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Tuesday, December 25, 2007

Death

...is INEVITABLE.

That's the most important thing I learned in medical school I think. I've met so many people who ask me, how can I prevent from having... renal failure, hypertension, diabetes, stroke, cancer, etc. And I've also met people who told me, I'm ready to go.

Death is inevitable, either by illness, or by sudden death from other outside sources/forces (e.g motor-vehicle accident). Yes people...we are going to die!!! We can delay those diseases, but I would say, if you've been well (i.e no chronic illnesses) for half a decade of your life, then you should be expecting it soon. You WILL GET IT, sooner or later. You may die of heart attack at age 45 years old, and yes, by standard statistic that is a young age indeed, or you may die of the same cause at the age of 85. And many factors play into that role. Important thing is, don't make it any faster.

'Dying of old age' is a term we used for those who died above 70 y.o, undiagnosed, i.e - no post mortem done, so we assume. If you want to know the real cause, then we send the cadaver for investigation, and from there we'll conclude that he/she have certain organ damage, usually a stroke, or a heart attack. We often see this people die 'peacefully' in their sleep, and I do hope so. And just because we don't know the real cause of death, doesn't mean we have to send everyone to the mortuary to be investigated. There are times when 'conditions' are 'accepted' as death by old age.

This is my third on-call since I moved to Cardiology, and this is my second death I've encountered here during my calls. Here's something I've found while waiting for the mortuary to pick up a patient's body...

  • The practice of burying the dead may date back 350,000 years, as evidenced by a 45-foot-deep pit in Atapuerca, Spain, filled with the fossils of 27 hominids of the species Homo heidelbergensis a possible ancestor of Neanderthals and modern humans.
  • Never say die: There are at least 200 euphemisms for death, including "to be in Abraham's bosom," "just add maggots," and "sleep with the Tribbles" (a Star Trek favorite).
  • No American has died of old age since 1951.
  • That was the year the government eliminated that classification on death certificates.
  • The trigger of death, in all cases, is lack of oxygen. Its decline may prompt muscle spasms, or the "agonal phase," from the Greek word agon, or contest.
  • Within three days of death, the enzymes that once digested your dinner begin to eat you. Ruptured cells become food for living bacteria in the gut, which release enough noxious gas to bloat the body and force the eyes to bulge outward.
  • So much for recycling: Burials in America deposit 827,060 gallons of embalming fluid—formaldehyde, methanol, and ethanol—into the soil each year. Cremation pumps dioxins, hydrochloric acid, sulfur dioxide, and carbon dioxide into the air.
  • Alternatively . . . A Swedish company, Promessa, will freeze-dry your body in liquid nitrogen, pulverize it with high-frequency vibrations, and seal the resulting powder in a cornstarch coffin. They claim this "ecological burial" will decompose in 6 to 12 months.
  • Zoroastrians in India leave out the bodies of the dead to be consumed by vultures.
  • The vultures are now dying off after eating cattle carcasses dosed with diclofenac, an anti-inflammatory used to relieve fever in livestock.
  • Queen Victoria insisted on being buried with the bathrobe of her long-dead husband, Prince Albert, and a plaster cast of his hand.
  • If this doesn't work, we're trying in vitro! In Madagascar, families dig up the bones of dead relatives and parade them around the village in a ceremony called famadihana. The remains are then wrapped in a new shroud and reburied. The old shroud is given to a newly married, childless couple to cover the connubial bed.
  • During a railway expansion in Egypt in the 19th century, construction companies unearthed so many mummies that they used them as fuel for locomotives.
  • Well, yeah, there's a slight chance this could backfire: English philosopher Francis Bacon, a founder of the scientific method, died in 1626 of pneumonia after stuffing a chicken with snow to see if cold would preserve it.
  • For organs to form during embryonic development, some cells must commit suicide. Without such programmed cell death, we would all be born with webbed feet, like ducks.
  • Waiting to exhale: In 1907 a Massachusetts doctor conducted an experiment with a specially designed deathbed and reported that the human body lost 21 grams upon dying. This has been widely held as fact ever since. It's not.
  • Buried alive: In 19th-century Europe there was so much anecdotal evidence that living people were mistakenly declared dead that cadavers were laid out in "hospitals for the dead" while attendants awaited signs of putrefaction.
  • Eighty percent of people in the United States die in a hospital.
  • If you can't make it here . . . More people commit suicide in New York City than are murdered.
  • It is estimated that 100 billion people have died since humans began.


  • Adios...me going back to sleep...

    Thursday, December 20, 2007

    Cardiology, Serdang



    Here I am, 3rd day after registering in JKN Selangor, then to Hospital Serdang, I'm post call today...in Cardiology...scary. They were short of people in this department, but I don't mind. After all, it's a place to learn. My Obgyn posting can wait. Besides, got time to explore

    I kept 'apologizing' to my senior specialist that I have to disturb them during the call to confirm my plan.

    For heaven sake...Cardiology!?! Thank God I went through Cardiology as a houseman in PPUM...but only 1 month!!! I now bow to my previous MO and Specialist in Cardiology. Can I cilok them with me? haha I want them back!

    Friends, pray for me...

    Friday, December 14, 2007

    My Dream House


    I've been up since 6 am, and since then, I've been working and perfecting my dream house. It's been my dream since I was a child to live in my dream house. And there are a few criteria that I always follow in drawing up sketches...

    (House Plan from above. Entrance to the RIGHT.)

    1) It shall be a single story house...provided that the land is big enough. I'm just too tired with multilevel house. I had one since I was a child, and a big house at that (7 bedrooms, for 7 kids), it's very tiring. For those who dream of big house, well, good luck to ya, coz it's not just about affording the house, but also affording the time and effort to maintain the house. Even worse, I just don't understand a house that's more than 2 story high...maybe it's the view they are after.
    2) The back yard shall be BIG! So I can have all my family activities there, with enough privacy. Love barbecue, or just simple family gathering.
    3) The front yard is enough to occupy a porch for my car, a patio with few steps, and a small greenery. No bushes! Less maintaining issues.
    4) I shall have coconut trees (or at least one). I miss having to pick coconut fresh from the trees and drink its juices like I used to in my previous house.
    5) My kitchen shall be big enough, for it is where the heart of the home is (even though I'm not a good cook)...hehehe.
    6) At least 4 bedrooms - 1 Master bedroom, 1 for my boy(s), 1 for my girl(s), and another for guestroom/study
    7) Still have space for another extension for a bedroom. I like a big family :)

    (View into my living room, facing the front door. I'd like to have extra seating by the window)

    So I've been using my hubby's Microsoft Visio, but he needs his laptop at work. So I drew roughly on my graph paper. Some of the idea are integrated with K. Ida's & Nuar's plan (my brother & sis-in-law), bless them for being so great! Then I open up my SIMS 2, which I left without playing for more than 5 months now. I used to be a SIMS addict.

    Here's some pics I'd like to share...hehehe (smiling gleefully). Hope this dream will come true soon!(View into my dining room, through a short 'hallway' where I can put my displays. And off course, my hubby's aquarium in the dining room. The door separates family area and the dining area, for privacy if its needed. It is easily open up like a sliding door for space. The living room and dining area is the same level, because in case I need to do kenduri - and my mother always reminds me - there'll be a lot of spaces without interruption)


    (My herb garden, with a small deck/patio for breakfast or tea. If you look closely, it's just outside facing the dining are. To the left is a small door connecting to my dry kitchen. This is an extra area in case the dining area is not enough. I can open the sliding door into the open air. If you can remember from the previous picture, there's a big sliding door that separates the dining area and the family room. So the small door connecting the kitchen from outside would help tremendously in terms of 'privacy')

    So far, that's the major stuff. Other's are just a matter of interior design. My kitchen has dry and wet area. Malaysian cook must have this, because it's humid weather + oily food will just destroy the furniture as well as (expensive) plates & saucers (that's what my mother told me).

    Some may say I'm wasting my time by redoing this again and again. But if I don't, it'll stuck in my mind, and I can't concentrate on other things. It's better for me to put it down, and now I can see it visually. It's great for focusing on what I want in my life. Even if you don't believe me, I'll just convince myself...hehe.

    Sigh...two more years to go and save up money! Now, let me plan how to get there :)

    Thursday, December 13, 2007

    My plan, Mama's plan, House plan, not plants!

    I'm back with touching up my house plan...woohooo. Kemas2 folder atas dresser, I found house plan the one Kak Ida made, the one yang Mama suka sangat tu. But made some changes a little, just minor feet conversions, because I can't understand in millimeter hehehe. Sorry K Ida.

    Going home this weekend...Mama is finally getting a maid. She doesn't want me to find one, coz she wants to find herself. I just prepare for the paperwork and money...$$$. Huh, punye la susah nak pujuk dia dapatkan maid. Now that I'm pregnant, I used myself as an excuse...

    "Nanti masa pantang siapa nak tolong Mama masak, angkat barang, pergi pasar...bla bla bla..."
    She replied..."Oh ye tak ye..."

    Yay! Misi berjaya. I give myself a pat on the back.

    Finally visited K Chal's Photopages! hehehe comel nyer anak2 saudara ici. Tembam2, debab2, dhomok2, grrrrrrrrr. Nak macam tu jugak! Hmm, must eat lots! I want to post pictures of them, but this friendster blog not canggih enough...hermph! Even more reason to change this blog elsewhere...Last resort is to save and post, can't link the pic to my K Chal's photopages.

    Havingfun

    Sunday, December 9, 2007

    Post Natal Care

    I received a newsletter from a site which I subscribe to eHomemakers.net

    Even if I'm not a Homemaker, but I really believe in what they do, and I really like to support these mothers. I know that knowledge comes not only from school books and money doesn't always come from working for other people.

    So I read through the advertisement and saw Shadira's Post Natal & Beauty House. I'm so glad there are still people saving our old traditions. There's nothing wrong with maintaining the old ways and improvising it with new knowledge. After all, knowledge are God's gift.

    Not everyone is blessed with a Kampung anymore. I'm just glad my mother knows how to get the herbs, and basic things to do during confinement period like bertungku. But for those who wanted the service but unable to get because they don't know where to get?

    So for those who are living in KL area (Shadira's is around Bandar Tasik Selatan), and in need of extra help, or even just a post natal massage, here's where you should go http://www.shadirabeauty.com/index.html
    I'm sure they are very affordable. In fact, maybe they even provide trainings for other possible home makers out there. I hope their business grows ;)

    Saturday, December 8, 2007

    Must Change Perception!

    I small talk to hubby.  He reassured me my dream house will be built in abt 2 years time, if there are no really big financial issue like - retrenchment and economic crisis.

    Even though I don't totally believe him, but I talked it out.

    I must tell myself, I MUST make it happen, because I WANT it so much.  I can't depend on people right?  It's not that I depend on their money, the house is going to be built out of my savings and my loan anyway.  So what if they won't let me "rush" it, or won't let me built it, I'll just have to find a land and built one. In fact I'll just give them the tongue :p!

    I CHOSE TO BE HAPPY!

    Now, (ticking my head), what's my next plan.  Hmmm, money money money!

    -----
    COMMENT:
    AUTHOR: Shahrizal Azwan
    DATE: 12/08/2007 07:23:00 AM
    Terima kasih melawat blog saya :) Nice blog U have. Buying a house is like a dream come true. Good luck!

    Feeling down

    Your Depression Level: 44%
    You seem to have mild depression.
    A lot of people fall into your range, and it's quite possible you don't need treatment.
    If you've been feeling this way for a while, you may want to seek help.

    Are You Depressed?

    Been feeling a bit down since a week ago. No motivation. Hospital placement process is a contributing factor. Made worse by my <strike>tarnished</strike> delayed dream of my life - living in my own house.

    This low feeling is what I think made my immune system went into the drain. I am now 5 days ill, bacterial infection, on Tab. Augmntin 625mg BD. Whatever I smell stinks, and the cough is disturbing my sleep. I don't feel like going out, and I pity my partner who covers for my duty.

    I should think of happy thots, focus on goals that are attainable within this few months. Maybe that will help forget, and in time accept what has been planned for me.

    I'm going home/Kajang this Sunday, and I'm singing this song...

    [Crap! tried to embed youtube, but friendster blog doesn't allow. Maybe I should just shift this whole blog to www.blogger.com]

    Chris Daughtry, Home 2006

    I'm staring out into the night,
    Trying to hide the pain.
    I'm going to the place where love
    And feeling good don't ever cost a thing.
    And the pain you feel's a different kind of pain.


    Well I'm going home,
    Back to the place where I belong,
    And where your love has always been enough for me.
    I'm not running from.
    No, I think you got me all wrong.
    I don't regret this life I chose for me.
    But these places and these faces are getting old,
    So I'm going home.
    Well I'm going home.

    The miles are getting longer, it seems,
    The closer I get to you.
    I've not always been the best man or friend for you.
    But your love, it makes true.
    And I don't know why.
    You always seem to give me another try.

    So I'm going home,
    Back to the place where I belong,
    And where your love has always been enough for me.
    I'm not running from.
    No, I think you got me all wrong.
    I don't regret this life you chose for me.
    But these places and these faces are getting old,
    So I'm going home.
    I'm going home.


    Be careful what you wish for,
    'Cause you just might get it all.
    You just might get it all,
    And then some you don't want.
    Be careful what you wish for,
    'Cause you just might get it all.
    You just might get it all, yeah.


    Oh, well I'm going home,
    Back to the place where I belong,
    And where your love has always been enough for me.
    I'm not running from.
    No, I think you got me all wrong.
    I don't regret this life you chose for me.
    But these places and these faces are getting old.
    I said these places and these faces are getting old,
    So I'm going home.
    I'm going home.

    Friday, December 7, 2007

    How 'straight' can u be?

    Surfing the web for interesting motivating blogs, and stumbled upon Dr. Azwan's blog with a very cute article. Read here.

    It reminds me a lot about an article I wrote in another blog (a private one), a recollection of my memories surrounding my family. I'd like to share one here. I hope my bro doesn't mind, but it's a very cute story indeed. I think my family will ROTFLOL like crazy reading it because they all knew about it.

    I'll just cut and paste the excerpt...

    P1 : Lurus mengalahkan pembaris




    I wrote this once on my other blogs, and I feel I should include it
    before I go on about this special member of my family. (edited)


    24th January, 2005

    Had a wonderful Raya, my dad bought a whole cow and slaughtered it behind
    his house. He was 66 years old! Very tough and macho old man. Unlike my
    iron-like-arms 2nd brother, he can't stand blood. Well, can't blame
    him, the blood is not even oozing, it's spurting, so the guys put daun
    pisang to cover it.


    So the night was filled with food and food and food with hearty laughs.
    When everybody left, it was just my immediate family. That's when the
    story came up again. It was about my 3rd brother, P.


    I was in a 3 week anaesthetic posting, and we had basic life support
    programme (aka CPR and stuff). So I asked P to teach me how to do CPR.
    He went training in the marine once, so CPR is inevitable.


    P: When I was training on the ship, we didn't have those mannequin.
    There's this one guy who had a girl as the partner. We really had to do
    the whole show...on live person...including mouth to mouth. And the
    girls, dah la pakai swimming suit. He got soooo nervous, he
    fainted...TWICE!


    ici: really fainted? fainted as in...dizzy or fainted?

    P: haa la...pengsan! My instructor had to wake him up for several
    minutes.I said, apa laa punye lelaki, dah dapat free, tak nak pulak!
    Then he smiled and said...Ici tau tak siapa?


    My eyes widened...and he said...P laa! :lol: My lil brother and I was
    practically rolling on the floor, and my Mama who was there terpaksa
    tahan daripada terkencing.


    What? my brother fainted? It can't be! He can't be that lurus can't he? Oh my
    gawd! I mean, the most nicest guy would at least 'pretend' to be shy
    and embarrassed, but nontheless juz can't wait to plunged in and
    sucked...well, blow the breath of life into that girl.


    But my bro, had to faint twice before he saved an opposite sex.

    Where can you find a man like that nowadays?It's not like he's 13...he's 30 years old!

    * * *

    My
    eldest bro, A, made a stupid joke once. He asked us, what's the name of
    an animal that looked exactly like an elephant...the feet, the ears,
    the size...but doesn't have the trunk.


    So we gave our answers...a hippo, rhino, even dumbo after an accident, etc...all wrong. Then P innocently said...MAMA?

    Aiyoo, and his tone of voice was so innocent that my mom wasn't even insulted! Our tummy almost burst that day.

    The answer was elephant cacat...stupid joke...but P made the day alright.


    Wednesday, December 5, 2007

    Current must do list!

    My new mantra...

    1. Monthly $$$ input into my ASB - make a mental note...deduct straight from salary. Must find out how once I register to my new hospital.

    2. Must not take anymore money out of ASB!!! No matter how emergency it may seem

    3. Aim for the stuff, save, then buy. No buy now, pay later (but I knew that...hehehe, I've always done that.)

    4. Future plans - Unit trust funds!!! argh, when am I going to start? my baby is coming up in February. Hmm, must ask hubby to invest in Takaful Malaysia for Education plan + health rider. Yup yup, his responsibility <grin>.

    5. Make a blog about my achievements and future goals. I lost my little notebook about my achievement so far. Maybe it's at Mama's house, all my books are there. Ni nak refer book for my ortho posting pun susah, sebab takde tempat dah kat rumah ni nak letak my stuff yang bertimbun tu. Sigh, oh well, just live with it.

    I've finished with sewing for my baby. Most of the stuff I need right after newborn dah siap. Certain stuff I will only buy after delivery. So far, according to budget, I've spent RM700 for baby, RM300 below my initial budget. Yay! Me smart hueheuheueh. Thank God datang dari family besar. Big stuff like car seat, bassinet and cot sumer dapat dari elder sisters. Maternity blouse pun beli 2 je, coz my sis in law bagi yang lama. woohoo...well some ppl can say I'm a big saver, some people can say I'm stingy. Who cares.

    Since dah habis hobby sewing barut and bedung and bibs (why do all start with a B?), I'm surfing on how to save more money for the future. My future and baby's future. Dah download banyak excel worksheet on retirement plan, personal budgeting.

    See, if I want to retire by age of 45 (let say laa), that's 18 years more, and if I save about RM6000 a year in ASB(that's RM500 a month), by that 18 years, I already have RM200,000 in ASB. haaa! nice kan? Arwah Abah kata susah2 dahulu, senang2 kemudian.

    Hmmm, macam mana nak handle money for building my house in next 2 years ek? kalau naik gaji pun, maybe naik RM 200 jek. Nasib baik government officer boleh dapat 4% interest jek. Hmmm, tak per tak per (self assurance kih kih kih), bila the time comes, I can make adjustments to payments to ASB and home loan.

    Sometimes I wonder where my hubby comes into picture. Yeah...I wonder...

    -----
    COMMENT:
    AUTHOR: Ici
    DATE: 12/05/2007 11:31:29 AM
    Haaa...dah set up a new blog called 'Shoot for the moon...'

    still banyak nak edit. need the motivation :)
    -----
    COMMENT:
    AUTHOR: Kawthar
    DATE: 12/05/2007 05:55:38 PM
    Sis dear, banyak nak fikirkan bila dah start ada baby ni... and 'where my hubby comes into picture'... that sounds familiar :) Still, we need to have goals.. somebody has too.. I also just started unit trust, so kalau nak nama agent, just let me know. I like her because she helps you a bit on your financial planning as well and keep updating so that you know what's your position 6 months from now, 1 year from now, etc.

    Same with education insurance fund. Baru je got one for Ammar. Amin dah ada. Pakai Prudential (takaful plan). When it comes to financial matter, mmg memeningkan but focus on the long-term and usaha. InsyaAllah berjaya.

    hmmm... bilalah nak jumpa ici ni...
    -----
    COMMENT:
    AUTHOR: Ici
    DATE: 12/06/2007 02:10:13 AM
    Hmmm, weekend ahad ni ici ajak Rusydan balik rumah Mama. Sabtu dia ada sumthing. Jom jumpa jom!

    Kawan ici pun kata Prudential takaful bagus. Well, Takaful malaysia pon okay jugak, but not as strong as Pru.

    Yang Unit trust pulak, tengah tengok2 Public Ittikal. Dulu kek man pun mentioned it, but I need the money for the wedding. But now I think I can start :). I have a name of an agent, along with my frens.

    Will see u soon :))))

    Wednesday, November 28, 2007

    It's a girl! A very active girl

    Did my 2nd trimester scan yesterday. Still considering where I'm going to deliver. Well, bayangkanlah, due date somewhere in February. And guess what? My medical posting had just been released 2 days ago...I'm suppose to report to Pengarah Kesihatan Negeri Perlis...yup...PERLIS...nunnnnn di atas sana. I'm suppose to meet them before end of December. Haha, gelabah semua orang kat rumah ni.

    But anyway, where ever I'm going, I have to go somewhere in December or January next year, and by that time dah almost 32 weeks. I still haven't book my hospital for delivery!!! Off course, like everybody else, I'm appealing for a closer placement for my MOship. Coz once I got the place, I'm going to stay there until I quit the government, or further my study for Master program, or until they hate my guts that they just want to throw me out. The earliest I can think of is 2 years. Since that's the new goverment policy. It's not 3 years anymore. So in the mean time, got to equip myself with an international certificate, at least passing part 1 of...erm..MRCOG (UK) maybe?

    My MIL is trying her very best to get me to Negeri Sembilan or Melaka - closer to KL - she finally found out that posting in KL or Selangor is out of the question (she called her 'friend' somewhere up there in Putrajaya. Off course she didn't know that when she got me into UMMC when I started my housemanship. Well, now she's pulling her old wires. Me just wait and see...I'd rather like it that 'fate' has decided, but everyone else is very insistent.

    I was just wondering why they didn't just send me to sabah and sarawak. Kind of fun isn't it? Totally new environment. Hmmm, but I just read MMR forum, and got really scary vibes. I'm not equiped to be a medical officer, but then I won't ever be equiped if I stay in UMMC as a house officer anyway. If I am placed in general hospital, it's different. There are senior officers and lecturers to consult. If I am placed in district hospital, the whole place is going to be run by me. Oh boy, even if Ici tak sarat mengandung pun, I don't know if I can handle it. Sigh! But bila lagi nak go through this thing kan?

    Anyway, back to the scan...it's 98% sure that this baby is a girl. At first I thot it's going to be a boy. Lasak betul! 16 weeks dah rasa gerak sana sini, macam ada twins pulak. At 5 o'clock in the morning dah wake me up, regardless how many times I told her I need the rest. Hmm, from the scan, dagu for sure from me, and hidung pun mancung, kaki pun panjang. But we'll see again next month. Hubby haven't seen a live scan yet, so planning to bring him to one next month.

    I'm filling up my time with my old hobby...sewing. At least hubby doesn't have to see me monyok almost everyday coz feeling bored. I've made baby barut for newborn and baby barut for above 5 months old (bila dah meniarap nanti). I'm going to buy a little bit more cotton fabrics for bedsheets and receiving blankets. This time it can be flowery coz dah almost sure it's a girl. But God is great, He just might give everyone a surprise.

    Waiting for December sale!!! Bila nak start nih? Gonna buy baby stuff after this. Budget semua less than Rm2000, and that includes EVERYTHING including teeny weeny stuff like cotton balls. Thanx to my sisters who's willing to pass down baby stuff, like car seat, bassinet, the cot, and some maternity clothes. I still need to search for stroller, but that can wait much later.

    Okay, need to get ready for work soon. My baby has already woken me up and I can't sleep anymore.

    -----
    COMMENT:
    AUTHOR: Kawthar
    DATE: 11/28/2007 05:31:57 PM
    Hi Sis...
    Haaaa.... Kena pergi Perlis??? Aisey.. biasalah, when it comes to family news, I'm always the last person to know kan..

    Sekarang je yg duk kl ni pun jarang jumpa.. lagilah kalau dah pindah Perlis. But you know what, in a way it's a good thing jugak. Otherwise, how can you gain experience, ye tak. Cuma not the right time jelah. Ici pun dah sarat mengandung. Nanti kat sana, for sure kena hangkut bibik dari sini wokey.

    Whatever you decide, janganlah lupa nak beritahu k.chal ni. boleh gi antar baby cot and car seat tu.
    -----
    COMMENT:
    AUTHOR: Shakirah
    DATE: 11/29/2007 01:55:30 AM
    Betul ke nak mai Perlis? Shakey, Azizul, Ainur, Amirul ade kat sini. Junior : Hazimah ngan eamy. Sekrang HO kat Perlis ramai so don't worry. so kalau jadi transfer contact la shakey 019-2582516
    -----
    COMMENT:
    AUTHOR: Ici
    DATE: 12/05/2007 11:24:46 AM
    uwaaaa...tiba2 teringin sangat nak dok jauh jauh. tapi apa nak buat, dah hantar appeal letter. Pastuh dapat Selangor...hmmm (boringggg). Tak adventure langsung life ici nih.

    Tapi takkan tak bersyukur pulak. I just hope it's for the best. I pray that it is for the best.

    Heeee, ramai pulak kat sana, seronok pulak dengar.

    Sunday, October 14, 2007

    Wednesday, September 19, 2007

    Stressed...

    at work, and nothing else does it other than the people around you. This bulan Ramadhan is a real trial for my patience. It's been only the first week, and I kept getting home exhausted of my feelings and thoughts of anger, and I HATE IT! I don't want to feel this way :( I know I easily get moody when I'm hungry, but this is BEYOND me.

    Why is there so many double standards in our lives? I don't know how, but the radiology system at my place needs a change. They need to see the patient more than just what's on screen or some written papers! Just because the father of the radiology staff got a suspected stroke, they easily say, 'Oh! we can easily slot in MRangio today!'. And there's a guy in ICU who's GCS dropping from 13 to 9 to 6 to 3, they couldn't do because they don't see the urgency to it?! Suddenly they can EASILY SLOT IN this VVIP, and not at least one other urgent case for the day???

    Off course we need the MRI if we can't see anything in the CT scan! Dhuh, if we can see in the CT, why do we need the MRI? How could we go on with the management if you can't back up support for the diagnosis. Isn't it a good thing if even we ask for a CT scan or whatever, that it turned out to be negative? It surely excludes a life threatening possible diagnosis ain't it? Stupidas.

    They can't even liased with their own fellow radiologist for the best mode of investigation. They turned down our Ultrasound doppler for thrombosis, discussed with their senior or lecturer, then suggested for a CT Angiogram for better mode of visualization, AND THEN they ask ME to go ask from the lecturer in charge of the CT Angio. Their time is SOOOO precious sitting on the chair in front of the blackened room, asking the patient to be sent down within 5 minutes from the wards, and I bet not a single one of them have EVER HELP push the patient from the ward, with wires and oxygen tank haywired, to the trauma centre. Imagine pushing just 3 patients on their sick bed from the wards to the radiology centre, and most of them are not that slim! But I bet the radiologist don't have that kind of imagination.

    One of these days, I'm just afraid that I'd snap some nasty words into their head. Just because I'm a houseman, I got rejected. Some doesn't even let me finish my sentence, and ushered me off. Off course none of these radiologist relatives won't have to face what some other patient have to face, because they OWN the place don't they?

    Maybe I need a break. Maybe I should go to another district hospital where there's no such intelligent people that we feel so dependent on, like the radiologist. I'm going home everyday feeling so tired because I have so much anger after seeing these kind of people. It's surely draining my strength and my pahala puasa.

    There are times when I felt like crying in the car on the way home. Not because I couldn't get the urgent CT/MRI/whatever, not because I got scold by them, not because I felt that I didn't manage to do my job, but because of this anger that I felt in myself. And I know then that my heart in not at peace. And I pray to God to grant me that peace of mind, for He knows that is the greatest gift he could give to me, and that is the best gift I could ever receive from Him in this life.

    Tuesday, August 28, 2007

    Birthdays, Babies, and Buncitness

    First of all, happy birthday Mama! And happy upcoming birtday to Nazli and Nadzmi (the twin terror their mom called them). And happy belated birthday to my niece Aisya too!

    PawSecond, I'm pregnant! 3 months and going, and going, and going...and thus the Buncitness. Perut dah buyut skit, but I think it's mostly fat. Took the booking scan, it's according to date. My nephews Nazli and Nadzmi are excited because my due date is 28/2 2008 or 1/3 2008, but since 2008 is thn lompat, they were somewhat hoping it would be on 29,2 2008.

    (Click on the picture to enlarge)

    Malu_la
    In the scan, the baby looks very shy. Just kept the arms crossed in front of the face. And when got nudged, he/she pushed back with both arms. We took the pictures and distinctly saw the 5 little fingers in each hand.

    I've also completed my 1 year of housemanship. Now juz filling up my placement forms. I don't know where to go, hopefully nearby. Sort of afraid because feeling inadequate of skills and knowledge, maklumlah, PPUM hahaha. Oh well. I'm in Medical posting now, and Alhamdulillah I got posted into Haematology. Funny eh, my late father had CML. Next month, Neurology :(. Hopefully all goes well.

    Saturday, February 10, 2007

    I got another nephew!

    That would be the eleventh! And OMG!!! He weighs 3.9 kg! I thought Kak chal said the estimated birth weight is 3.7, then she went out to Chillies the night before she delivered, and the baby gained another 0.2 kg. Hebat betul anak kak chal ni.

    But I guess it's nobody's fault. It's in our genes. We have a strong family history of diabetes, so big babies is expected. Still, I don't want my first baby to be more than 3.5 kg!!!

    When I was in the labour ward, you can actually expect who's first child will deliver fast, and who will take more than 10 hours. I mainly talk about first child, because after the second, the babies can pop out (oh yes, we actually use that word) anytime. For 2nd child onwards, these mother can deliver anytime, from the time they move their butt from the wheelchair...to the bed.

    There are quite a few numbers of policewoman and women-soldiers who deliver at the hospital. These are the woman who I usually watch out for. They can deliver within 4 hours of active stage (active stage means he opening is already 3 cm or more). I think it's because they are active, always on their feet.

    So when I talk to women who don't do much physical activities, i.e officework, stay at home, or simply 'saya memang tak buat banyak kerja, rehat je jaga kesihatan', I'm very sorry they'll probably will take a lonnnnnggggggggg time bearing the contraction pain.

    As for doctors, especially house officers, it's expected that we'll get pre-term babies, and bleeding during pregnancies are common. We simply have to be on our toes most of the time, and sometimes it's because we can't help ourselves. We don't the baby we are carrying, we just wanna finish the task at hand.

    Today, I worked for half day only. When I got home, Rusydan said I slept like this...

    Image0022
    so he left me be. I thought of kemas rumah, but oh well. Besok lah. Hehe.





    I'm taking care of the paediatric surgery ward without any partner this month. That means working everyday including both saturday and sunday, but at least those weekends are half day unless I'm on-call. But my medical officers and lecturer are great. I hope they don't have any problem with me. I hope I'm getting better at inserting lines for little tiny babies. It's a cruel world.

    But I really like it there. Sometimes I'm too busy to even play with the babies, but I take time to pat and stroke and pinch them when I gave them IV drugs or when I pass by during my rounds. Sometimes I do my own pm rounds at 2 juz to remind myself which patient is facing which illness and receiving what treatments. Remembering 16 different patients is not that easy.

    Can't wait to see my nephew Ammar. Hmm, now me and rusydan have to think of other short names starting with the letter A for our kids. Rusydan kata kena cop nama awal2 so that kak chal and abg aswi tak amik dulu. hehehe

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    COMMENT:
    AUTHOR: Ahmad Salman
    DATE: 03/23/2007 07:59:36 AM
    hahaha... kalau tido je kerja, malas la maman nak teman kan ici. maman pon boring...
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    Tuesday, January 23, 2007

    I'm Waiting for March

    I'm taking 9 days leave for my end of posting, in this case, surgical posting. I just haven't figured out what to do yet. I really want to travel, but I don't know where and do what. I'm still googling.

    Anyway, at least I got one good news today. The management is considering to put me in Medical posting next. I'm still managing the thought that I'm going to be the next team leader.

    I met Mama today. I was tired, but I'm glad I met her today. We talked. Mostly I listened. I haven't meet up with my family members for such a long time, I feel awkward and out of place. I feel better in her arms just now, feel so safe. If anyone ask me who's my true love, I have to say sorry to my husband because it's not him, it's my mother.

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    COMMENT:
    AUTHOR: Ahmad Salman
    DATE: 01/25/2007 10:31:43 AM
    kesian abg rusydan. xpe rusydan ... maman ade. haha!!!
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    COMMENT:
    AUTHOR: Ici
    DATE: 02/01/2007 06:25:28 AM
    Tak nak kesian kat dia! (ici buat muka cebik) hehe

    Monday, January 22, 2007

    Black Book

    I wish for this blog not to be my little black book...stories of my downs and no ups.

    But I need to 'pen' this down. I hope I'll forget about it once I throw the thoughts out of my brain. The start...Saturday night, a patient admitted from Accident and Emergency, suspected acute appendicitis, and one of the order for her was KIV op under E (E for emergency).

    Sunday morning round, my team wanted to observe the patient first, as the clinical signs is not strong enough to suggest acute appendicitis. So I wrote the orders, KIV op under E, and continue observation. When the round almost over, they asked me to cancel the patient's name under the list. Hmm, if the pt was put KIV under op, why did they list the patient for op? But I did as they ordered. And what do you know, when I got to the list, the nurse told me patient was under GA (general anaesthesia) already. I called the OT, talked to the anaes to stop the op. The surgeon must be angry, and called my team doc. I didn't know what the conversation was between them.

    But pt went for appendicectomy eventually. She did have inflammed appendix (the doc told me, lucky me!).

    This morning, my doc told me the consultant knew abt the case and the miscommunication (mismanagement?). He asked me what I note down in the notes the day before, and what I did with the list. I told him exactly what happened. He said next time I should write down properly, 'Not for op yet'.

    I felt the blame was totally put on me. Stress was mounting today, but life continues. I really feel they are blaming me.

    And then, my current team leader told me that I'm probably the next team leader for next month replacing him. Common la, I'm not a good leader. I've already put my name on the 'caution!' list in the Surgical department...today made it twice!

    I don't want this extra responsibilities. The medical officers would just laugh if they announce I'm the next team leader, the person who made big mistakes twice in 2 months.

    Being a houseman here sucks. 4 months in Obs and gynae, never been able to do forceps, vacuum, mrp, evacuation of POC, DnC and LSCS. It's already a good thing I've voluntered to join their OT. And being 2 months in Surgical, I only watched appendicectomy twice, and a colleague of mine in a district hospital already performed the operation in less than 2 month!

    I feel like an attendant with a price in signature. We are here to run errands, take blood, trace notes, trace CT scans, trace folders because it kept missing, sending the patient down for radiological procedures, sometimes because the attendant is missing.

    They say the MOs in GHKL would treat the junior MOs from this hospital like House officers. I understand why.
    I hope this phase pass. I sure don't have the mood to go to do my 'routine' tomorrow, but we just have to early, 630 am because it's op day.

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    COMMENT:
    AUTHOR: Ahmad Salman
    DATE: 01/24/2007 06:12:16 AM

    yeah... i know it sumtimes is hard being a leader. u n i have the same lack of leadership skills. but we have to lead one day kan? i always tell myself this. but i dont do much about it. hmmm. that is what really worries me. well, if it makes u any better, u've always lead me, eventhough u dont boss me around like other sisters do. ooop. i drop the 'pin' didn't i. hehe. (nasib baik kak chal n kekman x layan friendster ni)...hehe. i guess i would say that ur leadership would be in ur kindness. that's y u were never meant to be a true leader. look at along. i could imagine problems and considerations he has to evaluate that comes from all sorts of angle. but he clears his mind and focuses on his objectives. sure it doesnt satisfy all parties but what the hell. leaders need to be brute sometimes. i'm learning step by step on how to be like that. focused and determined. and with adik2 yg macam kite ni...eee xtau lah.heee.

    well, arriving at my point... u're leadership is in ur kindness. that's y u were never good at LEADING. but u are the best at ADVISING. look at ur friends. they're always going to u to voice their problems as if u had more than 2 ears.

    well, next time a problem calls for u to make a decision, clear ur head, be focused on ur goals, and shoot. ofcourse u miss once in a while and of course that is vital when it involves a person's life. but remember that u have considered, and ur inaccuracy was the result of ur inexperience. of which i could say is the span of only five years of trying to understand the whole system of the human body and only months of housemanship. begin with His Name and all will be well. insyallah.

    panjang niiiiih!!!! canne canne?(kamil dgn muka risau) bye... ceklat dah habis blum?
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    COMMENT:
    AUTHOR: Ici
    DATE: 01/25/2007 02:53:08 AM

    smalam mama cakap Kamil pujuk Kak Chal to dokong dia. Dia kata, alalalalala, alalalalala. , dengan mulut comel n pipi tembam dia tu. Hehe. Geram!
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    Sunday, January 14, 2007

    I killed someone


    Not deliberately, but I feel that I've contribute a lot to it. So a colleague told me that I shouldn't feel bad because 'she' wouldn't help herself to get better. But it was my fault she didn't recieve two days of IV Pantoprazole. I should have told my lecturer that the Pharmacy wouldn't let deliver the stock to the ward.

    If I had given that two days dose, she wouldn't have rebleed. Probably? Mr Y said I may not have been the cause of the rebleed, but I feel that I am. So the OGDScope said that there was no more bleeding after that episode, but she did bleed a lot even for that one day episode of melena. Because of that, she didn't have to go for partial gastrectomy.

    But she did have acute renal failure, and then suddenly develop pulmonary oedema. And 1 week later after I got transfered to another surgical team, I found out she had been sent to ICU.

    I didn't saw her today. I saw her son. I saw a troly for a dead body came in the ICU this morning, and my heart sunk. I knew it was her. I need to find out tomorrow what she died of. Was it the bleeding duodenal ulcer? The massive pulmonary effusion? That would have been prevented by pleural tap, and we've done that for her already. Or is it the acute renal failure just worsens whatever her underlying condition?

    I remember how difficult it was to take her consent...for any type of procedure. We had to console and persuade her for every procedure, and it would take hours. I remember when she came, she said she wouldn't mind dying, she just want to go back. We wanted to do an emergency laparotomy, and when she finally agrees at 6 pm (she was admitted since 10 am), it was a perforated duodenal ulcer. We had to call for relatives who can persuade her again and again. She kept wanting to go back to Kedah. She was only in her 50s.

    Is it because she didn't believe in us? Maybe so. Maybe I should have visit by her bed more often even after I change team, but that's the past I can never go back to. Sometimes I go back to her notes, to see her progress, but this last week, I didn't.

    I just feel bad about it. The thought was clouding my head even when Rusydan took me the movie to see Eragon, when I'm riding the lrt, and even when looking at Primavera shoes! The worst thing is, I saw the family in the hallway, but I didn't know what to say to them. I didn't even say 'sorry'. Guilt, I guess.

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    COMMENT:
    AUTHOR: Ahmad Salman
    DATE: 01/24/2007 05:26:46 AM

    dont feel bad for urself ici. u did ur best. even the greatest doctor in the world could not stop death. but this is not the question is it? u're asking urself did u do ur best... well, take it this way. guilt is good to feel the sorrow so that we may live a more meaningful life. luv ya sis.
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