Negarawan

young then..  

The passing of Tun Ghafar Baba last weekend was much expected.Knowing his condition since his ICU admission in October last year made me wonder how long can he survive.Not to mention the cost being admitted in ICU for 6 months !! Al fatihah.

Its funny though , how at one time he was very unpopular amongst the Malaysian public.Eventhough i was very young , i remembered the time when he was announced as the replacement for Dato Seri Musa Hitam as DPM in 1986. Though he was a well known figure during the 70's but his "dissapearance" during Tun M's eraly days made people ask.. Encik Ghafar who ?? Everybody was very sceptical with this "undynamic" looking fella and could not relish the thought of him becoming the next PM !! His English command was always a suspect but he managed to hang on and do his job as required. Certainly a loyalist and a strong grassroot politician .He managed to strengthen Tun M's power during the SAD UMNO political power struggle in 1987. When Tun M had to go for his bypass, Tun Ghafar was the Pemangku PM and everybody wanted Tun M to recover fast as the public could not imagine him taking the oath as PM !! haks.. Certainly Tengku Razaleigh / Musa Hitam was preferred then .

I certainly symphatized his political downfall when Tun M decided to promote his protege during the 1992 - 93. Tun Ghafar had to fight for his survival against Dato' Seri Anwar for the deputiship of UMNO. Tun M did not announce his support for Anwar but it was an open secret. I encountered Tun Ghafar then in MAYC hotel ; My lodging for the Pidato Piala Diraja National finals in 1993. He organized a dinner and we participants were somehow brought into the political talk. He with Dato Seri Sanusi Joned lambasted Anwar and Tun M's policy then . i remembered how he was sad as he felt used as a political tool.

" Habis madu , sepah dibuang... "

Tun Ghafar had to relinquish his post when the majority of nominations went to Anwar. He was embarrased and shamed in such a way that showed how crude politics can be. I am glad that the Government see him as a "Negarawan" for his deeds especially his efforts in upgrading the rural Malays.

Politics is certainly scary eih...

Car service

service 

My car needed its first 5000 km service. It was due on the week Dzaeffran got sick , so it was delayed. I was keen on sending to my regular mechanic in TTDI , but because this is a new car ; i decided to give Proton service centre a try. Well , to take advantage of the free coupon cum warranty. Abang Fathul suggested for me to try out their Platinum centre in Mutiara Damansara.

I went there yesterday.The centre has the state of the art design and looked really modern and cool. The waiting area was really comfortable with ASTRO HBO on . Definitely first class fascilities. There were many cars parked and i can see lots of protons manned in their workshop area. And of course, for the first time seeing lots of ASEAN plate numbers around !! haks.. Don't think they can beat my 101 !!

Honestly , i am impressed with their service. Well , not exactly on my car because it was just a normal rountine service but their PR. THe executives there were certainly friendly and helpful.They certainly made me feel welcomed and my usual fussiness dissappeared yesterday.I've always emphasized the importance of customer service and i was satisfied.Its always about customer service that makes one pleased with the product no matter how crap they can be. MY working experience in PETROSAINS cultivated this awareness and i still hold strong to the concept.

Reading through what their CEO pledged in the papers certainly made my usual sceptical side to tone down and give PROTON a chance.Its our national symbol and lets give them the time they need to make it the best in the world..

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Badwi

Apparently , i'm only updating my blog on a weekly basis ! I can't help it with my current lifestyle - being a nomad between my SS2 home and mak's place in Damansara Jaya. I wish i could just lead my normal life in our cozy home.Unfortunately , this will not be until late May. Wifey prefers to be at mak's house so that she can concentrate on her studies.Talk about being kiasu..haks.. but it is for the better. Its getting nearer each day.

Its not that we cannot cope in SS2 , but sometimes she trusts her mother more than me to take care of baby Dzaeff.My care is not up to her required standard. haks ! Not that i am complaining but somehow my "presence" in mak's place is needed ; eventhough i don't really do much .Hence my endless short stops in SS2 to pick up my clothes for work the next day. Being in ICU is taking its toll as i get tired easily after work. Eventhough its ok to be in mak's place ,it is not as comfy as being at your own home sweet home.Hence , my minimal contact my "lovie-dovie" at home. Sapa ? My PC lor...

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steps 
I was a bit affected today post call. We lost an 18 months old boy early in the morning. He was in ICU the day before and was completely fine. He was operated about 12 days earlier for Hirschprung's Disease. He was well and discharged well from HKL but was readmitted 3 days later for severe diarrhoea. He was severely dehydrated that he needed inotropic support to maintain his blood pressure. Hence his ICU admission for a central venous line. I have had not much of experience in paediatrics but being in Selayang certainly my knowledge grew exponentially. We discharged him to the ward early friday morning with his dehydration corrected well.

Unfortunately , his only IV access went "kaput" at about 4 am in the morning. Their on call MO called me for help but i was busy myself in the ICU.On top of that , i was about to leave to 7A to intubate a patient in impending respiratory collapse.

Then , at about 7 am , the paediatrics house officer gave me a ring asking for help.

" Siapa doktor on call hari ni ? Dia dah datang ke "
" Dr . Kee... " i said. " What's up ? "
" The boy we referred to you earlier collapsed.. and we are having difficulty intubating him .."
" What ??? Kat mana.. i'll come now !! " i said in a hurried up to 8B.

I was glad in a way when i saw the tube was already in. The Paediatrics specialist was there and explained to me they had to resuscitate him for 15 minutes as he went asystole. He did not look good at all as i glanced on to the portable monitor.There was only a single IV| access through the intraosseous route which means that his peripheral veins must have collapsed really bad. She was pleading for an ICU bed and i quickly ran back to sort out the bed for him.

When the baby arrive in ICU , he was in a really bad condition. He was on triple inotropic support and did not look good at all. His pupils were already dilated and not reactive. As we were adjusting his ET tube , the baby went bradycardic and we had to recommence CPR. It was really bad.. The two paediatrics specialists were panicking and we tried our best to revive the baby. His abdomen was really distended ; a suspiciously suspecting perforated anastomoses. We did the CPR for 30 minutes but it was obvious from the beginning he was not responding at all to our drugs. His size was exactly like Dzaeffran and i could not stop thinking if it was my baby.

His mother broke down really bad when we informed her the bad news. She was hysterical and needed restraining. She was crying all her might as she did not expect her baby to deteriorate as such.

" Tak mungkin !! tak mungkin... semalam ok jeee....****zzzzz.... !!!"

I can empathize her feeling as the baby was perfectly allright the day before , wanting to jump out of the ICU bed so much ! He was supposed to be transfered out to HKL that morning for further management by the primary team who did the surgery. Somber mood was all over ICU. She cried and cried and fainted. Her husband was trying hard to console her but he himself was crying in pain. It was a sad scene and my tears were flowing slowly as well...

I was deeply disturbed by the event. To see Dzaeffran smiling at me when i got back home was such a relief. I cannot imagine if what happened to the poor mother happen to me. I am deeply grateful to the almighty for baby Dzaeff , and insya allah will try my best to fulfill my duty as a good father and teacher to the beautiful gift.

New make over..

Hmmm.. what is walid and umi up to.. 
hehe.. new toy eih.. 
what is this funny feeling on my head ?? 
the new Castello look.. 

P/S We wanted to do this for quite some time but never had the opportunity to do so.. until this weekend.. sorry baby Dzaef !!

Hospital takes

visitor 

I just discovered that my digi camera can snap short movies ..and with sound !! haks.. Thanx Azad for telling me..


Recovering 

The scare..

sick 

It was a havoc and tiring week for me and wifey. Me coping with work and wifey with one month to her exams. We never thought that Dzaeffran would not recover from his flu which started last weekend. Being doctors; we assumed that his URTI was viral in origin , thus self limiting and with good supportive treatment , he would be ok in no time. Unfortunately, our assumption was wrong.

It became difficult to control his fever as his temperature spiked to 39-40 C especially at 2 am in the morning. Our vigorous tepid sponging did help to reduce his temperature but somehow he did not get better. On Monday evening , wifey thought she heard Dzaeff wheezing thus brought him to a nearby paediatrician. There was no nebulizers needed then but his cough was getting worse. Come Wednesday morning, he started to refuse feeds and that was not a good sign.He was breathing fast and we can sense his discomfort. His temperature spiked despite numerous suppositories of diclofenac and paracetemol.


admission 


24G IV line 

Mak called on Wednesday morning saying that he looked really ill and very very warm. I told her to bring baby Dzaeff to Selayang. Wifey freaked out knowing that Dzaeffran was really ill. I guess her pregnancy trauma hit her hard. I asked a friend of mine in paediatrics to examine Dzaeffran and she suggested admission.Thank you Anis !! His chest x ray looked fine but his lung findings were a bit worrying.

He was started on IV Cefuroxime and was on full drip maintainence as he still refused feeds even breast milk.He did not look dehydrated but certainly toxaemic. I was worried if his temperature remained high that he'd have fits. Alhamdulillah , with the treatment he received the temperature was controlled. His cough however became worse. His auscultation findings were terrible that he needed 4 hourly nebulizers.On top of that he needed nasal prong oxygen to help with his oxygenation. I never thought his chest recessions were serious enough for such intervention !! It was a trying time for wifey as her mind was a bit off ; having to prepare for her main exam in 4 weeks time !!


Nebulizer 

Dzaeffran's initial blood investigation showed his white blood cells to be within the normal range. Aaah.. a simple RSV pneumonia we thought . However , his C Reactive Protein was sky high at 11 ( normal < 0.8 ) and the specialist was very suspicious. To our surprise , his blood grew streptococci pneumonie which means that he REALLY HAD BACTERIAL PNEUMONIA !!! Haks.. well , this can happen to anybody oo and that includes us eventhough both of us are doctors !!

Alhamdulillah , Dzaeffran recovery was swift. His usual smile came back and he became more active each day.Wifey was certainly the very glad with the progress and it showed with her enthusiasm to continue studying while in the hospital.

smirkin 

Dzaeff is still in the hospital. He needs to complete 7 days of intravenous antibiotics to ensure his recovery. I had to re insert his IV access today as the old one on his left hand was swollen . haks.. Dah jadik anaes , kena pandai pasang line ahh...( though i had palpitations while inserting ! ) It was indeed a very stressful week and i hope he will be discharged as planned on wednesday..

New rotation

the procedure 

Started my ICU posting in Selayang today. I was preparing myself for a busy month as ICU posting was the most demanding area of anaesthesia during my HKL days. Post call , I'm usually knackered and my off day will be spent on bed. Selayang has less ICU bed but we are practising the "open" system where the primary team will have the say in the management of the patient.So maybe not as busy as HKL lor..

My first day in Selayang ICU was very mild. There was nothing much to manage as yet.. being a new day with mostly having old patientsaround. After rounds , Dr Suresh ( our cool Intensivist ) offered us to do tracheostomy on a particular patient. As i've never done it before , i volunteered myself .In HKL , it was only the consultants and specialists doing it. So why not ?

It was quite scary really. Imagine , poking somebody's throat and inserting a device for the patient to breathe.This 28 year old man , who developed really bad bleedingintracranial haemorrhage ; and the neurosurgeons had opted to treat him conservatively. He did not recover neurologically ; which means that he remained stone with the ET tube in him.Sort of vegetated . We don't think he will progress from what his current condition is. Therefore , the indication for tracheostomy.

Dr Suresh guided me well and i managed to do it without totally traumatising the patient !! Of course , we had to make the patient relaxed and paralyzed first before doing all this .After dissecting the area i poked my patient with a needle to get a free flow air gushing out from my syringe. Dr Suresh viewed through the fibreoptic scope from inside to ensure that i don't poke through to the oesophagus !! Then, I had to use brute force to insert my "rhino" ; a dilator before inserting my trachy. haks.. Nasib baik tak pecah tekak noo.. heks..

Not bad for my first day in ICU. Looking forward in doing more procedures !! haks..

Who's who..

classico.. 

I reckon Mafiz is the only person who retained his body weight 10 years after these pictures were taken.

What happened ah to us ? haks... I never thought i have my current physique esp my current trousers size. haks !!


good old days..  

Down..

hello..hello...  

Baby Dzaeff is down with flu during the weekend. Slowly recovering to his old smiling self ! Walid loves you ok..

Similarity

the mum 

Went through old pictures recently. To our surprise , there was similarity of wifey's baby pic with baby dzaeff !!

Oh no !! I cannot imagine a male version of wifey in dzaeffran !! haks..


the son..