Monday, August 31, 2009

1st H1N1 fatality for docs.. becareful to my fellow colleagues..

A doctor in Seremban just passed away because of H1N1. I'm not sure what were her risk factors but being the person who see multiple H1N1 patients everyday, health care workers are at the highest risk to get the infection. How well one copes with it, is entirely by chance as how the mutation pattern of any virus.
This latest casualty will cause major tremor to the medical fraternity. It is bad enough to be facing the risk ( as how we do everyday anyway) but with this evidence i wuld not be surprised if some doctors may opt out. I predict the new guideline from KKM will be ,doctors with high risk factors would be exempted from being in contact with possible infected patients.. I really dunno.
Its a mixture of signals with swine flu; between anotherbenign virus infection or a fatal one which nobody has the answer.

Sunday, August 30, 2009

Happy 5th Birthday of my blog!! is 5 years old! Coinciding the birth of my blog with the National day was a good idea as I have 2 things to celebrate :)
I've managed to keep it going so far.. alhamdulillah. Of course, facebook and twitter has taken over the popularity score amongst the masses, but i like blogs a lot. A lot of changes through out the years and compared to 2004, the alternative media is more powerful now!
It has been 5 years of my life in here ; not fully though but of course the memorable moments archived. I thank Allah for his blessings for the last years. I'm in specialty training with three beautiful kids. What can you ask for more?

Thursday, August 27, 2009

Life can be cruel but we have to be thankful..

The orthopods posted a case; a 17 year old girl with advanced osteosarcoma which needed AKA. They needed to do it on a Sunday because it was oozing slowly; she had a histroy when at an acute stage her Hb was 3 !!!
I was very surprised when she arrived; an anaeroxic girl with a football ( literally) below her right knee. I wa surprised to see her in such look that my initial thought that she had some syndrome to start of with. Upon questioning her father, she was a normal child until about a year ago. They even had a biopsy done when it was very mild; just a small growth below the knee.
Father was not keen for any operation then and resorted to various traditional treatment. It was painful that she was bed bound and i guess , they let it grow and i don't know how they ignored it; the smelly and bloody growth! It grew and grew until one day , she was unconscious at home. The family brought her to the closest hospital, and yes..she needed at least 10 pints of blood before she was ok.
Doing the amputation was a big risk itself, she was merely 12kg in weight and i cannot afford to let her loose blood more than 500ml! That is nearly half her blood volume!! To see her in such a stage was sad; because she is still young but she was having bad contractures all over with bad bed sores! I have a feeling she was neglected because her hygiene was really bad and i felt so sad for her. Her prognosis was poor from her current condition.
" Doktor.. kalau kaki dia potong sikit je boleh tak?"
I was left speechless.. I don't know what to say.

I was just lying on the bed; waiting for Subuh after my sahur when i received a phone call. Apparently an obstetric emergency! A patient who'd just delivered from another centre with Post Partum Haemorrhage was on her way to ou centre and needed blood urgently. I enquired where was my Obs Anaes oncall as I was the registrar that night ; and the obs staff mentioned they can't get through her.. OK i said.. but then i received a second call almost immediately.. saying that the lady had collapsed in the ambulance! I was telling them to divert and send the lady to our A@E..
i got a 3rd phone call.. the lady was already here and in labour room ! Arrrgghhh!! Why labour room? The most inadequate place for resuscitation ! I quickly dashed to the labour room which was situated miles away from the general OT..
True enough when i arrived, Rusnaini was leading the resuscitation ; them telling me she was cold and blue, pulseless on arrival. I had the defibrillator on and the ECG did show VF.. We CPRd and shocked her 5 times !!! It was bad , the young mother who'd just delivered their first baby could not have expected this to happen! We tried our best to revive her but it was futile from the start. We resuscitated her for 1 hour before calling it off.
The emotions of her family members upon receiving the news was bad.. and understandable. She was ok 4 hours before but now she was dead. Everybody was shocked!
Of course, there were a lot of questions on how it became this way but i don't think i can comment as I'm sure it'll be inquired soon enough.
I was very thirsty.. and it was just 7am.. what a day to start in Ramadhan... :) but i prevailed :)

"Feeling" the equipments

We recently had tutorial sessions to discuss and describe the anaesthetic equipments that we use everyday. It is an important yet vital part of our Part 2 exams and OMG!! I feel so incomplete and blur.. hahaha the main reason maybe because i never sat down and read properly dedicated literature or book on this topic. I thought my knowledge was fine but how wrong can i be !!!
As anaesthetist, we have to be really confident with the equipments that we use day in day out; I remember Dr Hashim my consultant in Selayang who's very good at it.. He knows everything ; fingertips wooo... The good thing about being comfortable with your equipment is, if something goes wrong you can identify it and rectify it ASAP! Instead , i too depend on the MA in charge or the nursing staff !! hahahaha Anaes Gen X lah ni..

HAd a look at Basir's book( Shaikh and Baha). He actually bought it which cost a bomb!! Usually we'll be cheapskate and get a photocopy version of it but for this book; i reckon the original book make things crystal clear. I kinda like this book which is concise and full of colour pictures! However, when i tried to search it in our library; i'm dissappointed that we don't have it

I only managed to get WARD's from the department's library which is thicker and more detailed. I kinda like it too ..hahaha ( janji ada gambar kaler2 banyak..oklah tu) but it is a bit too bulky to bring around for short reads.
At least , i'm starting to be a bit serious with my reading.. I hope that it is a good sign! :)

One thousand million smiles

Read on the paper that TV3 will be showing a never been seen before concert by Arwah Sudirman.Cool i thought.. growing up seeing him performing creatively on TV was certainly an inspiration. He's a cool joe and watching this on Merdeka day will be fun and meaningful!

Wednesday, August 26, 2009

Be clean or exposed

Permatang Pasir by election result came out last night without a surprise. Being DSAI's homegrund, it would be unthinkable for PR to lose there unless there was a really BIG shift of opinion against him. For PR, the by elections so far has proved how influential they can be and should never be underestimated.Eventhough the mainstream media highlighted the glorious campaign & painted a rosy picture for BN; the situation is not BN's pot.
It was a bitter electorate experience for Rohaizat and it was not purely because of the lost which was in a way expected . The manner how his skeletons in the closet was brought out to the public really ruined his reputation. After he was introduced as a candidate, looking young and fresh ; glimmering with new hope.I guess the BN hardcore party goers were thinking the unthinkable to happen. He was up against the PAS candidate who lacked the firepower of a proper statesman.
When the bar council controversy came out, it was startling . Damage control was acceptable but of course one may question how in the hell did the vetting committee missed this? And the second wife issue... perrgghh.. sorry bang , that is a no-no especially among the malay lady voters. Rohaizat is definitely in trouble with his first wife as it is an issue which will hurt and pose humiliation! He was not able to answer to the allegations convincingly and even tried denying it.
The moral of the story: If you have a dodgy background or you did something really stupid before, own up before somebody else dig it up! Its the internet age and you cannot hide it... transparency they say....

Saturday, August 22, 2009

Iftar 1 Ramadhan

Its 1st Ramadhan today and following the yearly tradition of this day, I present you my cooking !! ( cam sama last year jeee...) Hahahaha And of course, this is my first time embracing ramadhan in Bukit Jelutong.
Its good to get my kitchen especially the oven going again as it has always been the victim of hiatus and over-enthusiasm which produces nothing!
Ramadhan Al Mubarak to everyone!!

A physiological marvel: Sir Usain Bolt

World Athletics Championship Berlin 2009
World record times created :
100m : 9.58 200m : 19.19

Is he the greatest ever? Seeing him run is orgasmic!!!

Drs in and out

I came across Tun Dr. M's blog regarding doctors and when people touch this subject, i have a very strong opinion on this.

1. The grass is always greener on the other side. Money is always the main factor of any switch in any profession. Malaysian doctors who are currently working overseas were indoctrinate informally to work outside even before they start. This is more obvious to those who obtained their degree overseas. Parents who paid for their children’s education would expect none other less than this. Students under government scholarships meanwhile were planning their way out of the contract. This situation is not helped when the Malaysian health system itself is being ridiculed by our own medical professionals wherever they are!

2. It is a fact that once a medical student undergoes his/her training, it has always been about individualism. The target was to pass the MBBS exams, proceed to postgraduate and be a clinical consultant. Personal aim takes priority than mass aim. Never was there any formal approach to instill patriotism to serve the nation. Some would argue that this maybe idealistic and not realistic but why shouldn’t we? Why can’t we be proud of our country and whatever means we do should be for the country? Israelis do this very well and why should we not look up to this value?

3. One big factor for the medical-health sector brain drain is due to the lack of post graduate opportunities in Malaysia. A rigid hierarchical system is at place, hindering the ambitious to fast track their career climb. Opportunities would be denied even more with the increasing number of doctors that we produce every year. What happen is these doctors had to resort to overseas collegiate programmes which was designed to be “people-friendly” – anybody from anywhere can take the exams. One should realize that the reason why it is internationally recognized is because of history, past reputation and masses but not due to its quality. After spending a lot of money in getting the coveted qualification, it is of logic to reclaim the money by working there! Unfortunately, due to the financial stability and being in a system which recognize one’s talent; the thought of contributing to the country is lost. In fact, applying for PR or even citizenship comes into mind!

4. It is the thick colonial thinking we have which had encouraged the ongoing brain drain trend. This is unfortunately complemented by the rigid non-recognizing talent policy by the Ministry of health. There should be a paradigm shift to change this mindset and formulate a thorough plan even from medical schools to maintain the wealthy talent pool in the country. We’ve lost a lot of our talent to Singapore; look at their medical health system which has a huge number of our Malaysian doctors running it! Who else can we blame if not ourselves?

Feelings of ramadhan

Its ramadhan again ; time moves so fast that I can still remember what i wrote in my 1st of ramadhan entry last year! It looks like I may resort to cooking my own iftar tomorrow.. hhehehe
To all muslims; this is the month of full blessings. We are all encouraged to multiply our efforts in ibadah to take advantage of the "pahala" sale offered by Allah. It is a month of reflection; to look back at what you have achieved so far in life and evaluate it in tandem with god's will and not wrath.
I find ramadhan to be challenging every year ; i dunno why it is specifically during this month I am always tested. THe non-presence of satan is guranteed but still one has to fight within in finding the best solution for all. Its not easy to maintain one's composure. Sometimes thinking about it can make my mind go bonkers. Honestly i still can't figure why I am not insane by now..perhaps I am already!! hahahahaha Its easier to be misunderstood these days which i can't comprehend the facts. Once bitten twice shy they say..
Well, they don't call it ramadhan for nothing, right? hehehehe Ramadhan Al Mubarak to all my dear friends:)

Thursday, August 20, 2009

QAS's Prep Course for egypt bound med students..

I was recently invited to attend and give short talks to future med students who are going to Egypt. I really am amazed by Allah's plan as I'm sure the organizers had never heard of me and vice-versa.It was also by chance that a friend of wifey called up and asking if any of us were interested. Apparently , those who were scheduled to take the session could not make it and the organizers had to look for last minute replacements.
I've always love to talk to future and current med students as I feel that at that very young age , you don't really know what "shit" you're getting into!! Its very nostalgic becuase I was in their shoes before. In a way , doing this regularly will keep me youthful! Getting information is the most important thing at this early stage because the idealism we had about being doctors at that age is totally false!! And med school itself is a torture and not for the weak soul !! THe idealism of doing good for mankind is not bed of roses! And this is just about going through med school as i did not intend to tell them yet about housemanship!!
I was entrusted to prepare short presentations about intro to Anatomy,PHysio,Histology and Biochemistry.. the core subjects as first years! My word.. it was not easy to prepare slides for this 4 "kena paksa belajar" subjects! It can be really boring you know!! Hahahaha I tried my best and thought real hard the day before.. how not to bore the kids and the challenging part was to keep them interested in the 4 hours !! Lama gila !!
I had to tell them the reality of med school ; its never going to be easy from day 1. The culture shock,struggles and perseverence of the prolonged period of training!! Hahaha I hope that i did not deter anybody from continuing!!
It was a good session.. the kids were enthusiastic and optimistic. I know they enjoyed my life- experience jokes( i am glad when they laughed.. kalau tak malu la ..lawak tak jadi..hehe) as well as the gory pictures from my collection for show!! I really hope that it was beneficial for them because i know i benefited from the seniors in UK while doing A-levels. Again, I am always overjoyed to share my thoughts with future docs. In Palembang last year , I had a session with the UNSRI kids.
To the Alexandria and Tanta Univ bound med students in September 2009, All the best and good luck in your quest to be doctors insya allah.
**memories.. my superb HO team in UPM Surgical ward HKL.. thanx dr zek for the pic!!

Congratulations to my brother meng !!

I must congratulate you for your updated status as a Mech Eng grad !!
Tahniah meng..after all your struggles you've managed to obtain the much coveted degree.. Now..JOURNEY OF LIFE BEGINS! !!

Tuesday, August 11, 2009

The grass is greener..

So i heard ( well, heard it directly from the horse's mouth too!) that few of my "role-model"s in Anaesthesia is moving on with their lives! Meaning they are off too the private sector! As Anaesthesia specialists they are the best in their field and I am sure those who've come across them would agree as much!
Money is certainly the motivation factor here ; getting at least 5 FOLD more than what they earn now is an offer one cannot resist. That is the unfortunate lure which only a stupid fool would refuse. Its easy to say we want to help mankind and treat the unfortunate but in reality, life is about expenses and the more money one has, the more one can be sure off. Lots of loans to pay off , car , housing , child education etc and life is not getting cheaper by the day.Its true that private life can be taxing and busy but at the end of the day , the amount of money justifies it!
Wifey herself is contemplating because of the thesis trauma she had in these last few months of her speciality training( if there was any training in the first place). Some are made for it and some could just not do it ! Wifey found out late to realize she is not into academia life so much. After hearing what my seniors will be getting , wife herself went into the angan-anagan mat jenin mode!! Ahahahaha
Well as for me.. I can't really say whether i will continue to serve or join the "dark" side. I still have not passed my exams yet! It is very early for me to say but of course , this topic is a possibility and a reality check for every of us. You enjoy working with the chaos and havoc in government seting but after sometime maybe it is not the point anymore..
I reckon what is important is our true intentions ; niat. And in sincerity insya allah , god will reward for ones' deeds.

Sunday, August 09, 2009

H1N1 worry

"abnormal" attendance for a Wedensday morning CME in UMMC !!
The increasing number of deaths due to the swine flu is worrying everybody out there. This is especially to young parents who fear for their children; reported deaths of children with mild symptoms certainly brought a lot of people back to the clinics. At one time the euphoria sizzled out and everybody thought it was ok.
Currently the situation is bad in the emergency department as well as out patient department. The healthcare workers must be praised for their tireless effort to entertain the uncontrollable stream of patients! My salute to them and a big BOO to those who does not understand the situation and condemn our healthcare workers! I am truly appalled by the self-importance attitude by these individuals.( refer to the readers column in the mainstream media)
It is a big concern to us; the bigger risk takers in the clinics/hospital to face the "potential" swine flu patients. We hold a better "chance" to get infected and our families are the immediate risk.Please think about that before saying we are not concerned or efficient about the matter. In fact , Dengue post a worse mortality risk compared to H1N1 but of course, old "diseases" are broing to be highlighted in the media.
The current risk is certainly happening and notsomething that we can stop immediately. A lot of public awareness is needed to heed it off as there are no direct drugs that can kill it off or any "apple" to make us doctors go away. A few of my colleagues have had contact with infected patients and that has cause a lot of anxiety. I am looking vey closely at this matter and i do hope that it will not cause more damage to what it already has done.

Monday, August 03, 2009

Congratulations Chip Sharil!!

TO my friend Sharil Sharudin aka Chip...Congratulations!!! TAHNIAH!! Welcome to the club!! ( handsome habis tu... :)
The last of the Mahawangsa gang got married during the weekend. We were all waiting for him to get married to complete the circle. Never too late to embrace happiness right? :)
It was good timing because it was on the Adidas KOTR day ;meaning good recovery lunch was at hand!!!
Azad el al , Mafiz et al , Azlan et al, Nurleena , Alfendi , Edrin with his daughter was around when we came. We were not able to get a bigger group pic when Azad , Mafiz and Nurleena went off early but it was fun to see each other again. Reminiscence of JEBAT came out very strongly and the MMBBUUAAHH spirit is still much alive! Of course , we were in the same English 1119 tuition class at one time and that was how the four of us had strong recollection of old jokes.. hehehe

Adidas King of the road 2009

Route : around Shah Alam
Event : 22km.. ( halfway , it became 22.7km!)
Adidas King of the road is an event which is heavily subscribed internationally. Having it in Malaysia made everybody keen to be a part of it , whether u are a runner or not. Unfortunately , it has the negative reputation of bad organizing.Initally it was the BENCHMARK till the latest edition of KL Marathon came along! Kamal and Mafiz could not make it because of health reasons and the 3 of us were there to tackle the 22km event.
I was up by 5am and i was glad that the vitagen i drank the night before was working. I had a full "flush" making me happy to start the race.As the stadium was nearby , I decided to go after subuh and by 6.15am the atmospheric carnival was visible. Azad and Edrin were together and i onl manage to see them after the start. Tan Sri Khalid let us off at 6.30am and the whole crowd were running. Almost everybody ran and so i thought.. hmmm.. ni memang event runners ni.
I wore my powerbar shirt which i bought last week. Hehehehe dah mcm bule lari sket kena ada gaya sket dak ? hahahaha
Shah Alam hills were mild but long. You have to endure and the mental power n picture is important to make you continue running regardless the speed. My last 20k event was in January ( as i missed KLIM) therefore to push myself to do this was a feat on its own. I did manage to squeeze few 7-9k runs in the evenings after work for the past3 weeks.I am glad i did that!! hahahaha We were from the stadium and took a right turn to Sek 6 and all the way to 7 and to Padang Jawa. Then it was S 24 , 18 , 17 and the next thing i know we were in front of the Aquatic centre. ( nampak pendek je kan? tapi lari tak sampai-sampai!! )

By the 18th km, i was already fatigued. Had to stop-walk for a bit as my legs were cramping really hard! It had been quite sometime since i last pushed my body to this stage! I guess this time around I was aiing for PB therefore forcing myself forward as compared to my previous 20k runs where i took my time to finish it. I guess i am fitter now ( but not as fit as those running 1h30min laaa) . I did 2hr and 31min ( according to my own timing) Ok la tu eh.. hahaha
Ok.. now the the organizing part..
1.The water stations were better as they were aplenty. Tak mati kehausan la lari 22k kiranya .This was the main complaint the last time around and I guess they learnt something here.
2.On arrival , there were only few MILO and 100plus station around and guess what , it ran out way too early before the exhausted 22k runners came around. No food around which was surprising compared to all the ones i've joined... hahaha nampak sangat ADIDAS dah bankcrupt. Ada hati nak organize runs lagi lak tu ???
3.I am not sure if the runner who collapsed at the 20k point is ok or not.( read in in another blog) He fell and there were no organizers around to pick this up. Apparently a fellow runner and passer-by helped out to get him to a nearby hospital. I know that as runners we've signed the indemnity form but then.. the organizer should be more alert and provide some assistance here! Its going to be a negative point if he has morbidities in the end..
I did enjoy my run however. I met the OGKL gang ; Deeno n wife, Fahmi and wife , Syuk at the end and it was good to see them! It was tough to complete the course but in the end it was exhilarating. The runner's high of endorphin is true and i look forward to push myself again!!

****UPDATE :
The man who collapsed passed away today.. RIP Gary Leon Robert..