NINETY NINE

Recently I went to another ward to see a patient who was referred to Oncology. When I arrived, the patient (an 80 over year old Chinese aunty who speaks only Cantonese) was being examined by a medical student, in the presence of 2 other medical students & their clinical tutor.

Medical student: (listening to patient's chest) Aunty, breath in & out...

Patient: (staring blankly at medical student, obviously not following the command)

Medical student: Aunty, say 99

Patient: (same as above)

Medical student: Aunty! Say 99

Patient: (still same as above)

Medical student: (shaking her head & turning to clinical tutor) Patient not co-operative

TOP 10 REASONS FOR EMERGENCY LEAVE

1. Maid ran away
2. Train new maid
3. New maid ran away
4. Kad ATM patah, need to go to bank
5. Grandmother died (for the third time this year)
6. Ran over a cat, need to send car to carwash (to remove evidence)
7. Tap burst, house flooded
8. Kad ATM baru sudah ready, need to go to bank again
9. Car window jammed, can't wind up
10. Maid came back, pregnant

Some are genuine, some are not. Obviously some are made up by me.

No. 6 happened to me last year...I ran over a cat in front of the Emergency Department on my way to work on a Saturday (passive call). But I sent my car to the carwash only after I have finished my ward rounds. It took me a week to recover from the trauma of killing a cat in this manner.

No. 9 also happened to me on new year's eve of 2008. It was early in the morning when I had just arrived at the hospital gate. I did not take emergency leave but sent my car to the workshop for repair & then came back to work as usual. That was definitely a reminder that my "milo tin" (kancil) is getting old & need to be replaced in the near future...

ROLE REVERSAL - AHHHCHOOO

I have had allergic rhinitis for as long as I can remember, usually triggered by

• Dust


• Pollen


• Cold


• Hot/ stuffy environment

Most of the time, the symptoms are short-lived. But it has recently gotten worse, partly due to stress at work & partly due to my neighbour who smokes like a chimney.

There are 4 areas at my workplace that I cannot stand:

• Ward (too hot)


• Clinic (dusty air-cond)


• Radiotherapy planning room (too cold)


• Oncall room (dusty air-cond again)

That will be like.....my entire department! Prevention is better than cure, but I can't be not going to work, right?

Went to see the ENT specialist & had scope done (ahhhchooo). I dread having any foreign body in my airways as it will always trigger a reaction. I still remember sneezing whole day after having nasal swabs taken from both my nostrils before my trainee internship (final year) in Waikato Hospital in New Zealand. I had no choice as it was compulsory for all final year students.

Anyway, I am now being diagnosed as having severe allergic rhinitis associated with severe bilateral turbinate hypertrophy (the ENT doc calls it "kissing turbinates"). The pic shows only 1 of the enlarged turbinates.

The symptoms are better with nasal steroid spray & anti-histamine, but the turbinates are still "kissing" each other. To put it crudely, it's like having 2 marbles stucked in the nose :p

I have been advised to have the "marbles" removed for long term relief.

MERDEKA FOR NOW

I'm finally out of the "south pole" after 6 gruelling months. Will be putting up a few delayed posts.

SOUTH POLE

I’m completing my attachment at the current hospital & will be going to Hospital Kuala Lumpur (aka HKL aka Hell of KL) for the next 6 months. Based on previous experience, I would probably, most likely, not see sunlight throughout that period of time (ie go to work before sunrise & come home after sunset). A friend asked where am I going, where there is no sunlight? South pole??

Well, I don’t have to go that far. The place is just in KL. I don’t actually mind not seeing sunlight, not that I love the sun very much. But to work 36 hours a day is no joke (there are actually many other “Iron Ladies” in the country besides Tan Sri Rafidah Aziz). Mr. Liow says we are allowed to go home after 24 hours? We’ll see if that’s possible & I’ll be the happiest person…

In the meantime, I’ll have to “hibernate” from internet again. Sayonora for now. Will be back once I get to see the sunlight again.

CREATIVE PATIENT II

My colleague showed me this poem written by one of the patients whom we are treating:

Tiap-tiap penyakit ada ubat
Carilah seberapa cepat
Jangan lewat jangan lambat
Di Hospital UKM ada tempat

Malam tidur siang jaga
Makan atau minum ada selera
Staf-staf baik belaka
Ramai kawan sungguh gembira

Layanan staf-staf saya hargai
Banyak nasihat yang diberi
Tanpa bayar hanya pri
Betapa senang rasa di hati

ROLE REVERSAL III – BUYING MC

I felt sick two Wednesdays ago. It was kind of like a sudden onset thing. I mean, I was totally okay the day before, except for feeling a bit tired & sleepy. I was with the rest of the team (specialists, medical officers, nurses) at grand ward round when I started feeling feverish & having joint pain. I tried to ignore the symptoms till the end of the ward round, but it just got worse after that. I developed chills & rigors with some rashes on my upper limbs.

My diagnosis was viral fever. Had my FBC (full blood count) checked. Haemoglobin & platelet count were within normal range, but TWC (total white cell) was slightly raised. I thought that was peculiar, as bacterial infection would cause TWC to go up, not viral. But at least the platelet count was normal. I don’t mean to be paranoid, but living in a condo where people come to do fogging every fortnightly, I have to think of dengue fever as a differential diagnosis.

I still went to work the next day. I thought I’d be okay with regular paracetamol & increased fluid intake. Afterall, viral illnesses are self-limiting. But before I even started work, I felt sick again, with uncontrollable chills & rigors. I was already on 3 layers of baju & got the staff nurse to get me extra blanket. My symptoms subsided later in the day, with paracetamol & I actually managed to work full day.

I could prescribe medicine & order investigation for myself but I couldn’t sign my own MC. Neither could my colleagues & I couldn’t go to the Staff Clinic because I’m not a hospital staff (I’m just doing attachment). So I’m left with no other choice but to “buy” MC from the nearest GP clinic the following day.

At the clinic, the doc found out that my throat was injected & I was still having fever at 38.1°C. It came as a surprise to me as I did not have any symptoms of sore throat or cough. But it made sense, as bacterial throat infection causes white cell count to up & fever with chills & rigors is possible. I was given a course of anitibiotic & MC for the day.

Upset that my initial diagnosis was wrong, I checked my throat upon reaching home. It was really swollen & looked almost obliterated (gasp). I took my medicine diligently & recovered in no time.