Wednesday, November 26, 2008

Aging gracefully....

Case 3

A 21 years old Malay man who is a C*lcom service operator, complaint or sore throat

HappyDoc comment

This case is straight forward. There was no other associated symptoms. From examination he had simple upper respiratory infection (mild) which usually resolved spontaneously most of the time. He asked for one day leave so that he can recover quickly and regain full energy which I think a reasonable request.

We have a brief talk and he told me that he just dropped out his diploma recently and doing his current work as contract basis. He is a cheerful and pleasant types person with good communication skill. He had a bright ambitious face. I advised him to pursue back his study as he is still young and he still have a lot more to learn about life. I believe that he can be a successful person one day. Sound like..... I concern to much .... or maybe it's a sign of aging he he (err...when you start to concern too much and talk a lot he he) and I do like the term aging gracefully very much. Do this term applied to you..........?

Aging gracefully, no botox, no collagen, only cream he he....

Monday, November 24, 2008

More or Less

Case 2

60 years old Malay lady with background of diabetes, complaint of generalized body weakness

HappyDoc comment

Hurm... A little bit difficult to tackle this lady problem since the complaint is not very specific. Various medical problem can cause generalized body weakness. She controlled her diet well and she just visited her regular doctor recently and was added new medication. On further questioning, she do feels hungry, a bit sweaty and palpitation. A ha, that clue was really helpful! A simple and quick glucometer revealed that her blood sugar is 3.0 mmol (which is very low) She had hypoglycaemic symptoms!


She need glucose to correct her hypoglycaemia. Since she was still alert, i immediately grab lollipop and give it to her (the lollipop is reserved as bait for children who did not co-operate during physical examination and it look very cute for a 60 years old granny eating lollipop). But all her symptoms quickly resolved after that.

HappyDoc concern

It will take hours taking about diabetic and the complication. Diabetic is not all about treating blood sugar level alone. Education is the most important part and managing the complication is even harder. A home blood sugar monitoring will alert those with diabetic if their sugar is not well controlled. You need to balance between hyperglycaemia (excessive sugar) and hypoglycaemia. Yeah....It all about balance, like Ying and Yang and just like how hard we try to balance between our work and family (i.e as son/ daughter and as father/mother). It was never easy right?

Wednesday, November 19, 2008


I received a bad new today. One of patient that my team and I has been taking care for the past 3 months lost her battle. She passed away yesterday due to post-operative complication. It give a big shock to us for a while after my team and I visited her empty bed at ICU today. She was a very pleasant lady and optimist person to start with. She looking forward to do the operation despite knowing the risks and she might not seeing again the world after the operation. She did very well on day 1 until day 3 after the operation before everything turn to a mess yesterday. I feel very sad for her but a part of me telling me that she died for what believe for and she did what she feel right for her. May Allah bless her and placed her with good people. Amin

Saturday, November 15, 2008

Sleepless night....

I did locum (part-time work) at a private clinic yesterday and I've come across these 3 cases:

Case 1

A 19 years old healthy Malay boy who is a cook complaint of insomnia for the past 1 week.

HappyDoc comment:

I need to exclude if this boy had symptoms of depression or taking any stimulant types of drug as this can disturb your normal sleep pattern. The most important question to ask is the lifestyle. If he took a lots of caffeine late night, this can be one of the cause. This boy admit that he work in the shift basis and the symptom worsen when his shift changed. He claimed that if he did not have adequate rest, his work performance on the next day will be affected. He also denied taking sleeping tablet before.

Most of the cases, lifestyle modification alone is adequate. Play some sport in the evening, avoid caffeine after 6pm and do not sleep during day time alone do help fighting your insomnia (Or in other word, practice healthy lifestyle)

HappyDoc action:

I prescribed him just a few tablets sleeping pills with lots of advised (Hurm... I don't know weather he listen to my advised or not) I told him, regular intake of sleeping pill can cause addiction and if he get caught by the police and get his urine tested, he might be face with lots of trouble. I advice him to take only when he really need it.

HappyDoc concern:

Overdose of sleeping tablets can cause death. I don't want this to happened and that why i only gave him 3 tablets only to be used in desperate night. My other concern is he might use it for wrong reason like putting the sleeping pills in the somebody's drinks and do bad thing(figure it out itself, think outside the box he he). My other thought is he might be cheating on me. He is actually a sleeping pills addict he he... Err, maybe all my concern is not true. Probably, I think to much he he...

to be continued......

Thursday, November 13, 2008

You are welcome....

It just a normal working day and i am in the lazy mood for this week (he he...) Then suddenly my hardworking ward clerk pass me a card. Initially, I thought it was a wedding invitation card as school holiday is around the corner but i was totally wrong. It a "Thank you" card from one of my patient who just discharge few days ago. Well, i don't expect it from her and her family as my team and i treated her same as other patient (as stated in our oath). But the good thing is it lift up my mood to work harder on that day.

I realized that a simple thank is rather important. If your staff done a good work, praise them and say thank you to them. If your mother or spouse cook a meal for you, do not forget to thank them as well. Believe me, cooking is not a simple task he... he..and i would like to thank you (yes you) for reading this entry he he... Have a good and productive day everybody : )

Saturday, November 8, 2008

O Negative

What is your blood type?
General speaking,
O -ve = universal donor (generous type of person, scarifies her/himself for other need he he)
AB +ve = universal recipient (he/she can received all types of blood but can only donate for those with same group. What does it sound like?... Selfish? he.. he..)
err... well, this is not totally true actually..

I decided to do something good today. It takes very little effort but lots of courage to do it. I heard the in the morning news, that Malaysia blood bank had a shortage of blood. No wonder it is so difficult to get blood for patient in the ward nowadays. It's a considerately quiet day for me at work today. So, after work decided to drive to Pusat Darah Negara at Jalan Tun Razak for blood donation (sound noble huh he.. he..) This going to be my 6th blood donation over 8 years period. I tried to do it more often but time is the constraint factor. My blood group is O negative, so you decide what types of person I am he... he...

This is my hand with needle in-situ. (I tried not to cry when the nurse poking the needle he.. he... hey it's painful OK, try yourself)

1 pack of blood = 450 ml = 1 life saved

If you are a healthy person, be a good citizen and donate your blood today. Lets do a little contribution for those who need.....

Monday, November 3, 2008

A walk to remember

"Once upon a story in Melaka...."

Dr Frapp and me was attending a weekend seminar recently at Melaka, the historical city. It was a fully sponsored trip and I must thanks AZ for organizing such a great event. Everything went smooth until Dr Frapp and me decided to get back to KL earlier since we already had personnel programme planned earlier. Dr Frapp and me leaving the hotel after had our dinner there.

The first half of journey was considered quiet boring. Then, suddenly a saw very thick mist on the other side of the road. I start to feel uneasy but i did not mention about it to Dr Frapp hoping that it's all my illusion. Few minutes after that. there was funny noise from my car. Shooot... why things must go wrong in the middle of the night and we are 128 km away from KL. I slowed down my car and park it at the roadside. After having quick unprofessional look, i noticed that my timing belt is 1/4 gone. To make thing worse, i cannot start my engine after that. Now we stuck in the middle of nowhere and in the middle of night hu.. hu.... (But I kind of enjoys it actually he he.. A dull predictable life with everything goes smooth is sometimes boring right? he he) But I definitely freak out if I was alone at that time....

This is where the event take place.

Help from PLUS came after we waited 1/2 hour in dark. I managed to start back my engine and we decided to get back on the wheel and drive slowly to KL like 50 km/h... So, 128 km from KL, driving at 50-60 km/h.....Yeah you do the calculation.........Dr Frapp and me were singing together all along the way as we tried to minimize my car energy usage by not turning on the radio (I realized later this action was unnecessary he he) and we quiet enjoy it he he...

We finally reached KL at 1 a.m tired and sweaty. Our total journey is 4 hours instead of 2 hours. That night trip would be the longest journey ever from Melaka to KL but it going to be the unforgettable one. Today, I learned a new lesson, "It is not how fast you can get to your destination matter but how and whom you share your journey with is more important........."

Saturday, November 1, 2008

Convocation day

My younger brother had an accident recently. He was on his motorbike with his friend before a reckless lady driver in a white Kancil hit my brother from the back. He felt, kiss the road and hit his face badly leaving multiple abrasion wound.

To make thing worse, he loss his consciousness after the accident and he was bought immediately to Hospital Serdang.Lucky for him, he regain his conscious but he couldn't recall anything about the accident even where the accident took place. The last thing that he can remember is he is eating mee bandung and the next thing happened is he wake in hospital bed with wound all over his body. Thank God (Almighty Allah) he had no neurological deficit and his CT brain was normal, no intracranial bleeding. My diagnosis is: cerebral concussion with multiple superficial abrasion wound (especially over the face-habislah saham jatuh).

The not so good thing is, his convocation day (for his degree) is in 4 days time. Just imagine he is going to walk on the stage, received his scroll with face full of scars, had picture taken, and that picture is going to be hang in my parent house permanently. But wait, take it from the positive site, at least he can take the scroll by his own rather than somebody else take it for him. And that convocation picture, i believe that a little touch from photoshop will solve the problem right he he... there no problem without solution...