HAPPY CHINESE NEW YEAR!!!

it's the year of rabbit and the mood of chinese new year is everywhere. it is especially so here in taiping because so many ppl came back to this small town to celebrate the festival in their hometown. it happens once a year, and the traffic jam became so congested by the vehicles from outstation and some are even from oversea! although it is not as bad as KL, but still the cars had clogged up the small roads here that make me feel lazy to leave the house.
red lanterns hanging at almost all the houses and ppl start going shopping frenzy in our limited shopping malls here for preparation for the festival.
though i'm not preparing much for it (just bought a blouse and a skirt, few angpows, tht's all), i'm infected by the mood and already in holiday mode. :)
wish everyone a Happy Chinese New Year!

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!

so tired...

long time since i feel this tired during on call. think my passive call today was worse than my active call yesterday. it's nothing extraordinary yesterday, with admissions for accidents and head injury, appendix, abdomen pain and, of course, upper gastrointestinal bleeding. done 2 OGDS (stomach camera), 2 operation, see CT scan for head injury and managing pt in full blown sepsis (severe infection). hardly anytime to sit down n rest my legs. but somehow manage to pull through the nite, although didnt get much sleep.
but really, the ward turned into nightmare today. so many admissions in the morning into our female ward. we have 9 elective admissions for operation tomorrow. 3 of them manage to be shifted to second class ward in another ward, but still we have extension of 6 in ward 17( and it is still before 5 pm). pt have to be placed in the middle of hallway and corridor near the toilet. so uncomfortable to both pt and working staffs. then i began my second call by starting a laparotomy case (major case for abdominal injury) early in the morning (w/ my specialist of course) and later have to review pts in periphery wards till 1 pm, before breaking off for a quick lunch and came back to hospital for another 2 urgent OGDS for bleeding cases. my colleague who is active call today started his marathon of appendix in operation theatre since morning. one of the scope i repeated on the same pt i scoped last night coz she bled from the site we took biopsy for tissue study. though the biopsy was indicated, i felt half-regretted for doing the biopsy for her.
i was stucked in the hospital till 5 something before i had chance to go home n took nap of 2 hours, before coming back to hospital to review a referral from medical department. my active call colleague finally came out from operation theatre and hopefully he wont need me to go back to the hospital tonight. the ward was so bad that three of our surgeons took turn to drop by and making sure e/thing is fine.
tomorrow i'm going to be elective operation for the whole day. though i'm not a religious person, but, oh well, God bless me to have good night sleep tonight. :P

dec is marry month!!

attended 2 wedding within this single month! seems like the end of the year is good time to get married. haha. both are good friends of mine n had wonderful wedding ceremony done for their big day. feel happy for them and wish them happily ever after :D

but it also mean a bit loss from my pocket money bcoz of the ang pau.. haha

watched 2012

recently watched the movie in taiping cinema with my husband :) as whole, i think it's a great movie, with so much effort and time n money being put in to give us the ultimate impressive effect. storyline was quite straightforward i would say, as expected, issues of humans' differences bound to be brought up n the ulgy side of human when it comes to life n death situation. i love the part where the ground started to give way n how the whole town being split up and submerged into the sea. the only safe place is the sky! building the ark was impressive too. after watching the movie i actually was a bit worried whether anything would happen in 2012. :P

i'm legally married!

090909, on this day, i signed down my name in the marriage certificate in an ordinary looking association building in Ipoh. witnessed by both our parents, we exchange our rings in elated mood. but seriously, after that day n the mini honeymoon we spent in langkawi n now back to work, it seem there's nothing different at all. not that i'm disappointed or want to complain. i just realized it's a small step forward in our future. maybe the ceremony not done yet, tht's y i feel e/thing is the same as usual. work, eat, go home, sleep, n the cycle go round n round. n we still only can meet up in weekends n holiday.

hope by end of next year, we could really live like a normal couple :P haha.

6 weeks in ICU

we are having rotation posting to ICU in our hospital for 6 weeks. each MO (medical officer) from our department will go to ICU to work and learn critical care in anaesthesia by rotation. and this week it is my turn to go. already went for a week, n being there just confirmed one thing at least: i really dun like ICU :( so many ill patients, all with pipe down their throat and not responsive to our call. of course, they do respond when they get better and got transferred out to general ward. and managing them increases further the stress level. work load otherwise is much less compared when working in surgery, due to we have more colleagues to help out in lesser wards... but i do start missing my appendix already :P

had some emotional trauma happened related to work recently, but luckily i'm recovering now. and hope things will be better when time passes.

end of the month would go back KL to start planning my wedding schedule. busy scale escalating....

recent plans

things start to get busier with months go by. :) most likely my schedule for coming year will be like these:

Aug till mid sept: ICU posting for 6 weeks to learn about acute management in ICU and hopefully ventilation settings :) challenging as those are new things to me (again...)

sept 9: memorable day for me and my darling for registration of marriage. the event will take place in associate registrar of marriage in ipoh witness by both our family.

sept 22: it's my MRCS exam day in KL. currently revision is underway n hopefully i can finish reading the book. but i'm trying not to put so much stress on it. greater stress means poorer performance from me. :P

oct 3: i'm part of commitee for basic surgical workshop to be held in the hospital on this day. so meaning while preparing for my wedding n exam n learning new stuff in ICU posting, i also working as secreatary in this project

dec 5: my friend's wedding dinner in penang. already promised i will go :D

dec 26: family trip, including my dear, to langkawi for three days. good time to relax.

jun 2010: another friend's wedding dinner in ipoh. very good friend of mine. :)

july - aug 2010: hopefully my wedding dinner here. :p

oct 2010: may have chance to apply for master of surgery. UM programme offers training in hosp ipoh n in-campus in KL. a win-win situation

so, something like this. busy time ahead.

i'm having bad luck recently...

recently had bad luck with my car. she made funny noise 2 weeks back then suddenly cannot start my car one hot afternoon. luckily i was at home. but i had to take the half day off n ask for help. at the end, it was becoz the battery was dead. i changed a new one with $250. most likely can tahan till one year.

i had another jump today. i went to pick my colleague in her neighborhood which i had never been there before. just when i'm making an U turn, my car overran a divider beside the road and one of her front wheels hang half an inch above the ground, unable to proceed or reverse. i was so frustrated and worried whether she sustained any internal injury :P luckily a few uncles staying in the neighborhood helped jacked my car up and placed few bricks under the wheel and i was able to reverse my car back behind the divider. it took half an hour there. phew... luckily nothing is leaking from my car, but i sensed something might be wrong to her absorber... will have to bring her for checkup again next time i go back kl

but seriously, didnt expect the neighbors were so helpful. things would be much different in KL. for the first time, i'm glad i'm in this small peaceful taiping working. :)

brain tumor? brain abscess?

patient presented with gradual worsening GCS and generalized weakness. there was no history of trauma or fall, nor low grade fever or fit. she recently undergone some ovarian surgery. so unlucky for her to have this. she was referred to hospital Ipoh as well for further investigation.