Zero Carbs Week

Back to diet.

Zero Carbs

Off Day

First thing  of the day,TRAIN

Rocky and Elsa

Top up their food

Treats for them

 

Diet

Food

Short getaway

Swimming day

BBQ at home

Movie time: GOAT

More food

Tanjung Karang

Now it's for the baby

The First Step :Boredom

 

It was a rainy day.Not the usual sunny day that it used to be.

Not much patients,just one Indian lady in her late 40s that came 

for annual blood screening.

I went out and just gazing the rain,the moving cars,scruffy cat at the corner, 

a guy that walking towards his car with a cigarette in his mouth.

'Men created multiple ways to die early,'I thought and craked a smile 

in guilt.

'You are one of them that smokes despite knowing it's a chemical that would 

kill you,'thought of the day.

'Sheltering from the rain?'the woman behind the counter from KK Mart asked.

I just smiled.Not in the mood for conversation.

'What could be the first step for a better life?'my thoughts started to wander while 

staring at a magazine cover displayed infront of 7Eleven.So much of unnecessary problems

in this world.The main 3 culprits;politics,religious diversity and lack of money which

leads to crime.

Elon Musk is taking care of the space and environment,Boyan Slat ,the founder of 

Ocean Clean Up is taking care of the ocean.I should take care of mankind's safety.

My mind grew heavier with my thoughts.Our society becaming like a black hole.

A dying star ,collapsing in on itself.

Crime and rape should end.Or at least under control.

When it never happened for us or people we love,we just see it as a news 

and scroll our feed.What if someone hurt my family or my son,or my future daughter??

The thought was like a ceaseless mind-cramp ,something too uncomfortable to bear 

yet too strong not to avoid.

I remembered being enthralled by the boredom that I used to experineced back in

Bangladesh and how I overcome it.

Now I can't be bored.I need something to numb it,be it an activity or indulgence.

It's good if it is healthy but unfortunately in my case,it wasn't.

Maybe the first step would be,

be comfortable by being uncomfortable and being bored.

I miss this place.

Friends

Ortho Ot

Reincarnation:Change Your Life

 

Watch here

It’s been a very long time.

I put on so much weight.

Procrastination at its peak.

Brain fog daily, unmotivated with life.

Chemicals became my friends.

I’m not me anymore.

Less monstrous,but definitely not a being.

Why not rebuild it?

Reincarnation;into something that were not there before,

never before.

Do something that have been never done before or maybe do it again in 1000 times better.

Challenging.Can I?Can you?

Why not?

Been disappeared for months.

Many do,some returns and again disappears.

In the cycle of life,in the pain of time,many are breathing but barely living.

I decided to live .

This only life,

for one last time.

For my Shiv📿

For mankind 

For all the humiliation.

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.