Tuesday, April 22, 2008
Hospital Care...
I did round today and i noticed this in one of the patient... please do take care of this small basic thing...
See the way the branula is being anchored, and the extension to the ventilator tubing, leaking without being noticed by the nurses in the ward... there is persisted hissing sound from the tubing...
Monday, April 21, 2008
Pay before you stay??
I would like to share this incident that I have encountered recently...
I am going for the MSA meeting this coming April in Langkawi. The venue is in Awana Langkawi but it is fully booked by the MSA secretariat. They offer other hotels. I have no choice but choose one cheaper hotel, Aseania Resorts Hotel, Langkawi which costs 150RM per night. I called and made the booking... it was not a pleasant first impression... it took so long for the operator to answer my call, and when I said I would like to make the booking, they transfered my call to the hotel reservation which again put me on hold for 15mins. Then, after I mentioned that am attending the MSA, they passed me to the person in charged, and I was told that I have to fax in the hotel reservation with my particulars and credit card details. As I have previous made hotel reservations with my credit card and there were no fault so far, so I faxed and made the hotel reservations.
Two days ago, I received my credit card statement. I was shocked that the hotel has charged me the full amount of 3 days stay even before I'm going to the hotel!!! I have traveled many places and made hotel reservations online, as i know, they will swapped the credit card for deposit and when we checked out, they will only billed you and teared off the deposit slip...
I called the hotel management about the above matters, to my dismay, they told me, full payment has to be made before you stayed in the Hotel!!
Am I missing out something??
I am going for the MSA meeting this coming April in Langkawi. The venue is in Awana Langkawi but it is fully booked by the MSA secretariat. They offer other hotels. I have no choice but choose one cheaper hotel, Aseania Resorts Hotel, Langkawi which costs 150RM per night. I called and made the booking... it was not a pleasant first impression... it took so long for the operator to answer my call, and when I said I would like to make the booking, they transfered my call to the hotel reservation which again put me on hold for 15mins. Then, after I mentioned that am attending the MSA, they passed me to the person in charged, and I was told that I have to fax in the hotel reservation with my particulars and credit card details. As I have previous made hotel reservations with my credit card and there were no fault so far, so I faxed and made the hotel reservations.
Two days ago, I received my credit card statement. I was shocked that the hotel has charged me the full amount of 3 days stay even before I'm going to the hotel!!! I have traveled many places and made hotel reservations online, as i know, they will swapped the credit card for deposit and when we checked out, they will only billed you and teared off the deposit slip...
I called the hotel management about the above matters, to my dismay, they told me, full payment has to be made before you stayed in the Hotel!!
Am I missing out something??
Tuesday, April 15, 2008
New Spec...
It has been awhile am using my spec... managed to get a new pair this week... want to try out something new... the 2 Inch series.. fashion...
Sunday, April 13, 2008
On Call...
Yesterday 12 April was my ICU call... it was bad.... bloody bad... patients collapsed like flies and dialysis for bed 1, bed 4, bed 6 and bed 7... all happen in one day and half way thru the dialysis, BP of the patient drops... but the nurse in charged of the dialysis was not there with the patient....
Then ward staff nurses called, "doctor, patient di wad 12, pergi ke wad 7 untuk dialysis on ventilator, itu punya ventilator tiba tiba henti berfungsi, boleh pergi ke wad 7 ka?" (in english... Doctor, the patient in ward 7 which is from ward 12 went for dialysis in ward 7, currently the verntilator stops functioning, can you please look into the matter?) I rushed there, looking at the MA ambu bagging the patient... the staff nurse didn't connect to the main power supply and the ventilator was on battery till it fails...
I guess nowadays, the nurses are not like those days... these days, the nurses are not well communicate in English... even the word 'prone', they can't understand...
One more incident, ask for GXM blood of a patient and this nurse, wrote down the consultant name on the sample blood tube (patient's blood) and asking the consultant for the IC no to be written on the sample blood tube to be GXM!!! Can you imagine that?!!
Then ward staff nurses called, "doctor, patient di wad 12, pergi ke wad 7 untuk dialysis on ventilator, itu punya ventilator tiba tiba henti berfungsi, boleh pergi ke wad 7 ka?" (in english... Doctor, the patient in ward 7 which is from ward 12 went for dialysis in ward 7, currently the verntilator stops functioning, can you please look into the matter?) I rushed there, looking at the MA ambu bagging the patient... the staff nurse didn't connect to the main power supply and the ventilator was on battery till it fails...
I guess nowadays, the nurses are not like those days... these days, the nurses are not well communicate in English... even the word 'prone', they can't understand...
One more incident, ask for GXM blood of a patient and this nurse, wrote down the consultant name on the sample blood tube (patient's blood) and asking the consultant for the IC no to be written on the sample blood tube to be GXM!!! Can you imagine that?!!
Sunday, April 06, 2008
Medical' Perspective on Why the BN Lost
A 'Medical' Perspective on Why the BN Lost in the Recent Elections
Saturday, 29 March 2008
With the thrashing that they got in the 12th.GE, the BN is now in ICU and they are doing a post mortem to find out what happened.
To help BN with this task, the following medical report has been prepared to identify the diseases/illnesses that have been plaguing it and how these ailments have caused this sickening organization to become so sick that major surgery is now being considered.
Diagnosis
Overeating – gorged themselves and ate too much of the people's money
Heart failure – did not have a heart to really care about the rakyat
Rectal cancer and constipation – did not expel all the shit from the system
Diabetes – fondness for sweet things, i.e. saying sweet things to try and con the rakyat ( in plain English, lying)
Stroke – stroked too much of their own ego and became too arrogant
Overworking – too busy running here and there cutting deals for own benefit
Alzheimer's – forgot to play the proper role of an elected representative
Obsessive-compulsive neurosis – obsession with cleaning, especially sweeping things under the carpet
HP6 – a mutation of the deadly H5N1 ( bird flu) virus which manifests itself in the form of idiocy or semi-idiocy, thus the descriptor ' half past six ( HP6)'. Many members of the BN are infected.
VD – Very Deaf. Did not listen to the grievances of the rakyat and did not heed the healthy advice and feedback from bloggers.
Color Blind – a form of visual impairment which is directly the opposite of being color blind. There is a fixation on color and everything must always be discussed in terms of 'color' – Malay, Chinese, Indian etc.
Liver problems – failure to de-Liver on promises
'Inverted Cerebranus ' – a new form of disease where the cerebrum and anus are transposed causing highly irrational and objectionable behaviour, like brandishing ancient weapons and ranting racial slurs and threats
Prognosis
Not good and definitely a terminal case.
Chances of recovery are 1 in a gadzillion, about the same odds as Osama converting to the Jewish faith and becoming a messenger of world peace.
Cure
No known cure. Euthanasia recommended.
Suggest to drink lacquer – at least it will ensure a beautiful finish.
By Political doctor
Saturday, 29 March 2008
With the thrashing that they got in the 12th.GE, the BN is now in ICU and they are doing a post mortem to find out what happened.
To help BN with this task, the following medical report has been prepared to identify the diseases/illnesses that have been plaguing it and how these ailments have caused this sickening organization to become so sick that major surgery is now being considered.
Diagnosis
Overeating – gorged themselves and ate too much of the people's money
Heart failure – did not have a heart to really care about the rakyat
Rectal cancer and constipation – did not expel all the shit from the system
Diabetes – fondness for sweet things, i.e. saying sweet things to try and con the rakyat ( in plain English, lying)
Stroke – stroked too much of their own ego and became too arrogant
Overworking – too busy running here and there cutting deals for own benefit
Alzheimer's – forgot to play the proper role of an elected representative
Obsessive-compulsive neurosis – obsession with cleaning, especially sweeping things under the carpet
HP6 – a mutation of the deadly H5N1 ( bird flu) virus which manifests itself in the form of idiocy or semi-idiocy, thus the descriptor ' half past six ( HP6)'. Many members of the BN are infected.
VD – Very Deaf. Did not listen to the grievances of the rakyat and did not heed the healthy advice and feedback from bloggers.
Color Blind – a form of visual impairment which is directly the opposite of being color blind. There is a fixation on color and everything must always be discussed in terms of 'color' – Malay, Chinese, Indian etc.
Liver problems – failure to de-Liver on promises
'Inverted Cerebranus ' – a new form of disease where the cerebrum and anus are transposed causing highly irrational and objectionable behaviour, like brandishing ancient weapons and ranting racial slurs and threats
Prognosis
Not good and definitely a terminal case.
Chances of recovery are 1 in a gadzillion, about the same odds as Osama converting to the Jewish faith and becoming a messenger of world peace.
Cure
No known cure. Euthanasia recommended.
Suggest to drink lacquer – at least it will ensure a beautiful finish.
By Political doctor
Friday, April 04, 2008
The 'Tidak Apa' Attitude
Today, I have the opportunity in setting up a slide show in the hospital CME in remembrance of late Dr Tan Bee Hooi.
I reached hospital at 710am, clocked in and went up to the auditorium. I saw a man opening the door to the auditorium. I was happy that at least I can set up the computer and check if the system goes well, just like how i check my GA machine, preparing the emergency drugs everyday before my day start.
I can't find the main switch and there is no computer system around... luckily I brought my Mac. I went to the library to see if the person in charged of the PA system was there... met the librarian, he told me at 730am the person in charged will come... I looked at my watch, it was 735am!
OK... the speaker came... fellow colleagues and other medical staffs turned up... but there was still no sign of the PA guy... it was 745am...
The hall was almost full... still there was no sign of the PA guy... no computer, projector was not on...
810am... I can't wait any more but offer my Mac, but no point cause the main switch for over head projector and microphone was not on... 815am... the PA guy turned up with the lap top... without a single word of sorry... just showing his 'tidak apa' attitude...
Hello boss, what time is it??!! it is 815am!! and the hospital CME is supposed to start at 8am... you are the support team person in charged of the PA system, you are supposed to come at least 30mins before audiences turn up!!! Is this the way you suppose to work??!!
Mind you... your tidak apa attitude will cause you dearly if everyone is behaving like this... imagine you are the critical ill patient and we doctors have the tidak apa attitude, how do you like it?? or your loved one is seeking treatment and waiting for doctors to come, do you want this to happen to you??!! No right?? So, PLEASE don't behave like you are the boss... one day you will taste the medicine...
Just like the Saturday allowance for doctors who run OT, the Health Minister already announced the 80RM/hr claims for MO and 200RM/hr for Specialist... but when we submit the call claims, the office in charged will say, no statement of that to allow doctors to make such claims...
Sigh... the so called system...
I reached hospital at 710am, clocked in and went up to the auditorium. I saw a man opening the door to the auditorium. I was happy that at least I can set up the computer and check if the system goes well, just like how i check my GA machine, preparing the emergency drugs everyday before my day start.
I can't find the main switch and there is no computer system around... luckily I brought my Mac. I went to the library to see if the person in charged of the PA system was there... met the librarian, he told me at 730am the person in charged will come... I looked at my watch, it was 735am!
OK... the speaker came... fellow colleagues and other medical staffs turned up... but there was still no sign of the PA guy... it was 745am...
The hall was almost full... still there was no sign of the PA guy... no computer, projector was not on...
810am... I can't wait any more but offer my Mac, but no point cause the main switch for over head projector and microphone was not on... 815am... the PA guy turned up with the lap top... without a single word of sorry... just showing his 'tidak apa' attitude...
Hello boss, what time is it??!! it is 815am!! and the hospital CME is supposed to start at 8am... you are the support team person in charged of the PA system, you are supposed to come at least 30mins before audiences turn up!!! Is this the way you suppose to work??!!
Mind you... your tidak apa attitude will cause you dearly if everyone is behaving like this... imagine you are the critical ill patient and we doctors have the tidak apa attitude, how do you like it?? or your loved one is seeking treatment and waiting for doctors to come, do you want this to happen to you??!! No right?? So, PLEASE don't behave like you are the boss... one day you will taste the medicine...
Just like the Saturday allowance for doctors who run OT, the Health Minister already announced the 80RM/hr claims for MO and 200RM/hr for Specialist... but when we submit the call claims, the office in charged will say, no statement of that to allow doctors to make such claims...
Sigh... the so called system...
Thursday, April 03, 2008
Story of a Cab Driver...
Twenty years ago, I drove a cab for a living. One night I took a fare at 2:30 am, when I arrived to collect, the building was dark except for a single light in a ground floor window. Under these circumstances, many drivers would just honk once.
But, I had seen too many impoverished people who depended on taxis as their only means of transportation. Unless a situation smelled of danger, I always went to the door.. This passenger might be someone who needs my assistance, I reasoned to myself.
So I walked to the door and knocked. 'Just a minute', answered a frail, elderly voice. I could hear something being dragged across the floor.
After a long pause, the door opened. A small woman in her 80's stood before me. She was wearing a print dress and a pillbox hat with a veil pinned on it, like somebody out of a 1940's movie.
By her side was a small nylon suitcase The apartment looked as if no one had lived in it for years. All the furniture was covered with sheets.
There were no clocks on the walls, no knickknacks or utensils on the counters. In the corner was a cardboard box filled with photos and glassware.
'Would you carry my bag out to the car?' she said. I took the suitcase to the cab, then returned to assist the woman.
She took my arm and we walked slowly toward the curb.
She kept thanking me for my kindness. 'It's nothing', I told her. 'I just try to treat my passengers the way I would want my mother treated'.
'Oh, you're such a good boy', she said. When we got in the cab, she gave me an address, and then asked, 'Could you drive through downtown?'
'It's not the shortest way,' I answered quickly.
'Oh, I don't mind,' she said 'I'm in no hurry. I'm on my way to a hospice'.
I looked in the rear-view mirror. Her eyes were glistening. 'I don't have any family left,' she continued. 'The doctor says I don't have very long.' I quietly reached over and shut off the meter.
'What route would you like me to take?' I asked.
For the next two hours, we drove through the city. She showed me the building where she had once worked as an elevator operator.
We drove through the neighborhood where she and her husband had lived when they were newlyweds. She had me pull up in front of a furniture warehouse that had once been a ballroom where she had gone dancing as a girl.
Sometimes she'd ask me to slow in front of a particular building or corner and would sit staring into the darkness, saying nothing.
As the first hint of sun was creasing the horizon, she suddenly said, 'I' m tired. Let's go now'.
We drove in silence to the address she had given me. It was a low building, like a small convalescent home, with a driveway that passed under a portico.
Two orderlies came out to the cab as soon as we pulled up. They were solicitous and intent, watching her every move. They must have been expecting her.
I opened the trunk and took the small suitcase to the door. The woman was already seated in a wheelchair.
'How much do I owe you?' she asked, reaching into her purse.
'Nothing,' I said
'You have to make a living,' she answered. 'There are other passengers,' I responded. Almost without thinking, I bent and gave her a hug. She held onto me tightly.
'You gave an old woman a little moment of joy,' she said. 'Thank you.'
I squeezed her hand, and then walked into the dim morning light. Behind me, a door shut. It was the sound of the closing of a life.
I didn't pick up any more passengers that shift. I drove aimlessly lost in thought. For the rest of that day, I could hardly talk. What if that woman had gotten an angry driver, or one who was impatient to end his shift?
What if I had refused to take the run, or had honked once, then driven away?
On a quick review, I don't think that I have done anything more important in my life.
We're conditioned to think that our lives revolve around great moments.
But great moments often catch us unaware-beautifully wrapped in what others may consider a small one.
PEOPLE MAY NOT REMEMBER EXACTLY WHAT 'YOU DID, OR WHAT YOU SAID, ~BUT~ THEY WILL ALWAYS REMEMBER HOW YOU MADE THEM FEEL.
But, I had seen too many impoverished people who depended on taxis as their only means of transportation. Unless a situation smelled of danger, I always went to the door.. This passenger might be someone who needs my assistance, I reasoned to myself.
So I walked to the door and knocked. 'Just a minute', answered a frail, elderly voice. I could hear something being dragged across the floor.
After a long pause, the door opened. A small woman in her 80's stood before me. She was wearing a print dress and a pillbox hat with a veil pinned on it, like somebody out of a 1940's movie.
By her side was a small nylon suitcase The apartment looked as if no one had lived in it for years. All the furniture was covered with sheets.
There were no clocks on the walls, no knickknacks or utensils on the counters. In the corner was a cardboard box filled with photos and glassware.
'Would you carry my bag out to the car?' she said. I took the suitcase to the cab, then returned to assist the woman.
She took my arm and we walked slowly toward the curb.
She kept thanking me for my kindness. 'It's nothing', I told her. 'I just try to treat my passengers the way I would want my mother treated'.
'Oh, you're such a good boy', she said. When we got in the cab, she gave me an address, and then asked, 'Could you drive through downtown?'
'It's not the shortest way,' I answered quickly.
'Oh, I don't mind,' she said 'I'm in no hurry. I'm on my way to a hospice'.
I looked in the rear-view mirror. Her eyes were glistening. 'I don't have any family left,' she continued. 'The doctor says I don't have very long.' I quietly reached over and shut off the meter.
'What route would you like me to take?' I asked.
For the next two hours, we drove through the city. She showed me the building where she had once worked as an elevator operator.
We drove through the neighborhood where she and her husband had lived when they were newlyweds. She had me pull up in front of a furniture warehouse that had once been a ballroom where she had gone dancing as a girl.
Sometimes she'd ask me to slow in front of a particular building or corner and would sit staring into the darkness, saying nothing.
As the first hint of sun was creasing the horizon, she suddenly said, 'I' m tired. Let's go now'.
We drove in silence to the address she had given me. It was a low building, like a small convalescent home, with a driveway that passed under a portico.
Two orderlies came out to the cab as soon as we pulled up. They were solicitous and intent, watching her every move. They must have been expecting her.
I opened the trunk and took the small suitcase to the door. The woman was already seated in a wheelchair.
'How much do I owe you?' she asked, reaching into her purse.
'Nothing,' I said
'You have to make a living,' she answered. 'There are other passengers,' I responded. Almost without thinking, I bent and gave her a hug. She held onto me tightly.
'You gave an old woman a little moment of joy,' she said. 'Thank you.'
I squeezed her hand, and then walked into the dim morning light. Behind me, a door shut. It was the sound of the closing of a life.
I didn't pick up any more passengers that shift. I drove aimlessly lost in thought. For the rest of that day, I could hardly talk. What if that woman had gotten an angry driver, or one who was impatient to end his shift?
What if I had refused to take the run, or had honked once, then driven away?
On a quick review, I don't think that I have done anything more important in my life.
We're conditioned to think that our lives revolve around great moments.
But great moments often catch us unaware-beautifully wrapped in what others may consider a small one.
PEOPLE MAY NOT REMEMBER EXACTLY WHAT 'YOU DID, OR WHAT YOU SAID, ~BUT~ THEY WILL ALWAYS REMEMBER HOW YOU MADE THEM FEEL.
Wednesday, April 02, 2008
Butter or Margarine... something to share...
Margarine was originally manufactured to fatten turkeys. When it killed the turkeys, the people who had put all the money into the research wanted a payback so they put their heads together to figure out what to do with this product to get their money back. It was a white substance with no food appeal so they added the yellow coloring and sold it to people to use in place of butter. How do you like it? They have come out with some clever new flavorings.
DO YOU KNOW.. the difference between margarine and butter?
Read on to the end...gets very interesting!
Both have the same amount of calories.
Butter is slightly higher in saturated fats at 8 grams compared to 5 grams.
Eating margarine can increase heart disease in women by 53% over eating the same amount of butter, according to a recent Harvard Medical Study.
Eating butter increases the absorption of many other nutrients in other foods.
Butter has many nutritional benefits where margarine has a few
only because they are added!
Butter tastes much better than margarine and it can enhance the flavors of other foods.
Butter has been around for centuries where margarine has been around for less than 100 years .
And now, for Margarine...
Very high in trans fatty acids .
Triple risk of coronary heart disease .
Increases total cholesterol and LDL (this is the bad cholesterol) and lowers HDL cholesterol, (the good cholesterol)
Increases the risk of cancers up to five fold.
Lowers quality of breast milk.
Decreases immune response.
Decreases insulin response.
And here's the most disturbing fact.... HERE IS THE PAR T THAT IS VERY INTERESTING!
Margarine is but ONE MOLECULE away from being PLASTIC..
This fact alone was enough to have me avoiding margarine for life and anything else that is hydrogenated (this means hydrogen is added, changing the molecular structure of the substance).
You can try this yourself:
Purchase a tub of margarine and leave it in your garage or shaded area. Within a couple of days you will note a couple of things:
* no flies, not even those pesky fruit flies will go near it (that should tell you something)
* it does not rot or smell differently because it has no nutritional value ; nothing will grow on it. Even those teeny weeny microorganisms will not a find a home to grow. Why? Because it is nearly plastic . Would you melt your Tupperware and spread that on your toast?
DO YOU KNOW.. the difference between margarine and butter?
Read on to the end...gets very interesting!
Both have the same amount of calories.
Butter is slightly higher in saturated fats at 8 grams compared to 5 grams.
Eating margarine can increase heart disease in women by 53% over eating the same amount of butter, according to a recent Harvard Medical Study.
Eating butter increases the absorption of many other nutrients in other foods.
Butter has many nutritional benefits where margarine has a few
only because they are added!
Butter tastes much better than margarine and it can enhance the flavors of other foods.
Butter has been around for centuries where margarine has been around for less than 100 years .
And now, for Margarine...
Very high in trans fatty acids .
Triple risk of coronary heart disease .
Increases total cholesterol and LDL (this is the bad cholesterol) and lowers HDL cholesterol, (the good cholesterol)
Increases the risk of cancers up to five fold.
Lowers quality of breast milk.
Decreases immune response.
Decreases insulin response.
And here's the most disturbing fact.... HERE IS THE PAR T THAT IS VERY INTERESTING!
Margarine is but ONE MOLECULE away from being PLASTIC..
This fact alone was enough to have me avoiding margarine for life and anything else that is hydrogenated (this means hydrogen is added, changing the molecular structure of the substance).
You can try this yourself:
Purchase a tub of margarine and leave it in your garage or shaded area. Within a couple of days you will note a couple of things:
* no flies, not even those pesky fruit flies will go near it (that should tell you something)
* it does not rot or smell differently because it has no nutritional value ; nothing will grow on it. Even those teeny weeny microorganisms will not a find a home to grow. Why? Because it is nearly plastic . Would you melt your Tupperware and spread that on your toast?
ICU Block...
This month, I will be in ICU block posting... no need premed... but still lots of things to learn... Hopefully this ICU block posting will be enjoyable as it will be my last month over in Penang General Hospital before I enter 3rd year in USM Kubang Kerian, Kelantan... more glamour... New Castle (Kota Bharu)
New Blog Post...
It has been awhile for not posting up anything since my last blog post...
Just creating a blog spot for myself to write out and ventilate out if i can...
Hopefully am able to keep this blog spot alive...
Just creating a blog spot for myself to write out and ventilate out if i can...
Hopefully am able to keep this blog spot alive...
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