Chasing the dream

Ambulance Call

2011-09-06T07:35:00.001+08:00

Below are the pictures of the ambulance call centre in Hospital Serdang. Here is where they receive emergency calls and send out an ambulance for rescue.

It feels so high-tech in there

The call room

My dearest friend, Dr. Syima

Syima demonstrating the cervical collar

My post-call face :P

As we both (Syima and myself) were post call, we decided to go for the ambulance calls. The first one was a funny one... the caller informed that the patient is having SOB (shortness of breath)... complaints like this one I can layan because if it was trauma I would have definitely backed out. I had trauma cases, I get goose bumps with palpitations and some day I'd feel nauseous. I always avoid the case industrial injury cases where they come with half-amputated fingers... urgh.. gross! Anyway, back to my ambulance call story... we arrived at an office in one of the shop lots in Taman Equine. A young girl lying on the floor was in sight, semi-conscious... and there was also an acupuncturist who was doing her work. And guess what the ambulance team did... we stood and watched what the acupuncturist was doing for 10 minutes. It was so awkward! We were thinking... what should we do... leave? because it doesn't seem like we were needed as the girl was already awake.

The ambulance caller (who was her boss) apologized to us because he called both ambulance and the acupuncturist who happens to be next door. To cut the story short, we still brought her to the hospital... we reached there already, so the patient's boss told us to take her and get herself checked. The ambulance ride was horrible! The driver drove really fast, felt like I was in a roller-coaster!

Ok... hope more updates coming soon. I am so behind, this entry has been in my draft for days!

Iftar

2011-08-22T07:02:00.001+08:00

Yesterday, we gathered our friends for iftar at home. It's been quite a while since we all last met up with each other. The whole clique from schooldays came with their spouses and babies... as pictured below:

Sofiya AKA Yaya AKA Yayapiya

We started her calling all kinds of name depending on her act and mood

Me and Alia (the bride-to-be)

Almost all of us... I'm not in the picture

Now it's all of us

Sofiya and the handsome Alif

With Alia again

Look at Sofiya and Alif... Sarah was the only cool one in this snap

In an attempt of capturing all the babies together

Liyana's and Faiz's princess... Sarah

The evening was filled with laughters and of course... gossips and updates!

Hope to meet up for raya again.

Good flow

2011-08-21T23:23:00.000+08:00

Post-call right now. Had a really good sleep, got back at 2 pm today and straight away went to sleep until 6.30 pm. I woke up in confusion, not knowing what time and day it was. That's why Rasulullah larang tido after Asar.

I had a good call last night, I was in charge of the yellow zone. Patients were coming in in a constant manner but one at a time, giving me enough time to clerk properly and do whatever is needed. I had 2 ex-IVDU* patients... the worrying part was that I didn't know about their status until after trying many many times inserting their branulas!... even worse, unprotected pulak tu! It's a very good practise to use gloves all the time whenever you use needles, I used to do that while I was in the ward, but in ED, I don't know it's not practised. I guess everyone would use these excuses:
1. Easier to feel for the vein
2. Gloves are used as torniquet
3. It's faster when you don't use gloves

Speaking of IVDUs... I really feel sorry for them. And I feel it's unfair to judge them because everyone make bad choices in life, right? It's the degree of bad choices are different and most of the time, Allah covers up your 'aib' that no one knows about it. One of my patient yesterday came for acute exarcebation of asthma, and he said that he's been having the cough for 3 months and had lost a lot of weight. The first thing that comes to mind is TB of course. After nebulizer, his rhonchi was still there and his O2-saturation is only 92% on room air. He claims that he was feeling better, but you can tell that he looked breathless. So I thought that I'll give him a second round of nebulizer and give him IV Hydrocortisone... but it was impossible to insert his branula. I suspected that he was an IVDU when he said that he had a big vein around his thigh... and I looked puzzled, then he explained that he was an IVDU. That explains why he didn't mind me poking him countless times. He said that he stopped 10 years ago. At that time, I felt so sorry for him, he is already 56 years old, not married, no family, now lives with his brother... who wants a life like that right? I pray that Allah forgives him and all of us.

Tomorrow I'll be working on the pm shift ie. 3 pm to 10 pm which means I have the morning to do whatever I want. and I want to study!!! Let's hope that I'll feel like doing so tomorrow.

* IVDU = intravenous drug users

ED

2011-08-18T04:00:00.000+08:00

ED = emergency department, not erectile dysfunction ok! :P

Today is my day 6 in ED, alhamdulillah I completed tagging for 5 days and the department gave me a day off.. unrecorded leave! After tagging, everyone gets a day off to rest. I think it is really needed because working one whole day from 8 am to 10 pm is so tiring, so tiring that it's unexplainable. I developed all sorts of pain including neck pain, back pain, headaches and etc. But had to stay strong because everybody faced the same thing. The tagging part is the painful part, but the normal working hours is great because we work in shift system. ED is the only department that practises the shift system since ages ago, well it's understood why... on some days, you don't get to sit at all, and also, the turnover rate is very high so there is not need for continuation of care for a patient.

I have also noted that since entering this department, my level of patience has decreased. It's sad to admit... I do feel embarrassed to admit, but on a few occasions I scolded my patient.... haha. Yes, it's bad, I know. Now, every morning I keep reminding myself and added "I talk gently to my patients" as part of my daily mantra! The difference between the patients in ED and the ones in the ward is that in ED, they are straight from home and more anxious about what is going on. Hence, the are more prone to be rude, so you on the end being a doctor just feel like being rude back. That is why if you can handle human you can conquer the world because human beings can be very unpredictable. I especially get pissed with the MC-seekers. On my first day, I had a patient coming in with diarrhea for 3 days, and had an episode of sudden headache while reading the newspaper, and he also had peripheral numbness.... I was really trying hard to correlate between each symptoms hoping that I'll come up with a good diagnosis. The way he explained about his condition sounded really alarming, he was so dramatic and looked unwell. So my impression was AGE and diabetic peripheral neuropathy. The patient ended the session with "doctor, MC dapatkan?"... I said, "Yes, tapi untuk hari ni aje." He said that it was fine but he wished that the date could changed to tomorrow because he'll be working tomorrow! And I am talking about an old Malay gentleman... if it's a young man, I can understand, they maybe immatured still, but not an old man.

Anyhow... it's time for buka puasa. Selamat berbuka everyone.

Reaching the end

2011-08-06T05:58:00.002+08:00

Hi everyone! It's me, the lone-ranger in KLIA. I just noticed, my last 2 post was when I was in Alor Star Airport... 2 entries after that, in KLIA. It's been 4 months plus since my last trip back to Kedah. Poor Mr. Husband, it's always been him who has to travel back to KL almost every weekend. Of course it's a better option since he is the stronger one, right?

A loooottt has happened since my last update. I felt like blogging, but when the time comes, my laptop is not with me... dumb excuse right? When I get back home, I am just too exhausted to even think about what to write. But who cares, I guess I have no readers anymore.. hehe.

Well, if things go smoothly, I will end my medical posting next Thursday. I have one more assessment with one of the consultant, if she passes me, I get to proceed with the next posting. Please for me! Lately, the medical department started extending housemans, and there were cases where they tell you the day before you finish. So you cannot be too confident.

Wait.. The gate is opened.. better get there fast then I can settle in comfortably and continue blogging for the next 55 minutes!!!

Ok.. already in the waiting area. The aircraft is here, just saw the passengers from the previous flight leaving the plane, how I wish it was me. I cannot wait to get to Alor Star and see Abang. It's been a loooong 5 days. I keep on asking myself, until how long will we have to live like this. I hate the distance, but then again, distance does make our hearts grow fonder... hihi! Oh well, it's part of the sacrifices that I have to make in life.

I have no more idea of what to write.

2011-07-10T18:27:00.000+08:00

Handicapped? I felt so handicapped being laptop-less for the past 4 months. Life was so boring, I didn't get to communicate with the outside world, and of course, blogging. iPad cannot replace my laptop because it didn't have a proper keyboard, hence, typing was such a mess, it didn't feel right. No offense to the iPad lovers... it's good to use an accessory but not the main place to do your work.

Right now, I am in Low-yatt with Abang... there were so many people! What would you expect, on a Sunday afternoon, everyone is outside shopping with their loved ones. Alhamdulillah I am not on-call this weekend. I had been on-call since the past 3 weeks, it was so terrible, didn't get to connect much with my family.

In the on-call room

Oh yeah.. I'm in my third week of cardiology posting, I have one more week left. So far, I am loving it, especially the CCU. A big thank you to Dr. Ashraf Zaki for teaching ECGs, it made life a lot easier! Not only to him, to the nurses in CCU, learnt a lot from them too, they are so good at ECGs and many other things. I love the teamwork there, we all work as team regardless of the post... well, at least for some of us. There are only 3 housemans in cardiology so we do on-calls every 2 days, and it is quite tiring. Thank God the on-calls are light, depending whom you are on-call with, if you get to be on-call with a jonnah MO then you wont get to sleep. (Jonnah is a term we use to describe a person who attracts so many patients and complicated cases during the night). I am not saying anyone specific here... :P

I guess that's all for now. bubbye! Hope to updatewith more things later.

The Planned Kedah Trip

2011-04-12T15:37:00.000+08:00

I'm in Alor Star airport, waiting for my delayed flight. I was in kedah for 3 days, took leave for 4 days for my end-of-posting holidays. Oh yes, I managed to go through O & G posting without getting extended... I was quite worried at first as they extend people unexpectedly! It was my routine to solat Hajat before starting my on calls because I was really scared of having babies born flat because the bosses will always discuss the case and find out what the houseman was doing... I know it sounds scary but it is actually good so that we don't repeat the same mistake again. And alhamdulillah during my calls, things went smoothly, and I am so grateful for that. I always feel that when you are on call, it is Allah who gives you the guidance in what to do and how to react because sometimes you are half asleep when attending cases, you could barely think, so who else is there to help you but Allah.

I am really looking forward to a new chapter in my HO-life... Life in the internal medicine world! That is another challenge but I had always liked the subject in medical school, I hope working life is the same. You see, working and studying are two different things. As a student, I hated pediatrics, I found it very challenging, I never thought I'd like it! Things changed totally, I love PAEDIATRICS!!! And... I am having a dilemma choosing paeds and ophthal. Obstetrics is fun, I enjoyed it but i don't think I like the life because the specialist have to sleep in the hospital during on calls and it's not something I plan to do.

Urgh... I feel so lazy to start work tomorrow... Hate to admit it but it's true. I miss my husband already. It was so sad to see him walk towards his car just now but he had to go as he has classes at 5 pm so he cannot wait until my flight. On Sunday, I was a full-time housewife... Did the laudnries, cleaned up his room... And the best part was to waiting for him to come back home from work. I just realized that I miss this routine of being at home most of the time. Last time in Egypt, I was at home most of the time, studying and getting the house organized. In all of a sudden, once I started working, I no longer do all that. It's quite sad but I believe it is all temporary, life as an MO is less hectic. And I am very grateful to have a husband who is very understanding and supports my work. I don't think I could do it without him.

Ok.... They started calling the passengers. Have to go in now!!!

- blogging with iPad.

2011-03-12T23:25:00.000+08:00

Oh finally I can blog! It's been 4 weeks since I last had a laptop, my laptop is broken. It's so sad, it'll cost RM 4k to fix it, so I thought that it's better for me get a new one rather than fix the old one. I do feel sad, but I just don't want to think about it. So now, I am using my husband's laptop.

Anyway, a few updates about me. I have another month to go for my O & G posting. Time flies really fast! And somehow deep inside of me, I do feel a little sad about leaving the department, although I feel sad, I don't intend to return to the department again... hehe. I have nothing against the field, but I cannot stand the working hours! Life as an obstetrician requires a lot of sacrifice, and I salute those in the field!

Besides that, I am currently a weekend wife... well, not exactly weekend wife, because we get to see each once in two weeks, so life can be hell. But, there are its pros and cons of having a long distance relationship, of course there are more cons, but to soothe myself down, I just focus on the pros... I find that it's easier to communicate now, compared to before, we talk, but not communicate well. After being married for quite a while, we tend to forget about telling how our days go by and how we feel about it, and most importantly, how we feel about each other. The other day, we spoke on the phone for about 30 minutes, I don't I had any conversation for that long, talking about how we feel. Seriously! And... we stopped sweating the small stuff. Whatever it is, I miss my husband dearly... and as I am blogging right now, he is on his way back to Kedah, insyallah he will have a safe journey. I feel happy for him as he really enjoys his new job... the first thing he told me when I asked him about his first day was that his job doesn't involve getting told off by the bosses... unlike mine! Hehe.

On a different note, Tiyah is starting her work soon. She feels sad about starting so soon, so do I, it's because Sofiya is at the peak of her fun-ness! She has started cooing and responding to us, and she's getting cuter and cuter everyday, masyallah. Anyway, I hope Tiyah gets into Serdang, then it'll be like the old days in school.

Ok.. have to pen off now. Tomorrow I'm on call. Please pray that the flow of patient going to PAC is slow so that I get to focus well when clerking and make better diagnose, hence, manage patients better.

Bubbye!

One fine weekend

2011-02-18T22:49:00.002+08:00

The day began with a happy feeling and a stress-free mood... I didn't have to think about what time I needed to get ready to go to work. Although it was a holiday, I still woke up early to solat Subuh, even after Subuh, my eyes were wide awake and did not feel like sleeping back. I guess 'tidur lepas Subuh' is no longer part of me and I am very happy about that. Abang asked me whether we should workout together, then he came up with the idea of us cycling to the nearest nasi lemak stall and get breakfast for the whole house. It was a good idea... so the two of us went cycling. I never got to enjoy the peaceful ambience of Country Heights at 7.30 am until that morning, it was fun cycling, although I wished that I was more fit.. hehe. But it's ok, there no hills along the way. So we bought nasi lemak for the whole house. After breakfast, we started packing. At about 11 am, we were already in the van. Aiman drove and Abang was his co-pilot.. Mak and Ayah were busy minding their own business at the back seat, while Tiyah and I chit-chatted along the way... Sofiya... as usual, sleeping! She loves being in the car, she slept all the way, then when we got to the hotel, she woke up. How smart, eh?

We got to PD at about 12.30 pm, had lunch then checked-in to our rooms. The view was so beautiful, we booked the sea view room and it was indeed a moment to treasure. Sometimes I wished that my daily life was like this, but then I thought, I wouldn't appreciate this moments like this if it comes too often, correct? I'll just take things for granted. Anyway, after we checked-in, we rested for a while, I slept for about 2 hours, then Mak SMS-ed and suggested that we should go to the pool together... agreed by everyone. Hence, we went to the pool, the ladies looking like Teletubbies in the Muslimah swimming outfit... who cares, right? All I can say was that we had fun. Ayah didn't swim because he wanted to look after Sofiya while we swimming. Motherhood changed Tiyah so much because while we were swimming, every once in a while, Tiyah kept on checking out on what Sofiya was doing, the moment Sofiya put her fingers in her mouth, Tiyah was already worked up thinking whether the baby wants to be fed, hehe. She is a very committed mother and I just love seeing how she makes motherhood seems so easy and doable by everyone!

Later, we had our candlelight dinner... it was supposed to be couples at separated tables, but we requested for all the tables to joint together. The dinner was good, I had salmon... I'm a big fish fan! After dinner, the ladies went to the spa, got our massage. I slept 90% of the way, so basically, I didn't know what was happening... it was a tiring day. The boys watched football in the room, there was a Man-U match I think... lucky it was on, so we got to keep our boys + 1 baby girl occupied.

The following day which was on Sunday, had breakfast together, then went to the spa again. At 12 pm, we checked out and had our lunch by beach. We had nasi ayam... but it cannot beat Mak's recipe for nasi ayam, it's the best. After lunch, we headed back to Kajang... as soon as we reached home, Abang and I got ready to go to Nilai for Farhana's housewarming party. Loved her house, very cosy! The food was good too. Then rushed back to Kajang because I was supposed to meet Husna at KLCC by 6 pm, poor her, she waited for ages because I reached KLCC at about 6.40 pm. It was raining heavily, I could only drive up to 70 km/H due to safety reasons. I was so thankful when I reached KLCC safely, cannot imagine how I got the courage to drive alone in the heavy rain... but I believe, Allah is always with me. We hung out at Miss Kwan's cafe, the one beside the Madam Kwan... I had ABC and pinched some of Husna's food (don't know what the name was), it was good. Left at 9 pm, sent Husna back to TTDI... it was an enjoyable ride, catching up with our latest updates, at the same time trying to figure out how to get to her brother's place. Hehe. Thank God we finally found the place with the help of her sis-in-law's direction.

Reached home at almost 11 pm and watched SITI's show with Mak and Ayah on the show. They make me really proud, loved seeing Ayah playing the guitar! I had such a wonderful weekend. Cannot wait for the next holiday, which will months to come. I felt so motivated to get back to work... SERIOUSLY!

* Some of the photos taken during the trip *

Ayah and Mak

Devoted Atok

Who else..

Love the glass floor, but no fishes seen

Nasi Ayam

Perforated

2011-02-09T06:00:00.000+08:00

Day 2 post-call, it's 6 am, and I am listening to Dancing in the Moonlight while blogging... trying to start the day with a happy mood. I know today I will have a good day and stay awake, unlike yesterday. I had one hell of a call, I only had one LSCS (lower segment caesarian section) but still, I didn't get to sleep.

After the night rounds and clerking new cases, I finally got some time to rest, that was about 1 am. Somehow, my eyes were wide awake, to be honest, I was feeling scared... I had all kinds of ghost on my mind - thanks to the horror series advert that keep playing again and again! So I thought, I better to do some studying while I feel fresh, after about 10 minutes, my friend who was on call in the labour room called me and said that there is an emergency LSCS about to be pushed in. Luckily I was awake, so I went straight away. When I reached the MOT, I heard a lady screaming... she was 'cursing' in a weird language... she was Nepalese! No one understood her and she doesn't understand either one of us... PERFECT! The anaesthetist decided to put her under GA rather than spinal because we didn't think she'd cooperate. The operation went well, the baby was out after 2 minutes, Apgar score 7, 8, 9.

So I keyed in the notes of the operation, then my MO called and told me to go to the red zone in ED because there is a new case. Erm... red zone for a gynae case, I wondered what case it was! She was a Burmese lady who came in with peritonitis. It was the first time I felt board-like rigidity per abdomen, because all my past palpations were soft abdomen... VERY NICE, a new experience. Basically, it was a very tense abdomen, that's all! This lady had D&C done two days ago at a private clinic (which she claims she cannot remember where, obviously it was a cover up)... since the procedure, she was feeling sick. She developed fever and vomited a few times, it was challenging to dig up the history due to the language barrier. On X-ray, there was air under diaphragm, so we knew the intestines were involved... hence, the surgeon was informed. She was pushed in for a laparotomy, that was about 4 am... and my eyes could barely open, I don't know how my MO could stay awake! The operation was the interesting part, when the peritoneal layer was cut, feculent fluid started gushing out. We found a small uterine perforation with 2 small bowel perforation... and a lot of fecal matter in the peritoneal cavity. The specialist (gynae) said that this is rare complication of D&C, it occurs in about 1 in 1000 cases... but that is for the well-experienced surgeon. For the unexperienced, the incidence rate is much higher! I felt sorry for the patient but it was an unforgettable experience for me. So point of perforation in the uterus were sutured, but the small bowel had to be cut-off and sutured back with end-to-end anastomosis.

Currently, the patient is kept under close observation in the ICU, I hope she recovers well. She was very acidotic when she came in. My next on-call is next Monday and I look forward to that! :)

Here are a few photos captured weeks ago... just want to share.. :P

Iza, me and Laili

Murni and me

Conclusion: I am loving houseman ship although there are its ups and downs but overall, I love what I do because I surrounded by great supportive friends. Our days are filled with laughters!

Things I learnt overnight

2011-01-26T22:37:00.000+08:00

Before I start my entry, I'd like to say "Hi Dr. Laili!" ... she's one of my friend in O & G who had just found my blog... so I can no longer b*tch about friends at work... hehe.

Last night, I had one of the most amazing on calls, and this time, it doesn't involve getting a good long sleep... hehe! What I mean by amazing is the variety of cases that I got to see, unlike my previous calls, where most of them were either latent phase of labour or false labour.

Here are some of the interesting cases I got to see:

1. Inadequate pelvimetry.

2. Breech in labour.

3. A few decelerations noted on CTG.

4. About 3 cases of asthma during pregnancy!

5. Antepartum hemorrhage secondary to cervical erosion.

And thank God... no perinatal asphyxia! Being part of the obstetrics team, our main goal is 0 % perinatal asphyxia, and this motto has been reminded to us by our head of department almost every morning. So whenever I am on call, I try be as alert as possible to prevent the worse complications, especially involving fetal asphyxia as it causes long-term effects.

***

1. Inadequate pelvimetry

Anyway... the first unusual encounter was the inadequate pelvimetry. The patient is a gravida 2 para 1 at 39 weeks, she came in because of contraction pain. She also has 1 previous scar for breech, she refused external cephalic version and chose to proceed with elective C-section. I did vaginal examination on her, but to my surprise, the canal felt very weird, very 'sempit'! It was very difficult for me to put in my fingers in a little deeper as there was like a bony structure obstructing the outlet. So I confirmed my finding with my MO and he had the same impression, we thought that the pubic arch angle is relatively more acute than usual. So performing VE was little tricky. The patient did not want to take the risk of an obstructed labour, so she opted for semi-elective C-section, but the indication recorded was for maternal request rather than suspected CPD (cephalo-pelvic disproportion) or small pelvis. This is because to diagnose CPD, a proper pelvimetry (which includes the bi-ischial tuberosity diameter, curvature of the pelvic, spinous process is tipped or not and whether the pelvis can fit in 4 knuckles or not) must be done and the patient is not keen for such tests. Today, she had already given birth to a cute baby boy, birth weight 3.2 kg!

2. Breech in labour

The patient presented with a strong contraction pain, she is an unmarried mother who had no ANC check-up. She claims that she is around 8 months, based on her LMP (last menstrual period) somewhere in May. These kind of cases have to be handled with precaution because they have no proper screening so the risk of the transmitted diseases are higher... and also they forget their LMPs, no early scans, which makes estimation of gestational age difficult, we need to differentiate whether she is term or preterm. As for this girl's case, I will just treat her as premature, it is better to safe then sorry, so I planned for Dexamethasone before delivery. While I was busy clerking other patients, the nurses alerted me telling that the patient is about to bear down, so I straight away palpated her abdomen and performed VE. Per abdomen, it just felt like any other abdomen, I thought it was an engaged cephalic presentation, but via VE the os felt very very weird! There were like to many structures all clumped together, not like the usual cephalic presentation. With my very little experience, I tried to feel for other structures, and what a surprise, I felt the heel of the baby! It was a footling breech, and I could feel both feet. So I told the nurse to call my MO and he came right away, by scan it was confirmed that it's a footling breech. The initial plan was to proceed with emergency C-section but before we even got to that, the patient delivered vaginally. It was also funny how I got to be in the scene because I was on call in PAC, not the labour room. But what happened was that I chased the patient to the maternal OT to get her signed consent for the C-section, so when the other MO on call who was about to the surgery arrived, she decided to reassess the patient... and she decided it's better to encourage the patient to bear down and just conduct the delivery. I felt privileged to assist in a breech delivery... my second breech delivery! The baby was fine, but a little small, 2.2 kg, most probably a premature baby.

3. Fetal heart decelerations

Well... this a common thing actually, nothing significant about this story. The patient complained of strong contraction pain, no history of rupture of membranes. The CTG was not so nice, it showed a few late decelerations which could indicate fetal hypoxia. Sadly my MO wasn't around in PAC, so I just decided to do an ARM (artificial rupture of membrane) to check for the liquor colour and to speed up the process of delivery. Luckily the liquor was clear, not meconium-stained... so we sent the patient straight to the labour room... and alhamdulillah, the baby was born alive and healthy! To do an ARM, we're supposed to get the permission of the MO first... later I informed my MO and he approved my action. Actually, I was scared to ARM because I am not good at it... like last week, I thought I had already ruptured the membrane with the amniotic hook, but as it turns out, I didn't, the membrane was still intact, so the baby was born with the membrane covering him... hehe. Alhamdulillah, I managed to ARM 2 patients successfully!

4. Asthma during pregnancy

We just gave nebulizer to the patient, and discharged the patients as they were well after the nebulizer. All the cases were treated as AEBA (acute exacerbation of bronchial asthma) secondary to URTI.

5. Anterpartum hemorrhage secondary to cervical erosion

This lady is a primigravida at about 30 weeks gestation. She complained to per vaginal bleed with no history of trauma or massage, but recent sexual intercourse about 2 days ago. The blood soaked about half of a pad, and I saw the pad, it looked like menses bleeding! The one thing everyone should remember is, whenever a pregnant patient comes with a PV bleed, always confirm where the location of placenta is because it could be placenta previae, so performing VE will just make the bleeding worse. I asked my MO to confirm via scan and thank God it was at the upper segment. So we did a speculum examination and saw that there were cervical erosions, and there were active bleeding. There was also multiple small growths, so we took a PAP smear too. The patient was admitted to the ward for further observation. I had never encountered any bleed like this one, because the usual ones I see are just spotting and not fresh blood.

***

Ok, I am so tired because I didn't get to sleep at all last night, but the strange thing is, I don't feel like sleeping.. instead, I feel like 'lepaking'... cleaning up my room while listening to my iPod... one of the luxuries which I rarely get to feel lately. :-)

Sofiya at 6 weeks old

2011-01-22T14:23:00.005+08:00

Sofiya with mummy

Sofiya with 'bits' Atok's face

Sofiya on Atok's lap

Sofiya forced by mummy to take a photo and not fall asleep

Sofiya in the car, on the way see her friend

Mindset

2011-01-21T22:56:00.000+08:00

This time, I changed my mindset when being on call. Usually, I’d always aim to finish my work early and get some sleep. This tactic worked while I was in other postings, not in obstetrics. It is just impossible to sleep, be it on call in PAC, labour room or the ward… there’s always things to do. Actually, when you are on call, you are not encouraged to sleep, you are being paid for staying up. But what can you do, when you have to work the next day, and you are expected to work like a normal person who had the night to sleep! I wished that whoever is on call in labour room or PAC can get the day off the next day… but I know it wont happen, not even in my dreams!

The sight of PAC that everyone dreams of... empty!

After countless complaints to whoever I meet, I came up with a conclusion of just accepting the fact. No matter how many times I whine about it, nothing will change. I talked to my husband, and he gave a good tip, he told me to read Yassin everyday and insyallah, Allah will give me the strength during my night calls and things will go smoothly. I also changed my mindset, instead of thinking when I get to sleep, I just think about learning as much. I also put the thought of wanting to sleep aside so that I can concentrate fully on working. Hence, my on call last Tuesday night was a blast! I had 2 dedicated medical students tagging with me, so I we got to discuss gestational diabetes and I gave them tips on how to present cases.

The flow of patients in PAC is a lot better, I mean, no more patients who come non-stop. I wonder why… I guess the words of Serdang being fully booked has spread around, so patient choose other nearby hospitals. I also don’t know why patients from Banting, Semenyih, Gombak and many far away places still go to Serdang, there are lots of other hospitals.

I always pray hard that when I am on call, there are no bad CTGs that show fetal distress. I hate it when housemans get blamed for fetal distress, believe, it’s a sad scene, I just feel so sorry for my friend. I know he or she had worked really hard and yet they are not being appreciated. It’s a fact of being a houseman, the lowest form of existence in the hospital, hehe.

During times when I feel pissed that I don’t get to sleep, I look at my surroundings. I see other hospital staffs staying awake, especially the Radicare cleaners, may Allah bless them always. They have to continuously clean the labour room and even worse, they are not being treated with respect… with the low pay at the end of the month, nothing compared to us! I get emotional thinking what kind of life they live in, and at the same time, it makes me feel grateful with my life. That’s why it’s important to look at the people below you.

Ok… I better get some sleep and rest for tomorrow. Luckily I am not on call this weekend!

Swollen

2011-01-15T22:39:00.000+08:00

During my last call in PAC, I encountered something I've never faced before. While examining a patient, I heard like a 'kekecohan' from the front counter, in my heart, I thought it might be a BBA (born before arrival) case. So I excused myself from the patient and said that I need to attend to another case. The baby was not born yet but the patient has been pushing since the past 2 hours and even worse, her vulva was so swollen. I had never seen anything like it! It was so weird-looking. Being careful, I thought I'd better send the patient off to the labour room myself rather than leaving it to the nurses. At least I'm in the know if anything happens.

So when we got to the labour room, the nurses asked me to do VE (vaginal examination) because they were unsure of the station of the head. So I on a glove and did a VE. It wasn't the head crowning, it was the caput! I asked the patient why she had not come earlier, she said it was because she was waiting for her brother to come. She's an Indonesian with no passport, it's a common story that you hear in the labour room. Anyway, I encouraged her to bear down. I had expected that it'll be a quick delivery but I was wrong. I had decided not to do any episiotomy even though she's a primigravida because her vulva was too swollen for an epi. I thought it's better to repair the tear and hopefully it's minimal. I gave my very best to guard her perineum. After about 5 minutes, the baby was delivered with an outstanding Apgar score.. 9 at 1 minutes of life and 10 at 5 minutes of life! I was quite worried that the baby might be in distress especially when the baby had already passed meconium.

I felt sorry for her because I cannot imagine how much pain she was in... She was sweating! I didn't agree with how the other staff were talking rudely to her asking about her passport. Although she's an illegal immigrant, I believe that everyone should be treated with respect and gently when they are in pain, right? But later I clarified with another person why the nurses talk roughly to the illegal immigrants, the reason I got was because the child born will be a Malaysian, so they get pissed thinking about it. To be honest, I think it's quite a fair reason, hehe but I an against it. I just knew that Malaysia is too lenient when it comes to citizenship. Well, I dare not comment any further especially when I'm a government servant.

Erm... Speaking of government servant, I was so thrilled when I got good deals wit the hotel price! It was the first time that I felt privileged being a government officer, hehe.

I am so exhausted right now. Since my last on call I had been staying late at the hospital until 10 pm almost everyday! Lucky I get to go home early tomorrow. Plan to go to Pavillion with Tiyah and Sofiya!!! Cannot wait!

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Unplanned trip to Kedah

2011-01-09T19:39:00.001+08:00

I just arrived from Kedah... the unplanned trip. I had applied for leave on 7 January 2011 3 weeks ago, the leave was for a family holiday. Somehow, 1 week before, everyone had plans so the family trip was cancelled. I wasn't sure whether I should cancel or not, but I didn't say anything to my boss. So on Thursday night, I went to Gombak, my inlaw's place and stayed the night there... and I thought, ok, I'll just take the day off as planned. As holidays don't come easily for housemans, my husband and I booked a room in Royale Chulan, it's a good break for us since it's been quite long since we went on a holiday.

Went for breakfast at our usual nasi lemak spot... excited to check-in and shop... until my husband got a call from a professor in Kedah. He had asked my husband to go for a job interview held in Alor Setar the next morning at 8.30 am! Being spontaneous and flexible, I agreed and cancelled our Royale Chulan reservation and instead, we booked a flight ticket to Alor Setar. It's very unusual of me to agree to such things, but opportunities don't come easily.

Our flight back to Alor Setar was at 8 pm, checked-into Holiday Villa at 10 pm. Usually we stay at my brother-in-law's place but because of the holiday mood, we stayed at Holiday Villa. It's quite a nice hotel actually. I go to rest and went for a spa trip. Although the price was good, but nothing beats the spas I went to in KL! Seriously, I was really disappointed with the treatment. I caught the flu because of untrained spa therapist. I told her I was cold so while she's massaging my legs, she should cover the upper body with towel... she just covered with half wet small towel, so can you imagine how cold I felt. Even worse the aircond was full blown, so I kindly asked her to switch it off but she said she cannot because everything was centralized. Then after about 2 hours, I was shivering... then only she switched it off with the explanation that she couldn't switch it off earlier because there was a function going on nearby... WTF??!!!

The view from our room

The spa that I went to, the interior was nice, sadly the service was not good

After my husband got back from the interview, we went bowling with his nephews and nieces. I was last, haha.. not surprising at all. Farhati, our niece was even better than me! How embarrassing... she's only 12.

I had to put on a cardigan, someone caught the flu remember???

With Farhati and Safiya.

I feel relieved that during the break, I got to read a few important topics in obstetrics, hence, making me look forward to applying what I learnt from those topics. I cannot wait to start working tomorrow although I am partially deaf from the high pressure during the flight back!

Friday

2010-12-31T06:40:00.000+08:00

Yeay! Today is a public holiday! We still have to go to work but half day, even that is a blessing when you are a houseman. Look forward to having a long day with my family. Insyallah we'll be getting a new family member, on my husband's side.

Happy New Year! Speaking of new year, I should get my resolutions laminated and put it in my coat pocket so that I remember them!

Ok... have to get ready for work.

PAC

2010-12-26T18:42:00.000+08:00

This is the sofa which I use to sleep on during on call in PAC (patient assessment centre). Makes it easy to wake up right away!

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Tag call

2010-12-22T19:47:00.000+08:00

I just had my first tag call. Here in O&G, not only you have to tag until 10 pm, but you have to tag call too. Just incase some of you don't follow what I mean, it means I have to stay tag with someone on call. So in other words, on call just like any other day. I delivered 2 babies that night and one of them was a premature baby.

The first case that I delivered was really funny. I entered the labour room to do VE (vaginal examination), to assess how her labour is progressing. Then I put my two fingers in and felt the baby's head... and guess what, the lady kept on pushing! She wasn't fully dilated yet, so I told her not to push, and she kept on pushing down while I pushed her baby's head up. So I called my friend, whom I tagged with to confirm my findings. And yes, the baby's head has descent, station 0. The patient kept pushing while we keep telling her not to push yet as her cervix is not fully dilated. Seeing how fast she is progressing, I ran outside to take the apron and mask while alarming the nurses that I am getting ready to conduct a case. Then I ran back inside while putting on my apron and mask... then put on my gloves. As I was putting on my gloves, the nurse said that the baby's head is out already! To my surprise, the baby's was already out facing the perineum. I pushed the baby's head downwards, and waited for him to turn because I didn't know which direction to direct as I didn't see how he came out. Then the shoulder came out followed by the whole body. The delivery set which contains all the instruments needed was not opened yet, so there was no cord clamp. I had to 'clamp' temporarily but pressing on the cord with my fingers. Delaying can cause the baby to be polycythemic. Sorry to say but I found the patient very irritating, hehe. I know it's not nice. Because she didn't listen, we didn't have time to guard her perineum, and because of that, she had some tear which had to be sutured. Suturing for tears is a little more challenging as they are irregular, unlike episiotomy. While I was suturing, she was so uncooperative. She on moving and lifting her butt! I know it's out of reflex from pain, but she was overdoing it!!! Some people are just so difficult to handle.

After that case, I got to sleep from 12 am to 1 am. I woke up because my MO came in and laughed when she saw us (me and my friend) sleeping. So of course, we had to wake up. I was lucky that night, she was one of the cool MOs in O&G. And I didn't sleep until morning. Then I had to deliver a premature labour. Nurses cannot deliver premature cases so the doctors have to attend. Nothing eventful happened during the delivery, it was quite easy as the baby was small. I am so glad that the baby was ok, he was born vigorous and pink. The parents were really nice, they kept on thanking me, eventhough I was causing pain to the mother by suturing her episiotomy wound. Alhamdulillah the baby was not sent to the NICU.

At about 5 am, I had to enter the MOT (maternal OT) for an emergency caesar. There were 2 cases. Whatever it was, I was out of the OT at 7.20 am and attended the morning briefing at 7.50 am, without showering! :P I was hoping that the PAC (patient assessment centre) will be calm. Sadly, it was the busiest day I had ever had. I was aiming by 11 am, if things were under control, I'd go and sleep for a while. I didn't get to sleep at all. The patient's kept coming until we are fully booked. It was up to the extent that we had to transfer patients out to other nearby hospitals. There so many patients wandering around waiting for the ward to call them, the scene looked like the Grey's Anatomy episode where they have one big disaster... where the ED would be full of people walking around in distress. I had to handle a difficult family. The wife was in latent phase of labour, so we told her that she'll be sent to Kajang Hospital. Her husband refused because he said that he doesn't know where the hospital is, so I explained to him that his wife will be sent via ambulance and he can follow from behind. And guess what he replied back, "Nanti saya akan sesat bila nak balik rumah sebab tak ada ambulance!". At this point, I just cannot smile anymore, he kept asking why his wife cannot be sent to Putrajaya. We explained why, about the cost and the limited places there. He told me to call the hospital and confirm... and I did... as expected, fully booked. I just don't understand why they were so stubborn. But in the end, they had to agree. I told them that if they refuse to be sent to Kajang and they want to go to other hospitals of their choice, they'd have to sign an AOR (at own risk) letter. They understood and just agreed to our suggestion. I was so pissed, especially after a sleepless night.

That evening, after I had my dinner... I slept from 6.30 pm until 5.20 am the following day! Full stop!!!

* I still enjoyed my day though because it felt like I was doing something. But I hope it wont happen everyday!

A new rotation

2010-12-21T08:27:00.000+08:00

Today is my day 6 of tagging. During my early days of tagging, I was really energetic, but the graph is declining slowly. Sad to admit, but it's true. Usually, when I tag, I would sleep right away when I reach home, now that there is a new addition to the family, I play with Sofiya first then sleep at 12 am. I know that I am the one to blame, but I can't help it, I miss her at work. When I come home and hear her cry, I get excited because I know that her parents are up and I get to see her. Some nights, I SMS Tiyah telling that I am on my way back from the hospital, and she'll leave her door unlocked and I get to see Sofiya. Once, I slept Sofiya, to give some time for the two of them (Aiman and Tiyah) to rest and sleep... I awoken by Sofiya's loud cry. Then I quickly picked her up and knocked on Tiyah's door, poor Tiyah, she had to get out of bed and start nursing. Now, she has on calls every night!!! We try to help her out as much as possible. But I must admit, Aiman did a great job.

The MMS that makes my heart melt

Ok, back to my first day in the labour room. Since I had never conducted any labour during my days in the medical school, I was pretty nervous about catching up with the whole system. I am so blessed that I am the only tagger, so I don't have to compete for labours. The JM's (jururawat masyarakat) had been very helpful, whenever a patient is fully dilated, they'd call me and help with conducting. The first labour was horrible! I observed one labour then I felt like I was ready to start conducting. The process of conducting was not the horrible part, it was the smell of liqour... while I was conducting, I felt like throwing up. The nurses were so supportive and continued my halfway job and told me to sit down before I faint, hehe. The second one was better, the liqour didn't smell so bad, I just had to tie my mask a little tighter. Alhamdulillah, I got to conduct 3 deliveries on first day and a few repair of episiotomy.

Episiotomy repair was another issue... suturing was always my favourite part, I just love seeing the skin approximated nicely by the sutures, but... it wasn't that easy for episiotomy repair. The reason for that was, suturing in a tight canal was a big challenge! During my surgical posting, I was used to suturing on the external structures (eg. the abdominal skin), so it was easy... plus the patient was not awake! The current challenges are:

1. Uncooperative patients - I don't blame them, they just went through severe pain during labour, and next, having needle bites in their most sensitive part. The local anaesth given doesn't work 100%. I just encourage my patients to breath in the Entonox gas!

2. The tight space with so many structures surrounding, especially the vulvar vestibule with the bladder. So I'd have to be very careful so that I wont suture the bladder.

Insyallah I will get better with repairing episiotomy and tear. Anyway, I will blog more. A little tired.

Welcoming the birth of Sofiya

2010-12-20T12:01:00.000+08:00

It's been a week already since the birth of my first niece, Baby Sofiya. I received an SMS from my sister last Saturday, telling me that her cervix had dilated 4 cm. I was at my inlaw's place in Gombak, so the next morning, I went to Prince Court Medical Centre (PCMC) after breakfast with Mama (mom-in-law). I got to the labour room at about 9.30 am, to my surprise, Tiyah was in her happy bubbly mood. Even more surprising she was GLOWING with her colourful headband and some lip gloss! I thought that the augmentation might have taken it's action by the time I reached the hospital, I was wrong. Her obstetrian, Dr. Seri started her on a low dose, so the action takes some time. I stayed in labour room with her, I had fun talking and laughing before the active phase of labour. Tiyah's MIL and FIL was also there, we had nasi lemak and the trifle that Tiyah and Aiman had made the day before... while she was in labour! Hihi. Time was passing by really slow, I cannot wait for the labour and at the same time, I felt sorry thinking how Tiyah will be in pain. At about 1 pm, Dr. Seri came and performed amniotomy (ARM - artifical rupture of membrane)... she said that the next time she sees Tiyah, she wont be smiling and laughing. She was right! After about 10 minutes from the amniotomy, her contraction became stronger. Aiman calmed her down with his sweet words and reading the Quran. It was so touching to see the two of them and how much they loved each other... Thank you Aiman for loving my sister. Whenever Tiyah was about to have her contraction, she would alarm us and she will grab our hands. My dad couldn't bare seeing her daughter in pain, he kept looking out the window, refusing to see Tiyah with tears running down her cheek. I just admire Tiyah's strength, she didn't scream out loud at all. When the contraction got even stronger, she just hugged my mom and said, "Mak, sakit..." I just cried hearing her say that.

Tiyah and Aiman in the labour room

After about 1 hour, she felt like bearing down. Then Dr. Seri came and we waited outside for the active part of labour. I just stood outside the labour room and I heard all the motivation coming from the staffnurses and Dr. Seri herself. I was in tears, hugging my mom. Then, after about 2-3 minutes, I heard Sofiya's first cry. It was one of the best moments in my life! Hearing a baby cry after delivery is a big blessing... I realized this since I joined the obstetrics rotation. It was 4.42 pm. My mom didn't wait for the permission by the team to invite us in, she went straight in. I just too a peek behind the curtain, then later Dr. Seri saw me peeking and called me in. Tiyah and the baby was fine, alhamdulillah. Her eyes were blinking... looking up, I guess she was wondering what the hell just happened! Then we called Ayah... and he was overwhelmed with the fact that he's a grandpa! The same with Mak. Aiman azan in Sofiya's ears, and her eyes blinked non-stop! Then, they took Sofiya for her first top-to-tail wash... I stayed with Tiyah and left the room as soon as Tiyah fell into sleep. Aiman and Mak chose which clothes to put on Sofiya... then they pushed Sofiya to her room. I think, I can sit and look at Sofiya all day! The nurses came a few times to aid Tiyah with breastfeeding... Sofiya gets better and better at sucking. A few visitors came to see Sofiya, Aiman's siblings, aunties and uncles, including Alia Ali.

Sofiya and Papa

Sofiya after top-to-tail wash

Both parents after labour, both are tired

I went back home at 11 pm, I wish I could stay. The next morning when I woke up, the only thing that I could think of was Sofiya! I wished that I don't have to go to work and stayed with them in PCMC. Sadly, it was my first day in obstetrics, so I had to report myself and start tagging until 10 pm. The MMS helped!

Feel like blogging

2010-12-06T20:34:00.000+08:00

Hello everyone! Yes... it's been a while since I felt like blogging. I don't know why I had not been bothered to update about my life as a houseman. The weird thing is that it was because I had nothing to write about, not that I lost interest or anything, but it's because I didn't find them interesting enough to be put on my blog.

Currently, I am in charge of the acute cubicle in the male surgical ward. Oh boy! It is very challenging! A lot of intracranial bleed and other traumas. I can no longer take long lunch break, to be honest, no more lunch outside! And yes... I had so much time previously that I could afford to lunch outside the hospital. I hope no one from the hospital is reading this... hihi. Erm... I wonder whether there is such rule saying that house officers are not allowed to leave the hospital for lunch... what I know is that we can take our lunch break as long as our work is done. And I never leave my work undone.

Anyway, this morning, I came to work to find that my intracranial bleed patient had passed away yesterday. It was expected, we signed the DIL form already. DIL means death in line, it's a form that the MO and a family member signs after we have explained to the family regarding the poor prognosis. This form prevents any misunderstanding and allows that family to slowly digest the bad news. I wasn't around when my patient went, but I heard that his wife took it well, she had been taking care of her comatose husband for 12 days! He sustained subdural and subarachnoid bleed from a hit and run accident. I don't want to get emotional and wonder how his 2 little kids are surviving, it can make me upset and even cry...

Tomorrow is another half day! Yippee! Another public holiday. I can leave slightly later for tomorrow, unlike today, I was at the ward by 6.35 am. It's quite nice to arrive early actually because I get the best parking space!

Ok... I guess this is all. Insyallah this Friday will be my last day in the surgical department. I cannot deny that I feel a little bit sad and not bothered to change to a new posting. I already felt comfortable here. Nothing in life is permanent except change!

Niece

2010-10-21T21:48:00.000+08:00

With Tiyah, the glowing mommy-to-be

Currently, I am in Prince Court Medical Centre, at 9.30 pm, waiting for my mum to finish off her LASIK surgery on a patient. I feel a bit exhausted since after coming back from work, I straight away get ready to accompany her. Anyway, I was in the clinic again today, it was a bit chaotic since there was only one surgeon around, so I had to wait for quite some time to get their opinion on my plan of management.

I met my physics teacher today, she came to the clinic and I happened to be in the consultation room, it was so funny how I just happened to be there! It was nice seeing her.

One of my patient was diagnosed with breast cancer today, it was really hard trying to break the news, so I had asked my MO to do it for me. It's true, patients will try to remain calm and composed in front of their doctors when deep inside, their hearts were shattered. When my MO told her, she just said, "Ok"... then we gave her the options of treatment... and later, she said that it's such a sad news and shed a tear. I cried too, it was heartbreaking for me too, especially hearing that she had 2 beautiful children and the youngest is 1 year old. I just pray that once her breast and axillary lymph nodes are removed, she'll be alright and tumor does not recur.

On a different note, a happier part of life... I look forward to the birth of my niece. I just cannot wait to see that tiny baby that keeps kicking my sister's tummy. I just love feeling her feet kicking against her own little home, and even funnier when I get to watch her movement. Just now my sister was asking whether I want to enter the labour room with her... that made me think. I would love to, but knowing me, I don't I can bear to look at her in pain. It hurts to see your loved ones in pain. Well, we will just see how it goes...

Weekend off

2010-10-15T19:13:00.000+08:00

I'm getting my weekend off, and I applied for extra 2 days, so in total, I get 4 days off! It is exciting not having to get up early and leave for work, but somehow, thoughts about work did come across my mind. I am trying hard to get my mind off work because I don't want to develop a workaholic attitude. Now, I understand how people fall into the trap of being a workaholic, and in 20 years to come, they reflect back at what had happened to their lives. You get to see the reward right away in working life, that is why it is addictive. Insyallah I will shape my life towards family more than career.

Last Monday, I was part of Breast Cancer Awareness Day, organized by the surgical department. Being the emcee, I got the benefit of staying through the whole program, it certainly didn't feel like a working day! :D I learnt so much from the symposium, I especially liked the closing event, which was a forum with the breast cancer survivors. It was indeed very inspiring!!! One of them was telling how she got to know she had breast cancer, it started with nipple discharge, then the biopsy revealed it was malignant. She was so depressed, but some how, she found the courage and fought the cancer. The common traits that the speakers had was POSITIVITY. They didn't focus on the disease, they focused on getting well. For them, side effects of chemotherapy was temporary and it was worth facing since it leads to a lot of benefit.

I also learnt that, as a doctor, I should approach patients in a more understanding way and breaking bad news in a subtle way. Let them digest them bit by bit, instead of laying out the option of surgery as it scares them. Something that I didn't know until that day is that, patients try to remain strong in front of their doctors, they stop themselves from crying and try to remain composed. But what happens after their visit to the doctor is a totally different thing, they weep! I remember this one pediatric patient, who had SLE (systemic lupus erythematosus)... my specialist broke the news... and I was amazed at how strong the family was, no tears were shed. Not something I'd expect. I guess it was a different scenario on the way from the hospital.

Ok, have to get going. Maghrib already!

Uninspired

2010-09-29T19:23:00.000+08:00

The title says it... I had been uninspired to blog about how my days had been. Not that I did not enjoy my surgical posting, it's just that I don't know what to write about. Currently, I am starting to enjoy my posting, I think it's because I am now in charge of the periphery patients which involve our paeds patients, so I get really excited reviewing them every morning! It gives me such great joy entering the paeds ward, and it feels like home! I guess the kids really give me great inspiration.

The truth is, I care about my patients deeply and I love sitting with them and chit chatting with them, but... when I am in charge of the male ward, I feel awkward having to do so, I mean, they might think that I'm trying to hit on them or something. Children won't feel like that of course! The other day, I was in charge of the female ward during my on call, I just loved doing my rounds and chit chatting with my female patients, asking about how they feel, their tips on life, they are just like my grandmother! I even got a really tip on how to prevent stretch marks after giving birth! That patient's tummy has no stretch marks at all and she gave birth to eight children! For those interested, just message me personally... hihi.

Anyway, I am on MC-leave today. I was unwell since yesterday, I think it was due to exhaustion for my frequent on calls! So I decided to rest in bed today, well, that was what I planned, but I ended up running errands which had been delayed! I opened a new bank account for my Haji savings. I feel so relieved when I got that part settled because I haven't saved any money since I got my pay, I spent my money ruthlessly, too excited with the fact that I am earning, hehe. It will change this month! So excited!

Ok, I am waiting for trainer to come. I started working out again, and it feels good!

Difference

2010-08-26T20:47:00.000+08:00

Lately, I had been so lazy to blog and surprisingly, I have nothing to tell besides to whine about how much I miss pediatrics. Hihi. Well, maybe I am speaking too soon, because I am pretty sure that in a months time, I will start telling how surgery is so beautiful! One of the things I miss about paeds is the kids, I just love working with children. They are so adorable, and you wont mind if they throw tantrums, because they are kids! But... when my adult patient throw tantrums, sometimes I feel like being rude but I know I can't and it doesn't portray a good image of a muslimah doctor. So I have no choice but to try to understand the patient's condition and give them the benefit of the doubt. It's not easy being in pain. Being in the surgical ward has also made me feel very grateful about myself, especially my healthy. It's so scary looking at how they are in pain, loosing weight because of the disease complications, dying of cancer and many more. We just cannot complain, Allah has blessed us with so many things and yet we tend to take them for granted.

The work load is also different compared to paeds, I don't know whether it's because we have too many housemans in the ward, or it's the actual workload. The admissions are very minimal, around 3-4 patients in a day and the ward is not full. I am now in charge of one cubicle in the male ward... blissful! The on call was not so bad as we have 3 housemans every night and we get to help each other out so on call nights are no longer quiet and lonely.

Tomorrow I am on call again! Hope I have a good call!

****

As for my previous post regarding absolute contraindication of blood transfusion in a renal failure patient with anuria, here is why...

Blood transfusion can cause hyperkalemia, and this is dangerous as it can cause cardiac arrythmias, so we don't want that to happen. Potassium is mainly excreted in urine through the kidneys, so imagine if the patient cannot excrete the extra potassium and it accumulates in the body! That is all! I thought it was something good to know. I realize that when working, it all boils down to your basic physiology! So for the first years, do understand and a build a strong base of your physiology as it is very crucial in understanding how our body functions!

My first surgical on call

2010-08-25T07:12:00.001+08:00

Well... It wasn't so bad. Got to sleep for at least 3 hours. Good enough. Nothing compared to paeds on call, hehe. But I still miss paeds.

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what I learnt

2010-08-16T23:39:00.000+08:00

Today is my day 4 in Surgery. Finally beginning to feel happy because I started to have my own patients. Cannot wait for the tagging days to be over!

Something that I learnt today from the MO nephrology,

Complete contraindication of blood transfusion is when you have hyperkalemia with anuria

Will explain why later. I am so tired and I just want to sleep......

Finally.

2010-07-30T00:17:00.000+08:00

Before the procedure, at 2 am.

This morning, I woke up feeling very exhausted. Sometimes I wish that I get at least one day off every week for me to replenish my energy store. I am still tired from my sleepless night on call. I have no leaves left because I am saving them for our umrah trip, insyallah next Wednesday.

But anyway, I am very grateful for the fact that I got to do at least one exchange transfusion (ET) for one of my patients during my last call, two nights ago. It was totally unexpected because none of my friends had briefed me about the case. The baby was about 4 days old, presented with high jaundice, 345 umol/L. Currently, I am in charge of the general pediatrics ward, so I had not known about it earlier. I only got to know about it when I went to the NICU for my on call. Luckily my MO told me about the case. She ran bolus once, and the repeat bilirubin was rising to 351 umol/L and it's obviously not responding to the intensive treatment. It's an indication to proceed with ET... yeay! Severe jaundice can cause kernicterus which can lead to neurological impairment later.

His parents consented the procedure so we started preparing at about 2 am. As soon as the fresh whole blood arrived, I inserted the umbilical vein catheter then proceeded with ET. Before that, I did solat hajat because it was my first time and I was praying that everything goes well, no immediate transfusion reaction or what so ever. And... alhamdulillah, everything went so well, the baby stayed quiet and slept all the time... well, except once when he started kicking and kicked off his UVC, but it was easy to place back the UVC.

The main concept of ET is that we exchange the blood that is full of unwanted bilirubin with a new blood. The amount for exchange is based on 160 ml/kg, so for that baby, we planned to exchange 560 ml of blood. His weight was 3.5 kg. All of the steps were written by the staff nurse assisting, I cannot imagine if the staff nurse didn't document everything because it can be very confusing. You have to alternately draw blood from the baby then transfuse the clean blood, it has to be same amount, and the rate of transfusion has to be steady because if you push the syringe too fast, the patient might became unstable hemodynamically... and that is why we have the vital signs monitor on all the time.

For the early cycles, I draw 10 ml from the baby within 1 minute, then I flush the "waste" into the waste bag, then I take 10 ml from the donor's blood (this has to be done in 1 minute) and transfuse into the patient within 1 minute. It is done through the umbilical vein catheter. So each cycle is 3 minutes and you have numerous cycles, that is why the whole process usually takes about 2 hours. It can be a bit confusing because you tend to forget whether you had just taken the blood out or into the baby, and that is why, the assisting nurse jots down what you just did. To be honest, during the whole process, I felt like I was my iPhone game, the Fruit Juice Tycoon because the game had something to do with manipulating pipes... just like what I did in ET, hihi! I told my mum that I was glad I played a lot of games because it made pick up skills like this very fast!!! :P

This is the rough idea of what ET is about.

Ok... ET was such a good experience although I literally fell asleep as I was slowly pushing the syringe slowly. But I am glad I got to do it. Alhamdulillah. I have 6 more days in pediatrics. After this I'll be in the O&G department insyallah.

Oh yeah, I forgot to tell that post-ET, the serum bilirubin went down to 101 umol/L. Alhamdulillah we managed to save a patient from having kernicterus and the other related complications. Hope the baby lives a meaningful life and a happy life too.

Family day out

2010-07-18T16:16:00.000+08:00

I love post-calls. Post-call is a situation when you were on-call last night. The reasons why are:

1. Let's say if a friend didn't turn up for work and he/she was supposed to be on-call on that day, I will never be chosen to replace him/her because I just had my call, so I'll always be safe. :P

2. As I am about to punch out my card, I get really super excited when I think about being home and meeting my husband and family. It's not like any other day, because being away from my bed for one night makes me appreciate it more... nothing feels like home.

3. I feel good about myself since I knew that I had sacrificed my sleep for the sick. :D

And.... I certainly loved my post-call yesterday. The rounds at the ward was quick so I got to be home by 12.15 pm! Yeay!!! Oh yeah, on Saturdays and Sundays, we finish early, half day. When I got back, my husband wasn't around, so I used the opportunity to sleep and sleep... since we were going for a movie at 4.30 pm. We went to watch Toy Story 3 in Pavillion, it was just the 4 of us, none of the in-laws followed along. It's been so long since we went out as a family and it was really nice. The movie was really good, we enjoyed the movie all along. And it's the first time that my dad didn't sleep during the show, haha. He always sleeps whenever we go for movies, but not this time. The characters were so funny and the story line was written smartly... the movie managed to touch our emotions that we cried towards the end! I won't say more, don't want to be a spoiler.

Today, I am enjoying my Sunday off. I slept back after Subuh and got my room organized, which was due a long time ago.

Almost...

2010-07-15T09:38:00.001+08:00

For HO, we have a logbook that contains quite a list of procedures which we have to observe or perform before completing each posting. For paediatrics, one of them is ET (exchange transfusion). Sadly, I had never done it!

Last Sunday, I thought it was my lucky day because one of my patient had very jaundice. He was on his day 6 of life and presented with jaundice, according to his mother, he is feeding well and doesn't show any signs of sepsis. So we started him on triple photo and took another level of serum bilirubin... it was as high as 399.5 umol/L! So we ran bolus over 1 hour and took another serum bilirubin level after 2 hours... it went higher, 412 umol/L!!! So I got the consent from the mother and explained to her about the needs of doing an ET. She agreed and signed the consent form. Prior to that, we already took some blood for crossmatching so that when we plan to proceed with ET, the blood will be ready. Anyway, my MO inserted the UVC (umbilical vein catheter) as the exhange of blood will be done via the UVC. I couldn't do it because his umbilicus were already dried up, he was 6 days old already. So, after the UVC was inserted, we checked his latest serum bilirubin, and it went down to 325 umol/L! My MO called the specialist on call and he said that we don't need to proceed with the ET. How sad for me... because I was already excited about it. I even had a plan in mind of what time it will finish and when I will go to pray Subuh.. hihi.

So the next day, I spoke to my specialist about me not being able to do ET yet and I am almost done with paeds, and she said that it's ok because what's most important is that the baby is getting well... and I thought to myself, yes, that should be the main aim when treating a patient, which is to make sure that the patient is ok and if possible, avoid any risky procedures. It's actually my third time when I planned for ET but the bilirubin decreased, so it wasn't done... someone actually told me, it's because I bring good luck that's why my patient didn't have to do ET... I'd like to believe that! :D

Mischievous patient

2010-07-13T18:11:00.000+08:00

On Saturday, I was in charge of the paeds ward, in 5A. The same cubicle, which is the acute cubicle. I quite like the acute cubicle except for the part that the patients are dynamic ie. the patients keep changing almost everyday, so it's a little bit challenging to understand the progress overnight, especially for the new patients who came at night. So it's important to summarize the case when I present to the specialist the next day.

Anyway, one of my old patient came back. He was diagnosed with ITP (Immune Thrombocytopneic Purpura) in April 2010. Currently, he is being admitted electively for IV Immunoglobulin transfusion because his platelet was as low as 17! I like this boy, he is really cute, and very mischievous. For patients like this, we'd advise them not to move about and play with something that doesn't involve running or anything that can cause them to fall for fear of bleeding, especially intra-cranial bleeding. But for this boy, his mum told me that the more she tells him to sit and play gently, the more he runs around and jumps off his bed! So I asked his mum whether he enjoys watching DVD or not... and his mum said, yes he does... then I asked again, what DVD does he watch... as you can guess, "ULTRAMAN." No wonder he keeps on jumping around and try to follow the stunts in the series! So I advised his mum to stop buying action-based DVDs, thank God he likes Barney... I guess he'll start watching a lot of Barneys! Kids will always follow whatever they see on TV.

I pray that Tung Li gets better really soon. He's the kind of kid who still smiles you even after you prick a needle in his hand!

Is it really that bad?

2010-06-23T17:51:00.000+08:00

Before I started my housemanship, I heard numerous stories of how life is once you start working as a HO. Those stories almost made me feel nervous about starting the new life, but I thought I'd seek for an advice from the optimists. I asked one of my friend who is now a paediatrician in the making, he said that as long as you know how to manage your time, you can always go back early and have dinner with your family. He also said that you will learn a lot during housemanship, and he was right! Indeed, I learnt so much!!!

But of course, there are times when you feel exhausted and you have silly thoughts such as "why did I choose this field?"... I can't deny it, I did feel down a few times. What's important is that when you have those kind of thoughts, you have to shut it away straight away. But now alhamdulillah, I stopped having silly thoughts because I have settled down in my job and I got the hang of how to do my work properly. To me, in life, it's all about perceptions. You choose your thoughts and emotions. There are many times when you have to make a decision about how to react.

1. If I am being bossed around by the person above me, eg. they ask me to do all kinds of things, I can either feel depressed about being victimized or I make the best out the situation. What I usually do is that I turn it into a good experience for me to face. Although it is not my responsibility, I consider myself lucky for being chosen to do it. And also, I feel good about myself because my boss actually trusts me that he/she passed the job over to me.

2. Being a new houseman, I was told off quite a few times and most of the time, in front of the patients! I can choose whether I want to cry during the rounds, get all sensitive about the whole thing and make it personal or... I just consider their 'scolding' as a feedback so that I wont repeat the same mistake again. Actually, if you look at it, it is better for the specialist to tell you off because it shows that they actually care about you rather than them ignoring you. It hurts even more.

My dad keeps reminding me that everything that happens in your life shapes you. So I am the way I am because of what I went through for the past years, so it's the same with my job, whatever I do and experience will shape me. The more cases I clerk and manage, the more knowledge and experience I will gain. So why grumble when I end up doing other people's job, right?

... and this is how and why I find housemanship interesting and really enjoyable. Paradox?... I know. It all depends on how you want to perceive the experience. Ok, have to go off to sleep. I am on call again tomorrow. And I will get my weekend off for Tiyah's wedding reception.

Neonatologist?

2010-06-18T17:54:00.000+08:00

Today is my last day in the NICU, starting next Monday, I'll be posted back to the 5A ward. Honestly, I feel sad because I really enjoyed it here in the NICU, the work burden is less but I have to do more thinking here. But of course, there are days when it's so busy that I have lunch at 3 pm... it was quite a while ago. And poking small babies are much more easier, hehe, because their skin are so thin that I can see whether the needle is in or not. It's the branula part that is challenging because the babies move a lot. Many times I find myself getting pissed at the babies because they keep on kicking their tiny legs that the branula just fall off and I have to set a new line. Some babies are easy, some are just so challenging. I wonder how Monday is going to be. I have refresh back my knowledge on bigger kids, especially the doses of antibiotics!

Being here made me reconsider my career path, I felt like becoming a neonatologist. The main pushing factor is that there is no surgery and I want to do surgeries.... so that makes ophthalmology my no. 1 choice.

I just love the feeling of excitement of going to work every morning and seeing that my patient has improved. It is a good feeling and very addictive too. Recently, one of my chronic patient was discharged, he was born flat and diagnosed with perinatal asphyxia, then he developed nosocomial pneumonia, then later developed chronic lung disease secondary to recurrent pneumonia. He finished many courses of antibiotics. Alhamdulillah, he progressed really well, he managed to breathe properly without oxygen therapy, so he was discharged after 40 days in the ward (since birth). I pray that he grows up to be a good boy. I was glad that he didn't need home oxygen therapy. :D

I'm on call again tomorrow. Another weekend call. I cannot wait for the next weekend because I get my weekend off. It's for Tiyah's wedding reception.

Ok, have a nice weekend everyone!

VAD

2010-06-18T00:30:00.000+08:00

Sunday... I was not meant to be on call at all, I just had my last call on Friday, so being on call on Sunday would be very tiring. Initially, I was supposed to send my patient to HKL for the VP shunt surgery on Sunday, that makes my working hours really short, so I booked a facial at 5pm on Sunday. Luck was not on my side, well, that was what I thought at first, as soon as I stepped out of my car, my friend called me and said that I had to replace her call since her daughter is unwell and she wishes to be home. I was obliged to turn down her request because last week, she replaced me when I on leave due to my flu.

Anyway, I didn't start my day with enthusiasm like any other day, I just hated that feeling. Feelings like this really affects my work, I didn't get to insert any branulas! So I called up my husband, my mum and my dad... they consoled me well, I was feeling better after speaking to them. What made me feel even better was when my MO asked me to go the labour room and stand by for a vacuum-assisted delivery (VAD), as she was doing the UAC procedure. Before I left, she just told me what to do if the baby comes out flat. As soon as I got to the labour room, I heard the nurses and the doctors saying, "teran, teran... ," bla bla bla, all the depressing words, as if they were telling off the mother for not pushing correctly. I certainly wouldn't want to hear those kind of instructions when I am in labour! But anyhow, I guess they were to get their job done well.

The sound of the vacuum was loud, it was my first time seeing a VAD, it was an experience. I told the O&G team MO that I am still new, and I haven't completed my NRP (Neonatal Resuscitation Program) course yet! I was praying hard that the baby comes out vigorous... and thank God, as soon as the head came out, followed my the body, the baby cried, Apgar score 9/10/10. That was a relief, no resuscitation needed. The next challenge was, should I admit the baby to the NICU or not. Seemed like he had a boggy swelling... SAH (subaponeurotic hemorrhage), and this needs admission. But at the same time, it could just be a caput, the swelling wasn't tender. So I ran back to the NICU and asked my MO, she said that if I wasn't sure, it'll be better if I admit the patient to the ward... and so we did. And here is what the baby looks like after 16 hours of life. The head is asymmetrical, the parietal region was a bit edematous, it was from the vacuum... poor boy. He also had capillary hemangioma over his forehead. Luckily he was admitted, it was SAH. So 3 days of vitamin K will do him good!

I went to the labour room twice that day, the second case was for respiratory distress case. The newborn was found to be tachypneic and was grunting at 30 minutes of life. We put him under headbox and he was still tachypneic... and again, I admitted the patient to the NICU. And now, he is just completing his course of C-Penicillin and Gentamicin and is already well. So happy for him.

Ok.. have to go to sleep now. I hope I have a less hectic call this Saturday!

30-minutes journey

2010-06-15T19:25:00.000+08:00

Last Wednesday, I was asked to accompany a patient to HKL for a check-up by neurosurgical team there. The patient was a premature baby, born at 29 weeks, corrected age 36-weeker. He was really tiny! His head circumference increased significantly and was diagnosed with hydrocephalus. So he was scheduled to get a VP shunt.

It was a good experience going there because I got to go in an ambulance! My first time in the ambulance!!! I sat at the front, and it was funny looking at the cars moving aside, giving way to the ambulance, hehe. The journey from Serdang Hospital to HKL took exactly 30 minutes only... and we passed through a traffic jam on Jalan Tun Razak. The sirens was working the whole time, it was irritating for me! I guess the driver is already immune to the sound.

Ok... got to go. Too lazy to write everything. :P

Hyoscine ingestion

2010-06-05T14:02:00.000+08:00

I had the best on call last Saturday. There was no admissions after 12 midnight! And I got to sleep the whole night, the longest sleep I've ever had during on call, almost 5 hours! I was all fresh the next day, I didn't have the post-call eye bags.

What's interesting about my call was one case, a little boy ingested his grandmother's anti-psychotic drugs. Poor boy. He was only 3 years old. What happened was that he ate a few pills that was in his grandmother's medicine box, you know the ones where you keep according to the days. So there were about 10 pills in there. After he ate them, he pointed his mouth to his mother and it was then that they realize the medicine box had been opened. That's the thing about children, you have to be extra careful when they are around, you have to think ahead of them because at that age, they are very curious about many things and always wanting to try out new things. So on the way to the ED (emergency department), he was drowsy and fell into a very deep sleep. When we encounter cases like this, as in ingestion of poison/drugs, we need to call the Pusat Racun Negara. So I called them up and asked about the side effects (long-term and short-term) of each drug, so that I know what to look out for during our observation. Sadly, all the pills in the medicine box had no antidote. But stomach wash was done and so far, he was stable, except for the fact that his BP was relatively high for his age. After discussing with the officer in Pusat Racun Negara, I came up with a conclusion that he swallowed hyoscine and the officer at agreed too because the hyoscine pill is small and sweet, as it's sugar-coated, so it made more sense why the boy didn't spit out the pill.

He fell into a very deep sleep, he even peed, which normally, he is dry by day. I felt sorry looking at the parents, they were so anxious. The next day, he woke up and was back to himself! I had to prick him the next day because I needed to measure the drug level in his body and check his liver and renal function.. after the blood taking session, he was well and fully alert... who wouldn't be alert after someone pokes a needle, right?

It was a very interesting case because I got to know about the drugs in detail. Lesson learnt... always be careful and store medications away from children!

My life as a HO

2010-06-01T19:55:00.000+08:00

Many times, I was asked what my daily routine as a houseman is... well, here goes.

***

I leave house around 6.40 am, thank God, I was blessed enough to live very close to the hospital. The journey takes around 7 minutes, door to door, from my house door to the ward! Nice, right? Alhamdulillah for that. Then, as soon as I get to the ward, I check the computer and look at the progress of my patients overnight, and also check if there are any new cases in my cubicles. Oh yeah, before that, each HO will have their own cubicle, so you just review your patients... but, you still have to know other cases in the ward too... and that's the challenging part! At least get the rough idea of what is going on with the other patients. Ok, back to my routine... then after that, I review my patients and examine them. I enjoy reviewing my patients every morning, especially when they show positive progress, especially the asthmatic patients. Then, after reviewing them, I plan my management, either I want to proceed with the same plan as yesterday or change them. All my plan will be discussed with the specialist or MO, because sometimes, they have a better way of managing. It gets better with experience actually, because I remember when I first started, I never changed the plan because I was too scared in case something goes wrong, hihi.

After reviewing my patients, I key in my findings on the computer and also update the patient's notes so that it's easier for the other doctors to understand the case. Since Serdang is an IT hospital, so everything is done on the computer, including your lab/radiological orders, lab results, discharging patients and etc. I love this system because I can read the my patient's progress from any computers in the hospital.

Around 9.30 am to 10 am, the ward round with the specialists and consultants starts. This is the challenging part because I have to present the case to them... and again, it gets better as you go along. It was nightmare for me at first because I mentioned every single thing! Later I found out that I should present the relevant things only. The specialists hate it when I present with the papers in my hand because they expect me/us/anyone to memorize the case. It's true though, right now, I am trying very hard to memorize everything, including the lab results!

After the rounds with the specialists, I settle the things ordered by the specialist. Sometimes they order blood investigations, so I do them after the rounds straight away. As soon as they are all done, I go for lunch. Regarding lunch... before I started work, I was told that those who do not lunch are the ones who cannot manage their time and work too slow. So, I try hard to stay away from that category! But there are days where there are too many blood to take that my lunch is delayed until 3 pm, but I still get to have my lunch.

Since I'm in pediatrics, the rounds are tds (x3 daily). At about 2-3pm, I do my afternoon rounds and insert the notes on the computer. Sometimes the specialists join the afternoon rounds, sometimes they don't. Again, I take any blood investigations ordered by the MO or specialist from the afternoon rounds, and as soon as I am done, I get to go home if I am not on call. If I am on call, I do what I'm supposed to do quickly and by 5pm, I'm supposed to be at the ward where I am in charge of for that night, sometimes it's the same ward. For paeds, one HO is in charge of 2 wards... yes, it is tiring.

For on call nights, around 6pm, I buy my lunch (we get RM 15.00 worth of coupons) and shower quickly. At about 8pm, I start my evening rounds for the 2 wards. Night rounds are more relaxed since I just monitor their progress and make sure everything is ok.

Ok.. throughout the day, if there are any news cases admitted, the HO's are supposed to clerk the patients and do a full examination on the patient, and.. of course, manage the patients accordingly. Then, I discuss my diagnosis and plan of management with my MO or the specialist if he/she is around.

So that is basically it! My daily routine!!!

NICU

2010-05-27T19:35:00.000+08:00

Last Monday, I was transferred to the NICU (neonatal ICU). It's been great so far, although on my first day there, I was a bit lost, but by the second day, I enjoyed taking care of the neonates. Currently, I am in charge of the photo therapy room... and I just love looking at them in the morning. My job is... to check the nappy and check their stool, hihi... and check their TSB (total serum bilirubin) level.

I planned to blog more, but I have a date tonight with my dearest husband. Tomorrow is Wesak day, so I only have to go until 1pm! And... I am on call this weekend, but it's ok, I look forward to seeing new cases!

UVC - umbilical vein catheterization

with Dr Afida, our MO

With Aisyah

With my big boss, Iza... :P

Fitting in

2010-05-15T20:21:00.000+08:00

I had another sleepless night yesterday night... typical on call night, but with extra admissions and one emergency case. One of my patient, who was previously transferred from HDU (high dependancy unit) developed APO (acute pulmonary edema) in the middle of the night, passed midnight. I was clerking a simple febrile fit patient in ward 5B, then the nurses called me and told that the patient was in respiratory distress. So I straight away went to the ward 5A, and he was tachypneic, respiratory rate (RR) was 44/min. He had Dengue shock syndrome, with renal impairment. He was IV drip and at the same time, he drank lots and lots of water, hence the APO! I called my MO and she called the specialist on call that night. He suggested we should start the patient on IV Lasix to get rid of all the excess water and get the nephrologist to review the patient. So at 5am, I had to accompany the patient for hemodialysis... and.... at the same time, there were 4 new admissions, waiting to be seen! Oh what a night! In times like this, I realize that clerking can be postponed, I mean the full detailed clerking, the ones where you ask about every single thing. What's most important is to quickly review the patient, ask what happened and give the plan and get the nurses to administer the drugs that you planned for. Because if you were to wait until you clerk each one then manage, the patient might deteriorate by the time you come up with a diagnosis and action plan. It's skills like this you get to develop as you go along, and it takes time until you become really efficient. I just cannot wait until I become really efficient and get things done quickly, and not get palpitations every time I hear my phone rings telling me about patients! Speaking of the phone ringing, now, whenever my phone rings, my heart stops a few beats until I see that it's not "Hospital Serdang" calling. I guess I should start assigning the ringtones for everyone so that I wont get confused. During houseman ship, you are required to be available all the time! Even when you are not on call, when the hospital calls you, you have to go no matter what. But so far, I haven't encountered any situations like that. Another challenge when fitting into a new job is, you are required to do many things and finished them off really fast... I mean, I can do them perfectly, but at a slower pace, and specialists don't go by that pace!

On a different note, the other day, my patient asked whether I was on Facebook... how funny is that, right? He was a little boy around 12 years old, came in for acute exacerbation of asthma secondary to URTI. His mother thought that it might a good idea for him to contact me and chat.... WTH?? Anyway, I just laughed... I didn't feel comfortable. I understand the mother's intention, but I don't know... I haven't been filtering my friend request lately... most of them are mutual friends of my moms, so I just accept according to my mood, hihi.

**
Today, I had a short day at work, I went back at 2.30 pm. I went straight to Gombak to my inlaw's house. There was no one at home, my parents went off to Penang yesterday, so I thought, why should I stay home alone, so I joined my inlaws for an early dinner. Sadly, I had to leave before Maghrib since I'll be on call tomorrow, so I wanted to rest tonight before another long day. On the way back, I used a different route because there was an accident I think, an ambulance passed by me a few meters before and the cars were static. I don't know whether the accident was blocking the road or it's because people slowed down to see what's happening. Sometimes I wonder, why do people like to look at accident sites, isn't horrifying? I certainly ignore and keep my eyes focused on my driving whenever there are accidents! Anyway, I ended up going round and round KL trying to find my way back home... hihi... alhamdulillah I arrived home safely. It was nice long drive, not so long actually, extra 20 minutes. It's been a while since I drove, because since I started work, my husband or my dad had been sending me off and picking me up. I'm too lazy to drive and find the parking... besides, the hospital is only 7 minutes away from home!

Last Thursday, I had my H1N1 vaccination.... finally! The first liners were required to get the vaccine. I was really scared when the nurse was about to poke me! They laughed at me, hehe.. and they said, "doctor cucuk orang setiap hari ok, takkan nak takut!" so I admitted, yes I do poke people everyday, but I'm still scared of needles!!! But honestly, it didn't hurt at all, it was just like an insect bite. I prayed hard so that I wont develop any fever since I was on call that night, and alhamdullillah, I remained afebrile until today. But my arms hurt little bit, at the site of injection.

Ok... I have to get back to studying. I have a viva exam this Tuesday with the specialists. They want to assess me after one month of working and write a report to Cairo University, telling how their graduates are! I hope to do well and answer correctly! Please pray that I get better and better everyday. There are so many things to learn everyday.

Have a nice day everyone!

...

2010-05-09T18:59:00.001+08:00

I miss Egypt! :'(

So for those who are still in Egypt, enjoy yourselves!

Learning process

2010-05-07T06:27:00.000+08:00

Housemanship is another learning process, you get better and better as you go along. I learnt so many new things since I started work, particularly about the common diseases. They actually present with the same stories, but it's how you interpret the story that's important. Sometimes, patients tell you the irrelevant stuff and they go on and on about how their child got to become sick! I always try to remain patient, and still keep a smile on my face, when deep in my heart, I feel irritated, haha... mean, right? Whenever I start to feel inpatient, I keep telling myself, what if this person in front of me is my sister, I'd be happy to listen to whatever she says... but, at the same time, you just have to be smart about asking questions when you clerk. I like to listen at how the specialist ask the parents about the child's progress. eg. asking about nocturnal cough, when you ask the parents whether the child coughs at night, sometimes, parents say no, because what they think of is their child coughing in the middle of the night... so you can just ask, usually, at what time does your child start to cough.

Anyway, on my second on call, I got to sleep for 1 hour and 30 mins, same as the third on call, I am getting better at it. Last night (third on call), there were about 8-9 admissions, and guess what, I didn't realize it was that many. I guess it's because I just concentrate on the patient that I was handling, and not worry about the coming ones. I managed to sleep from 5am to 6.30am. I could have gone further but the nurse called me to remind about the Dengue blood taking. Another thing, when you are on call, you just hate it when your phone rings, every time my phone rings, I get butterflies in my stomach, hehe. Lately, I changed my perception towards getting the phone call from the hospital, instead of thinking "Oh no, another new admission," I'd say to myself, "Oh yes, I get to learn more and help another human being!"... it may sound simple, but it's the power of language and it really helps!

So far, I really enjoy my work, I'm getting the hang of it, and I know my patients in the ward. And, as you treat them, you grow love towards them. I just love going to work every morning and seeing my patient getting better. It's such a great joy. And, when they are discharged, I do feel a bit sad because I won't see him/her anymore.... but, it's even sadder when they come back after 2-3 days of being discharged. Speaking of that, yesterday, I had 3 reunions with my patient, hahaha.. two of them got nosocomial pneumonia and the other was another relapse of nephrotic syndrome.

Ok... I have to go now. I'm on leave today because I caught the flu and it's not safe for me to go to work. I got the infection from the kids at the ward obviously!

My first on call

2010-05-07T05:50:00.000+08:00

I was really nervous to think about me being on call, when I'm all alone, taking care of 2 wards! I started my first call last Friday... I was happy about the fact that I'm finally off-tagged, because I get to go back at 5pm instead of 10.30pm everyday! Life as a tagger was so tiring, I was at the hospital by 7am and leave around 10.30pm (the earliest) and again, the same schedule the next day. That's why I vowed to myself, I'm only going to tag for 2 weeks, I will try my best so that the specialist in charge allowed me to start my first call.

My first on call didn't go so bad, I only got to sleep for 30 minutes that night! Haha.. There weren't many admissions, but I blame it on my lack of ability to organize my work. First timer, so what do you expect right? The regular blood taking for the Dengue patients went chaotic! For Dengue patients, we monitor their FBC (full blood count) every 4 hours or 6 hours, depending on their severity... so I have to syringe out the blood around 2am or 4am... depending on the time planned. Besides the Dengue patients, if there are new admissions, I'd have to clerk and manage them. That night, there were only 4 admissions, which is too little amount to keep me awake all night! But deep in my heart, I know I will get better at it!

2010-04-29T19:18:00.000+08:00

Pediatrics

2010-04-22T23:07:00.000+08:00

Hello everyone!!! Thank God, I had an early night! Got to blog a bit about what I've been up to for the past one week. YES! It's already been one week that I've been posted to the Pediatrics ward. And how do I feel? ... erm... so far so good. I think I'm becoming more and more heartless each day. Hihi. I know I sound mean, but I am just not bothered to think about what they feel and just want to get my job done, and make him/her better quickly.

Earlier this week, I remember feeling sorry for the babies that I had to 'poke' needles into them, but now, I no longer feel the same. It's better that way so that I can concentrate on setting the IV line. Different ages have different challenges. The smaller the baby is, the more challenging it is to find the vein, but, they don't move a lot so it's easier to control the needles. The bigger ones have bigger veins so it's relatively easier but they are much more stronger, so they move!

Examining them is becoming more doable and easier. With children, you just cannot examine them like examining adults. We have to cater them, and not them listening to our instructions. If they don't want you to touch them, don't ever touch them or you'll waste minutes trying to console them and not find any lung findings. So you cannot do examination step by step according to the scheme. I got a very good tip from one of my MO, she said that start from far, like the respiratory rate, what color is the face, is he/she active... and later, get acquainted with them, let them play with stethoscope etc... before they start crying, quickly look for the lung findings. When they start crying... look at their throat, find any enlarged tonsils, then their ears. Nice, right?

Ok.. I have a lot to say but if I go on, I'll feel sleepy to get up. I plan to get up at 5 am tomorrow and study. Yes, you do have to study although you're working. I need to refresh my knowledge on pediatrics!!!

This is one of my favourite patient, before she was discharged. Known as Aira... really cute and cheerful! Oh gosh, I miss her but I am glad she got better. :)

First day at the paediatrics ward

2010-04-14T00:14:00.000+08:00

Ok... right now, I've been posted to the paediatrics department and I'm in the 'tagging' process. Which means that I'll tagged on to a senior house officer, and during this process, the working hours is a bit longer than the 'free' house officers. But it's ok, I enjoyed learning many new things today. I didn't think that I'll enjoy paediatrics so much... surprisingly, I did!!! It was fun working with children, especially the cheerful and active ones. The ones that wave to you, and smile back at you. They are so cute. But, on the downside, I have to learn to detach myself from too much emotions. Just now, there was one case where the infant met an accident but he was stable but his mother died. So he was scream "Mommy... mommy" all along, and that made me cry. I didn't think I'd cry ever during my houseman ship, but I did, not because I was being told off... but because a patient lost his mommy. It was heartbreaking to see him in tears.

Ok.. enough of sad stories. But whatever it is, I look forward to another fulfilling day tomorrow!

Kursus Induksi dan Kenegaraan

2010-04-10T01:20:00.000+08:00

I was called for an induction course and BTN (Biro Tata Negara) in Morib Banting for 5 days. I had a good time and learnt so much through out the whole course. Met loads of nice people and I felt very motivated to start work.

Alhamdulillah I got the hospital that I wanted, which is the Serdang Hospital which is 7 minutes away from home! I am very thankful for this because working close to home is vital for an efficient performance during work. Right now, I am praying hard that I get Medicine as my first posting.

* Actually, the post is longer, but then somehow, the draft wasn't saved and when I was about to post the entry, I was linked to another website!

San Francisco Coffee

2010-03-24T15:39:00.001+08:00

Oh Gosh I feel so conscious about updating my blog right now, the only reason why I am doing so is because I am in SF coffee waiting for my sister-in-law (Kak Wa) for her interview. Hopefully she gets the job... Ameen. So I volunteered to send her, and while waiting, I decided to hang out here, on my own... luckily I brought my laptop, so I don't feel like a looser. Hihi. To save me from further awkwardness, I also ordered Salmon Steak... I didn't want to just lepak with no food.. right? It smells so good... and here is what it looks like. Speaking of salmon, last week, my mom and I tried cooking it at home and it worked and tasted really good. We bought raw salmon from Cold Storage and grilled it at home.. things are so easy here because we have a bigger choice. There are lots of options especially on food, I get to choose whether I want healthy food or the unhealthy range of food.

Anyway, yesterday, I went for reflexology. Thank God it didn't hurt, the last time I went (few years ago), it was a horrible experience. The only point that hurt was the sinus point, and I did have sinusitis... I guess things are working well in my body, alhamdulillah. Before I start working, I have to go for full medical check-up and I cannot wait to see how my whole body is functioning (wishful talking).

My salmon is getting cold!

- Posted using BlogPress from my iPhone

Now I get it

2010-03-22T21:51:00.000+08:00

When I was still in Egypt, I had always wondered, why do our seniors stay offline when they get back. Was it so hard to stay connected, at least update their Facebook profiles, right?

Now that I am in their situation, I get why... it's because you have so many things to do in Malaysia, so surfing the internet comes at the bottom of the list!!! I didn't see myself being like this, but frankly, I check my Facebook accounts once in 2-3 days... in Cairo, I checked at least 3 times, always refreshing the page, hoping someone had uploaded new photos, hehe.

So what are the activities that had been keeping me busy? Well, here I don't have a fixed routine yet, but I just do whatever I feel like doing and there is always something to do. Never had I felt bored even when there is no one at home with nothing to do. I'll come up with things to do such as, talking to my maid... sharing cooking tips. I didn't get to this before since I didn't have any cooking skills, so this time, I get to give her tips of my own.... haih.. it gives me so much joy doing that. Besides that, I organized my room. Finally, I get to buy the storage boxes and put my clothes in proper storage boxes... this had been my dream since so long ago. It's different this time, because I am doing things properly and insyallah, it's for permanent.

Ok... Gotta go.

Holiday in Kedah

2010-03-11T10:21:00.000+08:00

Yeay! We're in Kedah right now. Yesterday we left right after I came from my interview in Putrajaya with SPA and MMC. For me, it went well. I couldn't answer perfectly but I just didn't want to mess my head with any negativity. Besides, the interview was just for formality, so why bother, right? My only preparation was learning the names of the ministers in Malaysia and learning the basic facts about SATU MALAYSIA! Haha.

The journey back was around 5 hours, my husband drove all the way up to Penang while I slept and later he asked me to drive because his body started to ache. It was an enjoyable drive... I kept myself alert by singing... poor Abang, he had to listen me singing Mariah Carey songs.

Ok.. will blog later. My brother-in-law called us to go out for breakfast...

This is PIA (Saffiya)

This morning, she woke me up and asked me to play congkak with her..

My Baby Sister's Nikah

2010-03-09T08:16:00.000+08:00

Alhamdulillah the nikah ceremony went great. Although the number of guests exceeded the expected number, the food was enough for everyone. My sister, Tiyah had always been the kind of person who didn't want to be same as anyone else, hence, there were quite a few unique things during her nikah. Her pelamin was also different... the colors were very vibrant and most of the comments from the guests were that they had never seen a pelamin like this! Haha. It was Tiyah's idea, and she conveyed her ideas to Nas and he designed the whole thing.. and alhamdulillah, we're very happy with the design. The pelamin is still up in our living room, Nas will take everything off after 2 weeks.

As for the food, Tiyah wanted a 'hawker-style' concept, instead of a normal buffet of Nasi Briyani. So we chose Chelos to cater the food... the menu was good, but I didn't get to taste them properly. There were grilled lamb, char kuey teow, Briyani daging, chocolate fountain, ABC, cendol and some traditional malay kuih. The only time I got to taste the food was when I 'stole' a few bites of my mother-in-law's plate. Hihi.

We cannot wait to get the pictures and videos. We hired Danial Zain as the photographer, his assistant is his wife, Maryam Zain... how sweet is that, right? I love the couple.. they are so so sweet and Maryam is supercool! I'm glad I met them.

Right now, the newly weds are on their honeymoon in Pulau Tioman... and all I can say is

that I miss them so much. Tomorrow insyallah, my husband, Kak Wa (SIL), Naufal and I are going back to Kedah... I cannot wait for that. I wished that I could put up pictures but then I am not using my laptop to blog.. I cannot get the wifi in my room (sigh)... and I am just not bothered to move things around. Ok... have to get back to studying for my interview with SPA and MMC tomorrow. Ohyeah.. yesterday, I finally found the time to report myself to Petronas... after two weeks of touch down!

Have a phenomenal day!!!

Quick updates

2010-02-27T21:12:00.001+08:00

Right now I am waiting for my sister, Tiyah. She's having her bridal pampering session at our old schoolmate's spa, Irma Shahadah. It was really fun catching up and laughing about our pathetic selves a long time ago. I hadn't seen Emma for 10 years. She's still her cute bubbly self.

Anyway, at home, I was a bit busy with preparing for my tiyah's wedding next week. I cannot wait to see her as a bride. Ok... Gtg. A really quick update. :)

Arriving in KL

2010-02-25T05:52:00.001+08:00

Alhamdulillah we reached Malaysia safely… but we got to the arrival gate a little bit late, our family had to wait for about an hour for us to come out. As we were pushing our luggage trolleys, we saw my uncle, Ayah Jes and later the rest of the family with a banner that says “Niah & Fauwaz”. Why Niah & Fauwaz? The story was, they rushed to go to the airport to fetch me that the letter C in ‘welcome’ was missed out, so they just put up “Aniah & Fauwaz”… the letter A was later stolen by a kid! Haha. But it was still very thoughtful of them to put up a banner… didn’t expect them at all.

At home, my in-laws were waiting and the food was ready. The menu was BBQ lamb, lasagna, mushroom soup, baked macaroni, apple pie and scones… The scones were scrumptious! Later that night, other family members came, I felt so touched.

I felt so happy when we finally reached home. All of my stress about the luggage was all gone… and again, I’d like to say thank you to all of our lovely juniors for helping us pack. You guys are the best!

CAI-DXB

2010-02-25T05:51:00.000+08:00

Morning of 20 Feb 2010: The moment we had been waiting for… I had a mixed feeling, sometimes I felt happy, and sometimes I felt sad. I felt happy to see my family in Malaysia but at the same time, I felt sad leaving Cairo. It was a heartbreaking moment when I prayed in my bedroom for the very last time, I loved that house and it played a very big role during my life there in Cairo. Some of our friends came to our house to send us off… luckily they were there, at least they could get take the luggage downstairs. Again, thank you. I am sorry if you get bored with the ‘thank you’ s… the fact is, up until today, we don’t know how to repay back your kindness… your help meant a lot to us.

Along the way, I kept my eyes open… looking at the streets of Cairo, not wanting to miss any moment during my last hours there. At the airport, some of my husband’s friends were already there… we said goodbye to everybody and went in rather late. We forgot about the fact that our visa had expired and we had to pay the fine… so to summarize everything up, we got to our gate about 40 minutes before the flight. But the timing was perfect and thank God we didn’t rush! That’s the thing about life, when you rush, you get all worried but in the end everything still turns out just fine.

On the flight, I slept a little. It was just a 3-hour flight to Dubai. As soon as we reached Dubai, we prayed Asar and waited for Maghrib before going out of the airport. After that, went to the moneychanger to get our Dirhams and off we went to Dubai Mall which was next to Burj Khalifa. Had saffron rice with chicken curry… my husband had grilled lamb… we walked around the Dubai Mall… and later went to see the dancing fountain show outside the mall. It was a very romantic scene! J We enjoyed ourselves taking photos!!!

* Will edit later and put up pictures.

Hello from Dubai

2010-02-21T04:12:00.000+08:00

Both of us

Alhamdulillah we reached Dubai safely. Our transit was 10 hours and now we have 5 hours left. As soon as we landed, we prayed then went out of the airport... went to Dubai Mall. We took a taxi from the airport and guess what, the metre starts from 20 Dhs! But I guess it’s ok, because we were too tired to get on the metro. Had dinner there, and it was delicious... Abang had lamb and I had chicken curry with safron rice. Delicious! And now, here we are in Dubai Airport again, blogging to kill time. :D

***

Today was indeed an exhausting day, physically and even worse, emotionally. We had to say goodbye to many things and it was very painful. The only thing that made me smile and excited about going back is the thought of seeing everyone at the airport in KLIA. I cried when I was alone in my bedroom just before I left... I will miss that room so much. We left the house with many sweet memories... and the thought of leaving the house for good really made me sad.

I want to thank everyone who sent us off... actually they came to say goodbye to their U. Fauwaz, I just tumpang aje... but fair enough... hihi. And Husna.. thank you for the sweet letter, we had fun reading it, it sure is a 'feel good' letter... you showered me with too much compliments and I know I am not like that at all, but still, I still want to accept them, hehe.

Farhana and Natrah.. thank you so much for staying up last night, helping Kak Niah to pack. You two are so sweet and you will always be in my heart. Farhana, you are such a good girl and I believe, Allah has lots of good things in store for you.. the same to all you girls.. Madihah, Rem, Ibtisam, Dalili, Fizah... just to name a few.

Ok.. now I feel sleepy. Better sleep. Bubbye.

My Phenomenal Week (I)

2010-02-08T16:16:00.000+08:00

My phenomenal week begins like this... well, day 1, Iqbal and I walked around our college snapping pictures of our lecturers, sadly, there were not many of them, it could be because we went very early in the morning and most of the professors usually come a bit later than that. But anyway, we got to take pictures with the doctor that we knew personally, which is Dr Hussein Khairy. He is a vascular surgeon and a very good teacher. And later that day, I went to Carrefour Maadi with Aeisyah and Husna... it was my last time seeing Aeisyah and it has been great knowing her, very polite and kind-hearted.

Me, Dr Hussein and Iqbal, with Rana in the background.

With Dr Mahmoud Salem an O&G specialist.

Me in front of the lecture hall... the place I once hated going, hehe.

And the day after that, on the 3 February, Paan and Fizah was kind enough to accompany me to shop for some stuff in Mohandiseen. I finally got my TEFAL pots and pans set... they are so much cheaper here and I so thankful that I found the things I wanted. I cannot wait to start cooking when I get my own house in Malaysia... this is me speaking when I am excited about the new kitchenware, and I bet when I reach home, I will just get comfortable with the outside food.. refusing to cook on my own. I just hope it wont turn out that way, it's been my dream to cook for my family! Anyway, after the Mohandiseen trip, Paan and Fizah joined me to watch my husband play football. Al-Fawwaz vs. Wadul Haq! I get so nervous when I talk about football because most of the time, I get it wrong... and my husband would just laugh at my ignorance, hehe... Hey.. I'm a girl ok! Speaking of my ignorance about football, I cheered for the wrong team that day, because I didn't realize that they changed sides. I clapped so loud for the second goal, thinking that it was Al-Fawwaz's goal... that was embarrassing, luckily Paan was there to correct me, hehe. Alhamdulillah, my husband's team won, he scored the first goal and second goal was scored by Apez. It was a good game... my judgement was based on the fact that my husband won ok! :P

The next day, Faaiqah and I went to see Dr Sherif El-Hawary for the last time. I felt really sad because I don't know when I will see him again... but he said that insyallah he will go to Malaysia again. After that, Faaiqah and I went for a quick drink at Beano's and she followed me back... we spent the whole day together that day, it was the last time that I'll ever get to spend my time with her as a 'single' lady here since the next day, her husband is coming. It was a phenomenal day, I had so much fun because we cooked together, dua ekor chicken... we just cooked not knowing how many people were coming. I had a small gathering, an unplanned gathering. The funny thing is, when I plan something, it rarely turns out to be really fun, it's the unplanned gatherings that turns out to be blast, I guess it's because I don't feel the stress of making sure things go according to plan and instead, I get to enjoy the flow of the day. Ellya and Fizah came from their class... later joined by Husna, then Sukainah (Nah) and Suhaila came. Nah came to test her make-up for her wedding... and it was such a great coincidence that Husna was around, so she gave a lot of suggestions on how I should do her make-up... which later lead me to leaving the whole responsibility to Husna... hehe. She's so good with her hands, it looked like she was painting when Husna was holding the brushes. Thanks Husna for helping me out there! The day of laughters went on until 1 am!

Ok... the next day, we woke up late and rushed to get ready to go to Israq's and Naimah's wedding. They were so sweet.. when I first heard about them, I was thrilled to hear that because two of the kindest people I know are getting hitched. Cannot wait to see how their offsprings!

After their wedding, Faaiqah and I went to Nah's new place to help her get some stuff done for her big day, that was another exciting event. I loved how Nah decorated her room... the bed sheets are all white, and I love white sheets! Then, that evening, some boys came to our house. I collapsed on my bed from exhaustion... and that night, Farhana and her housemates (Bintu Saadah, Wang and Shee) came to send something, I got excited when they told me that they were going to eat... so I got ready and joined them with the other girls! I just didn't want to stay home although I knew I should because I could feel that my body is telling me to stop! Hehe.

Me and the girls at the seafood restaurant, cannot remember the name.

I planned to make a long entry that summarizes my week, but I don't think it's a good idea because I get confused with the pictures not being in the right order and having to rearrange everything.

Spot the difference

2010-02-04T12:48:00.000+08:00

2003 - In Indonesia.

2009 - With Zaatil

All this while, I thought that I haven't aged. Hehe... but looking at the old photos proved that I was in delusion. hehe.

16 October 2003

2010-02-01T03:06:00.000+08:00

I was chatting with my aunty, I call her Mak Busu, she's my mom's youngest sister. I was asking her whether she's picking me up at the airport... and we got to talking how time flies. Then I recalled the night that my family and my in-laws sent us off to the airport, it was indeed a very sad moment. It was my first time being away... but the strange thing is, it felt like yesterday. I can still remember waving to my parents and my sister as I walked through the immigration gate.

I slept in tears that night on the flight. Oh yeah, but one thing cheered me up on the flight, we were upgraded to business class because the chief steward was my uncle's good friend. So he got us two seats on the flight and that made me smile. I remember arriving at the Cairo International Airport, it was chilly that morning. Arwah Ustaz Md Noor (the Malaysian Embassy officer) was there to pick me up but since I was with my husband, I didn't have to follow him. We got on the taxi and headed to our rented house, my senior then, Tuan Hazri had already found a house for us. When I went in, I was happy... I liked the house and got really excited about decorating the house!

We rested for a while, then my husband took me out for lunch in Tahrir. The streets seemed so different, totally new to me, the weather was new, the layouts of the clothes on the shop windows were also new... they were all something that I wasn't very familiar with. It took me while to get used to the life here, especially the notes... as you can guess, the 50 piasters and 50 Egyptian pounds. There were many times when I thought I had "lots" in my purse only to realize much later that they were just 6 pieces of 50 piastre notes which is only 3 pounds, not 300 pounds! Another thing that took time was the numbers in Arabic, it had always been my difficulty saying the numbers in Arabic (numbers more than 20) quickly since school... even worse when they (the shopkeepers) try to say them in English then got all mixed up. Disaster!!!

After about 2 days in Egypt, we walked around and found a Internet cafe, I was so excited and quickly emailed my parents telling about my house here. I really missed them (and Tiyah too) although my parents were coming one week after I arrived, they said that they planned it like that so that we wouldn't be that sad saying goodbye at the airport... but the truth is, I couldn't run away from the sadness... Ok, more on that later. Then, I remember Kak Wani calling our house phone and told me that they're coming to visit me, there were 5 of them (Kak Wani, Kak Min, Kak Maz, Kak Sarah and KD)... they lived nearby our place. When Kak Wani arrived, she looked very familiar... she was from my school! I had known that Kak Min was from my school so it wasn't a big surprise to me. Their visit really cheered me up, I couldn't have been happier... I knew I wasn't alone here. They told me about my kuliyyah and that I have one girl classmate, Faaiqah. I was excited to go to school but I thought that I want to settle my house first and go after 2 days.

The morning of my first day of school... well, I WAS LATE! I left house at 8 am, and Kak Min and her housemates had all left... we promised to meet at her house. I didn't know how to go on my own, neither does my husband. And he was late to his class, so he asked me, do I know my way back home... of course I did, it was just a straight road! Then, I went back home and at about 9 am, Kak Min knocked on my door to pick me up... and I followed her. I don't know why, but I didn't leave any note telling my husband that I had gone to school with Kak Min... silly me. But anyway, when I got there, I was introduced to Faaiqah, I can still remember, she wore purple that day... and was very happy to meet her. She was really nice and we bought books together, she told me what books to get and informed me about our timetable. Since our class will not start until 11 am, we joined the third year class (Kak Min's class) so that we could sit down. It was a pharmacology lecture by Dr Abdel Fatah, he was funny... although I didn't understand a word he was saying, I just laughed at his expressions.

Our actual class was ok, I was a bit worried because I didn't understand anything. But during the early days, I was bothered to go up to the lecturer to let them know that there's a small group of Malaysian students and it would be nice if they could speak in English. Some of them did and some of them didn't. I have to admit, I didn't enjoy class at all! I'd rather sit at home and be a housewife... still excited about my marriage and wanting to serve my husband 24-7. Hehe... I bet my husband wished I was still like that! :P

During class, one of my classmates came up to me, (I think it was Hamdan or Iqbal) told that my husband called Kak Min to ask where I was. He was so worried in case I got lost on my way back home that morning... he was relieved when Kak Min told I was at school. I didn't have my own number... so communicating was a bit difficult. The day ended at 2 pm... walked back to Kasr el-Ainy street with Faaiqah and she headed back to Nadi Siqah and I walked back home. When I got home, I felt really happy to see my husband! I think I was lucky to have my husband with me, I couldn't have done it without him. He helped a lot... every year, there's always a new challenge and he was always there for me. During the early weeks in Cairo, he helped me through the tearful nights of homesickness... I could still remember how much I cried when my parents left Cairo after their one week visit. It was very very painful, I can cry thinking about the way I felt. It's not that I didn't enjoy it here, it's just that I had never been separated from them... and I was very glad that I had a husband! I cannot imagine how I would have cried if I was alone! Thank you sweetheart for being very patient with me. I guess this is what happens when you marry a "kid".. hehe.

Ok.. back to my present life. This morning, I woke up with a big smile. I still cannot believe that it's all for real now.. I have finished my 6 year course of medical school. I am very thankful and very happy... I was quite worried because in my 5th year, I didn't take my clinical exams... and sort of regretted a bit that I didn't find the time to take them later. But it's ok, it's all fated and I am happy for what I got. Life is phenomenal!

Anyway, finally, we got a chance to go out together. It's our first date since I finished my exams! We went to the Thai restaurant that I had my farewell party last week. I think I overate... the food was too irresistible. :D

My husband ordered extra eggs... and guess what, they didn't charge! How nice of them. :D

60 Boxes

2010-01-31T00:50:00.000+08:00

Yesterday, we spent the entire day packing Abang's books into the boxes. Alhamdulillah, we got the assistance of many girls and boys, and their presence helped speeding up the whole packing process. I can now say, 85% of my packing is done! The thirteen of us were divided into 2 teams, one team wrapped the boxes with sticky tape and the other team put the books into the boxes, but before doing that, they'd have to write down the name of the books first. I was assigned to be part of the wrapping team! Yeay! Something that I had always enjoyed. I don't know how to thank them for helping us out, we were so touched looking at how hard they all worked. It took us 7 hours... 4 movies! It was quite enjoyable actually because of the movies played. We took pictures but they were not in my camera, so I'll get them from Farhana very soon. But the pictures below were meant to show the big progress made. :-)

Before I end my entry, I'd like to thank all of you (if you ever come across Kak Niah's blog) who came yesterday... The girls were: Farhana, Balqis, Rem, Lyanna, Madihah, Natrah... and the boys were: Rahman, Baihaqi, Copuk, Damak and Hafzi..

Now, I feel so much relieved because before this, I had been worried about not getting everything done by 20 February!

The boxes packed were put in one of the bedroom, we had the bed dismantled so the room had more space to store all the boxes. It was a really an enjoyable day, packing was as boring as doing it all by myself!

Again, thank you very much.

The empty shelves scares my husband!

Hotel Dash

2010-01-30T20:34:00.000+08:00

I was playing Hotel Dash game on my laptop, then I got a phone call from Iqbal, he asked me, "Have you heard the news?"... and I said, "what? the exam results dah keluar?"

And yes.. the results are out already. I am very happy and grateful for what I got. Thank you Abang, Mak, Ayah, Mama, Tiyah, Kak Na, Kak Wa, Kak La, Anas and to all of my family and friends for the great love and support... and of course your prayers.

Family

2010-01-29T18:20:00.000+08:00

A few nights ago, we went to Dr Yehia's place and went out to an Italian Restaurant, I cannot remember the name.. it was my first time there. I had grilled fish with lemon sauce... I didn't finish them because it was already late, and I don't eat that much past 10. It felt like it was my bedtime already... anyway, the food was good.

During dinner/late supper, Dr Yehia's kids, Dina (eldest) and Salah (youngest) were joking around with their dad. It was nice to see how much fun they are as a family and it made me think of my family. I miss having dinner with my family, from both sides (mine and my husband's)... updating each other with what had happened during the day and joking around. In my family, Tiyah is always the one who makes jokes that makes us laugh... we can laugh and literally fall of our chairs! I'm not kidding. She's one of the funniest people that I know. Very witty and her mind is full of ideas to make jokes... I think she got that from my dad because he is also witty! Abang's family also consist of funny people, so being around them really made me happy!

I think it's very important to have a good family bond... and I feel very blessed. Alhamdulillah for that.

Ok. this entry was meant to make me look forward to going back! Hehe.. I have 21 days left, 3 more Fridays!!!

A Penny Saved Is A Penny Earned

2010-01-28T06:38:00.000+08:00

Last night, I woke up at about 1pm because of my dry throat, it happens during the winter when the room is overheated. Actually, I don't like using the halogen heater because it dries up my skin so fast, and I hate it when some nights where I feel lazy to put on my face cream and the next day, my skin becomes so dry, it's as if I had abandoned it for weeks! Back to my story, since I couldn't sleep back right away, I turned on my laptop and logged in my food journal. Thank God I ate less than 1200 calories. Anyway, as I was logging in the data, I came across an advert on Livestrong.com that said "LOSE FAT REALLLY FAST" or something like that. So I clicked the ad and watched the presentation on the page, it took about 20 minutes... it was about how this guy lost fat really fast. The magical thing was that it was not by doing long cardio workouts, and not with low-carb diets. He had different plan, very different than what we usually hear. By the end of the presentation, I felt like I had to buy this program no matter what, because it sounded really good and I had wondered what the secret was, and I already clicked on the 'add to cart' button and was linked to the payment page. The whole program would cost $39.95 for a limited time, later, it will go up to $60! So I thought, I'd better buy it really quick before the price goes up. But... Thank God, I was saved this time (not like the last time, which I will explain later), it occurred to me that I should google first about other people's reviews on the product. I was glad I did that, as it turns out, the 'secret' program was a detailed exercise on how to increase your metabolism and what to eat. The program recommended that instead of doing long minutes of cardio, you should focus on weight lifting to build muscles, and when you have more muscle mass, your metabolism rate will increase and hence all the fat will be burnt off your body. That is how it works... which is exactly what I am doing right now, LIFTING WEIGHTS! Ok, I know I sound cocky, but I was really glad because I was saved for the frustration of buying an e-book telling facts which I had already known! I don't want to do it for the second time. Another problem with me is, I tend google too many things that I find it hard to stick to one program. I think, if I stick to what my trainer had told me to do, I'd get good results, it's just that when I read about something new, I feel like what I am doing is wrong. The truth is, there are many ways to reaching the perfect weight, so it's best if I stick to one method and remain focus and consistent.

So, why did I say that I don't want to fooled for the second time? Here's the story. A month ago, I accidently purchased an online TV membership, it costed $35, which came to no use at all. After I browsed the webpage, I found out that it was just links of online TV shows where I can stream and I found out about this too late because I had already paid! I had been doing it a long time ago and for free! Clearly that website was a scam, I emailed them and asked what the benefits were, and they never replied, all they replied was the links for TV series and movies where I can watch online. I felt so cheated, it's $35! I could have done so many things with that $35, and it was all because I didn't ask for opinions.

So the bottom line is, before purchasing any programs, ask around or google what other customers are saying about the product because most of the time, the products are not as impressive as they sound in the adverts.

Yeay! The pictures are ready.

2010-01-28T05:47:00.000+08:00

We had our graduation party last week, on the 21 January 2010, and I chose not to take pictures (I did, only 2!) since we got Afiq to help us. Here are some of the pictures, most of them are on Facebook.

Ok, about the event. Lina and I planned the party with the help of many friends... financially and emotionally, ;-) . We had the party at Orchid Restaurant, on the Trianon Boat. I was glad that everyone had fun, I totally enjoyed myself.

Bubbye Books

2010-01-24T02:33:00.000+08:00

Finally, I packed away 80% of my books. It was quite challenging choosing which books to pack in the boxes and which ones I should take with me on the flight. After some deep thoughts, these are the books that saved from being shipped and will be brought with me on the flight.. lucky you books! The include Dr Sherif's books (all of them), O&G Dr Mahmoud Salem and Principles of Surgery by the department of surgery. I thought that it's wise to keep them with me so that I can prepare myself for the interviews.. I was told that they ask you basic medical questions, and I plan to study for them.

It was quite emotional keeping them away, looking at my shelves being empty made me feel sad. The only thing that is keeping me happy about going back are the thoughts of seeing my family and living a more comfortable life. Life here is comfortable, but I have to admit, there were times where I shed tears due to unwanted events caused by the Egyptians. Hihi... Ok, let's not focus on that since I will be missing them when I'm back... I'm serious people!

Actually, I planned to put up some pictures, but my internet connection is very slow, it's because I'm downloading the latest episode of Grey's Anatomy. See you later alligator! ... and you're supposed to say, see you in a while crocodile.. nice right? My sister and I used to love saying it to each other! :D

Preserving or utilizing energy?

2010-01-16T16:26:00.000+08:00

Today was supposed to be the day where I take a rest and just lay in bed and watch movies. I did, but I can only stand this 'rest' for a like 3 hours, then I get restless thinking about doing it for the whole day, and I feel like going out already. I am having body aches, and I think it must have been the non-stop cooking/entertaining for the past 3 days. It was really enjoyable but I think at some point, one has to take a rest and just let the day go by instead of having to through the day ticking off the list of things to do. And today, there's no list.. well, I had a list, but I changed the due date to tomorrow.

Last night I slept early, around 7 pm, I was too exhausted! I even slept with my make-up on and didn't change into my pajamas, and now, my face is itching. Anyway, yesterday was fun, I had Husna and Aeisyah over for lunch and had a karaoke session. Then later that evening, we (the three of us) went to the restaurant where we're supposed to have our farewell lunch to set the menu. The owner of the restaurant made a really generous deal with us, she was very kind and took the fact that we're students into consideration. It was very kind of her, and I pray that everything turns out well and perfect.

I will end my boring entry with pictures...

Sup daging and ayam goreng

Thank you Aeisyah and Husna for your company, we should do it again!

What I thought I'd be doing

2010-01-15T15:05:00.000+08:00

Before I finished my exams, I always had this vision of me relaxing, playing as much games as I could, sleeping, endless movie marathons and other activities of the same kind that I would categorize as 'time-wasting activities.' As you can guess, none of the activities mentioned above had been done yet, I am still browsing the Apple Store for the latest games which doesn't seem appealing at all, not as appealing as they were 2 weeks ago! I even managed to post-pone watching the latest episode of Desperate Housewives... which months ago was my weekly excitement, the kind of thing that I download right away so that I can watch while eating my lunch. In conclusion, things change after you finish your exams, and as for me, I am pretty glad I had been doing good things like packing and cooking.

I said to my dad, I feel that I am busier after the exams and I am physically tired! I do feel exhausted at some point during my day, but I feel too excited to stop and give myself a rest. I only have one month left here in Egypt, a place that will remain in our hearts forever. The thought of us coming here again in a few years time calms me down. Ok, this morning, I was feeling a bit mushy about us going back and all, but it'll definitely change when we start planning about our lives when we return back to Malaysia!

Anyway, last night, my husband's class was held at home, I just cooked something simple... if I was a superwoman, I'd cook more, but mee rebus/bandung (or whatever the name is) was all that I could afford to cook for the lovely students.

My husband in action!

Ummi Sakinah and Fizah

The girls helping me out... or were they? :P

Naimah helping me with the daun bawang

With Liyana and Natrah in the kitchen that I'll never forget!

Thank you girls and boys for the lovely night.

Reaching the perfect weight III

2010-01-15T14:36:00.000+08:00

Yesterday, I called Rehab and she gave me a free session and wrote down the workout that should make me 'release' the extra weight faster. Notice that I said release the extra weight and not loose weight? It all came about when I was on the phone with my mom, then I was telling her about Rehab helping me loosing weight, then she said, there's a new term by Robert Anthony, you don't say loose weight, but release weight. Because when you say loose weight, it's something that you loose, so your subconscious will think about getting them back, but if you say release the weight, it will not come back! Nice, right? I don't know about you, but I kinda like the idea. Working with the subconscious mind is very important in reaching a certain goal, because with the correct mind set, goals come to you easily.

So yesterday, Rehab helped me through with the upper body, lower body and abdominal workout routine. There were 3 sets of 20 repetitions. It didn't seem that hard actually, I really enjoyed it. In between the weights, I will have to do a quick run for 5 minutes. One of the thing that I felt different was when she told me to do 100 sit-ups on the bench, I only managed to do 70.. :( and the other 30, I just did the basic crunch. She also told me to do the abdominal workout every time when I go to the gym... oh yeah, in the taxi yesterday, when the driver pushed the brake pedal, I could feel my abdominal muscles contracting, hihi... it's a good sign!

Ok, as for today, I will take a rest. My arms feel a bit sore, especially around the joints. I can go, because today I plan to do the lower body exercises and I will not use the same muscle as I did yesterday, but I feel extra exhausted because yesterday, I cooked for my husband's students... hence, I need to rest.

And.. I have RELEASED the extra 10% of the X kg of weight!

This is Rehab, this is an old photo of her

Reaching the perfect weight II

2010-01-13T00:35:00.000+08:00

The gym under construction, I wonder when they will finish, it's been a year already! It's not the gym actually, it's the level below the gym, it's going to be a restaurant.

So today, I got the strength to fight my laziness of going to the gym. At first, I was really motivated to go, I even packed my stuff after I prayed subuh, then I thought, it's safer for me to wait until the sun is up. So in the mean time, I browsed the net and chatted with my sister-in-law, Kak Muna. The longer I spent time on the computer, the more my motivation fades... I almost decided of procrastinating again and begin everything tomorrow. Thank God my husband is supporting me the whole way, so he told me that I should go. (Thank you sweetheart!).

And off I went... I jogged for 15 minutes then did the weights. Today, I pushed myself harder, I lifted heavier weights. Thanks to Effy, he shared tips on his blog about working out, and one of them said: If u can do up to 10 repetitions in one set, that indicates that u need to increase the weight because it won't gain muscle any more than it already did.

It was tiring, but very satisfying. A few weeks ago, I had wondered why I don't feel as tired as I did when working out with Rehab, now I know why, I think it must have been the light weights.. hehe. Last week, for my biceps (seriously? hihi), I lifted 3 pounds weight, but today, I lifted 5 pounds weight. I cannot wait to lift more weights tomorrow! I ended my workout session with a fast walk on the Nautical Treadclimber for 60 minutes, burnt 450 calories. And guess what, I hadn't eaten a proper meal today. I just had my usual protein shake twice and small biscuits that I bought at the gym.

Owh.. speaking of the biscuits that I bought reminded me of what happened at the gym's cafe today. Before I went upstairs to workout, I bought a bottle of mineral water and gave them 20LE, and told the staff that I will pick up my change after I exercise... I always do this because I don't want to go back my locker to keep the money or keep the money in my pocket, it's distracting hearing the shillings as I run. I gave my name and left, he nodded when I told him. So, after working out, I picked up the biscuit and told the girl (they changed the shift) to give me my change and add my biscuits to the total price, then she said ok, I think she didn't understand what I was saying because I spoke in English. Sometimes I get confused what language to speak... let me remind myself again, to the cafe staff, speak Arabic, but to the gym staff, you can speak English Aniah!!! Ok, back to the story, I explained to her that I want my change, then she said, there's no notes saying that they owe me my change. Then the girl called on of the gym staff and I explained to her again... then she asked me, "Are you sure you paid 20LE?, " I was a bit pissed because did she think that I was lying? But it's ok, I managed to control my anger, besides, what she thinks of me is not who I am! I just said that I was sure, but it's ok, if they are not sure about it, I will just and forget about the change, it's no big deal. Then I went in the locker room and took my money... when I got to the counter, the girl told me that she called her friend in the morning shift, and he remembered. They apologized and I just gave a 'ketat' smile... actually I didn't feel like smiling to her, but I thought that I have a month here left, and I don't want any awkward moments!

And.. in the changing room, I saw Rehab, my trainer. She looked very pretty, I envy her body, she looked so fit. She offered to write down some exercise down to help me loose weight faster!

Tonight, I'm going out with my husband to City Stars, but I will share food with him. Oh gosh, it's so nice after the exams, I could really feel how I lost my appetite, I don't think of food! And another thing that I like about this part of my life is how I don't have to rush. I didn't even bring a watch to the gym or even check my phone every now and then for the time.. life is phenomenal!

Graduation party

2010-01-13T00:08:00.000+08:00

11th January, a day after the exams finished, I joined the final year crowd for celebration at our beloved college. I cannot believe I am saying "beloved" college, hehe... shows how much I am starting to miss the school. Anyway, Faaiqah and Iqbal were the only malays there, the others joined us much later. So the three of us spent hours mingling around, taking photos, borrowing the robes of our friends.. basically, it was just a fun photography session! I'll just put up a few here since all of them are on Facebook.

Mahmoud, Iqbal, me, Faaiqah, Izwan and Munther

Faaiqah and me

(you'll be missed Faaiqah)

With the girls of our class. I know all of them, but I cannot be bothered to name all of them, I wish they have tags for the photos here like on Facebook!

With them again: Layla, Asma, (not sure what her name is), Rasha, me, Shireen, Faaiqah, Mona and Samah.

Izwan, the intelligent Asef (he's from Palestine) and me

These are photos from Izwan's camera. Thank you Izwan!

Final day of our exam

2010-01-12T23:50:00.000+08:00

Alhamdulillah, the exams are TOTALLY over. So right now, I can say that I am at total peace! It feels great and very different to what I was feeling months ago... at first, it was hard to believe. We just kept smiling all day, in fact, up until today, I still smile thinking that it's over! Insyallah all of us will pass with flying colours.

The last exam was X-ray and ECG. It went well alhamdulillah. :D After we finished our x-rays exam, we went down to the lobby and took photos, then later, we (Faaiqah, Lina, Izwan, Iqbal and I) went to Manial, to take a photo for the graduation magazine.

Tala and me, after the ECG exams. Tala left for Jordan that afternoon!

Me, Alaa and Ritika

And later that evening, I went to meet up with Battah and her lovely sister, Kak Sarah Hani at Costa Coffee Tahrir. I cannot believe I had that much energy! I guess I was too excited.

All of us, Battah, me and Kak Sarah Hani

I had a really nice time with Battah and K. Sarah Hani, we shared many things in common.. and it's so fun when our points of view are the same! Kak Sarah Hani is doing masters in North Dakota, USA. I feel privileged to know their family, such a loving family and very kind.

Ok.. so that night, when I got back, my husband's anak2 murid came for their class. And they cooked nasi lemak... very delicious! It was complete, from the ikan bilis, to ayam goreng, telur... I can drool just thinking about the nasi lemak.

Reaching the perfect weight

2010-01-07T12:07:00.000+08:00

I have a new short-term goal: Get back in shape!

Why?

To be in the perfect health, it's obvious, losing weight gets you there!
I have my sister's wedding this March, and I want to look good, don't want to spoil the event.
Good for my self-esteem.
I was in 'my ideal' shape before the holidays, but sadly, I didn't maintain the healthy lifestyle during my study leave, hence, I regained the extra weight. But it's ok, I'm not going to be so hard on myself for this, it's perfectly fine because it can be challenging to have a lot of things to focus on. My top priority was to do well in the exam, followed by being in the perfect weight.
I don't want to get comfortable being this size, the longer I leave it, the harder it's going to be. I have already packed my old clothes in my old size, and I am not going to take them out, because I will just grow back into the old size... and so far, I am not that comfortable wearing my pants in the new size.. HELP.. need to breath!

Honestly, although I justified my reasons for not maintaining the weight, I wouldn't recommend it to others, what's best is for you to still exercise and not to eat the sweet treats even though you have books to read. One of my mistakes was that I treated myself to cheesecakes for lunch, not daily though (thank God!)... at first, I felt guilty, later, I felt nothing whenever I over eat.

How?

Exercise at least 4 times a week, I plan to go to the gym 5 times once after this Sunday.
Each session should be about 2 hours, but don't get me wrong, the 2 hours include breaks in between. I usually do 1 hour of cardio to burn as much as I can, my new favorite cardio machine is Nautilus Treadclimber. I also
Eat less than 1200 calories/day.
No carbs after 7 pm.

Major challenges?

Too lazy to go to the gym. To deal with this, I shall force myself to go, whether I feel like going or not... this is called self-discipline.
Temptations to order high-calories food when eating out... ORDER SALAD! If not, I will split the food with my husband, poor him! Ok, a better idea, split the portion in two, keep the other half for take-away.
Sweet cravings. I will replace my sweet cravings with fruits. I just bought a kilo of oranges. The trick is, cut them right away and keep in a container and store them in the fridge, the same goes for apples and other fruits, because what I notice is, the boring part of eating fruits is to prepare them, so do it right away, in bulks, so that they can be enjoyed later.

How to stay motivated

Keep the Teri Hatcher picture on my mirror.
Blog about my journey.
Enjoy the whole process!
Log my exercises and what I eat at Livestrong.com

***

On another note, I had been asked a few times how I lost weight last year. Well, here is what I did, and what I am going to continue to do... I drink protein shakes in the morning, salad for lunch and little rice for dinner (sometimes loads of rice due to hunger from the long hours of classes... final year of med school, remember???). For snacks in between, eat fruits or Hall's mints (15 calories per mint).

Here is how I prepare my salad:

I like the small lettuce because it's not bitter. The big ones can be can be bitter especially towards the main stem.

Slice them up into smaller slices so that it's easier to eat, especially when you plan to pack them and eat them later, saves you from taking a plastic knife!

Spin the salad so that there's no water and it remains crispy.

Take what you plan to eat, it's ok to take big portions, they are almost 0 calories! Keep the rest in an airtight container, it's going to be easy finding yourself going to the fridge reaching for a salad because it's already there.

Add other greens that you like, olives and grilled chicken. NO SALAD DRESSING! It's a big waste if you take the dressing because they are high in calories, you might as well eat rice if you want to take the dressings.

* For the chicken, you can just buy the frozen chicken pane and cook them in the oven. Do not fry the chicken.

I am giving myself one month to loose X amount of weight!

Post-exam activities on my mind

2010-01-06T14:17:00.001+08:00

We've already bought our ticket to go back, it will be on the 20th February 2010, 12:15pm by Emirates Airlines. Insyallah we are scheduled to arrive in Dubai at 5.15pm local time and the next flight back to KL will be at 3.15am the next morning. We purposely chose a long transit because we planned to have a quick tour around Dubai, but sadly, had to forget about the plan because I felt lazy to settle the visa to enter Emirates. After a while of dealing with bangsa Arab you will try to avoid them whenever you can, so unncessary should be pushed aside. So now, we're trying to figure out, what will we do at the airport for the long hours... here are the possible options:

Relax at the Emirates lounge, 150AED for every 4 hours per passenger.
Check-in into the airport hotel, this one is crazy, they charge you per hour! Have to consider this option, just incase we get exhausted and want to sleep.
Just walk around the airport and look at the things they have, this wouldn't be so bad either because there's the two of us. I think it would be nice, we could find a spot at the airport, with a plug, and enjoy our time on the laptop.
Shop.. maybe... if I have enough fund, and most importantly, if they have the things that I NEED. This is the new me, I will buy only the things I need and I will not be lead my nafsu.

I am loosing my idea... it's because of a big cockroach running around the room, I just sprayed Ragon insect killer and it's still not dead... and, I swear, as I was typing about "it", it crawled on my pants. And guess what, still not dead, luckily I didn't step on it. I think I should move to my table with my feet up!

***

Now, I am safely blogging from my desk.

Ok, since I finished my written exams, it almost felt like the exams are over, you know how taxing they are. So I had been enjoying myself with a few activities including lunch outside with my husband, enjoying my time at the gym without having to look at the clock every now and then, cooking and calling Malaysia.

But, once I finish my exams this Sunday, I will have to start packing, and I want to do it systematically and in an organized manner. Because when the boxes arrive in Malaysia, I don't want to open the boxes just to look for something that I remember putting in one of the boxes! We plan to stay at my parents' for a few months before we find our own place so we don't need to unpack everything. Frankly, I look forward to packing, I started with one box already, but I don't want to get carried away yet, because once I start properly, there's a big chance that I will abandon my books!

Here are some of the pictures taken on the last day of our written paper which was on the 8th December 2009. YES... about a month ago, and I just transferred the pictures just now!!! Haha...

Where it all happened... this was my table.

My classmates.

Me, Faaiqah and Lina.

After the written exams, Lina and I went to watch A Christmas Carol 3D movie. It was a really good movie, we enjoyed it so much, especially the 3D effects, felt like I was flying! The 3D glasses costed 15Le, but totally worth it.

I have 3 days left before my viva exams. And today, I plan to practice the ECG interpretation and go through Endocrinology and Nephrology.

2010-01-05T04:35:00.000+08:00

Wife: Abang, pagi esok niah nak pergi gym lagi ok.
Husband: Ok.. bagus. Abang suke kalau niah pergi gym.

Hey... what's that supposed to mean? Hihihi...