Telinga berdarah di ICU

I'm in ICU atm. Alhamdulillah its been quiet so far. Dah selesai 3 malam aku night shift minggu ni, malam ni (Isnin) adalah malam terakhir for this cycle habis pagi Selasa kol 9am. Then aku off, kembali kerja on Thursday, day shift until la weekends. Minggu terakhir aku kat ICU. Sob sob sob. Then back to ED, doing a junior registrar job. Sob sob sob sob sob lagi. Aku suka ICU. 3-month-term is a short term for any junior doc for any rotation, if you want to learn something.

On the other hand, lega dah takde kerja dgn si orang gila Timur Tengah tu. In fact, since minggu lepas until next week, aku takkan jumpa dia lagi. Harap-harap our paths will never ever cross again. Amin.

Malam tadi best, aku buat 2x internal jugular CVC. I kno most ppl my level will be like.. "Whats so big of a deal is that.. aku dah buat berlambak.. tak heran pon.." Oh, well, it is a big deal to me. First we are dealing with an unstable patient who needs a central line. At the same time a sick patient will make doing a central line insertion hard. Thirdly, looking at the anatomy itself, internal jugular is right next (lateral) to the carotid artery, a major artery supplying the brain. So ada macam-macam risks di situ, plus its an invasive procedure. Internal jugular is not the only access for a central line. Ada lagi: femoral vein, subclavien vein, or PICC (peripherally inserted central catheter). Aku dah buat PICC hari tu. And what has taken me sooooo long dah nak abis ICU baru nak buat CVC? Entah ngapa setiap kali aku on either its toooo busy that we could hardly breathe, or patients dah sedia ada lines, or my reg akan buat the important lines. Esp. kalau kerja dgn si Timur Tengah tu, memang takde harapan la aku nak blaja apa-apa. Haram betul.
Kesimpulannye, memang aku bangga dapat buat 2 skali gus malam tadi. Harap-harap la dapat buat beberapa lagi central lines sampai la aku abis ICU nanti. Ye la, tempat mana lagi boleh buat these important procedures selain dp anaesthetics & ICU.

Ops.. ada call from the ward.

Ok dah balik. Unwell patient on the ward, tapi di assess oleh resident yg malas & dodgy. Ngamuks registrar aku. Hahaha. Tapi terpaksa la jugak pegi assess the patient. And seb baik patient to okay. Tak perlu masuk ICU. ICU dah penuh malam ni.

Tajuk telinga berdarah tu saja je gempak. Takde la gempak sangat. Tapi saja nak citer, registrar yg aku kerja malam ni ialah ED registrar yg amik locum job coz takde registrar malam ni. Aku kenal dia. Pernah kerja dgn dia byk kali since aku start kerja kat EH ni lagi. Rajin, pandai. Tapi, ya Allah! Swears like nobody's business, all the time. Perit jugak la telinga aku dengar dia komen itu ini, esp. pasal politics. Semuanye negative. Adoh, kadang sampai bini dia pon dia panggil B*! Korang agak sendiri la apa perkataan berbintang tu. Hahahaha. Takpe la tu, tak kisah. As long dia suka kerja dgn aku, and baik dgn aku tak buli aku cam si hampes tu. And dia pon one of the many ED registrars yg dah quit hospital training coz of had enuf with the politics, funding & working conditions. Rugi lah, Australian government still biar je rakyat jelata fall behind in their health care pasal diorang malas nak improve the situation.

Tak sabar abis shift. Lagi 6 jam nak abis ni. Aku datang lambat coz the day resident covered for me 2hours tadi. Jumaat hari tu aku dah datang awal for night shift to cover her. So dia balas balik balik tadi. Bagus la, aku ada extra masa nak buang kat rumah before coming to work.

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5pm, kat rumah.
Sambung. Hampes, aku tak dpt lelap mlm tadi koz registrar aku dok bantai tido berjam-jam. Aku sebenarnye tak berapa kisah coz dia kena gi court hari ni kasi statement. Bukan pasal dia punye salah. Tapi as a witness utk pesakit gila yg jadi penjenayah. Pagi tadi sebelum abis shift dia dah tukar pakai coat tie semua pasal kena gi court.

Actually semuanye quiet until around 530am, macam2 review from the ward. 2 yg boleh dilupakan. 1 post-op patient dropped GCS, mismanaged by anaesthetic reg & resident & ED & the whole ward basically. 1) The last BSL was 8.7 by the ambo, cant find any more documented in the rest of the notes since yesterday. Bila aku suggest check BSL while waiting for the bloods to come back & further brain storm apsal dia ni dropped GCS quickly... wooooo undetectable by glucometer & finally on ABG showed 0.2!!! Kami kasi la glucose cepat2 before dia koma terus. Slowly responding. 2) The rest of the bloods showed critically high lactate, low pH.. hence severe acidosis. Kami rehydrate her with dextrose. Bawak gi ICU. 3) She had ~3litres of bile washed out during her laparatomy for cholecystectomy. So she is pretty sick.
Kat ICU dia deteriorated, ni semua jadi around 730am++ when dah nak abis shift. Serious kelam kelibut. She appeared septic. Kesian that poor old lady. She is very sore in the tummy, ye la post op kan. Then kami tak dpt nak buat artline coz very peripherally shut down dah. Tiba big bosses pagi tu, lepas hand over, terus diorang intubate her. Harap-harap she survived. Kesian sangat.

Oh ye, ada this new med student final year of post grad from Deakin Uni datang buat her rotation here. Ches, sibuks je. Hahaha.. ada tanda2 jeles di situ. Ye la, dah la lawa, appears confident plak tu. Great personality jugak. Dgn aku yg tgh takde self-esteem buat masa ni mmg rasa nak suruh dia balik buat kerja apa dia buat before dia decided to jump to medicine. Post grad course for medicine ni slalunye shorter than the normal degree, utk org yg tak dpt buat medicine as their bachelor.

Lepas intubate tu aku balik rumah. Ingat nak singgah Chadstone to order this cookie cake from Mrs. Fields. Tapi dah ngantuks sangat. Balik je terus pengsan atas katil.

Flowers kat hospital

More on flowers.

Ni semalam lepas case prezentation, aku gi hantar payslip kat bangunan HR. Berkesempatan snap some flower pics.

Aku dah lama nak amik gambar these cute little flowers kat depan building tpt aku slalu hantar my timesheet, where the HR lives. Its not alwiz aku pergi sini considering bangunan ni separate from the main hospital building & jauh nak jalan. Kalau drive pulak kena bayar parking. Baik aku parking kat hospital parking yg dah memang2 tolak from my pay. Dulu ada straight route to it from the main building but since the construction of the new hospital Critical Care building, derang dah tutup jalan tu so kena lalu jalan jauh lagi to get here. Walau pon senaman kiranye utk aku, aku malas gila nak pegi sini coz banyak org gila melepak kat entrance building ni. Thats because the building is also shared by the Psychiatry In-patient units (one for adults, one for children/teens), and other Mental Health services. Tak tau la apsal pandai sgt HR gi share this building with Mental Health services ni. Dulu dah elok2 kat main hospital building. And pasal org2 ni melepak depan building HR ni jugak yg menyebabkan aku tak amik gambar bunga2 ni setiap kali gi hantar timesheet/ amik payslips kat sini. Mostly aku tak tau nama flowers ni.

This is the white version of the konon-konon weed yg aku citer hari tu

My favourite!! Comel sgt these deep red flowers

Cute purple flowers

Ada banyak lagi bunga, nanti2 aku usahakan amik gambar lagi, provided those psych patients takde lepak2 kat depan building ni. My life is very simple eh. Aku suka flowers yg kat pokok, but not bouquet hadiah utk aku coz nanti lama2 dia akan layu & aku jadi sedih kena buang bunga2 tu. Nak bela bunga sendiri plak malas. Baik bela sayur or buah, at least kenyang. Hehehehe.

Okay, am getting ready for night shift. Ciao.

Prezo petang ni

Assalamualaikum wbt,

Malam tadi aku tido lambat gila just for the final touch ups for my presentation. Hari ni plak bgn awal. Malam tadi dok mimpi about this presentation. Of course la aku takut coz topic yg aku dapat tu susah, it was supposed to be presented by an ICU registrar not watak picisan like me. And lebih menakutkan pasal bosses & their trainees in ICU/ ED +/- Anaesthetics will be there. Selalu meeting gini resident cam aku ni mana la pegi. Berdebar gila, cam kena AF plak. Takut aku gagap or pengsan terus je nanti.

Tajuk prezo aku ialah Neuroleptic Malignant Syndrome- A Diagnostic Dilemma. Dah siap dah semua mlm tadi. Tapi ni jap lagi nak baca satu2 mana tau ada menda aku miss/ silap ke. Kena careful in this kind of meeting. Maklumla org2 besar ada di sana.

Doakan aku selamat pegi & balik, doakan aku diberi kekuatan to face this meeting, doakan aku berotak cergas & tak mati kutu time prezo nanti. InsyaAllah.

Kalau aku lama tak update ini blog lepas ni, maknanye either coz aku busy sebab straight to night shift for the next 4 nights OR aku memang kecewa sgt dgn diri sendiri sebab prezo tu. Harap2 sebab yg pertama tu. Amin.

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Okay, Alhamdulillah case prezo ok je. Walaupon aku terketar2, yg penting dah pon disampaikan. Aku presenter last skali so mmg tak byk soalan, and tak meleret2 coz dah tak cukup masa. Lega aku. Hehehhee.

Petang tu kami went to the city for dinner, and lepas dinner dok melepak kat Max Brenner kat Melbourne Central. Kat QV punye slalu penuh & tutup awal. Btw, masing2 dah penuh perut masa makan sini and aku pon dah start reflux, aku tak abis my drink & the waffle. Sebab seat kami di sebalik dinding, maka senang la aku membungkus waffle tu. =P duit weh.

Nombor order kami kat Max Brenner. Coincident dgn giliran prezo aku ptg tadi

My drink: dark chocolate with crispy waffle balls

Tuty fruity waffles

Yummilicious!!

Hubby's expresso

Abis dah...

Nak tau apsal aku gila sangat dgn Belgian waffles kat Max Brenner ni? Sebab rasanye yg manis, tak rasa telur sangat (yg slalu buat aku cam mual sket), and dia tebal & crispy on the outside, lovely inside. Teringat zaman aku kecik2 dulu kat US. Love waffles! Setakat ni aku tak jumpa lagi waffle batter yg rasa dia mcm tu unless beli yg ready made tinggal nak masuk dlm toaster je. Ada yg crispy but then rasa telur kuat sgt, ada yg lembut macam getah. LG punye batter recipe aku tak try lagi coz lepas hari tu tak berkesempatan buat yet. See how we go bila aku dah try nanti.

Malam tu bercita-cita lah aku nak stay up lama-lama coz kerja malam this weekends, plus Friday aku kena gi awal covering for my fren & he will cover for me next weekend plak.

Cuti Australia day, bunga & rumpai

Malam tadi Dr. HAK & I went to the city to meet up with Dr. AI. Saja last kumpul 3 org girls mungkin last tahun ni coz Dr. AI dah nak balik M'sia in 2wks time. DIa nak berehat setahun from dunia perubatan ni. Sedih la jugak, member baik nak balik M'sia. Tinggal berapa kerat je kami kat sini. Went to eat at this nice restorant in Docklands.

Caramel pannacotta with citrus syrup yg aku & Dr. HAK order.. nyaaamm!

Sticky date puding yg diorder oleh Dr. AI.. sedaaap!

Hari ni plak cuti umum negara.. Australia Day. YL buat bday party for her daughter. Aku tak pergi coz kena siapkan this presentation for tomorrow (presentation yg akan menentukan hidup matiku for the next few months). Hubby pon tak pegi coz he's meeting up with his friend in the city.

Haaa.. ni nak kenalkan some of the flowers/ weeds kat rumah aku. Flowers tu sumer ditanam oleh tuan rumah. Some weeds (yellow ones) tumbuh sendiri coz kami separa malas jaga lawn. To me the flowers here are more cantik dp the flowers I had kat rumah lama dulu.

Tak tau lily apa ni

Ni mungkin sama geng dgn lily kat atas tu kot. Tak tau jenis apa
Ni pon sama, tak tau apa nama pokok bunga ni
Ni dia punye pucuk muda
Pokok rose renek yg aku tak sedar pon kewujudannye, tapi cute

Lagi pokok ros renek sebelah sana
Agapanthus purple depan rumah. (Thanks Lemongrass).
Ramai org rajin tanam ni. Ada kaler putih juge

Lagi rumpai kat halaman rumah... tak lama lagi selamat la dia kena cantas

Next time perkembangan cili & sayuran kat sini plak. Now back to work!