You know the way people complain about their siblings? Well, apparently having sisters is good for you and having brothers has the opposite effect. Then again, it’s not as if us girls didn’t know about this already, right?
Researchers quizzed 571 people aged 17 to 25 about their lives and found those who grew up with [...]
You know the way people complain about their siblings? Well, apparently having sisters is good for you and having brothers has the opposite effect. Then again, it’s not as if us girls didn’t know about this already, right?
Researchers quizzed 571 people aged 17 to 25 about their lives and found those who grew up with sisters were more likely to be happy and balanced.
I just blogged about the doubts the registrars and consultants have against an Intern working in an Emergency Department. Well, today, I just gave another reason for their case. It’s regarding a 4 month old baby girl. To those who really hated paediatrics during their medical student years, I hope they yet to pop the [...]
I just blogged about the doubts the registrars and consultants have against an Intern working in an Emergency Department. Well, today, I just gave another reason for their case. It’s regarding a 4 month old baby girl. To those who really hated paediatrics during their medical student years, I hope they yet to pop the champagne, for, albeit not having to do a Paediatric rotation as an intern, you will still come across them during the Emergency rotation. Same applies for O&G and psychiatry.
Back to my patient. I still can’t grasp the art of listening to a chest of >50 breaths/min accompanied by the baby’s cries. I called a “bilateral crackles” on her and increased work of breathing. The paediatric registrar clearly had not been impressed with my work, writing and emphasising the words “NO increased WoB, CHEST CLEAR” in the patient’s notes. No wonder my consultant called a “Fever with no focus” on the patient, she didn’t mention anything about my examination findings as well. Alright, fast forward a little bit, the X-ray of the 4 monther showed something not very reassuring at all. A widened mediastinum, coupled with a 2/52 of fever and raised WCC with normal CRP. That’s not reassuring at all. It points towards something really bad and cynical. Let’s hope it all goes well for her.
Maybe I am glorifying the Emergency job here a little bit. But really, starting out in the Emergency as a new doctor is a very steep learning curve. Especially there isn’t exactly a clear line between General Medicine and Specialty medicine and sometimes between the various specialties. I can almost imagine this conversation taking place in the ED.
~.~.~.~.~
Xiao : Hello, I am Xiao, one of the interns from the Emergency. I am looking for the nephrologist.
Doc : Yes,speaking.*yawn* What can I do for you?
Xiao : I’ve got this patient …..*yada ya..*
Doc : Wait wait. Why do you refer this patient to me?!?! Shouldn’t he go under Gen Med?
Xiao : I’ve spoken to them, they think this patient should come under renal.
Doc : If they think the patient should come under renal, THEY should talk to me. Get them to talk to me! *click*
~.~.~.~.~
Xiao : Hello, I am Xiao, one of the interns from the Emergency. I am looking for the nephrologist.
Doc : Yes,speaking.*yawn* What can I do for you?
Xiao : I’ve got this patient …..*yada ya..*
Doc : Wait wait. Why do you refer this patient to me?!?! Are you sure this is not a UROLOGY problem? You’ve done a CT KUB yet?
Xiao :CT KUB can only be done earliest tomorrow morning.
Doc : Then do it in the morning then speak to me. *click*
~.~.~.~.~
Xiao : Hello, I am Xiao, one of the interns from the Emergency. I am looking for the nephrologist.
Doc : Yes,speaking.*yawn* What can I do for you?
Xiao : I’ve got this patient …..*yada ya..*
Doc : Wait wait. Why do you refer this patient to me?!? This’s obviously a problem of the PROXIMAL tubule. I’m a DISTAL NEPHROLOGIST. You should get in touch with the PROXIMAL nephrologist, not me! *click*
~.~.~.~.~
Maybe some of the scenarios I painted above may not make medical sense. Oh well, I am a bit too tired to take note of it. In actuality, the seniors and the registrars here are generally very nice. However, everyone got their bad days. Even on their bad days, they are not even half that mean to slam the phone on me. Hehe. I’ve always keep this in mind:
If shit happens to the patients you see in the ward, you can always call a MET.
If shit happens to the patients you’ve discharged in the Emergency, you call your indemnity lawyer.
Inevitably history will judge Abdullah as a weak and ineffective PM, one whose tenure is embarrassingly amongst the shortest in history. In fact his tenure would have been the shortest if not because he managed to delay it so that he has more than one month longer in record than Tun Hessein Onn.
It's nice to wake up at the ungodly hour of 9am, without being jolted out of sleep by the alarm and knowing that, if I chose, I could go on sleeping and no one would be harmed in the least (not that they would anyway).
So had a relatively lazy Saturday where I finally dragged myself out of the house to the Liverpool Empire to catch the Witches of Eastwick. It was surprisingly good, and provided plenty of entertaining moments, though we did wonder about the subject matter and there being plenty of kids around - colorful language and sexual innuendo abounded - parents would have a lot of explaining to do.
The story, for those too lazy to follow the links, revolves around 3 women living in a town small enough that everyone knows who's seeing who, and the conjuring up of a devilishly handsome man that proceeds to charm the lady-folk of the town, with both creepy and hilarious effects.
Here's hoping Riverdance will at least be as good when we watch them in April!
Saturday night saw us at Jody's where a number of Malaysian medics had been invited. It was nice to kick back and chat, if a little too medical-oriented:-) (what an amazing phenomenon that when medics gather, the conversation always turns back to work) and considering his house wasn't too far from ours, we stumbled home at 1am without too much difficulty.
Have decided in bits what to talk about on Thursday (benign prostatic hyperplasia management) and am a little miffed at finding out I am working the next couple of bank holidays.
It's been exactly 4 years since I started this blog. Reading through my Blogger archives was a fun - and occasionally, embarrassing - experience, and I don't think I regret most of what I've written.
However, I am getting older, and going to start work in government service soon, and what I write will become more of a liability to myself. So, I've decided to go someplace I can be a bit more discreet. And avoid the saboteurs described in an earlier post.
Thank you all who have followed me thus far, including linking me, and should you still be interested in following my life & my views (chewah!), my infrequent postings can now be found at sheenapunya.wordpress.com.
Everything was so easy, living in the bush. Lots of work to do, with concrete ends in mind. Coming back to the real world, with unending bad news, and myriad ways for me to make my life complicated, makes me yearn to be back in the quiet rhythm of life. But life is meant to be complicated I guess. I wish I didn't have to make it so.
On another note, some pictures up on Facebook. Ly Anh's here in Kuching so doing the tourist thing again, so will update more in a few days time. Lots of thoughts running through my head, but they're not able to be run out onto paper or screen. Sigh.
Being at home for so long has rendered this blog nearly forgotten about. But I'm back. For now at least. I only blog when I'm ridiculously bored or utterly depressed, and it seems I have been neither of late.
Like today, I went to KL. As embarrassing as it may sound, today was one of only a handful of personal trips to the city in my entire lifetime. This of course doesn't include the times I'm merely sending someone somewhere there.
Because today seemed to be the day of firsts, I had my first taste of Spanish food too. Apparently 'tapas' means 'really pricey food served in really small portions'. And Paella is like the fried rice you can get at SS2, except devoid of MSG and approximately nine (9!!!) times more expensive. I might as well have EATEN the money I spent tonight; maybe I wouldn't be nearly as hungry as I am now (digging through a snack plate and a Zinger meal as I type).
Things started to look up as we headed out to Luna Bar. 33 floors up. Chairs, lounges, sofas surrounding the hotel swimming pool, overlooking a brilliantly lit half of the twin towers rising into the night sky. And some annoying club-like music in the background that threatened to detract from the ambiance. But still the good company more than made up for it :)
A beer and a few cocktails later (including a Flaming Lamborghini, which turned out to be as interesting a show as it was a drink), we headed back to the Grand Millenium. Any hotel with a lobby big enough to get lost in is worth 5 stars, and this was one of them. I would've crashed in the sofa, but I sobered up enough to head off home and spare my friends from having to sleep through my snoring.
Then I stopped by KFC, and I here I am, chomping on cheesy wedges.
In the comfort of my own home.
Listening to John Mayer before I go to bed.
In Your Atmosphere
I don't think I'm gonna go to LA anymore I don't think I'm gonna go to LA anymore I don't know what it's like to land And not race to your door I don't think I'm gonna go to LA anymore
I don't think I'm gonna go to LA anymore I'm not sure that I ever really could Hold on to your hotel key of your bedroom neighborhood We're sleep walkin' in Hollywood
I'm gonna steer clear I burn up in your atmosphere I'm gonna steer clear Cause I'd die if I saw you I'd die if I didn't see you there So I don't think I'm gonna go to LA anymore
I don't think I'm gonna go to LA anymore I get lost on the boulevard at night Without your voice to tell me 'I love you, take a right' The ten and the two is the loneliest sight
I'm gonna steer clear I burn up in your atmosphere I'm gonna steer clear Cause I'd die if I saw you I'd die if I didn't see you I'm gonna steer clear, oh yeah I burn up in your atmosphere I'm gonna steer clear Cause I'd die if I saw you I'd die if I didn't see you there See you there
I think I'm gonna stay, gonna stay... All the street lights say nevermind, nevermind All the canyon lines say nevermind Sunset says we see this all the time Nevermind, never you mind..
Honestly, I have lost my creativity and wit to transform thoughts into words after this unforgivable disappearance from blogsphere.
Today is the first time in 3 years since my adventure in Glasgow has left me feeling naked, unshielded and insecure. Glasgow has been sunny miraculously since passing my exams, 4 days ago. And it is still sunny.
I was comatosed in bed when I heard the loud unhappy snap of my letter box at 930 this morning. The sinister loud clasp of the letter box was like a warning sign to me, I knew the postman was up to something bad.
There was a huge white enveloped lying at my feet, it looked pretty harmless except for the bold Clydesdale Bank print staring at me challengingly. Unable to take challenge, I peeled the envelope violently. I recalled vividly opting for the ‘paperless technology’, as denying a hard copy of your bank statement not only keeps you happy as you remain oblivious to your spendings, it also saves trees! You happy, the trees happy!
THEN IT HIT ME! £389.27! £389.27!
The bank was writing to tell me that’s all I have! Eyes still sore from the 68th episode of The Gems of Life at 4am yesterday, I re-scanned the blurry pathetic figures which announced my severe state of poverty.
£389.27.
Apparently, Mr. Clydesdale was writing to tell me that my standing order for flat rent would not go through the next month if I didn’t feed my account. Oh, and I conveniently forgot that my scholarship had officially ended - 1 month after my finals. This 389.27 was meant to pay for my rent, my unlimited cinema movie card, my mobile bill, my tesco shoppings, not to mention my very occasional wee indulgences for the next freakin' 4 months!!!
Limp, I leaned against the couch and wondered about my imminent bitter fate. Behind my bank statement a glittery envelope from New Look beaconed….
I got a bright pink New Look credit card which showed that my £28 debt was due!
I ignored the sour taste of regurgitated acid in my mouth and decided to pretend that these all did not exist.
Now, let’s see... what I am going to wear for the Salsa class later…the lesson fee goes to Wateraid charity ohkay!
KUALA LUMPUR: The Ministry of Health will soon introduce a two-and-a-half year diploma course in Islamic Medical Practice at a local university here.
The director of the ministry's Traditional and Complementary Medicine (T&CM) Division, Dr Ramli Abd Ghani, told Bernama the course content was developed with the assistance of prominent local practitioners like Dr Harun Din, Datuk Amran Kasimin, Dr Hatta Sharom and other T&CM practitioners.
The aim was to train Malay healers in the true teachings of Islam and to avoid "syrik and khurafat" (polytheism) practices in some Malay-Muslim communities, he said.
Dr Ramli said the graduates, who would be certified registered practitioners, would be self-employed to treat "santau" (a kind of deadly poison coupled with magical incantations) and other spiritual problems.
They might also be employed in selected government institutions in the future, he added.
Dr Ramli said the division was also working on introducing degree courses in traditional Chinese medicine, acupuncture, naturopathy, homeopathy, Malay medicine, Ayurvedic medicine and Chiropractic care.
It would also introduce diploma courses in acupuncture, naturopathy, aromatherapy, reflexology and Malay massage, he added.
Dr Ramli said these courses could be offered at the International Medical University, Universiti Sains Malaysia, Inti College, Cyberjaya University College and Community College.
Most of these courses would be conducted by local lecturers and some, like Chinese traditional medicine, acupuncture and Ayurveda, might need the assistance of foreign academicians, he said.
Dr Ramli said the division was also working with the Association of Malaysian Spas (AMSPA) operators to establish local training institutions so as to develop the local spa industry for health tourism.
He gave the assurance that all these courses, which were part of the T&CM, would be properly evaluated with the cooperation of the Malaysian Qualifications Agency (MQA) and it would be ensured that the practitioners provided safe and effective services.
He said the T&CM was gaining worldwide recognition, and that Malaysia would also develop this sector as it was popular among Malaysians because almost 14,000 patients had opted for the T&CM since its introduction in three government hospitals, in Putrajaya, Kepala Batas and Johore Baru, about 18 months ago.
Dr Ramli said the division was set to expand the service to three other government hospitals one each in Terengganu, Sabah and Sarawak by August this year.
He said that by 2010, the T&CM service would be available in 10 government hospitals and two clinics in the country. - Bernama
Seriously the minister of traditional and complementary medicine needs to resit his degree. Complementary medicine is one thing, quack is another. Degree in Naturopathy? Homeopathy? Chiropractors? Dude, don't you know these things have NO evidence at all?
Employing graduates to treat spiritual stuff in government institutions? What's he thinking? As if medical resources are thin enough.
I love it because it is just the right size, not too big like some how malls are that when you are at 1 end and realise you forgot to get something from the other end the very thought of hiking all the way just repels whatever crave you had to shop.
AND they have
Sake Sushi if you want to splurge, Roti Boy if you dont want to splurge MPH is you want to splurge, Reader's Corner if you dont want to splurge Parksons if you want to splurge, Flea Market if you dont want to splurge Key Ng is you want to splurge, Love It if you dont want to splurge Handphone dealers and techie shops if you wanna upgrade yourself, maxis reload centre if you cant afford to upgrade yourself
The ambiance just makes me sigh with contentment, just thinking about skipping up the carpeted slopes makes me happy! (oh ya 1 weird fact about the place though, the architecture might be alil confusing for beginners, because they have slopes connecting certain levels and to get to the other level you might have to make a big round)
YeappaedsEOP is over and done with, not as bad asaforecasted. My case was a newly diagnosed Diabetes Type1 presenting with a DKA. I never really imagined the social impact of such a diagnosis on a child before; until i saw it infront of me. I listened as the MO was counseling the mother about a "21 food exchange". Diabetics especially type1 where there is near total deficiency of insulin, have to watch the amount of carbohydrates they feed into their bodies. Too much and they can go into DKA like this little girl, too little and they can have hypoglycaemic attacks because of the insulin they are injecting into themselves. In the "21 food exchange" she can basically eat as much fibre, meat, fats, other food groups as she wants, but when it comes to carbs there was a certain formula. In the list given to the mother, there was a section listing all possible forms of carbs one would take bread, noodles, rice, crackers, and next to each was a measurement correlating to portions, like say 2 spoons of noodles equals 1 carb portion etc. So in a day, she was to take 21 portions of carbs, devided 5 for breakie, lunch, dinner making a total of 15; and 2 portions for morning tea, evening tea and supper (if im not mistaken) respectively making a total of 21. Obviously her mother was paying full attention to what the MO was telling her, and i have full confidence from the resolution in her eyes that she would do all she could do to monitor her daughter's carbs intake. But looking at the little girl, i worried. She was four, and still had that mischievousness about her that was expected, could she carry this lifestyle the rest of her life? Knowing that an unaccounted for mentos or ice cold cocacola after sports day could land you in a hopital bed? Injecting yourself with insulin 3 times a day before you even know what intravenous drug users are? Tough.
And we've seen cases of uncontrolled DM1 in teenagers, whether it is rebellion poking its early head or pure lack of motivation (which is logical, how could anyone be motivated to poke themselves with needles day in day out, minus the high drug users get? you're not even entitled to a sugar rush), it is dangerous if someone doesn't get into these kids soon and get them to want to want to participate in their own health.
Okay so that was exam on wednesday, but we have a class that was postponed to friday afternoon (the very class im waiting for now) so i was stuck here waiting for time to pass in my room as the others continued preparing for their EOP on thurs and friday respectively. I could have used the extra day or two i had to do something productive like finish some PaedsMCQ questions to prepare for the paper in May, or finish my IMS also due in May, but
I'm gonna look back on this day and *tsktsktsk * myself, for which medical student facing EOS semester completely wastes 2 precious days lazing around doing nothing? I amaze myself.
BUT i read my Neil Gaiman he is good, although abit freakish at times, but goooood! and started abit on IMSlar so im not a total slob, not yet but very close.
Many times this week i found myself with the urge to vent out and whine, about circumstances, humans, myself, things, and i realised how dangerous this blog could be had i not been the forgetful and lazy person i am. Had i not been too lazy to come up with clever ways of writing something but at the same time concealing something, so people would not go "OMG i know who she is talking about *psst psst*", i would have been close to making a big mistake. It is quite a job taking responsibility for our tongue. And although it would have given me GREAT satisfaction to get it all out, maybe get a few "here here" ,i know in a long run it ruins people and relationships. Tough being the one with a brain. When you are expected to be the civil one, you are not given credit for any good behaviour just scrutiny and wagging fingers the minute a strand is out of line, but when four legged creatures start walking on 2 and behaving, all heaven opens up in hallelujahs.
cheonghei matters aside, T-minus 6 hours to Subang Parade!
1. Midway through my paediatrics posting.. and I realised that I still have a long way to go, from the backlogged amount of things I need to read up, to the online assignments (doing it can be the bane of my existence since I can be real ignorant about EBCP and HSM). Ok, so I've gone from never handling a child before, to watching one die during emergency resuscitation (heart failure) last week, to entering the neonatal ward (finally).. At times during classes, can feel kind of stupid lar when quite a number of questions duno how to answer (still in the process of refreshing medicine and surgery from last year), but at times, I also duno how to impart to people who asked that I survived (or should I said stumbled my way thru) last year not by my ability or intelligent capacity (ie not by how much i studied), but by God's grace..
2. A phone call from home left me with something I don't really need at this point of time: a reminder of past and ongoing issues. Nevertheless coping with God's grace.
3. 2 weeks ago, watched a movie - Fireproof; about a firefighter whose 7 year marriage is falling apart, amid his attitude problems. As they prepare for divorce, his father challenged him to a 40-day love dare to save their marriage.
From the movie, 2 scenes struck me deep inside: 1. Caleb's dad suggested that things probably are not working probably because he is just doing the bare minimum to get past. In other words, need to go all out and give our best. 2. After Day 20, Caleb becomes frustrated that his wife is not responding at all to his efforts, because he has been relying on his own strength. His dad explained to him that the halfway point is the most difficult because you have to decide whether your heart is really into it or not.
Ever felt that with very passing day, as we get busier, as new things pop up, as if you are knocking on a door which will never ever open? But I wanna thank a friend who forwarded his reflection on whether certain things are worth it. In the past few weeks, thankful to have been refreshed.. Stories of Joseph who went from prison to prime minister, the 4 men helping the paralytic through the roof and the woman with a blood disorder who pushed through the crowd; people who got more than they could have ever imagined.
Yesterday Sunday worship, there was a song that really spoke to my heart, it was previously sung by one sister, a teacher, who shared her testimony last week - in summary how people around her did not give up on her, and despite the various trials and challenges, her persistence paid off, her character got moulded as she continued to lay down herself, and she was able to be a blessing and encouragement to many people. A simple song, but one which brought forth a deep longing and revival inside which I have not felt in a while.. Responded, knelt down and prayed. Kukerjakan VisiMu
Bawaku berjalan bersamaMu Tuhanlah yang jadi kekuatanKu Dan taruh RohMu dalam hati ku Agarku kenal kehendakMu
Chorus Ini aku ingatlah Tuhan Ku berikan hidupku bagi Mu Berapapun harga yang 'kan ku bayar Kukerjakan visiMu
This week has been just non stop eating and sleeping, and I can literally feel my pants getting tighter! No joke! More reasons to shop? If my half empty wallet agrees, that is...
But back to food and more food, this week had been CRAZY! (feels weird saying this after Psychiatry) Ordering in or being master chefs ourselves, we had fun, be it -
posing with the food, all engrossed in preparing them, taking a rest bite while making them, caught eating them,
or simply cooking them, we had an enormous deal of craic, not to mention stuffing ourselves silly with our own creation and masterpieces. All these talking will not suffice, if I don't display our array of mouth-watering work to make stomachs growl. (I know mine is at the moment...)
As all of you might have known, I had such a week due to a coward joker who imposed me and left a comment at POTS blog. God bless you, for who you know you are, you really need it.
I would like to share something with all of you, my gf sent this to me [...]
As all of you might have known, I had such a week due to a coward joker who imposed me and left a comment at POTS blog. God bless you, for who you know you are, you really need it.
I would like to share something with all of you, my gf sent this to me when I was facing this problem and it did help to calm me down and think carefully how to face this problem. Here it is, written by Daisaku Ikeda, a prominent figure in the buddhist world.
” One cannot become a starring player in life if one is easily swayed by one’s emotions over every little thing. Strength of character lies in performing the drama of life with courage and confidence, practicing self-reflection and self-control under any circumstances. “
I would once again like to extend my heartfelt gratitude to my family members and gf who have been so supportive of me, my friends for believing in me, and to YOU, thank you for making me realised that I’m so lucky to have such great people around me, and teaching me such a valuable lesson in life.
" target="_blank">Myriad of experiences
