When You Procrastinate

Things I need to do by Friday, 5pm.

1. Fill up my log book.
2. Get my log book signed.
3. Get my leave form signed.
4. Fill up my call claims.
5. Submit the log book, leave form and call claims.
6. Get my ticket to go back home.
7. Pack my bag.
8. Find someone to send me to the train station.
9. Meet the O&G HOD/specialist/MO.

I hope I will be able to get all of this done.
This is what you get if you postpone everything to the last minute.
Everytime I do something like this, I regret, and I vow that next time, I will do things in advance - but that never happens.
Anything that is considered not urgent, can be put off.
And this is the result.

I just found out today that I won't be going to medical after all; I'll be going to O&G. I think medical is a bit saturated for now, hence the rearrangement.

To tell you the truth, I don't really mind.
I don't mind going to any department, except A&E - don't think I am ready for that yet.

Too many things on my mind now, can't really think of things to say.
Hope I can settle everything that I need to get done.

Nonsense

Another week has passed.
How fast time flies.
I've been working for almost 8 months now.
Doesn't seem like it's been that long though.

If everything goes according to plan (i.e I am not extended) I will be finishing Ortho soon.
I can't believe I am saying this, but I think I will miss this department.
There are some really nice people in this department (although there are some I will not miss AT ALL).

A friend of mind pointed out - it's easy for us to say now that we kind of like the department, 'cos we are already leaving it.
I remember hating this department when I started out.
Eventually things turned out quite well.

Maybe it's because when I first entered the department it was an entirely new thing (trust me, Ortho and Paeds - 2 different world), and so it took me quite some time to adjust.
Maybe it's the different way the department is run.
Maybe it's the different people (Specialists, MOs, HOs) that I had to get to know.

Well, right now, it all doesn't matter.
All that matters - I'm leaving soon and I am looking forward to it.
(I have one week of holidays before my next posting :P)

One thing I am sure of though - I do NOT want to become an Orthopedic surgeon.
It's not that I hate it or anything, but I don't think that the job is meant for me.
My luck with ILNs is one proof.
By the way, today I assisted in another ILN - this time, the guide wire refused to go in for some reason.
Haih....

It was a rather slow day - went for passover, then breakfast, then OT, then waited for 5pm to go back to the hostel.
For the past few days, I have been going out here and there after work, and all of a sudden I felt like I had a lot of time on my hands since I came back right after work.

I finally cleaned up my cupboard, folded all my clothes and arranged it properly (after a long, long time).
I even had an urge to iron all my clothes and hang them up.
Thanfully, I managed to talk myself out of it.

This post is full of crap.
I wanted to write about a more serious topic, but my brain refused to co-operate.
Some other time, maybe.

Today, I would like to share a story/joke with you. It happened quite some time ago, about 5 years back (maybe more).
My cousin sister, who was about (?)5 at that time, was trying to get me to play with her. She wanted me to hold the end of a skipping rope.
Cousin : Chechi, hold here.
Me : Say the magic word first.
Cousin : (thought about it a while) Abacadabra!

Well, I then had no choice but to hold the skipping rope and play with her.

Friends

It's been a week full of drama and gossip here in our Ortho department.
But I am not going to talk about that here.
It's an interesting story, but it is not sharable (does such a word exist?) on the net.

The past two days, I have been hanging out with my friends quite a lot. Just having lunch and chatting. It's nice to just lepak like that.

I do know, however, that I will never be close to them as I was with my friends in Russia.

In Moscow, we go to classes together, we come back together, we go shopping together, we go out makan together, we stay together.
We don't really have any other choice.
We don't have a home to go back to during weekends.
We don't have anyone else to turn to when we are in need of help.
It is hard NOT to get close.
Basically, we know almost everything about each other.

My friends (the ones I was really close to), know exactly what I like to eat and what I don't eat.
They even know what kind of dresses/tops I would like.
They know about my family and extended family.
They know all my bad habits (and frequently scold me when I do them).

We have talked for many hours, sometimes late into the night (or early into the morning).
We have watched countless movies together.
We have fallen asleep together - 5 people on 2 single beds.
We have shared cups and plates and swapped clothes.
We have shared secrets and many, many stories.

I miss them.
And I know they miss me too ('cos I know them damn well).
:P

Recently, I learnt that when a SSG (split skin graft) is done, slits are made on the 'donor-skin' for 2 reasons :
1 - so that whatever fluid (blood or serous fluid) doesn't get collected beneath the skin and will be able to seep out.
2 - so that the skin can be stretched

Playing The Blame Game

I just don't get it.
Why is it SO hard for some people to just admit their mistakes?

I've done it myself.
Kept quiet, lied, to protect myself, to make sure that I wasn't the one to be punished or blamed.
But every time I do that, I feel bad.
I can still remember the times I did such things, although it was a small thing and it happened a long, long time ago.
Even though years have passed, each time I think about the times I have put the blame on another person, I feel ashamed of myself.
Guilt, is not at all a nice feeling.

So, I wonder, how people can do this everyday.
Put the blame on someone else.
Just pretend to not know anything, just keep quiet, just let another person be blamed for a mistake that was his/her fault.
Don't they have any conscience?

I guess this is what life is about; playing the blame game.
Sad, isn't it.

Would you like to be the one taking all the blame?
How would you feel if people blame you for something that is not your fault?

Have a heart.
Do the right thing.
Even if it means that you will be scolded, punished - at least you won't be burdened with guilt.
Unless of course you are so heartless and are unable to feel guilt - then I have nothing to say;do as you wish.

But this is what I believe - what you do to someone today, it will hit right back at you another day.

Today, I learnt that people will say and do anything to stay out of trouble.
At work, the most important thing is documentation.
Inform everything, write everything, make sure you do whatever it is you are supposed to (and WRITE IT DOWN!!).
At least, in the end, you will be able to say that you did your job right.
And when you are the one to be blamed - you have proof that it was not your fault.

Do I Bring Bad Luck?

The Ortho department has two different types of surgeries - the emergency ones, and the elective ones.

Emergency OT is open 24 hours a day and as the name implies, caters for all emergency surgeries (surgeries that have to be done fast to prevent complications) like open fractures, laceration wounds, diabetic foot ulcers, compartment syndrome, etc.

The elective OT does all internal fixations - e.g. plating, screw fixation.

We have 2 elective OTs - short OT (8am-3pm) and long OT (8am-9pm). Both the OTs will consist of a specialist, an MO and a HO (and of course a scrub nurse).

I have had my fair share of elective OTs.
One of the surgeries done in elective OTs is the interlocking nail (ILN), usually for fractures of the femur or tibia.

This is an X-ray post-ILN of the femur

It is a relatively simple surgery (I have heard rumors that a specialist has the record of completing the surgery in just 20 minutes!).

I have assisted in a few ILNs.
Each time, there will be some problem which will delay the surgery - sometimes causing the surgery to take up to 2 hours to complete!!

One of the surgeries - we found out intra-op that the patient also had a patella fracture.
So, we had to do tension band wiring for the patella.

Another time, the 'jig' got stuck and it took us forever to come up with a way to get it out. The patient's bone was SO strong, my MO was suffering throughout the surgery.

Once, the patient's bone was SO osteoporotic, the guide wire kept puncturing out from the bone instead of going in the bone.

There was one time when the fracture couldn't be reduced properly with the traction. We tried adding on traction, releasing traction, and abducting the leg.
I forgot what worked, but it was after a long, long time that we managed to get the fracture reduced.

And just the other day, while trying to fix the nail with a screw, the screw somehow got lost inside the patient. My MO spent quite a lot of time trying to locate the screw and take it out.

What's with me and ILNs?
Why can't I have one simple ILN that finishes in less than an hour?
:(

Today I learnt that for multiple myeloma, the following investigations need to be done (if I remember correctly).
-skeletal survey
-plasmaphoresis
-24 hour urine for Bence Jones protein
-ESR

My 200th Post

Well, what do you know..this is my 200th post!
It's been about 18 months now, I think, since I started blogging.
Comes to an average about 11posts a month, 1 post every 3 days.
Not too bad, right?

I never knew that I had so many things to say.
(Although I do have quite a number of posts which are actually forwarded mails)

The past few days, my mind has been rather blank.
Last week, there were SO many things that I wanted to blog about, but then since last weekend I just seemed to be out of ideas. I haven't finished my 'vacation' stories, but then wasn't really in the mood to go through the photos, choose the ones I want to upload and resize them and upload them and write about them.

I had last weekend off actually.
I have to tell you about Sunday.

I went to Jusco.

At first I thought of watching a movie - but then there wasn't any movies worth watching.

Then, I went to Popular to get story books.
But then nothing really caught my attention (plus I had 2.5 unread books), so I didn't buy any.

Then, I went to Jusco - there was sales, thought that maybe I can get some work clothes.
The clothes that had discounts - couldn't find any that I liked.

Then saw a top (non-work). Wanted it in black.
There wasn't a single black one in my size, and so I had to buy it in pink.

Then there were jeans - looked nice.
Tried it on.
Too big.
There were no smaller size.
They had so many different designs of the jeans (same brand), but none in the size that I wanted.

I gave up.
Decided to go to the ground floor and get myself Twisties instead.
Guess what - there were no Twisties BBQ flavor.
ARGH!!!!!!

That night, for dinner, I went to Wooley's for dinner.
Wanted to get the fried stuff (dunno the proper name for it) they have there. (Really yummy).
Shop closed.
Haih..
Maybe it just wasn't my day.

Anyway...I finished reading Slumdog Millionaire yesterday.
The story is quite different from the movie - the concept the same, but the 'inti' itself is slightly different.
The book finished rather fast - I would have liked the book to be longer, with more questions (and answers), to get to know more about the life of the hero.

I am reading a different book now.
Am rather addicted to reading for now.
Maybe that's another reason I am not really in the mood to blog.
If I finish this book, then I only have 1 more unread book.
Have to make a visit to Jusco or Parade sometime soon.

Today, I learnt that the Ilizarov method can be used not only for bone transport, but also to stabilize fractures, just like an external fixator.

Don't Mess With Children

A little girl was talking to her teacher about whales.
The teacher said it was physically impossible for a whale to swallow a human because even though it was a very large mammal its throat was very small.
The little girl stated that Jonah was swallowed by a whale.
Irritated, the teacher reiterated that a whale could not swallow a human; it was physically impossible.
The little girl said, 'When I get to heaven I will ask Jonah'.
The teacher asked, 'What if Jonah went to hell?'
The little girl replied, 'Then you ask him'.


A Kindergarten teacher was observing her classroom of children while they were drawing.
She would occasionally walk around to see each child's work.
As she got to one little girl who was working diligently, she asked what the drawing was.
The girl replied, 'I'm drawing God.'
The teacher paused and said, 'But no one knows what God looks like.'
Without missing a beat, or looking up from her drawing, the girl replied,'They will in a minute.'


A Sunday school teacher was discussing the Ten Commandments with her five and six year olds.
After explaining the commandment to 'honor' thy Father and thy Mother, she asked, 'Is there a commandment that teaches us how to treat our brothers and sisters?'
Without missing a beat one little boy (the oldest of a family) answered, 'Thou shall not kill.'


One day a little girl was sitting and watching her mother do the dishes at the kitchen sink.
She suddenly noticed that her mother had several strands of white hair sticking out in contrast on her brunette head.
She looked at her mother and inquisitively asked, 'Why are some of your hairs white, Mum?'
Her mother replied, 'Well, every time that you do something wrong and make me cry or unhappy, one of my hairs turns white.'
The little girl thought about this revelation for a while and then said, 'Mummy, how come ALL of grandma's hairs are white?'


The children had all been photographed, and the teacher was trying to persuade them each to buy a copy of the group picture.
'Just think how nice it will be to look at it when you are all grown up and say, 'There's Jennifer, she's a lawyer,' or 'That's Michael, He's a doctor.'
A small voice at the back of the room rang out, 'And there's the teacher, she's dead.'


A teacher was giving a lesson on the circulation of the blood.
Trying to make the matter clearer, she said, 'Now, class, if I stood on my head, the blood, as you know, would run into it, and I would turn red in the face.'
'Yes,' the class said.
'Then why is it that while I am standing upright in the ordinary position the blood doesn't run into my feet?'
A little fellow shouted,
'Cause your feet ain't empty.'


The children were lined up in the cafeteria of a Catholic elementary school for lunch.
At the head of the table was a large pile of apples.
The nun made a note, and posted on the apple tray:
'Take only ONE . God is watching.'
Moving further along the lunch line, at the other end of the table was a large pile of chocolate chip cookies.
A child had written a note, 'Take all you want. God is watching the apples.'

Ambulance Ride

The other day, I accompanied a patient to Penang.

Before I left, another doctor told me this :
Riding in an ambulance (with its siren on) is a very different experience.
She said "it's like Moses parting the Red Sea".

My experience - yup, many people moved out of the way.
On the highway, there was a place where they closed one lane because of some road repairs or something like that, so there was a bit of congestion.
However, the ambulance was allowed to go on the lane that was closed.

Red light - no problem.
Long queue at toll - just ignore everyone else and go right to the front - and don't bother stopping to take the ticket or pay.

The journey took us about an hour plus.
Thank God the patient's oxygen supply was sufficient, or we would have had to change the oxygen tank, which is not an easy task in a moving ambulance.

Going to another hospital gave me a different kind of feeling.
It's like going to another school for some function/event/competition - you just don't fit it.

I managed to meet up with Beng that day, although it was just for a short while.
Not going to comment much about Beng - he sure 'perasan'. :P

The ambulance driver didn't switch on the siren on the way back.
I had no problem with that.
I was postcall.
I slept all the way back.
The staff nurse just laid on the bench at the back of the ambulance and slept.
I slept in front (more comfortable).

That was my first ambulance ride as a doctor.
I guess there will be more in the future.
The ride was OK since the patient was stable.
Hope all my future rides will be as fun.
:)

Today, I learnt that a type III odontoid fracture doesn't need a skull thong and it doesn't require surgery - a Halovest or a Minnerva jacket for immobilization is enough to treat the fracture.

Day 1 In Lisbon

01/07/08.
We flew from Barcelona to Lisbon.
We spent quite some time travelling and then getting to the hostel and then settling down in the hostel, so we didn't really do much sight seeing.
We just walked to the places nearby the hostel and bought train tickets for our 'trip' for the next day.

We had lunch in a cafe near our hostel. This is where we tried Sangria (a wine punch typical of Spain, Portugal and Italy) for the first time.

Just went for a stroll. Had delicious ice-cream!

________________________________________________

I finally managed to buy the book Slumdog Millionaire the other day.
The original book's title is Q&A, but since most people (like me) don't know that, they have reprinted the book with the title Slumdog Millionaire.
I don't like the cover of the book, but am really looking forward to reading it (am actually already halfway reading it).

Today, I learnt that in an MRI, the spine is grey in colour. If there is cord contusion, then it will be hyperintense. Cord contusion cannot be corrected with surgery, so whatever neurology the patient comes in with, most likely it will be permanent.

Day 2 In Barcelona

I have not been able to stick to my 1 year-ago events.
It was too tiring - putting up posts for the days that I was oncall.
Besides, I had other things that I wanted to blog about as well.

However, I would like to finish what I started - I have about 3 days more of the trip left.
So, here are the pictures we took on the 30th of June 2008.
It was our 2nd day in Barcelona.
As I mentioned previously, Barcelona is all about Gaudi.
On this particular day, we visited 2 other Gaudi creations - Casa Mila and Casa Battlo.

Our first stop - Casa Battlo

I think Gaudi never liked straight lines


That is a fireplace - cute, right?

Have you ever thought of doing up your window in that shape?

The Casa Battlo chimney

One of the rooms that was done up to show what it would have looked like during the period the house was built - compare this picture to this.

Next up - Casa Mila. This is a model of the place.

The many different chimneys - this is what Casa Mila is famous for.
No 2 chimneys are the same.

The windows are positioned in such a way as to receive the maximum amount of sunlight.

A chair designed by Gaudi. We were not allowed to sit on sit, but the curves supposedly 'correspond' to those on a human body, making it extra comfortable.

After that, we went to the Barca stadium.

A visit to the market.
Even now, looking at these sweets make me drool!

Colourful, no?

Me and Puspha then proceeded to go on a bus ride around Barcelona, just to pass time. And guess what, we met Von Yen, Swee Hung, Jan, Beng and Quek!! Such a coincidence! But it was just a short meeting 'cos we were headed in different directions. Still, it was fun to meet them.

And now I miss them.
:(
Just wish to sit and lepak and talk till dawn like we used to.

There are a few quotes that I would like to share with you.
'Thing do not change. We change.'
'If at first you don't succeed, you're running about average.'
'Never grow a wishbone where your backbone ought to be.'

p/s - here is a post I wrote on that day from Barcelona.

My Sister's Keeper

This is a book I read recently.
I think it is going to be made (or has already been made) into a movie.

It is about a family of 5.
They have 3 children - the eldest a son and then 2 girls.

The 2nd child was diagnosed with leukemia when she was very young, and because of the lack of a suitable donor, genetic engineering was used to 'create' the 3rd child - so both the daughters have very similar DNAs (I guess).

From a young age, the younger daughter (Anna) had been donating bone marrow, blood products etc. for her elder sister, Kate.
Now, Kate has renal failure.
She needs a kidney.
The most suitable match - Anna.

But Anna doesn't want to be a donor anymore.
And she wants to sue her parents so that she has the right to make her own decisions regarding her body.

The story goes on about how each of them feel about what is going on, the stresses one faces when there is a sick member in the family.
Anna is not really cruel, she doesn't want the sister to die, but then she has also had enough of unnecessary procedures.
The parents are trying everything they can just so that Kate can live a little longer.
Will it all work out?
Will Kate get the kidney?
Will she live if she gets the kidney?

One thing I like about the story is the way it is written - basically you get to go into every characters head.

I enjoyed most of the book, but I think the ending was a bit too abrupt.
Overall, a good book.
A must read.
A sad story, but it made me think of certain things in different ways.

Transformers Sucks!!

Transformers was everything that I expected it to be and worse.

I really don't understand how people can actually watch the movie and come out and say that they enjoyed it.
What is there to enjoy in the movie?

The dialogue sucked - it was SO PREDICTABLE!!
The humor - lame, stupid. Most of the attempted jokes - I have heard before.
The acting - FAKE!!
Storyline - what storyline?
It was like they were trying to rush the story along so that they can prolong the fighting scene.
The robots - well, they are just robots, nothing much to say about them.

The whole movie was basically about the transforming from vehicles to robots to vehicles and fighting and fighting.
Half the time, I didn't know what was going on, who was fighting who.
Couldn't even see who was winning or losing.
You just see metals clashing here and there.

There was so much movement and noise that it was hard to concentrate on what's going on.
The ending was so abrupt - I was like - "Huh! What just happened? Is the movie over?"

I honestly don't get why the big hoo-hah over the movie.

From the very beginning, there were so many wrong things with the movie.

The Chinese are covering up by saying there is a chemical spill?
There are buildings/cars crashing everywhere with robots walking around - how does a chemical spill explain that?

The robot was destroying the pyramid and the blocks were flying everywhere, except anywhere near the guy who was trying to kill it.

A guy who works in a meat shop knows all the government secret.

The bad robots could find the hero's parents in no time at all, but found it hard to locate the hero himself. I wonder why....

The Egyptian government had no problems with the American government invading their country - planes can find in and out of their country at any time!

There are many other things I found ridiculous about the movie- just can't think of what right now.

Anyway, I was just wondering -
How do the transformers reproduce anyway?
Do they grow old?
Do they have families?
Are there any female transformers?

All in all, it was a horrible movie.
The only thing that kept me awake was my Twisties.

But the animation was good - am sure the whole transforming thing was not easy to do. And they did that a lot - too much, in my opinion.
Maybe my eyes were too tired to catch up with the movie - was postcall.
Maybe I am just biased against the movie.

However, I can assure you - I would not have enjoyed the movie no matter what.
And if you haven't watched it - don't bother. You are not missing anything.

To all Transformers fans out there -sorry.

Today, I saw a patient. Known case of cerebral palsy. He couldn't walk until the age of 15 when he went for a surgery to correct the deformity of his legs. He can walk now - but with the age of crutches - and from what I saw, even then he is suffering. However, he said that he doesn't like using a wheelchair - he said it makes him lazy. He has a degree in accountancy - he can get a job easily with his degree, but then the moment he makes an appearance in the interview, he doesn't get the job. He now works as a volunteer teacher (if I am not mistaken).
I just wanted to share this story with everyone.
He is a guy to be admired.
My hats off to him!