My Life... 命運@機會

Tonsilitis... unable to swallow properly... strepsils never work... tot it will just get better after one or two days... but... no... new symptoms coming... blocked nose, stomachache, runny nose, headache, fever, rigors, chills... all come at once... spending time hiding under the blanket with lots of paracetamol and decongestant.... Just flown back from Malaysia a week ago... working in hospital... looks like i am in the high risk group for getting the infamous swine flu....

Access the NHS Swine flu service... done the questionaire and given the authorisation code for Tamiflu.... to take or not to take?? What should i do?? Is it swine flu? or is it just common flu... what should i do?? Done a bit of research online realise tamiflu not helpful but just something to help to make the recovery process slightly faster... and i have already have the symptoms for more than 48 hrs.. so tamiflu not for me then.... hopefully i will survive....

together with all the worries i have at the moment.... not helping... making the recovery process harder... no one will be able to help... hopefully things will get better... the light at the end of the tunnel is never ending... now another tiny dimmer light at another end.... going for that light seems like a better option now to make things slightly better... hopefully things will finally settled... hope to put an end to all these nonsense.... Hopefully God created this other light for a better future for us... Pray for me and my family... hopefully things will start to settle and things will get better sooon..... Father lord...

Potassium of 7.5 Doc... in a very haemolysed sample.... but with urea of 68 and creatinine of 450.... what do u wanna do doc.... Previously all normal blood.... (EXTREMELY DIFFICULT TO BLEED.... SEVERE DEHYDRATED)

(For those non medic out there... high potassium meaning bad... dammm bad.... can die one ... well... and this post might be extremely boring for you... can stop reading now.... )

-_-'''

That's exactly my expression when i received that call from the ward....

What would you do?
(A) Call For Help
(B) Ignore it
(C) Go and see the patient while ask for an ECG
(D) Continue flirting with A&E Nurse

For those who knows me well... my answer obviously is (D).... :-þ

No... i did not.... (C) was what i did.... that's what we all do anyway.... get a ECG and normally it's normal so just ignore it then repeat another sample... and pray hard it's just because of the haemolysed sample...

BUT... this time round.... ECG showed stonking Tall tented T wave V2-V3... Flatenned P Wave... just the type of ECG u will see when u flip open the ALS book... So the next question is... to TREAT or not ??

(A) Give Calcium Gluconate and rpt sample
(B) Give Insulin+Dex and Salbutamol Nebs
(C) Ignore it

(A) that what i did... it did not get better.... K+ came back 8.9 -_-'''''''''' Steady and calm... gave (B) now.... done Blood Gas.... pH 7.25, PCO2 3.8, PaO2 13.8, HCO3 17, BE -9.5... what else can i do now??? Having just done ALS... Sodium Bicarb the next step??? if not she will just get Cardiac arrest because i did not manage to reverse the reversible cause... Ppl... what would u do?? let me know....

Lots of thing happening since my last entry... firstly... I am no more FY1 Doc... i'm now FY2... haha... what's the diff?? Nothing really... other than changing how i introduce over the phone when i answer my bleep... no more surgical house officer... but SENIOR House Officer...!!!
No more attached to Vascular... nightmare team over... now to ENT.... Still couldn't believe i got over it... not entirely smooth sail... lots of bumpy rides and unforgettable one... without forgetting Mrs. A's surprise visit... which grant me 2 weeks off... The day after we swap over... Lagy still pulls me away from my new team asking me how all his patient doing... without realising we have already changed over.... Bumped into him on the corridor with his new houseofficer who happened to be the hottest Fy1... The only comment he could give to me was '' Hey Teck, Look now... we have a better looking bunch then u lots'' bitter... -_-''

So how is it like being a SHO? Running the surgical side of the Hospital as the most senior Dr sometime is again not for the faint hearted... One Important tips for every junior Drs, next time always get hold of your registrar mobile no... cause the bloody bleep will never be loud enough to drag your registrar out from the cozy bed to help you... The first set of nights where Mr. W the consultant surgeon, with a reputation that i shall not disclose here,whom i met for the very first time, caught me eating pizza in the mess before the working hours is deeem unacceptable. Not a very good first impression... :( I am actually not allow to be in the mess before my working hours, i am suppose to be working the minute i step into the hospital... and his comment about me when he first saw me.... " SO, you are the famous TECK '', left me and the rest of the team puzzled about what is the factor that have made me famous... the other comment that Mr. W said to the surgical directorate director (N.V)

Mr. W: How can the night team not consist of a SHO?
N.V : Hold on, you are wrong... you did have a SHO... that's Teck....
Mr. W: Oh no... Teck is not a SHO, he is pretending to be a SHO...

(His comment above was not unfair... because the day before, i was still a FY1, the next day i am already a FY2 )

Covering orthopaedics was not great experience... accepting too many inappropriate referrals have made my registrar annoyed... and me having to discharge them myself hopefully to keep him happy really not the ideal way of practicing medicine... putting my GMC registration hanging on a very thin string... So far... all the ortho cases have not been repeating... until now... i have not got a single case which is similar to the other... amazing what ppl could do especially on a bright sunny days.... instead of keeping themself safe when doing the good outdoor activities fun... they rather live life the dangerous way by presenting themself to Emergency Dept with broken humerus, radius, ulnar, femur, hips, tibia, fibula, clavicles, ribs, maxilla, jaw, skull or torn biceps, triceps, achilles tendon etc. So far the most bizzare injury i have attended was lifted off ground playing kite surfing and fall from 10m high... sustained no major injury other than 2 broken incisor teeth... Being the only Orthopaedics specialist in the hospital at night is really . ridiculous when ED is only staffed by two other fellow FY2s who have not done orthopaedics before... My conversation with an A&E sister about the state of the A&E at night.... :

Me: Don't you think it's absolutely a joke when the A&E is only managed by two Fy2 doctors... who in fact none of them are trained neither in ALS, ATLS nor APLS...
S/N: Well... that's not true... we have been through all this before... our consultants have got this planned....
Me: Oh, really... tell me about it...
S/N: Well, you see... although there's no senior drs down in A&E at night... there are still senior Drs of all specialties up there that shall be called immediately if have troubles...
Me: True... that's true... in the ideal world.... BUT... just consider tonight... do u know who is around tonight? It's ME... and me alone... covering General Surgery, Urology, ENT, Orthopaedics... my registrar's sleeping at home 5 minutes away.... Paeds SHO is again another Fy2... The medical SHO who happened to be my friend... another FY2... well ya.. medical SpR is around... SO to be honest... the only senior Dr. in the hospital tonight... is the medical SpR.... I am sure your consultant did thought about it... but i bet he/she forgot to tell the department their great plan
S/N: ..... Ooops...



I bet all the non doctors outside who happen to reading this entry must be thinking...
(OMG, I better make sure myself not getting admitted to that hospital)
(What kind of Hospital is this guy working in ???)
(Hmmm.... OH NO... how can we give our life and our love ones to all these people... )
To be FAIR ppl... your life will be fine... coming to hospitals at night... similar things are happening throughout the UK... especially in the district general hospital... we might not be able to help you the time you admit urself to the hospital.... but we and the nurses are definitely capable of prolong your life till the bosses come in... SO NOT TO WORRY!!!

Well... here i am starting my nights again tomolo... so ppl .... please take care of yourself... dun come to hospital at night... if you happen to pick up by the ambulance (touch wood) ask them to divert you to poole or bournemouth... don come to Dorset County... Although i doubt it would be much better on that side of the world...

*Sigh Sigh* To add on... Friday did not get better....

New patient not being seen during ward round when i was busy in other ward yesterday because my colleague did not bring the consultant to see him... turned out to be my whole team fault...

Patients not handed over to the juniors after being reviewed by our registrar without our presence turned out to be our fault again because of the absent minded registrar... and his poor communication...

Blood got stucked in the pod system in the system that delay the surgery happen to be our fault as well... get a grilling and cold and hard slam on the door by the consultant...

Patient refusing to be cannulated and being aggresive and deemed not safe for us to approach...thus bloods not taken for 2 days... turned out to our incompetency as well....

"Team!!! I expect a higher level of care for my patient in my team!!! " said the boss...

And just being woken up by a fast phone call today from night house officer... telling me that another houseofficer deleted our one and only list from the computer accidentally but refused to admit her mistake.... thus a new list is created based on a random piece of old list dated few days ago... when there were such high turnover and at least 7 new patients lying in the hospital which might be missed during today round...

Oh GOd... i really do not want to go in and work this monday!!!

*Sigh*... have u ever been blame by someone for something that you have not done... or something that went wrong but it's just not your fault.... or something just happen during ur absence and being ignored by your colleague but it just went all wrong just on the first day when you are back onto the work...

Started my Vascular rotation... Always been interested in Surgery and putting up my hope real high about getting into it... wanting to get involved in all those sophisticated surgical skills that i yet to master... so much expectation... so much hope to have such a good time... Previous houseofficer who have done surgery posting gave good feedback about surgery but, they have straightaway rolled their eyes once i mentioned i am going into vascular surgery and wished me good luck... so ya i did enter the rotation with some reserves in mind...

Enoxoparin not prescribed to post op patients after two days in hospital while i am away starts to develop symptoms very much suggestive of PE... turned out to be my fault because i am suppose to telepath such reminder to my colleague while i was away ??

Acute Pulmonary Oedema being missed by two of my Registrars during ward round, turned out to be my fault as well when my role during the ward round was just to write down whatever they said in less than 10 seconds...

and not being able to attend theatre to assist in operation turned out to be my fault as well when my team has 35 patients that need to be seen daily and looked after... when the other team have less than 10 patient shared between 3 of them...

Inaccurate fluid balance recorded by the staff nurse turned out to be my fault again... because i was supposed to make sure i have eyes on everyone back to make sure everyone in the ward do their work properly...

Deranged U&E which being left by my fellow team mates for 3 days without doing anything... turned out to be my fault tooo when patient deteriorate...

what else ..!!! this is madness!!!

this is enough!!!!! No MORE!!!! I NEED TO TAKE CONTROL... Never before ever I felt like not going to work the next day.... well... guess i have to carry on!!! Jia you lo!!!

I am pretty sure that everyone will be able to experience some culture difference whenever u visit another country. Other than the local, sometime you also realise that being the minority in a place, all our fellow malaysian strangers whom you have not met before in your life, would approach you and say hi and asking where are u from and all... suddenly you will felt Malaysians are all so friendly... I think most of us would have this sort of experience... some encounter would brought you some extra benefits like more chickens or side dishes when u meet a malaysian cashier working in KFC... but most of them would leave u with lots of ????? ... For example; Was waiting for lunchtime in victoria rail station with Glen in Costa, we were talking in hokkien quite loudly as we normally do... then one chinese lady in her 50s approached us and speak to us in HOKKIEN!!! (For easier understanding sack, i used english below)

Auntie: Where are you two from?? Singapore ar??
(Me and Glen shocked coz someone interrupted our super educational conversation)
Glen: Malaysia
Auntie: Oooo ... (look excited) which part?
Me: Kuching le... Where are u from? Are u from Penang? (from how her hokkien sound)
Auntie: No no... Port Dickson... What are you guys doing here??
Me: Working and studying lo...
Auntie: Huh.. what? can get visa meh?? Eh you, really one or not?? Dun be illegal immigrant le... can go into jail one...
Me: Really one... no problem getting visa at all...
Auntie: (Look unconvinced... change her target to Glen) So (looking at glen) what are u doing ?
Glen: Study lo...
Auntie: Study what?
Glen: Medicine
Auntie: Wah, you wan to be lokun ar (Doctor) ? Where you study?? How long have you been studying? What kind of lokun you studying?
Glen: St. George, 4 year lo... general... (pointing at me... ) this one working already le
Auntie: (Looking at me) so what are u working??
Me: Lokun lo...
Auntie: Stop lying la.... come on.. tell me ... what are u working as??
Me: !@#$%^&* Auntie, really one la.... -_-"
Auntie: (Finally looks a bit believed after i said many many time really la) wat kind of doctor are you?
Me: General lo....
Auntie: Oh... junior lokun is it... Anyway, boys i got to go now... you all take care k... all the best
Then she left... leaving me and glen burst out laughing non stop for the next 3 minutes...

I believed in life... we have to make many decision... decision is easy when you have no other choice... straightforward and get on with it without chance of looking back and no place for regrets... it gets rather complicated when you realise that there are so many other choices... and each of the choices actually create different opportunities and will ended up in different ways in life... some steps that you take might create a quicker pathway to achieve what you always wanted in life but it will also make life slight tougher in the process... and the other option does give you a more relaxing pathway but it involve a lot more hurdle in each level... So now... just to make things slightly more complicated... we also need to find the balance between social life and working life... which one of these is more important to me... again another choice that i have to make... "List out the pros and cons of each choices to help you make decision" that's the advice from most people that i have talked to... and yes indeed i listed them down... and unfortunately, it did not make things easier for me... and decision till now has not been made and authorities are demanding a definite answer soon... so what should i do? Stick with Plan A? Plan B?? or even create another option Plan C or just give out and go to plan D?

23rd January 2009, going back home for Chinese New Year for the first time after 3 years spending these auspicious and exciting festivals in United Kingdom. Chinese new year is very much celebrated by Chinese around the globe and it's often regarded as the most important celebration by the Chinese regardless of Chinese from mainland China or Chinese from southeast Asia or even the minority Chinese in America or other parts of the world. People from foreign country hardly understood and nor being explained the meaning of it. In simple words, it's similar to Christmas celebrated by them yearly where family members gathered around on this day to share the sweets and bitter moments of the years and to start a new year with hope that tomorrow or rather next year would be a better day or year.

Woke up at 0700 in the morning and getting ready to get to the bus station is unusual for me, because normally I wake up at 0840 for a 0900 day in to work. It really proved that how much it meant me to be able to catch the bus to make sure that I reach home on time for this important celebration, even Raymond, my housemate was surprise to find me awake making breakfast (normally I just skip breakfast or a simple and quick one). Then I started my long journey home starting with a kind lift from CP to the bus station. Then travelling with the 'best' bus service provider, National Express to airport. Met a HongKy tourist on the bus and chatted with him the whole journey. Arrived at Heathrow Airport Central Bus Station and not surprisingly, it was still as busy as usual, travellers wheeling their trolley making the noisiest and most annoying rumbling sound. Always thinking that if someone is going to invent something to get rid of that noise. But today, I was not too bothered with the noise because there was something for me to look forward to…

It was my first time travelling with KLM (Royal Dutch Airline) purely because it was the cheapest way to get home when I booked my flight back in October. Heard so much bad reviews about the airline, so I did not have high expectation at all before taking the flight… but actually it's not that bad after all… well guess I should write an entry just about KLM in the future. Terminal 4, an unfamiliar terminal to me, rather disappointing one as it's undergoing some major renovation. Nothing much to talk about the terminal… so let's skip to the flight which was more eventful… Had bad feelings about the flight before… like some Chinese saying, muscle twitching at the eyelid could mean something bad… especially travelling one week after the successful landing of the American airways at Hudson River… and after watching Snake on the plane starring Samuel L Jackson (a rather ridiculous and disturbing but entertaining film) thanks to Matt who recorded in the Digibox he has. I just couldn't help to think about all sort of possibilities there… Not the snakes part I hope…

Arriving at the gate 30 minutes before departure and not being able to see the plane outside at the aerobridge just make me wonder… is my flight going to be delayed because the plane is not here yet? But later it proved that it just me being paranoid as my plane is actually at the other side of the wall… guess other than the price to pay for using the aerobridge, there must be a price to pay as well to park the plane at visible sight for the passengers. Another cost cutting measures I suppose which I think Dato Fernandes or other budget airlines' CEO would be able to explain a lot more… Was glad that we were called to board the plane on time and felt rather sure that catching the connecting flight from Amsterdam to KL one hour after arriving at Schipol Airport Amsterdam should not be very much a problem. Had a short telephone chat with the customer service operator of KLM one week before the flight about the short connecting time but he convinced me in a Dutch accent that Schipol Airport is the world best airport ever with the best infrastructure and system that would ensure a connecting time of 50 minutes is more than enough.

Everything went so well until the minute after they closed the cabin door. The captain announced that due to adverse weather condition in Europe, we were to be stranded at Heathrow airport until further notice… we were also told that we could expect a 50 minutes delay…!@#$%^&* A Malaysian lady next to me who was travelling to KL with the same connecting flight as mine started to panic and made so much noise and demanded the person in charge to talk to her… I can still remember what she said until today not words by words but she was not able to put out a argument point at all… "I have always travel with MAS airline before this and I did not have such problem before, why is it the first time I travel with KLM, this happen, this is not acceptable, can I have a complaint form to fill in please" I was like WTF, it's not KLM fault that the weather decided to get bad before we depart… sometime people can be so ridiculous isn't it… for goodness sack at least a better point next time… I was worried about the connecting flight too because if I miss the flight to KL, it would mean missing the flight to Kuching too…
Waiting patiently and finally we departed Heathrow airport 45 minutes late. Landed at Schipol Airport 45 minutes later, prior to disembarking, the captain announced that all connecting flight passengers should make our way to the boarding gate for immediate boarding… Schipol airport is indeed a huge airport, running from gate D to gate B require 25 minutes of brisk walking… -_-" but with heavy hand luggage, maybe slightly longer… In short, I made it at the end, they even delay the flight to KL for almost an hour just to accommodate the 50 passengers including myself from my earlier flight. Thank God!!

As the plane descended, and as we are approaching sea level, the gradual increase in outside temperature make me feel so warm both physically and emotionally. Here I am back in my home land. The feeling is indescribable… Nasi Lemak, Char Kuey Teoh and most importantly my family :-) As we landed and the captain announced Welcome to Kuala Lumpur International Airport, I was so relieved and glad and nearly wanted to give him a standing applause… Although without the "To all Malaysians, Welcome Home! " announcement which was usually made by MAS airline pilot, I've already felt home sweet home…

But wait… my journey home did not just ended here… I still need to make my way to Kuching!!! At the conveyor belt, waiting patiently for my checked in luggage, the authority suddenly announced that some luggage were stranded at Schipol Airport because of the short connecting time.. I was like… NO WAY!!! That's another shot of adrenaline to complete my day… but I was not the unlucky one… my luggage was one of the first luggage to emerge from the conveyor belt… Stepping out to the arrival hall, where there are many anxious looking faces waiting for their love ones arriving. This scene, I would unsuitably describe as anxious and eager parents waiting for the delivering of their baby in the delivery room… in this case… the exit to the arrival hall would be the… :p

KLIA was decorated with some simple Chinese New Year themed banners and lanterns and miniature Chinese Garden. Simple yet meaningful. They even got someone dressed as the Fortune Wealth God with two sweet looking girls and four Indian Boys with billboards on their body making out GONG XI FA CHAI distributing sweets and mandarin oranges and fortune cookies to visitors in KLIA. Mutiracial eh…

Well… the journey to Kuching is not as exciting, as in it's just another normal flight to Kuching but just that the flight is actually packed with passengers.. And MAS seem to have new colours for their chairs on the Boeing 737. It is now consist of different colour according to the theme colour of MAS logo… kind of unique… but I felt it's rather looking a lot messy… but hey… it's special :P On the flight home, was sat next to a group of IMU students (I believe so after eavesdrop them talking about IMU and metabolic disorders during the flight… how boring medical students are nowadays… talking about medical conditions on the flight… my God… Touching down to Kuching International Airport… so glad and exciting for 2 reasons. First, thank God for sending me home safely and to get back to my family for this yearly event and secondly, no one was ill on the whole journey on the plane that require a medical assistant (something that I dunno what I will do if it really happens … Good Samaritan or not :P )

Kuching is still great… no one burst out in tears when seeing me or what… not as dramatic as some of the scene which you can only see in operas or movies… (hmmm… is that why DRAMATIC is created to describe such scene)…well I did just saw them in July 2008 anyway… Home sweet home finally!!! Leong, my younger brother who I have not seen since ages ago… Ong's Family Reunion again after so long!! And Angpows !!! Hooray :P Mom and dad who looks older again everytime I got back but still as healthy as ever… glad that they remain healthy but it's does make me feel kind of sour inside me when I realised that time flies really… wish I can spend more time just to be near to them… Brothers and sister who grown up so much that make me feel what I have been missing here since leaving home…

Reunion dinner the next day make me realised that how much I missed my mom's cooking… and just spending times decorating the house to welcome the event… cleaning up and washing the cars… getting ready for the new year… it's amazing how simple chores like these could make me feel how much I actually miss home… Fireworks and firecrackers were amazing creation by human being to lit up the dark skies when it's approaching 12 am on the 26 January 2009 GMT +8… :)

So… what did I do for Chinese New Year Celebration this year after missing them for 3 years consecutively… Other than reunion with family… I also met up with some friends from University, High schools and even primary schools… Some are still doing their bachelor degree and some even PhD and some are already stepping into the realistic and cruel society as working adults… In summary ex teachers turtle Su Choo (exported) and blur Ming Ying (importing someone from Sibu) doing great saving lives as pharmacist in Sarawak General Hospital, brainy Roy (gossip king) who decided that getting a bachelor degree is not great enough for him so decided to go for Phd… the amazing 'mandarin improved so much' Felix as usual smart and doing so well while finishing his last few months as med student , Min Chen who is so busy the whole time during CNY have settled down in managing peoples IT problems in finance in KL, Paul the lawyer who is going to rock Aussie land, Joel who is still so fond of Jap finishing his degree in NUS, Sim who still remains the same after 5 years always looking at things from a totally different perspective, joshua who claimed his "Bakting Soup" is best in town and the mysterious eng tao Richard constantly having unreadable thoughts in his mind… Great Bunch I have to say!!! \(*0*)/

And through Facebook (the amazing portal to keep in touch with long lost friends), Kevin Wong, long lost primary school buddy found me… even though I used James Ong as my name on facebook… a name which I have not started using until college… Dunno how did he find me… but yeah… he found me… !! And through him, we found so many ex primary school mates that I lost contact for more than 14 years!!!!! The little autograph book not covering in dust that I kept since primary school finally came out from the closet and seriously brought back memories from back then… Although the reunion night on 30th January 2009 was not as overwhelming as we wanted it to be because only 10 ppl out of 56 people turned out… Well, in short… Kevin doing so well his million dollar business in oil and gas, Winston who was so quiet the whole night, Chai Jing who got married taking over Teacher Chai's can as the next Teacher Chai (her husband's surname's Chai too…), Sin Hui who none of us recognise at the start working as interior designer who promised to give me discount the next time I see her, Xiao Zhen who looks the same after 14 years working as drafter in the company who build Boulevard, Yuen yuen who is now the lucky one getting married sometime this year as the next 'tai tai', Su Fen who only came at the last 5 minutes before the reunion gathering ended, Benjamin who was in Leeds before with Kwong Kok in ING taking care of your retirement plan, Jia Mei teaching product design in world renowned Lim Kwok Wing Institute, Edmund Kho big tauke analyzing ppl since we were all primary school kid and ching ting who's taking over the million dollar business from daddy (so guys out there watch out man) ...

Wish i can talk more .... but seem like this post is getting a bit too long winded... i will have to write some other day about the chinese new year celebration... so much mixed feeling now back in UK... and the same question that have been hitting me hit me again when i return... well... if you know me well... u know wat is bothering me... so... i have to make a decision real soon... GOd... help me here please... at the mean time... i got life to save!!! hehe... and life goes on~!!