Mistake as a Doctor :Listen to Others but Act According to Your Heart. .

 When I first started, I can't even take a patient's blood properly.

I can't insert a branula properly. Initially, most of the time I failed.

With time and experiences, I can sensed that I became better. Doesn't matter how difficult, by hook or by crook, I will insert the branula nor take the blood.

The only time I failed nowadays is when I listened to others opinion, ignores what my mind saying and get distracted with other's voices. 

Today there's was a hemato patient that requires branula. He is on chemo so the smallest size will do but other two houseman already poked him 5 times.

It's like breaking a person's trust five time which means I can never try more than once. Doesn't matter how difficult it is, when I really find for the veins, I always ended up with two options. Two sites that you know that it's guaranteed either one will work. Here's where your luck play its part. Multifactors can causes a failed insertion. When they called me for this kind of situation, I know it's only one time attempt.

Moment before insertion, I don't know if that nerd is a first poster or super senior, but he's just annoying. I don't know if he's smart or just a nerd that burden mo's for every small shit. If I'm an Mo, I wish i would never work with house officer like that.

"Hemato Mo said if can't get more than three times, inform Mo,"he said.

" Then why the fuck you both poked him 5 times, "I thought. 

I just kept quiet and opening the blue colour sterile branula. 

 Inserted and there's back flow, I removed the needle and tried to push it inside. I just can't stop the blood from flowing out through the branula despite how much pressure I gave, so i just wanted to insert quickly and secure it. 

"Did you release the tourniquet?" Nerd asked. 

'Just do it on your term or open it because he's seeing?' A confusion came in. 

I picked the second, tried to open the tourniquet with another hand, branula moved, and it's gona. I can't flush in the water through the branula and the patient felt pain ;means it's came out from vein and settled  in the dermis layer. 

I just wasted everything. 

For 3 minutes I sat at the corner and was thinking about it. 

'Why you didn't follow your heart?' 

'Why?' 

'You was good and you messed up because of other's opinion.' 

I learnt that medical is a team work. Almost all the jobs out there is a team work. You works better in a team but always, ALWAYS LISTEN TO YOUR HEART. 

You can take people's opinions but decision must be always your ;according to you heart. 

As a Doctor, Prioritize Yourself First

 

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"If you constantly compromise things in your life, how will you ever realize your full potential?" he asked.

He is one of the person that I really admire during my surgical posting.Surgical was like a family for me and I don't really know why I had that feeling. Soon to be a surgeon, he handle everything in a very calm manner.

I wondered how he could do that;always, never failed once. 

One day I asked him.

" Life will screw you in many ways,"that was his first response.

My first posting was partially surgical based as well. Suddenly, you have to enter OT. Training hard a day prior, can't eat during the day are a bad combo in an OT setting especially when you are handling an obese patient. Your muscles lacking the essential sleep and nutrition bombarded with the stress thinking when they will scold you, that's another deadly combo.

During my first  few weeks, I have been chased out from OT because my muscles eventually fatigued retracting a lady's thick fat abdomen with a BMI of 48.2;starving for a sip of water. 

Hence I stopped gym. 

Months later, I met him and he told me something precious. 

"Remember, before you take care of some one, you take care of yourself because you're always replaceable. Doesn't matter how good you work, there will be someone better and smarter than you. Always prioritize yourself. 

It's not selfish, it's just taking care of you. "

I didn't expect it from him. I thought he would say the same as others, patient comes first bla2.. 

" A well educated looking guy with an acknowledgement that he's having HIV will smile to you. Don't believe anyone, wear your gloves before you take his blood,"he said. 

Whenever I experienced it myself, I believed that, he said it from his experiences. 

Always take care of your self. Do what you love and what is good for you. 

How to Find Your Peace

 

"Make peace of your mind first," he said while looking at the waves.

"Happiness come in wave," he continued.

"Hmmm," I nodded.

"How?"

"We will never find peace of mind until we listen to our hearts," he said. 

"How?" my never ending how continued. 

"Simple," he looked at me.

"Stop fighting with your thoughts." 

Consequences of Skipping Medication

 

It was a chaotic morning for a Sunday.

Usually weekends will be less stressful, calmer than week days.

That day, it was different.

Patient came with GCS 3/15,intubated at ED for airway protection, sedated with midafentanyl cocktail.

Multiple IV lines, IVI adrenaline, IVI insulin sliding scale, sedation pump at the side, cardiac and bp monitoring machine on another side; the place was literally in a mess.

Beeping sound from every machine available there was disturbing. 

She's a 60 years old lady, with diabetes and hypertension. History from the daughter clearly showed that, she's not compliant to her medication. She used to skip her pills.

Self made decision that took a toll on her life, causing her to lie flat infront of me.

Blood pressure on arrival was 210/148mmhg.

CT brain shows acute pontine bleed secondary to hypertensive emergency..

If.. If she took her medication regularly, today, everything would be different.

Today wouldn't be her last day on earth.

One year of Housemanship

 

It's been a year since I started housemanship in Malaysia.

When I was in Bangladesh, I loved OT.

Used to work without realising it's already night.

Loved being in hospital without realizing that the the clock is ticking, the hours are going by.I just loved getting my gloves wet with bloods.

Today, it's a different scenario. 

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I don't know if it's the system here or the people ; with a terrible attitude. 

The title might seem glamorous, but it's not worth it. 

Don't make a wrong choice.

Regrets :Monster

"Are you doing it right?"

"Are you living your life?"

"Take a look at everything you're doing."

"Will you do it all over again?"

"Are you happy with it?"

"Sometimes all you need is 30 seconds."

"Just thirty seconds to remember the fact that you will never get the same breathe twice."

"Live it, don't look back."

"One day, you'll look back. Be proud of yourself. Don't regret it." 

Batu Caves, Malaysia :Conversation with an Uncle.

Little Message to my Nephew

We're 29 years old apart.

One day you might scroll, or check my blog post and might be reading this. 

Remember, life is a blessing for few, a curse for many. 

It's not a pessimistic tone but a hard reality. 

Someone, something going to hurt you, will make your life hard. 

Many to hurt you, few to encourage you. That's humans.

Sinful proud beings.

At the same times, someone out there, a complete stranger will reminds you that life is worth living. 

Keep them with you, ignore the rest. 

Environment will constantly insist comparison with others. 

There  will be someone better than you in many different aspects of life but no one can be you. That's your GIFT. 

Reading a CT Brain

"Why this patient is still here? We suppose to discharge him today right?" the surgeon asked.

"Neurosurgeon from HSB said the CT brain shows evidence that the bleeding is worsening, so they wanted to keep him for another 5 days and repeat another ct brain."

"Show me the latest ct film," my surgeon asked.

I always felt that even thought he is a surgeon in traumatic ward, his knowledge of reading radiological film is far more better than anyone in the hospital.

"Look at the film, can you tell me the volume of the bleeding in his brain?" he questioned.

I was in a mourning silence for a moment.

"Do you know how to calculate the volume?" he added another question. 

"I have an idea," I answered. 

"How many slices are the in the old film?" 

"6 in a row," I said. 

"The latest one?" 

"5," I said after observing the film which I didn't do previously. 

"If we magnify the image, do you think the size might visually appears big even though it's the same?" the surgeon asked. 

It make sense I thought and nodded. 

I continued, "I asked the neurosurgeon but he said, if you don't know how to read, go to the radiology department and ask them." 

"See, this is how they teach," the surgeon sighed to my ward Mo.

"So what you felt?" he continued. 

I looked at him for a moment.

"Like.. I'm... stupid," I whispered. 

He smiled. 

"See, how I see the film and how he saw it seems totally different right, even though it's the same film.Our perspection about ourselves is the kinda same. How you felt about you self might be wrong.Change it." 

In the mid of an Appendicectomy

"This isn't just a normal appendicitis. It felt like an appendicular mass,or maybe a perforated appendix. So better we go in by midline laparotomy, not Lanz incision,"the surgeon said.

Both of us looked at the surgeon with a blur look and nodded.

" His muscles are still very tight, can you giving a little bit more muscle relaxant ?"the surgeon ask  the anesth MO.

" Sure,"she said.

In the mid of ths surgery, the surgeon asked," Thiva, what you gona do after you complete your housemanship? "

" Don't know boss. Maybe will go into surgical or ortho, "my friend who is the second assistant answered.

" You? "surgeon looked at me.

" I want to be on Forbes magazine, "I answered without thinking for a second.

" That's too ambitious man. Then you can't  stuck here in medical field right? "

I smiled.

" One day I'm going to read your article then. All the best man,"the surgeon said with an encouraging tone.

" I doubt it doctor. There's only seven months left for me to be 30.Certain dream will remain as a dream, forever. "

He looked at me and smile.

" In seven months, a lot of things can happen. Certain dreams came particularly to us for a reason. It meant for us. Believe it. If you can see it in ur mind, if you have the courage enough to speak it, it will definitely happen. "

Starting Back

"Seeing you after so long. What happened?"

He made a gentle tap over my right shoulder.

I smiled without saying anything.

"Drifted, maybe, as usual,"I kept it short.

" I know that feeling, "he sighed and continued," When you go away for a long time, you return as a different person. You never come all the way back. "

I don't really understand why he was saying that but it's a sentence with a deep meaning.

It's not about losing weight and muscles. In any situations, if you went far, it's hard to return back like before. Sometimes it's helpful, sometimes it's regretful. 

The only way to make a worthy journey is to finish what you started.

My First Patient In Trauma Ward

I still remember the day when I first met him.

His story started 10 years ago with a small motorbike accident.

When I saw his 10 years old history 

with multiple surgeries to fix his intestinal bleeding, my first thought was,' I'm done'.

New ward, three surgeons, I'm definitely won't be able to remember every shit and they gona screw me for this. 

"Don't worry, I'm here for quite a long time. They knew my case well. They won't ask much." 

I stopped flipping his report and looked at him. 

"Did he heard my mind voice?" I questioned myself with a surprised look. 

He smiled. 

"That's what everyone felt when they saw me for the first time." 

He answered my voiceless question again. 

From that day onwards, he was not just a patient but a friend as well. 

Each time during dressing, I can literally touch his intestines because it was such a big open wound with his peristalsis visible to my naked eyes. 

Weeks later.

" Bro, what is the first thing you wanted to do once you're well and out from here?" I asked him. 

"Get a job and repair my room tiles," he answered with a sense of discomfort. 

His vacuum dressing was partially soaked. 

"I already informed my wound team MO. Today he will come and change the dressing,okay?"I tried to make him feel better. 

" And I wanted to buy a new phone for my sister, "he uttered slowly. 

I can sensed that he really wished to live a normal life like us. 

" God didn't bring you this far to leave you. Everything will be fine soon , "I shared the quote that my consultant shared in her WhatsApp status that morning. 

I was believing that the quote was true for sometime. 

Today he's no more. 

But he made me realized something.

Each soul crosses our path for a reason. Either for their growth or to make us grow. 

Misconception of Mastectomy : Devastating Consequence

"Can I walk again ?"she asked with a smile.
I'm not sure if she's smiling for real or she's faking it but for me, I felt as if she's suffering inside.
She's smiling for the world around.



"Why you didn't do mastectomy when you first diagnosed with breast cancer 2 years ago? "I asked her.

"I don't know.Many said you can't walk,it will be painful etc.I thought chemo alone would be sufficient.I don't know who will take care of me when I can't walk.That's why Dr."

"Your doctor didn't tell you anything?"I questioned.

"She did but.."she paused for a moment.

"Did you discuss with anyone before you decide?"I asked again.

"No..but I was completely fine for two years.I went to work with bicycle, I was very happy and active.Just past three days I can't" really move my legs."


Her husband passed away 4 years ago.They adopted a son but she mentioned that the 19 years old boy doesn't care that much about her.

When I knew her history,that sentence 'I was happy' hurts me.
I could feel her pain but I can't do much except talk to her often,took care of her.
That's all.All my knowledge,all my empathy meant nothing I felt.

Each person crossed our life for a reason.
This video was because of her,for other people like her.
If you know anyone that facing such problem , clueless regarding treatment, procedure nor the process,feel free to mail or dm me.
If I don't know, I have such kind hearted surgeon and consultant from O&G and surgical to discuss with and willpwill the knowledge to you.
Goodday.

pranasteya@gmail.com

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https://www.instagram.com/lakdhesz/

How we prepare a mastectomy patient.
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Next Department: Surgical

At last I finished O&G with lots of dramas.
My second posting was Surgical.
Completely a new chapter,new environment.
For every single thing,we have to refer and request,my biggest uncomfortable aspect in medical.
Unlike Bangladesh,here everything seems complicated. As well as my life.
Day 3 in new department and I'm not liking it that much;maybe for now.
"What should I do?"I asked my self.
Let's compose the second song.
That's what I felt and I sat to write the lyrics..
"Write a song for me this time,"she asked.
I smiled and penned my second song for her.
It's a different feeling,to be honest a feeling that I can't put into words.
Not into love but the feeling that there is someone who is crazy about you is more than enough.
She is indeed magical.
Annoying,young girl with lots of dramatic expectations which doesn't suits me at all.
Yet,it seems different.
A single song changed everything, let's see how my next song gona impact my life.

My Way of Handling Covid-19

"What are you thinking?"he asked.
"Nothing bro,just thinking about life ."

"About Covid-19?"he teased.

We both smiled.

"Somehow this Covid-19 making life miserable right?"he sighed.

"Ya."I replied.

"Okay , we're doctors right?Tell me how would you treat covid-19?
Do you think turmeric is a good way like how our Indians proclaiming..?"he questioned.

"I'm not sure, it's an antibacterial and antiseptic so..,"before I finished he interrupted,"See the logic, it's antibacterial and corona is a virus,so how could it kill a virus?"he asked.

"It's sounds logic but we aren't sure if it can act as an antiviral as well right?So.."

"Hmmm,sounds legit too,"he replied.

"It spreads rapidly but wasn't virulence as SARS and that's the only advantage..But it turned the whole world chaotic."

"Do you think it's man made or as Bill Gates predicted it meant to happen?"he asked in a curious tone.

"With how the worlds  economy went haywire and how certain countries are free from it and how certain countries trying to monopoly the economy, I'm not really sure what to say..
Either it happened itself , someone made it such a way to be less virulence or someone failed to create a strong virus."

He gave a puzzled look.

"How  would you cure it if you're positive?"he questioned.

"I will tell you but it might sounds stupid."

"You don't usually tell something stupid so tell bro,"he assured.

"I'm the only HO in the same department for 6 months and you're feeling that I'm not stupid ?"

"I knew well why you're still in O&G .You only do if you're intended. So cut the crap and tell me!"he sounded.

"You see,few years back ,when my sister came from school with her contact lens strongly adhered to her pupil,we tried eye drops,we tried to pull it ,we tried so many ways and we failed.
Initially I thought I have to bring her to clinic. I was getting ready to go to gym at that time and I went back to keep my protein shake in the fridge and I saw onions.
Well, onions can make you cry naturally so I thought let's try it.In few seconds of cutting the onions into half near her,the lens came out along with that natural tears.

Few days back, a pregnant patient came with complaint of abdominal pain.She was having Hodgkin lymphoma and was on chemo. Everything was normal,her baby,her uterus everything!Not a single pathology at all.
We were puzzled and I asked her if she went to toilet and she said she's didn't pass motion since her last chemo.
It was post chemo ilecus.
Simple diagnosis that even Mo's missed because we always see a problem with  sophicasted  way to treat it.

For me,that corona virus attached to your throat wall and if your immune is good,with time it's subsequent event limited  with upper respiratory infection.If your immune is bad, it went downwards with the secretions into your lungs and causes pneumonia."

He was quietly listening.

"It can be killed by ultraviolet rays,more sensitive to heat and ethanol more than 70%.
So it's definitely won't survive in high pH right?"I asked.

"What you mean?"

"If you can try thymol gurgle to remove it,why don't you bring it in into your body and kill it? I asked.

"How?"he puzzled.

"Okay, it's might sounds stupid but if it's me, I would drink a spicy soup till I'm having secretions all over my tract and nose and bring it into my stomach during initial stage .You will be eating so respiratory tract is closed,all secretions enter stomach not lungs and stomach acid will play it's role."

"Sounds logic bro.."he said.

"Stomach acid can even melt a razor, so a virus is nothing because that virus act more on our lung cells.
If the later stage,we can depend with chroroquine and antiviral but during intial stage,this is how I treat me and treating I'm exposing my self to covid suspected cases every day.I won't even wear a mask and lot of patients tend to hide their past history but I already figured out a way how to overcome it.This is how I managed."

Better scientific details about Covid-19,how viruses act and how the treatment works will be uploaded next.
 COMING SOON.