Ahmad Sampang ibnu Hajiri, MD

A Personal blog by a Tausug medical student (now a doctor!) from Sulu and the stories that inspired him.
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Aspire Summit 2016
Clerkship Day 210
Out of Post

Last April 9, 2016 I attended the ASPIRE SUMMIT 2016 held in GT Toyota at UP Diliman. It was the end of our rotation in Rehab Med and we actually have free weekends. It so happened that I was free that day so I signed up and registered myself online a few months ago. At first, I thought this was one of those conferences for young entrepreneurs and I don’t even remember why I signed up, haha! But with nothing much to lose, I went anyway. I might learn something for future projects I have in mind.



I was wrong on one thing though: This was not for entrepreneurs but for “young leaders for change”. I am more than glad that I attended anyway. It was a summit showcasing different organizations (NGOs and private companies) all managed by young and inspiring leaders! I never even knew who the speakers were until I got the programme, and guess what, two of the speakers were among those that I really admire: Rep. Sitti Djalia Turabin of Anak Mindanao and Bam Alegre from GMA News!


With Rep Siti Djalia Turabin-Hatamn. One of my "crushes" :)
GMA 7's Bam Alegre on responsible use of Social Media

A lot of other organizations like Haribon and the Yellow Boat were also introduced. They presented their respective programs, all are equally important and inspiring. Among those that really inspired me the most was the speech of a volunteer teacher from Teach for the Philippines, Ms. Liang Borlagdan.

Awesome speech.
Photo c/o ASPIRE Summit's FB Page


After listening to her story on how she started her journey of becoming a teacher, and even sharing her students’ stories as well, my once-dwindling dream and passion to teach was once again rekindled. It is just amazing how a single teacher can touch the lives of hundreds they teach. They (our teachers) are indeed our REAL HOPE. They mold our future, they guide our next generations to be better persons and become an integral part of our society. Yes, I still wanted to become a teacher like my mother one day. Maybe I can still do that in the future, I could be a doctor AND a teacher. I will teach in the morning and visit my patients during the other half of my days. Hmmm. Seems hard, but plausible! :D

There were also intermissions and games held while taking breaks, and guess what, I participated and won this awesome Asus Powerbank: ^_^

I don’t want to believe that I am the ONLY post-graduate participant that day. But it seems that I actually am the only one! Haha. I feel so old attending an event participated mostly by undergraduate students from different colleges and universities in Metro Manila. But then again, it was worth it. Too bad though that I didn’t have anyone I know with me. And I regretted not finding a new friend during the event as well. I was just too shy! Haha. Just kidding.

From: Pinoy Catalyst


Just glad to have a free day spending it on a different kind of passion I always have in my heart: Volunteering and serving other people. Alhamdulillah for that day indeed! :)

Learn more about ASPIRE Summit here: Link

Clerkship Day 204 to 216: Rehabilitation Medicine

Continuing on our ever-delayed journal on “How to survive Clerkship in UP-PGH” (I made up that book title), let us talk about the things to know about clerkship in Rehab Medicine.

General Info (What you need to know):

Duration of Rotation:
2 weeks
Number of students:
8 (sub-block)
Important hours:
Time in: 7:30 AM (They’re strict on this!)
Time out: 4:30 PM (Yup! It’s that early)
But students preparing for the G rounds the next day will usually stay until 8 to 9PM.
Wearing uniforms
REQUIRED!
Duties:
At least once a week for each student. 2 students will have only 1 duty for the whole rotation.
Weekdays: 5PM to 7AM the next day
Weekends: 8AM to 8AM the next day
No true posts. Post-duties to stay until 4:30PM except weekends.
SIC work:
At most 2 patients each student, with one “G” patient each.
With interns?
Yes, but only during night duties. They have OPDs during the day and all patients in the ward are handled by the clerks. Learn more on Ward Duties.
Residents
Some are toxic especially during “G” rounds but most of them are really kind and approachable. They will really teach you if you show interest to learn something. High yield mentoring.
Call room
Yes. Pretty decent, good airconditioning, enough chairs but no beds -_-
Two restrooms just outside the call-room. Clean and well-maintained.
Wi-Fi connection is moderate. I recommend bringing your own LTEs.
What’s unique?
·  The “G” rounds, once a week.
·  You have to attend the PT and OT sessions of your patients every day. Don’t forget to take videos of their sessions! You will show this to your RICs.
·  There are three different charts: Orders chart (the regular chart), the PT/OT Charts and the White chart for SIC clerks.
·  SIC clerks have separate charts (the “White chart”) to input your SIC notes and progress notes.
What to watch out for:
The “G” Rounds. Learn more about it below.
Required Paper works:
·   Index card/attendance
·   Patient log and endorsement sheets
·   Reflection paper
·   SIC notes (handwritten!) 24 hours after receiving the patient.
·   Updated Progress notes of your patients every Friday
·   Outgoing notes by the last Sunday of your rotation
Other activities
·   4 SGDs
Toxicity level
6/10
It’s actually chill



I think I have tackled most of the important things above. I will just then give more details on some points.

The Ward Duty

Update: Starting April 2016 (our rotation) ER Duties are no longer required. So YEAYY!!! 

There are only 16 beds in Rehab Ward which is the "deeper" half of Ward 5 (the other half occupied by Neurology). Each clerk is assigned with 2 patients each. 

The Ward duty begins at 4:30 PM and ends by 7AM the next day during weekdays. On weekends when most students are free, the duty team are expected to be in Rehab Ward from 8AM to 8AM the next day. Students on duty (one clerk and one intern) will be in-charge of conducting chart rounds on all patient and carry out all orders during their duty. There are minimal procs (blood extractions) and they are usually done by the non-duty SICs during the day unless they are time-bound. Conducting to Radio for XRays, UTZ, MRIs are rare. There are usually no monitoring unless there’s a toxic patient (usually only one in a week). You can basically take turns monitoring and have enough time to sleep in the call room and wake up at around 5AM to carry out any procs.

Each duty student is required to present and endorse a new case (usually referrals) to the Senior resident on duty the next day. It’s a one-on-one teaching endorsement, so it’s cool and you will learn a lot :) Just be sure to inform your resident ahead of time so that he/she will be able to schedule a meeting with you.

What to bring? The usual PE Stuff: BP App (sphygmomanometer), a thermometer, your pulse oximeter and stethoscopes are often enough. Bring a laptop and lots of movies if you feel like watching any, or your unfinished books to read. This is perhaps one of the best duties to spend those.

The callroom with the round table. It also serves as the "Research Room" so a lot of journals and research papers are "kept" here.

Don't forget to write your name and your contact number on the white board located at the nurse station whenever you're on duty!

The entrance door to the PT and OT Gyms. It's supposed to be locked during the night. Ask the ROD for the keys. 

The hallway of the Mezzanine going from the callroom. 
 The SGDs
There will be four sets of SGDs: Neuro, Burn, Spine and Pedia. We were told that Neuro SGD would be done bedside, but we prepared Powerpoint presentations to all of them anyway. It turned out we could use the PPTs in all SGDs. The division of labor would depend on how your group (esp your LO) would agree upon. What we did was assign 2 students for each SGD who will take care of getting the History and PE and acquiring copies of the chart and lab results. Ideally, those who will not be in G rounds on that week will be the ones to be in-charge of the Hx and PE. We had a flexible assignment of tasks though because there was a sudden change in our sched so we swapped roles along the way.

The SGDs are quite toxic. Sometimes the case will be given to you 2 days before the SGD and there are patients that are not in Ward 5 (Burn and Pedia patients particularly). Everyone must know the case: as it should be, but let’s face it, we usually end up dividing the task and focusing on thing only. The consultants are particularly keen on Hx and PE and not much on pathophysio and management but most of them are quite forgiving if you failed to do one or two tests. One of them is pretty notorious for grilling students during SGDs but he/she teaches well. Always be prepared and read up on your patients’ case days before the SGDs. Never appear sleepy during SGDs or you will end up getting the attention of your consultant!! Always be sure to have your Resident monitor check your presentation the day before your SGDs, their tips and suggestions are really helpful.


Rehab Clerks preparing for the SGDs

While waiting for our preceptor, we had enough time to fool around ^_^

The “G” Rounds

Once a week, the dreaded “G” rounds would swamp and wreak havoc to the ever-peaceful Rehab Ward. It is the longest 4 hours of a clerks’ life in Rehab Medicine. The “G” stands for the surname of the well-known (and most feared) consultant in Rehab Medicine in PGH. Everyone knows her. And everyone knows that you should never, ever face her during G rounds unprepared. And worst, it’s GRADED! (-_-)

Each student will be assigned one G patient (they are from beds 1 to 8) and each week, 4 students will be “sacrificed” to present to her their assigned case during the G rounds. The students are expected to know everything about the patient assigned to him/her especially the History, the pertinent Physical examination findings and the course in the ward. Knowing by heart the patients’ condition (from pthophysio to treatment options) and the service’s management goals is a bonus.

Reading scripts or your patients’ records are not allowed. You are required to memorize everything and report to her right then and there. It’s OK to glance on your script if you miss something, but more often than not, looking at your notes is a big no-no. You must always appear interested but never, ever laugh or even smile! We were told that that is something she never liked students doing during her rounds. She would often ask questions in the middle of everything and you must answer that question to move on. If you cannot answer it, she will turn the questions to your fellow clerks/students. And if all else fail, the Residents will be there to save you (or get drowned with you). Your RIC will surely help you prepare for G rounds. They will ask you to prepare your script and practice with them days before your G rounds, so always follow what they ask you to do. They are your greatest comrades in this battle.

Academically, the G-rounds are actually one of the best opportunities to learn about your patients’ condition. There are things that you and your RIC might have missed that would certainly come out during G rounds. Just the mere “fear” of failing would push you beyond your usual self, to read on about your patients’ case. And you will never forget those that you learned in G rounds ever again (after experiencing the stress of course!). But fret not! If you have prepared well days before it, you will surely survive the G rounds without a smile!

There's this kiddie park fronting the entrance to the PT/OT gym. This is where I practiced my script for the G rounds. I kept repeating my script while walking around here. I think I made around 8 laps tops. 

Before the G Storm: Trying to stay sane while refining our scripts for the G rounds

After the storm: The first four "tributes" to the G Rounds. Survived without smiling!


Readings/References:
Not required but good-to-have. Really useful during SGDs and G rounds.



ENJOY REHAB!

I think that’s all for Rehab Med. One last tip on how to maximize your stay in Rehab:

Talk and spend time with your patients :) As you will have at most two patients only, you will have enough time to know them more. I only had two patients during my whole stay in Rehab Medicine and their stories are always worth listening and looking back into. You can read about them here: "Disabled" and "A blessing".

Hope this mini-guide would help those who will enter clerkship in Rehab Medicine in the future. I now these things often change every now and then, but most of them are the same. If you think I missed anything, lease do inform me so that I can edit this post. You can easily contact me thru my FB Page: AhmadHajiri.

Thank you for reading and Maasalaam! (with Peace!)
-Ahmad ibn Hajiri

Clerkship Day 212
Rehabilitation Medicine Day 11/14


There are so many things in our daily life that we often take for granted. Take for example the ability to walk. Or the ability to hold things with our hands. And what is so unbelievable is that we never really recognize their importance, until we lose them. Yes, a cliché statement but nevertheless real.

I only had two patients during my 2-week stay in Rehab Medicine, and both of them taught me a lot of things. Here I will talk first about Riza (not her real name).

Riza is a 22 year old female diagnosed with Systemic lupus erythematosus (SLE) for almost 10 years now and due to her chronic use of steroids and her lack of follow-ups, she ended up developing Avascular Necrosis (AVN, means cellular death due to lack of blood supply) of her hips one year ago. She had difficulty moving due to severe pain and she slowly lost her ability to walk. Last month she underwent a surgical procedure called Total Hip Arthroplasty (THA) of her right hip. To put it simply, a part of her pelvic bone and the head of her right humerus were removed and replaced with either an inert metal or a high-density polyethelene material. Yes, exactly like having a metal part in your body as we see in anime or movies. Cool, right? But it’s not as cool when she had to be admitted in the hospital to train how to walk again. All these while being careful not to put too much weight on her affected side for a few weeks. Her left hip would also need the same procedure but we need to let her heal and train her hip muscles (and a lot of other muscles) first for her to ambulate freely with some assistance. There’s also this problem with the expenses. So before then, her second THA will have to wait.

What THA looks like. Photo owned by orthoinfo.org

Since day one of her admission, she’d been undergoing her physical therapy sessions with her PT on ambulation and balance. She started with using her walker, then just yesterday we moved on to using crouches. She’s getting better each day of her sessions. Which is really good.

For a 22 year old female who actually lost the ability to walk because of a condition she herself did not chose to have, one would think all hope would be lost. One would think that a young woman like her would end up becoming depressed, saddened by the mere sad state she is in. To be labelled as “DISABLED” for the rest of your life is indeed not a joke.

But what I saw in her was none of that. Each day as I accompany her to the PT gym, she would walk with great determination and hope in every step she take. Yes there were painful steps (I could see her face wince with pain once in a while for each misstep she take), but in her eyes was that undying determination to go on, to do better, to go beyond what her condition had limited her to do. I was amazed. Humbled in fact, to see how one person could overcome all these trials and face each day with a determined smile. That she may be limited and challenged on one of the most basic and easily neglected functions of our body (walking), but it won’t mean that all hopes are lost.


Indeed life gives us so many wonderful things but we often miss their importance. Indeed, there is just so much in life we owe to be thankful of. Say, Alhamdulillah! (All praise is due to God!) For giving us these simple gifts… Simple gifts that is yet so important that just losing one of them, would mean a very devastating change in our lives.

Be thankful. And never lose hope. For all hope will be lost, only when you give up and stopped trying. Let us learn from Riza: That it is indeed nothing to be ashamed of for having disabilities, so long as you never allow your heart to be “disabled” as well.


Salam kasilasa!

-Ahmad

(My other patient in Rehab, Andrew, also taught me a lot about life. Hopefully I could share that to you some day )


March 30, 2016
Clerkship Day 208
Day 3 on Rehabilitation Medicine

I received a text message from my dear cousin yesterday:

"Ungud (couz), are you free tomorrow? Ama is asking if you're free..." it read. Yayang (as we call her way back then) is my first cousin and a childhood friend, a humble daughter of my favorite maternal uncle. She's also in Medschool and we're on the same year (4th year). Right after reading her message, I was immediately reminded about something: IT'S HER GRADUATION DAY ALREADY!

I was not on duty that day but I still have to go to PGH and attend to my patients. I was only free after 4:30 PM, I told her and her father. I really wanted to attend the graduation ceremony and witness and feel that "feeling" of seeing your batch-mates (from other medschool) finally stepping up to the stage... receiving their fruits of labor... their diplomas... and being called "Dr. So-and-so". Maa sha Allah! But I just can't leave my post -_-

But then instead of me going to their place, they decided to "celebrate" here in Manila instead (they had a hard-time looking for a Halal restaurant there) and besides, we have other cousins who are staying around Manila. And so we had a wonderful Family Dinner.
The Sampang Family :)


And because I failed to bring my gift to her (haha) I am writing this impromptu letter instead.

Dear Ungud:

Al-Hamdulillah and Mabrook my dear cousin! ^_^ We are so proud of you! You have finally reached the end of your four-year struggle in Medschool and now you are ready for your next challenge: Post-Graduate Internship (PGI)! I know you may feel like you are not that good, but honestly, you are more than that. Because you are BETTER and GREATER! :) I will always pray that Allah will keep you strong and steadfast, for this road that we have decided to take is indeed a very long and exhausting path. I am just glad I have a cousin beside me to get by :) Pasari na maun kahunitan kita, in sha Allah dumatung da in katan ha kabayaan sin Allah :) 

As Allah always reminds us in the Holy Qur-an:

"Fainna-maal 'Usriy yusra... Inna maal 'usriy yusra." (For indeed, in every hardship, comes ease...)
-Surah Nashr 94:5-6
photo not mine :r


Come to think of it, your name was derived from that word! YUSRA = Ease :) So in sha Allah everything will be easy for you, Allahumma Ameen.

And here's another favorite verse in the Qur'an:

photo not mine :p and I'm too lazy to look for the owner


Yes. We still have a lot to go through. And this letter, this blogpost, I am dedicating to you :)

Salamkasilasa!

Your proud couz,
Ahmad


=0=0=0=
As for me...

Her graduation actually reminded me of my own journey as well. Wow! My fourth year in medschool is almost done (Hey! I am supposed to be graduating as well!!! #bitter Haha just kidding.) But I still have another year to finish (internship) before I could feel that excitement and enjoy the mesmerizing smell of our toga... and perhaps by then, I could finally cry my heart out. Dzah! #dramapamore haha.

For now. I still need to survive the remaining days of clerkship. One day at a time :)

-Ahmad




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just saying. -Dr. Ahmad