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Friday, December 31, 2010

Penutup Tahun 2010: The book

Dah pon 31st Dec 2010. Abis dah 2010, new year start esok. Macam-macam jadi this year, and I'm sure all these are only for the better of us masing-masing kan.
Okay, seb baik aku teringat buku baru yg aku buka masa awal 2010 dulu (sini). Lets look back if any of these I've achieved.

- To be happy... have I been happier this year? Probably.. still ada ups & downs but biasa la tu lumrah alam. I just have to stop & smell the flowers, enjoy the sun in my non-stop race of life.
- To remember more of the goods & let go of the bads... I've been trying bit by bit, and hidup lebih tenang by letting go of the bads.
- To work on my anger issues, and to work on my expectation to others... Again, bit by bit & its getting better. (Pikir pasal kulit je, kalau tensen-tensen selalu kulit jadi hodoh.. heheheh)
- To work on my career.. Yes, was working hard during Anaesthetic rotation, and slightly merudum along with my self-esteem sejak start ICU ni. Another milestone is dah register dgn Australasian College of Emergency Medicine, so kiranye dah dalam training. More I hafta work hard for next year's exams. This 2010 is like form 4 to me, kira cam honeymoon la konon. Next year will be my SPM year equivalent.. so kena wake up lah, work harder in 2011, no excuses!!
Huhuhu... I'm still thinking of doing something else other than medicine, but I guess hafta achieve something first at least so that I could locum bila-bila when the time comes.

- Jaga body, jaga makan, jaga kulit.. Yang ni pon merudum nampaknye this year. Happier= makan banyak junk & malas senaman. Tapi takde la naik melampau-lampau this year, just 2,3 kg je. Next year kena improve la nampaknye. I'm freaking out of my age, yo!!
- To rely less on drugs... Yang ni aku berjaya. I dont remember when the last time I had Stilnox. Mebbie ada kot 5mg 1dose, but I barely remember that, so meaning that mebbie aku takde langsung amik Stilnox this year. Antihistamine ada la kot sket-sket, but kurang than last year. This year I didnt go see a doctor for antibiotics coz I didnt catch any bacterial infection. Lega. Just lepas G.O.R. hari tu baru kena viral selsema & now recovering slowly. Body & joint aches, sometimes je amik simple analgesia & sometimes amik glucosamine. The rest I'm taking natural stuff (meaning makanan yg sedap-sedap, sihat-sihat).
- To take care of my car better & to drive better :) Alhamdulillah, driving better & selamat so far with my new baby. In terms of mandikan dia hari tu aku & adik aku basuh kereta. Before that ntah mebbie 8bulan dah kot. Hahahah. Service kereta je belum lagi. Dah berbulan-bulan due nih. Macam malas gila nak gi workshop tu. Oh, and aku dah kasi hubby drive my car sket-sket. Dulu bukan main kedeng lagi, bukan apa, aku malas nak adjust mirrors semua lepas dia drive. Leceh lah.
- To be more organized with my life :) Janji yg perlu disambung sampai akhir hayat. Especially yg berkaitan dgn filing system & internet. Aarrgghh.. internet ni memang laaaaa.
- To save more $... This year aku kagum dgn aku & hubby coz kami dah kurang shopping & only spend money wisely. Mebbie sebab dah ada tanggungjawab (kereta aku tuh, & rumah sewa baru nih) and cita-cita lain. Alhamdulillah, semoga rezeki kami bersambung & diberkatiNYA.
- To improve my cooking skills :) Boleh la sket-sket. Sejak ada oven best dalam rumah ni, lagi la semangat aku nak baking/grilling/etc. Plus dapur best kat rumah ni buat aku rasa nak masak all the time. Jimat duit boleh bawak bekal gi kerja.
- To garden more :) & care for the environment more :) Awal-awal tu especially kat rumah lama... hampeh je. Now dah kat rumah baru semangat sket. Especially the right season to bercucuk-tanam, and self-sustain lifestyle is the hot trend now. Jimat.
- To be closer to the creative side of mine :) Belum lagi nampaknye. Mebbie boleh sambung next year.
- To belajar tahan sejuk more :P I've noticed aku tahan sejuk lebih sket than before. Masa family aku datang hari tu, aku ingat aku tak tahan sejuk, but there was one time yg aku tak pakai jacket/sweater & diorang komplen sejuk. That was when aku perasan yg aku dah sedikit kebal rupanya.. selepas 10 tahun di sini, selepas 10 winter.
- To play more :D gaems, sports, boardgames, all :D Sports sendiri-sendiri like walking, jogging tu biasa la. Computer tu toksah kira la, memang hantu. Hahahha. Boardgames & games berkumpulan tu kurang sket this year coz masing-masing busy plus aku pon busy with my work. Banyak kena kerja weekends so kurang masa bersosial. See how it goes in this coming 2011.
- To improve my social life more :) Definitely, especially with my close friends & those friends that kurang spend time with sepanjang tahun ni. But will see how it goes in 2011 coz masing-masing akan jadi lebih sibuk, especially those taking exams nanti. What about with the Yang TakTerhormats? Same like the azam tahun 2010, again aku nak get on with my life & ignore this matter.

- To do more for my family :) and those precious people around me :) Yes, this year. Aku bersyukur, Alhamdulillah, dapat spend banyak masa this time with these precious ones. But tu lah, coz of my career tak tau la mcm mana in 2011 ni.
- Last but not least... most important... to improve my relationship with beloved hubby...
Continuous no question.. Semoga kami bahagia ke akhir hayat & sentiasa diberkatiNYA.. amin..

There, banyak rupenye azam tahun baru 2010 dulu. Kita tengok cam mana aku punye azam tahun baru 2011 nanti. Azam tahun baru awal Muharram dulu kira tak?

Selamat Tahun Baru 2011 everyone
Semoga apa yg dicita menjadi kenyataan, with all hard & smart work, luck & joy.
Take care, all.

Penutup Tahun 2010: Hot hot hot STUFF!!

Beberapa kali aku bangun tengah malam tadi coz panas & dahaga. I knew that it was going to be a scorching 40°c today with crazy wind. Pagi ni cepat-cepat buat laundry apa yg patut. Masa jemur kain & water the garden pon dah panas + humid. Terasa cam kat KL time tgh hari. Lucky this new house is cooler than the old one. Masuk rumah rasa sejuk sket, but tak lama lepas tu kena pasang kipas.

Sebulan dah Melbourne rugi nice summer weather. Ingat lagi aku dok bebel-bebel the horrible summer weather a few weeks back. La ni baru nak start summer gila in real time. Fenomena cuaca La Nina (adik pompuan kepada El Nino). Does that mean that we are gonna get late winter? Bagus jugak tuh.

Best eh weather kali ni?
Tengok weather forecast yg aku saved dlm 1hour ago. Temperature tulis 31°c masa tu. Bila aku tengok balik la ni dia tulis 33°c, and its 12pm already, I'm sure the temperature will continue to rise until it reaches the lovely 40°c! Masa tu baru la tau cam mana this house withstand the heat. Kalau rumah lama tu, around 35°c dah rasa nak pengsan dah despite bergelen-gelen air minum & macam-macam kipas pasang. And Vic gov dah kasi amaran about fire, mostly pasal angin kuat not bcoz of the temperature. Aku doakan takde la bush fire this time. Kasihan bumi ini.

Tengok weather forecast kat tempat-tempat lain kat Aussie ni. Wah,
jiran kami Adelaide pon blistering hot jugak! Queensland now banjir besar, meaning harga pisang, mangoes & some other fruits & vegies akan melambung-lambung la. Victoria banyak import raw food items from Queensland. Sydney punye temperature milder than Melbourne & Adelaide. Nampak mcm best je, but living cost there melampau. Perth hari ni cooler than Melbourne coz I guess they have had their heat wave a few days/ weeks back. So kiranye ni giliran Melbourne la eh.

Haaaaa.. ada bakat tak aku jadi weather gal kat TV?

Hmm... nak gi tengok fireworks tonite. Aku masih lagi jakun dengan fireworks until now. Esp. now nak tengok cam mana my tax money dibakar setiap tahun for the New Year & Mumba festival.
Kan best kalau family aku ada to watch the fireworks together.

Thursday, December 30, 2010

Great Ocean Road: Cape Otway

Lama dah aku biar blog ni bersawang. La ni baru sampai seru nak sambung balik. Seb baik langit cerah.. perfect blue sky gitu. Time yg sangat best buat laundry. Aku capai je apa yg boleh dibasuh walaupon bakul laundry dah kosong. Rugi biarkan cahaya matahari begitu saja. Pagi2 tadi dah gi attend my garden.

Last Sunday 19-12-2010, my family & I went to Port Campbell National Park situated in the very far West of Victoria. Di sinilah terletaknye the famous Twelve Apostles (now dah jadi 7 coz batu2nye collapsed a few years back). This is the most famous attraction sepanjang Great Ocean Road. The cliffs & pantai ni menarik & penuh sejarah coz menjadi tempat settlement oleh pelayar2 dari UK mostly back in kurun ke-18 & kurun ke-19. Also byk tempat2 ni ada kesan2 kapal2 tenggelam dulu.

We took the long route iaitu sepanjang Great Ocean Road yg sangat panjang itu dari lepas Geelong sana sampai la ke hujung dekat-dekat Warnambool. Saja ikut jalan jauh coz nak tengok the cliffs & laut. Hujan kejap lebat kejap rintik2 kejap suam kejap. Aku drive cam kura-kura sepanjang jalan belit2 tu. Takut wwoooo.. member aku pernah role over accident kat jalan tu. Dah la hujan lebat poor view lagi. Perjalanan ke cabin kami di Eastern Reef, Port Campbell tu took about 7 hours, sepatutnye dlm 4-5hours la. Tapi pasal jalan cam kura-kura & stop byk tempat tu yg lama tu.
Oh ye, hubby tak ikut coz he had to go to work. Best kalau dia dapat ikut skali.

We stopped kat Apollo Bay konon nak lunch break kat park situ. Malangnye hujan lebat gila so makan dalam kereta je la. Sebelum tu ada lalu this lighthouse, Split Point Lighthouse before sampai Apollo Bay. Tapi malas la nak singgah coz hujan.

Peta besi kat info centre Apollo Bay. Yg X tu ialah Melbourne.
We were heading to Cape Otway, then Port Campbell.
Then kami teruskan perjalanan ke Cape Otway, tempat paling hujung/south di Victoria ni. Terasa cam hujung dunia pun ada. As expected tempat ni mendapat segala macam angin dari South Pole sana. This is where the Cape Otway Lighthouse is situated. Cam tak caya je hujung dunia ni ada lighthouse gak. On the way berhenti sebentar tepi jalan kat hutan tu coz ada free range while koalas kat pokok2 eucalyptus.

Perjalanan ke Cape Otway lighthouse
Hutan simpanan di mana koala bebas. Ada nampak koalas?
Two of them.. mak & anak
Lagi
Cuba cari lagi mana koala-koala itu?
(sambil nyanyi lagu 'Where's Koala', ikut lagu 'Where's Wally')
Hensem tak adik aku sorang ni? Ada sapa-sapa nak berbesan ngan aku?
Cape Otway Lighthouse
Pemandangan dari atas lighthouse. Terketar-ketar jugak la dah tiba kat atas tu.
Menggigil aku amik gambar mengadap laut ni.
Angin kuat gilaaaaaa.. takut aku tergolek masuk laut
Aku cuma mampu pusing separuh je kat atas nun. Takut wooo!!
Gayat abis!
Laut dia penuh dengan batu.. imagine kalau jatuh, gol terus!
Perjalanan ke Port Campbell diteruskan. Banyak farm along the way from
Werribee tadi lagi. Nice view
To be continued...

Sunday, December 26, 2010

Sudah pulang :'(

:'( sedih pagi tadi dah hantar abah, mak & adik ke airport for their flight back to KL. It was such a short sweet break here in Melbourne, rasa tooo quick masa berlalu, not enuf :'(

And suddenly reality hits, and my chest & head hurt :'(

'Til next time, bila dah hilang homesick ni baru aku sambung memblog. I kno its been a while since I posted something but buat masa ni, like alwiz, this is my sulking time.. lucky ada lagi 1 week of annual leave, good time to sulk & recuperate & hopefully stand back up on my feet :'(

:'(

Alhamdulillah, a few hours ago dapat msg that mereka dah sampai di KL tadi dengan selamat.

Saturday, December 18, 2010

Welcome Abah, Mak, Adik kecik

Awal betul aku bangun hari ni. Kejap lagi mak, abah & adik sampai from KL. Tu la mcm-mcm plan aku for the next week ni. Surprise.. heheheh.. baru now nak tulis kat blog :P

Sambung saki baki kemas semalam. Pagi ni aku just nak kemas apa yg mampu saja. Very much apologize mak, abah & adik aku tak sempat nak kemas all.

Malam tadi sejuk gila. Almost feels like winter. Aku dikejutkan dengan storm. Aiii, cam mana la nak buat laundry, jalan-jalan nih. Tengok weather forecast jap. Uhuk, terbatuk aku tengok the temperature. Sejuknye, kesian la family aku datang sini sejuk + cuaca buruk.
Ok lah. Nak go have light breakie then siap-siap gi amik diorang kat Tullamarine Airport. Hopefully diorang selamat sampai ke bumi Melbourne ni & aku pon selamat sampai kat airport nak amik diorang. Amin. Tak cukup tido malam tadi.

Nanti sambung. Tak sabar nak jumpa diorang dah ni. :')

Kemaaaasss cepat!!

Tension gua tengok the weather forecast. Adoi.. Last week forecast kata sehari dua je akan hujan for this coming week. Rasa lega la sket kat situ. Aku ada banyak plan for this coming week.
For a start, bermulalah my 2nd annual leave for the next 20days termasuk Jumaat pagi lepas balik from night shift.

Then sejak semalam mendung je, setiap 3,4 jam aku dok tengok weather forecast mana tau tukar plak kepada cuaca best bermatahari suam-suam kuku. But until just now ini haaaa weather forecast.
Huhuhu... summer dah nak dekat sebulan dah. Tapi weather still wet spring lagi. Bila nye nak gi beach, bila nye nak gi sun bathing, bila nye nak bercucuk tanam, and yg paling penting bila nyee nak abis kan laundry yg dah menimbun tu.

Lagi satu, apsal aku still berjaga until now? Siang tadi dah tido lama, maklum la tido dalam kekecewaan yg amat sangat after night shift. Then paksa diri kemas lagi barang2 kat rumah ni. Ada banyak lagi stuff in the boxes yg amat menyakitkan mata aku. Most of things left are alat tulis books mags essentials documents masa study dulu & skarang. Tu yg dragging tu. Baju-baju & dapur & shower & living room senang je nak susun atur. Basics. Adoh. Dekat sebulan dah ni aku pindah nih... ntah bila ntah nak abis kemas.. Hubby kata hopefully we wont be moving anytime soon coz kita punya barang baaanyaaaaaaak la sangat. I hafta agree. Mostly banyak barang kumpul2 sejak zaman bujang masing-masing & sejak 10 thn dulu aku di perantauan.
Hopefully during this annual break yg sikit ni aku akan berjaya spring/summer clean my house for good lah.

Friday, December 17, 2010

Geram & lesu

Pagi semalam masa hand over kat dalam bilik meeting, lagi skali that particular boss tanya aku pasal XRay. Dia tanya pasal the equipments position on XRay i.e. the endotracheal tube (ETT), peripherally inserted central catheter (PICC), central venous catheter (CVC), intra-aortic balloon pump (IABP), etc. Biji mata aku ni dah kering tak boleh bukak dgn ngantuknye & blurry vision lagi. Seb baik aku tau jawab most of it except the IABP position :’(( Tension!!! Aku memang rasa cam nak bunuh diri lama dah setiap kali kerja dgn this consultant. Tadi pon rasa cam nak nangis la jugak, buat muka sedih lepas tak dapat jawab. Masa dah nak abis meeting tu dia mcm puji aku did a good job removing the IABP from a patient weekends hari tu. Consolidate aku nyer kesedihan. Which, saat tu aku rasa mmg nak merajuk & nangis kat situ jugak.
Aku ngadu la kat registrar aku yg dia tak suka aku tu la pasal kot dia asik put me on the spot je. Apsal org lain dia tak tanya, sedangkan bukan aku sorang je yg tak tau banyak hal kat ICU ni. Aku tanya sorang lagi resident dia tau ke apa yg si consultant tu tanya aku tadi, dia cakap dia pon tak tau & tercengang-cengang gak. Tak tau la betul ke or dia saja nak make me feel better.
Baik bangat registrar aku tu dia kata pasal dia suka la dia asik tanya je. So that aku tak lupa apa-apa yg aku belajar & supaya aku move forward. And understandably thats how they learn at Uni tu la pasal bijak sampai now. Not like how I had my studies at Monash dulu... ada pihak uni kisah tak masa tu.. huhuhu... Aku sangat tension bila tengok this particular boss rostered bila aku pon on.

Malam ni plak aku sangat bengang dgn registrar yg kerja dgn aku. Ni registrar baru bukan yg semalam punye. They rotate so that resident & registrar akan overlap, supaya satu satu cycle takkan dua-dua doc baru for that week. Aku noticed lama dah dia ni memang asik nak pick on me je. Scrutinizing betul! Dari hal aku lembap sampai la hal aku nyer work attire pon dia nak tegur. Tadi dia tegur apsal aku sensing lengan baju sampai Nampak lengan masa nak buat arterial line kat patient baru masuk ICU. Aku yg dah memang bengkek dgn dia lama plus dengan anger issue aku ni obviously lah jadi lebih bengkek. Aku jawab la balik abis tu cam mana nak buat aseptic technique kalau aku takleh sensing lengan. Dalam dok argue2 tu last-last aku snap balik, so aku ni takyah la jadi doctor ye coz kena jaga semua menda kena tutup aurat pakai jubah purdah bagai. Bagi aku, aku dah pakai kemas & menutup aurat pada standard aku untuk bekerja. Last last dia cakap dia kasi nasihat sebagai adik-abang & even his wife pon dia suruh jaga betul-betul. Last-last we dropped the subject coz masa tu aku dah berasap-asap geram tak nak cakap dengan dia.

Ok, apsal dia sibuk-sibuk, dia ni dari Negara timur tengah nun, dok Aussie to further his career coz peluang lagi bagus kat sini. And aku respect dia coz dia pandai & sebagai Muslim, dia sangat menjaga makan minum & ibadat dia. Agaknye dia dah lama kot dok perhati aku ni tak menutup aurat sangat esp. masa buat procedures or patient’s physical examinations.

Masa end of the shift lagi la sakit hati aku rasa cam nak hempuk je dia. Masa meeting hand over tu ada skit2 aku cakap in between the breaks. Pas tu dia boleh marah aku next time jangan interupt dia bila hand over. Eh boleh plak gitu. Padahal kalau registrars lain semua encourage the juniors to join in for the hand over to practice & to learn. Dia je nak supress org lain konon dia je hebat.
Hangin je aku balik rumah pagi tadi.

Susah pon susah, bagi aku hal ni lebih banyak catch 22 for duniawi reasons. Dalam hal ni aku seboleh-boleh tak nak berbicara banyak. SEmua orang tahu hal ni, and bukan hal tepuk dada tanya selera. There’s a line to follow. Islam memang is a way of life, Cuma umatnye saja yg memilih which one to follow most of the time. E.g. paling simple kalau dah pinjam barang orang silalah pulangkan balik secepat mungkin sebab kena respect tuan punye mungkin nak guna/ susahkan dia kalau takde menda tu lama. Other e.g. Islam menghormati hak-hak wanita dan lelaki, tapi sesetengah manusia memilih utk menindas the other gender. Aku rasakan iman aku masih lemah, siapalah aku untuk mengulas hal-hal ni...

Satu badan aku hangin sejak last week lagi. Aku rasa sangat marah, at the same time sedih. Rasa macam takde an outlet to just luahkan/vent out keserabutan otak aku ni. Kadang-kadang kalau aku tak rasa anti-social sangat aku akan share with my doc frens coz i feel like mebbie they are the ones yg paham the life of a junior docs. Orang lain hanya mampu bersimpati, kalau tak pon menyampah atas kelemahan ini...
Docs are human beings too..

Bila aku fikir-fikir balik, what am I angry about... Aku marah at the situation. Mostly marah kat diri sendiri... hal aku bengap & lembap sebenarnye salah aku. Hal aku berpakaian berpakaian pon salah aku sendiri. Sebab salah sendirilah makes me feel more frustrated + disappointed with my own self...

Dan satu kesimpulan aku out of all this.. aku benci male chauvinistic person macam si registrar timur tengah ni...!!! GRRRRRR!!!

Thursday, December 16, 2010

Pembahagian itu

4++am. I’m in ICU. Alhamdulillah semua patients stable.

Got to work early tadi, dalam 10min awal. The day docs cam pelik apsal aku awal, slalu lembap semacam je kan. Hehehe. :P
Went to send hubby to Malvern East train station coz he gotta get his car from the city. He left work early around midday coz he was unwell. Kesian hubby L I didn’t realize he called during that time coz I was already fast asleep. Bila bangun in the evening hubby was lying down flat on the floor in the lounge mengadap tv. Kesian dia. Makan pon taknak coz kurang sihat. Hopefully it wasn’t something that I made yesterday.
I didn’t get to spend that much time with him before work coz aku bangun pon lambat. Sempat makan some junks before going to work, then left to send him to the train station. Tu yg sampai awal kat spital tu :P

Kat hospital ni ada 12 ICU beds. The hospital is only funded for 9. In a critical situation where u need more beds, this hospital can create 3 more beds, provided the 6 are not that sick but not ready for ward yet that these will be stepped down to HDU (high dependency) patients, instead of ICU (intensive care). Which means, 6 will be very sick ICU patients needing 1 to 1 nursing & the other 6 will have 1-nurse-to-2-patients nursing. Kalau ada people yg need ICU beds & ICU are full, these patients will need to be transferred to a different hospital that has ICU beds available. And kalau hospital ni really desperate, the 6 HDU patients sometimes are discharged to the ward prematurely with ICU liaison team reviewing them daily on the ward. This is in term of the nursing.

In terms of satu katil brapa cost untuk man & service (linen, etc) will be ~AU$3500. Tu belum masuk if the patient needs ventilator, intra-aortic balloon pump, Vigileo cardiac index machine, monitoring, ionotropes, art line, CVP, all the nitty gritty termasuk setiap gauze, gloves, fluid drip, syringe, oxygen mask, blablablabla. Cost akan naik. So imagine if a patient is ready to go to the ward but ward bed is unavailable. So the patient will be stuck here in ICU, using all the resources that’s meant for a sicker patient needing ICU.
Expensive.

See how the resources are spread out kat spital ni? Tu baru ICU je. Well most public hospitals are like this. Ada Nampak tak kat mana funding might be a little bit not enuf along the lines?

Sibuk plak aku pasal finance & economy of the hospital. Yup, as u grow further into ur career its not only ur patients that you have to think about. U also hafta think about especially your own professional development, which means training & passing assessments. And, whether u like it or not, u hafta think about the funding distribution & expenditure of the unit u r in as well. Pretty much these will actually influence ur patients’ care. As much as ideally kita tak peduli about all these complex things and nak treat patients based on what we actually learn at uni/ along the way. But pretty much being a doctor doesn’t only mean a person who treats a patient, but also a leader, an educater, a carer of the funding, a manager, an advocate..
not to forget; a friend and a human being...

Waaahh, philosophical plak aku ye.. seperti kata one of my intensivist bosses.. ICU is all about physiology, pharmacology aaaaand philosophy.. heh..

Lepas abis shift pagi ni kena gi hantar timesheet kat HR. Nak dapat gaji kena la pegi every fortnight hantar timesheet kat building yg sama dengan psych ward tu. Bohsan betul. Setiap fortnight aku kena jalan kaki pegi situ. Kadang kalau not rostered terpaksa drive jauh-jauh semata-mata nak hantar timesheet bodo tu. Hubby kata apa punye health care system la Negara maju ni still guna paper timesheet to get paid. Apsal tak guna online system je, bukan takde technology tu kat Negara maju nih. Hmm... malas dah nak komen banyak-banyak.. just don’t get me there. Aku memang bersetuju sangat dengan kenyataan dia. Haha.

Oh ye, risau plak aku tengok weather forecast for the rest of December. Macam spring punye weather forecast plak. Aiyaaaaa... aku ada macam-macam plan for the next 2 weeks ni.
Hmm... Hujan rahmat...

But I hope that starting this end of week until at least Boxing day it will be a very nice day everyday... Amin! Ada lah plan aku, nanti cerita.

Tuesday, December 14, 2010

Baking delight!

Ni aku tengah practice stay up coz malam karang aku kerja. Last time practice memang berjaya coz aku tido kol 8pagi. Tapi now dah dekat kol 4pagi. Aku letiiih sangat. Tak abis lagi terluka pasal last week's shifts.
I woke up on Monday a.m. feeling like crap. Slalu kalau tak nak bangun dari katil is becoz aku ngantuks biasa la dah memang diri ni pemalas besar, tapi pagi tadi rasa letiiiihhh badan & emosi.. rasa cam nak baring stay sulking in bed.

Time aku decided to get out of bed was the time movie kat channel Go! baru start, movie More Than Meets the Eyes. Sedih movie ni, based on a true story about a young woman who lives with her daughter & her husband. She teaches at a school for visually impaired young children. Then she herself developed macular degeneration & loses her vision. Soon after that her husband is diagnosed of brain cancer & passes away. She & the daughter have to move to kawasan kampung near her parents' place. Macam2 hardship diorang hafta face. She becomes a successful motivational speaker & finally finds new love, a very successful wealthy man. Nangis aku tengok movie ni. Masa tu aku insaf kejap, ramai lagi manusia lagi malang dari aku yg masih ada food to eat, masih ada internet & books to study, masih ada family & friends around me, masih ada functioning brain to go through life... :'((

After doing some laundry, tergerak hati nak bake a cake for hubby since semalam tak sempat nak buat apa-apa. Ni resepi asal from Dapur Tanpa Sempadan, 'Death by Chocolate Cake' (klik here for recipe). Aku halvekan the recipe coz kami 2 orang saja dalam rumah ni. Kalau buat full recipe alamatnye sampai berkulat la kek tu dok dlm fridge. I didnt have susu cair, so aku gantikan dengan separuh susu pekat rendah lemak & separuh susu segar. Aku tersilap bubuh gula biasa instead of gula halus. Aku takde baking powder, hanya guna soda bicarb je. And aku takde loyang bunga-bunga cam yg CMG guna, so I used my small baking tray bentuk bulat. Ni la hasilnye...

To me walaupon kek ini bantat rupenye, rasanye sedaaap, the consistency dia macam brownies yg selama ni aku buat tak jadi tu. Mungkin bantat coz aku terlebih excited buka pintu oven cepat sangat nak test dah masak ke blum. Tadi masa jilat-jilat senduk lepas dah bubuh batter dalam oven rasa cam manis plak, tapi bila dah bakar not that sweet. Just nice. Ingat nak hias dengan mandarin pieces or nectarines, tapi hubby kata dia nak cam gini je. First time aku buat kek kat Aussie ni, jadi plak tu. Hehehhee.. thanks to this oven kat rumah baru ni.

Hubby dengan gaya tersendiri potong kek dari hujung sana.
Dia kata ni cara praktikal untuk potong kek!
Hubby pagi tadi cakap nak dinner tom yam. Aku teringin nak masak nasi lemak or nasi ayam. Malas nak dok lama-lama kat dapur coz of the sambal. And aku tak pernah masak nasi ayam in my whole life. Tadi dok usha-usha webbie nak masak nasi ayam, tapi teringat hubby yg teringin tom yam, so kensel je la. Next time aku berlatih masak nasi ayam. So this was our dinner tadi.

Tom yam simple, ayam bakar simple (bubuh madu, kicap, halia je),
telur masin simple, nasi goreng cina simple, air apple blackcurrent juice.. simple!
Haaa.. segala macam aku masak tadi. Aku suka masak tapi selalunye malas, bukan apa dulu malas masak coz takde masa plus dapur rumah lama tu mengah sket. Now pon malas gak masak walaupon dapur ni lebih ceria, sebab takde masa (banyak la alasannye tu). Tapi kalau time aku masak, memang all out. Pas tu hari lain mandom je saaampai la the next time aku teringin nak berasapkan dapur tu. Kagum lah aku kat orang-orang yg masak hari-hari despite diorang busy.

Now lagi 4 jam nak kol 8am. I still feel like crap. But, hafta paksa diri stay up and study. Boring betul kena study aaall the time, tapi apakan daya, otak aku tak secergas those gifted doctors/nurses kat spital tu. So kena la usaha lebih sket. Sesakit-sakit dada aku teringat diri sendiri memalukan diri for the past few weeks kat ICU, aku kena la mentabahkan diri to bangkit. Jap dengar lagu 'Above the Wreckage' from Dishwalla jap.. kasi ada feeellll nak study...

Sunday, December 12, 2010

Happy Birthday Hubby Tersayang

Happy Birthday Love!!!

(gambar from Google)
Kalau ikut waktu Aussie it will be arvo nanti baru boleh celebrate kelahiran seorang jejaka gagah kacak berani. Tapi pasal dia lahir di Scotland nun, kita celebrate pukul 2 pagi waktu Aussie (bersamaan dgn 3 petang waktu Scotland) ye? Hahahahhaa.. celebrate pagi2 buta Isnin tu pas tu terus Subuh skali. Cun gitu!
Tak sempat nak edit bagai coz aku pon dah bgn lambat to go to work. Tak best langsung kena pegi kerja on the day of orang tersayang. Mine? Tak kisah.
Malam nanti aku edit kasi entry ni cantik gila. In the meantime kasi hubby tersayang sleep in kejap.

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Updated.

Kata-kata cinta to my dear hubby takleh tayang kat sini =P Rahsia rumahtangga.. hehehehehhehe..

Came back from hospital, one of my worse shift to my self-esteem ever in my career, aku ajak hubby gi have munchies kat Pancake Parlour at Chadstone Shopping Complex. Ye la, kat Melbourne ni mana je yg bukak late other than bar & kelab malam ronggeng. Pegi je the shopping mall yg 10minit jalan kaki tu, tapi kami tak jalan kaki lah. Dah malam around 9++. Yg bukak kat situ hanyalah Pancake Parlour selain dp Coles & Woolworth.

Birthday boy tengah main internet while waiting for the food
Potato chips
Pancake, salad, baramandi with lemon butter
All in all aku takkan recommend nak makan dinner sini coz the only food yg kami boleh makan are the food yg tak sedap di tekak. Utk dessert boleh la kot or utk emergency mcm ni. Kalau kat KL nun boleh go out pekena teh tarik & nasi lemak kat small mana-mana yg masih bukak kalau aku balik lambat gini.
Esoknye tu baru aku nak masak lebih-lebih sket coz got a day off & kena stay up utk night shift on Tuesday.

Saturday, December 11, 2010

Mengisi masa lapang jap

Aku kat ICU ni. Amik break jap dp buat manyak gila discharge summary. Jap lagi kena buat lagi satu kerja paperwork in ICU. Sabar je la. Aku memang tak suka buat paperwork, tapi I guess buat paperwork in ICU buat aku berfikir sejenak pasal all these conditions.

Tadi ada neonatal code blue. My registrar was on the phone with the big boss about an unwell patient. Aku terus sprint ke maternity ward. Sampai sana baby tu dah bernafas kembali, paediatrics consultant dah ada kat situ with the whole O&G & paeds team. Baby kiranye dah selamat. Aku pon balik semula ke ICU. Registrar aku relaksasi kat kerusi depan computer. Dalam aku termengah-mengah tu dia boleh tanya.. "Why did u go there? We dont really have to go there coz we are adults ICU care." Hmm.. oooo gitu. Tapi rasanye kena pegi jugak esp. yg buat ED training coz semua org wajib tau pasal neonatal resus for ICU, Anaesthetics, ED, paeds & O&G training.

Sedih betul aku membodohkan diri depan consultant tadi. Malu gila dengan semua org di atas kebengapan aku. Rasa cam nak bunuh diri time tu jugak. Macam jauh je lagi perjalanan aku ni nak sampai tahap pandai cam gitu. If I had only a tenth of their wisdom pon aku dah bersyukur dah :(

Tension gak member2 ajak kuar makan tonite kat Megumi, Frankston. Walaupon jauh dari Chadstone, tapi agak menarik utk pegi sebab food dia sedap. Pasal aku rasa bersalah terhadap diri sendiri so I sed no to their invitation. Diorang dah pandai, plus diorang takde nak amik exam next year mcm aku (yg sorang tu kena amik exam cam aku tapi melagha gak... jeles aku). Takpe kot gi berfoya-foya gitu. Hmm.. rasanye aku kena lah jadi anti-social macam masa aku buat anaesthetics hari tu. Seksaaaaa jiwa raga aku. Kena skema for the rest of this term continuing until end of next year jugak coz exams in September 2011. Which means macam raya Aidilfitri tu sipi-sipi je.. huhuhuhu....
:'((

Friday, December 10, 2010

Takde mood hari ni =(

Dua hari dah started ICU again, dua hari takde mood. Terasa bodo, menda simple in ICU pon tak tau. Tu la padahnye asik main internet je time days off. Dah la asik kutuk org tu bengap, org ni sengal, skang sendiri bengap & sengal..
Sob sob sob.
Bagus la tu, setiap hari make a fool of urself in front of everyone.. nice one...
Lagi 2 hari over the weekends jadi sengal kat ICU okaayh.
Bagus la tu, takyah jadi doc dah lepas ni, sapa nak doc bodo kan...
Entah bila nak insap ntah..
Sob sob sob....
:'(( :'(( :'((

Wednesday, December 08, 2010

Santai jap

Sebu dah otak aku baca pasal advanced life support nih. Tak abis-abis. Baru bab cardiac arrest, tu baru secubit dari juta-juta info aku kena baca untuk advanced life support. Tepuuuuu loya dah nih.
Dah la sejuk, gelap, storm tak berhenti-henti dari pagi.

Okay, tak nak kasi otak aku arrested aku pon dok blog hopping dari semasa ke semasa.
(Haaa... mana tak nye tak abis-abis study, dok main internet je manjang).

Ehh.. break in between 2 ayat time study, kalau tak cramp la otak aku.
(Haaa.. ye la tu, buang internet tu, focus dik ooiii.. exams dah dekat kan).
Aku guna internet utk tengok all those on UpToDate, eMedicine, Medscape, etc
(Konon sangat.. lepas dua ayat, gi main fb la blog la, ntah apa-apa)
.
Tu untuk menten waras.
(Waras tengkok hang main-main time study, mana tak bengap, blablablabla... kang kat spital, sendiri mau ingat la... apa bosses botaks tu pesan hari tu?)
.
Bosses aku memang banyak yg botak, ada yg baik, ada yg jahat.. eerrkkk... SMART, SHARP, SLEEK. Bukan SLOW, STAGGERING & STOOOPID!!!
(Haaa... dah ingat dah? Sendiri mau ingat wooiii!).
Errkk..

Tu aku gaduh dgn diri sendiri.. all the time. Nope, I neither have schizophrenia nor bipolar disorder or psychosis.

Ni kena gak bubuh sini, aku sangat suka entry ini. Sempoi & geli jambul aku baca. Wakakakkaka..
Mulia betul cita-cita adik ni- things yg dia dah janji nak buat dengan bini tercintaaa.
Korang kena baca, innocent je bunyi points dia tapi very good reading. Yg penting original!!
Nih some of the snapshots dari entry dia yg aku sangat suka gelak takleh tahan.

-Pakai baju yang kaler sama. Matching tu. Baru terserlah kebahagian kami. Dan kalau ada orang nak mengorat aku. Macam "Eh eh. Mamat handsome tu dah berwife la. Rugi betul tak mengorat dia dulu. Dah la handsome. Cute pulak tuh" Okay cukup =.=

-Setiap hari akan suap makan. MAKIN GUMUK NANTI CAM NO?

- Sembahyang/Baca Al-Quran bersama :')))))))))

Adoh, aku pon nak nangis baca ayat ngaji tuh.. sob sob sob.. terharu, dik!
Haaa.. amacam, best kan entry ni? Lawak innocent cam ni memang aku suka sangat.

Salah satu hobi terbaru aku sejak aktif semula berblogging ialah blog hopping. Segala macam blog aku jengah. Life story & pengembaraan yg sempoi paling aku suka. Biasa la aku busybody tak hingat. :P Then review/step-by-step pasal food, mekap/ fesyen, yg banyak tags/survey. Dan lain-lain. As long as kemas, tak semak dgn widget2 yg kasi computer aku slow/hang, tak sakit mata silau pasal kaler coordination dia, senang nak baca coz otak aku yg serabut ni susah sket nak process menda-menda komplex kalau selain dp hal kerja.
Banyak la aku punye syarat nak baca blog orang. Blog aku? Hahhahahaha..
kan hari tu dah masuk BLog Aku Memang Best kat Ben Ashaari nyer segment.

Aku ada a whole list of blogs yg aku wajib masuk setiap hari. Yg dalam bloglist kat blog ni, yg aku follow, dan jugak yg aku bookmark. Selalunye aku bookmark dulu baru aku click button follow kat blog orang. Coz button follow tu leceh & lembap. Kengkadang lupa terus nak follow. So kalau aku takde dlm follower korang tapi korang dah tinggalkan pesanan kat comment/shoutbox maknanye aku tak sempat nak click follow la tu, tapi ada dalam bookmark aku yg dah berjela-jela tuh. Lagipon semua org pon setuju kan, numbers are just numbers & adakah followers tu indication yg blog kita ni bagus (duit dan masa saja numbers yg penting dalam hidup aku, sungguh!). Ikut tujuan nak berblog.. Heheheh. Korang tengok la followers aku byk mana tuh. Macam la femes sangat nak kasi pesanan penaja kepada pembaca kan.. hahhahaha.. takpe, hidup mesti peraaasaaaannnn diva...

Haaaa... sambung balik la ooiiiii.. gi study!!

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Dalam bersuka-ria gelakkan lawak kat atas tu, ni dapat satu berita pasal Mat Gebu pemilik Dapur Tanpa Sempadan, dia kehilangan abangnya pagi tadi. Mari kita sama-sama sedekah al-Fatihah buat abang beliau. Semoga arwah dicucuri rahmatNYA & ditempatkan bersama-sama dgn org2 beriman di sana. Semoga Mat Gebu & family diberi kekuatan menghadapi semua ni. Amiin.

Locust & pesto & kek batik

Tidaklah gitu aku masak locust skali dgn pesto malam tadi. Hahaha. Ssaja nak citer pasal locust yg aku sangat sibuk-sibuk amik tau. Ngalahkan research terkini dalam medicine plak kan. Of course la... aku geli!! Dengar berita dah sampai ke Doncaster, suburb sebelah hospital tempat aku kerja & kat Noble Park nun, suburb yg sangat dekat tempat YL tinggal south of Clayton. Meremang jugak bulu roma teringatkan they are actually close to where I live. Setiap hari aku dok baca news sambil tengok-tengok kiri kanan mana tau terserempak dgn locust. Bila takde rasa lega sangat. Bila pikir balik, apsal plak aku nak terserempak dgn locusts geli tu. Aku pikir-pikir kalau terserempak sure aku akan pengsan jap, hmm, tapi daripada pengsan memalukan diri baik aku amik gambar hantar kat TheAge.com.au pas tu jadi femes =D Hehehehhe... amik kesempatan kat bencana alam.

Setiap hari kuar berita. Ni berita terbaru hari ni pasal locusts, dari TheAge.com.au They are here in Melbourne suburbs but in small numbers. Lega aku dengar. Mebbie semut & lalat lebih banyak dari mereka ni now since its warm & humid & angin. Aku harap diorang terhapus semuanye soon. Tu gambar atas tu gambar map kedatangan locust swarms 2,3 hari lepas punye berita. Terbaru punye peta aku tak jumpa plak.

Oh, ada plak yg suggest nak control locust boleh la bawak ke meja makan sebagai ganti udang bakar bbq. Klik sini. Boleh la masak taco (diorang ni kata great for kids), bbq, stew, etc. Wek, memang aku pernah dengar belalang goreng rasa macam udang goreng. Ni citer dari member-member aku yg pernah makan belalang goreng kat Sabah nun. Uuuuhh.. selagi nama dia locust aku akan geli nak pikir. Hahhahah.. kalau belalang okay kot.. teringin jugak.

Okay, tu cerita locusts yg membuatkan aku obsessed. Ni plak cerita akhirnye Victoria is not the place to be. The current gov dah scraped off the slogan. Victoria takde slogan lagi. Maknanye aku kena pindah ke Perth or Brisbane la kot tak lama lagi. Gaji doctors lebih banyak di situ & doctors are more appreciated there. Haha. Boleh gitu?

Apa lagi berita menarik hari ni kat TheAge.com.au? Jimat duit aku tak payah kuar duit beli suratkhabar. Sampai bila ada suratkhabar kat tea room ICU pon aku tak selak coz dah lupa macam mana nak baca suratkhabar kertas. Oh ye, diorang report doctors tak jaga kebersihan bila jumpa patients. Well, malu aku terpaksa agree on this. Aku kan OCD. So banyak jugak aku perhatikan docs tak guna alcohol rub or basuh tangan when touching the patient or patients equipments. Aku ni haaa sampai aku punye stethoscope ada cracks lagi sebab asik guna the alcohol rub each time kena patient. Punyelah OCD sampai bila salam orang including the bosses pon aku basuh tangan/ avagard. Tangan aku pon sampai mengelupas nampak kedut-kedut dah asik basuh tangan/ guna alcohol rub tu. Sudu pinggan cawan semua bawak dari rumah, tak nak guna tea room punye. Geli. Hahaha. OCD.
Dalam news tu jugak puji nurses & midwives jaga kebersihan. Betul sangat la tu. Aku perhatikan kat ICU tu sama jugak cam docs. Malah lagi jijiks. Diorang empty or check the IDC (indwelling urinary catheter) pas tu terus pegang pen tulis atas chart. Pas tu pegi sana sini dalam ward. Geli lah. Tak pulak guna alcohol rub or basuh tangan. Pegang-pegang access/ equipments. Tu tak pulak kecoh. Biasa lah dunia very patronizing, condescending towards docs. Heh!

Eh, lupa pulak nak cerita pasal dinner aku semalam. Hahahha.. suka sangat ngutuk orang sambil-sambil perasan diva aku nih. Hahaha. Kan dah berjela-jela entry ni. Hari pon dah hujan ribut sejuk gila & sangat gelap gelita rumah ni. Belom pon tengah hari.

Malam tadi sebab aku still recovering from lethargy & sore body so kansel lah nak buat mee hailam yg dah lama aku kempunan. Ternampak pulak pesto dalam one of the MasterChef mags so aku pon try la buat. Tambahan pulak kat webbie SalamDuaBenua nun pon ada pesto dia buat. Aaaiihhh.. lagi la meleleh air liur aku. Seb baik most bahan dah ada.
Ni recipe dari Taste.com.au.
The real pesto
Ingredients (serves 4)
  • 175g fresh basil leaves
  • 50g pine nuts, lightly toasted (aku guna mix pine + almond coz tu je yg aku ada)
  • 3 garlic cloves
  • 125g grated fresh parmesan (ni pon aku guna pizza mix yg ada mozarella, parmesan, cheddar & tasty cheese coz itu je yg aku ada)
  • 200ml extra virgin olive oil
Method
  1. Place the basil, pine nuts, garlic and parmesan in a food processor and process to combine.

  2. Gradually add the oil in a thin, steady stream and process until you have a smooth paste.

  3. Store in an airtight jar (with a layer of olive oil covering pesto), in the fridge for 5 days.

  4. To freeze, make pesto without parmesan, then stir it into the defrosted pesto before serving.

Senang, cuma perlu rebus pasta je & bakar instant sausage rolls beli kat Dandenong hari tu. Kami makan dgn fettucine. Kuah pesto tu patut menggerutu tapi aku blend sampai hancur, heheheh, aku takde food processor guna je lah blender/ magic bullet tu. Aku mula-mula tu dapat agak apa reaction hubby, coz dia ni kan kadang-kadang takleh ngam dengan makanan yg pelik-pelik pada mata dia (like most lelaki kan =P ). Seb baik dia okay. Well, pesto ni kena get used to the taste baru boleh tau kesedapannye, like most dishes lah.
Dessert plak kek batik, recipe amik kat k.Ummi klik sini. Hari tu aku try Mat Gebu punye jadi keras sket & chewy rasa full of chocs. Yg ni coz dlm recipe k.Ummi tu ada nescafe & telur so rasa dia ada sikit-skit kopi & kek batik ni lembut gebu. Aku suka yg Mat Gebu punye & hubby pulak suka yg k.Ummi punye. Gilir-gilir lah. Hari tu aku buat lebih ikut recipe K.Ummi & bawak gi spital, seb baik diorang sumer suka yg ni.
Oh, semalam pagi pegi pasar aku beli this Ferraro Rocher. Laaamaa gila tak makan, hari tu curi satu patient punye teringin. Hahahaha. Tak curi, tu choc thank you kat ICU so aku amik la, lapar. Feveret kami sekeluarga nih (termasuk la choc Toblerone & Maltesers) So semalam rembat sekotak besar, hari ni dah tinggal separuh, rebut-rebut dgn hubby.

Tuesday, December 07, 2010

Intensive care unit

Genap sebulan aku into my ICU rotation. Awal-awal dulu terasa cam asing gitu coz selama ni aku mana biasa 'continuity of care' in physical medicine. Lepas internship dulu, amik year off with some bits & pieces. Residency job terus started with surgical rotation (vascular & surg nites), then paediatrics which is acute care jugak (most patients are not that sick & contact with patients mostly sehari dua saja), then emergency medicine, then psychiatry (woooohh.. dreadful sangat). Psych tu kira continuity of care la, tapi mental health and aku tak minat mental health yg amat frustrating. Pas tu this year is my critical care year, which I started with 5 months of emergency medicine, then anaesthetics (tough sangat!), then those stoopid cover weeks at those 2 stoopid hospitals yg aku benci sangat-sangat, then now baru lah ICU. A really intense internal & surgical medicine. Sesuai sangat nama dia Intensive Care.

Disebabkan pindah-randah ni, aku tak berapa sempat nak cerita pasal my journey in ICU so far.. apatah lagi nak study for ICU. Yes, sampai now aku terasa sangat bebal setiap kali pegi kerja. Apsal gitu? Every single aspect of the patient counts, which in conclusion ICU comprises of pharmacology, physiology & pathology/natural Hx of conditions/symptoms in details.. tambah lagi satu bab yg paling aku lemah skali: social aspect of care. Oh ye, working in ICU reaaally kena build up muscles especially upper body. Nanti aku citer.

Ni nak cerita pasal some interesting patients care I've encountered with sejak start kerja ICU nih. Ni kumpul sejak sebulan dulu. Tak ingat chronology nye.

Minah young adult blom 30 pon lagi. Masuk ICU bcoz of cardiac arrest kat rumah. Punca mebbie severe diabetic ketoacidosis that causing severe metabolic acidosis yg menyebabkan jantung dia stopped for a long period. 2,3 kali kena DC shock in the ambos. 3 hari kat ICU tubed/ventilated, with consistent fixed non-reactive dilated pupils, then orbital oedema. 2 hari terakhir despite all the supports, developed hypernatraemia, diabetes insipidus, tachycardia. Bosses aku kata signs of brain death, most probably from hypoxic brain injury from the prolonged down time masa dia cardiac arrest tu. Which means, no perfusion to the brain & the brain no longer controls the rest of the body. The skin is only warm bcoz of the ionotropes & ventilator. All the supports cuma nak jaga all the organs independantly. So basically orang tu dah kira mati lah. Of course la macam-macam issues dgn minah ni. T1DM who's very non-compliant, dok dgn family pon family dia tak jaga dianyer DM & dia dah developed all the microvascular complications of diabetes termasuk diabetic foot with all the gangrenous parts on the toes. Geli kan.
Back to her condition in ICU. First time aku tengok intensivists buat clinical brain death examination. First time jugak aku tengok 4 vessels cerebral angiogram to prove that memang dah takde circulation to the brain. Brain dah lama mati so dia oedematous & stop circulation from the heart. Allah swt Maha Besar, Maha Berkuasa. Insaf aku kejap. Terkebil-kebil jugak aku tengok all these processes, seb baik bosses aku ajak aku to all these sampai la ke family meeting. The family didnt want organ donation. Fair enough even though sad jugak diorang rejected the notion. It is a very difficult topic. But unfortunately to harvest these organs kena buat within 12-24hours of the death, tambahan lagi kalau mmg dah 2 hari brain dead cam minah ni kan, which also the saddest time for the family. So bila dah gitu, family agreed on stopping the supports coz the minah memang dah lama passed away in ICU. Yup, kalau stop supports for living human they will probably die within days/weeks slowly. Tapi pasal dia dah brain dead 2 hari in ICU possibly, so bila switched off the supports (drugs & machines) tak sampai seminit rupa dia yg warm, pink mcm org tido tu terus berubah jadi rupa mayat yg sejuk, kelabu, keras. Memang bukti dia dah lama mati sebenarnya. Masa tu when we removed all the arterial/venous access takde setitik darah pon keluar. Masa tengok perubahan kaler kulit dia within seminit tu aku rasa cam muka aku pon sejuk jugak. First time tengok the process of death sedemikian rupa. Ye, aku dah banyak kali certify death, some even worse rupa mayat tu. Tapi tu hanyalah a snapshot of the mayat, not the whole process mcm ni. Sampai sekarang aku teringat-ingat the arwah.

One of the night shifts aku kerja 2wks ago, code blue neonatal just 1/2jam before aku abis kerja. Seb baik aku ingat lagi neonatal resuscitation course yg aku buat last year masa buat paeds. Bub lahir sihat, robust. Then was found unconscious not breathing no circulation, in bed with mum mebbie lepas breastfeeding kot. When the ICU team got there, the junior docs yg jaga the mum & the bub dah buat CPR & neopuss kat baby tu. Which returned the circulation quickly. Aku took over the airways using the neopuff after sometime while the senior docs were trying to get access. We got the circulation & O2 saturation right but baby was floppy, didnt even take any breath during each reassessment step. Last last paeds consultant intubated the baby, NATs ambulance sampai (ambo yg specialize in neonatal emergencies) & brought the bub to hospital yg ada neonatal ICU kat Melbourne city. Last time aku dengar from the paeds team minggu lepas the bub wasnt looking good, most probably ada hypoxic brain injury & the NICU/ paeds kat spital tu were withrawing the care already. How sad. Teringat aku si nurse in charge kat special care nursery yg bising-bising kat kami masa kami tengah still continuing resus. Dia boleh cakap baby tu tak bernafas sebab tak cukup carbon dioxide cuba biar je dia sendiri tanpa neopuff sure dia bernafas sendiri punye. Cheh, my reg kata dia rasa nak hentak kepala nurse tu masa tu jugak.

Ada patient yg ada cirrhosis (end stage liver failure), with complications. Masuk ICU pasal bleeding from oesophageal varices. Malam yg aku kerja tu, dia tak berhenti-henti berdarah. Keluar dari dia punya tube, mulut, NGT, IV line, IDC. Coagulopathic + oesophageal varices. The day before tu dah emergency scopes bagai. Seb baik time aku, kami bagi bags of pack cells, FFP, gelofusine, etc. Lama-lama dia stop bleeding. Tak tau apa jadi dgn dia coz aku ada break many days before returning to ICU again.

Ada sorang tu, overdose. Dah extubated time aku returned to work. Tapi pasal heavy alcohol & drugs user, heavy smoker sebelum ni maka dia withdrawing dalam ICU. DIa ada active hepatitis C. Masa dia tengah delirius/ withdrawing dia spitting to people, aggressive both verbally & physically. Code gray called & my boss re-intubated him. First time aku tengok kes gini. Selalu nye terus jab dgn potent anti-psychotics or benzodiazepines. Oh, baru teringat yg dia ni neuroleptic malignant syndrome coz dia overdosed on anti-psychotics.

Ada sorang visitor from the UK visiting the daughter yg baru lahirkan baby. Cardiogenic shock kat rumah & kena gi emergency angiogram. Brapa kali kena shock dalam cath lab. Sampai kat ICU, circulatory response very very poor despite maximal drugs of 60 adrenaline 60 noradrenaline & machine supports. Boss aku kata by the look of it mebbie dia akan mati within 3-5jam in ICU. Masa di family meeting breaking the bad news to the family, boleh pulak boss aku yg tidak bermoral tu gurau-gurau pasal baby dgn daughter patient tu sebab baby tu nangis lapar agaknye time meeting tu. Haaiishhh... Oh ye, si boss ni jugak yg buat lawak tidak bermoral masa tengah family meeting dgn arwah DKA yg aku cerita kat atas tu. Masa aku citer kat kawan aku, dia kata mungkin itu coping mechanism dia kot masa highly distressing situation. Kalau tak buat lawak dia plak yg akan mati coz intense sangat. Cheh, bagi aku dia tetap tidak bermoral time tu. Masa dia kecoh minah tu not organ donor lepas kuar meeting aku buat tanda sssyyyy then suruh dia sambung lawak dia bila dah dalam bilik doctor. Abis la kalau family minah tu dengar. Seb baik boss aku tu jenis happy go lucky tak marah kat aku.

End of last week. Malam pertama aku kerja. Best la tido beberapa kali, gilir-gilir dgn registrar. Time nak abis shift kol 730am pagi Sabtu tu, code blue. Pakcik tua ada pulmonary fibrosis & other medical comorbidities found unconscious not breathing no circulation. Nurses yg buat CPR. Aku jaga airways bagging the tube sementara anaesthetic reg, ED reg & my reg tried as much as nak cari access coz mamat ni dah peripherally shut down. Dia still kat ICU intubated but last time I heard my boss kata nak withdraw care coz dah ada tanda-tanda dia takkan baik & akan mati regardless the supports.

Sabtu malam plak. Baru je start the shift dah ada code blue. Minah ni brapa kali masuk ICU pasal of her chronic lung issues & still a heavy smoker despite of the condition. Druggie, alcohol, smoking & non-compliant to meds & care. Masuk spital kali ni pasal pneumothorax, mebbie her alveoli yg ada bronchiectasis pecah ke apa. Stable dah 2,3 hari sebelum code tu. Code tu pasal acute dyspnoea (takleh bernafas tiba-tiba). Buat XRay masa code tu, takde plak exacerbation of her pneumothorax, & the intercostal catheter kat left lung tu functioning well. Half hour into the code dia tetiba unconscious not breathing no circulation. So 6 orang gilir-gilir CPR while anaesthetic reg looked after airways. Bergelen-gelen kot adrenaline kasi kat dia. Still takde circulation. Aku looked after the bloods & drugs for intubatio. Then gatal-gatal nak join CPR coz aku tengok some dah penat. Yup. Memang penat buat CPR. You hafta exert your whole upper body to give the 1/3-1/2 chest wall depth with each compression, straight arms, it has to be 30 compressions & 2 breaths continuously for 2 minutes then reassess. Aku buat la 2,3 round gilir2 dgn all the docs. Woooh.. gila penat. Sampai now my upper arms & upper back sore. Pompuan tu is much smaller than me. Kami gilir-gilir 7, 8 orang buat. I cannot imagine org buat CPR sorang-sorang kat rumah, tambahan pulak kalau mangsa adalah sangat besar. Pendek cerita, after more than 1/2hour worth of CPRs medical team agreed on stopping the resus since she already had fixed dilated pupils & no circulations despite all.

Malam Ahad. Aku sampai-sampai je, ada new patient baru lepas code blue, middle aged BMI of 50 (berat dia >150kg) with all sorts of medical comorbidities including cardiac failure. Member aku yg kecik dp aku kata dia gilir-gilir dgn very few docs buat CPRs sampai tangan dia lebam teruk. Total of 45minutes of resus coz dia kept on in & out of circulation, dapat DC shocks lagi. Pagi Isnin tu boss kata mungkin dah ada some signs of hypoxic brain injury dah based on his neuro, circulation & numbers were doing. Dia jugak kata yg kemungkinan besar masa CPR tu the compression werent even reach the supposed depth coz of his large & rigid chest wall, hence the hypoxic brain injury.
Lagi sorang minah masuk ICU at the same time due to a large heart attack requiring urgent stents.
And at the same time sorang mamat tua just being released from theatre post emergency repair of ruptured infrarenal abdominal aortic aneurism. Beberapa jam lepas tu, a middle aged lady datang to ICU coz of overdosed of ibuprofen & antidepressants that she was found unconscious at home.
Woooo.. malam yang sangat intense bagi aku. Sore body tak abis lagi CPR pompuan tu malam sebelumnye.
Seb baik ada chance time out dengan helping the nurses in ICU to decorate Christmas tree & other decorations. By that time aku dah had enuf of everything & opted for paperwork depan computer rehatkan perut, otak & kakitangan aku. Huhuhu...

Haaa.. macam-macam kan keep my adrenaline pumping. Ni baru sikit. Ada banyak lagi kes-kes critical. Tu la yg bila balik rumah mandom semacam je. Heh.. study study study.. tak nak jadi bengap in ICU.

(gambar tribute to cartoonstock.com)

Salam 1 Muharram 1432H

Aku abis night shift for the week yesterday a.m. Ingat nak stay up selama yang boleh coz Thursday nanti aku back on days. But sampai rumah je dah penat gila & my body was sore all over. Dok atas katil sambil tengok internet, terus terpadam sampai la hubby called in the arvo. Arrgh! 6 jam aku kaput rupanye. Rugi satu hari.

Afta dinner wit hubby, kepala aku dah pening satu macam tambah dengan sakit badan lagi. Aku dok rehat kat katil around 930pm.. padam lagi skali. Tup tup bangun kol 3 lebih pagi tadi. Patut petang semalam aku & hubby dok berjemaah sempena 1 Muharram hari ni, takde rezekilah dah keadaan tidak mengizinkan. Baca doa saja.

Selamat tahun baru,
1 Muharram 1432H to all.
Semoga hidup kita lebih diberkatiNYA,
Semoga kita semua diberi kekuatan utk lebih berusaha demi mencapai nikmatNYA,
Semoga kita semua diberi kekuatan utk menjauhi murkaNYA,
Dan akhir skali & paling penting, semoga kita
semua lebih bersyukur kehadratNYA.


Hari ni aku kena back to study. Pagi semalam one of the bosses dok ajak aku review patient lepas aku abis night shift. Waduh! Susah gak kalau boss suka kita, aku tak sampai hati nak tolak even tho aku rasa cam dah nak pengsan. Dia ni cam tak ingat plak aku baru abis 13hours of night shift. Dia dok tanya 5 significance of R wave in V1 in ECG. Waduh, dgn otak yg kosong & tak malunye aku jawab PE! Wakakaka.. nampak sangat bodoh. Malu aku! Kat ICU semua org sibuk pasal PE, semuanya PE (pulmonary embolism). Seb baik takde org dlm bilik patient tu. Lepas dia cam geleng kepala baru la aku kasi jawapan yg betul.. posterior infarct. Aku ni mmg suka memalukan diri dulu baru kasi jawapan betul kan. Hehhehehe.
Anyways, dia cakap dia on the floor on Thursday. Dia kata dia nak aku sleek, sharp & smooth bukan slow, soft & stoopid. Waduh, amik kau!

Sunday, December 05, 2010

Happy XXth Birthday, Mak

Today is my mum's birthday.
Called Malaysia when I got home from work this a.m. tapi takde org angkat, tadi baru dapat cakap dengan my mum bila bangun tido petang tadi, dia cakap dia tengah solat Subuh. Yeah, I thot so, coz masa sampai rumah pagi tadi it was ~9++am, which means it was only ~6++am in M'sia.

Too bad I could not be there to celebrate, bukan la nak buat party ke apa (tapi kalau ada joget joget ronggeng jap pon best kan, mak? =P hahahahhahaha), but kalau boleh celebrate by just a good family dinner either eat out or aku yg masak (fuiiihh... mulia banget cita-cita nak masak sempena birthday mak).

So this is my simple but all means, my wish to my beloved mum, who is now in KL :'( jauh nun (but alwiz dekat di hati).

HAPPY XXth BIRTHDAY, MAK
Thanks for all the things you have done for me & the family,
Semoga panjang umur & murah rezeki alwiz,
Semoga hidup diberkatiNYA alwiz,
Mintak maaf salah silap,
Akhir kata, LOVE you alwiz.


From your beloved anak
(yang perasan) dara sunti. MUUAAHHHSSS.

(gambar tribute to Google)

Saturday, December 04, 2010

Aku WAKIL RAKYAT TERLAJAK, okeh!!!

  1. image
1. Segmen hangat dari Mr. Ben Ashaari Aku ini WAKIL RAKYAT , okeh !

2. Soalan cepu emas 999:
    • Tempat pemastautin anda ..
Di suburb Chadstone, Victoria, Australia. Temporary saje buat masa ini. Tempat abadi.. pandai-pandai la korang jawab okes.
Anyways, electorate/territory Chadstone ialah dalam Chisholm. Mungkin macam Taman Permata kat dalam daerah Ampang Jaya gitu kot kat M'sia (betul ke?). Ada 2 main councils here kalau tak salah aku: Monash City Council ( Chadstone, Oakleigh, Huntigdale, Clayton, Glen Waverley, etc)& Whitehorse City Council (cover Box Hill, Balwyn, Burwood, etc) Victoria & electorate voting baru je lepas. Rugilah rakyat jelata aku tak bertanding hari tu.. ahaks!
    • Kelemahan serta kekurangan di kawasan anda ..
Woooo.. banyak sekali (Biasa aku nih).
i. Sejak akhir-akhir ini Monash City Council (equivalent to MPAJ contohnya) dah malas nak potong rumput kat taman perumahan sini, especially kat taman-taman permainan. Hubby kata skali pandang macam slump plak kawasan perumahan yg indah ni. Nak kata diorang ni puasa sebulan macam kita berpuasa di bulan Ramaddhan before hari raya Aidilfitri.. tak pulak. Christmas dah dekat nih. Kalau terkena bala locust tu aiyooo.. abissss. Makanan banyak.
ii. Kedai makan, kedai supermarket, kedai la dan services tutup awal. Mostly tutup around 5-6pm (ni pon dah ok berbanding 10thn dulu) & tak bukak weekends. Supermarkets & some food place je tutup around 10pm, Officework tutup midnight, satu Safeway kat Ashwood & McDonalds 24hours. Time winter lagi sedeh. Awal gila tutup. At least peak summer nanti banyak yg extended time mebbie 7pm. Chadstone shopping mall start tutup lambat selamat 3 minggu from 9th Dec.
iii. Some places tak banyak lampu jalan. Aku yg kerja ikut shift ni kalau balik midnight kadang terasa buta & takut jugak. Maklumla crime rates makin tinggi, sama naik dgn inflation kat sini.
iv. Recycling & green truck datang alternate weeks. Domestic rubbish plak datang seminggu sekali. Kinda susah untuk households yg suka buat sampah macam rumah aku ni. Bin akan penuh setiap hujung minggu, kadang melimpah-ruah, jenuh tunggu bin truck datang.
v. Jalan menuju ke Emergency Dept at the hospitals (e.g. MMC, Box Hill Hospital) sangat lah sesak & sempit. Messy. Hospitals kawasan ni pon tak cukup beds, doctors, etc. Tak cukup parking utk doctors kat spital nun. Kat BHH takde residents quarters, cuma menumpang kat bilik consultants yg nuthing tu. Makanan kat cafe hospital mahal & tak sedap.
vi. Last but most importantly, masjid/surau sini still sangat susah nak cari & susah nak cari parking utk solat berjemaah esp solat Jumaat, solat Terawih, solat raya. Monash Uni ada a good religious centre for most religion (diorang ada their own bilik, utk muslims pulak ada satu bilik pompuan & satu bilik lelaki siap ada tpt wuduk masing-masing). Ada satu kat Monash Uni area yg ramai lelaki pegi solat Jumaat setiap minggu, a few years back ada residents kawasan tu komplen kat council tak kasi org parking situ utk solat Jumaat. So now dah ada restriction 15minit je parking tepi jalan, which is kinda hard. But yeah, bukan salah residents situ je, sometimes org gi solat Jumaat ni main parking je kat dalam kawasan rumah org. Hospitals seperti Monash Medical Centre & BOx Hill Hospital ada religious area/ room, which is good if to compare with 10-15yrs ago. Dalam Chadstone shopping mall/ Oakleigh shopping mall takde Quiet room/Religious room.
vii. Oh ye, di Victoria ni banyak orang tak kerja & sekadar makan duit dole/Centrelink (which is duit taxpayers) then beli dadah guna duit rakyat. Berasap je aku dengar the figures hari tu masa buat Psych rotation. Most of them takde usaha nak kerja pon coz dah dapat duit free kan. No wonder la crime rates makin tinggi kat Melbourne ni.

Panjang plak aku komplen eh. Kata dah, aku ni sangat suka komplen.
    • Apakah perubahan yang akan anda buat di situ ..
Wooooo.. macam-macam.
i. Aku akan paksa Monash City Council (and also Whitehorse City Council) potong rumput setiap 1-2minggu sekali in warm seasons & 3-4minggu sekali in cold seasons.
ii. Aku akan wajibkan kedai & services penting tutup lambat on weekdays & bukak on weekends. Chaddy mall bagus ada post office, Medibank, Medicare, banks open on Saturday. Other places tak. Weekdays, mebbie these services boleh tutup kol 8pm & weekends termasuk Ahad tutup kol 5pm. Kedai makan please la tutup midnight on weekdays & beyond on weekends. Penting okay utk orang malas masak macam aku ni & kerja shifts. Lain-lain kedai silalah tutup kol 10pm or midnight ikut category.
iii. Aku tau ni tak berapa environmental friendly if I wanted more street lights. But aku rasa kalau for season yg banyak matahari boleh bubuh solar panel & storage utk generate tenaga to feed these street lights. Tingkatkan security system e.g. polis peronda utk setiap kawasan adalah wajib, walaupon setakat ni Alhamdulillah hidup kami di Chadstone ni aman. Tapi di Oakleigh, Ashwood, Huntingdale, Clayton nun..
iv. Aku akan paksa developers banyakkan parking utk buildings around these hospitals, and at the hospitals supaya jalan raya menuju ke Emergency Department tak sesak. Aku akan paksa government tingkat funding utk health care system to adress those complaints yg aku ckp kat atas nun. Ni mungkin aku kena bawak bouncer kot nak gi bebel kat diorang tetiap hari.
v. Aku akan suruh councils tambah pekerja bin truck diorang. Then suruh diorang angkat domestic rubbish 2x weekly. Tambahan, recycling & green rubbish buat tetiap minggu takperlu alternate weeks. Oh ye, aku akan tambahkan public library, sports centre yg ada include special time utk female participants, halls utk majlis keramaian. Ada lagi yg tertinggal list tak?
vi. Ni kira berjihad la ni kan. Aku nak tambah & surau/masjid kat setiap suburb. And adakan satu bilik solat/religious centre kat setiap shopping mall cam kat M'sia. Mulia tak usaha murni aku ni?
vii. Orang-orang yg dapat duit Centrelink/ dole ni aku akan paksa diorang cari kerja within a certain period, but at the same time aku akan sediakan vocational/ technical training centres supaya diorang boleh train/kerja utk baiki kehidupan diorang. Wajibkan diorang masuk sini kalau tak nak cari kerja. Then wajibkan diorang ada kerja tetap lepas lulus training kat sini & aku akan wujudkan system pemantauan supaya they dont end up on the streets menyusahkan rakyat. Aku jugak akan sediakan banyak counseling, support groups & centres especially utk mangsa dera kanak-kanak. Wooo besar betul cita-cita mulia aku ni. Sapa nak fund sumer ni? Of course la taxpayers, sapa lagi. Hmmm.. macam mana nak cari pengusaha dadah & senjata haram ni sampai ke lubang cacing?
vii. Khas untuk kereta aku, family aku, kroni aku: increase the speed limit on the road khasnya setiap kali aku nak lalu. Tak perlu ada driver. Yang penting kenderaaan sekeliling aku kena kasi laluan, especially time aku nak gi kerja =P
ix. Akhir kata, untuk kroni aku jugak: permudahkan peluang pekerjaan, property gain, etc. Kehkehkeh. Dah kata aku berkuasa kat kawasan ni kan. Haaa.. cepat-cepat la pikir modal apa untuk jadi kroni aku. Banyak untungnyeee..
    • Bagaimanakah anda nak menangi hati penduduk di situ ..
Oooo.. untuk mengempen ni kena la ada DUIT. Mula-mula aku kena la ngorat the government kasi funding banyak kat electorate aku ni. Sila la guna taxpayers money tanpa segan-silu. Then kempen habis-habisan. Kalau kena berarak pun aku sanggup. Pas tu buat ala-ala supermodel melambai-lambai ke arah para peminat masa berarak tu. Buat muka comel menggoda sekali sambil kenyit-kenyit mata. Sure semua jatuh hati punya kan. Sekali-sekala guna bomoh-bomoh black magic kasi lagi umph pemerintahan aku. Aku of course akan guna politik wang.. tapi pengundi la tabur wang kat aku kasi aku menang. Hehehehhe.. Alah, duit tu pon utk kesenang penduduk nanti, slain nak support aku gi shopping balik M'sia or kat Europe & U.S. nanti. Hehehehhehehehe.. ngam kan?
    • 'Janji manis' anda pada penduduk di situ untuk pilihanraya akan datang ...
Tak perlu panjang-panjang. Perubahan yg aku dah propose kat atas tu la sebahagian dari janji-janji manis bak madu kat penduduk untuk pilihanraya akan datang. Semangat untuk maju aman makmur mesti ada, hidup penduduk tetap aku utamakan (di samping kesenangan hidup kroni aku). Pendek kata semua orang akan untung & bahagia kalau aku jadi wakil rakyat kawasan ni. Bukan tu je, korang-korang ni pasti bangga riak mendabik dada lagi bila aku dah jadi wakil rakyat nanti. Kembang segala-gala. Heh! Lain-lain cadangan utk memajukan kawasan ni akan diambil kira pada mesyuarat parti akan datang (especially yg kasi untung kat kroni aku).

~~~~~~~~~~~~~~~~~~~~~~~~
Okay, Ben. Aku tau ni entry terlajak. Baru perasan segmen khas Ben Ashaari yg sangat menarik ni masa menggodek-godek blog tengah kerja. Tapi Ben tulis tamat 4petang 3/12/10, aku post menda ni aroiund 4 PAGI 4/12/10, 12jam terlambat. Kalau Ben tak siarkan kat blog dia pon aku tak kisah coz this segment ni cukup menarik kasi otak aku bangun sket kerja night shift nih. Boleh gini Ben?

Biasala sesi merapu aku di pagi buta during a very long 13hour night shift in ICU. Seb baik patients semuanya stable (mana taknye, mereka dok diam-diam intubated!).

Sesi merapu lain akan disambung depending on how my night shift tonite. Ciao!

Friday, December 03, 2010

Locust plaque.. yucks!!

Patutnye aku ni kena start masak dinner ni. Jap lagi kol 730pm dah kena bergerak dp sini to work. Why I'm still in front of the lappy? Coz sibuk meng'google' resepi nak masak pajeri nenas. Bukan nak resepi penuh, just nak tau apakah rempah-ratus dalamnye. Mengidam la plak ye.

Anyways, ni berita geli yg buat aku betul-betul rasa loya. Sejak sebulan lebih dah start dah, tapi ni berita lebih gempar dari dulu. Berita pasal monster locust swarm heading to Victoria.. sooon.. from TheAge.com.au.

Typical locust: Male on top (aauuww)
Aussie punye
Apa itu locust? Locust tu ialah the swarming phase of the short-horned grasshopper from the family Acrididae. Ada macam-macam jenis. Yang dah lama menghurungi Australia ni ialah dari jenis Chortoicetes terminifera. Orang sini panggil locust. Ni binatang native kat sini & is a significant agricultural pest threat. Banyak sangat kat pedalaman New South Wales & bordering states yg lain, including northern Victoria, also di Western Australia. Especially teruk di musim late spring & summer and dia spread through dia sendiri terbang & warm wind bawak dia, mostly ke tempat banyak makanan dia & to the coastal area (cuaca moist & warm). Dia slalu bertelur kat superficial layer of the warm & humid soil, kadang boleh mencecah millions dalam 1 hectar tanah.

Dia suka sangat kat daun-daun hijau. Skali datang dalam a massive swarm & boleh botak semua tanaman. It is also a significant threat to the traffic coz skali datang boleh hilang view on the road. Kat sini dah start badan kerajaan yg memantau locust ni coz walaupon dia tak gigit orang tapi in a wider view dia boleh cause disaster to the traffic & to the food chain.

Apsal aku kesah sangat? Aku geli laaaahhh. Yucks. Aku ni memang lemah sangat pasal insects ni. Kadang boleh rasa nak pitam. As much as I am a 'green' person, most of the times aku tak suka pokoks ialah sebab the insects, ulat-ulat, binatangs. Sejak bila aku lebih phobia kat insects/binatangs... sejak aku start blaja medicine... insects, binatangs bring a variety of diseases. OCD tak aku?
I know my area here ni slalunya selamat from most natural disaster in Victoria, Alhamdulillah. Tapi tu la.. aku takut pitam tengah-tengah drive nanti kalau aku ternampak sekor dua menatang ni. Huhuhu... masalah dunia. Mintak-mintak la these insects tak sampai kawasan Chadstone ni.

Drought, heat wave, bush fire, thunder storm, flood, hail storm, locust, crimes.. Banyak betul natural disaster kat Victoria ni kan. Aku doakan supaya kami semua selamat from all these heartaches. InsyaAllah.. Amin.

Okay, time to cook & get ready to work.

Info + pics tribute to Wikipedia & Google.
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