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Monday, February 27, 2012

Hujan daaa..

Mengikut kajicuaca, sejak semalam hujan lebat thunder storm esp in the northern, western areas. Kat kawasan aku hujan non-stop since last night. Not lebat though. Gloomy. Akan berlarutan selama beberapa hari akan datang. Seb baik I did berbakul-bakul laundry a few days ago masa tgh panas gila, during the 35°c-38°c days.

Hujan. My pokok cili & strawberries yg berjaya diselamatkan buat masa ini.
I'm restarting my detox again. My way of detoxing myself. I was doing so well until about 2wks ago where I started eating junks again & no exercise. Guess wat, naik balik 2kilo! Grrrr! Sejak semalam aku start balik my detox plus senaman semula. Aku rasa this time aku tak nak yangyok senaman tapi tak nak overdoing it either, nak consistent bersederhana je. Supaya metabolism just nice & consistent, tak nak yo-yo lagi dah. Detox ni just nak kickstart again. Like I sed before, my detox is avoiding junks for a week, reduce food portion, balanced diet but more towards veg & fruits & simple protein, and my homemade detox juice frm my recipe books. Aku still makan nasi & lauk, but reduce portion & healthy replacement of stuff e.g. tak guna santan tapi guna susu, kurangkan garam, kurangkan gula, kurangkan minyak, rebus mana yg boleh asalkan lalu nak makan, etc. Just sederhana je, coupled with senaman. Even with these measures, my berat senang turun & badan senang tone.
This time akunyer detox juice made of grapes, blueberries, strawberries, blackberries & coconut water/ pomegranate water. Sedap!

So, I was working over the weekends. Started at a weird time ever: 5pm. Abis midnight. Not complaining, coz it means aku just kerja 7 jam je.

Sabtu: one of the bosses started a buddy thing, where a registrar buddies with a resident.
I think in a way nak minimize interuptions kat big boss yg in charge of the floor, and also nak encourage registrars to take more responsibility/ leadership role. So aku dibuddykan dgn this resident. In a way, ok la bangga la jugak boss percaya kat aku, the resident percaya kat aku (or terpaksa percaya kat aku.. hahaha), aku pon dipaksa berfikir on the spot & praktis my listening/ leadership skills. Yg tak bestnye, seriously selain dari layan patients aku sendiri & layan those handover patients, aku kena layan my resident's patients jugak. Rasa cam all these interuptions just delaying my own patient's management. Unfortunately, tu lah dia tanggungjawab as u go higher up.
Cases yg best on Saturday: dengue fever in an Aussie who works in East Timor tapi pulang bercuti di Melbourne. Funny & almost embarrassing coz I had never seen any dengue fever in my whole life. Surely, I've heard of people dying of dengue haemorrhagic fever kat M'sia but tak pernah tengok depan mata sendiri. Now I know. Then ada this patient with myeloblastic disease with massive hepatosplenomegaly; liver & spleen dia besar gilaaa! Good textbook cases that day.

Sunday: aku was working in green stream. A locum boss was in charge of green. As much as she was being very supportive & nice, aku rasa cam dia kurang percaya kat aku. Semua patients yg aku d/c dgn dia, dia nak jumpa & manage kalau boleh. Hahaha, kelakar coz tahun lepas aku cam whinging that aku tak nak manage pt by myself. This year aku komplen plak boss nak tau pasal pt aku. Oh well, we need to have balance & check to ensure safe medical practice.
Anyways, interesting cases semalam: nasty distal radius & ulna fracture in a 7 year old boy, kami reduced kat ED under ketamine sedation. Somehow kat sini diorang berhati-hati guna ketamine. Not like in 3rd world countries where ketamine is readily available. Orthopaedics registrar datang buat reduction. Then this wound on a forearm of a 13year old. My boss suruh aku ajar sorang intern ni yg tak pernah buat stiching lagi sejak dia start ED. Its a straight forward 2 inch wound so boleh la aku suruh dia buat. Tapi lepas 2 stitches dia buat, si parent ni tetiba tak kasi plak, nak aku plak yg abiskan. Aku dah la busy dgn other patients. Tapi aku abiskan jugak la. Its a shame la parent tu tak kasi that intern buat. They have to learn somewhere & the best way is to do it themselves in an uncomplecated straight forward clean wounds like this, which we dont get all the time. Other cases are not so interesting but not difficult at all: suicidal lady, removal of a piece of broken glass from someone's foot, sprain toe, anaphylaxis, another wound in a 2y.o. girl.

Malam ni aku kerja nights straight until Thursday night, abis pagi Friday. Aku kena gi tido in the evening for a few hours so that tak ngantuk first night nanti.

Friday, February 24, 2012

Cuaca best untuk jemuran

Love the weather today & I love my house.
3 laundry cycles aku dah buat & dah jemur. Half dah kering in 2 hours time. Good dose of sunshine for my trees. Good dose of sunshine for my skin provided aku slap on thick & frequent layers of sunblock. Good dose of sunshine for my study mood =). And dalam rumah just nice & suam, walaupon kat luar tu lebih panas dari kat M'sia, temperature dalam 35°c. Best!. Aku belum pasang kipas lagi kat ruang makan/ ruang tamu ni.

Adelaide nampaknye hampir mencecah 40°c today. I think when it gets to 40°c, aku lebih rela gi kerja dp dok rumah. Coz kat rumah ni takde aircond & selalunye bila dah >40°c tu dlm rumah ni pon akan jadi panas semacam walaupon pasang kipas. And kami akan jadi lembik semacam coz tak tahan panas.

Esok akan panas jugak, so I think I will scout around on what else to wash. Mebbie selimut & linen & towels & some more floor mats kot. And InsyaAllah nak buat gardening & kemas rumah sket early morning before panas.

Nak masak apa for dinner tonight?

Berehat jap

Dah hampir seminggu aku berehat from bersenaman & study. Maka beratku yg dah elok-elok turun tetiba naik hampir 2kg, simply coz no senaman & sedentary life in a week termasuk kat spital. Aku rasa mcm each time aku period sure size seluar & baju naik 1 size. Angin satu badan, physically & mentally. Hahah. Blame it on my menstruation: Dysmenorrhoea & menorrhagia.
Letih jadi pompuan ni kan. =P

Alhamdulillah aku tak kena panggil masa aku oncall over the weekends. Got the day off on Monday as well. Then was working a.m. shift Tuesday & Wednesday. Not bad coz patients banyak tapi doctors & nurses pon banyak. So patient flow memang fluent. Then the doctors that I was working with over the 2 days were the cool ones. Termasuk my ED physician/ Intensivist boss who is my idol. Hehehhee. So memang mood baik je kot, despite sakit-sakit badan.

Ada category 1 patient datang on Tuesday, out of hospital cardiac arrest with long down time. Wasnt my patient but I was the procedure doctor. Was happy with my arterial line, didnt get to do the CVC because family & medical team decided to withdraw treatment, mainly coz long down time & patient was showing terminal signs already. Selamat, coz I was sooo sleepy that morning that I almost confident that if I proceeded with the CVC, sure miss & bazir au$300 for the CVC kit. So this patient went to ICU to pass away.

Some other interesting cases I saw during those 2 days: Acute appendicitis yg aku diagnosed clinically despite the odd history & findings (it takes guts to confidently diagnose something yg tak ikut black & white of medical textbooks). Compound crush fractures of a hand. Sepsis 2° to severe cellulitis, that we managed to exclude necrotising fasciitis.


Semalam pegi registrars' teaching kat spital. Cool gila kami ada this new fibreoptic camera laryngeoscope for intubation. We had a briefing by the rep on that stuff. I personally have used this to intubate a severely overdosed patient 2 weeks ago during my night shift, and I found that it was significantly easier & quicker using this. Great. Not much strength & lifting needed, and the screen to observe the airways is excellent. This gadget is great for difficult airways, trauma intubation, cervical spine precaution & to remove upper airway foreign body.
Tapi aku still rasa we still need the traditional intubation skills using the old metal laryngeoscope. Which needs a lot of left arm muscles, di mana aku punye memang flabby & lembek. :P

I think yesterday's registrars' teaching was one of the most comprehensive ones. Lepas glidescope briefing & practicals, kami blaja new guidelines on procedural sedation for children, in particular using ketamine & nitrous oxide. Most of the registrars dah guna these great 2 sedatives either in ED, ICU, theatre. Tapi yesterday, we had the briefings on the new guidelines & also ada practical stations.
Then my idol boss refreshed us on the details & hardcore stuff of acid-base/ blood gasses use in sick patients. Best la. But by the time abis glidescope briefing tu aku dah ngantuks & tepu. So tak tau brapa byk the rest of the tutes masuk dlm otak aku smlm.

All in all teaching smlm memang best. Hopefully I get to see these stuff in the near future for real life practice. Ntah ngapa now rasa cam semangat nak kerja plak with all these refreshments. Selain dp new cool doctors to work with in ED & ICU, my plate is full of work stuff. I'm going to this APLS course in a month's time (advanced paediatrics life support), then the primary exams in August/ Sept (InsyaAllah pass, then boleh maju ke advanced ED/ ICU training.. yay!), on top of the many presentations during registrars' teaching & mengajar for the medical students/ interns/ residents. Banyak this ongoing lifelong professional development stuff. Seems positive & hopefully stays positive & smooth. InsyaAllah.

Aku kerja arvo shifts this weekends, then straight to weekday nights Monday until Thursday night, abis pagi Friday, again with awesome docs. =)
Now kena sambung study.

Saturday, February 18, 2012

Perihal size badan

Berat badan aku mmg naik gila-gila masa annual leave 5wks end of last year. On my last day of holiday in M'sia, berat aku dah jadi lebih berat dari my dad & my 28yo brother. How sad!! Ni la jadinye kalau makan tak ingat dunia, pas tu senaman yang yok skadar berjalan-jalan di pasar malam or shopping malls dgn tujuan mengisi perut & mengosongkan dompet.
Seperti yg aku agak, balik Melbourne terus takleh pakai all my work clothes. Seb baik cuaca kurang best
and seb baik jugak aku kerja kat ED maka boleh la pakai jeans, t-shirt or sweater nipis gi kerja. Haru! And most people at work were like.. "you are so fat!" written on their face when they look at me. Cheh! Dr. HAK & akaknye directly cakap aku gemuks! Chissss! Tapi takpe, tak terasa coz it was a wake up call.

So balik je dari M'sia aku terus started my quest to lose weights.

I changed my food regime. Instead of makan 15x sehari bertambah-tambah, aku kurangkan portion each main meal & make them regular 3x with small healthy snacks in between. I've been trying to eat biggest meal for breakie, setakat ni sederhana saja coz slalu ngantuk kalau kerja pagi manakala kalau arvo shift just sempat makan for brunch. Usually my midday meal will be the smallest. Aku pastikan aku makan seimbang for the main meals: kena ada carbs, protein, fat, lots of vegies. I dont keep junk foods at home anymore, unless aku kerja night shifts di mana those junks utk bawak ke spital share with night ED staff. Tell ya, the cravings for junk food memang the greates for the first 3wks lepas balik sini. Simply coz kat M'sia asik makan je walaupon not junk, so kat sini the good foods takde but junks are everywhere. Aku pastikan setiap hari akan ada dessert, which will be only fresh fruits not pastry/ all those sugary sweets. Seb baik aku & hubby bukan jenis suka desserts unless kalau makan luar/ visit org, and aku pon jenis malas & tak reti make desserts unless sekadar potong buah. Kalau cravings sgt baru la aku makan sesudu dua chips or chocs. Soft drinks memang dah lama takde dlm rumah ni mostly coz these hurt my gastritis.
3rd week of my diet change, aku start on this detox regime plak. Sebab apa lambat, sebab nak try biasakan diri with the diet change & curb the cravings first baru start on detox. Kalau cut off everything cold turkey takut aku yg pengsan nanti. Detox ni tak le yg strict gila tak makan apa-apa selain dp detox juice & fruits je. That detox week aku kurangkan lagi portion all my foods, makan soft protein, tak sentuh langsung all the junks & I made daily 2,3x detox juice recipes frm my juice recipe books. Sedap, and by the end of that week, badan rasa ringan & segar.

Di samping tukar food style, aku try senaman setiap hari or setiap dua hari. Mula-mula tu definitely on my crosstrainer & using the weights. Short bursts of exercises during my free time, esp kalau dah bosan study. Dalam 5-15minutes each time, 2,3 x sehari kalau hari tu aku tak kerja. Kalau kerja just buat sekali dua je. Takde la dedicated 1/2jam to 1 jam beberapa hari seminggu, kerana aku memang malas. Kelakar kan coz most senamanholics will say that my regime will definitely not do anything. But to me, enuf to increase my heart rate & improve my circulation, takde la sedentary mandom ngantuk je. Then bila cuaca elok sket, I'll try to brisk walk outside. Rugi dibiarkan cuaca best sempena summer ni, nanti dah masuk autumn & winter haaa.. depressed je coz tak brapa boleh nak senaman outdoor.

Tambah lagi shift malam mmg tak sempat nak makan langsung, and kadang kalau arvo shifts busy gila aku skip my foods & minum something filling. Totally not healthy yg ni.

Apa hasilnye? ----> Now dah 10wks since I returned to Melbourne frm my hols. I've lost 6kg.

First 2 weeks ada la dlm 1kg je turun. Lepas detox tu & another 5weeks terus turun another 5kg. Now maintain sejak 3minggu lalu. Mostly now aku just kisah about the ukurlilit rather than weight, even though kalau dapat lose
another 2kg (+2kg lagi kalau rajin) for the next few weeks, thats an added bonus lah. Kena increase my exercise plak now coz food wise aku dah berjaya lawan all the cravings & dah berjaya biasakan dgn makanan seimbang & healthy.

Alhamdulillah, most of my baju & seluar kerja dah boleh muat. Takde la rasa sedih setiap kali berdiri kat wardrobe sebelum gi kerja pikir nak pakai apa coz takde yg muat. Hahahhaa.
Well, this adventure of weight loss memang seriously lah kasi lesson kaw kaw nyer kat aku. Geli with the lipatan lemaks, sakit hati that I couldnt fit in most of my work clothes & (pang ke muka) when actually I was heavier than my dad & adult brother masa tu. Fuh!
Kali ni memang aku actively dieting (my way of dieting) & senaman. Kalau tahun-tahun sebelumnye aku just rely on my night & arvo shifts, dan juga replacing most of my baju/seluar kerja coz malas nak berusaha kurangkan size badan.

Harap-harap my weight & size at least turun ke weight & size asal sebelum aku balik cuti hari tu.

Wednesday, February 15, 2012

Termiss nombor!

wwwoooopppsss! Aku termiss yg ke-2000 on this blog! Sorry peers. I vowed earlier to have another give away for the 2000 readers. Totally forgot.
But, its all my bad anyways, been lazy & busy with work & stuff tu yg jarang masuk blog ni.

Anyways, my next favourite number is 2505, which signifies my birth date =) Pretty number kan?
So anyone yg dah sampai to this number, please printscreen & leave comment on any of the entries, I will send sth special, InsyaAllah! If it's me, then special gift to me.. =D

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Ni pesto spaghetti aku buat semalam. Simple tak perlu masak. The first edible pesto I ever made, recipe found kat Taste.com.au.

Ignore my burnt baked chicken nuggets. Those unmatched cutlery beli satu set kat Borders. They come in different designs & colours for each sudu teh, sudu makan, pisau sapu roti & garpu, hence mmg takde match. Satu set utk 4 org. (chewah, promote plak.. Borders dah terkubur kat Australia).
Recipe dia guna 1/2 cwn fried pine nuts (goreng tanpa minyak), 2 cwn compact fresh basil leaves, 2,3 biji garlic, garam, 1/2 cwn olive oil. Aku guna pine nuts + almond + peanuts coz pine nuts aku dah tinggal sesudu besar je. Also secawan lagi aku campur dgn vietnamese basil a.k.a. kesum frm my garden, aku kurangkan garlic.
Nyam makan dgn fresh cherry tomatoes, pastirna, marinated mixed pitted olives & baked chicken nuggets.

Monday, February 13, 2012

Lama gila tak update

Gila lama tak update.

Now dah masuk minggu ke-2 of the new working year for 2012. Makin busy with work & studying. Skang aku dah jadi 2nd year ED registrar. Ada 2 org last year HMOs now dah jadi junior ED registrar, which means I'm no longer the most junior.. tak dapat all the attentions anymore :( jeles!! Hahahaha.. takde lah. Gurau. But that means aku lebih dipercayai oleh bosses & at the same time hold more responsibilities. Ada a few new registrars starting as well frm other hospitals, mostly are seniors. Some seniors are out at other hospitals doing their whatever rotations. One of the junior ED registrars that aku baik with moved on to Royal Melbourne Hospital buat her ICU rotation. Other senior registrars pergi ke Eye & Ear Hospital, Royal Children Hospital, & Monash Neonatal ICU, etc. Tengok diorang moving on to their rotation of choice buat aku berkobar-kobar plak nak study abiskan my primary exams cepat2, so that aku pon boleh buat rotations yg aku nak like the Children's, Eye & Ear, ICU, etc.

Talking about new year, new doctors starting all over Australia for the new working year. Plus the medical students. I've noticed with the new juniors in ED, some have a lot of attitude... berlagak, degil, malas. Mula-mula aku ingat aku sorang je yg terlebih sensitive. Rupenye most specialties are having the same issues with the juniors. Huh... generasi skang ni makin besar kepala eh. Aku dgr cerita hari tu dari medical registrars yg one of the interns kat ward was telling the consultant what to do with a patient... whooaaaa.... berani! Kami dulu masa students & interns tak berani nak bersuara, & sentiasa berusaha keras utk bosses nampak kerja kami bagus. Slalu kami sanggup balik lambat nak siapkan kerja & sampai kerja awal. Skang ni.. wooohooo... lain dah. In ED, kami cuma kasi chance the juniors nak get used to the first 1-2weeks, we'll show them around & make sure that they learn. Kalau masuk minggu ke-3 macam ni jugak.. kena la. Bunyi cam garang kan, tapi tu la, diorang ni kami tengok, the attitude memang tak bleh blah. Ada je yg baik, sopan, takut-takut tapi rajin. Those people kami kasi more time at the same time encourage diorang jadi berani & confident. Tak kisah kalau diorang dumb, slow, junior tapi rajin & polite, coz these are the kind of person that u want to be in ur team, and will definitely go far to success. Kalau dumb, slow, junior AND rude & pemalas... hmmmm silap besar...

Kaki bebel jugak aku nih. hehehhee..

Anyways, aku dah kerja 3 weekends in a row termasuk semalam. Hari ni aku kerja night shifts sampai thursday. Esok pagi kena gi jumpa GP for a f/u of GI investigations I had last week. Then kena jumpa specialist in the next few weeks. Jumaat ni plak lepas night shift kena gi service kereta. Weekends aku on call.

Bila masanye aku nak study nih?
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