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ASMA NI TAK BOLEH SEMBUH KE?
May 26, 2021
"???????? ???? ?????? ?????????? ???????????? ????? ???????? ???????????? ?????? ???????????????????? ???????? ?????????????? ???????????? ??????????."
Asma ni satu keadaan yang sangat selalu kita jumpa di fasiliti kesihatan. Terus terang, memang selalu sangat. Ada yang bermula masa kecil, boleh jadi berleretan sampai dewasa, boleh jadi selesai masa kanak-kanak. Ada yang masa baby beberapa bulan pun dah mula kena. Ada yang masa dewasa baru dapat. Ada yang masa mengandung je dapat asma.
.
?????? ???????? ???? ?????????????????????
Asma ni radang pada saluran pernafasan yang kronik. Maksud kronik ni ialah berlarutan, tempoh masa yang lama. Radang tu akan buat saluran pernafasan tu sempit. Kesannya, udara yang kita hirup tu tak dapat masuk ke paru-paru, lalu kurangnya oksigen dalam darah.?????? ?????????????? ???????? ?????
Presentation dia selalunya susah nafas / nafas laju / nafas berbunyi, batuk + sesak dada. Apa yang penting perlu tahu? Asma ni boleh mengancam nyawa kalau tak dirawat! Sebab dia melibatkan sistem penting badan kita - sistem pernafasan. ?????? ???????? ?????????? ?????????????????????? ?????????
Fuh, macam-macam sebenarnya. Ada yang akan kena asma masa dia batuk/selesema. Ada yang kena bila terdedah pada asap rokok. Ada yang bila main dengan binatang berbulu (biasanya kucing / anjing). Contoh lain:
- allergy pada debu / asap / habuk / pollen / binatang lain
- jerebu / apa-apa pencemaran udara
- suhu sejuk / makanan sejuk / buah-buahan
- stress pun boleh menyebabkan asma ya
- ada yang induced oleh senaman / apa-apa aktiviti lasak
Asma untuk orang yang selalu merokok tu actually namanya ???????? (?????????????? ?????????????????????? ?????????????????? ??????????????). Konsep penyakitnya sama tapi biasa berlaku pada orang dewasa yang terdedah pada gas yang berbahaya, senang cakap asap rokok. Bukan setakat perokok ya kawan-kawan, kalau kita dikelilingi orang yang merokok pun boleh mengundang! ???????????? ???????????????
Ni ialah soalan-soalan kegemaran doktor kalau anda datang dengan simptom asma. Hadamkan bagi yang memang ada asma & selalu datang hospital ambik nebulization / inhaler / perlukan rawatan dalam wad. Basically ni ialah basic info sejarah asma anda.
??. ?????????????? ???????????????????????? / ?????? - bila kali pertama? macam-mana kekerapan dalam setahun / beberapa bulan kebelakang? Bila last guna / dapat? Ada sejarah masuk wad tak? Kalau ada, apa tahap tertinggi dapat oksigen - nasal prong / facemask / venturi mask / intubate?
??. ?????????????? ???????????????? - ada sesiapa tak dalam keluarga yang ada asma (terutamanya first degree family - adik-beradik, ibu bapa)? Kalau ada, terkawal tak? Ada follow up / pakai inhaler apa-apa tak?
??. ???????????????? ???????????????? - ada tak bangun pagi akan selalu batuk? Ada tak tidur malam terganggu atau selalu terjaga disebabkan batuk? Ada yang tak boleh exercise berat sampailah semput sangat-sangat?
??. ???????????????????? ?????????????? - apa yang selalu mengundang asma tu? Ada yang makan tembikai je, terus batuk-batuk dan semput. Ada yang baru lepas renovate rumah, batuk-batuk disebabkan habuk & debu lepas tu semput. Ni semua berbeza ya ikut diri masing-masing. Ada yang semudah tidur dalam aircond / bilik yang sejuk.
??. ?????????? - ni maksudnya badan kita bagi tindak balas pada sesuatu allergen. Ada yang resdung (selalu bersin pagi-pagi atau dek kerana habuk macam tu). Ada yang banyak allergy pada makanan. Ada yang mata selalu kemerah-merahan. Ada yang kulit kering (eczema). Bila seseorang ada atopy, lagi tinggi chance dapat asma ya.
??. ????????????-???????????? ???????? - doktor akan tanya ada perokok / haiwan peliharaan / carpet ke kat rumah. Sebab ni antara punca biasa yang menyumbang pada asma. ?????????? ???????? ?????? ???????????
Untuk yang pertama kali, silalah pergi ke hospital / klinik terdekat. Anda perlukan ubat untuk legakan dan buka semula saluran pernafasan.
Untuk yang memang dah diagnose dengan asma, tolonglah compliant dengan ubatan anda (inhaler tu). Inhaler ada dua jenis ya.
??. ???????????? (????????????????)
- yang ni paling biasa digunakan ialah Salbutamol, nama lainnya Ventolin. Pakai ikut arahan doktor / bila perlu sahaja. Pastikan kita prepare inhaler kita sentiasa ada dengan kita sepanjang masa. Serangan asma ni bila-bila boleh jadi ya, terutamanya bila ada sesuatu yang trigger.
??. ???????????????? (??????????????????)
- yang ni doktor akan review keadaan pesakit sama ada perlu pakai atau tak. Jenis inhaler ni ikut fasiliti / tahap masing-masing - paling biasa namanya Budesonide / Fluticasone. Kalau level asma jenis tinggi tu, tolonglah jangan terlupa ambik tiap-tiap hari. Ikut prescription yang doktor bagi. Kalau ikut guideline GINA terbaru, kes asma simple pun dah digalakkan bagi preventer taw. ???????????? ???? / ???????????? ???????????? ????????
Dah ada ubat, jangan lupa follow up. Doktor biasanya ada bagi review 3-4bulan untuk tengok macam mana badan kita respon pada ubat. Kalau kita compliant dan simptom terkawal, doktor akan turunkan dose sikit-sikit sampailah kita hanya perlu pakai pelega bila perlu sahaja. Kalau tak terkawal, kemungkinan akan dinaikkan dos / tukar ubat / rujuk pada pakar respiratori.
Semua pesakit asma (terutamanya kanak-kanak), kita akan sediakan asthma action plan, diari batuk untuk disemak masa follow up. Asthma action plan ni akan bantu untuk seseorang tu bagi pelega sendiri dahulu ikut tahap sebelum perlu ke hospital atau tak. ???????? ?????????? ???????
Untuk kanak-kanak, kita akan minta ibubapa belikan aerochamber untuk pastikan ubat sampai ke saluran pernafasan dengan efektif. https://www.youtube.com/watch?v=o0M1lLpOu4U
Rutinnya, doktor / ahli farmasi akan semak teknik tu berkala (biasanya masa appointment kat klinik) - sebab tu please jangan skip TCA. Kalau terlepas, tolong call klinik dan dapatkan tarikh baru.
Fahamlah kawan-kawan, asma ni tak boleh sembuh tapi boleh dikawal. Sama macam orang allergik udang, sama ke penghujung nyawa dia akan dapat kesan pada diri kalau dia makan udang. Hampir sama macam asma. Asma ni kalau tak dirawat dengan baik, lama-lama simptom tu makin teruk dan makin susah nak tindak balas pada rawatan biasa.
Bukan sedikit ya, pesakit asma perlu ditidurkan & diberi bantuan pernafasan (intubate). Kalau sebelum pandemik Covid pun banyak, semasa pandemik ni lagilah mencabar nak beri rawatan. Bayangkan lagi budak-budak kecil baru beberapa tahun dah kena intubate disebabkan asma yang teruk. ????????????????????
1. Asma boleh dicegah - mencegah jauh lebih baik dari merawat.
2. Kenal pasti perkara-perkara yang boleh trigger asma kita dan elakkan.
3. Pastikan kita ikut arahan pakai ubat (compliant to medication).
4. Pastikan teknik pakai inhaler yang betul.
5. Elakkan terlepas appointment rawatan susulan.
Hanis Amanina
Hari tu kena present acute severe asthma. 
Pasar Presint 8
October 20, 2020
Finally I found a place that I can do groceries shopping without having to worry about the price. Thanks Kak Mulan :)
For the early 2 weeks of my stay in Cyberjaya, I kept on buying stuffs from Grocers (name it - Village Grocer, Jaya Grocer, Star Grocer yada-yada), so I posted Instagram stories asking for help and opinions. A lot of information came into my message box.
One of them is Pasar P8. It is actually very close to Hospital Putrajaya.
So, I went there on Saturday with Haziq and haha of course I love the place!
It is a market in a neighbourhood surrounded by apartments, a school, a food court, a local library in Presint 8.
The price of vegetables, fruits, fishes, meats, chickens etc are affordable. I can say, it is almost similar as in Mydin etc.
The market will be the place for me to get my groceries on regular occasions :)
Here is the map. Luckily it opens daily.
Sweets
October 19, 2020
HO: Doktor, ada banyakkkk coklat kat pantry, mak ayah Bed X bagi.
Hehe I was excited to be honest. We usually received some food from discharged patient, sometimes brownies / cake / breads etc and we will just put them in the pantry and make announcement to other colleagues.
"Cepat-cepat, nanti habis."
And to my surprise, we received a box full of sweets!
Though I didn't really eat these but it did give me happiness and put a smile on my face behind the face mask. :)
Thank you for the thoughts :)
May Allah help and give us courage to continue working with good quality. Ameen.
Cyberjaya,
20201018
These Tiny Tubes
October 18, 2020
Poking babies for some blood investigations is not that easy. First, we need to decide if poking them / to insert IV line (branula) is really needed. Then, of course we need to explain to mothers why we need to do that.
I always tell my patients (since housemanship phase) that our blood is like our identity. I think I have mentioned this in previous post too. We can check many things from few drops of blood. :) And I love the facts that we can do so.
In paeds, blood taking procedures are RARELY be done bedside (means most of the time, we will take the babies / kids to the procedure room) and we will ask the parents to stay outside of the procedure room, or simply stay in the patient's room. Why? I don't think people loves to see their kids crying with the pain initiated with poking them. Right? I have witnessed lots of mothers (usually) have tears flowing on their cheeks every time they hear their children crying in procedure room.
And to be honest, kids have really good memories - name it from their eyes and even from their body memories. Huhu. Every time we just hold to check their hands & foots for any possible veins, they usually will start crying. But some others are cool haha. Some will only cry once the needle is inside.
From left: EDTA tube for adults - EDTA tube for paeds - plain tube for adult - plain tube for paeds
EDTA tube - usually for full blood count, full blood picture
Plain tube - for renal profile, liver function test, serology etc.
Tricking the children with some videos are helpful to be honest. It helps to distract the kids. For babies, I discovered that playing some sleep lullaby can help to calm the babies. :)
I always asked my husband why on earth would he prefer Paediatrics compared to Medical Department. He said that both are busy departments, one handling general medicine for babies & children while the other one for adults. But, at least seeing cute babies sooth his mind to continue working. Lol. He handles kids better than me though we both are the youngest in the family.
And now, both of us are Paediatrics MO. Haha. Life is very funny sometimes.
Anyway, please pray together with us to be blessed with kids ya :)
I still remember I will ask your prayers when I was in medical school & housemanship. Hopefully, you will not mind to keep praying for me too.
May Allah bless your day :)
Cyberjaya
20201018
Open the Book, Seek Help.
October 11, 2020
Have you seen this book before? Hehe
This is a famous book in medical setting, especially in Paediatric Department. It is available in PDF form but most superiors prefer the juniors to have this book in pocket.
It is called Frank Shann.
A book consists of name of drugs and doses used. In Paediatrics, the dosages depend on the weight of the baby / children, hence you can see doctors start to open this book every time endorsing medications. Plus using calculator too.
For example, the most common drug used for fever / pain relief in kids.
Syrup Paracetamol 15mg/kg/dose 4-6H (max 4g/day)
Which means,
- the name of the drug: syrup Paracetamol (brand name can be like Panadol)
- the dose: 15mg/kg/dose. For example: a kid with weight 10kg, the dosage for him is 150mg.
- maximum dose if 4000mg/day
- 4-6H: means taken every 4-6hourly
- if taken every 6 hourly: the kid will consume 150mg x 4 times = 600mg (still below the maximum dose)
There are too much of information that health care workers need to remember. And again, it is really hard to know every single doses for every drugs in this world. So, this book makes it easier. Of course, it is helpful apart from calling the pharmacists and double confirm the dosage hehe.
Same goes in life.
Have we ever feel we had too much of things happening in our life?
We are human beings. We are not robots.
Even robots have the guidebook, so do we.
And what do humans have?
Yes.
Al-Quran.
Open the book, seek help. :)
Don't be ashamed.
This is simply a reminder for myself. Huhu.
Cyberjaya
201011
New Life, New Adventure
September 26, 2020
Assalamualaikum, hello guysss!
Hehe actually I am not really sure who's still reading this blog, but whoever you are, thank you for dropping by.
So, where should I start?
First and foremost, I just moved to Cyberjaya and work in a hospital in this area. I can say, it is so-called 'first class' hospital as it does not provide 3rd class beds so far that I know. Still struggling to adapt here though I have been working in this hospital for a month.
The environment is different.
The colleagues are different.
The system is totally different.
The approach is different.
The working 'politic' is different
Well, different hospitals have different styles. That is common.
I only know one person who used to work together with me in my previous hospital. And to be honest, the main reason I choose this hospital is because of the location - in between Perak & Johor so that we can take turn to go visit our family. Oh yaa, my husband is originally from Johor.
Luckily I choose to rent a unit of 2 bedrooms quite close to the hospital. About 10minutes journey. Quite a number of people suggested for me to rent around Seri Kembangan, Dengkil, Bangi, Puchong etc for a cheaper rent. But, I am from Perak, I am not used to drive 30-40minutes just to go to work, passing through highway with tolls and facing traffic jams.
"Dah kerja kat sini, kena la lalui. Itu lumrah."
Well, yeah I understand.
I tried to look for alternatives. It was either I spend money for lower rent (which was RM100 lower?) for cheaper place to stay but need to face those journeys... or I spend higher amount for somewhere closer.
I chose the latter.
But, I totally respect those who choose the former. :)
During the first few days, I can already feel the differences in living cost - where it was not easy to find a small kedai runcit, simple kedai makan etc. So I initially doubted my decision. However, after I went through my first oncall which was working at 8am today only to punch out at 5pm the next day... I finally relieved with my decision. Having microsleep while driving was totally not good. I was glad that my unit was not that far.
I honestly dislike oncall system. I had experienced oncall system when I was at early phase of housemanship (where the system was changed to shift system later). Staying awake for 36hours from 5-6am till at least 6pm the next day... I hate it. -_-' Some people maybe don't really mind oncall system but my body actually cannot take it.
I didn't get the department I choose. So that's another challenge. To make decisions for managements on something I don't have passion about... is really a challenge. People always say 'just try first, maybe you will develop your interest.' I tried. A month passed, still the feeling is not there. Haha.
Why are you pushing someone to do something they don't like?
But again, people will say, 'bersyukur lah kau masih ada kerja.'
Hahaha okay then, I rest my case.
Don't worry, I will still do my best. I will always try to do my best within my limit. :)
“Dan boleh jadi kamu tidak menyukai kepada sesuatu padahal ia baik bagi kamu, dan boleh jadi kamu menyukai sesuatu padahal ia buruk bagi kamu. Dan Allah mengetahui sedang kamu tidak mengetahui.” Al-Baqarah ayat 216
Last few days, I had a talk with a colleague who is currently in the same boat.
S: Perasan tak, Allah uji kita benda yang kita tak suka.
H: Kan... Lagi kita tak suka, lagi Allah bagi. Memang nak ajar kita kesabaran. Mungkin nak kita overcome perasaan tak suka tu.
And yeah, we are the chosen one to join the Covid team at quarantine centers in November-December. Alhamdulillah tak kena deployed ke Sabah. T_T
Doakan yaaa.
p/s: anyway, sorry for the negative vibe post. Haha I just need to rant it out first then I will be cool insyAllah.
Cyberjaya
200926
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