Tuesday, March 28, 2006

Latest Sensation


durr.. Posted by Picasa

Congrats to Miss Durratun Nasihin for her 4 silver medal feat in the recent concluded Melbourne Commonwealth Games. If not because of the World class Canadian , she would have swept the golds easily !! haks.. Anybody know how i can have her autograph ? or perhaps phone number so i can guide her for good SPM results later this year !!! haks..

Anyway , Kudos to Malaysia for achieving their target of 7 gold medals .Badminton was the usual suspect for our gold , but 4 ? that was remarkable !! Lawn bowl will definitely be Malaysia's next frontier to achieve gold in olympics and of course.. i would like to congratulate our hockey team ! Eventhough it was only bronze but it meant a lot to the whole of Malaysia ! I loved their current gameplay. Certainly full of passion and desire with mostly the young lads out there !! Keep it up !!

P/S Malaysia Boleh !! Proud to be a tiger..

Monday, March 27, 2006

Kisah Benar


ok.. Posted by Picasa

Its confirmed ! I'm goin to UM soon. Got the letter today. Registration will be on the 31st of May.haks.. I'm gonna be a student again. A new chapter in life huh.. haks.. Now.. i can register to be a :true" member of GPMS ! haks..

In the midst of all this , i managed to finish a book i bought today. I'm just a keen history buff and i could not resist to buy this book. I do recommend those who has similar interest to read through. Only for histroy keenos ah.. kalau tak minat sejarah ; then it'll be boring !!

Title : Ousted ! by Patrick Keith.

It is a well written account of events that lead to Singapore's seperation from Malaysia. I liked the way Keith describe the histroy ; seeing it in 3 different perspectives ; Tunku's , Lee Kuan Yew's and the rest of them. So many things revealed and certainly had me glued to during my locum today ! haks.. The author is currently in Australia therefore explaining his frankness on writing everything that happened then. It was interesting to learn about these facts ; how the racial rot that existed for so long. I suppose , we have not learn anything from the past , as things that happened then as it was written , is still pertinent . Suspiciousness and championing own races are still a strong de-facto in our local politics.

Our politics never really grew. It is still divided and polarised as how it was many years ago.I guess we like to keep it that way. In the midst of debates urging national unity ; it is quite a paradox with what is being practised. Lee Kuan Yew tried to champion his concept of a true Malaysia but obviously , it was his realpolitic to gain support. The way he manipulated Tunku to merge as Malaysia was just a ploy for his greed of power !! haks.. Thats politics ; only a handful are pure nationalist ; like Dato' Onn who was unfortunate not to succeed in having an "ideal" idea of governance.

Job Satisfaction


circle of life Posted by Picasa

Job satisfaction is something ideal which is difficult to achieve especially during the early years. We try to do our job properly but not everybody are enjoying what they do. At the end of the day , it's the pay-cheque that counts. Its about what produces the magic papers that guarantees life. Especially nowadays when money is everything.

I am not quite sure whether i achieved this nirvana on Sunday morning , but i felt good , really good keeping my patient alive. In the midst of chaos , he pulled through but the prognosis.. It did not look good. He is still on the ventilator in ICU ; fighting it so much that we had to sedate him .

This pakcik underwent a laparotomy early Sunday morning , at 2 am. He was my last case for the night. A 65 year old Pakcik , with Diabetes and Hypertension ; history of abdominal pain with sign and symptoms of intestinal obstruction for 3 days. His sugar control was haywire ; most likely due to peritonitis with an unknown cause.

We saw him in the recovery area before hte surgey to assess him . He looked troubled , difficulty in taking long breathes due to his distended abdomen. His SPO2 was at its best 82%. Otherwise , he was very alert and calm ; reciting quranic verses. A short history taking revealed he was a very active person ; moving around like either yours or my grandparents.

The laparotomy went well early in the operation. His airway was easy so i gave Halina to intubate him. His saturation picked up to 98% after pre oxygenation but it quicky went back down after artificial ventilation is given.Haemodynamically he was stable ; after fluid resuscitation he was fairly stable. Unfortunately , the surgeons were unable to find the source of 800ml of pus collected ; the whole bowel was out but his oxygenation is still poor. His PEEP was already 10 but his oxygenation remained 78 - 82%.

2 hours into the Op his BP started to decrease. Called my Consultant to inform him about the likelihood of this patient not to be extubated post Op. His BP went crashing all of a sudden , with his heart rate following suite. I tried to do something but i didn't know what was wrong with the patient ! I panicked !! Gave him Atropine , but it did not help at all. I was in the midst of preparing Noradrenaline when my Consultant came in ; and i saw the panic look in his eyes !!

His heart rate was going down.. 65... 50... 43... 35... Shit !! Bp was low.. 50 / 30 mmHg. Dr HAshim gave adrenaline , but he did not respond. Surgeons stopped the Op . A moment of standstill beckoned. I was preparing for the worse.. the patient was going !I told the nurses to prepare adrenaline and atropine for CPR .Syringes and needles were flying around with drug ampoules all over the floor. Another bout of adrenaline was given... and his heart rate picked up. Adrenaline and Noradrenaline inotropes were started .. and his BP picked up. He was a fighter. Maybe it was not his time to go as yet. Boss quickly inserted the triple lumen and the surgeons managed to complete the Op. Unfortunately, his bowels were markedly distended so they did not really close his abdomen.

I was glad that we manage to save his life then. I felt really good but seeing his poor saturation with a distended abdomen ; it did not look good at all. But somehow , i felt satisfied because somehow i know that he is not ready to go yet.

Tuesday, March 21, 2006

Kudos for the gold


the new game Posted by Picasa

My call was very calm yesterday as 1 only had to do 1 LSCS after office hours at about 4 am in the morning.

I managed to catch our national heroes in lawn bowl late afternoon on tv . Haks.. I was so excited by the game ; it was as if watching footie ! haks.. A bit funny though as the game is very mild in nature and it was great to see our team trashing the Australians on thier home groud for the gold .Who would have thought we could snatch the gold under their nose. Caya la !! Malaysia Boleh !!

I never understood the game till yesterday . It looked fun and mimicked the simple games i used to play with marbles during my childhood. Apparently , there is another game called PETANQUE which was much more similar !!! and people do compete in the olympic games !!

What say you Kamcheng gang ? Maybe we should change our weekly badminton session to play this new game? Who knows amongst us , a pearl waiting to shine in lawn bowl ?? Bule represent Malaysia in the future !! Amacam ?

Sunday, March 19, 2006

My first ever Anaesthesia conference...


the meeting Posted by Picasa

It was a good meeting. This was my first opportunity attending such an event. It was useful and something i look forward to go to next year! It was casual as there was no such thing as compulsory attendance. I realize tham Most of the anaesthetist came to meet old friends and enjoy themselves. The activities arranged were family oriented and i saw the kids enjoying it. Too bad wifey is a bit busy studying thus her non presence in this conference.

It started on Thursday with the airway workshop. We were exposed to updates as well as hands on with our "toys". It was cool meddling with airway gadgets ; trying the fibreoptic intubation , multiple ridiculous looking laryngoscopes etc. Shakti was with me only for this event as he had to work the next day.. so half the fun dissapeared!


post dinner with the selayang contingent .. somehow males are the not the dominant species in this specialty  Posted by Picasa

On Friday , the biggie began. My word , there were like 700 of us whom bout 450+ were anaesthetists. Mak ai.. banyak gile orang !! Who's who in Malaysia's anaesthesia field were there. Met lots of people from around the country who basically runs the Malaysia's hospital operating theatres. The staff nurses from HKL still recognized me ! haks.. it was kewl meeting back with them and obviously everybody commented on my weight.. hmm..

The speakers were good and certainly inspired me more to do anaesthesia.WHo's who in the journals were around and it was certainly nice seeing them !! I enjoyed the talk by Dato Hassan ; IJN's anaesthetist who showed us his video on regional anaesthesia during CABG ( Coronary Artery Bypass Graft ).Imagine , being awake while your chest ripped out and your heart repaired !! Scary isn't it ! Really really kewl visuals !! And the scientific paper presentation competition. Certainly something i would like to consider in the future !!

Managed to squeze in time in between to visit Mak Long and En . En's wife is due anytime and i wish them the best.. Insya Allah..


booth Posted by Picasa

Tuesday, March 14, 2006

Away

I'll be away in Melaka till the weekend. I am attending the Annual Anaesthesia Conference with all my colleagues from all around Malaysia. It should be interesting.

Hope thati get to snap good pictures for this blog !!

Sunday, March 12, 2006

Photos for memory


Grand-Dad's minime Posted by Picasa


maktuk dearest Posted by Picasa


with nenek Posted by Picasa


pijak tanah Posted by Picasa

fotong la.. fotong lah..

I received a shock when i arrived in TTDI yesterday morning. I had a bad call the night before and slept for a bit only at 6am !!Cases went on and on with the bummer bad laparotomy that needed ICU admission midnight , and had to settle really emergency orthopaedics cases early in the morning. I was really knackered and lucky enough not to overslept ! I arranged my alarm to be tirggered at 7am , instead i woke up on my own at about 7.45 am.The marhaban was to start at 10am.


Sani's piece Posted by Picasa

"Besarnya ! " i said. Mama told me she wanted to do the berendoi thingy with a traditional cradle. Having been to few of these events myself , i could imagine her vision. But .. as you can see , somehow Sani ( the person who's famous for pelamin's in TTDI ) installed this huge "buai" and caught me by surprise !! Thank you Elly ( my sis ) for sponsoring the "buai". Oh my god.. it was beautiful and certainly the aura of grandiosity was there.Apparently it was used in one of the royalty's event.. Merasa jadik anak raja la Dzaeffran semalam !!!


Marhaban Posted by Picasa

The event started on time. I was lucky to have Fiqar's mum to lead and Megat's mum to be one of the "vocalists" as well. Some sort of Kamcheng's fellowship bond demonstrated here. Thank you to both aunties for making the event a memorable one. Dzaeffran certainly enjoyed the event. He awed everybody with his cute kopiah when he went down to take his place. I dunno whether this is an indication of him being a very sociable person in the future.. but he never did make a noise during the event. He even went to sleep during the berendoi !! He did not ran amok after he was woken up for the "jejak tanah" adat. heks... As if he had never touch the ground.


potong jambul Posted by Picasa

Dzaeffran was lucky as Maktuk from Muar came for this event. This was her first time seeig Dzaeffran and her first time out of Muar after a bad pneumonia last week. She was admitted for 5 days and Alhgamdulillah recovered well. She was keen to be here yesterday and we stayed over in TTDI last night to be with Dzaeff's beloved moyang.


di endoi Posted by Picasa

Alhamdulillah it went well. Thank you for those who managed to drop by.. especially during this busy school holidays. Lan Tipah made a surprise appearance ! Thanx Lan for coming..

Thursday, March 09, 2006

Kings of awful strikers


mourning.. Posted by Picasa

I bet today ,all liverpool fans would be depressed and not motivated to work. We were banking on them to bounce back and defend the title in Paris come May. Unfortunately , it was not meant to be. The mighty Liverpool fell in disgrace at their own backyard.

I cannot believe I actually watched the game from 0330 to 0550 just now - and currently I am waiting for Subuh prayers. I changed my shift with a fellow colleague in order to watch what i suspected to be our last Champions League game for the season.. and i was right ! I dunno what time i'll wake up but i will be in my OT at 2pm !!

The strikers / forwards are just not scoring goal.. why ? because they are s**t crap. A very simple reason.. haks.. Morientes sucks , Crouch is pure "crouch" , Cisse makes me puke , Garcia ..haks.. takyah cakap la , Kewell is dead , Fowler just not there yet.. damn..i can';t stop rambling. Me and Dil had the discussion last night and boy.. he shares my sentiment. Its the curse of Liverpool you see.. Only pure "scousers" are successful.You can be good elsewhere , but when you come to Liverpool , you'll be rotten real bad. God help us..

One thing i noticed during the game , how it confirmed the Kop ( Liverpool's supporters ) are truly legendary. I could here the crowd singing our anthem , near to the end of the game , eventhough knowing that the European Cup is not ours this year . They were singing all their might with full of passion and pride."Youll Never Walk Alone" was simply demonstrated here. I guess the players themselves must have felt the guilt so much to dissapoint the Kop today. Respect giller.. True fans , loving their club no matter what.

Its definitely not our culture here in Malaysia ; e.g. Selangor or be it the Malaysia team fans. If we were down 1 - 0 at 70 minutes the crowd will be jeering , swearing and throwing things towards our own players ; creating the negative aura and mentality. SOO KIASU... And by 80th minute , everybody will be going off the stadium which till today i cannot understand.I will stay at the stadium whether we win or lose.. because thats how you watch a footie game !!! And when the team is not performing like Selangor in the current Super League ; nobody comes to the stadium. But when the team is in the finals , then everybody would gush and rush ; claiming to be hardcore supporters. APA HAL ???

I do hope that Rafa will consider drastic changes to the team come next season.haks.. Kalau tak lama-lama.. kena jalan sorang2..

p/s Banking on Lyon to go all the way to win Champions League !! Go Gerarld Houllier !!

Wednesday, March 08, 2006

Invitation


Invitation cards in process Posted by Picasa

I reckon it would be easier to do it this way. But only to the faithful followers of this blog lar.. which i don't think there are that many and i reckon i know most of you .My mother had made simple invitation cards but due to my busy nature of job , it is quite difficult to get hold of you guys..

Anyway , if you don't already know.. You are all invited to :

Baby Dzaeff's POTONG JAMBUL ceremony !!

Venue : 147 , Jalan Athinahapan TTDI
Date : 11 March 2006
Time : 12 - 3 pm
Itenary : Makan !!! haks..


Well , most of the itenary will be in the morning ; marhaban / zanji / etc from 10am. It will be led by Fiqar's mum's zanji group. It will be an all women's affair . My baby is already 3.5 months old but it's my mother's hajat you see ; Ye la.. cucu sulung !! haks..

So , if you happen to be around TTDI area this Saturday , do hop in to my parent's place for lunch !!!

P/S this is jemputan ikhlas !!!

Sunday, March 05, 2006

Si Bongkok Tualang Tiga


how much will he cost now ?? hhehehe Posted by Picasa

I was about to sleep after Dil came over tonight and was doing my routine channel flicking . P Ramlee's Sumpahan Orang Minyak was on and somehow i was glued to the tv. I have not seen this movie for quite some time. It was a bit ironic though ; in the midst of our petrol hike controversy ; RTM decided to air Orang Minyak !! haks.. He must be an expensive icon now and i don't know how he can maintain his status.. haks.. Guess what was on RTM1 at that same time ? IT was our PM ; PAK LAH giving a speech earlier today in defending the government's decision to increase the petrol price !! haks.. Pak Lah vs Orang Minyak... hmmmm...

Anyway , the movie was entertaining. P Ramlee was very creative in making the movie a success. It was definitely ahead of its time. The movie reflected certain social issues which is still pertinent till today. Si Bongkok ( should i explain his physique after mentioning his name ??) was shooed away from his kampung because of his ugly looks. He was initially a very humble and kind hearted individual. He managed to get a facelift by the orang bunian ( plastic surgeon kot.. ) .He was given 1 wish to choose anything from the magic book and he chose to be "beautiful" instead of having a happy life. When he returned to kampung , he became a bit of snob and proud of himself ; disobeying the promise he made earlier and was banished by the plastic surgeon when he committed a crime.

I mean , who would not make that choice if we were in his shoes ? Not everyone are born to have a face like tom cruise or maya karin ? ( heks.. maya karin je la skrang ni.. ) Who wouldn't want to be like our Dr Sheikh , the handsome orthopaedics surgeon who is one of Malaysia's potential first astronaut ? And to not boast or flaunt with god's gift is a like.. rugi laa.. heks.. I suppose that was why god gave me my looks and not like the ones mentioned above.. Definitely a potential orang minyak.. HAKS !!!

Then the interesting part came about. He was cursed to become invisible because of his sin. Then satan came.. heks.. with his interesting mask and made a pact with Bongkok. Bongkok transformed into the legendary Orang Minyak ( looked like Darth Maul though dunno whether Geroge Lucas was inspired by this movie ) The catch was in becoming human again , he had to be a serial rapist ..raping 21 girls in 7 days to be exact !! HAhahahahaha.. The raping scenes were symbolic ( air laut berkocak laa.. tangan dok genggam2 pasir pantai laa... ) Ada ke patut.. the famous X marks the spot trademark on victim's face.. gile horny P Ramlee!! The ending was a bit dissapointing for me unfortunately.

I suppose in life itself , we are tempted to do certain things which is not in line with our religion , culture and beliefs. It needs our own strong will to resist such temptation. Its hard but it is the right thing to do. As humans , we know what is right and what is wrong but somehow.. we tend to risk ourselves. I know its hard and i am speaking from my own experience.And having your own child scares you more.. Very very dodgy.. You pray to god that your next generation will be protected and blessed by the all mighty..

Haks.. Imagine , Sumpahan Orang Minyak creates one's muhasabah beofre going to sleep. Gile dakwah moden...

p/s I love the new F1 Petronas advertisement !! Kewl german speaking kampung boy !!

A teacher taught

I think YANG ESA had given me the SIGN to buck up my knowledge and skill in anaesthesia.I have not been reading nor revising in late . I don't need to really but i suppose it is my responsibility to renew and enrich my knowledge. haks.. I'm just lazy because i know i will have to work extra hard when i enter UM this June.

I had 2 difficult intubation cases in the last 2 days. The first one was expected , considering the magnitude of his submandibular( jaw ) abscess. The swelling was around his neck and he himself was a bit obese. I had my specialist in to do this one ; and i could not visualize the vocal cords. Obviously , it was easy for boss to insert the tube.. although we were a bit worried too as we could not ventilate him well.

Yesterday;s case was a bummer. I had a tagger with me. She is fresh from her housemanship posting and decided to join anaesthesia. Me , being myself. kononnya jadik cikgu la dok mengajar.. heks.. And this fella , a 50 year old chinese man , whose Airway looked normal , thin..and should be a piece of cake. I gave my "padwan" to intubate. There was no problem in ventilating the patient. She said she could not see the epiglottis. i said..ok.. let me show you.

" Ok.. just observe me closely. You gently lift up.. haa.. you can see the epiglottis right.. then you just lift.. eih... alamak.. "

I found the epiglottis but unfortunately i was not able to lift up to see the cords.Shit ! Malampati III , I nearly panicked. then we bagged him , it was alright. his saturation never decreased. I tried again with a longer blade.. but still , I just could not locate the bloody larynx. Told the nurse to call my specialist. She came eventually , and we managed to intubate him via the bougie ( a special apparatus ). haks !! Tula.. kononnya nak mengajar.. tak dapat pulak tetiba !! haks..

I'll be going for MSA's airway workshop in Melaka next week. I one day course in enriching us with airway knowledge especially handling the un "handlable". heks.. It should be fun as Shakti will be there too..

Thursday, March 02, 2006

Appreciating milestones..


milestone Posted by Picasa

I am starting to appreciate the joy of being a parent. It is so beautiful.. watching your own flesh and blood develop day by day. At times you are worried that he might not be as how you expect them to be. But at the same time , you are just happy to see him living his simple life !!


first baju melayu Posted by Picasa

We bought him his first baju melayu after the clinic trip. We brought him to Jalan Masjid India - Wisma Yakin at 4 pm !! It was a hot afternoon.. but Dzaeff behaved well. Mak was surprised when she heard that we brought the baby there ! Where did i bought his attire ? Kat Den Wahab laa.. mana lagi !! haks... Kawaaiiiii... heks..


like father..like son.. Posted by Picasa


i hate Man U !! Posted by Picasa

Clinic day


Atuk scan.. Dr Baskaran Posted by Picasa

We went to HKL on Tuesday for Dzaeff's TCA with his Paeds Dr. It was a routine follow up as he was admitted to SCN at birth. We had a good day and visited Dr Baskaran , the famous OnG feto-maternal consultant who followed up Dzaeff from 5 weeks of life . Imagine.. scanning baby Dzaeff from then till birth.. every week without fail !!! haks...

Thank you Dr TP Baskaran for your kind service..