Polycystic Ovarian Syndrome (PCOS)

PCOS is a condition in which there is an imbalance of a woman's female sex hormones. Copyright © 2012, A.D.A.M., Inc.


The symptoms for PCOS include changes in menstrual cycle. Changes as in you may experience amenorrhea (absence of menstruation, for months, on irregular basis) or after a few months, the cycle gets normal. In addition, the number of days of menstrual flow could be irregular too as well as the amount itself. it may gets heavy at times and some cycles may prolong for more than 5 days or less.  This is due to the imbalance of estrogen and progesterone (the female hormones) in your body, imbalance as in it's either too high or too low, and not of normal range. In simple words, on the first 5 or 7 days of your cycle, the endometrium wall sloughs off, this is the menses. Estrogen (produce due to the release of follicle in the ovary which slowly grow into ovum) level slowly rises since the first day until the 14th day in which ovulation (release of egg) occurs due to a surge in lutenizing hormone(LH).  the growing follicle release the ovum and degenerate into corpus luteum and produce progesterone. so, now, your progesterone levels slowly rise. Under the influence of estrogen and progesterone, the endometrium wall continues to thicken, to prepare for implantation and blood supply of your foetus. However, if your ovum are not fertilize on the 14th-15th day, the corpus luteum eventually degenerate and cause a drop in both progesterone and estrogen. so, the drop in both the hormone actually cause the sloughing off of endometrium wall and your menses begins. it is another cycle! 


Next, the symptom includes an excess of male hormone and possess masculine characteristic notably hirsutism (excess hair), acne and deep voice under the influence of excess testosterone. testosterone is derived from cholesterol, synthesized in the body or from the diet. testosterone gives rise to the female hormones just now. so, i was just thinking that the high testo cause high estro, and we need a low estrogen to trigger the menstruation. and a high estrogen also inhibit the production of follicular stimulating hormone to trigger the growth of follicles hence the egg production. therefore, ones with PCOS has infertility too.


In addition, one with PCOS have the symptoms of gaining weight easily. they might appear overweight or obese!




Guess what. i have been having the sign and symptoms of PCOS since forever. i thought it was the stress that cause my irregular menses but then when i was in the obstetric & gynaecology (O&G) clinic, [clinic is where i get to learn the most, even get to palpate a few pregnant ladies today. but clinic also signifies eternity standing and straining of my back] a girl presented with such condition and PCOS was the diagnosis. And her presentation was exactly the same as mine. i have irregular menses and i havent have my period since last chinese new year! this is not the stress i am very sure. do i have hirsutism? probably but not so very obvious like growing the mustache hair. And i defnitely have mild acne problems. it could be diet though. And lastly, i have weight problem. no wonder i never lost weight and always that heavy. haha?! expect to lose some weight with my binge eating and gorging of food? 


gawd. i think i am seriously in big trouble. do i need to go for checkup too? but if the diagnosis is also PCOS, i would probably have to be on hormone therapy. i dont mind being infertile though. it's not as if i am having kids or planning to at the moment. the weight problem and acne thing bothers me a lot though. actually i have been ignoring this problem for a very long time that i couldnt even remember when. now finally get to know that my presentation has been about PCOS. i feel sick.

book of tomorrow

spend my day watching Grey's Anatomy. now. it seems like everything starts making sense already. and everyone (well most of the main characters) has been on the department of surgery and no wonder there r no people from other departments like radiology or psychiatry. because it revolves only Surgery. they are trained to be surgeons from that very first season, starting from the first year internship to residency (registrar or resident), fellowship and attending (consultant). gawd. i feel like watching season 1 all over again.

instead of opening my books and start studying, i am still exhausted from everything. mentally and physically. i am such a pig. i sleep early and still wake up late in the afternoon.

i like watching GA so much. last semester break, i read on Cecilia Ahern's latest Book of Tomorrow. theres a lot of quotation inside and her words move me a lot. she mentioned that she thinks that it seems as if the books are picking on the readers not the other way round. books that come at some point of your life to give you an enlightening on matters that are revolving around you. and i couldnt agree more because the moment i finish or halfway thru, i believed every words she said in the Q&A section. Book of Tomorrow just came by my life at the right time. and watching the last few episodes of GA give the same impact to me as well. Yang has to be my favorite character. she's so much like Blair. full of sarcasism and confident. i can really laugh out loud. but on the season's finale, i especially like what Dr. Callie's saying about how life can be miserable at that moment for you (was referring to Dr. April kepner who just failed her board examination) but eventually everyone goes thru that dirt of life just like hers, it was a tough life full with ups and downs (lost her husband and stuffs) too but she's now happy and enjoying her great damn life. there are still a lot of inspirations from GA, like Meredith's. maybe i will just save that for next time. 

anyway, i should really stop pampering myself with my insane materialistic needs. i just bought myself a really cute minibar and i think i just opened the fridge door for like a thousands time a day. i feel like getting myself pretty clothes and cute(and comfortable) shoes. i should really repent on my relentless spendin.
  

god must be crazy

there is a humongous lot of things running inside my mind. it happens when i start to stop blogging for a few days and left my blog in a hiatus. it is something that i wish to keep as a consistency but sometimes days went off meaninglessly while some day brings a lot of insights. and some random day, you just cant seem to get access to internet although your mind has been actively pouring out every possible ideas on what to blog.

i shall probably start this post with my gratitude towards that omnipresent power, that omnipotent force, that Almighty Creator. now i fully comprehend the saying : pray like you've never prayed before. i have  experienced that. i was holding the incense and mumbling to the sky, to a plaque, to a statue and sudden tears start to well up in the corner of my eyes. and for a second, it was a total blank. a complete lost in thought and you are lost of words. you dont even have to say your prayer because deep down, you know that He knows. yes. you can stare straight off into the space, the whatever is pictured or reflected before your eyes but you know He was there. cant see it but you feel it. i never believe in burning the joss sticks and paper for the offerring to the Goddess or the deceased but it was more on tradition and culture. and of course, because my parents ask me to. at this moment, i was connecting the dots backward and trying to complete the mystery and my doubts. and i just couldnt believe the magical and power behind it. it's faith. i guess all things happen for a reason and for me, it just proved to me that there are really things that are beyond the visibility of our naked eyes and whatsoever science that cant prove it and the fact that i am doing medicine and not supposed to believe in any illogical, no scientific prove 'bullshits'. i just couldnt afford to give a damn because i have faith. and faith transcend possibilities. 

i am really thankful that i have made it thru this far. i am officially a third year medical student and it really wasnt an easy journey for me. i know that difficulties lie ahead but i want to make it thru again, no matter what turmoils lie ahead so badly because what doesnt kill me just made me stronger. it hits me that i want to really work hard this time. and i am really truly sincerely serious about gaining the knowledge. i dont want to live a simpleton life anymore. He has made me go thru a lot of hells but somehow, i dont know what He did to me that brings me to heaven and i love Him more. reflecting back, even if it's just mere luck, i guess there must be something 'controlling' that brings you that luck. and the same goes with the bond and realtionship with people that tie you together.    

and now it was really an exhausting day for me. i walk like a thousand miles every day, to and fro hospital. my legs feel super sore and ache so much. guess i was complaining too much while there are many who are in obstetric and gynaecology posting suffered more than i do. perhaps i should lessen my walking back home on interval between classes. gosh. never forget to mention the unending hours doing ward rounds with Miss/Mister (Surgeons are addressed this way) and stand rooted to the ground for eternity listening to the bedside teaching. it is undeniable that third year and clinical years are supposed to be more intriguing and challenging. we finally get to practice, to observe, to see with our very own naked eyes on the presentation of illness of patients which supposedly help in our understanding and tackling exam questions. but it is really stressful to know that your fundamental and basic is not solid enough that i fear someday this 'empire' i am building will collapse even though now i am trying very hard to reconstruct it and remodify the base hopefully with the help of a few contractors and engineers and architects. it really hits me hard this time that i want to study hard and smart and know things because now, it's Homo sapiens that i am dealing with. i just hope that there are no more second thoughts after all of the wasted time. frankly, there isnt any detour left for me. i am stucked here and instead of thinking a way to get out of my 'mistaken' route chosen, i better off walk till the end of the tunnel. i just want to see how far i can endure all the agony and setting my threshold of stress higher, day by day. and hopefully one day, i will become a better person. 

well, seriously there's still a lot to blog about what i have seen in these few days in the wards. trust me. it doesnt get better every day. it is really painful to see sick people. and you cant do a thing to help them. worse, when you try to seek help from those who are suppose to help, they dont even give a damn. 

a little bit of love

hah. so how is this? :D

thoughts?

they say that taking picture of oneself aka camwhoring is an act of self-loving. hah. okay. it's more on vanity.

my face looks super round right? my father was so adamant about me going for the haircut last couple of weeks. he claimed that i wont look "pretty" with short hair. just nice with long hair, the one i always wear myself as, dry, messy, unkempt and well, just plain messy and boring. yeah. so i am beautiful in my father's eyes. so mum was like, okay let's see how 'not-pretty' she is with short hair. and that took another few days before we eventually hit the salon.

well. i often do not like to take any side whenever they bound to have different opinions about things. like how mum always nag Pup to drive using a different route for just a 15 minutes ride. and how Mum would complain about Pup bad habits of random-placing of things. Of course, Pup would take revenge whenever he has his chance and moment. and if i were to present, i would just shut my mouth. none of them are always right about their own stands.

i guess it happens in every relationship. they are doing just fine. three kids and have their own careers and plenty of leisure time. and growing old. but i think i used to blog about relationship thing before on how difference relationship goes from the dating until marriage until the kid comes around and the kid all grown up. the spark they use to share seems to evaporate thru the course of time. inevitable, ive never seen them dating together and wonder if it was like those i watch in movies or read in novels. i detest seeing young couples hovering and lingering around the public place. i dont know why but sometimes it was really an ugly sight. therefore, i would really love if my parents spend their time to read The Wedding (Nicholas Sparks). not just my parents of course, to all those aging parents who lost that little something in their relationship. the book sends a great message and it has to be my favourite if i have to choose one. and today, it really warms my heart to see an old couple, holding their hand tight, the woman clutching to the man as if it was their last day of earth. and what surprise me is that they are of different ethic-the one who wear head scarf. i think i just witnessed the definition of true love.  

back to my hair, my father cant stop laughing and teasing us after we got home from the salon. Gawd. He can be really childish sometimes.i just give him the dumb and i-dont-find-it-funny look. i think he's just teasing my mum's cuz she got her hair shorter than mine, like the one you see in the 60's, 70's. i dont know. like she had just walk out from the 60's movie. anyway, i think i would go for a little trimming in the next couple of days because it has grown faster than i  expected. furthermore, it's too thick at the back.