Thursday, January 22, 2009

wimp


I used to think this dude is 'just all right'. Now he's officially a wimp.

Right after he gave back the gun to the madman and put No. 13's life in jeopardy.

I don't care if his reason for that was to find the truth and diagnose a disease.

Because No 4.2 rule states : Never gamble with people's life... esp your friends.

That's it for me, U.S television scriptwriter is offficialy now in rigor mortis.

Baik aku tengok cite Puaka Niyang Rapik. Lagi lazat!

(psstt! TV3 Khamis mlm.. muahaha!)

Saturday, January 17, 2009

?

There had been some comments which I find bit strange & out of ordinary lately. Although I try to be friendly and polite by publishing those comments. I must say I'm not really comfortable with them.

So I've decided that those comments which I find 'just doesn't make sense' will be deleted.

Thank you again for visiting.

Friday, January 16, 2009

Surprised

It was a long day at clinic, my last patient was a 24 year old University lass who is unfortunate enough to have systemic lupus erythematosus (SLE) which is a multisystemic autoimmune disease that can practically attack any organs in the body.
She was diagnosed 3 years ago when she presented with a seizure which was labelled as cerebral lupus. The prednisolone she took is designed to tame the illness and its side-effect made her face look look puffy.

The prednisolone was taken off last year as she was well enough and declared to be in remission. She was happy with the way it was. However now her test showed a sudden surge of protein in her urine.

That put her at a high likelihood of lupus nephritis - a risk which strong enough to compel me to restart her back on prednisolone. She was unhappy yet content. Her best friend rubbed her back as I broke the unwelcome news.


Then the day got busy again, at 4pm I got a phonecall from the dept secretary.
"Doc.. we got a package for you"

"HUH package.. for me?"

I came home with a grin pasted on my face. A wide grin which usually doesn't belonged there.

I love wonderful surprise.

Thursday, January 15, 2009

HAPPY BUFDAY!




HAPPY BIRTHDAY TO YOU !


HAPPY BIRTHDAY TO YOU !


HAPPY BIRTHDAY TO YOU !


HAPPY BIRTHDAY TOOOO YOUUUUU!!

Tuesday, January 13, 2009

Good stuff


A nice way to spend one's evening is by going to one of those drug talk or latest update on some newly released drug made available to Malaysian docs.

The drug company would play by their book, the modus operandi includes a 1/2 - 1 hour talk by a physician who is an expert on the subject (whom is paid a hefty chunk of $$) at a nice venue usually a 5-star hotel.

Plus not to forget are all those free goodies up for grab like notepad, bags, cute pens etc so that the docs would never run out of ink in case they need to prescribe the new meds to their patients.




Last but not least, can anyone resist a free 7 -course or buffet dinner (those fresh osyters and all you can eat sushi) at the end of the talk, while gossiping about medical scandals and what not.

Whatt?? A form of bribery did you say?

BURP!

Monday, January 12, 2009

Destinasi



For you (yes.. you)

Diskriminasi menjatuhkan aku
Reputasi kini menjadi bisu
dan aku, ku layu disitu

Mengharapkan sesuatu yang baru
itulah impian aku

C/O

Dan bila kau menghilang
Musnah la, musnah impian
tuk menggapai bintang
terangi hidup ku

Ku mahu kau tahu
engkaulah, destinasiku
dalam ingatanku .. oh oh oh

Kerana diri ini tak daya lagi
menempuh hidup yang ku temui
dan aku, ku tunggu .. oh oh oh
disitu

Friday, January 9, 2009

Sugar



The guy with the AAA didn't make it. He died last night after his heart went into abnormal rhythm called ventricular fibrillation.

However this afternoon we got a new case, a 28 year old lady with a type I diabetes mellitus since 9 years old which resulted in diabetic nephropathy now causing nephrotic syndrome.


Her immediate problem now however was having recurrent hypoglycaemic attack apparently from her long acting insulin called glargine. The effect is catastrophic since she's not eating well recently due to her infected diabetic foot ulcer.


Nephrotic syndrome made her body and limbs swollen up and filled with fluid which make it almost impossible to establish an intravenous access.


I was happen to be in the neighbourhood when Husin and Hasan, the ever hardworking orthopods MO were struggling in setting up IV line on her. Multiple jabs and pokes had left her body all bruised up.

With her glucose level of 1.9 we know she wouldn't last long. Without sugar the brain would get screwed and she could risk slipping into coma and irreversible brain damage. So we need to find a way to give her sugar quickly, and she's too drowsy to take anything orally.


3o minutes had passed and we were losing time, so I decided to do a femoral line by inserting a triple lumen into her right groin.

A gush of dark red blood filled in the syringe as the 16 gauge needle pierced her femoral vein...

Soon after a 50CC of Dextrose 50% went into her, she woke up and asked us "Huh! Who the heck are you.. where am i?'

Me and the orthopod boyz look at each other and laughed our ass off.

Tuesday, January 6, 2009

Heaven



"The ruptured abdominal aortic aneurysm was severe.. he got huge hematoma inside his peritoneal cavity... but Thank God we went in quite early" Joe the relatively young surgeon looked happy.


"What worried me is his blood pressure was on the low side for 2 hours post-intubation.. and now I suspect the kidneys are failing" a veteran anaesthetist voiced his concern.


"What's the urine output?" Joe began to sweat.


"Not much.. the CVP is low, even after 1 pint of Hartmann challenge, now he's already had positive fluid balance by 5 litre.. " another anaesthetist walked into the room.



"Better call in the nephro team. Make sure the primary team make the referral, just in case we need to dialyse him" Joe concluded the afternoon ward round.


Outside the ICU, rain is pouring down from heaven.

Saturday, January 3, 2009

Haven



Many people talk about New Year resolutions.

What I reckon is more important than a bunch of resolution is to realise and appreciate that the sun is still where it should be. We take things for granted these day. May it be our health or our loved ones.

Last night a 68 year old man spent his new year's eve fighting for his life on the OT table, having stranger's hands inside him cutting into his tissues trying to repair his ruptured abdominal aortic aneurysm (or AAA). While his wife sitting anxiously in the waiting room with tears on her face. Perhaps that was the longest 4 hours of her life. And for him time stood still.

It made me think about what really matters in the coming of this new year.

It's all about appreciating what belongs to us. What is ours right here, right now... this moment. And the fact that all of those are actually 'loaned' to us by God. And He can take them all away in one single moment if He wants to.

Having said all those... hearing goodfriend's laughter in the living room and seeing sweetie-pie sitting at the kitchen table enjoying her choco spread with a smile on her face. Now that would be my haven.

Life. Carpe diem.

Thursday, January 1, 2009

New era


WELCOME 2009.

It was both a good start and a meaningful one coz she's there with me to celebrate the dawn of the new year together.

Eventhough it is a simple countdown but it's a truly meaningful one.

Looking forward for the rest of this year. Hope it will bring a new era to our life.

Thank you sweetie.

(... psst did I tell you that you look lovely tonight)