Dinners in Puteri harbour

Last week i had a back to back dinner in the same place! Haha Its in Fraser's place, a new hotel and resort situated in Puteri Harbour. The theme coincidentally was related to each other so i did not have any issues wearing the same thing twice! Haha

Its definitely something staffs would look forward to each year when celebrating such events. Its an important tool in companies and societies; as it will create the feeling of commitment and loyalty. Loyalty is important to nurture in a company but it must be with reason.

I enjoyed the night out and good fun to see people being happy celebrating with each other :)

Saham Akhirat

Last weekend i joined a friend of mine with his consistent charity week during weekends. He and his family would be visiting the asnafs in two places for breakfast. Sometimes they provide dinner as well. All the money is collected via FB- Salam Akhirat. I got to know of it via FB and am very impressed with his commitment. I've always wanted to follow them and hence last weekend i was back in KL.

 It was more of bringing Qayyum as well. I would love to expose him to charity work. With exposure one would understand why the deed is very addictive. Some would do it to show their worth to others but a number would do it quietly. However, for donations sometimes one must publicise galantly as that is how people will know aboutthe programme. I'm always impressed by Malaysian/s generosity. 

We went to 2 places. The first a tahfiz centre for boys. The second is the home for numerous young girls aged between 4-6.

Sometimes it would make a person be thankful for what he has after doing such things. I want Qayyum to know how lucky he is in this world. Alhamdulillah, to have what he wants and see how people who longs for what he has.

Alhamdulillah, it was an enjoyable trip. Hopefully I can follow my friend again in the next few weekends im back in KL. 

Simulasi mati

Tidur itu simulasi mati,
Apatah diberadukan anestesi merealisasikan hakikat,
Kapan mata tertutup dalam terpaksa,
Yakinkah kita dibangkitkan kembali ke alam fana,
Atau apabila mata mula menyapa,
Di alam barzah rupanya berada,
Maka yakinkanlha syahadah,
Redha dan pasrah; Qada' dan qadar..

10 Jamadilakhir 1440


P/S An unexpected token from a patient :)

Biannual mission Cambodia 2019

Lai! Lai!

I am very honoured to be involved with this project with Syariz. This will be my forth mission, and the istiqamah is real. It has always been a fulfilling trip for me and perhaps the one that i look forward to each time. I have been questioned by sceptics and unappreciative individuals for my commitment but perhaps unless you do these things then only one can explain why one loves to do it repeatedly. 

Its not just about helping the needy but also my own muhasabah going into remote areas and looking into these kids eyes; poverty, sidelined and hope. 

Do contribute in ringgit and sen if you don't have the means to volunteer yourself. 

I will update the progress of this project as it reaches its time. 

2 years JDT

Two years here in Iskandar, Johor. I never imagined that i will be here. I'm enjoying my work, good staff members, good colleague, good remuneration (hehe mestilah no 1!), exciting cases in a tertiary centre. What else could you ask in your career?

RA Masterclass Nov 18

Papa visit to Gleneagles Medini Dec 18

Esteemed Department :)

A thin line between deed and riak

One thing good about blog nowadays, whenever you want to rant it will be in a way personal until somebody actually browse into your blog. Really-really reading your blog. I imagine that one will know one is sincere and not for seeking attention. Unlike the current social media medium; when your post is out, it will appear on a number of people's timeline. Somehow or rather, people will know what you feel at that moment and there will be a thin line between venting out and seeking for attention. 

I guess i understand why the act of "mengungkit" is not encourage in our religion. Its evil on both point: the person who boasts on her deeds doing it to hurt another and the person being boasted upon, feeling sad and discouraged. There is no winner in that situation except to hurt the other again and again. Using it as an argument is really hitting below the belt but i guess that is life when the objective is to be always right. 

Any point arguing with such person? Nope absolutely pointless! Haha but its easy to say this out but when you are in that situation it is very difficult not to engage in the name of defending yourself. I have however learnt throughout the years to not be jumpy. Its so easy to reply to the arguments and just say things to hurt the other. What is the point? I guess when one is happy to keep it to oneself is the ultimate self control. Takda faedahnya hahaha 

Allah berfirman: "Wahai orang-orang yang beriman! Jangan rosakkan (pahala amal) sedekah kamu dengan perkataan menyebut-nyebut dan (kelakuan yang) menyakiti, seperti (rosaknya pahala amal sedekah) orang yang membelanjakan hartanya kerana hendak menunjuk-nunjuk kepada manusia (riak) dan ia pula tidak beriman kepada Allah dan hari akhirat. Maka bandingan orang itu ialah seperti batu licin yang ada tanah di atasnya, kemudian batu itu ditimpa hujan lebat, lalu ditinggalkannya bersih licin (tidak bertanah lagi). (Demikianlah juga halnya orang-orang yang kafir dan riak itu) mereka tidak akan mendapat sesuatu pahala pun dari apa yang mereka usahakan. Dan ingatlah, Allah tidak akan memberi pertunjuk kepada orang kafir." (Surah al-Baqarah : 264)

Dying blogging

People dont read blogs as much as it was at its peak. Since facebook, twitter and instagram came into the picture, blogs are slowly diminishing. I have to concur to this because i dont browse through blogs anymore. Most blogs that i read are inactive now. Who would have thought, this blog thingy would be somehow ancient after 10 years. I was at my peak of blogging then circa 2008-2010  :) But i guess that is how life is.

People tend to browse facebook and twitter more because less writing to read? Haha the truth is people's focus and attention is less with facebook and twitter. As one can see the language used in fb postings are short ; the long winded ones will be skipped anyway. If you are looking for followers, then fb and twitter would be the instrument. Blogging is a different ball game. 

My own blog entry has been pathetic the last 2 years so I am guilty as well to let this trend continue. I can give all the reason to justify myself but the truth was i sort of lost interest in blogging :) Simple, straight to the point. Blog is something personal - diary like. Its nice to share thoughts and ideas in this medium. 

I am lucky my blog is still around; remember geocities? I do hope that blogspot will be around for the next 10 years. As a back up i should copy and store it somewhere. Looking back at what i wrote then, kelakar juga ( haha puji diri). I guess the blog serves as a virtual diary that can be read by many; that will diminish unless being search upon. 

If there are still readers of my blog and in particular this entry, thank you. Thank you for keeping the blogosphere alive. And if we can keep the momentum going, do not be surprise if there is another wave of blogging happy bloggers and readers who will make it popular again! 

Hope and despair

Scenario 1

Patient just woke up from her anaesthesia in recovery . The first thing that she did was looking at her previous stoma*  site. The operation planned was to rejoin the previously parted bowel due to an unexpected growth that caused sepsis.

*It is an artificial opening that allows faeces or urine either from the intestine or from the urinary tract to pass.The stoma is created of an end of the intestine, which is brought to the surface of your abdomen to form the stoma (opening)

"Eh, belum buat operation ke?" She asked. She was still dazy due to the anaesthetic effect.

The stoma was the cause of her depression. She was still young of child bearing age and was looking forward for this day. Gone will be the days when she does not have to see her stoma bag full with her faeces. She became withdrawn after the surgery because she felt embarrassed to the society. She felt herself dirty carrying the faeces back all over.

"Bila nak buat operation?" she asked again. Tears were slowly flowing.

Its tough to break the news to her for the failure of the intent operation today.

Scenario 2 

"Biopsi akan diambil terus dan di hantar ke makmal. Kami akan  dapat result dari pathologist dalam masa setengah jam. 

Kalau result negatif, kita akan buat lobectomy.

Kalau result positif, kita akan tutup"

The patient with her husband nodded. It must have been the umteenth time somebody is explaining the objective of the surgery today. I did see on the notes ; my surgeon and my respiratory physician detailed extensively the consent explanation.

That morning, the whole family waited outside the OT. With hope for a miracle. Based on the CT scan and PET scan, it did not look promising. Her father was in his wheelchair, her two children brought their toys to play with knowing how boring it can be waiting. Her husband was full of hope, requesting my nurse to keep the "yasin" in the pillow throughout the surgery.

We did not proceed with the surgery after receiving the call from the pathologist. 

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

Handling the family and patient's emotion is not easy. In my profession, I would be one of the first to witness the hope and expectations as soon as the bad news come around. Its an everyday story everywhere.

Seeing this all make me wonder how we should be thankful for whatever we have at the moment. The moment the crisis steps in, its a roller coaster ride. Its easy to think how we do not have enough but if we step back and look around us, we would be surprise how lucky we are to have what we already have. Its so easy to see our own misfortunes but when we compare, what we thought was bad is not as how people dealing with worst scenarios have to deal with. 

Arrogance, self mindedness is something i would pray to god to not me fall into the trap of declaring as such. That is why I appreciate my work, it reminds me a lot how lucky i am. 

Aneurysm Sonata

ANEURYSM SONATA

The path of hope,

Lies in thy little fingers,

Cautiously swaggering,

Loops and twirl,

Perfection sought neither,

Never say never,

As night reaches dawn.

Angio suite

00:01 30 December 2018

2018 dalam kenangan

Cambodia HBB missions x2.
Mt Pulag (Luzon) expedition.
Finals Champions League, Kiev, Ukraine.
Mt Siguniang expedition.
Beijing AACA.
Doha, Qatar - ECMO course.

Not bad eih juggling my time to do this. :) 

New Year 2019!

Hello 2019!
Wow another year gone just like that.
The new dawn of a new year towards 2020.

2018 was an eventful year, with ups and downs. Some you would want to remember forever, some you would prefer not to be reminded off. But hey, for me, no regrets. It should be as such then I am as normal as anybody else.

Unfortunately, an old habit resurfaced and that made me sad. The habit who'd haunt me in the past and I thought it had been let go. Obviously not and slowly it is creeping into my day to day mind. God willing i do hope that it is just another phase.

2017 was pathetic with only 7 posts. 2018 did not fare well either with 10.

So to 2019!! Lets do it! To more adventures, more endevours and unbreak my heart!

Bohemian Rhapsody review

Watch this movie the other day.

Totally enjoyed it , the music and the story was good paced.

It was the tragic story of Freddie Mercury, perhaps the best rock performer ever seen.

I never knew he was not caucasian nor did i had the interest to look up his biography before. Perhaps his strong association with LGBT and knowing by reputation his galant lifestyle.

The music in this movie was good because it was all Queen. I must say the band is really talented with 3/4 of them can actually sing.

It was an interesting journey of his life and his passion. Though from my reading , a lot of his "other life" is not highlighted in this movie. Brian May and Roger Taylor emphasized in their interviews they only want to highlight his amazing talent.

And indeed he is, as i am stuck to youtube watching all his past live performances. 

My favourite actor ever..

Siguniang, China Dafeng Summit 19-28 October 2018

It was a wonderful trip. Almost a reunion of Stok Kangri in 2016. 10 of us, new to me was Hani, Abang Rahim and Mat Dinz from Labuan. Usual suspects: Pak Am, Deeno, Abang Ayob, Mang, (Ustaz Wong aka Great Leader), and Loe. 

This trip to China was my first, and my first impression of China will be WOW. They are a great country and somehow we have to be at par with them. How could you not as their civilization spanned more than 1000 years BC? 

Summitting on my birthday was a first. It was very memorable. I could not have asked for more.
Thank you team for making this trip something to remember!

42 on 24/10

42 on the 24th of october 2018.
Dafeng, Siguniang Summit, Sichuan, China. 

#tragedi6bomba

It was a sad week. Initially the devastating quake in Sulawesi, and we then lost 6 brave fire & rescue personnels in Puchong.
It was sad to loose these heroes.
I will not go into the controversies around the tragedy for now but it was the reality of their job. They will put their life in the line of fire (literally) and this incident showed just that.
Alfatihah

Standby mode

PASKAL - Sentiasa terbaik!! - movie review

I was asked to do a review on this movie, "lama dah you tak review movie eh?". I watched this yesterday, at noon ( ponteng kerja kejap hahaha). My expectations before the show? Well, The trailer was good but how many times have we been fooled by awesome trailers especially malay movies. I was crossing my fingers hoping that PASKAL will not receive the same fate. I rate PASKAL highly because I have had the opportunity to be with them during TRYLA many years ago. Our own "Navy Seal" if one wants to compare. 

From Wikipedia : 

"The Pasukan Khas Laut (Naval Special Warfare Forces, Jawi: ڤاسوكن خاص لاوت), commonly abbreviated PASKAL, is the principal special operations force of the Royal Malaysian Navy.

PASKAL's task is to conduct small-unit maritime military operations that originate from, and return to a river, ocean, swamp, delta or coastline. PASKAL also perform unconventional warfare, guerrilla warfare, counter-guerrilla warfare, jungle warfare, counter-terrorism, close protection, hostage rescue and foreign internal defence."

I went in without reading the full review, saw the ratings and thought hmm should be good. and..

My verdict? 

WOOOWWW ! TEBABOOOO! Awesome yeah!! 10/10 from me :)

The plot:

The plot was how you expect it to be. Good vs evil and how evil stemmed from injustice of the system (lateral thinking) - Cite Batman & Black Panther pun same theme. Nobody is wrong and nobody is perfect. The 2 big incidents were based on 2 true ops and that gave the goosebumps while watching the events.

The characters were real and the dialogue were not pretentious. Seeing the flashbacks of their training an initiation was surely heartwarming. They are the best! I wished that we could have seen the test of throwing them in the middle of the sea with all limbs tied, and waiting them at shore. Imagine berenang macam tu!! 

The action sequence:

I must praise the  meticulous details being given attention to on the weapons and assets of TLDM that was shown. It was as real as one can get. Submarine tu cool habis :) I guess having the Navy and PASKAL themselves breathing down the producers neck, they have to produce this perfectly. It is our special forces dignity at stake! True enough, the director brought justice to this piece. 

Action sequence were hollywood standard. Check it out Tom Cruise!! I had the thought that we might go Hong Kong style where the action sequence maybe good but there will always be something missing unlike the Hollywood action flicks. But PASKAL wasn't Hong Kong! Betul cam hollywood siot.. Hahaha Okay, they maybe some logic stuff you would want to consider but hey, tengok Rambo lagi mengarut oii.. Give credit to our own local production! Thumbs up! 

Overall it was an enjoyable movie. I maybe biased because I love Malaysia but seeing our special forces being given the honour to be potrayed as such in this movie, memang tersentuh :) 

Well done! 

Merdeka de Elbrus 2017

Merdeka Climb 2017 Top of Europe, Mt Elbrus.
For 2018, I was in Cambodia.
But for big mountain project ke mana yah? 

Cambodia hernia HBB project

Merdeka this year I wasi n Cambodia again. This was the third installment of the project initiated by Syariz last year. Alhamdulillah, we have been consistently doing it for 6 months. The programme is simple, First 2 days in HBB ( Hospital Beyond Boundaries) to conduct charity surgeries. Then we'll be off to the deeps of kampungs to perform the sunathon programme.
It is a very fulfilling act. I enjoy doing this and I hope to remain m istiqamah to do this.
If any of you are keen to join us, please contact me or Syariz. We will fill you in with the details :)

Malaysia Baru

Assalamualaikum,

WOW! My last post was almost a year ago! What happened yeah? What happened? Allahu akbar! Ive left my blog for a year and honestly, today it suddenly triggered me whatever happened to my blog. Good that it is still around but obviously I've been blog dormant for almost a year.

A lot has happened and changed. I guess the catalyst for my absence was the event that took place in OT almost the same time. It was something that shook me and I guess I tried to stay away from writing my feelings due to the possible medico-legal implications later. Well, it is still not sorted yet but we'll see what happened.

I am still in Gleneagles Medini. It will be 2 years by November again. I am still at times running up and down to KL as my family has yet to move here. They might in the future but i really don't know when. Let time tell. Qayyum has settled his UPSR and now in a KPM tahfiz school alhamdulillah. Who would have thought he would be interested ( till date) to be a tahfiz and I pray for his perseverance.

Malaysia? Haha ni lagi best. Who would have thought the possibility of Mahathir-Anwar combo to lead the country again. Who would have thought that Mahathir, the 93 year old gaffer rose to lead the country again? In politics nothing is impossible. Today is the nomination day for Anwar to rejoin the parliament in Port Dickson. It is an interesting plot happening at the moment. Whatever it is we hope the best for Malaysia.

The people in Malaysia voted for change. Whether the whole Malaysia is ready for this change, we will see. It is rethoric but it was something that Malaysia needed. To define the baru is interesting as it has only been 61 years since independence. It was in 1970 that we first started to restructure the society. Changing mindset is not overnight and take generations to achieve. We pray the best for Malaysia.

As for me, i do hope to be consistent in blogging again. It is a good feeling to be able to write on the blogosphere - the popularity of blogs has come down with the presence of facebook, twitter and instagram. Hoever i do believe that blogs will be around for a long time. I am not looking for viewership, but it serves as some sort of personal journal of one's life.

Write up burnout

The most obvious reason for my sudden appearance in the blogging world today is obvious: my TV malfunctioned. This is the bad thing about LED TVs, the backlight can just decide to stop working and you become a blind TV watcher. Well, this problem has been going on for few months but because it went Ok after few days of not switching it on. Haha thats how easy going i am. I know i should have it repaired as it is still on warranty. but MALAS.. 

Honestly, since working in the south; my creative mind had deceived me. I am not keen at all to be in front of my laptop screen and type whatever is in my mind. Its difficult for me to lay out any story line and write it up. I used to have it free flowing, an all nighter for one story. Thats how my mind works. Unfortunately, i cant reproduce that at the moment. Hence my off time even from blogging. To say that im superbusy is not totally true. I was busier before ; looking back at my blogging history since 2004, I produce lots of my writings during the busy years of my masters programme. 

I believe I'm suffering from a Writing block burnout. I was thinking about writing stories for our future DIAgnosis or even my future solo book. BUT I CANT!! Haha memang kering otak to write :)

I have one book which is done but i have to make it longer because it is too short. (Not too short like HIPNOTIS). I really need to work at it because i believe there is a story to be shared with everyone. I foresee it to be liked by the mass readers but need lots of fine tuning to it. Haha.. Hopefully 2018 will be the year it can be published. 

The test to this will be after I've repaired my TV. Haaa.. then we'll see whether the exodus will be repeated.

Insha-Allah, the whole family will be going for an umrah trip soon. I am looking forward to refresh my iman. Honestly, it had gone downhill since last hajj and perhaps this visit will rekindle the light to maintain the aim for jannah.

Whatever happened to time?

Yes... time moved swiftly without us realizing it. It goes on and on. Memang betul la surah al asr. Sesunnguhnya manusia dalam kerugian. By not appreciating time, memang kerugian.

I don't know why I;'ve stopped blogging since March. Too busy? Thought block? And suddenly there is a vacuum in this blog between then and today. Its already November. It will be one year now in Medini since I was unexpectedly expedited to move. I wish i had the motivation then, as there were a number of exciting things that happened. 

Life has been plentiful. There were a number of clinical achievements unlocked. I am enjoying my time here with my work. It is such pleasure to work in not so pressured working environment. Of course politics is difficult to separate wherever you go. I do hope that this time around it will be different, life free from politicking and looking for favours to survive. Being with a fairly green and foreign administrators can be challenging. But then again, how can life be perfect? There is no such thing. It is us who would decide to make it perfect to our own liking. 

I summitted Elbrus end of August Alhamdulillah! It was a superb achievement as there were a number of luck factor that was with us. Lets plan for the future of which to climb :)

However, I am not 100% settled here as we are still in the grey of having the whole clan move south. Being settled in KL, I can understand why it will not be easy to start over. I am lucky that my line of job allowed me to do so. I can only thank Allah for his rizq and be thankful everytime.

Happy Birthday GMH :)

 Birthday celebrations and Cardiac Services launch

 Our Annual Dinner last night :)

Historical March 2017 - Tale of two specialties

Alhamdulillah, March has been very kind to us. We have crossed boundaries and leaps towards our brand namesake. I am very happy to have been involved in these two milestones that we have achieved here in Medini. Bearing the name Gleneagles, this is what we can comfortably fulfill our potential. It is not an easy feat but I guess when we do it for patient's sake, god will help us achieve it ho help more people. 

Honestly, I am blessed to have dedicated and enthusiastic people to work with. I know what they want to achieve therefore that is my role as the team player. I may not bear the glorious end as the surgeon in charge, but as the anaesthetist who ensures what feels impossible to be a reality

Awake Craniotomy

When i was approached by my neurosurgeon about the possibility of doing it, I told myself Why not? By principle it is a simple thing to do. Its the precaution and anticipation that will make a difference whether it becomes successful or you have to abandon the initial plan.

The challenge for me was for the awake-awake-awake procedure! Wow, thats an uphill task but of course not impossible.

Important VIP points:

1. Patient must be counselled properly and understand every detail of the procedure. They must be fully motivated for this procedure.
2.Regional anaesthesia skill for the scalp block. This must be superly perfect.
3.If patient throws a fit during the procedure, there must be a solid plan for airway protection.

I did my research by lookingthrough the literature and case reports written by colleagues in Malaysia. MOst of them were more comfortable with sleep-awake-sleep method so i suppose what I was going to do is pioneer "ish". I was lucky as the surgeon adopted a position which was convenient for possible problems if it arises.

Alhamdulillah, the good teamwork with had made this procedure successful with good outcome.

CABG

This was the marker of a tertiary hospital. It has always been its KPI since the start and after 1 year and 3 months, i present to you CABG.

The preparation was immense. 80% of my OT staff had never seen one before. We had a thorough preparation from the nurses to the PCAs. What i value most was their eagerness to learn and cross that boundary. My surgeons are both renowned in CTS and certainly the 2 Cardiothoracic surgeons that you want to work with.

When the day came it was goosebumps all over. I started UiTM's first and now its Gleneagles Medini. The profile of our first patient honestly may not be the typical first case you want to operate on. But then again, with cardiologists being more daring than before, one cannot expect CABG cases now without a challenge.

Alhammdulillah again, it went smooth and well.

And till date,  we have done 3.

Logs

HAd an interesting chat with an old friend yesterday. We discussed the importance of keeping a journal for future reference. Hence, blog. A very important pieces of writings that will be preserved forever. (Unless bankcrupt la)

I will cherish this picture forever, taken before the opening ceremony of the Annual Scientific Congress Malaysian Society of Anaesthesiologists and College of Anaesthesiologists Malaysia 2017 in Berjaya Waterfront, Johor Bahru.

Getting prepared for the big day

We are getting prepared for our big day. Our first open heart surgery very-very soon. This i suppose will be the landmark of how my current centre will be. We have currently doing great things with the neuro team and now the cardiac team is set to go.

 The OT staff themselves are excited but at the same time having palpitations. Its not something trivial as the preparation must be perfect. This reminds me of the time when we prepared for our first case in UiTM. It was nerve wrecking preparing for the day. Its not just the equipment and number of staff, it is also the mindset of the whole team. One thing for sure is once this gets started, there will be no turning back! 

Its not just the OT, but the ICU staffs are gearing up themselves for the start. They've been working hard these past few months because of the neuro cases we have been handling. I must say they did really well to cope with all that. Now another frontier is beckoning. 

Alhamdulillah, i must say the team we have is a good one. Both surgeon's are of recommended reputation. I have an experienced perfusionist and at the same time, enthusiastic nurses who are ready for any challenge any day! 

Lets do it!! Bismillah..

#DIAgnosisFobia

Yes! By today it can be bought at the nearest MPH stores!

The latest in our series! However, this was more to explore our fictional creativity side.

Enjoy the stories yea.. but be WARNED!

Crawling back into the scene 2017

Wow.. how time flies! Totally neglected this blog! The longest hiatus I've been in. Well, it has been very busy sorting out lots of things here. The move, the relocation, the job, the responsibility!

Haha.. but seriously! my last post was in December and now its March. A good 3 months before I feel like i need to blog again! 

It had been a hectic 3 months and things a falling into place. I was literally thrown into this new responsibility down south and had been working hard to organize things amidst the busy OT list. Alhamdulillah, i 've managed to secure my partners in crime and in time, i will be freely blogging again without hesitation. 

I am blessed with a group of dedicated staff in the OT and enjoying every single moment. At least that part of my stress was never an issue. The cases we do here are variable, I have definitely upskilled my paediatrics and neonatal anaesthesia as we have a very active paediatric surgeon in this hospital. The variety of cases we have at times can be complex! Being a tertiary centre that was the challenge i have to take. Nak sangat, haa amik kau.. hahaha

Alhamdulillah, we are doing hi-fi neuro cases ( which i will blog about later) and coming soon is the cardiothoracic cases. I'm sure the numbers will increase with time. With my colleagues set to join me soon, Im sure I'll be able to find time for recreational activities. Even now, I'm back keen with badminton as there are a number of staff who are keen enthusiast.

I cannot promise but I will try to make 2017 a merry year with more post than 2016!