Relief - that is what I feel. At least for now. My presentation is over and now I can relax...until it is time to study for my assessment which is next month. The only problem is, next month is not really that far away, and I have a couple of 'events' coming up so I guess time is not really on my side.
But then again, I don't think more time will make much of a difference. The more time one has (or at least I have) the more one procrastinates, right?
Life has been good recently. I have been enjoying myself in Anaesth. It is not just that the working hours are shorter, but I actually enjoy myself at work. I don't dread going to work like when I was in....let's just say another department. I don't have to review patients or take blood from a patient millions of times or set branulas that keep on 'bunking' and I don't have to put up with crap from other people around me. Almost all the MOs are very friendly, and even the specialist too.
Here is what I go through everyday - go to work, prepare drugs and then the patient comes in for op. Put the patient under and just monitor the patient till the op is over and then reverse the patient and send him or her out. I don't have to see the patient's family and answer questions (the worst part is when a patient has 10 relatives who all insist on approaching you one a time to as the same question). I don't have to review the patient (I know I've told that already - goes on to show how much I really hate reviewing patients). I don't have to do discharges. I don't have to do many other mundane ward work.
Life is good.
Although I do get irritated with some patients - chronic pain patients. They come under anaesthesiology as well and I was posted in the Acute Pain Service for 2 weeks and had to see these patients in the clinic. They come to the clinic and complain of pain everywhere. Some are genuine, but most of them...I don't know. Maybe their pain is real, or maybe it is just psychological. But then when a patient says that her headache gets better when she takes her gastritis pill, don't you think something is wrong? And if someone tells you they play the piano for 14 hours each day and does 3600 repetition of some exercise in the gym - would you believe them? How about a husband who complaints of pain but is allergic to all the painkillers in the world whose wife is also a pain clinic patient and is ALSO allergic to all the painkillers in the world? The best part - their child is SO allergic to prawn that she develops some allergic reaction if their neighbour cooks prawn and they can smeel it. *Sigh* To believe or not to believe...
Anyway, there is no real purpose for this post. It's just that I think I have been ignoring my blog for so long..probably because I am having long dinners and by the time I come back I am too lazy to write and the people to blame are my dinner buddies...typical human - always put the blame on someone else.
I will try my best though, to write more often....if I can think of things to write. :)
Wednesday, October 20, 2010
Saturday, October 16, 2010
Monday, September 13, 2010
10 minute presentation
I am supposed to do a presentation on Fink's hypoxia - something I have never even heard of before.
Usually, when I don't know something, I rely on Wikipedia to help me understand it first before reading other websites for more info.
But, all Wiki had to say about this topic was this :
The Fink effect, also known as "diffusion anoxia", "diffusion hypoxia",or the "third gas effect", is a factor that influences the Po2 (oxygen saturation) of alveolar gas. When soluble gases are breathed in (e.g. nitrous oxide, N2O) large quantities can be dissolved in body fluids rapidly. This can lead to a temporary increase in the concentration of oxygen and carbon dioxide in the alveolus, causing an increase in their respective partial pressures.
The effect is named for Bernard Raymond Fink (1914–2000), whose 1955 paper first explained it. When a patient is recovering from N2O anaesthesia, large quantities of this gas cross from the blood into the alveolus (down its concentration gradient) and so for a short period of time, the O2 and CO2 in the alveolus are diluted by this gas. This could potentially cause the partial pressure of oxygen to decrease and could temporarily lead to hypoxia. The decrease in CO2 could also potentiate this effect as ventilation would be suppressed, leading to potential hypoxaemia. Nonetheless, this effect would only last a couple of minutes and hypoxia can be avoided by increasing the fractional inspired oxygen concentration when recovering from N2O anaesthesia.
I don't understand what Wiki is trying to say and other websites don't have much info as well.
How am I going to do my presentation?
How slow would I have to read what Wiki said in order to stretch the presentation to 10 minutes?
Usually, when I don't know something, I rely on Wikipedia to help me understand it first before reading other websites for more info.
But, all Wiki had to say about this topic was this :
The Fink effect, also known as "diffusion anoxia", "diffusion hypoxia",or the "third gas effect", is a factor that influences the Po2 (oxygen saturation) of alveolar gas. When soluble gases are breathed in (e.g. nitrous oxide, N2O) large quantities can be dissolved in body fluids rapidly. This can lead to a temporary increase in the concentration of oxygen and carbon dioxide in the alveolus, causing an increase in their respective partial pressures.
The effect is named for Bernard Raymond Fink (1914–2000), whose 1955 paper first explained it. When a patient is recovering from N2O anaesthesia, large quantities of this gas cross from the blood into the alveolus (down its concentration gradient) and so for a short period of time, the O2 and CO2 in the alveolus are diluted by this gas. This could potentially cause the partial pressure of oxygen to decrease and could temporarily lead to hypoxia. The decrease in CO2 could also potentiate this effect as ventilation would be suppressed, leading to potential hypoxaemia. Nonetheless, this effect would only last a couple of minutes and hypoxia can be avoided by increasing the fractional inspired oxygen concentration when recovering from N2O anaesthesia.
I don't understand what Wiki is trying to say and other websites don't have much info as well.
How am I going to do my presentation?
How slow would I have to read what Wiki said in order to stretch the presentation to 10 minutes?
Thursday, September 2, 2010
Clean - for now
KTM started a new train service recently - the ECT.
I don't know what ECT stands for - tried googling for it but couldn't find it - maybe it stands for extra-cepat-train or electric-current-train.
(I did a mistake!! It is ETS - electric train service. No wonder I couldn't find the information I was looking for...got it confused with ECT -electroconsulvise therapy)..:P
Anyway, I took the train last weekend, Ipoh to KL and back from Seremban.
It was quite a comfortable ride.
Compared to the KTM commuter, there was more leg space and was cleaner (since it IS newer).
I didn't see any cockroaches running around (yes, I have seen them in the KTM commuter) so the ECT gets one point for that.
I am not sure about the toilet though - I have a policy against toilets in public transports - never go unless desperate.
They had people walking around (steward-like) offering assistance to those who needed them. One guy even put our bags up in the overhead compartment and brought it down when we reached KL. They were all polite and pointed out that they have a power socket near every row of seat that one can use while on the train. Now I can watch movies on my laptop on the way back home! The train that I took from Seremban to Ipoh even announced the stations before and when we arrived at the stations!
The airconditioning was super-cold. I really don't get it - we are Malaysians, not Alaskan. Do we need the air-conditioning to be so cold? I understand if it is the operating theaters, but why must offices and shopping complexes and shops and trains and buses be sofreaking cold? Can't they just regulate the temperature to that the users don't have to shiver or bring jackets around?
There was a TV where a video (which was replayed and replayed throughout the journey) showed how the whole ECT idea was realized (I think). The video showed a train in Korea which could go up to 300kmph!! Imagine that, going from Ipoh to KL in less than an hour! I do hope the TV will show a different video or a movie next time though, there is only so many times one can watch a bunch of Malaysians looking at trains.
Oh...using the ECT, it takes about 2 hours to go from Ipoh to KL and 3 hours from Ipoh to Seremban - that is an hour of difference from the KTM commuter. They have a few express trains that stop in 4 or 5 stations only and a few others that stop in about 10 stations, which means that they don't stop in all the stations like the KTM commuter. The maximum speed as I know so far is 150kmph (the driver had to catch up on time since we were slightly delayed in KL).
The price, for now - RM30 to KL (KTM commuter is RM12 and RM22 for economy and 2nd class respectively) and RM38 to Seremban.
If you ask me, to and from KL, I don't mind the 1 hour difference if the price is more than doubled. But then if you prefer comfort, then the ECT is definitely the better choice. For my parents, I would take the ECT as they need the leg space; me, I put my leg up most of the journey so it doens't really matter.
For the ride to Seremban and back, definitely the ECT is better. Otherwise, you would have to take train from and towards Singapore which is ALWAYS delayed. And the price difference is not that much as well.
The current price is the promotional price - I have no idea what the price is going to be like after this. Hopefully it won't be too expensive or I have to stop going back home so often (and risk my parents forgetting that they have another daughter beside Phoebe).
Here are a few photos of the train - see how clean it is and look at how much more spacious it is compared to the commuter (if you have been in the KTM commuter)
I don't know what ECT stands for - tried googling for it but couldn't find it - maybe it stands for extra-cepat-train or electric-current-train.
(I did a mistake!! It is ETS - electric train service. No wonder I couldn't find the information I was looking for...got it confused with ECT -electroconsulvise therapy)..:P
Anyway, I took the train last weekend, Ipoh to KL and back from Seremban.
It was quite a comfortable ride.
Compared to the KTM commuter, there was more leg space and was cleaner (since it IS newer).
I didn't see any cockroaches running around (yes, I have seen them in the KTM commuter) so the ECT gets one point for that.
I am not sure about the toilet though - I have a policy against toilets in public transports - never go unless desperate.
They had people walking around (steward-like) offering assistance to those who needed them. One guy even put our bags up in the overhead compartment and brought it down when we reached KL. They were all polite and pointed out that they have a power socket near every row of seat that one can use while on the train. Now I can watch movies on my laptop on the way back home! The train that I took from Seremban to Ipoh even announced the stations before and when we arrived at the stations!
The airconditioning was super-cold. I really don't get it - we are Malaysians, not Alaskan. Do we need the air-conditioning to be so cold? I understand if it is the operating theaters, but why must offices and shopping complexes and shops and trains and buses be so
There was a TV where a video (which was replayed and replayed throughout the journey) showed how the whole ECT idea was realized (I think). The video showed a train in Korea which could go up to 300kmph!! Imagine that, going from Ipoh to KL in less than an hour! I do hope the TV will show a different video or a movie next time though, there is only so many times one can watch a bunch of Malaysians looking at trains.
Oh...using the ECT, it takes about 2 hours to go from Ipoh to KL and 3 hours from Ipoh to Seremban - that is an hour of difference from the KTM commuter. They have a few express trains that stop in 4 or 5 stations only and a few others that stop in about 10 stations, which means that they don't stop in all the stations like the KTM commuter. The maximum speed as I know so far is 150kmph (the driver had to catch up on time since we were slightly delayed in KL).
The price, for now - RM30 to KL (KTM commuter is RM12 and RM22 for economy and 2nd class respectively) and RM38 to Seremban.
If you ask me, to and from KL, I don't mind the 1 hour difference if the price is more than doubled. But then if you prefer comfort, then the ECT is definitely the better choice. For my parents, I would take the ECT as they need the leg space; me, I put my leg up most of the journey so it doens't really matter.
For the ride to Seremban and back, definitely the ECT is better. Otherwise, you would have to take train from and towards Singapore which is ALWAYS delayed. And the price difference is not that much as well.
The current price is the promotional price - I have no idea what the price is going to be like after this. Hopefully it won't be too expensive or I have to stop going back home so often (and risk my parents forgetting that they have another daughter beside Phoebe).
Here are a few photos of the train - see how clean it is and look at how much more spacious it is compared to the commuter (if you have been in the KTM commuter)
Monday, August 23, 2010
Where Are The Flags?
It's the 23rd of August.
Just 8 more days for Merdeka.
It doesn't seem like it though.
Here is what I remember of Merdeka Day a few years back.
The Jalur Gemilang everywhere - in front of all shops and in (or on) almost all vehicles. Some flew the flag in front of their houses, some decorated their whole car/van/lorry with flags.
Now, I just see a few pathetic flags aound the padang, and it takes me a while to remember that they are there because it is the Merdeka month.
What happened to all the elaborate Merdeka day celebration?
I am not going to point my finger at anyone though.
I have not done anything and nor am I going to do anything to mark the day.
To me, it's just another holiday, another excuse to wake up late (if I am not working), as it is for most of Malaysians.
I don't even stay awake for countdown anymore - I used to because they had good programmes on TV.
When I was younger, I used to wake up early on the day itself to watch the parade. Now, I don't have a TV in my room, and even if I do, I doubt that I would do as I did previously.
It's not that I love the country any lesser than I did before, but somehow the spirit is no more there.
Why - I am not sure. But from the looks of things, it doens't seem like anyone is in the Merdeka spirit anymore.
What went wrong?
Just 8 more days for Merdeka.
It doesn't seem like it though.
Here is what I remember of Merdeka Day a few years back.
The Jalur Gemilang everywhere - in front of all shops and in (or on) almost all vehicles. Some flew the flag in front of their houses, some decorated their whole car/van/lorry with flags.
Now, I just see a few pathetic flags aound the padang, and it takes me a while to remember that they are there because it is the Merdeka month.
What happened to all the elaborate Merdeka day celebration?
I am not going to point my finger at anyone though.
I have not done anything and nor am I going to do anything to mark the day.
To me, it's just another holiday, another excuse to wake up late (if I am not working), as it is for most of Malaysians.
I don't even stay awake for countdown anymore - I used to because they had good programmes on TV.
When I was younger, I used to wake up early on the day itself to watch the parade. Now, I don't have a TV in my room, and even if I do, I doubt that I would do as I did previously.
It's not that I love the country any lesser than I did before, but somehow the spirit is no more there.
Why - I am not sure. But from the looks of things, it doens't seem like anyone is in the Merdeka spirit anymore.
What went wrong?
Saturday, August 14, 2010
Bob's Big Mistake
Bob works hard at the office but spends two nights each week bowling, and plays golf every Saturday.
His wife thinks he's pushing himself too hard, so for his birthday she takes him to a local strip club.
The doorman at the club greets them and says, 'Hey, Bob! How ya doin?'
His wife is puzzled and asks if he's been to this club before.
'Oh no,' says Bob. 'He's in my bowling league.
When they are seated, a waitress asks Bob if he'd like his usual and brings over a Budweiser.His wife is becoming increasingly uncomfortable and says, 'How did she know that you drink Budweiser?''
I recognize her, she's the waitress from the golf club.I always have a Bud at the end of the 1st nine, honey.'
A stripper then comes over to their table, throws her arms around Bob, starts to rub herself all over him and says, 'Hi Bobby. Want your usual table dance, big boy?'
Bob's wife, now furious, grabs her purse and storms out of the club.
Bob follows and spots her getting into a cab.Before she can slam the door, he jumps in beside her.Bob tries desperately to explain how the stripper must have mistaken him for someone else, but his wife is having none of it .
She is screaming at him at the top of her lungs, calling him every 4 letter word in the book.The cabby turns around and says,'Geez Bob, you picked up a real bitch this time.'
Bob's funeral will be on Saturday and all are invited .
Monday, August 9, 2010
Ice Cold
Day one in anaesthesiology.
It was quite an interesting day.
First I was in GOT where MO D tried to input lots and lots of information into my brain (of which I hope at least some entered), and then I followed another MO for premed (pre-operative evaluation) and then I tagged with another MO in OOT during which he tried to give me more useful information.
Too much information + too slow a brain = blur.
Guess I need a bit more time.
But you know what, I am enjoying it.
For the first time after a long, long time, I am actually looking forward to going to work tomorrow!!
Maybe it's the MOs and specialists who are super nice.
Maybe it's the absence of daily ward work and reviews.
Whatever the reason, I hope this feeling stays.
The only thing I don't like is the cold!! The OT is freezing. Maybe I ought to get my winter clothes or my thermals and some socks! Must definitely remember to bring some long sleeves to wear in OT after this.
It was quite an interesting day.
First I was in GOT where MO D tried to input lots and lots of information into my brain (of which I hope at least some entered), and then I followed another MO for premed (pre-operative evaluation) and then I tagged with another MO in OOT during which he tried to give me more useful information.
Too much information + too slow a brain = blur.
Guess I need a bit more time.
But you know what, I am enjoying it.
For the first time after a long, long time, I am actually looking forward to going to work tomorrow!!
Maybe it's the MOs and specialists who are super nice.
Maybe it's the absence of daily ward work and reviews.
Whatever the reason, I hope this feeling stays.
The only thing I don't like is the cold!! The OT is freezing. Maybe I ought to get my winter clothes or my thermals and some socks! Must definitely remember to bring some long sleeves to wear in OT after this.
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