An Apple Makes All The Difference

Argh!
I just found out yesterday that I have to do a presentation on the 1st of June.

The title - osteoporosis.
Seems simple, right?
But you don't know my specialists.
They are capable of asking questions regarding things that you take for granted.
Sometimes it is the simplest things that you don't know the answer to.
So I have to make sure I know the topic well.

I have to do a Power Point presentation.
There must be less words, more pictures.

There is actually a high chance that I won't have to present on Monday because Monday passovers usually take longer, but I still have to be prepared in case there are not many admissions this weekend.

Will I have enough time?
I am oncall tomorrow.
I have plans for Friday and Saturday.
I am passive call on Sunday.
I hope I have time on Sunday to do the slides.
I don't even know where to start.
I have never actually done a Power Point presentation before.
Guess there's a first time for everything.

Anyway, here is a story I would like to share.
There was a patient, (A) who was in the ward for a fracture, awaiting op.
He is a drug addict.
Opposite him, is a patient who has already gone for op.
This patient is a John Doe - nobody knows who he is (even he doesn't seem to know his name) and he has no visitors, nothing.
John Doe said that he is thirsty and asked for water.
The nurse gave him water.
All of a sudden, A called me over and gave me a plastic bag - I was wondering what he was trying to do.
Then he told me - "Bagi 'kat dia, sian dia takde apa-apa." (give it to him, pity him, he doesn't have anything [to eat])
A gave John Doe an apple.

Such a simple gesture, but such a sweet one.
It was something that I never expected from A.

Today, I am going to learn about osteoporosis. You can too. Just google it. :P

Woman!

I've received a couple of interesting mails recently.

This mail was titled - If woman controlled the world:














The second mail was just a short one, a quote:

Whatever you give a woman, she will make greater.
If you give her sperm, she'll give you a baby.
If you give her groceries, she'll give you a meal.
If you give her a smile, she'll give you her heart.
She multiplies and enlarges what is given to her.
So, if you give her any crap, be ready to receive a tonne of shit!

Today, I learnt that everyone needs friends. Friends to talk to, friends to go out with, friends to complain to. Without friends, life would be miserable (at least for me). I am glad I have friends around me. P/S - I miss my old friends!!

Higher Pay For The Fairer Sex?

I think this week will pass by very quickly.
Today I was in the short OT.
For some reason, I find that time passes by very fast when I am in the OT.

Tomorrow I have a passive call.

Wednesday will be my sleeping day.

Thursday I am oncall.

Friday I am going for a wedding rehearsal after work.

Saturday - my cousin brother is getting married.
And I am the bridesmaid!!
I don't really know what it is I am supposed to do - which is why I have to go for the wedding rehearsal.
I really hope I don't do something stupid like stepping on my saree or worse still - on the bride's saree.
What if I drop the bouquet?
I am quite well known for my clumsiness.
Hmm...

Sunday, I have a passive call again.

And my assessment is next week.
ARGH!!
I don't know anything about Ortho.
How am I going to get through the assessment?
I don't think I will have the time to study.
And even if I do have the time, where do I start?
What to study?
What will they expect me to know?
ARGH!!!!!
I HATE EXAMS!!

Anyway, it is going to be a busy week.
I don't know if I will be able to blog.
The thing is, nowadays, I seem to not have many things to blog about.
Certain things I want to talk about, but I don't think it is appropriate or advisable.
Hopefully my "blogger's block" won't last for long.

This week, I learnt that it is not cheap to be a girl. When a girl goes for a function/party, she has to wear a dress/skirt/whatever and has to think about what chain to wear, what earrings to put on, what to wear on the hands (bracelet, watch,bangles), what shoes to wear, what handbag to carry. AND they have to match.
Yes, I do know that it is not a must, but in general, that is what girls do.
I think employers should consider having a different pay scheme for girls and for guys. It is not that we WANT to spend more money, it's just that we HAVE TO!

A Quiz!

Seems like many people on my Facebook list are creating quizzes about themselves.
I thought I would give it a try too.
Here are the questions I came up with.
(you can give it a try too)

1)	My favorite drink is ________.
a)	orange juice
b)	teh O panas
c)	coconut drink
d)	teh O limau ais
e)	vodka + 7up

2)	What is my favorite movie?
a)	Ayan
b)	Fast and Furious
c)	Star Trek
d)	A Knight's Tale
e)	Harry Potter

3)	What would I be willing to eat for 10,000 dollars?
a)	Dhal
b)	Insects
c)	Porridge
d)	Mushroom

4)	My favourite way to relax
a)	A packet of Twisties and a good story book
b)	Sleep
c)	Watch a movie
d)	Chat with friends over lunch/dinner
e)	Get drunk

5)	When did I stop caring about the fact that I am shorter than average?
a)	In primary school
b)	In secondary school
c)	In university
d)	Who said I stopped caring?

6)	How much time do I need to get ready for work everyday?
a)	10 minutes
b)	15 minutes
c)	20 minutes
d)	30 minutes
e)	45 minutes

7)	I hate buying _________
a)	jewellery
b)	shoes
c)	clothes
d)	food

Are You Willing To Sacrifice Your Leg?

Sometimes it is sad.
Sometimes it is scary.

Do you know how many patients are admitted to the ward everyday for diabetic foot ulcers (DFU)?
Do you know how many patients have had their toes or leg amputated due to gangrene secondary to diabetic foot ulcers?
Too many.

The thing is, such 'wounds' are preventable.
People should not get such bad DFUs.

Diabetes is controllable.
Yes, most older Malaysians have diabetes (in fact, I once thought that it is a sure thing that once you grow old, you WILL get diabetes and hypertension).
But why isn't their sugar level controlled?

First of all, people should take the initiative to get themselves checked for diabetes, since it is such a common disease in Malaysia.
Once they are diagnosed, they should control their food and also take the medications given to them and go for regular checkups - these are things people rarely do.
People think diabetes is a simple disease.
People choose not to care about the disease.

If they get a wound on their feet, they think it will get better in a few days.
When it gets worse, they decide to wait for another couple of days.
When it is very bad (foul smelling, has pus discharge) and they can't walk or the toe is gangrenous, then they decide that it is time to come to the hospital.
ARGH!!
Why are Malaysians SO unconcerned about their health?
When will this attitude change?

All one needs to do is make sure their sugar level is controlled and take care of their wounds.
Is that so hard?
If you think taking care of a wound is too time consuming for you, imagine what life would be like if you have only one leg?

Today, I learnt that an ACL tear is more common than a PCL tear. However, since I am only halfway reading about this topic, I can't say anything more. If you are interested in this topic, please read about it online. :P

Friends Or Colleagues?

Yesterday, I had my first OT (operation theater) call.
It was quite a sudden thing - I replaced a friend of mine who took emergency leave.

It was quite interesting to note that the equipments used in an Ortho OT is similar to tools you find in a toolbox.
We have hammers, drills, screws, screw-driver-like-thingy, rods and pliers.

I don't have much to say about the OT itself.
It is cold.
Basically, as housemen, we just assist the MO or surgeon during the surgery.
Time passes by quite fast though, which is a good thing.

I was just thinking - I have quite many colleagues, but how many of those can I consider my friends?
Are all my colleagues my friends?
What is the definition of a friend anyway?
So, I do what I do best - I googled for the answer.

I found 2 definitions for a friend :

1. A person whom one knows, likes, and trusts.

2. A person whom one knows; an acquaintance.

Personally, I prefer the first definition - however, it is not easy to find someone that you can trust 100%. You can't just go spill your guts to every Tom, Dick and Harry, right?
But then the second definition is too common. What if you know the person but you don't like the person - is that person still considered a friend?

A colleague - A fellow member of a profession, staff, or academic faculty; an associate.

If I were to accept the second definition of a friend, then all colleagues are to be considered friends. However, if I agree with the first definition, then I can separate my colleagues into 2 groups - those whom I introduce as my friends (I like them) and those I introduce as my colleague (don't really like them).

Now, I think the first definition makes more sense than the second.

So, if I were to introduce someone as a colleague - paham-pahamla that I don't really like them. :P

I think I am crapping already. Must be the lack of sleep. Time to stop for today.

Today, I learnt that people will say/do anything to save their asses. Do your own work. Don't trust another person to do things for you. If something goes wrong, you are the one who will be blamed.

Lightning!!

Some interesting storiesfacts about lightning that I read in The Star today..


Ammunition explosion

On July 10, 1926, lightning struck the Navy Ammunition Depot near Mount Hope, New Jersey, United States. Millions of pounds of TNT were ignited, resulting in three explosions. Nineteen people died and 38 were wounded.

Lansa Flight disaster

On Dec 24, 1971, Lansa Flight 508 with 92 people departed Lima for Peru. A lightning strike ignited the fuel tank on the right wing, and the plane disintegrated.

Pan American tragedy

On Dec 8, 1963, Pan Am Flight 214 took off from Puerto Rico to Philadelphia with 73 passengers and 8 crew members. As the aeroplane waited in a holding pattern prior to landing, lightning struck, igniting the vapours in its reserve tanks, causing the plane to explode. Nobody survived.

(Note: Following the disaster, aviation regulations have made it mandatory for commercial aircraft to have built-in lightning protection for their fuel tanks and lines and, since the 1980s, for electrical and electronic systems as well.)

Football team killed

All 11 members of a football team died after lightning struck and 30 others injured during a match in the Democratic Republic of Congo on Oct 28, 1998. The other team survived, which led the superstitious Congalese to speculate that black magic was involved.

Massive blackout

Lightning struck the electrical power grid near Paka, Terengganu, on Sept 29, 1992, causing a near total blackout in the Peninsula – 80% of the population was left without power for 33 hours.

Death camp

Two hikers are killed and another 22 are injured at Gunung Rajah, near Bentong, Pahang, on May 3, 2004. The group were camping on the peak when lightning struck a tree nearby.

Train collision

At least 43 people were injured when two KTM Komuter trains collided near Seremban on March 2, 2004. A power surge from lightning paralysed the electronic signalling and communication systems, rendering KTM controllers “blind”.

Wrong shelter

Teenager Hezrill Remmy Ng was killed by lightning on May 26, 2006. He had taken cover in a small zinc-roofed shelter at a park in USJ 16, Subang Jaya. This drew public attention to the dangers of such council-bult gazebos.

Depot inferno

Lightning struck a 90,000 litre petrol tank at the Petronas Dagangan depot at the Pasir Gudang port, Johor, on April 28, 2006. The fire, which spread to two other tanks, could be seen from Singapore.

Soldiers hit

On Nov 21, 2008, 43 soldiers from the Royal Malay Regiment were shocked when they were sheltering in a tent on a hill clearing near Kota Belud, Sabah, when lightning struck. An army officer was killed and seven others were injured.

Today, I learnt that changing the arrangement of your room/house really changes the way your room/house looks.

(And I learnt that lightnings are really dangerous).

How Corrupted Is Your Mind?

Well, today I am going to share a picture with you...one that many of you might have seen before, but by luck, some of you might not have come across it yet.


Now, don't be shy.
Don't lie to yourself.

What do you see in the picture?








Scientific research showed that children can't recognise erotic scenes.
Instead they see 9 dolphins.

On the other hand, adult's mind is rather "corrupted" so adult person may have problems spoting 9 dolphins at first eye glaze.

If you have trouble spotting dolphins in the first 6 seconds, then your mind is heavily corrupted, and you are seriously obsessed with sex!


Today, I learnt that Hansen's disease = leprosy.
I don't know about you, but the moment people say leprosy, I imagine fingers and toes dropping off. According to Wikipedia, this is not true. For more info regarding leprosy, click here.

Am oncall tomorrow.
*Sigh*

Emergency?

When one is on call (on a weekday), there are only certain types of cases that one expects to see.

For instance, in Paeds, you expect children to come with fits, asthma attacks, sudden high fever, severe diarrhoea and vomiting - things like that.

In Ortho, you expect people to come due to fractures due to accident or falls.

However, that is not the case.

Can you imagine clerking a case of sacral sore at 3am?
The sore would have been there for a few weeks or even months.
Why do they have to come in at 3am?

Better still - diarrhoea for the past 1 week, decreasing in frequency.
Getting admitted in the middle of the night.
If the diarrhoea did not have to be checked for the last 7 days, why can't it wait for another 7 hours?

My friend said she once clerked a patient who came for menorrhagia for the past 3 months.
She came to the hospital in the middle of the night because the husband only had time to bring her to the hospital then.
The husband must be a really, really busy man to not have any spare time for 3 whole months, don't you think?

I recently clerked a patient who had dry gangrene of the toe for the past one week.
What prompted him to come to the hospital at 11pm and not earlier?
I have no idea.

If we get such cases in the ward, imagine just what the A+E people see each day.
People come to the A+E for every minor thing that can wait.

The A+E is for accidents and emergency.

If your leg has hurt for the past two years and you suddenly decide to get it checked up, you can wait until the next day, when the outpatient department will be open.

You do NOT have to come to the hospital at 2am for a wound that you have had for the past month; it can wait a few more hours.

People, be considerate.

Today I learnt that wedding banns are announced (?read) for 3 consequtive weeks before a couple gets married. So, if anyone has any objections regarding the marriage, they have 3 whole weeks to bring up the matter.

Everyone Has Their Own Dreams

Random Post

Unfortunately, the passover didn't go as well as I hoped.
I answered the question that I was asked to present, but I was then asked on how LAs actually work and about it's toxicity. So, that is my homework for today - to present tomorrow. I don't really mind actually, at least I will learn something.

I am oncall tomorrow.
Every call is a stress.
Every call is a challenge.
Every pre-call is a depressing day.

Anyway, I heard Ipoh was quite a happening place today.
I have no idea what happened.
I have no idea who is the MB, who is the government.
Our day in the hospital is no different.
Admissions, clerkings, discharges.
Life goes on as usual.

Just the other day, there was a news article about a 6 year old boy who probably died of Paracetamol (PCM) overdose.
Supposedly, the doctor prescribed 2 tablets of PCM to be taken 4 times a day.
I wonder how such a mistake could happen.
A 12 year old would probably generally know that kids take 1 tablet of PCM while adults take 2.
(As a doctor, you calculate the amount based on the child's body weight - 15mg/kg)
They have set up an inquiry for this case for now - let's see what happens next.

Have to study my LA now.
Till later!

Today, I learnt that carbon dioxide in the blood stimulates the respiratory system - the carbon dioxide drive; which means, that the reason we breathe is because of high carbon dioxide level in our blood stream.

However, as we live in a polluted world, by the time we get old, our body is almost resistant to carbon dioxide drive (I don't know why) and we depend on oxygen drive - which means that when there is low level of oxygen in our body, we breathe in more.

When someone has trouble breathing and we give them oxygen, then the oxygen drive does not work (as there is no hypoxia). And so, if we prolong the supplementation of the oxygen, we are basically not helping the patient as we are surpressing their oxygen drive.

(p/s the things that I learnt may not be very accurate, it is just what I understand from what I hear/read.

A New Thing A Day

I decided that I should take the effort to learn something new everyday.
It can be anything - related to work or just a general thing.

A new thing a day, or at least a new thing every blog entry.

Since it is a little late right now, and I am kind of sleepy, I am not going to think very hard about what to write for today.

I was given a 'homework' by one of my specialists that I have to present during passover tomorrow. That will be my 'new thing for the day'.

Today, I found out why local anaesthetic(LA) doesn't work if the area of interest is inflamed/infected.
LA is a base. Inflamed tissues are acidic.
So, as the LA is neutralized, there won't be sufficient amount of LA to penetrate the tissue and produce it's effect. (something like that la)

Hopefully it will go well during passover tomorrow..

Just Another Scratch

I was postcall on Saturday.

After work, I drove to KFC, tapau-ed my lunch, went back home, ate then slept.

The next day, I walked towards my car and this is what I saw.


Who did it?
I have no idea.

When did it happen?
I don't know.

What can I do about it?
Nothing.

Life goes on.
As it is I have another scratch on the other side of my car (my fault).