Raya dah nak habis..

Syawal will be over very soon. It had been a good celebration by Malaysians despite the uncertainty of economy by the number of invitations I received for open house. In a way it spoilt me because I've been eating, eating and eating... gained weight and my running traning programme .. hancus !! hahaha
I am keen to organize my own open house ; inviting family, neighbours and friends for a good food and meet up after a long hiatus. Facebook reunited me with lots of old friends and how nice it would be to see them again. This is especially since we've moved to the new place.
However, my intention was shot down to the grown and buried 7 feet under.. hahahaha with statements like..
"Rumah belum habis pindah nak fikir open house"
"You always think about enjoying yourself and I have to do the shit work.."
WTF? Which i felt there was no point arguing with wifey when crappy negative statements like that were produced. I refused to be drawn into purposeless and stupid argument and if I do, I'll be the stupid one!!
I guess I have to wait till the time she comes out of her antisocial mode.. Patut pun tak ramai kawan..

National Anaesthesia Day - Day2-3

After the hectic first day, day 2 and 3 was just a breeze. Day 2 was about Prof YK continuing her Acute Care Workshop. I've always enjoyed Nawar's session on Losing Control. A true life experience of hypoxia and death with videos to depict it will always be the highlight of this workshop. His invaluable experience in the Top 10- Astronaut selection is priceless and only those who had been there can share it well with all the audience.

Day 3- Friday was the MSA CPD ( Continuous Professional Development) lectures where we had our own Profs namely YK Chan, MArzida and Patrick to share their knowledge and we had Dr Sharidan from UKM as well with us. The topics were interesting but I guess being on a working Friday, only those who were really free would be able to join us.

Overall, I reckon the committee had their share of fun and stress while officially skiving from the usual normal routine! I must congratulate Meng Li, Lai, Carolyn and of course the backbone staff of Susanty, Sham , Zahu and Khairil for without their upmost commitment behind the scenes, we could have embarrassed the department.... BIG TIME... I salute Prof Marzida for her persistence and calmness on managing crisis situations which I reckon if I was in her shoes ..dah lama meletup!! Hahaha And of course, to Prof YK Chan for her vision on her pet "Acute Care".I wished that we had the VC himself on the opening ceremony to see how we manage to organize it well, thus i do hope that the DVC who came on his behalf would be kind enough to mention it. However, as one of the insignificant events that can be unlikely!

However, I am a bit dissapointed that we did not have the full suppose-to-be support from the department. Who else should celebrate Anaesthesia Day if it is not us? The attendance from the department with the greatest human capital in the hospital was appauling to the max. I know my colleagues were all very happy to come for these events at least on the opening ceremony cum book launch day but they were tied up to do list in the OT. I don't know why it was not at all possible to have the OT list half day that day.. Are we just plain degraded slaves who do not have any rights at all? I cannot comprehend the level of communication we are at !
It was a good experience for me and I realize that in the future, I know what I want my department to be like.

National Anaesthesia Day 2009 - Day 1

Prof Emeritus Datuk Dr Alex Delilkan the LEGEND.. always known as the full time cricket player and part time doctor.. :)

The first successful documented anaesthesia was given on the 16th of October 1846 by William TG Morton in Massachusetts; hence the beginning of a specialty in Medicine!!

The Anaesthesia day is celebrated with the intention of providing the public information regarding our job and career. By history, we were always the comic superheroes; men behind the mask who save lives but slowly that is changing! Its not about recognition per say but more of the medico-legal implications where when things go wrong, we are the obvious scapegoat!! hahahaha

UMMC after at least 4 years hiatus ( maybe longer.. no documentation available to check) held its own celebration from the 14th to 16th. I was roped into the committee because I volunteered to do it anyway.. hahaha My last involvement was in HKL before I left; and it was fun as we had our own "OT machines" in the lobby area for show. In UM it is a bit different, we are doing activities for these 3 days. Today was the launching and we were proud to have Prof Dr Hamzah , one of the TNCs to officiate. VC gave us his word earlier but I guess he had other priorities to fulfill on Wednesday afternoon. Our TNC launched 2 books as well, one by Prof Alex Delilkan and the other Prof YK. THe launching ceremony went well despite the earlier scare of nobody attending.( I have some issues on this but i don't want to mention it here..) It went smooth and we fulfilled TNC's KPI for us to settle it in 30 minutes. I guess the highlight of the day was VC's speech read by TNC when he mentioned about the 5 year masterplan.. :)

Of course, when the TNC was ushered to view the exhibition, I could not resist the temptation to play few short videos which I thought was interesting and fun to watch by the audience !! Hahahaha

I guess I must have inherited ( somehow) the cheekiness from Prof Delilkan as he is indeed a vey fun loving smart individual. His Prof Emeritus status is legendary as he was the first Prof from the medical fraternity to receive this award. He did inspire me in a way to do Aanesthesia when we had him for critical care teaching when I was undergraduate. To hear him speak in the afternoon about his passion on medical ethics was refreshing. Thanks Prof and I hope someday to follow your footsteps in achievements!!

That was day 1.. still 2 days more to go..

Looking for an airway?

It was a challenging ENT list today. I had fun in terror but it was definitely a good experience. What happened today showed how the important communication between ENT surgeon and anaesthetist is needed to ensure the success of the op planned. It was not easy but having a common interest( shared airway) prompted the 2 disciplines to collaborate!

We had a patient who had almost 100% obstruction above her trachytube; subglottic stenosis which was caused by ETT high cuff pressure during her ICU admission which caused necrosis and fibrosis. We did a Shian Lee which in the beginning i had no idea about! till our thorough discussion with the surgeon. It was interesting as I had to insert the J tube first before the start the Op! the stoma wassmall and i struggled initially to push it in! That was the easy part; the tricy part was when they hadto pull the Jtube out and go through and through with the Shian Lee stent.. hehehe suspen gak but it was m first time doing this and it was cool...:)

Then, i had a go at jet ventilation for another man with a similar problem but this time they were looking at trying once more to laser the stenosis to enlarge it. It was just not the airway but he had a bad heart; with a 35% ejection fraction!! hahahaha so imagine me & Alvin( the lecturer) threading very gently not to cause overshoot on either side. The jet part was a bit unsmooth in the beginning and i managed to get hold of the rhythm as we went by.. At this stage i have to be competent at this not only for my exams but for my future role as a specialist..kenalah pandai buat!!!

Thank you Mr ENT for the good coordination. Plan is certainly important and the execution was excellent i thought! A is always for airway right? :)

Watch my priority!!

I really don't know why i feel so tried nowadays.. I did not manage to fit in any runs during ramadhan and so far in syawal it is not any better. Luckily my Salzburg trip had lots of walking in it.. ada lah calories burnt..
I guess the big bulk reason pertaining to my dilemma at the moment would be my late nights, juggling studies, family, activities and interest..( saja tak nak tulis FB here.. hahahaha ) I'm involved in a lot of things and I reckon thati have to straighten up to set my priorities..

M Anaes Part II May 2010... guess, this is my MAIN priority atthe moment. I do realize that I have not pushed into the right gear towards it though. My seniors told me its common but then hey, I'm not that bright to start of with therefore shouldn't i start early? hahaha ( cakap sorang-sorang..)
Let me list down what i will be doing from now on till Dec la kot to explain why i feel i'm doing lots of other things..

1. 14 - 16 Oct National Anaesthesia Day celebration in UM.. I'm involved heavily in it..
2. 24 My birthday .. hahahaha don't think I'll be super busy here..
3. 26-31 Oct Murud-Bario expedition.. in my quest to complete BIG 5
4. 1 Nov- Genting Trailblazer- really need to train now for this.. but i guess imeediately after an expedition trip, should be ok kot.. hahaha
4. Whole of November.. in IJN.. busy all the way and its a bit too late to do this posting isn't it?
5.Whole of December - ICU..

Hehehehe.. i really can't stop doing this to myself eih? a virus i caught since my school days.. checkmate..

MEME: Save Yvonne's sight..

Dah lama gua tak main tag or kena tag or anything like that.. but this time , ok lah ; its for a genuine cause.. ( kena tag ngan Nor ni..)
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Twenty-two year old Yvone has a rare genetic disease – neurofibromatosis type 2 – that causes benign tumours to grow in her brain, spine and along her peripheral nerves – since she was 16. The disease is incurable.

Yvonne has survived several surgeries to remove tumours – one on her spine and the rest on her brain. She is now semi-paralysed on her face, deaf, partially blind, has poor balance and a stiff right leg. Right now she needs to undergo yet another surgery.

Yvonne, who runs a blog (www.yvonnefoong.com) is the author of I’m Not Sick, Just A Bit Unwell, (picture), has been raising money on her own to pay for her operations, is losing her eyesight. The operation is due in December and once again she needs to raise funds for it. The cost of the surgery is USD44,000 (RM154,770) and the cost of her hospital stay for two weeks is USD915 or RM3219.

She has already raised RM10,000 of this but obviously still has a long way to go. She’s hoping to raise the rest by republishing her book I’m Not Sick, Just A Little Bit Unwell in English and Chinese.The books are now available in Malaysian bookshops and from her website store. She is also selling T-shirts at bazaars and via her store. You can read about her surgery and donate to her fund here.

Yvonne Foong is in danger of losing her eyesight thanks to neurofibromatosis (NF). Please find out how you can help her by visiting her blog at http://www.yvonnefoong.com.

You can also help by sending on this meme. If you do, please follow these meme rules:

1. Create a blog entry titled “Meme: Save Yvonne’s Sight”

DAH BUAT...

2. List three things you love to see. Add in the picture of Yvonne’s book cover. The URL is http://www.yvonnefoong.com/images/banner/my-story.jpg

A) GUNUNG DAN BANJARAN DARI PUNCAK;SAUJANA MATA MEMANDANG..

B) MY CHILDREN LAUGHING..

C) LIVERPOOL WITH ALL 6 CUPS.. hehehe

3. End with the line, “Yvonne Foong is in danger of losing her eyesight thanks to neurofibromatosis (NF). Please find out how you can help her by visiting her blog at http://www.yvonnefoong.com.”

PTO.. hehehe

4. Tag 5 blog friends. Be sure to copy the rules, OK?

MAFIZ SURIANA TUN M KJ DR ZEK

5. If you have a Facebook account, please check out Ellen’s new invention, a “feme” pronounced FEEM, a meme designed for Facebook. And if you want to blog about NF, that would be great too!

YUP..DONE THAT..

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I came across Yvonne and her illness when i was surfing the net to look for info on neurofibromatosis. Qaisya had few cafe au lait spots at birth and that triggered my worry . I had t be prepared if she was at risk of NF; but so far Alhamdulillah.. she's ok but I kow Yvonne is not. I really do respect her ways of coping with her disease and of course, pray for her health to sustain health in enjoying life ( i know she is doing it to the max since her diagnosis!!)

Yvonne Foong is in danger of losing her eyesight thanks to neurofibromatosis (NF). Please find out how you can help her by visiting her blog at http://www.yvonnefoong.com.

Will we stay lucky forever?

I am truly sadden by the catastrophic disasters which happened last week. It was one after another and to think that one was on our left and the other on our right ... hmmm..scary.. MY condolonces and Alfatihah to the victims of the tragic natural disaster in Samoa and Padang..

wiped out coastline..

strong heritage relationship with us Malaysia..

What if god would just change only 10 degrees of quake origin angle? It would have been us and the thought of "quake-free" as we are off the tectonic plate is myth after all. Impossible is nothing and with the current haywire climate change, anything is possible. I know for a fact that we are ot prepared ever for such a tragedy and if it hits us.. the damages would be unimaginable..subhanallah...
Looking back though, these disaster characteristics are very concordant to the signs of armageddon which i learnt yonk years ago. The description is as it is and of course, with all the turn abouts in the world. THe thought of death and end of days is interwinned with my readiness to face it if it really happens during my lifetime ( ironically la tu..hahaha) One cannot avoid and one has to embrace it with faith i suppose...

If i am being given the chance to be on ground zero to help, I would not hesitate at all .. Call me.. Insya-Allah!!!

Salam Aidilfitri 2009

Maaf Zahir& Batin!!
MAfeitz Mamat

Syawal eve

Holiday mood was in the air. I was still working today because it was pointless to take leave as I'll be celebrating in KL this year. Wifey is covering locum for the first 3 days of raya which I don't mind because it would be a start to more prosperous time to come.. hahahahah We would only go back to Muar later to visit Maktuk and the rest of the Atuks who alhamdulillah is still around.
My OFMS list was supposed to be at least an 8 hour job but it was cut short to less than 5 hours due to unexpected exploration which revealed minor repair job than was intended. MY boss for the day,Vas even let me off early which was nice of him to do so! Thanx Vas!!
It was nice to see the OT decorated in such a way to sooth those who this year would be working on Aidilfitri period. Ex
To the Nursing and Supporting staff of UMMC OT, Salam Aidilfitri and Maaf Zahir Batin!!

Remembering Salzburg

And to think that I was in Salzburg last week!!!

I reckon we chose the best congress to go; My interest is regional anaesthesia and Salzburg, Austria was definitely the place to be at. Mind you, we attended the congress on its full 3 days in contrast with people's perception that the congress was just an excuse to visit Europe( which was in a way) but we did not forgo the academic reason to be there. It was a mind opening experience as we got to meet the who's who in regional anaesthesia.The knowledge sharing session was simply awesome as these are the real experts.In Malaysia, we don't have anybody who is comparable yet; the nearest would be my Sifu, Ling!! Hahaha

with the living legends or RA!!

who's the cadaver?

modern state of the art congress centre
Salzburg is a beautiful town with its surrounding scenery simply breathtaking. It's the birth place of Mozart and was made famous by the movie the Sound of Music! The rich tradition of culture was obvious and highlighted to visiting tourist. We were lucky that during the opening ceremony, we were entertained by the city orchestra and soprano who delighted us with Mozart's and Hyden's piece.( save duit..hahaha)
Being typical Malaysians, we really used the one day Salzburg card!! hahaha With euro 24 spent, we went for the expensive trips to cover our cost namely Mt Unternsberg, river cruise and to the top of Salzbur fortress! We did visit the museums but as the majority of us were not that ken on history of arts, it was just for "cukup syarat"..eg Mozart's home, Mozart's museum, Salzburg museum etc)

Unternsberg cable car station top

river cruise

on top of Hohensalzburg

We did not miss the modern part of the city as well witha visit to Europark, world's best shopping complex !! ( budak2 bandar betul) and why not to its IKEA as well? hahaha we had iftar there for rememberance :)
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We were due to go to Eidelweiss, Grossglachner via the scenery route which is legendary. Unfortunately, it was cancelled as the road was closd due to bad weather. We were dissapointed initially but Shahnaz came with a bright idea that we go to Munich!! After surfing , I found that it was just nearby with a 2 hour train! So 2 countries at once!! Why not?

We were surprised when we only had to pay euro 30 for 3 of us to and fro to Munich. Apparently it was a special day-return pass for 5s! We boarded the double decker train and obviously sat on the top deck.. hahahaha I really love the superfast euro trains..:)
Munich is a modern city and not really a tourist attraction. I guess maybe i would not have the opportunity to visit this town more famous for football then anything else ( of course, there was the Munich 72 incident of terrorism as well..). Shahnaz was keen for Munich because of BMW welt, a centre for BMW lovers! There was the museum and showroom which showed the best of BMW!! If we had more time, we culd have visited its plant hahaha hmm.. my future car perhaps?

in front of the huge BMW complex

home of Bayern Munchen.. we should have gone at night to see the colourful display..

Marienplatz, Munich

Munchen by night..
We had iftar at a kebab shop near the train station called Taknakmakan( or something like that..hahaha) The interesting about that shop was it sold not just Halal Turkish delight but chinese as well.Apparently, the owner was half german with his wife from China, chinese-muslim. They were very friendly and I do recommend that place if you happen to be there. :)

I really enjoyed this experience and was thankful having to great colleagues who were great travel partners. It was full of fun and laughter with serious touches when needed. We maximized our time there and I wuld not have thought, after leaving UK 10 years ago to have this opportunity again to explore. The trip made me felt 20 again:
i) the "Usain Bolt" sprint in Schipol, Amsterdam to avoid missing the plane; damn BIG airport!!
ii) my luggage which did not arrive in Vienna in time that became my trump card to explore Vienna before taking the scenic 3 hour train to Salzburg
iii) the 30min hike to Mt Hochtron from Unternsberg and witness the beautiful scenic Austrian Alps
iv) backpacker style walk in Munich catching time to visit selected attractions..
Wow.. Alhamdulillah and that just the list on top of my head which is just the tip of the iceberg! Ramadhan in Europe was also rejuvenating and challenging! I thank god for this opportunit which was a good time out before I endure my coming months towards my finals.. :)

Back in town..

Yup.. flew back on Sunday. Arrive in KL on Monday. On call Tuesday.. Wednesday macam nak mati!!! hahahaha I had it all wrong as i thought it would make me better to beat the jet lag but instead I've made it worse! I'm damn bloody knackered at the moment and my eyes are wide awake! My lips cracked because of my stubborness to not use the lip balm when I was there.. and i am hurting a lot !!
I will definitely blog about my Salzburg-Munich experience in my later posts.. but don't think i can do it now.. still uploading the pics to my facebook s well as my hard drive. 500++ pictures to download can be a wee lil bit too long :(
It's nearing Syawal now and I went to school for Tarawikh with the main objective : fulfilling my zakat to Ustaz Ahmad.. hehe Mafiz, Azad and Fiqar had already had their tun in the last 2 weeks, so it was me left. I chose the 27th night as well as 16th of September Malaysia day to sponsor "moreh" KFC for the kids! hahaha It was a good day to do it especially with SMTTDI's surrounding of tarawikh:) It brings a lot of memories which will account as events that happened 20 years ago!!!
Its unfortunate that this year we were not able to hold any Kamcheng ramadhan events.. insya allah , Syawal will bring us closer:)

Around the ESRA congress

excellent view of Salzburg from Festung HohenSalzburg


The Malaysian delegate

listed..ehehehe

proud to present..

Peter Hebbard came to view our poster.. he was the creator of the block we did

Anatomy institute

ESRA and the sound of cadavers

I am currently blogging from the comp terminals provided by the organizer. ( I'll post the pic later) I'm very impressed with this congress so far and it is certainly not just a learning experience; but to see consultants lead by example. They are marvellous speakers as well as demonstrators and it motivates one to be like them in the future. We went to the cadaver workshop and it was really good. Now I can see why anatomy is as important to anaesthetists!!!
We've just done our presentation session this morning and it was good. The judge seemed to be impressed with our subcostal TAP block and there is a tiny bit of hope that we might win one of the prizes?? HAHAHAHA Harapan menggunung ! :)
We are waiting for Shahnaz's turn to present. I will write later when we're back at the room tonight.

Salam dari Salzburg!!
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updated..

Untensberg.. i just had to do it!

I am currently very-very tired. It was a hectic day today, we really went all out to visit Salzburg;s attractions with our Salzburg card. Tomorrow till Saturday will be purely conference related and that was why since it was only registration and exam day today.

I managed to coax Shahnaz and Ling to climb up Untensberg.. the highest peak near Salzburg.Its a major attraction never to be missed! Indeed eventhough we were assisted by the really high cable car to 1778m, there was still a 30 minutes hike to be peak!!

Arrghh.. i am too sleepy to continue. I will blog more later tomorrow:)

The Journey to Salzburg.. the beginning

I am currently blogging from my room in Salzburg.With Ling and Shahnaz ;our poster presentation submission were successfully accepted and that became the trump card for our presence here. Regional anaesthesia recognition is fairly new in Malaysia and I guess the reason why we are enthusiastic in probably taking the subspeciality exams soon. Its not often that i have this chance to do 2 things together.. for my future career as well as my love of travelling.

Due to unfortunate miscommunication, I was alone on KLM while both of them flew with Lufthansa. My flight was from KLIA to Amsterdam and then to Vienna instead of Salzburg directly. I kinda enjoyed the flight and managed to sleep in the plane to avoid jet lag on arrival. However, the time of transfer was very short , less than 1 hour and I had a bad experience with the immigration. ( travelling alone, given that i have a BIN in my name as well as my Malaysian passport reporting my travels to indonesia .. high risk !!) I had to run all my might so that i don;t miss my flight.. Jauh gile from C17 to E78!! MAk aii... baru lepas sahur and i was so thirsty making that dash!! )

I arrived in Vienna in one piece, still trying to catch my breath and i guess because of Ramadhan..god was testing me again. My luggage was nowhere to be seen!! AAArrrghhh.. Apparently it was left behind because of the short transit time. I was assured by the KLM staff that my bag would be sent to my in the evening directly to the hotel where I am staying. Ok.. and next was my journey from Vienna to Salzburg.

I decided to use the train as it should be a good experience crossing through Austria. From the airport i took a shuttle directly to Wien WesBanhouf . The good thing about europe rail is its easy to plan your trip!(learnt from my UK experience in the past).And of course, being sehelai sepinggang i decided to tour as much as possible of Vienna in that short one hour! This was not in my original plan considering my big luggage. I went around and of course got carried away.. so again I was running again to catch my train!! Hahahahaha Gila dahaga woo.. but that was never the reason for me to give up on my fasting! Weather was too excellent that it was definitely too hot! Apparently there is an ongoing heat wave.

The 2 hour train trip was good as the scenary was excellent. I arrived in Salzburg train station 230pm and both Shahnaz and Ling were waiting at the hotel. Luckily Garni Evido was so near to the station that i can spot it right away! ( Off colour red building..mind you in Europe!!)

We went around Salzburg old town later that evening and had my iftar. My legs were so gello by then because of my persistent walk through out the day!!

Both Ling and Shahnza is fast asleep and I am about to join them soon. Tomorrow will be the registration day and i believe there will be more adventure to come.. :)

The smelly call courtesy of Fournier..

Yup.. I am back in the general pool and of course to start it off, I was oncall yesterday. I had 2 excellent colleagues with me and the call was uneventful. But then.. we had loooongg cases to do.. which can be a bummer as weget bored easily! When we anaesthetist do a good job, everything is under control and when there is no internet access in the OT , it can be really LONG!
Of course in every call there will always be one case that you'll remember.. and this case I am about to blog will be something i will cherish and of course live to tell the tale. We had a 45 year old man who came with a really bad scrotal swelling; he was suffering from sepsis 2o to Fournier's gangrene.
When I passed through the reception, there was this strong stench which i could not really point out to what it was. It had the nasi goreng ikan masin smell and i thought it was brought about by the numerous order our boy got from Kampung Kerinci Bazaar. The mystery came to a discovery as i was seeing this man.. in pain and looked very ill.. it ws from him!! The gangrene stench was very pungent as it made a lot of heads turn when they passed the reception.
And of course.. during the procedure.. Ya Allah... the smell of pus and faeces was so bad that you can sense it from 3 OTs away and that is from outside! To be in the OT was a punishment as the air was filled with the septic molecule ! It was really bad that a bypass colostomy had to be done as the communication between pus and faeces was there.. it was SO DIRTY.. and of course, the cocktail combination giving an olfactory high stimulation.
I went in.. went out.. the smell stuck on my srubs and i needed to change m scrubs to get the feeling off ! The urosurgeon kept smelling his fingers after the op.. and repeatedly tried to wash it off to much avail! Hahahaha GILA BUSUK!!!!!
I will always remember this Fournier.. oh Fournier..
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I was given the opportunity by my department to speak in this morning's University CME regarding Do not resuscitate orders. Its not frequent you get trainees to address the UMMC staff on Wednesday mornings.To my surprise before i went into the UMMC auditorium, I saw the poster and..hahaha.. the big topic was LECTURE !!! I am giving my GRAND LECTURE? HAhahahahaha . The "speaker by" part was an English letdown as this poster was for public viewing! I guess UMMC must next time strictly vet simple English mistakes like this to avoid embarrasment to the institution.( you know how irritating hearing THATS MEAN??!!)
Being post call, i was a bit groggy to start off with.Of course, the audience was not as full as the H1N1 talk but it was adequate for me to convey my point.I've always enjoyed speaking in public and this time around I shared ith them 2 video clips.. one was of Mr Bean doing CPR ( which was hillarious) and the other, from grey's anatomy on DNR which i topped up with the frankenstein IT'S ALIVE classic! I was nervous to start off with but i guess i did OK. Its fun to do this once in a while and of course, will be another additional point in my CV...