Wednesday, July 7, 2010

Life between pre-call, on-call & postcall

Time flies as I went through paeds department. All I could say that it is overall a good training. Met some of the cutest children. And some not so cute, but certainly memorable ones.
In particular, the baby who loves to smile and had the habit of taking a deep breath when one blew air onto his face. (malabsorbtion syndrome)
Then there is the boy who can only count the number 4. (Eventration of diaphragm)
Then the boy who smile and say ‘hi’ to doctor eventhough he is literally out of breath.
(pneumonia)
The girl who stop crying when I sing ‘you’ve got a friend in me’. (hyperactive airway disease)
The boy who remind me of cookie monster :)
(pierre-robin syndrome)
The girl who like to scratch her backside. (barter syndrome)
The boy who want the precise piece of his Nasi himpit size covered with even spread of peanut gravy. (steroid resistant nephrotic syndrome)
The boy who can still eat chipsmore cookies while having his iv line inserted. (acute lymphoblastic leukemia)
They will all be part of my treasured memories who got me through this hectic department.

Saturday, April 3, 2010

Moscow: tear-striken

it is a sad day in Moscow when it was struck by the bombing attack lastweek. I was so shook by the news. And to learn that fellow malaysian was actually on the scene, in the same wagon when it happens just sent the chills to the core.
i was studying there for a good 6 year. the 6 years that made me now a half-blood moscovites. i was pretty attached to the place, i must say. I met few of the wonderful ppl i became friend wif. Part of me grows there.
when i saw a picture on The Moscow Times this morning, i couldnot held back the sadness i felt for the loss of victims’ families and Moscow itself. It is such sadness that could not be contained within anymore. The photographer captured the emotion so well with his lens.
I pray silently for those lives lost.

Friday, April 2, 2010

Black Hawk Down

i was just discharged from hospital today. was admitted for 3 days due to pain on my right lowerback. Turns out to be a stone down my urinary tract causing hydronephrosis.
they dont have a clock in the ward. I was placed in a 2-person room specially reserved for staff member who got sick. Apparently, i was the only inhibitant for the whole 3 days. time was something that seems most inconsistant. the only ‘time’ i remember is between the wakes from the pain, the jabs then the nauseating episodes of vomit and then, it is back to slumber.
nurses came in every once in a while. every so often, they will stop by to check my vitals. they do appear to come in intervals. mostly on time. sometimes they are late. but it never bothers me. In fact, the short conversation was the one thing that kept me from fading away.
my regular heart rate is about 45-55. it is not normal by medical book standards. most people have a heart rate of 70-80. Mine was less by some reason, but it was normal. (i had it check out when i was in med-school).
most of the time the nurses will be alerted with the number the see on the screen :”45?” “are u okay doctor?”… i would explain to them it is my normal heart rate. they would turn away with some disbelieve on their face, but otherwise, woud proceed with their other errents.
The funny part is, when i was in great pain. My heart rate will rise to somewhere around 80. That is a whooping 30+ difference from my baseline. (it is normal to have heart rate increasing in reflex to pain stimuli) And the nurses will give a big smile and say “well, all is normal!”.
Obviously, it is not normal. cant they read the subtle grimmace on my face? the body language telling them otherwise? Usually, i would bother and just order for another jab of IV.Tramadol. IM just wont cut it for me.
The worst part of the jab is the after-effect. Soon, a swirling sensation will spin in my head. Coupled with the pain i am already in, sweat will breaks on my forehead. For a brief moment, i can hear my breathing gets rather heavy…Then, came the gushing wave of vomitus. If you wonder what it was like. It is like getting your gut turned insde-out…
soon, everything will settled in the burred out ways and i will return the long slumber i was in, before i get woken up by another pain attack.
Pain from a renal colic is excruciating. Those who didnt know will never knows. If you want me to put it into words, then i’d describe it as the sensation worst then being kicked in the balls. (please dont mind my language). The bastard just wont give it to rest. It will keep hiting you again and again until you give in.
In medicine, we usually rate our pain from 1-10. that is what we call a “pain score”. one being the least painful, and then 10 is like when u get a heart attack. Pain from renal colic could go up to 8 by my standard. Usually, i could handle pain score 2-3 (which is somewhere between mild and moderate). But when it hit pain score 4-5, that is where it gets tricky. Your mind will start asking question wether the pain will reduce back to score 2-3 or will be became more violent, hitting score 7-8.
The logic is, one would want the jab before the pain becomes too much to handle. So, i’d have to decide FAST. The reason simply being (1) it takes some time for the medicine to work (2) It also take MUCH time for the nurses to come, to prepare the jab… until you “finally” gets the jab.
To call the nurse, they designed the “nurse buzzer”. Well, i dont really know what it is really called, but it is the very button u pushed to get the nurse in. They made it conveniently close to the bed where u can just reach out and press it swiftly. However, no matter how close it was within reach, it usually took my a good few minutes to press it.
the dillema to press the buzzer, is that u wont know for sure if the pain in getting worse or better. so, like most sane people , i’d to wait it out, and decide if it is REALLY getting worse?
…. and if i have one good tip from this whole hospital ordeal, it is this: NEVER HESSITATE to push that button. Stop being a thickhead and think you’re tough, the pain will ONLY get worse!
after seemingly endless cycle of waking up-and sleeping, i finally got well enough, to be able to push myself up beyond the boundary of the perimeter of the bed, and let in the sun and refreshing breeze.
And apparently, after the long-standing pain, the stone finally trickled down my ureter and now resting just a few milimeter from my bladder. The surgeon decided i wouldnt need to go under the knife. Rather, he would have me wait for the kidney stone to be flushed out from my system the “natural” way.
So, off i go, being kicked out of hospital before actually being healed.
# special thanks to Dr.Dar of Hospital Tengku Ampuan Afzan, who had troubled himself in order to helped me locating the nature of the illness. He had shown kindness and efficiency in his work, and it meant a lot for me.

Friday, March 12, 2010

when was it?

it has been a while since i stayed up late like this doing nothing but staring into the darkness of the room, listening to radio playing endless streams of songs. 988FM is playing some soft tune tonite. mostly love songs by artist unknown by me… i wondered when was it, that i last let myself drown in such emo mess… strangely, it is refreshing.
i went for “Alice in the wonderland” yesterday. watched it alone. it is a nice movie. i laughed a lot. but now that i think of it, i’d rather to have someone to laughed together with :/
hahah, i think midlife crisis must be catching upon me.
dear friends, wherever u may be… i do miss u

Monday, January 25, 2010

Dinner talk: execution of criminal

today, we were discussing about criminal execution over dinner.
nephew01: is it true that we hang criminal to death?
nephew02: of course, they tie some brick on the foot of the criminal, then put him on a plank then kick off the plank and let him fall. that is how i heard it was done.
me: yea somewhat, but malaysia have 2 type of death penalty, one is “gantung sampai mati” (= hang till you die) and another is “hukuman gantung” (= only hang)
nephew01: then if only hang, surely a lot of ppl will survive
me: unlikely, by the force of body falling, usually one will snapped their neck
nephew01: the magician wont die, since they know magic
nephew02: oh, then it will be exhausting for the executioner to hang them repeatingly
me: …
nephew02: why dont we electricute them?
me: US is doing that, hanging is the “malaysian” way
nephew01: which one is more painful, hanging or electricuting?
me: … how do i know, i never got hanged or electricuted before
nephew02: in China, they shoot them to death rite?
me: yes
nephew02: so i heard, the executioner will stand in circle and shoot the criminal in the center. that way, the criminal will surely die, unlike hanging
me: if they stand in circle, then not only the criminal will die, all the executioner might die too, shooting at each other :p
nephew01: LOL
nephew01: why not just toss them into the volcano
me: well, that might work, if only every country got a volcano
nephew02: nevermind, indonesia can lend us the volcano
me: … (wow, how diplomatic of them to think indonesia gonna lend us a freaking VOLCANO!)
nephew01: but it will be a hassle to climb the volcano everytime
me: we can just build the prison next to the volcano
nephew02: or we can fly a plane over and push them down
me: LOL
nephew01: come to think of it, might not be a very good way, if the volcano erupt, it will be dead body all over
us: LOL
nephew01: we can actually dig a big hole and push them all from the plane. that way, we kindda took care of the funeral one shot.
me: but it is not very cost effective to fly a plane everytime we wanna execute a criminal.
nephew02: we could just tie them to the aeroplane tire and dragged them all the way till they die
me: LOL… (yea, they might just die before u took off) or we could just drive a lorry into them
us: LOL
such educational dinner talk, rite? now i can rest assure our future is secured if my nephew becomes the leader of the country next time. next time a judge will pass down a death sentence, it will sound like this: Hukuman mati dengan dilanggar lorry sehingga mati!

Tuesday, January 5, 2010

2010: not yet 2012

2010 started with a BAM!… i meant that quite literally. BAM! as in collision kind of bam. As 12 midnite clocked-in on us, it actually slipped passed without much celebration. we were busy resuscitating a 16 year-old kid from a motor-vehicle accident. I succeeded intubation on 1st try, yet it wasnt enough to pull him back from the damage that has been done. pronounced brain dead somewhere near dawn.
I stepped outside from the hectic ER and watched the sunrise over the horizon. breathed a bit of fresh air — air without the smell of blood.
that’s how my newyear rolled by.

cheering things up

needed something to cheer urself up? how about listening to a song? :)
this song always gives me the warm and fuzzy feeling. thank God for Youtube (and thank you google inc. too of course)


i’m hitting the low-point of my health this week… pray that at least my spirit will see me through.