humOngOus stOnes!

salam,

owh daku sangat mengantuk sekarang.tapi takleh tidoq lae.have to wait for Isha prayer which is very late during summer time.11.30 baru masuk waktu.

i was reading on renal medicine as preparation for tomorrow's clinic at 1.30 before my eyes got sore and watery as the results of xtreme sleepiness.so here i am,typing word by word while waiting for the clock to strike 11.30 so that i can perform my prayer and off to my dreamland.

how's ur day everyone?moi?this morning i scrubbed in(not really scrubbed tho,just change my clothes) to OT for the kidney-related operation called pyelolithotomy:

Surgical removal of a renal calculus through an incision in the renal pelvis.

this is quite a major surgery because renal calculus or kidney stones are usually removed
by :
*extracorporeal shockwave lithotripsy which using ultrasonic wave to shatter the stones

*percutaneous nephrostomy to relieve obstruction

*uteroscopy+/-laser or percutaneous nephrolitotomy using keyhole techniqueto remove stones.

pyelolithotomy; open surgery to remove the stones is rarely done since more advance and less painful techniques existed as mentioned above.perhaps the patient i'd seen had a huge collection of stones or calculi buried deep in her kidney that first i thought was the kidney itself on the X-ray.how stupid i am because kidney is not radiopaque on X-ray but the stones are!hahah...i was asking my friend....
"where's the right kidney,i can't see it?"
my friend was like.....
"this is not the left kidney lah,this is the collection of stones!"
"howaaaa......this big arrrr?"
seriously,it resembles the real kidney in terms of size and shape.tipah tertipu.ahaks. they took more than 2 hours to get the stones out with the biggest piece is as big as biskut makmur atau biskut kacang di hari raya.sorry i couldn't find any other objects as comparison nor has the same size as the stone.ahaks.kira satu cointainer kecik full of the removed stones la.although i had to stand more than 2 hours,the experience is more than worth it.

later that afternoon,met wif friends,having scones wif tea while discussing global issues.GLOBAL gila key,dr mesia ke america.from phyton died with perforated bowel to depressed monkey with ascites.muahahah.reached home at 8,lapar dan mengantuk.unlike yesterday,i was released early.sempat buat retail theraphy lagi.di mana?here------->

.blue and flat.
n.i.c.e

okies.enuff for today.c u soon peeps.
muah2x!