A pleasant surprise

It has the jejak kasih screenplay written all over as I had a surprise reunion with my best friend when i was in standard one , SRKDU !! haks..

I had a lady who underwent caesarean the other day which was the normal daily routine in this rotation. Somehow , when i flicked through her medical notes , i saw her husband's name which stimulated my memory neurons... Wan Adli.. a best friend who simply dissapeared when we entered standard 2 !! I cannot recall what happened to him ; just that he did not turn up when we resumed class !!

Anyway , his wife did ask me a favour of reciting azan to their newly born baby which i gladly did ( my practice anyway) and when i was done with that , i quickly went out of the OT and met him. Ohh.. he still looked the same but obviously he did not recognize me :)

I introduced myself after congratulating him and he was so shocked to have discovered , the doctor who anaesthetized her wife was an old friend of his !!!

The odd one..

The beautiful header completed a dream tournament for a war-ridden country ; IRAQ !! The winner of Asia Cup 2007. I watched the game last night during my call ( which shows how good the call was !! ) and they really deserved the win.

And guess who their coach is ? Hakss.. Viera ..an FAM reject as he was removed and fired few years back after dismal performance of our national team !! Few of our current national team did train under him then ; and we said that he was a lousy coach.. I chose to believe our judgement but obviously , as how things have turned out for Malaysian footie :- we're the f***ed up ones !!!

He coached Malaysia.. we sucked really bad.. He coached Iraq... won the Asia Cup !!! haks.. that tells it all ... The never ending story of how we've deteriorated so bad in football...

Tales from obstetrics OT

I'll only be on call this weekend.Somehow Hady arranged the roster in such a way that every month we will only do one weekend stretch call for the 4 of us. Fair i should say ; that I've spent my last 3 weekends doing various activities to my liking !

My day job for now is not very tiring ; in charge of the Obstetrics elective list AKA the CAESaR's List. We will only have from 1 - 5 caesareans per day ; and the time I go back will depend on who does the surgery. The other day , I went back at 6 pm.. and we only did like 4 patients !!! haks.. Not problematic list but maybe inexperience problematic surgeon ! I do pity though for the patients with virgin ( no abdominal operations done before ) abdomens - not being well done will ensure complications either to conceive or for the next caesarean..

80% of my caesareans will be done under regional anaesthesia ie either spinal or epidural. What is scary to my patients will be the thought of being awake during the operation. The technique performed will numb and paralyze one's body from one's midrib and below. Spontaneous breathing and consciousness maintained during the operation.Sedation is possible but for caesareans it is not encouraged before the baby is delivered ! Of course the surgical site is covered from the patients but one can still hear the buzzing and sounds of a surgeon cutting one's abdomen !!!! Thus ; the need to fully explain and counsel in such a manner that these patients of yours will be safe in your hands. And somehow , i enjoy this part !! :)

The technique is fairly straight forward and simple. One just has to have the knowledge of position , what can be poked and what should not be poked ..as well as the complications that may arise with the technique. A local anaesthetic drug is injected into the sub arachnoid space - ie a small space where your brain fluid flows in one's spinal cord ; with the mode of action being blocking one's nerve root that supply the sensation and motor function from the abdomen downwards..

When your patient is not that fat takpe... but when her BMI is like 45 !! hakss... Imagine the difficulty of me unable to appreciate the space for injection while palpating !! hakss.. As you can see from the picture ( top to bottom )

First needle : Atrocan 26G with its special introducer...
( macam tak sampai jer... but hit a vessel.. so withdraw and change )

2ndneedle:Pencan 25G with green needle 18G as my introducer
( confirm tak sampai !!! )

3rd needle : Pencan 27G which is longer
( Hit the bone and the needle was bent as it was too flimsy )

4th needle : Pencan 25G which is as long as the above
( PRESTO !!! Success!! )

All that after lots and lots of manipulation of the needle...
And of course , my favourite laryngoscope ; McCOy...
but that..is another story.. :)

Line tak clear..

Dil with his delicious choc indulgence during our weekly badminton...

I felt betrayed... I was hurt so much..
I tried and tried again... in vain..
I was at lost.. searching for comfort..

yeah.. my wife was on call yesterday.. but that is not the reason for my disgust...

Whatever happened to STREAMYX yesterday ???
I can't connect the whole day !! Asyik2.. remote computer not responding..
can't believe I felt so lonely ; losing my saviour during wifey's call.. haks...

Slept in such dissappointment... :(

24 JULY 2007 !!

HAPPY BIRTHDAY TO YOU...

HAPPY BIRTHDAY TO YOU !!!!

HAPPY BIRTHDAY TO UUUMMIIII...

HAPPY BIRTHDAY TO YOUU......

to my dearest wifey.. many happy returns !!!
from , me , dzaef n qaisya...

p/s n to dil too.. hahahaha... who shares the same happy day !!

Try this !!!

This is so funny that it will boggle your mind!!
And you will keep trying at least 50 more times to see if you can outsmart your foot,but you can't.
1. While sitting at your desk, lift your right foot off the floor and make clockwise circles.
2. Now, while doing this, draw the number "6" in the air with your right hand.
3. Your foot will change direction.

I told you so. And there's nothing you can do about it!!!!

The reasons.

for my affection to travel in such physically demanding situations...


solitude

good company

natural beauty..

always the time for self reflection and peace of mind...

Bah Gading

The price to join this trip : RM130
The price to see you and your friends smile when you arrive at the top : seposen.. hahaha..

I had a very good weekend and thankfully my legs did not fail me today to go to work. ( eventhough I was late > half an hour !!) I must say that my 2 weeks intensive training in Kiara Hill paid off handsomely as I managed to maintain my speed and stamina for the long trek. Compared to my two previous trip , the pain on the day after is reduced and I am able to walk , go down the stairs , pray without limping ! I just love outdoors !! The trek was a combination of log trek / river trek / "canak" trek and in two type of extreme weather conditions ; very-very hot laa.. and very-very wet laa.. !!! A definite ROJAK kind of experience which was tough but SATISFYING !!!!

13 July 2007
We assembled in Teratai Restaurant at about 9 pm and by 1030 - we were off by a charter bus to Bidor. I knew half of the participants from my previous trip - there are the "kewl" gang of OGKL and enjoyment with stress free environment guranteed !! There were 39 of us - and of course majority were the "OTAI"s from various climbing groups in KL... gulp...

14 July 2007
2 am Arrived in Bidor - and we were told that only 1 4WD Hilux was available instead of 2. Therefore - the rush to maximize the 4WD and lesser trip ! Man !! he reality of being a sardine yourself !! We parked ourselves at the corridors of Bidor masque and took turns to sleep waiting for our turn !!

4.30 am Arrived in an orang asli settlement after an hour of 4WD through a palm oil and papaya plantation in the dark. Mind you , standing behind while looking to the front was only fun for the first 10 minutes , after that wahh.. macam nak muntah beb !! Hahahaha.. Most of us arrived when it was still dark and we parked ourselves at the nearby SK Sentua. Kewl eih , in the

ANd somehow the next morning , after some big group discussion , we discovered that we were kilometers away from Pos Gedong - the other orang asli settlement which was suppose to be our starting point !!

830 am An OGKL history as we started trekking very early !! It was hot when we started as we walked through the log trek - it was a C grade trek but of course ; walking uphill and downhill continuously in hot weather with the heavy backpack was no fun !!!

1100 Arrived with the first group in Pos Gedong orang asli settlement and we parked ourselves under a big ( maybe > 100 years old ) Durian tree in the middle of the kampung !! We waited for our sweepers to arrive while relaxing and enjoying the breeze in a very peaceful valley.

1230pm We were introduced to our guides ; Bogei and Pak Atan. After a short discussion , they suggested that we use the river trek rather than the log trek as it was very-very hot. I only understood why the route we took were better on the way back !!

We trekked along the river and it was not an easy one ! Of course you get wet as you cross the river , again..and again.. Tip toing on the edge of the river on the slippery rocks were quite dangerous considering our heavy bags but thankfully nothing bad happened.


3pm The river trek ended here and we converged to the point between this trek and the log trek - next was to the last water point before we shoot up to the base camp. Mind you !! A grade B+ track and only for the strong willed.It was not easy to walk...and climb... and look up ..haiiyyoo.. still up..up..and away !! This was where my legs nearly failed but somehow I managed to push myself and maintain the pain.. I know if i stopped , it will just go crampy..and damnn... how laa..

7pm We arrived at a site which was still a long way from the base camp , and half of the group is like an hour's walk away from us.( thank you walkie talkie !! ) It was getting very dark ; and the trek was no way easy to trek during day walk - more if at night. The problem was the log trek which was there before seemed to have been eroded and split into two - a big gap like a "big drain" in the middle. We had to trek on the sides and imagine if any of us like ..woopss... jauh wwoo jatuh !! Therefore , we decided to camp there for the night. Of course , Bogei was adamant by saying..

"tak jauh .. dekat jer..."

but relatively , their dekat is not our dekat !!
Last group arrived at 10pm in the dark but we were relieved to know that everybody was alright and no catastrophies.


15 JULY 2007
830am What was supposed to be a 7am trek was delayed because of everybody being so tired from yesterday's trek. We started off on a jovial mode ; trying to swallow the fact that it'll be a long day trek - at least 9 hours !! The only advantage of today's trek was leaving our bags on the campsite ; shoulders spared for now ! No more log trek but hardcore jungle trek. And the "dekat ajer" base camp was like 2 hours walk.. and mind you it was a Grade A climb !!

And of course , it had to rain.. heavily pulak tu. We saw the skies were a bit gloomy early morning but tryin to deny the rain fact. Unfortunately , it poured heavily and the wet trek did not help the ease of climb. It became so slippery that when you walk along the edges , you hold on so strongly to maintain your grip.. scary woo..

11am The A Grade climb in the woods turned to A+ climb which was punishing you more and more as you ascend. I suppose this was where one's mental strength comes in ; to continue and finish your aim ... The wet rain became colder and colder as tou climb. It was freezing that you just wanna continue walking and not stop..

Alhamdulillah.. Subhanallah... touching the beirut at 5318 feet ! I did it ! but of course we were unfortunate to arrive in such a weather as you can almost see nothing with the fog and cloud folding the top of the mountain. The breeze was chilling but it was satisfying ! SEJUK TAPI BEST !!! Hahaaha.. It was quite unfortunate that the pictures I took was blurrish because of the wet condition.

5318 ft.. Puncaknya sudah kutawan..


Pak Atan n me on top of BAh GAding..

1230pm After spending an hour on top of the hill with camwhoring etc.. We were too cold ! We were hoping that the wind and rain will stop so that the view will be clear and of course ; nice pictures !! but it was not meant to be and my fingers were all numbed..

We descended back to the base camp - and the last water checkpoint.

430pm After a late lunch ; we were on our way back !! But mind you the log trek was not as easy as one thought it might be !! We had to go really..really up.. and when coming down.. really really slippery sandy trail which really worked our knees out !! And again , it was about one's mental strength to just go and not thinking about when it will end so much !! Looking back at the log trek , you can't stop wondering what would have happened to the moral of the participants if we had to endure the track the day before.
My god , if it was" ..bila nak naik pulak ..ni asyik turun jerr..." today ,

I cannot imagine asking .. bila nak turun pulak ni ??

730pm We arrived at the 4WD pick up point near Pos Gedong and Tok Batin was there waiting for us !! And with him was a durian seller who brought almost 18 - 20 durians with him !! haks.. imagine the satisfaction.. hmmm...hmmmm.. durian... haks..

Arrived in KL at about 3 am ! We had few problems with the 4WD initially who refused to make more than 2 trips but the organizers managed to settle the problem and all 39 of us on the bus back to KL by 1am .

Wow.. a satisfying trip. Certainly a lot of memories and experience gathered to be shared with my young ones when they grow up.. :)

Pictures on the net

Rush it

It was 3 am in the morning and I had one emergency caesarean to do for fetal distress. We were quite busy with 4 OTs running at that same time for various really dire emergencies.

"OT mana staff nurse ?" 12...

So i slowly walked to my OT to set up ; checking my machine and preparing my drugs before my patient arrives. With 4 OTs running and mine being the 5th , there are not many staff for me to work with..

"Mana monitor saya ? "
"Tu.. Dr... "
" Haaa... kita still pakai machine ni ke ? ni tahun berapa punya machine ?"
" Boleh Dr... Ot ni biasalah... " referring to OT 12 which is used mostly for LA eye cases..

It was the old green coloured monitor ; you know the 70's series using the sine/cosine waves osciloscopes...
Can't believe I am half way through year 2007.....

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

I'm off to the Mt Bah Gading trip tonight !! yea.. yea... for the excitement , but will I be Ok on Monday for work ?? hehehehehe...

Cats and dogs

The ongoing war between surgeons and anaesthetist will always be the story to tell in the coffee room everyday. Ask any surgeon , or any anaesthetist ; how we would talk badly about the other person is ! Should this be the way of the future ? Obviously not lar..

Common quotes :
Anaesthetist..
"Mr X insisted on doing that case and he didn't mind us ventilating the patient in the ward post op.. Palliative case what he said ..."

Surgeon
"PAtient came all the way from Penang and they cancelled his case because his BP is not well controlled .. short procedure only , takde otak ke ? "

" Don't worry .. it's a 20 minutes job.."
and we ended up 8 hours in the OT with 10L blood loss !!

Patient is being resuscitated ; CPR on table...
" Can i continue with the case ? "

It all boils down to communication between the two professionals. I myself would not be throwing tantrums if the surgeon was nice to me. Nice not in the sense of "ampu" or begging for mercy but for sharing information and being professional . Being open about the operation ; whether it's a f**ked up job or not should be the way because at the end of the day it is about the patient and not one's ego. People make mistakes and by excellent , well mannered communication will ensure optimum management and ultimate results for everybody's benefit.


this "RUmah Tumpangan Chow Kit road"-style bed awaits me tomorrow as I will be on call.. again..and again..and again...

When it is new , it is so exciting..

Took our keys yesterday..


Went to the place...
Wow... so refreshing to have a place of your own..
Starting to imagine what i want to do with my study and Home theatre..


Tapi dah pokai la bang... hahahaha... nak pindah pun , tahun depan kot... :)

TAK MAKAN NASI KE ?

That headline on Harian Metro summed up Malaysia's pathetic performance during the 5-1 whipping by China... nad i was worried earlier. How so much i wanted it to be untrue and Malaysia be the giant killer in the tournament.. but i know all Malaysian football fans are so dissapointed and angry...

Alfatihah to Arwah Mokhtar Dahari who passed away on the 11th of July 1991... how sad that we were beaten and humiliated on this day...

Weekend of celebrations !

Congratulations to scrubber's wedding reception in Saloma Bistro last Sunday ! However, due to Dzaef's over enthusiasm ; i was not able to be a keen photographer!! He was so excited that we ran all over the bistro and I had to catch him again and again. The food was excellent though !! I'm currently waiting for Nana's captures that would surely be beautiful !!

To AKmal and Najmiah - SELAMAT PENGANTIN BARU !!!
It'll be in the history books ; the newly weds being LATE for their reception !!! Hahahaha !!

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

On another note , we managed to arrive at Fiqar's place to celebrate Ilhan's 3rd birthday in the evening ! It was raining cats and dogs .. & the search for Ilhan's present was not as easy as i thought it was !! The rain eventually stopped and the young guests certainly did not waste the opportunity to take a dip in the suppose to be "wet" party !!!

cruel..

Cruel.... very cruel indeed...

I was shocked reading today's news on Ying Ying's death. And the news at 8pm tonight confirmed that the remains found were most likely to be hers. Only the day before that her mother publicised her lost and as the plot thickens ,her mother and boyfriend was remanded by the police ; major suspects in the killing of such a sweet innocent child.

Here I am in the hospital , ensuring adequate pain relief for mothers on delivering their child or giving anaesthesia for in - utero distressed babies , people are killing innocent children for their own benefit. I can't believe that we are becoming like the stories we watch on tv! I mean , if we can "blow-up" somebody literally , why not kill the children ??

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

Thailand drew with Iraq. Vietnam surprised everybody by beating UAE. And we are up against the mighty Chinese tomorrow.. Friendlies before the curtain raiser of Asian Cup 2007 did nto favour us at all ; and seeing our National team played in those matches , is certainly worrying me. Sayur ke ni ??

Viva Malaysia.!!! All the best boys...

** on call again today.. busy mornin - afternoon with caesareans... sapa la yang jonah ni...

The clock ticks..

t
I have another 16 weeks to face my wrath... tick tok...tick tok...
exam larr.. scary thinking about it as day goes by. Macam budak-budak pulak eiks ? Being all grown up now and still having the exam jitters. Its not at all easy and I have friends who just gave up as they cannot stand the stress. Few continued and attempted the exams more than three times ; I salute their courage and determination to proceed and achieve their dream. Me , this will be my first attempt and as any tom , dick and harry would want to make it their one and only attempt. It would be more relaxed if you don't have other things to handle in your mind.And only if.. only if you'd have more support from those close to you.....

Its not that I've not been studying , I'm doing it definitely more than I can ever remember. Perhaps much more intense and focused compared to my undergraduate days !!! I suppose what matters most is whether you can perform when it counts. To be knowledgable and at the same time cool and adamant. You would like to think yourself as that...hahahaha.. but to get the knowledge at your finger tips is a challenge.

I'm glad that I'm done with the emergency rotation ; It was tiring and you feel so jaded and lethargic ; almost burnt out ! Did my Obs call yesterday :- it was much more relief and less stressful compared to the night shifts in A&E. Looking back , it was like a total nightmare !! hahahaha... My hats off to those doing A & E Masters..

Intensive course : 6 - 17th of August..

p/s I'm on for Mt Bah Gading: 13 - 15th July!! I really need the rush....

Can't get this out of my head...

 Menapak jalan yang menjauh
Tentukan arah yang ku mau
Tempatkan aku pada satu peristiwa
Yang membuat hati lara

Didekat engkau aku tenang
Sendu matamu penuh tanya
Misteri hidup akankah menghilang
Dan bahagia di akhir cerita

Cinta.... tegarkan hatiku
Tak mau sesuatu merenggut engkau
Naluriku berkata
Tak ingin terulang lagi
Kehilangan cinta hati
Bagai raga tak bernyawa

Aku..... junjung petuahmu
Cintai dia yang mencintaiku
Hatinya dulu berlayar
Kini telah menepi
Bukankah hidup kita akhirnya harus bahagia

Bagaimanapun hidup hanya cerita
Cerita tentang meninggalkan dan yang ditinggalkan

Pak Long's bundle of joy !!!

My heartiest congratulations to Azam ( bro in law ) for the arrival of ( name yet to be announced!! ) his lovely baby girl on Saturday 30th of June 2007. I missed it though as I was on duty in the UMMC ER ! Wish i was there too... :) I'll visit my first ever niece soon..

Looks like Qaisya will now be the best"test" of friends with her new cousin . Dzaeffran ? Sorry boy.. I suppose Pak Long's attention to you will not be as before !! hahahahaha...