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Planning for a trip + getting prepared for a change of workplace + wondering what's happening to family ties + getting involve in health service programme = headache and excitement!

Bismillahiraahmanirrahim...

Mencabar

Selasa lalu adalah oncall yang mencabar. Tengah malamnya aku menerima panggilan daripada seorang colleague, yang mana dia terpaksa ambil EL kerana ibunya masuk wad. Maka tinggal kami berdua. Aku dan rakanku yang postcall dan gravida. 

Morning rounds habis cepat, hanya lima patients, alhamdulillah. Klinik pakar tanpa pakar...hanya kami berdua. Rakanku sampai lambat ke klinik kerana ada new case masuk. Kami dah limitkan patients awal-awal, namun ada dua tetamu tak diundang. Seorang PPK ( rasanya dari ED) pandai-pandai masukkan nama cucunya tanpa bertanya pun pada SN in charge. Aku tahu dia staff, tapi at least nak masuk rumah orang bagi salam dulu pada penjaganya. Serve you right, datang hari tu tiada pakar pun. Seorang lagi yang tak diundang ialah defaulter, suddenly decided to continue follow up that day. Sanggup tunggu walaupun lambat. Whatever. Tengah tengok patient, SN called, ada another new case masuk!

Habis klinik pukul 12,alhamdulillah. Balik ward terus clerk case. Ermm...child very well, low grade fever...Only WBC 30,so the OPD MO got her admitted. Lepas tu masuk satu lagi case, plus two referrals...one from Ipoh, nak transfer febrile fit patient sebab belum 24 hours. You know that you still need to observe her,yet you allowed her to be discharged to parents, and travelled themselves from IPoh to BM?!! With branula in hand! Guess what, the child only arrived at 9pm, with no branula in hand! I ended up not admitting her.

1) Its already more than 24 hours for observation

2) Child afebrile for 24 hours

3) Mother not keen for admission

The other referral was from HC, referred by a young MO for pneumonia, which turned up to be only URTI and discharged the following day.

I only had lunch at 2 pm, then continued with admissions..

Tak terkira dah berapa admission petang tu...di selang seli dengan surgical dan ortho. Ramai pula yang alleged fall with cerebral concussion bagai...

Enam petang..dua kes masuk serentak. Croup and dysentery.

Severe viral croup....prominent stridor, recession, tachypnoic, SPO2 91% under room air...parents were very cooperative. I loaded him with neb budesonide, im dexamethasone and finally the magic drug,neb adrenaline. Child improved immediately! Syukur pada Allah yang mengizinkannya. Masa tu aku dah terfikir kena prepare intubation dah. ED MO yang attend kes ni dulu dari Paeds juga, he made the right diagnosis but managed him wrongly. Ada ke patut bagi neb salbutamol dengan alasan tiada budesonide? Dude, pharmacy is just next door!

Kes lagi satu tu was wrongly diagnosed, dia bukan dysentery, dia tak passed stool langsung! Dia cuma ada PR bleed, query cause! Budak tu aktif bukan main. AXR normal, aku observe saja, KI V refer surgical. In the end discharged je esoknya.

Baru ingat nak rehat, satu lagi kes masuk. AGE with severe dehydration! Four years old Burmese girl, who had just came to Malaysia two days earlier. ED dah bagi bolus, so aku bagi deficit and maintainence fluid. Lethargic sangat.

Pukul 8.45pm baru check in bilik oncall. Soooo tired. Bersihkan diri dan baring. Masa nilah referral dari Ipoh tu sampai. Dah agak dah! Settle yang tu, masuk bilik semula. Baru terlelap, ada dua 

lagi new case. Masa tu nearly 12 midnight...MasyaAllah...

Aku bad mood masa ni. Muka serius saja. Kenapalah datang malam-malam ke kecemasan. Apa yang cemas sangat? Dua-dua budak came in walking. So where is the severity and urgency for admission?!

First case...anaknya tiga tahun lebih dan bertudung. Bapanya berjubah dan berjanggut. Ibu tiada. Bila nurse nak check BP, budak tu meraungggggg macam sakit sangat! Yes, bila BP cuff tu inflate, memang sakit, tapi tak perlulah sampai meraung tengah malam! Aku tengok dekat kad ED, si bapa refused blood taking after first attempt fail. Baik pula ED hari tu, ramai patient yang admit mereka dah ambil darah. Maka aku pun batalkan hasrat nak ambil blood culture. Temperature 40 C. Bapanya kata esok pagi saja, kerana anaknya takut. Fine. Kes lagi satu URTI. Memang dry budak tu,aku start IVD.

Pergi labour room pulak. Ada low birth weight baby, 2.2kg. SN sana buat kecoh sebab ada inevitable miscarriage at 20 weeks, ada heart beat, estimated weight 500g. To resus or not to resus? O&G specialist punya plan, to allow labour, to call Paeds if heard beat present after 30 minutes born. Biar betul? Awal-awal tak bincang dengan paeds, bila born alive nak lepas tangan kat paeds untuk decide kah? Aku tanya MO obs, what was your discussion with the parents? No answer. Aku malas nak fikir, they never referred to me, I pretend that I did not know the case. Aku balik bilik tidur.

3.30 am...SN called and informed result. The AGE patient punya urea creat tinggi! Aku dah agak dah, so repeat stat. Terfikir juga, kena refer HSJ ke? Kena dialysis ke? Sebab terlalu penat, aku tidur balik sampai pagi. Mujurlah second urea creat dia dah normalize...

Esoknya aku dah semangat nak ambil bloods budak bertudung tu. Temperature 39-38 C. Boleh pula si bapa refused. Katanya anaknya dah okay. Lagipun anaknya takut dan sakit. Encik, semua budak menangis bila ambil darah...Si bapa minta nak discaj. Pulak!!! Dah la specialist on leave, dia nak AOR discharge pula. Nak segera pula tu. Oh ya, budak tu tak immunised sebab  si bapa refused. Aku cakap, tunggu kami sediakan dokumen untuk keluar wad, lepas tu baru boleh keluar. Aku maklumkan pada sister. Sister pun dah pening, masuk baru lapan jam, dah nak discaj. Nanti matron dan pengarah bising pula. Tengah bincang- bincang macam mana nak buat, patient tu abscond! 

SN call nombor si bapa, boleh dia tak mengaku itu nombornya!

Dua laporan polis dibuat.

Esoknya, kami classify as abscond, after 24 hours missing.

Sister called si bapa guna mobile phonenya, si bapa angkat, sister cakap dengan lembut, minta si bapa datang balik untuk settle bil dan sign dokumen untuk balik, dia terus letak telefon!

Astaghfirullah...

Sorry to say, kamu membawa imej Islam, tapi akhlak kamu tak seperti Muslim. Saya amat kecewa dengan sikap tak bertanggungjawab kamu. Kamu susahkan kami, semoga Allah akan susahkan kamu pula. Kamu datang ke hospital meminta bantuan untuk merawat anak kamu, tetapi kamu sombong apabila kami cuba membantu. Kamu suarakan pendapat kamu seolah-olah kamu seorang doktor yang arif. Habis tu buat datang hospital, kalau kamu pandai sangat?

Kamu berdosa dengan orang-orang yang kamu offended, sehinggalah kamu datang meminta maaf. Semoga Allah balas perbuatan kamu. Jika anak kamu yang tanggung pembalasannya, kamu jangan menyesal.

Jika anak kamu sakit lagi, malah collapse sekalipun, jangan sesekali bawa dia ke sini lagi. Kami ada ramai lagi pesakit yang tahu hargai dan hormati kami.

Namanya, wajahnya, suaranya, akan sentiasa kuingat!

Berhenti Merungut!

Aku perlu berhenti merungut tentang kepenatan...

Apalah sangat yang aku buat dan berapa banyaklah sangat sumbanganku terhadap Islam jika dibandingkan dengan orang lain.

Oncall yang tiada kesudahan...kurasakan terlalu kerap hingga mengundang tekanan. Moga berita baik yang kuperolehi ini bakal mengubah dan menambahbaikkan kualiti kerja ku nanti.

Sungguh, aku terasa sayang untuk meninggalkan jabatan ini, setelah 9 bulan menjadi sebahagian daripada keluarga besarnya. 

Mana mungkin dapat kutemui staff yang baik-baik seperti mereka...telatah mereka pasti aku rindui nanti. 

Segala ilmu dan pengalaman yang kuperolehi akan kuamalkan sebaik mungkin.

Penat...

Tubuhku dah tak fit seperti dulu. Pagi tadi walkathon dengan ayah di Taman Botani, puas dapat mengejutkan otot-otot kakiku dan memercikkan keluar peluh. Aku berazam untuk kembali aktif beriadah selepas ini.

Penat...

Minda dan emosi. Kesihatan mak yang tidak memuaskan. Maklumat yang perlu kukorek dari consultant mak nanti. Ketidakcukupan sokongan emosi dan moral untuk mak dan ayah. Mereka ada tiga anak, jadi mana yang dua lagi? Perlukah mengabaikan ibubapa setelah memiliki keluarga sendiri? Itukah yang diajar oleh Rasulullah? Tidak kira apa pun yang kulakukan, tetap tidak mencukupi. Mereka masih perlukan perhatian daripada anak-anak yang lain. Hujung minggu pasti kupulang ke rumah mak ayah, walau di hati teringin untuk berbujang bersama kawan-kawan. Postcall pun acap kali aku pulang ke rumah, menjenguk dan membantu apa yang patut. Mampukah aku buat begini lagi setelah berkahwin kelak, sedangkan aku perempuan, isteri yang wajib berada di sisi suami?

Multaqa Ulama yang berakhir semalam mengundang pelbagai reaksi. Secara tiba-tiba semua orang mahu memberi pendapat sebaris ulama. Yang tidak pernah nampak muka di usrah pun lantang menyuarakan pendapat. Selamba mereka mengutuk ulama sedangkan ilmu di dada sendiri tidak setinggi mana. Ulama bukan maksum, mereka juga ada kelemahan, tapi mereka juga berilmu tinggi, amalan mereka banyak...sekurang-kurangnya kita hormati mereka dengan menjaga lidah kita. Mereka pewaris nabi. 

Aku harus selalu bertanya, apa sumbanganku terhadap Islam? Berapa jam sehari aku ingat Allah? Bagaimana pergantunganku terhadap Allah?

Usah tunggu diri menjadi baik dahulu baru nak menyumbang, kerana hidup hanya sekali.

Semoga aku berjaya menjadi sebahagian daripada mata rantai dakwah ini, sahamnya nanti ingin kubawa ke akhirat kelak. InsyaAllah.

Exhausted

15/8/13

Cuti raya habis. Oncall.

16/8/13

Post call, balik rumah parents, bawa parents ke Hospital Sultan Abdul Halim, Sungai Petani, melawat mak caq Timah.

17/8/13

YB dan isteri pulang beraya. Ke rumah saudara mara dan berakhir di Juru.

18/8/13

Oncall 24 jam lebih.

19/8/13

Post call, balik rumah parents lagi sebab bagasi masih di sana.

21/8/13

Oncall lagi.

24/8/13

Oncall lagi, 24 jam lebih.

25/8/13

Postcall, ahad. Tak balik rumah parents sebab study sepanjang hari untuk NRP.

26/8/13

NRP course at HSJ. Ada MCQ.

27/8/13

NRP day 2. Berdiri sepanjang hari. Megacode assessment. Balik rumah parents petang tu.

29/8/13

Oncall lagi.

30/8/13

Postcall, balik rumah parents.

31/8/13

Bawa parents ke Selama Kedah, melawat sepupu sakit.

Selamat hari merdeka!

1/9/13

Oncall 24 jam lebih.

6/9/13

Oncall lagi.

7/9/13

Postcall,dari tempat kerja terus ke HPP untuk Paediatric update course sampai pukul 4 petang.

8/9/13

Day 2 course. Habis course terus balik rumah sewa, then terus bertolak ke Taiping.

9/9/13

Dari Taiping ke Ipoh dan pulang ke Penang, sampai jam 7pm.

10/9/13

Oncall lagi.

11/9/13

Postcall, balik rumah parents, bagi buah tangan from Perak.

14/9/13

Oncall lagi, 24 jam.

Here I am. Mungkin ini weekend call terakhirku, insyaAllah.

No weekend break since lepas raya hari tu. How exhausted I am.

Weekend Gateway @ Taiping

An offer to boarding school brought me to this old town. I have relatives who stayed here but they moved to other town a few years back.Even though I rarely spent time cruising around the town area during my schooling years, the memories it has built still remains strong.

TAIPING

I recently revisited Taiping last weekend. Such a wonderful visit though very short. Thanks to my friends who held their wedding dinner at one of the seafood restaurant in Taiping. That afternoon I actually had to leave my course earlier so that we could reach Taiping before the sunset.Three of us, housemates, departed to Taiping at 4pm and reached the town an hour later. The shops, houses, quarters houses, Kamunting prison and the bus station...all looks familiar to me. It has been 11 years since I graduated from the school. I came back several years later but only went to the zoo and to my relative's house.

Sentosa Villa...catched my eyes when I was browsing for accommodation, plus the special price that I obtained. I rarely go for holiday, so once I go, why not get the best place to stay? It is situated on the hill, some where five minutes from the lake garden. The room was clean and spacious enough, the bathroom I like the most. The view was superb, Subhanallah, such a picturesque natural view.

We left for dinner at 7.30pm, looking for Soon Lee Seafood Restaurant, located somewhere at the town alley. Parking was a challenge. Our friends prepared special table for Muslims, and we were served Nasi Beriyani, chicken, spiced prawn, cuttle fish , vegies, fruits and orange juice. Alhamdulillah. Thanks my friends for being concerned. Both couples look so cute and smart in their dressing. I wished to see captain in his formal military suit but he wore only blazer. There was no swords also. Yet the parents impressed me as they were wearing kebaya and batik. :) The event ended around 10 pm, we stopped by 7-11 to buy some snacks and headed back to Villa.I slept soundly that night as I was too tired from lack of sleep.

Good morning Taiping...woke up with wonderful feelings. However there was shortage of water for a while that made me unhappy temporarily. We had breakfast in the cafe, surrounded by nature. Chinese fried rice, mee goreng mamak, boiled egg, samosa, popiah, porridge, fruits, orange juice and a cup of coffee...safely entered my gastrointestinal tract. Then we had a tour around the villa. Very close to nature. Thank you Allah for giving us opportunity to reach that place.

We checked out at 11.30am...and decided to head to Ipoh. On our way, we stopped by a RM2 shop and bought many things..this kind of shop is rare...so we didn't want to miss it, and we also stopped by the lake garden to snap some memory photos. Along the highway, I saw greenish mountains and hills..and that made me remembered of our last usrah on surah As-Saff 1-3. The first sentence said, " Whatever is in the heavens and whatever is in the earth declares the glory of Allah; and He is the Mighty, the Wise." Even mountains and hills say prayers for Allah. We humans, with brains and hearts, should say prayer even more!

We reached Ipoh an hour later and headed straight to Batu Gajah, before reaching our destination, Kellie's Castle. With RM5 entrance fee, we had our own tour inside the so called mysterious castle. Glad to be able to see a castle again, after the last one in Ireland. It started to rain again when we finished our tour. We had a coffee break at its cafe before heading to R&R Batu Gantung, where we had mee curry, bought nasi lemak for dinner, had our prayers and finally shopped some fruits at cheaper price! I bought duku langsat, jambu air, guava and some sour fruits.

Our journey was uneventful despite the heavy rain, alhamdulillah. We arrived home at 7pm and that ends our weekend gateway...

Eventful

Too many things happened lately...to me and to the people around me. Last weekend was the second weekend I spent here in mainland. I didnt go home, just because I needed to study for NRP. Mondy and Tuesday were the first time I went to HSJ on my own. Parking was not bad though, as long as you reach before 8am, you'll find one.

NRP in HSJ was tiring. Spent most of the times standing up, at the megacode station. It was also tough to satisfy our instructor's standard. I was in the same group with two housemen and two nurses. Great to know kak Norsuzana, an experienced and dedicated nurse, and Husna, a young innocent nurse. At the end of day two, I went back home, this time, I happily used ferry.

Those were the tiring days...slept soundly at night, woke up with body aches in the morning. 

Thursday...oncall again. Countless calls...luckily the uneventful one. My JM was admitted for labour, we waited with anticipation but eventually she had to deliver in HSJ, assisted with vacuum. Friday was our ward Raya celebration. Plenty of food...nasi tomato, ayam masak merah, dalca, nasi impit, lemang, rendang, soto, lime juice...specialist sponsored chocolate chip walnut..alhamdulillah. I went back home right after filling up my tummy :) yet the sad part is one of our ward sister was absent...her father was involved in MVA and critically ill in ICU.

Saturday...I brought my parents to Selama Kedah, to visit my 61 year old cousin who suffers from stage 4 lung carcinoma. Thanks to Waze, we got there easily. This cousin of mine was a heavy smoker, that might be his causative agent. Allahuakbar, once I saw him I was surprise...he became so thin that I hardly recognized him. He loss his appetite and unable to pass motion for 20 days. The family showed me his CXR, MRI and CECT results. I was speechless when I saw the word stage 4. Metastases to vertebrae. Refused radiotherapy. Request AOR discharge. Prognosis is very poor. Only Allah knows. Whatever will happen, at least, I already brought ayah to see his nephew, who once very close to him. May Allah ease his life.

Sunday...oncall again. Four admissions in 24 hours, good achievement. My CP patient got admitted again, the third time in one month on my oncall day.

Monday morning...the devastating news came..the father to our ward sister passed away at 3 am. Innalillahiwainna ilaihirajiun. We went to visit in three cars and four motorbikes but the funeral has just over. So heart broken to see our sster, who was a happy person to cry in our hugs :( 

When we returned to the hospital, we noticed that our JM's baby was admitted for jaundice. So it made our life easy, not having to go to her house anymore but just to visit mother and baby in our own ward.

Tonight I must study!