JooneY CantabilE

I'm far from being old... 24 only nia

2009-07-01T03:00:00.000-07:00

19.06.2009 Dinner at Ling Min's, Salford

Thanks to Ling Min for my very first 24th birthday present this year. She offered me a nice and healthy meal with steamed chicken and boiled lobster and white rice. Ling Min, i'll treat u dinner when you come to Preston, i promise... It's really nice to catch up with you and share our gossips. Haha!!!

20.06.2009 at Uncle Chin Lye's, Cardiff
Thanks to my dear cutie cousin Roxie for choosing me this pink/white pyjamas.
Thank to Stevie for buying me this little Teddy crystal that i'm still thinking what' the use of it...
Thanks to Lowri for the bath set and the lovely birthday card. I shall see all of you in Penang during the summer break. take care ya!!!

21.06.2009 11 Medway, preston (all the way from Liverpool)
Thanks Hui Lin for such an early birthday wish. You were the first who posted a birthday card for me... I dun mind that the card was plain. It's the heart tha counts... Very kam dong~~ See you in Blackpool next year, ok? or maybe in kl when i go home...

27.06.2009 Moor Park, Preston.
Thanks to the Preston/Manchester year 3 for coming to this gathering. It was originally a visit to Lake District but then it was cancelled because of the rainy weather. Although the plan has changed to going to Moor Park, i believe we all had a great time playing "baling slipper". (I had imsonia that night for being too active and my whole body was aching the next day...)
Thanks to everyone that came that day...ie.. the people in the pic...
Look at the number of candles... all over the cake.. and it took me so long to blow off all the candles...
Make a wish... Sincerely make a wish... I wish all of us could score in the exam... Results coming out next week. Dun worry. With the power of my wish, we could all pass and have a great summer break at home!!!

29.06.2009 Glasgow
I took a day off to Glasgow to attend my friends' convocation. My dearest Intec housemates--> Fiona and Lydia. Congratulations girls, well done!!! I know you would be the great pharmacist and enjoy your working life...
Thanks for the treat of the chicken caeser salad and Passion fruit J2O. Remember our next meeting perhaps in Seremban? japanese food?
Thanks to Moose that made a creative birthday cake for me by piling up the left over chips (contributed by Michelle) and the bacon stick. You were the special guest!!! Came all the way for my birthday.. I'm so so touched.. (I know you are not, just pretend you are, ok?) that was really a random surprise when you presented "the cake" and sand the birthday song...
Thanks to Ben, siew chin, chee mei and moose for this present from body shop. the second bath set i have got this year. i like it and i'm considering bring it back home...
and the birthday card... really empty wei... Nvm... i'll get the people to write up and send me wishes when i see them... Got plenty space for the sban people i guess...

29.06.2009 11 Medway, Preston (all the way from Green Street Homes, Seremban)
The most touching present i have received in this year that moved me to tears...
Walau, really couldnt stop tearing... It's from my beloved mama...
when i opened it, it had the music... the happy birthday music... when the music started playing, my tears started to build up in my eyes... couldnt help at all...
Ma, why u made me cry on my birthday....
My eyes just get blurred when i read the messages... I know you miss me. I miss you too... Only 9 days to go and i'll see you, ma... Very fast only...

30.06.2009 11 Medway, Preston (all the way from Aberdeen)
Thanks to Jackie that made the effort sending me the card despite busy preparing for his exam...
Hey boss!!! Ur calculation paling "zhun" that the card reached on time on the exact day!!!
Since you have done something good(ie sending me birthday wishes), i believe u can score good results for you exam... Trust me... Also trust yourself...

30.06.2009 Unknown location, probably Semenyih, Malaysia
thanks to Xiao dee that dedicated a post: Happy Birthday my sis, in his blog to wish me happy birthday. but why u copy the post last year, not sincere also... hey, you still owe me my birthday present... Dun try to run away from me...

30.06.2009 Esatz east Restaurant, Preston
Thanks to Fleur that helped to organise the dinner. And also the rest that came and treated me the dinner. I appreaciate it... we just knew each other for not more than a year. But i'm really grateful that we could actually have dinner together on my big day!!!
That ice cream was really a surprise.. thanks ya...
My favourite card of this year... Really like the messages on it... It says...

Your mind is sharp and functioning, your teeth remain intact
And you can still go dancing 'cause your hip bones haven't cracked
You pee without assistance, your walk is sure and brisk
And you haven't got all the wrinkled, grown a hump, or slipped a disc
Your hair's not turned all white yet, you've got a ticking heart
And you exercise discretion when you can't hold back a fart
You don't crank up the thermostat because you're always cold
and though you've aged another year...
You're far from being old!
Thanks for letting me that I'm still young!!! Happy birthday to me!!!
I had a miserable birthday last year but this year was brilliant!!!
Thanks to all my freinds and family that wished me in person, by texts, by email, by facebook, by msn... I feel so sweet and lucky to know all of you...
with all the blessings and wishes this year, i believe it's a better year ahead for my 24th year of life!
And this will be my 100th post in my blog... a memorable one..
"I'm far from being old... 24 only nia"

Melaena

2009-06-01T10:51:00.000-07:00

I went in late for the ward round in Chorley this morning at about 1030am and the patients were shifted to a brand new ward and it took me some time to figure out where the new ward is. So finally i was in the ward and trying to catch up from the ward round as i have not been into the ward for 2 weeks. Then the crash alarmed just rang and i didnt know that was the carsh alarm... (How stupid am i....) But i could figure out something wrong happened as the staffs including all the doctors ran towards one of the pateint. Then i tried to have a look but unfortunately the nurses responded quickly by pulling up the screen. I just stood there and didnt know what should i do... ( i think i look stupid that time...)
Because we were all in the new ward, the doctors were looking for gloves and the crash trolley. One of the nurse brought in the Obs monitor. The nurse then pushed out the wheel chair that had a bowl that was conveneint enough for immobile patient to pass motion. And on that wheel chair i could see stain of melaena (blood mixing with stool)... Oh dear, the patient has got some sort of GI bleed... I tried to peep in through the curtain, then i could see the patient lying on the floor with pool of melaena that dirty the floor and her clothes. I could hear the doctor said that she wasnt arrested but she was collapse after opening her bowel. (probably due to vasovagal response plus acute blood loss.)
Matt and Ross were with me that time, Matt went to get gloves, Ross went to look for the patients notes, and me stupidly standing there, couldnt do anything... So my Reg asked the nurse to get some fluids for resuscitation . After stabilising the patient, he went to arrange an urgent endoscopy. Then my SHO was there to trying to get the patients up and examine her again to make sure she's had not injured herself from falling just now. The FY1 was taking her blood and now i finally have some role in the whole picture... I helped the FY1 to send the blood to the lab( the blood was taken at 1130am and came back with the result of Hb 6.1)
So... we tried to check the history of the pateint. She initially came in with falls and developed episode of ? haemoptysis ?hematemesis last saturday. (But considering she had melaene, she could have had hemetemesis) But no history of taking NSAIDs which put her at risk of develping GI bleed. She already had 2 units of blood transfused that time. So we followed her through to the endoscopy unit. Upon endoscopy, 2ulcers were found that are actively bleeding. The surgeon who conducted the endoscopy injected 6ml of Adr to try to constrict the vessels and reduce the bleeding, and applied clips twice to stop the bleeding. He managed to stop the bleeding of one of the ulcer and slow down the bleeding from another ulcer. In short, the patient's still bleeding. He said that the patient would need surgical intervention as there wasnt much could be done endoscopically. A gastroenterologist came in to review her and agreed with the surgeon but.... considering that patient is 80 year old and she has pulmonary fibrosis... So she might be at some risk for anaesthtics.
Now the issue is to refer her to Preston (which has better ITU care considering that the patient might need it after surgery) or do the surgery in Chorley (as she might not be fit for transferring). After viewing the pros and cons, discussing with the surgeon and anaethetist, the decision was... Refer the pateint to Preston for emergency surgery. Meanwhile, IV omeprazole was prescried for her since she has got 2 big ulcers. So the paramedics came up and Matt and I decided to follow the pateint through and hopefully we could go into the theatre and see how would the surgery be carried out. Matt spoke to the paramedics and we actually went onto the ambulance with this patient. Matt was carrying the blood box (at this time, i think the patient is transfusing her 4th unit of blood) and i was holding my notes and we set off from Chorley to Preston. When i was in the ambulance, i felt that i was one of the movie star in some show...rescuing patient in something goes wrong on the ambulance... hahaha... in fact, i did nothing. coz the patient was stable and alert and she looked quite well..
It only took us 10min to reach the hospital, (normally the shuttle takes 20min) we reached at 3pm. The pateint was sent to SAU and we waited with her for the surgeon and anaesthetist to come and review her. And after all the hassles, the patient was finally sent to the theatre at 5pm. And the surgeon open up her duodenum and showed us the ulcers. The bleeding was stopped already by that time. They stitched up the ulcers to prevent recurrent bleeding. And by that time, it was already 630pm. And we didnt have any lunch yet, we asked to go off and i was just very excited that i could have such a precious experience. Thanks to Matt!!!
So i will probably drop by to ITU tommorrow to find out how the patient do post-operatively. But this is it... Melaena, once you see it, you'll never forget!!!

出口

2009-05-31T11:34:00.000-07:00

词曲：徐佳莹

火车行到伊都阿末伊都丢哎哟磅空内
磅空里面的我啥咪拢不惊因为有你的期待
回荡在心口的一字一句暗夜中将我照亮
那是最温暖也最有力量的你给的星光

就算不知道出口是什么模样
我会继续的前往
挣脱了捆绑
主宰心里头的天光

就当不知道失败会是怎样的重量
这小小的舞台有我大大的梦想
还有你陪伴的目光
看我不迷失方向
为你而闪烁的模样
看我为你而闪烁的模样

So... Random....

2009-05-31T05:06:00.000-07:00

Life is unpredictable. For the past 1 year, i live alone, far away from my family's protection and i met these random people in my life. I might just see them for few minutes but their speech and action could make me remember them for life. Some of them left me happy memories but some of them just remind me of how sweet my family was being my angel and guardian throughout my life.

Here i would like to share 2 occasions that i met these 2 random feeling that remind me of my friends and family...

1. Young Malaysian Chinese Girl Vs. Perverted Indian Muslim Old Man
There was this RANDOM old Indian man that i met on the bus was saying hi to me, and being polite i said hi to him as well. Then he started to ask me am i from Malaysia, then i said yes... then, again being polite, i asked him where was he from, he said Mumbay, India. Ok... Fine.. I thought our conversation would end here. But... he started asking few weird questions... eg: Are you a Muslim? Are you Married? (Stupid Me!!! I should be more alert when he asked these questions but I was just stupid and naive....) Ok finally we talked something more normal... He said he likes durian, then again being polite i said me too....
Then finally the bus reached the bus station. I was about to go off, he came to shake hand with me... (I know it's weird, again i should be smarter and run away when the bus reached the station..) Stupid me!!! The very wrong thing i did was........... I took my hand out and shook hand with him........ And the next moment... I was stunned... He moved his face towards me... And i believe my pupils were dilated as a result of fight and flight response because i could see his lips clearly. He moved his face towards my face and he.....KISSED on my cheek... I was totally IN SHOCKED!!! and the next thing i knew was i walked away from him.... I feel that i was MOLESTED... He's a muslim... even if i am single.. how could he do this to me??? He is just a random people. even if i am in UK, it's normal for their culture to hug and give a goodbye kiss... but i just couldnt believe it happened to me.... Never ever had anyone kiss on my cheek apart from my lovely cutie cousins... and of course never ever to be an old man... I would probably could accept it if he was a young, cute, charming, white guy...
For once, i regret not bringing any friends with me... For once, i hate myself for being too naive and not alarmed... For once, i wish i could have a boy friend could help me go and punch the old man... For once, i wish my family is around and comfort me or even take legal action against this perveted "uncle"... But it's too late... I couldnt recognise the old man even if i decided to sue him . Hahaha...

2. Young Malaysian Chinese Girl Vs. Young African Muslim Man
So another random experience on the bus, I couldnt believe this would happen as it was just 5 min journey from the hospital to my former house. So i met this African guy who said hi to me, and being polite, i said hi to him. Then he asked am i a chinese? I said i am a malaysian. Am i married? and i am a honest person i said no (probably i can consider lying to avoid all the troubles, i hope the Buddha will forgive me when i lie, but i was just to honest... and stupid...)Then he started telling me that the story of his relatives in London married a Malaysian... I felt it's weird, i didnt want to know the story... What has it got to do with me??? But obviously i didnt say that...
Another weird thing would be he showed me his ID and asked am i a student, oh yes, i am... so.... I didnt want to see his ID... What has it got to do with me??? Then for the very first time in my life, there's some one that praised me and i felt very weird instead of feeling happy. He said that i have got very NICE TEETH...Out of so many parts of my face... It's not my eyes, not my nose, not my lips, but my teeth.... And this coming out from someone that i first met...
And i reached my stop already, i quickly stood up and told him that i'm getting off soon. Then guess how he ended our RANDOM conversation??? He lifted his hands up and started praying in the bus... And wished me luck for my studies... (I think i should feel touched but i could only say thank you...)
At least, this African man is less harmless than the Indian old man... But, afterall, he's just weird...

If i could bring a friend with me, maybe the outcome of the story would be changed. Hahaha... But i guess this is part of life, meeting random people... Luckily i didnt lose much apart from losing a kiss... yuck yuck.. now that i think of it, i feel like going to wipe and clean my face..... Ishhhhhhhhhhh....

你是友情，还是错过的爱情？

2009-05-13T11:42:00.000-07:00

最近，周杰伦的《蒲公英的约定》不断在脑海中出现，想起了那一句。。

一起长大的约定那样真心与你聊不完的曾经
而我已经分不清你是友情还是错过的爱情。。。

当然，我和你没什么约定，别说蒲公英了，连个大红花约定都没。。。
反正约定与承诺都只是包袱。。。倒不如像现在一样顺其自然得更好。。。

我的真心，从没让你知道，也不知道该不该让你知道。。。
我喜欢和你聊的不止曾经，我喜欢聊现在，更喜欢聊未来与我们的梦想。。。

而我应该还分得清楚，你是友情，或许比友情多一点吧。。。
友达以上，恋人未满的境界。。。
肯定的是，还没到爱情，单方面的真心，怎能说是爱情。。。
如果不是爱情，那就不会错过了，我错过了吗？

你不是真正的快乐

2009-05-11T12:25:00.000-07:00

作词：五月天作曲：五月天

人群中哭著你只想变成透明的颜色
你再也不会梦或痛或心动了
你已经决定了你已经决定了
你静静忍著紧紧把昨天在拳心握著
而回忆越是甜就是越伤人了
越是在手心留下密密麻麻深深浅浅的刀割

你不是真正的快乐你的笑只是你穿的保护色
你决定不恨了也决定不爱了
把你的灵魂关在永远锁上的躯壳

这世界笑了於是你合群的一起笑了
当生存是规则不是你的选择
於是你含著眼泪飘飘荡荡跌跌撞撞的走著

你不是真正的快乐你的笑只是你穿的保护色
你决定不恨了也决定不爱了
把你的灵魂关在永远锁上的躯壳

你不是真正的快乐你的伤从不肯完全的愈合
我站在你左侧却像隔著银河
难道就真的抱著遗憾一直到老了然后才后悔著

你值得真正的快乐你应该脱下你穿的保护色
为什麼失去了还要被惩罚呢
能不能就让悲伤全部结束在此刻重新开始活著

你说

2009-05-10T08:57:00.000-07:00

你说
猪流感蔓延至英国，要我照顾自己
我知道了

你说
我没有良心，因为忙着读书
但我有打电话给你

你说
我去旅行时要自己小心
我会小心的

你说
要买生日礼物给我
我超感动的

你说
要寄包裹给我
我在等着

你说
有千言无语要告诉我
我在听着

你说
你想念我
我明白，我也想念你。。。的手艺

你说
你爱我
我了解，但我就是没有勇气当面说出口
我也是。

保重，妈。
母亲节快乐。

Swine flu

2009-05-01T09:18:00.000-07:00

The first time i have heard of Swine flu was earlier this week because my clinical partner was telling me that the outbreak has reached UK. As time goes by i heard it more frequent from the news from the radio and stupidly i thought it was "Swan flu" as it's derived from Avian flu and Swan is associated with the birds. In fact, that was not the case, Swine flu is related to the pigs rather than the birds.

I only cleared my doubt about "Swan" flu until mum called me yesterday as she knew that Swine flu has crossed over the Atlantic Ocean and came to UK, she confused me with the term "猪流感” which literally means Pig flu as Swine flu was transmissible by pigs. Finally after Google it from the internet, i found out that i have mistaken Swine flue as Swan flu. My mum was worried as it can cause death by just the flu itself. While blogging about this topic, BBC news has released an update that there are now 11comfirmed cases in UK and one NHS clerical worker has infected.

Everyone gets very worried, not only the public but also the NHS staffs. The hospitals are more aware and alert and and having meetings and discussions on how to manage this outbreak (personally i think it's stil too early to say as an outbreak, and certainly not a pandemic yet but it looks like it's going towards this trend.) And, we as the medical students have asked to attend a talk about the trust policy and management of this outbreak 2hours ago. Our hospital has decided to split Preston, which's taking the flu-admitted patients and Chorley, taking the non-flu patients. And in Preston, 4units are selected to accomodate the patients, which are the respiratory ward, 2 side rooms in Paeds ward, the Primary Care Trust, and also A&E. The pateints would be admitted to the isolated room as to prevent infection but the dilemma is you want to save them at the same time we are restrciting the patients as they are contagious.

Patients are not allowed to get out of the room unless they are going for urgent investigations. Even if they need to go out and use the lift, make sure the lift is empty. Visitors are not allowed to visit the patients at the moment to prevent the spread. If you find yourself having flu, the advice is stay at home and ring the GP to come and visit you instead of you going out to the hospital, approaching the public and spread the disease.

The infection control team has came out with the rules of prevent spreading. We were advised to put on the PPE-personal protective equipment and the sequence of putting on and removing are important. Put on the apron --> mask-->gloves. Remove apron-->gloves-->mask. remove the mask last as you dont use the gloves to touch it and contaminated to gloves and further contaminate the apron/ your own clothes after that. But do not forget to wash hands and alcohol gel is effective against the infection. The normal mask is only useful for 2hours, and need to be changed every 2hours. FPP3 mask can last longer for 4hr and our hospital is going to order extra as a mode of prevention. Next, we were recommended to bring our clothes and change while working in the hospital so that we dont bring our dirty/contaminated clothes back home and infect other people at home. We were told to check the updates from Health Protection Agency on the infection control.

The whole approach will be different when it comes to a pandemic. At the moment they would swab all the patients that come in with flu-like symptoms. But when it comes to a pandemic, it's no point to swab the patients, just treat the patients immediately as per Swine flu management. By looking at the condition now, prevention is better than cure. And the group of population that the hospital is trying to protect are the repiratory compromised and children. Every unit that is involved is working on it and helping to prevent a pandemic from happening.

We shall pray and wish to condition does not turn worst. Remember, PPE, hand washing, and now might be the best time for us to stay at home and study for finals. Metta to everyone.

想念

2009-04-02T09:34:00.000-07:00

Check this out...
http://www.youtube.com/watch?v=ed_IYszq2vc

Can you feel the love?

Weight gain? weight loss?

2009-02-22T11:06:00.000-08:00

I think girls like to look slim but i am the odd one, don't really care about my physical appearance, as long my BMI is within the normal, who cares how do i look like? My brothers are always the one who tease me on my weight and body shape, but then, it doesn't affect me at all.

To be honest, i have been gaining weight in a gradual pattern ever since puberty because i thought that my appetite was still like what i had. I ate a lot when i was growing, and continue to eat so much after the growth spurt, but in fact, i do not need that much nutrients anymore, so what happen to those nutrients? They are stored in my body, as a result, i look "roundish" than i used to be. And every year after chinese new year, i notice that i have to buy a slightly bigger size shirt than the previous year.... What a sad case, i'm gaining weight in a very small scale, steadily, gradually and it's even saddest to say that i do not feel like losing weight at all. Just be myself...

And last year, i came to UK for my elective posting, i had terrible tootheache, and for that 2 months when i was suffering from my toothache, i didnt eat too much, i had sandwiches almost everyday. So when i went home, i noticed that i lost 3kg by restricitng my diet. And that was the first time i feel that changing dietary pattern can really affect the weight. However, i regained my weight very fast in the four weeks time when i went home because i extracted the decayed tooth and continue to eat all the nice food in Malaysia.

And for the past few months, i notice that i'm losing weight again, intially it was pointed out by my friends, they said i look slimmer but i didnt take it seriously. Human may lie to me to make me happy, but my clothes would tell me the truth.
First evidence, i notice my clothes get a bit loosen, i blame on the washing machine that spin my clothes til they become looser. But then, one day, i took out the top that i do not wear it very often because i feel it's tight especially when i button all the buttons. When i say i do not wear it very often meaning that i do not wash it very often, there's no chance that the washing machine going to danage the top. So, I put the top on and surprisingly it just fits nicely to me and do not feel tight at all even i buttoned it up!!! Second evidence, i went shopping to buy new clothes for chinese new year. And i could fit into a smaller size shirt which i couldn't last time. Not only the shirt, long pants as well...
And now... i need to think this seriously, i weighed myself, i have lost 5kg from the previous time. As a medical student, suddenly, a lot of things came into my mind. Is it cancer? No, no, no... I'm too young for that... Is it hyperthroidism? Em...maybe not, i dun feel agitated, heat intolerance, no sweating, no palpitation.... I do not have diarrhoea, so it couldnt be malabsoption disease. What else it could be? Stress? Depression?

Think simple..think simple..
maybe just because my mum is not around to cook delicious food for me. so i eat simple...
maybe because i walk a lot so save up bus fares... Exercise can burn my extra calories...
maybe...maybe... ergh.... i cant crap anymore....

i started to scare that it might be something wrong with me but i feel i am normal....
i weighed myself again one day and... oh dear i lost another 2kg in 2weeks...
Em, now i know what's wrong....It's the weighing scale!!! I have been weighing myself with different scale, it's not accurate, maybe they never calibrate their scale...yes yes... I believe the problem is the scale...

After having all thos efunny toughts in my mind, i need to take this seriously. I think that i should maintain my weight, because it's really unusual that i lost weight and it never happen in the past 10years of my life. I just denied that i become slimmer...That may just be every girls' wish but not mine.

I started on a plan to regain my weight. I went shopping, i bought chips, sweented cordial, honey, apples... I learned to eat snacks at tea time... I had heavy dinner. And had apples for supper. Deng... deng.. deng... deng... I regained the 2kg weight in just 5days... haha... I feel i am normal now... Mission accomplished!!! I'm back to myself. From this experiment, i realized a fact that it takes lesser time for me to gain weight but longer time to lose weight. But again, who cares?

I think people who is reading this post would think that i m carzy. but when something unexpected happen in your life, even it's as trivial as losing weight, you would still deny it and take some time to accept it...
Should I just accept the "lighter" me instead of the "heavier" me to save up all the troubles to put on weight???

她的医院 Hopsital G

2009-02-15T14:07:00.000-08:00

I decided to blog about this as a new post because it contains a dream, our dream, me and Ah Girl, that's why I name it Hospital G.

她说：她的医院，要让病人住得舒服，有家的感觉。要让病人能选择菜单，有多样化的口味。
我说：要是我，我要有病人教室，教导病人须认知的医学常识。要他们知道药名，和吃药的原因。

她说：她要当院长，聘请有责任有爱心的医生，一起打拚，为民服务。她是Hospital G的院长。
我说：她可以请我当小儿科专科医生，我要当小儿科部的主任。我是Hospital G的副院长。

我们都说了，要一起工作，在芙蓉开医院。
还有三年才毕业，还有十年的政府服务，到时候，我们说不定能一起实现我们的梦想。

一切都是梦，但有梦总好过没梦。
让我们为这个梦一起加油吧！！！

Miss my blog

2009-02-15T13:56:00.000-08:00

I'm supposed to blog about my Christmas trip...
I'm supposed to blog about my New Year's eve...
I'm supposed to blog about my mock osce
I'm supposed to blog about my Progress Test
I'm supposed to blog about my Krakow-Prague trip
I'm supposed to blog about my Chinese New Year celebration
I'm supposed to blog about my CNY resolutions
I'm supposed to blog about my lots and lots of stuff...

But, i was lazy...
everything has been delayed...
I've lost the feel to update those posts

Life is about feelings
When it's over, and you cant catch back, you'll just lose it...
Revive and look forward...

Start a new life...
A new post...

遗失的护花使者

2009-02-15T07:51:00.000-08:00

想问他
630和10，
谁比较重要？

想问他
UK的地球人和CHERAS的火星人，
谁比较重要？

再见了，
我的私人司机
我的专属钢琴师

祝你们幸福。。。

41, Taman Indah Baru

2009-01-14T05:52:00.000-08:00

Original post by Mr Tan Jin jack

Words in red-- edited By Tan Jane June

Here's a post specially dedicated to my old house in Lukut. 41, Taman Indah Baru.
As you would know from my profile, I was born in Klang, but actually raised in Port Dickson.
(Not for me though, I was born in KL, and raised up in PJ, Shah Alam and Kland until the age of 6, started my primary and secondary education in PD.)
I spent 1-2 year (I believe) at Bukit Samudra before moving to this house, (that time we didnt have enought money yet, so we rented a house when we first moved to PD), which I spent about 15 years there. (I guess it's less time for me, as i went to INTEC and IMU, but i do go home on weekends if possible) Now, I am a proud resident of a bungalow in Green Street Homes, S2 but I have to admit, I do miss my old home. (Yes, me too!!) But then, it has been sold and will no longer be ours.

Anyway, I will try to introduce my old home, which cultivated me to be a academically gifted student, which shaped the me today. This home is just about 2200sq feet, including the compound.

Some of the pictures suffer from poor quality. It's wise that you don't open them up to see in detail. You'll regret.This picture was taken one day when we went back to PD to 'zhap' our things. Obviously, we were no longer staying there already as you can see the rubbishes were being cleaned out and put outside. (I miss the deco for CNY la, we used to help mama for the decos) So, shall we proceed to the living room?

This is the living room, quite small isn't it?
Don't get me wrong, I did grow up with a TV and most of the furniture are being brought over to the new house that I currently resided in, so you'll see it to be less packed. To the left of this picture will be the master bedroom, and on this plan, it will be sure that the TV was at the left of the photographer. (The table in the living room used to be my study table as i would only be at home on weekend.) So, how it became in the end?

This is it. A clear and spacious living room. If you looked up the previuos picture, you can probably find that there's curtains. We actually intended to leave the curtains for them but they decided not to take it. What a big waste. They wouldn't know it will be at least RM500 to settle all the curtains, unless they know how to sew it.

If you wonder what the heck is the window in the living room, then the answer is here. (the place i miss the most, used to be my private bedroom and study room when i was in secondary school. But it was invaded by xiao dee ever since i moved to college) It's the study room. For the time I left this house, it's study room, but it had had many purposes throughout its service in this 15 years. I can remember vividly it was once the bedroom for we 3 siblings. (that was when we were all still very young) There's a double decker, and the bottom had a pullable bed at the bottom. That was a great moment. And, I guess at that time it also served as a study room as well.
So, after a few years, when the upstairs had finally converted its status from store room to bedroom, this room had actually converted to be a personal room for my sis. (See, my personal room but unfortunately only for a short period of time, i used to study a lot in that room when SPM was around the corner.) That was her study room, and bedroom but everyone had access to it easily. And don't know change how many times it finally got developed into my study room. (thanks to me, my generousity that donated this room to you and me have to migrated to upstair and be the parasite to hoi's room.) But on the wall that had the little drawing, it actually had my poor piano on it. And, to tell you a secret, the table was placed there because that direction fostures study luck!

A bad angle about the room after clearing off. But, it provides a picture anyway.
Moving futher in, will be the kitchen.

That was the kitchen where I mastered my cooking skill. (Kitchen is not my base, as i don't cook very often at home, but the most of the time i spent here is to makan, and of course help my mum with cutting and washing of the ingredients. But to be honest, i spent very little time cooking here. Comparatively, i cook more in UK) At the corner, was a stove. This image was taken with a warm yellow light on, so the image seems a bit yellow. A dining table was supposed to be there (left of the sight), and touching one end of the wall (the unseen wall at left.). That dining table was indeed a very legendary one which I think is older or about the same age as me, but still looks very sturdy and solid. Well, it's made from niato (spelling?), a wood that can stand humidity quite well. (What happen to the dining table? We used to fight for nice seat in the dining hall which could get chill air from the wall fan. Because it's a wall fan, and it could only blow to limited direction) Same wood is also used for the kitchen cabinets as shown. (it used to be attacked by rats and cockroaches at night sometimes, and we had a lot of rats catching and cockroaches killing projects going on...)

The clear-off-ed kitchen. The condition of those cabinets are still okay, IMHO. But considering it was under humidity attack for 15 years, and the wood still held through, it's quite impressive. BTW, do you note the spot on the third door from the right? It was made by me as I accidentally tore off the formega layer. If you stand on the place where you view the empty kitchen, the stair that leads to the hidden upstair is on your left.

Indeed, the house doesn't come with an upstair. The upstair was made from scratches. I don't know why the idea came into my dad's mind but the upstairs certainly serve us fine, as a storeroom at first, and then our bedroom.

Those two pictures are the view on the upstair. First towards the right and second towards the left. There should be a bed with frame on the 2nd picture, where my bro slept. (So this is Hoi's room and i was just a parasite in this room with least power at all... No right to choose which bed i could sleep, no right to choose when to switch off lights, no right to trun on my own music....Coz i only use this room on the weekends and also holidays... Very cham de...) The first picture shows the old mattress that we used to sleep, but we switched to a newer one before moving into the new house. Those are leftovers. (Parasite like me didnt get to sleep new mattress, i had been sleeping on the old mattress til we moved into the new house) If you asked why my bro got the right to sleep on a bed with the frame, then I can tell you right away that it's because that upstair was said to be belongs to my bro. He's the first person to spend a night there and also one of the main contributors in converting the store room into a bedroom.

I regretted that I actually didn't shot any photo for the master bedroom while I don't find it necessary to shot the toilet and the ACTUAL store room. Anyway, please continue to read this thread, we'll talk about the compound.

Yes, it is like that. I am lucky to actually has photos of the green compound. (Wah, got tropical forest de feel..) Apparently the compound wasn't cleared as early as the others and hence it's preserved while the photos were taken. Very green right? Very 'forest-like' isn't it? No doubt, that's our old house, and one of the pride that we own. It's managed by my parents. There are flowers like orchids, fruits like mangoes, flavours like pandan and spices like curry leaves. (Mama planted flowers and papa grew fruits...) We really appreciate the environment. (Not really, coz this place made our house got more mosquitoes) Despite the small house, every guest is amazed by our little forest! Too bad, it's now like this..........
So, you call it deforestation? We really feel sad that the new owner has no appreciation on the floras, but leave it. We have moved a majority of them to our new house, and our new land is becoming greener and greener!

Hmm, just an extra picture to add before I end this thread. A wild grass that grows strongly from the crack of the cemented car porch. Hope everyone can behave like that, be a strong one. I actually tried to destroy it (without very brutal force though), but failed. I hence left it like that. Guess, it's now being destroyed by the new owner.
Hope you enjoy my post that comes with photos. Rarely I did that!

Now only i can understand that how much effort my mum and xiao dee put in to clear the house for the new owner with my dad and hoi working. I feel so guilty for not being able to help and my mum even fall sick after working too hard for the cleaning...
So long, 41 Taman Indah Baru...
No matter what happen, PD is still my hometown even now my house is in Seremban...
I am proud to say that I am from PD....

My Christmas Break- Episode 4: Day 3 in Vatican City

2009-01-03T13:26:00.000-08:00

So Day 3, we set off to the Vatican City, the smallest country in the world. We visited their museum and art galleries.

There were a lot of pictures and painitngs in the Vatican Museum that shows the history of the Kingdom of Rome. And this picture is the one i like the most because i understand it. The two person in the middle were Aristotle and Plato, the knowledgeable philosophers in Rome. Most of the pictures were telling stories of the crucifixion of Christ. I could hardly appreciate them as i'm not a Christian, but i could appreciate all their hard work on painting on the wall and the roof. It's amazing!!!

And this is the art work i love the most in their art gallery. It's a very artistic work that shows the crucifixion of Christ.

And finally, we arrived at the Sistine Chapel. No cameras were allowed but it was too crowded in the Chapel and everyone was taking picture and the guards just coulndt be bothered to stop them. So, i also quietly took pictures in Sistine Chapel.

The famous painting done by Michelangelo especially the one just above my hands. It describes that how God created the world. And the picture above my hands was showing that Adam (the first person in the world created by the God) on the left and also the God on the right. They were so closed together but yet they still couldn't touched each other. My friend was explaining to me that this shows how eager the God wanted to help the human.
And me trying to copy what Michelangelo drew by posing two of my fingers as close as possible but not touching each other yet..

Our last destination on Day 3, was to the St Peter's church and St Peter's square.

Look at the crowd... We have spent our time in St Peter's from day time til night time coz it was around the time for sun set... And we had a chinese dinner that night and went home to rest after that...

My Christmas Break- Episode 2: Meeting random people

2009-01-03T10:29:00.000-08:00

I should start my story from Day 0, before setting off to Rome, I spent my time in this restaurant-May Flower in Liverpool. I sang K with the other seniors and met the first random people in the trip apart from my Preston seniors, who is Miss Hiew Sing Yee, a Liverpool Y4 but doing placement in Burrow in Furness, originated from Miri.

Then early morning at 0430, we set off to the Liverpool John Lennon Airport and met another two random people of the trip. One was the Wythenshawe Y4, Mr Yee Kim Wah and the other was a freind of my housemate, My Tony Lau ( a combination of Tony Leong's and Andy Lau's name).

Actually i cant say he'sa random person as i do know him, just that we weren't that close before the trip... I discover that he's a joker, has very good skills in posing the poses of the statues.

So this is Mr Tony Lau, originated from Sandakan, who is currently working in Manchester, and he's the only non-medics in the whole trip.

And then, on Day 1 in Rome, here i met another joker of the trip, Mr Yap Kok Hooi who spoke a lot of Cantonese and me became Fleur's translator all the time when she didnt understand. Mr Yap is from Kulim, Kedah and is currently studying in Dundee Y5, going to graduate soon.

Then on the same day, we met 3 other seniors that flew from Edinburgh to Rome.

So, now i introduce you this nice gentleman from Kuching, i actually know him through his brother and also my good friend from Kuching. I feel that he always being bullied by his friends but he seem to enjoy it... So he'sot really a random people as i knew him when i was in IMU, and he is.. Mr Tay Poh Sen.

Then i shall introduce you this lady that is not afraid of cold at all. While i was wearing 3 layers in Rome, she only wore a thin jacket. I wish i could have that kind of power to withstand the cold in UK.... Her name is Lee Yan, and sorry for not konwing her surname, and she promomisd to come visit us in February.

Then the next random people is Mr Soo Kok Foong... But he's a half random people coz i know him but he doesnt know me... Simple reason, i still remember that he ragged my group during our orientation by stealing our group flag... But i dont think he still remembers it... Picture taken on the Rialto bridge in Venice... I like the view...

So now we have all 13 memebers in Rome, including myself, Fleur, Wilfred, Siew Sing, William and Emily.

And then here i met another 2 girls Seet and Yee Leng ( I hope i spell the name correctly)
They are on R1 and L3 position.

Last, but not least, the whole Mentakab gang who were in the same car with me for my Aviemore-Aberdeen trip.
From the top row, left to right, Miss Esther Ng, Miss LiLi Hong and also Mr Hew Kent Keat.
Ad the bottom left is me and the bottom right is the host of Aberdeen, Mr Liew Yen Eit.

It's too bad that i dont have their individual picture. But i really had lots of fun with them...

A trip that mixing with the random people...
At the end of the day, i gain a lot of random experiences...

My Christmas Break- Episode 3: Day 1-2 in Rome

2009-01-02T10:50:00.000-08:00

Day 1 in Rome, I arrived in the faternoon and went to our B&B to leave our luggage. Then by the time we left the B&Bl, it was already late noon and the sky was getting darker. We went to collect Kok Hooi and after that walked down to St Giovanni in Laterano (It's a very nice church...) And we found a place for dinner and walked to Colosseum to look at its night view. Dang...Dang.... The night view of Colloseum, and i couldnt believe that it was just loacted at the road side.

Then we walked back to our B&B after recruiting all 13 members of the trip and we all had a good rest and started our memorable journey the next day.

Day 2 in Rome, our first destination, to Piazza di Spagna, it is pronounced as Spain-nia, the 'g' is silent.

When you walk up the Spanish Steps, you could see the view of entire rome and the most busy shopping street, Via Condotti. This is where you can find all the barnded products but that was not my place of interest as i only had limited budget for the trip...

After that, we decided to walk along the River Tevere all the way to Paizza Del Popolo, a big open area where they had one of their Christmas market.

And then we spent some time to look for the restaurant for lunch, after that we walked to the Pantheon, which has converted into a place of Crhistian worship from a temple. This building is one of the building that renders the ancient monument in Rome and it has a hole on top of the dome. On the floor, there were small holes as well to drain away the water when it rains. I do not understand why it was designed that way, maybe because that's special...

,
And that were my hands forming the circle to enclose the round hole.

Last destination of the day, we went to the famous Fontana di Trevi. Itss name came from the 3roads (tre vie) that converged on the paizza. It appeared in the tvb drama, 冲上云霄。Visitors could throw a coin over the shoulder into the fountain if they wish to come back to Rome again. By the way, the central figure of the statues is Oceanus.

However, i did not throw the coin as i believe that if i were to go back to Rome, i would still go back even if i did not throw it.

The end for Episode 3.

My Christmas Break- Episode 1: The Christmas tree

2009-01-01T08:45:00.000-08:00

I have never paid attention to the Christmas trees in Malaysia because i don't celebrate Christmas at all. But ever since I am in the Western country, i try to understand their culture and i notice that Italian can make more creative trees than the English...

This was a huge CT that i saw in the cetral of Cardiff and it was as high as a building of 4levels.
This golden CT was the first one i saw in Italy. It was made by the Ferrero Rochie Chocolate Stall in the train terminal station.

Next, it's the transparent CT which i believe would be very beautiful when the lights on it are on. This was located in the Piazza di Spagna in Rome.

This CT looks very simple but look at the tip of it, it has a Mercedes sign, it's a Mercedes CT. This was located at the junction of Via Condotti (which is known as the street of branded products) and Via Del Corso.

Dang...Dang... Dang... Dang...Dang... The Madacascar CT situated in the shopping mall in Rome. Cute lei..

Another normal CT but with special decorations. The round circle things that hang on the tree are drawings on paper plate drew by the little kid. It was found in Venice.

Another creative CT that made by card board. It looks plain without decoration but i like it because it's simple... This was displayed in one of the shops in Venice.

This is the most creative CT that i ave seen in Venice. it's made by the wooden sticks and stack them accordingly by lenght.

Last, but not least, my favourite CT... with the hanging socks that form a "J" shape. I have the feeling that this was specially made for me, J.J.Tan....

天堂与地狱只在一线之差

2009-01-01T08:04:00.000-08:00

天堂篇
新的一年，有新的希望。打电话给老朋友，聊了一番，超开心的，毕竟真的好久没联络了。之后，与堂妹整家人上网，我还有机会和他们讨过年的红包。虽然不能回家过年，但公公已答应把我的红包保留起来，等我暑假回家时给我。一切都那么美好，直到小弟打电话来。。。

地狱篇
家里刮了大风，都散了，全部人的放弃了。可是，在怎么样，我也不能放弃他。和他通了电话，真的好难过，我好担心他，可是他说他已张大了，不用担心他。难道只就是人长大了，翅膀就硬了，那为什么我的翅膀就没硬过？只想对他说：珍惜现在所拥有的，回家吧回到最初的美好。。。

好人难做

2008-12-11T12:56:00.000-08:00

我想做好人
但事与愿违
总值有别的事挑战你做好人的决心，毅力，耐性，与脾气。。。

但偏偏又做不了坏人
没有做坏人的勇气
做错事又容易内疚
真是不懂那些贪心鬼，自私鬼，是怎么欺负人又不会觉得自己犯错了？
该羡慕他们吗？

No。。。
No。。。
No。。。
要相信善有善报
恶有恶报
不是不报
只是时候未到。

PBL-problems based life

2008-12-03T06:59:00.000-08:00

What's life?
My house mate says life is difficult.
My clinical partner says life is complicated.
And i say life is...problems...and lots of problems...

Life is about money $$$$
Recently because of some misunderstanding between me and my sponsor, i would only be able to get my allowances for this month 28days later. And how am i going to survive for this month? Everything needs money. Food needs money, rent needs money, traveling needs money... And i have just planned to go Italy with my friends in Christmas. And after that, i planned to go Aviemore skiing with the other group of friends. And in this month, i have to spend a bit extra for holidays and buying Christmas present for friends. Luckily, i didnt overspend for the last few months and i'm now using the money carefully so that my bank account wont be overdraft. Now i know why people can get stress up when they dont have $$$$.
有钱不是万能，但没有钱真的万万不能啊！

Life is about study....
I was so slack for the first few months and now when i started to get serios with my studies and i noticed.... I~ actually~ have~ so~ much~ to~ study~.
I cant blame anyone for that as i started it late and probably my aim is too high that i would like to cover as much as possible but i couldnt finish it within a month before my exam starts. So now what can i do? Slowly digest... Slowly memorize but not to miss a sinlge point... It's hard as it requires discipline and the greatest enemy of my discipline will be my sleeping bug... Winter is around the corner and my brain is so used to going to bed a couple of hours after sun set... But now the sky is getting darker earlier and becoming bright later in the morning. And i would just like to lie down on my bed and refuse to wake up... especially during weekends...
However, i still need to work hard, i am pushing myself to study... push hard... and work hard... I cant let my parents down... I can let myself down...

Life is about friends and family
December is an exciting month as my friends would come over to visit me and at the same time i am going to visit them... These are friends that we have not seen each other for ages... And i have just noticed that on the day my good friend arriving Preston, i would have to see my mentor on the same day... But nevermind, i would have some other friend that could take care of him...
But, my mum told me that my grandparents came to visit her all the way from Penang. And i wish they could come and visit me as well, not only my grandparents, but also my parents and my brothers... We used to spend time everyday when i was young, but even if when i am in college or university, i would still go home on weekend to spend time with them...
But now, regardless of weekdays or weekends, we could only talk to each other through the internet.
I miss the time we have dinner together, i miss the time we go shopping together, i miss the time we sing together, i miss the time we have fun together...

When one goes away, the other one would come. 一波未平，一波又起。How to solve all at the same time? And everyone copes with it differently. And my way of coping is... to blog... to write it out... Not expecting to have a solution yet...
But at least, i would feel better...

Miss Silver, happy belated birthday!!!

2008-11-26T10:28:00.000-08:00

This post is dedicated to my childhood friend, or maybe not really childhood, i was already in primary school when i knew her. It's her birthday on 25h nov, and i have forgotten her birthday once which made me super guilty and now i'll keep that in my mind.

I have just called her this morning and i was very happy that she still remembers me( so touched...) She could recognize my voice without me introducing who i am.

And now it's time to talk about Miss Silver, i like to call her ah ngan(in cantonese) coz her chinese name is 银。So i label her as Miss Silver, i even save her phone number as Slver Koh. Now to clear the doubt, her surname is Koh, not Silver. (but i still like to call her ah ngan)

First impresion of her, smart student, how smart? The type that super not interested in biology, knew her aim since she started to learn science, used to claim that dissection is very cruel (if i am not mistaken, this was the reason she decided not to take pure science). Then what's her main interest then? I only label people as smart student when they can solve mathemathical questions easily. And she's one of the rare one (as a girl) can score very good results in maths and physics. And that's why she always has the honour to become our treasurer and ambulatory human calculator when we go shopping.

Now that i think about it, we have never be in the same class in the five years of secondary eductaion. We were in the same class from stadard 4-6, and never since then. How do we become close friends then? I have no idea, probabaly this is what we call 缘分。We have very similar personality(she might not agree with it 因为我很容易发脾气,she rarely lose her temper, unlike me, haha). Our thoughts are rationale and logical. (can kind of predict that as she likes maths and reasoning) 物以类聚嘛！ This is how we became very close as we worked together for chinese society and also red cresent. I was the VP and as i have mentioned, she was the tresurer.

Have we ever had conflicts/frictions before? Maybe we had, but i really couldnt remember. Perhaps our mums had. My mum was just being too protective as ah ngan and i were in the same year, of course there would be some competition to a certain extent. But i treated it as 良性竞争, we competed in UPSR, PMR, and SPM and other exams but it turned out to be a win-win outcome eventhough there was competiton. We even competed for role model student before in standard six and of course she won because her academic result was better than mine. And do you think i am the loser? No, no... I scored better result in my SPM and i end up doing medicine under the government scholarship. (Haha, revenge successful!! No lar, ah ngan i am just kidding, dont angry ya) And now... she's doing not too bad, final year in UM, doing telecommunication engineering. (until now i still dont understand why did she choose this course)

Ah ngan, everyone has already working except both of us. We must work hard and to prove that we are competent to work in the community even though we are graduating later than other people in our year.

Hereby, i attach a pic to show you who Miss Silver is...
And here is the pic of my jay chou calendar for the month november. At the right hand corner, that is the farewell gift given to me from her few days before i came to uk. And i brought along with me... Thank you very much for the gift
Last, but not least, all the best for your future undertakings!!! 生日快乐。

SHE 安静了

2008-11-23T16:11:00.001-08:00

詞/Selina
曲/周杰倫

只剩下鋼琴陪我站在這裡
夢想中屬於我們的婚禮
卻成了單人結婚進行曲
在這場愛情角力的拔河裡
愛我還是愛你你選擇了自己

撒嬌的可愛的黏人的愛哭的照片裡曾經的都是你喜歡的
如今我還在原地你卻走回你的記憶

你說我愛你太多就快要把你淹沒
你害怕幸福短暫一秒就崩落
分開是一種解脫讓你好好的想過
我想要的那片天空你是不是能夠給我

你說我給你太多卻不能給我什麼
分不清激情承諾永恆或迷惑
愛情是一道傷口我們各自苦痛
沉默是我最後溫柔是因為我太愛你

只剩下鋼琴陪我站在這裡
夢想中屬於我們的婚禮安靜了在我枕邊的夢裡
我知道相愛原本就不容易
愛不是1加1 努力就有結局

撒嬌的可愛的黏人的愛哭的照片裡
曾經的都是愛著你的
臉頰的淚還溫熱卻沒有人握我的手

天使Vs恶魔

2008-11-22T08:45:00.000-08:00

当有人开我玩笑时
天使说：“忍一时风平浪静；退一步海阔天空。没关系，他只是在开玩笑而已。”
恶魔说：“忍个屁！退你个头！你不给他点脸色看，还是会被欺负的。”

我听了天使的话，只因为我想当好人。

当有人又在开我玩笑时
天使说：“没关系，自娱娱人。人家开心，我也会开心的。”
恶魔说：“你有没有搞错啊？！让别人的快乐建筑在自己的痛苦上，你是笨蛋啊？！还嘴啊！”

我又听了天使的话，沉默是金，我相信总有雨过天晴的一天。

当有人不停地反复的开我玩笑时
天使说：“上一次都放下了，这一次又何必提起呢？好人有好报。”
恶魔说：“好人面具都带了这么久，都快窒息了。何必再当好人呢，只会让人起到你的头上来！清醒吧！！！”

这时
我犹豫了
恶魔说得对，你做初一，我做十五。我何必静静的让你欺负呢？我应该出声反驳。我受够了！！！
不对，大声并不能解决问题，撕破了脸皮，以后相处就尴尬了。。。
哪里还有以后啊，现在都受不了了，管以后干什么。。。你以前都敢爱敢恨，现在干麻畏畏缩缩的，想做什么就做啊，想骂就骂阿！！
不可以，出门在外靠朋友，吞下去就没事了，以和为贵嘛！！
谁跟他是朋友阿，忍他一次就以为我很好欺负，他想说什么就说什么，我也可以啊，想这样多干嘛？
睡一觉，明天就没事了。
明天这个人还在，事情发生了。没得改变的。
上一次都过去了，只一次就算了吧。
不能就这样算的，这次不解决，雪球只会越滚越大，裂痕也会越来越深，到时再爆发，连累更多人而已。

恶魔说的话越来越长，天使慢慢的静静了。
谁赢了？
恶魔说越多，让人越烦。
天使沉默了，可是不代表他人输了。

相比之下，这时，天使让人感觉很有风范。
恶魔就像喋喋不休的老太婆。

如果我还嘴了，我和对方还不是一样。尽做一些没经过大脑伤害人家的事。
可是，我没办法向天使那么大人有大量的原谅他。
我生气，气在心里头。
我想报复，却没勇气赋予行动。
因为我有良心，但我要着良心来干嘛？
只会让自己难受。

天使和恶魔还在竞争中。。。
而我，就会使他们的争夺的牺牲品。
站在天平的正中央，天使握着我的右手，恶魔拉着我的左手。。。
我不要去右边，也不想往左边。
我只想跳下去，离开这个烦人的天平。

Boring posts...

2008-11-19T04:41:00.000-08:00

i wish to write interesting stuff but i am in GP posting for a month and really nothing interesting going on.
i would be in icu next week. hopefully it's going to be more exciting...
a lot of reflection to do as i have been just sitting, eating and sleeping and not doing any revision.
i miss exam
i want to be more discipline
i want to be more hardworking
i want to shock ppl with my medcial knowledge
i want to be the top student

but i just know how to dream....
and my dream wont come true if i dun put in effort...
i need motivation...
i need to let my chakra to leak out and motivates me
(the result of watching too much naruto)
gambatekudasai
(the result of watching to much J drama)

ok. time to study...
or perhaps..
time to eat lunch
time for a nap
and finally time to study...

Criteria of my future husband

2008-11-19T03:40:00.000-08:00

I am sitting in the com lab again in this boring wednesday afternoon. So this might be a very boring topic, it's just some personal thoughts that i would like to share in my blog.

I always dream about how my future husband looks like. Old/young? Normal/disabled? Tall/short? Fat/thin? Malaysian/non-malaysian? Chinese/non-chinese? But all these are just physical appearances and what i do really care is the inner beauty, the wavelenght and the character. I always said i dont want to marry someone who smokes / drinks and my mum told me, never try to set a criteria for it cause i might end up falling for someone with all the negative criteria that i have set.

Ideally, i hope he's a musician that can play piano, not only pop songs but also classical. The best part is he can sing while he's playing piano. Trust me, not all pianists can sing and not all singers can play piano. For example, my house has someone that can play piano but has a big room of improvement in singing. Next, he needs to play some kind of sport, preferably basketball. Coz i think basketball players are cool!!! Last, but not least, he has to love his family especially his parents. (Yeah, you are right. He's the one in your mind, Mr Jay Chou!) And i know he's unreachable and a super unrealistic dream that he would be my husband. But there's also a trouble to marry him as all the papporazi and news reporter would target me and i would lose my freedom!!! (Arghh, Xiao Jie, dun think too much....) So Jay Chou is just a dream...

Ok, who's next? There's this hong kong tvb drama series called "The Golden Faith" and the hero in this show was starred by Gallen Loh. And this character was named Ivan and... He's really my dream husband that possibly acievable. He was an adopted child but he cared for his family. He inherited a company that being managed by his father before he passed away. And he took over the company temporary to train his younger brother, Oscar to be more capable of managing the company. But, some how Oscar misunderstood him but Ivan never ever do anything to harm him even though Oscar intent to kill him. On the other hand, Ivan had a blood-related brother and he sacrificed his relationship for him. I give him 100marks for his personality and character as he's really someone that you would only see in a show. But... the thing that i do not like a bout him is... He's a businessman. I always think that businessmen are cunning, selffish and materialistic. Say no to businessman... (But i never know coz i might eventually marry a businessman after being so defensive. Haha!!)

So, stop dreaming of all those all-rounded, 100% perfect man to be my Mr right. Now that i am in the medical world, my partner would be more likely a healthcare worker. Probably a consultant? surgeon? or pharmacist? dietician? or (turun pangkat) charged nurse? nurse? or (the worst thing i have ever think about) a cleaner in the hospital.

Technically speaking, i wish not to marry a doctor as it's going to be very boring if you only mix around with people in the sane career. But practically, it's good as he would be more understading if we work in the similar setting. Nowadays, i have been surounded with anaesthetists as my coordinator is also an anaesthetist. And i think amaesthetist are cool really... especially those who specialised in cardiothoracic surgery.

What would happen if a paediatrician marry an amaethetist? would their child become a paediatrcian anaethetist???

ha, think too much.
i should have used the time i blog on this boring stuff to study but this topic just came into my mind.
i would never know who i would marry.
maybe it's a lady and not a gentleman? (my parents might have heart attack if they see this...)
or maybe i decided not to go into marriage? (second heart attack...)

ok, after all, it's just some thoughts.
dun take it seriously...

Maturity

2008-11-17T06:20:00.000-08:00

Maturity stops you from mourning
Maturity stops you from screaming
Maturity stops you from crying
Maturity stops you from doing stupid things

Maturity makes you becoming silent
Maturity makes you becoming ignorant
Maturity makes you becoming tough
Maturity makes you becoming lone ranger

Am i mature?

I wish i was there...

2008-11-11T08:40:00.000-08:00

73 days I am away from home, not the longest time yet, my maximum record was 120days away from home which was just few months ago. In total, I have been away from home for over 200days!!! If I say I never ever have homesick, taht's a LIE!!! And i do not lie, so i do miss my family, especially my brothers. (Papa & mama, please do noy be jealous ya...)
My first homesick episode ever since i came to preton was when i read xiao dee's blog on our house warming party and his piano fair. I really wish i was there. But unfortunately, i am in UK, doing my clinical practice.
Then the next time was my mum rang and told me that her blood pressure was high and she had headache that she couldnt cope with and she needed to take pain killer which she normally doesnt take at all. At the same time, she complained of numbness over the hands, arms and neck which sounds like the symptoms of stroke. During the period of time, i just started my clinical palcement in stroke rehabilitation ward, and i saw a lot of people who need help in moving around, feeding and even washing themselves. Oh, i dun want to see my mum in that condition!!! She was worried as my uncle died of complications from hypertension, and it runs in her family. I was worried to but i try not to show it to my mum and convince her to go for medical check-up. After talking to my mum on the phone, i just couldnt stop myself crying and i wish i was there with her. I wish i could bring her to see doctor and just comfort her... But i am away from home... I was really hopeless at that time, and spoke to my borther and made him to bring my mum to see the doctor. Thank God, everything turned out to be fine and my mum's blood pressure was back to mornal. The neurological symtoms that she experienced was just the once and only episode.
And... i felt homesick again last friday night, the worst thing was i wasnt alone. When the feelings came, i was surrounded by almost 15people in a room. We were watching a video which was a birthday present of my senior, and in the video, his friends and his family sent their respective wishes to him as last thursday was his birthday. I dun know them at all, I am not even very close to this senior, but i was touched by the video. My tears was just pooling in my eyes when i heard the messages and wishes given by his mum and sister.By looking at their bond, it reminds me of my brothers, especially my younger brother (hoi, dun be jealous ya, sometimes i would think of you also but lesser compared to xiao dee la). And i just couldnt help and cry again, it was so embarassing in front of so many people. I quickly rushed out of the room and sitting on the staircase and just let all my emotions flew out with the tears. I was settled down in a while and to be honest, this time i wish my family was here. What does this imply? I was homesick...
And now, there's no resistance to that feeling when it comes, just try to call them up to make sure they are happy and healthy. Or try to make myself busy with stuff so that i wont think of it.
I will also make sure i am also happy and healthy. That is what they really want to hear.
I am fine really :=)

Stories of Histrory Taking

2008-11-05T04:08:00.000-08:00

1) I was posted to MAU-medical assessment unit one day and i was asked to clerk a new patient that was just admitted to MAU. So i went with my clinical partner and we saw a lady on the bed and a young man besides her. We started off by introducing ourselves and asked why the patient was there. And the young man told us that his mum had stroke and she couldnt speak. (OMG, tak kan want to clerk her by using sign language/ non verbal method?) Then her son started to tell us stories that she has weakness on the right side. (OMGx2, she couldnt even do sign language coz one side of her arm was paralysed!!!) I stared at my clinical partner and seeking for help. And we decided to ask the young man for her details then. He was telling us that he found her collapsed in the morning.... But he didnt know about other details, eg: past medical, drug, allergic, smoking and drinking history coz he didnt stay with her and his mum just came over from spain to visit him... (Arghhh... what a difficlut case) We tried to ask closed question directed to the patient, eg: Do you smoke? And she nodded. We asked again to confirmed and she didnt respond. ( i think she's confused) As a result, we didnt obtain much of her medical history but we still presented her case to a SHO and he sorted out the documentation...

From the medical studnet point of view, i feel sorry for the patient, but it's really hard to obtain history from someone who couldnt express themselves even if we are willing to help... It's even harder to obtain history from them if their family dont know they are not close to their family.
The moral of the story is update ur family or friends with ur daily life so that they would be able to provide information to the doctors if you KO one day (touch wood!!)

2) I was asked to clerk this gentleman who has very interesting cardiac history in a GP clinic. (OK, cardiac history, set in my mind, probably he has ischaemic heart disease. Ah, boring! Chest pain again...). I walked in and started with my opening question: What are you here today? ( i always feel that this is a good question to start with for history taking but i found out i was wrong until i met this chap) And he said that he's coming back for his prescription. (Em... Sweat!!! I cant make this a chief complaint and i cant derive any questions from there for history of presenting illness) So, i moved on to asking about what medications he was on ( i regret starting off with drug history coz it was weird to do the history taking in a reverse order) He told me he's on warfarin(first thing came into my mind was DVT-deep vein thrombosis), simvastatin (this is an expected drug if he has IHD), ramipril (OK, he might have hypertension) and two other drugs that i couldnt remember. (there's no GTN, asprin, and beta blocker. it's so strange?! maybe he's not an IHD case) Ok from the drug histroy, i moved backwards to ask what medical problems ha has to make him on those drugs. (Deng deng deng deng!!! this is the interesting part) He said he had cardioversion 3 weeks ago and they put him on warfarin. (OK, next think backward, why was he cardioverted, must be something wrong with his heart rhythm) He said he had palpitation for 18months. (See, i was right!!!) And then i was stucked, palpitation ah, not chest pain ah, and i was trying to apply to SOCRATES. Coz i never clerk a history of palpitation before... After that, i asked about his family history, smoking and drinking history and the GP came in to review my history. I didnt even ask about the regular/ non regular and fast/slow when he had palpitation. ( what a simple mistake) And after that 10min history taking, i really learnt a lot!!!

From the medical student point of view, not all clerking in CVS is chest pain or shortness of breath. Not all diagnosis would be angina, myocardial infraction, and heart failure. Do not forget about arryhthmia, especially atrial fibrillation!!!
The moral of the story is do not make any assumption or have any expectation coz life is so unpredictable!!!

3) I was in ICU-intensive care unit and i was asked to clerk Mr Big (that's not his real name, the staffs called him Mr big because he was very obese) I appreciate this clerking coz it's the only case i could clerk in ICU as most of the patients in ICU were in sleep, intubated, on a ventilator and not suitable for clerking. Mr Big was fit enough to talk as they are going to discharge him from ICU to medical ward. Of course, i started with the same question again, "Why are you here today?" ( i clerked him before the second case, so i was still very used to my method, i think i am going to change soon, coz it's no longer very useful.) And he gave me a weird answer saying that he was there because the staff couldnt find the equipment to move him away. (See, it not a very good question as the reply wasnt what i want) So i rephrase my question, "why do you come to the hospital?" and he answered me that he came to the hospital for some breathing test. (OK, i asked the wrong question again) I repharse it the third time and make sure that he would fully understand, "Why do you come to this ward and why were you admitted to the hospital?" (and this time i was fairly sure that i could get the answer i wanted, mana tau...) He said: I dont know... I dont remember how did i come in and i dont remember who brought me in. I just remember that my GP came to see me and asked me to come to the hospital for a breathing test and next thing i could remember after that was i was alreday in this ward. (So Strange... How am i going to write this in my history? Cheif Complaint: patient dont know what happen to himself) I guess he was collapsed and he didnt even remember whether he collapsed or not (Yau mo gau cho ah??? Makes my life so difficult) And luckily his wife and his mum came to visit him at that time. I could obtain history from them and they told me that he always felt asleep and he wouldnt remember what's going on when he was in sleep. And i went to read his notes after that and the diagnosis for Mr Big was Sleep Apnoea. He collapsed( or felt asleep?) in the hospital and the anaesthetist was called to go see him as he stopped breathing at that time. That was how he admitted to ICU.

From the medical student point of view, ask the correct question to get the correct answer!!!
The moral of the story is also ask the correct question to get the correct answer!!!

Sports and leisure time

2008-11-05T03:51:00.000-08:00

Every wednesday afternoon is sports and leisure day for manchester medical students. Everyone gets half day off on wednesday and i think it's a good day as wednesday is just the mid-day of a week, and it's really nice if you can have a break.

And my wednesdays turn out to be a better day as i always finish pbl on wednesday. (tuesday is a sad day coz i always have to rush and do my pbl on tuesday evening). So i would be super free after my pbl in the morning... No need to go ward, no need to go clinics, no need to go GP sugery, no need to go home visits, no clinicla teachings...

And i would be in Blackburn ON MY OWN... as i don't go back to Preston and most of my friends are in Preston. The only people that is with me is my clinical partner, but he's going to Preston for shopping!!! (I was left alone)

But my mentor (who is a SHO in GP training)( she's an oxford graduate wei... Super Keng!!!), offers to teach me but she's working in A&E in another hospital. And i'm lazy to take the shuttle bus to that hospital....

And what's going to be my plan to spend the whole afternoon?
According to my past experiences, i would either sleep or watch series... Very rarely i would study... Or maybe i should make a change this time...
And now... I 'm blogging... Would i blog the whole afternoon? I never know...

稻香

2008-11-02T05:43:00.000-08:00

词：周杰伦曲：周杰伦

　对这个世界如果你有太多的抱怨跌倒了就不敢继续往前走
　为什么人要这么的脆弱堕落请你打开电视看看
　多少人为生命在努力勇敢的走下去我们是不是该知足
　珍惜一切就算没有拥有

　还记得你说家是唯一的城堡随着稻香河流继续奔跑
　微微笑小时候的梦我知道
　不要哭让萤火虫带着你逃跑乡间的歌谣永远的依靠
　回家吧回到最初的美好

　不要这么容易就想放弃就像我说的追不到的梦想换个梦不就得了
　为自己的人生鲜艳上色先把爱涂上喜欢的颜色
　笑一个吧功成名就不是目的让自己快乐快乐这才叫做意义
　童年的纸飞机现在终于飞回我手里

　所谓的那快乐赤脚在田里追蜻蜓追到累了
　偷摘水果被蜜蜂给叮到怕了谁在偷笑呢
　我靠着稻草人吹着风唱着歌睡着了

　哦哦午后吉它在虫鸣中更清脆
　哦哦阳光洒在路上就不怕心碎
　珍惜一切就算没有拥有

　还记得你说家是唯一的城堡随着稻香河流继续奔跑
　微微笑小时候的梦我知道
　不要哭让萤火虫带着你逃跑乡间的歌谣永远的依靠
　回家吧回到最初的美好

Jooney Thermometer

2008-10-30T06:12:00.000-07:00

Weather in Preston-Blackburn-Manchester is getting colder nowadays. And i find myself to be a very good indicator for the temperature and it's quite accurate in estimating the surrounding temperature. The followings are my findings:

When i need to put my gloves on when walking on the street and my ears and face are numb because of the cold~~~It's 0-4'C

When i need to wear my skarf and use my thick coat and there's mist coming out from my mouth when i talk~~~It's 5-8'C

When i just need to wear a jumper/jacket~~~It's 9-12'C

And when it's 13-16'C, i can even wear short sleeves and walk on the street provided that there's no strong wind...
And stop dreaming la.... Winter is coming... NO more 12-16'C...

It's all <12'C now and it can go to <5'C at night...
Believe it or not, Jooney's thermometer has unknown specificity and sensitivity... But, it's very accurate!!!

My Clinical Partner

2008-10-28T05:23:00.000-07:00

Personal Details

Name: You know who
Age: 22 in 19days
DOB: 15.11.1986
Race: Malay
Religion: Islam
Occupation: Of course is the same like me, third year med student.

Chief compalint (on my cp, ie clinical partner)

Whenever you ask him to make a decision, he would say:"Dun ask me, man! I dun mind."
Whenever you accidentally do someting wrong, he would grab the chance to tease you and say:"I can do wrong. You cannot!!!"
Whenever you accidentally say something wrong, he would immediately want you to admit it and say:"I'll do that also, but i dun admit. You must admit!!!"
Whenever you are late for maybe just 5sec, he would blame you and say:"I can be late/I never be late (in fact, this is not true...) But you cant be late!!!"
Stop saying the work "FXCK" in front of me, i feel very uncomfortable whenever he uses that word!!

History of presenting complaint (SOCRATES)

Site: of course is on me la
Onset: ever since we were cp
Character: i hope he was kidding when he was mean to me...
Radiation: no radiation notice yet, so far his target is only me, didnt c him do the same thing on my other friends yet
Associated symptoms: Nil..
Time pattern: Mostly day time coz i dun see him at night.
Exacerbating factor:Not very sure... Coz i am always nice to him...
Relieving factor: When i offer him coffee, he would treat me nicely, i guess. he even helped me with my pbl.. :=)
Severity: It varies with his mood. When he's happy, he can play songs for me, even Jay Chou's.

Past medical(academic) history

Absent in lecture
Absent in CSU session
Absent in PBL
Generally he missed 90% of academic hours in IMU
he scored A for haemato (according to him, that's the only A he got) which i only got A- (He beat me!!!) , the reason was because he attended the dengue lecture, not because he did revise or study. What a smart person!!!

Family History

Parents are not doctors but have high expectations on him.
They would buy him a car if he passes exam with distinction and i have asked him to save a place for me. Ha, this is the priority of being his cp!

Social history

He smokes but he says he'll quit when he reaches 10pack years which is the time when we graduate and qualified to be a doctor.
He dosent drink BUT he likes to ask me to drink vodka...
Diet a bit problematic coz he can only eat halal meat, as a result of that, he only eats tuna and prawn sandwhich everyday.
He eats chocolate for breakfast and his favourite drink is Oasis citrus.

Systemic review
Sleep, appetite, bowel, micturition, weight all normal and no change.
The only thing that has changed was his attitude towards studying. He's positive and active in learning which i think it's a good change. Not sure will people from IMU believe this when i tell them..

Diagnosis
Jooney Bullying Snydrome?

Plan/Treatment

To treat him as nice as i can so that he wont bully me anymore. But i doubt this will work.
Help him do some research on PBL as he helped me before
Make him quit smoking asap so that he would thank me for being concern of his health and treat me nicely. But this is going to be a MISSION IMPOSSIBLE!!
Discharge him after being one year of CP?

Conclusion

This is just a joke, Mr Azman.
Dun take it too seriously!!
Quote your favourite line:"Chill la..."

I'm ALIVE!!!

2008-10-25T03:14:00.000-07:00

When all the bad things are gone.... good things would come.
I believe that would happen on me....

For once, when i knew i have to go to Blackburn, i really felt like going to pub and drink and make myself drunk. But now, after experiencing my clinical life there for a month, i enjoy it despite the fact that i have to travel everyday.

And then, here comes the story of my new phone. I ordered it on line and it said that i would get it the next day. But i waited for 2 weeks and rang the people and found out why. (at that time, i really felt like scolding people... but then i think my skills were deteriorate after not scolding people for very long time, coz no target in Preston that i could fire...) And they were telling me they didint have the stock and replace it with the othe colour... Ok, fine! whatever... just send it to me asap... And finally i got it the next day and i LOVE it so much... I just lost a earpiece that comes with the phone and i was sa sad... Didnt enjoy my friend's party at all and i went home alone sadly... But after all, i feel that good things would come after each episode of sadness. I shall wait and see.

Look, my little buddha with my new phone that i love so much...

And then, at the same time, i was struggling to find out why my computer couldnt go online.... I was surviving by using the library computer and also friend's computer to keep myself as a human in the millennium century. And finally i repaired it myself and my computer was reborned, meanwhile, and there's regeneration process going through my system. And... I'm alive!!! Finally i could get in touch with people bec from Malaysia or even friends in Scotland... The distance seem to be shorten with all the advance technology.

Take care, my friends and family.. I'm doing well here..
Bad things were gone and good luck is by my side. I have faith in myself!!!

It's only you....

2008-10-10T04:10:00.000-07:00

There is just one thing in this world that would make me home sick....

I do miss our malaysian food, eversince the raya celebration at my house. We had nasi lemak with ayam goreng... But this wont make me feel home sick....
I do miss my mum's cookings, but i am used to not eating her food eversince i left home to college... But this wont make me feel home sick...
I do miss the nice and warm weather, but i am doing fine with the waether here as long as it doesnt rain... But this wont make me feel home sick even though the weather is getting colder...

It's not a phone call back home....
It's not my dad's email...
It's not my mum's voice...
It's not hoi's computer skills

It's you.... Xiao Dee!!! It's your blog....
I chose the wrong time to read your blog today. I was in the hospital computer lab and your blog moved me to tears again. I wish i could hear your stories from you but not through your blog.

It reminds me of the things happen in the family...
I'm always the last one who knows.
Recently, i couldnt go on line, and i couldnt get first hand news from all of u...
It's time for me to fix my com problem...
It's just too shameful to sob in the library

I really miss u all so much...
And i have to go for lecture 30min later with red eyes...
Xiao Dee, it's all ur fault....

Chain email

2008-10-06T12:42:00.000-07:00

Finally now i can get hold of my IMU family. When i looked through the email, is sounds like a med student forum. It's all about our medical postings. And i like WL's story, for once i thought that's from YS(no offence, YS, i just thought that u r more filial to ur grandparents). But towards the end of the story, i realised is not YS, it's our Funny King- Mr WL.
Guys, i really miss our time in BJ n vista.
It's really nice to hear from those in aussie n nz, n of course those from msia.
n to those that r in UK, we must meet up one time, hopefully u guys can come over to preston to visit me la.
thanks to those who initiated this chain email. i really appreciate the chance to c what happen to u guys. take care. n keep in touch!!!

Be confident!!!

2008-10-02T11:37:00.000-07:00

I had a few more examinations in CCU today. But then i got a lot of things wrong. I am still not able to pick up crackles, murmurs... I even mistaken a soft abd as guarding. But then i am happy to learn from mistakes. At least, i remember.
However, i was uncertain in presenting my findings. Partly because of language, partly because of knowledge. Sometimes i cant think of the accurate word to say... Sometimes i just knew the outcome without knowing the mechanism...
I used to be a very confident person but when it comes to physical examination. I was scared, scared of doing wrongly or performing weakly.
Just need to come out with my style.
Jooney's history taking and examination style.
When i am able to establish and practice my style, i know i am going to succeed.

Just thought of something out of the box:
Clinical life can be very tiring but...
It's so fun.... It makes u think 24/7... It makes u think that u r still alive...

I am alive to seek for more confident!!!

Placement in Blackburn

2008-09-30T15:27:00.000-07:00

After a day of induction, finally today i have started my official clinical placement for my first module: HLB- Heart, Lung, Blood. My first posting in Royal Blackburn Hospital is in Critical Care Unit. I had a very interesting day despite my clinical partner was absent. I did a respi and cvs examination on my own. And both were female patients!!! And clerking a patient who was uncounscious on admission. I was blank when writting the report and i didnt know what to write for chief complaint and associated systoms. Coz the patient wasnt complaint of any symptoms at all!!!
And i performed an ultrasound on the neck. I DID IT!!! all on my own with the verbal guidance from the registrar as he needs to see the vessels in the neck in order to put in the central line. Changing the direction of the probe to look at different anlge for carotid arteries and internal jugular vein.
A lot of things were very different from what we learn in medical school. In a real clinical settings, problems arised when you come into practice.
For example,
1) The pateint has both arterial lines at the radial pulse, then I had to find a space near the radial artery to palpate for the pulse....
2) The patient has kyphoscoliosis, the first time i did percussion and auscultation on the back but not in a straight line downwards. I had to follow the shape of the spine to percuss and auscultate and compare.
3) A female pateint who had aortic stenosis and i actually picked up ejection systolic murmur on my own. but then the problem is she has breasts on her chest... and then i could palpate the apex beat. but i had totally no idea how to locate it when i moved along the intercostal space coz i couldnt feel for the rib!!!
After a whole day of hard work, i kind of more appreciate that i am in Blackburn. Although i was on my own, but it's a brand new world that welcome me a lot. So i just relax and enjoy my postings for the next 13weeks...
p/s: never expect myself to adapt so quickly, hopefully this happiness would continue....
Good luck, Jooney!!!

It doesnt rain today.... But i cried yesterday

2008-09-26T06:27:00.000-07:00

There's a phrase in chinese said that the day would be sunny after a rain. But then it doesnt rain today and it's sunny.
Life still goes on even my appeal wasnt successful. Balckburn here i come~~~ i would normally put !!! at the end of the sentence but i really dun feel like putting it on. i dun feel excited, i'm just feeling calm. after a few days of waiting, i kind of accepting the fact that i'm going there reagrdless what the reason i gave to the dean. now my main concern is to stay there or staying back in Preston? to travel everyday or to get accomodation there? at least it's comfirmed i have to leave and i could stop myself from dreaming...

i want to end the law of bad attraction and create the law of good attraction...
instead of saying why i havent receive my phone yet???
i should say: my new phone is coming soon!!!
instead of saying why i have to go Blackburn???
i should say: Blackburn, i'm going to conquer you!!!
instead of saying why my com cant go on line???
i should say: I would sort this out very soon!!!
Would everything good come to me soon? I want good things to happen... I want things to go as i wish but... sad to say, in the real world not all things would go as u wish...
so just accept.... accept the fact that those bad things are over, and i'm waiting for my new n happy life in a new place!!!

Tears flew out yesterday... and it's accumulating today... i wonder when would it burst. i'm trying hard to hold it, to hide it from ppl....
But i know it's going to burst, it's just a matter of time...

the post today is very random... but i'have been very moody since last week, pretending that i'm happy. i'm trying to be tough and mature but it's really hard.
can i be more childish and do things without thinking the consequences???
ppl ard me would nvr bother. they just care abt what's the plan this weekend. n i would just have to listen and hiding my tears...
it's not a shame to cry but it's a shame i have no freinds to open up my feelings with...
it's just to hard to get true friends here...

i m going to end this post at a random point. pls dun ask me what happen as too many things happened and i duno where to start. but if u r really my true friend, just pray for me n i'll be fine.

Focus, Think, Stand up & Speak out

2008-09-22T09:33:00.000-07:00

This is my new motto of being a medical students in Prseton.
fisrt of all, must FOCUS in all lectures and PBLs. coz the ppl here hv very strong accent, if u r dreaming for 1 sec, u might not be able to follow the whole story and seem very lost in the lecture.
next, must THINK!! cannot think hard, must think smartly and think wisely. the manchester students are very good in stimulating their brain to think, unlike us the malaysian students that are so used to spoon-feeding based education. that's why we r always slow in giving answers coz we dun use our brain to think frequently.
finally, i must learn to STAND UP & SPEAK OUT... chances are there, but i cannot just be like in malaysia sitting at my own corner to study. to gain more knowledge, to improve and advance in this country, they key is to ask questions. never afraid of asking supid questions, jsut voice out our opinion.
BUT.... somehow this is quite difficult to achieve as we dun normally think... so we dun normally think of any questions.... if u dun have questions, u remain queit...
cycles go on... and on... and on... and i m still in the stage of focusing... a little bit of thinking.... and a very long way towards standing up and speaking loud....
i have to be determined, it's all in my mind....
Focus, Think, Stand up & Speak out!!!

time flies...

2008-09-12T05:12:00.000-07:00

finally our first week of ICL has come to an end...
what have i gain so far? only one word, MALU~~~~
I FEEL SO EMBARASSING for myself as we go along the time table. eg: communication skills lab, basic life support, airway training, glucosemeter training, cannulation, iv infusion, urinalysis....
basically i have learnt a lot of this thing from IMU formally or informally but i still cant master tthe skilss for 100%....
i just feel that i have put in so much effort to go till this far but i did not advance for the past few months...
"a lot to catch up" is actually an excuse
"a lot to recall" is the truth...
laziness would always make u not moving....
so i should be more dedicated from this second...
ren zhen!!! jia you!!!

Orientation/ Induction Week

2008-09-10T04:08:00.000-07:00

I came to manchester/preston with an empty cup, hoping to fill in with information and resources... I wouldnt say i enjoyed a lot so far coz their orientation was boring... super boring....
Maybe i should start on with the comment thing first...
First of all.... weather... it wasnt very cold yet as now is till consider as summer although autumn is coming up... But the worst thing is--> it rains very day.... My shoes and pants get wet... i even got splash when a bus pass-by because i was walking to close to the road...
Next next...Classes/ Meetings/Breifings...
of course, i believe all students, regardless what uni you in, u would hv to meet the dean frist.. we, the direct entry student was asked to go for a briefing on the day before we met the dean as they would brief us on the medical schools and departments, the medical school student reps in MANCHESTER... but it wasnt really applicable for me as i m not going to stay in manchester as my base is in PRESTON which is another city further away from manchester. if u take train, it will take u 45min for a trip... but i am happy to find out that preston is one of the stop for the train to glascow and edinburgh... as i hv friends there....
and the second day for us, the direct entry students, aftyer meeting the dean and listening to their speech, we went to the stduent service centre for registration. i was lucky that i was sponsored by the government and everything went so smoothly without any trouble at all, which means i do not need to come to manchester another day to sort it out... i got my swipe card on the day itself and i can now proud to introduce myself as STUDENT OF UNI OF MANCHESTER!!!
and here the third day came, we were giving briefing on Royal Preston Hospital which is the base of our hospital... and also some of the staffs and most imporatantly, they briefed us on the ICL (Intro to Clinical Learning) which is an induction course the last for three weeks, before we go into clinical settings...
then here came the first weekend for my second visit to UK... i planned to visit my uncle and to collect my stuff as i left a lot of stuff at his palce in my first visit. and because of that i missed a super huge dinner with the seniors on sat night. there were 80seniors from Y4, Y5, FP1 nad FP2 and also my batch mates, the Y3 students... and that was the saddest experience i had ever had in travelling in UK.... the journey from manch to cardiff is only 3hr. i departed at 2.30pm but eventually i reached my uncle's house at 8.30pm..... what a terrible trip!!! the train was moving slowly... and it terminated at hereford and i was told that the railway was flooded and the train couldnt move over... so i was "invited" to take the bus to newport and myuncle picked me up from newport train station.....
and this week is my second week.... also boring week as it's an oreintation week for the preston students...
looking forward to see what's going to happen this week. ha!!

40 days in Malaysia

2008-08-18T07:04:00.000-07:00

From 20th July, the time i arrived KLIA to 30th Aug, the time i am leaving Malaysia, i have 40days to spend at my hometown. I have so much things to do in these 4odays and finally my preparation has come to an end.

Day 1 I went shopping with my family in IKEA on the day i arrived. To be honest, i was tired but i was happy that i could met my family after separation of 16weeks.
Day 2 I did my medical check-up in a private hospital near my house as requested by my sponsor, JPA.
Day 3 I met IMU seniors in Mid Valley and also my friends. We watched "Red Cliff" together as i didnt step into a cinema for 16weeks.
Day 4 I went back to my old house to shift my stuff to my new house. At night, i met my Sban friends and invited them to visit my new house.

Day 5-8 I went back to Penang to visit my relatives there. And ate all the food that i have missed.

Day 9 I went to IMU to collect my academic transcript and on the same day, i went to extract my decayed tooth in the dental clinic.
Day 10 I cleaned my own room and set up my new wardrobe with my bro.
Day 11 We ordered a lorry to carry our furnitures from old house to new house. And a very tiring day...
Day 12 I went to KL to apply my student visa.
Day 13 I went to JPA for briefing to collect my flight ticket and allowance. On the same day, i went to KLIA to change my flight date from 14th aug to 30aug due to misunderstanding between me and JPA officer.

Day 14-15 Finally, i could stay at home and no need to go out on as my cousin came to visit me.

Day 16-20 I was asked to attend Kursus Kenegaraan that organized by Biro Tatatnegara. And the day i came back from the camp, i watched Beijing 2008 Olympic opening ceremony with my friends... That was my farewell with my beloved friends....

Day 21 I went back to my dad's kampung, Ulu Yam to pay respect (bai bai) to my ancestors. And of course i wont miss the delicious Loh Mee...
Day 22 Nothing much to recall, i guess i was chilling at home...
Day 23 I brought my grandpa to PathLab for his medical check-up as he keeps complaining his knee pain, i suspect it was due to osteoarthritis. But it was just too hard for me to tell him in Hokkien.
Day 24 I went to KL again to collect my student visa but some how it was quite depressing as UK granted me a 2yr visa as opposed to 3yr duration of my course due to error in my financial affidavit.

Day 25-28 I stayed at home chilling and watched Taiwanese drama-"Fated to love" as
recommended by my cousin.

Day 29 I went shopping with my family again. At night, stayed tuned to astro and watched the final match of badminton men's single. As a malaysian, i gave my spiritual support to Lee Chong Wei. But as an audience, i gave Lin Dan a round applause for such a good match.
Day 30 And today, i did something that i wished to do since the first day i came back. I cut my hair to the length that i am comfortable with...

Another 10days to go...
I would need to start to pack my stuff to UK...

It has to come... The day i leave my family to pursue my dream...
Nothing can be done even if i feel sad...
The only thing i am trying to do now is treasure every second that i could spend with them as i am using these 40days to compensate the 1yr period that i wont be around...
I am happy
I am contended
I am grateful
:=)

home sweet home...

2008-08-12T08:22:00.000-07:00

finally i am back....
finally i have internet connection...
finally i can blog...

but then, i was busy...
i am busy...
i will be busy....

i was busy with student visa application, medical check-up, pre-departure briefing, kursus kenegaraan....
i am busy with cleaning my new house, packing and unpacking my stuff, decorating me new room....
i will be busy with visiting relatives before i fly to manhcester, house hunting in preston, and spending time with my friends and family...

no matter how busy am i, i am happy to be here... my home town...

< ?? hr

2008-07-18T04:36:00.000-07:00

i am leaving singleton hospital < 1hr
i am leaving swansea university in < 5hr
i am leaving wales in < 19hr
i am leaving london in < 24hr
i will be back to malaysia < 37hr
i will be back home in < 39hr
i just need to wait for another 2340 minutes...
which is euivalent to 140400 seconds
140400...
140399...
140398...
140397...
140396..............................................................
when i count to 1s, that's the time i can see my family...

Sayonara...Goodbye... ZaiJian...So long...Selamat tinggal

2008-07-17T05:26:00.000-07:00

What would i miss the most in Wales?
1) my cutie "ang mo" cousins
2) my kind and friendly coulleagues
3) free coffee everyday in the hospital
4) clean environment without cockroaches
5) cool and nice weather that wont make u sweat
6) green grass and pretty flowers
7) food, eg: muller's youghurt, joe's ice cream, subway's burger, walker's snack...

What wouldnt i miss at all in Wales?
1) Potatoes!!!! no more potatoes when i go back
2) Sanwhiches!!! say no to sandwich, "tak nak"
3) strong wind... when the wind blows against you, it can make you very hard to step forward
4) Proper "kuai low" english... i want to speak pasar/broken/malaysian english with all the 'la', 'mei', 'wor','ma'....
5) dogs that like to run around!!! bye bye, doggy...

Sayonara...Goodbye... ZaiJian...So long...Selamat tinggal
to all the people, events, things and places in Wales

Another 4 days to go...

2008-07-16T05:12:00.000-07:00

I am going back home in few days time... Very excited... Finally i can go home and spend some time with my friends and family
most probably staying at home for one month time and need to fly again to manchester to start my clinical practice in september...
so i need to spend my time wisely... as i have too many things to sort out...
1) my medical report to JPA
it was supposed to be completed 2 weeks ago but because i was in Wales, i was allowed to post to them later... i hope it wont take me long but according to my friend they waited quite long in government hospital and it's quite costly to do it in private hospital...
2) collect my unconditional offer letter and apply for my student visa...
IMU has got my offer letter and i need to go British Council to apply for my student visa... i already got the form and the photocopy of my passport plus the photo... what i need to do now is just bring it to the office in KL
3) have a hair cut
I cant imagine myself not having hair cut for 16weeks... My friends would know that i trim my hair quite frequently as i like my head to be light...i couldnt think well when my head is heavy although my long hair only weigh <100g
4) decorate my new room
i am moving to new house very soon and my dad hag bought the other furnitures and only my room was left empty because i am not at home... he only got me an air cond and wardrobe. i am using the old bed... but anyway, i wish to get a study table and a chair... i'll go shopping to get new furnitures for myslef... HOORAY!!!
5) eat as much as i can.... especially home-cooked food
i miss my mum's cookings, especially her luo han guo soup, herbal chicken, fried dou miao, steamed fish, fried prawn... and other malaysian food, eg: bak kut teh, nasi lemak, satay, asam laksa, ulu yam loh mee... i wish i could sapu all the food in the 4 weeks and maitaining my weight at the same time... what a great challenge to me.....
6) meet up with my friends...
i hope to meet up with my imu sban friends in sban... do u guys 1 2 go for movie or sing k?
hope to meet my ex-housemates in bukit jalil as they were working for imu...
hope to meet up my pd friends in UM as our beloved headboy is going to graduate on 7th aug... really need to go and wish him all the best...
and also miss ds who supported me a lot...
7) meet up with my relatives...
i miss my beloved and cutie cousin, eg: an an, jia jia, shi shi, er er, and hong hong...
of course also not so cutie one, eg: tomboy xin and liverpool yong...
and also my grandparents, my uncles and my aunites...
8) last, but not least... to spend some time with my family
i'll use this one month time to compensate what i did not do for the past 16 weeks...
papa, sorry that i still wont buy cigarrete for you but i'll go shopping with you to look for nice furnitures, ok?
mama, sorry that i always reply ur sms late and make you so worry about me but i will go back penang with you to visit ah gong and ah ma, ok?
ah hoi, sorry that i couldnt do much when u were admitted to hospital and as a medical student, i felt so hopeless when couldnt help you at all... but i'll try my best to do whatever you requested as long as i can make it... go pc fair? go mayday concert? go low yat? anything u wish, ok?
xiao dee, sorry that i couldnt find any score for you and bring you so much trouble for these 16weeks... but i promise to invest in your new piano, ok?
thank you to papa and mama who give me so much support, spiritually and financially to fulfill my dream to come to learn with uncle
thank you to hoi and xiao dee who take care papa and mama on my behalf... sorry to make u guys the middle man between two of them... sorry to make u all take up so much burden... i am the eldest child and it was supposed to be my responsible...
i love all of you... muak...

LET IT BE...

2008-07-16T04:49:00.000-07:00

On monday, i was supposed to go to the gynae clinic and it was cancelled.
On tuesday, i was supposed to go to the antenatal clinic, but the consultant was too stressful and refused to run the clinic.
On wednesday, i was supposed to go to the diabetic antenatal clinic and they already had another elective student...
at the end, i couldnt attend all the clinics in the morning...
and this morning, i received an sms from my brother saying that my com certified kena virus.....
the virus was so smart to infect my com at this time... when i am going back home soon. nothing much i can do now, just waiting to go home so that my bro can fix it for me.
everything just gone wrong and i wasnt really upset at all...
learning to take things lightly, i think....
i was disappointed for a while but i know nothing can be changed even if i fell upset.
SO, JUST LET IT BE....

Obstetric & Gynaecology posting

2008-07-15T02:43:00.000-07:00

I've decided to write for this posting in advance even though i've another 4 more days to go. I do this only for two weeks and no ward rounds this time as attachment to this department is very different form others. as the consultant in charge of elective students for O&G created a time table for me, unlike last time i went to the medical/surgical/paediatrics ward in the morning and stay until i feel like leaving. In the wards, i normally follow the consultants for the morning ward round and then follow the junior doctors to do bloods and review the patients. But then, in O&G i have to follow my time table as created.

MONDAY Gynae OPD & Post-menopausal bleeding clinic
TUESDAY Antenatal Clinic
WEDNESDAY Diabetic Antenatal clinic
THURSDAY Gynae theatre
FRIDAY Labour Ward

So basically i do not get to follow the progression of the patients as they only come to clinic once.
But i can still share with you things that i've seen in clinic but it wont be as interesting as cases that i've seen in the wards...

1) Gynae OPD: the most commom complaint would be menorrhagia for young lady and uterine/vaginal wall prolapse for old lady.
2) PMB clinic: i get to see transvaginal ultrasound scanning to measure the endometrium thickness and also endometrail biopsy... (:p)
3) Antenatal: nothing much, basically just follow-ups to check BP and urine...
4) Diabetic antenatal clinic: this is a super busy one cause there were a consultant, a diabetic nurse, a dietician, a midwife, a student nurse and a medical student (that's me) in that clinic. 6 person to see one patient and everyone would interview the patients to find out her medical condition (by the consultant), her daily blood sugar level (by the diabetic nurse), her diet control (by the dietician), her baby's condition (by the midwife) and her BP+urine (by the student nurse). i am the only one not doing anything in the clinic because i dun know what can i do...
basically i just sat there and watched....
5) theatre: very good experience, i get to see vaginal hysterectomy and also abdominal hysterectomy. In vaginal hysterectomy, the cervix and the uterus were removed together as the patient had uterine prolapse. In abdominal hysterectomy, only the uterus was removed as it was enlarged til the size of 12-16weeks pregnant due to presence of big fibroids.
6) labour ward: very unlucky that day as there was no delivery... and i had my free time to do something else that day....

i think it's going to be the similar things this week. i will update new post if i would see anything more interesting...
and this is going to be the shortest clinical post compared to thers of my posts...

My first meditation experience in Swansea

2008-07-10T13:29:00.000-07:00

I was invited to a meditation group by my colleague.
We found out both of us are Buddhist after working together for 3months.
They have meditation and dharma discussion in her house every thursday.
I was looking forward to go to this meditation as i was looking for a group of dharma pals in this land.
But i was quite scared as well coz i do not meditate for quite some time... (perhaps the last time was half a year ago)
And today, i was brought to her shrine hall. And Mel played the buddhist hymn from cd her player while waiting for her other meditation friends.
Mel (my colleague) introduced me to her other dharma friends., Owen and Jean. We chat for about fifteeen minutes.
Then Mel told me that they normally sit for 30min. it was quite long for me but i very pai seh to say i cant do it.
so......
i started to meditate with them, concentrate on my breathing....
as time goes by, my back started to ache....
my right leg started to feel numb...
i tilted a bit to change my position..
but it lasted a few minutes...
then i started to feel numb again...
i focus back to my breathing...
breathe in.... breathe out.....
and finally the bell rang and it was the end of the meditation.
i massaged my legs and make myself more comfortable in a sitting position.

i recalled a lot of moments that i spent in buddhist society...
after the meditation
i remember
my beloved dharma teacher, Bro Tan Ho Soon...
my beloved dharma senior, Miss Lee Xin Er...
my beloved president, Miss Ho Pei Jen
and the rest of my dhrarma pals,
eg: Ling Min, Jackie, Mok, Ei Leen, Hwee Hong, Kian Hwa, Yi Cheau, Kean Aun, Chun Wai, Si Wei..... ( i hope i did not miss anyone)
of course i woulndt forget the juniors...
Chun Loo and friends...

Happy hour passes very fast,
it's the time to say goodbye...

We spent 2hr sitting and talking in the shrine hall...
I really enjoyed the calm and peaceful moment with these foriegn dharma pals...
For the first time, i really feel that no matter what language you speak, what's your skin colour, what's your hair colour...
as long as we are the followers of the Buddha...
We are bound together...

Thanks, Mel
Thanks, the Lord Buddha

眼泪

2008-07-09T14:25:00.000-07:00

词曲：黄国伦原唱：范晓萱
青春若有张不老的脸但愿她永远不被改变
许多梦想总编织太美跟着迎接幻灭
爱上你是最快乐的事却也换来最痛苦的悲
苦涩交错爱的甜美我怎样都学不会
ha......
oh 眼泪眼泪都是我的体会成长的滋味
oh 眼泪忍住眼泪不让你看见我在改变
孤单的感觉你从不曾发现我笑中还有泪
oh 眼泪眼泪流过无言的夜心痛的滋味
oh 眼泪擦干眼泪忘掉一切曾有的眷恋
眼泪是苦眼泪是伤悲眼泪都是你
眼泪是甜眼泪是昨天眼泪不流泪

http://www.youtube.com/watch?v=xYhF_VkzEFo

这首歌，与所有爱哭包共勉之。
只要是让你成长的眼泪，就痛痛快快让他流吧！

Mission Impossible: A walk along the beach 走在鹅海边

2008-07-08T13:26:00.000-07:00

鹅海means swansea. i created it. i went for a walk last week. recorded a few video.
sorry to those who cant understand mandarin. i'll try my best to translate.
dun doubt your ears, it's my voice. i know it's sound very different. but it was me...
the wind was strong that day. sometimes got sand flew into my mouth, very difficult to talk.
i was introducing the bridge in the first video. the bridge had fallen long time ago and now became the road for car to pass.

i was a bit disappointed to look at the sea. it wasnt very nice that day, on the low tide.
just felt like singing a song that related to the sea at that moment.
the first sng came into my mind, 阿妹的听海。
“听~~海哭的声音。。。”
key有点起太高了,还好没破音。
but it was out of tune, super out of tune.
i am sorry to torture your ears.
i just think it was funny... singing while sand blowing into your mouth...
if this video makes you laugh, then i am happy even if you laugh at my
unbearable singing...

another song came into my mind...
the very popular one, even mus knew it...
the champion song for chinese song singing competition 2006 in imu
"你怎么舍得让我的泪。。。流向海~~~”
i know i am not good at singing la...
but it was just fun...
if anyone saw me recording this video, they might have thought that i am mad.

tease me la,
criticize me la,
laugh at me la,
i know i am not good,
but at least i have the courage to make the first step,
even it's something silly to you,
it makes my life different from others...

hope u enjoy the video.
sorry again for my bad *infinity singing.
i wanst intend to prove that i can sing
i just want to tell you that i've achieved something impossible...

Jay Chou rocks!!!

2008-07-07T08:48:00.000-07:00

Jay Chou was the greatest winner for Taiwan Golden Melody Award (something equivalent to Chinese Grammy award) 第19届台湾金曲奖,which was held on last Saturday 5/7/08.
Unfortunately he couldnt attend this award as it clashed with his concert in china.
The good news is he won 4 major awards out of 8 nominations.

最佳年度歌曲《青花瓷》
The best song of the year Qing Hua Ci literally means Green Flower Vase
which was recoreded in his latest album: Jay Chou on the Run 周杰伦牛仔很忙

最佳作曲人《青花瓷》周杰伦
The best pop song composer Qing Hua Ci by Jay Chou

最佳作词人《青花瓷》方文山
This song QHC won the best lyric as well and it was written by Jay Chou good partner 方文山 Fang Wen Shan.

最佳专辑制作人《不能说的秘密》周杰伦
The best album producer Secret OST by Jay Chou

最佳作曲人《不能说的秘密》周杰伦
The best classical song producer Secret OST by Jay Chou

Hereby i attach a link to the music video for this great song: Qing Hua Ci
http://www.youtube.com/watch?v=AMHuRzqfmgg

And also the lyric by Fang Wen Shan
素胚勾勒出青花笔锋浓转淡
瓶身描绘的牡丹一如你初妆
冉冉檀香透过窗心事我了然
宣纸上走笔至此搁一半

釉色渲染仕女图韵味被私藏
而你嫣然的一笑如含苞待放
你的美一缕飘散去到我去不了的地方

天青色等烟雨而我在等你
炊烟袅袅升起隔江千万里
在瓶底书汉隶仿前朝的飘逸
就当我为遇见你伏笔

天青色等烟雨而我在等你
月色被打捞起晕开了结局
如传世的青花瓷自顾自美丽你眼带笑意

色白花青的锦鲤跃然於碗底
临摹宋体落款时却惦记著你
你隐藏在窑烧里千年的秘密
极细腻犹如绣花针落地
帘外芭蕉惹骤雨门环惹铜绿
而我路过那江南小镇惹了你
在泼墨山水画里你从墨色深处被隐去

天青色等烟雨而我在等你
炊烟袅袅升起隔江千万里
在瓶底书汉隶仿前朝的飘逸
就当我为遇见你伏笔

天青色等烟雨而我在等你
月色被打捞起晕开了结局
如传世的青花瓷自顾自美丽你眼带笑意

special thanks to Miss Tomboy Tan who provided me first hand result of the award.

My birthday wishes are flying back to malaysia....

2008-07-04T04:55:00.000-07:00

first of all, i would like to thank all my friends & family that wish me happy birthday....
through msn, email, phone call, leaving comments in my blog, and most importantly sending me birthday cards...
next i would like to apologize to those who posted the bday cards for me....
i just went to the accommodation office to collect them and...
i was told that
"all mails have sent back to the senders....."
OMG!!! my heart was frozen at that moment...
meaning that i wont be able to get my birthday wishes....
it might not get back to the sender....

who shall blame for?
blame for ppl to post it late?
(of course not, they've put in so much effort!)
blame myself for checking it late?
(i checked it last week, no mail for me yet...)
blame the staffs for not keeping my letter?
(summer break has started, all students had gone home, they have no reason to keep the letters)

i feel so bad now... wanted to cry but no tears come out coz it was already frozen....

1hr 48min 的电话粥

2008-07-02T04:50:00.000-07:00

原来讲这么久的电话会。。。
让耳朵与电话变得很烧
让电话差一点没电
让人兴奋过头睡不着（因为是一通半夜煲的粥）
让人隔天醒来超没精神（因为睡眠不足）

没什么重点的一通电话，除了那一句“生日快乐”。
互相寒暄温暖一番，在聊一些生活上的琐碎事，分享些对人事物的观点。。。
原来年轻人就是把青春浪费在这种事情上。

但。。。就是很爽

除了写作让我疯了，原来讲电话也让我疯了。

我当医学生的“医”点“医”滴

2008-07-01T11:59:00.000-07:00

我的“医”意孤行
从小立志当医生，中途虽然曾经动摇过（我曾梦想过当新闻主播）。
到最后，付出了十三年的努力，拚了老命的读书，以考进医学系为目标。
家人曾经劝我选择别条路，因为毕竟对他们来说，经济方面会有些吃力。
可是一意孤行的我，从没放弃过（或许说天真的我，从没认真考虑过学费的事），只知道把书读好，认真地上课考试。
幸运的我，竟然意外的得到政府奖学金，让我有机会梦想成真。
（真的不知道踩了什么狗屎运，因为我不是最top的学生。但我真的很努力。。。）
就像唱阿杜的歌那样，坚持到底，如今，我已经是大三的医学生。

对医学知识的“医”知半解
还是学生的我，每每碰到经验老道的医师前辈，都觉得自己知道与了解的都只是冰山一角。
老实说，对医学知识的贫乏和一知半解，是不够格当医生的。
因为病人的生命在你手上，你必须完全的掌握医学知识，为他们提供最完善的治疗方法。
那样，才够格被人称呼为高人“医”等的doctor。
这个level, 是我的目标，冲吧，希望若干年后，能听到我的病人向我道谢，说一声：“Thank you, Dr Tan."

不经“医”事；不长“医”智。
经验对一个医生来说是非常重要的。
当junior的我们，常常就得向前辈偷师。因为他们吃盐还多国我们吃米呢！
尤其在看诊的时候，年轻的医生很可能断错诊。
就算诊断无误，也有可能开错药方。
用药不当，解药分分钟可能成为毒药阿！
切记！切记！

不可能的“医”刀两断
从没想过当外科医生，更没想过握手术刀。
因为这不是我的那一杯茶。
菜刀都不怎么会握了，更何况是手术刀，绝不能拿病人来开玩笑阿！
或许受了日剧白色剧塔的影响，对外科医生没什么好感。
但无可否认，动手术是医学里不可或缺的治疗方法。

第一次的“医”针见血
在这次的实习中，小妹三生有幸的第一次为病人抽血。
当时的心情，真的是既期待（我超期待的），又怕受伤害（怕病人受伤害）。
结果。。。只能说是半成功啊
因为我把针插进了血管，但血刚流出来就凝固在tube内，无法取得血液样本。
真是不好意思，还好那位病人大人有大量，不记我这个小人过。

外国留学的“医”路顺风
再过两个月，我就正式在曼联继续我的医学生涯。
还有三年，我就能正式毕业，成为一位合格的医生，为民服务。
当然，这条路不可能一帆风顺。
人生就自然是有起有落，没有哪一些低潮，怎能衬托人生巅峰的美好呢？

对家人无私地给予精神上的支持，我非常感恩。
对朋友无悔地付出，关怀与陪伴，我非常感恩。
对老师无怨地循循善诱与教诲，我非常感恩。
对纳税人无奈地把钱投资在我身上，我非常感恩。
不管你在我生命中扮演什么角色，因为有你们，才有今天的我。
感恩。

Window shopping in Swansea on 28062008

2008-06-30T11:10:00.000-07:00

Sat morning, i spent some time in Swansea before going back to my uncle's house.
From the bus station, i walked to the train station. On the way, saw a lot of shop houses.

British Heart Foundation - it sells shirts, shoes, bags... to raise fund for the BHF.
i like their logo, looks like an ECG wave, but with a heart shape... very special...

99p stores - everything under a pound.
the place where i bought my cheap umbrella and children beach sandal.

sports world - always got sales, they sell sport products eg: jersey, sport shoe...
the place where i bought my sport shoe and nike cap.
those sportsmen and sportswomen will definitely like here. they always have sales from 10-70% off.

Marks & Spencer - it sells trendy, fashion, tops and pants...
but i think only the working ppl can afford to buy things here coz they are quite ex..

Lloyds TSB - My bank. I opened the account in the university branch, not the city centre branch. I have heard stories of difficulty in opening an account as international student. i felt lucky to open it in the university branch as less procedure was needed.

COSTA - the coffee that u can find anywhere in UK
COSTA in UK= starbucks + coffee bean + kopitiam in malaysia
you'll see a costa coffee house in every station of their service centres along the motorway (just like our rehat in the highway)

Thomas Cook - i thought it was a cooking school when i look at the name
actually it was a travel agency

Orange - the phone line company. so far, the ppl i met are orange users in UK.
it's like maxis in msia, but then they sell very cheap phones in package with their sim cards.

Amateur1 on the street- playing some old songs with the guitar

Amateur2 with his dog. Look at the balloons behind him. Wah, i hope i could get one...

Look at this bus/lorry. it belongs to a yogurt company. they set up a tent from this vehicle to promote their products. i think it's very creative to just pull out the tent from the bus/lorry.

Wah~~ hundreds of teddy bears... very cute lei, they were displayed by a teddy shop.

Guess what is this? they are colurful, natural, organic soaps.... Looks very delicious!!!
But they are not edible...

The pigeons on the street is just like seeing sparrows in msia.

The black taxis in uk. I think they look like those cars that carry coffin. Touch wood....

No more pics liao coz my digicam ran out of battery.
But then i went to argos to lok at the furniture. i met an indian old man while flipping thru argo's catalogue. they have two, one thin one thick. the indian man asked me a question.
IM: any bad~~?
JJ: sorry?
IM: got bad~~(pointing onto the new catalogue that i was holding)
JJ: ( i thought he was saying...) not bad? very good?
IM: no... bad-do~~
JJ: oh, this one better? ( i was pointing to the old catalogue and guessing what he meant?)
IM: no~~ no~~ bad.. bad-do~
i totally have no idea on what he was saying, i continue to flip on the catalogue. finally the indian man saw what he wanted and pointed to me. it was a BED....
HE WANTED TO KNOW DOES THE CATALOGUE SHOWS ANY BED.....
super sweat ah... after struggling for so long, i finally knew what he meant.

i came out from argos after clearing my doubt with this indian old man, continue my journey to the train station, took the train back to my uncle's house.

Happy birthday to Tan Jane June

2008-06-30T07:23:00.000-07:00

This post was copied from my beloved xiao dee's blog.

Word in red are his writings
and words in black and bold are my writing

Happy Birthday to my beloved sis

happened to be one day...
a pregnant lady suddenly felt that her baby was moving...
but not like how it usually happened..
this time, the baby was trying to make her way out...
to know the world, to see the world after being enclosed in darkness for about 10 months..
but then the lady looked at the calender, it was just 30th june...
the doctor told her that her baby will only be delivered around july..
nonetheless, she got to the hospital...
and, after several tries.. the doctor decided to do the surgery, to 'take' the baby out...
(my mum was telling me that my buttock was at the bottom, unlike normal babies, they have the head at the bottom. the doctor tried to correct my position so that my mum can deliver normally. however, he failed to do so. they had to send my mum to do cesarean section as the amnion was burst.)
yeah, no one knows she was so eager to come out, perhaps in the surgery room instead of normal ward?
(xiao dee, the place to have an opeartion is called the theatre.)
the lady's husband signed the agreement, and without wasting any time, the lady was sent to the surgery room and successfully, the girl was delivered..
on the day of 30th June 1985...
(at 5.30pm in the afternoon, to be exact, my mum was sent to the hospital on 30th june early morning)
and yes, this is the first baby of the lady and her husband...
and due to the fact the baby came out so unexpectedly.. on the last day of june..
the girl was named June...
(good thing i wasnt born in july, i might be named July for that reason. @=@)
Tan Jane June will be the full name for her, following her till now for 23 years already...
(this name is gong to follow me for the rest of my life)

in this 23 years, this baby, has grown into a girl, and now a mature lady that is striving for her dream..
to be a doctor..
(to be more accurate, i want to be a paediatrician)
doing very well for her kindergarten..
(i was struggling in kindergarten as i went to an english kindergarten and was switched to a chinese one when we moved to PD from Klang. I didnt not know how to write Chinese at that time)
enroll in SRJK (C) Chung Hua Port Dickson...
being an excellent and cherry primary student before going to Port Dickson High School.
(the proudest time of my life was in primary3, being the only representative to go for story telling competition in Malay, English and Chinese. partly because nobody from my class would like to go. since then, i have very strong interest in talking and telling stories)
(next, my primary6 life was superb. i represented my school for the state level in a lot of competitions, eg: essay writing, public speaking, drawing competitions... i nearly became the role model student that year. but i was lost to one of my good friend with the score diffirence of 0.4)
Taking the 7A result, the girl went to STPD and make her peak success of her early year, by being the best student during her form2.
Though the 7A1B result of her SPM seemed to be a blocking stone for her future, instead, it has become her stepping stone..
(xiaodee, is PMR result, not SPM. u would nvr know what did i get for B... it was a shame to be i got B for chinese but i nvr retreat and still taking chinese in SPM. felt very sorry to my parents as they took my result for me. i went to a training camp that time)
a driving motivation originated from the dissatisfying result, has opened a bright way for her..
scoring a historical 11A1 1A2 result at STPD for her SPM, she managed to become the ever honourable JPA scholar, and yes, the respectable JPA medicine scholar..
she is on the right track to pursue her dream, becoming a doctor...
(a difficult track though...)

spending 2 years at Intec, getting 3A for her London A-Level and gets into IMU (International Medical University), Bukit Jalil and has always been scoring very well results for her subjects..
notable one includes a 6 A streaks for her semester exam... and only a few B includes in her exams/tests for the time she spent in IMU, clocked at 2.5 years...
(xiao dee, must be humble.. too many people did better than me lei.... i was a little bit shy to admit my achievements... be humble.. be humble...)

and yes, she got a break since last year december...
(super long break until i got poisoned by one million star, hong kong tvb drama, korean drama series and the sleeping bug...)
(i was now cleared from the sleeping poison but then still very addicted to one million star)
but then, she was a great person, has flew to UK to follow her uncle for posting..
to learn on herself, the clinical skills etc. and further discover herself...
she flew to UK during March, and is doing very fine...
(not very fine all the time. got ups and downs. but i guess, that's how life is...)
During September 2008, she will be in Machester...
(xiaodee, another error: Manchester)
studying in the World top30 university - the University of Manchester for her final few years of clinical skill for her Medicine course...

"She is my proud" -- June's mum..
(aka Mrs Tan:你是我的骄傲）
(yes, got grammar error.. should be pride.. but is her mum said in english de, not a translate one, so remain as it is)

and of course, not to forget...
Happy Birthday to Miss Tan Jane June..
(祝我生日快乐)
the girl that is going to spend her 23rd birthday first time outside of Malaysia, first time without us around!
(精神上在一起就够了）
yeah, all the best to you, sis...
you are mama's proud, you are my pride too.. haha..

"when dream is closing, you'll be lost." -- yoga (One Million Star first season winner)

but then, you will find your way back...
(ya, i will find my way back.)

Yes, there were times, Im sure you know
When I bit off more than I could chew
But through it all when there was doubt
I ate it up and spit it out
I faced it all and I stood tall
And did it my way

back on track, to be the ever best sis i could have...

SALUTE!!!
(last but not least, thank you for this special post.
i love it...)

Friday evening in Swansea

2008-06-27T12:39:00.000-07:00

Summer break has started and Swansea University is very quiet now.
The canteen was closed since wednesday. I'd been eating sandwich for one week. @=@
The were two mini shops, one was closed for the whole summer break, the other one only open for half day.
It used to be very lively in the campus, but it's very dead now with a very dead weather. ( it has been raining for the whole day...)
But the good thing is the medical students are still around, in my block-Cefn Bryn, consider half lively as they are preparing for exams. I can see them studying in the common room. Quiet and hardworking...

And... and... and... what am i doing in swansea on a friday evening? aren't i suppose to go back to my uncle's house for the weekend? whatever i say next is going to be censored...
*&%$@£¥γŪŊŕŜцуіẃ !!!!
My uncle rang me at around 5pm, i wonder why he rang me so early. Normally he rang me when he finish work and then we will go home together. i picked up his call.
Ch'ng: What time are you coming back home?
JJ: Are you finish working? are you leaving now? where are you now?
Ch'ng: Yes, i am at home now...
( oh shit!!! i forgot to remind him to pick me up)
Ch'ng: i am not working in today...
JJ: why are you not working today?
Ch'ng: i was attending a meeting in XXXXX. you dun know?
(oh shit!!! he didnt tell me that...)
JJ: i cant go home now. i am doing data entry for the research project. it's raining now. i dont think i'll go home today.
Ch'ng: it's safer to go home tomorrow morning. there might be no bus at night.
(yes i know, the last bus to your house leaving at 6.20pm from newport. it takes me 1.15hr to reach newport from swansea by train. and i cant leave by 5.30pm. there's no way for me to go home right now)
JJ: alright, i'll go home tomorrow morning. see you.
(ish..... i normally have a lift by going back with my uncle... i've to spend extra £9 to go home...) that's the end of the conversation and my monologue.

anyway, i wasnt feeling so bad. (what a strange feeling...)
perhaps i wasnt looking forward to go back...
i was planing to go shopping tomorrow.
then i can spend some time in swansea before going back home, provided hat the weather is good.

thank you for your concern

2008-06-26T07:19:00.000-07:00

to all my dear friends that sent me email, thank you for your concern.
i am feeling better now, but not back to 100% of my normal optimistic personality, it's on the way heading towards there.
i believe it takes time for me to fully recover, so no hurry.
the outbreak last night was a cumulative effect, long time nvr express any sadness at all.
it just burst out and the effect was as serious as si chuan earthquake. @=@
i just need some time to settle down to re-construct my mind.
i am missing someone that i used to love so much...
i hope she will be back, one day...

i wish someone was there

2008-06-25T15:47:00.001-07:00

this is my 5th post of the day. i think i am mad.
i know i wasnt depress. but i just cant control my tears from flowing out.
i just need some attention, especially when my birthday is coming soon.
i wish to be myself, my true self.
i wish to reveal my true personality to my uncle and family...
i wish to reveal my true feelings to my parents...
i wish to contact any of my friends to cry in front of them...
i wish not to pretend i am tough
i wish not to pretend i am quiet
i wish not to pretend i am mature
i wish not to act as other personality
i have emotions...
i have feelings...
i have conflicts in my daily life
there's no one that i could share my problems with...
i do not want anyone to get worry about me...
but i just cant bear it anymore...
i am the only person to share my problems with...
how much do you think i can take...
i am not a superwoman...
i really wish someone was there at that moment...
stupid tears...stupid me...

疯了。哭了。忍了

2008-06-25T15:00:00.000-07:00

疯了
花了将近三小时的时间来整理我在小儿科部门的病例。真的快疯了。
突然想到戴佩妮的爱疯了。第一次写到头痛。不过写得很爽，感觉是自己人生中的一个里程碑。
还蛮期待同学们的反应。不过算了，也不是为他们而写。

哭了
上星期不小心的哭了，还哭得蛮久。
不是号啕大哭，默默的哭，向当初看一公升的眼泪那样，眼泪不知不觉就流出来了。
莫名的被人吼了一顿，承受不了，无奈的哭了。
当时真的很讨厌自己。。。
本来我就是非常真性情的人，生气时就大骂，伤心时就大哭，开心时就大笑。
可是，最近，我的演技进步了。
所有的感情都隐藏起来，只因为我寄人篱下。
就算哭，也只能偷偷的哭。
以前非常不明白为什么身边的朋友会把情绪压抑着，因为我都觉得那样非常伤身。
直到现在，我才知道。那样才是成熟的举动。
自己过去的所作所为非常的幼稚。
写着写着，眼泪又不知不觉地流下来。。。
我好怀念幼稚的时光，根本不用演戏。
我好鄙视现在的我，完全跟我的原则背道而行。
原来原则在你没有后援会的时候，是不管用的。
以前不管我如何表态，我总有朋友挺我，撑我，大力的支持我。
现在，我只希望有人让我依靠，哪怕只有一个人也好。。。

忍了
为了我的父母，就算被人破口大骂，我忍下了。
不想让他们失望，不想让他们担心，总装的自己很坚强。。。
又是伪装的自己，我快受不了了，还是忍下来了。
本来就很讨厌表里不一的人，没想到如今我也是其中的一分子。
好像忍住现在的眼泪，可是好难。
难道只有一个人的时候，我好要伪装吗？
忍不住了，真的忍不住了。。。
不听话的眼泪，流下来了。。。

Paeds Attachment Week 4

2008-06-25T13:56:00.000-07:00

1) 11y/o boy came in yesterday with the complaint of red itchy urticaric rash, initially on the knee joint and ankle joint, now spreading to the chest, neck and the back. the rash appeared on his right knee and right ankle on the weekend, after playing in the woods. he developed joint pain and swollen knee and ankle the next day, he was referred to the hospital by the GP after that. according to the mum, this boy had taken a course of antibiotic for one week prior to admission. but it was unlikely to be an anaphylatic reaction after completing one week of antibiotic treatment. this boy didnt have any allergic history and his diet was the same as usual. it was unlikely to cause by food as well. patient's mother claimed that the pattern and location of his rash were changing, but was much better after taking piriton(anthistamine). the registra beleived that it might be an allergic reaction caused by a new kitten that was taken home one week ago. as mum was saying that her nose was allergic to the kitten, and therefore she sent the kitten away. but the problem with allergies is it is hard to find out what the allergen is, unless there is a second allergic reaction. and anything common in the 2 reactions that comes in contact with the patient would likely to be the cause. so the only management is avoidance of any possible allergen to prevent it from happening again.
2) 3m/o baby girl came in with vomiting since birth on week1 of my attachment. initially she was sent for ultrasound scan and barium follow through, and the results came back to be normal. they tried on other milk for her as the consultant thought it might be cow's milk intolerance. at the same time, she was given ranitidine because the consultant thought she's reflux as whenever the mum reported her vomit, it was just a little bit of water. she was taking her feed normally after that and was discharged at the end of week2 with the diagnosis of reflux. however, the baby came back on the weekend with the similar complaint. the consultant started to be suspicious as no one had ever witnessed the vomit before, the vomits were all claimed by the mum and the mum was known to have postnatal depression. on week3, mum sent in a pinky urine to the nurse and everyone started to worry of her having haematuria/urinary tract infection. the urine was sent to for microscopy and no red cells was found. the paeds trainee requested them to keep the urine but the microbiology lab refused to do so as they said that the pink colour was most likely due to dye. the urine sample was then sent to the biochemistry lab and they agreed to keep the urine sample for further investigations. however, the next urine specimen was clear and normal. as a result, it was not likely for this baby to have UTI. at the end of week3, her vomit was settled and she was sent back home again. BUT...... she came in again on week4... SWEAT AH!!! with complaint of diarrhoea and vomit. this time the stool sample was sent for culture and the result came back to be positive for Clostridium difficile. Oh My God!!! she finally picked up something more serious than her original sickness due to prolonged admission in the hospital. she's now treated with metronidazole. her father finally appeared in this admission. coz all the while, i only see the grandma and the mummy. i could see that her mum was interacting better as compared to the first admission. the parents now show more concern on the baby. i hope she would get well soon.
3)1y/o boy was sent to another hospital for repair of tetralogy of fallot on my week 1 of admission. the first time i saw him, he was very stable and didnt not show the squatting position as what we learnt from textbook. but when i saw his x ray, it was a "boot-shaped" heart as he had right ventricular hypertrophy. according to the paeds trainee, he was very bluish last time and underweight. they fed him and his weight gone up dramatically. although his weight still abit low for his age but it was within the acceptable range and he was fit for the surgery. he came back on week2 after the surgery with vomiting and diarrhoea. he looked more pinkish and had a midline scar on his chest. the stool was sent to the lab and came beck to be positive for clostridium difficile. he was on conservative treatment to maintain fluid balance but his weight had came down after the surgery. he did not have enough nutrition as he kept vomiting. they tried to feed him through NG tube but his vomiting and diarrhoea havent settle even after taking 5days of metronidazole. the consultant was trying to get hold of the microbiologist and dietatian, as he needs nutrition and gain more weight. let's pray for him...

Paeds Attachment Week 3

2008-06-25T11:45:00.000-07:00

1) 17d/o female baby came in on week 1 of my attachment, complaint of persistent vomiting for past 1 week after feeding. the vomitus was non bilious, mainly milk and water. one of the consultant witnessed her projectile vomiting was she vomited onto the pants of the consultant. her blood was alkolotic as a result of the vomiting the other consultant did a test feed(ie palpation after feeding) to look for pyloric stenosis, but no mass was palpated. a palpable pylorus on the right to the umbilicus would indicate a positive test feed. normally, pyloric stenosis is more common in baby boy of 6months with family history. this baby girl wasnt fit with any of the risks. she was then sent to do ultrasound scanning after that but it was negative. a second opinion was taken from another radiologist, a second ultrasound was done to pick up any chances of pyloric stenosis. however, the second scan was again negative. the consultant was trying to work out the cause of her vomiting. they changed the type of milk to feed her and the vomiting seem to be settle down a little bit and the baby was starting to gain her weight. she was sent home at the end of week2 but re-admitted on week3 with the same complaint. her mum was very worried and once again a third ultrasound scan was done. and... finally this time, the radiologist picked up a thicken pylorus of a diameter of 11.7mm and, mucsle thickness of 4.3mm. this girl was then send to the other hopsital for pyloromyotomy.
2) 5y/o young boy, came in over the weekend, with the complaint on 1 day diarrhoea and 4times vomit and 3days of abdominal pain. on examination of the abdomen, there was no guarding, soft & non tender. blood test showed a high CRP of 209 & raised white cell count. this boy was given a conservative management to maintain his fluid balance for the next day. however, there was still persisting suprapubic pain and with a spike of temperature on the second day of admission. the surgeons came in to review him but they thought it was just an acute gastroenteritis as his brother was having diarrhoea and vomiting as well. however, the paeds consultant was not convinced to let him home as his CRP was still 109 with persisting pain when he passed urine. he ordered an abdominal ultrasound scan after seeing him on monday ward round. the ultrasound scan showed a mass close to the bladder in the pelvic area, the radiologist proposed a CT scan for him. and the CT showed an appendicular mass, suspected as an appendicular abscess. the paeds consultant was relieved as they could pick it up although the surgical team had missed it. this boy was then sent to the theatre immediately to drain his abscess and he'd a wash to clean his abdominal cavity to prevent further infection.
3) 8w/o baby girl came in because of neonatal abstinence syndrome as her mum was taking methadone(one type of opiod) during pregnancy. she has been in the hospital since birth but i only seen her the first time in my 3rd week of attachment. to prevent her from having withdrawal syndrome, she was taking regular oromorph(one type of morphine) with reducing dosage over period of time. her mum was found to be HCV positive (i suspect that she got it thru sharing needle) and this baby would have to do a HCV PCR test 3-6months later after the window period. she just had her first immunisation yesterday, it was delayed because of her neonatal abstinence syndrome. on top of that, she has congenital umbilical hernia but it wasnt a problem to her at the moment. the baby has very serious social problems and the parents did not come and visit her throughout her admission. her only guardian was her grandma but her grandma did not visit her very often. her main carers at this moment were the nurses in the ward. the social nurses were trying to get hold of the family members as she has no other reasons to stay in the ward once she is out from her oromorph. the plan now is to make her guardian to come in on friday to look after her 24hr til saturday. and discuss with the nurses on any problems handling this baby on sunday. and the baby can be discharged next mon.

Paeds Attachment Week 2

2008-06-23T15:01:00.000-07:00

1) 4 y/o little girl, brought in to the hospital late at night, was sent directly to the high dependency unit as she had high random blood glusoce of 21/22/23 mmol/dL overnight. She was complainig of polydipsa, polyuria and nocturia. she had one episode of projectile vomiting prior to admission. blood gases was done on admission and she was found to be acidotic. glucose and ketones were found in her urine. a diagnosis of diabetic ketoacidosis was made by the night staffs. Insulin and IV fluid were given to try to bring down her blood sugar level and correct her acid-base balance. During the ward round in the morning, the little girl looked very alert but a random blood test was done and her level was still as high as 18mmol/dL. it was still consider diabetic even she just had her breakfast. a diabetic nurse was arranged to see the parents to educate them on insulin injection. however on the second night of admission, her random blood sugar went down to 2mmol/dL. it might be due to insulin over dosage. she was given a chocolate bar at night by a junior doctor and the blood glucose level went high up again. the next morning, when they discussed the case with the consultant, he said that giving chocolate was not a good choice. instead, we shall just monitor the patient. if there's no severe problems caused by the hypoglycaemic level, the correct thing to do is adjust the next dosage of insulin instead of giving glucose. this girl was then discharged from the hospital with an appropriate dosage of insulin injection. but the follow-up system in this country is very good as the diabetic nurse will go to her house to make sure that her mum is able to give her insulin as required.
2) 5y/o girl complaint of intermittent abdominal pain in the morning in the past 1 week. the parents thought that it might be an excuse for their child refused to go to school. however, this girl was in pain this early morning at 5am, pressing on the tummy and squatting down. the parents started to take this seriously as this wasnt the usual time for her to wake up and they knew she was in real pain. they brought her to the hospital and the consultant reviewed her later in the ward round. blood test that was done on admission showed a raised amylase level of 1320 but with CRP<3. style="color: rgb(255, 0, 0);">infective pancreatitis as a result of viral or bacterial infection. she was given a course of antibiotics and pain killer for symptomatic treatment. the pain was subsided on the fifth day after admission and this girl was discharged as she was back to her normal self. however, the consultant would like to review her in his clinic after 2months as he was the paeds gastroenterologist.
3) 21d/o baby girl came in with post feeding apnea. the registra who clerked her witness the episode of her going blue/cyanosed after breast feeding. according to him, it happened just few minutes after he took the histrory and the baby's face just went blue and she was crying. this baby was a preterm, normal spontaneous delivery at 36 weeks of gestational age and with the history of polyhydramnion. her absent of breathing after feeding was thought to be cause by infection. full septic screen was done, which involved the blood test, lumbar puncture/CSF test, urinalysis and chest x ray. none was contributory. the consultant picked up a murmur and she had an echocardiogram done and only 2 branches were found from the aortic arch. it could be normal in some people to have the third branch coming out from any of the two branches. so there wasn't much concern on it as the perfusion on her upper and lower part are normal. a video-fluroscopy was done in the following week to look at the velopharyngeal closure as the consultant suspected she was having tracheo-oesophgeal fistula. the result showed traces of aspiration and the second video fluoroscopy was arranged in 2 weeks time as there wasnt enough evidence to suggest tracheo-oesophgeal fistula. because of her poor feeding, she was put on NG feeding and she was very stable and tolerating very well with her feed. the parents were educated on NG feeding and this baby girl was discharged home with the NG tube as there wasnt any other issues once her feeding was settled. she was still awaiting her second video fluoroscopy.

Paeds Attachment Week 1

2008-06-23T13:19:00.000-07:00

1) 11y/0 young boy, had Hx of cerebral palsy with swallowing difficulty, came in to the hospital because of aspirated pneumonia. Because of the cerebral palsy, he had distorted hand joints and severe scoliosis. His right scapula was very close to his pelvis, it was just approximately 5cm apart. His neck was extended. He was looking down all the time when he was watching tv because of his extended neck. On examination, he had crackles on auscultation. He was feeding on NG tube as he had swallowing problem. He had a slower mental development as compared to children of his age. he couldnt talk like a normal 11 y/o child. from the management point of view, he was given a course of antibiotics to treat his pneumonia and the physiotherapist came in everyday to help him to do his physiotherapy. Unfortunately, he died of sudden death on the following week due to sudden cardiac arrest, no signs of bradycardia before he died. I was so shocked when i heard the news. not feeling very sad, am i too cruel? i dun know. as he would suffer more with his on going cerebral palsy if he were to grow up. he had to overcome his physical, mental and psychosocial barrier. i felt sorry for the family. but it might be a good thing for him to be free from the sufferings earlier in his life...
2) 9m/o baby girl, came in with referral of other hospital. She has lots of chronic problems and was referred to our hospital for close monitoring. She has an undiagnosed nerological disorder, leading to bilateral diaphragm paralysis, hypotonia and left sided sensory neuronal deafness. She was suffering from chronic respi failure and bronchiectasis, was needed ventilation fron oxygen. Her main concern would be failure to thrive as she has these chronic and untreatable conditions. On examination, she was breathing with her abdomen. she did not have much expression due to low facial muscles tone. she was underweight on her first two months of life, but she was getting better after having proper amount of feeding in the hospital. she is clinically well apart from her congenital problems, is currently staying in the hospital waiting to be discharged.
3) newborn baby boy, approx few weeks old, preterm baby with normal vaginal delivery. he came in of neonatal epilepsey as he's had epilepsey since birth. according to the parents, he would have 5-6 attacks per day that last for 5-10seconds. he came into the hospital as parents complaint that there were increase in frequency and duration of his attacks. We witnessed one of the episode during the ward round. his lips were smacking and his left arm was just suddenly became stiff and it lasted only few seconds and he was return to his normal state. on examination, he was a floppy baby. his old medical notes showed that he had agenesis of corpus callosum. it might be the cause for the baby to have low muscle tone. he was given phenobarbitone to treat his epilepsy. his frequency, duration & characteristic of epileptic attacks were monitored everyday. his serum phenobarbitone level was checked everyday to ensure his has a good and safe bioavaibility of phenobarbitone in the blood circulation. however, this baby was transferred few days later to another hospital with a paeds neurologist, to have a better care and treatment on his neurological problems.

Adaptations in UK

2008-06-21T03:28:00.000-07:00

I have been here for nearly 13 weeks, and i am still trying hard to adapt...
first and foremost, the use of language. my first language is chinese and i was brought up in a chinese-speaking family. as a result, i do not use english as common as chinese. but things are very different here, english becomes the primary language and everyone speaks english. however, the english that speak here is also different from the english i speak in malaysia.
eg: when they say: lovely, cheers... it's equivalent with saying "thank you"
eg: when they say: excuse me, my dear/darling.. it doesnt mean you are their love ones, it just mean the same thing as: "excuse me, miss..."
eg: when they say: here we are/ alright/ okie dokie.. it means "okay"
apart from these, the englishman are very polite and gentlemen. they would always say: "please/sorry/thank you" even for a very small matter.
when they open the door, they would normally wait for you to pass before their turn.
whenever they see you, they'll ask "are you alright?". just like chinese like to ask "have you eaten?"
they like to say :"hi/hello!" regradless whether they know you or not.
i am still in the process of absorbing and adsorbing their way they use this language...
next, is the accent of the english. my aunt, emily is an english who speaks south coast acccent. but the place i am working now is wales. the local people, ie: the nurses and the patients speak english with welsh accent. they speak as if they are singing. but the good thing is most of the consultant do not speak welsh english, that makes me less trouble in listening to them...
next, the food and drinks. I AM VERY SICK OF POTATOES!!! there isnt much choice in terms of food.
breakfast: toast/cereals/yogurt + coffee/tea
(o/s: i wish i have roti canai/chu chiong fun/yau char kuai/nasi lemak +milo/neslo)
lunch: chips/sandwich/cottage pie/pasta + sweets with custard + fruit juice
(o/s: i wish i have fried rice/fried noodle/fried kuey teow/mixed rice/chicken rice + soya/limau ais)
dinner: chips/cheesy pasta/sausage/sandwich/pizza/steak pie/fish fillet + soft drinks
(o/s: i wish i have chinese home-cooked dishes, 3 dishes of fish, meat and vegetables with one oreintal soup + chinese tea)
sigh... those will only appear in my dream...
the culture of drinking alcohol is very strong here as there is a pub in the university. for once, i thought that was a restaurant and i was thinking of trying the food there. at that time, i could see people holding a cup of beer walking out from the door, and i decided not to go there anymore.
next, the weather. i do not have much problems with the weather except for the first few weeks. it was still late winter and early spring. i would have to wear 3 layers of clothes with gloves on whenever i need to go out. at home, i was wearing socks and it was cold when u step on the tiles without wearing socks. the weather is much better now, but occasionally raining and has strong wind. i am staying in 4th floor. whenever the wind blows, the trees wave up and down with the scary noise. i would shut my window pretending nothing happen outside. it would be a very strong resistant if you were walking on the road when the wind is blowing. weather forecast is very important and very reliable in this country as compared to malaysia.
another strange thing is the day time is getting longer towards summer. 4am in the morning, the sky is bright until 10pm at night. i was once woke up at 4.30am, thinking that i was going to be late by looking out of the window, however, it was still very early. it was dark at 8pm in malaysia and normally i was advised not to go out at that time but it would be safe in uk because 8pm is just as bright as 8am.
next, the working hour. they normally work 8hr per day and they hardly work overtime. if u plan to go shopping, u must go early as all the shop houses open until 5.30pm and close after that, the public toilet as well. i couldnt find a toilet once at 6pm as i was waiting for the bus to go home. but the public toilet in the bus station was closed and i'd to hold it until i reached home. sunday is a very good business day in malaysia but in uk, nobody works on sunday. shop houses are closed except for those hypermarket like tesco. do not think that u can go shopping on your off day, as sunday is also their off day.
next, you can see dogs everywhere in uk. but they are not stray dogs.
eg: in the park, along the beach, outside tesco, in the car, on the street....
the englishman treat the dogs like part of their family member. they bring them for jogging, shopping, picnic...
but in malaysia, only a small group of people take good care of their dogs. they treat their dogs like a security guard rather than a family member.
I MISS MALAYSIA SO MUCH. I MISS THE CULTURE. I MISS THE FOOD. I MISS MY FRIENDS. I MISS MY FAMILY.

Audit meeting

2008-06-20T06:29:00.000-07:00

Last week, i was told to prepare an audit of hepatitis c treatment as there would be an audit meeting this morning. i have promised dr ch'ng when he first mentioned to me, so he asked to see the specialist nurse that looking after the hep c patients to obtain the relevant data. after talking to the specialist nurse, i knew that she was not in her office on wednesday and i decided to use her computer in her office to do my audit. i went through the patients' details, their hep c genotypes, their response towards treatment... it took me 2hours to sort things out... finally i have completed the audit and i saved a copy into the computer.
however, yesterday, after attending a paediatrics teaching during lunch break. i received a call from dr ch'ng saying that i would have to present the audit that i have done... okie... he asid that this would be a very good training for me. i know his intention and without hesitating, i just said yes. coz it wouldnt be very difficult if i was just going to report on my findings from the audit. i went to his office after that as he would like to do the power point presentation with me. i sat in his office, looking at him opening different folders, different files, cut and paste, and within 1hr. the power point was done. but it was far more than what i was expecting...
the title of my presentation was " management of hepatitis c".. hang on a sec... i ddint know exactly what treatment to use, as far as i am concern, the duration of treatment varies upon individual, the prognosis varies upon individual as well. the only thing i knew was the outcome of the treatment, i knew how many patients was completely cured from hep c as i was the one who did the audit. the power point that he made was full of graph, pie charts, tables, flow charts, and not many of words... of course, he put in the data of my audit. i got two copies of the clinical guidelines from him and i was planning to read through to prepare my speech for my presentation.
last night, i went through the presentation once to get a rough idea on the slides and the flow of it. next i started to prepare my speech by reading through the guidelines and trying to fit the relevant content into my speech. there were 15 slides and i was given 10minutes to talk on it. i came out with my own draft and started to speak in front of my laptop as if i was presenting. my main problems were i couldnt speak fluently, and i wasnt confident in what i was presenting as i wasnt the one who did the power point. i spent 2 hr at night to get it done until i was confident enough with my presentation. i was afraid to let dr ch'ng down as he provided me a very good opportunity.
this morning, i was told that i am the second presenter. i couldnt pay attention to the first presenter at all ( sorry ya, senthil). i was having palpitation and i tought i might have tachycardia as well. i palpated my pulse rate, it was 66bpm, it was normal actually. towards the end of senthil's presentation. i was asked to get to the front to prepare my presentation.
i stood up and clicked on the mouse, looking at the audience (only ~10ppl), started on with introducing myself. next, i moved on to describing a brief history of hep c infection, and methods of diagnosing hep c. then, i went through the needs of treatment, types of treatment, and duration of treatment. finally, here comes my audit, the outcome of the 16weeks therapy on 20patients. ( the conventional way was a 24weeks treatment) From the audit, it has shown that 11patients were completely eradicated the virus from their body, 7 of them still awaiting for the results and 2 of them didnt turn up for blood test after treatment. "...In conclusion, 16weeks treatment was as effective as 24weeks treatment. Thank you." that's the end of my presentation.
phew~ finally it's over. at the end of the audit meeting, i was invited to review the meeting with other presenters. dr ch'ng pointed out my weakness which was lack of knowledge. i knew that by heart as i couldnt answer the questions proposed by a consultant. but the other presenters were praising me that i was doing very well. (+_+) but i knew it wasnt a very outstanding presentation.
thanks to dr ch'ng for giving me this opportunity and preparing the power point for me.
thanks to mdm yeoh, my primary school english teacher who trained me for choral speaking for one year. ( as a result, i get to learn correct pronunciations)
thanks to pn tee who trained me for chinese public speaking in my secondary school. ( as a result, i get to develop my courage and overcome stage fright)
thanks to imu that trained me to do a lot pbls. (this presentation was just like doing another pbl)
thanks to ling min who gave me support and opinions.
thanks to myself that i did not add in manglish which i was so used to it.
bye bye to all the "em..., ~la...., ya...., ~ma..., ~wor...."

不堪回首的记忆

2008-06-18T15:14:00.000-07:00

Now that i think of it, i notice that my memories has gotten worst. i could only remember significant moments as i grow older. If you were to ask me what can make me frustrated, it would definitely be my poor memory. I start to forget events, knowledge, people, places that i come across and time that i spent. i could only remember things that i am doing routinely as i am doing it everyday. i could only remember special occasions as they were special. things that i came across only once or twice hardly stay in my mind.
and I HATE THIS... i hate to have partial memory, especially when it comes to studies and medical knowledge. i knew i knew it, but i couldnt retrieve that piece of information from my memory. i would have to spend some time to read again... but then, several weeks later, i face the same issues, and i could only retrieve 50% of what i had input weeks ago...
my golden rules of studying... (1) revising notes (input to the brain) is important for you to pick up and absorb knowledge (2) sit for exams (output from the brain) if you knew where and how to retrieve the information in exams, and then you would know how to retrieve it next time.
unfortunately, i have no exams for the time being. my memories were simply stored in my brain. not organised at all. sigh... i miss the time when i have exmas... am i crazy???
纯姐姐名言：何谓记忆？要记得（INPUT），再回忆（OUTPUT）。有进有出，才记得牢。

十八岁的异想世界

2008-06-18T13:20:00.000-07:00

谢谢十八岁的小弟提供以下的文章，有兴趣阅读其部落格者，请游览http://jin-jack.blogspot.com。

一只熊迎面而来。猜一成语。
有备而来！（有BEAR来）

看三級片和看烹任節目有什麼相同的地方呢?
有得睇無得食

在树上唱 RAP 的小鸟。猜一字。
桑（注意！在樹上唱著YO!YO!YO!)

有人晕倒时，哪一首新年歌不能唱？
迎春花。因为 “幸福来幸福来大地放光彩”听起来像 “醒不来醒不来大厅放棺材”。

By the way, i was touched by your post number 100 (posted on 5/6/8), though i knew what would be the outcome when reading through it. 真的有虅井树的感觉！！！Shall i say i am jealous of your experince even though it's not a good ending. i believe that our suitable partner will appear when the time has come. 有缘千里来相会，小弟，别灰心。Have you ever thought of writing a song for this story?
What did i do when i was 18year-old? Working as a clerk for the first 2 months while waiting spm result...then, started my sixth form for 4months... then, surprisingly got scholarship after appealing... then, started off my medical journey since then in intec.... My parents expected me to be rebellious at that age especially my dad, he said all kids are rebellious at aged 18 as they think they are adults.

有些人的十八岁是叛逆的。
有些人的十八岁是无聊的。
有些人的十八岁是甜蜜的。
有些人的十八岁是平淡的。
有些人的十八岁是孤单的。
有些人的十八岁是精彩的。
我小弟的十八岁是他的蜕变期吧！从一个纯情的男孩蜕变成稳重幽默的男生。期待你破茧成成熟大方男人。
纯姐姐名言：长长长长长长长，行行行行行行行！
要这样念：changzhang changzhang changchang-zhang, hangxing hangxing hanghang-xing.
意思是祝愿你时时刻刻，长长久久的蜕变成长；在不同的行业里，也事事精通样样行！

What's so special about paediatric ward???

2008-06-17T05:48:00.000-07:00

This month, i have decided to do my posting in paediatric department. It was very different from medical and surgical ward as there were rules to protect the children. it was different in singleton hospital, but i think generally other hospitals would be the same. What are the major differences???
1) the entrance: the entrance to the ward was locked, you can only enter with the password or the nurse's permission. generally only parents, relatives and health care workers are allowed to the deparment. security wise, they are trying to protect outsiders to get hold from the children. they have 24hr visiting time open to only the parents, unlike other wards that have limited visting hour to the visitors.
2) the bed: neonates, infants, babies and children. they have different size of beds in the ward available for patient of different age. normally they have extra bed of adult size for the parents in case they would like to stay overnight with their kids.
3) the decoration: there were cartoons, pictures and posters pasted or painted on the wall of all rooms, even the patientsi toilet. even the nurses have to wear colorful apron. and medical students like me are not allowed to wear white coat in the ward as this might frighten the kids??? i wonder...
4) the playroom: you definitely wont see this in the medical or surgical ward. it's full of toys, and most imporatantly, they have well-trained nurses to play with kids.
5) specimen bottle: the blood bottles are only half of the size of the normal one. so little and so tiny and i think it's cute when i first look at it... but it was nvr a nice experience to see blood taking from children as they look so misarable when blood was taken from them. needles and canula were smaller. everything was in a mini version even the plaster. the consultant would have the paediatric sthetoscope too, with a mini diaphragm.. so cutie..
6) a full trolley of milk of different fromula: milk for non-breast fed babies that provide similar nutrients with breast milk, milk that special for low brith weight babies, milk for catch-up growth babies when they are undergrowth, milk for cow's milk intolerance.... a wide spectrum of milk formula which i think the nurses would know even better than the doctors
7) the noise: it's not a quiet ward, i would say. babies that are not feeling well, will cry.. babies that were taken blood or doing lumbar puncture or in pain, will cry... babies that are hungry, will cry... babies that scared of stragers/doctors going near, will cry or will scream... next, it's the noise coming from the tv, it's a very important entertainment for the children other than the playroom. the dostors always need to turm down the volume or switch it off during the ward round. it was just annoying sometimes... but i am getting used to it now...
This is my 3rd week in this department. and i think... i think... i love it so much. i used to have very strong interest in paediatric but i just dont dare to step forward and admit it. as i am not a very pateince person, even tough i think i am a caring person. there were a lot of challeges to work as a paediatrician, you need to know how to deal with unwell and sick babies, you need to know how to communicate with desperate parents, you need to know how to treat them...you would end up in big trouble if you fail to manage them properly. there was one big issue happening in malaysia saying that a baby's arm was necrotic and gangrenous due to the faulty practice of a house officer. but then, after spending approx 2weeks time, i have made up my mind, I WANT TO BE A PAEDIATRICIAN!!! this my target, a very long way to go, a lot of skills to master, a lot of guidelines to follow, a lot of knwoledge to learn... but i need to have strong determination to push me to reach my ambition. jia you!!!

Cases in surgical posting

2008-06-17T05:45:00.000-07:00

I was too addicted to the korean drama series and taiwanese programme for the past 3weeks and totally neglected my blog. Despite being in the paediatric department this month, I was busy with the research data entry and doing my own private study. Now i would like to present the cases i have seen in my previous posting- the surgical department. To be honest, surgery is not my cup of tea, i have chosen it to be my second posting just because i think i need to go but not that i am interested to go. We have early surgical ward round, normally it ends within an hour, it was boring and less busy as compared to the medical ward. The more exciting part for this posting would be going to the operation theatre.
For the first time i knew i could go to the OT, i was excited. I have been looking forward to see surgical cases, eg: cardiac bypass, thyroidectomy, nephrectomy, colectomy, gasterctomy, appendectomy, cholecystectomy, hysterectomy... however, i knew the surgeon i was attached to was a general surgeon, i woulndt get to see neuro-, cardiac and orthopaedic surgeries. He's Mr JB and he would only deal with surgeries that involve the lower GIT as he other colleagues would cover the other surgeries as they seperate their cases according to the parts in abdominal caivty that they deal with. So basically i have seen loads of lower GIT and pelvic surgeries last month.
The main diffenrence between attachment of medicine and surgery would be you dont normally know what the patients come in for, coz their surgical date was pre-arranged weeks or months ago in the surgical clinic. So the history for the following cases that i am going to present may not be very complete or accurate.
1) A 80y/o men, came in to the theatre for chronic abdominal pain. Abdominal X ray was taken and the colon was noticed to be dilated. Other investigations have done to find out the cause of his colonic dilatation but none was contributory. The surgeon wasn't very keen in doing surgery on him as he was old and might not have good prognosis after that. However, the patient himself insisted to get rid of the pain by removing his colon. So on the 1st may 2008, which was the first day of my surgical posting, i witnessed a total colectomy that took two and a half hour. The normal diameter for colon is approx 5cm and his has gone beyond that, approx 8cm and was really super dilated. The surgeon has made the diagnosis of pseudo-obstruction after looking into his abdominal cavity and removing his dilated colon. he took the picture of it as he said he doesnt normally see this size of colon as according to his experience, he's only seen 2-3 cases per year. there was no organic cause that can explain his dilatation and this gentleman was sent to the ICU after that. However, his pain did subside but he was on a slow recovery. He was admitted to the ward for the whole one month and when i have left to the paeds department on 1st june 2008, he wasnt discharged yet. Coz in between his admission, he developed pnemonia and couldnt eat well after the surgery. I sincerely hope he's getting better although i do not know what happen to him after that.
2) Middle-aged men, who came in for right hemicolectomy as there were two large polpys in his caecum on colonoscopy. After removal of his caecum and rt colon, an ileostomy was formed in his right iliac fossa. A hole was cut across the skin and abdominal muscles, to let the terminal ielum to pass through. The terminal ileum was brought out to the external surface to prevent the enzymes from digesting the skin and an ileostomy bag was stuck onto the skin to collect the faeces. The rt colon that was removed was cut open, and the two polpys were seen, and their size were >2cm. the surgeon thuoght that they were adenomatous polpys and cancerous. it was a right choice to remove it before it was spread to the lymph nodes.
3) 40+y/o M, who came in for a sigmoidectomy as a mass was found in his sigmoid. it was supposed to be a simple surgery but unfortunately the surgeon found an adhesion between the spleen and the colon. He wasnt sure that was the mass extending from the colon or it was just an adhesion as a result of scarring. the spleen was known to be the a very fragile organ in our body and it could rupture very easily. while the surgeon was looking at the spleen to look for any scarring or infarct, somehow... i didnt know how it happen... the spleen was torn, as i didnt dare to question the surgeon. it was happened within a second... blood flew out from the torn spleen and suction was required. the surgeon had no choice but to remove the spleen. on removal of the spleen, an infract was noticed on the parenchyma of the spleen, that might lead to healing, scarring and further adhesion of the scar to the colon. then, the surgeon worked out on his sigmoidectomy. after removal of the sigmoid, a colostomy was formed on his left iliac fossa. as opposed to the ileostomy, colostomy was flat. a hole was cut and the colon was stitched onto the circumference of the hole. similar to the ileostomy, a bag was tuck onto the skin to collect the faeces. before stitching back the midline scar of his abdomen, the surgeon tried to cut a small piece of the normal spleen to implant it onto the omentum. hopefully, the implanted spleen can still carry on with his normal functional reticuloendothelial system. anyways, this patient has to take life long antibiotic as a reslut of splenectomy and anticoagulant to prevent thrombus formartion after the surgery. poor thing....
these are the major cases i have seen and i think it's worthwile to share with my fellow colleagues. the other surgeries are incisional hernia repair, partial spincterectomty/ anal fistula treatment, biopsy of anal intraepithelial neoplasia, laparascopy, laparotomy, stoma repair...
i was once very kei poh, went down to the theatre even Mr JB was not around, the nurse was kind and brought me to the other theatre to see mastectomy and axillary lymph nodes excision. that was a bonus to my surgical posting. email me if you are interested in knowing more on other surgeries as this post is already quite long. hope u enjoy reading it.

Shopping in UK

2008-05-27T14:11:00.000-07:00

Shopping in UK is never a good idea to spend your leisure time, is not a good shopping spot for the shopaholics either. But i still took some time to shop with my mum when she was here with me for the first month. Some of the items are consider cheap and quite a good bargain to buy it here and some are totally scare you away from buying it after looking at the price.
After spending 8 weeks of life in UK, what have i bought?

1)The most important one, to get my self a mobile and sim card in UK.
£29.99 ( mobile phone costs £19.99 + £10 of credit for my simcard) ~RM189
The phone i got was a simple one, sony ericson W200i with inly 256MB of memory.

2) Londsdale sport shoe. I bought it simply just because my mum was getting my two bros a new pair of shoes, and i wanted too.
£ 10 black leather shoe, consider very cheap liao. ~RM63
Buying sport shoes here is really o smart choice especially for those branded ones like nike or adidas, it is much much cheapier here. do you want me to get one for u???

3) of course i need to get my self a pillow and duvet cover la. i didnt bring it from msia as my luggage was fully packed with other stuff. I bought two here from ASDA ( a very big hypermarket in UK other than tesco), one for spare.
They cost £13.50 for 2sets. ~RM85

4) A pair of beach sandals. i didnt bring any sandal or slipper when i came as my aunt told me that it was very cold and nobody would ever wear sandal out. But i am getting myself one as the weather was turning better as now is the spring season. Spring in wales is just like weather in genting or cameron, very windy and nice.
£0.99, yup it only cost me 99pas i bought from the 99p shop as it is for children but it fits my size nicely. i think most of the asian can try to find their clothes and shoes in the children department if they cant find any in the men or ladies department.

4) A mini shinny bling bling purse for me to store coins. people in Uk use coins more common than notes. and this purse was only £1 but the key chain with the letter "J" was more expensive, it was £2. i bought it from portsmouth when i visited there with my uncle's family. ~RM18.90

5) A nike cap and a pair of gloves. I am not a pinky girl, pink is not my favourite but i bought these pink gloves and cap partly because they are cheap and i need them.
Cap £4.99 and it was made in Vietnam. ~RM31.40 at that time i finally understand why vietnam can produce cheap pirated nike jersey as the manufacturer is there.
Gloves £3.99 ~RM25.13
6) An umbrella that cost £99, i bought it at the same shop i bought the children's beach sandal. ~RM6.23
7) Body moisturizer, a very imporntant things to me as for the first few weeks when i was here, i developed snake scale skin due to the dry weather. as a result, i decided to buy myself some body lotion. i think this is the best and cheapest i can get. it was only £5.00, ~RM31.50

8) I am a bags collector as i like to collect bags. i would always change my bags and bringing different bags since my secondary school. i made up my mind to get a bag in uk as well and i chose this blue bag pack and i really like it a lot as i am bringing it everyday to the hospital. It was £8, ~RM50.4
My parents especially my dad would scold me if he see this post as i am spending money for shopping in UK... But i am spending it wisely after taking into the consideration that i really need them. I think i spent even more on transport fees, bus fares and train tickets. i would need to spend ~£9 per trip from my uncle's house to singleton hospital if my uncle is not working. further more, because of my toothache, i spent another £12 to do a dental check-up and i will have to pay £39 for the dental surgery to extract my tooth as there is abscess in my decayed wisdom tooth.
钱不是万能，没有钱万万不能。I am spending all my money just hoping to get more clinical experience and i think it's really worth it as i am gaining a lot. I shall share it in my next post.

Things that i treasure the most at this moment

2008-05-27T12:03:00.000-07:00

Due to limited luggage weight, there's nothing much i could bring over from malaysia. Other than daily necessaries, i purposely brought things that given by my good friends and family. Now, it's my time to share what are the things that i treasure the most.

First and foremost, my coat was given by my dearest papa. It gives me warmth when i m cold. It was very useful when i first came to UK as that time was still late winter early spring. Thanks ya, my dearest dad and happy farther's day.

Next, is my lovely crystal given by my mama. The purple crystal bracelet was said to give you energy of wisdom and the yellow "hu lu" pendant was said to give me energy of good health. My mum is a person who believes in all these feng shui and crystal energies. Thanks ya, mama. I will take care of myself and not to worry too much.

Then, this is my mini jay chou 2008 calender given by jay, my brother. he knew jay chou is my idol, he purposely bought one for me, i was so touched... i pin it in front of my desk so that i can look at my idol everyday. thanks ya, flyoo's boyfriend.

this cutie buddha meditating laptop skin was given by my xiaodee. he bought it as he accidentally scratched my laptop surface. i like this laptop skin because it shows the enlightenment of the buddha, whenever i look at this picture, i feel i was enlightened too.

This picture was taken in th Buddhists camp last year. i had a lot of memorable moments with my dhrama pals. and thanks to the juniors that developed the photo and gave it to me. i miss u guys.... sadhu...
this watch was my 21st birthday present given by my good friends in imu, i really treasure it a lot. by wearing it everyday, makes me feel that this group of friend are spiritually with me. Thanks ya, my good friends...

Lastly, this mini buddha statue was bought in an international Buddhists forum. i place it in front of my desk as well but most importantly the buddha is always in my heart. may the dharma shine in me... sukhihotu...

感人故事

2008-05-22T07:22:00.000-07:00

截至5月22日10时，四川汶川大地震已造成51151人遇难，288431人受伤，累计失踪29328人

1) 7天仅吃半张卫生纸
　　5月20日凌晨4点30分，急救车将一名被埋170小时之后获救的村民送达第二军医大学长征医院医疗队实施紧急救治。抢救的专家们当即到位，并组织会诊。经各项检查结果显示：监护仪、生化等病人的关键指标都相对正常，生命体征平稳；心跳、呼吸正常，血压139/100，偏高；神志清楚，对答准确。
　　记者昨日来到设在安县中学的第二军医大学长征医院野战医疗点，见到了彭国华。他经过军医抢救后，已经脱离了生命危险。他告诉记者：自己能够维持现有状态，是因为一直坚信自己能够活下来。
　　彭国华说，他带进去的一支手电筒、一块电子手表发挥了关键作用。电筒提供照明，一直到他被救出，还有余电；手表一直给他提供准确时间。
　　5月12日下午2时28分左右，他进洞准备放置爆破的炸药，他听到一声闷响，洞口一黑，他知道发生地震了。
　　彭国华说，他在离洞口12米远，80cm×80cm范围的矿井空间中生活，里面一片漆黑。头两天一直躺着。第三天开始喝自己的尿液，一次只喝一点点，他一直坚信会有人来救他。第五天是最艰难的时间，他感觉很饥饿，开始吃身上带的半张卫生纸。当时他的信心有点动摇了，特别是第六天(5月18日)晚上产生一次比较明显的余震，他更加担心因为余震有危险，外面的人停止营救他。但是，他还是没有放弃，强烈的救生意志使他振作。第七天早晨，他终于听到洞口传来挖掘机的声音，再后来，他又听到了弟弟的呼喊。他想答应，但已经没有办法做到。
　　昨日下午，在彭国华的病床前，他的亲人纷纷闻讯赶来看望他。他的妻子文友会亲昵地靠在他的脸旁，给劫后余生的丈夫默默传递温情，这一画面很感人。
　　记者问彭国华有什么感受，他回答说，活着真好！

2) 100小时——“喊”回来的一条生命
“小心他的头！抬起来！用力！注意左边！好！好，出来了！”5月16日下午6时30分，刘德云在被困100小时后，被从废墟中救出。
　　当天下午1时，空降兵驻开封某部队营长孙念安在德阳什邡市红白镇的一处废墟上搜索。他不停地冲着废墟大喊：“有没有人？底下有人吗？”
　　“有。”废墟下传来微弱的回应，孙念安有点不敢相信，“通过对话，我们发现被困住的人思维还很清醒，说自己是来做生意的，已经被困4天了，讲话声音还很清晰。”
　　刘德云被困的五层大楼，地震过后，已不足三层高。救援中，为了确保幸存者的生命得以继续，战士们不断对他喊话：“你要坚持下去！”
　　16日下午4时，战士们辟出一个仅容两人容身的空间，继续向下开进。
　　有战士问刘德云：“能不能看到光？”刘德云回答：“能，我能看到你们。”“营救人员根据他的回答分析出具体位置。由于一个横梁死死压住刘德云的左脚，被压住的左脚已经组织坏死，消防战士对其进行了左脚自脚踝以下截肢。两三分钟后，被困100小时的刘德云重见天日。

3) 手术时突发地震医生背起病人就跑……
5月12日14时30分，四川省成都市二医院，心内科手术室，一台“心动过速手术”正在紧张进行，患者是73岁的胡俊卿婆婆。突然，室内一片黑暗，监护仪黑屏，“哗啦啦”一声巨响，手术器材散落一地。“地震了！”医生张文勇迅速拔下多根导管，背上婆婆就往楼下跑。
　　此时，整栋住院大楼里面，医护人员们来来回回，背、扶、抬，撤离重症病人。王副院长扯着嗓子喊：“各科室的医生，在天黑之前赶紧抢出病案，医疗不能终止！”内科区、外科区、紧急救援区内一片忙碌，穿着白大褂的医护人员穿梭在各病床之间，输液、缝合、打针、安抚惊魂未定的病人……
　　外科救助区里，35岁的罗大鹏守护着熟睡中的妻子，忧心忡忡：“一个小时前，她为我生了个女儿，这么一折腾，不知道伤口受影响没有？”而他的女儿，正挥舞着粉红的小拳头，好奇地打量焦虑的父亲。小家伙刚到人世，她不知道自己刚才经历了一场如何惊心动魄的“生死大转移”。
　　二医院院办秦主任介绍，地震发生后，该院在院坝中紧急成立了“临时指挥中心”，后勤组负责发电、搭建雨棚、准备急救药品；救援组负责撤离病人，确保病人继续治疗。截至当天15时20分，全院近900名住院病人转移到院坝上的“临时医疗点”，无一病人在地震中受伤。

Acute toothache

2008-05-22T06:39:00.000-07:00

I have been suffering from this gum pain since sunday. the pain was unilateral, right sided, comes and goes. it radiates from the gum near the molar teeth, spread along the muscles of mastication to the temporo-mandibular joint. the aggravating factor might be opening and closing my mouth as i am using my facial mucles. the pain was suddenly very intense on tue evening. i tried to take 600mgm of paracetemol at 7pm to relieve the pain but it didnt work. then, i looked into the mirror, there were no ulcers or redness on the buccal mucosa. it's unlikely to be an oral infection. after discussing it with my friend, according to his expereince, it was likely to be an eruption of my wisdom tooth that causes all the pain. however, i checked on line, the normal age for wisdom tooth to grows would be age18-20. I am too old to have one now.
finally i decided to consult my uncle about it. we both came to a conclusion it was most probably due to the eruption of my wisdom tooth as i havent had one yet. the only advice he could give is to take some pain killer to relieve it and try to see a doctor tomorrow. that night, i took 1200mg of paracetemol and it worked. (the max dose is 2000mg in 24hr)
the next day, i went to see a GP. my first time seeing doctor in foreign country. she was kind and she tried to checked whether was there any abscess. obviously, she couldnt find anything and she asked me to see a dentist. The major difference in seeing a doctor and seeing a dentist is seeing the doctor is free of charge and seeing the dentist is costing money. that was why i didnt go see dentist in the first place and hoping that the doctor would offer some help.
unfortunately, i have to see the dentist. i went to the dental clinic on the same day to make an appoitment. i was told that they charge £30 for an emergency appoitment since i had an acute pain last night. i nearly faint after hearing that figure, as it means it will cost me rm200 just to get an appoitment. the earliest normal check-up appoiment, with no extra charge would be somewhere in end of june. i got no choice but to make an appointment that time on fri morning.
i was still having the pain sometimes in these two days but it was mild. as a result, i went to cancel my appointment. just so happened that they have a slot for normal check up appointment next fri noon. so, i decided to change my appointment to next fri, as the consultation fees for normal check-up vary from £12-£39 depending on what the dentist will do.
i do hope that there would not be other complications or dental problems that cause the pain. i shall wait until i see the dentist...

China mourns as death toll rises

2008-05-19T04:19:00.000-07:00

China today began three days of mourning with a nationwide silence at 2.28pm (7.28am BST), precisely one week after the 7.9 magnitude earthquake struck.
It coincided with an announcement that the official death toll had risen to 34,000 and news that 200 rescue workers had been buried by a number of mudslides over the past three days in Sichuan province.
Air raid sirens and horns of vehicles, trains and ships marked the end of the three-minute silence and national flags flew at half-mast across the country and at Chinese embassies worldwide.
All internet entertainment and game sites have been taken offline and users redirected to sites dedicated to commemorating earthquake victims, the Chinese news website sina.com reported.
Beijing Olympic organisers said the torch relay - due to reach Sichuan next month – would be suspended for three days "to express our deep mourning to the victims of the earthquake".
The confirmed death toll from the quake rose to 34,073 and the council - China's cabinet - said 220,109 people were injured.
Officials said the final death toll was expected to top 50,000.Rescue work has been hampered by a series of aftershocks and landslides.
The state news agency, Xinhua, quoting a Sichuan provincial official, said workers had been buried by mudslides while repairing damaged roads.
The official gave no death toll but said three of incidents took place in Yingxiu, close to the epicentre.
Rescue attempts elsewhere were given impetus by the freeing of a handful of survivors.
For further details, please go to http://www.guardian.co.uk/world/2008/may/19/china.chinaearthquake

I find myself very useless as i was worrying of myself these few days. Instead after watching the video about sichuan earthquake that i have just downloaded, i really think that my problem was not a big deal as compared to them.
They had lost their house, most importantly they might have lost their loves one. Children might have lost their parents, becoming the orphans. People who managed to survive may become immobile as a result of severe injuries. Even if they managed to run away from the disaster, they have so much problems in hands. Where to find shelter? Where to find food? Where to find water? Lastly, where to find their family? I do not what i can do to help them at this moment. But i do hope metta radiation would work this time. I sincerely wish them from the bottom of my heart:
May they be well and happy...
May they be free from physical and mental sufferings...
May they be calm and peaceful...
sadhu...

I am on my own

2008-05-19T03:14:00.000-07:00

I have been describing myself as a lonely person these few weeks. I think i have to wake up and step forward. Loliness makes me feel weak. I dislike myself in this way, being lazy and so demotivated. the path is tough, i 'll have to struggle to reach my destination. Being alone is a fact, but i can view it positively. I should say: "I am on my own!" It has the same meaning but it gives me more courage. There is no way i could advance if i keep my self alone. But if i make the first move on my own, i believe that i would gain a lot more. I have to unseal myself.
J.J.Tan, open up your mind and your heart. The path is long and I have faith in you.
Today is a good start and keep it up. Jia you!!!

May I be well and happy

May I be free from physical and mental sufferings

May the dharma shine in me...

Sadhu Sadhu Sashu...

Happy Wesak Day

在这条路上，我好像迷失了

2008-05-18T12:29:00.000-07:00

第一届超级星光大道冠军得主林宥嘉曾经说过：“当梦想越来越近，就会容易迷失方向。” 现在，我终于了解这个意思。因为，在异国的六十七天里，我的确向着自己的目标，一步一步地靠近，但也渐渐的遗忘了曾经的坚持。随着日子一天一天的过，懒散的基因漫漫的渗透进身体的每一部分。当初的意志也越来越薄弱了，开始怀疑这条路我选对了吗？
在过去的两年半内，不管考试多么的辛苦，我从来也不曾埋怨。心里的天使逐渐成长，促使我相信自己的选择是对的。这条路虽然难走，但我走定了！然而，一个人离乡背井，傻傻的走着这条路时，对自己的怀疑也越来越多了。身边的每一个人，都是走着这条路的，但原因和背景都大不相同。我开始惭愧了，凭我现在的能力，拿着政府奖学金，是不是在浪费纳税人的钱？心里的魔鬼开始嘲笑自己，高估自己的天分，没看清眼前的事实，往往总是把世界想象得太简单，太美好。这个时候，人类的自然反应就是逃避。我开始不断的自我催眠，自我放纵，为自己制造不同的借口，一次又一次的让自己停滞不前。难道身边没有同伴的关系吗？没有人提醒你，没有人鞭策你。回归到原点，只能怪自己的意志力不够坚定。
对这条路提出怀疑并不是不好，可是当你只有一个人的时候，像破了头，也得不到问题的答案。只能选择逃避，肩上的担子越来越重了，感觉再也撑不起来，开始怀疑自己，在何年何月何日，我的信心才能回来呢？一直以来在你身边的人，此刻都远在他乡。亲爱的家人，敬爱的老师，可爱的朋友，都曾是我身后的靠山。如今的我，就像大漠中的沙，散散的，难以凝聚，随波逐流。
我清楚，了解，明白我要坚定，保持清醒，从这团迷雾中找到出路。迷失了并不可怕，只要不放弃，在大漠中，我也能成为一棵屹立不倒，茁壮成长的仙人掌。
明白归明白，现实是残酷的。我正在寻找正确的方向，我不可能回头了，我要向前，只是我还在徘徊。因为我不够坚定，我需要巩固我的意志，强化自己，才能在迷失的这条路上，把梦想捉住，把自己的天使找回来。
我，要相信，我自己。

Medicine is a business

2008-05-16T06:13:00.000-07:00

In my opinion, medicine is always a service, a health care service.
But, nowadays, the drug dealers have made medicine into a business, a potential profitable business. Why would i say so? It was because the drug dealers are so creative in promoting and advertising their company, and also their products. Their would distribute some free gifts that have their company or drug name printed on those items.
Now, i would like to take this opportunity to introduce you the free gifts. Then you would know how creative they are.

1) PEN, the most common fee gift given out by the drug companies. All doctors and nurses need to use pen everyday for writing and recording. So this is the easiest way to promote their products as other health care workers would know when their colleagues are using it.

Types & examples of pen:

(A)the pen is not a normal pen, it is a "bi-cranial" pen as it has two heads. One head functions as ball pen the other head functions as highlight pen. Very smart la, the designer... But blue high lighter is not a very good choice....

(B) this is a yellow high lighter but then the design of the cap is very special. It is a hooked cap. The blue thingy on the cap can be opened and you can hook the pen on your stethoscope.

(C) I know u have heard of 2 in 1 shampoo, but have u seen a 2in 1 pen? The pic shows an orange highlight pen with a space that keeps mini sticky index pads at the end of the pen. Can you see the strip of orange paper? That's the mini sticky... Super creative lei....

2) Sticky note pads- the second most common free gifts. Other than pens, these sticky note pads are widely used in the hospital especially when one needs to leave a message to his colleague on the patient's documents.

3) Can you figure out what is this? It is called a clip dispenser. The white thingy on top are the clips. The transparent holder with blue button is the dispenser. I would never thought that a drug company would spend money to make a clip dispenser as free gift. It doesnt look cheap to me...

4) Last, but not least, in such advanced country, there is no doubt that their free gift would be more high tech.... Look, i got a 1GB pen drive here. Haha. It came with the beautiful box... I think this is the most precious gift i have ever got from the drug company.

I got all these items when i attended the seminar or talk or meeting held in the hospital. the organizer would normally invite one or few drug companies to come and promote their product. they are not only competing in the sales of the drugs but also the creativity in making free gifts. I am impressed with their creativity... Salute...

My first day in Singleton Park

2008-05-13T13:44:00.000-07:00

There was a park behind where i stay. A super big park that has several gardens, it's called Singleton Park. I like to spend sometime to jog or walk there. This park has tall trees and green grass. The gardens have pretty and beautiful flowers.

It was so relaxing when u get the chance to stay so close to the nature after a long busy day of learning in the hospital.

The local people would always like to bring their puppies or dogs to the park. Some teenagers would like to ride on their bike and cycle on the path in the park.

On the first week when i was in Swansea university, i have decided to explore this park. i admired my own courage without knowing what place i would go to as i only knew there were a lot of people going in and out through that entrance behind Cefn brynn. i didnt even know it was a park in the first place. out of curiosity, i brought my mobile phone and started my music player and set off to the park.

i followed and walked along the path in the park without knowing the direction, just simply took a junction because i thought i could find my way out by following the way i took in. i reached a point which i could see a big land of greenish lawn. i walked away from the path towards the middle of the lawn. Wow!! for one second i thought i was freed, just like a bird in the sky, walking happily on the lawn with my favorite songs playing from my phone.

all of a sudden, i could feel something push me on my bum. i was shocked and thinking of who would be the one behind me. i dun know any friends yet that dare to crack a joke on me by touching my bum. normally if someone were to push u down, they normally push your shoulder to make u lose your balance, not your bum. i quickly turned and.... i saw a dog. What a relief... at least it's not someone ham sap.

the dog is a golden retriever, according to the owner, it's name was leo. Leo was only 1 year old. but, he was as big as a mature dog, strong enough to jump and push me down. Leo was playful as he kept chasing me when i tried to walk away from him. the owner eventually tied him up since i was so scared that Leo would bite me. after that, i had a nice chat with Leo's owner. she's a midwife working in Singleton hospital as well. We started to talk about the hospital and the doctors that we knew. Apparently she knew my uncle. ( i didnt know he was famous in antenatal department.)

she introduced the park to me and said that it was larger when she was young. but some part of it was developed into housing areas. she recommended the botanical garden which i didnt get a chance to see yet as it closes at 6pm and i normally go for a walk after that time. at the end of our conversation, she showed me the way back to the university.

and now, this park has become my favourite spot for me to "lepak" (a malay word that means wander around) during my leisure time.

周杰伦- 千山万水

2008-05-13T09:46:00.000-07:00

作曲：周杰伦作词：方文山

千山万水无数黑夜等一轮明月
梦的边陲风吹不灭从不感疲惫

东方无愧第一是谁让我们追求完美
我态度坚决面朝北平地一声雷

做好准备这一回起跑后绝不撤退
痛快一起努力的感觉
我们拥有同样的机会

梦想挟带眼泪咸咸的汗水
你我同个世界爱从中穿越

梦与希望在飞我向前去追
有目标就不累等着我超越

远远抛开一切过千山万水

Cases in surgical posting

2008-05-13T05:40:00.000-07:00

I was too addicted to the korean drama series and taiwanese programme for the past 3weeks and totally neglected my blog. Despite being in the paediatric department this month, I was busy with the research data entry and doing my own private study. Now i would like to present the cases i have seen in my previous posting- the surgical department. To be honest, surgery is not my cup of tea, i have chosen it to be my second posting just because i think i need to go but not that i am interested to go. We have early surgical ward round, normally it ends within an hour, it was boring and less busy as compared to the medical ward. The more exciting part for this posting would be going to the operation theatre.
For the first time i knew i could go to the OT, i was excited. I have been looking forward to see surgical cases, eg: cardiac bypass, thyroidectomy, nephrectomy, colectomy, gasterctomy, appendectomy, cholecystectomy, hysterectomy... however, i knew the surgeon i was attached to was a general surgeon, i woulndt get to see neuro-, cardiac and orthopaedic surgeries. He's Mr JB and he would only deal with surgeries that involve the lower GIT as he other colleagues would cover the other surgeries as they seperate their cases according to the parts in abdominal caivty that they deal with. So basically i have seen loads of lower GIT and pelvic surgeries last month.
The main diffenrence between attachment of medicine and surgery would be you dont normally know what the patients come in for, coz their surgical date was pre-arranged weeks or months ago in the surgical clinic. So the history for the following cases that i am going to present may not be very complete or accurate.
1) A 80y/o men, came in to the theatre for chronic abdominal pain. Abdominal X ray was taken and the colon was noticed to be dilated. Other investigations have done to find out the cause of his colonic dilatation but none was contributory. The surgeon wasn't very keen in doing surgery on him as he was old and might not have good prognosis after that. However, the patient himself insisted to get rid of the pain by removing his colon. So on the 1st may 2008, which was the first day of my surgical posting, i witnessed a total colectomy that took two and a half hour. The normal diameter for colon is approx 5cm and his has gone beyond that, approx 8cm and was really super dilated. The surgeon has made the diagnosis of pseudo-obstruction after looking into his abdominal cavity and removing his dilated colon. he took the picture of it as he said he doesnt normally see this size of colon as according to his experience, he's only seen 2-3 cases per year. there was no organic cause that can explain his dilatation and this gentleman was sent to the ICU after that. However, his pain did subside but he was on a slow recovery. He was admitted to the ward for the whole one month and when i have left to the paeds department on 1st june 2008, he wasnt discharged yet. Coz in between his admission, he developed pnemonia and couldnt eat well after the surgery. I sincerely hope he's getting better although i do not know what happen to him after that.
2) Middle-aged men, who came in for right hemicolectomy as there were two large polpys in his caecum on colonoscopy. After removal of his caecum and rt colon, an ileostomy was formed in his right iliac fossa. A hole was cut across the skin and abdominal muscles, to let the terminal ielum to pass through. The terminal ileum was brought out to the external surface to prevent the enzymes from digesting the skin and an ileostomy bag was stuck onto the skin to collect the faeces. The rt colon that was removed was cut open, and the two polpys were seen, and their size were >2cm. the surgeon thuoght that they were adenomatous polpys and cancerous. it was a right choice to remove it before it was spread to the lymph nodes.
3) 40+y/o M, who came in for a sigmoidectomy as a mass was found in his sigmoid. it was supposed to be a simple surgery but unfortunately the surgeon found an adhesion between the spleen and the colon. He wasnt sure that was the mass extending from the colon or it was just an adhesion as a result of scarring. the spleen was known to be the a very fragile organ in our body and it could rupture very easily. while the surgeon was looking at the spleen to look for any scarring or infarct, somehow... i didnt know how it happen... the spleen was torn, as i didnt dare to question the surgeon. it was happened within a second... blood flew out from the torn spleen and suction was required. the surgeon had no choice but to remove the spleen. on removal of the spleen, an infract was noticed on the parenchyma of the spleen, that might lead to healing, scarring and further adhesion of the scar to the colon. then, the surgeon worked out on his sigmoidectomy. after removal of the sigmoid, a colostomy was formed on his left iliac fossa. as opposed to the ileostomy, colostomy was flat. a hole was cut and the colon was stitched onto the circumference of the hole. similar to the ileostomy, a bag was tuck onto the skin to collect the faeces. before stitching back the midline scar of his abdomen, the surgeon tried to cut a small piece of the normal spleen to implant it onto the omentum. hopefully, the implanted spleen can still carry on with his normal functional reticuloendothelial system. anyways, this patient has to take life long antibiotic as a reslut of splenectomy and anticoagulant to prevent thrombus formartion after the surgery. poor thing....
these are the major cases i have seen and i think it's worthwile to share with my fellow colleagues. the other surgeries are incisional hernia repair, partial spincterectomty/ anal fistula treatment, biopsy of anal intraepithelial neoplasia, laparascopy, laparotomy, stoma repair... i was once very kei poh, went down to the theatre even Mr JB was not around, the nurse was kind and brought me to the other theatre to see mastectomy and axillary lymph nodes excision. that was a bonus to my surgical posting. email me if you are interested in knowing more on other surgeries as this post is already quite long. hope u enjoy reading it.

Cefn Brynn 409

2008-05-09T08:46:00.000-07:00

Cefn Brynn is the name of the building, 409 is the room number.
In short, Cefn Brynn 409 is the place i live in swansea.
This is my room. A room of freedom, a room of happiness, a room for dining, a room for studying, a room of sleeping & most importantly a room of myself.

It has 4 walls, 1 ceiling and 1 floor.

Now introducing the 1st piece of wall.
There were bookshelves, a study table, a chair, a fridge and drawers. I put my books on the bookshelves. they were all given by my uncle, i only brought mac cleod. I keep all my food in the drawers. I have a picture of jay chou in front of my desk & another group picture of buddhist camp. regret not bringing my family pics. sigh...

Next wall, the wall of entrance.
The door is opened into the room and i have my personal basin with two water taps. One for hot and one for cold. The drinking water can just be obtained directly from the cold water tap. However , the hot water is not drinkable. Drinkable hot water can be taken from the common kitchen. I can do simple washing & cleaning in my room, eg: wash my face, hands & brush my teeth. And there is a small piece of mirror on top of the basin.

The next wall, i have my wardrobe, a cushion chair which i use to put my clothes and a bed.

The last piece of the wall, it's a big window covered by the blue curtains. I have a radiator, the white thingy on the left of pic and ot's partly covered by my bed, which is functioning only when the weather is cold. My bed (with the pillow & duvet) were pre-arranged at the side of the window.

Dang dang dang dang... this is the view out of my window. The view of swansea university. Where is Singleton hospital? It is on the right side and cant be taken seen from my window. Too bad...

Oops, i miss out the ceiling & the floor. there's a fluorescent light on top & no fan or air-cond in the room. The natural air is the air-cond in this season. I think most people will get a fan when summer is coming. The floor was carpeted and it's nothing special.

So basically this is where i live!!!

What anaesthetists do???

2008-05-09T03:12:00.000-07:00

I am attached to the surgical department in may 2008. As a result i get to see how the anaesthetists and surgeons work in the operation theatre once a week. The anaesthetist i met was Dr Suwee. She was so nice and she liked to ask questions. Her favourite questions were "what can go wrong with this procedure?" and "how to make sure this procedure has done correctly?" So i am here to explain what's happening in the anaesthetic room before the patient was sent to the theatre.

I have only seen 2cases of epidural. The anaesthetist would locate spaces in btw T8-T12 vertebrae, and local anaesthetic was injected into the skin. Then a needle was pierced through the skin, then to the supraspinous ligament, then to the infraspinous ligament then finally going through the ligamentum flavum, that's the destination-- epidural space. To make sure the needle is in the correct place, while piercing the needle, saline was injected through a syringe until the needle reaches a point of strong resistance, that is the ligamentum flavum. Once the resistacne towards the injected saline has gone down, it means that the needle has passed through the ligamentum flavum. A tube was inserted followed by the needle and the needle was taken out after that. The anaesthesia was given by injecting through the tube, an extra 1ml has to be injected as there is a dead space in the epidural. The tube was then stuck to the back of the patient and it was left open just in case extra anaesthesia was needed during the operation.

Then is the time to give sedation. Two infusions were given, they were propofol & remifentanil. The infusion rate was increased for abt 1min?? to make the patient asleep. And then it was switched bec to a lower rate to maintain the sedative state. How do u make sure the patient is in deep sleep? first n foremost, it a very straightforward method, by calling the name loudly and wait for response. Next, it;s a very unpleasant way, by pulling the eyelashes gently and wait for response. Normally, if the patient doesnt open his eyes, meaning that he's already in deep sleep. These are the manual method, they do have a monitor to check for the level of consciousness which i dont khow to interpret.

After that, here comes the intubation to maintain the air supply. After the intubation, i was asked to listen to the chest to ensure that the tube has gotten into the trachea, not the oesophagus. The breath sound has to be equal on both sides, and look at the chest movements and look for steam in the tube. If all these are present, u can be pretty sure that the intubation was done correctly. Then, check the patient's ability to breathe on it's own, keep an eye on the SP O2 level on the monitor, basically that's all.

What comes next? Maintenance of blood circulation, checking for blood pressure and heart rate. A mini ultrasound was used to locate right internal jugular vein & carotid artery. This is the most direct way to know the BP. A tube was inserted to the int jugular vein all the way down to assess the right atrial pressure. the tube was left open as well just in case IV infusion or blood transfusion were needed. It's normal to see the patient of 80/60mmHg as the BP was suppressed to prevent uncontrolled bleeding. One litre of saline was given to maintain the blood volume and to prevent the patient goes into hypovolumic shock.

On the other hand, (literally means the other hand as one has the saline infusion, the other hand has another infusion), muscle relaxant was given as an injection. this is to relax the muscle so that the surgeon would easily cut through the muscle layers.

so here comes the favourite question, what can go wrong with these procedures...
1) bleeding as so many needles and tubes piercing through the skin
2) risk of infection as so many foriegn materials were introduced to the body
3) anaphylaxis as there might be allergic reactions to the drugs
4) air embolism as air bubbles might be introduced into the bloodstream

that's all i could remember, i believe there are much more risks in giving anaesthetics. One simple word- Anaesthetic, concludes what i have all mentioned. It sounds simple but it takes about 20-30min to get it done. Do u think that's the end of the job? No, the anaesthetist has to send the patient in the theatre and monitor the cardiac and respiratory function, level of consciousness, amount of analgesia... throughout the whole surgery. In other words, the patient's life is in the anaesthetist's hand. After the surgery, the patient was monitored to recover to his optimum state in terms of cardiac & respi function. So the anaesthetist has to review the patient the next day after surgery to make sure the patient is back to normal.

Now this the end of the story.
To my fellow colleagues, think twice if you really decided to become a anaesthetist.

2008-05-06T13:11:00.000-07:00

春天花会开鸟儿自由自在
我还是在等待等待我的爱你快回来~~

Beautiful, colorful and wonderful flowers in
St James Park, London.
Pic taken on 26/4/08.
Super nice weather without putting jacket on.
Temp: 18 degree celcius.

3 interesting cases in general medicine posting

2008-05-06T11:44:00.000-07:00

1. In-patient, 60+y/o male complaint of oedema in both legs, on admission both legs were swollen, the diameter was as big as a long ruler ~30cm. this has caused a limitation of mobility in this gentlemen. He has a past medical history of prosthetic femur on the hip. Both femur were replaced 10years ago. LFT, RP, CXR were done to rule out liver failure, renal failure & cardiac failure. the results were normal. Inflammatory markers were tested and the result was negative. what would be the diagnosis if everything looked normal? according to the registrar, this gentlemen rarely walks and he normally sits on the chair and doesnt move much. due to prolonged immobility, the veins were pooled in the legs and caused the leds to be oedematous. Walau A~ there is no underlying organic cause, the swelling legs were just simply because the patient was lazy to move around. therefore, the management is just giving diuretics to loose the extra fluid in the legs. Score of interesting: 8/10, nvr come accross in my life that the admission was due to laziness in moving.

2. Out-patient, 50+y/o, chinese female. ( i remember her the most because she is the only chinese patient i have seen in uk so far) she came to the clinic for follow up of her hepatitis. but she ended up telling stories not related to her hepatitis. it was because on the blood result, she has cleared her hepatitis virus. no viral load was found in the blood. however, she and her spouse had spent nearly 45 min to talk to the registrar and consultant. She was diagnosed with carcinoid sydrome few weeks ago, but it was not in the GIT. It was an incidental finding from a polyp in the bladder. The mass was found in the bladder when she went for ultrasound screening for cervical ca. On operation, the surgeon intended to take biopsy sample of the polyp, but the polyp wall off on its own. As a result, the tissue was sent to the lab and carcinoid cells were found. Initially the specialist thought it would be a benign tumour but nvr thought that it would be carcinoid. Acc to the specialist who was looking after this lady, there were only 8 cases of carcinoid in the bladder in the whole world. it was super rare. This lady had complaint of flushing, lethargic, mood swing and all the while she thought that was pre-menopausal syndrome or her hepatitis flares over the past few months. do u think that's the end of the story after the polyp removal? No!!! The specialist thinks that it would be secondary deposit in th bladder. there might be some primary in elsewhere. Her urine 5HIAA-5 hydroxyindoleacetic acid was monitored for few days after polyp removal to make sure there are no extra neuroendocrine function. She has to go for Ct scan the following to check for any primary carcinoid. I didnt get to know what's the out come after that coz i only seen her once in the clinic.
Score of interesting: 10/10, carcinoid in the bladder lei!!! it was even more rare than male breast cancer!!! It was unbelievable when the patient came to a gastro clinic to tell stories of carcinoid, not in the GIT, but in the bladder.

3. 80+y/o female, admission for pneumonia. blood and sputum was sent to lab for culture and sensitivity. this old lady was a known MRSA(methicillin resistant Staph aureus) patient, all staffs who visited her must wear gloves and gown. this is to prevent the staffs transmit the bacteria to the next patient they are in contact with. her lab results were sent back. she was suffering from sepsis & pneumonia of the same causative agent, it was staph aureus. but not the MRSA one, is the normal commensal staph aureus. the consultant was thinking of any other source of staph aureus infection that predispose to this attack. no dermatology history of staph aureus infection, would it be the bone then? lumbar X ray was taken and no injury seen on the X ray. So... so.. so ... at the moment that the consultant was scratching his head, this lady's medical notes was sent to my hospital from the previous hospital she was admited to. she had subacute infective endocarditis few months back!!! murmurs were heard on examination actually, but this lady was known to have a past medical history of valvular heart disease. her old medical notes have cleared all the doubtd of the source of staph aereus of her sepsis and pneumonia. Immediate treatment was given regardless the cause of infection. she started on antibiotics and her blood test were improving as inflammatory markers went down. but she still looked ill and renal function was deteriorating. very very very sad to say that she was the 1st patient whom i followed throughout in the ward and was not discharged back to home. she passed away the day after the consultant diagnosed her of SIE. Her renal function and cardiac function were compromised even tough she was dong well in recovering from infection.
Score of interesting: 9/10, 1st time not seeing patient in ward round the next day because they have gone to heaven or hell, but not bec to their home.

initially i wanted to write 10 cases. after finish writing the 1st one, i saw the length of my 1 case, i decided to share 5 cases. but after finish writing the 2nd one, i decided to share 3 cases of my posting. not because i am self-fish but i think i m writing too long. i hope u would enjoy reading this la.

猜不透

2008-05-04T15:58:00.000-07:00

[title:猜不透] [artist:张韶涵] [album:欧若拉]

作词:王雅君 张耀威 作曲:陈依依

满天的星星在闪烁 点不亮心中的暖和
为什么你不懂我的梦 只是勉强笑了
就像我们凭直觉走 找不到同一个出口
从现在到心痛要多久 还有没有以后
有时 假装沉默是否有点难受
到底期待像什么一眨眼又让心伤透
关于你们手牵手 还是关于你和我
你说你就是在我左右 下一秒却又让我
猜不透

http://www.ffdivcxjr99.cn/data/updata/1143703178.mp3

This is a chinese song that i recently get addicted to it.
It means unable to guess/ unguessable？？
It is always very hard to guess one's mind.
What does he or she think?
It is even harder to understand our own mind.
What do i think?
What do i want?
真是想不透，猜不透。

Launching for my first blog

2008-05-02T06:29:00.000-07:00

This is my first blog named Jooney.
I welcome all guest to attend the launching of my first blog in blogspot, the details are as folow:

Time: 1430 (UK time)
Date: 2/5/08 (It's david beckam's birthday)
Venue: Cefn Brynn 409, Singleton Park, Swansea.

It's free of charge and no refreshment is provided.
Thank you for your attention.
Hope you would enjoy reading my blog.