my first rejection. dont worry there will be more to come

Hospital Kuala Krai call, MO Paeds refer for obstructed inguinal hernia. Tapi esok pagi nak transfer KPJ. Tak sempat cakap apa2 dia dah hang up.

Aku terkedu.
1) aku tak oncall
2) aku kerja di Lahad Datu

Laju aku call balik. Cakap dengan operator minta sambungkan kepada SCN. MO tersebut sambut..

Dan aku terjaga dari tidur. Pagi ni ada herniotomy satu, budak ni dulu obstructed hernia. Bangun la berkhidmat untuk negara...

aspirate je la

Usually when people refer me, I don't ask much. I'll just go and see the patient myself. Unless I couldn't be seeing the patient (stuck in OT or other more urgent matters) or wouldn't (phone consult for a TCA).

Today one Medical MO referred me back regarding one patient's neck lump. They're treating as smear negative TB and the only other sample left they haven't got a culture from is the neck lump. My surgeon already saw that patient and he said not to touch the neck yet, USG first. Get sample from her sputum and her ruptured axillary swelling. Both of which came back AFB not seen. 

I told her to aspirate that thing if they really want. Because Radio not granting USG while patient is warded in SARI. We don't do trucut biopsy at the neck and FNAC is just a fancy thing where I bring a lab technician and her stuffs with me while I aspirate things. 

Might as well aspirate that lump (which my surgeon palpated as a cyst) and send whatever it is they want to send. 

"Then I'm referring Surgery to aspirate it."

"You're referring me to aspirate that thing je?" 

I frowned but my tone was even, pressing on the "je". I couldn't believe what I was hearing. They do neck central lines, they tap here and there. But they're referring me just to poke an unchanged swelling with a blue needle.

"Yes. Medical are stupid like that."

I never said that and never thought of that. Woah. This girl degrading herself so much for sarcasm or what? What's her deal. 

At that point I stopped saying anything and just let her talk. Which she then said she'll document this and this as Surgical input, to monitor the progression of the swelling, get USG as outpatient and will refer back if indicated. I told her the USG outpatient was already the plan when my surgeon saw the patient and she can just give the patient TCA SOPD with that USG. 

They started ATT already. What difference does it make now? 

SARI is being handled like COVID. I help prepare the PPEs and our hospital production is 'kais pagi makan pagi, kais petang makan petang' so I know how precious the PPEs are. Dude my fingers hurt from getahkan all those boot covers and long cap so I'm not going to simply go see patients in COVID or SARI ward, don a PPE for a quick non urgent procedure any doctors can do and then ciao. 

Nope. 

it's only april but 2020 is too long already

When I walked back to my car today, I was thinking how my 2020 resolution was to be deeper than my superfluous self. 

Which was why I confessed. 

Things didn't turn out how I hoped it will. Maybe that's what was written, maybe it's the best for me. But in a way, it affected me more than I would ever admit. Because instead of sticking to being deep, I am now back at being superfluous.

What happened today was that I was sitting on the counter watching the ward go by when Rayner caught my staring at nothing and gave me a finger heart. I replied with two finger hearts. I had a grin on but actually didn't feel anything more. It was a fun harmless flirt. Rayner has Elsie and I.. have Kevin. 

And at that point I felt I should just stick to having fun harmless flirt with whoever I wanted.

But never will I flirt with anyone who shows even a tiny bit of genuine interest. Nah, I'll pass. Too much. I did that and I felt horrible. Shouldn't play with feelings. People will get hurt and I don't want that on my conscience. Also I'm a wuss.

Which brought my train of thought to Kie and how she told me to be brave and give a chance to whoever come the opportunity.

But it was contrary to the fact that I didn't give Fitri a chance. Because we're colleagues and I cannot have failure because then my work life in Lahad Datu will be ruined. It will suck to move back to Likas before my year here ends. 

I thought maybe it was just for the time I'm here in Lahad Datu, but I was proven right though because he is fragile. I think he has been mentally and emotionally abused for a while now, me not knowing where I stand will be bad for him. He is my friend before any of this happened and I didn't want to lose that. I am selfish for wanting him as a friend. Especially now that Syukri Fadhly Arif gone from the ward and Fitri is the one left. Huh.

Eh stop this. Stop talking about this. You're not desperate. 

I'm not. I'm just getting it out of my system. 

that time i was a banana in pyjama

Day 1: Sunday April 1st

I was oncall. I remember feeling feverish, generalised malaise that 3pm and spent my free time head slumped over the counter. Fitri was working PM and saw me rummaging the medication trolley and he asked me what I needed.

I need PCM, I told him. I couldn't find them and I gave up. I went to the MO room behind the counter and tried to rest. 

He came in and gave me a whole strip of Uphamol. I grinned. Great stuff that thing, I hate the Paracil we used to have. So I dawned 1g of it and get on to see a referral.

I should have a gap of six hours in between doses but I have to function, I need my malaise to back off and my headache to subside. That night I remember downing another 1g just 3 hours after my last dose because Kamal showed up, wanted me to supervise him a CVL insertion and that gave me a headache because I have two cases waiting for me in ED. I ended abandoning the procedure because it was dragging my time and CVL insertion for TPN was "not my priority tonight".

Day 2: Monday April 2nd 

Postcall. Damn tired. Harith was oncall and clinic was running. I ended up slouching at the counter and left Harith to pick up my leftovers. He was doing a dressing and all I did was sat on the patient's bedside chair and vented how tired I was with Kamal. Harith said he'll talk to him.

I felt bad. I felt I was too harsh with Kamal. I shouldn't use my health as an excuse to be harsh to people. I should be nicer.

We had lunch at Rumpun that day. I didn't even finish half of my food. By the time it was 3pm, I had already taken 6g of PCM.

I think I punched out after Maghrib. I went to my car and slept. I was still so feverish but to rummage my bag for PCM was a hassle, so I decided to sweat it off. Couldn't really sleep but couldn't really drive in that condition either. Fitri was asking about me but I didn't reply him much citing I was still feverish. I conveniently didn't reply when he asked where I was because I was afraid he'll show up and drive me home. I shouldn't impose that much on him. 

I woke up at midnight and felt better a bit. Then my message notification popped up. It was Harith. He was asking what was I doing still at the hospital at midnight. 

Ah. I drove back instead of replying, because I wasn't sure where he was when he saw me. And then I replied him. I told him I had a fever and slept in the car because I was too tired to go back. 

He asked if I was okay. If I need food or something. 

I didn't ate much. But I couldn't really build up the appetite to eat anything. I told him I got home already. Thanks bro. He told me to tell them if I needed anything. Yeah, okay. And after that I replied Fitri's message.

Day 3: Tuesday April 3rd

I woke up at 7.40am feverish and headache. Urgh do I have to work? I know it was viral because all I have was feverish and malaise. Some vague stomach discomfort too but with barely eating, who knows if that was a symptom or a cause? On Day 1 I wanted to check my temperature and asked my staff for it but they said they have to disinfect the thermometer first and I didn't know if they were serious or not but it was too much hassle to further question it, so I didn't. Wouldn't have changed my management, I still needed PCM anyway.

The day schedule ran through my head. It was a Tuesday. We have one elective OT. A tumour case I admitted, my working diagnosis was an obstructed colon cancer but my surgeon said it was a perforated appendix. CT showed I was right. We were proceeding with hemicolectomy KIV stoma today.

So both surgeons will be in OT. Kakak and another one will be in OT. Harith will be postcall, who's oncall? Ah the other one MO left. Nabil still on leave. And me on my bed.

I decided it was safe to come in late today. I texted the team saying I was feverish and will be late today. I punched in at 8.50am that day. Came in and helped Harith did rounds. He knew I was sick and told me to rest. I did my round sitting next to patients and when I was done, I went and sat quietly at the counter.

Both Rayner and Fitri was working the same shift. Rayner was helpful as usual. Then I asked Fitri if he could ask Bed 7 at what time he was NBM and Fitri replied jokingly "Nak tanya dia niat ke tidak?"

I remember telling him I don't joke about work every time he joked back at me when I was asking about work. And now when I was shit tired and he knew I wasn't feeling well so why did he have to do this to me? I sighed and without saying anything walked to the patient myself, hurriedly because I was upset with Fitri and at myself for even depending on him. He chased after me but I ignored his presence and asked the patient myself and I left back to the counter without another glance at him.

I was upset. Stupid Fitri can you not joke about work?

He didn't know I was upset until later that evening when he told me he was feeling feverish too, and I told him it was probably because I was cursing him all day.

Miss Doon finished OT that noon and complained what have we been doing that morning, why didn't we get any accreditation work done. I was silent because her complaints were pounding my head and I took some more PCM. But really, when you're at work you should get work done.

I also snapped how the AM nurses didn't do their job and got dragged to almost half hour before office closing time. What a short tempered day.

Day 4: Wednesday April 4th

I was feeling a bit better and stayed in clinic whole day.

Day 5: Thursday April 5th

It was an OT day and I stayed out, trying to conserve energy because I was going to be oncall the next day. At PM Kamal had a paed perforated appendix and Miss asked me to assess the kid. Yup, perforated. We fluid resuscitated and went in.

Kamal opened it. I assisted. He couldn't fish out the appendix and after multiple attempts and several times holding him back because I was worried the appendix be amputated, I asked him if it was okay for me to take over. He said okay.

And what do you know, it really was amputated. It was actually all macerated. Base wasn't healthy. We ended up calling the surgeon. Miss came and we did hemicolectomy for the kid.

I think we finished around 10 pm. I was tired and effing hungry. Didn't have lunch. I went back and stopped by Red Rose. Took a seat and Fitri texted me to "look forward".

To what, I wondered. He then told to literally look forward and there he was at the farthest end away, with Kamal. He invited me to join their table.

I passed. Told him if he was alone I'll be joining, but I was too tired to deal with Kamal. Ahh writing this I realize I am such a bitch at Kamal, he doesn't deserve all this. I should be kinder.

Anyway I had roti canai kosong and then I left.

Day 6: Friday April 6th

I was oncall. No breakfast per usual and I was nauseated. Like really. I want to retch up. So I bought myself a sausage bun and that helped a bit.

At noon Dija dragged me to lunch at O&G's party something. I had some food but really I wanted to throw up. I finished the meal and went back to 4B where I vomited out every single thing, including the sausage bun.

I was still so nauseated and didn't dare to eat anything. It was a hassle going to the toilet to vomit. I was walking around reviewing patients with a yellow bag in my pocket. Did my PM round with the surgeon and I didn't let on a bit that I wasn't well.

Damn I wasn't well. Not so feverish so I didn't need PCM, but what the hell is this nausea? I wasn't eating so I wasn't vomiting. My stomach hurts. My urine was so dark I was probably dehydrated, I need an IV but I don't want people to see. I laid down most of the evening and thanked God I wasn't so busy. I skipped doing proper documentation for my oncall round and looked forward to postcall the next day.

I had one two cases at ED and went down to see while complaining at the ED MO I was nauseated all day. Of course Pojie suggested a UPT. I went back to 4A, retched in the toilet and went to the counter to get the oncall room's key. I didn't say anything to the nurses, I was too spent.

Day 7: Saturday 7th

Postcall and Harith was oncall. We were doing rounds with Miss Doon while I refrained myself from running to the toilet to retch. Harith had an unstable intraab and hell was the OT that I had to assist. I had a maternal referral that I forgot to show Miss Doon and I got an earful because she found out about the case from her friend the O&G specialist oncall that night. (Anyhow the diagnosis and management was the same as mine).

It was only at 3pm that I excused myself from work. I went to 4A and asked for an IV. Vic didn't dare to poke me because my vein was collapsed and even so she would be trembling to poke a colleague. Harith assessed and said she should be fine. Vic poke but nothing came out, so she surrendered to Rayner.

I gave myself 1 pint NS and tried to sleep in the MO room. Post bolus I didn't feel like peeing so I asked another one. Afterwards my urine were still too yellow and I didn't think much of it. I went home and sleep.

Day 8: Sunday 8th

I woke up with the same too yellow urine and a glimpse at my reflection in the mirror had me do a double take.

What the.. is that jaundice?

Oh shit. Why am I jaundiced? And the urine.. it's not concentrated from dehydration? Is that tea coloured? Oh shit what have I done to myself.

Fitri was asking if I was okay. I told him I think I'm jaundiced and that I'll go to ED later in the noon.

I drove, walked myself. Didn't even prepare for an admission of course. I just wanted to see how's my LFT (shouldn't be that bad right?) and maybe walk out again. The triage MA grinned implying I was well despite a week of illness since I told him I drove myself so I told him I only came today because I was jaundiced.

Chiang assessed me. My tongue was dry so she sent me for an IV. Took my blood and all. Did a bedside scan, my IVC normal but couldn't see my gall bladder at all. 

My counts were not septic. No AKI, no acidosis.

And what do you know, my ALT was 3110. Fuck.

Interviewed by the Inspektor Kesihatan because they sent out Dengue Test thinking I had dengue with transaminitis. IgG positive the rest were negative, keepsake from my Sept 2016 compensated dengue shock with transaminitis.

Arif came while I was blanketed at the Obs Bay. Arif as always, always there when I need help. He was in Peninsular for a course the whole week I wasn't well and I didn't know he was back already. He actually just got back in Lahad Datu that day and went to 4A to give Yana some food she was craving, and Fitri who was working PM told him I was at Obs Bay so he came and checked on me.

"Tiqah, Tiqah. Aku baru tinggal Lahad Datu sekejap." His tone was kind and somewhat pitiful.

He bought me nasi with telur dadar that day but I was too nauseated to eat anything, and he remained diligently sending me breakfast everyday for the rest of my admission. Such a babe this bro. Arif I owe you my sanity and a chunk of my life.

Arif and Fitri saw me again when I was brought up to 5B for admission. They took my grab bag from my boot and left me for the night.

Day 9: Monday 9th

The team stormed me after they did their round. I was on IV, starting on Rocephine. Miss Doon was digging my history and was appalled when she realized I abused PCM. She called up the Radiologist and demanded my USG HBS that dot.

"You puasa?"

"Saya makan sikit breakfast tadi." A piece of bread and Milo.

"Dia makan la pulak.." She complained to the phone. I grinned and shot back "Makan salah, tak makan salah.."

I was so proud of myself that I didn't give any hint to my surgeon that I was unwell the whole week. And mind you she is usually observant and perceptive.

That morning Savin texted me asking how was I doing and I sweatdropped. I asked him what did he hear and that was probably not the right thing to ask, because he then knew something was wrong.

He drove from Beluran afterwards and was scolding me by noon before he accompany me for my USG. I had an acalculous cholecystitis.

Later I took a selfie because Savin Fathni and I reported duty in Sabah together with Imran. So I thought hey why not send this to Imran haha and posted in the Ex HRPZ in Sabah group. Took a selfie and it really downed on my how yellow I am. "Wth gigi aku lagi putih dari mata aku!"

Imran never responded to the picture, but my sweetheart did. He immediately texted me after I send out that selfie but I was a bit slow at replying (because I had company) so he texted Savin as well, who told me to reply "the loverboy faster".

Day 10: Tuesday 10th

I was tired but I need to get out of bed. Savin escorted me to 4B and I settled Paed Surg visiting OT list with my IVD and all, made sure I ate the laksam Arif bought for breakfast and that I drink up. Farah had a field day comparing my yellowness to everything.

That night Hannan sent me a supermoon he caught on camera. "Aku nampak this super bright big orange moon and it reminds me of you haha"

He was talking about that time I drove back from Semporna and saw the biggest orangest moon ever and I texted him while driving to go look out his window. He couldn't see the moon from his place that time though.

Writing this, I guess he was just a worried friend. Maybe I have a tiny bit of space in his orbit. He was not, as Savin used, a "loverboy". We used to read the same book but at different chapters with me ahead of you and you gave me one of the best time of my life. But I've let you go.

Thank you for remembering me, you'll always be a sweetheart to me.

Day 11: Wednesday 11th

Aslamiah brought me dinner while Arif and Fitri came and we played poker on my bed hahahaha. I guess that's it for me, the girls will think something is up.

Anyhow I floored them! I really did! Also Nicole was oncall and made few stops to discuss cases with me. I felt useful. She also played a round of cards with us and floored us in that one round.. She's something.

I also got an earful from Kak Elli from only now telling her of my admission.

Fitri and Benny came after Benny's PM shift ended. Benny poked me but didn't get a line. Fitri poked me a green one at my left cubital and it hurt a lot. I endured, but I couldn't sleep at all because I had to keep my arm fully extended.

I was counting seconds until my 6am Rocephine.

Day 12: Thursday 12th

I pulled my line off.

Mom arrived that evening and Hanan, Aslamiah and Laila were entertaining her. Laila inserted a new line for me for my Day 5 Rocephine cm. Mom rested at my place that night.

Day 13: Friday 13th

Day 5 of Rocephine and please please let me go home. The bed is too hard, the pillow will break my C2.

And I was discharged. I shouldn't be discharged yet but we were having COVID-19 cases and they need to let well-er patients go back. Dr Dina said she trusted me to take care of myself and I nodded. I have mom.

I had Hepatitis A with acalculous cholecystitis. And I get a new friend in the form of Kak Betty my Bed 19 neighbour.

I was on MC until 23rd. I didn't do any calls the rest of March.

fujioka

After last night's post, somehow I remember I used to be so close with Aiyad. One time we were talking about Minami-ke and how similar I was to Kana and then he said

"Satu hari aku harap kau jumpa Fujioka kau"

Or so was his word. 

I hope so. Allahumma, aku nak kahwin tahun ni. Tunjukkan aku kepada jodohku. Allahumma ameen. 

fma brotherhood

Over the weekend I stumbled upon FMA Brotherhood on Netflix and it was the best decision ever.

I've finished all 64 episodes. I hated Ed naivety and Winry at point uselessness and applauded the adults for doing what needed to be done. 

Then I realised the kids naivety was a lesson for them to grow. And Ed grew. Winry wasn't so useless after all. 

It's a story of family. And communication is vital. Hohenheim should have communicated with his sons from earlier on, but I guess he didn't want to burden them. But you need to communicate nevertheless. 

Ed and Al are lucky because they have each other. They always have each other. 

So yeah. Everyone need another significant other. I agree. Totally agree. Whatever the label is, you need a significant other. 

But don't go looking for something you don't have. Just be happy with what you have. And you'll find it in time, God's will.

One of these days I'm going back to Japan. Solo trip, let's do it. And get a pair named Haru to Hayate.