camwhoring..

mobile phone quality..  

Its the 4th day of ramadhan today and I'm doing ok. Since i have my new mobile phone camera , why not have a try on snappin few pics here and there at work ?

Not bad eih..the quality..


my workstation 

monyok boy.. 

Alternative news..

If you're looking for alternative Malaysian news on the net , log on to TV PASby PAS lar... hahaha ! Its definitely a step forward in using the freedom of information dissemination on the Internet.

You wonder how long will they be able to air their show until the ruling government will decide to curb and sensor ???

Ramadhan datang lagi..

Its ramadhan again , the month of tawaddu' and ibadah.The holy month of restraining oneself to observe suffering and taubah.
I'm looking forward to this month as it will help me a lot to cleanse myself.

To fellow Muslim bloggers ; Selamat berpuasa dan beribadat. To kamcheng brothers ; we should arrange an iftar gathering soon.

p/s Badminton tuesday nite.. still jalaaannnn....

Do you appreciate your rights ?

something to do with my current crisis.

HUMAN RIGHTS

THE RIGHT TO make mistakes . . . and be imperfect
THE RIGHT TO refuse requests without having to feel guilty or selfish
THE RIGHT TO judge your own behavior and take responsibility for your own actions
THE RIGHT TO offer no reasons or excuses to justify your behavior
THE RIGHT TO change your mind
THE RIGHT TO feel and to express feelings, including anger, as long as you don't violate another's rights
THE RIGHT TO be competitive and to achieve
THE RIGHT TO enjoy rest and leisure
THE RIGHT TO have your needs considered as important as the needs of others
THE RIGHT TO decide which activities will fulfill those needs
THE RIGHT TO have your opinion respected
THE RIGHT TO be independent
THE RIGHT TO say "I don't know" or "I don't care"
THE RIGHT TO get what you pay for
THE RIGHT TO ask for information from professionals
THE RIGHT TO decide when to be assertive
THE RIGHT TO not be responsible for another's attitudes and/or feelings
THE RIGHT TO be treated as a capable adult and taken seriously.

Lebih apa lagi..

Have you seen the Celcom post-paid advert on TV ? Somebody made a joke out of this yesterday and only NOW i got it.. hahaha..

ku seru..  

LEBIH APA LAGI ??

Can i answer that ??
haks.. Dil.. ko nak jawab gak ??

P/S Hidup Pontianak...

The new thang..

the new toy.. it goes with my car.. hahaha 

MY old motorola handphone is a real nuisance nowadays. I've had it for almost 4 years and iti s a very DURABLE phone i must say. ( with all the abuse in the hospital , battering and Dzaeffran's latest craze of throwing ) Unfortunately , the battery life is really bad that it can only last for like.. mm.. not even 6 hours ?? I tried to look for replacement battery but unfortunately , the world has evolved so much that it went extinct !!

And today , out of the blue ; I bought this new handphone. I was on my way to Kiara hill for my jog after work when it rained. I proceeded to TESCO Mutiara to have a look at mountain bikes as I need to have one to pursue my "Powerman" dream. Beginners maahh.. cokia ones to start off with !

Benq-Siemens s88 is really trendy looking with cool camera function ! The best thing about it maybe the USB port which will make my mp3 downloading a piece of cake ! ( as if i don't have a digi cam..duhh.. ) I was thinking of getting a PDA phone but i was not keen on its size and to bring it around. Somehow , the salesman was lucky to have me passing by. He was doing his job by promoting the phone and its function. I did ask a lot of questions that annoyed him a bit but he hid it well. I could see his face when i told him.. Ok.. I'm buying this phone ! haks.. Ezy-pay method makes it affordable.. :)

I wonder if they have ezy-pay for mountain bikes.. haks. tak lari budget.

The last supper..

from left: Zaini , Dil , Raja Ahmad , me , Mafiz , Azad , Izzat , Izan , Ervan. 

It was kind of Izan to invite us for dinner cum short gathering today in view of the coming Ramadhan. Izan by the way is the latest member of the Sri Petaling badminton enthusiast group. It was at his newly opened restaurant in Sri Hartamas called mama mia ! It sounds Italian but it was actually japanese !!

Me , Izzat and Raja Ahmad car - pooled and we arrived in Projet station at about 830pm. Coincidentally , he is also PROJET Hartamas manager so parking was not a problem for us. I tell you.. the most eligible bachelor in KL and he is still single !! ( takde brokeback mountain aahh.. ).

The food was delicious and very tasty. I really enjoyed my food and I would say the whole gang was impressed with it too ! It felt so nice to eat especially after my 5 km jog today in the evening. Desserts were wonderful and Mafiz certainly had a cake binge ! Azad brought back something for his wife and I'm sure he'd get his treat as well for his Sapkone dish !! hahahahaha...

Thank you Izan for the food and I'm definitely recommending this place to everyone ! Its also a place I'd like to bring my family for dinner soon...

my share 

Coup de'TAT

invading ..  

We were having our supper in 223 when this happened.Thailand is under Military rule now !! Thaksin over-throwned by the military in Bangkok and he is in New York ! How convenient.. This shows how our region is very fragile and politically unstable.

Coup statement:

Now the Administrative Reform Group under the Democratic System with the King as the Head of State, comprising commanders of the armed forces and the National Police Bureau, has gained, without any resistance, full control of the situation in Bangkok Metropolis and nearby provinces.

For the sake of maintaining peace and order in the country, people are asked to render their cooperation. We apologise for the inconvenience.

And you wonder if our political feud here may receive the same fate...

Passion for adventure

I was suppose to go for a weekend trip to Genting Highlands with Mama and Papa yesterday. Unfortunately , that had to cancelled last minute because of a stupid fuss. I really wanted to go because it'll be Ramadhan next weekend and it had been quite sometime since I last enjoyed myself at the theme park. Really need the adrenaline ..

Because of the original plan , I did not register myself to join the ICU conference which is held in Sunway Pyramid this weekend. Really spoilt my weekend with the unscheduled cancellation. Otherwise , it would have been fun to join and see my anaesthetists from all around Malaysia in Sunway. Anyway , Shakti called me up before lunch and pushed me to come and join their afternoon session. Initially i was reluctant because I cannot just crash in without paying right ?? But .. as i did not have anything much to do I went to the Sunway COnvention Centre.

It was nice to meet your fellow colleagues , mentors and bosses from your old place. I met few of my classmates who are doing anaesthesia now !! haks.. never thought that IMU would produce many anaesthetists when we did not even have a permanent lecturer of anaesthesia then !!

**************************************

Dunno why really ; it suddenly hit me. I suppose after watching a programme on TV late last night regarding adventure race done in Langkawi ( Langkawi Wilderness Challenge) this year. Not explorace lar.. but something similar to that.I've always been interested in this field but somehow after I got married ; it just faded away. With my current physical condition ( my weight and my fitness) it seems a bit off to just start offand GO for this passion.I'll be closely watching a fellow blogger Ee Van ; more famous as the Explorace 3 participant than as an old friend of mine. He's an inspiration !!

Well , I'm going to pursue this interest after raya. Hopefully ramadhan will help with my weight and I need to start on my fitness regime. ( tinggi cita-cita tu !! ) It'll be a bit tight with my Master programme but i reckon i can fit in few weekends along the way for this. hahahaha.. My kamcheng fellows , wanna join ? It'll be gruelsome , tiring but i gurantee you the adrenaline it gives after the project !!

A close call

I had a bad call on Wednesday. It had been quite sometime since i felt so tired during the call and obviously collapsed the whole day yesterday. This was a typical HKL type call which drains everything out of you.

The day started off with an eye emergency ; to decompress the pressure built up in the eye due to a bad swelling after an accident. It was uneventful but i had trouble with the ecg tracing. I had to test it on myself before concluding that patient's skin maybe thick and intefering with the detection !! It took the ENT guys 3 hours before we're done.

After an uneventful insertion of ICP monitoring device , we were pushing an 87 year old who's just had a major surgery the day before ; coming with a hypovolaemic shock. At the same time , there was another old fella in his 80/s with a bleeding Gastric Ulcer on the other OT !! The two theatres were running at the same time and Prof had to visit both of the OTs concurrently !!

Most likely , it was due to a failed anostomosis causing massive bleeding and DIVC in patient. She was so "white" when she came and kept on vomiting blood. We quickly induced her ; I was doing the Sellick's manouver - and for the first time in my life I really pressed hard. I could feel the reverse peristalsis and fluid forcing through my fingers !! Now i know why cricoid pressure is DAMN important !!

Her ECG was showing MAJOR ECG depression - and the surgeons started straight away. Out came 2.5L worth of clot from her distended abdomen and she was badly bleeding. My consultant and Specialist were there too and we were literally squeezing all the blood that we have into her. It was a very stressful situation but luckily everybody stayed cool and we managed to recover her haemodynamics . She was then placed in PASCA with a total blood loss of 5 L.Thats why elective surgery can be so dangerous.

After that , we proceeded with few another laparotomy for perforated Gastric Ulcer which was uneventful and at about 11 pm ; the ENT team rang up and posted a retropharyngeal abscess with airway obstruction.They were not able to view his vocal cords via indirect laryngoscopy. Waahh !! this is bad . I've seen few before but this was the worse i've seen ! Patient was literally gasping with a loud stridor ; ( like a donkey ) . This was a thin 25 year old Indon , he looked really bad. He has been having the symptoms for 4 days and treated in Muar. It was becoming bad and he was referred to UMMC. His neck was stiff and he can't open his mouth due to pain. He can barely speak and looking very-very uncomfortable.All his fingers wer clubbed and we wonder if it is something chronic ? We didn't have any ICU bed left...

We were sorting a bed for him when we noticed that he was sweating badly. Quickly Prof pushed the patient into the OT and another drama began. We tried for awake intubation but it failed as the structures were not visible !! He then began to desaturate and we had to resort to inhalational induction. He was desaturating badly that his ECG showed alternate VT and bradycardic that we had to commence CPR ! Adrenaline and atropine was given , and he recovered. Prof at the mean tie managed to tube her via Bougie but it was really blind as she could not recognize any structure. It was very scary with 5 anaesthetists there reviving the patient !!

1 Liter of pus was drained from the abscess and due to not having any ventilators present , the ENT team did a tracheostomy for him. He did not look well and i guess sepsis was on board. We managed to wake him up and he was breathing comfortably on his trachy. I guess , it was much-much better compared to what he had before..

We were done by 3am ; and only then i could throw myself to the bed and slept like a log....

Not something new..

ticket lottery ke Tun ? 

This is a common practice in the Bahagian level of every UMNO election. "The list" has always been a norm ; not something out of ordinary. Whether in the envelope there will always be RM200 or even more , Wallahu a'lam. It will be between the individual and god. Sincerity to appoint leadership determines the future of a race and society's fate.

I wonder why this was not highlighted during his 22 years of power ?


try no ni minggu depan... 

The first time...

It was an eventful day for me as I did my first CABG ( Coronary Artery Bypass Graft ) case today. HAving quite a number of trainees this year , I suppose my Consultants felt that even first year trainees should be exposed to cardiac anaesthesia which is something unique. The manipulation of our own physiology reaches nirvana ( literally !! ) in this sub speciality and major Op.Reading and doing the case are two different things ! SO macam orang jakun , I was so soo excited with the op today..

Cikgu Rezwan was supposed to undergo this procedure but he'll have to wait till he is better and fit for this major operation. This is truly a 50-50 kind of Operation where once you're anaesthetised and bypassed ; you don't know whether you'll wake up or not. One can just die on table.. scary eih..Tun M went for this Op 15 years ago and with the technology at that time.. it was a very risky operation !!

Basically the operation is about creating a bypass / graft of blocked vessels that supply the heart with oxygen. So how do you repair one's heart if it is the main vital functional organ that provides life to humans ? Can you just stop the heart and repair it .. an then revive it later..??

Yups.. that was exactly the procedure !!


aritificial humanoid.. 

Imagine for about 1.5 - 2 hours :

a) a machine taking over your vital physiology of sustaining life.
b) no breathing / ventilation .
c) heart stopped using a cocktail of drugs.
d) all monitoring and ventilator switched off.
e) body cooled to 20oC.

Basically, you are dead for that duration ; the machine ensures enough perfusion to the brain so you don't die.. I wonder how our "roh" copes with this condition of being temporarily "dead" ? Theoratically , as anaesthetists it is possible to make the patient aware during this time... Interesting eih..

When the bypass graft was done , you "kickstart" the heart by defibrillating ( ZAPPING ) the heart.. and hope that it will contract normally as before !! haks.. Amazing isn't it !! Subhanallah !!

Battered spouse syndrome

You've heard about this syndrome ? somehow , it is a part of our habit in things that we do everyday. Sure , we tend to loath wives who kept going back to their husbands despite the physical and verbal abuse they get .They will somehow still cling on to them.It is difficult to understand why if it is quoted in that context. However , let me give you an example how I have this syndrome in my life..

Exhibit 1 : Liverpool FC

Damn.. Liverpool was battered yesterday by everton and somehow I could sense that here we go again ! Year after year , Liverpool kept having bad starts in the league eventhough the aim is to capture the Premiere League title. Every year without fail Liverpool will make me swear on tv seeing their game play and humiliating loss !! YOu feel so frustrated and you feel like just not watching their games anymore .Unfortunately , come next weekend , it'll be the liverpool game that I'll be looking for.Hoping that things will change. Liverpool is still the team for me.. forever..

Exhibit 2 : Kenny Rogers roasters

This is one restaurant that will frustrate me and wifey everytime we go there. No matter which branch , The Mall - The Curve - One Utama ; I'll end up complaining of their pathetic service. Everytime , there will be something.. either their tardiness , rapport , food quality ,mesti ada la punya. And everytime , I'll reassure wifey that it'll the last time we'll eat in this chain of restaurant. But then.. hahaha.. we kept coming back !! Well, primarily because its the only place where wifey's favourite dish ; Hot baked jacket potato is served. I suppose , until we have another jacket potato serving restaurant , we will continue to dine in Kenny Rogers despite the crap and pathetic service.

As you can see , we have this trait in us. Just ponder your thoughts and I can assure you that aaahh.. tak sangka...

Astro-doc.

It was announced at 11am today , HUKM medical officer Dr Sheikh Muszaphar Shukor and Malaysian Armed Forces dentist Capt Dr Faiz Khaleed have been selected for training in Russia.
Congratulations to both of you !!

It just had to be a medical doctor as Malaysia's first astronaut.Dato'ship will definitely on for either of them when they are up there.

kat

I'm really suffering from a bad cough at the moment. I've recovered from my URTI , no more fever but my non productive cough is persistently making me uncomfortable.

I was on call yesterday , and the cough was obvious with my colleagues and nurses voicing their concerns. It was Ok in the morning , but with the cold air conditioned OT environment it made my cough worse especially last night. I was coughing non stop late last night doing my last case. I have never thought myself to have asthma but a colleague suggested that maybe my irritation is caused by some hyperreactive airway activities ; aka bronchospasm. I auscultated myself and yes.. there were ronchi !! damn..

So last night.. was MY FIRST EVER NEBULIZER episode !! hahaha.. I looked really funny with the nebulizer mask on , sitting by the corner in PASCA.( a small corner in the OT where we put our complicated post operative patients ) The nurses were actually laughing at me as i admitted myself to the unit.

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THe call was allright ; as i managed to do quite a number of new things with my Senior MO in charge. He's a kewl Jo and taught me certain interesting tricks in anaesthesia. Usually we are taught in theory to use certain drugs but rarely do it. LAst night , we made it into practical and yup.. it was useful !! Good old KETAMINE.. hehehehehe..

One thing unique about UM is that we practice regional blocks extensively. All my orthopaedics Op patients yesterday were on this purely local technique and alhamdulillah most of my blocks worked. There was this 25 year old malay boy , who was assaulted when he was drunk and being young and thin , he was the perfect candidate for us. His right hand needed reconstruction and we managed to make him agree for a regional brachial plexus block. He was apprehensive in the beginning having the thought of not being put into sleep during the procedure. I reassured him and we did the supraclavicular block easily.

Of course during the procedure we gave other drugs to sedate and make him sleep but it is not General anaesthesia.GA has its complications and in a way , if we can avoid it , we should. Midazolam is a very good drug and the other benefit was we were able to extract extra information from him willingly. He takes all kinds of drugs under the sun !! damn it, and to think that he is a final year undergraduate student in one of our universities in Malaysia !! .. He was satisfied having the whole of right upper limb numb and heavy ; not being able to feel anything at all during the procedure.

Will i become a regional anaesthesia blocker ? I'm forming a club here...

kewl ad..

future