THREE deaths in one night. All occuring within 2 hours. Bad eh?
Pt 1: He looked pretty grey, with a low BP. He was not giving us much history. All we knew was he was short of breath and unwell. A chest x-ray revealed a convincing right pleural effusion. The whole of the right lung field was white. A chest drain was then inserted into him. He was tolerating the procedure well, and the chest drain went in pretty easily. Yellowish purulent fluid came out from the drain, which meant that this patient probably has an empyema (pus in his pleural cavity). All of a sudden, as the SHO was stitching the drain in place, the patient's saturation dropped from 93% to 88%, 70%, 60%, 40% ...and undetectable. This heart rate was dropping fast too...until it reached asystole. Fuck! CPR was performed and patient needed to be intubated. However, he did not survive it. It was a very traumatic resuscitation, trust me.
Pt 2: In the receiving unit, patients will be brought up to the ward after having been seen in the A&E first. An elderly lady was wheeled into the ward not too long after the event above. Her family members were asked to wait in the waiting room while the nurses admit the patient. As soon as the elderly lady was taken into one of the rooms in the ward, the nurse who accompanied the patient closed the door and said, "This lady actually died in the lift on the way here." WTF?! Looking further into her notes, the patient had a very low blood sugar level of only 1.9, and guess what? The smarty pants A&E doc gave the patient an IV infusion of normal saline?! What was he/she thinking??? Give 5% dextrose at least....but really you should have treated the patient's low sugar level before bringing her up...maybe a stat 50% dextrose? Imagine the horror of the whole situation!
Pt 3: He had a bad chest infection. His family members were informed that his prognosis would not be good, and they agreed not to resuscitate him, should he goes into a cardiac arrest. The patient was rather agitated towards the last moments of his life. His daughter left the room for only a few minutes to get something, and unfortunately, her father took his last breathe at that time. sigh.
Three different deaths in one night. Hope it doesn't get any worse than this. I was quite traumatized after the first patient. But, I still got to pull myself together to carry on clerking in other patients. Life is tough.
Thursday, January 11, 2007
Saturday, January 06, 2007
Life is...
I came across an interesting statement while hanging around in the city today.
"Life is like an egg, either getting smashed or getting laid"
Just like an egg, we humans are vulnerable. In life, we get "smashed" with stress or illness, and we get "laid"...errmm, you know what that means (that's if we are lucky enough).
"Life is like an egg, either getting smashed or getting laid"
Just like an egg, we humans are vulnerable. In life, we get "smashed" with stress or illness, and we get "laid"...errmm, you know what that means (that's if we are lucky enough).
Wednesday, January 03, 2007
Puncturing The Lumbar Spine
I am happy with myself today. =D
As a student or even as a young girl, I have always watched doctors carrying out lumbar punctures (taking some fluid out from the spinal cord for investigations), either on the telly or in the wards. I figured it was a difficult procedure, but hey, it was not that complicated afterall.
Can't stop smiling from ear to ear....why?
COZ I've done a lumbar puncture successfully! yay!!
Mind you, my first one was carried out last week. I failed miserably at that time. However many times I've tried to angle the needle in a different angle, I did not manage to get any cerebrospinal fluid (CSF) from that patient. Poor lady. I have to thank her for being so patient with me. (ssshh...she didn't know that I have never done a lumbar puncture before). After about 20 minutes, my SHO decided to take over, and as expected, she got the CSF in no time.
Today, another patient required a lumbar puncture to rule out a subarachnoid haemorrhage and infection. Guess what? The CSF was pouring out after inserting the needle on my first attempt! =) hmm...lucky? I guess doing a lumbar puncture requires alot of luck and of course, some skills-lah! =P (kekeke....I know I know...I shall stop praising myself...)
I can't wait to do my next lumbar puncture!
As a student or even as a young girl, I have always watched doctors carrying out lumbar punctures (taking some fluid out from the spinal cord for investigations), either on the telly or in the wards. I figured it was a difficult procedure, but hey, it was not that complicated afterall.
Can't stop smiling from ear to ear....why?
COZ I've done a lumbar puncture successfully! yay!!
Mind you, my first one was carried out last week. I failed miserably at that time. However many times I've tried to angle the needle in a different angle, I did not manage to get any cerebrospinal fluid (CSF) from that patient. Poor lady. I have to thank her for being so patient with me. (ssshh...she didn't know that I have never done a lumbar puncture before). After about 20 minutes, my SHO decided to take over, and as expected, she got the CSF in no time.
Today, another patient required a lumbar puncture to rule out a subarachnoid haemorrhage and infection. Guess what? The CSF was pouring out after inserting the needle on my first attempt! =) hmm...lucky? I guess doing a lumbar puncture requires alot of luck and of course, some skills-lah! =P (kekeke....I know I know...I shall stop praising myself...)
I can't wait to do my next lumbar puncture!
Tuesday, January 02, 2007
The Most Miserable Day of The Year
I woke up this morning and turned on GMTV. Apparently, today is officially the most miserable day of the year! hehe. The reason being it is back to work for most people after a long break which began since Christmas. So everyone will be sort of dragging theirselves to their workplaces.
Actually, I think today should not be the most miserable day of the year. It is just the 2nd day of the new year. Everyone should have a positive attitude, what has happened in the past is over.....look forward! Imagine if you're already miserable today, you're going to make yourself even more miserable throughout the rest of the year! haha.
But I certainly can understand the miserable feeling. After all the fun and the dinners, it is now time to go back to routine. Sigh. Everyone must be feeling really broke right now too, having spent money on buying presents, food and booze. (I only have 5 quid in my purse). And as usual, we could blame the weather for making people feel down....it is gloomy and getting colder.
Oh well, miserable or not, that's the way it is....but to cheer yourself up, remember, summer is very near, and christmas is just another 11 months and 23 days away! :) Keep smiling!
Actually, I think today should not be the most miserable day of the year. It is just the 2nd day of the new year. Everyone should have a positive attitude, what has happened in the past is over.....look forward! Imagine if you're already miserable today, you're going to make yourself even more miserable throughout the rest of the year! haha.
But I certainly can understand the miserable feeling. After all the fun and the dinners, it is now time to go back to routine. Sigh. Everyone must be feeling really broke right now too, having spent money on buying presents, food and booze. (I only have 5 quid in my purse). And as usual, we could blame the weather for making people feel down....it is gloomy and getting colder.
Oh well, miserable or not, that's the way it is....but to cheer yourself up, remember, summer is very near, and christmas is just another 11 months and 23 days away! :) Keep smiling!
Monday, January 01, 2007
Mi Reflejo
We are now in the year 2007. 2006 has passed really fast. So many things occurred to me last year. I suppose that is the way life is...it is never perfect and we have to just accept whatever challenges that are placed upon us. I shall attempt to recap the main events in my life this year...here goes!
January: I remember I was in Dunfermline at that time doing my surgical shadowing as a 5th year medical student. I loved the whole rotation ...learnt loads and saw many interesting things. The junior doctors whom I was shadowing were really nice to me. The only downside of it was the accomodation was very cold.
February: From Dunfermline, I moved on to Yorkhill, Glasgow for my paediatric cardiology block. The accomodation there was worse than the one in Dunfermline. For once, I was able to appreciate heart murmurs...and I am proud to say, by the end of my 4 week stint there, I was able to differentiate an innocent murmur from a pathological one. :P
March: hmm...probably one of the saddest month of the whole year for me. Split up with my loved one. A sad ending which was totally unexpected. And it really did affect me....I was sad everyday, and could not concentrate on my work. I remembered staying awake for more than 24 hours trying to complete my case discussions....
April: It was spring time. I spent some of my time taking photos of pretty daffodils. oh..and went to St. Andrews with my friends during my Easter holiday. It was a nice relaxing week off.
May: This month was filled with stress! The deadline to hand in my portfolio was near and I was not even close to completing it. I remember struggling to find the correct words to use in writing my "10 curriculum outcomes" for my uni. It was a real pain in the bum. hehe. Oh...I could still remember the stress and fear I had while waiting for my turn to face my examiners. It was the VIVA examination...and I have to say...the pressure was so great...I was worried and scared. The worst thing was all my housemates have sat for their exam and I was the last one. PHew! I managed to pass the exam!
June: Finally, my summer holidays have started! YAY! I was so looking forward to the trip to Italy with my friends. It was fun and boy, I really do miss the hot sun in Italy. The trip to Italy was fantastic and I ate like maybe 6 gelatos?! I dunno...but I know the food was great, shopping was fun and I took so many photos.
July: It was graduation time. My family came up from Malaysia, including my granny. I took them around Scotland and we ended the holiday in London. It felt great meeting my family and spending time with them. I also went back to Malaysia for a really short break (about 10 days or less). A short but sweet holiday. This is also the month where I said goodbye to Dundee and my cosy rented house. *sob *sob
August: 1st of August marked the first day of my life as a working human and a doctor. It was scary...I didn't know how everything worked, and I was in a totally brand new environment. My rented room was way smaller than the one I had in Dundee. I remember complaining of having to pay council tax and pay the rent, whilst my other friends had accomodation provided for them. (but now, I think I'm quite happy paying those fees...) 31st August marked the first time I get proper wages! yay! So happy that I spent bout 20 quids for dinner at TGIF!
September: Getting tired and stressed at work (even after a month at work??) But it was ok, as long as I get paid! Now, I could finally understand the shitty jobs that we junior doctors have to do...
October: Oh...I couldn't wait for my holiday. My parents came up and we all spent a week at Spain together. It was lovely. It was THE time to escape the cold weather in Glasgow and it was great to have a short break away from the hospital. Ate loads in Spain and bought many stuff home too. I have to admit I felt that for the first time, I did not need to ask my parents for spending money. Instead, I sponsored their trip there. hehe. It was an achievement for me, to be honest. :)
November: Back to misery...ie, hospital. I was literally dragging myself to work. haha. It was a rather busy month too because I was working in the high dependency unit and was in the receiving ward for 2 weeks. I remember being pissed with the radiologists for not wanting to do the scans that I have requested. I remember looking after a patient who was suffering from acute alcohol withdrawal. I gave him about 50mg of IM diazepam and 40mg of IM haloperidol and some diazepam too...it did nothing to him!
December: This is the month where I changed to Medicine. To be honest, I didn't really like the change in the first place. The ward rounds are longer in Medicine, and I didnt have time to have lunch. It was so much busier than working in the surgical wards. Only in medicine that I managed to do ascitic taps and my first lumbar puncture a few days ago! :) (it was unsuccessful though). Oh...not to forget, I also received a number of sarcastic remarks from my seniors. December was also the Christmas month. Although I did not receive alot of pressies, I really enjoyed the atmosphere here. The last day of the year was spent working in the medical receiving unit. I was so tired by the end of the day and just simply went to bed after midnite. The weather was awful, the wind was too gusty and hence, the hogmanay in Glasgow was cancelled!
So there you go...a small little recap of the events last year. It was eventful but there are all experiences that would teach me to be a better person I guess. I hope 2007 will be exciting!
Happy New Year my friends!
May 2007 bring you loads of joy, happiness, love and luck!!!!! CHEERSSSS!!!!!
January: I remember I was in Dunfermline at that time doing my surgical shadowing as a 5th year medical student. I loved the whole rotation ...learnt loads and saw many interesting things. The junior doctors whom I was shadowing were really nice to me. The only downside of it was the accomodation was very cold.
February: From Dunfermline, I moved on to Yorkhill, Glasgow for my paediatric cardiology block. The accomodation there was worse than the one in Dunfermline. For once, I was able to appreciate heart murmurs...and I am proud to say, by the end of my 4 week stint there, I was able to differentiate an innocent murmur from a pathological one. :P
March: hmm...probably one of the saddest month of the whole year for me. Split up with my loved one. A sad ending which was totally unexpected. And it really did affect me....I was sad everyday, and could not concentrate on my work. I remembered staying awake for more than 24 hours trying to complete my case discussions....
April: It was spring time. I spent some of my time taking photos of pretty daffodils. oh..and went to St. Andrews with my friends during my Easter holiday. It was a nice relaxing week off.
May: This month was filled with stress! The deadline to hand in my portfolio was near and I was not even close to completing it. I remember struggling to find the correct words to use in writing my "10 curriculum outcomes" for my uni. It was a real pain in the bum. hehe. Oh...I could still remember the stress and fear I had while waiting for my turn to face my examiners. It was the VIVA examination...and I have to say...the pressure was so great...I was worried and scared. The worst thing was all my housemates have sat for their exam and I was the last one. PHew! I managed to pass the exam!
June: Finally, my summer holidays have started! YAY! I was so looking forward to the trip to Italy with my friends. It was fun and boy, I really do miss the hot sun in Italy. The trip to Italy was fantastic and I ate like maybe 6 gelatos?! I dunno...but I know the food was great, shopping was fun and I took so many photos.
July: It was graduation time. My family came up from Malaysia, including my granny. I took them around Scotland and we ended the holiday in London. It felt great meeting my family and spending time with them. I also went back to Malaysia for a really short break (about 10 days or less). A short but sweet holiday. This is also the month where I said goodbye to Dundee and my cosy rented house. *sob *sob
August: 1st of August marked the first day of my life as a working human and a doctor. It was scary...I didn't know how everything worked, and I was in a totally brand new environment. My rented room was way smaller than the one I had in Dundee. I remember complaining of having to pay council tax and pay the rent, whilst my other friends had accomodation provided for them. (but now, I think I'm quite happy paying those fees...) 31st August marked the first time I get proper wages! yay! So happy that I spent bout 20 quids for dinner at TGIF!
September: Getting tired and stressed at work (even after a month at work??) But it was ok, as long as I get paid! Now, I could finally understand the shitty jobs that we junior doctors have to do...
October: Oh...I couldn't wait for my holiday. My parents came up and we all spent a week at Spain together. It was lovely. It was THE time to escape the cold weather in Glasgow and it was great to have a short break away from the hospital. Ate loads in Spain and bought many stuff home too. I have to admit I felt that for the first time, I did not need to ask my parents for spending money. Instead, I sponsored their trip there. hehe. It was an achievement for me, to be honest. :)
November: Back to misery...ie, hospital. I was literally dragging myself to work. haha. It was a rather busy month too because I was working in the high dependency unit and was in the receiving ward for 2 weeks. I remember being pissed with the radiologists for not wanting to do the scans that I have requested. I remember looking after a patient who was suffering from acute alcohol withdrawal. I gave him about 50mg of IM diazepam and 40mg of IM haloperidol and some diazepam too...it did nothing to him!
December: This is the month where I changed to Medicine. To be honest, I didn't really like the change in the first place. The ward rounds are longer in Medicine, and I didnt have time to have lunch. It was so much busier than working in the surgical wards. Only in medicine that I managed to do ascitic taps and my first lumbar puncture a few days ago! :) (it was unsuccessful though). Oh...not to forget, I also received a number of sarcastic remarks from my seniors. December was also the Christmas month. Although I did not receive alot of pressies, I really enjoyed the atmosphere here. The last day of the year was spent working in the medical receiving unit. I was so tired by the end of the day and just simply went to bed after midnite. The weather was awful, the wind was too gusty and hence, the hogmanay in Glasgow was cancelled!
So there you go...a small little recap of the events last year. It was eventful but there are all experiences that would teach me to be a better person I guess. I hope 2007 will be exciting!
Happy New Year my friends!
May 2007 bring you loads of joy, happiness, love and luck!!!!! CHEERSSSS!!!!!
Sunday, December 24, 2006
Bert Was Killed!!
When I was a kid, I grew up watching Sesame Street. I love the characters in that addictive series, namely, Cookie Monster (the blue hairy monster that gobbles loads of cookies), Elmo (the adorable pinkish furry thing), Oscar (the green garbage monster who has a cute orange worm) , and the lovely duo, Ernie (the one in the horizontal striped shirt) and Bert (the yellow long faced thing).
I was taking a walk at the German Xmas Market in Glasgow when I came across a shop, which caught my attention. The reason will be revealed in the picture below:
Hope you could see the picture clearly.
I found Bert(s) hanging from the roof of that shop! He was actually hung with a rope, right across his neck! OMG! He was killed!!
In fact, Bert wasn't the only victim, Oscar was killed too!
The scariest part was there were quite a few of them hanging down from the roof, and this was further exagerrated with white spotlights shown right at their faces!
If I were still a tiny gal, I would certinaly be freaked out when I saw that shop...
I was taking a walk at the German Xmas Market in Glasgow when I came across a shop, which caught my attention. The reason will be revealed in the picture below:
Hope you could see the picture clearly.
I found Bert(s) hanging from the roof of that shop! He was actually hung with a rope, right across his neck! OMG! He was killed!!
In fact, Bert wasn't the only victim, Oscar was killed too!
The scariest part was there were quite a few of them hanging down from the roof, and this was further exagerrated with white spotlights shown right at their faces!
If I were still a tiny gal, I would certinaly be freaked out when I saw that shop...
Sympathy, I have
I have been in the receiving ward for the past week. As expected, Monday was always busy....and so was Tues, Wed, Thurs and on Fri, the number of patients that came were less. I put this down to christmas...who wants to stay in the hospital on christmas day?
Christmas is a happy season. Everyone is looking forward to opening their presents or having a nice family dinner. During the last week, I felt quite sad to see a few patients dying or even suffering. I know this happen every single day but one particular patient filled me with sympathy.
This was a young lady who had 2 children. She was admitted with exacerbation of her chronic illness. I must say, she looked terrible. Her vital signs were not great. All of us in the hospital did not think that she would survive for long. During the visiting hour, her kids came up to visit her. One of the nurses asked the young children what they wanted for christmas, and they answered, "Mummy."
The nurse assured them that they would surely be able to see Mummy on Christmas Day. Unfortunately, (as you might have expected), that lady died a few hours later.
It was quite a sad case.
Christmas is a happy season. Everyone is looking forward to opening their presents or having a nice family dinner. During the last week, I felt quite sad to see a few patients dying or even suffering. I know this happen every single day but one particular patient filled me with sympathy.
This was a young lady who had 2 children. She was admitted with exacerbation of her chronic illness. I must say, she looked terrible. Her vital signs were not great. All of us in the hospital did not think that she would survive for long. During the visiting hour, her kids came up to visit her. One of the nurses asked the young children what they wanted for christmas, and they answered, "Mummy."
The nurse assured them that they would surely be able to see Mummy on Christmas Day. Unfortunately, (as you might have expected), that lady died a few hours later.
It was quite a sad case.
Sunday, December 17, 2006
Christmas is Looming Near
The christmas spirit in the UK is fantastic. In the city, you can see loads of people strolling along the shops, in search for THE perfect xmas pressie. There are so many pretty xmas decos and most shops would be playing an xmas song at the background.
My friends and I went down to Edinburgh on Saturday. And I just simply love the atmosphere there. The German chrismas market was interesting....a variety of gifts and food from Germany were sold. I treated myself to a German sausage bun and the famous Gluhwein, a special mulled wine that is drank warm. Aahhh....It was such a great feeling to drink warm wine in the cold chilly weather. The rest of the day was spent shopping at the market and also in certain shops along Princess St.
Oh, I was really broke by the end of the day. =)
The pretty tea light jars on sale at the German Xmas Market.
A ferris wheel and a carousel at the market too.
My friends and I went down to Edinburgh on Saturday. And I just simply love the atmosphere there. The German chrismas market was interesting....a variety of gifts and food from Germany were sold. I treated myself to a German sausage bun and the famous Gluhwein, a special mulled wine that is drank warm. Aahhh....It was such a great feeling to drink warm wine in the cold chilly weather. The rest of the day was spent shopping at the market and also in certain shops along Princess St.
Oh, I was really broke by the end of the day. =)
The pretty tea light jars on sale at the German Xmas Market.
A ferris wheel and a carousel at the market too.Saturday, December 09, 2006
S.T.R.E.S.S.
stress... stress... stress...
stress... stress... stress...
stress... stress... stress...
stress... stress... stress...
stress... stress... stress...
I know many of you might not believe me...but a few days ago, I was very stressed out at work. Never had I felt so worried about a certain patient in the hospital, until the extent I had shivers when I think about his situation. I think with all the stress built inside me, I have now fallen ill. (maybe I'm just a wimp, eh?)
God Bless His Soul.
stress... stress... stress...
stress... stress... stress...
stress... stress... stress...
stress... stress... stress...
I know many of you might not believe me...but a few days ago, I was very stressed out at work. Never had I felt so worried about a certain patient in the hospital, until the extent I had shivers when I think about his situation. I think with all the stress built inside me, I have now fallen ill. (maybe I'm just a wimp, eh?)
God Bless His Soul.
Tuesday, December 05, 2006
Yeah, Team Urology!
Today is the last day for me in the Urology Ward. I would certainly miss it.
I could still remember the first day at the ward, which also happened to be the first day at work as a junior doctor. Everything was so vague, uncertain and I did not have a clue what I should be doing or who those patients in the ward were. But now, after 4 months, I felt more comfortable than ever. I knew exactly how to prepare those patients for their elective surgeries, I knew the story behind the patients and I felt that I could work efficiently with the other members in the ward. The sad thing is, it is time for me to change to a different posting. sigh.
The other members include the staff nurses, the senior house officer, specialist registrars and consultants. And, of course, not forgetting my other 3 colleagues, who have affectionately given ourselves the name "Team Urology."
As a team, I felt we tolerated each other very well and there wasn't any problem that arose. I would miss the days when we had coffee breaks at Mables, the days when we sat down playing the game "10 Questions," the times when we started making fun of each other, the times when we worked hard to finish clerking patients....the list is endless!
As all good things must come to an end, my heart is heavy to leave Team Urology. Tomorrow, all of us are changing over to Medicine and we will be working separately. I do not look forward to the new environment all over again. Its nearly similar to the day that I first started working, except that I am probably more comfortable when it comes to prescribing and doing practical procedures.
Wish me luck!
I could still remember the first day at the ward, which also happened to be the first day at work as a junior doctor. Everything was so vague, uncertain and I did not have a clue what I should be doing or who those patients in the ward were. But now, after 4 months, I felt more comfortable than ever. I knew exactly how to prepare those patients for their elective surgeries, I knew the story behind the patients and I felt that I could work efficiently with the other members in the ward. The sad thing is, it is time for me to change to a different posting. sigh.
The other members include the staff nurses, the senior house officer, specialist registrars and consultants. And, of course, not forgetting my other 3 colleagues, who have affectionately given ourselves the name "Team Urology."
As a team, I felt we tolerated each other very well and there wasn't any problem that arose. I would miss the days when we had coffee breaks at Mables, the days when we sat down playing the game "10 Questions," the times when we started making fun of each other, the times when we worked hard to finish clerking patients....the list is endless!
As all good things must come to an end, my heart is heavy to leave Team Urology. Tomorrow, all of us are changing over to Medicine and we will be working separately. I do not look forward to the new environment all over again. Its nearly similar to the day that I first started working, except that I am probably more comfortable when it comes to prescribing and doing practical procedures.
Wish me luck!
Monday, December 04, 2006
The DT's
In case you are wondering what DT stands for, it is Delirium tremens, an alcohol withdrawal syndrome.
On Friday night, I was glad that it was the last day of my 7-day night shift. The night kicked off well, as it was the FIRST night which I do not have any patients waiting to be admitted. I did not have much to do either...in fact, the only thing I had to do was to chase a few blood results and that was it. I thought to myself, this certainly is a quiet night.
NOT!
I spoke to soon. Not too long later, a demented patient decided to pull out his IV cannula. After resiting it, a nurse came up to me and said, "Mr. B refused to take his diazepam."
Here is a brief description of Mr. B. He is a middle-aged man who was admitted with right iliac fossa pain (? appendicitis) and a past history of alcohol excess. The reason he was on diazepam was because he was suffering from alcohol withdrawal or DT.
Anyway, I looked at Mr. B, and he was lying on his bed quietly. So I told the nurse, "Well, if he refused it, there is nothing much you can do. We'll just keep an eye on him."
The nurse looked blankly back at me and disagreed. In her opinion, the patient was being aggressive, and really needed to be given some medicine to calm him down. So fair enough. I decided to coax the patient to take his diazepam. My efforts were futile ,of course, and it sort of triggered his anger.
Before I could think of what to do next, the nurse was ready with her IM injection of haloperidol and 2 security guards. She said, "I'm going to give this injection. Your senior instructed me to do so. " I nodded my head. The injection had to be given IM because the patient did not have any IV access. The security guards had to pin the patient down in order to allow the nurse to give the injeciton.
The injection did not work. The patient suddenly became more aggressive (I think the presence of the guards made him more agitated). Therefore, I gave another shot of haloperidol, an IM dose of lorazepam and a dose of IM diazepam. And belief me, the patient was still alert! He was swearing and cursing away, tried to pull away from the security guards, and even walked around naked.
The nurse came up to me and asked if I could give the patient more diazepam. I said, "No. The BNF said that we are not supposed to give another dose of IM diazepam until 4 hours later." (I was thinking to myself I do not want to overdose the patient). Again, she gave me this stupid blank look and was not too happy with my answer. I gave her back the same look. Honestly, I did not know what else to do. I sought help from my senior, who said she'll come up and review the situation.
See, I was not comfortable giving more injections to that patient. I do not want him to have an overdose...IM injections may take awhile to work...and if I just keep prescribing the drugs within a small time limit, who knows what would happen. What if suddenly the medicine just kick in?? Would the patient be overdosed on it?? I do not want to get into trouble for overdosing him. It would all end up to be my responsibility, coz I was the one prescribing the drug!
Anyway, the other doctors seem to disagree with me. They said just give as much as you can until the patient is sedated. By the time I left the ward to go home, the patient received about 40mg of diazepam and about 40mg of haloperidol. He was still wide awake and agitated. I think he really suffered from serious DT.
I am yet to find out his record-breaking total dose for the day. He was indeed one tough cookie, eh?
On Friday night, I was glad that it was the last day of my 7-day night shift. The night kicked off well, as it was the FIRST night which I do not have any patients waiting to be admitted. I did not have much to do either...in fact, the only thing I had to do was to chase a few blood results and that was it. I thought to myself, this certainly is a quiet night.
NOT!
I spoke to soon. Not too long later, a demented patient decided to pull out his IV cannula. After resiting it, a nurse came up to me and said, "Mr. B refused to take his diazepam."
Here is a brief description of Mr. B. He is a middle-aged man who was admitted with right iliac fossa pain (? appendicitis) and a past history of alcohol excess. The reason he was on diazepam was because he was suffering from alcohol withdrawal or DT.
Anyway, I looked at Mr. B, and he was lying on his bed quietly. So I told the nurse, "Well, if he refused it, there is nothing much you can do. We'll just keep an eye on him."
The nurse looked blankly back at me and disagreed. In her opinion, the patient was being aggressive, and really needed to be given some medicine to calm him down. So fair enough. I decided to coax the patient to take his diazepam. My efforts were futile ,of course, and it sort of triggered his anger.
Before I could think of what to do next, the nurse was ready with her IM injection of haloperidol and 2 security guards. She said, "I'm going to give this injection. Your senior instructed me to do so. " I nodded my head. The injection had to be given IM because the patient did not have any IV access. The security guards had to pin the patient down in order to allow the nurse to give the injeciton.
The injection did not work. The patient suddenly became more aggressive (I think the presence of the guards made him more agitated). Therefore, I gave another shot of haloperidol, an IM dose of lorazepam and a dose of IM diazepam. And belief me, the patient was still alert! He was swearing and cursing away, tried to pull away from the security guards, and even walked around naked.
The nurse came up to me and asked if I could give the patient more diazepam. I said, "No. The BNF said that we are not supposed to give another dose of IM diazepam until 4 hours later." (I was thinking to myself I do not want to overdose the patient). Again, she gave me this stupid blank look and was not too happy with my answer. I gave her back the same look. Honestly, I did not know what else to do. I sought help from my senior, who said she'll come up and review the situation.
See, I was not comfortable giving more injections to that patient. I do not want him to have an overdose...IM injections may take awhile to work...and if I just keep prescribing the drugs within a small time limit, who knows what would happen. What if suddenly the medicine just kick in?? Would the patient be overdosed on it?? I do not want to get into trouble for overdosing him. It would all end up to be my responsibility, coz I was the one prescribing the drug!
Anyway, the other doctors seem to disagree with me. They said just give as much as you can until the patient is sedated. By the time I left the ward to go home, the patient received about 40mg of diazepam and about 40mg of haloperidol. He was still wide awake and agitated. I think he really suffered from serious DT.
I am yet to find out his record-breaking total dose for the day. He was indeed one tough cookie, eh?
Saturday, November 25, 2006
Just Do It!!
Another one of my rants about the ward cover job that I am doing now. Before I proceed, I do apologise to those who become offended after reading this.
During one of the days, a young girl was admitted to the hospital with severe colitis, possibly a new manifestation of Crohn's disease. She was rather septic and in a lot of pain. The SHO wanted her to have an abdominal x-ray. But as she is too ill to go down to the dept for the x-ray, he decided that she should have a portable x-ray instead.
So it was my job to get the portable x-ray up to the ward. I paged the on-call radiographer about it. I waited for 10 minutues, and there wasn't any reply. I paged the person again, and still no reply. It took about an hour before I received a call back from the radiographer. I explained to her the situation and she said ok.
When she arrived at the ward, she saw that the patient was sitting up on the chair. (the reason the patient was sitting on the chair was because the nurses were changing her bedsheets, and she was just given a shot of morphine). Anyway, she went up to the SHO, who was standing nearby and said, "Is that the girl who needed the portable x-ray?"
The SHO nodded. The radiographer said, "Why do you need a portable one, when she could actually sit on the chair. I am sure she could go to the dept to have it done. A portable x-ray is not optimal and the quality is poor."
The SHO replied, "Yes, I understand the quality of the x-ray will not be great. But she is actually too sick to go to the dept. She might suddenly become unwell on her way there. We are worried that she might have a perforation."
"No, I'm not going to do it. She is sitting up on her chair. She looks well."
My SHO explained to her very nicely again his reasons. The radiographer was not impressed. She kept to her opinions.
Finally, after nearly 15 mins of disagreement, my SHO lost his politeness and became very blunt to the radiographer. "Ok, look, this girl is very ill, and where in your experience as a radiographer, were you trained to judge a patient who is sitting down on a chair, as a stable and well person? You have no medical knowledge to say that."
The radiographer turned red. Yet, she resumed her arguement. "Fine. Is this girl pregnant? I won't do the scan until you can proof to me that she is not pregnant."
"Here, look, her pregnancy test yesterday was negative."
"Fine. I want you to write another x-ray card for me."
"Ok. There."
So, the radiographer reluctantly performed the x-ray. I mean, what is the point of arguing. Just get on with it! Stop being such a pain in the arse!
During one of the days, a young girl was admitted to the hospital with severe colitis, possibly a new manifestation of Crohn's disease. She was rather septic and in a lot of pain. The SHO wanted her to have an abdominal x-ray. But as she is too ill to go down to the dept for the x-ray, he decided that she should have a portable x-ray instead.
So it was my job to get the portable x-ray up to the ward. I paged the on-call radiographer about it. I waited for 10 minutues, and there wasn't any reply. I paged the person again, and still no reply. It took about an hour before I received a call back from the radiographer. I explained to her the situation and she said ok.
When she arrived at the ward, she saw that the patient was sitting up on the chair. (the reason the patient was sitting on the chair was because the nurses were changing her bedsheets, and she was just given a shot of morphine). Anyway, she went up to the SHO, who was standing nearby and said, "Is that the girl who needed the portable x-ray?"
The SHO nodded. The radiographer said, "Why do you need a portable one, when she could actually sit on the chair. I am sure she could go to the dept to have it done. A portable x-ray is not optimal and the quality is poor."
The SHO replied, "Yes, I understand the quality of the x-ray will not be great. But she is actually too sick to go to the dept. She might suddenly become unwell on her way there. We are worried that she might have a perforation."
"No, I'm not going to do it. She is sitting up on her chair. She looks well."
My SHO explained to her very nicely again his reasons. The radiographer was not impressed. She kept to her opinions.
Finally, after nearly 15 mins of disagreement, my SHO lost his politeness and became very blunt to the radiographer. "Ok, look, this girl is very ill, and where in your experience as a radiographer, were you trained to judge a patient who is sitting down on a chair, as a stable and well person? You have no medical knowledge to say that."
The radiographer turned red. Yet, she resumed her arguement. "Fine. Is this girl pregnant? I won't do the scan until you can proof to me that she is not pregnant."
"Here, look, her pregnancy test yesterday was negative."
"Fine. I want you to write another x-ray card for me."
"Ok. There."
So, the radiographer reluctantly performed the x-ray. I mean, what is the point of arguing. Just get on with it! Stop being such a pain in the arse!
Wednesday, November 22, 2006
Clinical Emergency?
I am doing ward cover at the moment. It is busy busy. The worse part of the job is not the amount of tasks I need to carry out, but is the fact that I need to fill in so many requests forms for imaging.
On Monday morning itself, I filled in about 10 forms for CT and ultrasound scans. It is quite time consuming, considering the fact that you need to summarise the patient's clinical history in a few sentences, and you need to propose a clinical question too. As the days went by, I became more and more efficient in filling the forms up. hehe. Guess I got better at crapping!
Having completed those forms, I needed to bring them to the radiology dept to get the scans appointed. Since I am in the acute receiving ward, these scans should be done as soon as possible, so that we can investigate the cause of the patients' problems. Organising ultrasound scans are not as bad as organising a CT scan. The reason being, there are not many CT scanners available, and the fact that, the queue is just simply long!
So every morning when I arrive at the CT scan reception, I will be bombarded by the same question, "Is this a clinical emergency?"
This is a tough question. Clinical emergency....hmm...this is a very vague question. What do they mean by clinical emergency? Apparently, it means that the scan must be done in 24 hours. From my point of view, it means that if this scan is not done asap, the patient's life is at stake. Obviously, if the patient is clinically unstable, then, surely the CT scan needs to be done urgently. However, there are times when the patient is stable, but the consultant just wants the scan to be done immediatley. I am in a dilemma.
If I do not get the scans done, the consultant will not be impressed. If I want it to be done on the same day, I have to speak to the radiologists about it. And that my friend, is the scariest part. I really do not know how to convince them that the scans need to be done today, especially when the patient's condition is stable.
There was once when I wanted a patient to have a CT scan done on the same day of his admission. And the radiologist was not happy to do it on the same day. The patient had right iliac fossa peritonism. He wanted to speak to me about it. So I went down to the dept feeling rather worried about what I should say to defend myself.
Consultant radiologist: Tell me why do you want this scan done today.
me: Well, the reason is because we are not sure why the patient is having the pain. Maybe it is appendicitis, or localised perforation or even a caecal tumour?
Consultant radiologist: Ok, let me say this again. What I want to know is, is the patient going for a surgery today?
me: It really depends on the result of the scan, that's why we would like it to be done asap.
Consultant radiologist: Doing a scan today, the patient will not be properlly prep for it. So you will get a suboptimal scan.
me: The patient has taken the gastrograffin and she has been fasting since midnight.
Consultant radiologist: No, no, that is not the point. The scan will not be optimal to be done today. What is the plan for this lady?
me: *speechless for awhile. Well, the surgeon has not decided on a plan yet....all plans really depend on the scan results.
Consultant radiologist: Look, I am not going to do the scan until you can tell me what the plan is. Performing the scan in the next morning is the best.
me: Right ok. I'll find out what the plan is. (at the same time, thinking, just do the fucking scan! That was a totally pointless discussion)
Ok...so I went back to the ward and managed to inform my SHO about it. And he gave me a look that mean what a stupid question the radiologist directed to me. The SHO just told me to go back to me and get the scan done.
Sigh. Right. Right. So I went back to the radiology dept and tried my luck again.
me: Sorry doctor, I've just spoken to the SHO and he said the plan really lies on the result of the scan.
Consultant radiologist: No no. Go speak to your consultant, not your SHO.
me: But it was the consultant who wanted the scan to be done.
Consultant radiologist: Fine.
me: Thank you doctor.
Shheessh! That was a pointless arguement, don't you think? This is an obvious clinical emergency...because the patient is experiencing peritonism and the sooner the scan is done, the faster the appropriate treatment can be carried out.
I spent about 30minutes just trying to arrange the scan for the lady. The time taken to argue could have been used to do a CT scan, which will only take 20minutes.
On Monday morning itself, I filled in about 10 forms for CT and ultrasound scans. It is quite time consuming, considering the fact that you need to summarise the patient's clinical history in a few sentences, and you need to propose a clinical question too. As the days went by, I became more and more efficient in filling the forms up. hehe. Guess I got better at crapping!
Having completed those forms, I needed to bring them to the radiology dept to get the scans appointed. Since I am in the acute receiving ward, these scans should be done as soon as possible, so that we can investigate the cause of the patients' problems. Organising ultrasound scans are not as bad as organising a CT scan. The reason being, there are not many CT scanners available, and the fact that, the queue is just simply long!
So every morning when I arrive at the CT scan reception, I will be bombarded by the same question, "Is this a clinical emergency?"
This is a tough question. Clinical emergency....hmm...this is a very vague question. What do they mean by clinical emergency? Apparently, it means that the scan must be done in 24 hours. From my point of view, it means that if this scan is not done asap, the patient's life is at stake. Obviously, if the patient is clinically unstable, then, surely the CT scan needs to be done urgently. However, there are times when the patient is stable, but the consultant just wants the scan to be done immediatley. I am in a dilemma.
If I do not get the scans done, the consultant will not be impressed. If I want it to be done on the same day, I have to speak to the radiologists about it. And that my friend, is the scariest part. I really do not know how to convince them that the scans need to be done today, especially when the patient's condition is stable.
There was once when I wanted a patient to have a CT scan done on the same day of his admission. And the radiologist was not happy to do it on the same day. The patient had right iliac fossa peritonism. He wanted to speak to me about it. So I went down to the dept feeling rather worried about what I should say to defend myself.
Consultant radiologist: Tell me why do you want this scan done today.
me: Well, the reason is because we are not sure why the patient is having the pain. Maybe it is appendicitis, or localised perforation or even a caecal tumour?
Consultant radiologist: Ok, let me say this again. What I want to know is, is the patient going for a surgery today?
me: It really depends on the result of the scan, that's why we would like it to be done asap.
Consultant radiologist: Doing a scan today, the patient will not be properlly prep for it. So you will get a suboptimal scan.
me: The patient has taken the gastrograffin and she has been fasting since midnight.
Consultant radiologist: No, no, that is not the point. The scan will not be optimal to be done today. What is the plan for this lady?
me: *speechless for awhile. Well, the surgeon has not decided on a plan yet....all plans really depend on the scan results.
Consultant radiologist: Look, I am not going to do the scan until you can tell me what the plan is. Performing the scan in the next morning is the best.
me: Right ok. I'll find out what the plan is. (at the same time, thinking, just do the fucking scan! That was a totally pointless discussion)
Ok...so I went back to the ward and managed to inform my SHO about it. And he gave me a look that mean what a stupid question the radiologist directed to me. The SHO just told me to go back to me and get the scan done.
Sigh. Right. Right. So I went back to the radiology dept and tried my luck again.
me: Sorry doctor, I've just spoken to the SHO and he said the plan really lies on the result of the scan.
Consultant radiologist: No no. Go speak to your consultant, not your SHO.
me: But it was the consultant who wanted the scan to be done.
Consultant radiologist: Fine.
me: Thank you doctor.
Shheessh! That was a pointless arguement, don't you think? This is an obvious clinical emergency...because the patient is experiencing peritonism and the sooner the scan is done, the faster the appropriate treatment can be carried out.
I spent about 30minutes just trying to arrange the scan for the lady. The time taken to argue could have been used to do a CT scan, which will only take 20minutes.
Sunday, November 19, 2006
Fun-filled Weekend
My weekend was fun! I met up with my friends and we all went to a place called New Lanark, which is a UNESCO heritage site. It was about more than an hour's drive from the Glasgow city centre. The weather was very chilly, with minimal sunlight.
New Lanark consisted of many cotton mills during the olden days. The mills were managed by a famous man, Robert Owen. He was well-known for providing free health care, education and decent homes to those villagers in New Lanark. Today, New Lanark has been restored and we managed to get a glimpse of how life used to be during those days. The view was rather scenic because it is now autumn.
New Lanark
New Lanark consisted of many cotton mills during the olden days. The mills were managed by a famous man, Robert Owen. He was well-known for providing free health care, education and decent homes to those villagers in New Lanark. Today, New Lanark has been restored and we managed to get a glimpse of how life used to be during those days. The view was rather scenic because it is now autumn.
New LanarkCasino Royal was also one of the highlights of the weekend. We managed to get seats for this James Bond movie. omg, this Bond is certainly HOT! I thought this Bond movie was quite different from the others, but I enjoyed it.
This weekend has also been two days of indulgence. We indulged in coffes and cakes! As you know, chirstmas is just around the corner, and both Starbucks & Costa coffee came out with their special edition christmas drinks. Thumbs up to all the drinks. And I do not know why I was craving badly for a slice of cheesecake. So I had one for bfast on Sunday!! haha. It was
crazy.
Oh, and guess what? My friends and I discovered Nando's in Glasgow!! yay!! I LOVE Nando's. The atmosphere was very warm (similar to Chili's in KL). The food was great! Although the peri-peri sauce was burning my stomach, I still continued to dip my chicken into it. =P
As expected, time flew past so quickly. And now it is already 10pm on a Sunday night, which means I should probably retire to bed soon and get myself ready for work AGAIN! Nite nite!
This weekend has also been two days of indulgence. We indulged in coffes and cakes! As you know, chirstmas is just around the corner, and both Starbucks & Costa coffee came out with their special edition christmas drinks. Thumbs up to all the drinks. And I do not know why I was craving badly for a slice of cheesecake. So I had one for bfast on Sunday!! haha. It was
crazy.
Oh, and guess what? My friends and I discovered Nando's in Glasgow!! yay!! I LOVE Nando's. The atmosphere was very warm (similar to Chili's in KL). The food was great! Although the peri-peri sauce was burning my stomach, I still continued to dip my chicken into it. =P
As expected, time flew past so quickly. And now it is already 10pm on a Sunday night, which means I should probably retire to bed soon and get myself ready for work AGAIN! Nite nite!
Tuesday, November 14, 2006
Its a Sad, Sad Story
Today is the day which made me feel lucky.
I came across a very very sad story today and realised how lucky I am to be me. I have always felt that to be a soldier, one has to be very brave and willing to sacrifice his life for anything. Today, I found truth in my thoughts.
Picture this:
You (a young person in the early 20's) was sent off to another country to fight in a war. While on duty, you were caught by your enemy. The enemy hit you really hard, and left you in a subconscious state. They laid you on the road, and asked their team members in an oil tanker to drive over you. You were too weak to move out of the way. The tanker rolled over you, breaking your pelvic bones, your femurs, crushing your intestines (large and small), destroying your spleen and caused massive injuries to your nervous system.
The enemy stood by the side enjoying the view. You screamed in pain. But they do not care. Instead, they pulled you up and tried to kidnap you. However, your fellow soldiers managed to come to your rescue and saved you. But you were in an unimaginable state of injury. Your life was at stake.
The whole accident left you crippled, your intestines had to be reconstructed, etc etc. You had to stay in the ITU for months before you regain abit of your life back. Many complications arose, including MRSA infection, loss of sexual functions, compartment syndrome.... life you couldn't go any worse than this. But you survived and you are still sane.
That was the sad sad story that I came across today. It left me thinking about how people suffered in the war. I mean, yes I read in the papers about the evil side of a war, but I think it is only when you see the whole thing right in front of your eyes, that you actually understand and feel the suffering.
If I were a victim of war (such as the above), I think I would be left in a vegetative state. I would probably rather die than carry on with life, to be honest. A lot of praises + respect have to be given to these brave warriors or victims of war.
I came across a very very sad story today and realised how lucky I am to be me. I have always felt that to be a soldier, one has to be very brave and willing to sacrifice his life for anything. Today, I found truth in my thoughts.
Picture this:
You (a young person in the early 20's) was sent off to another country to fight in a war. While on duty, you were caught by your enemy. The enemy hit you really hard, and left you in a subconscious state. They laid you on the road, and asked their team members in an oil tanker to drive over you. You were too weak to move out of the way. The tanker rolled over you, breaking your pelvic bones, your femurs, crushing your intestines (large and small), destroying your spleen and caused massive injuries to your nervous system.
The enemy stood by the side enjoying the view. You screamed in pain. But they do not care. Instead, they pulled you up and tried to kidnap you. However, your fellow soldiers managed to come to your rescue and saved you. But you were in an unimaginable state of injury. Your life was at stake.
The whole accident left you crippled, your intestines had to be reconstructed, etc etc. You had to stay in the ITU for months before you regain abit of your life back. Many complications arose, including MRSA infection, loss of sexual functions, compartment syndrome.... life you couldn't go any worse than this. But you survived and you are still sane.
That was the sad sad story that I came across today. It left me thinking about how people suffered in the war. I mean, yes I read in the papers about the evil side of a war, but I think it is only when you see the whole thing right in front of your eyes, that you actually understand and feel the suffering.
If I were a victim of war (such as the above), I think I would be left in a vegetative state. I would probably rather die than carry on with life, to be honest. A lot of praises + respect have to be given to these brave warriors or victims of war.
Monday, November 13, 2006
A Week of Half Days!!
Yippee!! This whole week I'll be having half day every single day! =D
The reason was my colleague wanted Sunday off as he had something to do. So he asked if I was willing to do his Receiving Sunday (from 8-9), and he offered to do all my late shifts this week. I thought, oh well, I did not plan to do anything on Sunday, and not having to work long hours for the next few days would be nice. Hence, I agreed. I know it may sound abit silly to sacrifice my Sunday for that, but I didnt really mind. =)
So there you go, I had a half day today, and another one tomorrow, and the next day, and the day after....hehe. I think I got to enjoy my spare time for now because once I change over to do medicine for the next 8 months, I will never ever get a half day off. And medicine has a bad reputation of being very busy....and the worse thing is, I'll be paid less for working more.
Nevermind, will worry about that later. I enjoyed my half day today with my friend. We both went to Tesco to buy groceries. It was quite fun (I know this sounds rather pathetic, but shopping for groceries is now my new found hobby)! We, then, walked to Tinderbox, a famous cafe nearby to have coffee. Sipping a hot cuppa was really nice as the weather was icy cold. We sat there for about an hour and a half, bitching about other people or about work. It felt weird too because we were actually chilling out in working clothes....kinda felt a wee bit old.
I really had a nice chill out time, which was what I really needed, as I can forsee myself feeling rather miserable this month (the dark gloomy sky is not helping me out either).....Ohh... I can't wait for my half day tomorrow. I'm certainly going to make full use of it!
The reason was my colleague wanted Sunday off as he had something to do. So he asked if I was willing to do his Receiving Sunday (from 8-9), and he offered to do all my late shifts this week. I thought, oh well, I did not plan to do anything on Sunday, and not having to work long hours for the next few days would be nice. Hence, I agreed. I know it may sound abit silly to sacrifice my Sunday for that, but I didnt really mind. =)
So there you go, I had a half day today, and another one tomorrow, and the next day, and the day after....hehe. I think I got to enjoy my spare time for now because once I change over to do medicine for the next 8 months, I will never ever get a half day off. And medicine has a bad reputation of being very busy....and the worse thing is, I'll be paid less for working more.
Nevermind, will worry about that later. I enjoyed my half day today with my friend. We both went to Tesco to buy groceries. It was quite fun (I know this sounds rather pathetic, but shopping for groceries is now my new found hobby)! We, then, walked to Tinderbox, a famous cafe nearby to have coffee. Sipping a hot cuppa was really nice as the weather was icy cold. We sat there for about an hour and a half, bitching about other people or about work. It felt weird too because we were actually chilling out in working clothes....kinda felt a wee bit old.
I really had a nice chill out time, which was what I really needed, as I can forsee myself feeling rather miserable this month (the dark gloomy sky is not helping me out either).....Ohh... I can't wait for my half day tomorrow. I'm certainly going to make full use of it!
Monday, November 06, 2006
Smoking A Pot
Yeap....Look carefully, I'm smoking a pot! No kidding...it was my first time and it was really good.Gotcha!
I was actually drinking my tea infusion "Mate IQ." It tasted really weird....a mixture of herbs and flowery things. Hope it really did help to infuse my brain cells which have fungus all over after my break. keke.
This was how it looked like inside. It had a metal straw.
Back to Work
Its monday, which means it is back to work for me, after a 2 week break from the hospital. I am feeling so lazy.....
The weekend has been really good. I've managed to do so many things:
1. Watched 2 movies (The Departed and The Devil Wears Prada). Both of them were really good.
2. Managed to meet up with my Uni friends...had lunch together. And chatted away till midnite.
3. Bought a new cardigan for myself...the weather is getting colder and I need it for my night shifts in 3 weeks time.
4. Had weird tea infusions in a shop nearby. It was a really unique shop, secluded from the busy streets. The small cosy tea house was furnished with interesting pics and 2nd hand furniture. And the best part was the shop sold tea from all over the country, you name it, Afghanistan, Pakistan, Turkey, etc... They also have their own tea recipe...for eg, I tried Mate IQ. It was a super duper weird tea served in a funny bottle with a metal straw. Apparently, it helps to invigorate the brain cells. (which is what I need to start my work again...hehe)
5. Had a drama series marathon with my friend. She stayed over the weekend and we were both glued to 24.
So that was kind of like my weekend. It ended quite fast. Now, I need to get my ass moving and get ready for my work!
The weekend has been really good. I've managed to do so many things:
1. Watched 2 movies (The Departed and The Devil Wears Prada). Both of them were really good.
2. Managed to meet up with my Uni friends...had lunch together. And chatted away till midnite.
3. Bought a new cardigan for myself...the weather is getting colder and I need it for my night shifts in 3 weeks time.
4. Had weird tea infusions in a shop nearby. It was a really unique shop, secluded from the busy streets. The small cosy tea house was furnished with interesting pics and 2nd hand furniture. And the best part was the shop sold tea from all over the country, you name it, Afghanistan, Pakistan, Turkey, etc... They also have their own tea recipe...for eg, I tried Mate IQ. It was a super duper weird tea served in a funny bottle with a metal straw. Apparently, it helps to invigorate the brain cells. (which is what I need to start my work again...hehe)
5. Had a drama series marathon with my friend. She stayed over the weekend and we were both glued to 24.
So that was kind of like my weekend. It ended quite fast. Now, I need to get my ass moving and get ready for my work!
Friday, November 03, 2006
A Story of A Cat
Once upon a time, there was a cat, named Kitty Kat. She was a white cat with 2 brown patches around the ears and a brown-tipped tail. Kitty Kat lived alone in a palace which used to belong to a king a long looonng time ago. There was not alot of food around the palace, therefore, she fed on leftover food found in the dustbins.
One day, she decided that she has had enough of rubbish food and went to hunt for food. She walked along a small pond in the palace.
As she walked, she stopped and looked at her reflection on the pond.
"Oh, I still look very pretty and clean," Kitty Kat said to herself. She stared at her face on the pond for quite a long time, before it struck her. *ting (a light bulb just switched on)
"I'm looking at a pond....and what does a pond have? Pond has fish....yes....FISH! If I wait for one to appear, I won't need to eat rubbish food today."
So Kitty Kat waited patiently for a fish to surface. Suddenly, 2 orange fish appeared at the surface of the pond, where Kitty Kat was sitting."They certainly looked yummy...but how do I get to them? If I jump into the pond, I'll drown, coz I don't know how to swim. And I hate getting wet," Kitty Kat whispered to herself.
At this point, Kitty Kat was salivating. But it was such a shame she didn't know how to get it, or even try. The fish swam around her, but she just stared at them.
grrrr..... (went Kitty Kat's tummy)
After a few minutes, the fish swam away.
"No...no....don't runaway from me. Come back. I'm so hungry...." moaned Kitty Kat. She was disappointed for not even trying to catch the fish.
She walked away with her head down, angry at herself for missing the opportunity to have a nice dinner. That night, she ended up digging food from rubbish bin again to fill her stomach.
Moral of the story: Don't be afraid to try once you get an opportunity!! Once it is gone, it will never come back!!
Wednesday, November 01, 2006
Hola Espana!
Spain was great! The weather was good, the food was interesting and there were many exciting things to see. My parents and I stayed in a resort hotel just beside the beach in Southern Spain. Every morning, I woke up to the sound of the waves of the Mediterranean Sea. The moment I open my eyes, I could see the very blue sea and the sunrise. ahh....this was a perfect way to spend my holiday. =)
The beautiful beach in Benalmadena, Spain.
The rows of orange trees & me, holding an orange.
The above 2 pics: The picturesque Alhambra.
The La Pedrera, Barcelona (notice the sculptured chimneys).
Casa Batlo (another creation of Antoni Gaudi)
Me @ The Sagrada Familia
The beautiful beach in Benalmadena, Spain.In Southern Spain, my dad rented a car, and we managed to travel around Andalusia. We visited Seville, Ronda (a small city located on top of a rocky limestone cleft), Granada and Malaga. The weather was slightly wet in Seville but we still managed to check out the area. Orange trees were found almost everywhere in Seville.
The rows of orange trees & me, holding an orange.The visit to Granada was satisfying. I visited the great Alhambra. It was a palace built under Ismail I who ruled Granada at that time. The palace was big and it also had a nice paradise-like garden, known as the Generalife. Everything in the place had Islamic patterns.
The above 2 pics: The picturesque Alhambra.Nothing beats watching a LIVE bullfight in Spain. hehe. I paid about 45 euros for a bullfight. It was really exciting but at the same time, rather cruel. Besides the bullfight, I also managed to watch a flamenco performance. The flamenco was really good and I was amazed at how the dancers managed to move so swiftly and clap in synchrony. Not to mention how skilful they were with the castanets.
After spending a few days in Andalusia, we flew off to Barcelona. There the various street theatres along the famous street, La Rambla, did not fail to facinate me. I had my first tapas meal in Barcelona. Tapas is like small little snacks to savour on (something like dimsum). It was delicious.
The buildings designed and created by Antoni Gaudi (a famous architect) can be found in Barcelona. The La Pedrera (which is just an apartment) has a unique wavy structure. The roof is topped with tall sculptures which actually function as chimneys. There is also the unfinished Temple of Sagrada Familia. Antoni Gaudi only managed to build a small part of it before he was killed in an accident. Since his death, many people have taken over the project and plans have been made to ensure its completion by 2010. My family and I managed to take a stroll in 2 parks in Barcelona. One of it is Parc Guell, which is partly designed by Antoni Gaudi.
The buildings designed and created by Antoni Gaudi (a famous architect) can be found in Barcelona. The La Pedrera (which is just an apartment) has a unique wavy structure. The roof is topped with tall sculptures which actually function as chimneys. There is also the unfinished Temple of Sagrada Familia. Antoni Gaudi only managed to build a small part of it before he was killed in an accident. Since his death, many people have taken over the project and plans have been made to ensure its completion by 2010. My family and I managed to take a stroll in 2 parks in Barcelona. One of it is Parc Guell, which is partly designed by Antoni Gaudi.
The La Pedrera, Barcelona (notice the sculptured chimneys).
Casa Batlo (another creation of Antoni Gaudi)
Me @ The Sagrada FamiliaShopping in Barcelona was great. I did not buy anything in particular except for souveniers. I really enjoyed the entire trip and wished the days pass slower.
Friday, October 20, 2006
Spain Here I Come!!
YAY!!!!! I'm on holiday, finally! And I'm off for 2 weeks!! woohooo!!
The best thing is I'm travelling to Spain with mum & dad. I will be there for about 8 days....so no blogging for the time being ok? I pwomise to show some pics when I get back. =)
We are going to spend a half of the trip in Southern Spain and the other half of it in Barcelona.
Ok...I should probably go to bed...need to catch the early flight to Malaga.
See ya guys soon! Hope you all will have a nice weekend.
Adios!
The best thing is I'm travelling to Spain with mum & dad. I will be there for about 8 days....so no blogging for the time being ok? I pwomise to show some pics when I get back. =)
We are going to spend a half of the trip in Southern Spain and the other half of it in Barcelona.
Ok...I should probably go to bed...need to catch the early flight to Malaga.
See ya guys soon! Hope you all will have a nice weekend.
Adios!
Simply Gullible
Oh...it is not me! It was a female nurse in my ward. (Let's call her A).
There was a patient B in the ward who had a penile prosthesis inserted quite a long time ago. He was admitted for a different urological problem. Anyway, he probably was having some problem with his prosthesis and decided to ask A about it.
"Excuse me nurse, you know I have a penile prosthesis. I was wondering why my erections are not as long as it should be?"
"(A turns red) Errmm, I do not actually know, but I'll ask my colleagues and see if they can answer your question."
She told her fellow nurses about the question and everyone began to laugh at her. She did not go back to B to answer his question. As she was busy doing her other tasks, her colleagues decided to make fun of her. Let's name one of them G.
"Hey, remember you told us about the penile prosthesis problem? Well, the surgeon who performed the prostehsis insertion was just on the phone, and I have explained to him about that patient's problems. Apparently, there is a mistake in that batch of prosthesis. That is probably why his erections are shorter than normal."
"Huh, are you sure?"
"Yes....If you don't believe me, you can speak to the surgeon yourself. He also said that the length of the erection must be measured so that the default can be written down in a form, and this will be sent back to the manufacturer."
"Huh, I don't believe you. There is no way I am going to do that."
"Look, I am serious. You got to measure the length of the erections. As I said, the prothesis that was inserted into that patient has a manufacturing defect. We need to measure it so that we can let the manufacturer know how short it is."
"Right, why it has to be me?"
"Well, it is obvious isn't? You are the nurse looking after him."
"Right, fine. I'll do it."
A ruler was passed to her and she began to put on her gloves......
hahahahahahaha
She caught some of the other nurses giggling. And then it only struck her that it was actually a joke! A is just simply gullible!!
There was a patient B in the ward who had a penile prosthesis inserted quite a long time ago. He was admitted for a different urological problem. Anyway, he probably was having some problem with his prosthesis and decided to ask A about it.
"Excuse me nurse, you know I have a penile prosthesis. I was wondering why my erections are not as long as it should be?"
"(A turns red) Errmm, I do not actually know, but I'll ask my colleagues and see if they can answer your question."
She told her fellow nurses about the question and everyone began to laugh at her. She did not go back to B to answer his question. As she was busy doing her other tasks, her colleagues decided to make fun of her. Let's name one of them G.
"Hey, remember you told us about the penile prosthesis problem? Well, the surgeon who performed the prostehsis insertion was just on the phone, and I have explained to him about that patient's problems. Apparently, there is a mistake in that batch of prosthesis. That is probably why his erections are shorter than normal."
"Huh, are you sure?"
"Yes....If you don't believe me, you can speak to the surgeon yourself. He also said that the length of the erection must be measured so that the default can be written down in a form, and this will be sent back to the manufacturer."
"Huh, I don't believe you. There is no way I am going to do that."
"Look, I am serious. You got to measure the length of the erections. As I said, the prothesis that was inserted into that patient has a manufacturing defect. We need to measure it so that we can let the manufacturer know how short it is."
"Right, why it has to be me?"
"Well, it is obvious isn't? You are the nurse looking after him."
"Right, fine. I'll do it."
A ruler was passed to her and she began to put on her gloves......
hahahahahahaha
She caught some of the other nurses giggling. And then it only struck her that it was actually a joke! A is just simply gullible!!
Wednesday, October 18, 2006
07.30 am and still in bed
I woke up this morning thinking that it was only 6.30 am. But I jumped out of my bed the moment I saw that the time was actually 7.30 in the morning. Shit. I am going to be soooo late for work. Work starts at 8am. Shit. Then, I remembered that my friend, who gives me lifts in the morning, (let's call her L) has probably left for work first. I smsed her anyway to say that I was running super duper late.
I went for a shower kerbau style and was out of the house by 8 am. I walked fast, nearly running, to catch the train. Arrived at the city centre 10mins later and I had to walk a moderate distance to the hospital. As I walked, I was cursing myself for sleeping through my alarm (which was, in fact, a double alarm). Shit. Shit. Shit.
By the time I reached the ward (roughly 8.30am), sweat was kinda pouring down my forehead. The ward round was probably over by then. *phew Thank goodness my consultant did not see me walking into the ward late. Otherwise, it would be quite bad, wouldnt it? I cooled down and a few nurses spotted me late.
"Ling, you are sweating. You just rushed in, eh?"
"Hi Ling. There you are. You slept in, didnt you?"
"Ahhh Ling. You're here finally."
Those were a few comments I received from them. I giggled when I heard them. It was so obvious I overslept this morning. =D Being my usual efficient self, I managed to get on top of my workload today, despite being late. =P
My shift ended at 2pm today. Although there were quite a number of admissions today, both my colleague and I managed to clerk them all. I was quite happy that I was able to leave the hospital on time....for once. Just before I left, one of the senior doctors based in the ward saw me packing my bag and said:
"You going home already, Ling? You woke up late this morning, and now you're skiving away..."
hehehe...I started to laugh. It seems to me that the whole ward is aware of my "sleep in" this morning. And I really do quite guilty to be honest. It is so different when I was still a student. When you are late, no one really cares and you don't have any responsibilities to attend to. Imagine if I was the only junior doc in that ward, then, things probably could go worse. No one would be there for the ward round.
I pwomise I would be early tomorrow!! *fingers crossed
I went for a shower kerbau style and was out of the house by 8 am. I walked fast, nearly running, to catch the train. Arrived at the city centre 10mins later and I had to walk a moderate distance to the hospital. As I walked, I was cursing myself for sleeping through my alarm (which was, in fact, a double alarm). Shit. Shit. Shit.
By the time I reached the ward (roughly 8.30am), sweat was kinda pouring down my forehead. The ward round was probably over by then. *phew Thank goodness my consultant did not see me walking into the ward late. Otherwise, it would be quite bad, wouldnt it? I cooled down and a few nurses spotted me late.
"Ling, you are sweating. You just rushed in, eh?"
"Hi Ling. There you are. You slept in, didnt you?"
"Ahhh Ling. You're here finally."
Those were a few comments I received from them. I giggled when I heard them. It was so obvious I overslept this morning. =D Being my usual efficient self, I managed to get on top of my workload today, despite being late. =P
My shift ended at 2pm today. Although there were quite a number of admissions today, both my colleague and I managed to clerk them all. I was quite happy that I was able to leave the hospital on time....for once. Just before I left, one of the senior doctors based in the ward saw me packing my bag and said:
"You going home already, Ling? You woke up late this morning, and now you're skiving away..."
hehehe...I started to laugh. It seems to me that the whole ward is aware of my "sleep in" this morning. And I really do quite guilty to be honest. It is so different when I was still a student. When you are late, no one really cares and you don't have any responsibilities to attend to. Imagine if I was the only junior doc in that ward, then, things probably could go worse. No one would be there for the ward round.
I pwomise I would be early tomorrow!! *fingers crossed
Tuesday, October 17, 2006
Tragedy in The Toilet
This is written in retrospect.
It was a nice peaceful quiet working Friday. Both my colleagues and I have finished all our outstanding jobs and have clerked in all the patients that arrived at the ward. So, we decided to have our first coffee break for the week. (mind you, it was a busy week). Sat down at the usual coffee shop, and ordered my usual mug of tea with a scone.
15 mins later...
*teeeteeeet *teeteeeet (that's my pager going)
I made a face when it went off because I was lazy to answer it and was kinda surprised to get a page from the ward. I called the ward and was informed about a patient with a low haemoglobin of 6.5. The patient was actually a border in the ward. So I didnt know much about him.
So I quickly gulped down the remaining half mug of tea and rushed up to the ward to review that patient. I first looked into his notes to get some background about the reason for his admission. My effort was futile. There was no new notes written in his casenotes. The only information I managed to gather from the nurses was he was transferred from a different hospital and he is known to have diabetes.
Right. That wasn't very helpful, was it?
Ok. I decided to speak to the patient myself about his current admission. The patient was placed in a sideroom. The door to his room was closed, so I knocked at it first and opened the door. "That's weird," I thought. Patient was not at his bed. I called his name a few times, and actually went into the room to see if he was around. There was still no sight of him.
"Uurrghhh...uurrgghhh"
I turned around I followed the direction of the moan. There I found the patient lying on the floor, with his pants halfway down his legs, and faeces splattered all over him and some on the floor. *fuck
I shook him to see if he was alert. And thank god, he was. I shouted for help and the nurses came to clean him and bring him back to his bed. Remember this man has a haemoglobin of 6.5 and guess what? His faeces were very dark brown-blackish in colour. So there you go. I have found the reason for his problem. He was obviously bleeding from his upper GI tract. He looked very very pale, was tachycardic, tachypnoeic and sats were 88% on air. BP was still ok.
I've managed to get IV access on him in order to get crossmatch 4 units of red cells for transfusion. My colleague helped me to phone the SHO for review and he came almost immediately. I was supposed to take some blood gases from him too, but unfortunately, I failed miserably. The patient was very oedamatous to the extent where I could not really palpate for his radial pulse. There was pitting oedema at his wrist!
Oh well, the SHO managed to get the ABGs, and the patient was resuscitated and they took him for an emergency upper GI endoscopy.
*phew (so much for a quiet and peaceful Friday, eh?)
It was a nice peaceful quiet working Friday. Both my colleagues and I have finished all our outstanding jobs and have clerked in all the patients that arrived at the ward. So, we decided to have our first coffee break for the week. (mind you, it was a busy week). Sat down at the usual coffee shop, and ordered my usual mug of tea with a scone.
15 mins later...
*teeeteeeet *teeteeeet (that's my pager going)
I made a face when it went off because I was lazy to answer it and was kinda surprised to get a page from the ward. I called the ward and was informed about a patient with a low haemoglobin of 6.5. The patient was actually a border in the ward. So I didnt know much about him.
So I quickly gulped down the remaining half mug of tea and rushed up to the ward to review that patient. I first looked into his notes to get some background about the reason for his admission. My effort was futile. There was no new notes written in his casenotes. The only information I managed to gather from the nurses was he was transferred from a different hospital and he is known to have diabetes.
Right. That wasn't very helpful, was it?
Ok. I decided to speak to the patient myself about his current admission. The patient was placed in a sideroom. The door to his room was closed, so I knocked at it first and opened the door. "That's weird," I thought. Patient was not at his bed. I called his name a few times, and actually went into the room to see if he was around. There was still no sight of him.
"Uurrghhh...uurrgghhh"
I turned around I followed the direction of the moan. There I found the patient lying on the floor, with his pants halfway down his legs, and faeces splattered all over him and some on the floor. *fuck
I shook him to see if he was alert. And thank god, he was. I shouted for help and the nurses came to clean him and bring him back to his bed. Remember this man has a haemoglobin of 6.5 and guess what? His faeces were very dark brown-blackish in colour. So there you go. I have found the reason for his problem. He was obviously bleeding from his upper GI tract. He looked very very pale, was tachycardic, tachypnoeic and sats were 88% on air. BP was still ok.
I've managed to get IV access on him in order to get crossmatch 4 units of red cells for transfusion. My colleague helped me to phone the SHO for review and he came almost immediately. I was supposed to take some blood gases from him too, but unfortunately, I failed miserably. The patient was very oedamatous to the extent where I could not really palpate for his radial pulse. There was pitting oedema at his wrist!
Oh well, the SHO managed to get the ABGs, and the patient was resuscitated and they took him for an emergency upper GI endoscopy.
*phew (so much for a quiet and peaceful Friday, eh?)
Sunday, October 08, 2006
Urology Nite Out
A night out with my friends yesterday has allowed me to gain abit of social life. hehe. Eversince I started working, I have been hiding in my house most of the time or going out by myself. So the night out, with my urology colleagues, (hence the name urology nite out), was certainly something I had looked forward to.
The pub we went to was this place called "The Three Judges." It was located just about less than 10 mins walk from my flat. To be honest, the pub looked kinda dodgy from the outside. It seemed like a pub for the older population, not for young people like us. =P But one of my colleagues (lets call him G) kept telling us that it is the best pub in Glasgow. He said the pub has even won a few awards! Therefore, to proof his point, he decided to organise this nite out at that pub.
Upon entering, the pub has a pretty nice atmosphere. Everyone looks pretty sane, busy drinking their alcohol and chatting away. We managed to get a table at the corner. My guy colleagues were very kind to buy us gals the drinks. While drinking, we started talking nonsense. haha. G,who obviously is a regular customer at this pub, started pointing out a few customers in the pub and told us stories about each. It was quite interesting. One was a brazilian hooker, two gals who were sitting at the other end of the pub were lesbians, and etc....
I drank a pint of light beer, followed by a glass of raspberry beer. That was my first raspberry beer in my life, and it tasted great. This beer, according to my friend, originated from Germany. It has a very addictive taste: sourish mixed with the usual beer flavour. I was slightly lightheaded after the first pint, but I am by no means drunk. My friends were all laughing at me, coz as usual, I was as red as a tomato. And guess what? I learnt something new that nite as well. Apparently, some of us Asians, do not have a gene that metabolises alcohol properly. That is why some of us turn very red after taking alcohol. So I guess I am one of them eh?
Oh well, the night ended quite fast, and we were asked to leave coz the pub was closing. We chatted for awhile outside the pub. I was needing the toilet badly. My bladder was on the verge of bursting. So I quickly excuse myself and rushed home. hehe. *phew Lucky my detrusor muscles are still working well. =)
The pub we went to was this place called "The Three Judges." It was located just about less than 10 mins walk from my flat. To be honest, the pub looked kinda dodgy from the outside. It seemed like a pub for the older population, not for young people like us. =P But one of my colleagues (lets call him G) kept telling us that it is the best pub in Glasgow. He said the pub has even won a few awards! Therefore, to proof his point, he decided to organise this nite out at that pub.
Upon entering, the pub has a pretty nice atmosphere. Everyone looks pretty sane, busy drinking their alcohol and chatting away. We managed to get a table at the corner. My guy colleagues were very kind to buy us gals the drinks. While drinking, we started talking nonsense. haha. G,who obviously is a regular customer at this pub, started pointing out a few customers in the pub and told us stories about each. It was quite interesting. One was a brazilian hooker, two gals who were sitting at the other end of the pub were lesbians, and etc....
I drank a pint of light beer, followed by a glass of raspberry beer. That was my first raspberry beer in my life, and it tasted great. This beer, according to my friend, originated from Germany. It has a very addictive taste: sourish mixed with the usual beer flavour. I was slightly lightheaded after the first pint, but I am by no means drunk. My friends were all laughing at me, coz as usual, I was as red as a tomato. And guess what? I learnt something new that nite as well. Apparently, some of us Asians, do not have a gene that metabolises alcohol properly. That is why some of us turn very red after taking alcohol. So I guess I am one of them eh?
Oh well, the night ended quite fast, and we were asked to leave coz the pub was closing. We chatted for awhile outside the pub. I was needing the toilet badly. My bladder was on the verge of bursting. So I quickly excuse myself and rushed home. hehe. *phew Lucky my detrusor muscles are still working well. =)
Sunday, October 01, 2006
Ash Cash
Ash cash is new to me.
I have never heard of it before until a few days ago. My colleague called me and informed me that there was a letter addressed to me in his ward. He also mentioned that the letter does not seem to be from the hospital administrator. hmmm....It was abit odd to receive a letter from outsiders addressed to me in the hospital.
The letter was sealed in a white envelope. I opened it quickly, curious to find out what it was all about. My colleagues were sharing my anticipation too. Anyway, I took out a slip of paper, with the heading "Funeral Care," followed by a cheque.
"Ash cash" were the words my colleagues said simultaneously. I was baffled. They explained to me that everytime I fill in a cremation form, I will be paid by the company that carried out the cremation. After hearing that, I have mixed feelings. I felt guilty for being paid just by filling in a form after the death of a patient, but at the same, it was an extra bonus. Oh well.
I have never heard of it before until a few days ago. My colleague called me and informed me that there was a letter addressed to me in his ward. He also mentioned that the letter does not seem to be from the hospital administrator. hmmm....It was abit odd to receive a letter from outsiders addressed to me in the hospital.
The letter was sealed in a white envelope. I opened it quickly, curious to find out what it was all about. My colleagues were sharing my anticipation too. Anyway, I took out a slip of paper, with the heading "Funeral Care," followed by a cheque.
"Ash cash" were the words my colleagues said simultaneously. I was baffled. They explained to me that everytime I fill in a cremation form, I will be paid by the company that carried out the cremation. After hearing that, I have mixed feelings. I felt guilty for being paid just by filling in a form after the death of a patient, but at the same, it was an extra bonus. Oh well.
Friday, September 22, 2006
Digital Rectal Examination
5 years of medical school is a long time indeed. However, I did not have much opportunity to perform a digital rectal examination. I think I probably have done less than 10 as a medical student. Don't misinterpret me, I do not fancy sticking my finger into a stranger's ass. However, I have never felt for an enlarged prostate gland. So if a prostate gland is enlarged, I would not know it is actually big (coz lack of experience). You get what I mean?
Yesterday, my colleagues and I sat down to have tea. One of my colleagues, who was on-call for the whole week, complained that she was asked to do 5 digital rectal examinations, one after another. There were nothing interesting to find on the examinations. However, this topic led to another subject. Palpating for the prostate gland in male patients with them on all fours.....
hmmm....normally, the patient would be lying on his side with his knees bent at 90 degrees. According to a different colleague, he was told that it is better for the patient to be on all fours during the digital rectal examination, as it enables the examiner to get a better feel for the prostate gland. I do not know how true this is, but a few of them actually admitted that they have heard of this before.
All of us burst into laughter. And as expected, my fellow guy colleagues starting developing their own wild imaginations. (Imagine walking into the examination room, with the patient on all 4's and a finger in the rectum??!) You get the idea...... Don't think anyone of us would fancy doing the examination in that position.
Yesterday, my colleagues and I sat down to have tea. One of my colleagues, who was on-call for the whole week, complained that she was asked to do 5 digital rectal examinations, one after another. There were nothing interesting to find on the examinations. However, this topic led to another subject. Palpating for the prostate gland in male patients with them on all fours.....
hmmm....normally, the patient would be lying on his side with his knees bent at 90 degrees. According to a different colleague, he was told that it is better for the patient to be on all fours during the digital rectal examination, as it enables the examiner to get a better feel for the prostate gland. I do not know how true this is, but a few of them actually admitted that they have heard of this before.
All of us burst into laughter. And as expected, my fellow guy colleagues starting developing their own wild imaginations. (Imagine walking into the examination room, with the patient on all 4's and a finger in the rectum??!) You get the idea...... Don't think anyone of us would fancy doing the examination in that position.
Monday, September 18, 2006
A Weekend At The Hospital
Here are a few notes I wish to make about my weekend at the hospital.
SATURDAY
SUNDAY
SATURDAY
- It was a bloody long shift.
- My left eye felt sore.
- Oh great! I found that the contact lens in my left eye was torn. (no wonder it was sore)
- Had to remove it....and worked with one good eye = Headache at the end of the day.
- Spent 4 hours searching the entire hospital for a venesection kit. (Mind you, it was the weekend, most depts were closed. So, I phoned one dept to another, before finally, a specialist nurse, who was on-call from home, said she'll come over to the hospital to pass me a few kits).
- Acted as a translator. (Just realised that I have not been speaking Chinese for a looonng time...so I had some difficulty finding the correct words to ask the patient).
- Temperatures. Patients in the hospital just loved to get a fever, which gave me more work to do.
- 5 mins before I was meant to finish, a patient went into an epileptic fit. sigh.
SUNDAY
- Another long day for me. Arrived the next morning for work and found out that there were 13 admissions into my ward (it was meant to be 6 initially), and 2 from the other ward which I was covering.
- WTF?!
- A patient "decided" to fall out from her bed....so had to go and make sure she is alright.
- Referrals. I was asked by the consultant to refer a few patients to different medical teams.
- Noon. Most admissions have arrived, and so, I began to clerk them in.
- *gurling noise from my tummy. Hungry + Stress = :(
- By about 3 pm, I saw only 4 of the admissions. Still have 11 more to see!!! arrghhh!!!!
- A few other things cropped up and needed to be sorted out.
- 6 pm. Saw another 2 more admissions. And another 9 more to go!! And I'm due to be off my shift at 9 pm.
- Sat down for 5 mins to gobble some chocs to increase my depleting energy stores.
- I was nearly on the verge of breaking down....just felt I won't be able to finish them all by tonight. But, I managed to calm myself down and continued my work.
- 9 pm. 5 more patients to see. ("Go sl, you can do this," I whispered to myself).
- One patient was not happy that I saw him so late in the night. Sigh.
- 11 pm. I bumped into my colleague who was covering the wards downstairs. She looked awful and she admitted that she cried earlier on as she has had a rough day.
- 11.30 pm. With a few pre-op ECGs that need to be done and chasing results, I decided that I should leave the ward, before I missed the last train home, which was at midnite.
- 0015 hours. Arrived at home. Hungry. Headache. Knackered. Dead as a log.
- Could not sleep as the adrenaline was still kicking about in my body. Only managed 3 hours of sleep before I had to get up and leave early for work to complete my unfinished jobs.
Thursday, September 14, 2006
Itch
I hate itch. The moment you start scratching, the itch gets worse.
Recently, I have developed a funny rash. The skin around my neck began to feel really itchy initially. I began scratching away, thinking that it is caused by my hair poking around my neck. However, the next day, my body began to itch. This time, I put it down to dry skin, since the weather here in Glasgow is getting colder.
However, exactly a week ago, after coming back from a late shift at work, I realised that my whole body was covered with red little dots of rash. I was feeling super duper itchy. Nothing I do could help to reduce the itch. The rash also started to spread down both my arms the next day.
I became worried. Allergy? nah...neither did I use any new creams, nor eat anything different. Bed bug? Well, bugs won't bite me in this fashion. I was clueless. I did not feel ill at all. The only thing I had was a sorethroat which went away within an hour or so.
My whole neck area was (and still is) filled with red patches. I had to be careful with my clothes, so that I can hide the rashes . Otherwise, ppl would think that I'm suffering from a contagious disease (with the rash).
Clarythine did not help to relieve the itchiness. I decided to take Piriton instead, which worked wonders! Unfortunately, Piriton made me so drowsy that I felt so miserable trying to work and finish my jobs at the same time. hehe. Even the nurse in the hospital noticed that I looked so sleepy. But at least the rash is reduced. Not so red anymore and not too itchy. Tiny red dots are still visible though.
I think this rash could be a viral thingy or maybe just stress-related rash?? I dunno.
Recently, I have developed a funny rash. The skin around my neck began to feel really itchy initially. I began scratching away, thinking that it is caused by my hair poking around my neck. However, the next day, my body began to itch. This time, I put it down to dry skin, since the weather here in Glasgow is getting colder.
However, exactly a week ago, after coming back from a late shift at work, I realised that my whole body was covered with red little dots of rash. I was feeling super duper itchy. Nothing I do could help to reduce the itch. The rash also started to spread down both my arms the next day.
I became worried. Allergy? nah...neither did I use any new creams, nor eat anything different. Bed bug? Well, bugs won't bite me in this fashion. I was clueless. I did not feel ill at all. The only thing I had was a sorethroat which went away within an hour or so.
My whole neck area was (and still is) filled with red patches. I had to be careful with my clothes, so that I can hide the rashes . Otherwise, ppl would think that I'm suffering from a contagious disease (with the rash).
Clarythine did not help to relieve the itchiness. I decided to take Piriton instead, which worked wonders! Unfortunately, Piriton made me so drowsy that I felt so miserable trying to work and finish my jobs at the same time. hehe. Even the nurse in the hospital noticed that I looked so sleepy. But at least the rash is reduced. Not so red anymore and not too itchy. Tiny red dots are still visible though.
I think this rash could be a viral thingy or maybe just stress-related rash?? I dunno.
Sunday, September 10, 2006
Intriguing
Fracture of the penis.
hmmm....intriguing eh? How could this happen? There is no bone at the penis....so how could you possibly "fracture" it?
After doing my homework about this, I learnt that fracture of the penis is defined as the rupture of the tunica albuginea of the corpus cavernosum secondary to trauma. Lets go into the anatomy of the penis for awhile. The penis is made of a few erectile tissues , i.e., corpus cavernosum (left and right) and the corpus spongiosum. The tunica albuginea covers the corpus cavernosum. During an erection, these tissues enlarge, which causes the tunica albuginea to become thin and stiff. At this point, the penis is vulnerable to injury.
Fracture of the penis is not common. Any sudden blunt trauma or bending of an erect penis can tear the thin tunica albuginea, resulting in a fracture.It usually occurs during sexual intercourse. (Don't think I'm going to explain how it can get bent...use your imagination). Apparently, you would be able to hear a "cracking" sound when the fracture occurs. Oh my, it sounds really painful, doesn't?? If the injury is severe, the urethra maybe damaged as well. (The urethra is a tube that carries urine from the bladder to the external). Urgent treatment of the fractured penis is required, otherwise, it may become deformed. Although complications from this injury is not common, they include erectile dysfunction and painful erections in the future.
So people, please be don't be too rough during sexual intercourse...the last thing you want is having a fractured penis and spoiling everything.
hmmm....intriguing eh? How could this happen? There is no bone at the penis....so how could you possibly "fracture" it?
After doing my homework about this, I learnt that fracture of the penis is defined as the rupture of the tunica albuginea of the corpus cavernosum secondary to trauma. Lets go into the anatomy of the penis for awhile. The penis is made of a few erectile tissues , i.e., corpus cavernosum (left and right) and the corpus spongiosum. The tunica albuginea covers the corpus cavernosum. During an erection, these tissues enlarge, which causes the tunica albuginea to become thin and stiff. At this point, the penis is vulnerable to injury.
Fracture of the penis is not common. Any sudden blunt trauma or bending of an erect penis can tear the thin tunica albuginea, resulting in a fracture.It usually occurs during sexual intercourse. (Don't think I'm going to explain how it can get bent...use your imagination). Apparently, you would be able to hear a "cracking" sound when the fracture occurs. Oh my, it sounds really painful, doesn't?? If the injury is severe, the urethra maybe damaged as well. (The urethra is a tube that carries urine from the bladder to the external). Urgent treatment of the fractured penis is required, otherwise, it may become deformed. Although complications from this injury is not common, they include erectile dysfunction and painful erections in the future.
So people, please be don't be too rough during sexual intercourse...the last thing you want is having a fractured penis and spoiling everything.
Friday, September 08, 2006
Just Hours Before Death
Have you ever heard that a dying man is usually more active just before he/she dies?? I think that statement is very true.
I was involved in a care of a dying man recently. He was not speaking much when I first met him. Most of the time, he tends to mumble to himself. The last day he was alive, this person became quite talkative and, in fact, verbally abusive.
I remember asking the patient how he feels. He just told me to leave him alone. Then, later on, he began to vomit a number of times and I decided to keep a closer eye on him. As I started to count his heart rate (by feeling for his pulse just about his wrist), he started scolding me. He said, "What are you doing, you stupid bitch!"
It was funny. I was actullay not offended. But the fact that a man could be suddenly so talkative. A few of my friends have told me about their experiences with the dying person and most of their stories did mention that the patients were more active on the day of their death. Weird eh?
I was involved in a care of a dying man recently. He was not speaking much when I first met him. Most of the time, he tends to mumble to himself. The last day he was alive, this person became quite talkative and, in fact, verbally abusive.
I remember asking the patient how he feels. He just told me to leave him alone. Then, later on, he began to vomit a number of times and I decided to keep a closer eye on him. As I started to count his heart rate (by feeling for his pulse just about his wrist), he started scolding me. He said, "What are you doing, you stupid bitch!"
It was funny. I was actullay not offended. But the fact that a man could be suddenly so talkative. A few of my friends have told me about their experiences with the dying person and most of their stories did mention that the patients were more active on the day of their death. Weird eh?
Saturday, September 02, 2006
2 looonnnng weeks again...
Its the weekend. But I'm working. Again. =(
Why do I seem to be working every weekend? hmmm...I just did night on-calls over the weekend about 2 weeks ago. And I had the weekend off after that week of nights. Last week, I was at work from 8-9 on Monday and Friday. It was tiring because I did not have much time to recover from my deranged sleeping habit. And I SO totally missed the first junior doctors night out held on Friday nite, because of my shift and culture. It was to celebrate our first paycheck. keke.
Anyway, I will be having the next weekend off, but unfortunately the Monday after that weekend, I start a 2 week long working days.....AGAIN!!! urgh!! I MISS MY WEEKENDS!!!
Wished I was a student now...hehe...
Why do I seem to be working every weekend? hmmm...I just did night on-calls over the weekend about 2 weeks ago. And I had the weekend off after that week of nights. Last week, I was at work from 8-9 on Monday and Friday. It was tiring because I did not have much time to recover from my deranged sleeping habit. And I SO totally missed the first junior doctors night out held on Friday nite, because of my shift and culture. It was to celebrate our first paycheck. keke.
Anyway, I will be having the next weekend off, but unfortunately the Monday after that weekend, I start a 2 week long working days.....AGAIN!!! urgh!! I MISS MY WEEKENDS!!!
Wished I was a student now...hehe...
Friday, September 01, 2006
PAY DAY! PAY DAY!! =D
Did I just say "Pay Day"?
YES YES YES YES!!!!
hehe =D
I'm so happy. It was pay day on the 31st August 2006. And, of course, it was the Independence Day for Malaysia. (Although I am faraway, but I still have Malaysia in my heart). Selamat belated-Hari Kebangsaan folks!
Anyway, back to my pay day. See, this is my first proper job (I worked as a food server before). And to be paid after a few weeks of hard work really felt great!
Everyone at work was so excited. Rumours were spreading that our salary will be banked into the account at 12am automatically. So, I waited patiently till about 11pm. But I was dead tired and as usual, ended up falling asleep on the table. The next time I woke up it was about 4 something in the morning. And I remembered that I wanted to check how much I was being paid.
I quickly logged onto my bank account and was so happy to see my first salary!! I am now (hopefully) financially independent now. hehe. The good thing is the first salary is tax-free. Mind you, the tax here is rather high.
My friend and I decided to celebrate out first pay by having dinner at TGIF. The food was certainly much better than TGIF in KL. The atmosphere was great and for the first time, I actually did not feel guilty paying 20 quid for my meal. haha.
YES YES YES YES!!!!
hehe =D
I'm so happy. It was pay day on the 31st August 2006. And, of course, it was the Independence Day for Malaysia. (Although I am faraway, but I still have Malaysia in my heart). Selamat belated-Hari Kebangsaan folks!
Anyway, back to my pay day. See, this is my first proper job (I worked as a food server before). And to be paid after a few weeks of hard work really felt great!
Everyone at work was so excited. Rumours were spreading that our salary will be banked into the account at 12am automatically. So, I waited patiently till about 11pm. But I was dead tired and as usual, ended up falling asleep on the table. The next time I woke up it was about 4 something in the morning. And I remembered that I wanted to check how much I was being paid.
I quickly logged onto my bank account and was so happy to see my first salary!! I am now (hopefully) financially independent now. hehe. The good thing is the first salary is tax-free. Mind you, the tax here is rather high.
My friend and I decided to celebrate out first pay by having dinner at TGIF. The food was certainly much better than TGIF in KL. The atmosphere was great and for the first time, I actually did not feel guilty paying 20 quid for my meal. haha.
Wednesday, August 30, 2006
Conduitogram? Ileogram??
Have I got you clueless over there?
There are just so many words that end with -ogram. Kilogram, histogram, etc.
But what is a conduitogram or even an ileogram??
During a particular ward round this week, I was asked by a senior doctor to request a conduitogram for a patient. I was like, "sorry, what did you say?" The doctor repeated himself and I was still left dumbstruck. hehe. Silly me. But I have never heard of the word conduitogram, ever in my life so far. Later on during the day, the word fistulogram came up. Again, I was like, "What?!"
hehe....but fear not, I have now got the idea of the words ending with -ogram. They basically mean some form of investigative procedure, involving an x-ray and radioactive dye, to check for any holes or obstruction related to the organ or tissue. For example, a fistul-ogram. Fistul, comes from the word fistula, which is an abnormal connection between 2 organs. So, a fistulogram means investigating the fistula to check for any holes. If the dye leaks out of the fistula, hence, a hole is present within the fistula and that needs to be fixed.
Hope I did not get you ppl confused. But I surely have improved my vocabulary....keke.
There are just so many words that end with -ogram. Kilogram, histogram, etc.
But what is a conduitogram or even an ileogram??
During a particular ward round this week, I was asked by a senior doctor to request a conduitogram for a patient. I was like, "sorry, what did you say?" The doctor repeated himself and I was still left dumbstruck. hehe. Silly me. But I have never heard of the word conduitogram, ever in my life so far. Later on during the day, the word fistulogram came up. Again, I was like, "What?!"
hehe....but fear not, I have now got the idea of the words ending with -ogram. They basically mean some form of investigative procedure, involving an x-ray and radioactive dye, to check for any holes or obstruction related to the organ or tissue. For example, a fistul-ogram. Fistul, comes from the word fistula, which is an abnormal connection between 2 organs. So, a fistulogram means investigating the fistula to check for any holes. If the dye leaks out of the fistula, hence, a hole is present within the fistula and that needs to be fixed.
Hope I did not get you ppl confused. But I surely have improved my vocabulary....keke.
Tuesday, August 29, 2006
Don Quixote
Heard this name before? If you haven't, let me introduce you to Don Quixote de la Mancha, a man whose aim in life is to undo evil and protect the weak. He feels that his good deeds will glorify the woman of his imagination......(he turned his faithful servant girl into the love of his dreams).
Anyway, my friends and I decided to catch a ballet performance titled "Don Quixote" during the Edinburgh Festival on Sunday. I have watched ballet in the past and I, particularly enjoyed "The Swan Lake." Unfortunately, this ballet performance made all of us clueless and sleepy. I have to admit that we all did not know what the show was about. Most of the time, after every scene, my friends and I would end up discussing and creating our own interpretation of the ballet. It was funny...we all thought that this man is abit loose in his brain....probably having a bit of dementia as well. =P
When we first entered the theatre, most seats were taken up except for the cheap ones (like the one we bought). This was the first time Don Quixote was performed in the festival. Anyway, a scene is always follwed by a short interval. By the end of the first scene, a tall guy sitting in front of my friend left the theatre for good. Guess he thought it was boring. During the 2nd interval, a group of girls who were sitting in front of us left as well. hmmm....hope you get the picture of how clueless everyone was about the performance. keke
When the show finally ended with the lead character dead, we left immediately (just can't wait to breathe the fresh air outside and see the sun). A man who was making his way out looked at us and said, "Oh, did you guys get the booklet? (refering to the programme book on Don Quixote)" I shook my head in response. And he continued, "Here you are, you can have mine. I do not need it anymore." I thanked him for the book.
I do not know what did you guys think about what happened. For me, I thought maybe it was just a convenient way for him to get rid of the book because it would be a waste to dump it into the bin. But at the same time, maybe we all looked so "blur." =D haha....whatever it is, I'm glad to say that our interpretation of the ballet was right on track except for a few scenes. But, I think I have enough of ballet for now.
Anyway, my friends and I decided to catch a ballet performance titled "Don Quixote" during the Edinburgh Festival on Sunday. I have watched ballet in the past and I, particularly enjoyed "The Swan Lake." Unfortunately, this ballet performance made all of us clueless and sleepy. I have to admit that we all did not know what the show was about. Most of the time, after every scene, my friends and I would end up discussing and creating our own interpretation of the ballet. It was funny...we all thought that this man is abit loose in his brain....probably having a bit of dementia as well. =P
When we first entered the theatre, most seats were taken up except for the cheap ones (like the one we bought). This was the first time Don Quixote was performed in the festival. Anyway, a scene is always follwed by a short interval. By the end of the first scene, a tall guy sitting in front of my friend left the theatre for good. Guess he thought it was boring. During the 2nd interval, a group of girls who were sitting in front of us left as well. hmmm....hope you get the picture of how clueless everyone was about the performance. keke
When the show finally ended with the lead character dead, we left immediately (just can't wait to breathe the fresh air outside and see the sun). A man who was making his way out looked at us and said, "Oh, did you guys get the booklet? (refering to the programme book on Don Quixote)" I shook my head in response. And he continued, "Here you are, you can have mine. I do not need it anymore." I thanked him for the book.
I do not know what did you guys think about what happened. For me, I thought maybe it was just a convenient way for him to get rid of the book because it would be a waste to dump it into the bin. But at the same time, maybe we all looked so "blur." =D haha....whatever it is, I'm glad to say that our interpretation of the ballet was right on track except for a few scenes. But, I think I have enough of ballet for now.
Sunday, August 27, 2006
Bad Venflon Days
Let me first tell you what is a venflon. It is a needle-like plastic tube that sits in a vein to allow drugs to be given intravenously or to start a drip (where you get extra fluid into your body). In order to insert a venflon into a vein, a lot of skill and experience is required.
Throughout my 7 days of night shifts, I have been inserting venflons into numerous patients everyday. The minimum venflons per day was about 2, and there was one night, where there were nearly 10 venflons to be inserted! Venflons are easier to insert in those with big fat cracking veins compared to those with small veins.
You would imagine that after having so many practice over the night, I should not face much difficulty when asked to insert one in the future (unless of course the patient has really no veins palpable or visible). However, last night (which was my last night of night shift), I faced great difficulty. I had to try about 3 times in a lady before I'd finally managed to get it done. And there was a man with a big visible vein, and I failed on 2 occasions.
ARrgghhh!!
It was really frustrating. I was suffering from a Bad Venlfon Day, and this made me feel really shit because I was meant to be more experienced...I have been doing it for the whole week!! sigh...oh well, I think it was because my mind was sunconsciously smiling away because it was the last night. So there was lack of concentration? Whatever. Doesn't matter anymore....need to retire to bed early. My eyes are nearly half shut. Good night.
Throughout my 7 days of night shifts, I have been inserting venflons into numerous patients everyday. The minimum venflons per day was about 2, and there was one night, where there were nearly 10 venflons to be inserted! Venflons are easier to insert in those with big fat cracking veins compared to those with small veins.
You would imagine that after having so many practice over the night, I should not face much difficulty when asked to insert one in the future (unless of course the patient has really no veins palpable or visible). However, last night (which was my last night of night shift), I faced great difficulty. I had to try about 3 times in a lady before I'd finally managed to get it done. And there was a man with a big visible vein, and I failed on 2 occasions.
ARrgghhh!!
It was really frustrating. I was suffering from a Bad Venlfon Day, and this made me feel really shit because I was meant to be more experienced...I have been doing it for the whole week!! sigh...oh well, I think it was because my mind was sunconsciously smiling away because it was the last night. So there was lack of concentration? Whatever. Doesn't matter anymore....need to retire to bed early. My eyes are nearly half shut. Good night.
Saturday, August 26, 2006
No Sense of Urgency
My Thursday night on-call made me realise that some people just do not have the sense of urgency.
A patient developed post-ERCP pancreatitis, and she was in a lot of pain despite being prescribed with pethidine and a few more painkillers. She was mean to go down to the X-ray department at about 8 pm to check for perforation (which is when you find a hole in the abdominal organ). A clerk from the x-ray dept called back saying that there are about 20 patients in front of her. The doctor in charged told the clerk that this is urgent because the patient looks rather unwell.
However 6 hours later, I was paged by the nurse looking after that patient. The patient's blood pressure dropped quite significantly and her urine output was very low. The patient was also in a lot of pain and was feeling sick. I was like, "shit." I made my way up to the ward quickly and assessed the patient. She was quite tender at her abdomen. I asked if the x-ray was done, and guess what? The answer was NO.
I was like what?! Those 20 ppl in front of her should have all been cleared. Her condition does not seem too good and a perforation really need to be reuled out. So the nurse called the x-ray dept and they quickly made their way up to get the patient. Thank god the patient did not have any perforation.
Talk about inefficiency man. They did not realise the urgency of the x-ray. What if she really had a perforation?? Patient may die. Therefore, the moral of the story is an urgent thing really is URGENT!
A patient developed post-ERCP pancreatitis, and she was in a lot of pain despite being prescribed with pethidine and a few more painkillers. She was mean to go down to the X-ray department at about 8 pm to check for perforation (which is when you find a hole in the abdominal organ). A clerk from the x-ray dept called back saying that there are about 20 patients in front of her. The doctor in charged told the clerk that this is urgent because the patient looks rather unwell.
However 6 hours later, I was paged by the nurse looking after that patient. The patient's blood pressure dropped quite significantly and her urine output was very low. The patient was also in a lot of pain and was feeling sick. I was like, "shit." I made my way up to the ward quickly and assessed the patient. She was quite tender at her abdomen. I asked if the x-ray was done, and guess what? The answer was NO.
I was like what?! Those 20 ppl in front of her should have all been cleared. Her condition does not seem too good and a perforation really need to be reuled out. So the nurse called the x-ray dept and they quickly made their way up to get the patient. Thank god the patient did not have any perforation.
Talk about inefficiency man. They did not realise the urgency of the x-ray. What if she really had a perforation?? Patient may die. Therefore, the moral of the story is an urgent thing really is URGENT!
Thursday, August 24, 2006
The Quietest Night So Far...
My 5th night on call was, by far, the quietest night I have experienced. I was glad it was quiet. But there is a superstition which states that if you a quiet night the day before, you'll have a busy night the next day. hmmm...so I shall see what happens tonight. Hope nothing untoward takes place. *fingers crossed *toes crossed too.
The night started off quite weird. A nurse asked me to prescribe an antiepileptic drug for a patient. An oral drug has already been prescribed. However, the patient was not allowed to have anything through his mouth, so therefore, his drug have to be given in a different route other than the mouth. I looked up the drug guidebook produced by the hospital. I could not find any drug that matches the patient's oral antiepileptic. I asked if he can give the drug through the patient's rectum, and the answer I got back was, "Do you think if you were the patient , you would like to have your rectum stuck with a pill after bowel surgery?" I was speechless and just agreed that I would not like to take my medication through that method.
Another problem was some of the drugs which I thought were suitable was not stocked in the drug cabinet. sigh. There is no way the patient can miss his dose of the antiepileptic drug, because his epilepsy was never well controlled. I decided to seek help from a senior doctor on call. And she felt funny that the patient was not allowed to have his drug orally, especially when the patient is not vomiting or anything. So after much discussion, she said to just give the patient orally. I told the nurse the instruction from the senior doctor, and boy he was not too happy. I don't know about you, but I thought this whole issue was abit weird. I do not know much about prescribing antiepileptics and I was worried that the patient may go into an attack if I gave the wrong medication. haha.
Oh well, the rest of the night was filled with calls to prescribe pain relief and to look at a few patients who developed fever. I had about 1 hour of silence, in which I dozed off on the table for about 30mins and had toast with a cup of tea, prepared by a nurse. hehe.
Ok la...i'm counting down to my weekend! Just 2 more nights to go.
The night started off quite weird. A nurse asked me to prescribe an antiepileptic drug for a patient. An oral drug has already been prescribed. However, the patient was not allowed to have anything through his mouth, so therefore, his drug have to be given in a different route other than the mouth. I looked up the drug guidebook produced by the hospital. I could not find any drug that matches the patient's oral antiepileptic. I asked if he can give the drug through the patient's rectum, and the answer I got back was, "Do you think if you were the patient , you would like to have your rectum stuck with a pill after bowel surgery?" I was speechless and just agreed that I would not like to take my medication through that method.
Another problem was some of the drugs which I thought were suitable was not stocked in the drug cabinet. sigh. There is no way the patient can miss his dose of the antiepileptic drug, because his epilepsy was never well controlled. I decided to seek help from a senior doctor on call. And she felt funny that the patient was not allowed to have his drug orally, especially when the patient is not vomiting or anything. So after much discussion, she said to just give the patient orally. I told the nurse the instruction from the senior doctor, and boy he was not too happy. I don't know about you, but I thought this whole issue was abit weird. I do not know much about prescribing antiepileptics and I was worried that the patient may go into an attack if I gave the wrong medication. haha.
Oh well, the rest of the night was filled with calls to prescribe pain relief and to look at a few patients who developed fever. I had about 1 hour of silence, in which I dozed off on the table for about 30mins and had toast with a cup of tea, prepared by a nurse. hehe.
Ok la...i'm counting down to my weekend! Just 2 more nights to go.
Wednesday, August 23, 2006
Two Deaths in A Night
Yesterday night was an awkward day for me. When I first arrived for work, there was an elderly lady whose condition was deteriorating. I started to panic. At that point, the patient was for resuscitation. I was worried that I would be called in the event of a cardiac arrest, which will be my first real life experience as a newly grad doc....quite scary to be honest, regardless of how many times I have gone through the immediate life support algorithm during exams. However, a decision was made not to resuscitate her later on.
The lady finally did not make it till the next morning and passed away peacefully. It was such a sad occasion, as she was surrounded by a big group of family members, consisting of children and grandchildren. Everyone was in tears. I felt so sorry for them because the death was really unexpected. I was asked to certify her death.
Earlier on, before this incident, another man died as well. I was also asked to certify his death.
Approaching a dead person was quite awkward. I know what are the steps required to pronounce the person's death. But when faced with the situation I was actually rather nervous. It was really weird listening to a dead person's heart and chest. It was not totally silent. I could still hear some funny gurgling sounds. The person was also very cold to touch. And actually, while examining the patient, I was thinking, what if this person is not actually dead yet?? Would his spirit be agitated while I examine him/her?? It was really awkward. I was not really invovled in the care of these two deceased people. So I was not really upset about it.
Two deaths in a day's work....quite a sad day for those families. My condolences to them. As for me, I think I would be more comfortable touching the dead after today. Off to bed now.
The lady finally did not make it till the next morning and passed away peacefully. It was such a sad occasion, as she was surrounded by a big group of family members, consisting of children and grandchildren. Everyone was in tears. I felt so sorry for them because the death was really unexpected. I was asked to certify her death.
Earlier on, before this incident, another man died as well. I was also asked to certify his death.
Approaching a dead person was quite awkward. I know what are the steps required to pronounce the person's death. But when faced with the situation I was actually rather nervous. It was really weird listening to a dead person's heart and chest. It was not totally silent. I could still hear some funny gurgling sounds. The person was also very cold to touch. And actually, while examining the patient, I was thinking, what if this person is not actually dead yet?? Would his spirit be agitated while I examine him/her?? It was really awkward. I was not really invovled in the care of these two deceased people. So I was not really upset about it.
Two deaths in a day's work....quite a sad day for those families. My condolences to them. As for me, I think I would be more comfortable touching the dead after today. Off to bed now.
Tuesday, August 22, 2006
Isn't A Wonder?
Isn't a wonder when everything don't seem to go right?
I kind of give up on some issues in life at the moment. Everyone starts complaining to me, that so and so has done this, why didn't you try to stop he/she. Everyone has their side of story. Only those who were involved would know what actually happened between them. One would say he/she said abcd, while the other person would say he/she said wxyz. So all I can do is listen and stay neutral in both issues, apologise to the person who felt hurt and advice the other not to repeat the thing anymore, or vice versa. But at the same time, both parties are not happy and frustrated with the way things are. I agree that an arguement will never solve the problem. And either way, I feel both are at fault for arguing with each other.
So, I am left with a dilemma which no one would understand. Everyone thinks that I'm trying to runaway. But in actual fact, I am not. I just am clueless as to what else I can do. If the other person does not want to listen to my ideas, for f*** sake, I can't do anything about it!! Or if the other person choose to continue informing about his/her thoughts or feelings, I can't do much about it either because the situation is already as it is. There is no way of changing back whatever happened. I mean, yes, I understand that everyone is feeling rubbish about the whole thing, but can't you guys just see through my situation?? Do you think it is so simple to listen and not react emotionally to what you guys said?? Isn't a wonder why you people just can't leave me in peace?? I am human too you know.
For the past few days, I felt absolutely miserable. And no one would ever get how I feel unless they are in my shoes. Honestly, don't start advising me that I should express my feelings (which I have tried and have always ended in arguement with either parties). Everyday, I just can't stop looking back at what has happened. But, I know that only time will let me cope with all these bumps in life.
I got to leave for work soon. Isn't a wonder how the brain switches off troubled thoughts away from these things during work? I hope that would be the case, at least! Otherwise, I would not be able to function properly tonight.
I kind of give up on some issues in life at the moment. Everyone starts complaining to me, that so and so has done this, why didn't you try to stop he/she. Everyone has their side of story. Only those who were involved would know what actually happened between them. One would say he/she said abcd, while the other person would say he/she said wxyz. So all I can do is listen and stay neutral in both issues, apologise to the person who felt hurt and advice the other not to repeat the thing anymore, or vice versa. But at the same time, both parties are not happy and frustrated with the way things are. I agree that an arguement will never solve the problem. And either way, I feel both are at fault for arguing with each other.
So, I am left with a dilemma which no one would understand. Everyone thinks that I'm trying to runaway. But in actual fact, I am not. I just am clueless as to what else I can do. If the other person does not want to listen to my ideas, for f*** sake, I can't do anything about it!! Or if the other person choose to continue informing about his/her thoughts or feelings, I can't do much about it either because the situation is already as it is. There is no way of changing back whatever happened. I mean, yes, I understand that everyone is feeling rubbish about the whole thing, but can't you guys just see through my situation?? Do you think it is so simple to listen and not react emotionally to what you guys said?? Isn't a wonder why you people just can't leave me in peace?? I am human too you know.
For the past few days, I felt absolutely miserable. And no one would ever get how I feel unless they are in my shoes. Honestly, don't start advising me that I should express my feelings (which I have tried and have always ended in arguement with either parties). Everyday, I just can't stop looking back at what has happened. But, I know that only time will let me cope with all these bumps in life.
I got to leave for work soon. Isn't a wonder how the brain switches off troubled thoughts away from these things during work? I hope that would be the case, at least! Otherwise, I would not be able to function properly tonight.
Knackered
KNACKERED, is the best word to describe myself now. I am currently working night shifts for 7 days, and I am so knackered. Yet, I have only done 3 days of them. My eyes are stinging in pain and my mouth is dry because of lack of hydration. =( My shift is worth 12 hours long or more, depending on whether there were alot to do. I begin my journey to the hospital at 7.30pm to get ready for work, which starts at 8.30pm.
From 8.30 onwards, I have never had much opportunity to sit, drink or eat. The workload was just going constantly. From prescribing drugs to persuading patients to not run away from the hospital in the middle of the night, the type of jobs I faced during the night are rather funny sometimes. Just last night, I had to deal with a man who said the monitor that check the patient's vital signs is a gun?!
My pager just cant stop bleeping. It is worse especially when I'm in the ward in the middle of the night, when suddenly the pager starts to ring. The silence in the night is broken and you can hear patients grumbling in the background. *oppss...sorry!
Everyday, I only managed about 4 hours of sleep. And I just have to pull myself out of bed and stuff something down my throat, so that I wont get hungry later. But anyhow, I shall not complain too much, as I am sure there are many other people out there who are working far harder than me.
From 8.30 onwards, I have never had much opportunity to sit, drink or eat. The workload was just going constantly. From prescribing drugs to persuading patients to not run away from the hospital in the middle of the night, the type of jobs I faced during the night are rather funny sometimes. Just last night, I had to deal with a man who said the monitor that check the patient's vital signs is a gun?!
My pager just cant stop bleeping. It is worse especially when I'm in the ward in the middle of the night, when suddenly the pager starts to ring. The silence in the night is broken and you can hear patients grumbling in the background. *oppss...sorry!
Everyday, I only managed about 4 hours of sleep. And I just have to pull myself out of bed and stuff something down my throat, so that I wont get hungry later. But anyhow, I shall not complain too much, as I am sure there are many other people out there who are working far harder than me.
Saturday, August 19, 2006
*Dusting *Wiping * Vacuuming
*dusting I have not been blogging for about more than 2 weeks now. I didn't manage to get my broadband fixed till today!! =) I'm so happy that I could finally surf the internet from home whenever I want. *wiping I felt like "a frog under a coconut shell" since the last time I was connected to the internet. Imagine, I did not even know that there was a huge masterplan at the Heathrow airport till I picked up the newspaper left in the subway the other day. *vacuuming
*dusting (again, it is so dusty here)
During these few weeks, I've managed to use the computer in the library/wards to send emails. The computer in the library was alright, but I could not send any emails from my yahoo account. Moreover, the library closes at 5pm, which is when I finish work as well...so not much opportunity to use them. On the other hand, the computer in the ward was super slow! *wiping
Anyway, my broadband is finally here! So I'll keep this place as up to date as I can!
*vacuuming (finally, this site is clean and back to normal again!)
*dusting (again, it is so dusty here)
During these few weeks, I've managed to use the computer in the library/wards to send emails. The computer in the library was alright, but I could not send any emails from my yahoo account. Moreover, the library closes at 5pm, which is when I finish work as well...so not much opportunity to use them. On the other hand, the computer in the ward was super slow! *wiping
Anyway, my broadband is finally here! So I'll keep this place as up to date as I can!
*vacuuming (finally, this site is clean and back to normal again!)
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