so many ill patients

sometimes i just wonder y r there so many ill patients in the hospital... the 6 wards in medical department are always full with patients.. u cant find any bed left empty for over a night. it is even worse in ICU, coronary care unit and wards in other departments. r ppl getting sicker n sicker nowadays, or is it due to the population is so huge?
it's still stressful to see patients come into the hospital in late stage n ill condition. many of them would do better if only they've came earlier. everyday things happen as if to remind me there is only so much we can offer to the patients.

back to taiping

for the past half a month, i've completed one of my major life events.
i got married! able to hold 2 receptions in KL and ipoh on two different days. i'm glad that the receptions went well, with minor setbacks but all went well in general. it was tiring, but at the end, everyone is happy :)
the big day was on 10th july. my husband came to fetch me from my house as part of the ceremony. it was funny to see him giving away ang pau so happily. n i get to hear sing, a rare opportunity indeed. :D haha. it's the effort to sing that touched my heart
right after the reception in ipoh (1oth july) we went for honeymoon in Bali, indonesia for 4 days n 3 nights.
it was nice trip. we saw so many nice views and spent the most relaxing spa treatment 2 consecutive nights. food is sumptious, although not as nice as malaysian food. :D
felt heavy hearted to come back n prepare for work.
now that the events were over, we have to start thinking next plan in life. for my husband, it seem only natural that he continue to pursue his master programme in psychiatry. hopefully he can ask for outcampus n incampus program either in ipoh or KL.
as for me, i'm still very indecisive. was struggling between more stable lifestyle or pursuing master programme in surgery. MRCS is no longer recognized in malaysia. it is useful if i plan to work in oversea, but i dun think i would opted to migrate anytime soon in future. i felt interest alone is not enough to carry me throughout the whole programme. at the same time, i miss my family more n more. n felt more time to spend with my new family. there r other things i want to do. i want to try so many other things.
whatever decision i may make, i hope i find the answer end of this year.

shifted to master bedroom...

seem like simple task to just move my things back to the master bedroom after my housemate went back to ipoh. but it turned to be quite a mess.
the room was so dirty after my friend left that we have to clean it up first. luckily my dear was here to help me... i cant possibly do it alone, not mention my nose will start sneezing if exposed to dust for more than a minute. :P sweep and mop, that's how we start the day

then the mechanic came, to unload my air conditioner from old room and fixed to new room. new hole need to be drilled, and gone the clean floor we just clean... we went on to clean the TV, wardrobe, book shelf, study desk, toilet while the mechanic was at work at the wall near the balcony. cant believe there was so much dust and dirt hidden behind those things. books and files and paper notes were another headache to clean up. many i had thrown away... didnt use them in long time anyway... there were clothes i hve to send back to KL next trip... i dun wear them anymore n the metal in the wardrobe has started to bend due to weight. i hope it still can hang on till next year before i leave for ipoh, for good :)

after the mechanic left, we washed the room again, then shifted the furnitures in. study desk, wardrobe, book shelf, mirror etc etc etc... finally the bed.

took us the whole afternoon to complete this seem endless task. we then took a nice shower and went for nice dinner in the newly open Station One Kopitiam in Taiping Sentral :) the food is nice. i should have tried it earlier in Kl back then.

then we catched on a nice movie: Iron Man 2. hehe... alot of explosions and action. quite a nice movie. hope it will come up with the third episode. :)

we came home around midnight, n after a tired day, we hit the sack soon.

this is among many times that i appreciate and grateful that i have someone beside me. :) feel supported and taken care of, and that's a nice feeling to have.

among the food i take in taiping, after hard days of work :)

1. Jom Bali (Tesco) : seafood belacan fried rice, very spicy and appetizing :P

2. Jom Bali (Tesco) : what u get by mixing orange and rebena? Orangebena!

3. Tops (yes, they sell cakes n breads too) : omelete fried rice + iced white coffee, the most frequent combi i take esp on call. give me more than enough calories :)

4. Sushi King! the second sushi bonanza i went over the years. this time i went with my sis n mom in KL. these were already second round. :) yum yum~~!

the first one was in taiping with my gal friends!

5. Honey glazed chicken rice + hazelnut white coffee ice in Olden Days Kopitiam. another favourite combi of mine :)

6. Zhong Hua Hin (direct translation) : recently open dim sum shop in taiping~ average standard, but already a welcoming taste in taiping :)

places tht we can go in taiping:

1. Tesco

- Jom Bali, KFC, Rasa Mas, Secret Recipe, food court

2. Taiping sentral

- Mcdonald, Noodle station, Old Town Kopitiam, Starbucks, Sushi King, Kenny Rogers

3. Long Kee Bak Kut Teh

4. Gate cafe

5. BBQ restaurant, and Shun Shun Loi, just next to it

6. New Bee Guan chinese restaurant

7. Olden Days Kopitiam

8. Tops

9. Zhong Hua Hin dim sum restaurant

And recent addition to our list: A&W and Station One Kopitiam!!! (in taiping sentral)

some random words

Hypertension = high blood pressure
Diabetes mellitus (DM) = diabetes
Cerebral Vascular Accident (CVA) = stroke
Motor vehicle accident = accident
electrocardiography (ECG) = the long strip paper that give information about electrical conductivity of the heart

wedding photo

finally already decided which pics to choose for the wedding photo album. in the 2 days shooting, total of 589 pics were taken, and we were allowed to pick 40! any extra will be charged RM35 each! wah... expensive leh...

so we spend 4-5 hours cracking our heads which to pick. my parents n sis came all the way from KL to help me choose. my mother-in-law and sis-in-law also came to help. add n delete... add n delete... we finally able to decide on 42 photos! phew... would say great job done.. although feel so sakit hati cant get all the pics there! but too expensive to add on somemore. luckily they say if interested, i can always come back in 2 yrs time to order new album again, of course have to pay lah :D

oh, n also decided which photo to be in big photo frame for our wedding room, n picked another two for both our parents to put in house.

now, to start headache (again) on the guest list and arrangement of seats... so many ppl still need to be called n confirmed, esp those working as docs wan.. :P

post call...

last night i spent almost 12hours just inside the operating theatre with my specialist, performing major sugeries, 2 laparotomy for perforated viscus men, n i almost messed again with the later case. i had positioned the pt wrongly and placed the tv in wrong direction. i'm lucky for not scolded coz he's in good mood... but having particular bad experience (with him) made me felt plunged into depression again. when the moon rises, i was already praying the call will soon be over. i have other surgeries to do till didnt manage to see all newly admitted patients, or do ward to review inpatient's prob. another blessing is i have efficient houseman to help me in both wards. felt bad to have called my second passive MO oncall to see cases for me, n have to ask houseman to go medical ward to see pt for me.
woke up today with whole bodyache n throbbing headache. cant even set a proper line for pt in ward.
suddenly feel i may not cut out for surgeon, n sometimes feel intimidated to think of going for master for surgery...

happy chinese new year!!!

it is still too early, but oh well, holiday mood is approaching to me already! :D the shopping mall near my home in KL has already starting decorating for the festival. been there last month when we went shopping for puzzles, manga and wii video games! i'll be going back home again for chinese new year. my dear will not follow along since he also need to spend the new year eve with his family. i probably will only meet the weekend after the festival in ipoh. managed to get 1 week holiday to enjoy n relax. definitely wii nintendo is top of my list of activities!!! :D yippee!!! will try to take more pics also during my stay there.

wedding preparation

it's finally 2010. and it's time to start preparing for my own wedding due in July 2010. first, need to go start choosing my wedding gown from the photoshop in ipoh. will need opinions from several ppl to choose the right clothes. and so sad to say i havent been successfully cut down my weight n tone up my arms and tummy. gone with my resolution and ended up w/ utter failure :P just hope the computer can make me look better but still look like me. haha
the wedding dinner in heritage hotel will be taken care of by my hubby, starting w/ going through the dinner package and suggested invitation card to be sent to guests. the card actually look simple and modern, w/ sharp color and emphasize on red. but they only offer one kind of style... y not they offer a few more choices. :P
next up would the dinner in KL n segamat... both to be held before the one in ipoh... need to discuss those when i go back kl later w/ parents. in between chinese new year till June would have complete my photoshooting session in ipoh both indoor n outdoor n maybe go cameron highland as well.... we shall see. :)
start to feel anxious already...

late stage disease

there are few disease, especially cancer that, unfortunately, diagnosed at late stage or terminal stage because they present no symptoms at all till the other organ or systems get affected.

Pancreas cancer is notoriously difficult to treat because patients usually presented to the hospital late. only in late stage that patient will start experiencing some signs, such as yellow discoloration of skin and sclera. vague symptoms like abdomen discomfort, appetite loss and weight loss rarely alert them to come early to doctors

ovarian cancer too is insidious during the early stage, since there is enough space in the lower abdomen for the tumor to grow before it spread to other organ. vague lower abdomen pain, irregular menses and vaginal bleeding tend to be ignore by women and refuse to seek advice from doctors. some conservative ladies even preferred to see female doctors to discuss about menses... ovarian tumor can only be diagnosed for malignancy by histopathological examination, meaning cancer of the ovary can only be confirmed after the tumor is removed via surgery

men who have swelling over neck and chest, or more accurately, breast swelling should confirm the diagnosis by tissue study in health institute to rule out cancer. they tend to ignore the swelling till it progress to late stage

work routine...

occupation: medical officer in Department of Surgery in a general hospital

6.00 am: get up from sleep

7.25 am: leave the house and drive to hospital

7.50 am: reach the ward and start ward round

8.30 am: specialist came and start ward round again; Depending whether in elective operation list or not, need to start elective operation at 8.00 am in operation theatre; if scheduled to perform endoscopy procedure then we start outpatient scope around 8.30 am in day care ward

9.00 am: ideally need to go to clinic and help out seeing patient who come for follow up; but usually there are things in ward which hold us back.

1.00 pm: hopefully can finish the clinic and go for lunch; if doing scope in day care, then most likely we wont have lunch till 2 something :D haha...

2.00 pm: back to the ward to do afternoon round; to do procedures on patients if needed to, such as percutaneous drainage, urgent endoscopy procedure, case discussion with radiologist to get urgent imaging study; thurs evening is the day of choice for mortality meeting, houseman teaching or mo teaching, but due to reschedule if no boss is free to conduct.

5.00 pm: if all things go smoothly, can leave work at time

if our name is up in operation list, then above schedule is non applicable, coz most likely we'll stay inside ot almost the whole day and leave straight for late dinner

if we are on call that day, we receive calls and referrals from everywhere and have to attend patient with emergency condition asap, therefore the above schedule is not applied as well.

during on call...
we received referrals from peripheral hospitals (selama, gerik, parit buntar, kuala kangsar, etc etc... anywhere in the country if patient wants to come to taiping) via phone calls, meaning phone ringing non stop if alot of referrals.

after office hours, we take in phone calls from within the hospital as well, meaning from other departments in the hospital.

we perform emergency operations: some we can do, some only specialist can do

we perform urgent endoscopy, especially in the weekend

we do ward round at night in both male and female wards, ICU, Pediatric ward

we call our second call MO, who is passive call, for help if we stuck in ot and there is emergency case outside the ot that need to be assess immediately.

after on call for 24 hours, we continue working the next time with same routine till all work is done. when reached home, we take quick dinner and bath, then hit the sack for the rest of the night. :)

in between times of the work mentioned, we have to find time to study and read to keep knowledge fresh and updated, coz everyday medicine is changing!