We had to wake up earlier today...about 0640H coz our bus was leaving at 0740H...so we got ready, packed and checked-out....walked about 2 blocks lugging our luggage to the Intercity bus stop...we saw a shop that was exactly where the bus stop was...it had ads selling party pills etc etc...intrigued, but the shop was closed so didn't get to check it out...our bus left on time and so the 3 of us started our journey together....
The bus stopped at Geraldine for breakfast...i had a sweet chilli sandwich which was delicious...i think when you're cold and hungry, everything tastes good...our next stop was Lake Tekapo...which was a glacier lake...so the water was really a lovely shade of turquoise...there was a church there called the Church of the Good Shepherd...it's the most quaint church...and from the altar, you get the loveliest view of the lake...it started raining while we were there...and we saw a rainbow after that while we continued our journey...
I slept for a while in the bus...and the next thing i knew, we were stopping at Lake Pukaki...i think it's the 2nd largest lake in South Island or something like that...it was really huge...and it was dammed at a certain area...we finally reached Mt Cook Village YHA at about 1300H...there were only 3 accomodations there...it was either the YHA (for cheapos like us), a more expensive budget motel or the super-expensive hotel further up called The Hermitage..but we managed to get a 8-bedded dorm all to ourselves...and we paid NZD27 per night (coz we had the YHA card)...we met another lodger who also just reached the YHA the same day (but she came from Queenstown)...her name was Anna and she was from HK...she actually planned to stay in Mt Cook for a week...i guess you can afford that if you have time...
We had cheese sandwich for lunch at the pantry...from our grocery stock which was running low... then we bundled up and headed for Red Tarn Trail...it was raining and really cold...but the 4 crazy girls decided to go for a hike anyway....we were huffing and panting up the trail when about 1/3rd of the way, Elena met a Spanish couple who were on their way down the trail...we were told that apparently from where we were and from the peak, the view is pretty similar...so no point suffering another 2/3rd of the way yea? so we decided to turn back after taking enough photos...gosh! i'm really getting old...really not as fit as i used to be anymore...
We went to the visitor centre to escape the cold...and also to check out their display and exhibition... we were entertaining and amusing ourselves till about 5pm...then we went to the only restaurant there which was called the Old Mountaineer's Restaurant or something like that...we didn't bother checking out the one in the Hermitage Hotel...we ordered Margharita Pizza, Merino Pie and Spagetthi Napoli...the bill came up to NZD18.70 per person...we shared among 3 of us coz Elena was still persistent in trying to finish up her grocery stock...
After dinner, we went back to the hostel and bathed...ahhh..it was good to have a warm shower... then we hung out at the TV room and watched "The Talented Mr Ripley" on a VCR (i thought VCR was extinct) ...starring Matt Damon, Jude Law, Gwyneth Paltrow...Cam told us it was an interesting show and since none of us had watched it, we decided to try it out...so we snuggled up on the sofa, by the fireplace, eating chips and jellybeans...and chatted away...the movie started out interesting but it just got weirder and spookier...and i was really haunted by the ending...almost couldn't sleep that night...good thing i didn't have nightmare after that...
Sunday, September 26, 2010
NZ Trip - Day 5
After a totally knocked-out night, we woke up about 8am, got ready and packed...then we checked out and walked to the train station which was just opposite the backpacker...we shopped for our breakfast and bought some groceries...then we took the shuttle bus to the Interislander Ferry terminal...that cost us NZD2 but i'm glad we didn't try to save that NZD2 and walked there...coz it was quite a drive and there were a lot of turnings...hehe...
So we checked in for our ferry ride...had our breakfast while waiting to board the ferry...we were quite amazed when we boarded the ferry (which was called Arahura) coz it was huge...equipped with a cinema, children's playroom, private lounge, cafe and convenient store...we departed at 1025H and our journey lasted aout 3 hours...i slept part of the way but as we were reaching Picton, Cam woke me up to see the beautiful scenery that surrounded us...so we went up the deck and took lots of pics of the lovely view...after that, we went to the cafe and bought some Rush Munro ice-cream...i had maple walnut while Cam ate hokey-pokey...soon after, it was time to disembark...
We checked-in our luggage through to Christchurch so we didn't have to lug our bags while walking to the train station in Picton...we had about 25 mins to get from the ferry terminal to the train station...our Tranzscenic train left at 1400H and we travelled about 5 1/2 hours before reaching Christchurch...we stopped in between...for views and all...there was a place we stopped which was called Kaikoura...it was famous for whale and dolphin watching...we went down for a while and almost missed our train...along the way we saw seals, sheep, cows on the field, snow-capped mountains and Lake Gressmer, which was New Zealand's main source of salt...the lake was huge and it was separated into squares...and there were also processing factories nearby where we saw heaps of salt...
We reached Christchurch at 1921H...by the time we got our luggage, the info counter was closed...and the last shuttle bus of the day has also left and the train master told us that it would take about 40 minutes to walk to the city centre...so this was the story of how Elena came to join us in our New Zealand trip...so while we were pondering on how to get to the city centre, a Spanish girl came and asked us if we wanted to share a cab...there was another poor helpless Japanese girl who was left behind as well...so the 4 of us shared a cab which cost us NZD20 and stopped at Cathedral Square...the Japanese girl then left us to meet up with her friends...so the 3 of us went to the visitor information centre where we sought help to find a place to stay for the night...unfortunately the Japanese girl there wasn't too helpful..so we tried our luck at some backpackers...BB's Backpacker was full..so we found a backpacker at Gloucester St called Stonehurst...Elena decided to join us to share a triple room with ensuite bathroom for NZD83 per night...which was a pretty good deal coz the room had a TV, coffee/tea drinking facility and it was cozy...about the nicest backpacker we've had by far...
Cam saw a sign on the way to our backpacker which read steak for NZD10 on Wednesday night...so these 2 starving ladies went to fill our stomachs with sumptious steak while Elena stayed back to eat her bread...Cam was doubly happy coz the waiter who was serving us was cute...so after a hearty dinner, we went back to the backpacker...Elena told us she booked her Queenstown to Auckland flight on Sunday (29/8/10)....coz earlier i told her that we'd be leaving Queenstown on Sunday thinking that Sunday was 30/8/10...Damn! due to my stupid mistake, we have caused Elena to book the wrong flight...coz initially she planned to leave Queenstown on Monday as well but i think when i told her that we were leaving on Sunday, she must have decided to travel with us...
So in the end, Cam and i decided to change our itinerary...so we wouldn't be staying an extra day in Christchurch...so we booked our bus to Mt Cook for the next day for NZD63 and then our bus from Mt Cook to Queenstown the day after for NZD78...we also booked our Milford Sound tour on 28/8/10 coz we were afraid there wouldn't be time to do so coz everything was pretty rushed...the tour cost NZD145...really thank God that the reception at our backpacker was this very nice lady who was willing to help us although it was quite late at night...her name was Catherine...
Since we weren't going to go around Christchurch, Cam wanted to go to Cathedral Square to take some photos...it was drizzling a bit...and the square was devoid of human beings except for us 3 girls...and it was bloody cold...we even took a picture of the tram stop since we weren't going to take the tram...so thanks to me, we didn't get to go for river punting, the tram and gondola ride...after we've had enough pics, we went back to the room, bathed and slept coz tomorrow was a full day ahead...
So we checked in for our ferry ride...had our breakfast while waiting to board the ferry...we were quite amazed when we boarded the ferry (which was called Arahura) coz it was huge...equipped with a cinema, children's playroom, private lounge, cafe and convenient store...we departed at 1025H and our journey lasted aout 3 hours...i slept part of the way but as we were reaching Picton, Cam woke me up to see the beautiful scenery that surrounded us...so we went up the deck and took lots of pics of the lovely view...after that, we went to the cafe and bought some Rush Munro ice-cream...i had maple walnut while Cam ate hokey-pokey...soon after, it was time to disembark...
We checked-in our luggage through to Christchurch so we didn't have to lug our bags while walking to the train station in Picton...we had about 25 mins to get from the ferry terminal to the train station...our Tranzscenic train left at 1400H and we travelled about 5 1/2 hours before reaching Christchurch...we stopped in between...for views and all...there was a place we stopped which was called Kaikoura...it was famous for whale and dolphin watching...we went down for a while and almost missed our train...along the way we saw seals, sheep, cows on the field, snow-capped mountains and Lake Gressmer, which was New Zealand's main source of salt...the lake was huge and it was separated into squares...and there were also processing factories nearby where we saw heaps of salt...
We reached Christchurch at 1921H...by the time we got our luggage, the info counter was closed...and the last shuttle bus of the day has also left and the train master told us that it would take about 40 minutes to walk to the city centre...so this was the story of how Elena came to join us in our New Zealand trip...so while we were pondering on how to get to the city centre, a Spanish girl came and asked us if we wanted to share a cab...there was another poor helpless Japanese girl who was left behind as well...so the 4 of us shared a cab which cost us NZD20 and stopped at Cathedral Square...the Japanese girl then left us to meet up with her friends...so the 3 of us went to the visitor information centre where we sought help to find a place to stay for the night...unfortunately the Japanese girl there wasn't too helpful..so we tried our luck at some backpackers...BB's Backpacker was full..so we found a backpacker at Gloucester St called Stonehurst...Elena decided to join us to share a triple room with ensuite bathroom for NZD83 per night...which was a pretty good deal coz the room had a TV, coffee/tea drinking facility and it was cozy...about the nicest backpacker we've had by far...
Cam saw a sign on the way to our backpacker which read steak for NZD10 on Wednesday night...so these 2 starving ladies went to fill our stomachs with sumptious steak while Elena stayed back to eat her bread...Cam was doubly happy coz the waiter who was serving us was cute...so after a hearty dinner, we went back to the backpacker...Elena told us she booked her Queenstown to Auckland flight on Sunday (29/8/10)....coz earlier i told her that we'd be leaving Queenstown on Sunday thinking that Sunday was 30/8/10...Damn! due to my stupid mistake, we have caused Elena to book the wrong flight...coz initially she planned to leave Queenstown on Monday as well but i think when i told her that we were leaving on Sunday, she must have decided to travel with us...
So in the end, Cam and i decided to change our itinerary...so we wouldn't be staying an extra day in Christchurch...so we booked our bus to Mt Cook for the next day for NZD63 and then our bus from Mt Cook to Queenstown the day after for NZD78...we also booked our Milford Sound tour on 28/8/10 coz we were afraid there wouldn't be time to do so coz everything was pretty rushed...the tour cost NZD145...really thank God that the reception at our backpacker was this very nice lady who was willing to help us although it was quite late at night...her name was Catherine...
Since we weren't going to go around Christchurch, Cam wanted to go to Cathedral Square to take some photos...it was drizzling a bit...and the square was devoid of human beings except for us 3 girls...and it was bloody cold...we even took a picture of the tram stop since we weren't going to take the tram...so thanks to me, we didn't get to go for river punting, the tram and gondola ride...after we've had enough pics, we went back to the room, bathed and slept coz tomorrow was a full day ahead...
Thursday, September 23, 2010
Excuse me, i'm not your one-stop CBD insertion referral centre...
I don't know since when a urology MO has become the only MO who can insert CBD for patients who can't pass urine/ has swollen penis but apparently for the last few days, it has come to that...it's quite irritating to get referrals like that when there are hundred over patients in the clinic waiting to be reviewed...and as if i'm not seeing enough penises and scrotums per day in the clinic, i have to see them in other wards as well...
On Monday an MO from a particular ward called me up to help one of her patient who had bladder tumour and had acute urinary retention...she told me she tried inserting a size 16 urinary catheter but it wouldn't go in...so i went to see the patient...i tried size 18 and 20 but he probably had some anterior urethral stricture coz those sizes wouldn't pass through...i thought of inserting a cystofix but i couldn't even see which was the bladder proper from the ultrasound...so in the end i tried a size 14 and it passed through...phew!!! and i found out from the nurse that the MO didn't actually try inserting a urinary catheter on the patient...
On Wednesday, i got a call from the same MO...about the same patient...apparently his urinary catheter dislodged while he was sleeping...pretty amazing considering there was a water-filled balloon that prevents the catheter from getting dislodge and one would need to yank really hard and traumatize the urethra to get it out without deflating the balloon...i asked the MO to re-insert another size 14...she asked her nurse to call me back after 15 mins telling me she failed...fine! so i went to re-insert a catheter for the patient...couldn't get a size 14 in this time, so i tried a size 16...it went in easily...no resistance whatsoever...@#$#$%%^
The same afternoon, a Queen Casualty HO called me for CBD insertion...i had just left Queen earlier and had just reached SMC...reason for CBD insertion: to monitor urine output...patient was ventilated for APO...reason for difficult insertion: patient's penis is very oedematous...i asked the HO...did you try inserting it yourself...he said yes but failed...i asked if his MO tried and failed too...his answer, i quote "i don't think my MOs can insert a CBD becoz they haven't done it for a long time".... what the #$%$%&^*^&!!!?!!!
And an ortho HO referred a patient with generalized scrotal and penile swelling to me...patient has been practically bed-bound for a week...has low albumin...and he wants me to rule out scrotal infection....why do i keep getting referrals like that? when i was doing general surgery calls, i used to get referrals for scrotal swelling...now i'm i uro, i still get referrals for scrotal swelling...just wait till i'm back in general surgery...i will never see a scrotal swelling, ever again...
So i went to Queen Casualty after my rounds in SMC...i looked at the patient's penis...yea well, it was swollen...but i could still see the urethral meatus...no reason why any doctor who is not blind shouldn't be able to insert a urinary cathether for the patient...so i tried a size 14....there was only some mild resistance at the prostatic urethra which after some adjustment, the catheter was in the bladder...for goodness sake...i'm not a one-stop CBD insertion referral centre...
What is happening to the doctors these days? what? only uro MOs can insert CBD is it? if this continues, there will come a day when things get so bad that "refer to surgical MO for nasogastric tube insertion" becomes a routine...as it is, i've gotten 2 referrals "refer to surgical MO for proctoscopy"....as if we were never thought how to do a proctoscopy in medical school...oh Lord, give me strength to stay sane...this is really stretching my limit....
On Monday an MO from a particular ward called me up to help one of her patient who had bladder tumour and had acute urinary retention...she told me she tried inserting a size 16 urinary catheter but it wouldn't go in...so i went to see the patient...i tried size 18 and 20 but he probably had some anterior urethral stricture coz those sizes wouldn't pass through...i thought of inserting a cystofix but i couldn't even see which was the bladder proper from the ultrasound...so in the end i tried a size 14 and it passed through...phew!!! and i found out from the nurse that the MO didn't actually try inserting a urinary catheter on the patient...
On Wednesday, i got a call from the same MO...about the same patient...apparently his urinary catheter dislodged while he was sleeping...pretty amazing considering there was a water-filled balloon that prevents the catheter from getting dislodge and one would need to yank really hard and traumatize the urethra to get it out without deflating the balloon...i asked the MO to re-insert another size 14...she asked her nurse to call me back after 15 mins telling me she failed...fine! so i went to re-insert a catheter for the patient...couldn't get a size 14 in this time, so i tried a size 16...it went in easily...no resistance whatsoever...@#$#$%%^
The same afternoon, a Queen Casualty HO called me for CBD insertion...i had just left Queen earlier and had just reached SMC...reason for CBD insertion: to monitor urine output...patient was ventilated for APO...reason for difficult insertion: patient's penis is very oedematous...i asked the HO...did you try inserting it yourself...he said yes but failed...i asked if his MO tried and failed too...his answer, i quote "i don't think my MOs can insert a CBD becoz they haven't done it for a long time".... what the #$%$%&^*^&!!!?!!!
And an ortho HO referred a patient with generalized scrotal and penile swelling to me...patient has been practically bed-bound for a week...has low albumin...and he wants me to rule out scrotal infection....why do i keep getting referrals like that? when i was doing general surgery calls, i used to get referrals for scrotal swelling...now i'm i uro, i still get referrals for scrotal swelling...just wait till i'm back in general surgery...i will never see a scrotal swelling, ever again...
So i went to Queen Casualty after my rounds in SMC...i looked at the patient's penis...yea well, it was swollen...but i could still see the urethral meatus...no reason why any doctor who is not blind shouldn't be able to insert a urinary cathether for the patient...so i tried a size 14....there was only some mild resistance at the prostatic urethra which after some adjustment, the catheter was in the bladder...for goodness sake...i'm not a one-stop CBD insertion referral centre...
What is happening to the doctors these days? what? only uro MOs can insert CBD is it? if this continues, there will come a day when things get so bad that "refer to surgical MO for nasogastric tube insertion" becomes a routine...as it is, i've gotten 2 referrals "refer to surgical MO for proctoscopy"....as if we were never thought how to do a proctoscopy in medical school...oh Lord, give me strength to stay sane...this is really stretching my limit....
Saturday, September 18, 2010
NZ trip - Day 4
After a most suffering night on the bus, we made it to Wellington at 7am...feeling like a zonked out zombie...the bus stopped us at the train station...so we brushed teeth and freshened up in the toilet...then we went for breakfast at the cafe...had an Italian beef pie and hot chocolate with marshmallow....ahhhh..a warm meal to a bloody cold day...it was probably 8-9 degrees Celsius and it's cold even in the train station...we waited for our tour pick-up...we were going for the LOTR 1/2 day tour which we booked with Rover Tour...our guide Randall came on time and Cam and i were the only tourists of the day...
So off we started our tour...Wellington reminded me of Sydney/ HK...there were lots of houses on the hill...and practically everywhere faces the sea....Randall drove us to Mt Victoria...at the lookout, it was drizzling a bit...and we saw a double rainbow...it felt like a good start to a good day...then we went to the forest reserve where the 1st few opening scenes of "Fellowship of the Ring" were filmed...one was called "Shortcut to Mushroom" where Frodo, Sam, Merry and Pippin were running through a maze field and fell off a slope...followed by the "Get out of the Road" scene where Frodo sensed the Nazgul was approaching....and there was also a scene in the extended version where Frodo was sitting on a tree nook smoking his pipe while Sam was cooking bacon...Cam and i took turns to act out the scene for photo shoot...hehe...
Then we went round the Oriental Bay where there were lovely houses perched on hills...saw another dream house which was perched on a corner of the hill almost by itself...it was a mocha coloured double storey bungalow...beautiful exterior...and location...and i imagine the view from the house would be just amazing...unfortunately i didn't get a photo of it...
Randall drove us to the other side of the city where the Hutt River runs...scenes on River Anduin and River Rohan were shot on Hutt River...then we went to Kaitoke Regional Park where Rivendell was set up...the temperate forest really have the Rivendell feel...Randall made us put on a cloak and fake elf ears and hold a fake Legolas sword...then we posed for pics...posing for the pics was really funny...Cam found it really lame...but i had fun...we also walked the Swing bridge...and had morning tea there where we fed the mallard ducks with blueberry muffins...
After that, our tour was over...but Randall was very kind..he dropped us back at Downtown Backpackers to check-in...he said he was staying in one of the rooms there too...he helped to clean out the kitchen to reduce his rent...after that, he took us to Wellywood (NZ's version of Hollywood)... we saw the production warehouses where the likes of Peter Jackson film and produce their movies...we also visited the Weta Cave....saw a lots of collectibles for LOTR, the Chronicles of Narnia, King Kong etc...thought of buying the 'Ring' or Arwen's pendant...but they were so expensive...
Randall then took us back to our backpacker...we got a twin bunk with shared bathroom for NZD60 per night...the room was pretty old but at least it was clean...we were pretty tired but we still continued exploring Wellington...we walked along Queen's Wharf towards Te Papa Museum...totally dragged ourselves through the floors for about 2 hours...the exhibitions and displays were good...but i think we were too worn out to appreciated them...so we decided to have dinner...Randall told us Viggo Mortensen and the other LOTR cast stayed in Duxton Hotel and Viggo liked having lunch at the Green Parrot Cafe...we wanted to have dinner there but the food was a bit expensive...so we walked further down the road and found Pizzeria Napoli where we had Pizza Garibaldi for NZD18 and calamari fritti for NZD5...it was quite a good deal...the pizza was great...
Randall also told us we should catch a movie at the Embassy Theatre at Courtney Place which has the largest screen and hall in NZ (fills about 800 ppl)...initially we wanted to watch 'Inception' at 845pm but we were exhausted...but it was really a waste coz it's a must-do thing in Wellington..and Wednesday night was movie night so the tickets were NZD10 only...but i think we would have ended up sleeping in the cinema if we went...so we went back to our hostel and bathed...ate our kiwis at the dining room...then went out to see the night harbour view...the moon was full that night... so asked Cam to take a pic of me looking at the moon...
Since we were wearing slippers only and it was damn cold, we decided to get back into the warmth but then Cam realized she lost her camera cover...so we had to go out and hunt for it again...guess she must have dropped it when she squatted to take my moon pic...thank God we found it...then we came back to the room...talked a bit and slept really soundly...
So off we started our tour...Wellington reminded me of Sydney/ HK...there were lots of houses on the hill...and practically everywhere faces the sea....Randall drove us to Mt Victoria...at the lookout, it was drizzling a bit...and we saw a double rainbow...it felt like a good start to a good day...then we went to the forest reserve where the 1st few opening scenes of "Fellowship of the Ring" were filmed...one was called "Shortcut to Mushroom" where Frodo, Sam, Merry and Pippin were running through a maze field and fell off a slope...followed by the "Get out of the Road" scene where Frodo sensed the Nazgul was approaching....and there was also a scene in the extended version where Frodo was sitting on a tree nook smoking his pipe while Sam was cooking bacon...Cam and i took turns to act out the scene for photo shoot...hehe...
Then we went round the Oriental Bay where there were lovely houses perched on hills...saw another dream house which was perched on a corner of the hill almost by itself...it was a mocha coloured double storey bungalow...beautiful exterior...and location...and i imagine the view from the house would be just amazing...unfortunately i didn't get a photo of it...
Randall drove us to the other side of the city where the Hutt River runs...scenes on River Anduin and River Rohan were shot on Hutt River...then we went to Kaitoke Regional Park where Rivendell was set up...the temperate forest really have the Rivendell feel...Randall made us put on a cloak and fake elf ears and hold a fake Legolas sword...then we posed for pics...posing for the pics was really funny...Cam found it really lame...but i had fun...we also walked the Swing bridge...and had morning tea there where we fed the mallard ducks with blueberry muffins...
After that, our tour was over...but Randall was very kind..he dropped us back at Downtown Backpackers to check-in...he said he was staying in one of the rooms there too...he helped to clean out the kitchen to reduce his rent...after that, he took us to Wellywood (NZ's version of Hollywood)... we saw the production warehouses where the likes of Peter Jackson film and produce their movies...we also visited the Weta Cave....saw a lots of collectibles for LOTR, the Chronicles of Narnia, King Kong etc...thought of buying the 'Ring' or Arwen's pendant...but they were so expensive...
Randall then took us back to our backpacker...we got a twin bunk with shared bathroom for NZD60 per night...the room was pretty old but at least it was clean...we were pretty tired but we still continued exploring Wellington...we walked along Queen's Wharf towards Te Papa Museum...totally dragged ourselves through the floors for about 2 hours...the exhibitions and displays were good...but i think we were too worn out to appreciated them...so we decided to have dinner...Randall told us Viggo Mortensen and the other LOTR cast stayed in Duxton Hotel and Viggo liked having lunch at the Green Parrot Cafe...we wanted to have dinner there but the food was a bit expensive...so we walked further down the road and found Pizzeria Napoli where we had Pizza Garibaldi for NZD18 and calamari fritti for NZD5...it was quite a good deal...the pizza was great...
Randall also told us we should catch a movie at the Embassy Theatre at Courtney Place which has the largest screen and hall in NZ (fills about 800 ppl)...initially we wanted to watch 'Inception' at 845pm but we were exhausted...but it was really a waste coz it's a must-do thing in Wellington..and Wednesday night was movie night so the tickets were NZD10 only...but i think we would have ended up sleeping in the cinema if we went...so we went back to our hostel and bathed...ate our kiwis at the dining room...then went out to see the night harbour view...the moon was full that night... so asked Cam to take a pic of me looking at the moon...
Since we were wearing slippers only and it was damn cold, we decided to get back into the warmth but then Cam realized she lost her camera cover...so we had to go out and hunt for it again...guess she must have dropped it when she squatted to take my moon pic...thank God we found it...then we came back to the room...talked a bit and slept really soundly...
Thursday, September 16, 2010
Happy Malaysia Day!!!
Had a good call last night...thank God for His mercy....totally slept from 1130pm till 8am this morning... and amazingly, no calls...finally got up about 1030am to bathe....then went to K-box to meet Elaine for our Chinese lessons...asked Grace but she was tired from her call last night...so she didn't join us... we had lunch at K-box and sang for about 2 hours plus...sang some new songs...like JJ Lin's 一个又一个 , 神木與瞳's 宽恕, 好想为你哭, 王力宏's 材米油盐酱醋茶....but they didn't have his 你不知道的事...
After that, i came home and tried sleeping some more...but kept waking up...so decided to wake up... saw my boss online so was chatting with him...guess he was having a good call since he could be at home online...hehe...was feeling hungry by about 6pm...so had a stick of chocolate...and messaged Sharon if she was free for dinner...she was...so we went to Fruit Monster at Lintas...haven't met her for about 2 months de...so it was good to catch up...i was basically complaining about work...and she said i was scaring her into not coming back to work...hehe...
She told me she had a dream about me having a baby...i was like, weird...so i asked if my baby was brown...and she said it was a boy...and he looked like a Chindian...and she was carrying the baby and saying "he looks so cute"...good, guess he took after me then...hahaha...and i asked her, i don't suppose there was a 'husband' by my side...and she said, yea there wasn't...i hope her dream isn't prophetic...but funny thing was, i was thinking that if it did happen, then it wasn't a bad thing after all...i got my baby...it may be difficult to be a single mother...so i don't need a man who would add to my misery...Sharon's lucky to have Pang...he's a good husband and father...who loves his wife and would do the housework to help Sharon out at home...
Oh well, guess it's que sera sera...Happy Malaysia Day!!! tomorrow i'm on call again...
After that, i came home and tried sleeping some more...but kept waking up...so decided to wake up... saw my boss online so was chatting with him...guess he was having a good call since he could be at home online...hehe...was feeling hungry by about 6pm...so had a stick of chocolate...and messaged Sharon if she was free for dinner...she was...so we went to Fruit Monster at Lintas...haven't met her for about 2 months de...so it was good to catch up...i was basically complaining about work...and she said i was scaring her into not coming back to work...hehe...
She told me she had a dream about me having a baby...i was like, weird...so i asked if my baby was brown...and she said it was a boy...and he looked like a Chindian...and she was carrying the baby and saying "he looks so cute"...good, guess he took after me then...hahaha...and i asked her, i don't suppose there was a 'husband' by my side...and she said, yea there wasn't...i hope her dream isn't prophetic...but funny thing was, i was thinking that if it did happen, then it wasn't a bad thing after all...i got my baby...it may be difficult to be a single mother...so i don't need a man who would add to my misery...Sharon's lucky to have Pang...he's a good husband and father...who loves his wife and would do the housework to help Sharon out at home...
Oh well, guess it's que sera sera...Happy Malaysia Day!!! tomorrow i'm on call again...
NZ trip - Day 3
We woke up at 735am to get ready...then we went to the isite at 8am to book a rented car...we managed to get a car from Budget Rental Car for the day...cost us NZD70.00 for the day...GPS another NZD12.00...when we went to collect the car, we were whooping with delight to find the car of the day was a grey Mazda 3X...we thought we'd be getting an old small car...hehe...Cam was the driver of the day...she was so excited to drive...
Our first stop was the Wai-O-Tapu Thermal Wonderland which was about 45 mins from Rotorua... we walked around the reserve, which reeked of hydrogen sulphide...but otherwise, the place was pretty amazing...it was all misty with yellow smoke escaping from fumaroles...there were craters which were named Devil's Home, Thunder Crater, Rainbow Crater, Birdnest Crater etc...there was a Champagne Pool...a Bridal Veil Falls...Primrose Terrace...a Devil's Bath which was a small lake containing a funky green colour water...the whole place was really colourful...mixture of yellow, orange, brown, green... unfortunately we were rushing for time to catch the Lady Knox Geyser which was erupting at 1015am...
So we didn't manage to walk the whole reserve...about 1005am we rushed to our car only to find the place where we parked our car was locked...shit!!! it was our fault really coz the place was the staff parking...hehe...good thing we managed to find the guy to unlock the gate...so we made it in time for the Lady Knox Geyser eruption...it was really cool...apparently some guy found out that you can induce a geyser eruption by dropping a bar of soap into the geyser...so the guy demonstrated to us by dropping a pack of surfactant into the geyser....about 2 minutes later, the geyser started erupting...and swoosh!!! the eruption went as high as about 30 metres i think...after that, we went to some mud pools...of course we didn't get any mud bath...coz the place was boiling...blub, blub, blub...
Next stop was Lake Taupo...which was about an hour's drive away...we reached there about lunch time...there was nothing much there except for the lake...unless you were doing all the extreme sports like bungy jumping...we were rushing to Waitomo which was about 2 hours drive...so we ta pau a Subway Pork Riblet foot-long sandwich to eat on the way...i shared with Jeanne coz Cam ate the ham and cheese sandwich i made for our breakfast...so we were kinda doing the amazing race drive when halfway through Jeanne popped the question: Are we on the right track?...and suddenly everyone paused...and doubt crept into everyone's mind...and so Cam actually stopped by the roadside to check the GPS...of course we were on the right track...so phew!!!
We reached Waitomo with just 10 minutes to spare for our tour at the Waitomo Cave...we stopped at the Long Black Cafe to ask where to meet for the Waitomo Cave tour...took a toilet break there coz i had been holding my bladder for the past 2 hours...then we drove a bit further down the road and made it just in time for our 220pm tour...the tour took about 45 minutes...and our guide showed us the stalactites and stalacmites with odd designs...the highlight was when we went for a boat ride in the cave and saw thousands of glow worms on the cave ceiling...they were like stars in the sky.... really amazing!!!
Then we drove back to the Long Black Cafe to wait for our pick-up to Ruakuri Cave...our guide's name was Lucas, who was probably a Maori mixed Kiwi...he told us Ruakuri means 'two dogs'... Cam and Jeanne had the hots for him...kept calling him 'leng chai, leng chai, leng chai'...hehe...he had too much beard for my liking...the cave was cool (and freaking cold)...we had to walk down a spiral landing to get to the entrance of the cave...and the entrance to the cave is a futuristic, space-ship like hallway...we saw more glow worms...and more upclose too..and this time we could take photos of them...and we even saw the actual look of a glow worm...it wasn't too pretty...after about 2 hours walk in the cave, it was time to go...Lucas told us earlier that the acoustic at the spiral landing was great...so as we were walking up, at Jeanne's request, i sang "Wonderful Tonight"...really, the acoustic was great...it actually made me sound good...there was another elderly Caucasian couple with us on the tour...and the guy actually commented that "he felt like he was in heaven"...hahaha, i'm not going to read too much into it and will just take it as a compliment...
It was dinner time...so we stopped by at McDonald's before we started our drive back to Rotorua... i had a bacon and BBQ burger...they didn't have chilli sauce so we had honey mustard sauce instead...which was quite yummy...Jeanne drove the way back...at one T-junction, the GPS didn't show the way to turn and we kinda panicked a while...but we managed to reach Rotorua without getting lost despite the GPS bringing us through small roads...we went back to the YHA and bathed...Jeanne was staying another night at Rotorua before going back to Auckland...she stayed in a 4-bedded dorm...there were 2 Japanese girls and another black girl from London whose name was Naomi...
We found out that she had been travelling in Australia and NZ since November 2009...she even shared about how she got conned by a MoneyGram scam...she would be visiting Malaysia before going back to London...ahh...how nice...i wish i could be travelling that long...Cam and i drove the car back to the car rental place and dropped the keys...then we waited for our InterCity bus from Rotorua to Wellington which was scheduled to leave at 1125pm...the bus was actually late...so we went to a nearby backpacker to use the toilet before we boarded the bus...there was another guy waiting for the bus as well and he actually asked us if he missed the bus...like we would know... anyway, the bus ride was quite a horrible one as we hardly slept at all coz the seat couldn't fully recline and it was cold...but we made it to Wellington anyhow...
Our first stop was the Wai-O-Tapu Thermal Wonderland which was about 45 mins from Rotorua... we walked around the reserve, which reeked of hydrogen sulphide...but otherwise, the place was pretty amazing...it was all misty with yellow smoke escaping from fumaroles...there were craters which were named Devil's Home, Thunder Crater, Rainbow Crater, Birdnest Crater etc...there was a Champagne Pool...a Bridal Veil Falls...Primrose Terrace...a Devil's Bath which was a small lake containing a funky green colour water...the whole place was really colourful...mixture of yellow, orange, brown, green... unfortunately we were rushing for time to catch the Lady Knox Geyser which was erupting at 1015am...
So we didn't manage to walk the whole reserve...about 1005am we rushed to our car only to find the place where we parked our car was locked...shit!!! it was our fault really coz the place was the staff parking...hehe...good thing we managed to find the guy to unlock the gate...so we made it in time for the Lady Knox Geyser eruption...it was really cool...apparently some guy found out that you can induce a geyser eruption by dropping a bar of soap into the geyser...so the guy demonstrated to us by dropping a pack of surfactant into the geyser....about 2 minutes later, the geyser started erupting...and swoosh!!! the eruption went as high as about 30 metres i think...after that, we went to some mud pools...of course we didn't get any mud bath...coz the place was boiling...blub, blub, blub...
Next stop was Lake Taupo...which was about an hour's drive away...we reached there about lunch time...there was nothing much there except for the lake...unless you were doing all the extreme sports like bungy jumping...we were rushing to Waitomo which was about 2 hours drive...so we ta pau a Subway Pork Riblet foot-long sandwich to eat on the way...i shared with Jeanne coz Cam ate the ham and cheese sandwich i made for our breakfast...so we were kinda doing the amazing race drive when halfway through Jeanne popped the question: Are we on the right track?...and suddenly everyone paused...and doubt crept into everyone's mind...and so Cam actually stopped by the roadside to check the GPS...of course we were on the right track...so phew!!!
We reached Waitomo with just 10 minutes to spare for our tour at the Waitomo Cave...we stopped at the Long Black Cafe to ask where to meet for the Waitomo Cave tour...took a toilet break there coz i had been holding my bladder for the past 2 hours...then we drove a bit further down the road and made it just in time for our 220pm tour...the tour took about 45 minutes...and our guide showed us the stalactites and stalacmites with odd designs...the highlight was when we went for a boat ride in the cave and saw thousands of glow worms on the cave ceiling...they were like stars in the sky.... really amazing!!!
Then we drove back to the Long Black Cafe to wait for our pick-up to Ruakuri Cave...our guide's name was Lucas, who was probably a Maori mixed Kiwi...he told us Ruakuri means 'two dogs'... Cam and Jeanne had the hots for him...kept calling him 'leng chai, leng chai, leng chai'...hehe...he had too much beard for my liking...the cave was cool (and freaking cold)...we had to walk down a spiral landing to get to the entrance of the cave...and the entrance to the cave is a futuristic, space-ship like hallway...we saw more glow worms...and more upclose too..and this time we could take photos of them...and we even saw the actual look of a glow worm...it wasn't too pretty...after about 2 hours walk in the cave, it was time to go...Lucas told us earlier that the acoustic at the spiral landing was great...so as we were walking up, at Jeanne's request, i sang "Wonderful Tonight"...really, the acoustic was great...it actually made me sound good...there was another elderly Caucasian couple with us on the tour...and the guy actually commented that "he felt like he was in heaven"...hahaha, i'm not going to read too much into it and will just take it as a compliment...
It was dinner time...so we stopped by at McDonald's before we started our drive back to Rotorua... i had a bacon and BBQ burger...they didn't have chilli sauce so we had honey mustard sauce instead...which was quite yummy...Jeanne drove the way back...at one T-junction, the GPS didn't show the way to turn and we kinda panicked a while...but we managed to reach Rotorua without getting lost despite the GPS bringing us through small roads...we went back to the YHA and bathed...Jeanne was staying another night at Rotorua before going back to Auckland...she stayed in a 4-bedded dorm...there were 2 Japanese girls and another black girl from London whose name was Naomi...
We found out that she had been travelling in Australia and NZ since November 2009...she even shared about how she got conned by a MoneyGram scam...she would be visiting Malaysia before going back to London...ahh...how nice...i wish i could be travelling that long...Cam and i drove the car back to the car rental place and dropped the keys...then we waited for our InterCity bus from Rotorua to Wellington which was scheduled to leave at 1125pm...the bus was actually late...so we went to a nearby backpacker to use the toilet before we boarded the bus...there was another guy waiting for the bus as well and he actually asked us if he missed the bus...like we would know... anyway, the bus ride was quite a horrible one as we hardly slept at all coz the seat couldn't fully recline and it was cold...but we made it to Wellington anyhow...
Tuesday, September 14, 2010
Weird dream...
Dreamland is a treacherous water to tread on...ppl say that's where your subconscious desire is awakened...but is it really? for the longest time i haven't been dreaming...or at least if i did, it wasn't weird enough to spook me into remembering it...but this morning i woke up from a weird dream... i dreamt that i got back together with my ex...the good ex...ok, so you're thinking, that's not weird...in fact it's quite normal...it's just that i found it weird coz before i fell asleep last night, i was thinking of 2 different guys...neither one was my good ex...so how on earth did my good ex appeared in my dream?
Hmmm, so does it mean that subconsciously, that's what i want? but i don't even think about getting back together with him during my waking hours...even though i'll be seeing him more often nowadays since he's back in town...and he's already dating someone else anyway...and i'm not even heartbroken about that...or has my heart learn how to lie to my mind so well that my mind can't even tell that my heart is lying? or is it the other way round? can your mind and heart really be dichotomized? sigh...i'm so screwed up....
Just saw my ex-roommate Sharan's FB status update...i quote: Today I asked John if he wanted to buy a Dreamcatcher for the bike. He said "No dear, i don't need a Dreamcatcher anymore since i already caught my dream, i caught you". awwwwwwwwwwwwwwwwwwww (but i think he didnt want to spend money lah thats why)...quote end...hehe, that's so sweet and cute...so happy for her that she's happily married now...but can't help wondering when i'll catch my dream...if at all...
Hmmm, so does it mean that subconsciously, that's what i want? but i don't even think about getting back together with him during my waking hours...even though i'll be seeing him more often nowadays since he's back in town...and he's already dating someone else anyway...and i'm not even heartbroken about that...or has my heart learn how to lie to my mind so well that my mind can't even tell that my heart is lying? or is it the other way round? can your mind and heart really be dichotomized? sigh...i'm so screwed up....
Just saw my ex-roommate Sharan's FB status update...i quote: Today I asked John if he wanted to buy a Dreamcatcher for the bike. He said "No dear, i don't need a Dreamcatcher anymore since i already caught my dream, i caught you". awwwwwwwwwwwwwwwwwwww (but i think he didnt want to spend money lah thats why)...quote end...hehe, that's so sweet and cute...so happy for her that she's happily married now...but can't help wondering when i'll catch my dream...if at all...
Sunday, September 12, 2010
NZ trip - Day 2
Despite staying up late into the night with our girls talk, we managed to drag ourselves to wake up at 7am...we quickly got ready and lugged our luggage to the bus station...Cam, Jeanne and I were taking the 8am Nakedbus to Rotorua...needless to say, i slept most of the 4 hours-journey...totally missed whatever great view there was along the way...we went to the isite in Rotorua to book our tickets for the Mitai Village tour, YHA room and the LOTR tour in Wellington...we then left out luggage at the YHA (Jeanne was a bit pissed off at the reception guy coz he was quite rude) and started exploring the town...
We went to the Rotorua Museum which used to be a bath house...the building was quite Victorian...filled with cubicles of bath...apparently they used 2 types of water i.e. alkaline and free acid water which were claimed to have healing properties...the whole place reeked of hydrogen sulphide...whew!!! we saw a 20 minutes documentary about Rotorua and its volcanic eruption and the seats actually moved and shook when they showed the part on the volcanic eruption...that kinda kept Cam and i awake...then we watched another 30 minutes documentary about the 28 Maori Battalion...hehe, Cam and i totally fell asleep...we also went up to the roof which offered a great view of the town...tried to take lots of pictures but it was too windy to stay up there too long...
We went back to the YHA to check in at about 5pm..our triple room cost nzd93 per night...then waited for our pick-up to the Mitai Village for a night of Maori experience...that cost us NZD99 per person...by the time we got to the Mitai Village, we were quite hungry...but dinner was only served after the Maori performance...so we had to settle for our free drink to keep us from getting hypoglycaemic...our host was a very lively and interesting guy who told us that the Maori language has a lot of similiarities with the Malay language...how interesting...he showed us our Hangi dinner... a traditional way of roasting meat such as chicken, beef and lamb and potatoes and kumaras (sweet potatoes) over really really burning hot stones...gosh, that got me even hungrier...
Then we went to the river to watch the Maoris coming in their canoe...and watched the cultural performance...finally it was dinner time...and it was a buffet dinner...yipeee!!! they had chicken, beef, lamb, potatoes, kumara, salad and truffles and chocolate log for dessert...totally loaded on the lamb and kumaras...they were so yummy...after dinner, we had a bush-walk around the village...saw some glow worms...saw the source of the village water spring...actually drank a bit from it too...the host showed us a rainbow trout but i could hardly see its colours in the dark...after that, we were sent back to our YHA...had a nice warm shower in the common bathroom...then after talking a bit, all of us fell asleep...
We went to the Rotorua Museum which used to be a bath house...the building was quite Victorian...filled with cubicles of bath...apparently they used 2 types of water i.e. alkaline and free acid water which were claimed to have healing properties...the whole place reeked of hydrogen sulphide...whew!!! we saw a 20 minutes documentary about Rotorua and its volcanic eruption and the seats actually moved and shook when they showed the part on the volcanic eruption...that kinda kept Cam and i awake...then we watched another 30 minutes documentary about the 28 Maori Battalion...hehe, Cam and i totally fell asleep...we also went up to the roof which offered a great view of the town...tried to take lots of pictures but it was too windy to stay up there too long...
We went back to the YHA to check in at about 5pm..our triple room cost nzd93 per night...then waited for our pick-up to the Mitai Village for a night of Maori experience...that cost us NZD99 per person...by the time we got to the Mitai Village, we were quite hungry...but dinner was only served after the Maori performance...so we had to settle for our free drink to keep us from getting hypoglycaemic...our host was a very lively and interesting guy who told us that the Maori language has a lot of similiarities with the Malay language...how interesting...he showed us our Hangi dinner... a traditional way of roasting meat such as chicken, beef and lamb and potatoes and kumaras (sweet potatoes) over really really burning hot stones...gosh, that got me even hungrier...
Then we went to the river to watch the Maoris coming in their canoe...and watched the cultural performance...finally it was dinner time...and it was a buffet dinner...yipeee!!! they had chicken, beef, lamb, potatoes, kumara, salad and truffles and chocolate log for dessert...totally loaded on the lamb and kumaras...they were so yummy...after dinner, we had a bush-walk around the village...saw some glow worms...saw the source of the village water spring...actually drank a bit from it too...the host showed us a rainbow trout but i could hardly see its colours in the dark...after that, we were sent back to our YHA...had a nice warm shower in the common bathroom...then after talking a bit, all of us fell asleep...
Saturday, September 11, 2010
Yes, i know the patient needs blood...but i can't produce blood magically...
So yea, selamat hari raya to everyone...while everyone was happily eating their lemang and rendang yesterday, i was on call...and it was one heck of a call...as if my pre-call bad day was a prelude to an even worse one during my call...Yap and i were in the OT the whole day clearing up the leftover cases from the day before...a laparotomy with bowel resection, an open cholecystectomy, an I & D, 2 perforated appendix...don't ask me why we took so long, but we just did...and halfway through had to go ICU coz one patient died..what did i tell you eh? at least one death per call...
And as if that wasn't enough, i had to settle the uro patients....and there was a liver abscess patient in sepsis who was unstable...and the nephro ppl totally set my nerves off...they sent 2 patients from their ward to our side for Tenchkoff catheter insertion the following day...and the HO on call informed me that one of the patient's femoral CVC was removed in the morning because there was pus discharge from the insertion site...which was fine...it should be removed...but the least the nephro ppl could do was to bloody reinsert one and bloody dialyse the patient before they sent the patient over...patient's potassium was 6.1 and he was supposed to be for operation the next day...really, what were they thinking? expecting the surgery MO on call to settle their crap? well, they chose a bloody wrong day and person to mess with...so i asked the HO to call the nephro MO to settle their own crap...seriously, i should write a complain letter to the Head of Nephrology Unit and Medical Department to tell them how irresponsible their bloody MOs are...since my big boss has been telling me that the medical MOs have been writing him a lot of 'love letters' regarding our surgical MOs...
We finally took a break at about 10pm plus for the first meal of the day...by then i was just so hungry and grumpy and ready to faint...thank God the OT call HO belanja us at Upper Star (coz i taught her how to do appendicectomy)...i had lamb chop...felt like the best lamb chop ever coz i was raving mad hungry...then we had to rush back to OT coz there was still another appendicectomy...which i asked Yap to teach the OT call HO coz i didn't think i was in the right state of mind to teach...and we were expecting a 25 year-old guy from Hospital Kota Marudu who had an MVA and his Hb dropped from 11.9 to 2...we thought it would be a miracle for him to survive the 2 hours plus journey to KK...
But arrived he did...the casualty MO in SMC called me about 2am to inform me that the patient has arrived...when i saw him, his BP was 84/47 mmHg with pulse rate of 130...pale as sheet...abdomen was distended and tense...they scanned him in Kota Marudu and saw free fluid in abdomen...so i called boss on call and informed him...he asked to post the patient immediately for exploratory laparotomy and proceed...the patient had 3 pints of packed cell from Kota Marudu, one of which was transfused on the way...2 of which we started transfusing while he was in the casualty enroute to OT...we crossmatched more blood but could only get 3 pints from SMC...but we couldn't wait longer...so we started surgery at 245am...the 3 pints blood we had were quickly consumed...
Big boss was called in...patient's right liver lobe, right kidney and adrenal were totally smashed and bleeding profusely...they removed the right lobe of his liver, his right kidney and adrenal...surgery took about 3 hours plus...i was scrubbed in initially but as the blood seem to be taking forever to materialize, so i had to unscrub...and produce blood magically...although it was post-fasting month and the blood banks are low on blood stock...so i had to ask the runner HO to go to Queen to get blood...they could only give us 6 more pints...and a DIVC cycle...they took about an hour to get the blood back to OT...and while then i was helping the GA side to put up the IV drips, give medications...and i was getting scolded from the GA specialist on call for not getting the blood fast enough...and i didn't like the way she was implying that the surgical team wasn't controlling the bleeding fast enough...
The thing was, i agree that the blood wasn't coming fast enough...and that we weren't fast enough in controlling the bleeding...but in case that specialist didn't notice, i'm not God...i can't just snap my fingers and 20 pints of blood would appear instantaneously....big boss is not God...he can't just lay his hands on the patient and heal the patient...considering that he did a right liver lobectomy, right nephrectomy and adrenalectomy in about 2 hours plus, that's quite amazing already...though i must commend that the GA specialist did well on her side to keep the patient alive...anyway, i guess it's God's will that this patient survived the operation...he had a total of 12-13 pints of packed cell transfusion, 1 DIVC cycle and another 6 units of fresh frozen plasma...
Patient was sent to ICU post-op...and until 8am this morning, no one called to inform me that the patient has died...so i assume he would live...big boss asked me in the OT during the operation if i still want to do surgery after this...i told him, if i were the GA MO, i would still be awake while the operation is being done...what i didn't say was the only difference is that as a surgical MO, i can be ordered around by the GA MO/specialist to produce blood magically, whereas as a GA MO, i can order the surgical MO/HO to do the impossible...sigh, i'm just so tired...and tomorrow i'm on call again...and ppl still watch Grey's Anatomy/House/ER and think being a doctor is so cool...hahahaha...
And as if that wasn't enough, i had to settle the uro patients....and there was a liver abscess patient in sepsis who was unstable...and the nephro ppl totally set my nerves off...they sent 2 patients from their ward to our side for Tenchkoff catheter insertion the following day...and the HO on call informed me that one of the patient's femoral CVC was removed in the morning because there was pus discharge from the insertion site...which was fine...it should be removed...but the least the nephro ppl could do was to bloody reinsert one and bloody dialyse the patient before they sent the patient over...patient's potassium was 6.1 and he was supposed to be for operation the next day...really, what were they thinking? expecting the surgery MO on call to settle their crap? well, they chose a bloody wrong day and person to mess with...so i asked the HO to call the nephro MO to settle their own crap...seriously, i should write a complain letter to the Head of Nephrology Unit and Medical Department to tell them how irresponsible their bloody MOs are...since my big boss has been telling me that the medical MOs have been writing him a lot of 'love letters' regarding our surgical MOs...
We finally took a break at about 10pm plus for the first meal of the day...by then i was just so hungry and grumpy and ready to faint...thank God the OT call HO belanja us at Upper Star (coz i taught her how to do appendicectomy)...i had lamb chop...felt like the best lamb chop ever coz i was raving mad hungry...then we had to rush back to OT coz there was still another appendicectomy...which i asked Yap to teach the OT call HO coz i didn't think i was in the right state of mind to teach...and we were expecting a 25 year-old guy from Hospital Kota Marudu who had an MVA and his Hb dropped from 11.9 to 2...we thought it would be a miracle for him to survive the 2 hours plus journey to KK...
But arrived he did...the casualty MO in SMC called me about 2am to inform me that the patient has arrived...when i saw him, his BP was 84/47 mmHg with pulse rate of 130...pale as sheet...abdomen was distended and tense...they scanned him in Kota Marudu and saw free fluid in abdomen...so i called boss on call and informed him...he asked to post the patient immediately for exploratory laparotomy and proceed...the patient had 3 pints of packed cell from Kota Marudu, one of which was transfused on the way...2 of which we started transfusing while he was in the casualty enroute to OT...we crossmatched more blood but could only get 3 pints from SMC...but we couldn't wait longer...so we started surgery at 245am...the 3 pints blood we had were quickly consumed...
Big boss was called in...patient's right liver lobe, right kidney and adrenal were totally smashed and bleeding profusely...they removed the right lobe of his liver, his right kidney and adrenal...surgery took about 3 hours plus...i was scrubbed in initially but as the blood seem to be taking forever to materialize, so i had to unscrub...and produce blood magically...although it was post-fasting month and the blood banks are low on blood stock...so i had to ask the runner HO to go to Queen to get blood...they could only give us 6 more pints...and a DIVC cycle...they took about an hour to get the blood back to OT...and while then i was helping the GA side to put up the IV drips, give medications...and i was getting scolded from the GA specialist on call for not getting the blood fast enough...and i didn't like the way she was implying that the surgical team wasn't controlling the bleeding fast enough...
The thing was, i agree that the blood wasn't coming fast enough...and that we weren't fast enough in controlling the bleeding...but in case that specialist didn't notice, i'm not God...i can't just snap my fingers and 20 pints of blood would appear instantaneously....big boss is not God...he can't just lay his hands on the patient and heal the patient...considering that he did a right liver lobectomy, right nephrectomy and adrenalectomy in about 2 hours plus, that's quite amazing already...though i must commend that the GA specialist did well on her side to keep the patient alive...anyway, i guess it's God's will that this patient survived the operation...he had a total of 12-13 pints of packed cell transfusion, 1 DIVC cycle and another 6 units of fresh frozen plasma...
Patient was sent to ICU post-op...and until 8am this morning, no one called to inform me that the patient has died...so i assume he would live...big boss asked me in the OT during the operation if i still want to do surgery after this...i told him, if i were the GA MO, i would still be awake while the operation is being done...what i didn't say was the only difference is that as a surgical MO, i can be ordered around by the GA MO/specialist to produce blood magically, whereas as a GA MO, i can order the surgical MO/HO to do the impossible...sigh, i'm just so tired...and tomorrow i'm on call again...and ppl still watch Grey's Anatomy/House/ER and think being a doctor is so cool...hahahaha...
Thursday, September 9, 2010
Today is the first time i ever felt like quitting...for real...
I got transferred to a new rotation after i got back from a great holiday...i've always hated that unit even as a HO...you know how when you come back from a real high to a real low? that's like a great height to fall from...and today is the first time i ever felt like quitting..for real..one of our patient, a 15 year-old girl with history of cancer was admitted for ascites...we drained out about 1.5L from her abdomen 2 days ago...she felt better....this afternoon, when i was about to do my pm round, the nurse informed my HO that the patient's blood pressure dropped drastically...so the HO told me and we went to check on the patient...
So i gave her fluids...and do the necessary investigations...she looked quite drowsy and ill...i told my colleague who in turn told my consultant (who happened to come for pm round)...i thought he'd come to see the patient...but he didn't...my colleague came to help but as she was on call, she had to go to OT for a case...so i was resuscitating the patient with the help of the nurses and 2 HOs...we put in a central venous line...put in a urinary catheter to monitor her urine...tapped her abdomen coz it was so grossly distended and tense...by the time we did all these, it was after 6pm...
I was about to go home and wanted to have a last look at the patient to make sure she was ok...that was when i noticed she suddenly became unresponsive and looked like she was having a tonic fit... had to intubate her immediately...but of course, since this was in the ward, immediately took like forever...and the on call HO in-charge of my patient was an ultra-imbecile...thank God the other 2 on call HOs who were helping me were capable...i think Murphy's law was at work today...whatever that could go wrong, did...
I was in the ward till 830pm plus...we did CPR 3 times for the patient...shocked her twice...overloaded her...she went into acute renal failure...i just couldn't save her...she couldn't even live to celebrate Hari Raya tomorrow...i didn't watch her die...i left the hospital after ICU called to transfer her...i thought she would make it...or at least i prayed she would...but one of the on call HO msged me after i got home that she passed away...
I'm just so angry at the whole thing...at myself, at the bloody imbecile HO, at my boss, at my colleague...i shouldn't have to stay to settle patients after office hour when there're on call MOs...and i shouldn't have to be angry at stupid HOs even though they are stupid...i shouldn't have to be angry at my boss for not caring for his own patients...and i shouldn't have to be angry at my colleague because she left me alone to resuscitate this patient...but i'm angry at myself for feeling all these... i shouldn't even care...patients die anyway...in 2 days, none of the ppl involved in the situation would remember the patient...but it will haunt me...for a while...
I need to get a new job...where i won't have to see patients die...cause patients' death...maybe i really should go to NZ and become a seasonal fruit-picker/packer...or maybe i should become a wedding planner...at least i'll make ppl happy...instead of killing ppl...
So i gave her fluids...and do the necessary investigations...she looked quite drowsy and ill...i told my colleague who in turn told my consultant (who happened to come for pm round)...i thought he'd come to see the patient...but he didn't...my colleague came to help but as she was on call, she had to go to OT for a case...so i was resuscitating the patient with the help of the nurses and 2 HOs...we put in a central venous line...put in a urinary catheter to monitor her urine...tapped her abdomen coz it was so grossly distended and tense...by the time we did all these, it was after 6pm...
I was about to go home and wanted to have a last look at the patient to make sure she was ok...that was when i noticed she suddenly became unresponsive and looked like she was having a tonic fit... had to intubate her immediately...but of course, since this was in the ward, immediately took like forever...and the on call HO in-charge of my patient was an ultra-imbecile...thank God the other 2 on call HOs who were helping me were capable...i think Murphy's law was at work today...whatever that could go wrong, did...
I was in the ward till 830pm plus...we did CPR 3 times for the patient...shocked her twice...overloaded her...she went into acute renal failure...i just couldn't save her...she couldn't even live to celebrate Hari Raya tomorrow...i didn't watch her die...i left the hospital after ICU called to transfer her...i thought she would make it...or at least i prayed she would...but one of the on call HO msged me after i got home that she passed away...
I'm just so angry at the whole thing...at myself, at the bloody imbecile HO, at my boss, at my colleague...i shouldn't have to stay to settle patients after office hour when there're on call MOs...and i shouldn't have to be angry at stupid HOs even though they are stupid...i shouldn't have to be angry at my boss for not caring for his own patients...and i shouldn't have to be angry at my colleague because she left me alone to resuscitate this patient...but i'm angry at myself for feeling all these... i shouldn't even care...patients die anyway...in 2 days, none of the ppl involved in the situation would remember the patient...but it will haunt me...for a while...
I need to get a new job...where i won't have to see patients die...cause patients' death...maybe i really should go to NZ and become a seasonal fruit-picker/packer...or maybe i should become a wedding planner...at least i'll make ppl happy...instead of killing ppl...
Sunday, September 5, 2010
NZ trip - day 1 (and the day before)
I was post call on Friday and had quite the sleepless call...apparently this always happens before i go on holidays...did some last minute packing after i got home...bathed and finished up my laundry...my flight to KL was supposed to depart at 1530H...Jasmine sent me to the airport...was flying MAS...met one of my specialist, his wife and baby at the boarding gate (little did i know he would be my boss when i get back from my holiday)...as usual, the flight was delayed, thankfully only for 1/2 hour coz i only had an allowance of 1 hour delayed if i were to make it in time to check-in for my Auckland flight...couldn't really sleep in my KK-KL flight...so ended up playing with my specialist's baby... she's so cute...and miraculously, she likes me :)...
Checked-in on time for my Auckland flight, considering that Cam actually came later than i did...had a late lunch on the flight earlier...so just walked around the international departure area till our flight was called to board...we were flying MH131 to Auckland which was scheduled to depart at 2120H...which eventually departed at 2130H...i supposed that wasn't too bad...watched Little Big Soldier (starring Jackie Chan and Wang LeeHom) and had chicken briyani for late dinner...then slept fitfully...one of the trip to the lavatory, my specs actually dropped into the toilet bowl...it was flushed previously but i still felt yucks!!! totally washed it with soap multiple times...they served breakfast about an hour before we landed...hardly slept at all...
Finally we landed in Auckland airport at 1130H (minus 4 hours for Malaysian time)...thank God i didn't develop DVT...we got our luggage...thank God they didn't get lost...then we took the airport shuttle to Britomart station downtown...backpackers rate for return trip was NZD21...Jeanne (Cam's friend) was waiting for us there...so we lugged our luggage back to her place (about 15 mins walk) at 53 Cook Street...her apartment was a 2-room...a bit small but i liked the interior...very clean and sterile...after we put our luggage, off we went for lunch (together with Jeanne's housemate Neo) coz Jeanne was hungry...we walked pass the place where they had bungy...not the real free fall with you attached to a rope..this one is a ball-cage which sits 3 persons and it gets catapulted up for God knows how high and it bounces a few times before it gets back to the ground...pretty cool but we were all too chicken to try...
We had Thai food for lunch...actually it was just Jeanne and Neo eating...Cam was sick of Thai food and i wasn't hungry yet...then we walked to the ferry pier and bought ice-cream...did i mention it was like maybe 15 degrees celsius or less? and we were happily slurping our ice-cream in the friggin' cold...i had a hokey-pokey honey crumb which was seriously yummy :)...we walked as we slurped...saw lots of nice sailboats...then we went to Victoria Park and checked out cute guys playing soccer...wanted to go to Victoria Park Market but it was already after 5pm...in winter, everything close at 5pm...so we walked to NewWorld hypermarket instead...thank God that closes later...bought some groceries for breakfast...kiwifruits were so damn cheap...NZD 1.69 per kg..so we bought a few for our travels...
Went back to the apartment to put our stuffs...then we went to the Sky City to check out the casino..of course we didn't bother to play...too much at stake...then we went for Korean dinner which cost about NZD10 per meal...dollar to dollar, this is actually very cheap...but of course if you convert it to RM then it's not that cheap lah...since we'd walked quite the whole day, we decided to go back and rest...but as expected when girls get together, especially after having not met for a long time, there would be a lot to chat and catch up...4 of us ended up sleeping in the living room and had girls talk till past midnight...suffice to say everyone was sharing their experiences... hehe...finally fatigue set in and we all fell asleep...a long day awaited us tomorrow...
Checked-in on time for my Auckland flight, considering that Cam actually came later than i did...had a late lunch on the flight earlier...so just walked around the international departure area till our flight was called to board...we were flying MH131 to Auckland which was scheduled to depart at 2120H...which eventually departed at 2130H...i supposed that wasn't too bad...watched Little Big Soldier (starring Jackie Chan and Wang LeeHom) and had chicken briyani for late dinner...then slept fitfully...one of the trip to the lavatory, my specs actually dropped into the toilet bowl...it was flushed previously but i still felt yucks!!! totally washed it with soap multiple times...they served breakfast about an hour before we landed...hardly slept at all...
Finally we landed in Auckland airport at 1130H (minus 4 hours for Malaysian time)...thank God i didn't develop DVT...we got our luggage...thank God they didn't get lost...then we took the airport shuttle to Britomart station downtown...backpackers rate for return trip was NZD21...Jeanne (Cam's friend) was waiting for us there...so we lugged our luggage back to her place (about 15 mins walk) at 53 Cook Street...her apartment was a 2-room...a bit small but i liked the interior...very clean and sterile...after we put our luggage, off we went for lunch (together with Jeanne's housemate Neo) coz Jeanne was hungry...we walked pass the place where they had bungy...not the real free fall with you attached to a rope..this one is a ball-cage which sits 3 persons and it gets catapulted up for God knows how high and it bounces a few times before it gets back to the ground...pretty cool but we were all too chicken to try...
We had Thai food for lunch...actually it was just Jeanne and Neo eating...Cam was sick of Thai food and i wasn't hungry yet...then we walked to the ferry pier and bought ice-cream...did i mention it was like maybe 15 degrees celsius or less? and we were happily slurping our ice-cream in the friggin' cold...i had a hokey-pokey honey crumb which was seriously yummy :)...we walked as we slurped...saw lots of nice sailboats...then we went to Victoria Park and checked out cute guys playing soccer...wanted to go to Victoria Park Market but it was already after 5pm...in winter, everything close at 5pm...so we walked to NewWorld hypermarket instead...thank God that closes later...bought some groceries for breakfast...kiwifruits were so damn cheap...NZD 1.69 per kg..so we bought a few for our travels...
Went back to the apartment to put our stuffs...then we went to the Sky City to check out the casino..of course we didn't bother to play...too much at stake...then we went for Korean dinner which cost about NZD10 per meal...dollar to dollar, this is actually very cheap...but of course if you convert it to RM then it's not that cheap lah...since we'd walked quite the whole day, we decided to go back and rest...but as expected when girls get together, especially after having not met for a long time, there would be a lot to chat and catch up...4 of us ended up sleeping in the living room and had girls talk till past midnight...suffice to say everyone was sharing their experiences... hehe...finally fatigue set in and we all fell asleep...a long day awaited us tomorrow...
Thursday, September 2, 2010
Having the post-vacation blues again...
I'm back in KK...got back from Middle Earth on Merdeka day...then been depressed coz i found out that i'm going to uro...kinda expected that...but when it did happen, it still felt depressing...oh well, life goes on....adaptation is most vital for evolution...next to mutation, that is...
Will write more on my trip to Middle Earth when i have time...need to get some rest now...
Will write more on my trip to Middle Earth when i have time...need to get some rest now...
Subscribe to:
Posts (Atom)