today,
2/2/10
am: OPD saw a patient of habitual dislocation of bilateral shoulders examined her found how recruiting the infraspinatus can help in reducing the dislocation rate. Kibler’s concept of core stability to have good shoulder stability was explained. The patient had a proprioception problem.
pm: observed a reverse total shoulder arthroplasty
3/2/2010
Am: Rooms: pt with subluxing extensor tendon of the middle finger; pt with complete tear of the rotator cuff rt shoulder with ac joint artrhitis:pt wanted surgery we’ve put him on inj in the shoulder
Gave b/l first cmc joint steroid injections
Pm: rooms at St George clinic
Saw say about 20 of Malone’s personal patients. Many were interesting. One valid point was if subscap tests are positive and you find normal subscap at USG, suspect ant capsulitis and go for steroid in the Gh joint. The other is the test for PLRI. Saw a patient of PLRI secondary to cubitus varus post traumatic. Met a patient with gr III Ac joint disloc who has been planned for Tightrope. Clinic got over by 9 pm....walked down to the hostel...reached at 9 45.
Things to read:
Subluxing extensor tendons
Ac arthritis
Reverse total shoulder
Habitual shoulder dislocation
PLRI
Morrey is a good book for elbow. Hope I get it from the library. I would love to read it. I would also send a paper for the Ediburgh shoulder meeeting in Sep 2010.
Got to go to southern cross at 8 in the morning. May be a half an hour walk. Should have to wake up at 6 30.Bye.
4/2/10
Went to southern cross in the morning...did not find Ian thr was told he comes in the evening...went around to look for a coupla flats...got walking all the way...
Hectic list in the afternoon..8 patients...no time to think...2 knees and 6 shoulders...got to scope both the knees
Went on to put the portal and do diagnostic in 4 shoulders...make anterior portal in one...very efficient surgeon...i admire him
He was a real good teacher...love him for that....he did 5 subacromial decompressions and i double triple row repair of supraspinTUS TENDON. Wonderful Man!
Saw how efficient the whole team was!
Had dinner there at the hospital tea room
Will catch you again tom..have to go to Burwood in the morning at 7 is the bus...see you then...bye
5/2/10
Was up at 6 45 ready by 7 15 reached bus station at 7 30 was in the hospital at 8 00 had four cases two metal exit one shoulder arthroscopy and open cuff repair one scaphoid fracture fixation with bone grafting by dorsal approach
Was over by 2 pm
Went to st george’s waited for some time to meet Khalid over there...nice man...he took me to his house wonderful family they have got....he gave me a book on shoulder surgery and a suture table to practice...and a journal to read for the weekend....for the Friday meeting...
Has asked me to talk to Chetan about the AC joint thing...will possibly mail him tomoro...talked to mom dad yesterday...really felt very well...goin to sleep...
Had naan rice and malai kofta for 10 $ really wonderful and tasty...it’s a restaurant called little india...
Am goin to move to the room tomro any one either at Bealey ave or at sherbourne street...at the end of the day... Sherborne seems to be good...lemme think tonight...
14/02/10
Am one of the laziest buggers around....have not written a diary for so long
I have moved into a new house and it’s more than a week now...8 days
The house at Sherborne street
It’s good...my flatmates are Sam a chef from Auckland, Kathie from Korea learning English, two American girls and a french couple.
Today is Sunday.
Planning to do some useful work
Nothin I am gopin to gain from all this nuisance....drinking, partying and dancing to hip hop;;;
Every city is the same.
It has got people who try hard to earn money to spend it just to keep themselves on par with others;
Life runs in running after unnecessary things just to show;
Later on it becomes a routine that the inner motive is forgotten; a false sense of joy and satisfaction comes;
I have come here to learn shoulder surgery; I have to get serious; no time to roam around like a dog.
I have a lot to study. I see my consultants have worked hard and are still working so hard to keep up to their skills and knowledge. I am shallow and ignorant when compared to them. I have a lot to learn from them. I remember what Prof. Kotwal had said: “ Dont show off” it decreases the prospects of learining. It shows you are not prepared to learn. Prof Kotwal is gem of a person. Even if you know, dont show off. Ok...lemme do some useful reading today.
Bye
09/03/2010
I am atttending the clinical audit in the public. It is really really interesting. Registrars prepare and present all complications in the last three months.
Some of which I noted are
- Patella TBW failure twice possibly due to malposition of wires in the distal fragment
- Short PFN periprosthetic fracture – revised with recon nail
- DHS cutout treated with blade plate but fell short and went to varus
- Immobilize communited fractures – it may displace if mobilized early
- Be careful about Tip Apex distance in DHS
- Improperly contoured 3.5 DCP for fibula may pull out the diastasis screws
- Short PFN has larger proximal screw than Long PFN and the biggest long PFN is 10mm
- Look at X rays very carefully – can miss out subtle fractures
- Never be overconfident!!!!!
- --------do-------------
- Longer neck cut – overbroaching – calcar fracture
- Primary pyomyositis of hip!!!---?
14/03/2010
Much has happened since I last wrote. Most notable were my reading of “Half a life” and watching of “mystic masseur”. Both are stories of V.S.Naipaul, UK based author of Indian origin born in Trinidad. His childhood and his parentage are well traceable from his stories. He in the book talks about the problems or issues with people of mixed parentage. The hero of the novel happens to be one. His is father is a brahmin and his mother is a lower caste woman. In depicting his father, Naipaul has talked beautifully about the mundane man who is very comfortable in his routine life akin toa jail, ignorant or acting to be ignorant of it. His father breaks it by marrying a lower caste girl and then starts the problem. The hero, Willie starts hating everyone responsible for his status as a boy of mixed parentage, all including his father and mother. His father, he thinks had no direction and no ambiton and lived a wasteful life as a sant in an ashram. The author beatifully describes willie’s life and how he becomes very much alike his father.
We all seek hiding places...we all want to run away from problems...we want to be ignorant of problems and we are always afraid of losing the current comfort when it comes to taking up a challenge. That is how a common man is born, lives and dies. Willie’s father was expexted to lead a similar life marrying a same caste girl and working in the government for a maharaja. But he was not ready for that. But he was unsure of the next action plan. In a way, as the author says through him, he was destined to become a mendicant and run an ashram.
Willie sets out to study in London. He lives in London for three years. He writes stories and publishes them as a book.
Every man looks out for a woman who can accept and love the man as he is and more than that love for what he is. Willie is also on constant search and finds a woman in Ana. He becomes ready to do anything for Ana. He sets sail for Africa which is Ana’s place and lives there for 18 years.
An interesting story which has strengthened my desire to write. I will try and write as much as possible. The mystic masseur is another wonderful story about a pandit in Trinidad, his life and his acheivemnt.
A book appeals you only if you can identify yourself with some of the charachters in the book. Atleast that is how you start reading books. I have this peculiar instinct of doing stuff I see. If I read a book, i feel i should write one. If I hear a song, I feel I should sing.
Sam is sitting next to me and happily smoking a joint. He is a happy man. He always says I do what I like to do and I am happy. I really doubt if he ever wanted to be useful to others. I always wanted to be useful to others. But deep inside, being useful to others was a way to find your own identity and establish your own recognition. Of course, no one in normal ego life can live without that motive. This constant urge was which took me to New Zealand with all the arrangements made by almighty. When it comes to trusting him, then all arguments cease. A complete trust in Lord alone can deliver us out of the cycle of pleasure and pain.
I am finding a hard time figuring out the right statistical test for my analysis. I regret for not concentrating in the statistics workshop which i attended in Sep last year at lucknow. Every move of God has a purpose. The purpose is to deliver.
I am realizing that I am weak in English vocabulary. I have to figure out a way to improve it. I was reading the biography of Naipaul .This man does not have a straight personal life. After marriage, he was roaming with another married woman it seems. Writers or men with that bent often live in their own world.
I have to work on only few things:
- Shoulder – enriching my knowledge and skills
- Being truthful to my consultants
- Physique – very important
- Discipline – Self discipline
I ‘ll start writing my book soon.....:) Of course with Almighty’s direction!
22/03/2010
It’s been a good long weekend....
Went to Akaroa y’ day
In car
With Kathie
87 kms...
Went on the cruise
Went trekking
Had good food in the night
Contemplating now
Met Mr Mo Chaudhry on the cruise...he is a 65 yr old young man....gave me some advice
To make maximum use of this age
It seems i will regret later
Kathy’s advice was to hang out with girls...so that i can improve myself
Improve myself in taking care of my future wife
We set out from our house at about 8ish..
I’m receiving some good comments on the photos in orkut
I get into these things pretty late i suppose!
23/03/10 8 15 am St George’s OT
It’s been a thunderous night y day and i excused myself for getting up later than i planned today. But i am worried that I am not able to execute what i plan. I should be able to run for atleast half an hour from tomorrow.
Learning is on the lower side. Should start studying again..as hard as possible.
Not hardly....
8 pm Leinster chambers:
Looking into some literature...
Have to do a lot of reading!
Loads of other work to do as well!
Bye!
28/03/10
Complacency creeps in without notice. It is anature of the mind without thirst. It symbolises idleness and a harbinger of downfall. The urge to stay ahead is what pushes a man forward.
31/03/10
Morning, had a X ray session with Mckie, good Ilizarov case- done with TSF
