Just Because It is August | 2.0 :)

August 4, 2019

I realized I tend to reflect myself more in this month, I mean August. And yeah, August this year gonna be a step to another level in my life, insyAllah. :)


JUST BECAUSE IT IS AUGUST :)

PRIORITIES



To be honest, I regularly read my own posts and reflect how I used to be before and how am I currently. Obviously, life changed me a lot, from working experiences dealing with different kinds of patients, appreciating life when dealing of newborns and oldies etc. Nowadays, I am struggling to put my thoughts into words as I think I haven't properly reflect myself the past one year plus. And I miss to do so, very much. 



Just a recap of what I have go through so far - so that the future me will further appreciate how my life have turn myself into a better person, insyAllah.


1. I am already in my 5th posting, Alhamdulillah.

It means I have been in this housemanship for more than a year. To be honest, I still feel afraid to think about dealing with people's life. Recently, my new head of department asked this popular question to us, the new comers in Paediatrics - "Why do you choose to be a doctor?" Seriously, this is a very general question, yet can be quite tricky to answer. I bet different doctors have different reasons for this and there are simply no right or wrong answers. You can help people by being a doctor and you can still help people by not being a doctor. 

Attending newborn.


After a while, I realised for me it is actually medicine that chose me and Allah led my way towards medicine. It was hard at the beginning to have the passion as this job is physically and mentally challenging.

But, after few initial weeks of working, I can feel the satisfaction of being a doctor, despite I am still learning my best to be the good and safe doctor. It started with when the patient admitted to ward for some symptoms and I need to figure out what actually happened to the patient based on his/her clinical symptoms, trying to correlate with the physical examinations with the help of imagings (like ultrasounds / x-rays / CT scan ets) plus blood investigation then come out with a diagnosis and try to manage the disease with some plans.

The best feeling is when I would be the one discharging the patient after giving treatment and the patient got better and well. I really love the feeling when the patient does not have the symptoms anymore and when I can see clinically he is getting better - having appetite to eat, able to move around, able to smile and have better conversations with family members.


2. I am getting married soon, insyAllah.

We knew each other for a year plus, have been working together as well. Many colleagues were surprised about this as we don't really show our relationship to others, only those who are close to us knew about it. And I feel glad when the close friends keep on supporting us and still keep the info to themselves. :)

I feel so blessed when Allah gives me the opportunity to have this feeling and may Allah lead our hearts, together, towards the right path till the end, till Jannah, insyAllah ameen.

My parents were very excited to know about this, so do his... and for me parents' blessings are one of the most important thing I consider for a relationship. I love how he approached me, it was sweet, simple and direct, not leaving me with uncertainties :). The exact moment when I seriously considering to proceed was when he went to meet my parents and when he said something like this to me - "I would love to know more about you and to have you as my life partner, my best friend, my companion, my wife, the mother to our children, my partner in crime, my travel mate." 

Thank you Allah for sending him into my life and please guide us towards a happy and blessed marriage.

3. #kemasrumahwithhani

I just discover this FB group - #kemasrumahwithhani recently and I totally fall in love with all the posts. My brain wants to live a minimalist life but my heart keep on buying stuffs that I thought I will use. It was difficult to de-clutter stuffs without the guilty or sentimental feeling but some things I need to let go as I don't want to be a hoarder. Alhamdulillah, I can currently control myself not to buy random stuffs, hehe.



Try to explore the group, we can get ideas on how to organize our stuffs - even like how to fold the clothes, how to dry clothes in rainy seasons, how to easily clean the kitchen, how to deep clean the washing machine, how to do food preparation, how to decide when to keep or let go of our stuffs and etc. :)


p/s - pray for me yea and kindly share tips for a good marriage if you have any :)

SM, Perak, Malaysia
190104 

Recaps of Pangkor Run 1.0

June 24, 2019


16/6/2019 - Pangkor Island, Perak

To my surprise, there are lots of running events being organised around my working area - Manjung. Or maybe it is because currently I don't have much issue with logistic - like I can drive around to almost anywhere haha. So, after meeting few friends with common interest which is to join running events, we decided to give a try with this Pangkor Run. 

I were very excited to imagine myself running along the beach and yeah, it was one of the nicest feeling ever! :D


Anyway, I feel like I gradually losing my writing skills, so, bear with this one yea. :)

15th June 2019
Most of us were on postnight shift that day. It was quite an eventful night shift the previous day - with non-stop cases referred from Emergency Department and of course no sleep achieved that night hahaha. We were basically berkampung in ED attending new cases.

Went home around 10am, took our breakfast, did few pending stuffs here and there then... suddenly it was already 1pm. Actually we planned to take a ferry to Pangkor around 3pm. Unfortunately, the three of us overslept and woke up almost 5pm. We rushed to pack our bags, aimed for 6pm's ferry from Marina Island.

How to get to Pangkor from the mainland?
Only via ferries. I heard they want to redevelop the airport but later I guess.

You can take ferries either from Marina Jetty or Lumut Jetty.
It's been a while since I took the ferry from Lumut, so, not sure much about the rate and schedule. But if from Marina Jetty, here are the schedule and rate - much expensive but you can get to Pangkor at shortest time compared to Lumut :)

You can park your car around the jetty with RM15/day.


Ferry Schedule

Ferry Rates

Here is the ambulance boat - to transport patient from Pangkor Island to Hospital Manjung - for any emergencies that need further management in bigger center. There is a Klinik Kesihatan there, in Pangkor anyway. :)

We checked in Puteri Bayu Beach Resort that night, booked a room for girls and another room for boys. Rate was RM100 for each room, with 2x breakfast each. 

16th June 2019
Woke up around 5.30am, as the run will start around 6.30am. To be honest, this was the first event that really start the run on time, lol. Actually, even 5 minutes earlier. Run was okay but my pace was just acceptable. Hahaha. 

Dah lama tak lari, memang haru la pace nya.

5 of us. Another one was having AGE-_-'
Tadaaaa, here is the medal :D


After the run and taking pictures here and there, the girls decided to enjoy the beach and the view. Since the hotel was connected to the beach, we didn't have to take any taxi / walk far though. :)

The view was amazing. I have not much memories of Pangkor since the last time I went to Pangkor was ages ago! Even, I have been working in Manjung for 1 year plus, yet, I didn't have the chance to go there within this 1 year haha.


Loving the wave :D

Nak berenang, tapi segan :D

The water was really cold :D But, still mesmerizing!

The girls :D

The journey was short yet sweet.
Looking forward for more running events together with them! :)

Let's go home :)

I've completed my 4th posting in housemanship :)
Pray for my next one, guys!
It will be either Paediatrics or Emergency department hehe


190624
SS, Perak, Malaysia

MVA

May 13, 2019

My oncall last night was calm, alhamdulillah.... until 5am. I received an update from my colleague that he was going to ED for a new referral - intraabdominal injury, a condition in which I feel challenging to attend other than brain injury. 

MVA - motor vehicle accident.

I am not sure about the exact history, but this patient, Uncle L was riding a motorcycle and accidentally hit the tree. We are not sure about the mechanism much but it must be a very serious accident as the patient came to ED unconsciously. Blood pressure started to drop, which may indicate some bleeding was going on. 

He successfully underwent emergency operation (exploratory laparotomy + splenectomy) which mean, we cut open the abdomen to find out what was going on inside. There was at least a kidney dish filled with blood clot and approximately more than 3L of blood loss. And the spleen was totally injured and need to be removed. Few segments of liver were contused as well. 

Anyway, do you guys know how much blood the heart pumps out every minute? 5L/min!

And he lost more than half of blood in the body. So many blood transfusions going on this morning, my friend became runner to fetch blood between blood bank and operation theater. At least 3 large bore branula were in situ -  one for packed cells, one for cryoprecipitate & fresh frozen plasma, one for IV drip. 

He was still in critical phase and admitted to ICU post operation.



And actually there was another patient at the red zone this morning, he was also unconscious, lying flat just beside the patient we were preparing to transfer to operation theater just now.

Informed by my friend, he already passed away this morning, in his baju melayu and kain pelekat after finishing his Subuh prayer and he was being hit and run. Arrived in ED with no pulse, cardiac monitor showed asytole  (no heart rhythm), I've been told CPR was commenced and the team was unable to revive the patient.

May Allah bless you pakcik T_T

MVA of Uncle L and pakcik was not related, anyway.

Becoming numb and numb T_T

SS, Perak, Malaysia
190512


Evanescent Life

May 4, 2019



"Everything in this universe is evanescent.
Because it is evanescent, it is also precious.
Spend this precious moment wisely and beautifully."
- The Things You Can See Only When You Slow Down


This view is enough to make me smile to the ears :D

Wonder if there are people who're still blogging their heart out? :)

SM, Perak, Malaysia
190504


C.O.D

April 9, 2019


"COD is no longer 'cash on delivery' when I become a houseman...
May Allah bless and grant you Jannah, ameen."
- Hanis, 5th April 2019

Basically, death is not uncommon in Surgical department as well. 

Most of them are patients with advanced cancer that already metastasis to vital organs especially lungs. Not to forget, victims of MVA (motor vehicle accident) with ICB (intracranial bleeding) - bleeding in brain. I witnessed a lot of cases in which we ended up issuing Death-In-Line (DIL) and Do-No-Resuscitate (DNR) after discussing with the family members regarding poor prognosis or deterioration of patients.




To those who are clueless what is actually COD in medical line - it is a short form of cause of death. It is not easy to come out with diagnosis for a living patient and to be honest, it is even difficult to come out with cause of death as well. Superiors always remind us, be careful with what we are dealing with, document everything we have done and do everything that we have documented. 

There are few criteria before we can pronounce the death of patient.
  • check the vital signs - usually heart rate, blood pressure, SpO2 will be unrecordable - means cannot be detected anymore
  • check the glucometer (level of glucose in blood) - if too low, can be the cause of death as well
  • check the pupils - usually fixed, dilated
  • check lungs and heart sound - none... a bit tricky with patient supported with ventilator and we can still see lung expanding with transmitted sound on stethoscope 
  • check cardiac monitor - usually it will show a straight line (asystole) - print it out.


Usually if CPR is commenced to save patients life, it is only be done for up to 30 minutes. After prolonged shortage of oxygen, most of organs will slowly shutting down, especially brain. It is uncommon to go beyond that, taking note of resuscitators conditions as well. Commencing CPR is very tiring, pregnant lady should never do that. 15minutes of CPR = at least 165kcal of energy.

Slowly getting numb to this.
Ya Allah, guide me to Your light, ameen!

SM, Perak, Malaysia
190409






The Baju Kurung Girl

March 24, 2019

I adore girls with baju kurung in the hospitals, as I can't tolerate the heat much to wear baju kurung at work. The only time I wear baju kurung is when I have the shortest working hours which is normal shift (7am - 5pm), otherwise I will wear trousers with blouses instead :)


One of the thing I wish not to happen on the day I wear baju kurung is "dr, patient bed xx collapse / asystole" (in which I hope will not occur on any day pun actually) 

Because it seems so hard to climb up patients' beds to do chest compression. 😅

Doing CPR can drain much energy and I pray patients will have fast recovery and discharge very soon. Ameen!

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