SE7EN IN THE MORNING

sempoi

2009-02-10T11:14:00.000+08:00

allow me to see..

not much was happening this last few week

talak idea..

kotak fikirku kontang macam kolah surau sekolah rendahku dulu

thinking nak start balik gudang se

jadi GP lagi sempoi!

My babe under the sun

2009-02-04T10:59:00.003+08:00

Sepetang di Seremban.

Matahari panas menyengat pandangan lintang ku. Butiran peluh membasahi ruang dahiku yang semakin botak. Kotak fikirku menjadi lesu setelah seharian membajak ruang sudoku yang masih kosong.

Air sirap oh air sirap membasahi anak tekak ku yang gersang.

padan

2009-02-01T09:00:00.001+08:00

"Wake up and drink this fresh coffee." My brother said.

"Damn , what time is it? Aku mengesat taik mata.

" Eight!" Curtly.

"Bugger.. I'm late I'm gonna be roasted coffeebean for this"

"Padan muka.. tengok bola lewat lagi" he laughed at my face.

"At least mine trashed yours!... Padan back at ya" I left him frozen only in towel.

wimp

2009-01-22T15:55:00.001+08:00

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!)

?

2009-01-17T20:25:00.002+08:00

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.

Surprised

2009-01-16T16:35:00.001+08:00

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.

HAPPY BUFDAY!

2009-01-15T00:00:00.000+08:00

HAPPY BIRTHDAY TO YOU !

HAPPY BIRTHDAY TO YOU !

HAPPY BIRTHDAY TO YOU !

HAPPY BIRTHDAY TOOOO YOUUUUU!!

Good stuff

2009-01-13T12:01:00.000+08:00

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!

Destinasi

2009-01-12T21:37:00.002+08:00

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

Sugar

2009-01-09T00:05:00.004+08:00

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.

Heaven

2009-01-06T00:02:00.003+08:00

"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.

Haven

2009-01-03T00:17:00.012+08:00

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.

New era

2009-01-01T01:03:00.005+08:00

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)

Conversation

2008-12-26T20:39:00.006+08:00

In room No 6 was a 48 year old Chinese man connected to a breathing machine, he was bought in breathless with fluid filled his lungs and his blood pressure down in the basement.

There's not much surprise there since his heart only pumped at 31 percent of his normal ejection fraction.

Cardiomyopathy and acute pulmonary oedema are never meant to be together.

As he lied there looking as though he was asleep, his wife would came by and sat next to him talking to him and caressed his face.

She asked me whether he could still hear her. I dunno. I like to believe that he could. Even though he's sedated with 5mg/hour of midamorphine.

"Yes. Talk to him" I didn't look at her, afraid that she might knew I was probably lying.

As I leave the room, I could almost hear them talking to each other.

Haha

2008-12-20T21:29:00.000+08:00

Got this from MMR website.

A cardiologist died and was given an elaborate funeral. A huge heart covered in flowers stood behind the casket during the service. Following the eulogy, the heart opened, and the casket rolled inside.The heart then closed, sealing the doctor in the beautiful heart forever.

At that point, one of the mourners burst into laughter.

When all eyes stared at him, he said, "I’m sorry, I was just thinking of my own funeral………I’m a gynaecologist".

A proctologist fainted.

Trial

2008-12-02T20:57:00.001+08:00

The department's mortality & morbidity review or fondly known as M&M is an intense weekly activity that no MO (medical officer) likes.

Supposedly its intent is to highlight cases that shouldn't have ended up in mortuary. Just face it, people die.. and we can't stop that from happening. But the M&M is never about that. It's not the WHAT - but merely the HOW is what gonna screw the MO's asses.

Really.. what supposed to be an educating session for the junior docs i.e the HO (house officer), turns to get carried away into a court drama session at times.

"Are you saying that you didn't check up on that patient for the second time that night?" the professor asks the MO 'in charge' of that case.

".. but.. but I was busy.. with another patient in different ward" the young man looks like a pale moonlight.

".. not an excuse.. wrong answer...I expect.. " the professor losing his patience.

"You want answer?" a tone of irritation building up in the young man's voice.

"I want the truth!" the 60 year old professor stands up.

"YOU CAN'T HANDLE THE TRUTH" the MO hit the table with his fist.

-- a cengkerik make a sound in the lecture hall, and HOMO (HO-turning MO) just peed in her pants.

Popcorn

2008-11-22T20:49:00.007+08:00

Eagle eye is a one damn good movie, a smart thriller like this doesn't come often... though some of the concept isn't really original. A super computer develops sense of awareness and wants to annihilate humans.. hello is that you Space Odyssey 2001.

That Shia guy is all right for action movies... I supposed he had improved his 'panicked face' this time. Anyhow his potrayal of the legendary Francis Ouimet in 'the greatest game ever played' is rather convincing. Now that is one classic sport movie. A feel good - inspiring piece of work. Where the odd was played well and better still it's based on real life event.

On the other hand..

Romactic comedy genre make a comeback with 'Made of honour' which in a way make me wanna flirt with the notion of romantic idealism. Huh, I reckon hollywood has embedded the idea that there a soulmate out there for everyone. Blurrgh!

Oh Btw, Michelle Monaghan is such a babe. I'm officially in love.

Ciggie

2008-11-10T23:48:00.000+08:00

I walked into the oncall room and found Kamil a cardiology registrar stood at a corner staring out the windows. Something burning in his left hand.

"So u smoke?" Asking the obvious.

"Nope, I'm just using my becotide inhaler, asthmatic since 10" He laughed and took another puff. The tip of menthol-flavoured Dunhill burned slowly. Bit of ash on the floor.

"Here light this up" he nod me a ciggie

"Tempting, but I quit since 5th form, it gives me cataract" trying to think something witty for a comeback.

"okay catch you later.. I'm late for an angiogram" He threw the half burning ciggie out the window.

Nasib baik no one shouted adoi from below.

We do live in an ironic world.

Anger

2008-10-20T22:40:00.002+08:00

How do we deal with angry patient?

"Eh Doc!... Why took you guys so long to see us ah! You know how long I tunggu kat depan tu... anak I cry kat rumah.. and I have to pick my hubby kat tempat keje dia.. if like this besok pon tak abis!!" the 40 year old auntie grinded her teeth while showing her canine side to me.

I studied her face and posture. She looked as If she's gonna chew me slowly taking her time. Well she's a bit hairy too... could easily has a werewolf gene inside her.

Thank God it's not full moon.

Here is where I pulled out my multiple choice answer response template:

A) Well.. hang on there, I get you the doctor. I'm the new nurse here.

B) Shut up or I'm gonna rip that mouth of yours using this syringe.

C) Hmm (long pause) have a seat, how can I help you mizz?

D) Oh God.. please - please I beg you don't hurt me.

I gave her my best-actor performance smile, pull out a chair and have her seated. Without acknowledging her 'madness', I proceeded to the 5 min-consultation.

Gave her the priscription, and off she went.

Do not in any circumstances provoke the anger. Playing fire vs fire would not help in this case. Just chill, act cool and do your job.

I find that in most cases, these anger-outburst moment are not circumstantial. The feeling has already built up inside that person way back before they walk into the clinic. It could have been death in the family, fighting with spouse, didn't get laid for a month - you name it...

... the long-waiting hour to see the doctor, is rather the last straw that break the donkey.

With that I'm not implying that auntie is a donkey.

(Well.. hey but a werewolf sure! Heheh!)

Raya!

2008-10-05T19:50:00.002+08:00

Raya came and went in a smooth ride. No bump, no glitch in the matrix. Got a few days off and went back to kampung. What a nice way of spending one's holiday. 3 in 1 stuff - I love it.

Get away from hospital

Road trip

Meet the parents (my own parents)

The idiom goes that during holiday season, the hospitals in KL would be almost empty. Lotta people want to be discharge home (even they insist on AOR - 'against medical advice' ~~ Okay I admit I forgot why the abbreviation doesn't match).

On the other hand, the hospitals in kampung area - say Kota Bharu would be full. Coz the children who balik kampung would find that their papa & mama's foot ulcer, diabetes are not controlled and took them to hospital.

Ha ha luckily I'm working in KL.

Cuka

2008-09-19T22:19:00.004+08:00

"Doc tolong sign ubat ni" Juita nurse yang tembam sapa aku yang tengah dok tengok sorang patient.

"Eh sapa pulak yg order nyer?" Aku terkezutt.

"Dr Yasin.. dia nak cepat tadi.. die tak sempat nak tulis and sign kat drug chart" Juita bagi alasan yg kukuh lagi solid.

"Eh mana bleyyy... maneleeehh bahayeer, bukan patient I tu. I tak familiar ngan kes tu.. nanti ape-ape side effects nanti.. I yg kene.. sbb my signature kat situ" Aku buat muka seposen.

"Page Dr Yasin key...mintak dia sign sendiri. Byee" Langkah kakiku sayup-sayup ke arah pintu.

Juita tarik muka. Muka masam macam cuka.

Merdekaa!

2008-09-05T22:08:00.000+08:00

Merdeka was such a nice day to relax and unwind at home. But instead I was oncall coz someone really had to stay and guard the fort while the other foot soldiers were playing hollahoop with their kids at home.

Come what come may. We were ready.
Err.. btw, so you know.. our hospital was running low on ventilator and ICU bed.

Genesis

2008-08-22T23:06:00.000+08:00

What shall I write here?

1st day at blogging and I'm stucked with writer's block.

I suppose King, Clancy and Pak Sako had the same problem before. And those guys were giants.

Anyhow, let see how long I can keep myself interested with this blogging concept.