Tangent deviation

post badminton without azad this week 

The main reason why most of the kam-cheng gang decided to restart the badminton game on tuesday nights ; was to shed off the extra weight we have been gaining for the past few years. However i realized that the past 3 sessions , the objective is somehow deviated. Seduced by the dark side of the force.. We did sweat out solidly for two hours , but everybody had one thing in mind after 11pm...

haks.. the nature of being mentekedarah is still strong amongst us. Since we were introduced by Dil 2 weeks ago , the ultimate kuey teow of 222 , PJ , we've been a regular crowd there! And the way we eat ..man.. kuey teow belasah sekali 2 pinggan. dah la murah.. hehehehehe.. Azad n his boss Roslan however did not join us today due to his commitment to work. Haks.. good for you Azad..


RM2.50 kuey teow pujaan hati 

Hopefully , the kuey teow eating session will not take over the main objective ; that is to enjoy a good game of badminton !! haks..

p/s somehow.. the "world" fever hit us badly during the game..


corrupted bunch 

From eye to plastics

the fear 

Did the plastic ( plastic surgery ) list today. HKL is one of the few centres in Malaysia with this particular discipline.In the government setting however , the surgeries done are usually essential especially after recovery from major accidents ; eg reconstruction of the skull like the one i was involved in today. I don't think they do breast enhancement surgery here ; well as far as i know lar.. This is the beauty of anaesthesia , you are an essential part of every major surgery thus the exposure to various fields/sect of surgery.

My eye ( opthalmic surgery ) yesterday ended early. The main reason was because the first baby on the list died the night before. It was a bit sad though for the unfortunate 2 year old retinoblastoma child. Yesterdays surgery exposed me to 2 aspects of anaesthesia ; for eye surgeries and paediatrics. Being small they have their own problems and having an eye problem complicates it more ! It was fun however .. hehehehe prickin the poor little kid..

The plastic unit is headed by a kewl COnsultant surgeon called Dato' RAR... haks.. he is indeed an interesting character as i enjoyed my time with him just now. He likes to chat in the OT regarding all issues , from takut bini to travelling in europe.. haks.. and he loves Beethoven's symphonys. ( we all had an ad-hoc classical music lesson while he was doing the surgery ). but mind you his hands moved as articulate as his mouth ! haks..He wears bow tie to work and i guess that just sums it up ! He was fun though he has this image of being the most "fussiest" and "garang" surgeon in HKL. This was evident during the theatre itself as even his own Consultant dared not to speak up that much as he weaves his magical fingers. He ended the surgery with a Broery Marantika song ! ( haks.. believe it or not , he has a CD wallet in the OT and will instruct the nurses to play on CD's according to his mood !! )


Rae tube.. tapi ni baby nyer lar.. 

In terms of anaesthesia , plastics is a breeze and posed not much of a problem compared to eye surgery. The trick is to ensure our tubes do not intefere with the surgeon's surgical field. Usually we'll use the RAE tube which is curved where the circuit will be attached at the patient's chest level downwards.( we use this in ENT and eye as well ) We have to really plan well regarding extensions and iv lines as when the patient is fully drapped it maybe to late to access the lines !!

The surgeries they did today involved the head. The first was just a small excision of the preauricular sinus ( ada lubang ah dekat ngan lubang telinga )but mind u.. the dug in about 2 cm which is quite deep ! haks.. the second case was the excision of an AVM ( Arterio-veno malformation ) situated on the patient's forehead. Kesian that patient as it looked like a horn ( tanduk ) base ! He told me his friends called him "DAJAL" for that look ! haks.. The third case was challenging as they reconstructed the "excised" frontal skull . Basically the chinese man had a bad accident two years ago and in a life saving attempt act by the neurosurgeons ; they excised off his frontal side of the skull to the dismay of Dato RAR. So kepala dia cam depressed ah sikit. I suppose this is where plastic reconstruction is beneficial compared to the unnecessary cosmetic surgeries .

" You anaes guys must help us.. the next time you see neurosurgeons cut off and throw away parts of the skull , tell them dato' ahmad is not happy... " as how i remembered his statement made in an annoyed tone..

p/s hmmm.. cam interesting lak plastic surgery nih... Worlldd...

Cool weekend

my patient realtime 

Nothing really spectacular happened during the weekend. I suppose the big news in the Malaysian circle would be the suspension of Tan Sri Isa ; the vice president of UMNO. Imagine , the top gun of UMNO found guilty bribing the delegates during the election last year. The official announcement is suppose to be tomorrow but Hmmmm.. not really good is it ?

Haks.. well , though i do agree with this crackdown , it is disturbing to know that there were lots of voters ; among the members WHO ACCEPTED THE BRIBE. Giving is one thing but accepting and fulfiling the bribe obligation until he won handsomely rings few bells and flaws in the party circle.It just shows that corruption is part and parcel of politics and power. This definitely contradicts with the hopes and aspiration of "rakyat"...


brachial block , ni picutre from the net.. 

I was on call on Saturday. It was cool and nothing major really happened so my cases then was more of the "cold" ones. Saleh , one of the kewl new specialist spent some time with me teaching me about doing blocks. HAks !! and yes , i managed to do 2 on my own ! one functioned well the other one i had to give the LMA !! well , regional block anaesthesia is a skill on its own , not everybody can do it.

Regional local anaesthesia has its advantages. Patients do not have to undergo General Anaesthesia which has its own set of complications. Usually patients who undergo simple procedures with injuries like closed fracture of their arm bones ( ulna , radius ) would benefit from local anaesthesia. The trick is to paralyse the nerve roots which innervates the supplied area. Yesterday , i did the brachial block via both supraclavicular / infraclavicular approach. The procedure was simple , Incision and Drainage of wrist abscess. Haks.. its difficult to know whether you've succeed doing it as one has to wait for about 30 minutes before the arm is totally paralysed !! haks.. it was kewl when the boy suddenly complained that he can't feel his left arm at all !! I need to practice lots of time to be good at this.. haks.. memang kewl..


the machine of my life.. hehehe 

Went to the TTDI pasar malam at night. Haks.. well , its the routine activity on Sunday evenings. It is a favourite past time among the TTDI boys , we were brought up with this culture. Though many people would think that TTDI is an elite area ; but the pasar malam survived with regular show ups by the hawkers and loyal customers like me for more than 25 years !I used to go with the kamcheng guys without fail.It was like a social event , meeting and seeing people there ; and our buy was usually air tebu , soya , burger and apam balik. haks..

I met MAfiz and Megat there just now ! haks.. that just proves that eventhough we've grown up , pasar malam is definitely a must on Sunday evenings !!

Crisis in hand

doa for them 

Something really bad happened to a former colleague of mine in the medical deparment , Dr Shah Jahan . His youngest sister , aged 21 years old had been missing since Monday. The whole family is currently at lost and don't know what are they to do with this crisis in hand.

She called Shah on Monday morning to send her to UIA from home . She was to take her exams sometime in the afternoon. Shah went back and her sister was not in sight. He thought she might had gone on her own as he was a bit late. Later in the evening , the university called and enquired about her absence. Everybody was in shock as it was very atypical of her to do so.. especially in the midst of taking major exams !! They queried her friends regarding any possibility of her running away from home. However , her personality and not so colourful social life denies this . She had always been courteous and obedient to the family. No problems encountered in her 21 years of life..

The family is very anxious. They;ve made their police report and currently waiting. Waiting for what i don't know. Everybody is praying that she'd be ok , if abducted - a ransom call would actually give a bit of relief knowing that she is still alive. Her phone had been deactivated ; no way to know her location and abouts. With our current crime trend , one can never know. My sympathy to the family. Shakti went up to Bukit Aman today to see what he can do for Shah. Kudos to a dear friend helping another friend in need.

Shah actually came to work today ; though he was given the week off till the problem is solved. His argument , he's lost at home , everybody is crying and movement is scarce.. SHakti sent him back home as he was certainly not focusing and in a depressive state.

MY prayers for his sister and hoping for a good outcome. Insya -Allah..

p/s i cannot imagine being in his shoes...

Medics issue spotlight

And the issue continues..

Is this what we call political compromise ? Pakatan murni ? The MIC fellas ( Samy Vellu and Soothinathan himself ) certainly looked dissatisfied on tv3 interview tonite when asked about the issue. What they uttered certainly contradicted their gesture and body language.

Very dodgy when one plays with fire..hope that this issue will not spark anything racial and 69 memories triggered....

Wednesday, June 22, 2005
Sothinathan suspended, says PM
The only official designations left for S. Sothinathan now are that of MIC Sec-Gen and the MP for Telok Kemang.
His government post as the Natural Resources and Environment Deputy Minister has been suspended by the PM with immediate effect.
The PM said Sothinathan was suspended for criticising the government during Tuesday's parliamentary debate on MMC's derecognition of medical programme offered by Crimea State Medical University (CSMU), Ukraine.
The PM said he had advised the Yang di-Pertuan Agong who had consented to Sothinathan's suspension.
Sothinathan will resume his post at the end of the three-month suspension.

Indah khabar dari rupa

supernova 

Read an article in NST:" Tuan - Puan Doktor" and it was indeed very interesting and made me wanna blog about it when i get back home .To my surprise , A fellow blogger did comment on it (Nor) and it is interesting to see her point of view.

Every year ; especially for the past few years ; issues about students who excelled and were denied their so called "right" to do medicine were highlighted. Worse still, when people question about scholarship , meritocracy etc. I just don't understand why do parents push their children to do medicine so much ?? What is so great about being a doctor ??!!! ANd the latest issue about CSMU de-recognition worsens the situation considering Malaysia having an ongoing quantity problem in its hand.

Parents dream of having their children becoming a "tuan doctor" .The potrayal in media esp tv shows certainly boosts up the image and stature of doctors. However , i can say that what is shown does not apply to our Malaysian scenario. This is what most of us do not realize ! The reality of hardwork and commitment to our patients in ensuring the best healthcare delivered to them !! haks..We are merely "servants" to our patients literally !! Imagine ; having to take blood , set up lines , lap muntah a drug abuser who is HIV positive in the ward. Imagine having to go through 5 years of hell in med school and end up treating patients such as this ? Ethically challenging isn't it ?

I don't blame the young guns though.. Getting good results is definitely a pre requisite but there are lots of other criterias which is important for a doctor. When i was at their age , i was idealistic of course and conquering the world was possible ! haks.. but kids nowadays are supposed to be more matured and we are the ones who should expose them the reality so that decisions made would be based on facts and not emotions . And the governing body themselves are not doing justice to these students. I remember last year when this commotion came about with one of the solution being students applying for medicine are to be interviewed and a special aptitude test held. Potential students were to be given "experience" in the hospitals and this will be a factor before they commit themselves to the course. Hmmm.. macam takde je tengok gaya so far ?? What happened lar ??? Honestly , i would be happy to coordinate the programme if being given the chance to do so.

Regrets ? Me ? nope.. not me.If given the option i would still continue what i did then.Crazy it maybe but i dunno what other work can combine knowledge , communication , gung-ho excitement , playing with life and death , playing with publicly prohibited drugs and coping with illness.Few colleagues would disagree ; some had even quit on their second day of housemanship. Few had to be treated for depression on their first week. Being a doctor is definitely hazardous !!

All in all , one has to know really well about the world one wants to endevour. At the end of the day , it is what you want is important. not living for other people or hoping for stature and title !! Medicine is a very noble profession. One has to be very sincere and caring to last and fulfill the fard kifayah. If one lacks this criteria , then lots of regrets , dissatisfaction , grumblings and misery would be the picture of life as a healthcare worker.

To aspiring "dogs" ... Stay firm and be determined. At the same time , Please do know what you're getting into and decide before its too late...

p/s not very encouraging isn;t it.. haks..

Tic tac toe

happy couple 

Something that i just had to blog tonite : it happened during the weekend when i was in Malacca.

My wife asked me to buy tic tac ; she craves for this somehow in this pregnancy. To my generation ( i think.. ) we are quite familiar with this breath freshener , cool small tablets of sweets.

I went to a 7 eleven in Melaka Raya. To you who's been around that area before ; the nite life is a bit dodgy . Too many clubs , karaokes which is very-very-very active at night. ( ni background sikit ah.. so you'd understand the story )

So ; i was there in front of the 7 eleven counter at 6.30pm . tried looking for tic tac but to my avail ; was unable to find it. So i decided to ask the cashier. He was about 17-18 i think ; having the post SPM waiting-for-placement look.

" Dik.. tic tac ade tak ? "

he looked a bit puzzled. so i repeated ;

" Dik.. tic tac... tau tak ? "

he frowned.. and suddenly like a lit light bulb, he picked up something in front of him and passed it to me..

"Laaahhh... bukan ni la dik..gula-gula !!! "

He passed me a packet of playboy CONDOM !!!! haaakksss.. what an assumption !!Quickly i glanced through his front desk and i saw tic tac..

" Dik.. yang itu laah.. " i pointed to the tic tac small boxed packet.

He reached for it and gave it to me with a grin..

I know the place was dodgy, but one wonders if funny terminalogies or word refers to condom straight away ? hakss...

p/s the Ministry of Health can change their campaign tagline for free condoms to .. "have a tic tac, for a good knack paddy whack" .. haakss..

Special occasion

My grandparents  

En;s wedding in Muar certainly brought a lot of memories to Atuk and Maktuk. 12 weddings were organized in this Parit Setongkat house ; the last one in 1998 during Pak Cu's wedding. Both of them were happy being the host for this one of a kind function. Lots of relatives , extended families attended the reception today.It was special as well , as a special "cake-cutting" ceremony was done to the fathers in the family.

HAPPY FATHERS DAY !!


father's day special 

grandiose

Papa n Mama with En and Aleza : Tengkera reception 

En's wedding was definitely done most majestically as one can imagine. Anak lelaki ada 3 reception !! haks.. Well , he is the youngest and Mak Long certainly wants to "close the shop" fantastically !! Being the leading caterer in melaka ( organizing feasts for TYT,CM and most major government functions in Melaka )the food was definitely the best!!!

It started on Friday nite with the reception with bersanding in Melaka. I was not able to attend that as i was on call. They wore green and mama said that it was really big ! haks.. berzanji , katam quran , hadrah..u name it ! haks.. though the pengantin only came in at 930pm it went smoothly.


Auntie Ha , Mak Long , CM , Pak Long , Mama , Papa : pic with CM 

Saturday nite was the biggest gala. Held in Melaka mini-stadium ; the set up was definitely spectacular. Nearly the who's-who of Melaka was there that night. Tables were set up to receive 1000 guests ! haks..imagine that magnitude ! Memang besar-besaran habis !! The TYT was there , CM was there , SS was there too.. gile VVIP nyer function ! haks.. Well , we ; the uncles , cousins were running around to ensure the function goes on smoothly. Though there were few glitches ; we managed to pull it through!! haks.. I enjoyed the Cak Lempung group brought in specially from Seremban. the kids were really good ! Somehow ,i've always had this fascination for traditional music..


Mini Stadium reception : pengantin coming in 


us with the lovely couple 

And after 8 years lapse ; the last reception for our relatives was done in Muar ; Maktuks place. It was i reckon the best of all. It had all the kampung ingredients and flavour. It was strictly family ; no VIPS so no formality. It was funny to see PakCu running to the pengantin couple alone with the umbrella and bunga manggar as the rest of the group was nowhere to be seen !!! Everybody let their hair down today . I certainly enjoyed the Kompang group rendition of "Mama saya mau kahwin " and the MAWAR Muar group who really sang beautifully and eased the hot Sunday afternoon !!

p/s i'm struggling to open my eyes to blog this entry mate...


last minute setup in Muar 


maktuk's pleasure 

Fright nite

I'm on call today ..surprise..surprise... but my call today is the call wanted by all ! Its APS ( Acute Pain Service ) call.

well, what i basically do is providing acute pain service to the post op patients. In the morning i will visit my patients in the ward who is already on epidural analgesia or PCA ( Patient controlled Analgesia ) and check how are they doing.The thing is , by 10 am this morning i was free.. and macam jobless la jugak.. then after friday prayers , only 2 patients to review.. and again.. macam jobless. Though i;ve never tagged for this call , so belasah jer la today. Basically , what i do is wait and attend my patients if there are any problems or in severe pain in the ward. haks..

sounds macam takde kerja kan ? haks.. ut at the same time , i am also the substitute ; if multiple op are done at the same time , i maybe pulled into one of the OTs and run the show. so cam , depends on my luck ahh.. haks.. Anyway , now we have sufficient manpower and that is why we can afford to have one extra man here.. when he dont have enough people , then the one doing paediatric call will have to do the APS job which can be annoying at times..

I started this morning with 9 patients ,discharged 5.. and now at 7pm.. the list is climbing.. having 15 at the moment....

JUly plan

ICU 

Hmmm.. don't think i will be able to go to Ledang next month. Got to know that i will be posted to the General ICU ( Intensive Care Unit ) for 1 month in July ! haks..It'll be busy and tiring. The placement is a bit fast considering i'm still only 4 months old come JUly.Usually they'll post you after you're 6 months old. Well , i suppose kak zainah ( the roster maker ) loves to challenge me ! haks.. but i don't mind. In a way , i've been waiting to be trained in ICU.

Honestly , the reason why i joined Anaes was because of the ICU people. I remembered duirng my medical posting days , when the patient deteriorated ; we would call the ICU people to have a look and take over the patient from P2. Usually , when patient needs to be intubated and ventilated. The Anaes guys will always be SUPER COOL and see what's up and really cool managing the patient. One incident that i will never forget was when i was on call in CCU with Shakti. We had problems intubating one really fat patient. Tried multiple times ; with alternating defibrillating the patient as he went VF everytime we shoved in adrenaline. And then he came ( it was Rai.. heks.. ) he brought with him a small bag - and showed us.. haks.. McCoys laryngoscope.. memang cekap giller.. then , really liked his style and attitude. Almost all of them were like that !! Memang nampak kewl giller.. so i wanna be one lar.. hehehehehehe..

In ICU , the seniors told me i'll learn a lot managing the critically ill patients. The nirvana of medical care ; patients being almost 50-50 most of the time. Sounds scary in a way as death is almost always certain when one is admitted there.. Interesting eih ? It'll be busy and challenging , but that's what it is all about eih ? Kalau nak relax jer.. baik takyah jadik doctor..

Anyway , saw the DG again on tv today. dia ni media-savvy tul aah.. Apparently he announced that the government will not be recognizing CSMU in Ukraine for intake after December 2005. But the way he said it on tv , was really kewl i must say.He was always known to be a hardliner ; now being the DG i believe he is showing his colours ; which in a way upgrades the image of KKM .I suppose part of his vision on re"brand"ing The Ministry of Health towards ultimate professionalism. well, i don't mind having a DG like him - certainly boosting us ( doctors )image in public. * though dia jugaklah yg dok cakap nak tangkap doctors buat locum*

Impressive..

Read a reply letter by Ministry of Health's Director General , Dato Dr Ismail Merican in New Strait Times yesterday .. ( Tuesday 14 June 2005 ).Kalau fre-free tu bacalah.. it is interesting ! He was answering the issue made public by NST last week ; regarding the so called unprofessionalism and uncaring attitude of government health carers !

He really lashed out the claims and i must say the letter was well written. It was certainly soothing to see our big boss on our side ; defending his staff. True , our health system maybe patchy here and there but the media's potrayal can be unfair at times. He really answered them well with facts and in a way ; i must say that the disclaimer will definitely reply to his letter soon.. haks.. waiting on daily basis for their move.


a doc's pride.. 

I've always believe that it is easy to be a critic but definitely hard when you're on the other side. Most of us do not really know how Malaysia's health care system is run. We are only exposed to overcrowded hospitals, prolonged waiting time for consultation , bad services etc which will always be on the negative side. Our doctors , nurses and allied health workers i can assure you will do the job to the best of their ability. Trust me on this ! It is just that the workload is too much... too much for us to be perfect. And mistakes ,government red tapes worsens the already bad situation. What makes it "better" is when the bigshots , politiciaNS intervene with our system to their advantage.. and the whole set up becomes one f***ed up mess. Haks.. need i say more..

haks.. sorry lor.. luahan seorang pegawai perubatan kerajaan.. U41..

Makkah story

i will visit you again soon . 

Went to visit my parents in the evening. They just came back from umrah , together with Muti and Doya. Haks ! Well , havent seen them in 2 weeks and miss them a bit ! haks.. anak manja la katakan..

Anyway , they were excited with our presence. Mama kept telling about her experience there. Quite funny though , especially regarding their travels. It was good that my father is quite fluent with his Arabic ; therefore able to negotiate and tell the rude Arabs straight to their face regarding our dissatisfaction ! haks.. apparently , we malays are always bullied by them ; cant blame them though ; it is just our nature to be nice and non-complaining race.. hehehe.. pandai cakap belakang jer..

Anyway , according to Papa , Makaah has changed a lot since we were last there. There is lots of development ; as one can read from Nor's blog regarding her umrah recently. Wow.. can't imagine the growth the country had since i last visited them. He was able to complete multiple umrahs with the family. Muti was a great help and it was nice to hear he managed to do lots of the afdal thingy during umrah. I do hope that his umrah visit will open his mind and be more mindful in his future undertakings ; especially after all that has happened in the last 3 months.

Papa bought me one moroccon jubah .. which is really really kewl !! haks. it is hooded and i look like ob wan kenobi when wearing it !h ahahaha.. and the kopiah they got me was the unconventional type ; rupa macam usher la pulak.. hehehehe

read Azad's blog and yeaps.. we're going to Leadang soon .. insya Allah !! well , we planned it on the 25th this month ; however i checked my schedule today and discovered that i'm on call on that day..hmm.. bummer !!! Well , i suppose July will be a good month for another mountain climbing session !!!

p/s will write bout En;s wedding after everything is over this weekend in Melaka ! anyway , i don;t have my digicam with me now.. nantila ada gambar baru lawa dak..

Family building

special one 

Its that time of the year again. When school holiday commences, automatically the wedding season is on. It is during this time families gather and celebrate new union and expansion of family units ! I believe that most of us will attend at least few weddings this month , being it a friend , work colleague or even relatives .

My cousin En ( Mak Long youngest and only golden son ! ) will be getting married tomorrow.( i think there was a blog about his engagement early this year.. ) He is a very dear cousin of mine and we have this special bond between us. When i was young , i would spend my holidays in Melaka with him for that duration ! That happened from standard one to six ! Come form one , i was busy with my scouts , school activities and him with his . However , we are still close and he was my best man during the wedding. He did lots for me and i do appreciate that !

And becoming the youngest in his family , Mak Long decided to do it really big this time around ! Though tomorrow will be nikah and then on Sunday the girl's side reception ; Mak Long is going all out ; 3 days of reception the next week. Friday nite 17th of June in her Malacca residence , On Saturday nite 18th of June in Ayer Keroh mini stadium ( haks.. its that grand or what !! ) and lastly , on Sunday 19th of June in Mak Tok's place in MUar !! HAks.. splendid !!! Well, being johorean , we do make our weddings as grand as it can be !!!

To En.. my best wishes for you !

p/s mana nak curik digicam for the pics huh....

Dilemma

Somebody from Mercy sms'ed me today. They were enquiring whether i could go to Acheh sometime soon to help out in their hospital. Certainly , a very tempting offer !! Haks , i've actually applied a number of times but during the "hot" period , obviously it was a bit difficult for my name to be included. It will certainly be a really really good experience for me. Imagine , being one of the anaesthetist in the slowly functioning back to normal hospital..

Hmmm.. a dilemma indeed for me. Not that i don't want to go.. i DO REALLY WANNA GO.. but its quite difficult to leave my wife at this stage. hmm..

I will have to ask the opinion of my superiors tomorrow. I know they would encourage me ; hopefully Dr Ng will allow me to get the 2 weeks experience in JUly.

Cool Wednesday

my object of desire 

The morning started of well with our weekly kuliah subuh. Unfortunately , the absence of 2 key figures of our weekly CME impaired the proceedings! We were locked out from the conference room as nobody had the key ! It was as early as 7 am ! haks... Thinking back , this kuliah subuh has some religious association becuase besides discussing new knowledge ; we do ponder on death during the mortality and morbidity review !! Mengingati mati.. hahahahaha

At the end of the session , Big boss called upon my boss today and told us that we have a VIP patient for laparascopic cholecystectomy today ! Dr Salleh looked at me and i said.. eihh.. i have no idea lor as i was post call yesterday !! Hak.. tengok2 ..laaa.. Deputy Minister of Women and Family Development ; Dato Palanivel.. Shakti's father !!! hahahahaha .. I immediately sms'ed Shakti to inform him that i will be doing the case !!

Obviosuly because it was a VIP case , Dr Ng ( the big boss ) was in the OT. The MO who did pre med yesterday told her that the airway might be difficult ; hmm.. but to my assessment , i don't think so. Therefore , i volunteered to intubate the patient ; and yup.. i was right; Cormack-Lehane grade 1 though it was claimed that his Mallampati score was III.And of course , the Op went ok.However , Dr Ng refuse to leave our OT ; and Dr Salleh kept making excuses to be out of the OT !! hahahaha ..so i was there with her and of course had useful ad hoc tutorials lorr..

Haniza went for her scan today. haks.. and i know the gender of my baby !! However, i missed the scan session this week.. hmm.. Well, i will keep it as a secret till the baby is out and well..insya-allah...

Hmmm.. don't think i will be able to post any new pics this coming 2 weeks. My mum brought the digicam to umrah ! haks.. unless, i decide to do something stupid like buying a new camera soon.. haks.. well , don't think so but you'll never know ; just like how i "suddenly" bought a new badminton racquet for the badminton game last nite !!! hahahahaha

I did it !!

I should be sleeping by now.. but i;m still in front of the screen...

Yes.. thank Mirul !!! haks.. now i have music on my blog ! Something i wanted to do for so long but had NO expertise of doing it !!!

Enjoy the song yeah.. while reading my blog..

p/s sent mum , dad , muti and doya to the airport today for Umrah.. haks..wished that i was on the trip as well..

Jonah ride

I had a bad ... really bad call on Friday. I slept almost the entire day yesterday , went for locum and came back tired still. And slept the whole nite ! Still , i'm feeling a bit jaded today. Maybe a cup of kopi Gano will make me refresh for today's activities !

I was suppose to zap up the psy fellas on friday morning . Haks.. but things were definitely going tangently from the planned schedule. I arrived quite early about 7.15 am ; met the on call fellas from d previous nite.

" Good luck eks today.. Ada leaking triple A ( Abdominal Aortic Aneurysm )about 10 cm for you. 76 year old malay lady ! "


 

Mak ai..i said... Azrin , my new specialist , the new cool guy on the block was a bit panic when he heard the news !Its true what they said about new specialist being on call for the first time ; a very jonah period ! My partner for the day Tan , did the ECT instead and had to cover lots of other OT which went into distress as well.

It had been quite some time when he last did AAA.It was a bit haphazard initially as we had MRI list to do as well that morning ! Doing triple A is a bit complicated because massive bleeding may occur during the procedure. We were lucky though coz it was only leaking and not burst which would have been catatastrophic ! However once it is leaking you never know your luck though !

As we were doing the case ; multiple phone calls came in to inform cases ! Haks..and my list from only 1 , beranak to 4 pages ! And most of it big cases ! Damn it.. I had in the end 20 cases booked to do dor the whole night !And nobody was around to cover us ; so both of us missed Sembahyang Jumaat la pulak !!!

AAA went ok ;it went on for 4.5 hours and we did it ! Azrin was relieved when it was over. He was having a headache then as well as other OTs around the hospital were ringing for help ! haks.. but more was to come. Did a tracheostomy case from GICU. A 54 year old Indian lady ;3 days post thyyroidectomy . Thought that it was going to be a breeze but because of her previous OP , the ENT MO was unable to locate the trachea properly ! HAks.. the procedure which was suppose to be a mere half and hour went to 2 hours! The consultant had to be called in to do the trache ! And i can tell you , the unexpected length of time spoiled the day !

An 18 year old boy with volvolus came in immediately after being pested by Mr Kwan ( the UPM Surgery Specialist on call ) for a sigmoidoscopy KIV Laparotomy . Luckily he managed to untwine the volvolus through the scope otherwise unnecessary OP.

Immediately after that we had a relaparotomy for a 42 year old Malay guy , who was operated 3 x before this. His initial problem was gangrenous bowel and an anastomosis was made. However he went into sepsis and the leak from the fused bowel was repaired twice. However he did not recover and went septic again. He looked really ill and i reckon it was a good decision to proceed with his case. A funny thing happened during induction as i did not check his trache properly. There was no cuff and i had problems ventilating him initially. I did not realize that until i put hium on the ventilator ! Haks ! bodoh gile tengok air bocor ! However Azrin came to the rescue and changed the trache. The Op went OK.. and next we had another laparotomy !!!


our lovely on call room ; empty last nite ...  

It was nearing 11pm when this 13 year old boy was brought in. A psy case as this boy jumped from the 5th floor to the ground and hurt his abdomen ! He had splenic injury and a splenectomy was done. Haks.. macam2 la pulak..

Suddenly ICU called and we had to intubate a 95%^ burn case from Batu Pahat.. gile nyer jonah dear !! Azrin was shaking his head. None of us really had any rest throughout the day ! Dr Thohirah ( our consultant for the day ) was still around till then .. managing the PACU case from UPM elective list. Unfortunately the patient had to be defibrilated as she went into SVTin PACU !!!! hahaha.. i was already laughing at this stage thinking what next huh..

As we were about to call a 76 year old chinese lady for another relaparotomy at 3 am , Mr Kwan pushed a case from Nephro ; a 65 year old Malay lady k/c of End stage renal failure with hypertension and Diabetes with a vague history of IHD ; currently in hypovolaemic shock ; intra abdominal bleeding caused by iatrogenic Stab Peritoneal Dialysis that late afternoon.It was pushed in and induced , intubated early ; we barely had time to set up proper lines for her. Imagine doing her case stat without CVP , arterial line and she had only 2 working 18G lines !!!

SHe had almost 3 L of blood who went gushing out when the abdomen was incised. We were pumping in blood like mad and at the same time controlling her BP. She was initially on inotropic support as her baseline BP was damn low. Azrin was so tired that he failed to insert the CVP line x 5 ! haks.. i was bust running around and pumping blood into her..

Amazingly , she was very stable intra op. Alhamdulillah i would say.. And we booked uro ICU bed for her post op ; but post extubation she was really stable with a full GCS ! Considering her urea level we thought that she might be difficult to arouse ! By the time we pushed her to the recovery , it was already 6.40 am ! haks..

I was really.. really tired when everything was done. My god !! Did not expect it to be this bad. We had to postpone 2 major laparotomies , one BKA for the guys on call the next day. On top of that , 2 laparoscopic lap for ectopics , 2 appendicectomies , 1 semi-e strangulated hernia , 2 ERPOC and a trache to do.

It was a good experience though , another day in the daily routine of an anaesthetist on call ..