life is getting more complicated...

Remember when we were young?
Life was so much simpler

Symptoms and Diagnosis:
1. Skippy heartbeat when you think of him/her.
Symptoms then: Love
Diagnosis now: Ventricular fibrillation and Myocardial Infarction.

2. Restless trembling of hands, feet and other body parts.
Symptoms then: Love
Diagnosis now: Parkinson’s Disease

3. Constant smiling.
Symptoms then: Love
Diagnosis now: Bell ‘s Palsy

4. Absent mindedness, inability to focus on tasks at work or at home.
Symptoms then: Love
Diagnosis now: Early Onset of Alzheimer’s Disease

5. Weakening of knees and bursts of energy when he/she calls or visits.
Symptoms then: Love
Diagnosis now: Multiple Sclerosis

6. Inability to stop thinking about her.
Symptoms then: Love
Diagnosis now: Obsessive Compulsive Disorder

7. Bruising on neck and other tender areas.
Symptoms then: Love bites.
Diagnosis now: Leukaemia

8. Insomnia.
Symptoms then: Love
Diagnosis now: Benign Prostatic Hyperplasia

9. Feeling that you can smell/hear/feel her when not in her presence.
Symptoms then: Love
Diagnosis now: Schizophrenia

taken from Malaysian Medical Resources

Entering a new world

Alhamdulillah, my wife delivered a beautiful daughter on 26th July, roughly about 2 weeks ago. The 9 month journey of waiting has ended and my wife and I are now joining the club of parenthood.

Both of us are new in this world of parenthood and there are literally millions of things that I personally need to learn either by experience or by asking someone who is more experienced. Although I am a doctor and knows roughly regarding the developmental milestones of an infant and the commonly occurring healthcare related problems in children, the journey itself is a different thing altogether.

An example would be breastfeeding. It is quite difficult in the first few days for my wife to establish good breastfeeding technique. On top of that, the baby is becoming more jaundice due to insufficient breastfeeding. It took us lots of time and patience to establish the breastfeeding. At one point, I personally had to take the blood from my daughter to check the level of bilirubin. Fortunately, the bilirubin level is below the phototherapy level and she does need to be admitted to the hospital.

Staying in Malaysia means that you will encounter the tradition, that has been passed on from generation to generation. During the postnatal period, there are lots of taboos especially among Malays of things that you could or couldn't do during the postpartum period. There are certain taboos that made me wonder regarding its motives and whether it is actually beneficial to the mother and the baby. The hardest part in this subject is how to approach your parent and in laws and to voice out your opinion without hurting their feeling. Personally, I think it is very difficult.

A new world with thousands of challenges. Hopefully, my family will be able to go through it :)

Transition Period

I am now in a transition period. I have finished my 2 years of housemanship and currently works as a medical officer in a small district hospital.

All of the challenges that I faced during my housemanship are quite memorable indeed. There were few of happy moments interspersed with sad experience. The journey was quite arduous and few of my colleagues were extended and one of my good friend resigned from Ministry of Health. Few of those were diagnosed with mental illness due to harsh working environment albeit the current situation is slightly improved with the introduction of shift system.

Nevertheless, facing hardship is part and parcel of life. By overcoming great difficulty, we will be able to improve ourselves to a greater height than previously. 

"And certainly, We shall test you with something of fear, hunger, loss of wealth, lives and fruits, but give glad tidings to As-Sabirin " [Al-Baqarah:155]

 

 “Indeed amazing are the affairs of a believer! They are all for his benefit. If he is granted ease of living he is thankful; and this is best for him. And if he is afflicted with a hardship, he perseveres; and this is best or him.” (Muslim)

My next journey as a medical officer has just begins. Hopefully I will be able to remain steadfast in this long journey....

Abusing Emergency Department

After being in the department for almost 2 months, I have seen literally thousands of patients and about a small portion of the patients seen in the department does not warrant an admission to the emergency department.

Few of these patients will present with insignificant body injury and then, prior to being discharged from emergency department, they will ask for medical certificate for 2-3 days. This is usually seen at the end of long weekend / public holiday.

A small number of patients who has been under followup of specialist clinic presented for a variety of complaints. Upon further questioning, their motive is to seek earlier clinic appointment or to seek earlier date for surgical operation. Truth be told, the waiting list for operation in the government hospital is very long and it is extremely difficult to get earlier date for operation unless the patient him/herself has suffered an emergency complications of the organ itself. Otherwise, I personally recommend them to go to the private hospital for an earlier date for operation. In term of clinic appointment, it is quite difficult to get earlier date unless your medical condition has deteriorated significantly over the past few months

There is quite a big group of patient who came to emergency department for insignificant minor trauma. For example, they had been involved in an accident and then suffered a small abrasion wound about 0.5x0.5 cm. Apart from that, they are quite well. Although emergency department is reserved for all type of trauma cases, I don't think this group of patients should come to A&E. At least they should go to GP first to seek the appropriate treatment. Most of the time, this minor trauma will resolved by itself without any intervention.

Emergency department is for emergency cases. If the community keeps on abusing the department for non life threatening condition, I don't think the department can cope with the large number of patient and give the best treatment for all patients.

The Last Rotation

I am now in my last rotation as a houseman. ETD (Emergency and Trauma Department) and once it was called as A&E (Accident and Emergency).

This posting is one of the best posting as it combines all of your previous learning experience in the the other postings and sharpen your skill to diagnose and manage life threatening conditions. Apart from that, this department has one of the best shift system and even the tagging period, the period whereby the new houseman enter a department, is also enjoyable.

Personally, I might be thinking to join this department as a medical officer in the future too.