White Coat ?

Sometime ago in April this year, our new DG reminded all the doctors to wear our white coat when we are working in the hospital. And my Head of Department remind us as well during our monthly departmental meeting to wear our white coat whenever we see patients outside OT.

Aiyks... The last time I wear my clinical white coat was during my housemanship time, during my medical postings, that was way back in 1998 already... Nowadays, most doctors in hospital don't wear white coat, unless seeing patients in clinic.. It's damn hot wearing this white coat in the ward while during ward rounds or clerking new cases or seeing patients..

Those who always wear white coat in the hospital are mostly medical students or pharmacist or the physiotherapist or occupational therapist. Well, I also wear my white coat ALL the time previously when I was in the hospital during my medical student time.. So hot, really no joke !! Most of the time, when wearing this white coat in the ward, I will start sweating (made me looks like thyrotoxicosis patients with heat intolerance... having excessive & profuse sweating...) (Well, there's no air cond in the ward, only few pathetic fans ...)

Wearing white coat is really not practical, with many reasons behind it.. Not only it's hot(furthermore, our climate is so hot and humid).. & inconvenient, it's also very dirty as well.. It's proven already white coat is a source of hospital acquired bacterial infection. Adding the risk to the patients as well as ourselves & our beloved family members..

Imagine carrying all these dirty bugs back home !! Some more, who will actually wash their white coats daily? I don't think many will wash it weekly as well.. Some might only wash it once in few months!! So u can imagine how "dirty" is that white coat :P

I still prefer wearing the ICU blue shirt when working inside ICU or doing rounds outside.. As we are dealing with critically ill patients & doing lotsa invasive procedures as well, there's very high chance that our attires will be contaminated with sputum, tracheal aspirate, blood, vomitus, body secretions etc etc.. In fact, we need to wash our hands every time we move from one bed to another.. (handwashing is very important to prevent transmission of germs).. So, is it justifiable to wear white coat inside ICU?

My fellow colleague, LT has posted on this White Coat issue in his blog..

Normally, I just keep my white coat inside my car..(I think there's dog fur on my white coat as well, since my kai mui's doggy walked on it previously...). I only wear my white coat when "necessary", or "once in a blue moon"... My stethoscope is the "emblem" of my medical profession already, together with my name tag & card.. No need white coat lah...

Food stuff from Hattyai

My sister in law just came back from Hattyai, Thailand. She bought some food stuffs eg. crab crackers, cashew nut etc.. for me :) Initally, I thought the crab crackers is just the ordinary crackers with crab flavour :P Hahaha.. who knows, when my hubby went to collect the food stuffs today, then only I noticed the crab crackers is actually the deep fried real little baby crabs..


Little deep fried baby crabs...


cute or not? :D


Cashew nut

I've been tagged...

Aiyoh... being tagged by BabeKL.. *Scratch head*.... cos have to answer back all these questions..Mmmm... I masak masak once in a while only lah ...

What is your first memory of baking/cooking on your own?

I think it's some where when I was 9 or 10 years old time... frying eggs :) This counts too as well, right?:D hahahaa....
Later on I cook some simple dishes (for lunch & dinner) for my family as well during my secondary school days...

Who had the most influence on your cooking?

I would say - both my mother & my father.... sometimes I help them in the cooking, & learn little bit here & there from observation loh.. No specific measurements in their cooking - like a pinch of this or a drop of that... With experience, one will know how much to put in.. heheh...

Do you have an old photo as “evidence” of an early exposure to the culinary world and would you like to share it?

Nope... Never think of such things at that time..

Mageiricophobia - do you suffer from any cooking phobia, a dish that makes your palms sweat?

None at the moment lah...

What would be your most valued or used kitchen gadgets and/or what was the biggest let down?

I don't have fancy/expensive cooking utensils or kitchen gadgets. very simple :) I cooked using the kerosene oil stove leh previously during my first few years of cooking experience... that's during my primary school time .. Wonder how many of the younger generations have ever see a kerosene oil stove ?

Name some funny or weird food combinations/dishes you really like - and probably no one else!

Oh? none lah...

What are the three eatables or dishes you simply don’t want to live without?

(1) Fruits - I like fruits... Fruits can be my main dishes for the day... I like eating all types of fruits, but my favourite is watermelon.. There are few local Sarawak fruits that I like as well... but too bad, I don't know what's their name... (regret lah never take picture of those fruits previously.. )

(2) Chinese soup - I love drinking soup.. Just that too bad, I don't have time to cook this regularly.. Sometimes, I cook soup with slow cooker (the easy and convenient way, especially on weekends.. just put in all the necessary ingredients at night before going to sleep, and can drink the soup when I wake up in the morning), the taste is still nice..

(3) Bilin/Midin Fern - One of the local fern which is available in Sarawak... And I haven't see it else where outside Sarawak. I like it so much, each time I go back to my hometown, sure I will go & buy bilin fern from the market.. Bilin cooked with belachan - nice, delicious, yummy.. :D (Feeling like eating it now...:P)

Any question you missed in this meme, that you would have loved to answer? Well then, feel free to add one!

Three quickies:
Your favorite ice-cream… : Vanilla flavoured ice cream..

You will probably never eat… : Insects like cockroaches, or grasshopper.. or even scorpions (really a big no no - Can't imagine people eating this)

Your own signature dish… : My own version of fried chicken wing ...

And my own question that I would loved to answer:
Eating "experience" regarding types of meat that I have ever tasted...

I have the priviledges to try out made different types of meat actually.. Besides those normal meat stuff (chicken, pork, beef, mutton, rabbit, duck, fish etc etc..) , I have tried…mmmm... Let me recall back : Snakes, crocodiles, frog, dog (I ate dog meat when I'm small.. I think 4 or 5 years old time.. Now, for sure I won't eat dog meat again lah.. ), flying fox, sea turtle,(including turtle eggs as well), tortoise, pangolin, white mouse(hehee.. mouse also I eat ), donkey, camel, ostrich, wild boar, deer, bat, worms.. (i tried the silk worm in Beijing last time.. as well as the Sarawak sago worms..)What else? There's more, but i can't think of it at the moment.. Hahha.. ants as well.. this one I didn't eat or drink it on purpose, accidentally drink it without noticing it at the first place :P

but I will definitely not try the cockroaches or scorpions or grasshopper. disgusting.. Sounds gross to me loh.. i won't dare to eat these food stuffs... See lots of these foodstuffs in Beijing & Bangkok.. looks disgusting loh..

Oh ya… one yucky experience… I drank a glass of water full with black ants previously. That was during my secondary school time. Damn disgusting... I didn't notice it initially cos of drinking in the dark, without the light on. That time, i went to the kitchen late at night & lazy to on the light.. just poured the water into the glass & drank, then I felt something funny in my mouth and my throat.. When i on the light.. i nearly pengsan loh.. the glass of plain water is full with ants... thinking about it, made me want to vomit niah.. hahhaha… ----> very traumatised with this yucky experience leh. Really feel vomiting at that moment…

I am to pass to this on to 3 people... Who to tag???

This is indeed a very difficult task, since I’m quite down the chain mmmm... Let me think, err..… I’m gonna tag:

Ac of Notions of Ac (still thinking ...how delicious is his home cooked Grandma's "Chawan Mushi" (Steamed Egg dish)... When can I taste it :P ?)

Grace of My Life (Waiting to hear/read some authentic Sarawak dishes from this Iban girl from my hometown.... )

eVoL of Everlasting Love (I read about u cooking Macaroni in your blog, sure u have something to share about your cooking experience...hehhehe....)

Gasman of Palmegasman... My fellow "batman" colleague... (additional candidate.. okie mah.. the more, the merrier, hahahha... break the pass to 3 people rule, no problem, right?) :D

"Eventful" On Call

I was on call 24 hours inside the operating theatre(OT) yesterday.. The emergency theatre was very busy the day & night before, basically, operating for 24 hours non stop.

Start off my day with an Indian lady with necrotising fascitis of the lower limb for wound debridement.. She started crying since entering the OT.. She said she is scared but don't know scared of what... I explained to her about spinal anaesthesia but she started crying again & refused any surgery or further intervention. Well, I can give her General Anaesthesia(GA) but the problem is she has so many loose teeth.. all her incisors & canine teeth are loose. Very shaky indeed.. Can be pulled out easily without any force. I really have no idea how she eat with such loose teeth & why she keeps all those loose teeth? I guess she is scared to go for teeth extraction as well.. Risk of accidental tooth extraction (& more scary thin is tooth aspiration to the bronchus) if giving GA. After reassurance & wasting so much saliva talking to her, then she finally agreed to continue on with the operation.. I sedated her with iv midazolam and iv ketamine prior to spinal anaesthesia. Post operatively, she was smiling.. Well, nothing scary, right? :)

I have quite a number of orthopaedic cases yesterday.. Followed by open fracture right metacarpal for wound debridement, open reduction & mini plate. This girl has receeding chin but thank God, no difficult intubation :) Cormack & Lehane 2 with cricoid pressure..

I proceed with Wound Debridement & Split Skin Graft(or SSG) after that for a 77 years old lady... When the patient arrived to OT; I flipped through the old GA forms & I found out that... patient just underwent surgery two weeks ago, & apparently she has Parkinson Disease with stiff neck & very limited neck movement. She was intubated with awake fiberoptic intubation previously & post intubation, assessment with laryngoscopy showed Cormack & Lehane 3 vocal cord !!! Mmmm... next time, might be I really shouldn't do any SSG cases on weekends already.. Since this is non urgent case. I taste bagging with face mask & able to maintain airway.. before I give any drugs. So I just insert in Laryngeal Mask Airway (LMA) for her. The insertion of LMA is easy but have problems trying to secure it, cos the patient doesn't have any teeth at all, & the LMA keep on sliding to the side of the mouth.. I changed to size 4 LMA but the same problem occured as well.. Well, but manage to seal the airway properly, just that the position of the LMA is a bit weird..

The next case I did was tracheostomy. This patient has craniotomy & evacuation of hematoma few days ago.. GCS about 7/15 with poor gag & cough reflex..

After that, I did another 79 years old lady (so many geriatric patients today) for Incision & Drainage (I&D) for extensive left upper limb abscess & cellulitis.

Followed by another cases of Left knee abscess & I was told by the HO who booked the case that patient is for I & D only. I asked the HO specifically whether are they doing any extra procedures or not like removing the implant etc.. And the answer given was "no..." This lady has bilateral total knee replacement done earlier on for osteo arthritis both knees but complicated with infected implant. The TKR implant was removed earlier on & the space was filled up with cemented material, but she still have recurrent abscess..

This lady has very difficult venous access & really have hard time looking for veins.. I manage to secure a 20 gauge branula over the left hand (Well, since it's I & D, i didn't anticipate any much problem or bleeding or whatsoever.. She has nice neck vein actually, but that's my last resort if I unable to get any peripheral lines on the upper limbs) On table only, I noticed they actually want to do more than just mere I & D. Removing the cemented implant..& External Fixator if the wound is dirty or fusing the knee if the wound is clean.. Patient bleed so much intra operatively, more than 1.5 liter & her blood pressure was very labile, I gave her many boluses of iv ephedrine & iv phenylephrine to maintain the blood pressure while running fast colloid & blood products. She looked so pale.. I wanted to set some more big lines on the neck, but now, the neck veins collapsed already after the bleeding episodes.. became non visible already.. After the surgeon finish stitching the wound, I quickly set an 16 G angiocath at the right femoral vein & continue on running fluid for her. Her hemodynamic status stabilised after transfusing second pint of blood... These surgeons ah.. Inform earlier on lah what they want to do .. :(

The excitement haven't stop yet.. So many orthopaedic cases. Have another young boy. Allerged MVA with open fracture of ulna for wound debridement & open reduction internal fixation (ORIF). Then I had a guy fell down from height and had a penetrating injury to the neck with profuse bleeding. Blood is splurting out from the neck.. For exploration, ? vessel injury.. He had few puncture wound & laceration at the upper limbs & lower limbs as well.. Very tachycardic on arrival to A&E with heart rate of 150+. Manage to stabilise blood pressure & heart rate after fluid resuscitation but patient was pale due to bleeding.. Blood transfusion started intra op, Luckily it's just external jugular vein injury & manage to secure the bleeder fast :) The orthopaedic team did the toilet & suturin (T&S) for the laceration wound.. At this time, it's past 12 midnight already..

I have another case after that, middle age thin guy who swallowed his denture during drinking.. aiyoh.. From XRay, the level is at T1).. The ENT team did the oesophagoscopy & removal of denture.. Procedure was quite fast & patient was extubated half an hour later on.. It's 1:30 am already by then..





Post extubation.. noted patient having noisy breathing and unable to talk.. Saturation well maintained initially at 99% to 100% on ventimask 60% oxygen. He was prop up. Secretions ++ but he unable to cough out. He had difficulty in breathing with SOB. Impression was ? laryngospasm with upper airway obstruction. iv dexamethasone 8 mg given & patient was prop up almost 90 degree.. Nebuliser given.. Saturation was around 90 to 96%. Lungs clear.. Emergency intubation trolley was standby. Conditions much improved after neb & resolved.. maintaing SpO2 985 to 100%. He was observed for one hour plus in the recovery bay before sending him back to the ward at 3 am..(to be nursed in acute cubicle with oxygen supplement overnight & pulse oxymeter monitoring). What a day.. Finally can go to rest at 3 am in the early morning..

Plastic Surgery ..

One of our consultant plastic & reconstructive surgeon told me before that, everytime she has any assaulted case referred to her (like slashes injuries, multiple stab wound injuries, gun shot injuries etc..) she will surely ask the patient where the incident occured.. Well, she really has a point there ---> avoid going to those places in the future if possible, for your own safety :D She is really a very dedicated plastic surgeon & her surgical skill is excellent.., she is very famous as well :)

I was working in the Plastic & Reconstructive Surgery Operating Theatre yesterday.. Yesterday's case (Latissimus dorsi free muscle flap in lower limb reconstruction after motor vehicle accident) tooks around 7 hours plus.. faster than what I expected :) Sometimes, these sort of cases can take up 10 to 12 hours ... (Most of the plastic surgery takes longer hours than the other operations.. )

I think many have actually misunderstand what is the actual definition or meaning of plastic surgery. Many might only link plastic surgery with cosmetic reason... Actually the scope of plastic surgery is much wider than that...

Plastic surgery deals with the repair, reconstruction, or replacement of physical defects involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast, trunk, external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is just a component of plastic surgery.

Special knowledge & skill involving grafts, flaps, free tissue transfer & replantation is important. Competence in management of complex wounds & usage of implantable materials is required as well. Plastic surgeons have been prominent in the development of innovative techniques such as microvascular & craniomaxillofacial surgery, liposuction, & tissue transfer.

Haze ...

Haze strikes again..... Today, Penang island is covered by haze again.

I stay indoor since I come back home from work just now.. Don't feel like going anywhere when it's so hazy.. Cos it's very unhealthy. I will continue to stay indoor tonight.. But, tomorrow, I have no choice.. Have to go out, cos I'm working & in fact, on call tomorrow..

Talked to my friends in KL just now.. Apparently the sky is clear over there...

Looks like more people are going to fall sick in the next couple of days..
Better drink more water & avoid going outdoor unless necessary.. And don't do any outdoor exercises or jogging or hiking .. Likely, more asthmatic patients will get AEOBA or acute exacerbation of bronchiol asthma :( Our chest or respiratory ward will have increased admissions for the next few days... And surely, more will be down with cough or sore throat..

I hope this haze will go away soon. How I wish it will rain tonight :)

I just took these pictures few minutes ago... So stuffy, so hazy... :(

Art

I like drawing & painting since young.. Used to do that during my free time. But, since I enter university, I hardly draw or paint already, cos don't have time to do so... Just that once in a while, I still do some sketching on plain paper or on my notes :) Occasionally, I sketch on newspaper as well :D

I took few snapshots of the paintings that I drew previously with my digital camera when I went back home to my hometown for vacation previously... Since it's so many years back already, I had lost most of my paintings .. Since my family shifted house end of last year, I think I lost almost all my paintings already.. Except two special one, that I still keep together with me :)

Here are some simple drawings of mine :) Nothing great :) ...

This is my profile picture. I drew this during uni time.

Spaghetti

Have spaghetti for dinner today, prepared by my hubby.. Home cooked spaghetti with Bolognese sauce with tomatoes, minced meat, shrimp & scallop... Added in red wine as well :D

Delicious dinner

Give some to my doggy as well.. He likes it very much .. Licking the bowl till clean :)

Which Malaysian Blogger Are You?

I read few of my friends blog & notice most people has a post on this topic.. So I take part in the fun as well, Kenny Sia's latest personality test - Which Malaysian Blogger Are You? :D

Congratulations Chen, you are...

Jeff Ooi of www.jeffooi.com

You are humble, mild-mannered yet wise. Your knowledge is vast as an ocean, but when confronted with an issue you are passionate about you are tough as a mountain. You have an aura of style, quality, excellence surrounding you that cannot be denied. In a way, you are a rebel, but that's because you are always willing to help out your peers by challenging authority without asking much in return. People respect you. You are a natural born leader, people stop to listen when you speak, and follow you wherever you go.

Which Malaysian Blogger Are You?

Hahhaa... is it so? I don't think so lah..
Anyway, I just take part in this for fun :D

New staffs..

Every morning before, as a routine, I will check my GA machine & all the connections prior to starting any cases. Mmmm... today, this new Fabius Drager GA machine giving problem.. cannot complete the leak test, and there's lotsa leaking with the circuit.. This is the new digital GA machine, Check the connection, circuit, breathin bag,soda lime, and in fact everthing.. but cannot figure out what is going wrong. So, at the end, have to change to another GA machine (Ulco).. Still the older GA machine is more reliable :)

Today really "headache".. I have two new junior GA nurses in my operating theatre (like two or three weeks working experience..). Both of them still quite blur in many aspects. I have few paediatric cases in the morning, and I asked them to get the Ayre's T-piece breathing circuit for me.. Aiyk.. They don't know what is Ayre's T-piece breathing circuit... Aiyo.. this is the basic breathing circuit we use for paediatrics/children less than 20 kg leh.. Why they put two new junior GA nurses inside.. I prefer having one more senior or experienced GA nurse.

It's really headache each time of the year when the more experienced or senior staff nurses leaving or getting transferred.. Really have to spend so much time teaching these junior nurses especially those who just graduated from nursing school. I can say most are blur.. Big time headache !! And some of them take so long time to learn.. I don't mind teaching them, but there's a limit to everything lah.. Not that I'm racist, but from what I see, the Chinese or Indian one normally pick up much faster compared to the other group :) Of course there are exception as well.. There are many good Malay nurses as well, but these are the experienced or more senior nurses. Nowadays, really sad to say that, the nursing standard has really drop..

Just a side topic, today, there's a premature baby with body weight of 600 gram came for emergency operation. She's so small... So tiny.. So fragile.. Poor baby.. I take a picture of her with my palm Zire 71. (U can imagine right, how big is a 600 g or 0.6 kg baby..)

Gurney Plaza

Went to Gurney Plaza today after work. Reached there around 7:20 pm. I parked on the parking lots outside Gurney Plaza. I asked the parking attendant how much is the parking fare for half an hour. He told me "40 sen", followed by " Setengah jam cukup keh?" I answered, "Cukup...", "Lebih dari cukup.."

Hahah.. I think hardly have people going to Gurney Plaza for half an hour only.. Well, I only go there to buy or get what I want... I always plan things ahead or do things systemically.. No point wandering around or walking around aimlessly. I don't like to waste time doing window shopping either. Not my cup of tea :)

I went to collect my free Li-ion NP700 rechargeable battery. (I bought a digital camera, Minolta Dimage X50, 3 weeks ago. This is my 3rd digital camera...) (Get a free 512 Mb SD card, 200 free 4R digital photo prints, one mini tripod, one extra NP700 rechargeable battery (out of stock at that time), one carrying case & one sling bag together with the camera). Followed by buying few items from the Cold Storage Supermarket. Altogether took me less than 20 minutes.. :P

On my way back home, inside my apartment actually, I saw this cute "Basset Hound" doggy again. I see that dog many times already. There's one Dalmatian dog in my apartment as well. This Basset Hound dog is a bit dumb today.. Dunno why it ran towards my car.. But of course I didn't hit the dog lah...

Reached home around 8 pm... Tiring day..

BKT Instant Noodle (肉骨茶面)

Shopping for groceries in Sunshine Farlim hypermarket yesterday evening after visiting my KM (& her uncle's cute little doggy).. And I this Bak Kut Teh instant noodle catch my attention :) Hahha.. I'm really curious how it taste like, So I bought one pack back home (4 packets for RM3.20).. Each time seeing BKT or related stuffs, will reminds me of Will (since someone mentioned he has BKT blood :P)

I'm not a fan or regular eater of instant noodle. But I do keep instant noodle in my apartment as well inside my locker in the operating theatre. (These are my emergency food source when I'm on call in the hospital ... cos sometimes, can be so busy that we don't really have time to eat.) Sometimes, I'm just too lazy to cook proper meals or when I'm in a hurry...

I try the BKT noodle (肉骨茶面) today, mmmm.. not bad :) But.. of course cannot compare with the real stuff lah.. :D

Draw a Pig

Get to know about this website from Fredy's blog :)

Check out the site, Draw A Pig & find out what your drawing of a pig says about you & your personality. Try it.. Have fun :)

Click here to have a look at the pig picture that I draw . Hahhaa... The picture looks funny & weird, cos it's really a hard task to draw with mouse.. So difficult to control each stroke. :)

"Concerned" citizen? :)

On call yesterday in ICU. Yesterday evening I received a phone call asking the condition & progress of one of my patients (a near drowning case in swimming pool with severe ARDS). I asked the identification of the caller since we only tell the progress & conditions of patients to the next of kin. He said he is just a citizen who concerned about the patient.. Is it really so? Or he is just busybody or "kay poh"? Or is he a reporter? I don't know.. This is not the first time already.. We received several phone calls asking about the progress of this patients earlier on already.. from people like reporters & outsiders etc etc... Really disturbing especially when we are busy and have to pick up/answer phone calls like these..

But, well... we can't disclose ICU patients' condition & progress to others, other than the next of kin :) Have to respect the patient's privacy etc.. There are several reporters who wanted to come in & take pictures as well intially on the first day when the patient was admitted, but well.. this is ICU.. So no photos shooting or interview or visitations by unknown visitors other than next of kin or relatives...

Sarikei 泗里街

Sarikei/ 泗里街, my hometown.., also known as the town of swallows. I guess not many have heard or know about this small town, except that Sarikei is always being mentioned in the weather forecast.

Sarikei strikes my mind just now when I read about a post by Fredy with the title "U know u are Sarikeian when"

hahhaha... it really bring back old memories.... Reminiscing the old days..

I was brought up in Sarikei and have my primary education in SMB St Anne; & my secondary education in SMB St Anthony. I did my Form 6 in SMK Meradong since there's no Form 6 in Sarikei town at that time. I get all my reference books for my SPM & STPM from Anthonian bookstore .. The only bookshop available; Well, it's the sole supplier of textbooks & reference books at that time. Nothing much interesting in this small town where I grow up. One can see a huge pineapple near the Sarikei wharf.

Talking about Sarikei reminds me of few things...

Swallows.. in the late evening, folk in Sarikei town will see a huge bundle of swallows flying in the sky.. hence , that's how the name "town of Swallow" was derived...

Foochow... Most Chinese communities in Sarikei & Sibu are Foochows; well, I'm not Foochow, but I can speak Foochow...

Kam Puah Noodle 干盘面 .. One of the "delicacies" in Sarikei town.. Well, there's not much food selection over here.. Kam Puah Noodle is the well known noodle in Sarikei & Sibu town.. Everytime I go back home to Sarikei, I will eat kam puah noodle as well.. since this noodle is not available else where in West Malaysia.

Pineapple 凤梨.. Sarikei is well known for it's delicious, sweet & juicy pineapple... But mind u, these pineapples cannot be consumed in large quantities cos it can "cut" your tongue or the oral cavity mucous membrane..

I get to know CooknEngr too because of "Sarikei". He is also from Sarikei, but we never know each other previously.. I have a homepage previously and somehow he surfed & visited my homepage by searching the word "Sarikei" (I still remember that was way back in 1998..) and since then, we keep in touch with each other till now.. And I met him few times as well during his visits back home to Malaysia.. And I just get to know during CNY 2005 that my late dad & his late uncle were good friends as well (gather this information from his family photos). What a small world :)

p/s : I just noticed there's an orange hairy ape by the name "Sarikei" as well in Chester Zoo.

Happy Father's Day

My daddy was a nice, honest, simple, helpful & hardworking guy who was very dedicated to his work. He cared for us & tried to provide the best for us. Both my parents have brought me up to who I am today. I am so glad and happy beyond words & blessed have him as my daddy, and to my mummy as well. He was one of those olden days parents who didn't show his affections openly to us but we all knew he love us. He worked in Standard Chartered Bank (for 25 years prior to his retirement in 1985) & was awarded the best employee award. (Now, there's no more Standard Chartered Bank in Sarikei already.. the bank was closed down few years back..)

(Photo of my dad in his early 20s )

I still remember the scenario of my day riding his old bicycle to work everyday. I can say that most people in my small town, Sarikei (the place where I stay & grow up ) know my dad. And those people who know my dad will know that I'm his daughter cos I look like him .

My dad all the while was a healthy guy with no medical illness. Even at his old age at 70 years old, he didn't have any medical conditions like high blood pressure, diabetes, heart disease or any lung disease like asthma or COAD. He was very fit & he exercised regularly since young every morning and night time. He was a master in Chinese Kungfu "Tai Chi" .

However, I lost my dad quite suddenly due to severe lung infection, pneumonia. He was still alright & okay the day before he get the pneumonia & everything just happened so suddenly & he went downhill very fast. He left us within few days after that for severe bronchopneumonia with severe septic shock, at the age of 70 years old. It's quite shockening & sad to everyone in the family.. cos everything just happen so sudden & unexpected.. Something that I regretted was I never spend lots of time with my parents since I entered university & later on as well, after I starts working... cos I was away from home most of the time..

Daddy, I love u & I miss u as well.. Even though u left us 5 years plus already, u are always together with us in our heart...

Time waits for no one.

Treasure every moment you have.
You will treasure it even more when you can share it with someone special.

err... I just realised today is 19th June, & it's my sister's birthday as well.

My uni junior :)

One day, inside the operating theatre, I noticed someone who looks quite familiar (despite with the surgical cap & surgical mask), and I asked her whether she is from the same university with me, Cos she looks like my junior.. (But I don't know her name loh cos so many years already ... ) Indeed she is, but what surprised me is that she knows me & my name as well... (she mentioned my full name leh..) Hahaha... And she continue on telling me that she used my anatomy notes during her first year.

My goodness, She's four year my junior leh.. So long already, and yet the notes still been circulating around :P I never know my notes are so good, hahaha.... , but I do know my coursemates (same batch with me) photostated my notes :D (During our undergraduate days, we passed our notes to our junior who are one year below us; and we have the buddy system over there.. and somehow, my juniors subsequently recommended the following years junior to use my anatomy notes :D )

I don't even have the original copies already, cos I throw the notes away after graduation.. I still keep the textbook for reference ( Well, the textbooks are not cheap as well, some cost more than hundred per book).

Seafood platter

The seafood platter served in Fish & Co is quite nice, & something unique, cos it's served in a pan... & the portion is huge as well. The seafood platter for two, actually can be shared among 3 people :) (with seasonal fish, calamari, prawns & mussels in creamy garlic & lemon butter sauce, served together with rice & chips). (Well, it's a bit expensive, at the price of RM 48.90)

I didn't bring my digital camera, so I took a snap of the seafood platter with my palm Zire 71. (Well, the picture quality is not good compared to digital camera...)

The all-time favourite, "fish & chips" are quite nice, with huge portion too. Haha, & they have the "big fish drink" --> so that one can drink like a fish ?

Sprained ankle

I received an SMS in the early morning today around 4:40 am.. Luckily I was fully awake & working at that time, or else ..... I was wondering who on earth SMS me at this weird hour in the early morning? Apparently, the sender was "Michelin Man"... This cute chap has a minor MVA late at night.. He tried to avoid hitting a car that suddenly got into his lane & because of this, he knocked himself into one of the orange road divider thing.. & injured his leg & his ankle was twisted badly.. Poor thing.. Hope there's no fracture. But sprained ankle with ligament tear itself is troublesome as well, cos it takes time to heal completely.. I experienced that before :(

I sprained my ankle twice before during my undergraduate time (first time during my first year & second time on the same foot during my third year). The first time is my own mistake loh.. I stepped into the small drain accidentally in my hostel & twisted my ankle ... The sprain was quite bad & my whole ankle was swollen.. Damn painful :( I went for ankle XRay in A&E after lecture; luckily no fracture, just ligament tear.. The worst thing is that I stay in 4th floor in the hostel & it's really difficult for me to climb so high up to reach my room.. Every single movement is also painful. Should have used crutches at that time... Furthermore I have exam the next morning. If not, sure I will "ponteng" class for few days ... Cos it's important to rest the ankle & minimise walking..

Management for non complicated minor sprain ankle injuries are RICE (Rest, Ice, Compression dressing or bandage & Elevation of foot) plus analgesia or pain relief with medications eg NSAID..

On Call

On call yesterday.. Daytime was quite okay, and I thought I can go & rest at night time, but who knows, I have few cases from 2 am till almost 6 am in the morning.. (I don't mind busy in the daytime but prefer to have some rest at night..) First LSCS at night time was a 95 kg lady with polyhydramnios & unstable lie, in active labour & baby was in transverse lie at that moment.. Bleed quite a lot intra op but manage to stablise her hemodynamically by rapid colloid & crystalloid fluid resuscitation, and oxytocin 40 units in progress. As usual, we try to minimise blood transfusion especially in young, healthy patient cos blood transfusion itself carries risks.. VE examination after LSCS showed persistent oozing.. Inspection with SIM's speculum revealed labial tear.. Another case was suspected chorioamnionitis with maternal PROM & fetal tachycardia & deceleraton on CTG.. By the time this case was done, it's almost 6 am in the early morning already..

15th June

Just realised today is 15th June.. What's so special about 15th June? It's special to me, cos 8 years ago, on this day (15th June 1998), I report duty to Sarawak General Hospital & started my career as a doctor... Damn stressful at that time, cos I have to start on call on my second working day.

So fast time flies... Now is my 8th year in service already... I don't miss my housemanship time (well, that's the most "torturing" moment in my lives, and I don't think any doctors will miss those days. Still remember doing EOD or every other day on calls... so far, the most on calls I did during my housemanship time is 13 on calls per month), but I do miss the moments together with my colleagues during my housemanship time.. I still keep in touch with some of them. Everyone is working at different place already at the moment; Some have left the government service and open up GP clinics.

Parents & Kids...

Just came back from dinner.. Tonight, we have Will's favourite food - Bah Kut Teh as dinner. Well, the BKT here is not as nice as the one available in KL or Klang... (John always mention that Will has BKT in his blood; and BKT has become staple food for Will already) :P

kktan sent to me few photos of his kids today, including some of his newborn baby boy's picture.. Cute and adorable baby boy.. kktan, guess u must be missing your wife & your two boys a lot, since they are so far away at the moment :) over the South China Sea in Borneo Island.. Don't worry, your in laws will take good care of your wife & your children during the confinement periods.

Parents can really sacrifice for their kids/children.. Parents are indeed great. Their sacrificial and "unconditional" love. They can put down and let go everything for the benefits of their child/children. Parents will even to the extend of giving up their own lives for the sake of their children.. Parents will really have sleepless night when their child is sick..

I'm really glad I have good parents as well, who take care of me & my siblings well. I can still remember those sleepless nights of my parents when I'm sick. Those days, i sat at the back of the bicycle while my mum cycled to bring me to school :) I never attend any tuition classes before all these while, & during my primary school time, my mother help me in my study during my primary school time. Those good old times :)

But sad to say, how many kids/children will sacrifice for their parents? Many just take things for granted. Of course there are still filial sons and daughters who stay together and take care of their parents. We can observe all these sad happenings in hospitals as well. There are even sons/daughters who even refused to come to hospital to see their parent even being called on the phone although the parent is critically ill and may passed away any time.. Some will even switch off the handphone after being called several times to come to the hospital.. Really the ugly side of human :(

Exam...

I left my apartment around 6:30 am in the morning & reached my friend's place around 7 am. Not much traffic jam on the road cos it's still quite early.. Reach INSANIAH, Alor Setar around 8:30 am.

Mmmm.. Met with some "long lost" friends over there in the exam hall as well.. including two of my ex-colleagues in Sarawak General Hospital(SGH)... One is Adliah, my House Officer (HO) previously in Surgical Department & the other one is Annie, she worked together with me as MO in the Surgical Department previously.. The last time I see them was way back in year 2000, before I left SGH. I met one of my cousemate in university as well, and other friends as well.. I thought it's bad already for us to travel from Penang to Alor Setar to sit for the exam, but apparently, my other friends from Ipoh have to come here as well... And they arrive here yesterday night already. I think Alor Setar is the exam centre for the northern region this time & next time, don't tell me it'll be held in Ipoh.. :(

The exam questions... haha... Aiyoh.. have to answer 5 out of 8 essay questions.. I can't remember what exactly was being asked but it's something like "Perkhidmatan Penyayang Dalam Budaya Korporat", "4 elemen dalam Kempen Cara Hidup Sihat selepas tahun 2003", "Kekuatan Sifat Baik Hati dalam Tonggak 12", "Piagam Pelanggan", "Kempen Budi Bahasa Budaya Kita", "Kerja Kumpulan dalam Meningkatkan Mutu Kerja/KMK" etc etc... I don't know what I write inside the answer sheet as well :D Haven't write essay in Malay language for so long already... Kinda lost touch already.. The weather here is so hot, and made me feel so sleepy :) Feel like falling asleep inside the exam hall..

Have to go back to hospital after the exam to do my pre med rounds... Luckily not many patients to review :)

Tired...

Just come back home from work.. Busy day... So fast, now is 8 pm already.. Haven't start reading yet for my PTK exam tomorrow.. :P Have to sleep early tonight cos need to wake up early tomorrow morning.. Car pool tomorrow, going together with my colleague (he's my university coursemate as well) to Alor Setar. But I have to drive to his place earlier on in the morning. If the exam is held in Penang, then, will really save lotsa trouble.. At least I can wake up much later on & don't have to rush... I don't understand why they can't have more examination centers, since it's written paper only..

Earlier on today, on my way to work, witnessed a stupid cat crossing the busy road and ... the poor cat hit by a car --> causing the cat rolling around in the middle of the road.. I had to slow down my car to avoid my car tyres from rolling over the cat since the cat was rolling towards my direction. I managed to avoid hitting the cat but as I drove past, I looked back from the rear window. I noticed the cat still rolling around.. but no blood trace on the road.. Don't know whether the pooor cat is still alive or not..

Not feeling well this afternoon as well.. Feel nauseated for quite some time already till now.. Don't know due to what... But the nausea feeling is not as intense as earlier on already.. --> Give me more excuse to sleep early tonight :D

coming PTK exam ..

Well... I should be reading & preparing for this "si-tiu-pid" exam already which is coming soon (tomorrow, 14/6/05).. but I have no mood to read those boring topics... What the heck... Don't care lah.. Just write whatever I can answer.. & goreng goreng a bit.. Mmmm... Just remember, I think we have to answer those essay questions in Bahasa Malaysia, and ... I haven't write in Malay language for so long already.. :D

Durian

My husband went to the durian plantation in Balik Pulau last weekend together with his friends & they bought back altogether 40 durians (at the price of RM 70), I would say very cheap cos the durian are good qualities durians... I don't know how many durians he actually brought back home as they divided the durians among themselves and he gave some to my father in law as well... Apparently now his car "stink" with durians smell ...

I used to like durian a lot during my childhood time but no longer already nowadays.. Might be my taste bud change with age... We opened up the durians & kept most of the durians inside the freezer (became frozen durian).

My dog hates durian when he was small time (that was few months back). Even when we put the durian to his mouth, he will turn his face away.. (we called him "ang moh" dog at that time cos he hates durian). But... nowadays, his "taste bud" changes... he likes durian so much... and even begs for us to give him durian.. He will go and smell the unopened durians.. He even steal the durian seeds, hahhaa.... His favourite fruit is mango & durian..

端午节 Duan Wu Jie or Dragon Boat Festival

Tomorrow is 端午节 "Duan Wu Jie" or Dragon Boat Festival.., the 5th day in the 5th month in the Chinese Lunar calendar,(commemorates Qu-Yuan, one of China’s greatest poets and patriots, who protested against a corrupt government. ) I'm sure most of u know the stories behind this..

Well, I don't really celebrate all these festivals for many years already. Anyway, I'm on call tomorrow, and my colleague(she's on call as well tomorrow) promised to bring her "home made 棕子 chang"/"zhong zhi"/"chung" for me :) Things are different when I was back home last time ... I still remember during my secondary school times, I used to help my mother to wrap up the "zhong zhi", eg.. "bak chang" or "ham yuk chung", 'kee chang" or "kan sui (alkaline) chung", etc etc... Got special technique to wrap the rice and ingredients up with bamboo leaves ... Those were the days.. Haven't do that for more than 10 years already...

There is one old Chinese sayings that if visitors come to your house when u are boiling or cooking the "chang" or "zhong zhi" then 'part' of the chang, especially the 'corner' won't be properly cooked... I don't know how true is that.. but somehow, when visitors come, really, some of the corners of the chang is really uncooked.. funny... don't know whether is it just coincidence or ????? (Something which I don't understand..)

Well, nowadays, these "chang" or "zhong zhi" is available all year round ...

Anyway, my husband bought few "bak chang" yesterday.. from his secondary school friend's mother...She made "bak chang" for sale every year during the festival.. But quite expensive, RM3.60 per piece..But worth it, cos it's nice...

By the way, my colleague(she's my good friend as well), gave me one "bak chang" this afternoon ... that one is home made "bak chang" by her grand mother.. Nice & delicious as well :D That's my simple lunch for today...

PTK exam :(

Just receive the letter today, regarding the "silly" PTK exam that I have to sit... (under the SSM scheme)... This exam is held on 14 June 2005 (next Tuesday, and today is Thursday already, so 4 more days to go... ), So late they send the letter, and the worst thing is, it is held so far away, in Institut Agama Islam Negeri Kedah (INSANIAH) in Alor Setar. So inconvenient.. So sien, have to sit for this sort of boring exam :(

Well, i'm on call this coming Saturday. I think I will only read those stuffs on Monday. (Might be only on Monday night, cos I have to work on Monday as well...) Hahaha... all are essay questions, and have to answer all the questions !!! :D

And furthermore, It's something general involving topics like politics, government policies and plans, government structures, project development, government general orders, economy, budget, nation history .... etc etc.. How to read all these things in few days time? And I have lost touch with all these already.. Yeah, I agree that I study these things long times ago during my secondary school time, but that's so many years ago already. And i don't have any books or reading materials on these subjects.. I totally have no mood to read anything on this... And I don't know what's the "purpose" of reading all these things.... like a waste of time only. Not that we are going to use this later on in our lives. Well, just for the sake of sitting for exam :P

Congrats, kktan

Congratulations, kktan for the arrival of your second baby boy :) The anxious father sent me few sms yesterday morning.. The 3.38 kg little junior was delivered via emergency LSCS at 1:38 pm.

Hey, brother, I didn't expect u to follow inside the operating threatre and witness the whole event :) Although it's something very common & can be consider as "bread & butter" to us in the medical profession, but it's not easy for lay man to do so..

And sorry for calling u so late yesterday night, cos I was very busy earlier on...

Quote what kktan told me just now.. " I want to experience what it takes for a wife to bear a baby for 9 months & give birth. The emotions are almost gripping & yet so touching & beautiful"

(I enclosed one of the photos here with permission from kktan)

On Call

On call yesterday in Operating Theatre.. As usual, my calls are most of the time quite "busy"... Start the day with obstructed inguinal hernia followed by few other cases... Got a chubby one year old Indian boy allerged fall at home with laceration wounds on the tongue. The baby boy was very chubby and indeed have a hard time struggling to try to set branula for iv access...

Had 3 laparatomies yesterday ... First laparatomy - Intestinal Obstruction secondary to recurrent Ca Colon. Second laparatomy, a young 20+ chap with perforated gastric ulcer and third laparatomy, another 20+ young chap with stab wound injuries to the abdomen - complicated wtih small bowel perforation and epigastric artery tear.. Bleed quite a lot intra op but manage to stabilise his hemodynamic status after resuscitation with fluid & blood products. (This guy came into the hospital with part of the small bowel loops protruding & hanging outside the abdomen). Thought can rest after that, but had another MVA case with open fracture of lower limbs with ribs fracture.

One good thing at least there's no craniotomy yesterday... I still remember those days, whereby I had 3 craniotomies & evacuation of hematoma in a day :P till we ran out of ICU beds as well as ventilators...

Recent Heavy Downpour

Outcome of the recent heavy downpour --> falling tree branches blocking the road!!

Luckily the falling tree/branches didn't hit any passing vehicles or causing any road traffic accidents or injured anyone...

Something that catch my attention ....

I've been working in this field for many years already & throughout all these years, i have develop a very particular "habit". Nowadays, whenever i walk on the street or talk to people, it becomes a "natural response" for me to observe whether this person has any features of difficult intubation or potential difficult airway(eg. small chin, receeding chin, buck teeth, short neck, large goitre or any anatomical abnormalities etc) or looking at the hands, regarding visibility of veins; hehe... for any difficult iv or intra venous access for branula insertion. :) (especially those cute, fat, chubby babies....)

I talked with my fellow anaes colleagues before regarding this matter & apparently, I'm not the only one who do so :)

Well, throughout these years, I have intubated quite a number of difficult intubation cases, eg those with Cormack & Lehane Grade 3 laryngoscopy.. and indeed it's really hazardous if unable to maintain airway. In fact, I had 2 difficult intubation cases (Cormack & Lehane grade 3) during my last on call in Operating Theatre ... What a "bad day" to get 2 difficult intubation within few hours ...

Wyn's cute doggy..

After visiting Penang International Floral Festival 2005, i went to visit Wynnie and her "fei mui chai" doggy, Bobo.. Even though her dog is younger than Ah Boy (both are min pin), but her's is much bigger in size :)

Bobo seems quite irritable initially but with time, she became friendlier, and kept on licking and scratching my hands... (painful leh, Bobo ..).

And Bobo is very "camera shy" and dislikes taking photos.

Penang International Floral Festival 2005

Went to Penang International Floral Festival 2005 just now ( in Penang Botanical Gardens, from 29 May till 5 June, 9 am till 9 pm). Planned to go there yesterday but cancelled my plan cos of the weather. No point going there in the heavy rain :)

Initially i wanted to bring my Minolta Dimage Z2 there, but I just realised that the battery is weak; so I bring my old digital camera, Minolta Dimage E203 instead..

Not many flowers from overseas over there, only from few countries like China, Holland etc...

But i do like the giant Chrysanthemum flower from China. I took few shots of that..
compare with this.. the local chrysanthenum flower :)

Didn't stay long over there cos it's hot; moreover, i'm not really interested in flowers.. Just went there to have a look only. And I took a picture of our local national flower, hibiscus as well :) (in 3 different colours - red, yellow & pink)

I took this snapshot before i left Penang Botanical Garden, the "cannon ball tree"... I like this plant cos it's cute ...

LSCS

On call in Maternity Hospital that day.. Got lotsa emergency LSCS (Lower Segment Caesarean Section) that day,(i think 9 altogether.. started with few complicated cases in the morning... ), besides doing few epidurals for labour pain & attending referral for maternity patient with CRHD.

That night, around 2 am in the morning, there's one patient with 2 previous scar come in for labour.. As usual, i gave the patient spinal anaesthesia for the emergency LSCS, while the surgeon as well as the assistants & scrub nurses scrubbing up, preparing for the case. After i gave the spinal, the surgeon was informed by the HO that there's a cord prolapse case in the Labour Room..

Well, she had to unscrub & attended the cord prolapse case... and of course that case needed to be done first since it's really emergency.. So, we pushed the earlier patient out to the room outside the Operating theatre and observed her BP closely out there..

The cord prolapse case was done under GA. The patient was intubated with rapid sequence induction & cricoid pressure. THe LSCS went smoothly and baby came out well. I reversed the patient as usual after LSCS & sent her out the HDU for post op monitoring.. Later, i pushed back the other case back for LSCS, but her spinal effect already wear off since it's more than one and half hours .. Need to intubate her as well..

Really a tiring day.. I think it's almost 6 am already by the time the LSCS ended...

Gawai Festival

So fast, today is 1st June 2005.. It's really amazing how time flies...

1st June.. well, it's another day in the 365 days over here in Peninsular Malaysia, but things are different in Sarawak, the Land of Hornbills, my place of origin :) Today is the Gawai Festival (celebrated on 1st & 2nd June in Sarawak, and it's public holiday over there as well.. so folks in Sarawak has a long break for this holiday.. if they take off on Friday ...)

Gawai festival is the celebration of the end of harvesting season & the start of a new farming season. Today, throughout Sarawak, the Iban community celebrate Gawai in their long houses, villages or urban homes with open invitation, sharing the finest of their hospitality with the other communities, & not forgetting, the much merry-making, Ngajat dancing and drinking of tuak( a potent local rice wine).

Tuak... Haven't drink that for long time already.. I think the last time i drank tuak is during Gawai Festival in 1999. I was still working in Sarawak at that time.. Visit my Iban friend, she's not only my good friend, but also my housemate, university coursemate and working colleague as well.. I still keep in touch with her up to today and visit her each time I go back to Sarawak :)

Hahah... not forgetting, today is also one of my university buddy's birthday :) ...