Friday, July 29, 2005

What is inside

what is inside Posted by Picasa

entah ler.. just feeling crap. You know , one of those moments where you just feel like shit. heks.. ade ke..samakan ngan manusia.Tak baik betul.. I meant the feeling lor..Its quite difficult to explain what is bugging inside me. I know i've always been very difficult to open up or to share with others what i truly feel, thaT defines Mafeitz Mamat.

Live life without regrets they say. I solemnly agree with this statement. Sometimes you question yeah..why and why not. But one has to stay strong to the foundations of qada' and qadar.

I tend to be secretive ; always thinking that i can cope on my own. True in certain ways but sometimes totally false. Can i be that complicated ? haks.. I suppose that is the core for my "heartless" coping mechanism. Well , otherwise how would i have survived so far if i tend to go more with my emotions ??

But i suppose , that is how i manage my life thus far..

p/s haks... please ignore this blog. It's one of those moments..

Wednesday, July 27, 2005

White rose

white rose.Posted by Picasa

Condolonces to our honourable head of the class *forever* , Ms Nurleena Hassan ( ) for the passing of her beloved mother yesterday . Alfatihah..

The Kamcheng gang has lots of memories with Auntie Rogayah. A very friendly figure who's always the person you want to talk and confide to. In a way , she knew a lot about the gang's life ; what we did during school days and after. She knew about the friendship , relationship , betrayal etc.. and had always been there for us when we needed her. We;d always loiter in her home , sometimes without the presence of Nurleena herself . She'd always be keen and interested to update us with the latest updates and gossips in the TTDI circle.

Next raya will not be the same without her ; as every year we would go and visit the family without fail . ( we do go there occasionally then however.. heks.. ) She would always enjoy our presence as how we were too with her warm welcome. I will definitely miss her special LAMB MEAL .. only available on the first day of raya.

When she was diagnosed with Mets to the lungs from an unknown primary about a year ago , we all went like huh... how come ? There was never the time we would imagine her to be sick ; and she bravely tried her might to fight it.Her chemotherapy and regular pleural tap certainly drained her a lot. We did try to visit her from time to time.. but each time her condition worsened and it was quite disturbing to see her in such condition.

I received an SMS yesterday evening ; noting that she was in University hospital and looking bad. We rushed to the hospital at about 6.30 pm , Menara Utama , 1217 ; We first met Nurleena's dad ; he tried to smile on our arrival but we knew he was speechless. Honestly , when i saw Auntie , i could barely recognize her. Gone were the thin , youthful and cheerful looking mum , and in front of us.. her physique being cushingoid due to her high dose of steriods , very ill looking and really breathless. her Spo2 was hovering 86 - 89% on a modified BIPAP . Azad and Dil was there too.. All of us numbed and gone were our evil-like laughter.

" I dah puas nangis dah..kering air mata... " said Nurleena , i did try to crack few jokes as how i'd always do. " Thanks for cheering me up... "

I could see sadness and desperation in her eyes. The agony of losing a lovely mother was too painful to accept. I was lost for words too as deep in my heart , seeing Auntie in that condition ; she was deteriorating. told Nurleena about things to expect especially in the hospital when a patient collapses. We left her about half an hour later.. she was more keen to be beside her mum.. especially during this hour of need..

Early this morning..about 1.20 am , wifey received the sms.. Auntie Rogayah had peacefully passed away. Innalillahi wainna ilaihi rajiun...

To Nurleena and family , stay strong as this is allah's test for u guys..
Auntie Rogayah.. we will miss you.. and your non-presence will be so much felt..


Reaching the stars...

liverpool future supporter ( anak fiqar )  Posted by Picasa

Received this in my email today...

From :
Sent : Wednesday, July 27, 2005 10:10 AM


Terima kasih kerana mendaftar dengan Agensi Angkasa Negara (ANGKASA) sebagai calon untuk program angkasawan. Sukacita dimaklumkan bahawa tuan/puan telah dipilih untuk menjalani ujian seterusnya.

2. Sehubungan dengan ini, ANGKASA akan mengadakan proses saringan pemilihan angkasawan di beberapa tempat di seluruh Malaysia seperti berikut :-

Tarikh: 27 Ogos 2005, Masa: 7.00 pagi
Lokasi: Pangkalan Udara Kuantan ( Pahang )

Perasmian oleh Y.A.B. Dato’ Sri Najib Tun Abdul Razak
Timbalan Perdana Menteri Malaysia merangkap
Menteri Pertahanan Malaysia
dan pada
Tarikh: 3 September 2005, Masa: 7.00 pagi
Lokasi: Diadakan serentak di :

1.Kem Mahkota Kluang ( Johor )
2.Kem Penrissen Kuching ( Sarawak )
3.Kem Lok Kawi Kota Kinabalu ( Sabah )
4.Pangkalan Udara Butterworth ( P.Pinang )
5.Pangkalan Udara Subang ( Selangor )

3. Semua calon yang telah disenarai pendek boleh memilih salah satu lokasi seperti yang dinyatakandi atas dan semua calon dikehendaki mengesahkan pilihan lokasi ujian kecergasan fizikal tersebut dengan mengisi maklumat ke dalam laman web Angkasawan sebelum 7 OGOS 2005.

4. Semua calon dinasihatkan membuat persediaan awal dari segi latihan fizikal. Kelayakan minimum ujian larian 3.5 km ialah 20 minit.

5. Semua calon dikehendaki memastikan keadaan kesihatan mereka membenarkan mereka menjalani latihan larian dan ujian tersebut dan pihak ANGKASA tidak akan bertanggungjawab ke atas sebarang kecederaan atau kemalangan yang berlaku semasa latihan atau ujian dijalankan.

6. Untuk makluman tuan/puan, segala perbelanjaan persendirian untuk menghadiri ujian tersebut adalah di bawah tanggungan calon sendiri.

Sekian, terima kasih.
Agensi Angkasa Negara (ANGKASA)

HAKss!! me ..angkasawan ???? haks...
Well , dah jemput.. so kena training lar sekarang...

badminton fever..sampai anak beranak pun main badminton Posted by Picasa

Tuesday, July 26, 2005

Birthday daze..

woit..marilah dtg makan kek Posted by Picasa

Apa nak cerita hari ni eks ? haks..

went to Izreen's wedding last nite in Merak Kayangan with mum. My dad was away in Colombia so i guess mama wanted somebody to accompany her. Why me is the question that wifey asked frequently. tak puas hati lah tu.. haks.. Anyway it was a kewl wedding ; the food was good and the entertainment was excellent. I've always enjoyed going to weddings. We sat with mama's old classmates from Muar. HAks.. there is this one loud auntie who was very kewl.. but guess what was the main agenda discussed during dinner ? politics ? UMNO ? nooo.. it was about Akademi Fantasia !!! haks.. and i reckon they are the main contributors to the wealth gained by mobile phone companies ! She admitted that she spent RM1000 to vote for Keifli !! HAKS.. lawak tul ah..

bunga-bunga cinta Posted by Picasa

Work today was a bit relaxing and less stressful as the two main bosses are away. Both attending various conferences around the world ! haks.. Bahaya gak relax2 cam ni.. but i guess when you get the non-intesivist to administer , it is less intense !!! I still have to study for my ACLS on friday and saturday.. tapi tadi baca sikit dah ngantuk... haks.. i dunno how i;m going to do my masters...

Monday, July 25, 2005

24 JUly 2005

first pic of the new cam Posted by Picasa
It was wifeys birthday on the 24th !! oh yeah and it is Dil's birthday too. eppy besday Dil !!!! haks.. i was post call but luckily the call was cold. Had one referral at 5 am but it was a straight forward Acute exarcebation of bronchial asthma. The first place i went to after work was to Secret Recipe. bought the chocolate-banana cake and a bouquet of flowers . haks.. it certainly made her day !! Girls are totally smitten with flowers eih..

After lunch in chillis ( this was our second dine-in in chillis this week !! ) , we went to Mid valley mega mall today as wifey was implying something regarding her present. haks !! Dunno who gave her the idea !! Well , i did promise her before. But the gift must be universal ; which means that i can be use it too !!! There was also this FOTOKEM ( camera ) fair there ; so u notice how convenient eihh...

to dearest.Posted by Picasa

In the middle of bargaining ; wifey suddenly left the sales-person ..takde ribut..takde angin.. haks.. he was utterly confused !! but then , she did that not because of failed bargaining but because of an old friend who passed by.. It was RINA MEILENEE .. ! haks.. the A-level Batch mate we last met like 6 years ago !! haks.. it was good to see her again. She's currently working with khazanah and recently married !! haks.. dunno why lor.. been meeting BUX'ians more and more each day.. ari tu Syida ...

Anyway , we have a new digicam now ! haks.. the Olympus m-digital series !! haks.. It cost me a fortune but for wifey.. ok lor.. haks.. don't laugh aarr... Now , i don't have to depend on my mum's digicam for digital shots !! the cam looks good and i will definitely utilize it well. MAybe some pics of HKL GICU ?? hehehehe

new cam Posted by Picasa

Saturday, July 23, 2005

2nd last call

Today will be my 2nd last call for my ICU posting.!st of August , i'm back to the general pool. Its quite a bummer because my last call will be on the last day of my posting which is next Sunday. Yesterday we had our MCQ and short test with teaching by Dr Shanti. Kewl huh.. having teaching while doing the rotation. Well , i guess HKL's ICU and anaes pool are mostly the masters and trainee students. Therefore ; it is a bit exam oriented. Well , i do feel that i benefit a lot so far..

The day has been kewl so far.. not so problematic.. but who knows what is to come. PAtients are always ill but not that very ill which requires my upmost attention. Ha this guy . a 20 year old man , who sustained polytrauma , crushed injury of left foot , fracture shaft of femur , humerus and query spine fractures. Its quite sad to see his left foot being amputated. But he is not that stable as his BP is low. i am suspecting that he may have some spine fracture ; dunno which origin.. otherwise his gaseous exchange is good but somehow.. i dont have a good feeling bout him.

I have to sort out my "pelepasan dengan izin" from the ministry regarding my acceptance of the post in UiTM. It is not as simple as it looks. Too many bereaucracies and lots of delay and shit is happening. I checked with Badrul ( the perkhidmatan officer ) yesterday and the KKM , MMC is a bit lembab as well as i dont understand why it is taking them a long time to settle certain things. Now that the ministry is in Putrajaya , it is difficult for me to barge in and mee the officers. Phone ? haks.. thats a joke lar.. most of the time either it is engaged or suddenly nnobody is picking up the phone. EG yesterday ; i wanted to speak to the officer in charge in MMC , and the whole afternoon , i was unable to get them.

Anyway , i still have like 12 hours to go.. wish me luck , insya-allah.

Thursday, July 21, 2005

Midnight horror

cool flick Posted by Picasa

Dunno what got into her , we went to watch this horror flick last nite. HAks.. it was a kewl movie though.. i've actually watched the earlier version when i was younger ; therefore obviously the earlier version played a role in making me scared of being alone in the house.

Nowadays , if one watches how the horror movies trend goes , the influence of japanese ghost characters are very obvious. In this movie , how jodie ( the ghost lar ) was potrayed - resembled JU-on and samara. We tend to be more frightened by this young girl with long hair, in black and white figure. haks.. this was much different from the previous horror flicks where my favourite being the mightmare on elm street series ! I liked Freddie a lot !!

It is quite interesting , when we watched Amytiville horror ; our spine chilled because we reckon it was potrayed from a real story. So , things were thought to be true.. However , after a search through the net , i found out that the events were declared as a hoax by George Lutz himself during a court proceeding. Currently he is divorced with the family.. haks... so much about true story huh..

Wednesday, July 20, 2005

Chiladitis syndrome

Its 12.30am now.. I'm in the ICU consultants room. So far , it had been uneventful. The day was not so busy but i had to do a lot of travelling today ; accompanying patients to OT , to scans , asking for urgent appointments.. did not go for any referral yet. My current team is very helpful and cover each other well. I am glad that i am in this pool for ICU posting.

Beds are full , and i cant transfer patient out. I dunno why patients are so bad.. i mean we do extubate them , but somehow they are not that well to be discharged. The patient we sent out early morning yesterday was transfered in later in the afternoon ! Imagine having a 17 bed ICU for a 1500 bedded hospital ?? True.. Neuro , Uro , and Paeds have their own ICU , but the bulk of the patient is referred here ! ICu care is one thing , but post ICU care .. its just a bit appauling. Patients either deteriorate and die , or survive with careful care . It was unfortunate the other day , when one of our patients died memrely 24 hours after being discharged from ICU. a 24 year old man , recovering from Malathione poisoning , but was tracheed as he had lots of secretions which he could not cough out well. I reckon , he died in the ward because of the congested secretion in his trache... My boss was not all too happy about it..

A friend's wife recently discovered that her husband had another relationship before they got married. She was really distressed about it. However , the husband actually ended the relationship becuase he wanted the the wife thus marrying her.He had always yearn for her , but because their relationship went on such a roller coaster ; with unwarranted words said during their heated arguments , he wasn't sure where they were heading. The wife thought that this was such a betrayal as she said that it may had altered the decision of marriage then. According to my friend , he only wanted her and the other relationship was not serious at all.Alas , the ongoing big fuss about the matter. Interesting isn't it ?

Things happen , and will always be for a reason. Regardless whether it was good or bad , there must be something behind governed by qada and qadar. Though i am not the pious amongst men , but i do believe that god is great and full of revelation.
Different environment and different ways of life makes different perception and different standards. It is important that one has all the information and experience before judging and making decisions. Though our knowledge will always be limited ; but the best decision made then should be followed through and not regretted later.

I've always believe that one should follow one's instinct and always know what one wants.. Never compromise.. One does not have to satisfy others for the sake of the other , but has to satisfy one's need first. If this is not fulfilled , then the unsatisfactory factor will come in , making one's life about WHAT IFS.. be truthful to oneself.. if one can accept the other as he or she is , accept with no questions asked. but if one cannot tolerate , the moment one cannot , then do not tolerate. Just say no. Marriage is about how both parties solve the problems that comes about and not about fullfilling promises . Success depends on the mechanism of coping with intra-marital problems and deal with it. Not looking back in anger..


tah apa-apa mengarut.. well , it's so early in the morning. I was summoned to intubate a patient in ward 23 . the Medical MO was unsuccesful in her attempts hence my presence was needed.HOWEVER... No portable ventilator available.. she's not a good candidate for ICU ; Liver cirrhosis with pancytopaenia who collapsed most likely encephalopathy , i suppose they have to bag till morning. I was in the middle of writing the above piece when the nurses came to the door and told me there was a phone call... before that it was the desaturating patient in the burns ICU.. .. the patient aspirated loorr.. on ETT somemore..drowned on his secretions..

Well , the REAL reason i was on the net DURING MY CALL was because of an assignment. My consultant told me to have a look on Chiladitis syndrome whom one of our patient is having. Currently he;s so difficult to wean off even on the trache mask and she wanted to know whether the syndrome has anything to do with his respiratory embarrasment.

Hmmm.. mana nak carik ni..

P/S mak ai.. pening nye kepalaku ini sekrang..

Monday, July 18, 2005


the expanding badminton enthusiasts Posted by Picasa

Just woke up from my sleep .Still groggy.. HAks.. arrived home at about 3 pm after having lunch in KLCC with wifey. Yummy gak Chilli's steak coz i just crashed when i reached home.

Being on-call on Sunday was really tiring. My knees were screaming when we were doing night rounds at 9pm. On weekends , only 2 person will be doing all the work in ICU including seeing referrals. Yesterday , it was just me and aktar covering the whole HKL. On working days , they'll be 7 of us ; so having a good team like i am having now ; the one on-calls will be "rested" during the day while the others will slug it off. But usually , its all the same ; just that during the day the on-call doctors wont do any outside referral.

I wanted to visit a friend who is currently in the neuromedical ward who is down with myaesthenia crisis. He is due for wedding this weekend !!! According to his fiance ( this was thru her blog lar.. ) he is recovering and the wedding should go on as planned. Due to my hecticness during the day , though the ward was just one stairs down , I WAS NOT ABLE TO VISIT !! haks.. by the time i was relatively free ; it was at 2 am.. and i dont think it was a good time to visit !!!

I'll be on again tomorrow and will be missing my weekly badminton session. sob..sob.. Tuesday nights had always been fun and i will truly miss tomorrow night. As you can see from the picture above ; the gang is expanding and i just dunno how we've got into this kampung thingy of snatching a pic after every session !! haks.. but its cool aahh...

tarik nite post meetin Posted by Picasa

Yesterday's call was busy throughout the day but it was very "cool" during the night. All 17 beds were full with really ill patients and we were not able to admit anybody in.Though it seemed to be less work , but having to monitor closely the ill patients were tough as well. Every 10-30 minutes the nurses will alert me about the immediate problem.. and as if i know what to do !! haks.. belasah jer la to the best of my knowledge.

To make things worse ; the whole CIS system was down. I was not able to access previous notes and progress which was really annoying. This was the second time ; just like the weekend before. I just wonder , things can just muck up when wthe computer fails. So back to paper charting which in a way was WAY MUCH convenient.

There were no portable ventilators available most of the time ; and had to make decisions with the primary team regarding intubation and ventilation. I intubated 4 patients all around HKL ; there was this 1 12 year old girl in the Nephro ward which made my heart really sink!! haks.. She was a known SLE with renal failure and currently having cerebral vein thrombosis which made her fit vigorously. She was referred for ventilation ; cerebral protection. Her airway seemed ok and i was maybe a bit TOO CONFIDENT. And intubating in the wards in Malaysia is NOT REALLY THE IDEAL PLACE to do it. The staff are not really well trained and you just had to go on !! I failed to push the tube in , it was clear cut Cormack -Lehane GRADE I .. somehow the tube was slipping off the cord to the oesophagus each time. She desaturated few times , but i had just to go on and do it.. No help was really available and i was the "anaes"!! Kena buat jer ahh !! My blues were wet with sweat while intubating. I managed to intubate anyway ; eventhough it was a bit unconventional! But my jantung was reaaally.. reallly.. cam .. damn.. SUCH Adrenaline rush!!!.. So far she's ok.. and no complications post intubation.

I'll be seeing the UiTM faculty member on Wednesday post call. I need to know the details about my future post and the programme i am taking. Insya_Allah . i reckon i will be for the next batch of Masters but i guess i just need to be real clear about how to go about it...

p/s Sorry guys.. kena miss esok nyer fukuls...

Sunday, July 17, 2005


MY god.. the ulcer is really bad !! I am so in pain !!! It was a miserable Saturday. I was not able to eat properly ; though my appetite is there. Its just this excruciating pain to the ear everytime i open my mouth , even swallowing my own saliva... oohh.. tuhan je tau sakit..

Thankfully , during locum ; kak za gave me an ointment; sort of oral friendly local analgesic which sooth a bit of my pain. haks.. i would definitely recommend it to all !!! i was able to talk properly after that ; especially when one of my "regular" patient known to have cleft palate with slurred speech came in. I tried really hard to hide my own "slur" .. haks.. takut nanti dia ingat ajuk dia la pulak..

As i've mentioned before ; i do appreciate god's gift of taste and food. Nikmatnya when you're well.. and we tend to take it for granted then.. until..

Friday, July 15, 2005

MOuthful delight

it did not help ?  Posted by Picasa

The stress got me.. real hard. I suffered from my own doing ! haks.. |Working in ICU suppressed my eating habits.This was good news but ufortunately , i was dumb enough not to drink enough water. I felt it on Wednesday , itchy throaT. Then when i woke up yesterday morning.. aarrghhh... can't even open my mouth..


Used to get lots of these during my school days. It sort of resolved A LOT when i was in university ; cropped in for a while when i was doing my housemanship.. and now.. suddenly it made its famous return !! And to top it up i was on call yesterdat.. and my god.. the agony that i had to go through last night !! haks.. My speech was so slurred that i felt talking like Stallone ! muahahahas..

I cant chew nor eat properly !! I can only tolerate porridge ( which was meant for the patients! ) and nothing else. Even drinking plain water was excruciating! Tried visualing it in the mirror. It is situated on the base of my tongue very deep inside. The pain is unavoidable during speech as the ulcer slides on my wisdom tooth. uurrgghh.. sakit woooo...

There are things we take for granted and this is one of the way how god tests us! haks.. time2 ni la rasanya nikmatnya makan ! Subhanallah.. hahahahaha... ( macam tazkirah la pulak)

My call.. haks.. takyah ceritalah.. the nurses are laughing at me ; my jonahness is so obvious ! According to them , i'm like the only doctor so far not able to sleep during my calls ... Imagine , we emptied 5 beds during the day.. and i admitted 4 in cubicle last night !! Inserted triple lumens and double lumens... perrgh.. tengah2 pagi buta yg letih itu.. woooooohhh...

Got an interesting letter this morning.. haks.. well , remember the interview earlier this year with UiTM ! Got it ! haks.. was offered the trainee lecturer post and MAsters programme for Anaesthesia. Alhamdulillah! Cepat giller.. kewl... i'll be joining my wife i suppose in the medical faculty of UiTM. tapi fikir2 balik... alamak.. nak kena study balik looorrr..... hmmm.. do i really want to ? hakss...

Wednesday, July 13, 2005

Carrot Susu..

wowsers.. Posted by Picasa

Reference : The Star front page 13 / 7/ 05 ..

You guys read the article ?

Well..well...well... 2005 is definitely a year that make Malaysian Doctors and other associated healthcare workers smile.Initially it was the increase of more than 100% for our on call allowances and that was after years of pleading and trying ; for more than 20 years if i am not mistaken ( ref ; SCHOMOS MMA ).... all of a sudden the bubble just burst!

The welfare of Malaysian doctors are being taken care with a blast suddenly !! I've been arguing that the medical professionals and allied field should be rewarded in a different paying scale ; different from other government department/ Mainly due to our nature of job. Dato Dr Chua ( psychiatrist by profession ) really do know the grassroot problem and i can say.. doing a hell of a job since we had the last Chua...

It s definitely good news ! though the pay may not be as much or as luxurious as those in the private sector ; but with the perks and benefit i do reckon that less doctors will convert to privatism. The current new pay scheme is enough at least.. and i guess lots of dedicated doctors will stay in the government side which is in need.. so much in need.. Patriotism rewarded i say.. insya-Allah..

whussup doc...  Posted by Picasa

My ICU colleague , Jalil received a new family member last Sunday ! COngratulations to him !!! However , the baby is now currently in SCN ( Special Care for Neonates ) ,as he was born a bit early at 36 weeks ; the amnion being a bit smelly presumed having chorioamnionitis.The baby was intubated and ventilated ; suspected of congenital pneumonia. He is currently quite ill and lets all doa that the baby will be ok..Its his fourth child ! He came back to work to be on call today after taking monday and tuesday off. His wife and child is currently in Ipoh. Boss ( Dr. Tai ) was really concerned and he will have his leave starting tomorrow... haks.. and because of this urgent matter ; i'll be on call tomorrow !!!! And Sunday !!!!! aaarrghh.... takde bola la gamaknya... but ok lar.. i don't mind really. coz so far event though i'm still so "virgin" in this unit ; i reckon i do need to learn lots more..

Was suppose to go back early today as i'll be on cm. Somehow , i stayed for a bit ; initially wanted to observe how a tracheostomy is done in ICU. Haks.. halfway , it went wrong.. the trache wouldn't fit and the patient desaturated !! haks... i was initially the PAK PACAK ; aiming the light-lamp at them so that boss'll get a good view. However , my role changed tremendously ; being one of the active members resuscitating !! haks.. Alhamdulillah in the end , we managed to complete the procedure without any complications. The worse was when big boss ( Dr Ng ) came in suddenly without anybody knowing it !! haks.. She was actually there for a bit as she was overlooking all our ICU staff implementing our not so efficient CIS!!

Ok lar.. dunno when i'll update next. Hopefully not to tired to share my usual jonah calls...

p/s tunggu Dil nyer pic during our badminton session last nite.. cam kampung betul aa.. haks.. gi main badminton jer.. tangkap gambar..

Tuesday, July 12, 2005

Another heart-warming visit

assalamualaikum world..  Posted by Picasa

Wifey and I went for our routine antenatal visit with our alternative consultant in TTDI today.I am on the PM shift ; so i was able to follow today. Usually she'll go with her mum as it is quite difficult for me to get leave for the visit.

Wonders of 3d ultrasound scan Posted by Picasa

It was really heart warming to see the baby moving actively !!tak berhenti2.. haks.. dunno whether it is a reflection of things to come ! We failed to get a good picture, baby refused to stand still for the camera ! hahahaha.. Alhamdulillah everything looks good so far. the mass has shrunk apparently.Funnily though this is not the case when we visit Baskaran. Still praying hard that things will turn ok this time.Only time will tell..

praying to Allah..  Posted by Picasa

p/s very happy to see wifey smiling all the way....

Monday, July 11, 2005


the chemistry Posted by Picasa

I guess age has caught me down. I used to be very energetic ; doing nothing during weekends would be something unthinkable. I would plan my weekends well , be it work or pleasure. Nowadays ; it is the opposite that is happening. I've converted to domesticism !! hahahahaha.. well , to be specific ; lying in bed with the air-con full blast ..and just sleep.. wake up.and sleep... aahh.. a very tempting life cycle.. hehehehehe

Well , being posted in the ICU is certainly taking its toll on me. Being on-call in this unit means no sleep for the night. U just can't !! I tried the other day but i was woken up after 20 minutes of nap and the feeling was crap. I had a bad headache sleeping for that very short time with your body knackered. Therefore i told myself , better stay up and do any work that is posssible. If not , go through the case notes of the patients in the ICU ; coz one is expected to know from head to toe on the history and progress of the patient.

Mortality is high in our ICU. Expected la kan !!! Most patients brought in are really bad.. really really bad.. I issued 2 burial permits during my call on Friday. And i had the "honour" to break the bad news to the family members.The first was a 45 year old chinese lady ; in coma for 4 days after having a massive intracranial bleed in an accident ; and the son who drove the car could not accept the fact when i informed him that his mother is no longer in this world. Obviously guilt was high in the list as he was the driver of the unfortunate incident.

It was soothing to see how the second family coping with impending death. A 42 year old mand ; suspected of Dengue Haemorrhagic Fever with multiple organ failure ; had been on the ventilator for more than 1 week ; dialysed for his renal failure ; transfused with 4 cycles of DIVC regime for his bleeing problem , liver was totally out.. and he was living by the ventilator for days. When i informed DIL to the family , family members came in to recite yaasin for the dying man. The whole family was there and it was sad to see such a scene.and at 4.35 am in the morning after we withdrew most of his support ; he passed away. The family took it really well ; considering the sudden state he was in...

I managed to bring in my 54 year old indian lady to the ICU early Saturday morning. I took the referral from the MEdical team for exarcebation of bronchial Asthma. When i saw her she was quite ok but i knew she was going to deteriorate. UNfortunately there was no bed in ICU then. All 16 beds were full. I managed to convince the medical team to bring her to CRW for BIPAP. We brought her there but it was not really helping . One would expect with her irritating and annoying attitude ; obviously she got worse. BIPAP did not help and her chest went really bad ! almost up to the stage of going silent. I intubated her in CRW.. haks.. that was a heart stopping moment as it was not easy having untrained staff around you. But her condition was bad even with the ventilator. She needed ICU care as the CRW staff was not up to mark !! haks.. when the previous patient mentioned died , i arranged this patient to be transfered. Thats how it goes here ; the fast turnover of ill patients...

I was totally out on Saturday ; slept like a dog when i arrived back home. went for my weekly locum and slept again when i reached home. Sunday morning was an agony. I was so tired that i refused to get out of bed till about 11am. Still my body was aching and i was not feeling hungry. I was suppose to play footie in the afternoon but i was to jaded to do that !! haks.. but at night , i managed to convince myself to watch Mr & Mrs Smith in the new GSC screen in 1 Utama. It was worth it .. the seats were kewl , the sound was spectacular and the movie was good.. Angelina Jolie was really HOT !! haks.. patut pun ek Abang BRAD.... hehehehhheehehehe

Wednesday, July 06, 2005

Computer Integrated System guinea pigs..

IT savvy Posted by Picasa

Oh my god.. i'm so so knackered!! Slept for a while in the afternoon but wifey nagged that we should go out today. Therefore i had to force myself to IKEA as dearest wanted to buy new shoe racks. I was so sleepy that i tried to sit as much as i could in IKEA. She bought the striking orange coloured cool racks. As long as she is happy.. i am ! haks.. but the late lunch we had there was good.. mmmmmm..

Back to my ICU thingy ! Well , since i joined anaesthesia , i've always been the first batch of any new change in the department. My first week in anaesthesia was coincidental with the RE-OPENING of HKL major OT after 5 year closure ! haks.. and now , as i am posted in ICU ; I will be the first batch to implement the IT-SAVVY ICU : our Computer Integrated System on patient's monitoring. Well , maybe in overseas ICU , paper charting is ancient , but to us here.. we are still in the dark ages and only now about to move to the future. The newer hospitals like Selayang , Putrajaya are paperless and i suppose HKL being the premiere centre wants to be one too..

Haks.. obviously it is currently in a messy state. Nurses are more busy sitting in front of the screen trying to type in data rather than caring for the patient. Even among us doctors ; busy trying to figure out the software ! Luckily i'm used to this computer thingy and typing , so its not much of a problem for me. Some of my colleagues are dreading this as we are moving towards complete paperless ICU by next week !! haks.. But by the way the company ( who;s in charge ) is implementing the system , its haphazard , lots of bug interfering and everybody in the ICU is so so confused.. haks.. I'm the so-called IT expert now ! haks..

Well , we have to be positive and implement the way of the future..


I received my first tongue lashing from Dr Tai today for ventilating a patient in the ward instead of bringing him to ICU !! He was in fact a good candidate ; 50 year old man , exarcebation of COAD with underlying PTB recently diagnosed 1 week ago !! having a good premorbid history and only a single organ failure.. with 2 ICU bed available at 5 am... I did ask Jalil about it but..Haks..

" Why didn't you bring him to ICU ? Did you call your specialist ?? "

I was ultimately speechless !! haks.. well , not my fault really because Jalil was with me and the decision was his ! I was the junior one !! but at least i know what i should do the next time around.. Intubating a patient in P2 is not really rosy at 5am in the morning.. having to do so in the bersila position !! haks.. it was one of those war-zone type of beds you see...

p/s Hmm..maybe i should put my ideas of how an ideal ICU software should be.. good business tu... haks..

ON call havoc

Haks.. now i'm questioning myself.. why lar do ICU posting ?

I am currently in the ICU, HKL . Apparently it is a bit quiet now. All beds are full, just came back from seeing a patient referred from the Nephrologist. MAk Ai.. i was on my feet the whole day today ; and the early evening period was the worse ! haks.. am suppose to go and have my rest now while i can. Jalil n Izan have comfortably taken their short nap .. n i'm here still awake. just drank a cup of Kopi Gano.But i know , any type of coffee pun has no effect on me.. If i want to sleep , i'll doze off like a baby..

Even so , being new in this unit ; i'm still excited. haks.. though most of the time i'm quite blank on what to do ; but i suppose i have to learn really fast. My ventilator setting still kantoi la.. and the nurses kept bugging me..

" Dr.. Dr... ni tinggi laa.. ni rendah la.. ni itu laa... haksss..."

Today had been a good day for my arterial lines.. 100% record la in ICU ..but not the Puan Sri in CCU. Will tell you guys about it later..

Well.. wish me luck for the next 4 hours... hmmmm

p/s i bring the jonahness.. wherever i go... damn..

Sunday, July 03, 2005

You;re not safe..

bruised Posted by Picasa

Security in our public hospital has always been a suspect. Lots of unknown people are allowed to roam the hospital and this practice has been going on for years now. If one wears a white coat with a forged ID tag ; showing a confident body language when one sees the guard ; you'll be let into the building easily.

The baby snatching episode in SUngai Petani was an example how the system is flawed. And something that happened on Friday morning to one of my medical colleagues was very frightening and causing worries to us doctors doing calls like donkeys everyday.

The prelude to this was an episode on Wednesday when one of my Anaes colleague on her way back to the main building from Neuro OT in Neuro building was being chased after an unknown figure. She freaked out and she ran all her might to the guard . She then changed with a male counterpart to do the on call neuro cases.

Then on Friday morning ,BROAD DAYLIGHT !! an unfortunate 7 month old pregnant MO , in the ON CALL room ( our supposed to be safe area ) ; was assaulted and harrassed ! The unknown burly figure; with an indon slang came to the room and threatened to rape her..She pleaded for mercy .Begging for the safety of her unborn child.. the stupid fugitive took away her purse away and cruelly kicked and punched her then BANGED her head TWICE to the wall.She fainted and was floored unconscious.The assaulter left the room.

Luckily a colleague who was due to be on call that day came into room and saw her lying still on the floor an hour later. Quickly they called for help. She was admitted to CRW for care. She had bruises on her face and her GCS was full though. An MRI of the brain was done and showed some intracranial bleed ; however in the opinion of the neurosurgeons , she only required conservative managament. She is currently doing OK.. but obviously speechless and traumatized by that episode..

IMAGINE.. being assaulted in the room where we thought we were invincible ! If i am not mistaken , this is the first ever episode of such brutality happening to a medical officer in Malaysia. Obviously, this news was not highlighted in a hi-fi fashion in the media. It was on tv and papers but it sounded mild compared to the real trauma and the effect is on us the medical officers. Damn man.. how lax can the security be.. Imagine if the MO was raped in the room , Dunno how the management will gurantee our safety during our calls..

Everybody is afraid now.. the trauma is real , and definitely being on call nowadays bring shivers to the spine..

p/s don't think they will want to rape me though.. hehehehe

Its JULY !!!

 Posted by Picasa

My last entry was the night before my call on wednesday. Its sunday today and i'm damn knackered !!!! HAks.. don't have any plans yet for today. Managed to catch the Live 8 thingy till midnight but i was too tired to continue after we came back from uptown ; kena layan la my wife's craving for Jenny's kuey teow.

Started my ICU posting on friday and straight away i took the option to be on call on that day. It was a tagging call as i'm very new to the unit. I thought that it would be ok even though i was already on call on Wednesday. EOD call kan.. ok la.. but i was so wrong !! haks..

Wednesday's call was bad as the cases went on and on till about 6 am. My partner was operating the other OT so we were doing big cases hand in hand. I am definitely the Jonah guy lor.. and paired with Azrin ( the specialist ) ; calls will always be terrible !! haks.. The thing was about that night , we were doing other people's shit cases ; eg having to RE laparotomy ( openig the abdomen ) for leak , peritonitis , failed embolectomy . We were lucky though as the cases which was suppose to come in were not stable yet. In line was 2 ruptured AAA's and one axillary-femoral bypass with Left leg BKA ( below knee amputation ) having an ejection fraction of only 21%. Haks.. ni pass over to the next day nyer on call person lar..

The next day.. i slept like a baby till late afternoon. I was so tired !! Being on my feet for 24 hours was really exhausting ! haks..

happily i started my ICU posting on Friday morning. The tiredness was there but when Dr Tai ( the consultant) asked me whether i am ready ..i said OK.. no problem.. ( kononnya macho la ! ) hakss... and there i went , running around HKL with a tool bag ( our intubation kit ) in my hand . saving lives they say.. but it was quite fun especially going back to P2 where i used to work at. I was tagging kak Fadzlon and kak MUz. MY ICU team consists of the good and hardworking doctors ; IZan , Jalil , Kasturi and Aktar.

ICU care is pure medicine on the go. One has to have strong basic knowledge in medicine to manage ICU. My first day was a horror - the referrals were coming from left , right and center till our beds were full. Dah la tu , then one of the patient bled - UGIB with really fresh malaena ( black stool ) . We had to arrange an OGDS for her and it took quite some time to stabilize her as her BP kept crashing !On top of that , when we decided to reintubate her , she went asystole after the intubation !! Mak aii.. nasib baik 0.4 mg of atropine was enough to stimulate her heart.. We manage to bring her to the OGDS room. Luckily Dr Raj ( the gastroenterologist ) knew me so saved Kak Fadzlon the blushes when her ulcers did not show any evidence of bleed at 2 am in the morning.

Wow.. tu baru first day and i was floored yesterday. Today's rest should be sufficient for me to start a new day tomorrow..