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.




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.

 


Oncall Again

 


Day 2 of 2022.



The ward was freezing cold,colder than normal.Maybe because it was raining.


The babies were crying.Many of the babies were under phototherapy due to jaundice..Some of them, from far looks like pikachu,jaundice til their thigh.When one baby started to cry,the next baby will starts to cry.One after another,in few seconds,every baby will be crying in chorus.


Paeds isn’t my cup of tea.I can tolerate neonates but not older kids.


I have 27 babies for blood taking on that night.

Taking babies blood isn’t same as how we take an adult’s blood.

We have to wrap the baby so that he or she wont move their other hand,have to put them under a warmer,and each time when we bring the baby to the warmer,we must make sure they are well covered with clothes to prevent hypothermia.It’s time consuming and we can’t use a tourniquet hence we can’t really appreciate their veins.It’s just anatomy and luck.


Sometimes it takes 20minutes for a baby.If it’s iv line or blood cultures ,if your time is bad,it can even take hours.



Throughout this posting I used to wondered and I’m still wondering,how would someone choose paediatric and how could someone wanted  to be a paediatrician in the first place.


Maybe each person have a different mindset and their own way of seeing the world.Whatever it is,I’m just counting my days to leave this department;ASAP.



VP shunt

Polydactyl 





Last Day of 2021







It’s a sunny yet gloomy day.Klang won’t be able to stand another flood.Hopefully it won’t rain continuously.It reminds me of my childhood,my grandparent’s house.


When I was a kid,I love my grandparents  and their village more than my parent’s house.I’m a rare old school kid.Tree,jungle,river ,snakes,spiders,scorpion,chicken,cow,goat,I just love them.I felt entrapped when I was forcefully brought by my parents to their brick prison so called home.


When we were young,we used to wonder when we will be an adult but now as an adult,the reality hit us hard with a torn slipper.Being an adult is a miserable phase of life I felt.


In less than 12 hours ,I’m going to be 31.At 30,I felt like there’s only 20 30 years remains and I will die in another 20 30 years.

It’s an unnecessary feeling but I felt every second passing by is a second towards death.


Past 2 years I lived my life as a mediocre. Procrastinating,being lazy,slow and I just simply screwed my life for the past 2 years.In the end,I’m really tired being such a person.


“What is your goal?”when my friends used to asked me two years ago,I told everyone repeatedly;when I die,people should remember my name for at least  100 years.


Since I started working,I slowly drifted away from my goal and passion.With time,everything faded.I’m no more myself.


Today is the last day of 2021.A year that will be in our memories for a very long time.


Well,it’s time to say goodbye and to start a new chapter.This time,let’s live our dream.

Welcome 2022.






When Doctors do Mistakes

 






In medical, disaster do not simply occurs,they evolve.When things goes wrong,it is usually because a series of failures conspires to produce disaster.


A doctor shouldn’t dithered.It produce a wrong outcome.When you are lucky enough,a wrong decision won’t be big enough to cause harm to anyone.


When doctors make mistakes,it’s not something that we can talk about and learn from it.

To prevent a doctor from making errors,the system was created  in  such a way where there are multiple layers of  preventive  measures to prevent any unnecessary negligence.


The kid was a 3 years old boy with known case of thalassemia and transfusion dependent.The biggest reason why I hate clinic is because of  general paeds.It’s definitely not my cup of tea especially with problematic parents and over weight kids where I can’t even appreciate a single vessels,thanks to Mc D.


It took me 40 minutes to take his blood and set an IV access.We have to wrapped him with clothes and the sound pollution was unbearable.Thank god I didn’t delete my subway surf.I let him play the game and from  no where,he don’t feel anymore pain from the needle.KIDs.


“Madam do you have conjunctivitis?”my MO asked the mum while checking the kid.

From far I can see her teary eyes.


“No,I just ate prawn balls and started having this panda eyes.Just a normal allergic reaction,”she said.


“Lakdhes can you help me to check and see if her eyes are red ,”my MO told me.Unfortunately she is my age and my batch mate.


I don’t think it’s eye infection,it’s looks like an allergic reaction.


“Loratidine ,cetrizine?”



“Give piriton,”she said.


“Once every night/PRN?”I double checked.


“TDS.”



1 hour later,the pharmacist called.


“Doctor,you prescribed piriton for this patient right?”

“Ya,”I answered.


“The patient is breastfeeding,so piriton isn’t suitable.”


I didn’t expect her to have another baby too soon and I was stupid enough not to ask about it.

Cases Rejected By Other Clinics