Wednesday, June 28, 2006

Sidek Husin namanya..

With reference to my earlier entry on the long 9 hour surgery , I mentioned about the neck lump looking like one of our actor's..

And somehow , i came across him on the net !! haks.. This completes my story !

ni la dia...

p/s for you guys who don't really know him.. he was the fella who played Bachok in TOYOL.... BAchok... Mari Bachok... Mari...

A known figure

Guess who I'm gonna anaesthetize tomorrow ?

Haks.. saw his name on the list. I was not really sure if it was him ; then i met him during my pre anaesthesia rounds and confirmed..

Yup.. Rabuan Pit... the well known national athlete in the 80's.If you are still not sure , he was the malaysian who won gold unexpectedly in the 100m dash during the 1982 ASIAN GAMES.If you are still not sure.. then.. malu aahh jadi orang malaysia !! We seldom produce sprinters and he is one of our greats besides Dr M Jegathesan and the glamourous Watson Nyambek. He's 50 now and still looks youthful eventhough he has put on weight.

Haks.. saja jer nak tulis dalam blog...

Monday, June 26, 2006

A loss


I was studyin.. ( well.. was on my study table trying really hard.. ) last night , waiting for the England game when i received an SMS from Papa. Tok Jah had peacefully passed away at about 930pm Sunday night after being ill for about 1 month in Kuantan. It abrupted my pathetic attempt to study and made preparations to go back to Kuantan. Wifey could not find a replacement for her call and I went back with Papa and Mama after Subuh early this morning.

I don't know Tok Jah really well but we would often visit her everytime we are in Kuantan. My father's life story is a bit complicated you see. She is my father's real mother. She was married to my real grandfather ; Atuk Salleh in Terengganu. I never really knew what happened , but soon after my father's birth he was taken care by Tok Jah's sister , mak tuk and the man i called Atuk Aki , arwah my grandfather who passed away 2 years ago. Atuk Salleh and Tok Jah got divorced and both married somebody else. Tok Jah was married to Arwah Tok Mubin and had 9 children with him. Atuk Salleh remarried twice ( I'm carrying his genes you know.. hahaha.. ) , and had LOADS of children. I don't really know the clan of Batu 6 in Kuala Terengganu. I never understood the complexity of the family tree until i finished school. I used to boast of having the most grandparents of all time !!

Honestly,I am very curious but I had never asked my father why Atuk Salleh and Tuk Jah separated ; maybe Papa don't know too.Will it be a sensitive question ? Papa was taken care well by Atuk Aki and Maktuk who coincidentally had fertility problems ; at the same time occasionally would still be in contact with Tok Jah who was in Kampung Padang. My father has always been respected as the eldest brother amongst the siblings of a different father. Uncle Samad / Husin / Hasan / Mat Kassim / Amir / Zul / Mak cik Sah / Nor and Che Mek Su ( who is a trisomy 21 ). We seldom go to Kuantan for Ist day of Raya ; and i could scarcely sense Papa's loneliness of exile when we were there. If I am not mistaken , 1992 was the first time we slept and celebrated Raya together in KAmpung Padang. We were more to PRO- MUAR rather then Pahang -Terengganu.


We arrived in Kampung Padang at about 9am. Papa drove quite fast and the highway certainly makes travelling to Kuantan more convenient.It was very busy - everybody was waiting in the lawn area.The kampung atmosphere was really alive here. Arwah Tok Mubin was somebody who was wealthy , and his land area is quite handsome. Its like a small complex with small houses (occupied by his children) surrounding the main block ; and a dedicated surau in the middle of the complex.

Tok Jah's body had already been cleaned and the "kapan" was set. It was time for all the siblings to come in and have their last look before the face is covered.Papa was given the honour to lead the pack - being the eldest. I could feel the sadness and as i looked at everybody's face. Uncle Samad to Muldip had tears running after kissing their beloved mum for the last time.It was interesting to see how they try to hide their tears by distracting themselves by hugging their babies.

We prayed for Tok Jah in the built in surau - it was led by Uncle Zul , one of my uncles who is an Ustaz by profession. It was certainly touching to see how Tok Jah's children independently organized the event just now ; with knowledge and confidence. I suppose every parent would want this trait in their children and yearning for Sallehs and Sollehahs after every prayers.

I could not hold back my tears during the Talqin. I suppose nobody could when hearing Uncle Zul reciting the holy words . He was full of emotion and love ; having to stop a couple of times . He stattered ; not because of the jitters as he had done it dozens of time but he was trying very hard to stop himself from crying out loud. It was amazing to see how all the men there just cried and felt the true feeling of love shown by her son.

That was the end to a plentiful life lived by Atuk Jah for 84 years. Dzaeffran will never know her personally ; maybe descriptively in the future when he reads this blog entry. It was an emotional day but that is what life is all about. How we live our life in this world is at god's will and when the time comes ; He will take back what belongs to him. Alfatihah to my dear nenek.. and Semoga rohnya dicucuri rahmat..

Saturday, June 24, 2006

The long 9 hour surgery

something like this

I was involved in a long surgery with the ENT team yesterday. We kind of expected it , as the surgeons told us that it would take 7 hours and we estimated to add another 2. We were right. We started off at 12 pm and ended at about 9.30 pm with the patient extubated and responding well.

The day started in a panicky manner when we had problems with our first patient. A 72 year old chinese man who had bilateral enlarged infected tonsils with matted cervical lymph nodes. HIs airway looked ok on assessment ; and we were confident that we initiated nasal intubation. After induction , my senior gave the full dose of muscle relaxant and i laryngoscoped the patient. ALAMAK... The anatomy was distorted and i could hardly see the epiglottis.THe so called tonsils were blocking my view ; not to add the truama I caused when inserting the tube through the nose. Cormack Lehane IV tu !! Luckily his saturation was maintained at 99-100 % all the time ; showing us that it was more of a can't intubate can ventilate scenario. He tried a few times but was unsuccessful.

Called for help and Prof Lucy came to the rescue. It was indeed difficult and of course i had to take the rap ! Well , I've informed my senior colleagues and on their assessment did not anticipate this problem. We managed to intubate the patient and the Op went well. With the removal of his tonsils which were damn BIG .. I think it would be not that problematic to intubate him. But i suggest SUX should be the first drug to use..

Then we proceeded to the next case. 40 year old Malay man with a right parotid growth , a lump as big as a size 3 football ( YES IT WAS THAT BIG ! ) on his right side of the neck. Kind of reminded me of this one Malay actor. The NET team planned to excise the tumour and then re construct the neck using the chest muscle. ( something like the picture above ). I could not imagine if it was the plastic team who would take i reckon more than 24 hours to settle this. One thing though , we were lucky that there was no mass encroachment to the airway. But we were more careful this time ; we used SUX and we were OK this time around .COrmack Lehane 1.

We prepared the patient with all the invasive lines; My triple lumen was spot on on his left subclavian eventhough his size looked like a big challenge.We had problems ventilating him initially but managed to get good lung volumes after some time while altering his settings. The surgery started on time and went on..and on... and on.. and on..

The op was uneventful except for this one time when he desaturated to about 70%. The surgeons pressed on his long circuit connection and accidentally disconnected it. In the beginning I failed to bag the patient and he looked bad that i called for help. SOmehow , I managed to sort out the problem and when Vas and Yoga came in.. His saturation was already 99%.The Op was interesting and i should have brought my camera . Next time... next time..

It was long.. but not long enough as there will be times when surgery can go up to 24 hours. And being UM , there is no shift system ; so one has to stay on all the way till the end. Haks.. I'll write about it when i'm there.. don;t worry..

Wednesday, June 21, 2006

Trying again

sleep baby sleep

I just can't sleep right now. Its going to be 3 am soon.Glanced through my notes and books on topics for tutorial tomorrow. It has been a very busy 2 weeks with the Profs giving tutorials like nobody's business. It's not really for us the freshies ; but having rare chances for sessions with the Profs.. why not ? On the other hand.. I have yet to decide on whether i would be watching England's game tonight.Is it worth it ?

Came back from badminton with the guys quite late after our ritual "drink after the game" in 222. Nowadays we are eating less but drinks are free flowing with generousity. takde alcohol pun tapi perangai macam orang mabuk.. hahahaha..

Wifey got a bit excited as her period is a bit late. She started to have back her menses last month. She is still breast feeding though which may make one's cycle to be a bit haywire. It was negative.. I'm not sure whether she's keen or not but i know she yearns for another baby. Kalau positive.. haks.. giller power siot ..baru berapa kali.. haks.. but i suppose.. not that POWER yet la .. eih ??

Wednesday, June 14, 2006

Steady state..

I'm still adapting to the system here in UMMC OT. Iti s a bit different from what I'm used to , not just the physical machines , but how you work , who you work with and establishing rapport with the supporting staff.

Honestly , the machines in our OT are real old and looks old .I'm not sure why they are still keeping the old ULCO ventilator machines. Ancient giller !! I will snap pictures for your viewing some find day. Takde budget ke UM ni ? haks.. HKL and Selayang has better reliable machines. I miss my old Datex Ohmeda in HKL !! haks..

Everyday , I'm doing list with either a senior of fellow colleague. We do our pre meds ; see patients but we don't have to report to any specialist unless it is really problematic ! haks.. Well, i suppose it is important to develop our confidence in preparing anaesthesia plan as a specialist soon. It felt awkward in the beginning but coping slowly.. For example , I was sent to do ECT list ( electroconvulsive therapy - zappin them up ) for psychiatric patients on my third day of life .. belasah jer lah.. and yesterday , I was guiding a fellow colleague who had never done ECT before.. haks.. macam tera je..

It is definitely more academic here in UM. When the Profs speak up during our CME or tutorial , you can appreciate their knowledge and see how they apply simple physiology and pharmaco in our daily practice. Very high expectations woo..Haks.. I'm impressed really.. coz it was never academic but more of practical clinical practice before this..

P/S An I guess only in UM , they have a surgical remedy for failure of ejaculation..

Tuesday, June 06, 2006


new id

It'll be my third day tomorrow in UMMC OT.Here I am in an institution whose status pronounces grandiousity and overwhelming. My impression.. well.. haks.. lets just say I'll reserve my comments till i graduate. Let me go through the system first safely.. and then will I be frank with my opinion. Besides that , I'm still new so let me grow and mature with what is present here. I did my first eye list on Monday.. and well..well.. I was shocked to see my ventilator !! haks.. I'll be doing the ECT list tomorrow which will be one of the light lists over here.Thank god for that.

We had our orientation last week ; met most of the Professors in the Anaesthesia department. They are certainly smart and that is why they are the professors !! haks.. For the first time in many years ; we will have 12 trainees at one time. Usually they'll have only 5 - 8 people in a batch in the first year. KKM was certainly kind this year providing extra trainees compared to the yesteryears. I don't know all of them yet that well but i reckon i will get to know them in my coming four years here..

By reputation , Anaesthesia in MU is very demanding and challenging at the same time. Horror stories about the working hours and the kind of job that you do is certainly true. The teaching staff here admits that as well and it makes you wonder more about your decision !! haks.. Looking at the bright side , I suppose it is better to go in with certain negative expectation so that you can prepare mentally to pull yourself through.When something goes wrong , you'll be prepared for the worst and maybe able to recover succesfully. It will depend on how strong one's will will be.. Alamak... kenapa macam ni ha ???

The passing rate is not encouraging but people have done it before.When you think about it , of course it;ll be more justified to have specialists to be right 80-90% about their actions and treatment of the time rather than the iffy 50-50 ones !! I;ve seen the specialists who were previously trained here and they are the kewl joes that i admire.. Hopefully i will be one of them in the near future.

Here goes eih... 4 years of roller coaster ride..

Thursday, June 01, 2006

A budding rose on a different petal ..

UM - Dewan Jemerlang. 9.00 am 31st of May 2006.

Luckily , i put my logic cap on early this morning. I woke up and suddenly asked myself , where was this place ? I actually thought that we were suppose to assemble in the Postgraduate Centre. I did not ask anybody but just assumed. Hooked myself to streamyx at 7.15 am and searched via Google.

Laaaaa... dekat medical faculty rupanya ! Miles away from the place i thought it was suppose to be in. Parking was horrible though ; i had to walk quite a distance in the hot morning sun . I just had to wear all black with a white tie ( macam MAfia lah pulak..) - simply "brilliant" fashion sense isn't it.. haks...

Anyway , arrived just in time for UM's Dean of Medical Faculty introduction speech. There were about 100+ of us in the hall. Wow.. I'm actually moving on with time ; suppose to be linear in pursuing my "dream". Coincidentally , there were quite a number of familiar faces ; not just my peers from the UiTM fraternity , but individuals i met along my path so far.It was like a reunion meeting back colleagues from UK and Eire , to those during my IMU days and HKL friends. Everybody looking eager in beginning their next milestone of life or maybe putting one's leg to eternal agony and struggle !

What is the purpose really ? How sure am I in taking this step? Is it worth the gut and sweat to achieve titles of "GIST" or "IAN" ? ( N.B. Anaesthesiolo"GIST" , Paediatric"IAN" )

For money and wealth ? Well.. it IS a factor but i reckon it would be much simpler bridging in another path . Becoming a clinical specialist in anaesthesia does not gurantee cash rolling to you with a snap.

To enrich my knowledge ? Naahh.. I am not a keen academician. The training will only increase my experience and knowledge will compliment it indirectly. Reading is sufficient but how useful is it ? Only time will tell..

For the betterment of man ? Sounds corny and just shit crap . One may hope to do so but maybe only in one's utopic intention . We hope it have it in mind to do this job with sincerity and dignity.

A better life ? No life will be a better description in entering the Master programme. Will i miss baby Dzaeff growing whilst struggling to get all the info into my head ? Precious moments.. Without being in the programme itself I've had situations with wifey ; what more if one is in the programme ?

Life is about experimenting and making decisions.When an infant learns to roll , crawl and walk , they just do it and see what happens next. Nobody knows what is in store ; how things may come up or turn about.Life is never simple.Planning is one thing but the execution and the outcome may not be in the initial objective. It is suppose to create excitement and sense of achivement but it all depends on what we really want.

"Tawakkal" is the keyword said to bring a bit of calmness when one is in doubt. Lets just sit back , relax and "tawakkal" ..

p/s Maybe i'm just inspired by Magneto's and Prof Xavier's struggle in X-
en..baru je lepas balik movie..