OMG! Time is passing so slow!

I'm in the middle of my night shift. It is absolutely dead in here!!!

arrghh.....

I have seen all my acute admissions by midnight. There wasn't anymore referrals, until I received a call at 6 am, about a boy with abdominal pain. But he is going to be travelling from a different hospital that is rather faraway....so he would take awhile before arriving here. The ward was fine...apart from reviewing a few patients asthma or viral wheeze, there really wasn't much to do.

So my registrar and I had a cup of tea around midnight. Then we started to finish up the discharges, as the case notes were pilling up! We have done them all by about 3 am. Since then, I have been sitting about doing nothing...tried to do a few 'Best of Five Questions,' but didn't last long before I so totally lost my concentration.

I tried to take a nap...but only managed intermittent sleep for about 1 hour. After that 6 am call, I couldn't sleep. sigh. So now I'm wide awake, waiting for that patient to turn up...wishing that time would go faster...wishing that it will 9 am in 1 minute...so that I could quickly pass my page and handover to the day team!

7 nights

Its 1 down....and there are 6 to go.

Nights! Nights! Nights on call once again.

So sleepy now...need my beauty sleep. So nite nite.

It was Mummy's Birthday

It was Mummy's birthday yesterday.

I was on-call, so I didn't have a chance to wish her until it was 11pm her time back home.

Mummy was surprised to hear my voice, but happy. This is for you mummy.

Happy birthday to you mummy.
Wished I could be there to take you out for dinner or give you a big big biiiiggg huggie.
Happy birthday to you mummy.
Wished I could be there sing the birthday song and see you cut your cake.
Happy birthday to you mummy.
I miss you loads.
Happy birthday to you mummy.
I love you.

Mummy & me

Tsk Tsk...The Alcoholic in Me.

Remember I said that I drank a whole jug of beer in Germany? Yeah...so here are the photos as promised.

Let's get the party started! My first ever 1 litre jug of beer.





















Doing alright....managed to drink a quarter of the beer...The beer tasted really nice...strong with a slight hint of bitterness.


















Here's when I can't hide. I've drank more than 3/4 of the jug...my ears are starting to turn really red. They were, in fact, burning!



















Bottoms up!!

=) Finished my jug of beer. Whoa...it is a personal record!
















By the end of the whole drinking session, I was really full. My bladder was going to explode because of the amount of fluid I've taken in. It was undoubtedly unhealthy binge drinking!! But hey, I was still sober. And the plus point was I managed to get a good deep sleep that night!

Sushi

I love sushi. So when my friends asked me to join for sushi on Sunday, I was excited. We all headed to the new shopping mall in Glasgow, Silverburn. Apparently, the famous sushi store "Yo Sushi" has just opened there. This sushi bar is popular in Manchester, so my friends told me.

Its been a long time since I touched sushi. Even when I was at home last CNY, I didn't get a chance to grab a sushi bite. So I was really dying to eat one! Having said that though, I personally think that my sushi standards are very high. Back home, I really miss Genki Sushi. Imagine the crunchy soft shell crab temaki.....yummy.

Yo Sushi looked exciting. The whole bar was open right in the middle of the shopping mall. I could see different varieties of sushi circulating on the belt. So we quickly grab a seat and started to pick what we wanted to eat.

5 minutes later....I still haven't picked one.

Another 5 minutes....I still haven't seen any sushi that attracted my eyes.

I guess the sushi wasn't presented as yummy as the ones in Genki. None of the sushi were shouting to me, "Me, me....pick me! I am yummy!" I was a tad disappointed. But in the end, I chose the usual Unagi and salmon. They were nice....but I still think the ones in Genki were better.

Then, I went on to order a temaki roll. How sad, the ran out of the radish that is used to prepare the soft shell crab temaki...so I couldn't satisfy my cravings for the crab. I settled for crispy duck temaki instead...It was different, quite tasty....but I want my soft shell crab temaki!!! boo hoo.

All in all, I think Yo Sushi is "ok." But if you haven't eaten sushi for a long time....it will certainly satisfy you.

Choose Your Poo!

I've been wanting to blog about this for a long time... =P

I'm sure most of us have sufferred from constipation at some point in our lives. When constipated, we will try our best to eat more fibre to help solve the problem. If not effective, then, some of us would resort to laxatives.

I came across this pamphlet (shown below) designed by one of the popular laxative company, simply amusing.

(picture taken from the Movicol Paediatric Plan pamphlet)

It is a very educational pamphlet too, as it shows us that our poo can come in different shapes and forms. But after looking at it, you will probably think of your food differently. However, it gives us an idea how to manage constipation, especially in children, because kids can't really explain their poo to doctors. So people, choose your poo!

The Drugs Song

Got this cool song from a friend. Check it out!

Happy Deepavali

Happy Deepavali to fellow Indians!

To be honest, I didn't know it is Deepavali until my mum told me that she's not working because it is a public holiday in Malaysia today. Deepavali....makes me yearn for a bite of that crunchy tasty and oily muruku! What about those papadum you eat with the Indian curry...and the vade? Is that how you actually spell it?? You know what I mean, those deep fried dhall stuff. yummy!!

Sigh. Miss the atmosphere back home. Miss going to my dad's friends' house for Deepavali meals...

Shitty Day

Today just kicked off badly from the moment the clock turned 00:00 hours.

First, I could not sleep. I tossed and turned, tossed and turned, tried to count the number of sheeps that were jumping across the fence, tossed and turned again......before I finally fell asleep god knows how many hours later. My guess is 2 am. Then I woke up suddenly thinking that I have overslept, turned to look at the clock, and the time was only 3.27 am. I thought my eyes were playing games on me, so I double checked the time using my handphone. My eyes were not telling any lies. This trend went on until it was 6 am, when I finally decided that there was no point in sleeping anymore.

Secondly, the ward was totally chaotic this morning. There were outpatient clinic running in the ward, outpatient blood tests, elective surgical patients waiting for their turn to go to theatre, and of course, the acute admissions too. The nurses were flapping. They did not know how to cope with the work load...so everything was in a mess. When asked to do something, it would take them a long time before it was being done. But what really angers me is this "4 hour policy." I mean, hello, if you want to make it a 4 hour policy, make sure you do your job too. Stop hassling me to review patient X or patient Y, when you haven't even given the poor pyrexial child his Calpol!

Patients who were waiting for their blood test were getting impatient...Think there were about 3 of them. All the acute admissions came in a bus. So there were about 6-7 of them that came in together. So everyone was getting impatient! But hey, there is only one of me. I have to see these admissions, and do the blood tests for those outpatient ones. You just got to be patient people!!

Anyway, talking about impatience.....One of the parents yesterday were extremely grumpy. The moment I called their young daughter in for her blood test.....the first thing that came out from her mother's mouth was, "I'm no waiting for the ECG. Hospital X has looked at her heart, and the cardiology people said her heart is fine. I'm no waiting for another ECG to be done here."

She was refering to the ECG that has been requested for her. As usual, Monday mornings are always busy for such procedures, hence, the waiting time to get a simple ECG done is longer. The worse thing was, she also said, "I am no listening to a single word from that woman. Whatever she told me in the clinic was utter nonsense. I don't believe a single word she said. She didn't even tell me that the reason I'm here is for my wee girl to have some many blood tests and this ECG." She was speaking in a very angry manner. She added that, "I don't want to see her ever again...am not going back to her clinic ever again. I will get re-referred to another doctor."

I was confused, wondering who she was refering to as that woman. I asked her what she meant. I soon found out that she was talking about the consultant whom she met at the outpatient clinic. Honestly, I couldn't understand why she would say such a thing about that consultant because she is a really nice person.

She also asked me the reason for all the tests...and I informed her it was because her daughter is a bit small for her size. Mum thinks she's just petite. But guess she didn't realise that her wee daughter is also dysmorphic. Anyway, after kicking so much fuss, I asked her, "So do you still want me to proceed with these blood tests then?" "Aye...just do it," mum replied. Now, if you don't plan to see this consultant again, why do you still want to proceed with the tests?? I don't get her at all.

So everything was starting to boil my fire. The other thing that pissed me off was when this nurse came up to me and asked, "Can we transfer this baby to the next ward?"

"No, because she needs a cannula and blood tests before she can go across," I said.

"Why now when she's been here for more than 5 hours???" this nurse said.

arrghh...not this whole bloody 4 hour policy thing again!!! So I told her, "Well, she just had her ametop on about 20 minutes ago...so I'll need to let it work first before proceeding. Moreover, the decision about doing the blood test was made not too long ago."

She cheekily answered, "It needs to be done NOW."

What the fuck man.... when we decide to do the blood test is really up to us. You have been working in this paediatric unit for a longer time than me. You should know that we do not like bleeding kids unless it is really necessary. Sometimes I wish I could tell her, "Look, who is the doctor here." But then again, I hate being condescending and I do not want to be rude to her either.

It was such a shitty day. Glad it is all over. Knackered now.

Too Much Information

Do you sometimes feel that people share too much information?? I mean like seriously, TOO MUCH INFORMATION. I mean it is fine to share if you are close friends....but not when I hardly know you.

One example is my ex-colleague who started to have an affair with our registrar. He was and still is engaged to his wife-to-be. Well, I have no comments for their relationship. However, she chats too much about their relationship.....and that includes details of what they do in bed. She talks about it to almost everyone....I mean I feel sorry for the registrar because obviously he doesn't know that she's spilling the beans about their sex life to everyone. From being raunchy at sex to telling us when he lost his virginity. My, that is WAY too much information.

Another example which I felt totally grossed out about just happened over the weekend. My registrar whom I was on call with was talking to me about semen. It all started when one of our patients came in with ? cystitis. She said that everytime she drinks cranberry juice, her abdominal pain disappears. So, then came the Q&A part:

"Ling, what do you think that is in cranberry juice that makes it good for urinary tract infection?" asked my reg.

"Hmm....I just read about that on newspaper today...and now I can't remember! Something to do with its sugar content?" I replied (feeling like a total idiot...but I really did read about the power of cranberry juice in the health section of The Star on Sunday).

"It basically prevents bacteria from sticking to the bladder wall."

"Oh ok....I've learnt something new today!"

"Now, what does semen and cranberry juice have in common?"

I was like....HUH?! Why are you asking me about semen and cranberry juice....I answered anyway. "They both have high sugar content."

"Exactly, Ling. So what does that tell you?"

"errmm....its good for urinary tract infection prophylaxis???"

"Yes. And that's what I have been telling my girlfriend. I've been telling her that semen is good for her....she should take it."

I honestly nearly puked! Now that is really far too much information to share!!!

"Oh right," I answered, and thinking.....thanks alot for telling me that! I do not want to know what you are doing with your girlfriend in bed.

"Yeah, semen is good. I keep telling my girlfriend that she should take some semen," he repeated.

So I tried to joke back and said, "Well, I don't suppose it is clinically proven, is it? I don't think anyone would like to participate in a research of such."

He laughed.

Oh dear.....I'm an open person. But I think sometimes, certain information is better kept to your own self. That is honestly far too much information.

Happy Ending

Think the winter months have gotten into me. 6 pm is as dark as 9 pm. I feel abit miserable sometimes, loads of things running in my head. So many things that need to be sorted out...yet, I just can't push myself to do or face them. Happy ending? What is a happy ending? I know no happy ending. Everything is in a mess. Everything is in a horrible mess. I need to sort my life out thats it. When? I don't know....guess whenever I feel like it. Just gotta put a smile on my face, and take one step at a time.

Love this song...enjoy!

What Should I Treat It As?

A young girl, just about 2 years old, presented to me with coryza, cough and fever for 1 day. Parents noted increasingly worsening noisy breathing for the past 1 day. When I met the girl, she has audible wheeze and mild stridor. She had some tracheal tugging, and mild intercostal recession. Her chest had some scattered wheeze, no crepitations.

Now, it's decision time. Should I treat her as a viral-induced wheeze or croup?

I don't know.

So I rationalised to myself.
Right, her wheeze is more prominent...and she has got some wheeze in her chest. Hence, I should give her a steroid (prednisolone) and bronchodilator.

Or, should I treat her as a croup.....but then again, the treatment is also a steroid (dexamethasone).

Hmm.....hmmm....hmmm

Fine. I decided that I would treat it as a viral induced wheeze. Halfway through giving her the bronchodilator, her stridor became more prominent...and she actually started to cough..and that cough was a croupy cough. Hence, I changed my mind and treated her as a croup. I gave her dexamethasone instead.

Later on, I informed my reg about this. He said that he would have just given her the prednisolone anyway, because, during the olden days, prednisolone was the gold standard for either wheeze or croup. Oh well....decision has been made. At least she got a steroid of some sort. But decisions are never easy to make...and I cant imagine myself being more senior and making more decisions....Need to build more experience and confidence.

He agreed that she was a croup patient. Decisions....don't like making them. But my job nature doesn't allow me to escape from this.

The Letter

I just came back from work...and saw an interesting letter on the table. You know, sometimes, you can predict who the letter is from. But I couldn't in this occasion. Therefore, I decided to open it immediately.

Its a bloody letter from the insurance company of the vehicle which I bumped into. It states that they are holding me responsible for the event and they want my insurance company to deal with the whole thing.

Now, yes I am responsible. But there was hardly any damage to his van!! The damage was on my car....how could be possibly make any claim? arrrghh...This is really starting to stress me out. I hate dealing with matters like this. Maybe they decided to smash up their van abit more just to make the whole accident even more convincing....

#$%& guess I have no excuse for myself. I created this whole incident upon myself. sigh.

Guten Tag Munchen & Berlin!

Just got back from my holiday trip in Germany. I really enjoyed myself. People in Germany are friendly. I think I had enough wurst (german sausages) to last me for a year! hehe. Oh...not to mention, I had quite alot of bier (beer) to drink too (wait till you see a pic of me and a big JUG of beer!!). Anyway, the weather in Munchen (or Munich) was fantastic. It was sunny, but slightly chilly at night. However, at the foot of The Bavarian Alps, the weather was bitter cold, especially with the rain. My friend & I were lucky to have escaped the snow, because it started to snow quite heavily on the night we left The Alps. At Berlin, the weather was cloudy, and really cold. The fact that I only had a thin jacket on, made matters worse.

Anyway, here are some pictures from my trip!

Dinner...look at the 5 different varieties of wurst we had! White sausages too! yummmy!

A display of china potteries on the wall of The Residenz.

The park outside The Residenz.

The Olympic Park in Munchen.

Say Hello to the BMW Isetta @ The BMW Museum, Munchen.

The BMW Mille Miglia.

I can't own one, but I can certainly take a photo with it without any extra cost!
The BMW 7 series.

Sunny day at the palace grounds.

Schloss Hohenswangau (Castle of The Highland Swans..hope I got the translation right)

Schloss Neuchswanstein, Bavarian Alps. This castle is meant to be the inspiration for Disney castles.

Autumn in Germany.

The Alpsee Lake, Bavarian Alps. It was actually very cold, but I decided to take a photo without my jacket.

The Kaiser Wilhelm Church in Berlin, part of it was destroyed during the war. The square block beside it is where the church services are currently being held.

Inside the block of building....very blue and cool.

The Reichstag (parliament building)....the transparent dome above it provides beautiful scene of the whole city of Berlin.

Inside the transparent dome.

The bear is the mascot for Berlin. This bear in particular is made of broken ceramics.

Now, I have never seen such big grapes and big brussel sprouts ever!

The leaves are changing colour!!

The Berliner Dom and....a big fat bum on the left! =)

Part of the Berlin Wall.

ok....guess that was quite a few pics....hehe...but not alot for me though, as I am rather obsessive in taking pics....I have taken about 600 over pics in this trip! =P But not really happy with some of them because they were overexposed. I still haven't got the hang of using this panasonic cam...still prefer my broken down Casio Exilim.

Kate Nash - Mouthwash

Here it is! I personally do not get what the whole song is trying to say... but heck, its one fun song!

A very random song, but too catchy to not like!

hehe... I am so totally addicted to this song! Listen to it!

Mouthwash - Kate Nash

This is my face, covered in freckles with an occasional spot and some veins.
This is my body, covered in skin, and not all of it you can see
And, this, is my mind, it goes over and over the same old lines
And, this, is my brain, it's torturous analytical thoughts make me go insane

And I use mouthwash
Sometimes I floss
I got a family
And I drink lots of tea

I've got nostalgic don't know
I've got familar faces
I've got a mixed-up memory
And I've got favourite places

And I'm sitting at home on a Friday night
And I'm sitting at home on a Friday night and I hope everything's going to be alright

This is my face, I've got a thousand opinions and not the time to explain
And this is my body, and no matter how you try and disable it, I'll still be here
And, this, is my mind, and although you try to infringe you cannot confine
And, this, is my brain, and even if you try and hold me back there's nothing
that you can gain

Because I use mouthwash
Sometimes I floss
I got a family
And I drink lots of tea

I've got nostalgic don't know
I've got familar faces
I've got a mixed-up memory
And I've got favourite places

And I'm sitting at home on a Friday night
And I'm sitting at home on a Friday night and I hope everything's going to be alright

20 minutes Makes A Huge Difference!

I'm back doing my night on calls. It wasn't unusual that I did not manage to nap prior to the start of shift. Despite me trying to sleep later over the past few nights, I would still wake up, the latest by 9 am. I think the thought of starting a night shift just makes me slightly anxious...although you would have assumed that having done it before, I would be able to anticipate how it was going to turn out.

Anyway, slight anxiety, equaled to no sleep at all. The first night is always the most difficult one. It's because the body needs to adjust itself to the different rhythm. My Friday night was quite busy....didn't have a chance to have a break at all. So by the time it was 9.40 am, which was home time, I was feeling really sleepy. I decided to have a really strong cup of coffee....I put about 1 tablespoon of coffee into a mug!! Now, that is VERY STRONG coffee for my standard.

Gulped the whole coffee down, hoping that the caffeine would keep me awake for the drive home. It was more of mind over matter, as I do not get affected by caffeine. The first 15 minute drive was alright...I was yawning every now and then, but my eyes were still very wide awake. However, with only just 10 more minutes to reaching home, my conscious level just dipped.

My eye lids felt like they were tonnes heavy! I was struggling to keep them open. I started to play the music really loud, slapped my cheeks, and started to munch on a gum. Boy...I was glad to reach home safely. It was very dangerous driving!!!

During my night shift last night, I managed to squeeze in about 20 minutes nap...and it really made a big difference. I was WIDE AWAKE while driving home. But how often do you actually get a chance to nap during a night on call....Rarely.

There is certainly no doubt that sheer tiredness while driving can kill!!! Well, my heart goes to anyone that works very long hours/night shifts.....I totally understand how sleepy you feel after work.

I'm Saved!!!

With reference to my previous blog, thank god I was saved.

The rash turned out to be seborrhoeic dermatitis. *phew

Yikes!

*scratch *scratch *scratch

I'm feeling so itchy now. Help!

Just before I left work, I saw a young boy who presented with a rash. It was a funny rash, which I do not know what to make of it. The rash apparently has been there for a good 5 weeks now. He has been using a steroid cream which has made the rash worse. The boy was otherwise well.

My registrar reviewed the patient, and she too, did not know what was the cause of the rash. So we did a few blood tests, and they were normal. She decided to let the night on-call team review the wee boy as well.

So after informing the night team on call about the case, the first thing that came out from her mouth was, "Its scabies!"

I was like, "Nooo way...I touched him without even wearing gloves." Yikes!!!

She smiled and said the story sounded like it. But reassured me that if I had washed my hands after examining the boy, it should be ok. I wasn't buying it...the worse thing was, before taking the blood sample from him, I was actually carrying him in my arms, because mum did not want to accompany him into the treatment room for the tests.

Oh boy...now I'm feeling itchy all over. I was really paranoid....I washed my hands at least twice before I left the ward, and disinfected my stethoscope too. I really hope its not scabies...I shall get the confirmation tomorrow. And I will keep this blog updated...

Hope I can sleep tonight...*scratch *scratch

Body Attack & Balance....Totally Hammered....

I attended 2 fitness classes yesterday. It was a launching day at my local sports centre. Therefore, all the routine in the classes are new. I have always wanted to join one of the fitness classes, but never got myself to do it, because I couldn't get a partner to go along with me. However, I decided that I needed a change from my usual treadmill/cross runner in the gym.

So, my first class - Body Attack. Before the class, I kept wondering what would I be doing in the class. Is it boxing? Is it lifting weights? Is it aerobics? The fitness instructor was a fit and well toned lady. We started off with a tiny jog on the spot, which soon, picked up to lots of jumping, kicking, squats, etc...basically it was high-impact aerobics. I was working every inch of my body.... The music was excellent, fast and catchy. But after 30 minutes of it, I really felt tired. I couldn't really keep up with the pace (despite running on the treadmill for 3 miles at least twice a week!) My cardiovascular system failed me! How disappointing. Then, we started to do push-ups for about 10 minutes...my arms felt like they were going to break halfway through it, and again, I had to slow down. I could literally feel a piercing pain sensation in my arm muscles.

The whole class lasted for a good hour...and by the end of it, I was knackered. My body was hammered by myself! Sweat was pouring out from all my sweat pores. But it felt good. I felt like I really worked my body to the limit. Guess, the name body attack explains it all - Attacking your own body with high impact exercises.

Then, about 10 minutes later, the next class, Body Balance, started. Now this class is all about balance and stretching. It's a mixture of Tai Chi, yoga and pilates. I was quite glad that I attended this class after that muscle tearing experience earlier on. So I was stretching my muscles to relaxation...and at the end of the class, we laid down on the mat in a totally relaxed mood for about 5 minutes....Boy, that felt good! The music that accompanied the class was nicely chosen...very relaxing and nice.

After 2 hours worth of exercise, I was starving. Luckily it was near to dinner time and I met up with my ex-colleagues for dinner at Cafe Andaluz. The Spanish tapas was excellent. After dinner, it was a drinking feast until 3 am! It started off with 2 pitchers of sangria at the tapas bar, followed by, about 3 drinks in another bar...and lastly, we finished off at a bar in town, where we all had a shooter each and another drink! Boy, I was hammered! I felt really sick by the end of the whole night. I just wanted to go home and sleep....which was what we all did.

By the time I got home, it was 3.30 am...I pushed myself to take off my contact lens and changed into my PJs. Oh...and I also made sure I brushed my teeth...because sometimes I really can't be bothered to do that if I'm really really sleepy. =)

This morning, I got up 6 hours later...feeling refreshed and hungry, but with a terrible muscle ache all over.