Hidup mulia

For every expected mother, there is nothing more they desire then having a healthy new born child. Those who were in the position of deciding whether to sacrefice their life or the life of their baby (mother who had breast cancer diagnosed during pregnancy for example), would choose the life of their baby and end up dead as a result of delayed treatment causing a child without a mother. This is the undying love of a mother.

At the moment I was posted in the neonatal ward for a week which is part of 4 weeks posting in pediatrics. The case I mention previously was a case i’ve heard during a seminar done by the Obstetric and Gynecology Department.

In relation to that, I have a patient of mine who is 13 days old. She was a chinese baby girl and part of her story was taken from her mother who was sitting beside her child bed in the neonatal ward.

Just a brief introduction, neonatal is a baby less then 28 days, infant is less then 1 year, toddler is 1-4 years and more then 4 years old is child … Back to my patients mother..

When I 1st meet her mother she was lying on her bed talking on his cell phone. Seeing thats she was preoccupied with her "business" I look around looking for her child and the bed tiket where all the information was placed. I couldn’t find either one.. So I taugh perhaps the child was somewhere else together with the bed tiket so i decided to go back with Irni and plan to come back again later..

On my way out, I saw the mother with a baby out side her room. She was there for close monitoring. Her story started when her mother was admitted for delivery. During her admission, her fetal heart was unsatisfactory and vaginal examination was done only to found that the umbilical cord has prolapse. She was rushed to the operating theater and an emergency cesarean section was done to save her child. When umbilical cord prolapse, the fetal body part will press the umbilical cord againts mother’s vagina causing obstruction of blood supply from mother to fetal which contain oxygen and nutrition. Having an obstructed cord is like someone is closing your nose and mouth causing you to suffocate. So this is the scenario we are looking at here .. When the child was delivered she was not breathing. CPR was done and she come back however her breathing require and assistant from a ventilator machine. Post operatively she was place in the neonatal intensive care unit. Her mother visited her in the NICU on the second day.

During a week stay in the NICU she had multiple seizure and her primitive reflex which normal newborn child had was very mild and incomplete. She had what we call as hypoxic ischamic encephalopathy (HIE) stage 2. To me this is the worse thing that can ever happen to a new born child…  She had a brain damage ..

When I examine her, she didn’t open her eye, her body was floppy, her primitive reflex was very poor … If only her mother have seen the outcome of baby similar to her child in 5 or 10 years time, she would understand my worries … As I wrote the case on my note from the other site of the bed, I can see her mother nursing her with love and tender. Perhaps she aware, or perhaps she doesn’t, her child is going to be mentally and physically retarded .. I guess what ever it was, things has happen and she would love her no matter what …

Assalamualaikum semua … KAli ini saya nak menulis tentang ibubapa … Memang issue ni satu isssue yg lapuk tapi saya rasa ini isu besar yg perlu di utarakan berkali2 supaya kita tidak lupa … Sepanjang 2 minggu yg lalu saya berada di unit "consultation and liason psychiatry" … dalam unit ini kami bertemu dengan pesakit yang mengalami tekanan perasaan akibat penyakit yang mereka alami dan pesakit yg menghidapi penyakit tua seperti nyanyuk (alzheimer’s), nyanyuk akibat angin ahmar (vascular dementia) dan sebagainya .. Berbalik kepada issue kita, warga tua di Malaysia adalah individu yang berusia 65 tahun dan keatas .. pada usia ini, tulang mereka sudah rapuh, ingatan sudah tidak kuat, mata mereka sudah rabun dan mereka ada byk masalah kesihatan … Di waktu mereka seusia ini isu besar yg ingin saya utarakan ialah tentang tanggungjawab kita menjaga mereka .. Ketika saya dan kawan2 di memory klinik hospital seremban, kami menemui ramai org2 tua yg mempunyai masalah nyanyuk .. memang kesian dan tersentuh hati saya melihatkan keadaan mereka .. ada antara mereka badan berbau, ada yang kelihatn "lost", ada tuh percakapan mereka merapu2 dan banyak lagi … pun begitu saya terharu kerana mereka datang bersama anak2 mereka yang menyangi mereka.. melihatkan air muka mereka saya dapat rasakan, tidak mudah "berbakti" untuk org tua dalam keadaan begini .. tapi mereka tabah, mereka minta bantuan dan khidmat nasihat kami tentang bagaimana cara terbaik untuk memastikan ibu atau bapa mereka ini selesa dan sihat … walaupun hakikatnya .. ibu atau bapa mereka tidak kenal sebenarnya siapa yg menjaga mereka .. itu kehidupan .. umpama bola kan .. masa kita belum mumaiz dulu .. ibu bapa kita menjaga kita dgn penuh kasih syg walaupun mereka tau kita tak kenal pun siapa mereka … Dalam ramai2 pesakit yg hadir ada juga insiden yg menyendihkan saya … ada segelintir warga emas istimewa ini datang bersama org gaji mereka dgn kerusi roda … menurut salah seorg dr mereka, majikan hanya datang jumpa mereka untuk bayar duit shj .. kemudian balik ke rumah masing2 … atau ada yg datang bersama perkerja dari rumah warga emas … Saya tidak mahu "cakap besar" mendabik dada mengatakan anak2 ini lupa daratan dan berdosa besar kerana melayan ibu bapa mereka yg nyanyuk begitu kejam sekali .. mungkin masa mereka sihat (ibu bapa anak2 ini), mereka tidak layan anak ini dengan baik atau mungkin mereka dera anak2 mereka dgn teruk secara mental atau fizikal dahulu … kita tidak tahu .. tapi apa yg saya pasti, Allah menjadikan kita dengan akal dan timbang rasa … adakah kerana hajat kita yg ibubapa kita tidak tunaikan satu ketika dahulu "justify" perlakuan kita meninggalkan mereka disaat mereka memerlukan kasih sayang kita … Saya khuatir sebenarnya melihat  suasana  muda-mudi hari ini yg melihat cara hidup barat sebagai cara hidup yg sebenar dan melupakan nilai Islam … Adakah mereka akan memimpin tangan ibu bapa mereka, membasuh air kencing mereka di raung tamu dan menyuap nasi ke mulut ibu bapa mereka atau adakah itu sudah menjadi tugas org gaji .. Saya insaf ..

Teringat saya pada seorg pakcik berumur 75 tahun di ward geriatrik, unit di mana saya dan kawan2 saya bertugas.. pakcik ni masuk untuk menjalani fisiotherapy … dia mengalami stroke dan ini menyababkan dia nyanyuk ( vascular dementia) .. ingatannya semakin merosot setiap hari yang berlalu … akhir2 ini dia mula murung dan adakala cucunya perasan dia menangis di ruang tamu seorangan .. saya dapat rasakan kesedihan di hatinya … pesakit nyanyuk (alzheimer) biasanya tidak sedar mereka hilang ingatan .. buktinya apabila kita uji ingatan mereka ttg apa yg mereka makan untuk sarapan contohnya … mereka akan mereka-reka jawapan mereka, mereka selalu sesat, salah kira duit dan dalam kes2 yang sudah melarat teruk, mereka mula buang najis di ruang tamu atau dalam bilik dan sebagainya .. kesimpulannay mereka tak sedar dan kemerosotan ingatan mereka ini merosot perlahan2 … dalam kes pakcik ni dia mengalami penyakit nyanyuk disebabkan angin ahmar atau stroke di beberapa bahagian otaknya ( multifocal cerebral infarct) ..ini bukan alzheimer ya…. dan mereka ini biasaya menghadapi tekanan persaan yg agak serius … nasib baik dia memiliki seorg cucu yg amat baik hati .. lelaki pulak tuh … cucunya tinggalkan perniagaannya untuk menjaga atuknya .. dah 2 bulan berlalu katanya .. alhamdulillah moga Allah murahkan rezeki kau hafiz … Pengajarannya, galakkkan ibu bapa kita asah ingatan mereka dari sekarang dengan membaca byk2 quran ke surat khabar ke harry potter ke, main chess atau sudoku tuh, dam aji … dan always syg ibu bapa kita .. walau apa pun dosa mereka pada kita atau kekurangan mereka dalam membesarkan kita .. ampun kan …. kita anak mereka … semoga jasa kita di balas dengan Syurga Allah Taala … amin …

Having a strong foundation of anatomy and physiology is very important in medicine.. With it you can easily understand the underlying pathology of a disease and enable us to explain what went wrong to our patient .. Since its human nature to forget things we dont recall, memorizing those things is a huge challange.. AT the moment i’m in the library preparing my self for IJN posting .. The minor posting I had last week was o.k! I think i made one wrong diagnosis out of 8 .. so thats consider ok laaa ..

Since morning i’ve been reading on the autonomic nervous system which associated with the regulation of cardiovascular system .. easy said, it control the heart pump.. there are other factors that control our heart but my particular concern on nervous system because it enable me to better understand mechanism of action of the medical treatment .. Feel like my head is going to explode so I better get some rest …

Today’s news paper wrote about the political situation in turky. One of the presidential candidate ABDULLAH GUL was ask to withdraw by the military because of his ISlamic stand.. He is a consevative muslim and most of top ranking people in Turky  belive in sekularism hence they worried that Abdullah might change their way of life which started by Mustafar Kamal Attartuk .. I think few days ago, there was an article about TUrky’s school stundents were not allowed to wear tudung in school … What do you guys think ..

My headache has subside ..

Better continue studying ..

Gosh in 2 days time my minor posting is going to end .. I can feel that i’ve learn something but what ever it was, it’s incomplete .. 4 different posting, 2 weeks each .. To me its just too short .. My brain is not fast enough i guess .. Just finished doing the past year question, well more like reading the answer rather then actually trying to answer haha .. Medical student .. This is the quality of our future doctors .. Perhaps my brain needs more holiday but my gut feeling wants to starts working as soon as possible .. 2 days from exam and I’m here writing my blog .. What does that means ???? I don’t know .. The time is too short to cover everything so why bother .. Emergency medicine, opthalmology, dermatology and ear, nose and throat .. can you imagine having all these posting in one particular exam ..

Would i stress myself to even attemp to get distinction .. I can’t even get distinction for one posting let alone 4 .. SO i think i’m just gonna keep on reading the answer and the question from past year tomorrow and the day after that and hopefully .. it’ll come out …

Next month i’ll be doing my elective in IJN … There, i’ll be posted in cardiology for 2 weeks, anesthesiology 1 week and cardiothoracic surgery for 1 week … I’ve always wanted to work there and settledown here in KL … Its a good place to work other then the traffic jam … A lot of people life were saved here .. I’m actully a bit worried about cardiothoracic though, cause my future supervisor is a big shot consultant trained in mayo clinic USA .. you know the teaching hospital in greys anatomy .. Will I be able to impress him .. I’ve been planing to prepare myself for this but so far was unsuccessful cause busy studying minor posting.

Why do medical student study ? What motivate them to sit down for long hours reading, understanding and memorizing instead of going out enjoying life ? I have my own theory ..

In every posting, we had teaching session with our lecturer in the hospital .. We call it the bedside teaching .. A few of us will take history and perform physical examination and present the case during bedside teaching .. During this session our beloved lecturer will ask many question about the case presented and most of us try our best to show off our knowledge by answering his question .. Of course most of the time the bright student will answer the question .. As for the rest of us , well what to do we just cant remember .. Thats why we keeps on reading .. Lecturer will remember the bright ones and they will talk about them with other lecturers … We didn’t actually gain any throphy, it’s just that most of us were once the best student in our class .. ANd when someone prove that we are not the best anymore, we work harder to gain our title back .. A bit sad huh …thats the reality …

I dont have any specific thing to write actually .. I just open my blog and start typing what ever cross my mind .. Have a good day everybody ..

Hi everyone .. last night was my second night posted in emergency department… As usuall working in the emergency department you’ll see various kinds of cases.. MOst of the cases I saw so far were asthmatic patient came in for nebulizer….
I started working at 7.45 pm after having dinner with the boys and maghrib.. As i enter the red zone there was an old man complaint of vomiting feacal matter .. wow can you imagine .. Dr. Ben was there at that time reviewing the patient abdominal plain radiograph .. Yup ,,, there was intestinal obstruction but I was unsure of the diagnosis .. I’ll just came in so i don’t want to bother anyone .. After a whlie the siren rang twice which mean another patient will be brough in the red zone ( one rang means patient will be brough in to the yellow zone) .. I was thinking of middle age man with multiple fracture and bleeding all over his body … Instead there were a chinese couple with thier son .. Generally the Loh (the boy) looks weak .. Otherwise he is perfectly fine to me .. As usuall we examine the boy and asses his blood pressure, monitor his heart rate and oxygen saturation .. While the medical assistant prepared the patient, I took the opportunity to glance trough the Loh’s health recod .. He came in complaint of palpitation about one hour ago together with chest pain .. At that moment I was a bit shock actually but as Mr. paul said .. “No matter how wierd things may be seen, remain calm and organize your thoughs .. you are the doctor in charge of this patient” .. The first thing comes to my mind was how can such a young child suffer symptoms suggestive of a heart failure ..
The pulse rate of this child was more then 200 beat per minute (nomally 80-110 bpm) and the ecg showed absent P wave which indicate this child had a paroxysmal supraventricular tachycardia .. It just means that his heart suddenly pump very fast .. We need to reduce his heart rate as it may cause myocardial infarct and arrthymia or basicly leads to heart failure ..
There are a few way to reduce heart rate .. The first thing we did was massage his carotid sinus .. for those of you who watch grey anatomy, there was an episode where grey mother was admitted and she suddenly had tachycardia and Dr Yeng was there massaging her carotid, well thats what we did .. Secondly we brake an ice cube and put it in the cloth and applied it to the patient for head and face … LAstly a valsalva maneuver( we didn’t do this) it is done by asking the patient to blow in his mouth and close his nose… The method was so effective that Loh heart rate drop from 200 to to 90 which is the recomended pulse .. For a moment there we were releived .. However.. It doesn’t last long, a few minutes later, his pulse rate raised again .. we had no choice but to admit Loh .. A portable ecg moniter was attached to him and he was send to the peads ward..
In the ward, the Loh’s heart rate rises to more then 200 again .. This time ice pack and carotid sinus massage was not as effective as before.. My right hand was holding the ice pack on his forehead and my right hand was massaging his carotid .. Dr. Ka Kan was attempting to insert a cannula to the child and the specialist was looking at the ecg moniter thinking and planning i guess..
This time we need the second approach.. which is medical treatment.. IV adenosin was given intravenously .. I was unsure of the dosage but the first dose was not effective enough eventhough the pulse rate decreses .. HOwever after some time and lots of adenosin infused.. finally the pulse rate settle at 111 beat perminute ..
The time was 8.30 pm and I went back to the emergency department and continue my work there ..
This morning I went to see the Loh in the ward .. He look a lot better then last night, jumping up and down the his bed .. His pulse rate has come down to 80 beat per minutes..
The plan for him was if pulse rate rises again, oral propanolol 10 mg 8hrly and amiodarone 25mg/kg/min for 4 hrs ..
If he develop SVT again and again after he was discharge then we had to place a pacemaker to fixed his heart rate ..

Currently I’m in the pediatric ward, and this week, I’ve seen a few rare cases but serious and life threatening… The first case was a 5 years old Malay boy named Sani (not his true name) who just graduated from his kindergarten and was awarded best student among his peers.. He came with 2 weeks history of vomiting associated with lost of stability and 5 days history of unable to close his right eye, drooling of saliva from his right mouth angle and loss of hearing from his right ear.. He was such a bride and cheerful kid and very cooperative when I examine him.. His farther who is and army officer was also calm speaking to me with a Kedah dialect. There was no sign of infection and no history of ear pain. His blood pressure and his blood glucose level were also normal… It didn’t strike me initially but the actual first important sign was vomiting… During my examination, there were loss of frowning at the right side of his forehead when I ask him to look up, and when I ask to see his teeth the right side of his mouth was sagging or look like the mouth of “Two Face” played by Tommy Lee Jones in the movie Batman …His father told me, at night he had to put his palm on Sani’s right eye because Sani can’t sleep as he can’t close his eye.. This condition is commonly seen among adult and we call it 7th cranial nerve lesion. It is due to either bleeding or ischemia of the left side of the brain or probably any cause of nerve damage along the 7th cranial nerve commonly seen among hypertensive and diabetic patient.. This boy is 5 years old.. So it’s like being Dr. House I was trying to identify the problem by asking his father few relevant question which I myself was unsure what I was looking for… While I was talking to him, then finally all the ward houseman, medical officer, specialist and head department came and I had to move a side as they wanted to examine Sani and talk to his father.. I was unaware that a CT brain of the boy was done and they already find out the diagnosis.. It appears that there was a tumor growing at the cerebello-pontine angle of the brain and the growing tumor has increase the pressure inside his skull causing vomiting… The cerebellum involve in stabilizing our movement and the 7th and 8th cranial nerve goes trough the cerebello-pontine angle hence causing the presentation Sani’s experiencing .. I felt so sad and felt sorry for him, the kid has a brain tumor and needed a brain surgery to remove the growth… We call Hospital Kuala Lumpur and they requested that Sani is to be transferred to HKL first thing in the morning … After all of them had moved away, I continue speaking with Sani’s father.. I felt so guilty for laughing and joking with him previously. He still remain calm,but I can see that he was trying to control himself and if left alone there be tears falling from his eye… It’s a man ego I guess… He understood his son’s condition and I told him that it’s going to be a long recovery period with physiotherapy… I wish him all the best before I leave for the next session…

all this time i always wonder … how does it feel not being able to fall asleep .. finally i do .. The time is 2.02 a.m and i’m wide awake .. despite lying down for an hour in my dark room .. finally decided to stop attempting to sleep ..

During my psychiatry posting .. we meet a bunch of patients with insomnia .. well clinically there are 3 types of insomnia .. intial insomnia where patient have trouble starting to sleep, then we have frequent disturbed sleep and finally terminal insomnia where patient have frequent early awakening .. dispite of sleeping late night before .. most of the time we attribute this with major depressive disorder .. well there are other criteria to full fill other then insomnia before we can come to a diagnosis of MDD.. do i have depression then .. hopefully not ..  heheh.. better make another attemp ..

good night everyone ..

Tomorrow i’ll be having my clinical exam for obstetric posting.. Before i go further just wanna warn you all  that my language is going to be rojak coz i just finish my speed study for tomorrow exam.. plan to sleep after this and weak up early tomorrow.. England will play againts serbia montenegro at 12 … it would be nice to watch but better sleep lah .. got to be clear on my priority .. tapi bleh plak tulih blog memalam nih kan .. saje lepas tensen kononnya .. 

Anyway, for the past 5 weeks i’ve been seen lots of delivery and diseases related to pregnancy.. some got admitted due to post date pregnancy, some got bleeding trough her vagina, some got hypertension during delivery, some got anemia due to poor diet intake and memacamla .. so we need to help these mother so that they can go into labour and deliver her baby.. like i said before, our job is to provide good out come of the pregnancy …

Semalam aku oncall ngan shangkeree sampai pukul 10 .. we were in the operation theater .. ade seorang ibu nih dia punya tali pusat tercabut masa kita cuba nak keluarkan uri(placenta) dia. Aku ngan shank jumpa dia kat dalam labour room then kitaorg follow dia naik OT kat tingkat 3. Bincang2 sikit ngan Dr. Leong dan Dr. Aaron then we wait for the anesteologist to insert epidural to numb the lower part of the patient… Mula2 aku ingat it’s goin to be a short procedure .. it is actually .. cumanya masa anesthetis to nak masukkan epidural kat spinal cord patient tuh which is between L4 and L5 kalau tak silap aku,, suddenly blood pressure akak tuh drop to 51/22 mmHg (normal bp 120/80mmHg) .. it’s not so good because she can die due to insufficient blood supply to vital organ like brain, heart, kidney and adrenal gland .. because of that we cant continue giving her anasthesia and have to stabilize her by blood transfusion.. a pine of blood already been transfuse tapi bp akak nih masih tak naik .. dalam sibuk2 tuh the second blood cannot be given to her sebab surat kebenaran pemindahan darah tak ditemui .. Oh my god .. benda nih jadi kat depan mata aku .. Dr. anes tuh repeatedly suruh prepare blood tuh tapi sister OT insisted of getting the consent letter first .. there are 2 issue which arise here .. both are medicolegal issue .. to give or not to give .. dengan kebijaksanaan dr anes tuh, after calling her consultant, bp patient tuh dapat di naikkan tanpa perlu blood transfusion .. she did mention that the bp wont remain high very long .. so blood transfusion must be done eventually .. the sister incharge did prepare the blood but i didn’t see any second blood transfusion .. we manage to put into sleep and Dr. Leong buat manual removal of placenta untuk keluarkan uri yg tertinggal kat dalam tuh …  it ended shortly afterward ..

Terlintas dalam kepala aku masa kat dalam OT tadi, betapa seorang ibu bersambung nyawa demi melahirkan seorang anak.. akak tadi bole mati kalau tiada tindakan pantas dilakukan untuk menyelamatkan nyawanya …

On seperate occasion pulak Kat ward aku, ada seorang pesakit yang mengalami tekanan jiwa selepas kematian anaknya.. Sekarang nih dia mengandung lagi dan dimasukkan ke ward sebab komplikasi kandungannya.. anak dalam kandungannya didapati menghidap kecacatan tulang belakang..

Kandungan ni pun hasil perkahwinan dia ngan suami kedua .. masa mula2 aku tak sedar dia pessakit mental sampai satu hari masa ward round ngan dr krishna, akak nih buat perangai gile dia.. then masa hari dia dijadualkan untuk pembedahan c-section dia lari ke hujung ward melaung-laung sampai hentak2 kepala kat pintu ward.. kesian dia, dia tak sedar ape yg berlaku sebanrnya … On daily bases, setiap kali aku pintas katil dia, dia pasti akan tegur aku .. ape yang aku bole buat hanya senyum balik dan balas sapaan dia ..

selamat hari ibu untuk semua ibu dan bakal ibu .. and mama i love you so much …   

It’s really something if we think that people are watching us all the time, but it’s nothing if we feel that nobody care about what we do.. The thing is we will never really sure unless what we do have some impact to other people life or atleast make people treat us differently, either better or worse.

This is the true fact about life. I should know better considering my involvement in campus politics when I was in UM. Being public figure means ur personal life is everyone’s business.. And due to that, you can never have a personal life and do what ever you want. Everything you do must meet what the public demand you to do or decide. Difficult doesn’t it. Feel like trap in the world that you build.

In a society, everything is everyone business.. It’s actually a good system to make us diciplin and obey the cultural norm. It’s just that it hurts when you were the one being talk about .. It creates some level of stress, and make things more complicated for you to solve. Thats why controlling information is very important. Knowing when to open ur mouth and to who, is important.. Especially sensitive issue like race, religion and relationship..

Everytime we talk, we either confronting our fren, enemy or an imposter. This is something we can never really tell hence problem starts when we talk to the wrong people..  You guys probably wonder why am i writing on this issue..

Well sometimes common issue need to be raised, cause we tend to forget things we dont recall ..

I just came back from ward teaching with Dr. Wong. It’s the end of 2nd week of my pediatrics posting. I planned to impressed Dr. Wong today so I wake up early and did some revision before seeing her. During our session, instead of giving her beautiful pathophysiology, accurate symptoms and sign, good provisional diagnosis and the differential, I end up giving unrealistic menifestation and odd diagnosis. What a luck la .. Thankfully Dr. Wong is a sweet lady, she just smile at me, probably thinking how ignorance I was. I don’t mind, atleast i voice out my opinion. People always said, Malaysian student are passive. Hopefully I manage to change that perception to Dr. Wong today.

Anyway, those are just the opening statement, what i wanted to write here is about these little people in the wards. As we know, pediatric involve children age from birth till 20 years old. The diseases I saw so far were different. NOt something we commonly see in adult or as for me during my surgical and medical posting. Most of them were admited for respiratory infection, as their immune system are not as strong as adults. There are other causes also like nephrotic syndrom, sle, swollen bread and other foreign body and lot more.

In the ward, I was assign to Siti, a 2 1/2 year old girl who had a maningomyelocele. In layman term, the lower part of her vertebrae didn’t fully develop hence her spinal cord is exposed to compression and if that happens, she might present with neurological disorder like unable to control urination and walking disability. A surgery was done last year to treat her condition however she develop symptoms of urinary disorder. Ultrasound scan was done and show that she had a hydronephrosis of the right kidney. Poor child, her right kidney is dialted and if we don’t help her she migh loss her kidney. Hydronephrosis usually develop due to unidentified obstruction of the urinary tract causing a prolong high pressure in the ureter leading to distended ureter and kidney. They were no KUB plain radiograph hence I was unable to see if there is any obstruction. Her mother told me that Siti frequently pass urine and there was no incidence of abdominal distension before. It is very unlikely to see a tumor in a child hence carcinoma that obstruct the ureter is very unlikely. BAsicly it don’t know why she develop hydronephrosis. 

Siti was admitted electively so that we can teach her mother how to insert a chateter or what we call a continuous bladder drainange (CBD). Siti had a neurogenic bledder where she was unable to control her urination habits, hence we teach her mother how to insert a long tube trough her urethra into her bladder so that siti will be able to pass urine properly.

While listening to the specialist explanation about Siti’s condition, suddenly a father of patient from the bed in front of us scream, doctor ! doctor ! help, my child, my child. I look at him as he was waving while calling for help. The medical officer who was with us attended his call together with me and 2 other staff nurse. At the bed, I saw his son was shakking. He had what we call a generalised tonic clonic attack (GTC). It’s a convulsion commonly seen in many situation mainly among epyleptic and high fever child. As for this child, he had it due to fever which we call a febrile convulsion. Dr. Cindy hold the child and infuse diazepam trough his anus and shortly the convulsion subside. Then we gave him oxygen to ensure adequate oxygen supply to his lung. INsyaAllah he will be fine.

There are lots of nervous parent in the ward. I guess it is their normal nature. LAst night we had another convulsion attack from a different patient and the mother cried. In the morning, i had a mother who blame herself, thinking that  she cause her sons to be ill because she breast fed him, and in the afternoon while in the pediatric clinic, there was a mother who blame the madical staff for what she perceive as negligance that causes her daughter to suffered from cerebral palsy. As parent, i guess i can understand why there very irritable. Who doesn’t, if someone you love and care so much, fall sick, you also fall sick right !.

I do realize all this before I enter this posting and I was worried that i might not be able to clerk a single child because their parent might chase me away. However things wasn’t as bad, they welcome me to see their children and allow me to examine them. Perhaps thats is the kind of trust you get by wearing the  white coat. Eventhough i might not be able to treat their child, atleast i’m there to listen.