in my tummy just comes and goes..
(when this feeling comes, it's really uncomfortable)

Feel that my tummy is really sensitive..
I'm also not sure what I ate that caused this...
Ytd I really didn't feel like going to school..
but thinking of I had a patient ytd, so I went..

Now, it's almost gone...
ytd I din eat much...
and I made myself a ENO ginger flavored drink...
maybe the gas is all forced out so I'm feeling much better now..
SO no worries la...
I'm just curious why my tummy gets so sensitive recently..

A case to share with you

The boy that I was so sorry for..
His progression is pretty good..
so the coming monday will be his last visit(hopefully)
if everything's ok, then I'll wrap up the case :D:D:D
God bless him...

today I've got a quite difficult case...
just to share with you here shin...

She's a 22y/o female patient studying Medicine in IMU...
She came for postural check up, as well as a check for her knees..
She had a trauma on both knees when she was 15..
she fell from a van, landed on both knees..
that time she thought it was minor thing..
so she just did a basic dressing for her open wound with antiseptics..
since then, her knees got really vulnerable...
a minor hit, or even gentle tap on patella would cause her knees to bruise
(so she cannot really kneel down too)
when she was 17/18, before going to national service,
she saw an orthopedic, and her X-ray revealed normal,
the orthopedic actually prescribed her with physiotherapy,
but she doesnt think it helps.
and later after she entered IMU, she went to IMU clinic again for her knees problem..
and the MD prescribed physio as well, but same thing, she didnt think it works.
Usually she wont feel the pain, but once the knee get hit, or tap, it just get bruises very easily.
Hmmm so my clinician actually saw my patient after i took the history...
Not much examination was done on her, we just asked for knee (weight bearing) AP and lateral X-ray for both knees..
X-ray showed slight medial shift of the knee, and the medial knee joint space of both knees are diminished.
My clinician said she's very likely to develop into osteoarthritis without any intervention..

So this is my case...And I'm goin to look into her X-ray tmr...
Update you after I see her and examine her on monday?
Hmmm...you like me posting cases like this?
If yes, I'll do it if I see interesting cases...you can just read for pleasure :)

Repent...

Shin a...I'm here to repent...
recently I've seen a patient..
oh, it's on my exam day itself...
and the patient was a walk-in patient,
coincidentally I was free that time,
hence he became my patient..

I was very nervous that time due to the time contraint( 1 more hr to exam),
as well as the case type..
it's a wrist case..
so as what my clinician told me,
I took the history and got back to him..
he listened to me and asked me to do some examinations...

I just followed what he said but I didn't rule out fracture...
and I didn't do some neurological screen as well...
besides that, active, passive and resisted movement are important to us...
but I didn't do resisted(coz my clinician just asked me to do active and passive)

I was super nervous because I'm not familiar with upper limb at all!
So I just followed what the clinician told..
but, after my test, I thought for some time..
I felt that I'm seriously wrong...
I should have screened the fracture at the first place...
and I didn't really do muscle testing because my clinician already given me the diagnosis...

Luckily,
the patient got much better...
But I feel so so sorry to this patient that I didn't provide him with best care...
I would have done better if I'm more calmed and think more by myself(not only listening to the clinician)
He's such a nice guy, during he treatment, we chat quite a lot...
Shin...sigh..I really needa be more well-prepared...
and also always clear bout what I do...

My dear patient CXXX XXX XXXX,
I'm terribly sorry...I hope my clinician was right and hopefully the treatment plan works well for you... I'll pray for you to recover as fast as possible...T.T