Day 2 - Roadtripin' begins!

Wanted to wake up early at 6 but to no avail as expected. Sun rise was rather early but i guess we're too tired from all the journey the day before to catch the sun rise. Had a hearty nasi lemak for breakfast on Day 2. The friend we're staying with is such a good cook! Around 9 something, we headed off to Fremantle. Heard that's where you get to buy cheap souvenirs. 

It was cloudy and drizzling in Fremantle when we arrived there. Thought it'd be another sunny day so we could enjoy the beach but hujan rupenya di siang hari. heheh

First destination there was the Fremantle market. For me it's a common town market that sells fresh fruits, foods and goods. Since we dnt know any other nice market around Perth, we jst went for this. 

have no idea how to rotate this picture so yeah, exercise your neck

Since the town is located along the coast, of course going to the beach is a much. So we went to the closest beach which is the Bather's Beach. Duhh. The weather got much better by noon so we all felt like jumping in the crystal clear water to swim! 

In Fremantle, another not to be missed market is the E shed Market where u can find the crafts and souvenirs. Went to this one Chinese owned store called Megabes, i think theyre the cheapest. 

Had our lunch at the famous Kailis' Restaurant. Quite pricey but the fishes and seafoods are so fresh! worth the penny! Falling behind our itinerary, we then quickly left for South, to Rockingham via the coastal highway. 

Planned to go to the Rockingham Wild Encounters, and catch the ferry to get to Penguin island and feed the penguins. Unfortunately we arrived just 30minutes late to catch the last ferry there which was supposed to be at 3pm. So frustated coz i really looked forward to feed the penguins!! I think we spent a bit too much time looking and buying for souvenirs in the E shed market! haha! Takde rezeki agaknye..huhu So not wanting to waste the beautiful view of Rockingham, we spent the evening by the rocky beach at Point Peron. Many said Point Peron is safe for swimming and snorkel but as we were quite tight with the itinerary, we didn't get to snorkel and enjoy the coastal reefs lah.You can also go to Cape Peron for another amazing view as well.

Point Peron, Rockingham

Next up is Lake Clifton to see the thrombolites. they are said to be a living fossils! It's a very ordinary looking rocks in the shallow water but apparently it is 2000 years old. Again, unfortunately, when we arrived, the water level is rather high so they're all submerged underneath the water. So no thrombolites for us then! haha! As if to comfort the frustrated heart (since we missed Penguin island ferry and thrombolites), we were gifted with the ever so beautiful sunset view there in Lake Clifton! So it was still worth the long drive and sesat2 though. yeap I enjoy scenic view like this, i'm a hopeless romantic. lol. 

the photo doesnt really do justice to the sunset tho

This is how it supposed to look like when the water level is shallow

Off we go to Western Australia!!

Ola!

It's been a while since i last wrote about my travel and holiday. This time around, i managed to get a 6 days leave for an adventure to the western australia!!Weehu!

Booked the flight from AirAsia in May 2014 for a trip in October 2014. The 5 months wait is unbearable i tell u!! In Perth, we stayed at an acquaintance's place in Bentley. So at least the 3 days accommodation is well sorted. Our rough itinerary:

Perth City (1 night) --> Busselton (1 night) --> Stirling range (1 night) --> Perth City ( 2 nights) --> KL

Rough breakdown of our expenditure on accommodation and transport. 

Flight tickets: RM 718.00 (including 20kg check-in luggage on the return flight)

Perth accommodations: AUD 100 each for the 3 nights

Busselton hostel: RM 359.95 for 4 people 1 night

Stirling range chalet: 687.95 for 4 people 1 night

Car rental: AUD 329 ++ for 6 days

Day 1 - touched down in Perth

We arrived at Perth airport around 6am. Quite early isn't it. Excited lah katakan. 

Luckily one of us has a friend in Perth, so he kindly picked us up from airport and brought us to his house near Curtin Uni to freshen up before we get started with our packed holiday itinerary. 

We had roti canai for breakfast as soon as we arrive in Perth in a cafe called 'Sarapan'.The taste is quite okay, considering it's RM12 per piece! Haha! So once we're full, got our comfy car, we're then headed to Caversham Wildlife Park. It took us about 30minutes to get there. 

On a side note, I really recommend the car rental we got our's from. Simple, no hassle, no hidden fee. Excess reduction down to AUD300. No booking fee, no extra charge for unlimited km, non-UK/NZ/AUS licence, and additional drivers. And the staffs are nice too! We got ours from here:BUDGET car rental 

Entrance fee for the Caversham Wildlife park is $25. it's not a very huge safari, but big enough to introduce you to the famous wildlife of western australia. I'm not an animal lover, so it doesn't excite me much, but the kangaroo and koala definitely got me interested!! 

lazing around,while being fed lying. Good life mate!

Dont u just feel like hugging is this fluffy koala??? 

We missed all the show in the safari but i don't really mind. hehe! Next up in the itinerary is The Pinnacles. So we headed off up north before lunch as it took about 2hrs to get there. It is within the Nambung National park near the Cervantes town. With the clear blue sky, it's definitely a perfect weather to go there! Oh btw the entrance fee for The Pinnacles is $11. You can choose to either walk around the area or drive and park whenever u feel like stopping and take photo. We chose the latter :)

Beautiful view kan?!

You may wonder what are those pinnacles actually are. So did we! What i know is it is an amazing lime stones standing structure, formed by some natural processes in the dunes. More info, Mr Wiki  has it all for u :) 

Still thinking that we need more dessert and dunes, we decided to head down to Lancelin Dunes for some sand boarding. But unfortunately, we arrived there at abt 5:30pm. It was getting dark and the sky looked gloomy already. A lady from the mart advised us to just come again tomorrow for sand-boarding. How sad!! So we just went to the dunes ourselves without the board. 

                          

White sand dunes. If only the sky was not so gloomy, it'd have been a spectacular view in the dessert!

By the time we reached home from Lancelin Dunes it was already around 8pm. Had a nice deliscious dinner at home, and cozy rest after the loooooong day before the roadtrip begins the next day. 

Will be continued..

Long day at work, really.

was in post natal wards for screening yesterday. came in to work around 7.20am after buying some kuih for breakfast. was too tired to wake up in the morning as i was still exhausted from 7am-10pm shift the day before.

whilst preparing to read cases in 5A in the doctors room, got called by a SN frm outside tht they're looking for paeds doctor. was informed by a SN all the way frm 11B tht they have a hypoglycaemic baby with a dxt of 0.7!!! WHAT?!

hospital phones not working tht morning, tht's why she had to come all the way down. fine. so i went upstairs with the super shitty lift. not wanting to delay the Tx, i asked the nurse to call her colleague up there to give a bolus of D10% first. got there, the D2 OL baby looked really lethargic. pity him. dxt went up yo 1.4 after the bolus. 2nd one also given. in the meantime, managed to call my on call MO to attend the case. the child seemed to be in resp distress as well, so we intubated him and quickly transported him to NICU. 

phewh, all in all i came back down to 5A at around 9am. my MO is already there to do rounds but i havent read a single cases. lol. so we just ran through them together quickly. only 2 of us taking care of 4 postnatal wards today. so 5B is on me as well. in the middle of the rounds, my MO had to attend a call in LR. so in between, managed to read some cases frm 5B. rounds resumed around 10:30 and finished nearly 12 kot in 5B. then i continued my screening back in 5A. got branula insertions lah, bloods lah in between. then quickly went to 5B for screening, t'was around 2 something at that time. had to discharge baby really late that day. also, few more issues came up in 5A delaying my charting and discharge - vomiting baby lah, suctioning baby, a child needing eecho and pathological jaundice. phewh!! finished charintg everything around 7.15pm!! didnt even get to finish my breakfast kuih, what's more of having lunch!! had to come back at 9pm for on call! how's that?!

came for night call around 930pm feeling so exhausted already! wasnt that peaceful of a night either! managed to get a nap for abt 2hrs - OK la..had a last minute EMLSCS at 6.45am and reached home at 8am. long long day indeed. 

so tired i dont even know how to describe it. babies are cute. i like it, but i'm mentally, physically and mentally drained. 

Bad habits of Malaysian patients

I am 2 months into ED posting. it's a scary place really. I'm trying really hard to be careful in every diagnosis so i would do justice to my patient and at the same time avoiding any thing tht can jeopardize my career.
Putting the business and hectic aside, i kind of enjoy ED. what annoys me and get in my good mood to be a good doctor are bad habits of malaysian patients and their family. these are wht i have observed so far;

1) Complains about another doctor/healthcare staff
- I have a patient, an "atuk", speaks good english. he refused nurses to insert an IV line for him. so i had to go despite i was busy attending other urgent stuff. he kept complaining how last time there was this doctor who graduated frm ireland, tried >4x but failed to insert a branula for him. luckily, i managed after my first try. he praised me, asked where i graduated frm an be all nice to me.

sir, im not flattered at all. for us doctors, we dont need praises. we need respect. the moment u speak ill of our colleagues or nurses, that's the moment we lose interest in you.

2) Exaggerating illness 
i do understand people wont just seek medical attention if they're perfectly well. But just love to exaggerate. pain score 9/10, but they're saying that so comfortably. happily taking "selfie" on the hosp bed!

hello, we've seen lots of sick people. we knw how they look like. dont exaggerate, say it truthfully as it is, it's not like we're not giving u treatment if u make it less dramatic.

3) Doctor shopping
u've got your diagnosis of T10 compression fracture for your back pain from other other hospital, u've seen the specialist there, got your meds there. and u still come and see me for the same problem??? i sometimes wonder wht are they expecting. top up meds perhaps. if so then go see your doctor, get a letter so u can get a repeat prescription. not to another hosptial ED!!

4) Hard headed
we've seen so so many patients who repeatedly come to ED for unstable angina or DKA or hypertensive crisis because they default their long term treatment and follow up. now tell me, IS THAT FAIR TO US, YOURSELF AND YOUR FAMILY???

5) Clueless patient and parents
i do understand having a sick child worries every parents. but fever for 1 or 2 day, nothing else, feeding well, come to us at 1am. why ah?

6) MC seeker
self-explanatory.

7) VIP 
at least they think they are. paid RM1 in gov hospital, expected to be attended stat when it's obvious we're overwhelmed with patients who're more ill. a look into on my working schedule: if work pm, i came in at 1pm til 11pm. so i usually had an early lunch and pack dinner. but i rarely get to eat them, and just usually have them at 12am when i get home. some time not a single sip of fluids. not jst me, but it's quite the same for most of us HO especially in ed. it's not coz all or us are not time efficient but it's jst overwhelming. and there u are wanna play vip in here. i'm not buying it, sorry. private hosp might.



sometimes in green zone (clinic rooms), it can get up to 2hrs. i feel sorry for that as well. but lot's of other factors comes in. expect it if you come to ed for minor ailments. in yellow zone for major illness, u are attended to in less than 15mins i would say.

i'm not finding fault in my patients. and it's my job to attend to your illness. but play the patients role right as well. we need to educate our public so that everyone is treated fairly and more efficiently.

8) The expert
sometimes we do see patients who come in and the their first sentence is, "Doktor, sy rase sy kena masuk air la," "Err....kenapa yer?" "Sebab sy pening la, tak lalu makan" Okaaaaay.....


we have varieties of people in the community. some are funny, some are annoying. haha.
Dont get me wrong though, i do see lots of good and kind people as well. Just hope all of us can be pleasant to each other.

happy working!

it's been a while..

Wah!
i can finally write something here again! i thought i have lost my blog to some viruses coz i'v tried writing last month or something but it just wouldn't publish. Was feeling wuite down with the thought of losing this blog since i've had it since 2007!

anyhow, i am now halfway into my 3rd posting which is Obs & Gynae. Alhamdulillah. O&G is alright, good mxiture of ward work and surgical. But i dnt think it's my cup of tea. the enironment is not so favourable. can definitely feel the tensions during emergencies. all labours are like medical-emergency-going-to-happen kinda thing. and the blame game at the morning briefing...is just awful. nevertheless, i learn stuff, i really do. but the learning curve is not that steep. maybe because i dont put lots of effort into it like how i should.

here's few fascinating stuffs i encountered during this 2 1/2 months.

                                                               very bad decelerations

                              An even worse - sinusoidal pattern of CTG (found out mom had an abruptio)

                                                        Ruptured tubal pregnancy at 13 weeks

job scope as a houseman

...at least in a surgical department.
It was hectic at work today. As always. Love it or not, here's a list of what we do on everyday basis or whenever it needs.

1. know our patients' case inside out.
2. review and examine patients regularly.
3. take bloods.
4. set lines.
5. request for imagings - US,CT MRI etc
6. make referrals
7. chart patients' notes for every ward rounds
8. give chemotherapy
9. wound desloughing and debridement
10. simple toilet & suturing
11. assist in the OT
12. prescribe medications.
13. clerk new patients of course
14. discharge patients
15. admin stuffs - referral letters, re-admit forms, blood form, nutrition form etc
16. CME (continuous medical education) - presentations & seminars

that's not all, some addition..
17. off lines
18. ward procedures like NG tube, catheter insertion etc
19. wound cleaning and dressing
20. put up IVDrip
21. run errands for bosses (work related)
22. change venturi tube
23. flush lines/catheter
24. manual blood pressure
25. send bloods to lab
26. fetch transfusion blood from blood bank
27. call up patients for surgery/appointments
28. digitise imaging
29. flash CT image to other hospital
30. accompany patient in an ambulance to another hospital for referral
31. do tracheal suctions
32. do chest physio

that's all for now..will add to the list if i happen to do something bizzare later.

1 month into the working field

it's already a month since i started working in hosp selayang. how time flies.
busy? yes but still tolerable for now.  it's known to many that working as HO in Msia is harsh. long hours, mountains of jobs, fierce MOs and specialists, unfavourable working environment etc. Definitely some truths in that i must say.

the most difficult time is of course during the tagging period. 16 hrs of working for 2 weeks. sometimes even more than tht. i've done up to 20hrs! at least a day off each week tho.
many said tht surgical dept is the most accommodating as compared to other dept. well that's a bit worrying coz we've been scolded alot here so cnt imagine how it's like later on in other dept.
nevertheless, these are what i've learnt so far:

1) Every single moment is a learning process! - Indeed. I came in with almost zero. only God knows how difficult it is to adapt to a new system, at the same time being good and efficient at it. almost impossible. on top of that, this is also the time to practise all those theory learnt in med school. Altho a little slow,(i wish i'm not this lampi!) i do sincerely learn a lot from everyone-the MOs, specialists, senior colleagues and nurses.

2) Keep calm and move on! - feeling unfair, being wronged etc is almost normal. in the end, the mistake is almost always ours. so although it's bitter, take everything in. and then reflect. tht's the only way we'll learn i think. no point in arguing back, got bottled up and being stressed out. 

3) P.R.I.O.R.I.T.I.Z.E - that's the only way to be and feel efficient. heheh.

4) Work in team - we don't do this all time. we manage our own patients most of the time. that's where the problem lies. but, help each other out, and back each other up. no point in putting great effort just to shine by ourselves. seriously no point. and no one would appreciate that. 

i'm anxious every time i go to work. wonder if can do alright that day. and i'm anxious every time i go home at the end of the day. wonder if i've properly finished my work and if i've made any mistake. it's a form of disease i think. keke. hope things will get better with time.

i believe all great figures that we know now have had their moments of hard time. for every success, there's always a beginning. no one starts out perfect. the hurdles make them what they are. 

sekian!