I Need to Scream

So that's what I am going to do.

Please close your ears...or rather your eyes.

AAAAAAAAAAAAaaaaaaaaaaaaaahhHHHHHHHHHHHHHHHHHhHHHHHhhHHHhhhh

UUUUUUUUURRRRRRRrggggggggghhhhhhhhhhhhhhhhhhhhhhhhhhhhhhHHHHHHHH

AAAAAAAAAAAAAAAHHHHHHHHHHAAAAAAAAAAHahhhhhhhhhhhhhhhaAHhhhhhhh

#^%$(*&@#$^$%)(*&@#&*(%$^

Now I feel marginally better.

And now the headache begins...

I am happy that I have finished my night on calls. And it is the start of my holiday! =)

Now, what am I planning to do during my holidays?

Well, LOADS! But my top priority is to get a car.

So it will be a week filled with activities, such as, visiting different car dealers, bargaining, test driving, examining the car..etc...Sounds fun...No!

As it is now, I can feel the headache building deep inside my brain...and by the middle of the week, it will turn into a full blown one.

Apart from car hunting, I think my other priority is to treat myself to good food and good books. Enjoy myself as much as I can...that's the motto!

=D

Yay!!!

I have passed my driving practical test!! =) *phew

Believe it or not, despite years of driving, I actually felt nervous?!

Anyhoo, I managed to calm my nerves and I am proud to say, I didn't make a single fault while driving!

Well, the examiner minused 3 points from my total for "driving not according to speed."

I wish I could disagree with that. The speed limit was 30mph. So I drove between 25-28 mph. Apparently that is TOO slow. I must drive at 30mph....total nonsense I would say!

The bottomline is I have passed...and I can't wait to go searching for my car! keke...

Macam-macam Ragam

Kids can be really funny when they come into the hospital.

Over the past few days, I have came across various characters....and most of them seemed to be at the rebellious age of 13.

One of them took a few tablets of ecstasy and gulped down 3 bottles of cider. He came in totally pissed...and was so agitated, that he just couldn't even sit on the bed for even 5 sec! He managed to escaped from the ward and security found him sitting outside the hospital grounds asking people for cannabis?! Well, there is certainly no way to find cannabis around the hospital, so he was offered a cigarette instead.

Another drank abit too much of alcohol. Mum found him pissed. He was in fact urinating on himself....yuck! He came in just for observation....and the moment you said hello to him, he gave us all his middle finger! What character!

There was also a girl who refused to talk to anyone after having admitted after an overdose...she has alot of social issues...I pity the parents who were very sensible people.

Its a wonder that the age of 13 so many problems just arise. I remembered when I was 13, I was a goody two shoes in high school, trying to get used to the new school environment. I don't think I did anything naughty....hmm..well, in fact, I'm telling a lie...I think I attempted to escape from school a few times....hehe...

Oh well....without these kids...I think my night on calls would be pretty boring!

Strange Meat

I had dinner at a Mongolian restaurant, and boy, it was strange!

My friend and I walked in without knowing what to expect.....we soon found out that it was a buffet style restaurant. You choose your meat, add the sauces/powders/spices/oil available, pass it to the chef and he will fry it for you. Easy peesy.

Since it was after 7pm, we were entitled for a "full feast" that included a starter and a dessert. For starters, I ordered nothing too strange...the wild boar dumplings. The dumplings tasted pretty much like the usual "soi kow" back home but with a heavier porky taste. SzeLeng ordered crocodile bites?! yeah....crocodile. Boy, the meat was really tough!! It was chewy...nah...I didn't really like it.

Then for the meat selection, there was a wide variety to choose from. Eg, shark, springbok (an African gazelle), rabbit, venison, beef, lamb, zebra, kangaroo and etc. Where do they get the supply of such meat? Well, the springbok, crocodile, zebra and kangaroo were apparently culled from an African safari.

I was trying to be adventurous, so I pulled out my guts and tried the springbok and shark. I couldn't bring myself to pick up the zebra or kangaroo meat....they were TOO strange! The shark tasted just like any other fish...hmm..something like the haddock or cod. The springbok on the other hand, was nearly similar to the venison or beef. But it certainly has its own distinctive taste! I'd added different sauces to the meat...and yes, lots of chilli powder just in case I find it difficult to eat. I am proud of myself, I did ok. =)

I guess it is a true Mongolian restaurant...because I remember watching the telly when I was a little girl about Mongolia...and they do eat strange meat. At the end of our feast, I was really filled up to the neck...I could not eat anymore meat....and we finished up with a slice of Mars Cheesecake and a banoffee pie. Just the right sweetie food to end a meal!

I wouldn't recommend this restaurant if you're not up to strange stuff...but it is no doubt a fun place to have a meal with friends as you can challenge each other to eat weird meat....and I guess the restaurant said it all, "It is not a place for the faint-hearted!"

Dragging Myself...

My night on calls start tonight for the next consecutive 7 days.

The beauty of working in a district hospital is the working hours tend to me more sociable. I remember working in the city hospital over the last year has been really busy. I do not get any days off except the weekends. However, I have gotten 2 days off since Wednesday in preparation for my nights! So I really shouldn't be complaining. I have been really spending my time with myself, my friends, and the shops! haha.

However, I still can't help myself but feel really lazy to go back to work. Oh well, I am sure this time next week I will be smiling as it would mark the end of my nights and the start of my holidays! Right ok. I need to shut up. Ohh....I can't wait till next Friday comes!

Zzzooommm....

It was my first time.
I have never ride on it before.
I went from A to Z within seconds...which was really quick!
It was the ultimate experience....possibly the one and only chance I'll ever have.

=)

I sat in an AUDI TT today!

Now what were you thinking?

Anyway, it was really cool. I thoroughly enjoyed my ride home after work today. My registrar offered to give me a lift as he knew I do not have a car. It was really kind of him. The Audi TT was super sleek and I felt so tiny sitting in the car. Unfortunately, as the seat was pretty low, I could not really see the road very well....the fact that I am short made it worse. I love the roaring sound of the engine....love the feeling of the car accelerating...

Everything inside the car looked UBER cool....boy, wished I had the money to buy this car! But guess I can't really think about buying one yet, as I have yet to sit for my driving test! The journey home from Wishaw to the West End of Glasgow normally takes about 30 minutes on a good day...with the Audi TT, it took merely 20 minutes!

Schleeppyy...

I looked at my rota last nite. My shift starts at 4 pm today. Nice.... I thought to myself, because it means that I could afford to sleep in this morning. But heck no! I have to attend a pharmacy teaching at 9 am today. It was compulsory for all.

So dutifully, I woke up at 5.30 a.m.....I just couldn't sleep anymore. I got ready and met Laura at 7.50 at her place, before we left together. She drove. Teaching started at 9.15, and it only lasted for a good 20 minutes.

All the effort just for a 20 minute teaching about prescribing in children. I am SO dedicated, eh? Even my consultant asked me what am I doing in the ward when I was meant to be starting at 4pm. Well, you know, Dr. H said that it is compulsory and attendance will be taken. I wasn't keen on disobeying Dr. H because he is known to be very academic and strict.....furthermore, he is my supervisor for the next 4 months. So I really do not want to be in his bad books.

I travelled all the way back home after the teaching. Since then, I have been getting increasingly sleepy and restless. I want to go back to bed, but was worried that I will miss my train later. So I have been doing nothing except reading the news and surfing the internet aimlessly....

oh...yes, I was also religiously waiting for the post to come in....and was disappointed that there wasn't any letter for me. Now its time to change back into my working clothes and get the train to work...

I'm Better Now...

My frustration over what happened a few days ago has subsided quite significantly. My friends have been really caring and helpful. Thank you guys, you know who you are!

I had a fulfilling dinner on Thursday night, followed by coffee and blueberry cheesecake on Friday evening. Eating is really therapeutic, trust me. It kept my mind off things for awhile.

I woke up early on Saturday morning. The day started off miserably with quite heavy rain (and this persisted all day!). Anyway, just about 9 a.m., I was surprised to hear someone at the door. It was the post, and he announced that he had a delivery for me. I was intrigued, you know, wondering who sent me a delivery. I looked at the white envelope after putting down my signature on the document. Guess what? It was my debit card! yay! Talk about being efficient....the bank is really good.

Having my debit card has taken off a big load off my shoulders. I was getting worried that I wouldn't have enough money to buy food, to travel up and down Wishaw, to pay my driving instructor, etc... Yeah, my debit card is a true lifesaver! =)

With my debit card in hand, I had lunch with SzeL, Hoon and Peter at Nandos. keke...yes...you can get Nandos here in glasgow. We sat in Nandos for quite awhile, and then decided to go for retail therapy! Again, this was very therapeutic! haha.

This morning I woke up feeling better...less frustration, less anger....just happier. However, after my driving lesson, I could feel my frustration building up again. I kept thinking about my photocard...Fingers-crossed that it will arrive before Thursday, otherwise I will have to change the test date. =(

Oh well, nothing I can do. Just have to hope for the best.

F**K Sake!

I have finally managed to get in touch with DVLA yesterday afternoon to enquire whether or not I could sit my test without a photocard. The answer was NO. However, as I did not lose the paper part of my provisional licence, therefore, I could apply for a photocard replacement via the telephone and pay 22 quid with either my debit/credit card.

Great! I do not even have a debit or credit card because that f**king idoit stole it. argghh!! So I told her that I would get back to her.

I am blessed to have really good friends...Laura, my colleague, has kindly offered to let me use her debit card for the payment. It would take 15 working days before I could get my photocard replacement. Looks like I would not be able to take my test, which will be held next next Tuesday! And this really really sucks!!!!

urgghh!!!! I am really frustrated but I know there is nothing I can do. This will be the 2nd time I change my driving test date. The 1st time was when I found out that I would be doing a night on-call prior to the test day, and I would not be able to make it on time for the the test in the morning. So I have changed it to an afternoon session....But looks like I have change it again, as I am not sure when exactly I will get my photocard and I do not wish to lose my fees.

I have tried to look for a different date. The next available one will be at the end of September! I can't wait that long, because as it is now, I am having difficult going home after doing an on-call.

F**k sake!!!

Idiot

My purse was stolen today. In fact, the thief was so brave to steal 3 of our purses....well, it was 4 of us....because I found out that my other colleague also had hers stolen!!

I mean...if you want to steal...just take all the money you want. I really do not care. But I would really appreciate it if you leave my cards behind. I have lost my credit cards, Switch card, Dorothy Perkins card, Malaysian IC and driving licence, and my Provisional UK driving licence!!!!!


ARRRRGGGGgghghhhhhhh!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

That bloody idiot thief! Well, I guess I shouldn't say idiot...I should praise that thief for having a clean sweep of money today.

We all left our bags in the doctor's room. The door is usually closed, but there isn't a lock for it. We had teaching in the morning for about 30 minutes, and then, proceeded to follow the consultant on the ward round. I guess that was when the theft occurred. I was getting my purse for lunch...and that's when I realised that it was GONE! =(

This is the first time I had my purse stolen. And I am really pissed off. It was a real hassle trying to cancel my cards. I phoned the Malaysian Embassy in London to find out how I could replace my IC and driving licence. The advisor said thatI should not worry about it, as long as I make a police report and send a copy of it to them. They will then send a letter to JPJ and JPN, and send me a letter too. All I need to do the next time I'm home is show the letter to these two departments and I would get my cards replaced.

The only other thing that worries me is my provisional UK driving licence. My driving test is due in 2 weeks and I haven't been able to get in contact with DVLA all afternoon. I really hope that they would be able to issue me with another one before I go for the test. Otherwise, I doubt I would be able to take the test! And I am really desperate to get a proper UK licence.

ARRGGHHHH...

It was such a shite day. I totally lost my mood to do anything all afternoon. The day didn't start off well either as it was a bloody massacre in the ward this morning. I spilled blood all over the place while trying to take blood samples from babies. Kids are NOT easy to bleed. And the method of bleeding is very different from adults. urggh...I am not liking it at the moment!

Well, I hope whoever that stole my purse will never get married, and all his/her kids will be born without a butt. (just as the Chinese saying goes "Sang zhai mo si fatt." That should teach that person a lesson.

911 dont make me wait ♫

I was looking through my mp3 collections and I came across this one. 911. I was their big fan when they first started. I was 15 at that time, and I remembered going to Sungai Wang to watch them perform this song with my classmate....and yeap, I suppose you can guess who I found really cute! =) The best thing is I still remember the lyrics to this song!!! hehe...amazing!

Useless

2 days in a row....

2 days failing to cannulate 2 tiny babies...

totally useless...that's me I'm talking about.

sigh...think babies are really difficult to insert IV cannulas in. Firstly, I can't even palpate a vein... Secondly, their veins are super duper fragile. Thirdly, I'm just incompetent!!

I pity the babies that I've tried multiple times to insert a cannula. They must be in pain, especially one of them (which I thought I was successful....Not!). Because I totally blew that poor baby's vein....I formed a big lump while trying to flush it. uurggghh!!

Luckily the parents are patient and understanding...and I felt bad asking the registrars to cannulate the babies...oh well, what can I do.

A Day of Feats...

I had my 1st dim sum since last year today!! hehe...It was an amazing feat to not eat it for such a long period of time... Had dim sum at a chinese restaurant not too far away from my place. I think the dish that I missed the most was the "Pei Tan Chook" (or Century egg porridge). And yes, I obviously ordered it. To my delight, the porridge from that restaurant was comparable to the one at the shop in Taman Connaught (my favourite dim sum shop). However, the crunchy crispy flour thing that you would normally mix together in the porridge was missing.

And then, there were the usual Siu Mai, Char Siu Pau, Chee Cheong Fun, War Tip, and a rather big plate of fried noodles. The Char Siu Pau wasn't that nice, because the filling did not taste like the ones at home...but guess, that will make do. The War Tip came in a massive size! It was quite nice. The noodles wasn't really tasty, but then again, since I haven't eaten it for ages, it was ok. I certainly did not realise that I have ordered too much....so CK and I took our time trying to finish up the remaining food. But heck, that is probably the only dim sum I'll eat for the rest of the year...so I didn't mind.

I also got to savour my 1st Tau Foo Fah for the year!! Yes, yet another amazing feat...keke. It was the perfect dessert to eat today as the weather in Glasgow was extremely miserable. I asked Helen, my housemate to try it, but she didn't really like it. She said the texture was too soft for her liking.

Oh....CK bought a pandan swiss roll cake from the chinese shop...and boy, it was superb! Very pandan-ny and not too sweet either.

My oh my....it was a day of nice food....this is life.

Stranger in A New Place

I have finished my year as a houseman or better known here as "Foundation Year 1" doc on the 31st of July. It has been a year full of bitter and sweet memories. I do not think that I would ever forget the feeling of stepping into a ward as a fresh graduate. It was SCARY. But, as time past by, I have learnt many things, learnt to work more efficiently, learnt to be a "paper work" machine, learnt to act as a "good vampire,"(I cannulated many patients and took their blood for tests), learnt to treat patients...etc..

There are times that I dreaded to go to work, times when I wished that I had a different job, and times when I wished that I had more time to sort out my chores. It was a year filled with cold sweats (when I do not know what to do), tears (when I was really angry with that bloody SHO), and laughter (as I enjoyed working with patients and my fellow colleagues). I felt really sad to leave my hospital, my comfort zone.

On 1st August, I started work in a brand new hospital as a "Foundation Year 2" or SHO in paediatrics. It was equally scary, but in a different way. This time I do have some experience, except that I have not done Paediatrics since I was a medical student, and it really intimidates me when someone calls me a SHO. I felt totally incompetent over the past few days. I do not know how to prescribe medications for the children, how to manage their conditions...etc...I was kinda starting of scratch again. sigh. I didn't know how to work the computer system either. I felt like a total Stranger! sigh.

Hopefully, with time, I would be able to build more confidence in myself. But I can say that I would surely not do paediatrics as a career.

Back From Holiday

I have been back since Saturday, but I just didn't have the chance to write anything here. My holiday was good fun. The weather wasn't that great, however, there was one full sunny day and the others were kind of scatterred rain and sun.

Cornwall is a beautiful place. Loads of beaches, rocky cliffs, gardens, etc. Oh, I also ate the ever famous "Cornish Pasty" (a steak pie) and ice-creams (lots & lots). =) So I really enjoyed myself, and it was a very relaxing holiday.....slept alot....which is just what I needed to rejuvenate myself after a long week of on-calls.

I'll let the pictures taken during my holiday speak for themselves.

The Giant Head @ The Lost Gardens of Heligans

The Eden Project

A Garden of Yellow Lillies

A Field of Purple Lavender

Spiky Flowers @ The Eden Project

Land's End (yeap, this marks the end of the land in England on the world map)

Land's End

Young girl at the edge of the cliff

At Tintagel Castle

A Peek Through The Wall of Tintagel Castle

Me & My Cornish Pasty

Scarecrow decorating the road signs @ Cornwall

Cornwall Here I Come!

I'm going off on holiday!! =D

I will be off to the sandy beaches of Cornwall....hope the weather will be sunny...or even if it is cloudy, I do not mind, as long as it does not rain. I know the weather has been pretty awful lately...THE WETTEST SUMMER ever!

So will update once I'm back.

Hope everyone will have a good week!

Hmmpphh!

On call over this weekend...and was hoping to leave work on time yesterday, but failed.

Someone loss her consciousness...I personally think that she has a TIA. But anyway, it wasn't so much the fact that I had to stay on to help her...it was a nurse that kind of annoyed me.

While I was sorting out this lady, a received a page from a different ward about a patient who was admitted with diabetic ketoacidosis. She said that she didn't know why the patient was prescribed with 10% dextrose, instead of the normal 5% one. And the patient's blood sugar level was now 29! Honestly, I did not know the answer to that...All I know was that the ward has a DKA protocol and we should follow it. But yeap, there isn't any 10% dextrose instruction on the protocol. So I told her to look in the notes to find out the reason for that or try giving the acute medical receiving ward a ring (patient was transferred from that ward, they would probably have a better idea about what's been going on). Her answer was, "I'm too busy...I can't phone them. But I'm worried about this patient."

Right...let me try to understand her sentence. You are too busy to give them a call, but yet you're worried?! hmm...If you are worried, you would be able to put other things aside, and phone....I told her that I was busy trying to review this lady who has lost her consciousness but will look into the matter once I'm done. She said, "He can't wait that long."

WHAT?! So he can't wait, but you still refused to phone the ward to find out...GREAT! So I told her to stop the infusions at the moment till I go to her ward.

She's a total arsehole! She really frustrated me. Hmmpphh!

Hay Fever

I couldn't sleep all of Monday night....well, I'm telling a lie. I slept for a few hours, woke up, slept again, woke up...etc.

I think it is probably peak summer time. Therefore pollen is at the max level. My eyes were so itchy yesterday night...I sneezed a few times, and my nose felt quite itchy. When I woke up at about 8 am, my throat felt weird again...like as though I was going to have another sore throat. My eyes were still rather itchy, and slighly watery. I "ahchoo-ed" a few more times...and I decided that I had enough. I took one tab of clarityn. I felt better throughout the day, otherwise I doubt I could even concentrate while being on-call.

I really do not like Hay Fever!!!

Paint My Love - Michael Learns To Rock

One of my favourite songs!

A Lovely Weekend

I had a very relaxing weekend!!

On Friday after work:
- Spent 30 minutes on the treadmill
- Dinner with SzeL

Spent Saturday in Glasgow City:
- Watched Harry Potter
- Shopping
- Dinner at Pancho Villa (the mexican food wasn't that great)
- Had coffee and soaked up the sun at George's Square
- Karaoke session at home. SzeL & I were singing hits from Michael Learns to Rock because my parents told me that they attended the band's concert at Genting Highlands. MLTR reminded me of my childhood days when they were so popular!

And today:
- I woke up really early to catch the first train to Ayr with SzeL
- Had scone + butter + jam at a garden under the sun
- Picnic at the beach in Ayr with strawberries, ice cream, orange juice
- Shopping, Again!
- Dinner at a nice pub

Whilst having my shower, I realised that the skin at my upper left arm is red! Must be the sun... hehe...but I do not mind...I love getting a tan....because I will become so fair again, once autumn begins in just a few more weeks.

=) It was a lovely weekend! Now I do not feel like going to work...but oh well....tomorrow is a bank holiday but I'm on-call ...so here's hoping that most of the population is away on holiday in a different country.....which means less admission to the hospital! =P (yeah, right!)

Adabracadabra!

That was how quick Sirius was killed in the latest Harry Potter movie, The Order of The Phoenix. I thought that he was killed too easily by just a wave of the wand and the word, "Adabracadabra!"

But, I thoroughly enjoyed the entire film. I felt that the movie was darker than the previous ones, which really made it far more exciting to watch. I loved the way the movie creators projected the character Dolores Umbridge....She was extremely pink! Helena Bonham Carter played her role really well!

Oh...yes....and the much talked about snogging scene. hehe...It was nothing! Just an innocent kiss under the mistletoe...keke. I guess it gave the movie a wee bit of a "oomph" eh?

*Eeeksss...he is back again!

Remember my previous post about being chased out of the ward by a patient who was violent? If you don't, please visit http://sawling.blogspot.com/2007/05/scariest-moment.html

Anyway, I went to work this morning and saw a familiar name on the board. I went over to the room to see if it was really who I thought it was....and OMG! It was HIM!!

He's back again in the hospital with ...yeap...alcohol related illness....

eekks...really scary to see hime again...he just looks just the same as before. Scary.

Deaths and more deaths....

Although the medical receiving unit is not as busy as during the winter months, I have seen so many deaths recently. And the main underlying cause of their death was alcohol.

Alcohol taken in moderate amounts is fine...but too much, can damage your liver. People with alcoholic liver disease (ALD) hold the season ticket into the hospital. We spent so much money and effort treating them, but they do not appreciate us. Once discharged, they are back to their drinking habits again. And the whole vicious cycle begins.

Just over the past 3 weeks, about more than 5 deaths have been due to ALD. One guy in particular was a frequent flyer into the hospital. He was admitted with haematemesis.....Again. He was so popular amongst us doctors that almost everyone in medicine knew who he was. Bleeding varices was his main problem. He got them banded in every single hospital admission, and once he got better, he insisted to sign himself out of the hospital. However, this time, he said that he does not want anything done to treat his condition. He died within 24 hours. He was only in his 30s. I guess he was tired of his illness.

It is a shame that those with ALD die that a very young age. For example, 3 women died recently, and all of them are between age 30-35, with children at home!! Shocking! I know it is pretty easy for me to say, "Stop drinking." But the thought that these people drink like there is no tomorrow without even considering about their children really disturbs me. Oh well, who am I to judge them eh?

Superb Tennis

Ahh..what a nice way to spend a Sunday in front of the telly.

It was a nail biting Wimbledon men singles final match today. I am so glad that I watched it. Nadal put up a fantastic fight against Fedex. I got the nerves when I watched them play....can't imagine if I were the player....I would probably die of anxiety! (erm...mind you, I can't even play tennis! I would be picking up the ball more than anything else!)

Glad I wasn't working over the weekend! tee hee hee....oooh....I can't wait till the next Wimbledon match 12 months later! =)

Giggling All The Way

Shrek 3 is great! I just watched it today...and I practically laughed throughout the entire movie.

You know, some movies that have sequels become boring. For example, Pirates of The Carribbean 3 really put me to sleep. But Shrek The Third...was simply amazing!

I love the cute donkey-dragon babies, ogre babies, puss in boots....hehe...highly recommended if anyone has not watched it yet.

Sniffly Snuffly

aaaa....aaaAAAa......AAAHhhhhCCCCCHHHHHhhhoooooooo


aaaaaaAAAAAHHHHCCCCHHHhhhooooooo


AAAAACCCCChhhhhhhooooooo


*sniff *sniff *sniff

Woke up this morning with THE most painful sorethroat I have ever had. It was so painful to even swallow some water. But I did it anyway, to try to soothe the throat.

Not too long after that, this sore throat changed into a runny nose. I was sneezing all day, my eyes were very watery, my nose was super duper itchy. I was feeling cold, but was sweating at the same time. The day was AWFUL!

=( I came home and had a very warm shower. It did not relieve my nose. I had a hot bowl of soup, and that seemed to have cleared up my nose.....but not for long.

AaHHHhcCchhhooo....

There goes my nose again. I'm going to sleep now...and maybe swallow an antihistamine to reduce the itchiness. My eyes are so watery...I could hardly keep them open. So good nite ppl.

Raindrops Keep Falling on My Head

Raindrops keep falling on my head
But that doesnt mean my eyes will soon be turnin red
Cryings not for me
Cause I'm never gonna stop the rain by complainin
Because I'm free
Nothings worrying me.


The summer is so SOOO WET!? When I go to work, raindrops fall on my head, and when I walk back home from work, raindrops fall again. Raindrops KEEP falling on my head!!!

It is already July, and half the summer is gone. I have not seen the bright sunshine for ages....this is not summer...the weather seems to resemble autumn (although the temperature is definitely warmer).

The lyrics above is correct. I can never stop the rain by complaining. hmm...I'm not too sure about the "because I'm free and nothings worrying me" part. Heck, I am a busy woman....and yes....plenty things are worrying me.

hmm...for eg, I'm worried that I'll be blown into bits while riding on the subway/train. I'm worried that I won't be able to pass my practical driving test. I'm worried that I would not be able to treat kids when I start my paediatric rotation next month. I'm worried that I won't be able to wake up tomorrow morning on time (shh...did i mention that I slept in on Monday?! but I was safe...was only 5 mins late...keke) Oh boy....there are plenty things to worry about!

Right. Please forgive me for this totally random blogging.

I am in Love

Yes! I have fallen in love.

It's been a long time since I've felt like this. He is super hot.

I couldn't take my eyes of him.

His smile just melts my heart. His eyes are beautiful. As I watched him, I just wished I could give him a big huggie.

Oh...I have fallen in love....

...fallen so deep in love....

with Jude Law! =P


keke.....I know this sounds really daft. But Jude Law has always been my favourite actor.... and after having watched him in "The Holiday" just now on DVD, this fact still stands.

Another Day

It's my 6th day of being on-call today...very night when I reach home about midnite, I feel very hungry. I would eat something and then fall alseep in front of the telly. Simply knackered. Unsurprisingly, it has been busy....and I have reached the stage where I really could not be bothered to do anything...but I got no choice. Every morning when I wake up, I would tell myself, "It's just another day." To make matters worse, its Wimbledon time...and I wish I could stay at home and watch Federer or Rafael play tennis.....but nope....have to go to work! Sigh....hope the weekend will be peaceful for me.

I Wonder

The whole event yesterday magnified. Luckily I did explain to my senior what happened last night, because at 9.30 am today, the bloody SHO called up my senior to complain. She complained that there wasn't any medical review for many days. Apparently, medics were supposed to review the patient daily. But heck, we are no psychic....we wouldn't know that you wanted the review daily unless you tell us so. Everyone agree?

To make matters worse, the plastics consultant phoned my senior to ask what the hell was going on. Anyhow, my SHO was right, if they want to be anal about everything, let them be. As professionals, we need to be as polite as we can...and that would make them ashamed of themselves.

I couldn't help but also feel that the whole thing must have been sparked by me. I wondered whether I did the wrong thing. I wondered whether if I had been more polite to her the whole event would not be as complicated as it is now. I wonder.

And So I Cried

Have any of you felt so angry that you cried? Well, I ended up in tears today after work.

At about 5.30pm, I was still in my own ward trying to sort out an ascitic tap and pleural aspiration, when a SHO from plastics phoned the ward. She asked to speak to one of the medical staff. So, I answered the call. The SHO asked me to review one of the patients in her ward who was going for a skin graft tomorrow. I told her that all my seniors have left the building (it is already 5.30pm!). She insisted that someone needs to see the patient to decide whether or not this patient is medically fit enough for his skin graft, and whether or not he requires a blood transfusion. The patient was last seen 2 days ago by my consultant.

As far as I know, I have only met this patient once, because he was transferred to plastics for management of his skin infection the following day. I do not know what has been happening to him after that. I am aware that this patient is being cared by both the plastics and medical team.

I informed the SHO that I am only the junior house officer and if she wanted a senior review, she would need to page the on-call medical SHO. She cheekily said, "You have to page the SHO, because I do not know this patient that well." hmm....excuse me? Aren't you the person who is going to perform the surgery on this patient? "Well, to be honest, I do not know him very well either. I have only met him once, and I do not know of his progress thus far," I answered. Again, she insisted that I should page the on-call SHO to review the patient. "Right ok," was my answer.

2 hours later.....after I have sorted my ward out, I decided that it is not appropriate to contact the medical SHO on-call, as he totally does not know the patient...and by right, it should be my seniors that review the patient. So I thought I would just pop up into the ward to find out what the main issues were with the patient and if possible, try to sort them out.

At the ward, I looked into the patients notes and found that someone has spoken to the medical SHO about the patient, and a plan was in place. The patient was to get his 2 units of blood transfusion. So I told the nurses that they should proceed with the plan. And just as I was about to leave, the telephone in the ward rang, and it was the plastics SHO on the phone. She asked to speak to me.

"Right, first I was told this patient was for a transfusion. Then, someone told me that patient is NOT for a transfusion, and now you're telling me that patient should get the transfusion. So which one is it?" said the SHO.

"I do not see anywhere in the notes that stated that patient is not for a transfusion...so it would be wise to follow what the medical SHO has written down, ie, to transfuse."

"Right ok. You medical people always see the patient and do not do anything for them."

"If you are not happy with our treatment, please speak to the consultant about it."

"Now, can you crossmatch this patient then?"

"Err...no."

"Well, this patient has joint care and I am NOT your house officer. You do not need to ask the nurses to phone me up and ask me to crossmatch the patient."

"Neither am I your house officer. I never did ask the nurses to contact you about that. They did it themselves.."

"Fine. But I am totally swamped...so busy. You have to crossmatch the patient. You medics just leave everything for us to do."

"But the patient is in your own ward?! You wanted to know whether you can transfuse him...and I said ok. And now you want me to send a crossmatch sample?"

The SHO kept ranting away about how taking the blood sample is my job and releasing her anger at me. She was bloody rude. You know, she is on-call...and I am not. Why do I have to do her jobs?!

At the end, I know I was losing the battle, and I just said, "Fine ok," and slammed the phone down even before she could say anything further. I told myself to take a deep breathe and just take the blood sample at 7.45 pm!

After that, I left the ward....and mumbled to myself, "Fucking bitch." I felt so angry at the way she spoke to me, trying to sound all high n mighty and so bloody cheeky!!! I was very angry until I cried. It wasn't so much that she was being rude to me...it was more of the fact that she was just being so unfair.

Favourite Food

I've been sleeping all night long...had a splitting headache all day yesterday. It was awful. Dunno why...but I will blame the warm weather mixed with chilly spells as the culprit. Lucky that the headache is away now.

Anyway, yes, favourite food. I would say my ALL time favourite would be the one and only nasi lemak. =) The simpler the nasi lemak, the more delicious it is. I do not mind eating just the sambal and the nasi...yum yum. Crazy eh?

I know I can prepare this dish myself, but I can never make the sambal like the ones sold at the market back home.....sigh (makes think about the delicious spicy nasi lemak that mum usually buys from the market at home!). I remembered the last time I went home, which was during CNY, all I ever ate nearly every morning was, yeap, nasi lemak! hehe. (Think my arteries are probably 50% blocked after that trip!)

hmm...besides nasi lemak, I do enjoy asam laksa, maggi mee goreng (especially the one at Steven's Corner) and dim sum. =) Now, I am REALLY homesick.

Michael Buble - Home

All of a sudden....I feel very homesick and feel like going home....hence the song. Enjoy people!

A Big THANK YOU & HUGS

Thank you all my dear friends for your birthday wishes.
Those of you who called from Singapore/Malaysia....I am thrilled & happy to have received your calls today.

Thank you to Laura & George, for the lovely dinner tonight.

Thank you all for the presents. I really loved them all.

Thank you to my nurses and fellow colleagues at the hospital for your warm wishes.

I had an amazing day. I couldn't help smiling all day. I felt really blessed and lucky to have known people like all of you out there.

Believe it or not, my patients bought me a birthday present today! It was a box of celebration chocolates and a birthday card....aww....it was really sweet of the 3 of you.Thank you.

Thank you. CK for the cocktail shaker....will try to practise my cocktail making skills! =)

Thank you Green Pea for the lovely present...I do like it alot. In fact, I have put it on for 2 days dy. hehe.

Thank you. Helen for the birthday balloons that you put up on my door today....I am really surprised to see them when I came home!

Thank you SzeLeng & GeakPoh for the lovely dinner last week, and the wonderful presents as well.

Whoever I have missed out, you know who you are, and I thank you once again.

A quarter of a century old....what the heck. Life only just started. =D

A BIIIGGG HUG for all of you! Cheers!!

Happy Birthday to Me!

Happy birthday to me
Happy birthday to me
Happy birthday to sawling
Happy birthday to me!

How does it feel like being quarter of a century old? Just the same.

Now, back to my "birthday pledge," which I made in May. Lets go through them one by one.

1. NO more chocolates from now.
Failed miserably.

2. RUN 3 km in 30 minutes effortlessly.
Yes, I did it!

3. STOP ranting about the daily happenings in life.
Probably ranting less, but I STILL rant.

4. EAT more heathily.
I am trying my best, trust me.

5. SMILE more. Frown less.
Did ok.

6. READ 3 books.
Now, I read half of The Da Vinci Code, and about 2-3 mags. Does that count? Can la...I can bend my own rules. keke.

7. LOSE some weight.
Failed miserably too.

8.GO wall-climbing.
No one to go with. So didn't attempt it.


So...guess it wasn't quite successful, but oh well, nevermind. It was just for fun. Quite sleepy now....going to bed....but at the same time, I wanna stay up for longer on my birthday, because it is only once a year I get to celebrate me. keke =P

Plans for the day? NONE. I am planning to sit at home and chill.

M.O.N.D.A.Y. again.....

Monday. Never liked Mondays. Something normally happens on a Monday.

What happened today?

1. Well, to start with, the ward round took ages! It didn't finish till about 12pm, and it wasn't finished at that time. There were still 2 more to be seen.

2. Tried to get in contact with the person on-call for a specialty, but no one answered the page. Finally, I managed to speak to the person after like 5 pages!

3. An awful cardiac arrest occured in the ward opposite mine. I heard the emergency buzzer and went across. I knew something wasn't right the moment I saw the nurse pushingthe cardiac arrest trolley. Arrest, yes, that can occur to any patients in the ward. But it was a visitor that actually arrested! She didn't make it in the end. Her mum, who was sick patient, was devastated. (Imagine, we had to get the mum out of her bed, so that her daughter can be resuscitated!!! Awful!)

4. An emergency admission from the diabetes clinic at 5pm?! Arggh....I mean I could, of course, let the person who is on-call from 5pm onwards to sort that patient out, but that would be pretty irresponsible, I think.

5. My friend was being pretty nippy to me today, dunno for what reasons...probably because she's been nipped at by the sister in her ward. But hey, do not need to lash it out on other people ok?

hmm...can't remember what else happened today. But it wasn't till nearly 7pm before I left the hospital. Cooked something really different tonight: aubergines, spinach, asparagus, chicken with salsa sauce?! How weird is that? Oh well, need to start doing some work. *yawn

Hello Miss Sunshine!

Sunny sunny sunny!

I really needed the sun. I soaked myself under the hot sunshine today. It sort of lifted up my spirts a wee bit. Now, what did I do today? Ah yes, I treated myself by making a trip to the hair saloon. Finally, after months, I got my hair cut today. My head feels so much lighter. =)

With my new hair cut, I decided to head to town for some retail therapy (and to show off my new style-lah! =P). It wasn't like I bought anything. haha... I'm telling a lie. I bought a book by Mark Haddon (the writer of The Curious Incident of the Dog) and a pair of shorts. hehe. By the end of the day, I was actually sweating because the sun was burning, but I didn't care. You do not get such nice weather in Glasgow that often. Oh, I managed to eat an ice-cream too! It was my first time eating an ice-cream from the Skinny Cow range....and it was hell of a yummy low fat lolly!

I spent the whole day by myself. hmm...pathetic I know, but I actually enjoyed it. Having said that, I did not speak to anyone except to the cashiers and the hairdresser. I couldn't get hold of any friends....but its ok, peacefulness is a bliss. (damn it, hmm...I think I am not making sense here....ah well.)

Fed Up

Yes. I am fed up.

I know I am at the very bottom of the pyramid....but that doesn't mean I can pushed about.

Senior: Now why are there 6 patients for me to see and no one around to discuss the case with me?

Me: That's why I am here. (duh!)

Me: This patient is query for a CABG.
Senior: I do not know if this patient needs a CABG. Why are you asking me?

Me: This patient is query for a pacemaker insertion.
Senior: I do not know if this patient needs a pacemaker. I DON'T KNOW. (and threw the notes on to the trolley).

Now, what is the point of being a cardiology SHO3 if you do not know a single thing! Look, I know you are very busy, cardiology is short of staff, you have sick patients, but you know, there is NO excuse for you to be rude to other people.

Me: I have managed to get IV access in this patient. He really needs his IV fluid + potassium because his potassium is very low.
Nurse: Oh right. Ok.

.........4 hours later, IVs were not up yet. But as she was about to do it......

N: Oh dear, I was just about to put his IVs up, but he pulled the venflon out.
Me: Right. (at the same time thinking to myself, it should be up a loong time ago)
N: Would you mind putting another one in?
Me: Right ok. (I do not have a choice do I? I know you are busy...but you still managed to get your 2 tea breaks for the day...and what I was doing? Sorting out the whole ward all day without any food!)

N: Dr, this patient is query a UTI. I have not been able to send off a urine sample for culture.
Me: Well, try your best to get a sample.
N: Do you want to start him on antibiotics?
Me: He is already on it.
N: No he isnt.
Me: Yes he is. Let me show you.
N: Ahhh right...I see it now.

(arrghh....irritating!)

=D

I walked into the ward this morning looking straight at the bed where P was located.

I smiled from ear to ear the moment I saw him. He was sitting up having his breakfast, without any oxygen mask on. When I approached him, he even waved his hand at me and smiled. I was so relieved and overjoyed to see him well. =D He told me he was feeling GREAT! hehe.

I quickly walked into the doctor's room to announce to my seniors that P was still alive. We were all very happy that we have managed to treat him. =D

Today was a ok day. I finished work at about 6 pm and decided to walk home from work because the sun was just fantastic. I had made dinner plans with my friends, SzeLeng and Geak Poh. We had dinner at "The Two Fat Ladies." I have to say, although the food was abit pricey, it was really really good. We opened a bottle of white wine and sat down to chat for quite awhile. It was really nice.


Tonight was actually a pre-birthday dinner, as SzeLeng put it. hehe. Geak Poh bought me a box of chocolates and Sze Leng got me a really nice bag! In fact, it was a bag that I have been eyeing for quite sometime now. =) After the main course, we had a cup of coffee each. All of a sudden, the lights in the restaurant dimmed. I thought that the electricity supply has cut off or something. Then, the waitress who has been serving us started to walk towards our table with a light source behind a piece of paper. I thought she was holding a candle behind the paper to kind of brighten up our table. But to my surprise, a birthday cake was hidden behind the paper!!!

She said, "I heard it is someone's birthday today. So here is the cake. I would have sang a song for you but I really can't sing." I was really surprised. Speechless. Happy. Touched. Geak Poh bought me the cake. As the birthday gal, I made a wish and blew the candles. It was a sponge cake....yummy.

At the end of the day, I must be the happiest gal on earth. Glad to have great friends and they really cheered me up. =) Thank you guys....really appreciate it! Hugs to all of you!!!!

Depressing Day

AAAAAAaaaaaHHHHHHhhhhhhhh.......................


AAAAAAAAAAAAaaaaaaaaaahhhhhhhHHHHHHHHHHHHHHHHH..............................


Ok. Shut up Saw Ling.

I am feeling kind of ....errmm... dunno what word to use.... depressed? in a daze?

I dunno. Again, it is one of those days, in which I felt crap.

This is pretty weird, considering that I did not feel like that for patients in the gastro ward. Probably because I think most of their illnesses are self-inflicted. But in this cardio/endocrine/general medicine ward, it is really sad seeing people die in front of my eyes.

Today was a very great example. The events were as follows:

13:00 I inserted an IV cannula into P to prep him for his CT scan.

14:00 ATSP re: funny turn. P is known to have absence seizures and has diet-controlled diabetes. He was fasted from morning for a CT scan. When I approached him, he was acutely confused (he wasn't like that before). His vital signs were normal, and blood sugar level was 4.6. He seemed to be having a tiny seizure. Although I know that it is not THAT low, I decided that maybe I should pump some glucose into him, since he was fasted.

15:00 Patient's BM better, but he was more agitated. Whenever I asked if he was alright, he said, "Ok. Ok," and made funny lip-smacking sound. He was trying to climb out of bed. I thought this was weird. And decided to give him a tiny dose of lorazepam to calm him down.

15:30 Asked by the nurse to seem him again. This time P's face was purple. His oxygen saturations dropped to 83%. I started him on trauma mask and this only pushed his sats to about 92%. He became tachycardic, and an ECG showed ST depression on leads V4-V6, which were not present before. His chest sounded horrible and I thought he was in acute pulmonary oedema. I gave him a bolus of 80mg furosemide and he did get some diuresis from it. He was also in respiratory acidosis. I felt that I was out of depth. Because whatever I was doing obviously wasn't working. I tried to call my seniors, but the operator kept giving me the wrong page numbers. Finally, I got hold of my registrar, and he came in no time. He started P on a GTN infusion. When I left, P's condition was generally deteriorating. I think he is not going to make through tonight.


I find it really disturbing how a patient can just be so unwell within an hour or so. The fact that P was actually complaining to me about why he needed to be fasted for the scan, and how fed-up he was with hospitals, made this event a shocking and depressing experience. It is times like this that made me feel that I should not be a doctor. I feel depressed seeing him so blue and grey....sigh. =(

No Connection

*sob *sob *sob

My wireless is not functioning!!! It was working fine on Monday night. Then all of a sudden, I lost my connection..... and since then, I can't get it back. I have tried reinstalling the whole router, but it didn't work. How?!

Looks like I might need to ask them to pull the connection into my room....arrghh....

Really can't live without my internet...I mean I can connect my PC directly to the modem. But this means that I can't use my PC in my room. This is not good at all, considering that I need to complete some online stuff this weekend!!! =(

I will try to sort it out tonight again. Wish me luck.

ps. note that I'm writing this from the pc in the doc's room. keke. (hiding away from tonnes of job in the ward).....

Delirium in The Morning!

I woke up this morning at 5.30 am with confusion.

What day is it today?
Is it Saturday or Sunday?
Am I supposed to go to work today?

Those 3 questions rang in my head early this morning. I sat up almost immediately the moment I opened my eyes. I looked right at the clock and felt slightly relieved that it was still early. My heart was pounding from the sudden burst of consciousness.

It took me about 2-3 minutes before I worked out that I have been working over the weekend and it is a Monday. Pathetic I would say.

...

Its past midnight, ie, it is early Monday morning.

My eyes are weary, my calves are aching, the soles of my feet are burning......

Tired. You know, sometimes you are so tired that you just can't fall asleep? Bizzare.

And I hate Mondays......time to go to bed. And have to be back at the hospital in less than 8 hours.

=(

I think I am maybe too emotionally attached to my patients. But, I am only human, and as a human, you cannot control your feelings towards a person. At least that is what I think.

I have been with this particular patient of mine for nearly 4 weeks now. When I first got to know him, he was a chirpy lovely elderly man who was being investigated for a "lesion" in his liver. And as probably expected, this so-called lesion turned out to be HCC (hepatocellular carcinoma). Throughout these few weeks, I have to say, he was gradually deteriorating. Day by day, he was becoming more lethargic, less talkative and totally lost his appetite. I guess that is just how fast cancer can overwhelm a person. Whenever you asked him how he was doing, he would say, "I am brand new, dear. I feel fine, my dear. Just do whatever you need to do dear. I do not mind at all."

Today, for the first time, I saw him in tears. He was in extreme pain from his liver, and experiencing bad diaphragmatic irritation, which caused him to have recurrent hiccups. Even then, when I asked him how he was, he told me he was ok. When I saw him like that, I couldn't help to feel so sorry for him. Things weren't better when his family members (who are all lovely people) were there with him. His wife had to leave the ward as she was devastated by the sight of his suffering.

Tears began welling up in my eyes. But I told myself that I should not cry. I know that he doesn't have much time left to live, as even the gastro consultant, who specialises in liver, thought that he was not fit enough for any treatment. At the moment, we are just trying to provide symptomatic relief. Poor man. God bless him.

I do not think I can work in palliative care. I would be really emotionally attached to my patients...and I would probably be frustrated most times. =(

Macam-macam

Think this is my first post with a BM heading. These few days can be summarised as "macam-macam." Few pretty random/strange/ things happened.

1. A patient didn't get his MRI neck done. Why? The reason was "Oh, we only do MRI neck on Mondays, and since it was a Bank Holiday, patient has to wait till next week." Now...patient has already been waiting for more than 1 week for this MRI....and now he has to wait further. Great! Because of the delay in this scan, patient's transfer to rehab was delayed....and this is not good at all.

2. A patient has been pretty abusive, both physically and verbally, to the nurses and other members of the medical team. I was given the 'fun' job of accompanying him down for a CT scan, just in case he needed sedation to calm him down. At the radiology department, patient was reluctant to speak to anyone. I had to answer on his behalf. When he was asked to put his hands down by his sides, he refused to do it. But when I asked him to do it, he listened! Basically, he was listening to me. Today, he was really breathless and refused to use the nebuliser. However, when I went into his room and asked him to use it, he agreed.

hmmm...I felt really rewarded by the fact that the patient was actually listening to my advice.

3. A colleague of mine just can't stop crying all day on Tuesday. It wasn't like she was having a rough day....but I think she was being too hard on herself. She was upset about the fact that she had 7 discharge prescriptions to fill in. She was crying about a missing CSF sample. She was in tears about an urgent echo. I did not know how to console her, but I tried anyway..... Today, she again told me that she felt like crying! And I was like, "Crying will not help you solve the matter." I did not mean it in a harsh manner, but I really felt that I need to make her realise that crying is not going to make the situation any better.

4. "OUUUCCHHH!! YOU CRUEL BITCH! You like hurting people don't you?" shouted an elderly lady to me as I took some blood samples from her. I blushed as expected. I didn't mind her calling me that and it was really funny.

5. Consultant asked me, "Ling, have you seen the flat that I am planning to buy? It is off X street." "Oh ok...sure let's have a look, " I said. "Oh, you'll be my neighbour then. I live at Y street. Whoa, that is a really nice and beautiful flat." "Guess how much is it?" asked the consultant again. "Don't know." "It is about 400 thousand pounds." "Oh, that is quite pricey, considering that I am only paying 240 for my rent a month." I felt the whole conversation really awkward, because, I have seriously, never met a consultant who would share these things with me.

There you go. 5 rather random or unusual things that happened over the past couple of days.

Diagnosis Wenckebach

Check this out! My friend, Saw Sian, who just graduated with distinction from med school, sent me the link to this awesome video.

Congratulations to you gal! =) Proud to have a friend like you.

Anyway, this video is hilarious and creative. Will never approach Mobitz Type I or Wenckebach the same way again! =)

YYyyaawwwwnnnn..................

MmmmhHHHhhmmmmmmm

*yyyaawwwnnnnnnn

Sigh.

I am exhausted. The past week has been really busy except on Thursday. A few sick patients on the ward, one ended up in CCU. Another patient has worsening kidney function, and is extremely septic....he is brewing bacteria in his urine, and blood. The only antibiotics that the bacteria is sensitive to are gentamicin and tazocin. We really have to keep a close eye on his kidneys. So everyday, I will have to speak to the pharmacist and the microbiologist about what is best to do. It doesn't get any easier, especially when both of them have conflicting opinions.

Friday wasn't particularly busy. But I had to escort a patient down for a CT scan, just in case I need to sedate him for the procedure. Strangely, the patient was very cooperative and he was really not abusive at all! (I got a bruise on my arm last week because of him). I spent nearly an hour at the radiology department. When I arrived back at the ward, so many other things had to be sorted out. I had to speak to a patient and his family about his liver biopsy result. Informing them the result was quite scary, I have to say. I had to recompose myself and think about what I was going to say and how I was going to do it. There was a huge group of them, all very anxious to know of the result. Unfortunately, the result wasn't a good one. =(

I left work at a ridiculous time of 7.30 pm (everyday except Thurs)!! 2 and a half hours later!!!!! I know, I know, lots of other doctors back home work longer than me...but over here, finishing 2 hours later is against the law. haha.

Finishing late + eating crap + half spring/summer weather = intermittent GI disturbance + hay fever + watery eyes + exhaustion. Believe it or not, I fell asleep halfway through Pirates of The Carribean 3! (ssshhh!!! But I have to say the show was quite boring and too long).

I felt like shit on Friday. I had to cancel my trip down to Ayr to visit SzeLeng.

Now it is Sunday......arrghh....will be on call for the next 7 days. Great!

Bad Practice

I HAVE NEVER SEEN AN ULTRASOUND GUIDED LIVER BIOPSY.

Now, is there any point in me asking for consent from one of my patients who was scheduled to go for it on Tuesday morning??!

Who is the person performing the procedure?
The radiologist.

Who insisted that the patient needs to be consented in the ward before going for the procedure?
The radiologist.

This is what the GMC Good Medical Practice said about the issue of "Consent:"

If you are the doctor providing treatment or undertaking an investigation, it is your responsibility to discuss it with the patient and obtain consent, as you will have a comprehensive understanding of the procedure or treatment, how it is carried out, and the risks attached to it. Where this is not practicable, you may delegate these tasks provided you ensure that the person to whom you delegate:

• is suitably trained and qualified;
• has sufficient knowledge of the proposed investigation or treatment, and understands the risks involved

I AM suitably trained and qualified.

However, I am NOT the person undertaking the investigation.

I DO NOT have sufficient knowledge of the procedure, or how it is carried out and the risks (I know a few points...but not completely).

And it is never "not practicable" for the radiologist to obtain the patient's consent.

So tell me, why do I need to be the person consenting this patient? I have explained it to the radiologist himself, and the answer I got was, "Patient NEEDS to be consented before he leaves the ward. If you are not able to do it, get someone more senior than yourself. Otherwise, if I do not see the consent form signed, I will not do the procedure."

That is absolute pish! wtF?!

Even my SHO has not seen the procedure and she definitely was not happy to consent the patient. No one any more senior than myself was in the ward. Therefore, at that time, I had to consent the patient myself. I do not have any other choice. At the end of the day, if patient didn't get his investigation done, I will the one blamed.

It is totally illegal and it just shows super duper bad medical practice. And the radiologist just wanted things to go easy for him, ie, send the patient down, do procedure, and send patient back up to the ward. I know time is a factor, but it should never prevent anyone from abiding good medical practice. Anyone beg to differ??

What A B****H

One of my patients was meant to attend his EMG on Friday 10 am at a different hospital. However, there was a problem with his transport on Friday. Apparently I was informed by the ambulance that it was booked for 2pm not 10 am. Miscommunication!!!!

Anyway, the patient's EMG was rescheduled today at 2pm. And I wrote in the notes, "Patient's EMG has been rearranged for Monday 2pm. Pls arrange transport for the patient to ensure he doesn't miss this appointment again. Thank you."


Here is my conversation with her:

Sister: This patient can't go for his EMG. I can't get transport for him.

Me: He has to go. Can't we even get a taxi for him?

Sister: We have to send a nurse escort with him...we cannae do that cause we are short of staff.

Me: Alright. Well, just try and see what you can get.

Sister: It is at 10 am right?

Me: No...it is at 2pm...I wrote it clearly in the notes.

Sister: Ok.


Time now is 12pm.

Me: Sister, did you manage to arrange transport for him?

Sister: It is not our fault that he didn't go for his EMG on Friday.

Me: I never said it was your fault. There was miscommunication somewhere.

Sister: Fine.

...........silence. She didn't speak to me after that until she met me at the stairs when she was about to go home. Correct me if I am wrong, but did I even blame her for patient's missed appointment?

What a *toot!*

Bad Start, Bad Finish

*phew

What a day man! And I went to work today thinking that I would be able to finish on time. Wishful thinking indeed.

Had a bad start in the morning. I felt extremely guilty for what happened. It all began with the sister asking whether a patient, with poor renal function, needed to be given a drug that would protect his kidneys prior to his angiogram. To be honest, the cardiologist has seen the patient multiple times before this, and they are well aware of the patient's bad kidneys. So if they thought that the angio was going to bring more harm to his kidneys, they would have decided on a different investigation. Therefore, I told the sister that, "Yes, patient is going for his angio. Cardiologist didnt give me specific instructions about giving that drug to protect his kidneys."

Sister wasn't really happy with my answer. Then, my consultant to the ward came in, and the sister immediately approached him and said, "I spoke to the resident about this patient's poor kidney function. She said we do not need to do anything about it and just send the patient down for the angio." The consultant himself wasn't sure whether or not we should be giving any kidney protective drugs, and suggested that we contact the cardiologist about it. I couldn't get hold of him, so I left a message with his nurses, who advised to leave the patient in the ward first until the cardiologist gives the green light to proceed. After another 20 minutes, I finally managed to get hold of the cardiologist, and he wasn't too concerned about the patient's creatinine of 320. Off the patient went for the angio.

It was a total chaos during the whole event. Because, patient was transferred from bed to trolley. Patient was then transferred from the trolley to the bed when the nurse advised to keep the patient in the ward first. Then, once green light was given, patient was moved from his bed to the trolley again! Imagine the total chaos! I have to say I felt totally responsible for it. It totally ruined my thought process for the whole day. I apologised to the nurses for the chaos and also to the sister. She wasn't happy at all. And finally, when I met my consultant again later in the afternoon, I told him that I was really sorry about the event this morning. He said I shouldn't put the blame on myself because, really, the person who is going to do the angio should be responsible for the patient's kidneys. Oh well.

The day went on alright after that. However, about 4pm, an arranged admission arrived....and he wasn't the easiet patient to clerk in. The only information I have about the patient was a sheet of clinic letter. Patient himself was quite vague about the reason for his admission. Then at about 5 pm, a patient of mine went into acute urinary retention. I tried to pass the catheter twice, but no urine was obtained. Instead, bright red thick blood came out from the catheter. I was concerned that he might have clot retention in his bladder. I phoned the urologist on-call, and only about an hour later she arrived. As expected, she shoved a big rigid catheter into that patient, and out came 2 litres of urine!

At the same time, another patient became very septic...and so I had to sort him out. It was only at about 7pm that I managed to print out my blood request forms for the weekend. I left the hospital at 7.30pm! =( I was hungry, tired and slightly frustrated. So SzeLeng had to bear with my rants all night! haha.

So it was a bad start to the day, and undoubtedly, a bad finish too....sigh. Just glad it's Friday!

Don't Write Me Off - Hugh Grant

Finally, I've found this song... the nicest part of the movie, Music and Lyrics.

Kept My Cool

Doctor, doctor, come here now.
Doctor, when will I be going home?

You have to wait for the liver doctors to see you first before you can go.

Ok. When will that be?

I have contacted them yesterday, and she told me she'll see you today, some point in the afternoon.

Right ok. Will I be going home then?

Erm...that doctor will decide whether or not you can go home.


1 hour later...

Doctor, doctor, can I have a word with you?

Yes. What can I do for you?

When will that liver doctor see me?

As I said, some point in the afternoon....I do not really know.

So, will I be going home then?

It is their decision.


30 minutes later......

Doctor, come here.

Yes.

Can you chase that doctor up?

Well, I will phone them if they do not come by 3 pm ok?

But doctor, today is my birthday, and I want to get out from the hospital.

Happy birthday. I know you would like to get discharged, but it is not me who decides that.

Will you ask them to see me?

Yes. The liver doctor said she'll see you today.



Trust me...this went on and on for the whole day! It was nearly every hour that he kept asking me the same questions over and over again. Honestly, I was quite tired of answering him and being polite. But I can't be rude to him either. So I kept my cool ....until I reached home, when I started to rant away to my housemate.

Oh dear, I know...ranting AGAIN! It's addictive!

Need to Split Myself

Monday. Never liked Mondays unless it falls on a public holiday.

I was really busy today. Wished I could split my body into 2, so that one part of me joins the the consultant ward round, and the other half joins the registrar round. However, life is never simple...and you can never divide yourself into 2 seperate bodies. So, that's why, I ended up being busy. There were a few phone calls to make, bloods to take, scans to request...which really, weren't too bad. Having said that, I ended up staying late because there were a few sickies and at about 5.30 pm, my consultant approached me and said, "This man is sick. I need you to do these things. But, you do not have to do it, just hand it over to the on-call JHO."

Well, if I was being unkind, I would have handed over the task. However, I put myself into the on-call JHO's shoes. And if I were handed over these things.....I would not be impressed at all! So, i decided that I should just quickly do them all, and just ask the on-call person to chase up the results and review the x-rays.

As expected, the longer you stay in the ward, the more jobs you end up doing, which was the case this evening. The nurses kept asking me to do a few things or ask me to see a certain patient, until the extent that I told them, please do not ask me anymore!!! Otherwise, I would be stuck there till 9!

Sigh. Tired....didnt really sleep much. Off to bed soon.

Damn it...I can't stop thinking about the things I need to do in the morning in the ward.

hmm...think the first thing I should do is bleed that man.....then, insert a iv cannula, followed by a synacthen test...etc...oh yes...chase results....argh....

Stop....shut my mind up!

Raining on Sunday - Keith Urban

Keith Urban is one of my fav singers. Absolutely love this song!

My Birthday Pledge

Its just about over 4 weeks before I become a quarter of a century old =(
I know....QUARTER of a CENTURY?! Over these past 2-3 years, time really flew past so quickly. Anyway, since I have lived nearly 25 years of my life, I decided that I need to set a few goals that I MUST achieve before my birthday.

1. NO more chocolates from now. After that? hmm...shall decide then.

2. RUN 3 km in 30 minutes effortlessly. (now can only managed about 2.5 km in 25 min)

3. STOP ranting about the daily happenings in life.

4. EAT more heathily.

5. SMILE more. Frown less.

6. READ 3 books.

7. LOSE some weight.

8. GO wall-climbing.

There. ok...I shall be abit more realistic. I should achieve at least 5 of them before my birthday.
Wish me luck!

Yet Another Violence

A day after that patient chased me out of the ward, the next night, a patient in the DTs smacked a nurse right in her face. The poor lady was shorter than me and thin. She fell and hit the wall. Her right cheek was swollen and red.

I do not understand why do we need to admit people who drink too much alcohol. Once they get admitted, all we do is provide them with a few days worth of banana bags to replenish their vitamin deficiency. During their admission, they obviously go into alcohol withdrawal, whereby, they become violent, and agitated. We have to give them tablets/injections to calm them down. They normally get discharged within a week. And guess what? They go back to the pub and continue to drink their hearts out! A few weeks to months later, they get admitted again with too much alcohol. It is a vicious cycle indeed!

They do not appreciate what we are doing, so why are we even treating them? Instead, we get verbally and physically abused. And all the money spent on buying those tablets/injections to calm them down. They are bloody wasting our money, time and energy! I really can't stand them....but lucky me, patients with too much alcohol are so abundant here. sigh.

Scariest Moment!

It was 2.15 am, when I walked into ward X to insert IV cannula a patient. L, my colleague, was there with me as she did not have any jobs to do at her side of the hospital. Once completed, I heard funny noises at the other end of the ward. With the inquisitive nature that I have, I decided to walk towards the sound.

The funny noises/grunting came from a male patient whom I saw just a few hours before to insert an IV cannula. At that time, he was talking to me. However, when I called out his name at 2.3o in the morning, he didnt respond. He had his eyes opening spontaneously, but it was just staring blankly into the open space. His limbs were not shaking or stiff. hmmm...I thought he was probably having a seizure of some sort. The nurses informed me that he was admitted with alcohol excess and a probable head injury.

So I asked the nurse to do a set of observations on him. His vital signs were normal. I decided to put his bed flat down, just to make sure his airway wasn't compromised, but the grunting persisted. Then suddenly, his limbs started to shake violently, and as expected, he went into tonic-clonic seizure.

The entire seizure lasted about 30 minutes. I gave him 2 shots of lorazepam which finally stopped his seizures. He was not cyanosed during the attack, but I decided to put him on oxygen anyway. During the whole event, my cardiac arrest page went off, and I was like "Oh fuck!" Fortunately, the call was for anaesthetist only. It wasn't that I was worried about attending a cardiac arrest, I just didn't think I would be able to leave the patient.

After the seizure, his eyes were wide open and he was still not responding verbally to me. Since he was having a long fit, I decided to take some blood samples and an arterial blood gas from him. Whilst palpating for his pulse, his hands suddenly turned into fists! I thought it was a bit strange and continued to feel for a pulse. However, he suddenly sat up on his bed and stared at both me and L, with the MOST VICIOUS eyes I have ever seen in my entire life so far.

He had the eyes of a murderer. I know, it is not like I have seen a real life murderer (*touch wood), but his eyes were just full of anger, hatred and violent looking. Immediately, I stopped doing what I was planning to do, and told L to move back. Lucky L moved away quickly, as he punched out at her, nearly hitting her chest. I shouted at the nurse to call security.

I was trying to calm him down with the help of another nurse, but to no avail. He knelt on his bed, with his oxygen mask still attached, and continued to stare at me with those really malicious eyes. Horror of all horror, he moved forward with his knees towards me, and toppled down the bed, arms first. I was like, "L, I think we need to move back." L was already walking away from him, while I thought maybe I should help him up.

This patient got up almost immediately, and stared back at me. I turned around and started to walked really quickly away from him towards the entrance of the ward. L was ahead of me, and ran towards the ward opposite. I looked behind and saw that he was chasing after us. "Oh my god, he's after us. Run!" I shouted. We were outside the ward, before I saw security running up the stairs to Ward X. The patient stopped at the hallway and stared at me.

Security took hold of him and put him back into his bed. He was punching and kicking out at them too. The nurse that was with us was hiding under the table. Finally, after being pinned down by security, he flipped back into his normal self. He started talking, and demanded that he wanted to speak to a doctor, which was me, of course.

There was no way I was going near this man without further sedation. So I gave him a shot of haloperidol and that seemed to calm him down slightly. An hour later, he was still pretty agitated, but less violent. I gave him a small dose of lorazepam, and thank goodness, he fell asleep after that.

This morning, when I went back to the ward to do a few things, I overheard a patient talking to another, "That wee lassie was chased out of the ward last night." The other patient said, "She's a doctor, aye?" "Aye," replied the man. I heard them giggling softly away. I couldn't help but smile at what I heard.

I do not know why he became so violent after his seizures. It wasn't so much the fact that he punched out at us, it was his eyes that were so so scary (and the chasing part)! After the entire event, me and L were both shakened. Later in the morning, we talked about the episode again, but we started giggling. It seems quite funny now, but it certainly wasn't funny at that time. Hope I don't get haunted by his eyes!

Impressive

I saw THE most impressive chest x-ray yesterday. My colleague, L, was asked to see a man who dropped his saturations last night to 76% on errmmm, I can't remember how much oxygen. So she decided to request a chest x-ray in order to further investigate the problem.

We took the x-ray film from its folder, and gosh, we saw total right lung collapse! His entire right lung field was white on the x-ray and, he had the most impressive tracheal deviation I have ever seen!! The entire trachea was shifted to the right, and we could even see the branching of the bronchus, shifted into the right lung field. It was the perfect x-ray to show medical students.

Apparently, it was caused by mucus plugging, and L had to ask the on-call physiotherapist to come in to give us a hand.