Merdeka 6 years later..

Salam Merdeka 2010!! wow.. wow...wow... This blog is still going on strong despite the hiccup for the last few months. I do really hope to continue writing in this medium eventhough tweeter and facebook may seem to be the better in trend at the moment. But then again, whatever i've started i wil persevere and continue and insya Allah.. this blog will go on..till it become one of those published memoirs ( when I become somebody important la.. kan depa suka tengok the early thoughts.. hahaha)

Lets see how much I've progressed ever since my first ever blog in August 2004!!

TUESDAY, AUGUST 31, 2004

Merdeka Blues

Yup... 31 August 2004
Still in the excited mood to write this bloggss..

after 6 years.. I am still as ever excited!!

haks..lepas ni nanti sekali sekala lah ade entry.. bila buat macam ni kan , teringat cerita Doogie Howser. kan , he'll write the happenings of his life in his comp journal..

Accomplished that.. except thati don't have my own tv show yet..

I'm off today.. not on-call.. therefore had been on the bed for the whole day.. heks.. giller malas..

the paradox is i will be taking my MRCPCH PArt 1 exams next wednesday..

PAeds??? what was i thinking then.. haha

and what am i doing today ? not studying.. perrggh..

hahaha.. a common complaint most of the time intra-Masters..

memang gile ah.. dunno why i made the decision to take the exams during housemanship..
maybe i felt that i am suppose to fast forward myself as i am definitely 2-3 years back to my old colleagues..
I feel like i wanna catch on them.. tu la pasal.. i am 27 now.. and still just at the tip of my housejob.. tak lama lagi baru je nak jadi MO. Tengok my wife , she's now doing Masters and in 4 years time insya-allah , she's a Specialist.. hmm.. where will i be then ?

Alhamdulillah.. I am where I am now. Totally did not plan my pathway as an anaesthetist and alhamdulillah after 6 years, I've achieved what i never thought i could do. Congrats to wifey too for her achievement..

Anyway , while i;m still in the mood might as well just key in my thoughts for the day..
Still not out of the euphoria and adrenaline rush from the talk i gave in Kolej Matrikulasi Johor on Saturday.. never thought that i was able to catch their attention for 2 hours.. well , i suppose i have the charisma in me.. hmm.. have to strategize to realize this potential..

And YES... public speaking is a passion of mine and i enjoy doing it.. I enjoy teaching my students as well and I guess, I've found my niche with UiTM at the moment..

Ok.. i think thats all for today.. need to take my shower and pray.. pray to PASS MY EXAMS !!!! haks..

Now.. the exam of life which will go on. until the end..

then..2005

August 2010

Pari Bakar KJ

Ramadhan is the month of ibadah and repentance. It is a special month every year where Muslims fast and the ability to withstand hunger has always been compared to the sufferings of the poor every day. It is also the month of self reflection; as we pray to improve ourselves to be better everyday.

Being in a satellite family without a maid means that there is no way that i can have home cooked food when i return from work. Initially one child was OK but now with 3 to handle, it is definitely a challenge to both me and wifey to even think about cooking. In fact, I can say that my time in the kitchen is more than hers! hahaha

Anyway, so far this year if we're in Bukit Jelutong it would be bazaar food everyday. Unfortunately the Bazaar here has limited variety and I'm a bit bored with the food offered. in fact, maybe dah try semua kot.. hahahaha Unlike in SS2 previously, there were many options either in TTDI, Sg Penchala, KJ, Motorola.. byk tempat..

Of course, my favourite bazaar would always be in KJ. Hmmm.. the smell of my favourite stall; ikan pari bakar..perrghh... drooling man! Therefore, today since it was public holiday in Selangor; i went there just now.. and mmmmmm... ikan pari bakarku!!

So..selamat berbuka puasa..

MAfeitz Mamat

alternative airway.. another hole...

I've always wanted to do percutaneous tracheostomy but never had the chance to do it on your own. I've learnt about it either during conference or my postgraduate, but it has always been on a model or helping another to do it. In UM, we did not have any consultant to back us up therefore the young specialists were not so gung-ho about it. Besides that, if we were to plan for a perc.. then the patient had to fork out their own money for the set.. costing RM1000. And the prognosis and mortality can be high, and subjecting patients to fork out money for it can be a bit daunting.

Of course, with my current learning curve there will always be somebody senior supervising but I am really thankful for the chance to do it in Sungai Buloh. I guess Sungai Buloh ICU may have the highest rate of percutaneous tracheostomy performed, but i may have to check my statistics.

"Tracheotomy is a surgical procedure that is usually done in the operating room under general anesthesia. It ca also be done percutaneously by a simple Seldinger's technique with repeated dilatation. A tracheotomy is an incision into the trachea (windpipe) that forms a temporary or permanent opening which is called a tracheostomy. Sometimes the terms "tracheotomy" and "tracheostomy" are used interchangeably. The opening, or hole, is called a stoma. The incision is usually vertical in children and runs from the second to the fourth tracheal ring.

A tube is inserted through the opening to allow passage of air and removal of secretions. Instead of breathing through the nose and mouth, the patient will now breathe through the tracheostomy tube.

This is one skill I am trying to perfect it so that I am an expert.. and i guess, SUngai Buloh ICU can definitely provide me with that kind of intense training!! ENT surgeons!! I can do this too!!

Whats next helter skelter

Life can be so full of surprises as well as unplanned efforts. ( not talking about my 4th coming..by February 2011 hahah) Of course we have plans of what we wanna do but sometimes circumstances change and you have to balance between what you can offer and what you are needed for.
I've never thought about cardiothoracic anaesthesia eventhough I enjoyed my IJN posting. However, recent developments in UiTM may have change my perception as well as future plans. I never thought I'd consider it as my subspecialty training; as regional anaesthesia has always been a passion of mine.
Here I am being given the chance of a lifetime, and for me not to do it may not be wise afer all. The only thing that detered me earlier was the life as an anaesthetist in a cardiac centre. Mana ada life outside? Memang hospital tu rumah kedua literally and to lead that life ; its not something that i want. But looking back, my institution in the future would not be replacing IJN in total ( i hope!! or im totally screwed.. haha) if we are, then i need to get lots of colleague with me.. together.. then life might be bearable. However, being a University; I have to be super multi talented like Prof Patrick ( Dato' now..) and perhaps emulating him would be a good idea at the moment.
well..here goes.. Cardiothoracic.. hello? ...

jadi cam Prof Hwang pun ok gak.. haha but it'll be really scary to be his trainee.. haha

Life after Masters

Life has been hectic, and for all you know its ramadhan again. Life in ICU Sungai Buloh will always be busy because we have the biggest number of ICU bed in Malaysia. 18 full ICU and 6 HDW which we manage together. WOrking with the Consultant in charge was a change as the intensity of closed ICU can be felt like shivers to your spine. Being under one of Malaysia's expert is an eye opener; as we try to serve as the National Neurotrauma centre. Of course, the human resource issue from Dato Chua Jui Meng days of galant infrastructure becomes a legacy inherited without much can be done. I guess that is the only issue we are having at the moment; well been sitting on it for the past 4 years i guess. Nothing has change much here where Medical Officers who opted for Anaesthesia may have turned off because of such high intensity of care. The OT remains at only 4 but the ICU bed never shrunk instead bloom in size. I can see the stress that the ICU Consultants are having at the moment; and the possibility of fatigue may come sooner than expected. COnstant intense energy with lots of enthusiasm and positive energy to pull one through.
I was told about the harsh condition that new gazzetting specialist have to go through here.. only a handful remained as most of them who were did not opt to stay and serve. It was scary to hear all type of stories but after being here for 2 months; its not that bad after all. Of course on certain days you are late to go back home but that is part and parcel of ICU care. If only the team was bigger it would really help everybody and encourage more young ones to join the ICU.
As for me, doing intensive care has its advantages what not. Its the dedication which can be off a problem as the balance between patient care, career, family and what we want in life. My "tabik spring" to Intensivists all around Malaysia - only 24 now registered under NSR.. gile sikit!!!
I'm still learning, of course forever in this stage as i embrace the life of a specialist. The challenge now is not about caring for your patients, but to nurture the young enthusiasts and guiding them well in practicing safe anaesthesia. I reckon that will be the responsibility which can be taxing to few. Its not about me and my practice anymore; its about what my padwans do and will do.. sounds scarier when i put it this way..

Convo 3 August 2010

the 2006-10 batch pic..

It was an event which I never imagined could happen. Me & wifey graduating together. Of course, we wanted this during our undergraduate years but we never thought we could do so.. I mean, for what happened 11 years ago, the thought of receiving a post graduate qualification as a specialist was far off!

It was a proud day for me & wifey, especially dedicated to our parents. I am sure they were proud to see both of us on the stage ; of how they were many years ago on the same setting, same place Dewan Tunku Canselor UM. It was goosebumps all over as I was heading for Raja Nazrin for my scroll. Alhamdulillah.. I nearly cried and only Allah knows why.. for the journey of perseverance which tested me on my will. Thank you Allah..

the one advantage nobody told me about doing Anaesthesia is you get the best seat during convocation!!

Neglected ideas..

I must say that I have not been as persistent as how I've been in maintaining my blog. July was a very busy month for me ; I was regretting for committing for too many things! Hahaha but I reckon this has always been the way i've led my life. Its just when you have exams, you tend to prioritize as much as you can and when its over, all hell breaks loose!

I would partly blame it to the "non-friendly" internet policies both my Uni as well as Hospital Sungai Buloh. Sometimes, when i am relatively free; i would blog in between work. However, as all blogs are blacklisted, there is no way now for me to carve out my creativity spontaneously :)

I have lots of responsibilities now and things expected of me.. which i aim to fulfill and realize! Its not easy being the ones who should have the initiative to make things run. I suppose, it was based on our CVs that he picked us to be in his faculty.. i guess now is the time to show why he was right to pick us! Not to just sit around and wait..instead make things happen!

NB trying very hard to motivate myself after a roungh on call night..