CVS module

Start of CVS module..

Currently, I am still in "HOLIDAY MODE". I'm not into studying rite now. Gosh, help me. Give me back my spirit. haha.. ni semua cuti punye pasal. I can't wait to have another holiday.

My laptop is in trouble rite now. What should I do ek?.. Should I reformat or whta? There's a pop up window comes out everytime I switch on the laptop. However, it doesn't affect anything. I am just afraid of the consequences.

Oh, I forgot to tell the story of my holiday. I've been spending the whole first week at my sister's house being a baby sitter. Okay, it was fun since I like kids. hehe.. the second week, I went to Bukit Merah. This time, I went with my cousins. It was also fun. That's why I said it's not enough. I want more, u know.

First day of CVS, I had PBL. Nah, ambik ko. First day lagi dah ade assignment. For the first week, there were lots of lectures. I'm getting bored each time. I can say that CVS is the toughest module at the moment. Even MSK is much simpler.

" Influenza A infects the MRSM's students "

Salam

Berita Utama had reported that 199 students of MRSM Kuantan, Pahang had shown symptoms of Influenza A. What a surprising news, rite! However, there is no sign of virus H1N1. Also, students of SMK Sultanah Bahiyah showed the same symptoms. Luckily, there is no sign of virus H1N1 in those students.

Source:Berita Utama TV3

Influenza A H1N1

Salam..

Referring to the title, this disease had infected our citizen which means we are in trouble! The second person confirmed to have that disease is Perakian. So, I am expecting the next case will be in Perak (hope not since I live in Perak). Let us be extra careful with our hygiene and health. I am really worried if this case become worst when I starts school the nest semester. Let us pray that this will end soon.

Meningitis, leptospirosis and influenza A H1N1. All these disease come at once in our country. All the diseases are also fatal. The question is "Why?". Is it a sign of unhealthy lifestyle or poor medical practices? I just read on the paper today regarding this topic. The columnist give her opinion about our current situation. She says even with all the advance technologies in medical field, it can never go against the fate, against Him. I agree with her coz it's true, isnt it?? Even with all the new findings and advance technology, we still cannot find the cure of certain diseases and yet new diseases are produced.

swine flu?

New virus had invaded Mexico. Until now, there has been 152 people die due to this disease. and 1000 and more are under medical attentions. The worst is , it can spread via air which every single living things need for breathing process. That's why it can spread from human to human. Before this, the bird flu spread by a vector. WHO had declared that the swine flu is at stage 4 which means it is very dangerous. The virus, aH1N1 virus now had spread through America and the latest news is that the pandemic is believed had also spread to South Korea. Oh my God, Hope it will never cross the border.

Scientists said that they had never ever found this type of virus which is a combination of bird, pig and human's virus. Until now, there is no vaccine to cure this disease or i can say pandemic. Yes, it is a pandemic. This thing is getting serious in Mexico. All public buildings including schools had been closed for public until 6th May 2009. *What a long and terrible holiday for the students* . Luckily, there has been no single case in Malaysia. Hopefully, it doesnt come here.

The symptoms are the same as a normal influenza but there is a URT problem on the patient. The patient will have difficulty in breathing. So, I'm saying for those people who has fever at the moment, please seek for medical advice right now. Although the disease not reach Malaysia yet but who knows..

" Top 10 medical breakthrough in 2008 "

1. First Neurons Created from ALS Patients



Researchers at Harvard and Columbia reported a milestone experiment in July, using a new method — one that doesn't require embryos at all — to generate the first motor neurons from stem cells in two elderly women with Lou Gehrig's disease, or ALS. The technique, developed by Kyoto University scientist Shinya Yamanaka in 2006, involves reprogramming a patient's ordinary skin cells to behave like stem cells, then coaxing them into the desired tissue-specific cells.


2. Inflammation vs. Cholesterol Half of all heart attacks in the U.S. occur in people with normal cholesterol levels. Baffled? So were doctors. Smaller studies had hinted at the link in the past, but Ridker's recent research, showed that when people with normal cholesterol and high levels of CRP — a protein marker for inflammation in the blood — took statins, their CRP levels plummeted and their heart attack risk fell 54%. Compare that to the 20% reduced risk in people who take statins to lower cholesterol alone. Doctors say cholesterol and fatty plaques are still the main indicators of heart disease, but inflammation may be just as important, playing a key role as a trigger: It increases the instability of plaques, making them more likely to rupture, block heart vessels and cause a heart attack. ( inflammation is more dangerous..scary!! )


3. Scarless Surgery



A team at the University of California at San Diego performed the first such appendectomy in the U.S. in March, using camera-fitted scopes to guide the removal of a woman's appendix through her vagina. The technique is also helping some gastric bypass patients whose stomach tissue has stretched out post-surgery; doctors insert a scope through the mouth and gather up the stretched folds to shrink the stomach back to a smaller size. The technique isn't completely incision-free — surgeons make small cuts through tissue inside the body — but by reducing incisions through the skin, it could reduce pain and infection and promote faster recovery for some common surgical procedures.



4. Genomes for the Masses

Now you can map your entire genome and reveal some of its many secrets — for just $399 and a little spit. Right now, there's no way to know whether you'll get cancer just because you have the gene, but once the science has advanced, the hope is that such genetic mining will predict disease, giving people the option of seeking treatment before they get sick. ( Isn't $399 is little?? I mean for the American. I thought it would be more expensive. )


5. New Genes for Alzheimer's

There is no cure, no vaccine and no way to diagnose Alzheimer's disease without an autopsy. But there may be hope in the discovery of 4 new genes that contribute to the most common form of the disease. The newly identified genes may shed light on how to keep those nerves alive, which may be a therapy for the Alzheimer's patient in the future. Even more exciting, one of the genes produces a protein that nerve cells use to communicate, another function that declines when Alzheimer's sets in.

6. A Five-in-One Vaccine


Any parent can appreciate how much babies hate shots. So, welcome Pentacel, the first vaccine to immunize against five diseases at once — diphtheria, tetanus, pertussis, polio and haemophilus influenzae type B. The vaccine was studied in more 5,000 infants, who showed only minor side effects, including fever, redness and swelling at the injection site. Pentacel still has to be administered in four separate doses, three times between the ages of 2 and 6 months, then again between 15 and 18 months — but it cuts down by 30% on the 23 injections toddlers under 18 months normally receive. ( These days, children are so lucky. )

7. Gene Screens for Breast Cancer

Gene screens are fast becoming a powerful tool, not just for diagnosing cancer but for treating it as well. Breast cancer patients are also increasingly relying o n another gene test, OncotypeDx, which can determine the risk of breast cancer recurrence and which chemotherapy agents will work best against a particular tumor. So that chemotherapy will not have lot s of side effects to the patient.

8. Blood Test for Down Syndrome

One of the best ways to confirm Down syndrome before birth is by amniocentesis, which uses a needle to remove a sample of the amniotic fluid surrounding a fetus. However, there is a risk of miscarriage in this test. Now, a new genetic test may be able to pick up the disease with a simple blood sample from the mom-to-be. Because small amounts of fetal DNA enter the mother's bloodstream, the test is designed to detect abnormally elevated levels of chromosome 21 (an extra copy of it causes Down) in the mother's blood, which would indicate a baby with the disease. However it is still in the development stages.


9. Seasick Patch for Cancer Patients

Those motion-sickness patches can really help calm a churning stomach on a boat. So, someone decided to apply the same idea to deliver anti-nausea drugs to cancer patients after chemotherapy. One smalll thing can give benefits to two different disease.


10. Stem-Cell Trachea Transplant

In a transplant first, doctors in Spain gave Claudia Lorena Castillo Sanchez, 30, a new windpipe, constructed from a donor trachea lined with Sanchez's own stem cells. It's the first time a patient's adult stem cells, extracted from bone marrow, have been used to seed a new tissue or organ for transplant. Because the donor trachea was stripped of cells that could cause rejection, Sanchez, who suffered from tuberculosis and lost function of one branch of her trachea, avoided having to take the powerful immunosuppressant drugs that transplant patients normally require. Doctors expect that this type of transplant, which is still experimental, will need several more years of study before it becomes widely used. But Sanchez, for one, is happy she didn't have to wait that long; the mother of two is already back to work and enjoying dancing six months after her operation. ( A happy ending story.)

BELL'S PALSY

Salam and good day.
I wanna share with you my experience that will happen to only 1 of 5000 people in the world.

When I was in form 1. I had this neuro disease. When talking about disease, especially that is connected to the brain, people will get terrified. I had the idiopathic disease called Bell's Palsy. Actually, scientists believe that it is caused by viral infection. Luckily, I did the treatment early that I can recover fast.

WHAT IS BELL'S PALSY?
Bells palsy is a condition that causes the facial muscles to weaken or become paralyzed. It's caused by trauma to the 7th cranial nerve, and is not permanent.

WHY IS IT CALLED BELL'S PALSY?
The condition is named for Sir Charles Bell, a Scottish surgeon who studied the nerve and its innervation of the facial muscles 200 years ago.

HOW COMMON IS BELL'S PALSY?
Bells palsy is not as uncommon as is generally believed. Worldwide statistics set the frequency at approximately .02% of the population (with geographical variations). In human terms this is 1 of every 5000 people, and 40,000 Americans every year.

IS BELL'S PALSY ALWAYS ON THE SAME SIDE?
The percentage of left or right side cases is approximately equal, and remains equal for recurrences. ( I was on the left side.)

IS THERE ANY DIFFERENCE BECAUSE OF GENDER OR RACE?
The incidence of Bells palsy in males and females, as well as in the various races is also approximately equal. The chances of the condition being mild or severe, and the rate of recovery is also equal.

WHAT CONDITIONS CAN INCREASE THE CHANCE OF HAVING BELL'S PALSY?
Older people are more likely to be afflicted, but children are not immune to it. Children tend to recover well. Diabetics are more than 4 times more likely to develop Bells palsy than the general population. The last trimester of pregnancy is considered to be a time of increased risk for Bell's palsy. Conditions that compromise the immune system such as HIV or sarcoidosis increase the odds of facial paralysis occurring and recurring.

HOW DO THE SYMPTOMS OF BELL'S PALSY PROGRESS?
Very quickly. Most people either wake up to find they have Bells palsy, or have symptoms such as a dry eye or tingling around their lips that progress to classic Bell's palsy during that same day. Occasionally symptoms may take a few days to be recognizable as Bells palsy. The degree of paralysis should peak within several days of onset - never in longer than 2 weeks (3 weeks maximum for Ramsey Hunt syndrome). A warning sign may be neck pain, or pain in or behind the ear prior to palsy, but it is not usually recognized in first-time cases. ( my warning sign is pain behind my left ear and it only takes two days to be recognizable after the onset for me)

IS BELL'S PALSY CONTAGIOUS?
No, it is not contagious. People with Bells palsy can return to work and resume normal activity as soon as they feel up to it.

WHAT ABOUT RECOVERY FROM BELL'S PALSY?
Approximately 50% of Bells palsy patients will have essentially complete recoveries in a short time. Another 35% will have good recoveries in less than a year. ( I was in the 50% category. Thank GOD)


IS BELL'S PALSY LIKELY TO HAPPEN AGAIN?
The possibility of recurrence had been thought to be as high as 10 - 20%. These figures have been lowered as more has been learned about conditions that are now diagnosed as other types of facial palsies. Estimates of the rate of recurrence still vary widely, from around 4 - 14%. Most recent reports hover at 5 - 9%. The average timespan between recurrences is 10 years. (Hopefully, I will not)


Bells Palsy is caused by an inflammation within a small bony tube called the fallopian canal. The canal is an extremely narrow area. An inflammation within it is likely to exert pressure on the nerve, compressing it. Likewise, if the nerve itself becomes inflamed within this small canal, it can encounter pressure, with the same result of compression. The nerve has not yet exited the skull and divided into its several branches, resulting in impairment of all functions controlled by the 7th nerve. If only part of the face is affected, the condition is not Bell's palsy. If, for example, the mouth area is weak but the forehead moves, Bells palsy is ruled out.

SYMPTOMS

GENERAL	EYE RELATED
Muscle weakness or paralysis Forehead wrinkles disappear Overall droopy appearance Impossible or difficult to blink Nose runs Nose is constantly stuffed Difficulty speaking Difficulty eating and drinking Sensitivity to sound (hyperacusis) Excess or reduced salivation Facial swelling Diminished or distorted taste Pain in or near the ear Drooling	Eye closure difficult Lack of tears Excessive tearing Brow droop Tears fail to coat cornea Lower eyelid droop Sensitivity to light
RESIDUAL EFFECTS Eye appears smaller Blink remains incomplete or infrequent Tearing abnormalities Asymmetrical smile Mouth pulls up and outward Sinus problems Nose runs during physical exertion Post paralytic hemifacial spasm Hypertonic muscles Co-contracting muscles Synkinesis (oral/ocular well known, but can affect any muscle group) Sweating while eating or during physical exertion Muscles become more flaccid when tired, or during minor illness Muscles stiffen when exposed to cold, when tired, or during illnes

That's it. The blue bold ones are the symptoms that I had experiences since it differs among people.

pre med - part 5

THE LAST WEEK

It was the last week I would be here for this course.. Sedar tak sedar, it had been 5 weeks already. the scariest thing is the exam on the friday. We didn't had much time for revision. During our foundation, we were given a week for revision but now we were given only one day to revise. how could we revise in one day?? Unfortunately, I had to accept that this is what medic is all about.. everything must speed up including revision.To top of that, we still had another syllabus on that last week and it was about the liver and gall bladder. It was interesting but yet lots of things to be remembered and learned and that topic will be tested on Friday of that week too. So, I had to cram up my brain with all this stuffs within the few hours of lectures.

The exam consist of three parts altogether. The first part is MCQ questions..Kind of easy, rite? Actually, it's not..Because marks will be deducted for every wrong answer. So we cannot use the principle that our former teachers told us during our secondary school which is " try to answer even if you don't know".. The reason is, doctors should not make wrong choices in real life. If we dont know, then dont try guessing. It's totally dangerous. The MCQ was held for 1 hour with 100 questions (see? I tell ya, it's not easy). Then after 10 min breaks, the essay question started. The essay consists of three questions, each on every subject: anatomy, physiology, biochemistry. We had to choose one question only. The exam is for 15 minutes. Then we have this test called OSPE. The exam had 20 stations with different kind of question and stimulus. Then we answered those questions in turn. One station is for 3 minutes. Here it goes. First we have to answer a question from one station. It does not necessarily to start at 1st station. It can be either the 20th station or any station too as long as we rotate and answer all the questions. As soon as the ring bells, wehad to switch to next station. It goes on like this until we answered all questions and returned back to our first station. Looks like fun, rite? It was fun though 3 min is a very short time. And the questions were actually simple yet confusing. That makes the exam difficult. I had done my best, so I hope I will get the "blue pen" result =D

pre med - part 4

FOURTH WEEK

Second last week was not very hectic. We learnt about gastrointestinal tract or commonly called GI tract. Not so much new things, because we already learned this during our secondary school. Just a few adds here and there. The schedule for this week also was not packed compared to the second week. Probably because the lecturers wanted to give us time to study as we will sit on the exam on the week after. I want to share a few things that I learned before. GI tract is a continues tube-like tract in the body begins at mouth and ends at anus and its function is to digest food and absorbs nutrient essential for the body. Those which are nonessential is eliminated through a process called deafecation. Digestion mostly occurs in the small intestine. In order to digest food, there were lots of muscle movements(peristalsis and segmentation) and secretions (saliva, gastric juice, pancreatic juice, bile) occured. The movements and secretions are controlled by the nervous system and also endocrine system. Apparently, the muscle movements are all involuntary reaction. However, some secretions are controlled by nervous and some are controlled by the endocrine system due to hormone regulation. The most common hormones involve in this process are Cholecystokinin (CCK), secretin, Gastrin and Gastric Inhibitory Peptide hormone. CCK stimulates the secretion of pacreatic juice and the contraction af gall bladder. Secretin stimulate the production of bicarbonate ion (to neutralise the chyme). Gastrin enhances the secretion of pepsinogen and HCl in gastric juice also stimulate the growth of stomach cell. GIP inhibits the secretion of Gastric juice (when no food enters).

pre med - part 3

THE THIRD WEEK

It was the "bestest" week of all the weeks although it was very tiring.. I had to woke up at 5 in the morning.. We had a round tour at Sg Buloh's hospital, Selayang's hospital and Primary Care clinic. We also need the signature of the dr that were responsible for our activities. I did had a lot of fun time there and of course there were bitter memories too. But I prefered not to remember the bad ones.

Going to Sg Buloh..yey!

Our first hospital was Sg Buloh's hospital. We were welcomed by nobody so we wandered around the hospital and lastly aour class rep asked the clerk in the office. Then, we were brought to the lecturers' office. We had a short chit-chat with Dr Omkara Rubini Lingam (I thought he was a "he" but apparently he had turned to "she"..hehe). Actually, she is the one who was in charge with our visit to Sg Buloh. The first day there had been the "capture photos" day. We were brought around the hospital, to several wards and to the lab clinic (the clinic used by medical students for their practical).

Tu sambut raya ke?? ~^

Girls are dominant and the power is in our hands..yeah!

Who's the patient???? Who's the doctor???
And we had been caught red-handed playing with the weelchair..
huhu..

We have to wear labcoats in the hospital.. *peace*
Who's that guy?? Couldnt see his face..
I guess the camere didnt like him..ahk2

I still remember this ENT specialist that was in charge of us in Sg Buloh, her name is Dr ruzanna I think. She was very kind towards us. She motivates to become a persistent dr in the future. The funny part was she had a lot of advices on our marital age, on how to be a good dr and a good wife and also how to choose a husband.. funny because i never think about that yet.. What I can say, she is a good dr.

On wednesday, we had our visit to Selayang Hospital. The surrounding was really different compared to sg Buloh. There were lots of medical student too. We could see medical students anywhere we go. We were welcomed by Prof Hashim, a gyne (thank God!) and we also attended his class with the 3rd year medical student. I felt awkward because we actually didn't involved in the class but we "WERE" in the class. The lecture hall was superb. There were video cameras on the ceiling and our face suddenly appeared on the scrin. haha.. Seems like stars..There was also a technician room at the back of the class. Just like the studio where the artist do recording. In other word, it was amazing and really comfortable compared to our current lecture hall. On top of that, we didn't understand what were they talking about. If I were the third year student, I will be very tense. Ya, you know when people watching, you will never feel normal, rite? Then we were split to 2 groups. I was in the first group. My group was supposed to have a tour in the medical ward. The doctor who was responsible to lead us is very handsome (that's the main point) and respectable although he is literally strict. "Dont touch my patient", "The patient's condition was confidential", "I cannot emphasize more on that".. Those were his words that he said repeatedly. But seriously, he is HANDSOME. (Oh, I fell in love with him..hehe). He let us to interview his patient. He also taught us the technique of interviewing the patient: What should be asked, what should not, how to ask systematically, what is the criteria needed to be asked to the patients and others. The experience of interviewing the patient was a memorable experience. Thanks to our patient who was very cooperative.

girls power at Selayang's lecture hall..
really BIG isnt it?

I am the technician woman..hehe (change profession)

In the evening, we were supposed to visit the surgery ward but somehow the lecturer werent there. We waited the whole evening for nothing. One sure thing is, waiting is really tiresome. We also lack one signature that day. huh!.. I was not sure if i like this hospital or not. On the next day, we had ou r visit to the peadiatrics and gynecologist wards. Both were interesting wards.the kids were so cute although they were sick. The labour rooms were fulled!! and we had ann experience of watching a newborn baby in the resuscitation room. It was really fascinating watching the baby squirmed. How small he is! This remind me to the powerful God who gives us life and capable of take that back anytime He wants. Unfortunately for the other group, they didnt had any tour at all on that day. There werent any lecturers came to them. They were really frustrated waiting or the whole day long for nothing.

Finally, the visit to hospital was finished. We also visit the primary care clinic in Tmn Ehsan, Kepong.. There were crowd of patients in the clinic. The purpose of going to this clinic is to brief us in the importance of primary care. The lecturer that gave the speech was handsome and he delivered it energetically. After that, we were allowed to tour around the clinic. We were also free to asked any questions to the waiting patients. The best part was when I was in the OPD (Out patient department).The dr asked us to help him..haha.. i felt thrilled..Unfortunately, we didnt take any photos there.. huhu

pre med - part 2

The SECOND WEEK

The second week was very tough..
A lot of classes and lots of things to be digested in 5 days..
We learnt about the CVS and RS.. 2 systems that interconnects intimately.. Both are very important systems.. Not to mention musculoskeletal system.. All three systems in a week? Wouldn't had imagine I managed to do that...
There's a lot of things but since we were in pre-med, NOT medic yet, so we learnt superficially..
I could'nt write down all the terms.. There's too much this week.. Probably the most hectic week of all the 5 weeks..

I met this lecturer in the practical class of anatomy. He was sooo "funny" (actually not funny but I dont know how to describe it..hehe). He always strays from the real topic . And lastly we learnt by ourselves helped by the member from the other group because we couldnt stand him anymore..hehe. Kind of lack of respect, rite? But truely, he was very slow and sometimes his words were not understandable.. The fact that he is from Myanmar doesnt suprise me that his english ascent was different.He also asked us to explain again what he had explain again and again. No members are excluded except for yanie (eii..unfair btol!). I still remember his face, his smile, and his gesture. The most favourite thing that I couldnt forget is that in every class that he was in charge, he started it with an introduction NOT about the topic of the day, but about "CELL IS THE BEGINNING OF LIFE".. haha.. I think it was his trade mark. He also loved to ask questions and the questions must be answered.If not, he will kept asking. When I was in his class, my "silent mode" was turned off (Usually it was turned on during other lecturer's class..=D). The feeling was very calm..or org kata santai gitu..

pre med

I had entered this short program of about a month..
I would like to "cremate" my experiences of this pre-med program..

The FIRST WEEK:

The first day was very hectic. We got lost on the first day.. medical faculty is joining with mechanical faculty and we still lost..
It was all about introduction..
We were introduced to the lecturers..even the deputy dean was also there (what a shock!)..
We were also had been given briefings about the whole medicine course.. What is all about.. And most of the lecturers were expecting too much from us.. That made me feel suffocated because of too much expectation..
Then we were given module.
At the first glance to my module, I could say that the coordinator is very good. When it came to pronouncing her name, my tongue was twisted..Her name is Dr Damayanthi Durairajanayagam (Try to say it fast )..
There were a lot of foreign lecturers actually but mostly are indians. I wonder why there are lots of indian lecturers? Does Malaysian lecturers do not qualify enough to become the lecturer of medicine? I could hardly counted the number of Malay lecturers in the medical faculty..
The thing is most Indians do have good english but you know how they pronounce the words.. It was very difficult at first to understand what they were talking because they talked too fast. I couldn't cope up.. Gradually, it became much easier.. Well, everything is hard at first, rite?

During the first week, we learnt about the blood pressure of human body and nomenclature of the anatomy. I listed here:

Plane
1. Saggital plane
2. Mid saggital plane
3. Transverse plane

Relative to direction
1. Superior
2. Inferior
3. Lateral
4. Medial
5. Proximal
6. Distal
7. Anterior
8. Posterior

Relative to movement
1. Pronation
2. Supination
3. Reflexion
4. Extension
5. Protrution
6. Retrution
7. Circumduction
8. abduction
9. Adduction
10. Opposition
11. Reopposition
12. Dorsiflexion
13. Plantar flexion
14. Inversion
15. Eversion
16. Elevation
17. Depression

We also learnt about the blood pressure phisiologically..
Blood pressure depends on cardiac output and also total peripheral resistance..
Changes in the cardiac output or TPR can cause hypertension and hypotension..
BP is always stated in 2 numbers (systolic/diastolic) and measured in mm Hg.
The device that we used to measure bp is sphygmomanometer (pronounce it is worst than spelling it.Believe me) together with stethoscope..
BP also depends on our physical condition. Exercising, anxiety, fever, posture and many other conditions affects our bp.
Apart from the sphygmo thing, we also learnt about a new device to measure our breathing properties which is so called a spirometer. It was very hard to get an appropriate result. We can also estimate our lung age. Guess what, my lung capacity is enough only for 60 yrs more. I think there's a problem in the experiment. hehe
I think that's all about the first week. I think that is easy. BP, who doesnt know what it is?

Apart from all the bp things, we did entered the anatomy lab with cadavers in it! Sounds really creepy, huh? hehe..but na.. it's not creepy at all. I didn't even had goosebumps but it was a little bit scary. And the formalin was very ... i dunno what to say.. The odour was very pungent. It went straight to the nose and eyes.. then I started to got cough and my eyes started to tears.. That's the side effects of the inhaling too much formalin. There were about 8 adult cadavers (I think so) and 2 baby cadavers.. I couldn't imagine how I'm gonna dissect it in the future.. I felt sorry for it.. Juz to mention it, the cadavers had been kept there for 5 yrs.. that's a long journey..