Life of an Anaesthetist

As doctors working in OT , we do have our fair share of ups and downs. It can be really exciting or depressing at the same time . If you are a fan of ER , Grey's Anatomy or Nip and Tuck ; they are based on our lives and things that they go through are real . However , maybe too much drama and "sleep overs" being over emphasized ! We do have our normal routine days as well where it can be a bit dull and boring at times. Thats how our jobs are isn't it ?
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I gave gas to a small infant , 1 year old but is only 6 kg in weight. He suffers from Gut dismotility syndrome with failure to thrive and developmental delay; and so far intervention to his life has not been remarkable. His prognosis is bad but of course , as doctors we try to play god at times. Hoping that our manipulation would give him and his family better quality of life.
The Anaesthesia initially was stormy but we managed to secure his ariway and get his gases right. The Op done was to reverse his colostomy as it was not functioning how it was expected to be. It was uneventful except for an unexpected delay brought over from next door. Initially we wanted the little boy to be observed in PICU , but he was alright after an hour's observation in our recovery post extubation. I did reassure the mother that he would be alright ; and to ensure if his secretions are aplenty ; to be sucked out by the ward staff.
" Mafeitz... remember our kid yesterday ? " My Specialist came by to my OT the next day.
" Oh yeah.. Did he survive ? " I thought she was referring to the baby who bled like nobody's business next door.
" He died... at midnight.. irreversible bronchospasm.. "
and I said... " What ???? " and my heart just dropped.
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" Uncle.. How are you ? Ada " tong" ka ? " I asked.
Uncle looked at me and gives his thumbs up ! "Mana ada sakit ? " he ridiculed me.
Uncle Lai was this 65 year old gentleman who I just extubated and brought him to PASCA for post op observation. He underwent a major procedure to remove his bladder and "neobladder" reconstruction.Of course he lost 4 L of blood but we managed to balance his fluids intraoperatively. He was worried of the pain that he might get post operatively which I totally agreed. Post Op can be really hell if the pain control is substandard.
I inserted the epidural catheter at level T12/L1 ; and i guess it worked wonders as it was a morphineless Anaesthesia. Post Op pain ; as how he smiled and showed his thumbs up for me.
" Dr Mafeitz.. my father cakap you bagusla ; dia cakap tak sakit langsung lepas operation ! " her daughter told me ( our OT staff ) in glee..
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" boss .. I wanna post a case la from resus.. " The Urology MO approached me.
I was the SMO on call that day and happened to be at the reception.
" One 40+ year old schizo... he cut off his ear , his toe and his penis ! " he stopped for a while trying to stop his bursting laughter.. he was smiling ear to ear.. Of course , I was smiling too..
" Guess what.. he ate it all last night !! "
" WHAATT ??? Can you repeat that again ?? "
" Yup..he ate up his penis.. and now he's organless... " I was shocked but at the same time find the incident to be really bizzare ! The buzz spread around like wildfire and of course when the patient arrived in OT , it was like a VIP coming to OT !
And of course , being me.. I just had to ask him..
" You , lepas potong you punya benda aa.. u ada goreng dulu ka sebelum makan ? "
" No.. i ate it all raw.. " he told us with a non-affect expression.
( P/S I did take some pic for future reference.. don't think it is ethical to post it up on this blog ! But if you happen to see me , mintakla.. hahaha.. )

rambut sudah panjang oo....

Tengok tu Qaisya... Walid mid life crisis..

I was looking for my baju melayu suit to wear to work as usual on Fridays when suddenly..hmmm.. lets try out my wedding baju melayus . Surprisingly it fitted well!!! I showed it to wifey and was bragging about how i am now able to fit into the trousers comfortably and baju melayu without looking super fat ; which i never manage since the wedding day !! Hahahaha... My waistline actually shrinked !!!
Of course , wifey with her "menyampah" face uttered...
" Tengok tu Qaisya , Walid mid life crisis !! " and as if my 1.5 year old child can understand ! Hahahahaha Dzaeddran as usual is fast asleep and untouchable !
A certainly good motivation for me to be mindful of my food intake during iftar.. hahaha

1 Ramadhan 1429

In view of the current government's recommendation of "BIJAK BERBELANJA" , i present you my iftar for the first day of ramadhan this year !! Hahahahahha
Just felt like having simple plain sardine and fried egg with kicap for iftar.. Mmm... home cooked food is irresistable eventhough it is not fancy or plentiful.. Anyway , lama dapur tak berasap..
SELAMAT BERBUKA PUASA !! RAMADHAN AL MUBARAK !!

Ramadhan Al Mubarak

Its hard to believe that Ramadhan Al Mubarak is here again. Of course as usual , I missed the first night of tarawikh because of on call !! And now I can proclaim my SMO call in August was SO COOL... hahahaha Tunggu la September pulak.. Its good however to wake up today and not work on 1st of Ramadhan .. hahahaha
My tummy is growling and it is still very early in the morning !
Salam Ramadhan to everybody and hopefully our iman will be refreshed during this holy month..

Dah 4 tahun dah...

Wow... I just realized today that my blog celebrated its 4th birthday 3 days ago !! My first ever posting was on the 27th of August 2004.. Wow.. I've written so much huh ? Never thought that I'd be a constant blogger though it may not be the popular one. However , enough to archive for my future generation. Its a space for venting out !! Internet generation huh ... macam nerd la pulak.. hahahahahah
I guess blogging spurred me to do a lot of things and opened up my mind while reading others. Its a kind of pscho-therapy in a way ; sharing about one's life and trying as much as possible to be transparent. I guess there are bloggers out there who prefer to conceal more than reveal but that is one's personal choice. My blog definitely had lots of emotions documented throughout the 4 years. So many things had happened and so many life event turns that I've crossed.
Here;s for more to come ! And of course.. Happy Birthday Malaysia to all of us.. MERDEKA !!!

Raving for adrenaline

I guess my running mates and I are getting more "daring" and BELASAH mode. We've registered to join the Genting trailblazer on the 2nd of November !! Seeing the pics and reading other people's blogs ; it will certainly be a challenging yet "dirty" race !! Memang kepala sudah gila aahh... Betul2 mid life crisis huh...
In a way , it is a good motivational factor to train ; especially when October will be Syawal where we will be on the festive eating mode the whole month. Mind you , we've even registered for Klang 12K and Mizuno run. A certainly good run up to our 14K Genting trekking !
I've lost a bit of weight after my latest expedition and in a way quite happy with it ! I'm wearing my old trousers which i could not earlier as well as having to poke a new hole on my belt ! However , I am a bit dissapointed that I've not been able to do evening runs because of the heavy downpour these past few days. I've resorted to decreasing my food consumption which wifey is so surprised to see the discipline !
P/s I've placed the weighing machine in front of the toilet .. A certainly good way to know how much you've lost after the "session" !!! Hahahhaha

Mount Tambuyokon 8 - 10 August 2008

Tambuyokon 8462 ft / 2579m
I will never climb this mountain ever again !! Cukuplah sekali !! Hahahahaha.. Tambuyokon maybe the 3rd highest peak but the trail to the top was Wow... Masya Allah ! We started at 300m and the peak is more than 2500 m , tak ke mencanak tu ? Hahahaha.. The travels started from Pekan Ranau where I was just in the nick of time to get my new shoes ! The classic kasut getah which was all of our guide's official sponsor for their climbing shoes !

The journey started after dinner in Ranau. It was excellent ! Sup tulang tu.. mmg dahsyat and nice ! I guess eating proper good food in between the climbs. We took the 4Wd straight to Pos Manggis.It was a bumpy ride and it was raining. We crossed the river thrice but I was not sure whether it was the same one ! But it was my first time on a 4WD crossing a true wide river at night !!



8 August 2008
The trek to Tambuyokon peak was only 14 km but we were warned about the tough conditions and how we should approach the climb. The last time people went up there was in May and being untouched for a few months the denai trek maybe masked.On top of that , its PACAT ( Leech ) heaven !! Hahahaahaha.. The thing most climbers dread most. Therefore , before leaving the next morning we really had a field day spraying our legs with sheltox as well as the magical air tembakau..

True enough , the moment we step into the thick forest ; one could see how the leeches were dancing to see us.Especially when you stop .. ATTACK !!! Hahahahaha in a way , it was something that brought our mind off from the gruelling track because we were busy looking at our legs. I manage to fend off the big ones but the baby pacats manage to slip into my double layered socks..
According to the original plan we were suppose to shoot straight to Kem Musang which was the nearest camp before we reach the peak. However the guide were very sceptical of us reaching that goal We were keen on reaching the peak within a day but they were more prepared to bring us up there in two days ! Its OGKL man.. memang Impossible is nothing !! Hahahaha.. After negotiations ; we decided to camp halfway in Kem Kopuakan ( we call it KEPUAKAAN.. hahaha ) And Kepuakan is only 800m above sea level.. so to reach above 2500..haa..jawab la sendiri layan trek !!!


9August 2008
Again.. it was as to follow our tradition ; we started walking again at 2am from Kopuakan. According the guide , he expected us to reack Kem Musang in 6 hours but the whole group did it in 3 hours ! Hidup OGKL !!! Hahaha.. the trek was uphill and I was already getting tired. From Kem Musang to the peak ; 6 hours at least.. MAk AAIII... Jauh lagi tu.. hahahahaha
The trek from Kem Musang ; General ; peak had everything. It was mountaineer's haven ; the climb was vertical.. we had the Irau-like mossy forest , climbing on literally roots , and then the rocks.. I truly felt like a cliffhanger !! Memang kewl.. But at the same time.. IT was draining and we had to ration our own drinks to maintain one's hydration.. Memang PEWAAII..


We had to climb again and again while reaching the peak.. Memang ada 7 puncak tipu ! It was a mental game for us ; a real test to see how determine you are. I was fairly exhausted but Alhamdulillah , it was a good feeling reaching the top ! Subhanallah !! Tambuyokon pun sudah sampai laaa !!!!It was good and I'm glad I was on the trip. It was satisfying eventhough ada la badan, kaki sume jadi mangsa..
Thank you OGKL for making my dream a reality..Gua pun hardcore!!! hehehehe
" Apa yang penting..bekerjasamaa...."


blisters..

pacat..

Walking above the clouds....
I forgot to mention earlier , besides the pacat marks and blisters ; I did dislocate my shoulder during this trip ! Such morbidity !! Hahahaha Luckily I was able to reduce it ( put it back in place ) and continued the journey home. It could have been worse but the pain was .. tak bule cerita bang !!! I do still have immobilities but Ok la..

Mount Trusmadi 6 - 7 August 2008

I've delayed this entry log because life has been hectic since i came back. On top of that , I caught the bug from my children and it left my weight as how I like it at the moment !! Hahahaha...

TRUSMADI 8669FT / 2642 M
5 August 2008
Wifey made a surprise move by offering to send me to the airport. I was speechless because when it comes to Outdoor activities that I do , I will try as far as possible to trouble her. Thanx Ja ! Dzaeffran was with us as Mak was not keen for us to bring Qaisya to LCCT. As soon as we arrive , the usual suspects were there. The OGKL group ; Ramli , Muzammil , Tok Gajah , Syuk and Amir were the early birds. I was introduced to Nadir ; a seasoned mountaineer and I certainly envy his gear ! Cool giller... :)

The whole 17 of us then checked in and obviously with the recent Air Asia restriction on baggage , somebody had to be sacrificed and it was Syuk ! His bag was witheld and all of us took a bit of his stuff. And in upholding the true OGKL way , we were late ! Ahahahah We rushed through the immigration point and that was how we manage to bring parang and the forbidden stuff on flight!
We arrived in KK at about midnight and straight away , the van ride to TVRC ( Tambunan Village Resort Centre ). We stopped for supper which was a good introduction to Sabah !

6August 2008
We slept cowboy style at the TVRC outdoor hall. We already 1000 m above sea level so it was very cooling and comfy in our sleeping bags. Everybody was up and early as Deeno had planned a ownderful trip for us ! He was the Guide for Trusmadi as he'd been there twice before. After a good Nasi Lemak breakfast , we were on the 4WD to the foothill of Trusmadi. The 2hr ride was hell !! hahahaha.. I guess most of our butts were bursting from pain and NOTE : pakai cycling tights with pads is not a bad idea next time !!


We arrived at 1800m above sea level and everybody was in their high spirits to scale the 2nd tallest mountain in Malaysia ! The whole track to the peak was 7 km. Hehehe but it is the within 1 hour 7km that I do for the runs !! Initially the track was flat for the first 1.5 km till we reach the 4900m mark. After that it was up and up and up and up ! The track was fairly readily available but not as how Kinabalu is which maybe over commercialised. Semput jugak.. hahaha..Gaban or Gabby as how she is known as prepared us Nasi Himpit from home. Guess what ? Hancur bang.. hahahah.. that was a good laugh but luckily we had spare nasi lemak from breakfast ; so it was still funny !
We climbed at our own pace and the group spread out. My speed.. hmm.. About 1 km per hour ? and the speed lessens.. to 0.5 km per hour when it became steep!Tak percaya tengok climb profile !

The original plan was to climb to the mountain top by hook or by crook that day. However , when we reached the cabin site which was also the last water point ; hmmmm... we had a relook and rethink. We surpassed the 2000m height mark and it already felt cold eventhough it was 3pm in the afternoon. Then rain started and the consensus was for us to stay overnight at the cabin.. And it was not a bad decision!!! Dinner was as ever satisfactory and the whole gang slept early as we will start early again..

7 August 2008
We started moving out from the cabin at 230am and my oh my.. sejuknyeeeeee..... We only had 1.4 km to reach the peak but it was A LONG 1.4km! The climb was steep and we moved because it was too cold to stop. At about 3ish , it started to rain heavily. Ya Allaah... Only god knows how cold it was to walk in such condition. I was on Celebrex so my usual cramps did not show itself truely. Alhamdulillah , by 430 am I was at the peak of Malaysia's 2nd highest peak...



SUBHANALLAH.. we watched the sunrise and it felt really great to be up here and witnessing god almighty's gift to us. It was DAMN BLOODY cold but the satisfaction and adrenaline shoved everything off ! MY Admiral shoe which i thought could survive the two mountains gave away its life on top of this mountain.. Hancur kasut !! Hahahaha nasib baik boleh ikat-ikat.
We celebrated our achievement on top of Trusmadi till about 7 am and started the descend. Somehow it was not that bad as we were all eager to reach ground zero ASAP so that we can relax longer. By 1pm , we were at the foothill and after that the "sakit bontot" time again on the 4WD. We reached TVRC at about 430pm and cleaned ourselves up before the long ride to Ranau for our next climb. Time ni dah letih dah...

Sad day

It was a sad day for the radiology department yesterday. They lost a first year trainee , who was pleasant and liked by everybody. It was a sad atmosphere in ICU yesterday morning when the last ditch attempt of CPR was done . A big number of her colleagues were around ; especially after i informed my wife earlier after reviewing her as the SMO on call. She was then in the upmost critical stage of her life.
She was young , married with a 2 year old child. She was admitted last Friday for her worsening of symptoms; she wasn't known to have any other illnesses and was just not recovering from her bad URTI.Unfortunately , the sepsis was overwhelming. She fought hard to live but i really dunno which fulminant bug was condemning her to death.She was in severe septic shock , DIVC with all the complications that one can imagine. She was on major supportive care ; but she could not recover at all.It was too overwhelming and her time had come.

My condolonces to the family ; wifey was certainly disturbed and affected by the untimely death.
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Getting the SMO ( Senior Medical Officer ) oncall job is certainly a challenge.By right it is not my time yet to do it but the circumstances forced my batch to take the responsibility. The 4th years have a huge shortage and because we have surplus 3rd years , 2 of us will take turns to do the SMO job. the The "upgrade" can be a moral booster but at the same time a different kind of stress when one has to incorporate plans of management in the oncall.
Experience certainly plays a big role while managing and i guess by doing the SMO job one is trained for the future specialist role one will play for his/her lifetime. I reckon its good but it should be guided well so that we don't end up to just BELASAH or do things without proper knowledge.
Yesterday I had to sit in the PAIN clinic because both of the PAIN PROFs were away ; and the it was passed on to me to see the patients. They were not happy to be sent home so SMO lah kena pergi ! Hahahahaha.. Chronic pain clinic is a totally different dimension and i kinda learnt something while talking to the patient. Their NEUROPATHIC PAIN is real as real can be.. and WTF to do lah ? hahahahaha PR job was the main thing to do yesterday and ok lah , the patient went back happy.. :)
I;ve done 3 so far and alhamdulillah the 3 calls were cool ; too cool that i foresee i will be having a torrid and eventful call really really soon !

Kedah did the double treble..

I was in Bukit Jalil earlier tonight , hoping to see a miracle. It was the Malaysia Cup final and to not be in the stadium when Selangor plays is a mega sin. I missed the FA cup final because I was in Palembang so i guess , this time since I am around I should not miss it.
Kedah was expected to win this match that made Selangor the underdog team. When we arrived , it was obvious who were the winners ; absent were the usual Selangor final fans ; it was half empty on the Selangor side while on the Kedah side ; it was almost full. Unbelievable !!! The atmosphere was electrifying and the Kedah fans were really fanatics !
Selangor started well , scoring the first goal. At that time the whole bunch were jumping like mad because we thought it was a sign !! Unfortunately , the better team started to pressure Selangor and it was obvious how they controlled the game. Selangor let in the first goal with inch perfect through pass , and then a blaster a minute later ! The whole Selangor crowd went quiet. And guess what , Razman the no 3 defender had to make a STUPID mistake in the penalty box and gave a PRESENT to Kedah.. and they scored ! 3-1 down.. Dil , Fiqar and Kamal just went out the stadium looking to watch Liverpool on telly !! Hahaha 2nd half there was not much of a difference , Safee Salee scored a screamer : EPL quality goal ! However it was not good enough.. and as a Selangor fan.. I was utterly dissapointed for us not to win the coveted sacred cup... :(
Congrats Kedah for their true champion consistency... they were the better team by far !! As for Selangor.. takpe , penyokongmu masih setia... :)
p/sI will always remember that one Kedah fan who danced tak "hengat" punya everytime Kedah scored !!!

The mega launch

I was at L4T's( Leaders For Tomorrow ) soft media launch on Tuesday despite me being sick. I had to come anyway because I was holding one of the buntings , kangtak datang kena maki kang dengan Dil.. hahahaha
Surf www.l4t.org for further information..

Down and out

I've been sick for the past 3 days. I must have over-exhausted myself ; went over the limit of my physical ability ! I had a really bad viral bout which really floored me but i still manage to do my call on Monday despite the light headedness. Alhamdulillah the call was uneventful otherwise I myself would have collapsed ! I was anhedonic that even blogging was out of the question. I am better today and since I don't have a proper list today so here I am again.. blogging again !!!
I suppose I was still recovering from my TT expedition ; but last weekend i really walloped myself. I was the MC for Mat's ( Dil's brother) wedding in Sheraton and we started rehearsing at 3 pm that Saturday afternoon. The Tengku Temenggong Kedah was the VVIP therefore we needed to ensure that everything was smooth. The event ended at 11pm and of course , dah tidur kat hotel bersama anak dan isteri... hehehehehehe... boleh la pulak lepas tu layan Liverpool's first game till 2am ! mana nak penat..

And the best thing was , I woke up at 530am and prepared myself for the Merdeka 10km run in Datarn Merdeka !! Hahahah.. time ni badan rasa cam kuat lagi.. Azad , Mafiz ,Ruslan and Halim joined the run as well. Kalau lari cam biasa takpe , badan kan rasa cam best sikit afterthe expedition , so i really pushed myself in that 10 .8 km run ! Memang gile... After the run I felt a bit funny and went back straight to the hotel... dah la tengah panas ; kerana nak bagi anak happy I had my dip in the pool... AND THAT WAS IT..

I felt sooooo tired after that.. slept the whole afternoon and by late pm , chills and rigors... still , we had to attend Elly and Edzwan's wedding in Anjung FELDA. My body was telling me to slow down but I cannot miss my own sister's wedding can I ? It had the similar BALI theme as how wew were in BORA ASMARA. Elly wore full traditional JAVA costume and EDZWAN certainly looked like Dukun Dewangga from SUSUK.. hahahaha We went back home , and..hmmm.. memang confirm demam. I was very cold intolerant that i had to sleep outside the room because everybody else was hot !

Itu la.. nak buat cerita.. moral of the story.. when you're above 30.. you'll always be above 30.. the body will not lie to you.. :)

Some picture summaries from the trip

I still can't find the right time to write up about my trip as yet. I had to bring Dzaeff to the hospital today as he developed nasal bleed after a week of fever. I was just making sure that it is not dengue and the trip to the Paeds A&E this afternoon certainly drained my energy after my long day in OT.


Check out the Trusmadi Tambuyokon pics from one of the expedition members ; I am impressed with Nadir's pics ; certainly captured the "feel" during the 5 day long expedition.. :)


Our butt smacking 4WD ride

on top of Trusmadi


playing with the clouds near Tambuyokon's peak

Malaysia kita bah !

Puncak kejayaan

Trusmadi peak


Tambuyokon peak

Bruised and injured but fully satisfied

Its 4am now. Touched down in LCCT from Kota Kinabalu at 12 midnight. I still can't sleep and at the moment I'm clicking through all the pics of my trip.Yes.. i conquered Trusmadi and Tambuyokon ! Alhamdulillah.
Eventhough I am now very sleep-deprived , tired , both feet swollen and bruised with pacat's marks.. I just can't make myself to go to bed as yet. ( I'm also waiting for my laundry to finish.. ) I am still euphoric ; i smile as i go through the pictures. There were too many memories and experiences to treasure.
I will write about it later ; I definitely will !

Let the adventure begin..

I'll be away for one week. I'm not sure whether it will be possible for me to blog while I'm there.. but we'll see. I'm not bringing my Sony ericsson , therefore no mobile blogging possible ! ( ari tu my benQ rosak pasal bawak gi outdoor la.. ) Wish me luck and insya allah selamat pergi , selamat kembali..