From eye to plastics

the fear 

Did the plastic ( plastic surgery ) list today. HKL is one of the few centres in Malaysia with this particular discipline.In the government setting however , the surgeries done are usually essential especially after recovery from major accidents ; eg reconstruction of the skull like the one i was involved in today. I don't think they do breast enhancement surgery here ; well as far as i know lar.. This is the beauty of anaesthesia , you are an essential part of every major surgery thus the exposure to various fields/sect of surgery.

My eye ( opthalmic surgery ) yesterday ended early. The main reason was because the first baby on the list died the night before. It was a bit sad though for the unfortunate 2 year old retinoblastoma child. Yesterdays surgery exposed me to 2 aspects of anaesthesia ; for eye surgeries and paediatrics. Being small they have their own problems and having an eye problem complicates it more ! It was fun however .. hehehehe prickin the poor little kid..

The plastic unit is headed by a kewl COnsultant surgeon called Dato' RAR... haks.. he is indeed an interesting character as i enjoyed my time with him just now. He likes to chat in the OT regarding all issues , from takut bini to travelling in europe.. haks.. and he loves Beethoven's symphonys. ( we all had an ad-hoc classical music lesson while he was doing the surgery ). but mind you his hands moved as articulate as his mouth ! haks..He wears bow tie to work and i guess that just sums it up ! He was fun though he has this image of being the most "fussiest" and "garang" surgeon in HKL. This was evident during the theatre itself as even his own Consultant dared not to speak up that much as he weaves his magical fingers. He ended the surgery with a Broery Marantika song ! ( haks.. believe it or not , he has a CD wallet in the OT and will instruct the nurses to play on CD's according to his mood !! )


Rae tube.. tapi ni baby nyer lar.. 

In terms of anaesthesia , plastics is a breeze and posed not much of a problem compared to eye surgery. The trick is to ensure our tubes do not intefere with the surgeon's surgical field. Usually we'll use the RAE tube which is curved where the circuit will be attached at the patient's chest level downwards.( we use this in ENT and eye as well ) We have to really plan well regarding extensions and iv lines as when the patient is fully drapped it maybe to late to access the lines !!

The surgeries they did today involved the head. The first was just a small excision of the preauricular sinus ( ada lubang ah dekat ngan lubang telinga )but mind u.. the dug in about 2 cm which is quite deep ! haks.. the second case was the excision of an AVM ( Arterio-veno malformation ) situated on the patient's forehead. Kesian that patient as it looked like a horn ( tanduk ) base ! He told me his friends called him "DAJAL" for that look ! haks.. The third case was challenging as they reconstructed the "excised" frontal skull . Basically the chinese man had a bad accident two years ago and in a life saving attempt act by the neurosurgeons ; they excised off his frontal side of the skull to the dismay of Dato RAR. So kepala dia cam depressed ah sikit. I suppose this is where plastic reconstruction is beneficial compared to the unnecessary cosmetic surgeries .

" You anaes guys must help us.. the next time you see neurosurgeons cut off and throw away parts of the skull , tell them dato' ahmad is not happy... " as how i remembered his statement made in an annoyed tone..

p/s hmmm.. cam interesting lak plastic surgery nih... Worlldd...