Cuti 5 hari..

satu hari masa krismas..sabtu ahad memang cuti..so, aA tambah 2 hari lagi..isnin selasa..
bukan saja2 ambik cuti..ni semua sebab nak join my family rombongan kawen my cousin la..kat Sg, Gerisek, Muar..
masa 26hb tu, diorang baru bertolak dari KB..so, sampai dalam malam gak la..
berkumpul kat rumah aDA ramai2...makan nasik yg chef spesel masak..
malam tu sangat meriah..ada half tdo kat rest house, half tdo kat rumah aDA..
pagi esok nya, dalam kul 10 bertolak ke Sg,Gerisek..pg ni majlis tunang2 dulu...kul berapa plan aA xtahu la..ikut jer..tunggu jer..penat gak la..dahaga...cuaca panas...
alhamdulillah selesai semua...tunggu lagi kat asjid..untuk akad nikah plak..sebelah petang.

petang lak mendung gelap semacam..
dalam masjid tu memang suram la..dah la dengar x dengar tok imam duk cakap..x paham plak tu..pekat Jawa dia..
jurugambar ramai sanagt..yg kecik ada, yg besar ada...

dah selesai semua, kami menuju ke BP semula..rehat2..mlm kami kuar gi BP mall ramai2..makan2 sebab semua lapar..
kami round Pacific dulu..cari brg yg tak tercari..then gi makan sizzling kat Food Court..
kesian kat Ayoh sebab dia mintak sizzling tp org tu salah dengar n bagi dia nasik dlm claypot tu..
maka makanlah dia nasik tu..katanya mcm mkn kerak nasik..
tp sebab lapar, licin gak peiuk belanga tu..hahaha...
aA share ngan mok jer mkn sizzling mee..
sebab on the way balik aA beli ICEKIMO n donut big apple plak..
tu yang sedap..
kat big apple beli yg durian..sedap rupanya..
mcm mkn jemput2 durian..
next time kena beli lagi..
dh hbh mkn donut, aA balik ke rumah aDA...dgn harapan boleh la siapkan presentation..sekali tertido la...hahaha...esok la nampak gayanya..

gbr kami gi majlis tu ada kat facebook...
dlm page aA n page Kak Airin..page Yee xpasti dia dah upload ke belum..

A Sad Day for Me..part of it..

Hari ni saya post call..oncall hari ahad memang memenatkan..kes tak banyak pun tapi ward work yang banyak..ambik darah, set IV line, review patient, assist tu dan ini..

Jadi, bila pagi, mata memang agak mengantuk la..dapat tidur pun tapi yang tak berkualiti..sejuk menggigil..air cond kuat sangat..

lagi pun kes yang terakhir masuk dalam kul 4.00 pagi..clerking..then terus ambik darah untuk pagi tu plak..

Apa yang menyedihkan, my patient yang Treacher Collin Syndrome dah takder pagi ni..

# contoh baby Treacher Collin Syndrome..
(THIS ONE IS NOT THE EXACT BABY I WILL STORY)
Sedih sangat..

This baby already 65 days of life today..

Diagnosed to have Treacher Collin Syndrome with Resolved Aspiration Pneumonia and 3x Acute Life Threatening Event which is Asystole..2 times need Adrenaline..latest episodes was about one month ago..

Last night during my oncall..after night review..i feel like i wanna go and play and joke with him..as usual..

i call his name, i touches his head..his cheek, his chin and also his back..

he looks at me and his eyes follow me..extraocular muscle intact..

i can se that he's smiling to me..

what a wonderful feeling to have such bond with him..

so do the staff nurse who always feed him, give good nursing care to him..

at that time, the oxygen saturation is 100%..good..

until my MO called me to help her..so, i said to the boy "till we meet again"..

until 5am..he was feed via Ryles tube..

Staff nurse informed me around 5.45 that the baby had desaturated as low as 40% post feeding..the baby can't tolerate feeding and regurged a large amount of milk..milkcurd..

the milk came out from his nose n mouth..

they do suction n revealed milk curd...from the previous feeding around 2am..

MO attended the patient and was put under headbox oxygen 5L/min with the baby in left lateral position..

i attend him around 6.30am..he looks cyanosed..letahrgy looking..not like as normally he looks..

i know the baby won't survive..and also wooried if the ATLE will recur..

at that time the saturation around 80-95%..

around 7am..at this tme, i was sleeping for 10 mins..my colleagues told me that this baby desaturated again..he was given Positive Pressure Ventilation for about 20 minutes..

he's apneic..

luckily he can maintained the saturation at 70%..still bad..

during morning round with the specialist, i informed him what already happen that morning..so, this specialist proceeds with the examination..turn him into supine position..

and then put him bank in prone position..i put him back on Headbox..

STILL..NOT THE EXACT BABY..JUST A SAMPLE PIC

then, all of us noted that the baby became apnei..the chest not moved..the baby cyanosed, his limbs were hypotonia..
then, we start with the chest compression and ambu bagging..
around 20 minutes too..

however, around 11.30am..again..he became asystole and apneic..my frenzs do the chest compression..up to 7 doses of adrenaline adminitered..nothing..until around 1pm..he's gone.

during this time, i had exam for neonatal resuscitation porgrammed..until i finished my exam around 1.30pm, then i know this boy already RIP..

i can't hold my tears..went to pantry, meet the staff nurse..told her what already happen.
she's shocked with the news..
almost all the staff nurse will miss him so much..

Previously, this baby always crying during feeding time..and his cries will be the loudest among all the baby..
and we used to call his name everytime to calm him down..
Nurse in prone position to prevent the tongue pushed backwards and obstructed the airway.


This baby also got cleft palate, which makes the feeding..bottle or breasfed difficult..with the risk of aspiration very high..
His chest always got sternal recession..like AP diameter is very small everytime he breathe in..
The face..yes..typical Treacher Collin Syndrome..
he got down slanting lateral part of the eye, coloboma, no eyelashes at the lower lids, hypoplasia of mandibular..and blind pits between the tragus and mandible (this one i noticed last week)..also, the ears is malformed, other features..hmmm..dunno how to describe..
Mainly, this baby got problems with the respiratory tract..

Now, he's gone..and hope Allah's blessed with him..

Al-Fatihah..

SORRY FOR THE SPELLING ERROR AS I TYPED THIS BLOG IN THE DARK..my Roomate already fall asleep.for not disturbing her nice sleep, i just decide not to switch on the light..

Paediatric Posting..as a Houseman

it's almost a month since i entered Paeds Posting..as a HO..
now, i've been posted to SCN (known as NICU)..for neonates..
takut tu memang takut nk masuk posting paeds..semua kecik dan nano..
lagi lagi bila kena psoting kat NICU..triple kecik..kena set line kat budak2 kecik..mula2 memang takut n kesian la nk cucuk tp bila dh terpaksa cucuk..buat jugak..

afraid and not confident to do all the procedurews especially setting up the line..all are small in size..but it's my work to save lives..u want or dun want, u have to set the line, the branula so that the medication can reach the baby's circulation.

Edward Syndrome
- in NICU, again, for the 2nd time in my life i encounter with baby with Edward Syndrome, trisomy 18.
this baby is a girl, weight 1.7..currently 1.980kg..very small and cute. she will cry everytime she feel someone touches her..today is her 32 days of life.
prognosis for her is very poor. she also got some cardiac murmur at left sternal edge and we already planned for ECHO fo her later on..currently, she's been feed via Ryle's Tube..a tube inserted through the mouth to the gastric..she drinks 40cc every 3 hour.
Just now i searched for some information about Edward Syndrome. Usually they will die becoz of heart, kidney abnormalities and also due to apnea (stop breathing). Try search for the information in the Wikipedia..it's already will make u feel sad and pity for this girl..
i nearly drop my tears when i review this baby at 9pm just now..
She's got high nasal bridge (dia akan nampak ada hidung yg mancung), micrognathia (small jaw), trisomy fingers (overlapping of 2nd and 3rd fingers) and few more characters that currently i forgot..sorry..

during my student years, one Edward Sydrome baby only last for 8 days before she RIP.
i always tell the staff nurse at NICU to take care of this child, to comb the hair, to clean the face and hair everyday..so that she will look more tidy and cuter.

on this monday, we will repeat the blood investigation for her..i think i'm not able to do the blood taking. maybe i will ask help form other HO..if can't, i will do it myself..OMG..

well..already sleepy..nedd to sleep...post call..
next time i will story about Treacher Collin Syndrome..
if u want to know more about this two syndrome, just search from the search engine..
we dunno who will have this kind of baby later on..so, better know than not..

3-1...

abe najmi kato kelate menang 3-1..tp terbalik la pulok...
3 tu hok N9..

ayyyaaaaa....

ramalan tidak tepat langsung..

abih la stadium bukit jalil..luar stadium guano eh..mitok2 xdop gapo..

Kijang Mengganas..

Baru jah habih tagging posting Paeds..

kebetule buleh off Saktu Ahad..

buleh la tengok bola kat rumoh aDa..

ni tengoh berlangsung siare langsung final bola Liga Malaysia Kije lawe Ruso..

daging ruso sedap weiii...

baru jah 7 minit main..xdop gapo lagi ni..awal lagi..

Ruso main ganah la..hk no 17 tu buat 2x doh kesalahan...

dapat free kick ko Kelate tp xmasuk gol pun...

mujur..

penyokong Kelate 65ribu..total tiket 85 ribu..huahuahua...

hok bestnyo..sepupu sepapat 7 ore hok gi tengok live kat stadium..sore siap bawok kamera nk zoom lube idung Indra..

hk pasti, maso ni, semua ore kelate bersatu hati..xkiro hok duk mano..Gerik (tapi melarikan diri ke Penang nk gi tgok kat Kedai makan..), UKM (dengan TV hok xdop kala..hahaha), Batu Pahat, Belando, Kajang, Pekan, Pasir Puteh, Kuantan, Kg Tok Betek hok tengoh banjir, Kuala Krai dan di mana sajo...

Tahniah Tahniah...

k..nok concentrate tgok bola...

Gomo Kelate Gomo...cumo jange la penyokong Kelate wak jahak..x juruh..

minit ke 18 - N9 dapat gol sebutir...tidakkkkkkkkkk!!!!!!!!!!!!!!!!!......lopat Kije Lopat..

minit ke 20-huje turun..boh boh...Indra xgerok molek lagi tu..nyaghih Kelate masuk gol sedighi..bukey Indra la..

hattan gi tgok wakil n9..mano la Sabri Yunuh...hahaha

Open House di 2240-B

penat...
kenyang..
puas hati..
thank you..

thank you kepada yg datang open house rumah kami kat kuarters 2240-B..
and benda best pada hari ni ialah dapat compliment from specialist pasal spageti yg 1st time aA masak betul2..
sebelum ni tgk jer n xpenah tahu cara nk masak spageti..sekali pg td buat.alhamdulillah menjadi..

can u imagine betapa hepinya hari ni..hik hik hik..
thank you thank you..
semoga next time bila buat spageti boleh dpt rasa yg sama gak..amin..

Bebiri 2