Friday, April 24, 2009
Friday, April 10, 2009
Reminders
We've got to stop sweating the small stuff.
Because beautiful, precious, and meaningful things are often by character subtle, a moment of ignorance and we loose sight of them forever.
We've got to stop sweating the small stuff.
How much of what we devote ourselves to day in and day out becomes truly important to us in the end.
We've got to stop sweating the small stuff.
A few aged stained Polaroids can tell more truths than any high definition SLR.
We've got to stop sweating the small stuff.
Fragmented memories of car rides, glow sticks and jacob biscuits could feel more real than recent scenes of brashness.
We've got to stop sweating the small stuff.
Procrastination is simply stealing from ourselves.
We've got to stop sweating the small stuff.
Because that will just make us small people.
We've got to stop sweating the small stuff.
A plain as daylight, it is a waste of time but yet we set ourselves up for the fall over and over again.
Stop, breathe, savour the richness and love we forgot when we started growing 'older'.
Friday, April 03, 2009
Done with EOP
Have I ever told you about Subang Parade?
My favourites shopping mall in the world!!
I love it because it is just the right size, not too big like some how malls are that when you are at 1 end and realise you forgot to get something from the other end the very thought of hiking all the way just repels whatever crave you had to shop.
AND
they have
Sake Sushi if you want to splurge, Roti Boy if you dont want to splurge
MPH is you want to splurge, Reader's Corner if you dont want to splurge
Parksons if you want to splurge, Flea Market if you dont want to splurge
Key Ng is you want to splurge, Love It if you dont want to splurge
Handphone dealers and techie shops if you wanna upgrade yourself, maxis reload centre if you cant afford to upgrade yourself
The ambiance just makes me sigh with contentment, just thinking about skipping up the carpeted slopes makes me happy!
(oh ya 1 weird fact about the place though, the architecture might be alil confusing for beginners, because they have slopes connecting certain levels and to get to the other level you might have to make a big round)
Yeap paeds EOP is over and done with, not as bad asa forecasted. My case was a newly diagnosed Diabetes Type1 presenting with a DKA. I never really imagined the social impact of such a diagnosis on a child before; until i saw it infront of me. I listened as the MO was counseling the mother about a "21 food exchange". Diabetics especially type1 where there is near total deficiency of insulin, have to watch the amount of carbohydrates they feed into their bodies. Too much and they can go into DKA like this little girl, too little and they can have hypoglycaemic attacks because of the insulin they are injecting into themselves. In the "21 food exchange" she can basically eat as much fibre, meat, fats, other food groups as she wants, but when it comes to carbs there was a certain formula. In the list given to the mother, there was a section listing all possible forms of carbs one would take bread, noodles, rice, crackers, and next to each was a measurement correlating to portions, like say 2 spoons of noodles equals 1 carb portion etc. So in a day, she was to take 21 portions of carbs, devided 5 for breakie, lunch, dinner making a total of 15; and 2 portions for morning tea, evening tea and supper (if im not mistaken) respectively making a total of 21. Obviously her mother was paying full attention to what the MO was telling her, and i have full confidence from the resolution in her eyes that she would do all she could do to monitor her daughter's carbs intake. But looking at the little girl, i worried. She was four, and still had that mischievousness about her that was expected, could she carry this lifestyle the rest of her life? Knowing that an unaccounted for mentos or ice cold cocacola after sports day could land you in a hopital bed? Injecting yourself with insulin 3 times a day before you even know what intravenous drug users are? Tough.
And we've seen cases of uncontrolled DM1 in teenagers, whether it is rebellion poking its early head or pure lack of motivation (which is logical, how could anyone be motivated to poke themselves with needles day in day out, minus the high drug users get? you're not even entitled to a sugar rush), it is dangerous if someone doesn't get into these kids soon and get them to want to want to participate in their own health.
Okay so that was exam on wednesday, but we have a class that was postponed to friday afternoon (the very class im waiting for now) so i was stuck here waiting for time to pass in my room as the others continued preparing for their EOP on thurs and friday respectively. I could have used the extra day or two i had to do something productive like finish some Paeds MCQ questions to prepare for the paper in May, or finish my IMS also due in May, but
s.o. f.r.e.a.k.i.n.g. h.ar.d. t.o. s.i.t. s.t.i.l.l.
I'm gonna look back on this day and *tsk tsk tsk * myself, for which medical student facing EOS semester completely wastes 2 precious days lazing around doing nothing? I amaze myself.
BUT i read my Neil Gaiman he is good, although abit freakish at times, but goooood! and started abit on IMS lar so im not a total slob, not yet but very close.
Many times this week i found myself with the urge to vent out and whine, about circumstances, humans, myself, things, and i realised how dangerous this blog could be had i not been the forgetful and lazy person i am. Had i not been too lazy to come up with clever ways of writing something but at the same time concealing something, so people would not go "OMG i know who she is talking about *psst psst*", i would have been close to making a big mistake. It is quite a job taking responsibility for our tongue. And although it would have given me GREAT satisfaction to get it all out, maybe get a few "here here" ,i know in a long run it ruins people and relationships. Tough being the one with a brain. When you are expected to be the civil one, you are not given credit for any good behaviour just scrutiny and wagging fingers the minute a strand is out of line, but when four legged creatures start walking on 2 and behaving, all heaven opens up in hallelujahs.
cheong hei matters aside, T-minus 6 hours to Subang Parade!
My favourites shopping mall in the world!!
I love it because it is just the right size, not too big like some how malls are that when you are at 1 end and realise you forgot to get something from the other end the very thought of hiking all the way just repels whatever crave you had to shop.
AND
they have
Sake Sushi if you want to splurge, Roti Boy if you dont want to splurge
MPH is you want to splurge, Reader's Corner if you dont want to splurge
Parksons if you want to splurge, Flea Market if you dont want to splurge
Key Ng is you want to splurge, Love It if you dont want to splurge
Handphone dealers and techie shops if you wanna upgrade yourself, maxis reload centre if you cant afford to upgrade yourself
The ambiance just makes me sigh with contentment, just thinking about skipping up the carpeted slopes makes me happy!
(oh ya 1 weird fact about the place though, the architecture might be alil confusing for beginners, because they have slopes connecting certain levels and to get to the other level you might have to make a big round)
Yeap paeds EOP is over and done with, not as bad asa forecasted. My case was a newly diagnosed Diabetes Type1 presenting with a DKA. I never really imagined the social impact of such a diagnosis on a child before; until i saw it infront of me. I listened as the MO was counseling the mother about a "21 food exchange". Diabetics especially type1 where there is near total deficiency of insulin, have to watch the amount of carbohydrates they feed into their bodies. Too much and they can go into DKA like this little girl, too little and they can have hypoglycaemic attacks because of the insulin they are injecting into themselves. In the "21 food exchange" she can basically eat as much fibre, meat, fats, other food groups as she wants, but when it comes to carbs there was a certain formula. In the list given to the mother, there was a section listing all possible forms of carbs one would take bread, noodles, rice, crackers, and next to each was a measurement correlating to portions, like say 2 spoons of noodles equals 1 carb portion etc. So in a day, she was to take 21 portions of carbs, devided 5 for breakie, lunch, dinner making a total of 15; and 2 portions for morning tea, evening tea and supper (if im not mistaken) respectively making a total of 21. Obviously her mother was paying full attention to what the MO was telling her, and i have full confidence from the resolution in her eyes that she would do all she could do to monitor her daughter's carbs intake. But looking at the little girl, i worried. She was four, and still had that mischievousness about her that was expected, could she carry this lifestyle the rest of her life? Knowing that an unaccounted for mentos or ice cold cocacola after sports day could land you in a hopital bed? Injecting yourself with insulin 3 times a day before you even know what intravenous drug users are? Tough.
And we've seen cases of uncontrolled DM1 in teenagers, whether it is rebellion poking its early head or pure lack of motivation (which is logical, how could anyone be motivated to poke themselves with needles day in day out, minus the high drug users get? you're not even entitled to a sugar rush), it is dangerous if someone doesn't get into these kids soon and get them to want to want to participate in their own health.
Okay so that was exam on wednesday, but we have a class that was postponed to friday afternoon (the very class im waiting for now) so i was stuck here waiting for time to pass in my room as the others continued preparing for their EOP on thurs and friday respectively. I could have used the extra day or two i had to do something productive like finish some Paeds MCQ questions to prepare for the paper in May, or finish my IMS also due in May, but
s.o. f.r.e.a.k.i.n.g. h.ar.d. t.o. s.i.t. s.t.i.l.l.
I'm gonna look back on this day and *tsk tsk tsk * myself, for which medical student facing EOS semester completely wastes 2 precious days lazing around doing nothing? I amaze myself.
BUT i read my Neil Gaiman he is good, although abit freakish at times, but goooood! and started abit on IMS lar so im not a total slob, not yet but very close.
Many times this week i found myself with the urge to vent out and whine, about circumstances, humans, myself, things, and i realised how dangerous this blog could be had i not been the forgetful and lazy person i am. Had i not been too lazy to come up with clever ways of writing something but at the same time concealing something, so people would not go "OMG i know who she is talking about *psst psst*", i would have been close to making a big mistake. It is quite a job taking responsibility for our tongue. And although it would have given me GREAT satisfaction to get it all out, maybe get a few "here here" ,i know in a long run it ruins people and relationships. Tough being the one with a brain. When you are expected to be the civil one, you are not given credit for any good behaviour just scrutiny and wagging fingers the minute a strand is out of line, but when four legged creatures start walking on 2 and behaving, all heaven opens up in hallelujahs.
cheong hei matters aside, T-minus 6 hours to Subang Parade!
Wednesday, March 25, 2009
Crave:
.detours. 
.Excuses.
.Nourishment.
.chickens + monkeys.
.sprees.
.Nourishment ++. 
.Stupidity.
.Time.
Wednesday, March 18, 2009
Hai Babieeeeeeee
On the 2/3/2008, the very 1st day of our 5 weeks paediatrics posting, I had no idea what to expect save for the fact that I would be dealing with children for the next five weeks. I steeled my ears for the symphony of welcoming bawling, and armed with a rattle and Kitty Cat stickers, walked through the doors of ward 8A. My fear and motto before starting my on call was “Please don’t let me make anyone cry”.
I met my match that night in a toddler who was admitted for her 16th episode of febrile fits. She obviously had very good lung and laryngeal function as she sat on the bed assigned to me by my group leader; crying and complaining about a hurting right arm. I froze. With the help of a friend, we managed to bribe her with a rattle into smiling for us. I learned quickly from that incident that to survive this posting I would have to dig deep within myself and look for a certain “soft skill” with children; a skill too quickly stereotyped to naturally dwell in all creatures my gender. I have always been fond of children, but when I try too hard to impress them, I think that is when they become intimidating because those cries could really hurt an unprepared ego.
I also met a mother, caring for her 3month old infant who had been diagnosed with Edward’s Syndrome 1 month after birth, currently admitted for difficulty breathing and apnea when her mother noticed a blue discoloration to her skin. Imagine sitting by your daughter’s bed, not daring to sleep a wink because she might stop breathing and being so small and weak, no one might notice her soft cries. Her mother was able to give me a very detailed history, as though rehearsed many times, with jargons that I had to stop and clarify with her, which was when she told me she was a nurse for 13 years. She asked if I knew anything about this particular syndrome; having grown weary of doctors repeating the same gloom message that there was “no hope” for her daughter. I do not think it was a fault of the doctors, there is very little written about the trisomy18 condition, and it is known to carry a poor prognosis. As professionals we are not to mislead or give false hope to patients and family members. But it made me realize that to better serve my future patients, it may not be enough to sprout statistics and pathophysiology, I would need the art of conveying thick textbook knowledge to them, in a way that would help them understand the seriousness of the condition, but still leave them with enough inspiration to make the best out of the situation.
At the end of the night, it didn’t take me long to grow fond of the ward and our pint sized patients, you never drag your feet when coming to see a child, because when you enjoy it, it hardly feels like “work”.
*edit: pssst i just realised i chichichacha talk so much "inspire here" la "passion there" la, it would be super embarrassing if i failed paeds EOP or MCQ haha then i'll have to swallow my big words whole. Oh wells fingers crossed: EOP 1st of April and MCQ somewhere early march after Obs & Gyn posting. Heard MCQ is brutal wor *ngweaaaaa ngweaaa ngweaaaa*
**edit edit: I just found out my EOP examiner! cant say who it is because this is the world wide web but....*scared* hope i dont pee in my pants can ady shucks...
I met my match that night in a toddler who was admitted for her 16th episode of febrile fits. She obviously had very good lung and laryngeal function as she sat on the bed assigned to me by my group leader; crying and complaining about a hurting right arm. I froze. With the help of a friend, we managed to bribe her with a rattle into smiling for us. I learned quickly from that incident that to survive this posting I would have to dig deep within myself and look for a certain “soft skill” with children; a skill too quickly stereotyped to naturally dwell in all creatures my gender. I have always been fond of children, but when I try too hard to impress them, I think that is when they become intimidating because those cries could really hurt an unprepared ego.
I also met a mother, caring for her 3month old infant who had been diagnosed with Edward’s Syndrome 1 month after birth, currently admitted for difficulty breathing and apnea when her mother noticed a blue discoloration to her skin. Imagine sitting by your daughter’s bed, not daring to sleep a wink because she might stop breathing and being so small and weak, no one might notice her soft cries. Her mother was able to give me a very detailed history, as though rehearsed many times, with jargons that I had to stop and clarify with her, which was when she told me she was a nurse for 13 years. She asked if I knew anything about this particular syndrome; having grown weary of doctors repeating the same gloom message that there was “no hope” for her daughter. I do not think it was a fault of the doctors, there is very little written about the trisomy18 condition, and it is known to carry a poor prognosis. As professionals we are not to mislead or give false hope to patients and family members. But it made me realize that to better serve my future patients, it may not be enough to sprout statistics and pathophysiology, I would need the art of conveying thick textbook knowledge to them, in a way that would help them understand the seriousness of the condition, but still leave them with enough inspiration to make the best out of the situation.
At the end of the night, it didn’t take me long to grow fond of the ward and our pint sized patients, you never drag your feet when coming to see a child, because when you enjoy it, it hardly feels like “work”.
That was my first oncall report, written on the very first day of our paediatrics posting. And now that we are approaching the end of week3, I'm beginning to realise with a tug how much I am going to miss this very short posting of ours. I never saw myself as a paediatrician, maybe because I thought it too cliche that women are expected to go all "goo goo gaa gaa" and "molly colly" and "cutsie wutsie" and "itsy bitsy" and "bubu chacha" and whatever baby lingo you can rhyme together. When you are EXPECTED to behave in a certain way, there just aint no reason to prove people right, whether its feminism or the rebellion speaking, i do now know. I also personally do notlike to smother children, am i evil? haha
HAIH.
I thought I was strong. But I'm a weakling just like them. I'm hooked.
I find myself looking forward to going to the wards, it really doesnt feel like work at all. Things are interesting and intriguing again because you have to figure out what it wrong without them telling you, but at all times they are actually showing you in broad daylight what it wrong. We learn to be "opportunistic" doctors in dealing with the young because they will not always sit still for us to question, poke, and prod, so we have to rely on common sense, observation and some tact to get the information needed. A real tricky, sneaky, creative way of practicing medicine. I think that is it, i know why i love paediatrics, i love the creativity of it all. And I'm actually interested to come home and read about my patients, of course I was interested in my other patients I really enjoyed surgery before this posting, but none with this much drive before. Somehow they make it feel so worth it, like you really really want to do it, not only for yourself but for them.
THIS was the kind of passion I was looking forward to experiencing in clinical school, THIS is what being a 3rd/4th year medical student means. Although a little late, I pray I will find a way to guard it with all I have for the rest of this course and the rest of my (well "hopefully" if i graduate in one piece ) career. I may not end up a paediatrician convincing kids to trade in their sugarloadedgumrottingcandy for some wholesome VitaminC chewables at my clinic table, but I sure am glad it reminded me how to enjoy medicine again.
And of course I still havent mastered the feminine high pitched voice thingy women do when cooing a baby, i cant say like "hai babieeeeeeeee, oh babieeeeeeeeeeeeee" in the correct note. There is this perfect high octave note one must hit to achieve optimum results with these specimens. You can say "Hai baby" in a million ways, but I'm telling you man, that one sacred note is the key man, Da' key!
Bai babieeeeeeeee*edit: pssst i just realised i chichichacha talk so much "inspire here" la "passion there" la, it would be super embarrassing if i failed paeds EOP or MCQ haha then i'll have to swallow my big words whole. Oh wells fingers crossed: EOP 1st of April and MCQ somewhere early march after Obs & Gyn posting. Heard MCQ is brutal wor *ngweaaaaa ngweaaa ngweaaaa*
**edit edit: I just found out my EOP examiner! cant say who it is because this is the world wide web but....*scared* hope i dont pee in my pants can ady shucks...
Sunday, March 15, 2009
I'm going on a holiday! _ _ _
SUNDAY 7.30pm
Ironing room
After a heavy dinner of chicken curry and rice, Denise is ironing her Kamal Labcoats.
She is still a little disorientated, having just spent the day preparing her slides for seminar.
Stupid labcoat, why do I have so many labcoats. *iron iron iron*
"Eh Denise"
*jump*
Aiyo it's just dad, why does he always have to sneak up on us like that
"Lesley is having a break somewhere near April 11th"
*stare* the iron makes some hissing sound.
"Oh"
"I'm trying to plan a trip around that time to Bangkok, you have a break too?"
*eyes widen* who cares about hissing irons now man.
Bangkok?!?!
This?
And This?
And this?
HOHOHOHO
AND this punye Bangkok???!?!
"So?"
*soul comes back from Bangkok*
"Erm...(thinking)........... AIYA!"
"Aiya?"
"AIYA! Why must be April? My exam is on the 1st of April then i can have a self declared holiday till the 5th. But after that i start Obs & Gynae posting, its supposed to be very hectic i might not even be able to come home on weekends..."
"....."
*Bites into an apple and walks away*
*comes upstairs to whine to blog*
WAH LIAO WEI SOMEBODY BETTER BE GIVING BIRTH ON THE DAY OF MY SUPPOSED HOLIDAY OR ELSE AH.
Sunday, March 08, 2009
Road Signs
It is pretty lousy timing to choose the beginning of a new posting to blog, but we had such an interesting youth meeting this saturday i had to write it all down before i forgot once again.
We talked about reading the "Road Signs".
I hardly pay attention to road signs unless I'm in a new place or I'm lost. Thus when I'm in good old Subang, you wont catch me staring and pondering over the arrows and red bars. But I'm no longer in good old Subang am I? And maybe it was a good thing too, taking me out of Subang, out of my comfort zone. It is only when you are plucked out of your old life and put at the cross roads leading to whole new other that you bother noticing all these road signs. Scary, confusing, mind boggling at first when these brightly coloured boards stare down at you whispering "Decide.... decide.... decide!", you could do 1 of 2 things. You could decide that life isn't fair, that its too much for you to handle, and you proceed to crawl under the thick comforter waiting for someone to tap you on the shoulder, and just freaking bring you to the end destination. Or you could suck it up, decide to use some brain, some heart and some common sense and give it your best shot.
But if you never bother to read the road signs of your personal life, you might end up with a typical Denise KL trip : Always getting lost, and never going anywhere new.
I surprised myself yesterday when I told the group my current road sign would be the "NO U-TURN" sign. I didn't even know I felt that way until I saw the sign because it looks like such a pessimistic sign. But I'm at a place in my life where i feel there is no U-Turn, I'm more than half way through the course, spent an absurd amount of money, getting older by the minute, in a local private university. LOCAL. PRIVATE. Two words not usually seen together. Local would mean i should have spent less than those who went private, but I did not. Private would mean that my degree gets more recognition overseas, but it does not. Local would mean more chances of me specializing locally, but it does not. Private would mean more chances of me specializing with the private university i graduated from, but it does not. There are allot of other no U-Turn areas in my life, but would be too sensitive to share on the world wide web.
I'm sure there are plenty of nicer, gentler, more nurturing road signs out there that wont give you the shivers when you look at it, like the all inviting "Petrol station 1km ahead" sign, or the Hallelujah "Parking" sign. I was just too fixed, gaping at my "No U-turn" sign that i forgot to look out for my "Petrol station" and "Parking" sign, but i have since learned to look out for them everyday if it is possible because they are going to sustain me from now onwards.
He fulfills the desires of those who fear him; he hears their cry and saves them.
Psalms 145:19
"Come to me, all you who are weary and burdened, and I will give you rest. Take my yoke upon you and learn from me, for I am gentle and humble in heart, and you will find rest for your souls.
Matthew 11: 28-29
I think the most memorable take home message for me that day was when a friend shared what this sign meant to her:
"This is a 'stop, give way sign' it means to me is that i have to stop myself and give way for God to work"
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