Wednesday, August 31, 2005
48 years ago
The plan last night : we were suppose to loiter on the top floor of HKL at 12 midnight ; gazing the spectacular fireworks on display from KLCC / Dataran Merdeka . Being on trauma call ; it was possible to do so.. and so i thought.. Shakti was tagging with me so he was around too to celebrated merdeka with me..
Instead , i was in the OT with 5 orthopods surgeons doing a risky 70 year old lady for her recurrent infected hip implant !! haks.. the "nenek" was a chatterbox and kept talking to me !! haks.. oh yes , she was under anaesthesia : sub arachnoid block because of her multiple medical problems.( paralyzed her from the waist and below) I was risking it by not doing it under combined spinal epidural..which could ease any possible prolonged op. But seeing the Orthopods Consultant doing the op ; i figured that the op would not take long.
We started quite late , 1 and a half hours after she was in OT because her lines were impossible ! She had been in the ward for 4 months and her peripheral lines were next to nothing ! The only line present was a tiny 22G ( blue pod) needle on her left ankle !! Giller aper.. Even her external jugular veins were thrombosed !! We then inserted lines to the femoral and internal jugular veins ; anticipating profuse bleeding .. and we were right when they opened up she poured 400 ml stat and made her blood pressure to drop !! haks.. sakit jantung ooohh..
Her Blood pressure was lowish during the op... having a baseline of about 170 mmHg systolic , intra-op it was 90 - 100. I reckon it was to the amount of heavy bupivacaine i gave.. haks.. My specialist told me to only give a low amount like max of 2 ml considering her age.. but i gave 3 ml of 0.5% Bupivacaine anyway.. hehehe ..anticipating a long op. But i slowly syringed the drug .. so slow.. slow giller. heks.. well , my limited experience brought me to this conclusion to avoid the possible complications.. well , kena experiment la as it goes..
Well , that was my Merdeka 12 midnight adventure !!! I slept at about 6.30am ; having to sort out the REAL emergencies.
I'll be in Maternity come September.. should be interesting..
p/s letih ...
Monday, August 29, 2005
bukit kepong remnant
On Sunday night , i watched Bukit Kepong the movie for the 10th- 11th time. And everytime i watch it , tears will surely flow unconsciously. The "sebak" feeling is real as the movie depicted a true event that happened pre-merdeka. I was tired after the evening jog and the Newcastle vs Manchester match did not stimulate me enough , so i did my usual customary channel switch and stopped at a familiar scene of a movie i first saw when i was 6 years old.
Peristiwa Bukit Kepong is a reflection of Malay spirit , determination and willing to sacrifice . During this time it was not so obvious about defending the country ; but more to defending their loved ones. The culprits ? haks.. Communist aahh.. and the depiction was real that you really hate those guys during the run of the movie.
Hey.. the movie is kewl. it showed the typical malay fighters with machine gun but with "kaki ayam" !! you'll never see this realism in western movies. even leftenan Adnan could not match the realism shown in Bukit Kepong. It was sad to see how husbands died in front of their wives / children and vice versa. It brought me chills to the spine seeing our policemen shot one by one by the communist.
The movie ended at 130am and i was wide awake. haks.. The merdeka spirit is alive and burning in me. So hang your malaysian flag guys.. wherever.. whenever during this period !!
p/s Alfatihah to the Bukit Kepong martyrs.
Sunday, August 28, 2005
the first 12 candidates
Just finished my call and as usual , the habit that was nurtured into me by my father ; SUNDAY PAPERS !!! haks.. its always the first thing that i look for every Sunday morning.Whether i'm working or at home , i just cannot bare the thought of going thorugh the day without having a glance at it. Unlike other days , somehow Sunday newspaper always bring the best out of the newspaper ; not for their news but issues , articles and of course the entertainment part..
But the front page of >Mingguan Malaysia today made my heart go wild. Nope.. not Mawi , nor any super hot babe on front page.. but the news about the first 12 candidates who made the 20 minute mark for the 3.5 km run. haks.. yups.. i;m talking about the Angkasawan fitness test Part 1.
Haks.. i dunno whether i can do it !! Well , i've not been training vigorously for the past 1 month and its just one week away. Theoratically , i should be able to finish it in time ; but the real thing will be tough. I know i am currently overweight( haks.. took me quite some time to take it you know !! ) and not 100% super fit , but i know i can manage. Its the mental part which is important now where i have to have strong determination to finish it in time ; just as how i managed to conquer Kinabalu with my bad cramps the day before. I reckon that mine in Subang next Saturday will be less pressured as there will be 350 pariticpants compared to the 31 in Kuantan.
Well , No action talk only ( NATO ) pun tak guna.. I can do it.. i can do it..
p/s Pheewwwww.... gulp...
Friday, August 26, 2005
Thursday, August 25, 2005
keng yaik 2001
looks like all the political parties are going bonkers with posts...
Luckily the MCA fracas went down smoothly. Don't know whether Chua Jui Meng has anything under his cuff.The Cai tan trend is still well alive !! haks.. i witnessed this during the UMNO Bahagian meeting and i suppose it goes all the way to the top.
Now Gerakan and MIC are having their tussle. Hopefully the losing party in this Saturday's Gerakan party polls will not create GERAKAN part II as how GERAKAN came into the picture in the early 70's after the MCA crisis post May 69.
Well..it's all about power isn't it.. such lure , such promise..
Wednesday, August 24, 2005
the pic with future Mrs Azmi.. 10 years ago..
Azmi Khalid akan kahwini Normala Shamsudin
Aug 24, 05 10:25am Malaysiakini.
Menteri Hal-Ehwal Dalam Negeri, Datuk Seri Azmi Khalid akan mengakhir zaman dudanya dengan mengahwini bekas personaliti popular TV3, Normala Shamsuddin tidak lama lagi.
Kahwin secepat mungkin
haks.. his wife just passed away in March due to Leukemia. a bit too fast isn;t it.. a bit too obvious...
Reading Najmiah's Najmiah's blog regarding how her patient desaturated on her ; it is a real risk that all anaesthetist face daily. I can really understand the event ; how we feel like its the longest time of our life and how the patient sort of deteriotating as fast as they could !! Sakit jantung woo.. I have had my fair share of events which teaches me a lot in practising safe anaesthesia..( tu la pasal nak on call banyak2... haks.. )
Yesterday.. well , early this morning was another episode. I was in the general OT , doing my laparotomy for ruptured ectopic when Lim KY , the specialist on-call - came into my Ot and asked me to go to MAternity OT. haks.. well , being quite a distance from our main block and it was at 2 am in the morning, I would be the most suitable candidate to go ! Jon ( another colleague of mine ) was having problems with the ongoing caesarean which is turing out bad . Post-Partum haemorrhage !! The patient was bleeding profusely and he certainly needed help.. I know that if it was Saleh , Shih Pei , Azrin.. they would go and see the patient. But opportunities like this.. should not be missed..
After walking in the dark for more than 10 minutes ; i arrived in Maternity OT. Alvince was doing the op and he was shouting away.. cursing his staff to sort out things for him. Hoe was there too assisting him. The monitor showed her heart rate tachycardic.. 150 /min with BP maintaining somehow.. Jon was busy pushing in fluids literally..
I looked on the floor.. 10 fully soaked abdominal packs were on the floor with a full 2L sucker container . Damn.. gile banyak bleeding. The patient was shivering-cold , she was wide awake ; having only spinal anaesthesia witholding her pain as the procedure was not suppose to be this way. She was a 39 year old indon.. Para5.. the baby was already out long time ago.. Alvince was struggling to find the source of bleed. I helped Jon to sort out catching up the fluids.. pushing the 6 pints of blood.. laju giller.. haks.. In the end , Alvince managed to block the bleeder but she was oozing.. damn.. DIVC. transfuse lagi.. giller.. i dunno if she can stand all this input and transfusion reaction was so..so possible.
Alvince was whistling Malaysia Berjaya.. being sarcastic to the patient having saving her life. haks.. i know he always has something with foreigners. She was then suppose to go to ICU , as there was no bed available ; her monitoring will bei n PACu in the general OT. I saw her a bit uncomfortable and asked her why.. her saturation pre transport actually dropped.. listened to the lungs.. damn.. dah nak APO la pulak.. well, shoving in 12 L of fluids can be a bit to much isn;t it.. haks.. tickled her with a lasix and she poured out and became comfortable. This morning when i left her , she seemed alright.. i reckon she would be fit to be sent to the maternity HDW.. haks.
well , though it felt like my heart dropping from top of KLCC , it was good. I dunno.. usually in the morning post call , i have this endorphine.. a feel good feeling .. haks.. pelik tak? gile apee..
pinraha ( thats how cikgu used to pronounce it.. )
Wow.. it was indeed a very hectic 5 days !!
I was on call... the whole weekend ; Saturday , Sunday and Tuesday !! Well, initially i was suppose to be ON on Saturday and Tuesday. However ,i dunno what got into me on Sunday morning; post Neuro call.. The whole Sunday on-call team was in the pantry receiving pass-overs from the Saturday team. Azrin ( the specialist ) then asked me , whether i was keen to continue as Kak Maznah had a family emergency ; thus making the general emergency team to be short.
I know that initially they were joking but somehow i was considering it seriously ! My Neuro call on Saturday was ok as i had no major case that made me loose my sleep. So when i told them my intention :
" Hello... are you ok ? why do you wanna do a 48 hour call ? Nobody does that and by all means.. don't you have a life ??? "
haksss.. me ? no life.. interesting thought... haks.. Well , It was a strategic decision. If i do my call on Sunday , i will get Monday off which is much better than the off sunday. nO LIST AND NO PREMEDS TO DO !! Wifey will not be around in the afternoon and i don't mind doing it.. so ok la.. do the call !!! Sharmila , Suba , Ganesh.. were like .. haks.. i am indeed a crazy man. Initially wifey didn't take it well of my decision , but hey.. its for the best love...
Indeed , Sunday's call was cold. I was lucky.. otherwise , i was actually feeling the letharginess towards evening. Luckily there were no cases so i managed to catch my sleep. And at night , we "tutup kedai" at 2am , which is early compared to usual standards . HAks..
But yesterdays call , was bad. I only felt the tiredness yesterday as i struggled to maintain my sanity till 5 am in the morning...
p/s still groggy..
Friday, August 19, 2005
The whole of this week ; "somehow hajat tak kesampaian." I wanted to jog in Kiara since Monday but somehow , there will be events / happenings that prevented me from doing so ! The 3.5km running evaluation is just around the corner and i have not actually started on getting back my pace !! hakss... Can i do it in 20 minutes ? I know that if i am fully fit.. it should not be much of a problem.. heks..
Monday : on-call.. so mmg tak bule la..
Tuesday : watched War of the Worlds with wifey.. post call day out mah..
Wednesday : The Plastic case finished at 5pm , it was raining cats and dogs !!
Thursday : My Neuro list finished late as well. only managed to get out of hospital at 6.45pm
HAks !! it'd better be !! I was let off early before the Friday prayers by Kak MAznah ( a senior MO ). Our 2 cases were short as we were only doing craniplastys which were "plastic" type of surgery. The other OT was doing a heavier case ; craniotomy with tumour excision. Luckily i was not in there !! haks.. Yesterdays case actually went on up to 4 am !! Kesian MY specialist Dr Rapi.. he was all alone without any MO. I did help him to induce the patient and he was really grateful with that !!!
Hoping for no downpour today !!!! puuh kanan... puuh kiri..
look behind.. haks..
Wednesday, August 17, 2005
thank you boss..
Managed to sort out the last document for my "pelepasan dengan izin" from KKM. Thank you boss !! Never thought that you'd actually write a letter for me.. usually , the official chop and signature on my application letter was sufficient !!! Now.. the next frontier and challenge. To actually get the pelepasan.. hmmmm.. Wifey had a terrible time last year but she managed to pull through.. So i would just have to go through the vicious pathway..
I was so sleepy this morning after waking up for subuh.We had a very tiring badminton session last night . Wanted to ditch the Tutorial ; but somehow i dragged myself off my bed , into my satria and to our anaes conference room at 7 am this morning !! haks.. i was half dead while listening to Hafiz and Lip YAng. I certainly do appreciate these sessions as i don't think they do it anywhere else !! Bummer.. tomorrow morning is the department's CME which starts at 7 again ! haks.. and i 'm still not asleep yet..
Today's plastic list was suppose to end by 3 pm. Somehow , the last case dragged. It was a 28 year old lady with a mass on her left hypochondrial region ; initally diagnose as lipoma in Melaka . However , the mass became bigger and they did a CT , it was a funny mass , unknown origin and looked liked it was sticking to one of her ribs. It was intraperitoneal and everybody thought it was a simple procedure.
" It'll just be one hour " said Mdm Normah.. the plastic consultant.( a fit looking consultant woo.. haks.. ) it turned out to be a stormy 5 hour op.
When the surgeon was making the excision around the mass which somehow became bigger than expected .. the patient just just bled ! giller bleeding ; loosing almost 1 liter as Mdm Normah and her gang negotiated the mass. It was stuck to the omentum and it was bloody. her vitals became haywire ; heart rate up to 150 / min !! BP was shooting up despite Mak ai.. gelabah giller.. She only had i IV access on her left dorsum which was quite crap for resuscitation purposes. I had to insert another access on her other hand which position was awkward for me.Dah la draped kan..
" Pernah tengok Dr. insert branula backhand tak ? " i asked the GA nurse. She looked confused. haks..
I managed to do it anyway ! haks..in the most awkward and freestyle fashion ! haks.. But it was a good line.. Managed to catch up on fluids but she was in a lot of pain ! My morphine was already maximum so pakai wonder drug ahh.. ketarolac !! haks.. and yes.. it worked so well that when she woke up she was pain free !! ( considering the long transverse incision made by the surgeons.. ) They took of the omentum and the abdomen was bare ! The liver was exposed.. damn man ! They managed to close the abdomen with a mesh inserted. But my guess is she'd doomed to get incisional hernia sooner or later...
I'll be doing the neurosurgery list for 2 consecutive days before my FIRST Neuro call on Saturday.Belasah jer la.. A bit scary though .. haks.. but its my next step towards completing my anaes training.
p/s macam Jedi la pulak..
with me being away.. and with all the life events happening..
Lupalah Mal... to wish a dear member of the kamcheng boys.. on the 10th of August. Tahun ni lupa lak to at least sms.Sorry Mal..
So.. to Mal ( if you're reading my blog ) HAPPY BELATED BIRTHDAY..
Semoga Allah sentiasa melindungi dan menambahkan keimanan kita semua... haks.. macam bagi tazkirah la pulak..!!
Sunday, August 14, 2005
last formal pic of my grand - dad
felt a bit "terkilan" .. as before his death , atok abah asked En ( my cousin ) what happened to the photographs which i took during the wedding 2 months ago !! In fact , atuk -abah was perfectly healthy during the event ! I auscultated his lungs and it was perfect!!
I was the only photographer during that event ; And i suppose it was the last ever wedding ceremony to be held in 273 , Jalan Parit Setongkat Muar. Somehow , due to my busy schedule , i was not able to pass the pics to En.. and atok-abah remembered and wanted to glance through the pic..
Well , terkilan..tu terkilan though.. but i guess, what is more important now is to doa for atuk-abah ; in his travels through alam barzah and towards akhirat..
p/s Apabila tertariknya nyawa cucu adam oleh malaikat izrail , maka putuslah segala amal ibadatnya , kecuali ;
i) segala amalan pahalanya sepanjang hayat.
ii) amal jariah.
iiu)doa anak-anak yang soleh.
the night visit
I'm back... !!!! Just came back from Muar today.. i am so knackered. I was away for the whole week and it was certainly a very hectic one !! Missed the hanky-panky haze in KL whole of last week but i updated myself by watching Singapore Channel 5 news.. It was certainly the main news whole of last week !!
Though the trip was memorable as it coincided with Singapore's national day ; a family passing really took the zest out of it. My beloved grandfather passed away due to Sepsis.It was quite sudden in a way but considering his multiple admissions to hte hospital , the last being about 8 months ago ; it is something expected eventhough he was in his best of health for the last 2 months. He was 82 and i guess it was his ajal . Innalillahi wainnailaihi rajiun.. It was quite sad as he had always been the stalwart figure for the family ; always happy to see him everytime we go back to Muar for raya..
cool shot eih..
another attempt on macro photography..
Spent the weekend in Muar ; accompanying my grandmother. She's currently not in the best of health ; having frequent asthma attacks within the past 1 year. Infact , she was in the hospital for a week before my grandfather passed away. We spent most of our time in the house ; and i know she really appreciated our gesture. It was quite fun and nostalgic going through old pictures with mak-tok this morning.
Not really in the mood now to write about my adventures in Singapore. I'll write and post the pics on my next post - post-call on Tuesday. Well , surprise..surprise.. i'm on call lah tomorrow ! haks... Well , life goes on..
p/s Alfatihah to my dearest atuk-abah..
Sunday, August 07, 2005
We'll be going to singapore tonight.. yea..yea.. it had been quite some time since both me and wifey had gone for a holiday. Why suddenly ? haks.. interesting..
The last trip we made was actually last year to cherating.Before that we had like 6 monthly holiday , Desaru , Langkawi Berjaya to name a few. After that , i dunno what happened. I suppose me being busy in medicine , wifey starting her masters in UM. And being 6 months pregnant now , haniza decides that we should go somewhere.. as life will never be the same again after the baby is delivered.. nor for both of us to have quality time together as a couple..
Wifey wanted to go overseas ; hence ideas like going to Bali , South Africa , Australia or even New Zealand. Me being patriotic suggested something like Sabah , Redang etc ; partly because of the money and partly because i think we should go to somewhere pulau"ish" !! After a thorough discussion , we thought that going overseas or a 45km away island from mainland would not benefit us if something happens ; considering the stormy pregnancy haniza has had till now.Besides , the recent london bombing will give us headaches regarding the security checks. Besides that , dunno whether they will allow mothers who are 6 months pregnant to board flight.
Hence.. Singapore !! haks.. Well , i've never actually been there for holidays. Though we were in singapore last september , it was for purely exams and not for sight-seeing. So this week , from monday to friday ; i will have the chance to explore singapore with wifey. Guess that being in our neighbour's country is the best deal i could get. Bangkok was the other option but considering the happenings in the south , so baik takyah.
It will be Singapore national day next week , so i guess lots of goodies and things to do for 1 week !!! haks.. Nanti aku bawak bendera Malaysia to their "Dataran Merdeka".. ok tak ? hehehehe
p/s MAwi world AF champion ?? haks.. he's such an iconic figure...
Friday, August 05, 2005
badrul n me
After Friday prayers in KLCC , i was preparing myself mentally for a "so-called" meeting with Dr Ngau - The Deputy Head of Department for General Medicine. I was in fact informed yesterday by Kak Zila , the General Medical secretary. According to her , it was a closed-door meeting regarding something.. hmmmm.. a bit fishy.. Shakti was invited too and he was told we were to sign certain documents. thus making both of us wondering - if we did anything wrong or unlawful during our calls 6 months ago !! We had interesting stories when both of us were still Medicine MO's; our agressive management of things can be controversial at times.. but what the heck.. as long as we were doing our job as how it was suppose to be done in the overpopulated National Referral centre : KL Hospital..
TO my surprise ; it was nothing like that !! It was actually a farewell party to 2 prominent individuals of the medical department ; in conjunction with appreciation to the MO's who had left the department. Or as how Dr Ganesh ( Head of Gastro )put it ; Mereka-mereka yang tersesat jalan.... Wow.. i was certainly awed and touched by the department's gesture. Never have i felt such recognition ; especially because my stint in the department was only about 5 months. But then ; my sceptical side suggested that this is maybe a ploy to pull me back to medicine.. NEVEEEEERRRRRRRRR !!!
with Dr Ngau
Anyway , i gave my thank you speech and so did Shakti. Though we "betrayed" the department , the experience i gained in P2 , CCU , CRW and the calls were invalueble. As i said during my speech ; the medical stint made me a "MAN". hakss.. Honestly, the medical MO's are the most overworked officers in HKL , perhaps the country !! You can certainly HATE medicine just by going through the unpredictable and tiring calls.And the next day , you are expected to work like nothing happened the night before. As for me , it was not the deterrant factor ; in fact i enjoyed the stint but i hated the subject even from my stuent days. I know lots of people who are in there now are very dedicated to their work.. Keep it up guys !! Thats why you guys should be physicians !!
Dr Badrul , my specialist in P2 was suppose to do his subspeciality in Endorine in Putrajaya , to our amazement ; currently he is the temporary A&E Head of Department in Putrajaya !!! haaakkss.. I cannot imagine how the staff would react to his temper and voice !! Being a tower himself ; that is intimidating !! He's a good lad and if one misinterpret his action ; one can be hurt and be enemies with him !! Ask anybody in HKL - they will know him as the Specialist who really...really.. had to work hard to pass his membership exams... haks.. Anyway , glad to hear that he will be expecting his second child by March next year..
We were given neck ties as a token of appreciation. It was sweet ; considering us anaes who has this reputation of being a anti neck-tie-wearer during work !!
Will i go back to the "right" path ??? NEVER... i prefer to be astray...
wifey in KLCC convention centre
Yesterday was my first call for the general pool. Quite glad really to be back in the OT . My 1 month ICU-posting was really tiring ; most of the time post call ; i would sleep to "death" everytime i hit the sac. Even that sometimes is not enough , being tired and jaded during daytime was worse. Passing over in the morning was the worse ; the rounds would take ages and usually we would be on our way home after 10am !! However , the 1 month stint was beneficial. I was glad to be in the group of people who were dedicated and hardworking. I guess , as anaesthetist u have to act that way or otherwise it would be detrimental to patient care.
As usual , i was my jonah self. The staff nurses were laughing at me and predicted i will not sleep through out the night as how it had been during my previous calls. Sad to say ; they were true ! haks..It started with my partner. Usually they will be 2 anaes doing the first call. Eric had to do the trauma call as the person who was suppose to do it ; decided to break his fingers and he is on a week long MC !!! Therefore it was the "SOLO" call for me yesterday!! haks.. HKL's busy Emergency OT was for me to decide ! But Salleh ( my specialist) was kewl enuff to help me about during the long cases.
We had 3 major laparotomies yesterday ; 2 was re-laping and both ICU bound with another at 4 am in the morning. THose were the big cases ; all the others were appendicectomies whom we cannot delay because 3 of them were in their teens ; 11 - 13 year olds.And i manage to catch an hour's nap at 6.15 am !! haks.. hopefully i did not snore too loud !!
Though i was sleepy , me n wifey managed to visit the PIKOM PCFAIR in KLCC Convention Centre . We decided to be the early birds as obviously being in a new venue would attract thousands of visitors. We were not shopping for computers though ; just few accessories and ink cartridges for our thirsty printer. I was so tempted to get one of those PDA's.. but hmmmmm...steady stallion...steady...
Wednesday, August 03, 2005
tadaaa . ni gambar tangkap sendiri
I missed the badminton session with the kamcheng boys for this ? Imagine that.. haks.. Well , though i am a true fan of theatres , bangsawans , musicals , orchestra.. but dance ? haks.. i was indeed my first time. Well , not my idea really but i was coaxed by my dear wifey to attend the much acclaimed and publisiced dance show.. WILD ZEBRA..
favourite scene.. the rams..
Did i enjoy it ? haks.. i would be lying if i said yes ! half the time i was looking at my watch hoping that it will end soon ; as i may still have that tiny chance to go and play badminton ! in fact , i brought my gear along in the car !!! I was dissapointed though as there was no way that the show would end before 11 pm !!
At least i realize that dance is not my thing. I can't imagine watching through the Ramayana or Mahabrata ! haks.. its just not to my liking. I just cannot appreciate their movement or feel the sadness of unfulfilled love. haks.. I did laugh though when there were scenes of other animals besides the zebra... rams , ducks and monkey ! it was enjoyable.. and the crowd did appreciate it..
A bit of the synopsis ( at least from what i understood in the 2 and a half hour dance show.. ) : it was about the forbidden love between princess zebra and wild zebra prince. The Old Queen Bear ( princess's mother laa ) was hunting all the wild zebras for her wardrobe and magic mantle.. and surprise-surprise ; prince wild zebra was the 100th zebra to be killed for her to achieve the magic mantle. And the love affair happen la.. In the end , the princess died while trying to save his loved one.. well , the scene was suppose to be tragic , some people actually cried.. but me.. haks.. tak sampai la pulak the message..
P/S Adapun putera kuda belang liar itu menjadi buruan Permaisuri Beruang Tua. Maka musang pun menghasut sekalian haiwan di rimba untuk menghalang percintaan Puteri Kuda Belang itu.
"excerpt from one of the translation to BM in between the scenes.. never failed to make me laugh.."