Overdose

I was flat out yesterday. The whole day i felt sick , feverish , nauseous.. ooh.. slept most of the day. I'm not sure whether i overworked or overdosed by the anaesthetic gases during my on call on Tuesday.

Memories of HKL's call came back to me . It was bad , In Selayang most of the time you are alone and making your own decisions. The specialist is busy covering ICu and maternity thus making you to be on your own most of the time.I started at 9am and the cases went on and on for 24 hours. Called my last case at 7am and kudos to Marcia for replacing me sharply at 8 am.

I had 3 laparotomies - All 3 in bad condition. The first one was a relaparotomy - the had to go in as his abdomen is very distended and he was going into sepsis |( well , thats according to them , the truth is he is already in !! haks.. )They contemplated surgery for days and this was the result. It was really bad as the surgeons could not get into the bowel , they were just exploring the peritoneum and it had 3 L of blood and fluid collection.We had to transfuse a lot of blood and its product ; clinically he became white !! It went on for 5 hour ! I pity the man.. He had to be admitted to ICU and his prognosis is poor despite being only 27 years old.

The next case was a 30 year old gentlemen day 2 post MVA with intra abdominal injury. He was treated conservatively but he had to worsen during my call !Obviously, having spenic injury and uncontrolled oozy bleeding , they had to proceed with spleenectomy. He lost about 2 L of blood but being young lad , he covered it well. We supplemented his blood , and all in all we managed to extubate and send him to the ward.

This simple appendicectomy turned into a limited right hemicolectomy. It was unfortunate for this 47 year old man with no known medical problems , came in with an acute onset of right ilian fossa pain.. and when they went in his appendix was absolutely normal. However it was noted that he had caecal perforation with pus collection. The surgeon decided to give him the BIG CUT as there was no reason for that part to be perforated unless it was malignancy or TB. I was quite frustrated as i thought this was my last case for the night but it was not !! and finished it at abot 3.30 am.

Had one eye emergency of all days.. and we proceeded at about 4am. I was so tired. By then , i felt so dizzy and nauseous. I felt sick and tired..but i had to go on.
And then Gynae called telling me there is one possible ruptured ectopic. I was so knackered that i told my nurses to call the case at 7am sharp for me to catch a short nap. After Subuh , i managed to sleep for about 40 minutes when the counter called me. I felt so tired , and just sick ... so sick.. i have never felt like this during my calls.

By the time i was at home.. i was so tired and sick. No appetite.. and had to sleep the whole day. Luckily i'm on PM shift today.. so i can still continue my rest this morning before going off to work..