Thursday, September 23, 2010

Excuse me, i'm not your one-stop CBD insertion referral centre...

I don't know since when a urology MO has become the only MO who can insert CBD for patients who can't pass urine/ has swollen penis but apparently for the last few days, it has come to's quite irritating to get referrals like that when there are hundred over patients in the clinic waiting to be reviewed...and as if i'm not seeing enough penises and scrotums per day in the clinic, i have to see them in other wards as well...

On Monday an MO from a particular ward called me up to help one of her patient who had bladder tumour and had acute urinary retention...she told me she tried inserting a size 16 urinary catheter but it wouldn't go i went to see the patient...i tried size 18 and 20 but he probably had some anterior urethral stricture coz those sizes wouldn't pass through...i thought of inserting a cystofix but i couldn't even see which was the bladder proper from the in the end i tried a size 14 and it passed through...phew!!! and i found out from the nurse that the MO didn't actually try inserting a urinary catheter on the patient...

On Wednesday, i got a call from the same MO...about the same patient...apparently his urinary catheter dislodged while he was sleeping...pretty amazing considering there was a water-filled balloon that prevents the catheter from getting dislodge and one would need to yank really hard and traumatize the urethra to get it out without deflating the balloon...i asked the MO to re-insert another size 14...she asked her nurse to call me back after 15 mins telling me she failed...fine! so i went to re-insert a catheter for the patient...couldn't get a size 14 in this time, so i tried a size went in resistance whatsoever...@#$#$%%^

The same afternoon, a Queen Casualty HO called me for CBD insertion...i had just left Queen earlier and had just reached SMC...reason for CBD insertion: to monitor urine output...patient was ventilated for APO...reason for difficult insertion: patient's penis is very oedematous...i asked the HO...did you try inserting it yourself...he said yes but failed...i asked if his MO tried and failed too...his answer, i quote "i don't think my MOs can insert a CBD becoz they haven't done it for a long time".... what the #$%$%&^*^&!!!?!!!

And an ortho HO referred a patient with generalized scrotal and penile swelling to me...patient has been practically bed-bound for a week...has low albumin...and he wants me to rule out scrotal infection....why do i keep getting referrals like that? when i was doing general surgery calls, i used to get referrals for scrotal i'm i uro, i still get referrals for scrotal swelling...just wait till i'm back in general surgery...i will never see a scrotal swelling, ever again...

So i went to Queen Casualty after my rounds in SMC...i looked at the patient's penis...yea well, it was swollen...but i could still see the urethral reason why any doctor who is not blind shouldn't be able to insert a urinary cathether for the i tried a size 14....there was only some mild resistance at the prostatic urethra which after some adjustment, the catheter was in the bladder...for goodness sake...i'm not a one-stop CBD insertion referral centre...

What is happening to the doctors these days? what? only uro MOs can insert CBD is it? if this continues, there will come a day when things get so bad that "refer to surgical MO for nasogastric tube insertion" becomes a it is, i've gotten 2 referrals "refer to surgical MO for proctoscopy" if we were never thought how to do a proctoscopy in medical school...oh Lord, give me strength to stay sane...this is really stretching my limit....


  1. one day i had a referral to insert nasogastric tube for a ventilated pt cos the mo doesn't know how to do reply to the mo? i told him-u can start learning now. full stop. end of story..i am not the damn hospital prostitute.not paid well enough to let everyone f#$* me left right centre!

  2. ky, good for you...i need to learn to have more guts like you...i shouldn't let others take advantage of me...thanks for cheering me up :)

  3. What's happening to those dumb MOs??? The one on your Monday case.... is she really a med school grad or not?

    And the Queen Casualty HO's reply regarding his MO's.....wah lau......those MO's tak tau malu ke?

    In KY's case, insert NGT also cannot???? Goodness!

  4. che, i really don't know lah...i just feel so exhausted...

  5. We used to get alot of referrals for NG tube insertion during those good old days. Since you have changed to the dark side, the referral change to different tube insertion. :D
    Maybe you guys should organize a CBD insertion workshop and attendance is compulsory

  6. seriously? when i was in GA, never get any referrals for NG tube also...for CVL plenty use lah...organize CBD insertion workshop even if everyone attend, still will get referral for CBD insertion...

  7. Product of the System27/9/10 00:38

    It sounds like a burnout cry to me.

    You should go back to West Malaysia and start anew.

    At least people in general are more normal over there and you'll hopefully find a suitor befitting of you.

    If you apply now, maybe you can leave by middle of next year.

    Otherwise, stay put in your comfort zone aka Sabah only to wake up one morning and realise you're 36.

  8. i'll go back to West Malaysia when i get my really shouldn't plant ideas into my head POTS...even when i am back there, i still may not find a befitting suitor...just pray that i won't end up bitter...

  9. Even it is exhausting to get a physicians like, at least it has a good thing to you. At least you will know that how much important you to them, and you can show to them that even they have a higher education than you, at least you know how to do work much better than them. In your field, that it is more important.