GOODBYE 2010, HELLO 2011... reflections

FINALLY, another year had passed... and we are one year older, one year wiser, and perhaps we should count ourselves lucky that we had survived another year, made it through... while some others didn't. Working in a hospital, what more the ICU (Intensive Care Unit), kind of made me appreciate life more... now that i'm seeing death almost every day of my life... informing DIL to nearly half the patients in the ward... yup, it's a sad place, and we should appreciate every single day...


Last year, i made some reflections on the year 2009.... and this year... i think i shall make it a tradition, to reflect back again... to appreciate the gains,... acknowledge the loss... be stronger,... set new goals... and look forward for a better, brighter, if not happier, future... ^^ let's cherish and celebrate the new year together! ^^


2010 has been very eventful and fruitful for my life as a house officer in Hospital Melacca.


i remembered the girl with the ectopic pregnancy which came during my oncall with Dr Kuharaj...where the patient lost over 3 liters of blood... it keeps bleeding and pouring... Thank God, she was managed to be saved.... (read more in together, we can make a difference)


Then, there was the time i entered the houseman-greatest-feared-posting-in-hospital-melacca when i was VERY convinced that my boss loved my very much... and sometimes, i get a little demotivated as i slaved myself day and night... until one day, something GREAT happened... and changed everything.... and Dr Mitesh made it possible when i did my first skin-to-skin appendicectomy...


I entered peadiatrics.... and i learnt some interesting, yet sad stories.... and worked on every Raya Day...


and then came GA, General Anaesthesia where i actually get to do my very first spinal anaesthesia and it was AWESOME!




Well, apart from work, i did find something else...


I got very, Very, VERY CONFUSED at first....


some days could be depressing....


until finally, i found my LOVE-AT-First-Sight....


and that changed everything...




OH YES, not to forget, i had an AWESOME BIRTHDAY this year...


although i did not yet all that i've wished for...


i had a GREAT celebration with FAMILY and FRIENDS.... ^^


i got to spent it with a special someone this year.... and had some happy moments....




i keep myself reminded of my loved ones at home... my parents whom i loved very much...


Reminiscing the past made me missed my friends very much... the times we spent on the rocks.... the fun we had at SongKran  Festival, Bangkok...


oh YES, i also had some BOUTS OF PATRIOTISM....






and then i stopped at a COMMA.... and did a reflection....


Looking back, i think, generally, i had a great year... ^^

the commas in life

Uncertainties…


Life is a mystery
But a mystery can be solved
Well, Life’s mystery can’t
Which of course, complicates things further…


I cannot understand my very own life,
What more, to look out my life,
Or even bother to understanding other’s people life…


Sometimes, life feels like a [full stop]
Yeah, a [full stop]
Like it has all come to an end
And it is very VERY difficult to start a new sentence..


But my life,
At this point in time,
Maybe it feels like a [comma]
Yeah, a [comma]
Like waiting for something BIG to happen


I anticipate, yet I fear…
I fear of it being too BIG to handle
I fear it being a disappointment
And I drowned myself with millions of [what Ifs]
And then I start hitting the [backspace] button
Searching for the [delete] and [edit] key
But somehow,
Somehow, life does not allow that.
No, it does not.
Life just does not work that way.


So, long I stood,
There,
Just before the [comma]…

Pencil vs Eraser

 

Pencil: I'm sorry.


Eraser: For what? You didn't do anything wrong.


Pencil: I'm sorry cos you get hurt because of me.
Whenever I made a mistake, you're always there to erase it.
But as you make my mistakes vanish, you lose a part of yourself.
You get smaller and smaller each time.


Eraser: That's true.
But I don't really mind.
You see, I was made to do this.
I was made to help you whenever you do something wrong.
Even though one day, I know I'll be gone and you'll replace me with a new one, I'm actually happy with my job.
So please, stop worrying.
I hate seeing you sad. =)

I received this from and e-mail and found this conversation between the pencil and the eraser very inspirational, therefore, sharing it with you guys...
Parents are like the eraser whereas their children are the pencil.
They're always there for their children, cleaning up their mistakes.
Sometimes along the way they get hurt and become smaller (older, and eventually pass on).
Though their children will eventually find someone new (spouse), but parents are still happy with what they do for their children and will always hate seeing their precious ones worrying or sad.


Thank you MUM & DAD... i love you very much.....


Let's celebrate our parents... glorify them... appreciate them.... and above all, love... 

Thailand trip - Bangkok, Pattaya,Ayuthaya 2008

Those sweet memories i didn't had the time to blog about... or rather the procrastination kicks in... but looking back, we did had a great time... i went to Bangkok for a vacation during my 4th year medical school during our semester break.. went there with KitJing & sis, Queen, Scent and visited my good friends Nic, Ayuii & Golf... It was songkran festival, the water festival... it was so fun,.. and we got all wet...

missed them!

on the rocks...

i guess everyone has a rock story...

and this post is about being on the rocks...

like totally literally...
and no, it's not just about drinking...

and totally jiwang-ly...

saja...

Audrey on the rocks..

Audrey on the rocks..

shinyin on the rocks...

shinyin on the rocks...

shinyin on the rocks...

kitJing on the rocks...

kitJing & shinyin on the rocks...

kitJing on the rocks...

kitJing & shinyin on the rocks...

cherryQueen & kitJing on the rocks...

cherryQueen on the rocks...

kitJing on the rocks...

cherryQueen on the rocks...

cherryQueen & balaK on the rocks...

 balaK on the rocks...

 balaK on the rocks...

 balaK on the rocks...

kitJing on the rocks...

togather-gather on  the rocks...

i know, this post a little fei.. but i memang feeling damn sien ma..

p/s: if you have a rock picture that you'll like to share, kinda inform me, i'll be glad to add them to the rock collection.. hehe... after all, life is sien, so why not?

My first Spinal Anesthesia Experience

‘First give-PUSH, Second give- STOP’

‘First give-PUSH, Second give- STOP’

‘First give-PUSH, Second give- STOP’

The thoughts rolled through my mine, repeatedly, again and again, as I scrubbed my hands. It had been quite a while since I last scrubbed into the OR. My head goes through the process again, picturing myself doing it. Briefly, swiftly. I have seen this many times, I can do it – I tried to deceive myself, or rather, encourage.

The emotion tensed. My MO pat my shoulder, as if giving reassurance.

I am ready.

I have to be.

I put on my surgical gown. Glove size 6 and a half. Latex.

I spread the sterile set, arranging the instruments the way I liked it to be.

With my right hand, I shaked the 0.5% heavy bupivacaine, to-and-fro. Then, break the vial.

I carefully attached the 21G green needle to the 5cc syringe. 2cc was syringed out from the vial.

I added 0.5cc fentanyl, making it a total of 2.5 cc.

In another syringe, I syringed out 2cc of Lignocaine 2% (Local Analgesia).

I folded the the sterile green gauze into triangular shapes , neatly and placed them into a galipod as my assistant poured some disinfectant inside.

I prepared the spinal 25G Pencan needle, putting it through a 21G needle.

Then, I took a deep breath.

It is time.

My patient was seated up on the operating table, with straight back, head looking down, arms hugging a pillow.

‘Encik, doctor nak cuci belakang ya. Sejuk sikit. Cuba relax’ I said, with my awfully broken bahasa, with attempts to comfort the patient.

With a sponge forceps holding the green gauze, I cleaned the procedure site in circular motion. I repeated this procedure again, and then draped the site with a grean cyst towel.

I run my fingers by the sides of the man, trying to feel for the protruding bone (PSIS) and palpating for the intravertebrae space, locating for L4-L5. I marked the area.

‘Doktor nak bagi ubat tahan sakit ya. Sakit sikit macam semut gigit ya. Encik sabar ya.’ I said and injected the local analgesia.

Then I took a deep breathe.

‘Encik relax ya, badan tegak, kepala tunduk bawah. Doktor nak injek ubat ya. Cuba jangan gerak’

I rechecked the marking and space.

With the 21G needle guiding my 25G spinal pencan needle, I inserted the needle into the marked area, towards L4-L5.

I felt a resistance at first, then a give. –THE FIRST GIVE, I reminded myself.

Then, I inserted the spinal needle further, then I felt some resistant, gritty sensation, then another give –THE SECOND GIVE.

YES, this should be it!

I removed the trochar (inner needle).

I felt almost euphoric when I saw what I saw.

Clear CSF flowing out, driping out at the end of it, drop by drop.

Thank you GOD! My heart shouted.

I reconfirmed the flow with a syringe, slowly. Good flow. Then, slowly, I injected the prepared anesthetic solution in.

With a breath, I removed the needle.

The Staff Nurse sprayed the operation site and plastered it with a gauze. ‘Bolehlah jadi MO GA nanti’, she teased me.

The patient was layed flat again.

I monitored the blood pressure, making sure it do not drop drastically.

‘Encik okay tak? Boleh cuba angkat kaki’ I said.

‘Tak bolehlah,' he said. 'Kaki berat’ he replied.

‘Jangan risau, Ini kesan daripada ubat bius. Kalau rasa sakit, beritahu ya’ I said.

The surgeon rechecked with a forcep. –No pain

‘You may proceed’

He made an incision –No Pain.

YES, the spinal worked.

The surgery went well, completed in 49minutes. Patient had good anesthesia. Thank God for that.

I documented – No difficulty during procedure, single attempt, atraumatic tip, clear CSF, good flow.

My MO teased me, ‘There, wasn’t that hard, isn’t it?’

YA RITE! (sarcastically)

THERE – my first spinal.

The satisfaction & feeling – PRICELESS!

Gee, I think I am starting to like GA!! (well, maybe)

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-For the benefit of Non-medical related fields reader,below are some terms and  abbrevations used in the above article:

OR = Operating Room

MO=Medical Officer

CSF = CerebroSpinalFluid

PSIS =Posterior Superior Illiac Spine (at the level of L4-L5)

L4-L5 = Lumbar spine bone level 4 - 5

heavy bupivaccaine = anesthesia solution

Lignocaine = local analgesia

euphoric = high peak of joy, happiness

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DISCLAIMER: The author will not be responsible if this article or part of this article is used as a guide to one's medical practice. note that this is the author's personal experience and should never be used as a guideline.

ACKNOWLEDGEMENT:

Acknowledgement to Datin, The HOD, for permiting and encouraging House Officers to perform procedures under supervision and provide a good learning environment.

Acknowledgement to Medical Officers & Specialists for teaching us with patience and giving us the opportunity to learn and grow into better doctors.

Acknowledgement to my collegues and other House Officers for helping one another, and encouraging each other as we go through housemanship.

Acknowledgement to the hospital staff, staff nurses, PPKs, for being supportive.

Most importantly, Acknowledgement to patients, for having trust in us.

THANK YOU