Tuesday, 9 November 2010

A Good Physician is A Good Observer

I think i'm in LOVE ...
In LOVE with Neurosurgery ...
LOVE doesn't mean that you have to give all of yourself ..
But trying to give a little bit of yourself & try to understand & appreciate , right?

Today 9th Nov 2010

Dr Hatem showed us several 'pieces' of MRI (Magnetic Resonance Imaging) during clinical round ...
He was awesome ! Looks simple, but knowledgeable (for sure - He's A Professor)
He gave chances to everybody to try and talk , discuss about the MRI findings ...

This one case , female petient , 27 years old (still young) , 2 offsprings (children)
Complaining of excessive hair distribution ( bulu badan berlebihan ) , amenorrhea (stop menstruation-tak datang period) , galactorrhea (susu badan berlebihan) , and Cushingoid face (muka tembam-maaf, don't know the appropriate word to use) ..

And she actually came to Neurology Department after referred by endocrinologist from Endocrinology Department ...

What is her problem??

Masalah wanita ini, actually masalah hormon..
Nak tahu mengapa?? ^^,
Allah Maha Besar , segala puji-pujian memang untuk Dia ....

Dalam tempurung kepala kita ni, ada banyak struktur2 yang terlampau penting ..
OTAK ... The Brain .. Sebab itu, adanya tempurung kepala yang sangat keras dan tebal.
I've seen the surgeons here did craniotomy (surgical removal of parts of the skull) to expose part of the brain , to remove the tumors! SubhanaAllah, tempurung kepala kita memang sebijik macam tempurung kelapa .. dari segi kekerasan n ketebalan...

Back to the woman's story.. dalam banyak2 struktur penting dalam otak kita, adanya SATU kalenjar hormone yang PENTING - kalenjar pituitary (Pituitary Gland) .. kecil je, berat 0.5 gram ..

Kalenjar ni mcm kacang pea.. dibahagikan kepada 2 bahagian (depan & belakang)
Kalenjar depan dipanggil Anterior Pituitary - merembes hormon ACTH,TSH,LH,GH,PRL & FSH

Kalenjar blkang dipanggil Posterior Pituitary - merembes 2 hormon je - ADH & Oxytocin

Just try to imagine , when a 'foreign' structure come n interrupt this tiny ,cute gland?
This foreigner brings a disruptive influence on our body by secreting more n more unnecessary amount of hormones.. and then the female patient came to our doctor and complained.

When our Dr Hatem took out the MRI , these were the things we found :

(The yellow circles show the port where the foreigner take place)- not the actual pictures , but more / less the same

(This is the normal MRI we should have)

So, the approaches to this problem??
Would be surgery ... Transphenoidally / Subfrontally intervention ...

Wanita itu akan menjalani pembedahan membuang tumor itu
Wanita itu saya lihat 'sihat' kelihatannya , pipinya tembam ..
Jangan disangka org2 yang 'sihat' ni , sbnanya sbb dia banyak makan ,
sebab siapa tahu, mcm wanita ni, sebenarnya dia ade tumor kat otak!

Semoga semuanya kan baik2 sahaja.. Let's pray that she'd be happy soon!

"dan apabila aku sakit, Dialah yang menyembuhkan aku"