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!