Rehab product training
The training was held at the showroom somewhere in Ubi. The items were divided mainly to 4 categories: beds, walking aids, wheelchairs, and toiletries.
Now I know where usually hospitals get their beds. Haha.. It was a surprise to learn that there are actually mattresses designed to reduce pressure sores. The mattresses are kinda like airbags but when you don't feel the bumps when you lie down. However, you can feel the bumps causing a bit of imbalance when you sit on it. There are 2 kinds of mechanisms too. First, the mattress is made up of a series of air-filled tubes. The tubes have alternating air pressure and the air pressure will switch automatically every 8-10mins. Isn't it cool!! The second type is quite hard to describe. I liken it to a honeycomb configuration and the air pressure is also alternating for adjacent boxes. However, the air pressure between the boxes will not switch automatically.
The toiletries are kinda boring. I only learn that "comote" simply means the chair-like toilet bowl. My grandma has one and I always wonder what is under the thing. Actually it is just simply a bucket. Lol.. The bucket can be removed to clear the content. Some comotes can actually be pushed on top of toilet bowl so that the person can basically sit on the comote but expel their stuff to the toilet bowl instead of the bucket.
The walking aids section help to straighten some of my misunderstandings. Walking stick is to be held in the stronger side so that patient is able to grip it. I always thought that walking stick is to support the weak side because what's the point in supporting the already strong side.. Now I know I am wrong. Another misunderstanding is regarding crutches and elbow support. They are meant to be used in pairs! So no such thing as to support the weak side or strong side. I also learn about measurements. For walking stick, place the stick about 2 inches away from feet and the handle should be in wrist level. For crutches and elbow support, place the stick 6 inches away and the grip should also be in wrist level. And I learn that there is a difference in the purpose of crutches and elbow support. Crutches are meant for people who cannot bear weight on one leg (eg. post surgery, fracture). Elbow support is for people who can bear weight but has no strength to support the full weight (eg. patient with polio or legs disabilities).
The most interesting section is the wheelchairs. It is cool to see the various motorised wheelchair although I was disappointed that there was no offer to try one. Haha.. The most interesting thing is this device to allow wheelchairs climb staircases. Basically you mount the wheelchair to the device and the device will move (the base is like a roller mechanism, not wheels) up/down the steps while the wheelchair remains stationary. Wow! The demonstrator asked me to sit on the wheelchair and to try move the wheelchair down a staircase. It was damn freaking scary! Haha.. It felt like riding a roller coaster (I never rode one) and that was only from being pushed to the stair. Before he pushed down, he discovered that the wheelchair had not been secured to the device. OMG! That means I almost died!! Haha.. After that I felt so insecure about the device o_0
So yeah that was Friday...
Acne talk
I felt cheated for this! Due to mishearing on my part, I thought it was compulsory so I signed up -__- My only consolation was the hope of good food which was also NOT the case. The food sucks. The goodie bags are okay. I ran out of my acne cream (benzoyl peroxide 5%) and now I got 2 tubes of 4%. I wonder whether it would work if even with 5% I find it useless. Sigh.. I was hoping to get the sample of the one containing the medicine leh!! Haha..
Anyway, there was a LOT to learn. So I guess it was worth it to attend. Firstly, I learnt that there are more mechanisms to explain acne. Some hormones involved are androgens, growth hormones, and stress hormones. The androgens isn't really major since both males and females are equally affected by acne. The growth hormones explain that usually acne is self-limiting post-puberty as growoth hormones drop. Since I am still having lots of acne, that means I still have plenty of the hormones. Too bad they only help me grow sideways :'( And the stress hormones are kinda self-explanatory.
Secondly, I learnt about some explanation regarding correlation between food and acne. The speaker took milk as an example. The poor cows are usually milked after delivery. Then the cows are impregnated again. While pregnant, they are continuously milked until 1 month before the next delivery. That explains why milk contains lots of androgens. I drink milk everyday and perhaps that's why :( There is some relation with insulin receptors too and that's why eating a lot of sweet stuff (perhaps that explains chocolates and desserts) also may trigger acne.
Lastly is about the treatment. I am surprised that topical retinoids are actually sort of the first line. I always thought benzoyl peroxide as the first line, then antibiotics, the retinoids. The "in" thing right now is to use combination of topical preparation. Hmm hmm.. I remember last time I told a patient who asked whether she needed benzoyl peroxide if she was already using differin gel. I told her no need. Ouch!! My thinking was since she was already on the potent one, can forget about lousy benzoyl peroxide. LOL. And this talk changed my perception with regards to benzoyl peroxide. It is actually a very good substance as bacteria do not become resistant to it. Besides being anti-microbial itself, it can actually help to reduce antibiotic resistance when used together with antibiotic. Cool eh??
And I met my preceptor from 2 years ago during the talk. It was nice to catch up with her.
And after catching up with my friend in hospital, I cannot emphasize how lucky and blessed I am to be in community. I just hate their mentality and preference in training. No offence to anybody but I think seniors/teachers/preceptors should:
1) Expect their juniors/students/preceptees to be dumb/stupid/don't know anything (but that does not mean looking down on them)
Seriously don't assume "you should know this and that". They are there to learn from you. If they are already smart and they know everything, then they don't need you anymore. Jeez.. Looks like what they do in hospitals are just breeding the culture of bullying and scolding the newbies. With that, the only thing being taught is arrogance and other bad examples for future generations.
2) Not expect juniors/students/preceptees to know something if you never tell them previously.
I can't help but hate the culture of "read yourself" or "go find out yourself". If I can read and find out things myself, then I don't need you in the first place -> refer to point number 1.
3) Not scold (no matter how stressed you are). If you happen to scold them, apologise at least.
Newcomers definitely will do mistake. You have been doing the same thing for god-knows-how long and how you expect these new people to be as good as you. Jeez.. Scolding them makes them more nervous and they will do more mistake. Scolding them is scaring them from asking you questions/help when they are unsure about things next time and that's when more mistakes happen. Of course if you have told them previously, you have the right to "remind" them but not "scold".
4) Remember the days when you were still a junior/student/preceptee
In the past, you were also blur. You also did not know anything. You also forgot things. You made mistakes. You also needed to be told many times before eventually you got the hang of things. So now, give your juniors/students/preceptees the time needed (vary from people to people) for them to eventually get the hang of things.
On the flip-side, from the stories I hear, sometimes the juniors/students/preceptees are in the wrong. Never do or say something that you are not sure of. Always ask if unsure. Although this can be quite tricky if you are sure of the wrong thing (like what I do sometimes). But well, sometimes have to find out why people don't ask or clarify things. Do they try to "act big and know it all" or are they too scared because of the seniors will scold and look down?
For now, I am thankful for the place I am in :D
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