HFMD and First Warning Letter

Morning routine.6AM

7.12AM-Luckily no patients;YET

7.20AM 

Deep laceration wound,alleged industrial injury.

Unable to stop the bleeding.Compression and adrenaline pack doesn’t helps.Gave tranexamic acid stat dose.

Lazy to use diathermy(as it will be more painful ),hence used figure of 8 suture x 3 at different locations.

Managed to secure the bleeding.

8.10AM

Okay now it feels more like an ED

Then something weird came in .Dermatology isn’t my cup of tea to be honest.

He came one week ago,seen by another doctor,given injections and medicines but no improvement.

He diagnosed it as an allergic reaction. 

The rashes was blanchable and very itchy.I felt it’s nodular prurigo.

Most of the cases were HFMD.

HFMD was causes by coxsackievirus.

Coxsackieviruses cause a variety of diseases.

There have many serotypes and unfortunately they don’t have lifelong immunity ,which means patient can get them again later .

At least 24 serotypes of coxsackievirus A and 6 serotypes of coxsackievirus B are recognized.

Group A viruses cause herpangina ,acute hemorhagic conjunctivitis and HFMD where group B viruses cause pleurodynia,myocarditis and pericarditis.

Pleurodynia (fever and severe pleuritic type chest pain)

Myocarditis and pericarditis (fever ,chest pain and sign of congestive failure)

The difference between herpangina and HFMD :

Herpangina -fever and rash or oral ulcer localized in the mouth ,no rashes over limbs but in HFMD,fever ,oral ulcer /rash can be seen in the mouth and limbs.

There is no antiviral therapy for HFMD ,treatment is limited to symptomatic relief and respiratory support if needed.

Other important thing is,we need to notify district health department if someone is diagnosed as HFMD.

While I was in government,the notification will be done by me but at private clinic,the notification will be done by staff.

Influenza doesn’t required any notification but someone went and notified influenza as avian influenza which means bird flu.

Bird flu is something serious and I have no idea why they went and notified influenza in the first place and done it under Avian Influenza.AND they did it under my name.

Hence district health department sent a first warning letter to me.

Hope it will be the first and last.

Tie The Knot

 

“This is marriage or wedding?”he asked.

“Wedding,”I answered in a single word.

Wedding is one of the most uncomfortable event in my life.It could be essential for human life but wearing some fancy traditional attire,surrounded by so many people,some you don’t even know how they’re related to you,in the middle of crowd,sweating,so much of noise,distraction,unnecessary fake smile,genuine and not so genuine greeting,people from far with obvious body language that they’re gossiping about you..The list goes on and on.It’s just not my cup of tea .

“ Luckily we only have to do this thing once,”I sighed .

He looked at me,”With the same girl;yes.”

I just giggled.

I slowly started to feel cramping pain over my left leg.

“Could it be some DVT?Should I do a doppler?”

My thoughts wandering.

I could  see my cousin approaching me in hurry to say something .

“This is your wedding right?Please smile more,”he whispered.

It was awkward.I did,but maybe it’s too subtle for naked eyes to see.

Then from far ,I saw her with a group of girls and old aunties.

I smiled involuntarily.It felt different for someone emotionless like me.

The night goes on with many rituals that I don’t really understand.I just followed as per the priest‘s order and did whatever he said.

Some are annoying and slightly torturous.Still we do what we have to do.

At last ,I tie the knot and I make sure that all three knots done by me.There are some annoying aunties trying to complete the last knot,but I don’t give the chance to them.

Overall it’s a memorable ceremony which I don’t wish to redo.

Baby Shower

 

I still can’t  believe that I’m married and I’m gona be a father soon.

Time flies so fast that everything felt like happened yesterday.

Sometimes I felt that I’m not prepared for it.Maybe that’s how most will feel.

Baby shower ceremony went well.

It was hectic but memorable days.

Worth it for Rm650

Bella had a hair cut too.(After grooming)

There’s so many things happened in this past 8 months.I dont really write about them here but I learned valuable lessons during this hard time.It would be wise if I share it here so that others could learn from it.

Walked in to some random gym.Made some new friends.

Maybe I will start writing more frequently after this.

Maybe it’s time to take a drastic change.

Stay tuned.Do leave a comment .

Life as GP Doctor

It’s been a week since I officially joined private sector.It’s a different feelings to be a doctor in GP setting.

You’re alone,you have to think fast,you have to be precise,you have to come up with a diagnosis and differential diagnosis as quick as you can especially when you see some weird cases.The patient is sitting infront of you and expect you to utter something smart from your vocal cord.

When I was a surgical MO,all I have to do is pay attention to surgical based cases.If anything out of the syllabus,that makes us look dumb,we tend to have a magical word.

“REFER”

There are some surgeons who are exceptional.They are not only good at cut open human bodies,they are equally good in medical,ECG,patho physiology,pharmacology and to put in a single word,they are all rounder.

Most aren’t.

Do I miss hospital life?I do miss OT and getting my hand with gloves covered in bloods.Other than that,I don’t miss anything else.The stress,long hours of walking and standing,no time for food and water,getting humiliated by seniors and other departments MOs..It’s a big relief from all of that.

But deep inside,the passion to be a surgeon is still there and I figured out a way to accomplish it soon.

I realised, I studied more,I learned more and I did hands on more in GP.From paeds,pregnant ladies,emergency cases,skin ,geriatric,and many more that I don’t really understand,I learnt to diagnose and come up with my own management without risking anyone’s life.

And here,I have my own freedom to follow up on my patients.

I don’t have to worry if my surgeons will scold me if I spent a little extra time to listen to my patients.

“You are not breaking bad news to the patient right?So make it  fast and see the next patient.”

Sentences that I hate and the major cause why our healthcare system isn’t up to the excellency mark.It wont and it will never till arrogancy and ignorance are in the system.

Habits to Practise in Bodybuilding

 

The irony of life;

When you have time,you don’t have money.

When you have money, you don’t have time.

When you have time and money,you won’t have the energy.

Basically, I have plenty of time now. I was wondering what shall I do next...

Then a thought strikes me.

 I was wondering how could someone that facing so much of difficulties in their life suddenly could change their life into something else, someone successful but at the same time,another person that facing a  similar situation couldn’t do that?

What makes the difference?

What is their belief and their mindset?

How could they overcome that hurdle?

I thought,maybe I should ask them in person  and learn from them.

So I tried to approach them, those people that are doing well in their field.

Some are kind enough and replied   YES while many ignored.

The first person that I met was Jason,a young bodybuilder that have an interesting story of hardship and struggles but managed to became someone in his field.

It was really out of my comfort zone but I managed to interviewed him and asked few questions.(which I will upload on my Youtube Channel in few days )

I learnt that,it’s up to you, how you would like to see  a bad situation. Every bad situation is like a plot with twist in your life.It meant to happen and there is a reason for it to happen.

Time will make you realize the reason but first, you have to use it to change your life into something positive than dwell pessimistically on it.

Click here to watch the video

I left KKM but Never Quit Medicine

I had never imagined that I would resign my job, not even in my wildest dream.

My new hospital’s surgical department was very understanding and kind towards me.

They treated me well from the beginning.The HOD Mr Uma, Consultant  Miss Linda,Miss Leow,Dr K,Dr Ammar,who was my best friend in that department and Dr Hajar,a very charming and knowledgeable MO,these are my favorite persons in that department. I never worked with such an understanding team.I missed them.I can’t see them anymore bother me more than anything else.

I left without a proper goodbye as well. I’m not good in it. I don’t know how to react and act.

 

Unfortunately, due to various issues, I felt, leaving Taiping will be the best thing to do.

Initially I wanted to give one month notice but as I am a CONTRACT Doctor, the HR made some magical calculation and mentioned that my remaining leaves are only two days, not 22 days as per HRMIS. The first thing that they will do is stop your salary but you must continuously work for the next 28 days. *CRAP.

Hence, I paid my one-month salary and some fine as a penalty and gave a 24 hours’ notice and left.

It’s hurts but  one day, I might come to a realization that ,it was one of the best bold decision I ever made.(I hope I will .I will make it happen.)

 

 

From today onwards, I am going to work on my biggest dream (also my biggest fear).

From time to time, I will document it here so that I can read them a day. Few  years from today, maybe.

Goodnight.

 

 

 Click here to watch my final days at KKM.

 

Officially Married

 

At last completed my third song and finally got married.