Cook, Cook and Cook!

I havent mentioned this before, but one of my other resolution for the new year is to cook. Yes, I seriously need to spend some time cooking a meal for my ownself.

Over the past year, I have to admit that I have been cooking more than I used to, but it is still not good enough. Many a times after coming back from work, the tiredness and laziness just overcome my whole body, to the extent that I simply could not be bothered to stand in kitchen to cook a simple meal, like pasta or fried noodles/rice. But, is boiling some instant noodles for 3 minutes considered as cooking? Probably not.

This is even worse after a long day at work, or pre-night shifts. I keep telling myself, "Come on, how difficult can it be to chop up some vege/meat....put some oil in the pan, and cook yourself something edible?!"

Well, I think it is difficult, and requires alot of inspiration and effort. haha. The only time that I feel the urge to cook is when I have a friend over.

When I don't cook, I would eat loads of junk, just to keep me tummy filled. The junk includes sweets, chocolates, biscuits, crisps, breakfast cereal (even for dinner!!!!)..and ice-cream!! (I hide my face in shame just admitting to all these....) How am I meant to set a good example to my patients?!

So this is why it is very important for me to stick to this resolution of mine. Therefore, I have recently bought a few new recipe books...just so that I can get some ideas and make cooking bit more exciting/less hassle.

One of my new recipe books is called "Miss Dahl's voluptuous delights," written by Sophie Dahl, of course. I bought it because this book is written in a seasonal manner. So, they are different recipes for the 4 seasons of the year, and each recipe uses certain ingredients that are of more abundance in that particular season. Her instructions are easy to follow. Now, isn't that a good recipe book?

I shall update this blog now and again, whenever I attempt any of her recipes.

Also, since the start of this new year, I have followed a few of Nigella Lawson's recipes, which were taken from the internet. I love the way Nigella cooks her food. It is so different from other chefs, like Gordon Ramsay/Rick Stein.

Before I end, here's a treat for all you chocolate lovers/snack lovers out there. I strongly recommend Nigella's very easy to follow, and sinfully delicious "Churros with a chocolate dipping sauce" recipe. Yummmm....

Here is the link, so do go check it out:

http://www.bbc.co.uk/food/recipes/churros_with_chocolate_84833

=)

New Year ... New Look!

Welcome 2011!

I must admit that I have been struggling to write the dates in the case notes!

I keep writing too many number 1's. LOL.

Anyway, to celebrate this new decade, I have decided to change the look of the blog! I have chosen the wintery background because it is winter here in the UK. More snow has been forecasted over the next few days! *sigh

I should not really make any resolutions as I never keep up with them....but I feel the need to aim for a few things this year...and they are:

1. to run a 10k

2. to pass all my exams

3. to go home for a holiday

4. to travel abroad...somewhere!

Just 4 things to aim for this year....should not be THAT difficult!

wish me luck!

=)

A lil note to end the year...

another year has came and gone.

what can i say about 2010?

it has not been a bad year for me.

i managed to pass my exam after a few attempts, which was a great milestone for me.

i had a wonderful spring break visiting Paris...such a lovely place. i would go back there anytime.

i had a fun summer....this time, i travelled to Lake District, and visited the little towns at that place.

Autumn was the main highlight of the year...because I got to go home! yes....it was lovely. i managed to attend my best friend's wedding, and was even more surprised when she asked me to give a speech at her wedding. i also attended my cousin sis' wedding...which was lovely. i met up with most of my old frens, savoured all the tasty local cuisines...

then, came winter....which was BITTERLY cold. it snowed, snowed and snowed. my arms were getting very good daily workout, by just simply scraping the ice off the car! driving conditions were horrible....i feel so lucky that my car has been brilliant, apart from the signal light wiring problem.

it was soon christmas....where i spent the weekend working. it was busy and tiring. i received a few lovely pressies....got lovely purple gloves, 2 DVDs from the studio gibli company to add to my collection, a head massager, a box of chocolates, 2 tins of biscuits....However, i also received a rather odd xmas present, in the form of a luggage tag?!

anywho, it is new year's eve now...and i am happy that i am sitting down on my couch, in front of the telly, and typing this, with kylie minogue's music playing in the background. life has been very kind to me. i am blessed to have a lovely supportive family back home, a boyfriend that is so patient with me, a few good friends here that are there when i need them, a nice and cosy flat, a good job, enough funds to support my occasional crazy shopping spree...

so goodbye 2010....and welcome 2011!!! =)

Night Shifts.....again

My night shifts ended on Friday morning. The whole week was horribly busier than normal, most probably because people are catching various kind of illness during these few months as we approach winter.

The nights were made more pleasant by being on call with a hot Spanish registrar. *hee heeee

Yes, he is new in our hospital. He has lovely wavy dark brown hair, tanned, and I love his Spanglish. He is also tall and well built. (hopefully you could picture him in your mind). He is also extremely approachable, helpful and down to earth. The funny thing was actually watching how a few of the nurses with him in the ward! yes!

The nurses will come up to him to ask him to prescribe simple things like paracetamol or an anti-sickness medication...which is what I usually do for them. But rather than asking me, they approached the reg. While waiting for him to prescribe them, they just start to chat him up!

haha.

I bet the reg was enjoying all the attention. Some of them even sat down and had a little conversation with him...which was pretty unusual on a busy night shift.

Oh well, that aside, he is a great reg to work with, and I was glad to be on call with him.

errm.....yes ok, I probably did giggle a little too much whenever he cracked a joke! =P

Yay!

Finally got my MRCP 1 performance details yesterday. Yes, I passed, finally!

I really wanted to know which field I did best....After the exam, I felt I didn't do well in the clinical sciences, clinical pharmacology, infectious diseases (ID), neurology, dermatology, nephrology and respiratory.

Surprisingly, I did very well in ID, pharmacolgy, neuro and nephro. And even more surprising, I scored full marks in dermatology! I also did very well in geriatric medicine...maybe I should think about becoming a COTE specialist.

But I was right, my scores were quite low for the clinical sciences. I didn't do as bad as I thought in ophthalmology and respiratory.

Overall, I'm pretty pleased with the outcome.

Now, to prepare for Part 2.

The pressure is on...coz a lot of people at my stage has already gotten full MRCP.

Delicious Malaysian Food

My trip back home was all about catching up with friends, family and enjoying local food. And that was exactly what I did. Due to our multi-cultural society, we get to enjoy food from a vast variety of food, including chinese, malay, indian, western, japanese, korean etc.

I will not write much...but all I can say is MALAYSIAN DELICACIES ARE DELICIOUS! There are so tasty, bursting with flavours...yumm... I hope the following pics will make you hungry! =D

Ipoh white coffee, with kaya toast

Tasty and crunchy bean sprouts (or taugeh)

Ipoh Hor Fun

Char Kueh Kak

Nasi Goreng Peranakan

Asam Laksa

These food looked good rite?

Well, they were EXCELLENT!

If you haven't been to Malaysia, pls do plan a trip there...its well worth it! =P

6 more days and counting!

The only thing that is keeping me through the crap at work is the thought that I'll be home in less than 7 days!

woo hoo!!

I really can't wait. I am really excited coz I haven't been home for the past 2 years. But at the same time, I am rather stressed with it too. Well, should I say that the stress is actually GOOD stress. I mean it is NOT like exam stress at all, which I must say is BAD stress.

Now you may ask why am I stressed out?

The stress is because I have not much time left for packing.....I dislike the fact that I am on-call this weekend. If only I were off, I could take the time to pack my stuff, and also maybe do abit of last minute shopping.

The other stress is having to prepare a speech for my good friend who is getting married in exactly 10 days. Don't get me wrong, I am extremely honoured to be asked to speak at her wedding reception.....but the only problem is I have never done this before. I have never been to a wedding reception before! So I really do not know where to start! Anyone has any good ideas? Or anyone has spoken at a wedding reception before???? Please share your ideas and experience with me.

I am thinking of starting it with a lil LOVE quote, and then, proceed to talking about what I think of my friend as a person, and how she met her hubby and managed to keep the relationship strong for the past for more than 5 years.

hmm...it is easy to think of what to say...but it is putting those thoughts into words I find difficult. I still haven't started to write anything yet....and time is running short!! help!!

Those stress aside, I am starting to count down to the moment I step into my flight back home to destination: KL.

Physiological Changes to the Body During Stress

Gosh...its amazing what stress can do to one's body. I have been very stressed lately, with exams, portfolios and work.

Stress was at its peak yesterday because it was exam day! My body was behaving oddly.

I could not sleep...(waking up every hour from my sleep is NO sleep at all.

I struggled to eat any of my meals (but forced myself to otherwise my brain cannot function).

I have million butterflies in my stomach (highest number yesterday compared to the rest of the week).

I felt so nauseated that I nearly vomited in the train!

My heart rate was averaging from 90 to 100 bpm for most of the day.

I was having pleuritic chest pain for a few hours.

My fingers and toes were freezing.....and the palms were sweaty.

........... This morning, I slept bit better, still having some flashbacks about the exam yesterday....I just need to stop thinking of the questions and the answers..... Coz when you think about it, you want to know whether you have put down the right answers by looking it up in the book. If the answer was right, that's good....if not, I will feel very upset. So I'm really trying not to think about it.

It is time to get ready to work.... I am not hungry, but probably should have my breakfast otherwise I would be hungry later.

I am hoping for a stress-free day at work today....can't physically manage another stressful day again today.

Grim

Dying from cancer seems like the most dreadful thing. It is a slow and painful death. There will be numerous hospital admissions either for chemotherapy, radiotherapy or surgery. And let's not forget that these patients have to endure endless complications either secondary to the side effect of their treatment or because of countless infections.

It has been a grim day at work today. 1 out of 4 patients in the ward is suffering from terminal cancer. None of them are curable. Majority of them have a severe infection, while the others have new spread of their cancer.

I really can't imagine how much pain these poor patients are experiencing. It must be excruciating. We are trying to manage these pain issues with strong doses of opiates, and also putting them on a syringe driver. But we never seem to be able to keep their pain score at ZERO.

And it also makes my heartache when I saw a lovely man in the ward who was talking to me about 2 hours ago, and just as I left the hospital, he was unconscious, agitated and taking the last few breaths of his life. I know I shouldn't be surprised to see how quickly a cancer can kill you, as I have seen many of them in such situations, but still, I can't help it.

To top it all off, it upsets me even more when people drink far too much alcohol for their own good, and end up having liver damage because of it. Why do you self mutilate your body?! And once we have treated you and get you back on your feet....what do you do??? Of course! You go back to your old drinking habits. Within a few months, they bounce back into the hospital again, and the whole cycle repeats itself.

Have they ever thought of how previous their life is??? Why do they want to end their life so quickly??? Have they even thought of those patients suffering from terminal diseases that would prefer to live on for a little longer, but can't because they isn't any other way to cure them?

I dunno. I guess this is medicine and the reality of life for me.

The Big Changeover

The biggest day in hospital diary is the day where all junior/senior doctors changeover in August. Outpatient clinics are reduced or cancelled to allow for a less chaotic changeover. Team leaders from different departments in the hospital will be asked to do a short presentation to the new group of doctors, as part of the hospital induction.

On this day, fresh junior house officers begin their career as doctors, learning to apply everything learned in medical school into clinical practice.

On this day, ex-juniors become senior doctors, embarking on new challenges and bigger responsibilities.

On this day, most doctors will start work in a different ward or hospital, whereas a few others will remain in the same place.

This particular day is said to be the worst day to be admitted into the hospital, as errors do happen, and most things will be disorganised.

My changeover day was not bad at all. I started off doing night shifts, which is absolutely fine, because I get to escape the morning chaos in the wards. However, on my night shift, there was a junior doc who was absolutely terrified of doing anything! *Bless her!

She was terrified of writing up a patient's drug chart.

She was terrified of taking a blood sample from a patient.

She was even terrified of waking a patient up at 3 am for a physical examination!

Poor gal....I have honestly never seen anyone as scared as before!

Anyway, with a little push, she plucked up the courage to do a few basic things during the night shifts.

Apart from being terrified, she appeared absolutely clueless as well. The one thing that I remembered the most from that night shift was she didn't know how to prescribe paracetamol!

In my very humble opinion, I think that is the simplest prescribing task ever! How could she not know how to prescribe that? hmm...Maybe I am expecting abit too much from a junior house office.

The big changeover day has passed, and work resumes as usual for everyone.

Live or Die?

Wow....the season 6 finale for Grey's Anatomy is the best yet!

In fact, the storyline from season 4 onwards have been really good. I see each characters growing... most of the episodes were very meaningful. Somehow, I can feel what the patients and surgeons were experiencing. I feel my emotions floating into the scenes....I couldn't help but cry too!

Season 5 ended with George dead.....then, Izzie had skin cancer... and then, the unexpected happened. Dr McDreamy was shot!

Gosh....I was crying so badly when I watched the final two episodes....

I know it is only a drama...but heck, the creators have done a good job.

What Grey's Anatomy said was right. We all have choices. Life is full of choices...

Do we want to be a hero or a coward?

Do we want to fight or give in?

And do we want to live or die?

I know that these choices are not always given to us...but if we were given them, which will we choose?

Would you fight on to live.....or do you give in to your illness and die?

Do you become a hero, and try to save the day....or do you become a coward, and hide from all responsibilities??

hmm....decisions......

The Writer - Ellie Goulding

My favourite song at the moment: The Writer by Ellie Goulding

Love the the lyrics... here is part of it.

But I've got a plan

Why don't you be the artist

And make me out of clay?

Why don't you be the writer

And decide the words I say?

Cause I'd rather pretend

I'll still be there at the end

Only its too hard to ask

Won't you try to help me?

Such meaningful words....

Conversations in the Hospital

Thought I would share a few entertaining conversations I had in the hospital this month.

Conversation 1

This lovely elderly man was admitted with urinary retention, and subsequently developed a urinary tract infection. While examining him, I proceeded to ask him the routine 10 AMTS (Abbreviated Mental Test Score) questions.

One of the questions was, "What do you think my occupation is, if you look at me?"

Bear in mine that I was wearing a simple blouse and trousers, with my stethoscope hanging around my neck, and my pager stuck to my pocket.

He gave me a good look, and said, "Well, you're a beauty queen."

hmmm.....I wish I was. He scored 5/10....so guess he was pretty confused eh?

Conversation 2

A locum orthopaedic doctor came to my ward to review a patient of mine who possibly has a broken pubic rami. He examined the patient thoroughly as you would. Then, he started to write his findings down in the notes. While doing so, he looked up and asked, "Is it better to write; there is good moving of the right leg, OR there is good movement in the right leg?"

I know I really shouldn't be laughing at others, whom English is not their first language. I tried really hard to stifle my giggles. My colleague told him that the latter sentence was a better of describing the patient's range of movement. It was amazing that he could keep a straight face while doing so.

Conversation 3

There was a pleasant elderly lady in the ward. Unfortunately, most of us, when we grow older, we will lose our hearing. This lady was nearly 90 years old, and she looked alot younger than that. I asked her whether she smokes. She replied, "Well, yes I do...you know, its really hard to get rid of this habit."

"How many do you smoke in a day?" I asked.

"hmm...about 4 to 5 a day."

"Oh ok...so about 4-5 a day...."I repeated as I make a note of it on my records.

She said," No....not 45 a day....it is 4 TO 5 a day."

I laughed...and told her that I know she said 4 to 5, and not 45.

Treasure What You Have

It is such a common humanly mistake that we never seem to REALLY treasure what we have until it is taken away from us.

I thought the latest Shrek movie was excellent. It was funny, good animation and not to mention, the moral value the movie was trying to teach everyone. Shrek had almost everything he could dream off....a lovely ogre wife, Fiona, 3 cute kids, good friends (Donkey and Puss), and a nice place to live..... BUT (there is always a but), he felt that he has become a tame ogre, not fearsome no more. So he decided to exchange one day in his life, and that day, was back to a day he didn't have any friends, no family, and Fiona did not recognise him as his wife. He regretted his actions, and felt miserable. He misses Fiona and his family. He did everything he could to go back to his present life, and succeeded in the end. And like most animation, the story ended happily ever after.

I felt good after watching it. I realised that sometimes, I may have taken some things for granted...and I need to change my actions, change my attitude, to become a better person, less grumpy, and really appreciate the lil things in life that makes my life meaningful.

ahh....how's that for a new resolution?

That aside, I highly recommend Shrek Forever After to everyone! It is definitely way better than the previous one. Watch out for catchy words like, "Cat-tastrophic!" and "Ri-don-culous!"

McDreamy or McSteamy?

Grey's Anatomy rocks!! Yes it so does. I love this drama to bits! I wish there is a real McDreamy and McSteamy in the hospital that I am working in at the moment. haha.

I know alot of people will disagree with me. The storyline might be cheesy to some, or unexciting. They might think that some of the medical bits in the drama unreal. But who cares! Grey's Anatomy catches the essence of life as a doctor. Although I have to admit that the love life might not relate to everybody, but the happiness, disappointments, competitiveness, difficult decisions, life-saving measures....they are so real.

Many a times, while watching Grey's Anatomy, I found myself thinking about my own personal experiences. For example, I could feel the disappointment in Dr O'Malley when he found out that he had failed his internship. I could feel the joy in Meredith and Derek, when the finally managed to treat a patient's brain tumour successfully in their clinical trial. I could sense their tiredness at the end of the day....their need to just not talk about things at times.

I guess that is what attracted me so much to Grey's Anatomy....of course, not to mention, the existence of McDreamy and McSteamy makes the drama that even more exciting and hilarious....what more can you ask for?

If you don't watch Grey's Anatomy, then, you wouldn't know who they are. McDreamy is Dr Derek Shepperd...a talented Neurosurgeon...at least he isn't as grumpy and as arrogant as some of the Neurosurgeons I have spoke to. He is McDreamy, because I suppose he has that dreamy look in his eyes....Then a few seasons later, McSteamy arrived! He is a hunky plastic surgeon. The 2 of them are good mates. And I feel the complement each other in the drama very well.

If given a choice, I would pick McDreamy anytime....keke.

Anyway, I just completed watching Season 4 of Grey's anatomy. I finished the entire series in less than 7 days!! I have to admit that I have an addictive personality. Once I start watching a drama series, I want to watch the next episode immediately. That is why I NEVER EVER buy DVD box sets. I simply have no self-control.

I will need to get season 5 stat!

Welcome to The North East of England

It was a wonderful sunny weekend.

It is time to get rid of the heavy thick coats, time to put on a summer dress, and time to take those lovely sandals out from the store.

Yes....why hide in the house, when such hot weather is hard to come by.

So I decided to pay a visit to The Angel of The North.

I am not sure if you are aware of this wonderful creation of Antony Gormley. It is a big sculptor located in Tyneside at the North East of England. It is probably one of the most popular work of public modern art in England.

The wings of the angel is about 54 m in length. It stands on top of a very small hill, and it sort of welcomes you to the North East of England. The body is about 100 tonnes in weight, while the wings are weighing approximately 50 tonnes each.

As you can see, it looks simply amazing. I would highly recommend a visit to this place in order to truly appreciate and soak in the majesty of this sculpture.

Thanatophobia

Anyone heard of this word "thanatophobia?"

Thanatophobia = fear of death

I am sure many of us are afraid of death. No one knows how it feels like until the day actually arrives. It may come so quickly that you don't even feel it.....or, it may be a slow, painful, and gradual process. Who knows which kind of death we will suffer from.....

I have to admit that I can't help but think about death too. Death is inevitable in the hospital. Patients die, and we, doctors, certify the death. Within a few hours, the patient's body will be moved to the mortuary. Then, a new patient will arrive in the ward to take up that empty bed in the ward.

Yes, the turnover is fast. Yes, I have encountered many expected and unexpected deaths in the hospital. I should have been used to dealing with death by now.

But no.

Today, I felt really upset when I spoke to one of my patients. He has 2 failing organs...and that is a bad sign. Death is quite near. It is horrible seeing how someone could deteriorate quickly just within a few days. I explained to him what was going on. I told him that his kidneys are not functioning very well anymore, and that there is a limit to what we could offer him due to his other co-morbidites.

He said, " Doctor, I don't want my kidneys to fail...."

There it was.....the look in his eyes.....just broke my heart and soul.

I guess it would be even scarier for them to see the reflection of his fear in my eyes. I could only keep my cool, and tried my best to give him my honest opinion, with a lil encouragement. Its difficult. Once 2 organs are failing, the body will slowly shut down and fail completely.

I can't imagine how it feels like when you know death is inevitable. I can only hope that the person is as comfortable as he/she can be.

..................................

Unfortunately, he died peacefully a few days later. I was not surprised, but felt rather upset.

RIP. You are now in peace with your body and soul.

Is It Trust or.....is it just plain laziness?

hmm.....I kept asking myself these questions over the past 3 nights.

Yeap, I am doing the night shifts these week. Someone has got to do it...and it so happened to be my turn this time.

I am not complaining about it...

But I somehoe dread going into the shifts.

I mean, no one can predict how busy it is going to be....what sort of disaster is going to happen.... or whether it is going to be a quiet night (oh no, I said the dreaded Q-word!).

But, but, what really bothers me is my senior colleague I am working with.

Senior Colleague's name is J.

J is a medical registrar. So J has to oversee everything in the hospital. He is the boss at night, second to the consultant who is on-call from home. Yes, so J's responsibility is HUGE.

So I really wonder, how come J goes to bed every single night of these shifts from about 1 am to 6 am?? J has left me with all the acute admissions during that time. If it is a ok night, I really do not mind at all. But when there are 10 people on the board waiting to be seen, and more to come...surely, J should help out, no?

J is the registrar, yes, I know that.

But, this is the first time I'm working with J. So, J doesn't know whether I know what to do, whether I am careless or careful...etc.

So the question is.....Does J really trust me so much that he has left me with all the admissions? Or, is J just plain lazy? When J wakes up later, he will just say," Oh there were more admissions this morning, eh? Everything ok?"

Hmm...I don't know. I want to say that he trusts me. But deep down, I think there is a tiny bit of laziness there.

Unexpected Visitor

I seem to attract the authorities. This is my 4th encounter with the police.

This week, I came back from work as usual. I was really hungry that day, and quickly heated up my leftovers in my microwave. While enjoying my dinner, I suddenly heard a loud knock on the door.

I was like....hmm...who could that possibly be? I thought it was a delivery man, sending a parcel.

So, I peeped through the hole in my door.

Oh-uh, there was a police officer standing at the front of my door. Immediately, I could feel the adrenaline rush....my heart started to thump really fast and hard. A few thoughts came to my mind.

Did I commit a crime? Did somebody sue me? I dunno.

I opened the door to greet the police officer.

"Hello," he said.

"Ermm...hi," I replied.

"Just wanted to ask you if you knew your neighbour living over there?" he said, while pointing to my neighbour across the corridor.

"No, I don't know him. I don't know my neighbours at all," I said. (and this is true)

"You not seen him moving furniture or anything like that?"

"No I haven't. I've seen those girls living opposite him, but not see him."

"Oh ok then. Thank you very much," he said.

After I closed the door, I still felt weak in my legs. My heart was still thumping.

Don't get me wrong. I was glad that he wasn't looking for me.....glad that I wasn't in trouble. But I can't help feeling intimidated when I meet a police officer.

I speak to police officers occasionally in the hospital environment, and even prison officers. But I do not feel scared when doing so. It is probably because I was in a hospital, where there are other colleagues around me. While being at home, there is no one else.

I am so Stiff!

It was a lovely bright sunny day yesterday. I have been working for the past 2 weeks without any break.....therefore, I decided that it was time to soak up some lovely sunshine, and fresh air.

So what did I decide to do?

Go for a jog around the park.

It wasn't a bad idea to start with. I used to run 9 miles a week (6 months ago!). I stopped running because the weather was becoming colder, and I moved down here to M'bro. I had to quit my old gym....and was TOO lazy to get myself registered in a new one locally.

I got changed into my exercise gear. Did bit of warm up...and started to jog at a slow pace. After one round, I was panting like I have just completed a marathon run. My heart was thumping so hard. I could not continue running. So I stopped to catch my breath. After a few mins, I started to run again....but found myself stopping another time just before the second round was completed.

=(

Yes, clearly I have lost my fitness level...how upsetting!

I remembered being able to run around the park 3 times without stopping....and now, only just one round?! Gosh...how bad is that?!

Luckily there was the happy sunshine and fresh air to cheer me up a little.

This morning, I got up with stiffness all over. My quadriceps are stiff and achy....my lower back is just the same too.....sigh, these are the consequences of not exercising regularly.

I shall now attempt to run bit more regularly.....i hope! no more excuses, now that the weather is so much warmer!