Jemputan Kenduri di Bidor, Perak
3 hours ago
Best Eight in 2019 - What About 2020?
January 3, 2020
Haha, I was excited to follow the crowd to do this bestnine-thingy, yet to find that I don't even have 9 pictures to complete it. :D
But it was okayy, as all pictures in Instagram for 2019 are the selected one, to remind myself, how good my life has been. Thank you Allah :)
For this 2020, I wish to post and share my reflection more on my blog that has been away from me. I miss writing my self-reflection and actually Instagram is an easier medium to do so, but most of times, I feel my Instagram now is too public for me to share my feelings especially the one related to work. :)
I can't afford to write a long post which I feel really bad for that. I miss the moment I have free time to write.
Things change. I am looking at the bright side of it, yeay!
Shorter post, but regular one :)
SM, Perak.
20200103
Things I Would Love to Improve in 2020
January 1, 2020
Alhamdulillah, we entered another decade. It is 2020, guys! The year I've been looking for since I was a kid. All those 'Wawasan 2020' chants, I believe most of us still remember how excited we were when we need to draw things we imagine in 2020.
2020 means I become a year older, approaching 30's. Of course I feel old, but somehow we need to grow and move forward. We can never rewind the time, except in memories. Thus, I believe, 2020 is the year I would like to restart documenting my life, so I can recall and appreciate all things that going to happen later. :) sure, gonna use them to reflect myself too.
I started my 2020 in hospital, in which I had my night shift. Didn't have the opportunity to count down, but I was lucky enough to see live fireworks at 11pm (early one I guess). Emergency department (ED) never fail to have guests, I must say. Patients kept coming and cases that I've been expecting were real - those with burns and accidents. In medical setting, we call accidents as alleged MVA (motor vehicle accident) - it can be either motorbike (MB) skidded, motorbike vs motorbike (MB vs MB) etc - trust me, there are so many short forms for medical documentation which are not official but understandable.
Oh, back to the title, I rarely have new year resolution (I think) as growing older, I learned to put less expectation but still work hard to achieve something if I have put my mind for it.
So, this 2020 may see another part of my planning - to list down things I would love to improve and maybe you can try them too.
1. Prepare proper medications at home.
- I realised, there are a lot of cases in ED that really do not require patients to see treatment. It is not that the situations are not serious, but we do believe there are few cases that can be observed and proper care at home.
- For example, you have fever started around 8pm, instead of going to see doctor at 12am (4 hours later), why not you try to take Tablet Paracetamol 1 gram first, then observe the temperature trend. It is way better if we have thermometer at home so that the observation will be way better.
2. Read more.
- Since I have been binge-buying books during the previous Big Bad Wolf, I have been telling myself to read at least few pages per day OR to finish reading a book within 2-3 weeks. So, by the time the next Kuala Lumpur International Book Fair start, I have solid reason to buy more books.
- For now, I am controlling myself not to buy books even restrain from entering Popular bookstore.
- I decided to read more fictions, as I realized my brain is too tired to consume all facts / reflections in non-fiction books.
3. Travel more.
- Housemanship is obviously the phase where all junior doctors find it hard to juggle between work and life. After spending at least 10-15hours at work (the formal working hours), I find that my off day is only to be spent for sleeping or lazying around. I am too tired even to think, thus decided to sleep in my comfy duvet.
- This year, I would love to plan more trips around Malaysia and to attempt travelling around Asia or maybe Europe.
- I would love to plan for umrah again :)
4. To decide on further study plan.
- I am a family person, even before marriage, I love to spend time with my parents. Just, housemanship restrict me to do so. Even though my working place is just 2 hours away, I am honestly tired to drive and as mentioned before, I prefer sleeping.
- Studying is a another constraint. When I have spent 3/4 of my day at work, the time I have left is only for sleeping and relaxing. I find it hard to spend hours to do revision like when I used to be a student. I decided that I will try my best to study as much as possible during working hours. It works but honestly I still need to read back all theories - pathophysiology, the side effects, indications & contraindications of each stuffs.
- Haven't decide yet on which specialty I would like to further. A part of my heart says 'just stay as chronic medical officer' but due to current dilemma in health system, a part of my heart are considering to migrate - in which, I surely need to further my study to secure a better place.
All in all, I also have a plan to update my blog with at least 2-3 posts per week. Not sure how it is going to be, but will try my best. Short posts should be okay, I think.
Moonlight Over Manhattan by Sarah Morgan | Book Review
December 21, 2019
I bought this book just because the synopsis sounds cozy to be read in December, where Christmas is just around the corner. I believe some of us feel the same too, the urge of watching movies involving snow, winter, Christmas when it comes to December, right?
Title: Moonlight Over Manhattan
Author: Sarah Morgan
Pages: 376
Publisher: HQ
Publication Date: October 2017
Synopsis:
Harriet, the dog walker is known for her shyness and lack of confidence compared to her twin sister, Fliss who always be the speaker for her - until she realizes everyone has their own life to live to, including Fliss. After Fliss moved out from their house to another town to get married, Harriet needs to survive on her own. Since then, Harriet comes with a idea of Challenge Harriet - doing things that she normally would never do.
On the other hand, there is Dr Ethan, who end up fated to meet Harriet, as a result of Challenge Harriet. Thought that will be the only meeting between both of them, the world actually wants them to meet again and again, for the sake of Madi, Ethan's sister's dog - in which at the end Harriet moves into Ethan's place to take care of Madi. Ethan is clueless about taking care of a dog and he can't spend lots of time with Madi.
Living together surely blossom things around them. Harriet slowly become comfortable with Ethan, pushing the boundaries, till the time Harriet exposes her love to Ethan, where Ethan ends up reply nothing to her.
What will happened to the chemistry between both of them?
"Do one thing every day that scares you." - Eleanor Roosevelt
I think this is my first book by Sarah Morgan and I just knew that there are few other books in this series. Seems like this book can be read as a standalone as I don't find any difficulties to read through it :)
1. "What makes you so wise?"
"Age and experience."
I believe as we grow older, we tend to do stuffs more confidently, or maybe at least we feel calm. With time, it helps to develop our skills and knowledge on how to encounter specific problems. Same in life, we tend not to hold on grudges and anger for too long as we don't feel it is even necessary. Move forward and live the life.
2. "Skill is the ability to do something well. That usually involves two elements - training and practice. Being a doctor is all about training and practice. It's not magic.
A thing I look forward to read was the journey of Dr Ethan, who is currently a ER (emergency room) trauma team leader in one of the most prestigious hospital in New York. Oh myy, I can totally relate whenever the author describe the situation of ER there, including how Dr Ethan need to face the reality of that department.
The advice helps to reflect there are so many things to be improved in my career life. :)
3. "You always see the best in people."
Harriet said that sometimes she is trying to see the best because she just don't want to believe that people can be so unkind. Sometimes, I feel it is easy but on the other times, I struggle to do the mentioned above. Working in the area, it needs me to meet all kind of people, the rich, the poor, the lovely, the shitty, the kind, the unkind, the most calm, the most annoy - it involves a lot of energy to entertain humans. Haha.
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The book is surely one to go if you want to enjoy and relax :)
SM, Perak, Malaysia
191221
A book I bought during recent Big Bad Wolf. After realising the Kuala Lumpur International Book Fair is coming soon, I think I should start reading my TBR list so that I don't have to feel guilty to maybe buy some more, perhaps? :)
Title: Write This DownSynopsis:
Author: Claudia Mills
Pages: 248
Publisher: Farrar, Straus and Giroux (BYR)
Publication Date: September 2016
The book is about a twelve-year-old Autumn, who was closed to her brother, Hunter when they were young. But Hunter who is going through a rebellious, trying-to-find-his-own-path phase, keep on doing stuffs that annoyed Autumn and frustrating their parents.
Hunter is not into academics and sports, while Autumn is excellent in at least academics and kinda acceptable in ballet so Hunter felt left out when the parents seem not to understand his passion and keep on pushing him to do stuffs he dislike.
Autumn has a crush on Cameron, a friend in her journalism class. Cameron is actually a brother of David, where David is Hunter's band mate. There was one day where Hunter and his band mates accidentally read Autumn's poems for Cameron and since then Hunter keep on making fun of her sister for the cheesy lines. Since then, Autumn is passionate on getting her writing to be published to prove Hunter that her talent is not that bad.
There were ups and downs for Autumn to be a recognized writer. At first, the story line was bit boring for me as it shows how Autumn as a complicated girl, who always think of so many possible results of one specific event. Read the book and you will understand when I said Autumn thinks too much.
"She might even write something about him to show the world what a terrible brother he's turned out to be. But what if publication comes at the cost of revealing painful family secrets? Is being published worth hurting those you love?"
From the book, there are few things I learned.
Oh, I love Autumn's name, anyway, as much as I love the name Summer. :)
1. "Personal essays have a theme. They take the writer's personal experience and find some universal truth in it."
Well, seem this book has a lot to do with writing, these specific sentences remind me of blogging. There were few times, my friends asked me why I love blogging and why exactly I love reading stories of others?
That's the answer, I guess. Reading stories help me to learn new stuffs and at least learn about myself too.
Little did I know it happened in the Western world too. Haha.
When my mother called me by my full name, I know there is something that needs explanation. :D
In this book, there is a part of Autumn's journalism class that shares about how a review should be. Well, this is a subjective question to me, but the things Ms. Archer, Autumn's teacher described are quite nice to ponder on what good contents should have.
But, still, I am writing reviews my style and I see no problem as I am writing for self reflections and memories. :) Hehe
Oh myy, this is very true. In this current world we are living, words are obviously something that can soothe someone yet can also kill people. I still remember few patients coming to ED with alleged assault by family member, mentioned that they usually being attacked mentally with those harsh words before the physical assault came into picture.
Enough with four above, I guess. :)
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So...
Do Autumn gets to know Cameron at the end? What happen to them?
Do Autumn managed to get her writing published?
What will happen to the relationship between Autumn and her brother, Hunter?
What about their family?
I must say, the ending is cute actually :)
SM, Perak, Malaysia
191221
Vampire at Night
December 19, 2019
I saw this post in my draft, just the picture below.
I bet this post was drafted when I was in medical posting (at least a year ago).
Usually only in medical posting, we have huge number of bloods to be taken before 6am for a night shift houseman. Honestly, the process of blood taking is not that long (it can be as short as 1minute) ONLY IF:
- the patient is cooperative,
- the patient does not have any chronic kidney disease / on chemotherapy,
- the patient is not obese,
- the patient is not dehydrated,
- the patient is not a kid or elderly,
- the person doing the blood taking has good experiences.
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| Add caption |
The are two ways to take blood - from venous and from artery (in Malay, we call artery as nadi - the pulsating one).
For difficult blood taking, somehow taking blood from artery will be the best way instead. Just, I believe it is painful compared to via venous, but only arterial blood can give the best result to see the good is our oxygenation in our blood system.
Few problems you can encounter during blood taking (venipuncture) / branula insertion:
1. Delicate / running veins
- Usually these can be seen in elderly
- Our veins are elastic - the moment a needle is inserted into the vein, our vein will hold the needle in place (like... hugging the needle) - there will be no way for blood to escape - like a seal.
- But for elderly, their veins are less elastic --> hence, blood will slowly go out in from the hole in between needle and vein, leading to hematoma.
2. Neonates
- I believe many of us have seen the current issue about blood taking in baby.
- It is difficult to be honest - you need steady hands and at least one assistant. Usually taking blood from neonates without assistance is doable, if you cover the other limbs nicely and know how to retract the skin well to properly expose the veins beneath.
- But, to insert branula to a baby can never be done alone. Trust me, I have tried once, the branula was successfully inserted (just the way for blood taking is done), but the secure the branula will be another issue. Assistant is obviously needed to secure the branula on the baby's hands.
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| Gebu gebas |
3. Advanced kidney problem
- Especially patients on regular dialysis.
- In these patients, the blood vessels will slowly constrict (smaller diameter) --> hence the difficulties.
- They also will have one side of upper limb with fistula / prepared for future fistula, so we lost chance to take blood from one limb.
- Don't ever poke patient on the same side of limb with fistula - we are going to risk the pathway for him to do dialysis later by introducing injury / infection.
There are lots of more actually, you can further read about difficult blood taking here. I believe I have encounter almost all difficulties as shared in the link.
Not to mention, other situations to be taken into account - like, patients pergi mandi/solat/toilet, nak kejut patient dulu untuk bangun tidur, nanti ha terkejut tiba-tiba kena cucuk.
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| blood taking trolley |
I must say, blood taking / branula insertion is surely painful. But, reminds ourselves that blood is like our identity, it reflects the condition of our body - is the water enough? is the kidney / liver okay? is the blood sending good amount of oxygen? is there any infection - is it bacterial / viral?
So many things can be checked from the blood. Blood is precious. But don't worry much if you think doctors are taking lots of blood, we at least have around 4500 - 5500ml of blood in our body and usually the maximum amount taken daily is maybe 10ml - it is like 0.2% only hehe :)
20191219
SM, Perak
Latest Me.
December 18, 2019
Oh my, my last entry was in August, that was at least 4 months ago. There were obviously multiple life events happened in between those gaps, and I am looking forward for all the future uncertainties. :)
1. I am a wife :)
Alhamdulillah, on 16th of August, I became a wife to my husband, Haziq. The marriage life is going okay so far, alhamdulillah, still trying to understand each other's differences and preferences. I realized it is definitely true when people said you will never know someone until you get married to him/her. You wake up in the morning with him by your side and finish the day with him too - on good (non-night-shift) days. So, basically you can observe each other's liking at every minute of life if both of you are on off days.
To have a doctor as my husband is a blessing in disguise. Alhamdulillah.
Previously, I have no idea how to live my life talking about medicine at home, in the car, etc - practically everywhere and almost every time, like breathing medicine. But, right now, I am very glad to have someone who can genuinely listen to what I am sharing about - all the struggles of working, all the happiness achieving success at work, all the sadness of unable to revive patients, the lethargy, the hunger yada-yada.
Thank you for being there, my understanding husband. :) May Allah bless us with mutual understanding and love, always.
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| Source - https://www.marriage.com/quotes |
2. I move to a new house :)
It is an apartment, people said it is bit pricey for monthly rent but we both agreed this is the best bet we can get with the price - a lovely 3 bedrooms apartment, on a good level, with nice view plus fully furnished IKEA furniture and we basically the first one to rent the unit - so you can imagine how brand new and fresh items we are dealing with. :)
I am sure all of us agree that a comfy, lovely home is what we are looking for after a hectic working day :) Hehe.
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| View from the apartment. |
A room is specially allocated for our activity like studying, ironing etc.
Another room is the guest room - especially if the family members are coming for overnight trip :)
While we use the master bedroom.
Since the kitchen is kinda fully equipped as well, we have a target to cook at least 2-3 times a week. Sounds so lazy but that is the best plan we can try to do. Our schedules are quite tight, working at the hospital for at least 10-14 hours a day and coming home with lethargy - we can't afford for frequent home cooked meals.
Trust me, the moment we returned home at 10pm-11pm after working the whole day since 7/10am, we feel too tired even to stand properly. However, we are trying our best to at least complete these three things - 1) make sure our solah is done, 2) eat dinner/supper and 3) take bath.
3. I am in my final posting :)
Reading my old post about starting my housemanship, I feel grateful to see how far I have become. 3 months more towards the end of housemanship and there will be another battle of being a doctor.
Anyway, my final posting is emergency medicine (ED - emergency department). :D
I chose this department anyway, instead of anesthesiology, just because I would love to learn how to be a good front liner and to practice and develop more confidence to deal with emergencies.
Anyway, my final posting is emergency medicine (ED - emergency department). :D
I chose this department anyway, instead of anesthesiology, just because I would love to learn how to be a good front liner and to practice and develop more confidence to deal with emergencies.
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| During moulage in ED. |
ED can also be called as ETD (emergency & trauma), A&E (accident and emergency) or ER (emergency room) - this place witnessed hundreds of patients coming everyday (at least for minor specialist hospital) and of course it can reach up to thousands for state hospital.
So far, I am enjoying and appreciating all moments in ED because this is basically the place I can practice to give a plan as a MO. There are too many things to learn in ED - doctor skills, knowledge, empathy, how to improve patience, how to break bad news etc.
And this is the place I feel 'stupid' when encounter patients from departments that I've left quite long time ago. Since I just finished my Paeds posting, the knowledge is quite fresh in my brain and the skill of blood taking / branula insertion is still okay. Alhamdulillah. But when it comes to other departments stuffs, it takes me a while to come down to few differential diagnosis.
Still, I can't really tolerate patient who come to ED at 3am, with complaint of headache since 1 previous hour. We gave tablet Paracetamol (equivalent to Panadol) and the symptom resolved. The reason for this headache was the patient sleep late at night. T__T. Boleh tak rasa nak nangis? Kecemasan ialah untuk kes-kes cemas. T_T. Even if you have persistent headache and it is affecting your life very much (like taking frequent MC), you can go to outpatient department (OPD) or any klinik kesihatan for further management. Usually they will try to investigate the reason, make future plans and most importantly, you can continue follow up with them.
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All in all, I guess 2019 is amazing so far alhamdulillah. It has all the adrenaline rush, happiness, tears and smile. Adorable 2019.
* Moulage (French: casting/moulding) is the art of applying mock injuries for the purpose of training emergency response teams and other medical and military personnel.And this is the place I feel 'stupid' when encounter patients from departments that I've left quite long time ago. Since I just finished my Paeds posting, the knowledge is quite fresh in my brain and the skill of blood taking / branula insertion is still okay. Alhamdulillah. But when it comes to other departments stuffs, it takes me a while to come down to few differential diagnosis.
Still, I can't really tolerate patient who come to ED at 3am, with complaint of headache since 1 previous hour. We gave tablet Paracetamol (equivalent to Panadol) and the symptom resolved. The reason for this headache was the patient sleep late at night. T__T. Boleh tak rasa nak nangis? Kecemasan ialah untuk kes-kes cemas. T_T. Even if you have persistent headache and it is affecting your life very much (like taking frequent MC), you can go to outpatient department (OPD) or any klinik kesihatan for further management. Usually they will try to investigate the reason, make future plans and most importantly, you can continue follow up with them.
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All in all, I guess 2019 is amazing so far alhamdulillah. It has all the adrenaline rush, happiness, tears and smile. Adorable 2019.
20191218
SM, Perak
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