HANIS AMANINA

Zydan Says Hi!

2024-07-19T13:46:00.000+08:00

Assalamualaikum, wahhh it's been a while since my last post! I forgot about my blog until recently when I was given reminder to renew my website account. Haha I have been paying annual fee just because I don't want to lose my memories and posts here... the website, actually to be honest. It is not easy to secure a good name .com.

So, hi~

Introducing my little bunch of joy,

Zydan

He is 9months old plus now. So cheeky and full of ideas. This baby learns and adapts so fast to every single thing exposed to him!

9months milestone:-

Gross motor:

Zydan can sit without support but not really steadily yet. He is keen to stand and climb than sitting. Makes a lot of movement on surface - crawling for few steps then wriggling on his abdomen.

Oh, he can climb furniture now and keen on cruising here and there.

Fine motor:

I can't really appreciate his pincer grasp yet. But he totally loves seeing moving objects like vehicles or anything falling like fallen toys! Of course, while sitting on his walker / chair he loves to drop thing and tries his best to get out to pick it up.

Language:

He knows his name and can respond to our call. But now no really into taking pictures like he used to. He likes it when we cough (unintended / intended) and try to imitate that. He babbles a lot, especially during nesting time before sleep.

Social Behavior / Self-Care / Play:

Still mouthing on every single thing. Prefers baby led weaning than spoonfeeding. I will let BLW if it is before his bath time. Hehe. He just found out he knows how to clap! Thanks to repetitive song of "kalau rasa gembira tepuk tangan" yeayyyy

Alhamdulillah, thank you Allah for this gift.

Kindly excuse my motherhood's excitement.

And kindly pray for Zydan's safety and health, and for his eczema to be well controlled :)

Am I That Old / Young?

2022-05-27T19:01:00.000+08:00

Sambil masak makanan untuk lunch, saya pasang lah lagu kat YouTube. Macam biasa, saya akan buka Korean OST / piano instrumental, tambah lagi kalau dapat bakar scented candle... fuhh, antara me-time yang best.

Oh, hari ni tak kerja sebab ada kursus online. Dah lama sebenarnya menunggu kursus ni, sejak timbulnya nekad nak keluar cari rezeki kat tempat lain. And finally, it is here! Hehe done first day, esok ada lagi, Ahad pun. Mudah-mudahan berkat semua ilmunya.
Berbalik pada lagu tadi, sedar tak sedar lagu tu dah keluar sejak 2012. Means, masa tu tengah berada di perantauan. Kawan-kawan memang jadi keluarga lah kat sana, antara benda kita buat bila nak spend time together ialah layan lagu-lagu Korea ni. Hehe.
Now I feel old. Cuma tu lah, kadang-kadang tak sedar pun diri ni dah cecah 30an. Sebab rasa macam muda je lagi. To be honest, bila kerja kat klinik jumpa dengan pesakit yang pelbagai, quite a number jugak yang akan tanya umur. Haha taktahu la nak kata soalan tu sensitif ke tak tapi bila kita suruh dia teka, "hmmm, awal 20an?, tapi muda sangat lah pulak nak jadi doktor."
Is it a compliment? Haha
Pernah sekali ada pesakit umur 40an masuk, ayat pertama dia, "doktor ni mudanya, welcome to the real life." Gelak je lah sebab bila kita bagitahu umur, tak faham kenapa pesakit nak terkejut sangat. Takde la kita ni nampak muda sangat punnn.

Atau mungkin generasi sekarang nampak lebih matang dari zaman dulu-dulu?
Anyway... kursus tadi tentang perancangan keluarga, antara bread and butter kalau staff kesihatan nak santuni masyarakat sebab sangat penting untuk pastikan keluarga dirancang sebaiknya supaya ahli keluarga kita berkualiti. Walaupun belum dikurniakan rezeki cahaya mata, insyAllah ilmu-ilmu tu sangat bermanfaat untuk saya sendiri untuk diamalkan di kemudian hari. Antara isu yang dikupaskan ialah tentang teenage pregnancy. Daripada graf, nampak yang jumlah teenage pregnancy berkurang tahun demi tahun, tapi itu tak bermakna remaja kita tak terdedah dengan hubungan di luar nikah. Dan dengan perkembangan Internet sekarang ni, mudah sangat untuk seseorang cari jalan untuk gugurkan kandungan. Sedih.

Masa jadi houseman dulu, beberapa kali juga rawat wanita yang hamil luar nikah (bukan kandungan pertama ya). Sebab ini dah kandungan kelima, pakar menyarankan beliau untuk ikat saluran peranakan. Sebab diri sendiri pun beliau tak mampu jaga, ahli keluarga pun tak mampu nak kawal aktiviti beliar, apatah lagi nak mendidik anak-anak yang lahir. Semua anak-anaknya diserahkan pada Jabatan Kebajikan Masyarakat.

Terkadang timbul rasa cemburu dan kecewa bila kita menanti cahaya mata manakala ada orang yang begitu mudah sekali mengabaikan zuriat yang Allah dah beri. Tapi memang kena selalu istighfar, kena sentiasa yakin yang rezeki Allah bagi insyAllah sentiasa tepat pada masanya, di saat kita sebenarnya bersedia sepenuhnya. Usaha, doa, tawakal. InsyAllah.

Nanti kalau ada kesempatan, saya share lebih tentang input kursus. Banyak ilmu perubatan tapi akan cuba kongsi dari sudut pandang masyarakat. :)

Doakan kami dikurniakan cahaya mata yang sihat, sejuk mata memandang dan boleh bawa kami ke syurga. Ameen.

Desa Mentari

27.05.2022

Every Moment Matters

2022-03-22T14:26:00.001+08:00

Seems like lesser people read blog these days. Maybe I should redivert my thought instead of mainstream medium to blogging. It feels like yesterday when it was during my undergraduate phase to be exact, blog is like an open diary. Though it is not really a personal diary but sharing my life and experience here feels good, to meet friends with the same interest of writing is awesome too. But I think now people write more on Facebook, Instagram as more audience (?) maybe.

My blogging journey incredibly reduced during housemanship and even less after I became a medical officer. Blame the hectic working life, honestly. But I did tried to find some free times to write few informal articles or maybe just sharing about medicine and health. I posted on Facebook instead for people to read and gain something (hopefully).

Life has been a roller coaster since then.

I was in various places within 2years of my MOship, somehow I don't regret it despite occasionally I felt tired and annoyed of doing it (I meant, transferring workplace).

Emergency and Trauma
Paeds General
Surgical Oncology
Paeds General (again)
Paeds Covid
Paeds General (also again - back to so called base)
Paeds Endocrine

How can I adapt in totally different working environments, saving lives some more?
Surprisingly, I survived. Alhamdulillah.

There was one point, I lost passion. I did not even understand what were I doing. Being transferred here and there as in I was an invaluable ball. I woke up few times in the middle of night despite it was not my oncall night, unable to return back to sleep. Waking up, I felt heavy, can I survive working today? I was totally not looking forward for another day in the hospital. My sleeping pattern became terrible.

There.

Till one day, I don't feel totally good with myself. I got sick easily. I skipped meals. I performed my prayers late.

Colleagues, most are awesome and a few are not. Betrayal, talking behind your back, query about your medical leaves (when I was actually survived my housemanship without a single emergency leave / medical certificate). People always say 'remember the Hippocratic Oath' the so called infamous 'Do no harm.' oh yea, I agree, my ultimate goal in my career is always to be a safe doctor. I believe most doctors have this vision.

But, if doing so affected my own health so much, I finally know something is not right. I want to contribute to the community but maybe this is not the place.

That's it. I finally made my decision. To explore the rest of medical fields that may offer any opportunities to grow and learn so that I can still practice as a certified medical officer with a more work-life balance.

I can say I am healthier and happier.
The journey is still long, surely going to be windy. I pray Allah will always lead me through it.
I believe Allah's rizq is everywhere and insyAllah there will be something for me, ameen.

Pray for me. :)

Buat Bodo-Bodo Dengan Doktor

2021-06-17T20:55:00.008+08:00

𝗕𝗨𝗔𝗧 𝗕𝗢𝗗𝗢-𝗕𝗢𝗗𝗢 𝗗𝗘𝗡𝗚𝗔𝗡 𝗗𝗢𝗞𝗧𝗢𝗥

Di sesetengah hospital, ada yang review pesakit TDS (maksudnya tiga kali sehari - am review, pm review, night review). Ada juga yang BD (maksudnya dua kali review sehari - am review, pm review). Di tempat saya bertugas sekali, kita amalkan TDS review.

Alkisah night review di wad kanak-kanak.

𝘿𝙧: 𝙄𝙗𝙪, 𝙞𝙗𝙪 𝙛𝙖𝙝𝙖𝙢 𝙩𝙖𝙠 𝙠𝙚𝙣𝙖𝙥𝙖 𝙢𝙖𝙨𝙪𝙠 𝙬𝙖𝙙 𝙠𝙖𝙡𝙞 𝙣𝙞?
𝘐𝘣𝘶: 𝘛𝘢𝘩𝘶, 𝘢𝘯𝘢𝘬 𝘯𝘢𝘬 𝘣𝘶𝘢𝘵 𝘔𝘙𝘐 𝘦𝘴𝘰𝘬.
𝘿𝙧: 𝙏𝙖𝙙𝙞 𝙙𝙤𝙠𝙩𝙤𝙧 𝙗𝙞𝙪𝙨 𝙙𝙖𝙝 𝙟𝙪𝙢𝙥𝙖 𝙠𝙖𝙣? 𝙄𝙗𝙪 𝙗𝙤𝙡𝙚𝙝 𝙘𝙚𝙧𝙞𝙩𝙖 𝙗𝙖𝙡𝙞𝙠 𝙖𝙥𝙖 𝙙𝙤𝙠𝙩𝙤𝙧 𝙗𝙞𝙪𝙨 𝙗𝙖𝙜𝙞𝙩𝙖𝙝𝙪?
𝘐𝑏𝑢: 𝐸𝑠𝑜𝑘 𝑑𝑖𝑎 𝑘𝑎𝑡𝑎 𝑛𝑎𝑘 𝑏𝑎𝑔𝑖 𝑏𝑖𝑢𝑠 𝑝𝑒𝑛𝑢ℎ, 𝑚𝑎𝑠𝑢𝑘 𝑡𝑖𝑢𝑏 𝑝𝑒𝑟𝑛𝑎𝑓𝑎𝑠𝑎𝑛. 𝑃𝑎𝑠𝑡𝑢 𝑠𝑒𝑏𝑎𝑏 𝑚𝑎𝑠𝑎 𝑏𝑎𝑏𝑦 𝑝𝑒𝑟𝑛𝑎ℎ 𝑚𝑎𝑠𝑢𝑘 𝑡𝑖𝑢𝑏 𝑗𝑢𝑔𝑎𝑘, 𝑑𝑜𝑘𝑡𝑜𝑟 𝑏𝑖𝑢𝑠 𝑘𝑎𝑡𝑎 𝑘𝑎𝑙𝑎𝑢 𝑎𝑑𝑎 𝑐𝑜𝑚𝑝𝑙𝑖𝑐𝑎𝑡𝑖𝑜𝑛 𝑝𝑒𝑟𝑛𝑎𝑓𝑎𝑠𝑎𝑛 𝑎𝑝𝑎-𝑎𝑝𝑎, 𝑘𝑒𝑛𝑎 𝑚𝑎𝑠𝑢𝑘 𝐼𝐶𝑈.
𝘿𝙧: 𝙊𝙠𝙖𝙮, 𝙖𝙩 𝙡𝙚𝙖𝙨𝙩 𝙞𝙗𝙪 𝙛𝙖𝙝𝙖𝙢 𝙡𝙖 𝙗𝙖𝙨𝙞𝙘 𝙧𝙚𝙖𝙨𝙤𝙣 𝙠𝙚𝙣𝙖𝙥𝙖 𝙠𝙚𝙣𝙖 𝙢𝙖𝙨𝙪𝙠 𝙬𝙖𝙙 𝙠𝙖𝙣? 𝙆𝙖𝙡𝙖𝙪 𝙠𝙞𝙩𝙖 𝙗𝙖𝙘𝙖 𝙨𝙚𝙟𝙖𝙧𝙖𝙝 𝙨𝙚𝙗𝙚𝙡𝙪𝙢 𝙣𝙞, 𝙙𝙪𝙡𝙪 𝙥𝙚𝙧𝙣𝙖𝙝 𝙩𝙧𝙮 𝙗𝙖𝙜𝙞 𝙪𝙗𝙖𝙩 𝙩𝙞𝙙𝙪𝙧 𝙩𝙖𝙥𝙞 𝙩𝙖𝙠 𝙗𝙤𝙡𝙚𝙝 𝙩𝙚𝙧𝙪𝙨𝙠𝙖𝙣 𝙨𝙚𝙗𝙖𝙗 𝙤𝙠𝙨𝙞𝙜𝙚𝙣 𝙖𝙣𝙖𝙠 𝙩𝙖𝙠 𝙤𝙠𝙖𝙮 𝙡𝙚𝙥𝙖𝙨 𝙩𝙪.
𝘐𝘣𝘶: 𝘏𝘢𝘢𝘩.
.

Settle night review, saya pergi attend referral kat ED. Balik wad, house officer beritahu, "𝘋𝘰𝘬𝘵𝘰𝘳 𝘯𝘢𝘬 𝘵𝘢𝘩𝘶 𝘵𝘢𝘬, 𝘮𝘢𝘬 𝘣𝘶𝘥𝘢𝘬 𝘵𝘶 𝘬𝘢𝘵𝘢 𝘥𝘦𝘱𝘢𝘯 𝘴𝘱𝘦𝘤𝘪𝘢𝘭𝘪𝘴𝘵 𝘺𝘢𝘯𝘨 𝘥𝘪𝘢 𝘵𝘢𝘬𝘵𝘢𝘩𝘶 𝘢𝘱𝘢-𝘢𝘱𝘢 𝘱𝘶𝘯 𝘱𝘢𝘴𝘢𝘭 𝘨𝘦𝘯𝘦𝘳𝘢𝘭 𝘢𝘯𝘢𝘦𝘴𝘵𝘩𝘦𝘴𝘪𝘢 𝘵𝘶."

I was like....
Kena sabo lagi.
(sabo maksudnya kena sabotaj)

Jumpa senior MO yang round dengan pakar sekali, clarify balik yang mak dia siap boleh cerita apa nak buat untuk prosedur esok, macam mana pulak boleh kata tak tahu apa-apa. Dah jumpa doktor bius banyak kali dah sebelum ni (sebab ni kes MRI yang asyik kena postpone sebab tak dapat consent parents)

Fuh, paeds specialist RE-EXPLAIN sekali lagi, terpaksa inform anaesth team sekali lagi. Anaesth team siap datang pukul 12 tengah malam untuk RE-EXPLAIN tentang prosedur. 

Ayat ibu yang serious rasa kena sabotaj ialah, "𝘩𝘢? 𝘬𝘦𝘯𝘢 𝘮𝘢𝘴𝘶𝘬 𝘵𝘪𝘶𝘣 𝘱𝘦𝘳𝘯𝘢𝘧𝘢𝘴𝘢𝘯?"

Adoi.

Percayalah doktor akan berusaha sebaik mungkin untuk terangkan dalam layman terms untuk pastikan pesakit dapat basic idea apa yang akan berlaku. Saya sendiri akan lukis atau tunjuk gambar berkaitan untuk beri kefahaman pada pesakit, siap bagi analogi lagi dengan kehidupan seharian. 

Pagi keesokannya, specialist oncall datang wad sekali lagi tanya perkembangan kisah MRI pesakit ni, nak proceed ke tak, dah faham ke tak.

Kita bagitahu lah dah re-explain, anaesth team dah re-explain, consent taken. Terpaksa clarify dan tunjuk proof documentation sebelum ni yang dah banyak penerangan dibuat dan ibu faham.

𝙎𝙥𝙚𝙘𝙞𝙖𝙡𝙞𝙨𝙩: 𝙊𝙠𝙖𝙮, 𝙜𝙤𝙤𝙙. 𝙄 𝙙𝙤𝙣'𝙩 𝙪𝙣𝙙𝙚𝙧𝙨𝙩𝙖𝙣𝙙 𝙬𝙝𝙮 𝙨𝙝𝙚 𝙡𝙤𝙤𝙠𝙨 𝙘𝙡𝙪𝙚𝙡𝙚𝙨𝙨 𝙮𝙚𝙨𝙩𝙚𝙧𝙙𝙖𝙮. 
𝘔𝘦: 𝘮𝘦 𝘵𝘰𝘰. 𝘛_𝘛

Tolonglah jangan buat bodo-bodo dengan doktor.
Kalau faham, cakap faham.
Kalau tak faham, cakap tak faham.

Kalau ada Covid contact, cakap ada Covid contact.
Kalau tengah tunggu PCR result, cakap tengah tunggu PCR result.

Janganlah sabotaj kami. Kami pun manusia. 

Demam Sawan - Ibu Bapa Jangan Panik!

2021-05-29T12:04:00.005+08:00

𝘿𝙀𝙈𝘼𝙈 𝙎𝘼𝙒𝘼𝙉 - 𝙄𝘽𝙐 𝘽𝘼𝙋𝘼 𝙅𝘼𝙉𝙂𝘼𝙉 𝙋𝘼𝙉𝙄𝙆!
.

Deman sawan ni dalam bahasa Inggeris, namanya febrile fit / febrile seizure / febrile convulsion. 
.

 𝑨𝒑𝒂 𝒅𝒆𝒎𝒂𝒎 𝒔𝒂𝒘𝒂𝒏 𝒏𝒊?
Demam sawan ialah sawan yang berlaku disertai demam (suhu badan melebihi 38'C) dalam kalangan kanak-kanak antara umur 6bulan hingga 6tahun. Biasanya demam sawan berlaku masa hari pertama / kedua fasa demam tu. 
.

 𝑨𝒑𝒂 𝒚𝒂𝒏𝒈 𝒎𝒆𝒏𝒚𝒆𝒃𝒂𝒃𝒌𝒂𝒏 𝒅𝒆𝒎𝒂𝒎 𝒔𝒂𝒘𝒂𝒏?
Demam yang terlalu tinggi - boleh berpunca dari apa-apa jangkitan contohnya:
- saluran pernafasan bahagian atas - lebih kurang bahagian tekak (URTI / pharyngitis / tonsillitis / tonsillopharyngitis)
- saluran pernafasan bahagian bawah - pneumonia
- saluran telinga - otitis media
.

 𝑨𝒑𝒂 𝒕𝒂𝒏𝒅𝒂-𝒕𝒂𝒏𝒅𝒂 𝒅𝒆𝒎𝒂𝒎 𝒔𝒂𝒘𝒂𝒏?
Demam panas (atas 38'C) berserta tanda-tanda ni:
- kekejangan otot / tersentak-sentak (ada yang berlaku di kedua-dua belah kaki ataupun di kedua-dua belah tangan ataupun di kedua-dua belah kaki dan tangan)
- ada yang mata terbeliak ke atas
- ada yang mulut berbuih / air liur meleleh
- ada juga yang terkencing / terberak.
- dan biasanya kanak-kanak tu tak sedarkan diri ataupun tak respon bila kita panggil dia. 

Biasanya sawan akan berhenti sendiri selepas 1-3minit, jarang yang lebih 5minit. Kalau atas 5minit, bawak ke hospital / klinik SEGERA!
.

 𝑴𝒂𝒄𝒂𝒎 𝒎𝒂𝒏𝒂 𝒏𝒂𝒌 𝒓𝒂𝒘𝒂𝒕?
Biasanya bila kanak-kanak sampai klinik / Jabatan Kecemasan, sawan dah selesai dah. Ada kanak-kanak yang masih mamai / bingung, ada yang dah kembali dengan diri sendiri. 

Doktor biasanya akan buat routine blood test (bergantung):
- full blood count - check sel darah putih / merah / platelet (kat sini biasanya boleh tunjuk badan dia tengah ada infection tak)
- renal profile - check fungsi buah pinggang
- liver function test - check fungsi hati
- electrolyte (magnesium, phosphate, calcium, albumin) - nak tengok balance tak garam dalam badan

Biasanya semua results tu normal. Cuma kalau sawan tu berulang-ulang dalam satu fasa demam yang sama, ada yang sampai kena buat CT brain - ni semua bergantung pada keadaan pesakit ye. 

Doktor akan check jugak keseluruhan badan, especially sistem saraf (kita panggil central nervous sytem) - dari segi tone & reflex kaki, tangan etc. 

Untuk demam sawan kali pertama, ada hospital yang biasanya admitkan untuk pemantauan, rawatan, diberikan pendidikan tentang sawan. Ada juga yang dipantau dalam 6jam di Jabatan Kecemasan dan dibenarkan pulang dengan ubat & pendidikan tentang sawan.
.

 𝑨𝒑𝒂 𝒓𝒊𝒔𝒊𝒌𝒐 𝒖𝒏𝒕𝒖𝒌 𝒕𝒆𝒓𝒋𝒂𝒅𝒊𝒏𝒚𝒂 𝒅𝒆𝒎𝒂𝒎 𝒔𝒂𝒘𝒂𝒏?
Yang ni kita akan tanya sejarah keluarga. Kalau ada ahli keluarga yang pernah dapat demam sawan masa kecil, risiko kanak-kanak tu adalah tinggi untuk dapat juga.

Kita akan tanya juga ada tak ahli keluarga yang ada masalah epilepsy (sawan yang berulang-ulang & berpanjangan walaupun tanpa demam), ada tak ahli keluarga yang masalah pembesaran / tahap kecerdasan (developmental delay). 
.

 𝑨𝒑𝒂 𝒃𝒂𝒉𝒂𝒚𝒂𝒏𝒚𝒂 𝒅𝒆𝒎𝒂𝒎 𝒔𝒂𝒘𝒂𝒏?
Dalam kebanyakan kes, 𝘁𝗮𝗸 𝗺𝗲𝗺𝗯𝗮𝗵𝗮𝘆𝗮𝗸𝗮𝗻. 3-4% populasi boleh dapat demam sawan. 30% daripada tu boleh dapat demam sawan lagi di masa akan datang (fasa demam berbeza). Kalau dah pernah berulang lagi dapat deman sawan, risiko untuk dapat next attack akan lagi tinggi. 

Tapi untuk kes-kes tertentu, ada risiko boleh menyebabkan kecederaan otak.  Contohnya: 
- sawan yang berulang-ulang dalam satu fasa demam
- sawan yang berlarutan lebih 5minit
- ada masalah perkembangan yang lambat
- sejarah keluarga yang kuat

𝙁𝙞𝙩 𝙀𝙙𝙪𝙘𝙖𝙩𝙞𝙤𝙣 
- pendidikan tentang demam sawan - apa yang ibu bapa perlu buat masa anak kena demam sawan. 

Masa anak demam, check suhu badan anak. Sediakan alat termometer kat rumah, seeloknya yang check melalui telinga / bawah ketiak. Yang 'tembak' kat dahi tu tak valid sangat. 

Pastu, make sure dah prepare siap-siap ubat demam (Boleh rujuk sini untuk cara kira ubat demam - https://www.facebook.com/hanis.amanina/posts/10159297811497002) Please, ibu bapa perlu tahu cara bagi ubat demam taw. Ni perkara asas keibubapaan. 

Masa demam ni, longgarkan pakaian anak, buat tepid sponging (jelum dengan kain lembab), bagi ubat demam. Matlamat kita ialah turunkan suhu badan yang tinggi tu. Galakkan juga anak untuk minum air. 

Masa sawan berlaku pulak, perkara pertama anda kena buat ialah 𝗧𝗔𝗥𝗜𝗞 𝗡𝗔𝗙𝗔𝗦 𝗗𝗔𝗡 𝗕𝗘𝗥𝗧𝗘𝗡𝗔𝗡𝗚. 𝗝𝗮𝗻𝗴𝗮𝗻 𝗽𝗮𝗻𝗶𝗸. 
- mengiringkan anak ke sisi belah kiri.
- jauhkan barang-barang bahaya di sekitar anak - toys etc.
- jangan sesekali masukkan apa-apa dalam mulut anak (termasuklah kain, sudu dan sebagainya).
- jangan tinggalkan anak sendirian.
- perhatikan sawan anak, kalau ibu bapa dah bertenang - rekod video supaya doktor boleh tengok nanti.
- check timing - berapa lama anak kena sawan (biasanya 1-3minit sawan dah selesai dah).
- kalau sawan berpanjangan >5min, bawa ke klinik / hospital SEGERA!

Hanis Amanina
Moga bermanfaat!

ASMA NI TAK BOLEH SEMBUH KE?

2021-05-26T17:46:00.001+08:00

"𝘼𝙨𝙢𝙖 𝙣𝙞 𝙩𝙖𝙠 𝙗𝙤𝙡𝙚𝙝 𝙨𝙚𝙢𝙗𝙪𝙝 𝙠𝙚? 𝙎𝙖𝙮𝙖 𝙩𝙖𝙠𝙣𝙖𝙠 𝙡𝙖𝙝 𝙗𝙚𝙧𝙜𝙖𝙣𝙩𝙪𝙣𝙜 𝙥𝙖𝙙𝙖 𝙞𝙣𝙝𝙖𝙡𝙚𝙧 𝙨𝙚𝙪𝙢𝙪𝙧 𝙝𝙞𝙙𝙪𝙥."

Asma ni satu keadaan yang sangat selalu kita jumpa di fasiliti kesihatan. Terus terang, memang selalu sangat. Ada yang bermula masa kecil, boleh jadi berleretan sampai dewasa, boleh jadi selesai masa kanak-kanak. Ada yang masa baby beberapa bulan pun dah mula kena. Ada yang masa dewasa baru dapat. Ada yang masa mengandung je dapat asma.
.

𝑨𝒑𝒂 𝒂𝒔𝒎𝒂 𝒏𝒊 𝒔𝒆𝒃𝒆𝒏𝒂𝒓𝒏𝒚𝒂?
Asma ni radang pada saluran pernafasan yang kronik. Maksud kronik ni ialah berlarutan, tempoh masa yang lama. Radang tu akan buat saluran pernafasan tu sempit. Kesannya, udara yang kita hirup tu tak dapat masuk ke paru-paru, lalu kurangnya oksigen dalam darah.

𝑨𝒑𝒂 𝒔𝒊𝒎𝒑𝒕𝒐𝒎 𝒂𝒔𝒎𝒂 𝒏𝒊?
Presentation dia selalunya susah nafas / nafas laju / nafas berbunyi, batuk + sesak dada. Apa yang penting perlu tahu? Asma ni boleh mengancam nyawa kalau tak dirawat! Sebab dia melibatkan sistem penting badan kita - sistem pernafasan.

𝑨𝒑𝒂 𝒚𝒂𝒏𝒈 𝒃𝒐𝒍𝒆𝒉 𝒎𝒆𝒏𝒚𝒆𝒃𝒂𝒃𝒌𝒂𝒏 𝒂𝒔𝒎𝒂?
Fuh, macam-macam sebenarnya. Ada yang akan kena asma masa dia batuk/selesema. Ada yang kena bila terdedah pada asap rokok. Ada yang bila main dengan binatang berbulu (biasanya kucing / anjing). Contoh lain:
- allergy pada debu / asap / habuk / pollen / binatang lain
- jerebu / apa-apa pencemaran udara
- suhu sejuk / makanan sejuk / buah-buahan
- stress pun boleh menyebabkan asma ya
- ada yang induced oleh senaman / apa-apa aktiviti lasak

Asma untuk orang yang selalu merokok tu actually namanya 𝗖𝗢𝗣𝗗 (𝗰𝗵𝗿𝗼𝗻𝗶𝗰 𝗼𝗯𝘀𝘁𝗿𝘂𝗰𝘁𝗶𝘃𝗲 𝗽𝘂𝗹𝗺𝗼𝗻𝗮𝗿𝘆 𝗱𝗶𝘀𝗲𝗮𝘀𝗲). Konsep penyakitnya sama tapi biasa berlaku pada orang dewasa yang terdedah pada gas yang berbahaya, senang cakap asap rokok. Bukan setakat perokok ya kawan-kawan, kalau kita dikelilingi orang yang merokok pun boleh mengundang!

𝑨𝒔𝒕𝒉𝒎𝒂 𝒑𝒓𝒐𝒇𝒊𝒍𝒆?
Ni ialah soalan-soalan kegemaran doktor kalau anda datang dengan simptom asma. Hadamkan bagi yang memang ada asma & selalu datang hospital ambik nebulization / inhaler / perlukan rawatan dalam wad. Basically ni ialah basic info sejarah asma anda.

𝟭. 𝗦𝗲𝗷𝗮𝗿𝗮𝗵 𝗻𝗲𝗯𝘂𝗹𝗶𝘇𝗮𝘁𝗶𝗼𝗻 / 𝗠𝗗𝗜 - bila kali pertama? macam-mana kekerapan dalam setahun / beberapa bulan kebelakang? Bila last guna / dapat? Ada sejarah masuk wad tak? Kalau ada, apa tahap tertinggi dapat oksigen - nasal prong / facemask / venturi mask / intubate?

𝟮. 𝗦𝗲𝗷𝗮𝗿𝗮𝗵 𝗸𝗲𝗹𝘂𝗮𝗿𝗴𝗮 - ada sesiapa tak dalam keluarga yang ada asma (terutamanya first degree family - adik-beradik, ibu bapa)? Kalau ada, terkawal tak? Ada follow up / pakai inhaler apa-apa tak?

𝟯. 𝗜𝗻𝘁𝗲𝗿𝘃𝗮𝗹 𝘀𝘆𝗺𝗽𝘁𝗼𝗺𝘀 - ada tak bangun pagi akan selalu batuk? Ada tak tidur malam terganggu atau selalu terjaga disebabkan batuk? Ada yang tak boleh exercise berat sampailah semput sangat-sangat?

𝟰. 𝗧𝗿𝗶𝗴𝗴𝗲𝗿𝗶𝗻𝗴 𝗳𝗮𝗰𝘁𝗼𝗿𝘀 - apa yang selalu mengundang asma tu? Ada yang makan tembikai je, terus batuk-batuk dan semput. Ada yang baru lepas renovate rumah, batuk-batuk disebabkan habuk & debu lepas tu semput. Ni semua berbeza ya ikut diri masing-masing. Ada yang semudah tidur dalam aircond / bilik yang sejuk.

𝟱. 𝗔𝘁𝗼𝗽𝘆 - ni maksudnya badan kita bagi tindak balas pada sesuatu allergen. Ada yang resdung (selalu bersin pagi-pagi atau dek kerana habuk macam tu). Ada yang banyak allergy pada makanan. Ada yang mata selalu kemerah-merahan. Ada yang kulit kering (eczema). Bila seseorang ada atopy, lagi tinggi chance dapat asma ya.

𝟲. 𝗙𝗮𝗸𝘁𝗼𝗿-𝗳𝗮𝗸𝘁𝗼𝗿 𝗹𝗮𝗶𝗻 - doktor akan tanya ada perokok / haiwan peliharaan / carpet ke kat rumah. Sebab ni antara punca biasa yang menyumbang pada asma.

𝑴𝒂𝒄𝒂𝒎 𝒎𝒂𝒏𝒂 𝒏𝒂𝒌 𝒓𝒂𝒘𝒂𝒕?
Untuk yang pertama kali, silalah pergi ke hospital / klinik terdekat. Anda perlukan ubat untuk legakan dan buka semula saluran pernafasan.

Untuk yang memang dah diagnose dengan asma, tolonglah compliant dengan ubatan anda (inhaler tu). Inhaler ada dua jenis ya.

𝟭. 𝗣𝗲𝗹𝗲𝗴𝗮 (𝗿𝗲𝗹𝗶𝗲𝘃𝗲𝗿)
- yang ni paling biasa digunakan ialah Salbutamol, nama lainnya Ventolin. Pakai ikut arahan doktor / bila perlu sahaja. Pastikan kita prepare inhaler kita sentiasa ada dengan kita sepanjang masa. Serangan asma ni bila-bila boleh jadi ya, terutamanya bila ada sesuatu yang trigger.

𝟮. 𝗣𝗲𝗻𝗰𝗲𝗴𝗮𝗵 (𝗽𝗿𝗲𝘃𝗲𝗻𝘁𝗲𝗿)
- yang ni doktor akan review keadaan pesakit sama ada perlu pakai atau tak. Jenis inhaler ni ikut fasiliti / tahap masing-masing - paling biasa namanya Budesonide / Fluticasone. Kalau level asma jenis tinggi tu, tolonglah jangan terlupa ambik tiap-tiap hari. Ikut prescription yang doktor bagi. Kalau ikut guideline GINA terbaru, kes asma simple pun dah digalakkan bagi preventer taw.

𝑭𝒐𝒍𝒍𝒐𝒘 𝒖𝒑 / 𝒂𝒔𝒕𝒉𝒎𝒂 𝒂𝒄𝒕𝒊𝒐𝒏 𝒑𝒍𝒂𝒏
Dah ada ubat, jangan lupa follow up. Doktor biasanya ada bagi review 3-4bulan untuk tengok macam mana badan kita respon pada ubat. Kalau kita compliant dan simptom terkawal, doktor akan turunkan dose sikit-sikit sampailah kita hanya perlu pakai pelega bila perlu sahaja. Kalau tak terkawal, kemungkinan akan dinaikkan dos / tukar ubat / rujuk pada pakar respiratori.

Semua pesakit asma (terutamanya kanak-kanak), kita akan sediakan asthma action plan, diari batuk untuk disemak masa follow up. Asthma action plan ni akan bantu untuk seseorang tu bagi pelega sendiri dahulu ikut tahap sebelum perlu ke hospital atau tak.

𝑪𝒂𝒓𝒂 𝒑𝒂𝒌𝒂𝒊 𝑴𝑫𝑰?
Untuk kanak-kanak, kita akan minta ibubapa belikan aerochamber untuk pastikan ubat sampai ke saluran pernafasan dengan efektif. https://www.youtube.com/watch?v=o0M1lLpOu4U

Rutinnya, doktor / ahli farmasi akan semak teknik tu berkala (biasanya masa appointment kat klinik) - sebab tu please jangan skip TCA. Kalau terlepas, tolong call klinik dan dapatkan tarikh baru.

Fahamlah kawan-kawan, asma ni tak boleh sembuh tapi boleh dikawal. Sama macam orang allergik udang, sama ke penghujung nyawa dia akan dapat kesan pada diri kalau dia makan udang. Hampir sama macam asma. Asma ni kalau tak dirawat dengan baik, lama-lama simptom tu makin teruk dan makin susah nak tindak balas pada rawatan biasa.

Bukan sedikit ya, pesakit asma perlu ditidurkan & diberi bantuan pernafasan (intubate). Kalau sebelum pandemik Covid pun banyak, semasa pandemik ni lagilah mencabar nak beri rawatan. Bayangkan lagi budak-budak kecil baru beberapa tahun dah kena intubate disebabkan asma yang teruk.

𝑲𝒆𝒔𝒊𝒎𝒑𝒖𝒍𝒂𝒏
1. Asma boleh dicegah - mencegah jauh lebih baik dari merawat.
2. Kenal pasti perkara-perkara yang boleh trigger asma kita dan elakkan.
3. Pastikan kita ikut arahan pakai ubat (compliant to medication).
4. Pastikan teknik pakai inhaler yang betul.
5. Elakkan terlepas appointment rawatan susulan.

Hanis Amanina
Hari tu kena present acute severe asthma.

Pasar Presint 8

2020-10-20T08:00:00.001+08:00

Finally I found a place that I can do groceries shopping without having to worry about the price. Thanks Kak Mulan :)

For the early 2 weeks of my stay in Cyberjaya, I kept on buying stuffs from Grocers (name it - Village Grocer, Jaya Grocer, Star Grocer yada-yada), so I posted Instagram stories asking for help and opinions. A lot of information came into my message box.

One of them is Pasar P8. It is actually very close to Hospital Putrajaya.

So, I went there on Saturday with Haziq and haha of course I love the place!

It is a market in a neighbourhood surrounded by apartments, a school, a food court, a local library in Presint 8.

The price of vegetables, fruits, fishes, meats, chickens etc are affordable. I can say, it is almost similar as in Mydin etc.

The market will be the place for me to get my groceries on regular occasions :)

Here is the map. Luckily it opens daily.

Cyberjaya,20201018

Sweets

2020-10-19T08:00:00.001+08:00

HO: Doktor, ada banyakkkk coklat kat pantry, mak ayah Bed X bagi.

Hehe I was excited to be honest. We usually received some food from discharged patient, sometimes brownies / cake / breads etc and we will just put them in the pantry and make announcement to other colleagues.

"Cepat-cepat, nanti habis."

And to my surprise, we received a box full of sweets!

Though I didn't really eat these but it did give me happiness and put a smile on my face behind the face mask. :)

Thank you for the thoughts :)

May Allah help and give us courage to continue working with good quality. Ameen.

Cyberjaya,

20201018

These Tiny Tubes

2020-10-18T10:59:00.005+08:00

Poking babies for some blood investigations is not that easy. First, we need to decide if poking them / to insert IV line (branula) is really needed. Then, of course we need to explain to mothers why we need to do that.

I always tell my patients (since housemanship phase) that our blood is like our identity. I think I have mentioned this in previous post too. We can check many things from few drops of blood. :) And I love the facts that we can do so.

In paeds, blood taking procedures are RARELY be done bedside (means most of the time, we will take the babies / kids to the procedure room) and we will ask the parents to stay outside of the procedure room, or simply stay in the patient's room. Why? I don't think people loves to see their kids crying with the pain initiated with poking them. Right? I have witnessed lots of mothers (usually) have tears flowing on their cheeks every time they hear their children crying in procedure room.

And to be honest, kids have really good memories - name it from their eyes and even from their body memories. Huhu. Every time we just hold to check their hands & foots for any possible veins, they usually will start crying. But some others are cool haha. Some will only cry once the needle is inside.

From left: EDTA tube for adults - EDTA tube for paeds - plain tube for adult - plain tube for paeds

EDTA tube - usually for full blood count, full blood picture

Plain tube - for renal profile, liver function test, serology etc.

Tricking the children with some videos are helpful to be honest. It helps to distract the kids. For babies, I discovered that playing some sleep lullaby can help to calm the babies. :)

I always asked my husband why on earth would he prefer Paediatrics compared to Medical Department. He said that both are busy departments, one handling general medicine for babies & children while the other one for adults. But, at least seeing cute babies sooth his mind to continue working. Lol. He handles kids better than me though we both are the youngest in the family.

And now, both of us are Paediatrics MO. Haha. Life is very funny sometimes.

Anyway, please pray together with us to be blessed with kids ya :)

I still remember I will ask your prayers when I was in medical school & housemanship. Hopefully, you will not mind to keep praying for me too.

May Allah bless your day :)

Cyberjaya

20201018

Open the Book, Seek Help.

2020-10-11T19:00:00.003+08:00

Have you seen this book before? Hehe

This is a famous book in medical setting, especially in Paediatric Department. It is available in PDF form but most superiors prefer the juniors to have this book in pocket.

It is called Frank Shann.

A book consists of name of drugs and doses used. In Paediatrics, the dosages depend on the weight of the baby / children, hence you can see doctors start to open this book every time endorsing medications. Plus using calculator too.

For example, the most common drug used for fever / pain relief in kids.

Syrup Paracetamol 15mg/kg/dose 4-6H (max 4g/day)

Which means,

- the name of the drug: syrup Paracetamol (brand name can be like Panadol)

- the dose: 15mg/kg/dose. For example: a kid with weight 10kg, the dosage for him is 150mg.

- maximum dose if 4000mg/day

- 4-6H: means taken every 4-6hourly

- if taken every 6 hourly: the kid will consume 150mg x 4 times = 600mg (still below the maximum dose)

There are too much of information that health care workers need to remember. And again, it is really hard to know every single doses for every drugs in this world. So, this book makes it easier. Of course, it is helpful apart from calling the pharmacists and double confirm the dosage hehe.

Same goes in life.

Have we ever feel we had too much of things happening in our life?

We are human beings. We are not robots.

Even robots have the guidebook, so do we.

And what do humans have?

Yes.

Al-Quran.

Open the book, seek help. :)

Don't be ashamed.

This is simply a reminder for myself. Huhu.

Cyberjaya

201011

New Life, New Adventure

2020-09-26T09:01:00.002+08:00

Assalamualaikum, hello guysss!

Hehe actually I am not really sure who's still reading this blog, but whoever you are, thank you for dropping by.

So, where should I start?

First and foremost, I just moved to Cyberjaya and work in a hospital in this area. I can say, it is so-called 'first class' hospital as it does not provide 3rd class beds so far that I know. Still struggling to adapt here though I have been working in this hospital for a month.

The environment is different.

The colleagues are different.

The system is totally different.

The approach is different.

The working 'politic' is different

Well, different hospitals have different styles. That is common.

I only know one person who used to work together with me in my previous hospital. And to be honest, the main reason I choose this hospital is because of the location - in between Perak & Johor so that we can take turn to go visit our family. Oh yaa, my husband is originally from Johor.

Luckily I choose to rent a unit of 2 bedrooms quite close to the hospital. About 10minutes journey. Quite a number of people suggested for me to rent around Seri Kembangan, Dengkil, Bangi, Puchong etc for a cheaper rent. But, I am from Perak, I am not used to drive 30-40minutes just to go to work, passing through highway with tolls and facing traffic jams.

"Dah kerja kat sini, kena la lalui. Itu lumrah."

Well, yeah I understand.

I tried to look for alternatives. It was either I spend money for lower rent (which was RM100 lower?) for cheaper place to stay but need to face those journeys... or I spend higher amount for somewhere closer.

I chose the latter.

But, I totally respect those who choose the former. :)

During the first few days, I can already feel the differences in living cost - where it was not easy to find a small kedai runcit, simple kedai makan etc. So I initially doubted my decision. However, after I went through my first oncall which was working at 8am today only to punch out at 5pm the next day... I finally relieved with my decision. Having microsleep while driving was totally not good. I was glad that my unit was not that far.

I honestly dislike oncall system. I had experienced oncall system when I was at early phase of housemanship (where the system was changed to shift system later). Staying awake for 36hours from 5-6am till at least 6pm the next day... I hate it. -_-' Some people maybe don't really mind oncall system but my body actually cannot take it.

I didn't get the department I choose. So that's another challenge. To make decisions for managements on something I don't have passion about... is really a challenge. People always say 'just try first, maybe you will develop your interest.' I tried. A month passed, still the feeling is not there. Haha.

Why are you pushing someone to do something they don't like?

But again, people will say, 'bersyukur lah kau masih ada kerja.'

Hahaha okay then, I rest my case.

Don't worry, I will still do my best. I will always try to do my best within my limit. :)

“Dan boleh jadi kamu tidak menyukai kepada sesuatu padahal ia baik bagi kamu, dan boleh jadi kamu menyukai sesuatu padahal ia buruk bagi kamu. Dan Allah mengetahui sedang kamu tidak mengetahui.” Al-Baqarah ayat 216

Last few days, I had a talk with a colleague who is currently in the same boat.

S: Perasan tak, Allah uji kita benda yang kita tak suka.
H: Kan... Lagi kita tak suka, lagi Allah bagi. Memang nak ajar kita kesabaran. Mungkin nak kita overcome perasaan tak suka tu.

And yeah, we are the chosen one to join the Covid team at quarantine centers in November-December. Alhamdulillah tak kena deployed ke Sabah. T_T

Doakan yaaa.

p/s: anyway, sorry for the negative vibe post. Haha I just need to rant it out first then I will be cool insyAllah.

Cyberjaya

200926

MARA - End of Repayment

2020-06-30T21:21:00.002+08:00

Just before I finished my housemanship last March, I managed to settle my study loan with MARA. :)

Alhamdulillah!

I have been living as 'anak MARA' since my secondary school as I entered MRSM till I completed my Form 5. Then, I applied for MARA convertible loan to further my studies for A-Level and Undergraduate in Czech.

Thank you MARA for giving me opportunity to study abroad while exploring the diversity of mankind.

Thank you MARA for the first opportunity of European-bound flight. It was from KLIA-Frankfurt to be exact.

Thank you MARA for monthly allowance to help me survive.

Thank you MARA :)

When I was a student in Czech with the others, we have two bank accounts - one in Euro currency (as our allowance was given in Euro) and another one in Czech Koruna (for debit card etc). Every time we received the allowance, we need to go to the counter to withdraw the money in Euro and there would be some fee applied for every transaction.

What I did was, after I calculated every single details of my monthly expenses and decided to withdraw a lump sum of 3 months expenses. What I mean is, I do not have to do frequent withdrawal (hence I saved some money from paying the fee).

It was scary to hold a large amount of bank notes. So, after paying the apartment rent to my landlord in cash (she preferred that way, her unit was downstairs anyway haha), I immediately put the money into my Czech Koruna account. Then, all transactions to buy anything like groceries or cafe hoping (to study yea) or train rides were done by waving the debit card.

I honestly learned and appreciated the existence of debit card when I was in Czech. :)

MARA actually gave two choices on the method to pay - it could be either lump sum (with some discount) or pay monthly. I chose the second option just because the money I saved from Czech were needed for other stuffs (especially to settle down back in Malaysia after returning for good). It involved a lot of travelling to and fro- Kuala Lumpur for lotssss of stuffs plus I went for some medical courses while preparing for housemanship.

Anyway, payment is settled!

Alhamdulillah.

Thank you Allah for all of these experiences :)

Karma by Muharikah | Book Review

2020-06-11T15:18:00.004+08:00

Karma is the sequel of Stigma, written by the same author. This book was bought during previous BBW, and I somehow know that there will be another sequel (the last one) for this series, I decided to postpone reading it till Dilema comes out :)

I can't imagine of waiting for Dilema after dealing with Karma.

Title: Stigma

Author: Muharikah

Pages: 419

Publisher: Iman Publication

Publication Date: March 2019

While Stigma introduced the main characters, Karma is more focus on the relationships between Dr Iman & Dr Faris who got married together and how they managed their relationship with their hidden history. Dr Iman as we all know, is the boss in the ward that Dr Faris works in so it is undeniable that Dr Iman has the dominant side of her as a leader. While Dr Faris is still fighting with his struggle, unfortunately both of them were surprised with sudden bad news - Dr Faris has a lymphoma! And turned out he is HIV positive too. Dealing with both situations, we can see how both of them trying their best to save the marriage, though I feel mixed feeling with the ending. T_T

Based on online dictionary,

"Karma - (in Hinduism and Buddhism) the sum of a person's actions in this and previous states of existence, viewed as deciding their fate in future existences." - https://www.lexico.com/en/definition/karma

I love the quote :)

1. "Let the husband lead the family."

I am attracted to this part, maybe because I am still new in this relationship thingy, to be exact... approaching 10 months of marriage. Alhamdulillah. :)

I got the feeling when Faris' position is below Iman at the hospital, but Faris is still Iman's husband to be respected. Point noted.

Well, if you guys have been reading the blog for a quite some time, I guess you can see how independent I can be... especially with those solo travels. Yeah, I can be dominant too. But, I think through out times, I prefer being the follower. :D No matter how I am able to do something at home, I will try my best to include my husband in the decision making so that nobody feels left out. InsyAllah!

2. "Medical service is about human act and human touch."

This is also another reminder to me as a health care worker :)

I have love-hate feeling when attending patient as I can't help to feel annoyed every time I met some kind of cases / patients like:

accidents involving patients under 18, especially if they are not wearing helmet and do not even have license!
accidents involving drunkens!
patients who came in a worsened condition just because they ARE NOT COMPLIANT TO MEDICATIONS!
patients who came at 3 o'clock in the morning for something they already have for months and years and they don't even bother to get it checked before.
yada yada. Hahaha.

Banyak betul complaints. But, insyAllah for other cases, I am trying my best to give the best with the best attitude :)

Aha... quite a number of cases that I have attended involving huge stress or poor management of it that lead to suicidal attempt - taking paracetamol in huge doses (for eg: telan Panadon 4 papan!), drinking Paraquat (herbicides to control weeds).

3. "Tidak ada karma dalam Islam."

"Yang ada adalah ketentuan dan takdir Allah yang telah diatur buat kepentingan manusia itu sendiri. Setiap perkara yang Allah takdirkan, sudah pasti ada kebaikannya, walaupun kita membencinya."

In this novel, Iman feels like she has done too much sins that Allah is punishing her with lots of challenges. And I think this is the answer to the challenges :)

4. Miracles

"Allah itu Maha Baik, kan kak? Setiap yang pergi, sudah pasti ada pengganti."

Faris passed away. He did not the survive despite completing the chemotherapy etc as the cancer has spread to the whole body. To be honest, this is such a sad new especially after the patient has consistently compliant to all appointments and medications - seems that the limit of our knowledge and ability given by Allah.

But, to know a good news after the sad one... is so refreshing :)

Iman is pregnant!

My rating: ★★★★☆

SM, Perak, Malaysia

200611

Stigma by Muharikah | Book Review

2020-06-10T20:49:00.003+08:00

I bought Stigma during a book fair if I am not mistaken and finished reading it at that time. Just because I recently bought the sequels of the novel which are Karma and Dilema, I decided to reread Stigma so that I don't have to get confused with the characters. :)

Okay, what can I say about Stigma?

Title: Stigma

Author: Muharikah

Pages: 351

Publisher: Iman Publication

Publication Date: April 2018

Maybe we can start with a rough synopsis?

The novel portrays a life story with a medical background; Dr Iman Syahirah is the main character in the story, a medical specialist (a.k.a general physician) in an infectious disease ward, Dr Faris, a medical officer who work together in the same ward. They are in charge of patients with HIV / AIDS and the story plays around this topic.

Here come Dr Aleph, a cardiologist who ended up as Dr Iman's best friend.

One thing that makes me excited (yet scared) - all of them have the same internal challenge - attracted to same gender but struggling to live a normal, blessed life.

Yeah, it is scary because it is uncommon for me to see people in medical fields who are LGBTQ and to be honest I am not sure how to react if I meet any. T_T There are some people that I know, but we are not that close... so that's it.

---------------------

I don't want to comment much on the story line as it really depends on the preference of readers. Some may say the story presentation is a bit dull as it contains quite a lot of medical stuffs, but I don't have much problem with it as I have that background too. Yet, the author already explained every terms she used.

And maybe I am still a newbie with Malay novels, I find the book to be okay :)

So, as usual, what I love about doing book reviews is more towards what I have learned from the book hihi... let's go! :)

1. "Cuma Iman takut. Dalam dia menarik orang lain keluar dari kegelapan, mana tahu dia pula yang tenggelam di dalamnya."

This is when Iman shared with her best friend, Zarith after Iman met Aleph in a conference I think. Aleph is actually a lady whose appearance is like a guy, a gentleman. At that time, Aleph was actually attracted to Iman and trying to hit on her.... hehe okay kat sini rasa semacam kejap.

But what I like about both of them, they finally know about each others' past and struggles to change, even trying to support the process.

About the verses, to be honest, I don't much experience dealing with LGBTQ, but the verses sound so good, reminds me on how people afraid to get involved with people having bad issues because they are afraid if in case they got influenced to do the same.

Here, I am surprised to read that Faris furthered his studies in Jordan, while Iman in Egypt. Although they were in Islamic countries, they were still exposed to LGBTQ too. Maknanya, study negara Barat akan terdedah dengan budaya ni, rupanya di negara Arab sekalipun. Ahaa...

2. "The struggle is real."

This verse is quoted quite a lot through out the book.

When Iman trying to counsel her patients about changing the lifestyle, I realised people who are LGBTQ somehow know their preferences are wrong but at the same time, they also feel there's nothing can be done because they are born that way.

"Tapi, saya tak rasa saya ada pilihan pun, doktor! Dari kecil lagi saya suka kat lelaki. Saya dah cuba untuk suka perempuan! Saya memang tak boleh! Saya rasa geli!" - Johan

"Percayalah Johan. Kita semua ada pilihan. Cuma kita selalu biarkan nafsu dan perasaan buat pilihan untuk kita. I know, the struggle is real. Tapi yakinlah, jika awak benar-benar mahu berubah, Allah akan bantu awak." - Iman

From this conversation, I can imagine what if the advice given by Iman was actually given by someone else who is straight? The LGBTQ may even say that... "kau tak faham pun perasaan ni", in another word, we are saying out of empathy. Only if the patient know that the doctor herself was in the same shoes!

Anyway, yeah. Memang challenging untuk ubah nafsu. The feeling is real. The love. The preferences.

"Bukan hak kita untuk judge orang, Faris. Setiap orang tu pasti ada pengalaman silam dia. Ada trigger yang menjadikan mereka begitu. Ada seorang pesakit ni jadi gay sebab kena liwat dengan abang-abang senior sekolah asrama. Bila you dengar cerita mereka, you will understand and appreciate their struggles. Dari situ, awak boleh bantu mereka untuk berubah dan kembali kepada Allah." - Iman.

This makes me reflects a lot about my impression every time I met patients with known case of hepatitis, retroviral disease (RVD) etc. Some may even got the disease from husband / wife or even blood transfusion (though it is rare). We usually call them as 'biohazard patient', more towards our preparation to protect ourselves with PPE.

Maksudnya, bila nak ambik darah, kena pakai double gloves - walaupun kalau nak ditakdirkan tercucuk, tercucuk jugak. Getah lawan jarum, siapa menang? T_T

3. "Hati kita ni, Allah yang punya. Serahkan hati kita kepada Allah."

"Dah lama saya tak dengar orang nasihatkan saya macam ni doktor. Dah lama juga saya tak jaga solat saya. Asyik tinggal saja." - Johan

" Jangan putus asa, Johan. Allah ada. Awak jaga solat, Allah akan jaga awak. Awak berdoa dan minta tolong pada Dia, Dia pasti akan bantu awak. Awak hanya perlu bersungguh-sungguh. Ingat ya, Johan? Hati kita ni, Allah yang punya. Serahkan hati kita kepada Allah." - Iman

This conversation also reminds me how important of our prayers. I can relate with my work too. Memang tiap-tiap kali nak pergi kerja, doa banyak-banyak semoga Allah bantu. Alhamdulillah, even though I feel a bit sad because I don't have much opportunities to work with female senior doctors, I feel blessed that most of the male seniors that I've been working with are VERY HELPFUL. I believe Allah is helping me through them - their knowledge and experiences.

4. Umat Islam memang memerlukan ramai doktor pakar.

This hits me a lot. Huhuhu. Maybe because I am still contemplating of furthering studies or simply stay in this position till Allah knows when.

"Dulu, profesor saya pernah nasihatkan, dia cakap: pertama, tak ramai orang Muslim yang berjaya sempai ke peringkat tertinggi dalam perubatan. Kedua, bila kita nak treat pesakit kita, rasa lebih nikmat apabila kita tahu cara terbaik untuk merawat. Bayangkan jika kita tak ada ilmu perubatan, sedangkan mereka perlukan pertolongan. Bagaimana kita nak bantu?" - Iman

"Terakhir sekali dia kata, apabila dah jadi specialist, physically kita akan lebih banyak masa untuk luangkan dengan family kita. Cuma yang diperlukan adalah otak kita. Gaji pun bertambah, ada waktu hanyak perlu on call dari rumah sahaja." - Iman

Huhuhu....

Tapi nak sambung belajar balik tu... mashaAllah perasaan dia, serba salah betul. A lot of things need to be considered - money, place, family the most important. Based on my seniors sharing, ramai je yang bergolak rumahtangga bila ada yang sambung belajar. All need patience and understanding, right?

5. Dosa

"Dosa ini, pada awalnya memang kita rasa berat. Rasa gelap. Kita rasa sesal dan gelisah. Tapi, bila kita dah selalu buat, hati kita akan jadi gelap dari hari ke hari, sehingga kita tidak lagi merasai bahawa dosa itu satu dosa." - Ustazah Norhafizah

"Hati kita sudah desensitize dengan maksiat. Apa yang berlaku bila kita dah tak sensitif? Dosa tu jadi perkara biasa. Kita tak sedar dosa tu satu kesalahan. Apabla ada orang tegur, kita melenting. Apabila solat, kita dah tak rasa manis beribadah. Apabila baca Quran, kita susah nak menangis." - Ustazah Norhafizah

So true.

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Generally, the content is actually heavy but I glad that Muharikah managed to tackle it and produce the product with a light read :) There are too many things we can learned from this novel, insyAllah.

Good job, Muharikah :)

I can't wait to share my reviews on the sequels too :D

My rating: ★★★★☆

SM, Perak, Malaysia

200610

Houseman Bingo (Part 2)

2020-06-09T21:40:00.001+08:00

Let's continue with the next part. :)

This bingo is actually for my own memories, housemanship has its ups and downs, so, I treasure all experiences I had encountered when I was a houseman :) Maybe this post can be helpful for any new house officers trying to read around about housemanship - though there are lots of other people posting everywhere, hehe :)

10. Activate blue or / and red alert.

In the hospital I had practised as a houseman, blue alert means there are some emergencies going on in the hospital involving outpatients, family members or visitors.

Recently, there was a patient brought in to our ED after blue code activated. She was at the outpatient department, to be specific during the process on blood taking for her appointment date when suddenly develop fitting episode. With a known case of epilepsy, she was finally admitted for further management.

Others can be as family member who is taking care of patient in ward suddenly found unconscious. It is not that the ward cannot do anything to him... of course they will especially for basic life support. But the emergency team will be called to attend the patient and bring him to the ED for stabilization :)

While red alert can be found mostly in O&G department, involving pregnant women - eclampsia (sawan), post partum hemorrhage (pendarahan banyak lepas bersalin), should dystocia (bahu tersangkut masa bersalin), cord prolapse (umbilical cord di pintu rahim masa nak bersalin) - all of these cases are emergencies!

11. Send patient for xray by self.

This happened when I was in Orthopaedics. We were planning to get check x ray (means x ray that is done after operation) to see in formality if the operation is successful or not. The patient was put on some case (I can't recall the name) but it was a bit complicated to set it up. The radiographer need to remove the cast/sling first before shooting the x ray, but requested for Ortho team to be there to reset it back after the x ray.

12. Explanation letter.

Need to do this when in Ortho as well for some reason - actually I forgot details of this patient.

-_-'

13. Send specimens to lab by self.

It is a normal routine for housemen, despite we have PPK (pembantu perawatan kesihatan) but they could be doing other stuffs too, like sending patient for xray / to OT, taking food trays from kitchen etc. So, in daily life, sending specimens is our task too - especially in emergency cases in ward, like resuscitating patient.

14. Sleepless oncalls

To be honest, I don't fancy oncalls / night shifts. -_-' maybe that is one of the reasons I prefer myself to float in ED (other than I still can't decide which departments to go as I love all of them huhu). ED practices shift systems.

Oncall usually means, working for at least 24hours plus plus plus, for example going to work at 7am today and punched out at 1pm the next day. For some hospital, it can be up to 5pm the next day. I had no experiences with that shifts, as my previous oncall shift was different.

In O&G - 7am-5pm, go home to come back at 10pm and finish oncall at 1pm the next day - though we can be stucked in the ward / labor room between that 5pm-10pm.

In medical - 7am-12pm, break till 4pm, then continue working till 1pm the next day. The 4 hours break were totally UNPRACTICAL haha as the morning round will finish around 11am plus, and for sure it will be really hard to get all task lists done within 1 hour. Haha.... kalau bertangguh, tahan la telinga kena marah dengan family members sbb tak siapkan lagi surat-surat discharge semua. T_T

15. Meconium bath in LR

Meconium = najis pertama baby. Despite wearing plastic apron, our clothes / shoes can be soaked with the patients' meconium while we are helping the delivery. Meconium can be light / moderate / thick.

Stain in meconium means the baby already pooed inside the womb. This can be a problem later if the baby aspirate the meconium as it can pass through the lungs and cause the baby to have difficulty in breathing upon delivery. This is not a simple case - it can even lead to death!

16. Feed and took selfie with newborn in ward.

I really enjoy the feeding session in NICU (neonatal intensive care unit), you can see how eager some babies react to milk (be in expressed breast milk or formula milk). Usually if the babies need intensive care and monitoring, they will be admitted to NICU where they don't stay with mothers. So, the time for direct breast feeding will be limited and all mothers will be consented for formula milk.

Different situation in post-natal ward or special care nursery (SCN), where the babies can be still under pediatrics team's observation but they are stable enough to be left with mothers. :)

17. Belanja misi food.

Usually after end of posting :) Haha.

18. Mortality summary.

Haaaa, I don't like this one. First, it means our patient had passed away. Next, they need good documentation especially in cases that family members would like to have a formal medical report to claim with insurance company etc.

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Wow, suddenly I missed my housemanship. Haha, but like others, of course I don't want to repeat the phase again. Housemen leave home before sunrise, return long after sunset. Almost daily hehe.

Alhamdulillah. Thank you Allah for helping and guiding me through out the housemanship - with providing me good people around and experiences. :)

SM, Perak, Malaysia

200609

Houseman Bingo (Part 1)

2020-06-09T18:21:00.001+08:00

Found this in my phone gallery. Before I delete pictures like these, I feel excited to share it on the blog first. I have 9999+ images more to delete, seems like I have deleted nothing. Hahaha.

For this, I managed to achieve one Bingo. :D

1. No off for 2 weeks.

Yeah, it is possible for some department when you can accumulate two off days consecutively :) As a houseman, you are entitled to get one off day per week.

In my case, it was during surgical posting. We have this 2 weeks rotation for clinic which cover office hours (Monday to Friday, 8am - 5pm). So, you can either have your off day on Saturday or Sunday for each week. Otherwise, you can request to the team leader to allow you to work the whole 2 weeks and claim your 2 days off later.

Housemanship has flexible schedule though. It was hard to plan for holidays, sometimes.

2. Ate hospital food.

We called this - hospital diet. Trust me, almost 99% of the food are delicious! Usually the kitchen will serve different meals for staffs and patients. Even for patients, there are different food too - depends on each requirement, some may have high potassium diet, low potassium diet, low sugar diet, not to forget... we really care about patients' allergies too :)

Tomyam ayam

3. Felt like quiting.

Hehe, I felt this way every time I failed to give my best, or unable to save patients, or unable to recall knowledge that I've learned.

Medicine is a continuous learning, every day is a learning process and we encounters lots of new things every second.

Feeling like quiting is normal, just don't quit before you have really tried your best or have a strong back up plan. Find something to look for everyday. :)

4. Did a vacuum dressing.

There are different types of dressing to the wound. Dressing means technique to cover the wound - some simply with normal saline, some with special liquid, some with iodine. For vacuum dressing, we are basically put some negative pressure / put some suction to the wound, with the aim to remove all exudates (layman terms = air bisa?) and encourage growth of new healthy tissue :)

Something like this - source https://www.wjgnet.com/2218-6190/full/v1/i3/13.htm

5. Failed blood taking x5 on same patient.

It is actually common for patient with difficult blood taking which usually we ended up with taking blood from the artery. I encountered this when I was in medical department, especially when I was doing my solo HO night shift. It was hard to ask for help as others are busy too with their medical wards. T_T

6. Play with newborn in ward.

I enjoyed this especially in O&G department, hehe I called newborns as cookies fresh from oven. :) Their smell is soooo nice, especially after we cleaned them up. After a baby is born, the doctor will need to do basic baby check, to make sure the baby is generally healthy. If the mother has some pregnancy problem, like gestational diabetes mellitus, history of infection, big baby - we eventually will call the paeds team to do the check instead. :)

7. Kena 'buli' senior or MO.

Hmmm, sometimes I don't realised this, until another colleague mentioned to me something like, "Eh, kenapa kau pulak buat benda ni, bukan patutnya XX punya task ke?" Haha.

Bullied by MO, hmmm, not sure.

8. Get to know a supportive MO

There are lots of them to be honest. Get to know them and you will have more opportunity to learn more. :) Every department, I have my favourite MOs whom I found easier to discuss and plan for management as they will ask me back about the reasons behind those management. :)

"Kenapa aku buat macam ni untuk patient ni."

If my answer is "not sure, nanti saya baca part ni." And he/she will give due date to present back to him/her with the answer. Sometimes, even after studying that specific topic, my answer can be wrong. But I love how they were still being patient and explain the reasons.

These kinds of people, may Allah bless.

9. Punch out 4 hours after work.

HAHA.... many times during medical department, especially during postnight shift. You are allowed to go home after 1pm (during that shift system), but, what to do if the morning rounds sometime finished around 11am, and you have lots of task to complete before leaving the ward. Usually what made me stuck there was when I failed to complete my tasks especially the one involving office hours - like sending / receiving fax to / from another tertiary hospital about patients' previous records, requesting urgent radiology appointment, calling another office / klinik kesihatan - where the lunch break usually from 1pm - 2pm plus.

While I still have other pending stuffs to do like settling patients' discharge notes, assisting MO with procedures, urgent blood taking etc. Hahaha.

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Enough with 9 for this post, gonna share the rest in the next one :)

SM, Perak, Malaysia

200609

The Art of Letting God by Mizi Wahid | Book Review

2020-06-06T13:30:00.002+08:00

I have my eyes on this book for months but keep on postponing because of the price -_-'. I know RM50 is not that much for a book, to be exact a hard covered book. But as I have spent hundredssss of ringgit during the previous Big Bad Wolf, I need to calm myself from buying new books until I read at least a quarter of books I bought from BBW hehe.

So, here I am!

I managed to grab it at a discounted price during Pesta Buku Iman and I can say I love it so much! The book arrived just before Ramadhan, so I have spent the whole Ramadhan reading it, slowly. I even brought it to the hospital and shared things I read with my colleagues, then we ended up sharing our own experiences. It was lovely, alhamdulillah.

Title: The Art of Letting God

Author: Mizi Wahid
Pages: 147
Publisher: Iman Publications
Publication Date: March 2019

Back cover of The Art of Letting God.

Anyway, while writing this, I realised I don't have much book reviews on non-fiction (?) Actually I've been known by my family as a person who lacks fiction imagination haha, so I tried my best to read lots of fiction books to improve it.

Allow me to share snippets or beautiful verses from this book :)

1. The greatest temptation many of us find most challenging to deal with in life - is the temptation to give up.

This is very true, we have the temptation to quit whatever we are doing, for various reasons - financial problem, family problem, lost of focus, emotional attacks etc. But, the moment we managed to overcome this temptation, that's the beauty of success. It actually can be seen as one point in life, but to be honest, life is continuous journey so to overcome it needs life long courage and support.

In this book, the author described more about Prophet Moses (p.b.u.h) who was not only asking Allah for ease in affairs but strength, wisdom, patience, ability and support :)

2. Tawakkul is the word used to imply one's act of reliance on God or "trusting in His plan". It is also seen as "perfect trust in God, and complete reliance on Him alone.

Reading this verse, reminds me on previous conversation with a friend of mine who is an atheist. Medical school was a hard time. To get through each tests and years, I learned a lot about tawakkal and really, success is not only about studying smart but the idea of having Allah to rely on after our hard works.

"Tie your camel first and then put your trust in Allah."

She mentioned to me how stressful she was and asked how do Malaysians can remain calm. Haha. Only if she could see hurricanes in our hearts :D

"Maybe because most of us are Muslims? We usually leave it to God after we tried our best during the process of revising."

"Oh, I don't believe in God, but I believe my success will be from my hard work, that's why I need to study more."

In my heart... no wonder. Penat sebenarnya bila kita terlalu bergantung pada kemampuan sendiri sebab manusia memang bukan perfect, akan ada kesilapan dan kelemahan.

3. Believe that nothing just happens. Instead, everything happens for a good reason. And everything happens for you, not against you.

Most of times, we tend to argue about others rizq and complained why such opportunities do not come to us. And we tend not to realised how much other rizq have Allah blessed us with. Some may have a good occupation and income, but he may not have children yet. Some may be blessed with children but having difficulties in work.

The author also mentioned about the tools and ingredients to success that we may already have but we don't realised it - so, we ended up to keep wondering about our unanswered prayers.

"If all of you were to truly have faith in Allah s.w.t. He will certainly provide you with sustenance, just as He would give to a little bird, for when it leaves its nest in the morning with an empty stomach, but returns home in the evening full."

4. Friends, reject the cup of poison. Instead, drink from the fountain of faith, the reservoir of resilience, and the sea of spiritual confidence.

In the book, this part was described as we are exposed to lots of "poison" which would murder our thoughts and destroy our peace and happiness to its death.

I believe most of us have our own experiences.

Rejections from other people.

Bad words that push us down.

Refuse that poisons, reject that unproductive comments, go beyond.

5. "How do we know if we've forgiven somebody, and have completely moved on?"

The author listed down few check lists to see where we are and how much further we need to go to finally achieved the term 'completely moved on'.

Are we still interested to know about them?
Do we feel our blood boiling when we hear their name being mentioned in a conversation?
Do we feel awkward when we bump into the person?
Are our emotions still at the mercy of our senses being triggered by old memories?
Do we feel unhappy when someone tells us about the person's happiness?
Are we secretly stalking them?

I agree with the author with letting Gold be the one to "teach our enemies a lesson". We don't have to be one as Allah surely know the best lesson to give with the perfect timing.

"Those who spend in prosperity and in adversity, who suppress anger, and forgive others, verily, Allah loves those who do good." (Quran 3:134)

Let it go and let God :)

"Experience genuine peace in your life when you learn how to love in moderation, fear within limits and hate within reason."

6. Each new day, deserves a brand new beginning. Let go of yesterday's hurts, begin the day in the name of Allah. Just as He magnificently heals all of our physical wounds, trust in Him to supernaturally heal our emotional and spiritual wounds too.

I love the part "Never back away from opportunities to help others who are struggling, by making a positive difference in their lives" despite having this kind of thought, "But I'm not good enough".

Humans are never perfect.

Humans do make mistakes.

Even the first human Allah created - Prophet Adam, fell with persuasions of Iblis and eventually being casted out from Paradise, Prophet Adam repented for his sins and became the first Messenger of ALlah to humanity.

I know we are not prophet, but from this story, we need to believe that humans make mistake and Allah is always there to forgive us more that we are to forgive ourselves.

Beautiful :)

My rating: ★★★★★

SM, Perak, Malaysia

200606

Would You Ride Your Motorcycle Without A Helmet If It Was Legal?

2020-05-29T00:30:00.000+08:00

I was scrolling my Quora and came across this question. It is an interesting question if we are trying to answer it from perspective of healthcare workers like me vs riders.

To be honest, I don't have motorcycle license and have no skill to ride it as well. Haha.

And after working in the hospital,

I WILL THINK TWICE BEFORE RIDING ANY MOTORCYCLES. T___T

https://www.quora.com/Why-do-people-not-wear-a-helmet-while-riding-a-motorcycle

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**WARNING - THIS POST CONTAINS WOUND IMAGES**

Let me share with you a recent case I attended in the Emergency Department.

It was the morning of last day of Ramadhan, maybe around 4am. The patient was a 16-year-old boy, if I am not mistaken. He was referred from a klinik kesihatan that was 40km away, with the impression of: To Rule Out Skull Fracture.

Resources in Klinik Kesihatan can be limited, they can do chest xray, but not others. I've experienced a lot of referral to rule fractures from KK and to be honest, skills of doctors and medical assistants in KK are amazing. They are usually the primary team to stabilize patient in areas without hospital.

So, back to this case, he was brought in on a wheelchair, with lots of gauzes covering different parts of all four limbs. He could even walk from the wheelchair to the bed.

Usually, when we attend trauma cases, we use ATLS as guidance.

ATLS - advanced trauma life support.

The PDF itself is almost 500 pages! -_-'

Starting with A - airway + cervical

Patient able to speak in full sentences, no gurgling or stridor, no foreign bodies in the mouth/ nose, not on cervical collar, range of movement of neck was full.

Proceed with B - breathing + ventilation

Here, we usually use the acronym IPPA - which means Inspection, Percussion, Palpation, Auscultation
I - breath spontaneous, not tachypneic, chest rise was equal bilaterally, no chest wound
P - resonant percussion bilaterally
P - no clavicle tenderness, no chest tenderness, chest spring negative, no subcutaneous emphysema / crepitus
A - lung was clear, equal air entry
Don't forget to check the oxygen saturation too (SpO2)

Then, C - circulation

check other vital signs - blood pressure, pulse rate
CCTVR - Color of skin, Capillary refill time (CRT), Temperature of extremities (is it warm/cold), pulse Volume, pulse Rate
for this patient, it was all normal - pink, CRT <2s, warm peripheries, good pulse volume, pulse rate around 60-70.
then, we checked the abdomen - soft, non tender, not distended, no abdominal wound.

After that, D - disability

GCS was full E4 V5 M6, pupils 3mm/3mm equal reactive

Finally E - exposure / environment

Here, we inspected the whole body from top to bottom, from front to the back.
This boy has abrasion wound everywhere - shoulder, elbow, hand, shin, foot. But there was no swelling, no limb deformity, no limb tenderness, no limited range of joint movement (means, he can bend all joints normally) - so we don't expect any fractures here.
There was no spinal tenderness / step deformity during log roll
But the head was covered with bandage and we could see some blood stain. When we open the bandage, fuhhhhh there was jagged wound, quite big one! the skull was exposed. And there was no skin flap to cover back the skull.
We gave him antibiotics and painkiller too.
FAST scan done, no free fluid.

Something like this but smaller around 6cmx6cm size.

https://www.slideshare.net/vipinvenugopalnair/free-ld-flap-for-scalp-reconstruction-dr-vipin-v-nair

Okayy, I know there are LOTS OF MEDICAL TERMS here haha. It is okayyyy, you don't have to understand everything. :D

To make it easy, generally we can say that this patient was stable clinically, vital signs was okay. Just, if there was no jagged wound on his scalp, he didn't even need to be referred to tertiary hospital.

Biasalah orang accident mesti akan calar balar sana-sini. Takde patah, kira alhamdulillah sangat dah. Tapi untuk dia ni, kulit kepala dah terbukak, tengkorak terdedah camtu. Nak jahit kulit kepala pun tak boleh.

We managed to request CT brain in view of the wound was big and skull was exposed - just to rule out any skull fracture or any possible bleeding in the brain (ICB - intracranial bleeding).

Alhamdulillah, turned out CT brain was okay - no ICB, no skull fracture.

So, what we did for his jagged wound - we referred him to Surgical Team so that they can refer the patient to Plastic Team. In big hospital, you can see lots of sub-specialty for Surgery - neurosurgery, plastic surgery, ear-nose-throat, hepatobiliary team etc. But, we don't have such sub-specialties here. There nearest one for that is HRPBI - Hospital Ipoh.

If the wound was a simple laceration like the one below, usually we can suture it ourselves..

https://www.medicalimages.com/stock-photo-image-image9257585.html

I feel sad for his father, he looked very tired and when the surgical team informed him that the patient will be transferred to Ipoh, we could see his 'pasrah' face. I believe the importance of parenting, but kids nowadays can be beyond control.

This is one kind of accident that actually can be avoided.

Why?

The boy is underage, without licence, without helmet, went out riding motorcycle with his friends around 12am, speed at least 80km/hour and the mechanism of accident was as I expected - he said "kawan main motor himpit-himpit, saya tak boleh control motor tu yang terbabas"

Rasa sedih bila jumpa kes macam ni.

And there were countless cases like this EVERY SINGLE DAY.

So, if you guys or your family members are motorcycle riders, do remind each other kay.

Always wear helmet.

200530

SM, Perak, Malaysia

Day 10 of May Photo Challenge - Self Care

I Miss...

2020-05-15T23:21:00.002+08:00

... this view.

I miss travelling actually, walking around the airport to catch flights.

I miss sitting by the window and watch the beautiful scenery from the top.

I miss the feeling to pass the security control and to have another stamp on my passport.

I was actually planning to have a trip back to Czech after completing my housemanship hehe :D. Usually, after housemanship, we are allowed to use the remaining annual leaves and take a long holiday up to 27 days (if I am not mistaken). But my husband was still working at that time, so I decided to wait for him first to go later together. I went to the office to inform that I would be starting my floating (junior medical officer) soon.

Due to Covid19 outbreak, my friends who decided to take that long holidays were called to start working and our leaves were apparently have been frozen since March.

Ouch.

And I think travelling abroad is going to be tricky after this pandemic, right?

Maybe travelers need to provide supporting documents, health reports - new norms maybe?

Day 9 of May Photo A Day - I Miss...

SM, Perak, Malaysia

200515

The Sky

2020-05-12T22:45:00.001+08:00

Sunrise from the hospital, to be exact - the Emergency Department. :D

I think this one was taken on my post-night shift around 7am plus.

Sunrise.

Means it is another day.

Another opportunity. Another chance.

For?

Being a better person.

I always wonder, how did I survived housemanship the past 2 years. To be honest, I believe most housemen will have the thought of quitting, but due to every own reasons, most of them survived and still surviving. It was a tough journey. Hanis Amanina who you are seeing now is a lot different than who she was in Czech or before that. Hehe :D

Go with the flow.

Sometimes, I cannot deny that the HOship hurt my heart and feeling a lot. I believe it affects my personality, my attitude and my knowledge. Learning as a medical student is not the same as being a doctor itself. The responsibilities I need to carry every time I do something to the patients, always overwhelm me. Still.

But at the same time, honestly it gave me happiness as well - able to manage patients correctly, able to see patients getting healthy, surrounded with good and helpful colleagues, have the opportunity to say the first Assalamualaikum to newborns. MashaAllah, the feeling was AMAZINGGGG and I will never forget that! :)

I believe the key is not to give up.

Recently I read the The Art of Letting God, at the very first chapter, it shared about the greatest temptation. I agree that the greatest temptation to deal with is the temptation to give up.

"Are these goals truly achievable? Am I being realistic? Am I good enough? Am I worthy of such achievements? Or is it simple better for me to just give up?"

In the book, it mentioned about dealing with it is by asking help from Allah. When we looked back the story of Prophet Moses (peace be upon him), despite only asking for ease, he also asked for strength, wisdom, patience, ability and support.

I have shared a post about DOA PENERANG HATI when I was still a medical student. At that time, I was having difficulties adapting with Czech's exam system where almost all exams were done orally. T_T It was a struggle to speak medical stuffs or answer medical questions confidently in the exam because once you said something wrong, the examiner will directly know you are lacking something there and suddenly he will go deeper on something that you are not confident with.

But Alhamdulillah, that phase has passed. :)

Housemanship tooooo :)

Alhamdulillah alhamdulillah.

Anyway, still remember my collections of sky over 2014? Can't believe 6 years have passed. WOWWW. MashAllah :)

http://www.hanisamanina.com/2014/12/beautiful-sky-of-2014-part-1.html

http://www.hanisamanina.com/2015/01/beautiful-sky-of-2014-part-2.html

http://www.hanisamanina.com/2015/02/beautiful-sky-of-2014-part-3.html

http://www.hanisamanina.com/2015/04/beautiful-sky-of-2014-part-4.html

Day 8 of May Photo A Day - The Sky
SM, Perak, Malaysia
200512

6 Things I Learned from Ayla: The Daughter of War [Movie]

2020-05-11T23:05:00.002+08:00

I am not sure if you can find people talking about this movie on your Facebook timeline, but it happened to mine. I was a bit hesitated to watch at first but subhanAllah it was definitely a great movie to be appreciated! :)

It is actually a Turkish movie and I have no experience watching any before.

Synopsis:

The story played around the Korean War eras which was between 1950-1953, where United Nations came to help South Korea from being attacked by North Korea. One of the countries that send a lot of soldiers was Turkey. A Turkish brigade was sent there, one of the soldiers was Sergeant Süleyman. While Ayla was a 5 year old Korean girl, lost her parents when their village was bombed. The name Ayla was given after she was saved by Süleyman from a frozen night in the moonlight. Two of them developed deep connection as father-daughter, where Ayla could be seen around Süleyman almost every time and everywhere. They were together for almost 1.5 years.

Upon completing his task in South Korea, finally it was time for Süleyman to return to Turkey and he found it difficult to leave Ayla. They were attached to each other. Süleyman tried to leave Ayla at Ankara School but ended up trying to bring Ayla back to Turkey in his suitcase - his mission failed. Süleyman had to leave Ayla alone. Upon arrival to Turkey, he tried his best to get in touch with the school but the communication was disaster because of the war. Both of them reunited after almost 60 years. T__T

This is a real-life story where we can watch the documentary Kore Ayla on MBC in 2010.

There are lots of lessons can be learned from this movie.
1. "We have to learn to live together."
When Süleyman was asked to get rid of ants on their ship, a comrade suggested to use oil to kill them. But Süleyman refused to do so, instead he put a 'mountain' of sugar to feed them so that ants won't bite the people.
Isn't it cuteeeee? :D

Sweet!

2. War Ethics

Ayla was found in the sea of dead bodies.

"Cowards! They slaughtered everyone, even the children."

Somehow, I suddenly recalled the war ethics of Rasulullah - one of them is don't kill a woman / a child. Ayla witnessed her parents died and refused to talk, maybe she was traumatized. Süleyman didn't want to leave her anywhere, he ended up taking her to the base.

The very first time Ayla met Süleyman

I love the contribution of Turkey in this movie. The Turks offered to build a school for the children - that's Ankara School in Suwon. At the school, the Korean kids were gathered, given education, taught to survive in life. Here we can also see some Turks were really taking care of the orphans till one point, the Koreans felt they should take over those kids and find solution for their future. But, because of the war (Chinese started helping the North Koreans), the Koreans decided to let the kids taken care by the Turks first. If you watch the real-life footage of the documentary, you can see the kids can even sing a song about Ankara.
3. A kid can learn so fast!
Being traumatized, Ayla didn't speak at all for quite some time. But, we can see that she was observing her surrounding! She learnt the Turks by listening and could even count up to 54. Ayla's voice make a comeback when the troops were counting their number of soldiers. Here, Süleyman realised Ayla can read some Korean too but she could not recall her own name. Ayla was taught with Turkish language and she picked up fast and can make conversations with Süleyman.

Another heartwarming scene was when Ayla called him "baba" after learning about family. T____T
"Being scared doesn't prevent death. Even Suleyman the Great died."
Ayla overheard the soldiers chatting if they will be able to return home after this. Ayla mistakenly thought Suleyman the Great was her baba. She ran searching for Suleyman and cried.
I am cryingggggg too!
4. "Fathers always fight for their kids. They live for the promises that they make"

After failed his attempt to bring Ayla onto the ship back to Turkey, Suleyman accepted the fact that he need to return alone. He promised himself and Ayla that he will return to meet her.

The scene was heart breaking T_T

Can you imagine a small kid who had lost both parents in front of her eyes, now need to be apart with the one she loved as a father? T_T

5. The Marriage of Suleyman and Nimet
Upon return to Turkey, Suleyman received another bad news that her supposed to be wife (Nuran) had already engaged to another person. Suleyman ended up marrying a girl chosen by his father after a heart break.
After marriage, Suleyman moved to Istanbul and continue with his attempt to be in touch with Ayla. Somehow, his wife knew his plan and eventually they slowly search for the solution together. I love how supportive Nimet was to her husband.

"Look, Suleyman, I am so proud of you for what you have done for that girl. This is the man I fell in love with. We are married now. Allow me to help you find her." - Nimet.
"Your daughter is my daughter. Your promise is my promise." - Nimet.

LOVEEEE!

The ending T___T

6. Turkey is Korea's brother country.
This is because of a lot of contribution done by Turkey for South Korea. History is amazing, right?

It felt so good watching this film and managed to watch the documentary as well. T_T
Do watch this movie, guyssss! It is on Youtube (I shared below).Be prepared to cry. T__T

Day 15 of May Photo A Day - Reflection (in advanced hehe) SM, Perak, Malaysia 20200511

The Roadblocks

2020-05-11T11:19:00.003+08:00

I know that we are now in PKPB where almost all local roadblocks have been lifted. I think there are some at the districts' borders, no idea actually as I haven't try crossing the district yet.

During the PKPD, I need to pass through 2 roadblocks between my house and the hospital. It was supposed to be 8 minutes journey, but with roadblocks, I need to leave the house at least 15 minutes earlier. Less cars actually at the beginning and the middle of PKPD, but fuhhh the traffic was torturing towards the end of it, especially when we were entering the PKPB.

Kad Petugas Kesihatan

Similar to other health care workers, I received my own card too. Just sharing this here so that I can read this later. Still not fancy much to share life journey on Facebook. And I still prefer the blog to elaborate my stories and experiences than on Instagram.

Police / army: Assalamualaikum Cik/Puan. Nak pergi mana ni?

Me: Nak pergi kerja encik.

Police / army: Oh, kerja mana?

Me: Kat hospital.

Me: *I can see they suddenly took a glimpse on the front screen*

Police / army: Ohhh, maaf Cik/Puan, tak perasan kad ni. Okay, boleh jalan, lambat pulak sampai nanti.

Me: No problem. Terima kasih Encik.

I am not sure if the card is small to be seen, or maybe I put too deep between the dashboard and the screen so it could be hard to be seen. Haha

But, never mind as the questioning did not take too much time every time I mentioned about the hospital.

To make it even easier was by hanging my stethoscope around the rear-view mirror.

Honestly, I think they have a challenging task to check every cars. I felt so bad seeing them standing in the middle of the road under hot sun, even on rainy days too. T_T

Lots of time, the scenario was like this:

Police / army: Ohh doktor kee? Boleh check kami tak? *sambil gelak-gelak*

Haha, here I knew they were already tired. You know, sometimes, you can see a tired face trying to say something funny to cheer themselves. :)

Me: Bolehhhh, nanti saya inject sekali. Nak saya cucuk kat mana?

Police / army: *sambung gelak*

Thank you to all frontliners.

Now, everyone need to take care of our own.

Always think twice before leaving the house especially if we don't have solid reasons.
Always wear face masks outside especially if we are dealing with people
Always wash our hands / use sanitizers
Keep 1 meter distance with each other - social distancing.
Avoid 3C - closed conversation, confined space, crowded place.

Day 7 of May Photo A Day - A Throwback

SM, Perak, Malaysia

200511

I Made This PPE :)

2020-05-10T17:19:00.000+08:00

On last Wesak day, I had this opportunity to learn and watch the staff nurses making our own Personal Protective Equipment (PPE) in our observation ward, this ward was closed due to rearrangement of our Emergency Department into Respiratory area & Non-Respiratory area and has become our 'store' and staff area.

Respiratory area - attending patients with any complaints of SARI (severe acute respiratory infection) symptoms like fever / shortness of breath / cough / runny nose / sore throat / any history of Covid contact. Sometimes, the patients may come with other main complaints like infected wound over foot but just because he/she have any of these SARI symptoms, the patient will be attended in Respiratory area.
Non-Respiratory area - attending patient with any complaints without SARI symptoms

Me: kak, nak try buat satu bolehh?

SN: haa, nah try jahit bahagian lengan ni dulu.

At first I just need to sew the stretchy area over the end of the sleeves. Then, slowly and patiently, Kak Daini & Kak Atun taught me how to sew the whole PPE. Since I have no skills of using the sewing machine, my product was not that neat. Terlebih sana, terkurang ni. Hahaha. Nasib baik laa PPE ni pakai buang. If you compared to their products, fuhh, dah macam baju raya, kemas sangat!

My first PPE everrrr.

Honestly I only have the most basic skill for sewing, which means, I can only do hand sew like picture attached below.

Source - https://www.apartmenttherapy.com/how-to-sew-basic-stitches-221433

Though my mum is literally good in this, I guess I don't inherited the skill haha. For every Eid celebration, my mum will usually send some plain cloth to her favourite tailor and then she will make her own decoration on the dress with all those beads, labuci etc. For mine, my mum will 'encourage+force' me to the same so that I can survive with hand sew haha.

But, my skills of using the sewing machine - NIL

-------------

After completed one and a half of PPE suit, we heard the bell informing there were new cases in the respiratory area. So, that marks the end of my PPE sewing journey. Lol, when I returned to the sewing area later, seems like they already finished sewing. :D

It was honestly a nice experience.

Thank you akak-akak sabar mengajar!

p/s - my mother-in-law has awesome sewing skill too! :D

Day 6 of May Photo A Day - I Made This

SM, Perak, Malaysia

200510

My Fave Room

2020-05-09T23:05:00.000+08:00

If you have read my blog since I was still a student in Czechia, you must have seen this view somewhere. :) Hehe

Though it looks quite messy (read: too many colours), at that time, I was satisfied with the wall. There were lots of memories that I can see almost every second being in the room.

To those who have just being a reader to my blog, welcome :)

This is actually from my room back in Czechia, it was a rooftop (4th floor) flat, 2 bedrooms + 1 bathroom with toilet + a kitchen. When I tried to recall memories staying in the flat, alhamdulillah, I must say I should be grateful to be able to rent it due to many reasons

1. Nice landlord.

- though there was a huge language barrier (even with our agent), we managed to confirm our rental with agreed amount of monthly rent. The landlord was initially an uncle with his wife. After he passed away, his daughter took over (she even decided to return to Czechia to take care of her mother although she already settled down somewhere in African continents).

- I was beyond happy when they agreed after we requested to reduce our rental a bit (due to final year, I planned to do my attachment in Malaysia). And it was fated to be, I went home 4x that year (summer break - my brother passed away - medical attachment - back for good).

2. Strategic location

- it was located very close to the main train station, so it was such a relieve if my friends and I return late at night from Prague. At that time, we usually take a day trip to Prague to buy those varieties of halal meat or for usrah, so the final train was around 10pm (arrived at Hradec Kralove around 12am)

- Tesco was just within walking distance. I found to be awesome as I can go to Tesco any time I want haha.

- most official offices are around as well - Vodafone (internet plan), main post office, 2 shopping malls, library.

- peaceful neighborhood (despite being in the city center). The main road in front of the flat was only for residents and public transport, so there was no traffic at all!

3. Fully furnished.

- I am still searching photos of the flat (they are somewhere in the gallery), but the price is totally worth the flat - in view of most basic furniture and electrical appliances were included - fridge, washing machine, dishwasher, oven, microwave, 2 sets of bedroom furniture, full set of kitchen table. If I am not mistaken, it was CZK 12000 approximately RM2000/flat/month.

Alhamdulillah, this time around, I managed to get good landlord in Manjung too :)

Anyway, I miss Hradec Kralove, I miss Czech! Hehe.

Okay, off to night shift, pray for a smooth one kay :)

Day 5 of May Photo A Day - A Fave Room

SM, Perak, Malaysia

200509

Neighbourhood

2020-05-06T13:35:00.000+08:00

This was taken on the first day of PKPB. :)

The view look much fresher than before, I can say.

Day 4 of May Photo A Day - Neighbourhood

SM, Perak, Malaysia

200506