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31 Ogos 2009

hepi merdeka utk korunk sumer~
of course xde aktiviti2 lagha time2 bulan pose nie...
dok umah sudeh~
kalo duLu2


tu diah~ merdeka parade..
every year pegi smpai pom 5..
windu nye...


the most thing yg iols nk tggu sgt2..
nie la dia... bunga api...
peow..peow..boommm....... (harus bunyi x real langsung)



dan yg paling bengang skali..
bdak2 skang nie x tau g skolah ke x..
tgk kat berita dulu tuh, rukun negara pun x tau...
bkan dari darjah satu dok bace ikrar nie,
bukan bace owang puteh pun..
tuh pun xtau...

ekh..: yg iols marah2 sgt nie mcm la patriotik sgt ekh~


iols masok PLKN tau~
sgt patriotisme tau..kalo x iols amek MC jer...
xyah datang..hahaHePi 52nd independence

CuP CaKes oo CuP CaKes

sori to miZa...
so LaTe for Celebrate ur besday..
seem we sTart buzy in Hosp..
time breakfast je jumpe kumpul ramai2 skang nie..
start pkol 8am start ward round, clinic, seminar, on-call..
seem time breakfast esok baru kumpul reramai balek..
susah skang nk dapat mase lepak2 cm dulu~

cupcake nie plak pun secare x sengaje mak patient kitorunk yg buat~
snang ckit xyah g kedai memane..
tempah je kat die..

itS a WEAKend

totally tired n lethargic when come to friday~
rase nk balek but after come back from hosp on 5pm..
troZ tetidO then bangon2 dah pkol 8..
xdpt nk balek...baru ingat nak berhavoC sbloM puase nie..

toTaLLy relieve this weekend..
thX God sume bnDe2 merunsingkaN dah siaP dbuaT..
aLL seminar, case presentation, case write up done already...
jusT tggL exaM je 2 week froM noW..cuaK k..


arinie pun kaT hospital dok kewat2 jer ikot Dr round ward..
xde la tension sgt~


n then this morning i just assist Dr in doing procedure jer.. malas nk masok kelas...hehe
lumbar puncture..sakit tau!




coz my patient had been discharged ari rabu arituh..
lame k jage die, 12 hari admitted...coz nephrotic syndrome..thx God it is steroid sensitive..
hopefully die akan troz sihat jer, no rellapse... but i still contact with his mom, sbb kitorunk tempah cupcake kat mak die..hahaha..suke2 jer kan..


die tgh merajuk pasal kene amek darah..cian die~


patient baru nie lak, xla serius sgt..just croup jer...pagi td dah discharged gak~
x terjejas weekend ku...huhu



still remember this patient who develop respiratory failure during intubation procedeure last week...
it had been confirmed positive H1N1 ..
tHx God iOls yg terlibat dalam procedure nie x develop ILI..
ILI= influenza like-illness (term dguna pakai xnk kasik patient takot kate nyer)

nak LePaK sepuas puas nyer weekend nie...

berdePan dGn situaSi kematiaN

friday 7/0/09 at 1030am, endo-tracheal intubation was done for NSY,a 10 month old girl patient with bronchopneumonia...
during this procedure i was there at the bedside..
it was done by dr faisal (paed specialist) with 2 other dr in hosp sg buloh..



method to do




all the instrument is here



the procedure was started by given gas anaesthesia through the baby's mouth..
an eye which was open before had closed.. by assume the child had fully anesthetized, Dr faisal start the procedure by insert laryngoscope into the baby's mouth.. he found that the baby still not fully anesthetized, he pull out the laryngoscope..the baby's eyes still open..

then other Dr try to put anaesthesia gas into the baby's mouth..after a minute it still not work with that child, others Dr start prepare morphine for injected intravenously..

after a few second with morphine, the baby reacted well and went to sleep.. then the procedure started. the Dr tried many times to insert the tube...at last the tube was in the baby's bronchi..

but during that trial, spO2 of that patient is reduced..surprisingly it reduced from 90++ to 0..
but the Dr still ignored it while they busy to insert the tube.. after the tube was inserted, IV adrenaline was injected into the baby...again surprisingly, the baby's pulse rate was reduced... again it reduced until 0...

then the environment changed. sume orunk start gelabah.. one of the Dr jumped onto the bed and tried to give resuscitation..



resuscitation..
i should practice more on this...



after a few minute, IV adreanaline injected again as a last resort.. then the baby still not responding to the drug..

on 1110am..the baby dead..

i felt so down, some of my friends started to cry.. pape pun, in front the baby's mom at the outside, we just pretend nothing happen.. it hard to do so..

i just walked away from the room by without looking at the mother..

after a few step, we heard the mother cried sambil meraung raung..sampai satu ward leh dengar..

walaupun hidup mati ni diTangan Tuhan, iols sgt sedeh jugak biler iols disitu tgk je proses tuh terjadi...
sangat sedeh yer tgk orunk kehilangan one of their family member...and ni 1st time iols berdepan dgn kematian orunk and weols ade kat sebelah, watching sajork..
tangan iols berpeluh peluh, sgt berharap baby tuh leh survive..
so bende2 mcm nie mmg baru utk iols, xpnah nk ready pun, tp tetibe pagi tadik terjadi.. sampai ade yg nangis2...tgk dr2 len, cm xde perasaan jer..maybe dah biase kot ngan situasi nie..

so disebabkan tragedy nie kat hospita sg Buloh a.k.a mak hayam besa H1N1..maybe baby tuh suspected H1N1..specimen dah dhanta ke lab..result x kuar lagik..
kalo positive siapla weols sumer...kene perintah berkurung nanti..

so iols xdpt nk enjoy ma weekend..
so sorry for my fwen kat JB, xdpt nk balek JB..kang tbawak balek virus lak kat korunk~
i nak pinjam DVD nanti..haha
kim salam kt sumer...

ThX 4 da damN weeKend~

i juSt came bacK from JB yesterday..
it was saturday, 1st august..
first thing to come is traffiC jaM at KL...
seem there R SOME pollitical issue here~
it is daMn sLow there.. i arriVe at 12pm..

witF aLL stuFF i brinG froM jB..it quite heavy k..
jalaN ke LRT pasar Seni, damn hot..smpai berpeluh peluh..
meeT my freND at KL sentraL..

aT 2pm we Go to cHow KiT..
jusT to buY aLL medicinE stuFF there..
there are some reformation...
then police are everywhere..kecoh giler...

at 3pm we go to KLCC..ade PC fair...
then buy thing..mcm2..pastuh berat giler beg..
dan banyak sgt beg...

at 10pm kat shah alam..
thx God, my fwen Amir fetch me up..
and send me to selayang..
after 12am... he going back to his home...

neway thx to ALL who involved in my tour during thAT day..
Lame x jalaN kat KL tau..
seem i am buzy with hospitaL Life right now..

toMMorow claSS wiLL be oriented as usuaL..
tommOrow claSS, i wiLL start in paedriatic ward, lvl 8, hosp sg buloh..
start2 esok dah kene oN caLL...bapak borink!

oin..oink...