It's The Last Day of The Year 2011

Yes this is one of those entries where I reflect upon the year that is about to come to an end. So feel free to stop reading now as it may bore you.

I remember being really busy preparing for exams. In April, I sat Part 2 MRCP. This was quickly followed by a failed attempt at PACES in June. And as a result of my failure, I was unable to proceed to the next stage in my career. Fortunately, my 2nd attempt in October was successful, and because of that, I have completed my membership exams.

Should I say that obtaining full MRCP was somewhat life-changing for me? Well, I guess it was. I mean when I failed PACES, I felt really low. My confidence was down in the dumps, and I felt really embarrassed. The embarrassment was due to the fact that my junior colleagues passed theirs without much problem, and I seemed to be struggling with it. Yes, I have some ego in me. When I found out that I passed PACES, I was really super-duper overjoyed.

Then, it was time for me to choose which specialty I wanted to specialise in. I received 2 job offers; one in diabetes/endocrinology, and the other, in neurology. I chose the latter as I felt it was more interesting diagnosing the weird and wonderful neurological disorders. I am thoroughly enjoying the job at the moment, although I have alot to read up on.

Work aside, the only other exciting achievement for me was running and completing my first ever 10k. I was happy that I finished it in just over an hour. However, I regretted not training for it properly because I ended up with a very bad left knee injury, which left me inactive for a few months. I will definitely try to run it again this year, and aim for a better time!

My unhappiest moment in this year was when I was informed of my beloved doggie, Kiki's death in September. She suffered from septicaemia. I really do miss her alot, and think about her sometimes, especially, when I see other dogs walking in front of me with their owner.

This year saw me spending 2 holidays back home (which is unheard of since I came to the UK in 2004). =) Hopefully I would be able to repeat this next year. Nothing, absolutely nothing, beats spending holidays back home with my family and friends, whilst enjoying the comfort of being in the country where I grew up in!

2011 has been great. The 4 goals I set for myself in January have all been achieved; running 10k, travelling abroad (spent a week in Belgium in summer), passing exams, and going home. I am very grateful for what I have. I have also been very fortunate to have met new colleagues, who are now my friends, who have supported me while I prepared for my exams/job interviews.

What does 2012 hold for me??

I am looking forward to catching the London Olympics because I have tickets to watch badminton finals!! woohoo!!! Lee Chong Wei...dun disappoint me! I want to see you in the finals!! :P

I hope that 2012 will take me closer to my partner. I am seriously tired of the distance. I really just want us to be together everyday, that isn't too much to ask for, right??.... and deep down in me, I am hoping that we could settle down, get a house and slowly build a family.

I need to work hard and be geekier (is there even such a word?!) as I gradually build up my confidence, skill and knowledge in the field of neurology. It will be interesting to see how much I would have hopefully learned after 1 year.

Watch this space!

Happy 2012!!!

Cheers!!

It's Christmas!

Christmas celebration started off with lunch at our favourite restaurant, The Waiting Room, in Eaglescliffe. It is a wholesome vegetarian restaurant that serves delicious vegetarian food! The menu was rather christmassy, and we decided to order the traditional Christmas dinner. The turkey has been substituted with a carrot, walnut and apple loaf, with roasted parsnip, carrots and beetroot! delicious!

This was quickly followed by dessert at the same restaurant. I ordered the chocolate and raspberry roulade, served with ice cream....Mmmmm

On Christmas day, I was feeling very festive, and in the need to do some baking! I spent the whole afternoon baking 2 things; Speculoos (traditional biscuit baked before St Nicholas' feast), and cherry + hazelnut biscotti!

Speculoos in the jar, and the biscotti is on the baking tray.

After all the baking, it was time to treat myself to a lovely dinner. It was a very non-british dinner.... which really reminded me of the times where I spent xmas back home. The main dish was chicken briyani. There were also cucumber with sesame oil + chili flakes as the appetiser, and a vegetable salad with lemon + olive oil dressing.

A closer look at the cucumber dish.

Merry Christmas!!

=)

10 days & counting

Christmas is not too far away!

I put up my christmas tree during the first weekend in December. Mum said that my tree was fairly bare, so I decided to buy new xmas decos. Here is a picture of the new decos on my tree:

(note the dog with a santa hat, russian toy soldier, snowflake, and an angel on top)

One of my colleagues at work was really trying to get us into the christmassy mood by bringing this in.

Yeah...a Gingerbread House!! 100% homemade!

I thought she did an amazing job. It was too beautiful to eat...but, in the end, we all couldn't resist it. I started to pick on the choc buttons on the roof. Her gingerbread walls tasted very gingery and yummy...

Now, I just need to complete my xmas shopping. I have yet to get a present for my ex-housemate. I have left it a little too last minute, as I am planning to see her this weekend. So I will have to do some xmas shopping over the next few days!

A Weekend in Neuro

I survived the weekend.

Yes. It was my first 48 hour weekend on-call in neurology. I was rather worried about it. My fellow reg offered to swap the on-call with me, but I didn't want to. I would need to do the on-calls whether this weekend or later. Therefore, I might get it over and done with, and build up the confidence plus experience as I go along.

I did mini ward rounds in the ward on both Saturday and Sunday. I was finished by about 11 am. Then, I proceeded to review 2 patients in the high dependency unit. Both were in respiratory failure secondary to dermatomyositis and myasthenia gravis respectively.

So far so good, I thought to myself. No referrals yet. I decided to hang around in the hospital until about 3pm, just in case anything happens. But it was all under control. This would never be the case had I be doing general medical weekend on -calls!

The only phone call I received was early this morning at about 10 mins after midnight. Apparently, the medical registrar from this nearby hospital has been trying to contact me all evening. The switchboard dept in my hospital has got my name wrong, and they claimed that I was not on their on-call list this weekend; despite me ringing them on Saturday morning to confirm that I am on-call and even gave them my mobile number.

Anywho, the med reg was asking for advice on a patient whom they suspect might have Gullain Barre Sydrome (GBS). He was just wondering whether he needed to transfer the patient overnight to us. The patient was stable, and was not in any respiratory compromise. So I suggested that the patient remained in their hospital overnight, and be transferred in the morning. I ran that past the consultant and he agreed too.

The weekend was, otherwise, uneventful. I am glad that it was ok, but I was also hoping for a few more phone calls just so I get more experience etc. I look forward to more on-calls this week, and the months to come!

Day 3 Neurology

It's my turn to be on-call.

Any problems or referrals from 5pm to 9am the next morning will be directed to me.

I have done so many on-calls before this. They were mainly medical on-calls, and I almost always have a senior (who is not a consultant) that I could contact easily. This on-call is different, as I am further up the pyramid, just under the consultant. So I have about 4 to 5 years of knowledge and experience to back me up. And also, I have to admit that I am a little intimidated to contact the consultant on-call with me.

I am not going to lie....I am really scared and worried about the on-call yesterday. I mean, if the ward rings me about how to manage medical issues, you know, such as pneumonia, tachycardia, sepsis, etc, it wouldn't be a problem. What I am concerned about is managing the hard core neurology things....for eg, advice on changing anti-epileptic medications, or reviewing patients with weird neurological presentations.

I know I am still very green in this field. But I can't help but worry. And also, I will no longer need to be doing the on-call on site. I will be contacted from home. Yes, it is nice not to be running around the hospital in the middle of the night. But it is also a challenge for me to be able to provide advice/opinions over the telephone. I have to learn to trust the person on the other end of the telephone. I am not saying that they will be providing me with wrong information, but you know, it is different being in the hospital (where I could easily review the patient), and listening to the condition over the telephone. I really need to get used to this.

Interestingly, I didn't get any call until 10 something at night. It was a call from A&E.

"Hello, its the neurology registrar," I mumbled.

(mind you, I struggled to say the word "registrar," which shows how much confidence I'm lacking).

"Yeah, it's A&E here. Do you remember that lady with gallstones?" asked the doctor over the telephone.

"Errm...gallstones? Who are you talking about?"

"You know, the lady with gallstones whom the urology SHO reviewed earlier?" replied the doc.

"I'm sorry. But you are speaking to the wrong person...I am from NEURO, not UROLOGY," I told her.

"Oh...haha...I'm sorry to trouble you. Thank you!"

"ok bye" I said and put down the phone, somewhat relieved it was not a neuro call.

I couldn't really sleep for the rest of the night. It was probably because I was worried that I might not hear the pager, and also, worried that if were half asleep, I would not be able to provide good advice/suggestions, and speak with a clear mind.

The rest of my on-call turned out to be a quiet one. There were no further phone calls.

Honestly, I really need to take a chill pill, and stop worrying so much!

Day 1 Neurology

I have been building up myself towards this new role of mine....you know, from being the Senior House Officer (SHO) to a Specialist Registrar (SPR).

Today marks my first day as a SPR, in neurology, a field which is very much new to me. My knowledge and experience in neurology is pretty limited. I mean, I have a bit of stroke in the past, and also had a month's attachment in neurology. However, those experiences are certainly not enough to prepare me for what is to come!

I am the allocated ward registrar for the month of December. The day started off with a handover between me, the nurses and the SPRs who have been in the dept already. The handover took at least an hour, as they had to tell me important details about every patient (we have 15 patients). I know it is not many, but it took quite awhile for us to get around them.

By the end of the handover, my head was spinning. Alot of questions were running in my mind... What is this about limbic encephalitis? And what is ventriculitis? How do you treat it? What is TBM? (I soon found out that TBM = TB meningitis).

After that, I started my first ward round as a SPR. It was not an easy task, just because most of the patients have been there for a number of weeks. So it took quite awhile for me to grasp what was wrong with them in the first place. By the time I completed the round, it was already 1pm!

We all went for a quick lunch. Upon returning, the nurses were looking for me. They wanted me to review a few patients in the day room, there were 2 difficult lumbar punctures to do, and a few other bits and bobs. It really didnt occur to me that there were so many decision making tasks as a SPR. I also had to attend to a few phone calls from patients who needed some advice.

When I was a SHO, all I had to do was to ensure that the ward runs smoothly, get all the requests done and do as the registrar tells me to. But now, I am on the other end of the stick...it is me who gives advice, it is me who makes some of those decisions that SHOs can't make, it is me who have to take on more responsibility than before....

The only positive thing I found today was that I am starting my new role in a familiar environment. I know the nurses in the ward from my previous attachment. I am working in the same hospital, therefore, I know how to get my way around things. I couldn't imagine starting work in a completely new hospital...it would be even worse.

It was a wee bit overwhelming for me today. Thankfully, my senior registrars have been pretty helpful, in giving me some very much needed support and advice.

I hope for a slightly better day tomorrow.

ps. one last problem is that i need to constantly remind myself to write down my correct grade when i write in the notes. So far, i have been calling myself a "CT2," whereas it should have been "spr."