A lil note to end the year...

another year has came and gone.

what can i say about 2010?

it has not been a bad year for me.

i managed to pass my exam after a few attempts, which was a great milestone for me.

i had a wonderful spring break visiting Paris...such a lovely place. i would go back there anytime.

i had a fun summer....this time, i travelled to Lake District, and visited the little towns at that place.

Autumn was the main highlight of the year...because I got to go home! yes....it was lovely. i managed to attend my best friend's wedding, and was even more surprised when she asked me to give a speech at her wedding. i also attended my cousin sis' wedding...which was lovely. i met up with most of my old frens, savoured all the tasty local cuisines...

then, came winter....which was BITTERLY cold. it snowed, snowed and snowed. my arms were getting very good daily workout, by just simply scraping the ice off the car! driving conditions were horrible....i feel so lucky that my car has been brilliant, apart from the signal light wiring problem.

it was soon christmas....where i spent the weekend working. it was busy and tiring. i received a few lovely pressies....got lovely purple gloves, 2 DVDs from the studio gibli company to add to my collection, a head massager, a box of chocolates, 2 tins of biscuits....However, i also received a rather odd xmas present, in the form of a luggage tag?!

anywho, it is new year's eve now...and i am happy that i am sitting down on my couch, in front of the telly, and typing this, with kylie minogue's music playing in the background. life has been very kind to me. i am blessed to have a lovely supportive family back home, a boyfriend that is so patient with me, a few good friends here that are there when i need them, a nice and cosy flat, a good job, enough funds to support my occasional crazy shopping spree...

so goodbye 2010....and welcome 2011!!! =)

Night Shifts.....again

My night shifts ended on Friday morning. The whole week was horribly busier than normal, most probably because people are catching various kind of illness during these few months as we approach winter.

The nights were made more pleasant by being on call with a hot Spanish registrar. *hee heeee

Yes, he is new in our hospital. He has lovely wavy dark brown hair, tanned, and I love his Spanglish. He is also tall and well built. (hopefully you could picture him in your mind). He is also extremely approachable, helpful and down to earth. The funny thing was actually watching how a few of the nurses with him in the ward! yes!

The nurses will come up to him to ask him to prescribe simple things like paracetamol or an anti-sickness medication...which is what I usually do for them. But rather than asking me, they approached the reg. While waiting for him to prescribe them, they just start to chat him up!

haha.

I bet the reg was enjoying all the attention. Some of them even sat down and had a little conversation with him...which was pretty unusual on a busy night shift.

Oh well, that aside, he is a great reg to work with, and I was glad to be on call with him.

errm.....yes ok, I probably did giggle a little too much whenever he cracked a joke! =P

Yay!

Finally got my MRCP 1 performance details yesterday. Yes, I passed, finally!

I really wanted to know which field I did best....After the exam, I felt I didn't do well in the clinical sciences, clinical pharmacology, infectious diseases (ID), neurology, dermatology, nephrology and respiratory.

Surprisingly, I did very well in ID, pharmacolgy, neuro and nephro. And even more surprising, I scored full marks in dermatology! I also did very well in geriatric medicine...maybe I should think about becoming a COTE specialist.

But I was right, my scores were quite low for the clinical sciences. I didn't do as bad as I thought in ophthalmology and respiratory.

Overall, I'm pretty pleased with the outcome.

Now, to prepare for Part 2.

The pressure is on...coz a lot of people at my stage has already gotten full MRCP.

Delicious Malaysian Food

My trip back home was all about catching up with friends, family and enjoying local food. And that was exactly what I did. Due to our multi-cultural society, we get to enjoy food from a vast variety of food, including chinese, malay, indian, western, japanese, korean etc.

I will not write much...but all I can say is MALAYSIAN DELICACIES ARE DELICIOUS! There are so tasty, bursting with flavours...yumm... I hope the following pics will make you hungry! =D

Ipoh white coffee, with kaya toast

Tasty and crunchy bean sprouts (or taugeh)

Ipoh Hor Fun

Char Kueh Kak

Nasi Goreng Peranakan

Asam Laksa

These food looked good rite?

Well, they were EXCELLENT!

If you haven't been to Malaysia, pls do plan a trip there...its well worth it! =P

6 more days and counting!

The only thing that is keeping me through the crap at work is the thought that I'll be home in less than 7 days!

woo hoo!!

I really can't wait. I am really excited coz I haven't been home for the past 2 years. But at the same time, I am rather stressed with it too. Well, should I say that the stress is actually GOOD stress. I mean it is NOT like exam stress at all, which I must say is BAD stress.

Now you may ask why am I stressed out?

The stress is because I have not much time left for packing.....I dislike the fact that I am on-call this weekend. If only I were off, I could take the time to pack my stuff, and also maybe do abit of last minute shopping.

The other stress is having to prepare a speech for my good friend who is getting married in exactly 10 days. Don't get me wrong, I am extremely honoured to be asked to speak at her wedding reception.....but the only problem is I have never done this before. I have never been to a wedding reception before! So I really do not know where to start! Anyone has any good ideas? Or anyone has spoken at a wedding reception before???? Please share your ideas and experience with me.

I am thinking of starting it with a lil LOVE quote, and then, proceed to talking about what I think of my friend as a person, and how she met her hubby and managed to keep the relationship strong for the past for more than 5 years.

hmm...it is easy to think of what to say...but it is putting those thoughts into words I find difficult. I still haven't started to write anything yet....and time is running short!! help!!

Those stress aside, I am starting to count down to the moment I step into my flight back home to destination: KL.

Physiological Changes to the Body During Stress

Gosh...its amazing what stress can do to one's body. I have been very stressed lately, with exams, portfolios and work.

Stress was at its peak yesterday because it was exam day! My body was behaving oddly.

I could not sleep...(waking up every hour from my sleep is NO sleep at all.

I struggled to eat any of my meals (but forced myself to otherwise my brain cannot function).

I have million butterflies in my stomach (highest number yesterday compared to the rest of the week).

I felt so nauseated that I nearly vomited in the train!

My heart rate was averaging from 90 to 100 bpm for most of the day.

I was having pleuritic chest pain for a few hours.

My fingers and toes were freezing.....and the palms were sweaty.

........... This morning, I slept bit better, still having some flashbacks about the exam yesterday....I just need to stop thinking of the questions and the answers..... Coz when you think about it, you want to know whether you have put down the right answers by looking it up in the book. If the answer was right, that's good....if not, I will feel very upset. So I'm really trying not to think about it.

It is time to get ready to work.... I am not hungry, but probably should have my breakfast otherwise I would be hungry later.

I am hoping for a stress-free day at work today....can't physically manage another stressful day again today.

Grim

Dying from cancer seems like the most dreadful thing. It is a slow and painful death. There will be numerous hospital admissions either for chemotherapy, radiotherapy or surgery. And let's not forget that these patients have to endure endless complications either secondary to the side effect of their treatment or because of countless infections.

It has been a grim day at work today. 1 out of 4 patients in the ward is suffering from terminal cancer. None of them are curable. Majority of them have a severe infection, while the others have new spread of their cancer.

I really can't imagine how much pain these poor patients are experiencing. It must be excruciating. We are trying to manage these pain issues with strong doses of opiates, and also putting them on a syringe driver. But we never seem to be able to keep their pain score at ZERO.

And it also makes my heartache when I saw a lovely man in the ward who was talking to me about 2 hours ago, and just as I left the hospital, he was unconscious, agitated and taking the last few breaths of his life. I know I shouldn't be surprised to see how quickly a cancer can kill you, as I have seen many of them in such situations, but still, I can't help it.

To top it all off, it upsets me even more when people drink far too much alcohol for their own good, and end up having liver damage because of it. Why do you self mutilate your body?! And once we have treated you and get you back on your feet....what do you do??? Of course! You go back to your old drinking habits. Within a few months, they bounce back into the hospital again, and the whole cycle repeats itself.

Have they ever thought of how previous their life is??? Why do they want to end their life so quickly??? Have they even thought of those patients suffering from terminal diseases that would prefer to live on for a little longer, but can't because they isn't any other way to cure them?

I dunno. I guess this is medicine and the reality of life for me.

The Big Changeover

The biggest day in hospital diary is the day where all junior/senior doctors changeover in August. Outpatient clinics are reduced or cancelled to allow for a less chaotic changeover. Team leaders from different departments in the hospital will be asked to do a short presentation to the new group of doctors, as part of the hospital induction.

On this day, fresh junior house officers begin their career as doctors, learning to apply everything learned in medical school into clinical practice.

On this day, ex-juniors become senior doctors, embarking on new challenges and bigger responsibilities.

On this day, most doctors will start work in a different ward or hospital, whereas a few others will remain in the same place.

This particular day is said to be the worst day to be admitted into the hospital, as errors do happen, and most things will be disorganised.

My changeover day was not bad at all. I started off doing night shifts, which is absolutely fine, because I get to escape the morning chaos in the wards. However, on my night shift, there was a junior doc who was absolutely terrified of doing anything! *Bless her!

She was terrified of writing up a patient's drug chart.

She was terrified of taking a blood sample from a patient.

She was even terrified of waking a patient up at 3 am for a physical examination!

Poor gal....I have honestly never seen anyone as scared as before!

Anyway, with a little push, she plucked up the courage to do a few basic things during the night shifts.

Apart from being terrified, she appeared absolutely clueless as well. The one thing that I remembered the most from that night shift was she didn't know how to prescribe paracetamol!

In my very humble opinion, I think that is the simplest prescribing task ever! How could she not know how to prescribe that? hmm...Maybe I am expecting abit too much from a junior house office.

The big changeover day has passed, and work resumes as usual for everyone.

Live or Die?

Wow....the season 6 finale for Grey's Anatomy is the best yet!

In fact, the storyline from season 4 onwards have been really good. I see each characters growing... most of the episodes were very meaningful. Somehow, I can feel what the patients and surgeons were experiencing. I feel my emotions floating into the scenes....I couldn't help but cry too!

Season 5 ended with George dead.....then, Izzie had skin cancer... and then, the unexpected happened. Dr McDreamy was shot!

Gosh....I was crying so badly when I watched the final two episodes....

I know it is only a drama...but heck, the creators have done a good job.

What Grey's Anatomy said was right. We all have choices. Life is full of choices...

Do we want to be a hero or a coward?

Do we want to fight or give in?

And do we want to live or die?

I know that these choices are not always given to us...but if we were given them, which will we choose?

Would you fight on to live.....or do you give in to your illness and die?

Do you become a hero, and try to save the day....or do you become a coward, and hide from all responsibilities??

hmm....decisions......

The Writer - Ellie Goulding

My favourite song at the moment: The Writer by Ellie Goulding

Love the the lyrics... here is part of it.

But I've got a plan

Why don't you be the artist

And make me out of clay?

Why don't you be the writer

And decide the words I say?

Cause I'd rather pretend

I'll still be there at the end

Only its too hard to ask

Won't you try to help me?

Such meaningful words....

Conversations in the Hospital

Thought I would share a few entertaining conversations I had in the hospital this month.

Conversation 1

This lovely elderly man was admitted with urinary retention, and subsequently developed a urinary tract infection. While examining him, I proceeded to ask him the routine 10 AMTS (Abbreviated Mental Test Score) questions.

One of the questions was, "What do you think my occupation is, if you look at me?"

Bear in mine that I was wearing a simple blouse and trousers, with my stethoscope hanging around my neck, and my pager stuck to my pocket.

He gave me a good look, and said, "Well, you're a beauty queen."

hmmm.....I wish I was. He scored 5/10....so guess he was pretty confused eh?

Conversation 2

A locum orthopaedic doctor came to my ward to review a patient of mine who possibly has a broken pubic rami. He examined the patient thoroughly as you would. Then, he started to write his findings down in the notes. While doing so, he looked up and asked, "Is it better to write; there is good moving of the right leg, OR there is good movement in the right leg?"

I know I really shouldn't be laughing at others, whom English is not their first language. I tried really hard to stifle my giggles. My colleague told him that the latter sentence was a better of describing the patient's range of movement. It was amazing that he could keep a straight face while doing so.

Conversation 3

There was a pleasant elderly lady in the ward. Unfortunately, most of us, when we grow older, we will lose our hearing. This lady was nearly 90 years old, and she looked alot younger than that. I asked her whether she smokes. She replied, "Well, yes I do...you know, its really hard to get rid of this habit."

"How many do you smoke in a day?" I asked.

"hmm...about 4 to 5 a day."

"Oh ok...so about 4-5 a day...."I repeated as I make a note of it on my records.

She said," No....not 45 a day....it is 4 TO 5 a day."

I laughed...and told her that I know she said 4 to 5, and not 45.

Treasure What You Have

It is such a common humanly mistake that we never seem to REALLY treasure what we have until it is taken away from us.

I thought the latest Shrek movie was excellent. It was funny, good animation and not to mention, the moral value the movie was trying to teach everyone. Shrek had almost everything he could dream off....a lovely ogre wife, Fiona, 3 cute kids, good friends (Donkey and Puss), and a nice place to live..... BUT (there is always a but), he felt that he has become a tame ogre, not fearsome no more. So he decided to exchange one day in his life, and that day, was back to a day he didn't have any friends, no family, and Fiona did not recognise him as his wife. He regretted his actions, and felt miserable. He misses Fiona and his family. He did everything he could to go back to his present life, and succeeded in the end. And like most animation, the story ended happily ever after.

I felt good after watching it. I realised that sometimes, I may have taken some things for granted...and I need to change my actions, change my attitude, to become a better person, less grumpy, and really appreciate the lil things in life that makes my life meaningful.

ahh....how's that for a new resolution?

That aside, I highly recommend Shrek Forever After to everyone! It is definitely way better than the previous one. Watch out for catchy words like, "Cat-tastrophic!" and "Ri-don-culous!"

McDreamy or McSteamy?

Grey's Anatomy rocks!! Yes it so does. I love this drama to bits! I wish there is a real McDreamy and McSteamy in the hospital that I am working in at the moment. haha.

I know alot of people will disagree with me. The storyline might be cheesy to some, or unexciting. They might think that some of the medical bits in the drama unreal. But who cares! Grey's Anatomy catches the essence of life as a doctor. Although I have to admit that the love life might not relate to everybody, but the happiness, disappointments, competitiveness, difficult decisions, life-saving measures....they are so real.

Many a times, while watching Grey's Anatomy, I found myself thinking about my own personal experiences. For example, I could feel the disappointment in Dr O'Malley when he found out that he had failed his internship. I could feel the joy in Meredith and Derek, when the finally managed to treat a patient's brain tumour successfully in their clinical trial. I could sense their tiredness at the end of the day....their need to just not talk about things at times.

I guess that is what attracted me so much to Grey's Anatomy....of course, not to mention, the existence of McDreamy and McSteamy makes the drama that even more exciting and hilarious....what more can you ask for?

If you don't watch Grey's Anatomy, then, you wouldn't know who they are. McDreamy is Dr Derek Shepperd...a talented Neurosurgeon...at least he isn't as grumpy and as arrogant as some of the Neurosurgeons I have spoke to. He is McDreamy, because I suppose he has that dreamy look in his eyes....Then a few seasons later, McSteamy arrived! He is a hunky plastic surgeon. The 2 of them are good mates. And I feel the complement each other in the drama very well.

If given a choice, I would pick McDreamy anytime....keke.

Anyway, I just completed watching Season 4 of Grey's anatomy. I finished the entire series in less than 7 days!! I have to admit that I have an addictive personality. Once I start watching a drama series, I want to watch the next episode immediately. That is why I NEVER EVER buy DVD box sets. I simply have no self-control.

I will need to get season 5 stat!

Welcome to The North East of England

It was a wonderful sunny weekend.

It is time to get rid of the heavy thick coats, time to put on a summer dress, and time to take those lovely sandals out from the store.

Yes....why hide in the house, when such hot weather is hard to come by.

So I decided to pay a visit to The Angel of The North.

I am not sure if you are aware of this wonderful creation of Antony Gormley. It is a big sculptor located in Tyneside at the North East of England. It is probably one of the most popular work of public modern art in England.

The wings of the angel is about 54 m in length. It stands on top of a very small hill, and it sort of welcomes you to the North East of England. The body is about 100 tonnes in weight, while the wings are weighing approximately 50 tonnes each.

As you can see, it looks simply amazing. I would highly recommend a visit to this place in order to truly appreciate and soak in the majesty of this sculpture.

Thanatophobia

Anyone heard of this word "thanatophobia?"

Thanatophobia = fear of death

I am sure many of us are afraid of death. No one knows how it feels like until the day actually arrives. It may come so quickly that you don't even feel it.....or, it may be a slow, painful, and gradual process. Who knows which kind of death we will suffer from.....

I have to admit that I can't help but think about death too. Death is inevitable in the hospital. Patients die, and we, doctors, certify the death. Within a few hours, the patient's body will be moved to the mortuary. Then, a new patient will arrive in the ward to take up that empty bed in the ward.

Yes, the turnover is fast. Yes, I have encountered many expected and unexpected deaths in the hospital. I should have been used to dealing with death by now.

But no.

Today, I felt really upset when I spoke to one of my patients. He has 2 failing organs...and that is a bad sign. Death is quite near. It is horrible seeing how someone could deteriorate quickly just within a few days. I explained to him what was going on. I told him that his kidneys are not functioning very well anymore, and that there is a limit to what we could offer him due to his other co-morbidites.

He said, " Doctor, I don't want my kidneys to fail...."

There it was.....the look in his eyes.....just broke my heart and soul.

I guess it would be even scarier for them to see the reflection of his fear in my eyes. I could only keep my cool, and tried my best to give him my honest opinion, with a lil encouragement. Its difficult. Once 2 organs are failing, the body will slowly shut down and fail completely.

I can't imagine how it feels like when you know death is inevitable. I can only hope that the person is as comfortable as he/she can be.

..................................

Unfortunately, he died peacefully a few days later. I was not surprised, but felt rather upset.

RIP. You are now in peace with your body and soul.

Is It Trust or.....is it just plain laziness?

hmm.....I kept asking myself these questions over the past 3 nights.

Yeap, I am doing the night shifts these week. Someone has got to do it...and it so happened to be my turn this time.

I am not complaining about it...

But I somehoe dread going into the shifts.

I mean, no one can predict how busy it is going to be....what sort of disaster is going to happen.... or whether it is going to be a quiet night (oh no, I said the dreaded Q-word!).

But, but, what really bothers me is my senior colleague I am working with.

Senior Colleague's name is J.

J is a medical registrar. So J has to oversee everything in the hospital. He is the boss at night, second to the consultant who is on-call from home. Yes, so J's responsibility is HUGE.

So I really wonder, how come J goes to bed every single night of these shifts from about 1 am to 6 am?? J has left me with all the acute admissions during that time. If it is a ok night, I really do not mind at all. But when there are 10 people on the board waiting to be seen, and more to come...surely, J should help out, no?

J is the registrar, yes, I know that.

But, this is the first time I'm working with J. So, J doesn't know whether I know what to do, whether I am careless or careful...etc.

So the question is.....Does J really trust me so much that he has left me with all the admissions? Or, is J just plain lazy? When J wakes up later, he will just say," Oh there were more admissions this morning, eh? Everything ok?"

Hmm...I don't know. I want to say that he trusts me. But deep down, I think there is a tiny bit of laziness there.

Unexpected Visitor

I seem to attract the authorities. This is my 4th encounter with the police.

This week, I came back from work as usual. I was really hungry that day, and quickly heated up my leftovers in my microwave. While enjoying my dinner, I suddenly heard a loud knock on the door.

I was like....hmm...who could that possibly be? I thought it was a delivery man, sending a parcel.

So, I peeped through the hole in my door.

Oh-uh, there was a police officer standing at the front of my door. Immediately, I could feel the adrenaline rush....my heart started to thump really fast and hard. A few thoughts came to my mind.

Did I commit a crime? Did somebody sue me? I dunno.

I opened the door to greet the police officer.

"Hello," he said.

"Ermm...hi," I replied.

"Just wanted to ask you if you knew your neighbour living over there?" he said, while pointing to my neighbour across the corridor.

"No, I don't know him. I don't know my neighbours at all," I said. (and this is true)

"You not seen him moving furniture or anything like that?"

"No I haven't. I've seen those girls living opposite him, but not see him."

"Oh ok then. Thank you very much," he said.

After I closed the door, I still felt weak in my legs. My heart was still thumping.

Don't get me wrong. I was glad that he wasn't looking for me.....glad that I wasn't in trouble. But I can't help feeling intimidated when I meet a police officer.

I speak to police officers occasionally in the hospital environment, and even prison officers. But I do not feel scared when doing so. It is probably because I was in a hospital, where there are other colleagues around me. While being at home, there is no one else.

I am so Stiff!

It was a lovely bright sunny day yesterday. I have been working for the past 2 weeks without any break.....therefore, I decided that it was time to soak up some lovely sunshine, and fresh air.

So what did I decide to do?

Go for a jog around the park.

It wasn't a bad idea to start with. I used to run 9 miles a week (6 months ago!). I stopped running because the weather was becoming colder, and I moved down here to M'bro. I had to quit my old gym....and was TOO lazy to get myself registered in a new one locally.

I got changed into my exercise gear. Did bit of warm up...and started to jog at a slow pace. After one round, I was panting like I have just completed a marathon run. My heart was thumping so hard. I could not continue running. So I stopped to catch my breath. After a few mins, I started to run again....but found myself stopping another time just before the second round was completed.

=(

Yes, clearly I have lost my fitness level...how upsetting!

I remembered being able to run around the park 3 times without stopping....and now, only just one round?! Gosh...how bad is that?!

Luckily there was the happy sunshine and fresh air to cheer me up a little.

This morning, I got up with stiffness all over. My quadriceps are stiff and achy....my lower back is just the same too.....sigh, these are the consequences of not exercising regularly.

I shall now attempt to run bit more regularly.....i hope! no more excuses, now that the weather is so much warmer!

If Only I Can Split Myself into Two

Exactly....it is impossible....well, not entirely, it can be done, only that I have to lose my life.... *yikes (that's not ideal!)

I really do love my job. I really do...trust me. The only thing I struggle with is trying to be in 2 different places at the same time. I am sure many other doctors out there will agree with me. This situation is made worse when you're in an on-call shift, where you are IT. You are THE ONLY doctor on-call for the wards...in charge of looking after more than 100 patients during that shift.

I found myself caught in a dilemma over the weekend. The situation was:

• a patient was scoring a EWS of 12?!
• a patient complaining of chest pain
• a man who had more than 1 litre of ascitic fluid drained from him, and now hypotensive
• a patient with pyrexia
• a patient who has disseminated malignancy in severe pain (despite being on really high doses of opioids)

Now, I received these many calls within 10 minutes. HELP!

I told myself...prioritise....prioritise.....breathe....breathe....dun panic.

So off I went to see this patient with a EWS of 12. He was really really sick. After performing a few resuscitative measure, I quickly walked across to the opposite ward to check on the ECG for the patient with chest pain.

Great! Now he is in uncontrolled AF! A quick assessment was done followed by giving him a rate limiting medication.

Then, I rushed back to that sick patient....still very ill.... did a few more things for him....but he was too ill to be left alone. So I called the ward to ask about the hypotensive patient...who apparently looked "washed out" according to the nurses. I told the nurses to give him a fluid challenge to see if it would help.

The patient I was with was now scoring a 14. !!!!!!

I actually did contact my SPR for some advice...which he did provide...but clearly none of them was working. He needed HDU/ITU support. I called my SPR again...it took him such a long time to come review this ill patient (it wasn't like he was busy in the MAU!).

Anyhow, in between all these chaos, the poor cancer patient has been left in pain....I felt so guilty. I told the nurses to give him some IV morphine...but none of them could cannulate him... so I told them to give it s/c instead.

Finally the ill patient went to HDU. I was now able to leave him to carry on with my other tasks....

*sigh.... it was certainly a challenging day. I was so exhausted in the end. To add to that tiredness, was plenty of guilt. I felt that I was not doing a good job. The poor cancer patient was left in so much pain....in fact, he was in pain for nearly 9 hours, before I could sit down and calculate how much morphine he requires in a syringe pump.

Imagine if one of my family members were left in so much pain.....that would be horrible...I would not be happy to leave them in pain for so such a long time! Luckily the cancer patient and his wife were so understanding.

SIGH. Another sigh.

Glad I am not on call for the rest of this week.

Holidays!

Its so nice to have a great holiday.

I got back from Paris more than 1 week ago, feeling rather refreshed, rejuvenated and rested. =)

We were blessed with great weather there. It was sunny everyday, except on the day we left. As a result, we managed to do alot of walking and sitting around on the pavements, enjoying the beautiful view in front of us.

Paris is a great city. Everyone is so well-dressed. Every woman carries a beautiful handbag (well, almost everyone of them). The buildings look old, but are well maintained. The only criticism I have is that things are very pricey. A simple sandwich with cheese and pickles was priced at 4 euros! I found that really dear, as I could possibly get a sandwich similar to that for 2 pounds or less in Tesco. A small cup of cappuccino costs about 2 to 2.50 euros...and I could get decent coffee at the train station in the UK for 1.50 pounds.

Anywho, that aside, I thoroughly enjoyed myself. We went to visit most of the usual attractions, including the Eiffel Tower and Versailles. Eiffel Tower is stunning. It looks even more elegant at night.... The orange lights on the tower make it glows beautifully, and did you know that the tower twinkles (with blue lights) for 5 minutes in every hour? I sat down in front of the tower for at least 3o minutes just enjoying the wonderful sight!

Oh did I also mention that I forgot to pick up my luggage from the conveyor belt at the arrival hall in Paris airport? YES....silly me. I was too busy thinking about where to catch the bus to get to Paris city centre, and thus, just walked out of the hall without even getting my luggage first. I laughed at myself for being so careless....and quickly walked back into the arrival to get me luggage. Thank God it was still there.

=) ahh...holidays.....what will we do without them? Where will me next destination be? should probably start planning soon. Now that summer is near too, there is even more reasons to plan ahead! Remember, it doesn't matter where you go, as long as it is with good company!

Short Getaway

yay!!!!

In just a few hours, I'll be flying away to the capital of France! I'll be there for a few days.

I haven't been there since I was a little girl.....to be honest, I don't remember anything of that trip made when I was about 5.

Mum keeps telling me that I was a real grumpy girl then...My dad had to carry me because I was unwilling to walk. haha. Having looked back at those pics, I would agree with mum...I didn't smile in the pictures at all!

Oh well, I am sure I will enjoy it now. =) I am keeping my fingers crossed for good weather.

Till then...au revoir everyone!

In No Hurry...

Its been more than 1 week since I left my car at the garage.....and I have yet to hear anything from them. I mean how long does it take to just change the bumper??

I became very curious....which led me to pick up the telephone to call the repair centre. She struggled to locate my car at first (which kind of worried me a little). Then, she said, "Ahh....I found it. The parts of your car only just arrived yesterday. So they are going to strip your car next.....looks like we are looking into next week."

Right. Cool.

I was bit disappointed that it took quite awhile to repair....but then, secretly, inside me was a little sense of joy? ermm...yes, remember that I am driving a cool white sporty Fiat 500. And I am getting the hang of it. So, as much as I want my car back asap....I am also in no hurry to get it back because this replacement car is great! haha.

Talking about being loyal to my wee Peugeot.....tsk tsk tsk

Small Funky Car

I have to admit that I am enjoying my temporary replacement car. I know my poor Peugeot is in the garage being fixed at the moment....I am missing it....honestly, yes, I am. However, this replacement car is quite cool.

It has been voted the "Car of the year 2008", and also the "Best Small Car" award.

I am talking about the new diesel Fiat 500. It is a really sporty 3 door car. It is very easy to drive. The interior is funky and the seats are comfy. The engine runs smoothly, and I like the sound the engine makes when I start it....it ROARRSS! haha.

My only complaint is the colour. White is nice for a dress, but for a car, dirt can be seen easily. And....I am worried that I might just fill in unleaded petrol instead of diesel! I have been having a few nightmares about that........=( Well, I know I still have at least quarter of a tank left...so that should keep me going until the end of the week, before I start worrying about it.

So, if anyone is thinking of getting a small sporty car, give the Fiat 500 a thought! (ps. it does come in a beautiful fiery red colour!)

Hanging Loose

The mechanic came to estimate the damage to my car this morning. I was really glad that he came because I was kind of anxious just waiting to find out how badly the car was hit.

After taking a couple of photos of the car, he asked, "Hey, you still driving the car?"

"Errmm...yeah, I am," I replied.

"Right ok. Do you know that it is fairly dangerous to do so?"

"Oh is it? How come?"

"Well, as the result of the impact, your exhaust pipe is actually hanging down quite loosely...so it could fall off very easily. Secondly, even if it doesn't do that, because the exhaust is loose, it leads to an increase in tension at the front part of your car....leading to even more damage to your car. So be really careful when you drive up the humps on the road," Mr Mechanic explained to me.

To be honest, all I had in my mind was how unsightly the bumper was....It never occurred to me that the exhaust was also involved in the minor accident. How ignorant of me!

I was curious to find out how much the repair would cost (although, I know the money was not coming out from my pocket...).

"Hmm....probably at least 1000 pounds minimum, and the repair may take up to 2 weeks,"he said.

Wow....that is very dear....and 2 weeks in the garage???!! man...that is long. Oh well, I guess they have to adjust the bodywork, re-spray the paint, etc.

He will be picking my car up tomorrow to get it into the garage. My courtesy car will be arriving around the same time too. I really just want my wee car sorted asap.

It Just Happens...

So it was 9 o-clock Saturday morning. I just completed my set of night shifts. When I do night shifts, I run out of food from my house very quickly....because I have no initiative to buy food during the week. Therefore, on this particular Saturday morning, I thought of all the different type of food I wanted to get from the shops. I was already formulating recipes in my head for the week!

I left the hospital and thought to myself. "Hmm....maybe I should do food shopping after getting some sleep first." But, I was actually quite awake after the adrenaline rush I had throughout the busy night. I decided against that idea...and drove myself to get some food from Morrisons and M&S. yumm....

After paying nearly 20 pounds for food, I drove myself home, quite happy and contented.

Unfortunately, this feeling did not last long. As I was heading towards a roundabout, I noticed that a car had stalled just at the entrance into the roundabout. I, therefore, pressed my brakes to slow down. All of a sudden, I saw a fast car heading towards me from the rear. I thought it would have stopped before me....however, to my horror, the car moved closer to me...and at the very last second, the driver realised that he could not stop in time, and swerved to the left...........

BANG!

My heart sank.

My car slided forward. (thank goodness the car that stalled had managed to get his engine started and drove away, otherwise, I would have bumped into it).

All blood supply drained from me.....I felt weak.

Yes, I was knocked from the back. That idiot driver was kind enough to stop his car at the side of the motorway.

We got down from the car. He apologised for his mistake. I was still in shock. We exchanged details, ie car registration number, address and contact details.

My rear bumper was cracked and dented. I think my Peugeot is a tough car. The impact was quite hard....but the bumper was still intact.....well, maybe only just hanging down slightly. Luckily none of the lights broke. Obviously, part of the car paint was scraped off....it wasn't a very nice sight.

His car was damaged even more...probably coz his car was the driving force for the accident.

Sigh...I was like, "GREAT!!! This is just what I need after a long week of night shifts!"

I drove home...still alittle shaken. I was very glad that I was safe and unhurt. To be honest, it was a very minor accident....but MINOR enough to make me scared, shocked and traumatised. I really couldn't imagine being in a major accident.....it would even be worse!

When I got home, I contacted my insurance company immediately. I was really impressed by the efficiency of the system. Come Mon/Tues, I would be able to get my car to the garage for repair...and I get a courtesy car at the same time....all on the expense of the other driver.

I am alot better now. Just wished it hadn't happened. But things like that was probably going to happen anyway. I mean, if I didn't go food shopping in the morning, I wouldn't have been in this position, no? It just happens....I was at the "right" place, at the "right" time...

Sigh.

My Fingers Are Too Short!

I've learnt one very important fact in my life as a doctor yesterday.

MY FINGERS ARE TOO SHORT!

And I thought my fingers are quite long for my size because of my piano playing background. In fact, I recalled measuring my fingers with my classmates last time, and they were surely longer than theirs!

So I was quite surprised to find that my fingers are too short for a simple manual evacuation yesterday.

hehe.

For those naive to medicine, let me tell you the satisfaction of a manual evacuation. (no not really...not so much satisfaction....more of a disgusted feeling!)

Right. The situation was this elderly lady was in the post-operative period. She has been constipated for a good few days. She has tried various laxatives to help with it, but unfortunately, none was working. I suggested a trial of a phosphate enema (you know, those things that you stick up your bum to activate a bowel motion).

To my horror, the nurse returned to tell me that she was so impacted (ie, her anus was so stuffed with faeces), to the extent that she could not even use the phosphate enema!

The nurse asked me, "So what are we going to do?"

I dreaded the thought I had in my mind.....and I reluctantly said, "Guess, the next step would be manual evacuation."

A manual evacuation of faeces is when a person inserts his/her fingers in a rectum to digitally remove faeces inside it. It is helpful in people who are rather constipated....and just need to unblock the hard faeces that is blocking the rectum. Once evacuated, it makes it alot easier for the person to open the bowels again.

I couldn't have found a better time to perform this procedure......which was after my lunch! Perfect! (I was crossing my fingers that I will keep my food down).

I explained to the patient what I was going to do....and she told me that she did not care how uncomfortable the procedure was going to be, as long as she could get rid of the discomfort she was having as a result of the constipation. She was more concerned that it would be unpleasant for me! How thoughtful!

I said, "Don't you worry about me, my dear....that's my job...to make you more comfortable!"

Prepped with double layered gloves and lots of lubricating jelly, I started the manual evacuation by inserting 2 fingers into the rectum. And............my fingers could not really reach the hard faeces stuck inside. I could feel it with my fingertips. So I just thrusted my fingers deeper into her rectum, and at the same time, wishing if only I had longer fingers. The poor patient was looking quite uncomfortable. She told me not to worry about it. *Bless her! And eventually after a few minutes, I managed to dig out at least 4-5 blobs of really hard stools.

I have to admit that this was probably the most disgusting thing I have ever done! I really wanted to vomit...due to the smell of the faeces...and just the thought of me, digging out faeces from a rectum. (I salute you fellow nurses/HCAs/cleaners)

The lovely patient was feeling so much more comfortable after all of that. She was able to sit comfortably on a chair as she didnt feel too impacted. All the nurses in the ward was laughing at me for having to do this manual evacuation...and the wise registrar said, "Well done. The only time you won't do a manual evacuation, is when you're a consultant! This is probably one of the MUST-DO when you're a junior doctor."

It was quite an experience....and I am glad that I've helped to make someone's life better!

hmm.....if only me fingers are bit longer.......

I don't have a straw!

I couldn't stop myself laughing today. I know, I know, it is not very professional and nice of me to laugh at my work colleague....but what he told me today was hilarious!

He will be working this weekend on-call. So I said, "You have the short straw eh?"

He replied," What straw? I don't have a straw."

I was like huh?!

"I meant you are the unfortunate one that has to work this weekend," I told him.

He, then burst out laughing, and so did I. haha.

He said, "I didn't understand what you mean by straw. Guess it is just the way you say things here."

I wonder....

I wonder sometimes whether I am being ignorant, or, the nurses just don't pay any attention.

hmm...

An elderly lady has been admitted with severe heart failure. She has longstanding bilateral leg oedema for the past 5 years, and as a result she has suffered from a degree of venous eczema. Both her lower legs have looked red for years. She has been a patient of that ward for 2 to 3 weeks now, and the same nurse has been looking after her for the past 7 days.

Now, this evening, I got a worried phone call from her. She was concerned about these red legs which she has never seen before. So I went on to review it. The legs were as red as they were when we looked at it many weeks ago. There are not hot or tender. There are unchanged. The patient herself did not notice any change the in the condition of her legs either.

So I reassured the nurse that there isn't anything to worry about at the moment. I've also explained to her that she has venous eczema. The nurse said, "oh really? I've never seen her legs like this before....it is new." I replied, "well, I have been looking after her, and I am 100% sure that her legs have been like that for many weeks now."

I can only conclude that she hasn't seen those legs while looking after the patient. Or, she was just not paying attention during the ward round, because, we examine her every day, and expose her legs every day....so how could you not have noticed that?

I dunno.

GGGggrrrr

*GGRRrrr

The year of the tiger should start with a bang. The tiger is a fierce and ferocious animal. So I believe that I should begin it with something grand. Unfortunately, there isn't anything exciting in my life at present.

1st of January 2010 went on like any other day. In fact, it was strange having to countdown in the hospital. I had to do the night on call then, and the nurses, and my fellow colleagues, turned on the telly for awhile just to catch the live telecast of the fireworks display in London.

And look at how first time flew by. It is February already.

Well, if I can't start the year like the way the tiger pounces on its prey, then, I should end the Ox year with a few resolutions.

My new year resolution is to pass all the exams I am attempting. I really need to, if I am thinking of entering into the specialty of my choice in a year and a half. I seriously can't afford to fail any.....moreover, these silly exams are so bloody $$$ anyway.

My second resolution is to plan and go on a cycling holiday break during Summer. I have always wanted to visit a place in Europe that would allow me to do cycle around the streets, and doing some tourisy things at the same time. I've heard that Amsterdam and Italy are good places for this activity. So hopefully, if all go as planned, I might be able to do that this year!

And finally, I would like to save enough money to get me-self an iphone! haha. yes...what a treat eh? I have 10 reasons for wanting one, but one reason not to....and that is because I find the current package deals wee bit pricey. So, if I save enough, I won't feel the pinch, no?

So listen, I will try to update my blog more often (I know I have neglected it for quite a few months now). And, I will give myself a huge pat on the back if I do fulfil these resolutions. Till then, Happy Tiger Year everyone.