Jonah at its best..

Masya Allah !!!!! Subhanallah !!

The call yesterday was sooooo busy !! I was stuck in the OT for 24 hours ! I know the calls can be busy but waah , i was so knackered come morning and can hardly drive back home. What made it worse was the seniors ; ( Masters students Year 1 & 2 ) are away for their intensive pre-exam course for two weeks !! Therefore , the one on call will have to deal with all the electives as well as emergencies ; to top it up the epidurals as well in the labour room.

However , i was unable to do any epidurals yesterday. I just did not have the time. My apologies to the ladies who delivered yesterday in upmost pain. The Maternity Hospital in HKL is the biggest of its kind in Malaysia. Imagine , having only one anaesthetist to handle all the cases through out the night. I was one of the unlucky ones lah.. On Friday , i was able to take short naps in between , but yesterday.. Muahahahaha.. too intense.. too intense.. cases kept coming like Pipe BOCOR..


Unique aquarium in sentosa

Yesterday , there were 20 emergency LSCS done throughout the 24 hours. I managed 13 of that !! Eventhough it was just giving spinal/epidural anaesthesia , it becomes more of a challenge because of the blood losses that occur intra-op ; very operator dependant !!! The other 7 cases was managed by my colleague who i had to SOS ; 2 OTs were opened 3 times , and from 1am onwards - it was running simultaneously. I dunno why they had so many fetal distresses ; with bad CTGs yesterday ; hence the urgency of OP and having to call Ismail ( my senior ) to help out. I'd query any funny management in the labour room at that time.

I had one interesting case at about 2am. A multigravid lady with multiple problems ( PIH , GDM , I previous scar , macrosomic baby ) who was scheduled for Elective Casear ; in labour. Apparently , she had this really painful abdomen , and haematuria ( blood in urine ) . The OnG fellas pushed for urgent Casear for ? Uterine Rupture . Alamak... i said.. called boss and he sent Ismail to help out as at the same time we had one Thick Meconium Stained Liquor mother as well. I had no choice but to intubate the patient.

It was a nerve wrecking moment. The lady was 99 kilos and mak aih.. GEMUK GILLER , short neck.. thick chest wall.. I really had the table high to intubate. Alhamdulillah , it was ok.. luckily it was sort of impending rupture of the previous scar , not bleeding profusely just oozing. Managed to extubate the patient well without her desaturating. HAks.. the only event in that Op was after intubating and bagging - was ok.. good bilateral chest expansion and the machine showed the tube was in.. but when i converted to the ventilator ; SUDDENLY THE VENTILATOR malfunctioned !!!! ee eee leeehhh... i was pissed off as i had to bag the patient for 20 minutes before the MA came and sorted out the problem !! Tu la pasal , in Maternity they rarely use the GA ventilator . I DID CHECK IT BEFORE STARTING.. but it just decided to fail on me.. mentang2 la not a difficult intubation.

Ismail was unlucky next door . It was a bad case that ended up with HYSTERECTOMY. 40 year old Gravida 4 who came in with fetal bradycardia. The Op ended ok , stable but post op.. during VE , Blood just poured out like nobody's business. Shakti was unlucky as he came to visit me , but ended up helping Ismail to resuscitate the lady. The whole OnG team was there to sort out the case.. giller critical.Intermittently i went to Ismail's OT to help out on other matters like getting the blood for transfusion. After i finished my case at about 6.40 am , i went into Ismail's OT to help him. Imagine ; She lost like 10 L of blood intra-op. Managed to replace it and transfused 2 DIVC cycle. She was then sent to ICU for post op management. Giller massive transfusion ; will have to check on her tomorrow.

Dr Satber ( My Consultant ) came into our OT at 8am this morning. She was smiling and laughing at me seeing the mess in the OT with blood everywhere. The drapes were dirty and it was total post chaotic OT. I just smiled .. haks.. She was a bit worried if i "had" it with maternity posting. But funnily.. The endorphines were at its max .. WAA CAKAAAAP LUUU....