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between life death skip to main skip to sidebar between life death hold the line please our doctors are currently busy attending other patients you will be intubated shortly thank you 14 december 2008 epilogue over this years of blogging i have had wonderful experience of sharing my thought and journey with all of you fine people you have shared with me the lesson in life in your own unique ways for that i thank you however i must admit that through this years i also must have made mistakes and offended some of you which i sincerely apologize with that i wish you all the best in life thank you for everything dr frappucino posted by hmm at 6 12 am 4 comments 12 december 2008 the end nov 2006 dec 2008 now the way of life that i preach is a habit to be acquired gradually by long and steady repetition it is the practice of living for the day only and for the day s work sir prof william osler 1849 1919 father of modern medicine it s ridiculously amazing how fast i made a mistake after i vowed to change the way i communicate with others call it curiosity based impulsive act that borders the definition of being reckless by oxford dictionary even more devastated that it happened with the one i care about a friend of mine once said experience is what you get when you didn t get what you wanted just by putting something inspiring in my blog doesn t mean that i could embodied the principle immediately it s hard to throw your old habit and taking up a new one ring ring ring hmmm an unknown number on caller display i hope not a prank call or telemarketer ring ring ring hello yeah this is captain kangaroo speaking went into surprised state osler the original diagnostician master at bedside posted by hmm at 10 00 pm no comments 07 december 2008 c h a n g e no one can make you feel inferior without your permission eleanor roosevelt if not now when hillel this is how i m going to end 2008 with a commitment to overcome my personal weakness in my interaction with other human beings i have identified many flaws in my immature attitude and irrational behaviour over these years the weakness that founded my action came from my own lack of communication awareness and respect of other people stephen r covey in his book the 7th habits of highly effective people discussed the concept of being a proactive person being proactive means that one is responsible over his actions responsibility that breed from response ability or the ability to choose one s response his behavior for a given situation is based on his values principles and core belief and not pressured by his immediate feelings to surrounding or people influence over him he is not effected by the so called social weather his mood and thus the way he feels and reacts is not based on social circumstances but as a result of his own conscious effort whether people being nice or bad to him does not precondition his attitude toward others of course there will be hiccups along the way a brief moment of errors the road ahead is not all rosy and easy but in the end challenges are designed by god so we can overcome them welcome to 1430 h and 2009 ad posted by hmm at 8 20 am no comments labels hmm 04 december 2008 kidney licking good new unit rotation kicks in with december the amount of workload is pretty much heavier compared to the previous haematology posting when everyday feels like monday in nephrology we often deal with patients whom have multiple maladies ranging from hypertension diabetes to auto immune disease such as lupus ig a nephropathy bla bla bla where all the above can lead to renal failure as a wise man once said a broken heart needs no tomorrow well i ll be darned if a failing kidneys don t need no saviour in severe infection the kidneys are one of the first organ to go it constant need of a steady flow of blood supply prove to be its achilles tendon with a sustain drop in blood pressure that comes with infection or a failing heart kidneys will soon to learn its place in the cycle of the food chain if no action is taken urine will build up inside causing fluid overload drowning the lungs and heart toxin will be released into the bloodstream poisoning all organ from liver to brain a slow painful but a sure ticket to the mortuary room called it senandung malam express a dialysis machine is designed to replace a kidney s function in filtering and removing all the body waste product and excess fluid that pak cik johnny depp cannot pee out from his bladder an expensive form of therapy a person on haemodialysis would spent a 4 hour session a day for 3 days in a week hence a rm200 session can easily cost rm2000 per month oh yeah that is for the rest of his wonderful life rm2000 per month for kidneys rm5000 8000 for putting a stent in blocked heart vessels for more time to spend with your loved one priceless ps psttt all the traditional medication out there from atok akar kayu to medical hall ginseng has the potential of poisoning your lovely kidneys too posted by hmm at 8 13 am no comments labels on da job 23 november 2008 staying alive boy it has been a while since i had a bad on call like last friday it was the 5th call which put me in charge of all the warded patients that means 5 wards x 28 patients per ward 140 patients plus another 6 patients in the high dependency care hdw an on call officially begins at 1700 till 0800 the next day so at 5pm all doctors from all the 5 wards would call me up and pass over ill cases that need to be reviewed that night my average usually is around 3 4 cases however that night i got 11 cases to review plus 2 new admissions from icu and paediatric into the hdw yehaa come what come may at 1900 i came across julia a junior doc graduated from uk still in mid 20 s full of energy and zest in life with her shoulder length brown hair tied up into pony tail mean that she s ready for some action however she looked flushed and out of breath apparently on her way to attend a collapsed patient we both ran to the scene and a pool of nurses had already started cpr i took over as the team leader and coordinated the resus effort julia rattled out the patient s medical problems from the file as i bagged and intubated the chap a 65 year old man with a history of chronic pulmonary embolism suddenly collapsed without any prior warning we resuscitated him for 1 hour giving him the whole shebang at 2200 as i was munching on some cold karipaps i received another code blue from julia a lady of 68 year old with a diagnosis of a possible cancer just collapsed i met up with her and we went over the same routine and sang the chorus with a bunch of different nurses 0100 had a quick shower and speed gossip with nurses while having long overdue dinner nasi ayam goreng with air tembikai 0200 dozed off however interrupted by julia every 30 min for opinion 0430 woken up by julia to see a 74 year old man with type 1 respiratory failure due to right upper lobe lung collapse secondary to possible tb already put on high flow mask earlier so i called up a buddy in anaesthesia dept for cpap support 0600 helped another mo to do a lumbar puncture in an altered behaviour aggressive young patient possibly due to meningoencephalitis he still put up a good fight despite 10mg of midazolam and pinned down to the bed by me 0800 passed over to the saturday on call fella and rushed home for a dose of sunshine 1000 sipping a cold mochalicious ice blended in a gondola while staring at the blue clouds in lala land at the end of every bad on call lies a nice perfect day off the trick is to stay alive and age gracefully posted by hmm at 1 14 am no comments labels on da job 18 november 2008 silent night whatever it is i hate insomnia coz time stood still at midnight tonight countless trains of thought passed through my cerebral tracts in a repeat slow motion i hope they will derail and stop bothering me they even keep me pondering at the possibility of whether the sun will ever rise up again the next morning tonight i learn not to put up my hopes too high coz if i fall i d probably be too screwed up to get up again then the only logical thing to do is to learn how to fall wouldn t that be practical yes yes my dear pink panda time for your bedtime story yes don t worry captain kangaroo is gonna be fine posted by hmm at 8 24 am no comments labels hmm 15 november 2008 do we really talk to our patients sometimes patient needs someone who can listen to their problem and read between the lines doktor bertauliah sakit ape makcik makcik sakit dada makcik ni bertambah teruk sejak anak makcik meninggal dunia 2 minggu lepas doktor bertauliah memotong kalau macam tu sakit dada ni bukan real cumer emotional related jer makcik ambik ubat ni bla bla macam bagus if only the doctor listens carefully he would identify that the chest pain is only a cry for help and he could explore the miserable feeling of this old lady looking for symptoms of major depression hence a prompt referral to a psychiatrist on another note i still notice few of my colleagues unselectively use bombastic words and medical jargon when explaining the nature of a disease and its treatment to patients and still expects the old pakcik from ulu yam to remember his illness no wonder this phrase is kinda popular in follow up clinics hmm entah le pakcik nitak tau pakcik sakit ape ade doktor to bagitau dulu tapi panjang sangat and surely with that kinda answer he will get a smirk or sarcastic reply from the doctor posted by hmm at 1 08 am no comments labels on da job older posts home subscribe to posts atom about me hmm a little life anectodes of a man who s living and working in pj view my complete profile blog archive 2008 41 december 4 epilogue the end nov 2006 dec 2008 c h a n g e kidney licking good november 5 october 5 september 3 august 3 july 5 june 3 may 3 april 2 march 2 february 3 january 3 2007 59 december 3 november 4 october 2 september 3 august 4 july 4 june 5 may 8 april 11 march 5 february 7 january 3 2006 11 december 2 november 4 october 5