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Sunday, April 23, 2017

My First CSE

Assalammualaikum
Sorry I've been lazy and not updating my blog as frequent as I wanted to.
Today is a special day.
My first attempt at CSE (Combined Spinal Epidural) anaesthesia and I nailed it!

I did it under Dr R's observation and I was extremely nervous.
Thank God my hands did not shake as much as they did when I first attempted spinal anaesthesia under her supervision - she was assessing my competency at that time.

I know this is too much of a jump - I have not talked about my relocation, my current department and all.
I am quiet in a rush now, couldn't afford to write much.
But since today is a special day - my first CSE attempt - hence I feel very compelled to type them out.
Enough to say I am now an Anaesth MO in a small district hospital in Johor.
Yes, Johor.

Hiks.
'til then!

-Because life is a test-

-AkMaR-

 http://nur-akmar.blogspot.com

Thursday, March 16, 2017

My first CVL

Assalammualaikum!

It is already very late now - 11.19pm
I have a flight to catch tomorrow morning yeay! I'm going Sarawak for Fatin's wedding :D
Fatin married a BBC - British Born Chinese weewitt

But because today is one of those special days in my career, I decided I need to pen them down (or type, in my case)

So today, I was put on ICU duty, instead of GOT due to the lack of manpower in ICU.
And today also was my first time inserting a Central Venous Line (CVL)!
To non medical people, a CVL is a catheter (maybe "tube" sounds more familiar) that we insert into the body so that the tip of the catheter will lie in a patient's heart.
Yes, heart. The right atrium to be exact.
And we have to be careful to put into the vein, instead of the artery.

So today I inserted a CVL through a patient's internal jugular vein (that is the vein in our neck) - via US technique. 😆 😆

I know the older generations in medical would have laughed that I am so proud with this one CVL - they have inserted numerous during their HO years. I got my first only after I become an MO.

But, so what?
At least I have inserted one.
And this will certainly help me in future :)

So thanks Farid, for guiding me thru the insertion of CVL.
And Danny for being there, as an amateur as well hence I kept telling myself all the mistakes I did, are for me and him to learn 😀 😀

And I dont mind mentioning their names here - they don't even know the existence of this blog.


This is the check xray of the patient. We need this to ensure that the tip of our catheter is
nicely placed in the right atrium, not too low neither too high.
Til then!
Oh and I'll try to blog about my 48hrs Kuching trip :)


-Because life is a test-


 -AkMaR-
 http://nur-akmar.blogspot.com

Friday, March 10, 2017

Have A Little Faith

Assalammualaikum.

I've always loved Mitch Albom's work.
I feel that they are always very inspiring, funny and resonates well with our real lives.
And they are usually expensive - relatively, compared to other thicker books.

In every bookfair, I will always look for Albom's books.
I'll buy them if they aren't too expensive.
And during the last Big Bad Wolf book fair in Mines, I managed to get hold of one; titled Have A Little Faith - which cost me RM12.
Not too bad.



This book is well written, and it teaches a lot of life values.
However it is so very Jewish and Judaism-ish.

Albom's previous works are stories about his dying professor Morrie and his last words and life lessons. This book talks about his Rabbi - affectionately known as "the Reb" whom he knew from when he was a little boy but only recently reconnected with, when the Reb asked Albom to write his eulogy.
Let me give you a little bit of spoiler - it spans for more than 8 years, this book.
He describes how he grew closer and fonder of the Rabbi, the very being he was so afraid of and always avoided when he was young.

He described how well mannered, patient, peaceful, determined and kind hearted his Rabbi was.
The Man of God - that's how he always describe this man.
And I really really admired this Rabbi character - and I silently wish we have more Islamic preachers with these characteristics.
He keeps track of people in his congregation, made phone calls to the respective families when he heard of any weddings / child birth / deaths within, if he cannot attend the function.
He does house visits until he was too old to do so.
And he was well educated as well.

I like it that he MAKES phone calls, a rather dying trend of our society nowadays.
We WhatsApp, message, emails - which are actually not real conversations.
We can misunderstood and hid emotions with written conversations. We can always add "Haha" at the end of any sentence, to make it sound better, even if the sentence before might break our or the receiver's heart.
But when you call, you can hear the person's laughter, sorrow or even silence when the person at the end of the line tried to swallow her tears.

And anyone who have read my blog long enough will have noticed - I hate Zionism.
I hate them for oppressing and occupying the Palestinian lands illegally - and they hide behind the name "Israel" - which also equals to Jewish.
But not all Jews are Zionists though.
And the main character of this book is the Reb - someone of a different religion with me.
Someone of the religion that the Zionists hide behind.
Anyway, this sentence of mine can be politically challenged - lets put that aside for now.

The writer also talked about Pastor Henry Covington.
A determined, dedicated Christian pastor who was involved with lots of crime during his younger days - including drugs and was also jailed for some time.
And he formed and became the pastor of the My Brothers Keeper's Church - and has turned a new leaf. He described the man very well, and I believe Pastor Covington IS a miracle and a living proof  of what determination and faith can bring into a person's life.

Albom managed to make me fall in love with the characters, but of course, not the religions.
Most of the teachings are the same anyway, the Abrahamic religions.
Hence there was no reason for me to fall in love with the religions.

I hesitated though during the process of reading the book.
It took me more than one week, not because of the hesitations but rather due to the limited time I had.
And I thought of stopping myself from reading this book as it was too Jewish.
Will it benefit me more if read a more Islamic book instead?
Will this put me in the danger of Shirk?
I kept my mind open though - I am reading this book for the sake of reading it, and I already buy it anyway.
I will not let the book shakes my faith in whatever way.
And of course, it didn't.

I was very much absorbed into the story half way thru the book.
In fact, it taught me a lot about life and perseverance and having and keeping that strong faith.
And I am glad I did not stop reading it - just because I am scared it might make me turn my back towards Islam or, what will other people say if they know I read these kinds of books?
I was quite disappointed - oh why is Albom, the writer I admired is a Jew? I can accept him being a Christian or Hindu or Taoist. But Jewish?

But, come to think of it again, that was silly ain't it?
To think that my faith can be shattered from reading a non-fiction, non-biased book?
How thin was my faith?
If anything, after reading this book I felt my faith towards Islam just grew stronger.
I now have a better and more imaginable character to adopt into my life.
And I look forward to Albom's other works.

Let me end with a quote from the Reb

“Mitch, that's what faith is. If they spit in your face, you say it must be raining. But you still come back tomorrow.” 


-Because life is a test-



 -AkMaR-
 http://nur-akmar.blogspot.com

Thursday, March 9, 2017

Anaesthesia MO

Assalammualaikum.

Today I was scolded, or rather cynically told off by an anaesthetist.
She came in while I was looking at my phone during the surgery.
Perhaps she wasn't pleased with it - but to be fair I wasn't looking at my phone the whole time.
She came during that time I was looking at my phone, answering texts.
My luck.

It was an expected long operation - at least 5 hours.
Hence the anaesthesia practitioner MUST be present and continually monitor the patient.
I WAS monitoring the patient.
But I am still very junior in this field, there are still many things I don't know although I admit I should have studied more these past few weeks.

She then started quizzing me.
How do we calculate the fluids requirement for this patient?
Do I know the difference btw fluid maintenance, fluid deficits and fluid loss?
How do we calculate?
Fortunately, very fortunately I still have my HO-time note book in my pocket.
And I could produce a very good well calculated fluid regimens for her.
She complimented me for it, thank God.
But she wasn't happy that I did not calculate it before she comes in.
Hmm, some of my seniors will always skip this part hence I dont routinely calculate them - perhaps now I have to start practicing the good practice, and not just the routinely done ones.

The next question was on perioperative monitoring.
What do we monitor in long operations?
I could answer but I could not really tell the indications behind it - eg temperature monitoring.
Why is it so pertinent for us to monitor temperature in long standing op?
I know we have to avoid hypothermia, but why?
I know hypothermia reduces metabolic rate and sort of slow down our body, but I can't provide a proper answer for that question.

Well later on I found out that there is this thing called the Lethal Triad: coagulaopathy / hypothermia / metabolic acidosis.
Hypothermia leads to coagulopathy and met.acidosis which will in turn aggravate the met.acidosis and coagulopathy.

She then said something about Anaesth is a difficult field, people always think we sit idly during operations, but actually it is very difficult. She said I should read more, and not just sit down looking at my phone - right to my face.
And she walked off.

I felt so bad.
I felt so guilty
I felt like a disappointment.
My mood was so low the whole day. I did not dare to look her in the eye after that.
She was so nice to every other MOs - perhaps I have not gained her trust.
And from what happened today, it will be harder for me to prove myself.
I do not hate her. I brought this upon myself.

To make things worse, I woke up late this morning and was rushing to work.
Hence I accidentally wore sandals to work - instead of a proper pair of shoes.
And I have to go out to wards and do pre operative assessment for patients having their op tomorrow.
That made me feel even less professional - going around the hospital with sandals.
And I left my stethoscope in the car - which really, added salt onto the wound.

So now, I am sitting down and reading about anaesthesia concern on the types of operations I'll be doing tomorrow - the ENT list.
I hope I'll do better tomorrow.
And will regain the confidence I lost this morning.

-Because life is a test-



 -AkMaR-
 http://nur-akmar.blogspot.com

Monday, March 6, 2017

The not-so-wise tooth

Assalammualaikum.

People call the human third molar as the wisdom tooth.
It really is, a misnomer - as it is no wiser than my other teeth.
In fact, I think it is even more brainless than the others.
Why bother come out when you don't have space to - and make my life miserable past 5 yrs and now worse past one week.

So I had this wisdom tooth that started to appear some time before I continued my degree in the UK.
In UK, I think it was infected TWICE - within 3 years time.
I THINK it was infected, because I did not go to see any dentist there.
You see, somehow dental health is not included in the NHS free service (at least that's what people tell me)
Hence each visit to the dentist will cost about £20 - 30 - and thats more than RM100 - for a simple check-up, excluding the procedures or medication.
Thus I kept the pain to myself, gobbled down Paracetamol and it went away.
The first summer break in Malaysia, I skipped going to the dentist.
When the infection happened the 2nd time in the UK, I swore to myself that I will make it a point to visit the dentist in Malaysia when I get home.
And I did.
I just can't remember what the dentist did. I think she gave me an appointment date that I was not able to keep.

And then it wasn't so painful anymore.
Only some time it started throbbing and will usually go away after I brush my teeth so hard that my gum bled.
Then during my houseman year, it got infected again.
Not having time nor the luxury to go to the dentist, I kept the pain to myself again.
Earlier this year, it got infected again.
It was so painful and I was blessed to meet this one nice senior dentist in the hospital, that I asked for her help. She asked me to come to the clinic any time I can make it.

The first time I went, she said my wisdom tooth was impacted and inflammed.
But not infected - hence she prescribed me only Clorhexidine mouthwash - no antibiotics.
She also kindly asked her junior to do scaling for me. My God, it was soo "ngilu".
And then she asked me to come when it is not painful anymore.
I felt like crying - how can the pain go away if you are giving me only mouthwash?
I felt the pain was different from the pain I had before.

But it did went away.
One week later, I showed up again at her clinic.
She had another quick look and asked me to set an appointment with the dental asssistant, at a time convenient for me.
She will have to extract the tooth, if it is a simple procedure, I will get a 1 day MC.
If it's a complicated one, I'll need 3 days MC, as it will my face bengkak.

So I had to postpone the procedure until I completed my housemanship.
I won't be able to get a 3 day MC during my housemanship - it is just difficult.

So, I had the extraction done last Monday 27.2.17
She had a look and was saying things like "opening flaps", "making incisions", "gutters" and stuff - and she looked at me like I understood what she was saying. Oh come on, I'm a medical doctor, not a dentist.
I know what those words mean but I can't imagine the procedure.
But anyway, I simply nodded.
I felt so much in debt with her - and she's so nice that I do not wish to trouble her.

The extraction itself was horrific.
It wasn't painful but the sounds of the machine all scared me.
She was being very considerate and kept asking if I was in pain.
She injected a very generous amount of local anaesthesia that I didn't feel any pain at all - just some pressure.
But it turns out that my not-so-wise tooth was very big and angled in such a way that she can't simply pull it out even after cutting the gum open, making a flap and gutter and what not that I heard her saying to her junior while exploring in my oral cavity while I quietly trembled in fear.

She had to call the Oral Surgeon to come and help but the surgeon was preoccupied at that time.
When you're in this line long enough, you know that when people started seeking help, things are not going as smooth as you hoped. Well, not to scare you lot but it's the truth.
Be reminded though, informing the superior and asking for help from the superior are two different things.

In the end, she had to break my tooth before pulling it out.
Sounds gory eh?
Imagine hearing the grinding machine, working it's way in your mouth.
And my jaw was so tired of keeping my mouth open, I wished someone can just help hold my jaws open. The bigger the better - clearer field for the dentist.

So after pulling the little demon out, she had to suture the flaps back.
And I got a 3 day MC.
My appointment was at 9.30am - post breakfast.
I finished everything - including taking the meds from the pharmacy at about 1pm.
And I went straight home and sleep.
It got so painful as the local anaesthesia effect is slowly fading.
And the oral painkiller needed time to take effect.
I skipped lunch and by the time Akmal comes home that night, I was famished.

The next day, I had porridge for all my 3 meals and I was so much on top of the pain.
I took painkiller on time, and ate only soft food.
I was so pain-free and was certain can do the procedure again, if needed.
On my last day of MC, I started eating macaroni, and all was well.

Only on Thursday, the first day I started working - that the pain kicked in like crazy.
I was so much in pain I felt like crying all the time.
The throbbing pain comes and go.
When it comes, I felt like punching my face hard, right on the spot near my jaw where the tooth was so that it get numb.
I practically lived off Paracetamol, Ponstan and Ibuprofen on Thursday, Friday, Saturday and Sunday.
I asked Akmal to have a look at it a few times, and I made him explore around using a cotton bud which I really regretted after that as it worsen the pain and I had to push my cheek on my palm so hard against my pillow to sleep that night.
Last night it was unbearably painful that I had to skip dinner (but I had Manhattan Fish Market for lunch haaaaaa haaaa 😂😂 ).

And today was my appointment day to remove the sutures.
The day I've been waiting for since Thursday.
I did not want to go earlier since I did not want to be a burden.
I have used my privilege as a doctor enough, going straight to the clinic without having a proper referral letters and being able to call the clinic and change appointment dates to suit my schedule, and even had all the staff in the clinic calling me "Doctor" as I pass by - "Doktor, kumur mulut sini" / "Doktor, sakit lagi tak?" etc etc
I didn't want to be a crybaby hence I waited for this day.

And it turns out, the gutter, or the socket where my tooth sat was very deep.
And I had food particles stuck there.
And bacteria were happily feasting on them - hence the pain.
The dentist flushed the socket using syringe and taught me how to do it myself.
And they found some small pieces of broccoli in there (I was so embarrassed at that time - I had it during lunch ytd) 😳 😳 😳 😳
"Doktor makan broccoli yeeee" - said the dental assistant.
Hilang ayu oi.
But I did really gargle as hard, if I can describe it that way, as I can after every meal.

Anyway, now the pain is improving although it is still there.
If anyone were to slap my face now, I'll throw that person out of the window for the pain of the slap will cause more than skin damage to me.

Okay, that's enough for now.
I hope when I re-read this post in a year time, I will remember how painful it was.

And see, I wrote a 1000 words essay on "Removing My Teeth"
Hope this didn't bore you!

p/s: I know the wisdom tooth and the wise tooth ARE different.

-Because life is a test-

There. The size comparison of my teeth vs left index finger

 -AkMaR-
 http://nur-akmar.blogspot.com

Saturday, March 4, 2017

Korean Dramas and Their InfluenceS

Assalammualaikum.

I'm not proud of it but I have to admit that I am a fan of Korean dramas.
I must say, it has taken my free time away. I used to use them to read books.
This Halyu wave first came to Malaysia in 2004 I think.
I was form 3 at that time. The first few K-dramas were Full House, Stairways to Heaven and Winter Sonata.
I remembered SIGNING a contract with Mama - I get 3 hours of TV time per day but if I don't do well in my PMR trial, I will be left with only 1 hour.

Those 3 hours were for:
2 -3 pm Korean Drama at 8TV. Jewel in The Palace was aired at this time.
6 - 7pm Cantonese Drama on TV3
7 - 8pm Cantonese Drama on either TV2 or TV3; whichever more interesting. Later on, 8TV started airing Korean drama during this slot.

I did manage to keep my 3 hour TV time that year ✌

Korean dramas have their own attractions - those good looking actors and actresses are definitely their biggest magnet but they also have good scripts and storyline.
The plot - although sometimes predictable, is good and always some form of lessons in it.

The Theme

Each drama has its own theme and the story is made up revolving around this theme.
Descendants of The Sun - soldiers
Goblin -  supernatural world within our world
Jewel in The Palace - herbs, medicine and the kitchen of the palace




And each theme has substance.
Although they sometimes don't make sense eg the drama Emergency Couple where they made intern doctors working in the ED as the theme (I can assure you we don't have time to brawl over petty things in the hospital cafe if we're in our ED shift) but they are not vague either.
They showed the hours spent in the kitchen / military training / lectures and stuff.

The Script and Acting

Efforts are also put in to make the scripts real
The dialogues were carefully strung together.
And the actors actresses were convincing when they said it (of course, not ALL of them).

The Cons?

But let's face it.
The story itself is unreal.
How can they have so much time, to always hang out in a cafe (each drama will have its own cafe sponsor hence ALL the cafe scenes will be in that cafe, dal.komm cafe for instance - it appears million times in Goblin / DOTS )



The actresses don't do dieting - they eat everything from fried chicken delivery in the middle of the night to soju and BBQ chicken in the middle of the day - yet they are all so slim and thin and some were even muscular.

They are always doing exciting things. They are not even glued to the screen, watching K-dramas.
I always think, is this how life is in Korea?
They have time to go grab coffee en route to work?
They ride buses and tubes to work - only the rich has cars.
They walk around the beautiful parks.
They cry at the Han River banks at night when they are sad?

But how come I don't get to do that?
How come I am just so lazy to go out of the house to have a nice and peaceful tea time at the nearest cafe?
I rather stay at home - and watch Korean dramas, and watch them do all the things I wish I can do. The irony 😒

Anyway, I think I have to reduce my TV time now.
I have more than 3 hours per day of TV time nowadays, on my off days - which is really not good.

But then, with the increasing price of everything won't it be cheaper to just stay at home?
I pay a certain amount for my internet bills, no matter how many hours I stream every day.

Oh well
Til then,

-Because life is a test-


 -AkMaR- http://nur-akmar.blogspot.com


Thursday, March 2, 2017

Apple Support

Assalammualaikum.
So yesterday I talked about my silly blunder - deleting 80GB of my files
Saying "silly" makes it sounds cute.
It isn't really.
I really feel stupid and angry and disappointed at myself for losing 7 years worth of files.

So yesterday I set up an appointment time for Apple to call me back for technical help.
I made it at 7pm and completely forgotten about it.
Today, on the dot at 7pm - I received a call from a Singaporean number.
Then only I remembered it must be from Apple.
Once I picked it up, a computer generated voice greeted me - Press 1 if I would like to speak to their technician or Press 2 if I would like to reschedule the call.
Convenient eh?

So I chose 1.
And the call was directed to another operator that says something like I am in a queue and will be entertained shortly.
I have been wondering since yesterday - who will I be talking to?
American? Or Asian? Or better, Malaysian?
Will I be charged for this call?
When I first saw the Singaporean number, I was relieved and disappointed at the same time.
Relieved because it will be an Asian person talking to me but disappointed - why isn't their call centre in Malaysia??

Anyway to my surprise - the person on the other end of the line was an American man (from the accent)
And throughout the phone call, he was being really nice and understanding.
It's been a long time since I speak purely English - I've been mixing Malay and English + Chinese a lot in Malaysia (and proud of it).
This man's choice of words were very pleasing and professional.
He kept saying "Aaah yes, I understand", or "It must be hard on you" "Oh yes I did that once as well and felt really bad myself" bla bla bla.
I can only think that he must have undergone a really good customer service training.
He might not mean what he said (Yes, they are mostly very superficial) but it is very comforting to hear.

I kept comparing him to the many many Malaysian telephonists I've spoken to.
Although Malaysian telephonists are helpful, they are not generally friendly and understanding.
They are almost robotic, and sometimes even challenging or laughed at us.

At the end of the conversation, he was trying to tell me that he can't help recover my files - he very aptly put in a sentence - "Well this is a very good lesson and experience for you. Next time you will know exactly what to do and have the power to decide how you want it to be done"
So customer-servicey kan?

OK lah, that's all for now.
I have to come to terms that I will not be able to recover my 80GB worth of files.
To be honest, I do not know what I lost yet.
I think I must have lost all my travelling pictures.
As for documents, I will feel the pinch when I need them later.


-Because life is a test-


-AkMaR-
http://nur-akmar.blogspot.com

Wednesday, March 1, 2017

That blunder

Assalammualaikum.

Just a quick update.
Recently (about a month ago), I had a major problem with the internal HD storage space in my Macbook.
I was left with only about 2GB space.
Naturally I fiddled around and re - discover iCloud.
I've always had this uneasy feeling with online storage - I feel as if I risk exposing everything to the public if I were to store my files online. Hence I've never really explored iCloud.

But this time I was desperate.
I need the storage and my external HD wasn't working well.
So when I actived iCloud in my Macbook, it automatically transferred all my files into iCloud.
Then I found out that I only get 5GB of storage in iCloud for free. It won't be enough anyway. If I want more storage, I'll have to buy them.

Naturally, I did not want to pay.
Little did I know, it actually did not "copy" my files from Macbook to iCloud, it "moves" them.
For those of you who are used to these terms, you'll know what I meant.
It means I only have one copy of the files.
And I - like a fool - deleted those folders from iCloud (I thought there were two copies! One in iCloud and the other in the local drive!)
And suddenly I have 80GB of free storage left.
80 GB!

It took me a while to really understand what was going on.
I deleted 80GB worth of files and folders.
It was everything on my medical school years.
My eBooks, my lecture notes, my pictures, my working documents, every single thing.
I am now left with only songs and some pictures going 2014 backwards (I kept them in a different folder).

I downloaded various types of files recovery apps, but they couldn't help.
Until about 3 days ago, I re-re-discover iCloud.
And realised to my horror that,I did not delete my files from my computer.
I deleted them from iCloud! I should have used iCloud to recover them.
And iCloud allows recovery of deleted files up to 30days from the day we deleted them.
But I could only recover ONE eBook - my Lippincotts Pharmacology eBook :(

And now, I have been spamming iCloud support page to ask them if they can help me recovering files deleted past the 30 day grace period.
Wish me luck!


-Because life is a test-



-AkMaR-
http://nur-akmar.blogspot.com

Tuesday, February 28, 2017

Completing Housemanship

Assalamualaikum.
So I finally completed my housemanship last week, albeit being 2 months later than scheduled.
Wednesday 15th Feb was my last day.

For those who don't know, doctors in Malaysia have to first complete a 2 year training program before they can be a fully certified doctor.
Within these 2 years, we rotate through 6 departments; 4 months each. If you're deemed competent u'll complete within 4 months and move to the next dept.
If not, they'll extend your rotation for 2 months and u can only be extended twice before being asked to transfer hospital for a final assessment.
And during these 2 years, we are called HO (house officer).
After completing the training, we are called MO (medical officer).
I need to remind though, a house officer is still a doctor.

So how did my last day as a HO differ from my first day as an MO?

Well superficially, I brought a more fancy sling bag.
On Wed I brought backpack but on Thursday I brought my leather-like sling bag.

But apart from that, it did not differ much

I worked in the Emergency Dept for one day as an MO.
The next day, my appeal to float in Anaesthesiology Dept was approved :D
Hence since then, I am an Anaesth MO.

I used the word "float".
That is the term used for us who have finished our housemanship and is waiting to be transferred out.
In some hospitals, we can choose which dept will we like to float in. My place however, doesn't seem to be that flexible. We must float where they want us to.

Most and especially HOs in Klang Valley will be transferred out of Klang Valley once they complete their HO ship.
I applied for Melaka, however I am placed in Johor grrr..
I've since sent an appeal letter to KKM to be posted in Malacca and is still waiting for the reply.


-Because life is a test-


-AkMaR-
http://nur-akmar.blogspot.com

Wednesday, December 21, 2016

Leaving Time

Assalammualaikum.

I saw this notice on the board at my condo lobby two nights ago.


That means I will be living in the Stone Age for 3hrs on the 20th.
Why did they have to pick THAT day?
The day that I get to spend my day at home, since I will only start work at 9 at night.

I thought of millions things I wanted to do but couldn't.
The thoughts of not having a rotating fan above my head, can't switch my TV on, my WiFi will be off, I can't charge my phone, if I watch movie on my Mac- before I could finish the movie, the battery might have died - they all almost suck the life out of me (this is clearly an exaggeration).

So I imagined bringing my Macbook to Dal Komm in IOI City Mall - so that I can sit there and have a cup of (overpriced) coffee and look cool - perhaps with my erphones on. But I was too lazy.
I also texted Shuhada, asking her out. She can't make it.
Heck I even considered going to the hospital and help Alia screen little babies.

Instead, I made one of the wisest decision I made this week.
I picked up this book I bought from Big Bad Wolf last week.
And walla~ 36hrs passed and I finished it.


I have so many things to write about.
This is my list:
1/ Big Bad Wolf book fair
2/ My 2 years as a house officer
3/ My extension - one of the many things that made me doubt my career choice at the moment
4/ Shopping and cosmetics - a trend I see nowadays
5/ Korean dramas
and a lot other things

But since I have just finished the book about an hour ago, it still very fresh within me I feel so manic now.
For the past 36hrs, I almost feel like I'm living in the world Judi Picoult describes.
I long to read and explore further, and finish the book - to know what happens to each and every characters.
If not for my night shift last night, I might have finished the book in less than 10hrs.

This is a story told from the perspective of 4 people - Alice, Jenna, Serenity and Virgil.
And it amazed me how Picoult managed to wrap the stories nicely with lots of academical facts about guess what - elephants.
Alice is a woman who took Neuroscience for her undergrad degree - and later on became a scientist studying elephants.
This is her story, and Jenna's and Serenity's and Virgil's - and how their fates intertwined with each other. How they see each other and the events that occur around them.
This book not only made me feel like wanting to be an elephant researcher, it made me long to go to Africa and touch those elephants.
It talks about how elephants interact very much the same way as we humans interact with each other.
And the science and debate behind it since we can't actually quantify emotions.

It astonished me the amount of work - researches and readings that were needed to produce this book.
If Malaysian community can produce these kinds of authors / books, we would be very blessed.
- I see most of our artworks now are plain imagination without any substantial effort put in it. Even CPR is portrayed so wrongly in our Malay dramas - enough to make me shudder in embarrassment just by watching it.

I can go on and on talking about this book.
But I dont want to give any spoilers here.
You should read the book, and you'll agree with me.
The amount of work put was enormous.

Btw, why did I write about this?
While I was going thru my previous blog posts, I stumbled upon this .
The post I wrote on The Lost Daughter book, by Diane Chamberlain - in June 2014.
Truthfully speaking, I can't really recall the storyline but since I wrote about it, I figure it must have been a good book. Hence I looked for other Chamberlain's book during the Big Bad Wolf book sale 2 weeks ago.

Therefore writing about this book now not only introduce this book to my readers (if I still have any) - it will also help to remind me in years to come that I was once captivated by this story - Leaving Time.
The ending totally blown me away and I literally had goosebumps while reading the last chapter.

I don't usually read a novel twice - but if I had gone out of fresh unread book supply, I shall remind myself that I might want to read this again.


-Because life is a test-


-AkMaR-
http://nur-akmar.blogspot.com

Monday, December 5, 2016

Growing Up

I’ve been married for 6 months now.

6 months!

And I’ve moved out of my mum’s house into a rented apartment with my husband (even saying “husband” out loud is still weird for me sometimes)

So yea, since I started working 10 months ago, my life turned upside down.
I got so busy with my more-than-80 working hours every week, losing my social life; missing birthdays, weddings and gatherings (not yet funeral, though!)

I was very fortunate that my workplace is near to mum’s place and mum has a maid. So 6 months ago, my clothes and food were catered for.
I woke up to a breakfast (or at least a packed breakfast) and came home to a dinner, with my clothes ironed for me everyday.
I need not do the laundry, my room was vacuumed every week and my off day (only one a week!) can be spent sleeping, without worrying about marketing, cooking or washing.

So you can imagine how worrying it was for me thinking how life would be after the wedding, and the moving out.

6 months fast forward, I am still surviving, well.

I managed to do my laundry.
I cook once in a while.
I iron our clothes every week.
I managed to clean the toilet once a week or so.

My apartment is not full of stacked papers and files, unwashed dishes and piles of unwashed clothes hidden in corners or under the bed.

I don’t know how I did it.

Lots of help from dear husband of course.
And of course too, my mum and maid come by once a month for a few hours to help me with the ironing and floor mopping.
It may also be because I have become a bit more accustomed to this busy house officer life, so I was not as exhausted as when I first started working.

But hey, I still manage it, without going crazy or having a fight with dear husband.
Some supposedly modern feminist might say, why do I put the responsibility of taking care of the household on me?
Well, I was thinking about it too.
Islam has never said the woman of the house is responsible of the house chores.
But why do I feel that the duty is on me?
Well I suppose it is because the society has drilled it upon us.

Thank God, Akmal is far from the male-chauvinist type.
He would be the one putting our groceries into the fridge while I change.
He would be the one folding the clothes while I iron our working attires.
And he would be the one choosing chickens to buy in supermarket :-D

Of course, there were still times when we forgot to throw our garbage in the kitchen, that when both of us got home exhausted from being oncall, the smell of “fermented garbages” welcomed us. We swore to ourselves not to forget throwing the garbage, EVER AGAIN.
And the times where we were so tired to cook that we called pizza for dinner (I so hope restaurants start delivery services for nasi goreng, nasi lemak and those sorts).

We are still learning, and growing up.

-Because life is a test-

THIS POST WAS ORIGINALLY POSTED ON 20 OCT 2015 IN MY OTHER BLOG WHICH WAS CREATED WHEN I LOST ACCESS TO THIS BLOG


-AkMaR-
http://nur-akmar.blogspot.com

Saturday, December 3, 2016

Owning Only One Car

Assalammualaikum

Currently Akmal and I are using only one car.
We are sharing his red Proton Saga.
I returned the Kelisa I've been using since my A Level years to mum, and now my sister is using it for her class.

The plus point, I don't have to pay for car loan.
The minus point (but can also be the plus point), we always have to take turn to use the car.

Say...I work morning shift (until 5pm) but Akmal works long shift (until 10pm), that means I will drive the car home at 5pm and come back to the hospital to fetch Akmal at 10pm. If he finishes his work late (which is usually the case), I will need to wait until he finished his work.

Same goes if I work long shift and he morning.

If we have two cars - one of each (I've always fancied a Honda Jazz :-D), I can go home at 5pm and perhaps cook dinner while waiting for dear husband to come home.

But, if we have two cars that means in the morning both of us have to drive off separately.
We wake up at the same time, go down the apartment at the same time but drives off separately and look for a parking space separately. Not only it takes the already limited parking spaces but that will also mean Akmal and I will have less time together.

The journeys to and fro work are the time where we update each other - considering the busy schedule we have as house officers*.
I can't imagine having to drive to work separately.

So maybe...I'll hold off my Honda Jazz for now.
I can't afford it yet, anyway

- Because life is a test -

*This post originally posted on 15th Dec 2015.
In a diff blog, when I lost access to this blog*


-AkMaR-
http://nur-akmar.blogspot.com

Friday, December 2, 2016

I am sorry I can't save your baby

Assalammualaikum.
Okay so now I am almost at the end of my 3rd posting; Obstetrics and Gynaecology.

Obstetrics is when women pregnant more than 23 weeks are concerned, while Gynaecology deals with all women (physical) women-health problems, and if their pregnancy is less than 23 weeks old.

Get it?

You know in the movies and dramas where when a woman lost her pregnancy in an accident or something, the doctor will come up to her and say, "I am sorry we lost your baby" - in a solemn, empathic, guilty face?

I am very sorry to say it doesn't happen like that in real life.

Most women I met during my Gynaecology posting are women who have just had a miscarriage.
The foetus they carried just died - like that. Gone.

Most of the time, these women might be pregnant for 8 - 10 weeks (that is 2 months you know) and then they had a PV bleed and when we scanned, there is no foetal heart. The foetus died.
And we simply say, "The foetus doesn't make it" or in Malay, "Baby ni tak jadi"
And we take it scientifically - the sperm and ovum met, fertilised and divided. But the mitosis that happened may have gone wrong, the chromosomes that resulted is not compatible with life and the cells degenerate. That is the most common cause of miscarriages.

But to the woman, the thing that have died are not just cells.
The thing they carried in them were their babies - who they might have been very excited about. Who they might have imagined what gender could it be, how to call the babies, how should the babies call them - Mama? Papa? Daddy ummi abi?

To avoid having to deal with their emotions, I noticed that we tend to shut our emotions away from it. And by "we", I meant doctors.
What do I do if this woman in front of me broke into tears?
I have like 3 other women waiting outside the door, that might have had a miscarriage as well.
Can I afford to tackle this woman's tears? And all the women after this?

So I noticed that what "we" usually do is to say - "the baby doesn't make it"
And let the woman's family deal with her emotions - usually her husband is outside the door as well. We will call the husband in and explain.
We give them an appointment date - to rescan and the foetal heart is still absent, offer her a treatment - to remove the dead cells surgically or medically.

It's all so scientific.
There is no emotion.
But if i were to put emotions in dealing with all my patients - won't it be too tiring for me?
I will be sharing emotions with 20 sad women a day - everyday.


I am sorry your baby died, there is nothing I can do to save the baby, I know this is hard for you but you have to accept this, you can try again.


-Because life is a test-

*This was originally written on 8th Dec 2015. The time when I lost access to this blog, hence I created another blog.


-AkMaR-
http://nur-akmar.blogspot.com




Thursday, December 1, 2016

Weddings Here and There

Assalammualaikum.

Few years back, my phone gallery used to be full of outings or lecture slides that we were too lazy to copy on paper - but ended up not copying them pun at home.

Once I started working, my phone gallery became full of foot ulcer pics, scans and xray images.
You wont want to start scrolling through my gallery. My younger sister almost cried seeing the gory pictures.
Not to forget, the weekly timetables since sometime the timetable of the week was changed so many times we have many versions of it.

I am wiser now.
I've disable the auto-download feature on WhatsApp. That means I can choose not to download those gory pictures.
And I make it a point to delete those pictures every few months.
So I dont have that much of them now.

I went thru my phone galleries lately.
And I noticed there were so many wedding pictures.
My circle of friends is expanding.
People I know is getting engaged / married.
I used to go to my parent's friend's children's wedding.
Not anymore. I now go to my friend's wedding.

So these are the collection of weddings Akmal and I attended since our own wedding last April.

Of course, we shall start from my very own wedding.

11 April 2015


22 Nov 2015
Zawanah and Izzat's wedding.
They were both my seniors in my workplace.
People say they err got closer during Orthopaedics posting - which was my first posting.
And I was so clueless!




The house officers and little ones!

Syaira, me and Alia.

2 April 2016
Syahidah's wedding.
My 3 year housemate in Preston.
I don't know when she get to know this man, she was always very secretive 😒


Ibrizah and husband. She got married too in Singapore but I couldn' make it 😞


Well, as usual. Bobby @ Zulhilmi was Syahidah's photographer too

30 April 2016
Akmal's INTEC mate wedding
@ Perbadanan Putrajaya
- well I don't know much about this couple but I think they know each other from HACC - a club focusing on outdoor activities in INTEC.
I've never actually seen Akmal interacted with his peers for so his reunion was kinda new for me.


18 June 2016

Praba Shanmugam's wedding
Well she was my primary school mate! I've known her for more than half of my life.
This is one wedding that Akmal could not attend with me hence I brought Kak Ra instead.
This was my first Indian wedding and it was nice and I get to meet my favourite high school teacher! (well apart from my mum)


23 July 2016
Akmal's cousin's wedding
@ Johor

We actually made a one day journey back and forth Johor - Putrajaya on this day.
Akmal has so many cousins and many of them got engaged / married lately but due to our packed schedule, we always weren't able to make it.
Hence this time we really tried our best.



30 July 2016

Sharifah Farhana's wedding
Another school mate of mine.
I know her from Form 1 and I used to call her father "Shed", instead of "Sayyed"


27 Aug 2016
This was probably my most awaited wedding.
Alia and Faisal's wedding.

They are our colleagues in hospital.
They know each other from med school and were always being teased.
Their wedding was grand and nice and cosy, and tasty.
It was everything nice, except that it's far from my house and I was stuck in almost 2hrs traffic jam on my way there and then lost my way back from there.





And....
Was there any other weddings that I missed?
Can't remember, it's 1am and I need to sleep.
Fortunately it's my off day tomorrow.

Good night!

-Because life is a test-


-AkMaR-
http://nur-akmar.blogspot.com

Wednesday, November 30, 2016

Her E-Day

Assalammualaikum.
Yes, I'm back.
After like what, 5 months?

Fuh! Fuh!
It IS dusty, blergh.

*wipe wipe*



To commemorate this return, I'd like to write about Diana's engagement! :p
Ya that girl is now attached ♥

We've known each other since INTEC, almost 10 years now.
A short time actually, from an adult point-of-view.
One more person not to be forgotten when I mention Diana is of course, Farahin.

9 July 2009!

☘ 20 Nov 2016☘

Anyway, tarikh keramat itu adalah on 20.11.16
Nti next year tarikh lagi keramat akan muncul
Lepas raya katanye 😬

As usual, the photographer is the famous Zulhilmi @ Bobby
He's one of our college-mates and has been the photographer for many of our INTEC people weddings and events.
Want to see his works? Here
Want to contact him? Here

I arrived at 12noon sharp .
Wanted to come earlier however since hubs was postcall that day, I let him sleep in a bit longer.
I purposely arranged it so that my off day will be on that particular Sunday.
And I put in a bit extra effort to look nice that day 😋
Wore my byFatinSuhana dress for the first time (simply because I don't have a place to wear it to before and this was the perfect chance)

Sampai2 je I think the makan2 just started.
Diana was still inside taking pictures.
And even though I've reminded him to be my personal photographer of the day, Akmal (and me too) completely forgotten about it hence I did not have even a single picture of the event in my phone - apart from the wefie I took while he drives.

So these are the pictures by Bobby [credit]






So after the tangkap2 gmbr, Akmal and I walked out to err..eat.

And oh!
You know what they say that this world is small?
Well yes it is to some extent.

So Fuad and Diana met each other while they were both working in Sabah.
And it turns out Fuad's elder sister is my MO in Anaesth Dept.
Such a fate!

Me and Kak Hafizah
Guess who else I met?
Farahin!

But that wasn't all.
I was so not surprised seeing her, since we promised to meet.
What surprised me was she come with her fiance!
Yes, that naughty girl is also attached now. Lagi naughty, tunang senyap2.
Tiba2 je dah tunang.
Oh tapi dia pemalu. So they came in two different cars *shy shy, tp bagus la kan 👏 *

The food was superb.
The satay was nicely done, even tho the person grilling it was wearing a Juwett brace and both Farahin and I were so itchy wanted to ask his medical history, we decided the satay was more interesting than the brace.

After the food session, we went back in for second photograpy session 😄





[The 3 couples. Girls and boys dduk jauh2 k. Let me be in the middle. Haha.. Next year baru boleh tgkp gmbr rapat2 skit]

So Diana and Fuad, I hope the best for you both.
Cant wait for your BIG day 👰 !!

As I was going thru my picture albums, I found these pictures!

Taken in 2008 / 2009.
Gambar masa kecik2. Gelap berjemur and sgt school girls.

Sekarang boleh kot beli buku ni and khatamkan.. Hiks!





-Because life is a test-

-AkMaR-
http://nur-akmar.blogspot.com