Was That Even Necessary?

Why do people need to act like a complete arsehole?


I had a few encounters with my work colleagues recently during my weekend on call. I am a pretty easy going person. But I really could not tolerate those who are irrational.

I received a referral from the A & E department about an elderly gentleman who is now having difficulty swallowing and persistent vomiting. As a result, I was told he looked quite dehydrated. I said, "That's fine...just send him up to our medical ward for further assessment." Later, I received a phone call from the managers that his admission was highly inappropriate. First of all, I was told by this colleague of mine that I do now know this patient at all (which is very true...I have never met him before...so therefore, assessment is even more imperative, no?). Then, our conversation went on like this:


Colleague X: What are you going to do about his swallowing problem over the weekend?


ME: Well, there isn't much we could do over the weekend, until he comes extremely unwell, he which he may require an urgent endoscopy. Otherwise, we should give him IV fluids and make sure he hasn't aspirated."


Colleague X: Exactly. You can't do anything for him over the weekend. If he were to get a scope...you can only do it on Monday, so why bother admitting him?


Again, I had to repeat myself.


Colleague X: I find it really hard to understand why someone with your capabilities would want to admit that patient from A&E.

I was utterly shocked and speechless.


ME: OK, look. If you think this patient is well enough to go home, why don't you document that in his notes, and discharge him from A&E. From my point of view, as I haven't laid my eyes on the patient, I would not know if he is fit for discharge. If anything happens to him, I am the one responsible because I am the person on-call.


I was arguing over the telephone! It was embarassing because I was speaking in the medical assessment bay where new patients were waiting to be seen. After a good 10 mins worth of arguement, we both put the phone down. I felt that it was complete unneccessary. I mean, I know we were verging on being short of beds, but I honestly could not simply discharge a patient without seeing him first. And I hate to say this, but, you are only in charge of the beds....you are not trained to assess whether the patient is fit enough to go home!!!

Urgh...I felt so frustrated after that.

Then, the next day, I received another mouthful from another colleague. This time it was because she thinks the patient has no comprehension of what was going on. She was unhappy that I told the patient about her diagnosis of cancer, and that she her prognosis was poor.

The thing is, this poor elderly patient of mine was clearly living the last few days of her life....and she hasn't been told what was causing her to feel so unwell. When I first assessed her, she could tell me the events leading to her hospital admission, she was well orientated to time, place and person! So on that basis, I felt she was able to understand what was going on.

This fellow colleague of mine, (lets name her Colleague G), was again being inappropriate.

Colleague G: Look, I find it shocking that you think she has even the slightest understanding of what is going on. She is completely off her head. She mumbles all the time! And you told her she has cancer?

Me: I completely respect that. But when I saw her, she was orientated, and was able to tell me her history. And she is my patient, she has the right to know....especially when she is so ill.

Colleague G: Well, I find that hard to believe. I have been a nurse for more than 20 years...and I know for a fact that she is utterly confused and has no comprehension.

Me: Ok...I know you have the experience. But even if she is that confused, she still has to be told.

I left the scene....and about 1 hour later, I received a phonecall from Colleague G. Mind you, I was on-call that day.

Colleague G: Ling, just for your information, I went back to ask the patient if she remembered talking to you. She said, she recalled that a doctor saw her, and she said something was wrong with my tummy. But she couldn't remember what was wrong with it. So there you go, for your information, she has NO CLUE what is wrong with her!

I was like WHAT?!!! Do you actually need to purposely call me to just prove a point?? Is there any need to do so??

No there isnt! Even she doesnt remember, I am still responsible for her, and she has the right to know.

Me: Ok then. Thank you for letting me know. (I was gritting my teeth while saying that). bye.

Man....what is wrong with these people?!

OR,

Maybe I have lousy clinical judgement. I dunno. This is so frustrating.

The Best Gig Ever!

Today this will be
the greatest day of our livesbefore it all ends
before we run out of time

I LOVE TAKE THAT!!!!
They were my childhood favourite boyband! =D

It was my first time seeing them LIVE...and their CIRCUS tour 2009 was simple fantastic, extravagant, colourful....and simply mesmerising! They were supported by Gary Go and James Morrison.

The gig was at the Hampden stadium. I was glad I managed to get seating tickets, because the standing ones were so packed! The entire stage was designed to look like a circus. There were acrobats, a giant silver robotic elephant, fireworks, fire....... it was simply amazing!

They kicked off by singing "The Greatest Day." Then, when they started to dance their usual routine for Pray!!! It was really nice to see them reunited again. Every member of the band had the chance to take the lead vocals.

I love their outfits...they wore smart suits...and then, dressed up in clown uniforms, and painted their face in front of the audience. They each had a go at the unicycle too!

Also, when they sang my favourite song, "Back for Good," they created rain to resemble the music video. Take That sang most of their hit songs and songs from their current album "Circus."

This was certainly the greatest GIG so far!! The ticket was pricey...but I can understand why. 230 people were involved in it! Here are a few pics I took! And, I can't believe I spent some money buying their merchandise! I am really a big FAN!!!!

Bring on more good music, Gary, Howard, Jason and Mark!!! =)

The Greatest Night!

At the merchandise store....I got myself 2 Take That baby Tees!!

The tour trucks!

James Morrison

Let the circus begins!

Mark

Take That in clown outfits.

Simple, yet Memorable

A lovely homemade Japanese cheese cake...baked by Jaclyn. It was moist and tasty. Thank you so much doll!! hugs!

My birthday was pretty simple this year...and I, personally, like to keep it simple. We all had a simple homecooked meal, followed by the cake. Then, I opened my pressies....very pleased with them. I received a cute little ladybird pendant and also Bobbi Brown's eye make up palette! =D I was, and still am, beaming from ear to ear. In addition to that, I received more earrings and a pretty bracelet. Guess, a girl can never get enough of accessories, eh?

Yet Another Year

whoa.. thank god, i'm still here!

Yeap, its my birthday today. I can't believe how fast time has flown by! I am just glad that I'm still the same, apart from the worsening eye bags and wrinkly face. =P

I did not run any marathon or 5k or 10k last year. I did not travel to any EU country either, surprisingly! The year was filled with work most of the time, and moaning about the stresses at work. I spent alot of time sorting out paperwork for job interviews and also to allow my supervisor to gauge whether I'm fit enough to pass this year.

However, I did manage to get some time off to go back home, which was lovely!

Also, I've noticed that my immune system has been super low. I have been ill, again and again. Glad to say that my sore throat and cough are both away....but I am now bothered with Hay Fever! sigh....the pollen levels are quite high these days.... I have been sneezing my nose off so much....scratching my eyes too.

This year, I will be faced with a new challenge. I will be moving down south, working a brand new environment, and coping with living by myself. Excited? I don't know actually. I'm having mixed feelings about it all. I am pretty excited about the new hospital, but not too excited about moving here on my own. The fact that the town has been rated as the worst place to live in UK, is not helping either. Guess I have to just get on with it. Will see how it goes. I am quite stressed now just having to look for a place to live!

Anyway, Happy Birthday to me. Here's wishing me the best of health and luck this year!
CHEERS!

Hello!

I haven't blogged for ages!

I've been ill....AGAIN! Then, busy with work and on-calls.

Now, I have recovered alot....but still have this tickly cough, which is worse at night, when I try to sleep. As a result, I don't get much sleep! =(

Anyway, work has been tiring...and I really HATE (maybe this word is too powerful), or rather, I DISLIKE CARDIOLOGY!

Help! I'm drowing in the sea of ECGs, ETTs, and echocardiograms! The clinics are just too outrageously overbooked for 2 person....the new patient clinics are total chaos....just because on the same day, I have to arrange various tests for the patients, and following these tests, they will see me again to get the results. So the coordination goes haywire ...and the waiting time stretches...patients become unhappy....and the vicious cycle carries on!

sigh. On a brighter note, I have managed to get all my paperwork sorted...and my educational supervisor has signed me off! yay!

have a good day everyone.

Immune System @ Its Lowest

I haven't been ill for a long time. Interestingly, the past 3 weeks or so, I've been a viral target. It first started off with me developing bodyaches, fever, and abdominal pain. This soon (no surprises) led on to the development of diarrhoea.

Having recovered from that, I developed a really bad sore throat 5 days later. The following morning, my throat was so painful that it was difficult to even swallow..... and then, my nose started to run.

Lucky for me that I am on my annual leave. So I could take the time to recuperate. However, I would also like to use my days off to enjoy the sun and do things I like! But, sadly, the weather has been miserable. And, my nose was completely blocked over the past 3 days. It is alot better now, thanks to the antihistamine and pseudoephidrine tablets. I literally could not taste or smell anything.

My kind housemate even made me an aromatherapy steam inhalation thingy....and I could not even smell the scent!!! But the inhalation was great....it did help to decongest my nose a wee bit.

Now that I am much better, guess what? Today, I had a really bad splitting headache. I thought it was because I was hungry...so I had some sugary stuff. But the headache persisted. I took some paracetamol to no effect. Dehydration? Probably not, as I have been at home all day, and definitely drinking plenty of fluids. Therefore, I decided that I needed to rest. I hid under my covers for a few minutes...but my head continued to ache..

Guess it must be some really bad viral illness I have been suffering from over the past weeks. I do hope I get better soon.... my immune system is absolutely rubbish at the moment. I better infuse myself with more Vit C.

Anywho, time to go to bed now. Hopefully my sleep will put an end to my headache. Shoooo schleeppy.....yyawwwnnn...... Nite nite.

The Best X-Men Ever!

I decided to share my germs (sore throat & cold) with the other cinema-goers yesterday.

I went to watch X-Men Origins: Wolverine!

This is the best X-Men movie so far! Loved it! Thumbs up!

The story was fantastic.....the casts were great...and for once, at least, I understood what they were fighting for...rather than the previous X-Men series. And, I didn't really like Jean Gray.

In this series, there were plenty hot casts. One of them was Gambit. I was just a little disappointed that he didn't perform much. Also, Wade was really cool. Hugh Jackman was being his usual charming self. His girlfriend (Lynn Collins) was gorgeous....and her sister, was superbly cool! I wished I have skin like hers!

hehe....so yes, please go watch it! I am so looking forward to Transformers and Terminator!

ps....my sincere apologies to those who heard me snuffling in the cinema!

I Hate Hospitals!

I know I have probably blogged about this more than 10 times. But, I hate hospitals when the atmosphere is so unpleasant.

Yeap. I am talking about dying patients. I know, I know, I have repeated myself so many times about how much I am saddened seeing patients die in front of my eyes. I am going to blog about the same thing again today....coz I AM gutted! I know hospitals are pretty unpleasant to be in anyway.

Sigh. There is a pleasant lady in the hospital who is only in her mid 50s. She suffered so many complications from this abnormal mass in her abdomen. It was only 4 months later that we finally got to the bottom of her problem. We found out that she has cancer. Unfortunately, I think her illness is rather extensive, ie, the mass is pretty big, and her general well being does not allow for a surgical operation. Chemo would not be much benefit either.

In simple words, she is dying. It is very upsetting. She is such a lovely lady. Her family are all so nice. I hate seeing them, crying away in another room, and then, to enter their mother's room, putting on a brave front. I highly respect them for being so supportive. My heart goes out to them.

I mean, looking at her today, she looked awful.....extremely pale and green. It is certainly not a good sign. I could just feel myself welling up when I saw her. She just went downhill so quickly. Sigh. I hate hospitals when it comes to things like this. =( Booo....

Highly Inappropriate

Can anybody please tell me whether or not parenterally feeding a terminally ill cancer patient is appropriate??

Hands down who agree that it is INAPPROPRIATE to do so.

hmmm......

Recently, I was treating a patient with widespread cancer to the lungs, liver and also, the bones. He was ill. We initially gave him a course of antibiotics to treat his sepsis. He did improve a little.... but after that, he never picked up again. He became increasingly dehydrated, lethargic and more unresponsive.

His swallowing was impaired, just because of his decreased consciousness. The SALT (Speech & Language Therapist) also asked to review, and she, too, was in agreement that he should not be allowed to swallow as he would be at a very high risk of aspiration.

Funnily enough, the nursing staff decided to refer this poor patient onto the dietitian. This dietitian, then, wrote in the notes the following:

" Note patient is unable to swallow. Patient would not be able to meet nutritional requirements. Consider parenteral feeding (such as via nasogastric tube or intravenously)."

I was appalled when I read that. Why would somebody attempt to force feed a dying patient? Should we not let the patient die peaceful, rather than, jamming a NG tube down his nose or poking him numerous times to gain IV access?? And, what benefit would he get by feeding him? I mean, honestly, why do you want to feed him and prolong his suffering??

I really did not get that at all.....and I felt that it was a highly inappropriate suggestion! Anyone beg to differ?

My Rotations are Out!

My rotations for the next 2 years are out!

And I am pleased to say that I am very glad to have been allocated my top rotations! =D

I will be based in JCH at Middlesbrough for 8 months, then, I will move to North Tees for another 8 months, and finally finishing my last 8 months back at JCH. My rotations include the usual core medical stuff, ie, cardiology, respiratory, gastroenterology, diabetes and endocrinology....but they also include infectious diseases and ITU! yay! I really wanted to do both of them..and I will be!

Now, the flat hunting begins!

The Best I've Felt for The Week!

I can't remember when was the last time I was ill. I think it was during Christmas last year. I was down with a cold. Since then, I've managed to build resistance against all the evil winter bacteria/virus......until last Saturday, that is.

I felt so miserable. I was acutally having a lovely dinner at this nice Italian restaurant, called Battlefield Rest, when it all started. My body started to ache all over. My beef lasagne tasted really good, but I was struggling to finish it. When I got back, I was so tired and sleepy....not long after that, my tummy started to hurt. It felt bloated and uncomfortable. I also felt feverish.

This lasted all day Saturday. On Sunday, I felt alittle better. But, again, could not master the appetite to eat anything! I dragged myself through 2 long days of calls on Monday and Tuesday....and by Wed, I was absolutely done in.

I slept really early that night....and guess what? I was feeling nearly 100% on Thursday morning...and now, I'm back to my usual self! My tummy is rumbling because of hunger...and I could actually finish my meals! Its certainly the best I've felt all week!

I'm really gonna take it slow and easy this weekend...but I have managed to sneak in a few little choc pieces today at work...keke... I know, I know, I should really keep off the chocolate...but, but, but, they were dark chocolate...and they are meant to be good for you! :o)


Have a good weekend!

Congratulations!

My heartiest congratulations to my photographer extraordinaire, Kevin, on obtaining his diploma in photography!! Not to forget that you were top 2 in the class! What can I say, you absolutely deserved it!!! After all that hardwork you have put in, the sleepless nights, the long hours of looking at the screen trying to get the pictures right....man, I am extremely proud of you my dear.

Lets go get some champagne!

Could I Have a G & T Please?

Medicine can be pretty boring, especially when all your patients are stable. No cardiac arrest calls, no sound of the emergency buzzer in the wards, no patients acutely deteriorating. I would review my patients, change management plans as neccessary, and hope that they will get better.

So at times like this...we, doctors, need to humour ourselves.


Cancer patients who receive chemotherapy are at risk of developing neutropaenic sepsis. For those without a medical background, neutropaenic means having a low white cell count (white cells are important to fight infection), while sepsis, means infection. So, when your body is low in white cells, you have low immunity, therefore, would be prone to develop different types of infections.

Different hospitals have different hospital protocols for treating neutropaenic sepsis. In my hospital, we like to give our patients G & T!

Yeah, G & T.....Gin & Tonic.

Gin is a spirit which is flavoured with juniper berries. Apparently, juniper berries have medicinal values. They act as a diuretic and also an appetite stimulant. The latter being extremely important in patients with cancer, as their appetite is normally quite poor. I mean, if you think about it, when your appetite is poor, your nutritional intake would be inadequate, and as a result, your body would not have the energy to resist infections....don't you agree??

Well, no, as much as I would like to think that Gin & Tonic could heal infections.....actually G & T stands for Gentamicin and Tazocin...which is a good combination of antibiotics to treat neutropaenic sepsis. =P

See...it is quite pathetic, I know...but at least it lifts the spirits of our patients up, when you joke with them about their antibiotics.

Having said that, I've heard that in certain special circumstances (ie, where conscious patients who are nearing their end of life or around christmas period), a small dose of alcohol has been prescribed on their drug chart, if it was requested by the patients, and if the doctors were given the green light by their boss. Being in hospital is pretty miserable...so we like to keep some of them happy! Cheers!

Unhelpful Surgeons

Surgeons - All they are interested in is to cut your body open and fix things. If nothing can be fixed, then, it would be a medical problem. This really frustrates me.

Yesterday, a cardiac arrest call was put out. We were directed to the acute surgical admission ward, where, an elderly man was extremely breathless....his face was blue....his heart rate went up to 160 beats per minute. He was admitted for problems with per rectal bleeding. I wondered whether he may have developed a pulmonary embolism (a blood clot in his lungs), or became very short of breath because of anaemia.

At the scene, the surgical reg was standing....asking for an anesthetist....who eventually arrived after a few minutes. Having examined the patient, I told him my thoughts and actions. He said "ok." While I was busy asking the nurses to give me a few medications, I soon realised that suddenly, no one from the surgical team was there with the patient. I didn't think much about it initially. The patient settled down alittle, but was still not well. I tried to look around for the surgical reg...and I later found out that he has left to go to A&E! I was like, WHAT?!

He left me to sort his patient out.....by myself?! I mean, honestly, I can understand that you have a sick patient down in A&E, but you should not just leave without even informing me! That is very unthoughtful and down right rude. The problem was I do not know what his plans were for this elderly gentleman from his surgical side. It became difficult for me to make up a plan too. I was appalled by his behaviour.

I dunno about other docs. But I have honestly admit that I do find surgeons extremely difficult to work with. I mean I can understand that they would lack experience in managing medical problems...and I would struggle to manage surgical problems. However, more often than not, we, medical people, do not hesitate to say, "yes we will take over the patient's care." Unfortunately, this is not the same for the surgeons. For example, I have found patients with Ischaemic bowels who is not fit for surgery, being left in the medical wards....or patients with acute pancreatitis. They are just very unhelpful. Imagine, if we leave a patient with fast AF in their surgical wards...they will be screaming at us to take the patient over. Anyway, think I have ranted enough.

There are a minority of surgeons who are really good....but as I said, MINORITY.

Marley & Me - John Grogan

If you haven't seen the book before, here it is! Please do read it...THUMBS UP!!!!

In the movie, they used 22 different labs to act! =)

I Love You Too, Marley

Marley. What can I say about this extremely naughty labrador?

I read the book "Marley & Me" by John Grogan a few years ago.....and I absolutely LOVED it! The book is about the life of the author, with his dog, wife and children. It potrayed the ups and downs of marriage, and the outrageous behaviour of Marley, the WORST dog in the world. I laughed alot when I read it, but also cried towards the end of it, when Marley left to go to doggie heaven.

I was really excited when I found out that the book was made into a movie. Both Jennifer Aniston and Owen Wilson did well. I felt that they had good chemistry on screen. And the dogs were so so cute. The movie had the same effect on me. I cried when I watched the movie. It was really sad seeing how Marley grew older and finally, put to sleep. In fact, most people in the cinema were sobbing too. I think, unless you have the heart of a stone, or you just do not like dogs, it is impossible to hold back the tears.

I highly recommend this movie, although, I know that most people would rather watch a feel good movie...but honestly, this movie did give me a nice warm feeling. Having said that, it made me miss my little wee Kiki at home (who is 9 human years old, but in dog age, she is 49 years old!).....and Pecan, my other little doggie who does not belong to me anymore...

Addisonian Crisis

It was an extremely interesting on-call yesterday.


At about 7 pm, I was called down to Resus in A&E. When I arrived, I saw this extremely drowsy but rousable girl. Her fingers were icy cold with mildly cyanosed fingers. Her blood pressure was in her boots; it was barely recordable! She was also tachycardic and tachypnoeic. Luckily her mother was around to provide us with some background information.


We soon found out that she was recently diagnosed with Addison's disease. She has been vomiting for nearly 1 week. She did not have any diarrhoea. Her mother insisted that the patient has been compliant with her daily steroid tablets. Addison's disease is a rare illness in which the adrenal gland fails to produce adequate steroid hormones. Steroid hormones are important to enable the body to function efficiently, especially at times of stress. Treatment for the illness would include replacing the steroid hormones by taking life long steroid tablets.


It was obvious that she was in Addisonian Crisis!! It is a potentially fatal illness. Immediately, she was given a dose of IV steroid, broad spectrum antibiotic to cover for possible sepsis (although I could not find a source of infection at that time), and fast fluids. Despite all the fluid challenges, her BP hardly responded.....at best, the reading was 40 systolic!!! I could hardly palpate her brachial or radial pulses. To make matters worse, she hardly passed any urine after 4L of fluid!! I understand that those with Addison's will have hypotension......but I was not sure whether her low BP was purely due to her Addison's, septic shock or simply dehydration.


At the end, I had to contact ITU for assistance, and subsequently, she was started on an infusion of noradrenaline to improve her BP. Fortunately, she responded well to this. Today, she was sitting up on her bed, happily chatting away, when I went to check on her. Her BP was 120/60 (obviously with help from noradrenaline).

The interesting thing about her was actually her chest x-ray. Her first chest x-ray when she was in resus was actually normal. There was no focal consolidation. However, after having a central inserted, another chest x-ray was requested in order to exclude a pneumothorax and check position of the central line. It was in this second x-ray that finally we saw the source of infection. She had severe bibasal consolidation! So, she definitely had a really bad pneumonia. Fortunately, she already received a dose of ceftriaxone, which is good in pneumonias.

However, I really do not understand why there was no consolidation in her first x-ray. I mean, it was only 2 hours difference between the 2 of them. One of the anaesthetics SHO believed that patients are too dehydrated and shock when they first arrive in the hospital. As fluids are provided, the body starts to fill up and as a result, the mucus pluggings in the chest start to loosen up, and hence, that's when the abnormality shows. I don't know how true this is....but it sounds a reasonable answer.

Anywho, she was a good case. She was my first Addisonian Crisis patient. The other interesting patient was an elderly gentleman who I believe presented with urinary sepsis. He was in acute renal failure, with a creatine of 786!! And he was profoundly metabolic acidotic with H+ of 80, bicarbonate of only 5! Also, he had amazing ECG changes due to his hyperkalaemia! There were wide QRS complexes and tall tented T waves. His potassium was 7.8. He must also be extremely septic. His urine looked like pus....it was thick, turbid and smelled horrible! urgh... never seen such a yucky looking urine ever!

It was a really busy on-call but surely exciting. On-call again tomorrow...hope it's a little better.

Brew...ha ha, anyone?

It was a lovely weekend. It hardly rained. The sun was shining brightly, but the wind was extremely icy. So, it was quite cold, to be honest.

I woke up very early on Saturday morning, and managed to catch the qualifying round for the Australian F1. I haven't been to the gym all week because I was busy at work, so I decided to head to the gym to do my usual 5k run. I felt refreshed after that. My endorphin levels were starting to rise.....and I felt like doing something in town, ie shopping or catching a movie.

Jaclyn, Kevin's sis, invited me to catch a movie at the cinema. Before the movie, we went to this cafe called "Brewhaha." Yes, funky name, eh? I do wonder why it is called Brewhaha. It is a specialised tea shop, that also sells yummy cakes and sandiwches. It must be that upon drinking the tea, you'll be happy.....therefore, the "ha ha" bit of the name.

I had "Calming Tea," which was a mix of honeybush, vanilla and some flower petals....the taste was a little bland...but it was nice. Jaclyn had "Feel Good Tea," to soothe her tummy. We also had a slice of Lemon Drizzle Cake and Ginger Loaf...oooohh....yum yum. Would certainly go back...and this shop in Glasgow is the first tearoom for Brewhaha. You can check the shop out at http://www.brewhahaltd.com/

After adding more endorphins to our system (ie indulging in tasty food), we watched Duplicity. Oh...I really am so in love in Clive Owen. He is really hot. And I love the collaboration with Julia Roberts. If I have not mistaken, this is the 2nd time both of them worked together. The first movie was "Closer." The movie wasn't great....but the witty lines were funny.....and just ogling at Clive Owen was enough for me!

ahhh.....guess the nice time spent has compensated for my 1 hour less Sunday.

Please Do Not Take Me for Granted!

I was talking about moving on to a new place for my next job...and also, how much I am looking forward to the change. I spoke about my housemate....who can be so irritating at times. I have decided that, if she doesn't care about how I feel, why should I? So I am going to b**tch about her now.

Honestly, I do not think I am being picky or difficult. Think the problem is with her.

First of all, she does her dishes probably 2 -3 times per week. I mean, ok, fair enough, you are busy (when she only works from 9-3 pm daily). But, leaving your dishes in the sink, with all the food stains still stuck on it....is pretty unhygienic, don't you think? I am happy if you wanna use the pots and pans, but I am also living in the same house. And when I come back from work at 7 pm or later, I would like to prepare my dinner too. How am I going to do that if you have used them all up and not even bother cleaning them up?? I have washed them myself many times...but you know what, there is a limit to do that. I know she feels guilty sometimes about that, but she doesnt care less. If you were THAT busy, how could you be lying down on the couch from 6 pm to midnight, watching the telly? yeah...exactly.

Secondly, she has taken me for granted. Her notebook broke down TWO years ago after she spilled water onto the keyboard. I told her to get it repaired, but she only took it to her friend, who doesn't really know much about computers. Silly I thought. Anywho, she decided that she could use my notebook from time to time until she gets one. I caught her using it a few times, before even asking my permission. She must have felt awkward when I saw her in my room, clicking away at Bebo or Facebook.

I still remember what she told me, "Ling, do you mind if I use your computer to check my emails and stuff? I don't do that often...just once or twice a week....while I get myself a new computer?" I just said ok. TWO years down the road, she uses my computer everyday, she even uses it to bid for things on eBay, and other internet shopping.....and WORST of all, she has decided that the computer also belongs to her, and she has allowed her friends INTO MY ROOM and USE MY NOTEBOOK!!!

NOw now now now now......that is SO CROSSING the line. I mean, that is MY ROOM, and that is MY NOTEBOOK, who gives you the right to allow your friends to use my things?? I do not even know your friends...i know their names...and thats pretty much it.

I was so pissed off. I told her I was not happy about that. She just said "Ok." No apologies whatsoever. I thought that maybe I over reacted....but having spoke to my fellow colleagues at work, who are Caucasians as well, they agreed that my housemate has stepped on my tail.

I am not a calculative person at all. I gave her half the amount for the TV licence because she said she doesn't have much money. I hardly watch the telly because she hogs it from 6 pm to midnight, and also the weekend, watching soaps and DVDs....which is fine. I am not going to push her away just because I wanna watch a few of my interesting series. Now, she uses my internet connection and she uses my notebook DAILY....shouldn't she give me some money then?? Oh oh oh....did I forget to mention that she also uses my printer from time to time, without even asking me? How do I know, simply because she never puts things back in the same order!

URGGHH.... more recently, while she was using my notebook in my room, she felt her empty tea cup and an empty chocolate bar wrapper on my table. This is again, not the first time. She has left tissues on my bed and on the table in the past. She laughs away when I told her about it. She must have found it funny....I dont know.

She boils me up sometimes. I could go on and on about her annoying habits. I sure have some silly habits too, but I never take her for granted. She is, otherwise, ok to get along with. I have lived with her for 3 years, and I think I have tolerated her very well.....but I am losing the plot already. Oh, can't wait to get away from this flat...... although, I will surely miss the convenience and comfort of this cosy little flat.

You're Hired

" Thank you for recently attending our assessment centre / interview. I am pleased to offer you a CMT CT1 commencing on Wednesday, 5th August 2009."

Yes, I'm finally hired!! I have managed to secure a job!! Yay!! I am so SO SO happy, and feel so glad. Yay for me!! hehe. Actually, the offer email was sitting in my inbox on Friday, but I only checked my inbox on Saturday evening!

After 3 painstaking and emotionally wrecking interviews, I finally get into the medical training system! The anxiety before the interview could literally give me a heart attack. The uncertainty of what clinical scenario you would be asked on, which ethical dilemma they will test you on, the preparation of my own personal portfolio; all of them made me really stressed! The whole interview process itself was equally stressful. And I mean you could be an absolutely great person on a daily basis, but when put under the spotlight, you just change completely.

So I am getting out of my comfort zone, and heading towards the Northern Deanery, which includes areas like Newcastle, Durham, Carlisle, Cumbria, etc. My job commences in August...so this will give me some time to find a new place to stay and move my things down. This time I would like to rent a place and stay alone. It would be easier for mummy and daddy when they come up to visit me.

I am so looking forward to this change...just because, I have been in Scotland for 5 yrs dy. And I am looking for a new environment. Also, this allows me to move out from my housemate.... Don't get me wrong, I love my room, and my flat, and the West of Glasgow is just so convenient. I do get along with her. But, she occasionally takes me for granted....and that is really doing my head in. Will write a whole blog about it later. haha.

Well, I was beaming and so excited yesterday that I decided to just go down to town to maybe buy something nice as a treat. But all the shops were closing in 30 minutes by the time I got there. Also, I told myself that I would get myself an iPhone if I get a job....and and and....my notebook is so cranky that I also wanna get a new MacBook!!! I have wanted to get a new notebook for a llooonngg time...probably about nearly 2 years now. My notebook keeps hanging despite me trying to reformat it. So its time to get a new one!!! woohoo!!!

Think for today I might either go watch a movie or something la. See how. Go visit the gym first.

=)
=)
=) =) =)

"Lovely" Neighbours I Have....Not!

It was a long day at work. I came back from my night shift and felt really sleepy, having not slept alot the day before.

However, I only managed a good 1 hour worth of sleep! I decided not to try to sleep anymore and kind of potter around the house watching the telly and drinking tea.

I was in my room, when the doorbell rang. My housemate, Helen, opened the door. I thought it was her friend. However, later she shouted, " Ling, the police is here for you!"

I was like, "HUH!"

The first few thoughts that rushed through my mind were, "Did I kill somebody?? Did someone decided to sue me and the police is here to get a statement from me? Was someone I know in trouble and needs my help? Did I even do anything wrong???"

I quickly rushed to the living room, and there, stood a policeman, and his partner, a policewoman. They looked at me and the policeman asked, "Hi. Are you the owner of the baby blue Peugeot 206 with the plate S**B** that is parked outside?" I said, "Yes." Then, I was thinking....oh no, I must have been caught speeding!

Then he said,"Your neighbour reported you. They said you have not changed your tax disc."

I replied,"OOOHhh.... (scurried back to my room to get my new tax disc for the year)....here it is. I actually renewed it last week, but it must be that I have been so busy at work, and disorientated to the time, that I forgot to change it. I'm really sorry."

He studied it and said,"Oh rite. That's fine. But please remember to put it up, otherwise, I'll have to fine you at least 60 quid!"

"Sure, no problem. I'll definitely put it up today."

And they left the house.

I don't know how to describe my feelings then...it was mixed feelings. I was glad that it was just a simple expired tax disc, and not something outrageously horrible! Also, I was a bit shocked that my "lovely" neighbours would report my car!! To be honest, I do not even know any of them. Not spoken to any neighbours. And everyone living on this road just parks their cars along the street...they don't own a particular car parking lot. So it was not like they could be angry that I "stole" their parking lot.

That night, before I left to start my night shift, I made sure I changed my tax disc.....still feeling really "funny" that my neighbours have so much time to look at tax discs and report to the police if they found one that is expired.

I mean I have spoken to the police before....but those were at hospital level, you know, giving statements about patients, getting their help to restrain violent patients, etc....but man, NEVER had I imagine that the police would come to my house to check on my tax disc!

*phew

ps. tax disc = road tax

Overwhelmed!

I feel so overwhelmed from work! I wonder, sometimes, whether I am cut out for this job. You know, it's been 2 and a half years that I've been doing this, but, I still get ovewhelmed, especially when I am doing night shifts.

We do 7 nights in a row. My first night has been the worse of all, so far. It was such a busy night. There were at least 3 sickies at that time, 2 of which died on me. I really hate the feeling when patients die within a few hours of hospital admission. It just gives me this feeling that I have not done anything to save the patient. It feels as though I must had missed something, or was not doing enough to prolong his/her life.

One of them was an elderly lady, while the other lady was in her 50s! She just went became unconcious. We managed to get her back after about 3 cycles of CPR. That gave me some time to discuss the case over with the consultant, and we felt that, she would not be a candidate for ITU, so therefore, we had to just let her go.

I still get goose bumps just thinking about what happened. It was horrible. She was vomited bloody fluid during CPR, her colour was blue, her eyes were rolling, she was cheyne-stoking! gosh...I really hate my job now.

Anyway, she is in a more comfortable place now. Just feel sorry for her family.......and I just could not stop thinking whether I have missed something.

The rest of the nights were better....however, again, last night, it was absolutely rubbish. There were quite a number of admissions. A patient was extremely unwell in HDU, and I kept getting pulled up, down, left and right, by fellow nurses, and my team of hospital at night specialist nurses.

Sometimes, I wonder whether I was being slow in reviewing my patients....I mean, I really did try to be quicker...but I really hate missing things. Because it was such a busy night, I had to leave the work I was doing, to complete another. So everything felt like it was all over the place.

The nurse was like, "Have you seen Mr. Y yet?? He came in earlier than Mr. X....and you went to see Mr. X first." I replied, "Well, it's because Mr. X is sicker than Mr. Y, so he get the priority." And I was thinking to myself, helllo?! This is not a queue in the supermarket....the sicker the patient, the earlier he gets seen, regardless of who comes in first! And you claim that you are a senior staff nurse?! She then replied, "Well, its just because I need to write up my bit...and I'm going home soon." I then said, "Look, there's only one of me here. I have alot of other things to deal with at the same time. So I will see him as soon as I get a chance."

I really do not like to bitch about nurses....but, sometimes I can't help it! So my apologies first to anyone who gets offended by this.

I think it was Tuesday today, but it was actually Wednesday......which means, I have only 2 more nights to go. I get so disorientated with time and days on these shifts, that it is not even funny.

The consultant who is on-call with me, is actually my immediate educational supervisor. And whether it is because he intimidates me or I am trying to prove myself to him, I do not how to describe this little ache in my heart......I left work this morning with a horrible feeling that I have missed something. I found it difficult to sleep...only managed 2 hours today. I pray deep down that no disaster was detected and everything I did was okie. Sigh, I should try to de-complicate my life.

Please, Just Listen to Me....for once....

It was a good day at work. I had my ward round finished by 12 pm. I made all my referrals, and wrote my letters. I managed to sit down for lunch! And I spent the afternoon trying to catch up with a few patients' family members.

Pretty chillaxing, isnt?

Until...I met the niece of one of my patients.

Boy, can she talk, and moan, and groan!

She kept yakking non stop....and she just didn't seem to get what I was trying to get across to her.

Her uncle was actually just discharged from the hospital one week ago. He was admitted because an irregular heart rhythm. Unfortunately, he was readmitted yesterday. This was, it was because his blood sugar level was too high. We screened him for any source of infection, and he was clear. So, it was felt that his high sugar level was purely because he needed an increased dose of insulin. There was no immediate issues with his heart. He was reviewed today, and his blood sugar levels were alot better! And, both the consultant and I discharged him.

The niece was an unhappy lady when she found out about this. She was dissatisfied with his SHORT hospital admission. She was unhappy that "nothing" was done for him.

Now, who in the world would be unhappy over a SHORT hospital admission??? Isn't good to discharge patient as soon as we can?? Why keep a patient in the hospital longer than they should?? And, what is this whole issue about us doing "nothing" for him. He was investigated for any infeciton, we increased his insulin....and you claimed that we did nothing??! Gimme a break!

Then, she asked me this question, "His blood sugar levels have been ok most of the time. Why suddenly it became erratic?? Why did he think he had a hypo, when his meter showed that his BM was high?? It must be his heart that is causing this."

I was like....whoooaaa.....hang on, hang on, too many questions at a time. The moment I tried to explain my thoughts about his problem...she just cut me short and was not listening. At the end, she became frustrated and just stormed out of the room. I gave my explanation as best as I could....I explained to her that his high sugar level is likely because his body is so used to his usual insulin, and therefore, needed more. A high sugar level can you feel quite unwell, and his heart has got nothing to his high BM.

It was such an exhausting conversation. I was trying to reassure her that nothing sinister was going on behind her uncle's back, and we can not guarantee whether or not he will have another episode of hyperglycaemia. I mean, how is that possible? How could you tell the patient or family member that, "yeap, I am 100 % sure that he will never have a hypo or hyperglycaemia again!"

Anyway, I just wished she kept her ears open and listened to what I have explained to her, rather than just storming out of the room. OR, maybe I was simply rubbish at giving her the explanation?

A Waste of Energy

Anger & bitterness eat away at your energy.
It actually takes alot of energy to hate someone.
You're punishing yourself.
If you hold a grudge, if you're walking around hating somebody & seeking revenge on someone, it eats you up.
Having the revenge might give you a split second of some kind of twisted satisfaction, but it won't last.


I came across the above short statement recently, and found it really true. There are many a times in life, where we feel so angry. Angry about something, angry about a person, angry about your own self. However, anger does not take you anywhere. Learning to forgive is a vital step towards moving forward.

Disappointed

I really wanna shoot myself.


I so really wanna hide somewhere in shame.

I dunno why, but I always seem to disappoint myself at times I needed to do well.

Urggh....why oh why???


SIIIGGGHHHH


All of you who are cursing and swearing and feeling so nervous before you attend a job interview....don't worry, I'm also a member of the club. I think the general public has this preconception that doctors will always get a job, no matter where they go. I shall politely ask you to think again. This is not the case in this country. We have to fight for limited training jobs, and attend painstaking interviews, which also depends on whether you were shortlisted.


How do we get shortlisted? Well, if you can fill in your form properly, ie, show that you're enthusiastic...then, who knows, you might be the lucky one, invited for the job interview.


I know I have chosen this pathway myself. But somehow, I feel that others seem to do so well under pressure...whereas I just seem to crumble.


I attended a job interview recently. I did not do well at all! There were 3 different stations. One was on my portfolio, the second one was about my commitment and the third one was a clinical scenario station. I was not too bad in the portfolio station, but the other two.....sigh....was where I fail to live up to my own expectations.


I was blown away by a few "funny" questions, such as, "how will you be different when you are a registrar?" or "what would you have done, if you were not a doctor?"


I found these questions funny....I know they don't sound hard, but somehow, finding a way to answer them seem difficult, at least for me, anyway. Because you have to relate them to your current situation or make it sound positive. Why are they asking me about being a registrar, when I'm not even started in the training programme, which will take me 2 years before I become a registrar?? All I know is, when you're a reg, you have more responsibility, and more junior colleagues working under you. And if I were not a doctor, I would do actuarial science. How I can relate that to medicine? I dunno.

Then, in the 3rd station, I was utterly disappointed with myself. It was a simple case of jaundice....and yet, I forgot to say that I would request a coagulation screen as part of the investigation!!! And, oh, I could not remember the cause of pre-hepatic jaundice....

I was like....HELLO??? What were you thinking, saw ling??!!! Alcoholic hepatitis is like your bread and butter!!! You deal with such cases almost every day....and yet, you forgot to mention the most important blood test!!!!! The moment I stepped out of the interview room, suddenly an influx of information entered my brain. Of course, the answer to the latter question was..... DUH!!! haemolytic anaemia. My memory failed me....my nerves got the better of me.


Anyway, I could go on and on to moan about how badly I did. I had only one chance...and I have failed myself miserably. I know it is all over now....but I can't help feeling this way.

Let It Snow! Let It Snow!

"Oh the weather outside is frightful

But the fire is so delightful

And since we've no place to go

Let it snow! Let it snow! Let it snow!"

yeap, the snow is here, finally! In some ways, I guess I'm lucky. The snow is not too bad in Glasgow. But certainly, places down south were hit by the weather badly.....to the extent that public transport ceased working, schools closed, and people took time off as they couldn't get to work!

This is my 3rd year in Glasgow. I can happily say that this is the first proper winter for Glasgow! haha. The previous winters were extremely rainy. At least it has been snowing intermittently over the past week, and temperature dipping below 0. It was -5 last night.

Anyway, I love the sight of white snow. I love the sight of snow covering everything on the ground....making everything look so pure, and clean! But this wouldn't last long, as the snow will melt soon, and people will start walking on the snow. The sight would be horrible. So that's why I decided to capture a few shots of the snow from my room....here they are.

The snow covering the common compound outside.

Cars covered with snow too!

Great Girly Weekend!

To top off my annual leave last week, my gal pals and I travelled to Dublin for a really short weekend break! woohoo!

Most of my weekends here are pretty unexciting. I would normally just hang out with a few friends and Kev. We would spend time savouring different food, shopping, chatting, coffee-ing, and going to the cinema. There would be the odd times where we visit a local attraction.

Last weekend was SUPER Girliciously FUN! hehe.

My gal pals were Georgina (or George as she is better known) and Laura. Laura has been my good friend in Glasgow. We met on the First day of our induction as junior house officers in Glasgow Royal Infirmary. We were both very early. She sat beside me. Later, we found out that we were both working in the same ward. We grew really close since then. George, on the other hand, was a colleague whom I met when I was also a junior house officer. However, she is not as close a friend as Laura.

Anywho, we flew to Dublin late Friday night. The weather in Dublin was pretty dull, to be honest. There was intermittent drizzle on Saturday, while on Sunday, it was SO chilly. But we kind of expected the weather to be like that.

We had tasty fried brunch to kick off our weekend. We wondered along the streets of Dublin, and popped into different shops to do some window shopping. As it was a chilled outing, we could not be bothered to visit the museums or galleries. We just wanted to look at buildings and take pics! Shopping was slightly pricey because of the current foreign exchange rates....but I still managed to grab a few bargains....like a new coat from Pull & Bear! hehe.

It was also an extremely sinful weekend. I had never eaten so much JUNK!! We munched on bags of Doritos, Mars Planets, M&Ms, chips.... and had a little too much alcohol. We had complete English brunch on both days. I ate 2 sunnyside ups on Sunday! Somehow, at the end of the weekend, my cholesterol level must have doubled!

oh well, the most important thing is I have enjoyed myself. I felt rejuvenated. I was ready to face being back at work, and facing all the nonsense that I have to deal with in the hospital. =D

Brunch @ Elephant & Castle - this is the first time I ate 2 eggs in a meal

I've Found My Golden Coin

It is very common to see coins or sometimes, notes, lying on the street. Some think that picking up money on the streets is not good, and some think that it brings the person good luck. Some think that it is too much a hassle to bend down to pick it up, and some think that every penny is worth it...even if it was only 1 pence.

I hardly ever bend down to pick up money found lying on the street. Don't ask me why. I really do not know....maybe I'm just trying to be too honest. However, having said that, I've found my golden coin a few days ago!

That evening, I was happily window shopping in Borders. I walked around shop looking at magazines, and was also actually trying to rest my feet, as they were very very painful because the heels of my shoes were killing me! Anyway, as I made my way out of the shop, I was something glittering on the floor. I looked towards that glitter, and hold and behold, I saw a big golden coin lying there.

Maybe it was Chinese New Year, or maybe the coin had some kind of magnetic pull, I instantly walked towards the coin and picked it up! Let me tell you, it is not any golden coin. It is pretty special! Here it is:

=D hehe....I know, I know, it is a fake chocolate gold coin.....and it is from Starbucks Coffee.....but what the heck! I found it on the 1st day of the OX year, and I will treasure it.

I found the whole thing pretty amusing! I mean, what a coincidence, dont ya think??

........ secretly, I hope it will bring me loads of luck and happiness this year! CHEERS! Hope everyone is enjoying CNY back home!

OXpicious Year!

Ahh...its that time of the year again!

Its Chinese New Year...and it is the year of the "Niu" or in english, the OX.

GONG XI FA CAI!

I really miss the atmosphere back home...all the "dong dong dong chiang" tunes, the chinese new year goodies (bak kua, love letters, yee sang, etc), the ang pows, the exciting card games....and of course, meeting up with friends and family.

Over here in UK, it is yet another day....no Bank Holiday...everyone goes to work as usual...unless you have chinese friends, most people do not know that it is the first day of CNY. Lucky for me, my annual leave starts today for 5 days. Nothing much planned. Just going to chill, complete some work-related stuff, shopping, eating, hanging out with friends.....=)

Yesterday, I had dim sum with kevin and sis for our reunion meal. We had initially planned to cook...but guess we were all abit too tired to do that. After that, we went on to watch Slumdog Millionaire.

Thumbs up x 2 for this movie...It was excellent...a very simple story...it just shows how somethings happen for a reason because it has been written for you. You can't really predict what happens...but a little luck does play a huge role. Highly recommended. I think the next movie I would like to catch is the "Chindi Chowk Goes to China."

Anyway, here's wishing everyone a happy chinese new year!! My cousin sent this to me:

BULL-eye your goals

BULL-doze the year with abundance of good fortunes, health and wealth!!

CHEERS!!!

The Sky is Crying For Them

What a week! Never have I been this emotionally disturbed after work as I have last week. One after another sad events seem to be happening to all my beloved patients.

1. A young 66 year old man, with multiple metastasis to liver/lungs, but unknown primary, died within 2 weeks of being diagnosed. His wife was distraught. To make matters worse, he died while she went away to have a cup of tea as she didn't want to face her husband in tears.

2. A lady, aged 70-ish, who was diagnosed with a right parietal infarct in her brain, which left her with mild residual weakness of left arm, presented with worsening left sided weakness, to the extent that she kind of neglected her left side and was stumbling. An urgent repeat CT showed multiple brain metastasis, again, the primary cancer is unknown. Neither did she nor I expected this...as I thought she merely had an extension of her stroke. She was very upset....and the fact that she has worked in a Hospice for over 20 years, made her aware of what she is going to face in the next few weeks to months or years! She was so emotionally unstable...her son also lost his ability to calm his mother down.

3. A 75 year old man, with a history of weight loss and epigastric pain, presented with general tiredness, confusion and severe dehydration. He looked really unwell. He was jaundiced, cachetic, and very confused. We wanted to arrange an urgent CT for him, but unfortunately his poor kidney function did not allow for it. So we opted for an abdominal ultrasound scan, which revealed a mass at the head of pancreas. He died on the 4th day of his hospital admission. It was an unpleasant scene, as his wife, is a young Asian lady, who did not really comprehend English... so making explanation difficult...it was awful that we couldn't find an interpreter. However, luckily her friends were able to translate some English words for her.

At the end of the week, I was an emotional wreck. I know that dying is part of life, but honestly, informing family members the bad news was difficult and watching them cry for their loved ones, was even worse! I felt my heart twisting in pain, and could feel my emotions building up.... but I had to remind myself to maintain composure.

The poor wife of one of the patients asked me, "Can he hear me??? Can he see me?? Is he going to die today??" A felt a huge lump building up in my throat....I mean how are you meant to be responding to such questions?

And I wonder why the new year has started so badly for them all. The sky is also crying for them....the silly weather has been windy and stormy.

I do not know whether doctors should or shouldn't be holding back their emotions in circumstances like these. I mean, at the end of the day, I am just another normal human being. I remember being told at medical school, that as a doctor, I should empathise...but should NEVER ever cry with the patients or family. In some ways I feel that, if I cry, then, I will not be able to provide good support for them and I might be deemed unprofessional??? But if I don't cry, does that mean I am emotion-less?? I don't know.

Difficult Patients

There are so many types of patients in the world. They can be pleasant and cooperative, demanding and manipulative, rude and aggressive, confused, psychotic, etc...

Patients that I have found particularly difficult to deal with are those who are demanding and manipulative, and those who are rude and aggressive. I mean, look, you are in the hospital because you're not feeling well, so just blooming do as you're told.

My recent weekend on -call was probably one of the least busy ones. However, the amount of difficult patients I have to deal with was really pushing me to my limits, and I could feel myself losing my patience. One of the example was this:

I was paged multiple times by fellow nurses in a particular ward about this gentleman, who claimed that he was not seen by a doctor for 4 days. He has threatened to take an irregular discharge, and he was being really rude to the nurses. He has also been self-medicating in the ward (which is not allowed in the hospital environment). I was told that he was seen by the junior house officer the day before, who tried to reassure him, but he has refused to listen to him. He had insisted of seeing a senior medical doctor. Therefore, I was called along.

When I arrived, he had all his bags packed (but was still in his sleeping robe!). I looked through the notes, and I found 2 entries (one by the consultant looking after him on Thursday and another by a senior doctor in the same team). The last entry was on Friday. Remember that it was the weekend...and in this hospital, no formal ward rounds take place...and only patients who are acutely unwell, would be reviewed. So, the whole crisis about he "was not seen" was a total farce.

I introduced myself and apologised for taking such a long time before I had the time to see him. He accepted my apology. BUT, then came verbal diarrhoea of what he was not happy about. He was unhappy about this medications. He demanded to have a few of his medications that were stopped because of his worsening kidney function. He was unhappy about the way the nurses are treating him. He was unhappy about the fact that he is a medical patient in a surgical ward. He was unhappy about why his consultant has not been to see him over the weekend...etc...the list went on and on. He said I should have got the consultant to review him.

I got pretty fed up, to be honest. Who are you to tell me what to do? You are a patient, and you should do as you're told. If your allegations were true, then I'm happy to accept your complaints...but the fact was, none of them were!

Anywho, I could only apologised, and explained why his medications were not given, and stressed to him that it is the weekend, and only very limited medical team are on site.... gosh...it took me like an hour just to keep him happy! I could have used my time to review other sicker patients.

I suspect what might happen at the end of day is, he may well file a complaint. I remembered reading through one of the complaint letters addressed to a particular consultant.

"I am happy and satisfied with my medical care. But I am outraged that I was given a soup spoon to eat my porridge, and the trousers that the nursing staff provided me with (as I did not have any of my own) did not fit. It was too big!"

I laughed when I read that....what kind of complaint is that?? What is the problem between using a normal spoon and a soup spoon to eat your porridge...it is just the same. And, I think he was lucky enough to be provided trousers to put on before discharge.

Patients....what can I say? I guess it makes my job colourful.

*my apologies in advance to any patients who got offended by reading this post.

Treasure Your Life!

I was slightly disheartened when I went to work this morning. One of my patients died in the early hours of the morning.

He wasn't just any patient. He was such a lovely man....and to make me feel even worse, it was his birthday yesterday! He had no family members, and lived alone. However, he had caring friends, who sent him a surprise birthday parcel to the hospital! aww...isn't that sweet? Unfortunately, he was so unwell yesterday to even realise that it was his birthday, and he was quite confused. He was struggling so hard to breathe, and I could just see him deteriorating right in front of my eyes. Neither of his friends live nearby. Sadly, there was no one there with him to accompany him during his last few hours of his life.....he died alone.

May he rest in peace.

urrgghh....doesn't that just depress you? I just feel utterly sorry, and I know, by now, having been in this job for more than 2 years, I should be used to this....but no.

It just made me treasure my life even more. I mean, would he ever thought that he would be spending the last moment of his life on his birthday....and in the hospital.....and alone?? No, of course not. You'll never know what is going to happen to you...and I think the phrase, "Live each day of your life to the fullest" is so so true.

Let me be honest here. I feel disgusted when I see many people drinking too much alcohol, taking too much drugs, and just simply not treasuring their lives at all! I mean, yes, you may have a social problem, but heck, there are many ways to go around it, and not drain yourselves under booze and illicit drugs.

Ah well, who am I to tell them what to do with their lives.

Maggi, My Saviour!

Call me pathetic or sad....but I really got excited when I saw this at Tesco 2 days ago:

hehe... I mean, Tesco? Selling Maggi Mee?? They were even selling them in packs of 5! It was about 1 pound for 4 little packs of Maggi...which is actually not bad, considering that the currency has dropped so much.

Maggi is indeed my saviour, especially on days when I don't know what to cook, days when I finish work late and am absolutely starving, the cold, freezing, rainy days (like now)....etc.. honestly, Maggi is simply The Best! And it takes less than 5 minutes to cook!

I was just back in Malaysia 3 months ago. And I don't think they were selling this particular flavour back home.

aahhhh...yummy... maybe I shall eat Maggi later when I get back from work. =)

Can I have some spider, please?

Yes, I would like some spider, please??

Have you not heard of Spider? Ah man, you must be well out of date! Spider is the coolest thing, at least thats what I think anyway, which my friends and I created recently! No, it's not that insect, you call a spider, you numpty!

Spider = Spices + cider

haha.

We came across ready made spice packs in Sainsbury recently. It was THE perfect pack to make mulled spiced cider....instead of the usual mulled wine. It was dead easy. Just pour about 1 L of cider and add in the spices.....I threw in a couple more dashes of cinnamon powder and also, freshly grated nutmeg. Remember to serve it with freshly chopped apples.

It was tasty! The spices smelt great, and gave the cider an excellent taste. Both my housemate and I toasted to the New Year with some spider. It is even tastier in this below Zero degrees temperature.

Do try it! =)

Welcome 2009!

I honestly can't believe that another year has gone by!

2008 has been a "not bad" year. A lot of new experiences and adventures!

Let me take a look back:

• New job, with heavier responsibilities. So heavy that I felt rather intimidated by it when I first started the job. I am a little better now, but still approach my on-calls with butterflies in my stomach.
• I did some wall climbing at Edinburgh...which was brilliant...unfortunately, I have never been back because I do not have a climbing partner.
• I am certainly ALOT fitter now....I can run 5k in less than 30 minutes. =)
• I have been travelling!! I visited a few places this year....such as, Amsterdam, Isle of Skye, Gloucester, and Poland.
• Meet new friends both at work and socially. They are all nice people.
• I have been socialising more in 2008. I have been out to a few night outs...and xmas parties, which I have never really done previously.
• Oh...yes, I have also popped plenty of xmas crackers this year! hehe.
• I took over ownership of a black Ipod nano from my beloved brother. =P
• I am officially a gig-fanatic....thanks to Kev! haha. Yes, let me see, I have seen Duffy (which started it all), Radiohead, Oasis, Kings of Leon, The Ting Tings, Bon Jovi....and will be at Take That's Gig in June 2009! woo hoo...can't wait.
• I have matured more as a person. I began to realise the reality of being a doctor....the fact that I have to make important decisions with regards to treatment, I have to break bad news to them, and I have to watch them die in front of my eyes...for me, these are not easy to face. Every patient is different, everyone will respond differently to treatment, every patient is a new challenge.
• Even working with different bosses and nurses....they are a huge challenge. Patience is definitely a virtue. All the abuse I get from the nurses about how irrelevant they think my actions were, all the constant unnecessary remarks from the bosses...man, it's only now, that I began to realise that working is not as easy as I thought it was....
• and how could I forget, I met a special someone, called, Kevin...who is the most artistic person I have ever met. He introduced me to the art world, music, photography.... Who would have thought I would spend my weekend listening to a famous artist talking about his art work? hehe..yes... new experiences. Adam Neate, Banksy, Damien Hurst....never have I imagined that I would have a little knowledge about their famous works.

There are so many other things... all good memories, and some bad.

Hope 2009 will be more challenging and exciting for me. I have made no resolutions this year. My only wish for everyone is good health and good luck!

CHEERS TO 2009!!! =)

and of course, to my beloved Kevin, thank you for listening to all my rants....and thank you for being who you are.

ps...note the new look to my blog...and a new blog title too! =) Its a new year, Its a brand new start!

Treatment or No Treatment?

I have always found myself stuck in a difficult position in medicine. But I always believe that I could only do what I feel is right and best for my patient. Of course, I have to ensure that whatever I do, does not cause more harm to my patient. During the final months of medical school training, I began to accept that I am the person in charge of making decisions, that could either safe or kill a patient! Shite!

Last night, I found myself in such a position. A poor elderly lady with dementia and has been registered blind, was admitted to the hospital with a chest infection. Unfortunately, things turn for the worse, when she developed kidney failure and, looking through her ECGs (heart tracing), it was noted that she might have also suffered a silent heart attack. A further blood test confirmed that she definitely did have a heart attack whilst in the hospital. She was hardly passing any urine because of her poor kidney function. She had antibiotics and intravenous fluids running to treat her illness. Looking at her co-morbidities, I felt that she is such a frail old lady with hardly any quality of life. I made the decision that she should NOT BE RESUSCITATED (DNAR) in the even of a cardiopulmonary arrest, but we should, however, continue to treat whatever we can.

Later in the morning, she became even more unwell. She started to breathe really hard and her oxygen saturations deteriorated. I wondered whether she was overloaded with fluids or her chest infection has worsened. I made the decision to perform another chest x-ray and repeated a couple more blood test. At that time, I was assisted by a specialist nurse and a few other staff nurses.

The moment they heard that I was going to get another chest x-ray, they looked very puzzled. They questioned me about it. They said, "But she has a DNAR status. Why are we still doing chest x-rays and repeating blood tests?"

I felt abit frustrated with that question. From my humble opinion, although she is no longer for resuscitation, there is still an opportunity to reverse anything that could potentially be reversible. As far as I am aware, a DNAR means do not attempt to restart the heart when it stops beating, and NOT withdraw any treatment. If we were not going to do anything about her increasing respiratory distress, then why even asked me to review her?

I mean, let's face it, if she did have fluid overload, this is treatable with diuretis etc. And she only had 3 days worth of antibiotics, so if her chest infection is worsening, we could try to add a few more antibiotics to see if it will help. I mean, we should at least try a minimum of 7 days of antibiotics before we could say, "oh right, looks like she's not going to improve...we have tried what we could."

I don't know. I felt that my decision was not supported by my fellow team members. Deep inside of me, I still did not want to give up on that poor old lady. I know she is demented, she does not have a clue on what is happening, but I believe that if there is a chance to treat something, we should still try before giving up on a life....rather than let her die uncomfortably.

To treat or not to treat? DNAR or not, I personally feel that she should try our best, and only give up, if there is evidence that she has not responded at all.

Credit Crunch? yeah rite....

The much awaited Boxing Day sale has begun! In fact, because of the credit crunch, many shops have started their sale even before Boxing day.

I decided to pop into town yesterday to hunt around for good bargains too. And credit crunch or not, the people in Glasgow are spending money like there was no tomorrow! Some woke up as early as 5 am to start their shopping spree at Next (a famous brand here, and their sales start at 5 am!). The number of people shopping was crazy! I could hardly walk inside the River Island store.....and the queues to pay was up to the entrance! Talk about credit crunch, not!

I visited a few of my fav shops, ie Zara, Mango, Gap, Warehouse and Accessorize. =) I did manage to get myself a few pretty accessories, tights, and also a lovely purple dress from Zara. I was, however, disappointed that I couldn't find the thigh length cardigan at Zara....There wasn't much that caught my attention at Mango. But its alright, I am very happy with my purchases....

To be honest, the sale wasn't THAT great either. I mean, not all of the stuff are half price or less.... some of them only had 20% off or so. I am still looking to buy my body butters from Bodyshop....but I think I will do this online....because I get free delivery! muahaha.

okie...I am feeling very drained now...on-call last night was the quietest one I EVER had! But because I didnt rest before the on-call and also partly contributed by the 1 hour long resuscitation (in which the poor young lady died)....I am now absolutely shattered. The fact that I might have caught the cold from my kind patients doesn't help either.

=) well....me going to hide under duvet now!

Crackers n Cheese, Anyone?

I was really looking forward to watching Wallace and Gromit, "A Matter of Loaf and Death," last night....and I was not disappointed at all!

If you have no idea who Wallace and Gromit are, please cover your face in shame. =P

It is actually a clay animated comedy, starring Wallace, a chesse-loving man, and his ever faithful doggie, Gromit. They both work together very well to create all kinds of super high technology machines to make life easier for them....or for their own business. In this animation, they are both very funny and always supporting each other in their adventures. Although Gromit doesn't talk, his facial expressions say a million things!

Anyway, last night, BBC 1 premiered a brand new adventure, titled as above. Oh man, it was hilarious! There were witty lines, and an exciting storyline. This time, Wallace n Gromit started a new bakery business. However, Wallace fell in love with Piella Bakewell, a deadly murderer, who was killing all the bakers in town! It was up to Gromit to make Wallace realise that. So do catch their adventure on BBC iPlayer...

I was laughing my way through the animation....and *shhhh..... I watched it twice! muahaha. That's how crazy I am. Anyway, its breakfast time, and I might just have some cheese and crackers, with a nice cup of tea, would you like to join me?

Mince Pies n Mulled Wine

ahh...finally, here I am sitting in front of my notebook, on Xmas morning, hiding under my duvet, writing on my blog, which I have not done for AGES!

=)

so merry xmas everyone.

For once, I am not working today. I had a few old frens over for dinner last night. It was no traditional dinner though. There was no turkey, no christmas pudding...but we had tasty spanish paella, pakora, spicy curried fish, risotto, with buttered broccoli, runner beans and carrots. Pretty random menu, no? It was lovely though...not had such meals with frens for such a long time. Its amazing what work can do to you...you become so anti-social, and basically, you forget to enjoy life!

I was very sleepy and tired after dinner....and kinda fell asleep on the couch after a half a glass of mulled wine and mince pie. And I have woken up on the couch, greeted by the lovely glow from my xmas tree, which has been decorated with purply-black baubles! And oh, hehe....I still managed to open my pressies before I dozed off.

What did I get? I got a lovely embellished clutch from my best friend, Laura. Got a big box of Thornton's chocolate, a christmas cake, and a nice scented cande from Helen, my flatmate. Also, I received a lovely bracelet from another friend who's now in Birmingham. Ah Hoon gave me a lovely pair of earrings. There were a few other pressies which I have opened before xmas...and they were smellies from Lush (which were not the slightest bit smelly!), a lovely Xmas card holder (again, from Ah Hoon)....and the best of all, Kev gave me my favourite Take That CD, n cute little wee Nigel (that fat rat in Ratatouille). =D

hmm..let me see, this year's build up to Xmas day has been really excellent. Here are my reasons:
- From never popping a christmas cracker all my life, to cracking 4 of them this year.
- From never attending any work xmas nite outs, to attending 2.
- From never getting any pressies from ppl at work, to receiving 2 red wine bottles!

haha...so yes, I am quite chuffed about it.

No real plans today. Ah Hoon is flying to KL today. So I'll take her to the airport later. But, we will need to savour the huge almond pannettone first for brunch, accompanied by a lovely cuppa. =D

I am looking forward to watching Wallace n Grommit tonight. BBC is premiering a 30 min animation from Wallace n Grommit called "A Matter of Loaf n Death." Will be back to work tomorrow....NIGHT ON CALLS again! I always seem to be doing nites! ah well, shouldn't complain.

Have a lovely day everyone....I have alot more things to blog about...so will prob do them slowly over the course of this holiday period!

Spread the joy of christmas. Sing xmas carols. MERRY CHRISTMAS!


ps. my all time xmas favourite is Fairytale of New York.

If I Were a Boy

This song is fantastic! Boys might not like it for obvious reasons...

If I were a boy
even just for a day
I'd roll out of bed in the morning
and throw on what I wanted and go

Drink beer with the guys
and chase after girls
I'd kick it with who I wanted
and I'd never get confronted for it
cause they stick up for me

If I were a boy
I think I could understand
How it feels to love a girl
I swear I'd be a better man
I'd listen to her
Cause I know how it hurts
When you lose the one you wanted
Cause he's taking you for granted
And everything you had got destroyed

If I were a boy
I would turn off my phone
Tell everyone it's broken
so they'd think that I was sleeping alone

I’d put myself first
and make the rules as I go
Cause I know that she’ll be faithful,
waiting for me to come home, to come home.

If I were a boy
I think I could understand
How it feels to love a girl
I swear I'd be a better man
I'd listen to her
Cause I know how it hurts
When you lose the one you wanted
Cause he's taking you for granted
And everything you had got destroyed

It's a little too late for you to come back
Say it's just a mistake,
think i'd forgive you like that
If you thought I would wait for you
you thought wrong

But you're just a boy
You don't understand
and you don't understand, ohhhh
How it feels to love a girl
Someday you wish you were a better man
You don't listen to her
You don't care how it hurts
Until you lose the one you wanted
Cause you're taking her for granted
And everything you had got destroyed

but your just a boy

Green Man

The Incredible Hulk, Hell Boy.....what do they have in common??

They are human-like creatures that have distinctive skin colour.

For instance, the Hulk has green skin, while, Hell Boy has red skin.

Now, who would imagine that such skin colour actually DOES exist in this world??

Today, I met a GREEN man (he probably holds the world record for being SO GREEN!).

Yeap...no kidding. He is as GREEN as the Hulk, but with a darker shade. Nope, he didn't paint himself green. He is naturally green because he has too much bilirubin in his body! His liver is in fulminant failure, and I think he's not going to live very long. But, he was a real eye opener!

Hi, I am Dr. Death

I think one of the most obvious duty of a doctor that was NEVER stated in the job description is to break bad news to patients. Before I entered the clinical years of medicine, it never occurred to me that one day, I would be the one giving the patients bad news. And now, it has happened. Nothing could be worse than telling a patient that he or she has cancer, and only has a few more months to live.

And to add more "spice" into my life, what coincidence that I had to inform 2 of my patients that they have cancer on the same day! I felt like Dr. Death. In the morning, I sat down with a lovely patient, and broke the news to her that she has metastatic cancer. No matter how I tried to let the news out gently, I found it so difficult to even say the word "cancer." But I have no choice. I paused for a split second to wait for her reaction. And as expected, she broke down into tears. I felt myself welling up with tears too....but I told myself that I can't be crying with the patient... I need to be strong for her....to give her support. Not easy...especially when I can be rather emotional too.

Later in the afternoon, I thought my day was going to be better. Huh! Dream on! I discovered that another patient has an irregular shaped mass in her body. Sigh. I dreaded going through the whole process again. Anywho, I approached the patient. Luckily, her husband was with her. This patient admitted that she has thought whether she has cancer....and she was kind of mentally prepared for the bad news I broke to her. Unfortunately, as cancer is associated with death, she started to cry. Although I think her cancer is in the early stages and likely treatable, the general population would think that death is inevitable in a few years' or months' time.

Sigh. I felt like an evil person at the end of the day. I couldn't help but think that I had the Death Aura around me. I wondered, why in the world did I choose this profession.....I hate telling patients that they have cancer. I have done it many times since I started working...and you would think that it gets easier. Yeah rite.

Rock 'n' Roll Star

"Slip inside the eye of your mind,
don't you know what you might find,
a better place to play.
You said that you've never been
but all the things that you've seen
will slowly fade away."

"How many special people change
How many lives are living strange
Where were you while we were getting high?
Slowly walking down the hall
Faster than a cannon ball
Where were you while we were getting high?"

hehehe....
ooohh....I love Oasis, especially when they sing my favourite songs!
I am not a particularly crazy fan, but I thought it would be a excellent to catch them live! And I DID!

hehe... yes, they performed live in the SECC, Glasgow 2 days ago. And, it was a good performance. The whole concert hall was FULL! Although standing amongst the crowd would have been really fun, but I was glad that I bought seating tickets. The crowd was crazy; it was close to a stampede, and alot of them were performing the usual Glaswegian ritual of throwing beer around the hall. So I was glad that I escaped that!

They started off by singing "Rock n Roll Star," and they continued to belt out a few songs from their new album "Dig Out Your Soul." I felt that the performance was short, but that was partly because I really enjoyed it. The sang continuously for about 1 hr or so....and did an encore for 30 to 40 mins. They finished off with the song "I'm a Walrus," which was a hit song by the Beatles.

My ears were deafened by the end of the performance...but I really enjoyed it. Now I have their songs playing over n over again in my head! hehe. Loving it! Maybe I should catch their performance at Edinburgh's Murrayfield Stadium, with Kasabian and The Enemy, next summer? hmm...well, I will see what my working schedule is like first, because I think that gig will be held on a weekday.