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Saturday, January 21, 2012

Happy 28th Birthday, Adikku

Semalam birthday adik aku si H3 yg berada di Manchester & sedang menghadapi exams. La ni birthday adik aku lagi sorang, si H2 plak. Dah sangat-sangat dewasa dah tu, 28 tahun dah. Hehheheh.
Dekat je dengan usia lanjut aku nih. Hahaha.


Happy 28th Birthday,

Semoga panjang umur & murah rezeki alwiz, Semoga berbahagia hingga ke akhir hayat, Allah swt always has lots of great things in store for us, InsyaAllah, just hafta grab the opportunities & bersyukur.

gambar-gambar ihsan Google

Friday, January 20, 2012

Happy 21st Birthday, Adikku =)

Today is my brother H3's 21st birthday. I am here in Melbourne, tak diberi rezeki nak physically celebrate birthday with him :'( He is in Manchester having his end of 1st semester exams. Kesian =P, setiap tahun pon sambut birthday during exam time, no different this year. Dah la 21st.. a milestone where some people say a mark of full adulthood (kata orang-orang Western la kot). Anyways,

Semoga panjang umur, dilimpah rezeki yg diberkatiNYA alwiz.
Now dah dewasa, no more excuses to NOT be more matured & responsible =D Join me, mak, abah, abang & other adults in all those pening-kepala-adult-stuff. Hehehehhe.
Take care always,
We all love you lots.

gambar-gambar ihsan google

Sunday, January 15, 2012

Perihal a Better Weather Outlook

Alhamdulillah, the weather is looking better today. The past week has been soooooo miserable. Cuaca sangat la tak bestnye.. sangat-sangat sejuk. Dropped to as low as 10°c on most early mornings & nights, while max 16°c but due to the wind-chill factor rasa cam 12°c most of the time. Ada la dlm 2,3 hari time aku tido siang afta night shifts aku terpaksa bukak heater coz couldn't sleep at all sejuk sangat.

Mesti la aku rasa cam miserable coz its mid-summer but the temperature has been in the low 10s°c, while its supposed to be around high 20s°c to 30s°c. Summer tahun lepas & summer tahun ni, cuaca agak sejuk in summer & occasionally je panas yg sedap & sekali dua je panas membara cam 2wks ago. In winter pon sejuk jugak.. its like sepanjang tahun lah sejuk. Ni la effects of global warming. No wonder lah each time aku balik M'sia bunyi cam ngada-ngada tak tahan panas but at the same time nyampah kalau aircond/ kipas tu pasang kuat-kuat. Rasa cam my temperature tolerance has become narrower.. tak suka panas more than 32°c but tak suka sejuk less than 25°c.

Hari ni Alhamdulillah average 21°c, clouds clearing up. Aku pun dah 3 loads of laundry dah buat & jemur, tinggal nak lipat the 20thousands loads of baju yg dah kering =P Hehhehehe... Out of all the housework, rasanye ni yg paling malas aku buat =P
Anyways, the sun will give all the love that my pokoks need. Kesian diorang muram durja je sepanjang minggu lepas. Diorang mebbie survived coz setiap hari I never fail to borak dgn diorang. Ada a few of the cili padi dah start memerah. Mebbie next week aku dah boleh start petik some & jemur/ simpan dlm freezer/ fridge. Yaahoooo..

Ni weather forecast frm The Age:
Kalau ikutkan rain outlook cam sepanjang bulan hujan je kan. But I think that's probably in certain suburbs je kot, mainly the Western/ Northern areas. My area, Alhamdulillah, good weather nampaknye. Baru la rasa cam hidup sket with the nice sun outside.

Tuesday, January 10, 2012

Perihal Handovers

About an hour ago aku bangun dari tido. Seb baik sempat solat Zohor (Asar masuk 531pm nowadays). Working nights this week, frm last night 'til Thursday night. Aku kuar frm hospital around 9++am pagi tadi. Cam biasa junior reg looks after short stay uni (benci!!) & therefore the longest to stay coz of long handover for short stay, while still ada lagi patient on the floor to handover to the a.m. floor doctors.

Aku nak citer pasal how I made a HMO cry during a handover on Friday afternoon last week. Si HMO ni kita namakan dia "Dr. M". Dr. M handed over to me a syncope of unknown cause but stable, still in the mid of investigations prior to the patient being sent to short stay unit. I checked the medical notes written by this HMO, & when I noticed ada byk glitches, aku tegur la. Syncope = unconscious event, as an ED doc kita kena cover all basis. Meaning kena look at all possible causes: neurological, cardiovascular, metabolic. Then aku list down all the things yg dia kena buat before handing over to me: complete the history taking, tulis the drug chart coz patient tu punye regular meds dah overdue, fluid chart, anticipated short stay plan including disposition plan, etc. Haaa.. tengok tu, punya la banyak kekurangan. Mana boleh aku je nak buat semua kerja dia yg tak siap nih. Aku cam garang la jugak, kalau tak complete menda yg dia should have done earlier tu aku tak nak amik the handover.
Lepas dia buat menda tu dia got back to the doctors' room & nangis depan semua org including consultant aku & balik rumah.. Aku cam.. errkk.. takkan la cam tu pon nak nangis, bukan kasi patient mati pun.
Sebelum dia dok handed over to me that patient that day, dia ada handed over 2 terribly incomplete patients with bad consequences to me on Tuesday sebelum tu. Sure la aku hot sangat-sangat. Kisahnye: 1st surgical patient, dah accepted by surgical registrar over the phone & was going to theatre that very evening & plan was surgical registrar would see the patient before operation. In the meantime the patient should be fasting & having IV fluids, IV antibiotics, blood tests, pain killers. The handover was just babysit the patient coz kononnye semua dah settle. A few hours after the handover, nurses datang kat aku kata patient tu takde IV canulla hence tak dapat semua menda lagi, and he was getting more dehydrated. Apa lagi, panas aaaa kejap hati aku ni. Dah la when someone is sick, to get an IV access memang susah. Dgn si patient ni mmg susah gila sampai one of my bosses helped me using the ultrasound machine pon cam susah gila. Dah delayed dia punya treatment that could have helped in his recovery post-operation & reduced length of hospital stay. Seb baik kami berjaya buat semua tu before this bitchy surgical registrar jumpa the patient that evening, kalau tak sure ngamok abis dia. Geraaammm!!!
2nd patient ialah this poor 90yr-old lady functioning well lives alone kat retirement village unit, as per handover dia ni unconscious due to severe hypoglycaemia BSL was 1.3. Dia ni kononnye 'slightly' dehydrated due to gastroenteritis (surprise, surprise not properly enquired by this HMO). Dah resusitated by ambulance & now receiving treatment kat ED for hydration & for sugar replacement, before transfering to private hospital. Aku tengok notes.. hmm.. cam something missing je, most of blood tests cam tak complete & the initial resus management kat ED cam something wrong. Masa tu cam busy nak mati so on my side I missed looking into those during handover (silap aku). Then masa kat short stay tu patient tu deteriorated, lepas aku dah start my part of treatment aku gi balik ke dia punya notes. Memang banyak missing!! Aku yg memang ada anger issue ni lagi la panas je, tambah lagi baru je struggling dengan surgical patient tadi tu. Aku terpaksa order banyak lagi blood tests, rehydrate this patient, etc. In short she was actually in multi-organ failure way back in resus cubicle way before aku took this crap handover. Cam mana aku tau, aku tak order new blood tests, aku order retrospective blood tests. Meaning aku tak amik new blood frm the patient tapi order tests on the blood yg pathology lab dah ada 5,6 jam dulu tu masa dia mula-mula sampai ED. Seb baik ada sorang senior ED registrar ni baik hati nak tolong aku manage this patient. Aku risau la jugak bila balik rumah tu walaupon dah handover kat the night registrar. A few days afterwards, I heard from one of the bosses regarding this poor old lady. She deteriorated overnight, multi-organ failure, tak jadi nak hantar kat private hospital but terpaksa admitted at my hospital & very sick.
Grrr.. sure la aku geram gila. That patient could have died that night. Yeah, sure, she's 90. But she's a functional 90yr old & she absolutely didnt need to die due to medical mismanagement. She could have gone to the private hospital where she really wanted to go & discharged the next 2,3 days. Tapi dia admitted to hospital for 9 days. If she was my family member, I would want her to have a chance to be back to her previous function, given that she was functionally well prior to this episode. And I am a doctor & I am fully aware of the old lady clinical situation (which was initially simple to manage if the initial treating doc was aware as well).

In short, before I took the Friday handover frm this particular HMO, I talked to her about the 2 patients that she handed over to me on Tuesday & what she should have done right & what she could do better in the future. Dia cam tak berminat nak dengar semua tu.. just jawab.. "yeah yeah..". Aku sabar je lagi masa tu. Bila tengok another crap job of hers with that one, aku terus tegur dia lebih garang lagi. Good thing is aku tak yell at her, just slow monotonous firm voice & straight to the point. After all, dia dah HMO bukan intern lagi.

Memang all the juniors (HMO & interns) wajib discuss patients with the consultant in charge on the floor. So that takde missed care & this will be a learning opportunities for these juniors. Thats why its also important that these in charge consultant kena gi check all points of care with the junior doctors. Kalau the juniors malas/ miss stuff/ rasa cam dia pandai gila with their limited experiences, & unfortunately the consultant plak either malas/ super busy, memang akan jadi kes berantai la of missing stuff.
In that crap handover case, unfortunately the department was on bypass & superbusy so byk la swisscheese holes. And to me, whatever it is, the first clinician kena buat their job properly & clinically thorough (yg relevant je la). And after all, these clinicians are doctors not medical students. So sila treat patients like you are a doctor.

Kalau nak handover kat aku, aku kena tau semua since aku yg akan jaga these patients for the whole of my shift before handing over to the next person kalau diorang masih ada di ED. Aku tak nak inherit pts yg I have to go thru every single thing again myself & kena buat most of the investigations.. kalau cam gitu, patient's care is delayed & mungkin makin teruk. Its like cleaning other people's mess. Kalau diorang sakit aku yg bertanggungjawab nanti.. and kalau diorang sakit sebab unfortunate events/ natural course of the disease takpe, tapi kalau diorang sakit sebab the previous doc has missed lots in the patient's care.. memang aku marah sangat. Plus my time would be better spent to see the other patients waiting to see a doctor, than me wasting my time cleaning other people's mess.

Sabar je la...

Saturday, January 07, 2012

Buku baru 2012 (recycled daaa...)

Aku cam terfikir, patutnye aku buat azam baru setiap 1 Muharram, baru la berkat kot hidup aku ni. Takde la terumbang-ambing je.

Azam tahun baru kalendar omputeh ni pon since as far as I remember just started in 2010, just thot masa tu nak straighten up my life a little bit. Selama ni new year means fireworks on new year's eve then continue with everyday life. Rasa cam takde all those short term goals to look forward to. Just the long term goals yg nampak cam samar-samar coz ye la, setiap hari cam sama je.

So azam aku di dekad yg baru since 2010 ialah to make some list of azam tahun baru & recap these azams by the end of the year, and ada check point in the middle. And 1 change aku nak buat for this coming year is to make all these azams time 1 Muharram.

Masa 1 Muharram 1433 hari tu aku tengah bercuti with my family kat Tambun, Perak. Masa tu kami sama-sama baca doa akhir tahun/ awal tahun. Kat tv ada ceramah agama & bacaan doa masa tu. Rasa cam tenang & blissful, coz kat Aussie ni takde menda-menda cam tu. Ceramah dp pop masa xmas/ good friday ada la. Hahaha.

Okay, here it goes, recycled list for my azamz of 2012:

- To be happy... I want to smell more roses, listen to the ocean & enjoy the breeze more. I want to enjoy all aspects of life, good or bad, and let go of & learn frm the bads. I want my life lebih tenang & focused & more importantly balanced in all areas. InsyaAllah.
- To work on my career.. Yang ni kena lebih berusaha & lebih focused. Exams this year & early next year. No excuse. But along the way I want a more balanced work-life. Nak lebih professional & kurang emotional kat tempat kerja. Nak jadi lebih content & bijak.
- Jaga body, jaga makan, jaga kulit.. Yang ni kena lebih berusaha in terms of body shape & food intake. It is kinda challenging when my job is shift job, agak mencabar nak ada routine makan yg sihat & seimbang. But during my wake hours & work hours aku akan berusaha makan yg lebih seimbang, segar & sihat. As well as the exercise bit. Now dah tua kena lebih bersenaman utk jaga badan coz metabolism dah tak secergas masa muda-muda 10 thn dulu. Nak lebih menghargai masa rehat & tido. Dalam hal kulit pulak, I will continue with my new regime, InsyaAllah. Food & senaman akan beri kesan holistic to the skin as well. Agak mencabar bila tinggal di negara yg cuacanye berubah-ubah sehingga memberi kesan terhadap kulit.

- To rely less on drugs... Yang ni dunno yet. Since this year is going to be a bit mencabar I cant really promise to reduce my sleeping tablets intake. But since aku dah berazam nak jaga body & makan lebih lagi this year, I am sure the sleep will come naturally. InsyaAllah.
- To take care of my car better & to drive better :) Yes, definitely I want to look after my baby better than last year. :) And azam best ialah nak try to improve my driving skills in Malaysia. Yg ni hanya boleh buat time cuti nanti. Skills kat Aussie ni Alhamdulillah, boleh idup la. Hahaha.
- To be more organized with my life :) Hafta somehow do it properly. I'm kinda sick of the same old azams every month aku buat re: this esp the filing system. Hahaha. Plus nak lebih OCD in terms of kemas rumah, etc. Boleh gitu?
- To save more $... InsyaAllah aku akan lebih berusaha tak nak indulge too much, and to spend wisely. Aku pon nak avoid waste buy kurangkan beli brg dapur berlebihan sampai kena buang sayur setiap minggu coz tak sempat masak, nak back to my pre-cuti body so that takde baju-baju membazir kena beli baru, kurangkan makan so that tak 'membuang' banyak sangat (takde la bazir toilet rolls, water, toilet detergent & kurang mencemarkan alam). Lebih jimat electric & water & others. Ada azam nak beli rumah di Malaysia, InsyaAllah.
- To improve my cooking skills :) Nak lebih rajin memasak tapi portion still terkawal. Nak lebih adventurous in my ingredients. E.g. I started this year with trying beetroot. Mebbie next nak blajar about artichoke plak. I want to make my own veg-fruit juice. Etc.
- To garden more :) & care for the environment more :) Yang ni kena usaha lebih. Tak rugi berbakti kepada alam. Nak tanam more veg plants. Kalau boleh buang all the flowers kat depan tu & gantikan dgn pokok olive or other pokok yg mendatangkan hasil seperti kelapa ke kan best. Hahaha. Tapi apakan daya ni rumah sewa je.
- To belajar tahan perubahan cuaca more InsyaAllah.
- To improve my social life more :) I have to learn how to get around this one, especially this year & next year lebih busy dari biasa. Aku nak care more about my relationships with others. No man's an island kan. Buat again, hafta balance out on things.

- To do more for my family :) and those precious people around me :) InsyaAllah, ni ongoing sepanjang hayat.
- 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..





InsyaAllah, semoga tahun ni akan lebih baik, in one way or another, for all of us.

Perihal buku lama 2011

Looking back at my azam thn 2011 & what I've achieved in each area of those azams:

- To be happy... have I been happier in 2011? Happier in this rumah sewa baru, but some parts of my life ada kureng sket. Have opened up myself more to the flowers & thorns in life, still need to let go some..
- 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. I have to admit, I'm a little calmer now.
- To work on my anger issues, and to work on my expectation to others... Again, bit by bit & its getting better. Hidup lebih tenang di tahun 2011.
- To work on my career..
Yang ni a little bit lagging. My first year as a registrar, an ED junior registrar. Mula-mula ingat nak amik primary exams this year. Some glitches in 2011, so had to skip the Feb/March & Aug/Sept exams. Takde rezeki nak jadi nerd tahun ni. Still that doesnt mean aku berbulan madu sepanjang 2011. I was trying to get used to being a registrar. Tahun sebelumnye aku hanyalah HMO, tahun 2011 naik pangkat, which also means bertambah responsibilities & expectations. Selain dari kena lebih manage all those sickies, learn more high risks procedures & kena lebih pandai dari seorang HMO, kami juga now sedikit-sebanyak amik roles jaga quality control in ED practice, leading the juniors & also teaching those kiddies :D Berat tanggungjawab tu.
- Jaga body, jaga makan, jaga kulit.. Yang ni pon merudum nampaknye this year. Happier= makan banyak junk & malas senaman. Well, aku cam terajin senaman before balik M'sia in Nov hari tu. Yang tak bestnye, dah elok-elok turun best dah, balik M'sia je naik balik. Penangan reti tahan nafsu makan & malas senaman. Jenuh la nak turun balik nih. Skin thing, sejak aku tukar regime jaga kulit all together in the last 2 months of 2011, I've noticed big improvement, Alhamdulillah. Oh, I'm freaking out of my age, yo!!
- To rely less on drugs... Analgesia wise aku dah kurang sket, but sleeping help wise naik penggunaannye. Well, what else can I say, terpaksalah, with all the shift work & all the responsibilities. Sad enuf, many doctors who work in a high-stress environment do take all these help. And, I'm defending my colleagues & myself, aku rasa org lain tak brapa layak to pandang slack when we actually need all these pharmaceutical help.. they dont understand & will never understand what we are going through. Nonetheless, we appreciate others' sympathy & respect. (Emo la plak.. hehehe).
- To take care of my car better & to drive better :) Alhamdulillah, driving better & selamat so far with my baby. In terms of mandikan dia hari tu aku & adik aku basuh kereta. Blom lagi basuh kereta sejak diorang balik M'sia hari tu. Aku ada hantar service in July, dlm report tu diorang kata 'very very late'. Nak buat cam mano, mmg aku sangat busy & sengaja takde masa nak jaga my baby.
- To be more organized with my life :) Havent been good with this one. Totally my bad. Just lebih organized in terms of my pakaian, mekaps, kasuts, food & kitchen items. Filing stuff, my books, my studying, the lawns, kemas2 rumah semua tu agak ketinggalan.. but I think kinda better than in 2010 dulu.
- To save more $... First 1/2 of 2011 I think I wasted A LOT of money, in a sense cam mana org2 tensen melepaskan tensen mereka. Then second 1/2 of 2011 I think aku bertaubat & lebih bijak berbelanja & menyimpan. Takut plak bila teringat pembaziran besar itu.
- To improve my cooking skills :) Only some je new recipes aku tried in 2011. Agak kemalasan nak masak & baking in most months of 2011. But sejak balik frm visiting Dr. D & Dr S kat Adelaide hari tu, aku terasa cam semangat masak tu lebih sikit, looking at how rajin Dr. D cooks for her family.
- To garden more :) & care for the environment more :) I talked more to my plants. Kata orang kalau kita treat the trees dgn penuh kasih sayang, lagi banyak dia berjasa kat kita. Cuaca agak kurang best sepanjang 2011, pertumbuhan all the plants agak slow, but Alhamdulillah diorang selamat sampai ke tahun baru.
- To be closer to the creative side of mine :) Belum lagi nampaknye. Mebbie boleh sambung next year... again.. keadaan tidak brapa mengizinkan.
- 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. Sedikit kebal sejak 2010, dah 11 winters I went through now.
- To play more :D games, sports, boardgames, all :D Hidup kurang bersosial & beriadah in 2011. Thus the eliptical machine I bought in October. Been jumping on it whenever aku ada masa or teringin nak ride it. Since lebih busy with work in 2011, aku rasa ni satu bonus, tak perlu bersiap-siap utk riadhah outside. The other games memang merudum abis in 2011.
- To improve my social life more :) Terrible in 2011. Almost non-existant. All due to busier life in 2011. Memang jarang sangat jumpa org. Masa raya haji tu a little bit different. Kami baru lepas kemas rumah for the landlord routine inspection, and kebetulan plak aku tak kerja that weekend. So kami jadi jugak buat sedikit makan-makan, involving very close friends. Also, went to Adelaide to visit frens. First time pegi setelah 11 thn dok Au ni. Other than that takde la berjalan sangat in 2011.

- 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.
- Last but not least... most important... to improve my relationship with beloved hubby...
Perkahwinan mana yg takde hiccups. Enuf said.

Nak kena check balik azams tahun-tahun lepas & report tahunan, adakah ada improvement in 2011?




Semoga tahun baru ini akan lebih baik, in one way or another, dari tahun-tahun sebelumnya.. InsyaAllah...

Monday, January 02, 2012

Hot & sizzling new year 2012

Assalamualaikum & Salam sejahtera to all.

Not too late kiranye aku nak ucap selamat tahun baru 2012. Semoga tahun ini kita hidup dengan lebih aman, damai & gembira, berusaha lebih bijak & kuat, semoga kita diberi lebih kekuatan, motivasi & kemudahan menghadapi segala pancaroba kehidupan, semoga hidup kita lebih diberkatiNYA. Amin.

I feel like I havent stopped working at all since I came back frm my M'sia hols. Hari tu kerja weekends Xmas night shifts, then cuti hanya pagi Isnin boxing day lepas balik frm night shift & hari Selasa. Then sambung kerja morning shifts frm Wednesday sampai la semalam. Hari ni cuti 1 day only, then sambung arvo shifts sampai Friday. Urggh! Letih!

And yg 'best'nye, cuti 1 day, the weather is 40°c!! Great! Kalau kerja ada la airconditioning kat spital & my baby Mazda3 would be in the undercover parking lot. Now kesian dia terbakar kat halaman rumah nun coz kereta hubby is in the garage. Ni yg susah rumah just ada 1 garage.

Kat sini total fireban, extreme weather. Ni weather forecast & analysis of today's condition. Now dah dekat kol 1 tgh hari. Dah mencecah 36°c. Extreme UV since a month ago, so setiap kali aku bangun tido sure aku slap on sunscreen sebab tak nak kena skiin cancer (and tak nak hitam obviously) & kalau kuar rumah to drive during the day kena pakai sunnies sebab tak nak kena cataract. Ikut weather analysis ni kata, feels like 78.2°c! Mula2 tu aku ingat diorang cakap pasal °F. Gosok2 mata jap, rupanye betul la its in °c! Hahahahaha. Cuba click kat gambar bawah ni nak kasi clear. Tapi memang betul panas. Kena top up water non-stop la nampaknye.
Kesian pokok-pokok cili, mint, stroberi, kesum, aloe vera aku kat luar tu, harap2 diorang tak kering hangus. Kalau jemur baju ni 1jam dah kering menggoreng. Seb baik our lounge/ dining area now a little bit luas than rumah lama & the ceiling pon rasa cam tinggi sket, banyak plug for us to pasal all the kipas we have.
Hopefully tonight it will get a little cooler, kalau tak susah la nak tido, esok kerja nih.

Gambar-gambar credit to TheAge.com.au

Update (2145hrs):
Temperature now is about 35°c. Tadi max temperature kat sini at 4-5pm around 40°c. Alhamdulillah both of us survive today with lotsa icy water to drink, keep the blinds closed & kurangkan bergerak.
Alhamdulillah jugak this area takde kebakaran.

On the other hand, in the Western/ Northern Victoria, the temperature reached up to 43°c kat certain areas. Western/ Northern Victoria banyak kawasan farm/ grass. Aku bukak berita tadi, as expected, fire kat grass area in the Western/ Northern. Seb baik the CFA dah bersedia awal this time, so most of the fire dah dapat contained & padam in a mere short few hours. Kat news jugak kuar berita pasal org kena heat emergency, ada jugak emergency budak2 terkurung dalam kereta. Seb baik tak jadi apa-apa.
All those fire news make me more bersyukur that I dont live in the Western/ Northern or country Victoria. Alhamdulillah tempat kami tinggal now terlindung dari most bencana alam kat Victoria ni.

Esok another hot day, predicted max 37°c plus a thunderstorm. Aku kerja starting at 2pm, huhuhu, tengah peak temperature tu. Harap-harap masa tu la thunderstorm, takde la aku kehitaman hangus driving to work esok.
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