Today, I was given a very grave news that made me cry. Unfortunately I am not able to elaborate in detail what the grave news was about.It really dampened my morning.
So today, I went down to the sundry shop at my hospital to grab some ice latte (yes, I'm stressed, that's why had to get some coffee), and I noticed some PDN (Pusat Darah Negara) banners in the lobby. Yay, blood donation drive. Perhaps today is my lucky day, I get to donate blood. I have been trying for the past 3 years.
The first year my Hb was only 9, the second year I was having menses and last year I was on antibiotics. What do you need to donate blood. Well the process is simple. First of all you have to answer a questionnaire and fill your details on the blood card. There will usually be an officer there that will help you clarify the questionnaire. Then you go to the lab tech, who will take a sample of your blood for blood grouping and also see whether your iron content in the blood (heme content) is sufficient via float method, i.e. they put a drop of your blood in a special solution. If the droplet sinks means you have enough iron, if not then your iron content is low and you are not allowed to donate. Then you are passed to a medical officer, who will read through the questionnaire and see whether you are eligible to donate. Once the screening is satisfactory, you wait in line as they get you a couch to lie and donate your blood.
So excitedly I filled up the questionnaire which asks about your present health status and were you sick in the past 1 week, whether you slept more than 5 hours last night, your past medical problems, history of fits and mental illness, usage of certain medications, your high risk behaviour profile. Most of the questions were answered well except for migraine and a part on mental illness. I had a family history. I was excited until I reached the last 2 questions i.e. 16 and 17 taht completely blew any chance of me donating in this country in the long run. The question asks about whether i have stayed in Europe for more than 6 months within the period of 1980 uptill now. I grew up in the UK, definitely failed that last question. And until they decide to amend that clause, it looks like I wouldn't be a blood donor in Malaysia after all. Oh well, at least I can still donate my organs.
To my friends out there, if you are well and fit without any problems, and weigh more than 45 kiloes, and fulfill most of the criterias, please do not hesitate to donate blood. Our blood banks are running low and its the end of the year, festive season to be exact, and a lot of people are injured in MVAs requiring a lot of blood products. Its not hard to donate, and its a no issue since in 90 days your red blood cells will be regenerated, and thus back to normal. They will only take about 1 pint of blood depending on your weight and sex.
Some side effects immediately after donating would be some headache for some, feeling a bit tired and some even have nausea. But normally you will feel back to normal within the same day. You may also have some bruises at the site of puncture but it'll disappear within the week. As a blood donor, there are certain benefits for you, where you are given a red book with the benefits written in it. It would include given priority to be saved in event of catastrophe or any emergency, free ward stay in govt hospitals, upgrades to better class and if you donate more than 30 times in your life, the govt will pay for all your medical expenditures. Not bad for medical benefits no? And all it takes is just a pint of your blood perhaps every 6 months to 1 year.
Monday, October 6, 2008
Wednesday, September 17, 2008
Let's Talk About Beauty...
Perhaps many would be surprised at my latest change of career path. I guess I have always been one of those righteous doctors, who look like the type who would serve their livelihood for the patient's welfare. Well perhaps I was, few months ago. But I guess going through the midlife crisis that I am forced to go through, many would not blame me.
So let's talk about beauty. In the medicine world, there is a study of human beautification or so-called aesthetics. Despite accepted as being a stream of medicine, it is regarded by many as the dark side of medicine as it reaps profits beyond comparison, and the sole purpose of treatment is mainly for vanity. Funny, I should associate myself with such a field - when I continuously spare my time towards medical charity. But the more I study about it, the more intriguing it becomes. In fact, I have come to the point that I believe that I am giving a service to people by providing the proper expertise to help with on-going problems like obesity or a scarred face, to give renewed hope and increased confidence, and to provide safety to patient's rather than they go to some beautician.
So perhaps its not that bad after all? Medicine after all, for all it is, is more of an art than a science.
So let's talk about beauty. In the medicine world, there is a study of human beautification or so-called aesthetics. Despite accepted as being a stream of medicine, it is regarded by many as the dark side of medicine as it reaps profits beyond comparison, and the sole purpose of treatment is mainly for vanity. Funny, I should associate myself with such a field - when I continuously spare my time towards medical charity. But the more I study about it, the more intriguing it becomes. In fact, I have come to the point that I believe that I am giving a service to people by providing the proper expertise to help with on-going problems like obesity or a scarred face, to give renewed hope and increased confidence, and to provide safety to patient's rather than they go to some beautician.
So perhaps its not that bad after all? Medicine after all, for all it is, is more of an art than a science.
Monday, September 8, 2008
Back Pain
I woke up this morning with the most excruciating pain over my upper lumbar region. I could barely move my right side. I thought, "Oh shit, I have to get to work soon." Trying my best to sit up, I examined my back with my fingers and found what I was looking for - muscle spasm. Okay, at least its not a more drastic problem like a prolapse disc. And I did not have sciatica pain, which is a good sign.
But still I had to keep my back straight while walking and going on to my chores. I couldn't turn my body as it would worsen the pain, so I just prayed silently that it would go off quick, since I have a million and one things to do. Luckily I had some voren gel so I applied a nice amount at the area of spasm. Went to work and survived half the day without causing more trauma to it. In fact by noon the muscle knot was softer and I regained much more of my motor function.
Back pain is so common. So common that I guess if sit in any clinic in a week you must meet a patient who complains of back pain. The most common cause of back pain is muscle spasm, usually the paraspinous muscles of the back. The severity varies from very severe to mild back pain. Some very severe back pain leaves the patient unable to get up from bed or extreme pain on movement. The best treatment would still be back rest or keeping the back in straight position most of the time. Normally I would advise my patients to just sleep on a thin mattress on the floor to ensure proper posture. A soft mattress is always bad for a sore back because it does not support good posture while sleeping. Symptomatic relief would be to give some topical plus oral medications. LMS or methyl salicylate ointment 25% is a good topical pain killer, as it also gives a heaty feeling, and to most people its soothing. Another alternative would be Voren gel (volteran gel) or other NSAID gels which are usually cool instead of warm but they actually give a much longer effect than LMS.
For oral medications it will depend on the severity. My personal favourite is to give patients myonal or Eperisone 50mg which is an anti-spasmodic agent which has vasodilatational qualities together with Mobic (Meloxicam) 7.5mg bd (max 15 mg) which normally gives a fair good response to the pain in a few days. Sometimes I give Celebrex or Arcoxia - cox-2 inhibitors for pain relief which is good for acute pain. A more cheaper alternative is voltaren tablets or ibuprofen. For very severe pain, sometimes IM voltaren is given. Well it depends on which clinician you see. Despite all the hi-fi medications that we can prescribe, it will not be complete without proper advice.
First of all, posture is important. Keeping a good posture is the key to relieving pain fast and not causing any more trauma to the area. This would include sleeping on a hard surface, standing or sitting straight and for ladies, to come off the heels for a while. Secondly, we should advise not to life heavy objects, or move so suddenly as this may cause more trauma to the spasmodic muscle or perhaps cause new problems. Try to be careful when walking as not to fall and to be aware of uneven surfaces. Normally, doctors would prescribe MC for complete back rest for a few days - which means please rest. Some people get leave, but refuse to rest. Give time for nature to set its course.
Even though back pain is usually due to muscle spasms and improper posture, but you should err on the side of caution if you have persistent back pain that is worsening, accompanied by any change in sensation, any shooting pain down your leg, any abnormal bowel habits, if your pain was preceeded by any form of trauma that may have affected your back, back pain that gives you difficulty to walk for more than 3 days, if it is accompanied by muscle weakness and other abnormalities such as fever, rash etc etc. The safest bet is to make a quick stop to your nearest doctor for a proper evaluation and treatment.
But still I had to keep my back straight while walking and going on to my chores. I couldn't turn my body as it would worsen the pain, so I just prayed silently that it would go off quick, since I have a million and one things to do. Luckily I had some voren gel so I applied a nice amount at the area of spasm. Went to work and survived half the day without causing more trauma to it. In fact by noon the muscle knot was softer and I regained much more of my motor function.
Back pain is so common. So common that I guess if sit in any clinic in a week you must meet a patient who complains of back pain. The most common cause of back pain is muscle spasm, usually the paraspinous muscles of the back. The severity varies from very severe to mild back pain. Some very severe back pain leaves the patient unable to get up from bed or extreme pain on movement. The best treatment would still be back rest or keeping the back in straight position most of the time. Normally I would advise my patients to just sleep on a thin mattress on the floor to ensure proper posture. A soft mattress is always bad for a sore back because it does not support good posture while sleeping. Symptomatic relief would be to give some topical plus oral medications. LMS or methyl salicylate ointment 25% is a good topical pain killer, as it also gives a heaty feeling, and to most people its soothing. Another alternative would be Voren gel (volteran gel) or other NSAID gels which are usually cool instead of warm but they actually give a much longer effect than LMS.
For oral medications it will depend on the severity. My personal favourite is to give patients myonal or Eperisone 50mg which is an anti-spasmodic agent which has vasodilatational qualities together with Mobic (Meloxicam) 7.5mg bd (max 15 mg) which normally gives a fair good response to the pain in a few days. Sometimes I give Celebrex or Arcoxia - cox-2 inhibitors for pain relief which is good for acute pain. A more cheaper alternative is voltaren tablets or ibuprofen. For very severe pain, sometimes IM voltaren is given. Well it depends on which clinician you see. Despite all the hi-fi medications that we can prescribe, it will not be complete without proper advice.
First of all, posture is important. Keeping a good posture is the key to relieving pain fast and not causing any more trauma to the area. This would include sleeping on a hard surface, standing or sitting straight and for ladies, to come off the heels for a while. Secondly, we should advise not to life heavy objects, or move so suddenly as this may cause more trauma to the spasmodic muscle or perhaps cause new problems. Try to be careful when walking as not to fall and to be aware of uneven surfaces. Normally, doctors would prescribe MC for complete back rest for a few days - which means please rest. Some people get leave, but refuse to rest. Give time for nature to set its course.
Even though back pain is usually due to muscle spasms and improper posture, but you should err on the side of caution if you have persistent back pain that is worsening, accompanied by any change in sensation, any shooting pain down your leg, any abnormal bowel habits, if your pain was preceeded by any form of trauma that may have affected your back, back pain that gives you difficulty to walk for more than 3 days, if it is accompanied by muscle weakness and other abnormalities such as fever, rash etc etc. The safest bet is to make a quick stop to your nearest doctor for a proper evaluation and treatment.
Tuesday, August 19, 2008
Some people are just inhumane.
Recently last few weeks, as usual my department does grand ward rounds on Friday. As usual, we would see all our patients including pediatrics ward where we have children post tonsillectomies that we need to see.
So one fine day, we entered the ward and saw a baby cot placed at the nurses station. This usually signifies a child that has no guardian - be it due to an abuse case, for protection or abandoned child. This boy happened to be an abandoned child. After rounds, we went to take a look at the child. I have always been very fascinated by children, having two of my own although exhausting, does not influence me to stop having anymore - be it from my own womb or adopted.
This child was born with a congenital anomaly. He has microcephaly and appears to be spastic diplegic - okay in English, it means the size of the head is small and due to that he has difficulty in moving his two legs - its a bit stiff and has increased tone.
There was some familiarity of the child, but all microcephalic children appear the same. But this time my nurse pointed out that we have seen the child before. Sure enough, as I juggled my memory, I believe that I had inspected the child a few months back for hearing assessment. Excitedly, my nurse searched our records and found the details of the parents and we gave it to pediatrics. Unfortunately, nobody answered the phone and our last resort was through JKM. Uptil now, I haven't heard any progress, but he is under an orphanage now.
The boy was about 6 months old. He was small for his age which is common in microcephaly. He was well kept and we called him Ismail. I remembered when I was in pediatrics, I was usually very attached to the abandoned children. I would cry if JKM took them to the orphanage because I would help care for them, feed them. The problem with the orphanage, it is mixed with bigger children and there was not enough staff to care for everyone that the little ones tend to get a bit neglected because they cannot fend for themselves.
I feel very upset that people just throw away babies just like that. I mean, if you didn't want the child why bear him/her into the world? Perhaps you should consider not having any unprotected sex, or maybe get an abortion. Rather than throw the baby into the dustbin or in a bush. They are living creatures, humans in fact. Even cats we do not treat them in such way. Or maybe give them up for adoption. There are many couples out there who have trouble conceiving, who would be most happy to adopt a child. I myself would be most happy to adopt a child - at least I know I have made a difference in one human's life.
So one fine day, we entered the ward and saw a baby cot placed at the nurses station. This usually signifies a child that has no guardian - be it due to an abuse case, for protection or abandoned child. This boy happened to be an abandoned child. After rounds, we went to take a look at the child. I have always been very fascinated by children, having two of my own although exhausting, does not influence me to stop having anymore - be it from my own womb or adopted.
This child was born with a congenital anomaly. He has microcephaly and appears to be spastic diplegic - okay in English, it means the size of the head is small and due to that he has difficulty in moving his two legs - its a bit stiff and has increased tone.
There was some familiarity of the child, but all microcephalic children appear the same. But this time my nurse pointed out that we have seen the child before. Sure enough, as I juggled my memory, I believe that I had inspected the child a few months back for hearing assessment. Excitedly, my nurse searched our records and found the details of the parents and we gave it to pediatrics. Unfortunately, nobody answered the phone and our last resort was through JKM. Uptil now, I haven't heard any progress, but he is under an orphanage now.
The boy was about 6 months old. He was small for his age which is common in microcephaly. He was well kept and we called him Ismail. I remembered when I was in pediatrics, I was usually very attached to the abandoned children. I would cry if JKM took them to the orphanage because I would help care for them, feed them. The problem with the orphanage, it is mixed with bigger children and there was not enough staff to care for everyone that the little ones tend to get a bit neglected because they cannot fend for themselves.
I feel very upset that people just throw away babies just like that. I mean, if you didn't want the child why bear him/her into the world? Perhaps you should consider not having any unprotected sex, or maybe get an abortion. Rather than throw the baby into the dustbin or in a bush. They are living creatures, humans in fact. Even cats we do not treat them in such way. Or maybe give them up for adoption. There are many couples out there who have trouble conceiving, who would be most happy to adopt a child. I myself would be most happy to adopt a child - at least I know I have made a difference in one human's life.
Monday, July 21, 2008
Big Decisions, Risks and Action
I recently received a few comments concerning my recent decision to embark on a new field of medicine which is fairly new but well commercialized. Some were supportive, but there were some who just don't get it.
Leaving my comfortable work to embark on a more commercialized industry may sound like a bit drastic. But before coming to such decisions, there were a lot of arguments and rationalizing done - and statistically, my chances of being more successful lies outside the window, not inside. I may be in the medical field, but yes we do learn about statistics, medical statistics to be more exact. We were taught how to calculate risks and define our inclusion and exclusion criteria, thus finally giving us odds ratio or p value to a certain significance.
It is pretty much the same with any decision making. First you need to define the decision properly, the objectives, the methods you wish to use to achieve the objectives, inclusion and exclusion criteria, then list down the benefits, and the risks, and calculate - whether the benefits are significant or not, whether the risks are significant or not.hen you come with a conclusion or a hypothesis, when enough evidence then it becomes a theory. Its not like I'm jumping the gun.
I have decided and like always, if I have decided, I normally would stick to my decision unless God forbades it. I'm just upset that a lot of people just don't respect other people's decisions.
Leaving my comfortable work to embark on a more commercialized industry may sound like a bit drastic. But before coming to such decisions, there were a lot of arguments and rationalizing done - and statistically, my chances of being more successful lies outside the window, not inside. I may be in the medical field, but yes we do learn about statistics, medical statistics to be more exact. We were taught how to calculate risks and define our inclusion and exclusion criteria, thus finally giving us odds ratio or p value to a certain significance.
It is pretty much the same with any decision making. First you need to define the decision properly, the objectives, the methods you wish to use to achieve the objectives, inclusion and exclusion criteria, then list down the benefits, and the risks, and calculate - whether the benefits are significant or not, whether the risks are significant or not.hen you come with a conclusion or a hypothesis, when enough evidence then it becomes a theory. Its not like I'm jumping the gun.
I have decided and like always, if I have decided, I normally would stick to my decision unless God forbades it. I'm just upset that a lot of people just don't respect other people's decisions.
Sunday, June 1, 2008
Allergies
I have recently developed a skin allergic reaction to a sunscreen - banana boat SPF 50 to be exact. What triggered the allergy, well I'm still trying to find out. Perhaps its the content of zinc or other trace metals found in the lotion that has caused me to have spots like a leopard. Papulorash which only turns red when scratched, plus the itchiness is driving me crazy. Unfortunately, I was quite careless with the product. I should have been wary. Initially I tried a bit on my skin and nothing happened. So last Friday I decided to put more over my face, neck and both arms. Within minutes, papular eruptions was noted over my arms and later my ears began to itch. After 2 days, I'm still bumpy and my face still itch to the point that I had to void myself from much make-up. My face texture looks bumpy and I feel so spotted.
Allergies are a major hassle in life. A lot of people only have mild allergies (like myself) where you tend to have some skin reactions such as itchiness, redness, rashes, urticaria. Some get sneezes, itching nose and eyes, we call allergic rhinitis or conjunctivitis. Since allergies are so common, some people regard them lightly.
But some people do get very bad allergic reactions. They have very prominent swellings over eyes, mouth, nose, skin, extreme itchiness and sometimes break out into ulcers. Some get multiple forms of erythema and in worst cases, Stevens Johnson Syndrome which can be life threatening. SJS is an immune-complex–mediated hypersensitivity complex that is a severe expression of erythema multiforme. Some people suffer from anaphylaxis, which is usually characterized by swelling of lips, eyes, mucosa and shortness of breath after being exposed to the allergen. Treatment modalities would encompass antihistamines, steroids, and symptomatic treatment.
My skin allergy is improving, though I still feel my ears are as large as Dumbo's. I'm still scratching, and there are still spots on my arms and face. Yikes. And I'm going to the beach this weekend. Sigh!
Allergies are a major hassle in life. A lot of people only have mild allergies (like myself) where you tend to have some skin reactions such as itchiness, redness, rashes, urticaria. Some get sneezes, itching nose and eyes, we call allergic rhinitis or conjunctivitis. Since allergies are so common, some people regard them lightly.
But some people do get very bad allergic reactions. They have very prominent swellings over eyes, mouth, nose, skin, extreme itchiness and sometimes break out into ulcers. Some get multiple forms of erythema and in worst cases, Stevens Johnson Syndrome which can be life threatening. SJS is an immune-complex–mediated hypersensitivity complex that is a severe expression of erythema multiforme. Some people suffer from anaphylaxis, which is usually characterized by swelling of lips, eyes, mucosa and shortness of breath after being exposed to the allergen. Treatment modalities would encompass antihistamines, steroids, and symptomatic treatment.
My skin allergy is improving, though I still feel my ears are as large as Dumbo's. I'm still scratching, and there are still spots on my arms and face. Yikes. And I'm going to the beach this weekend. Sigh!
Thursday, May 29, 2008
A New Month, A New Life, A New Blog.
A new month is coming and it hails new opportunities and virtue. A new life is what I am experiencing, giving me a refreshing breath of air after my long turmoil in captivation. A lot has happened in the past year which has completely turned my world around.
I am a new woman, with renewed faith and dreams. I have found myself, after years of searching. I know now what I want in life. It is ironic how as kids we have dreams and we talk about the future, but in the process of growing up, we tend to forget that child in us, our dreams and aspirations. Then we start blaming life as being cruel, we become money-orientated and we lose sight of what really matters in life. We become selfish and forget the virtues we learnt as a child.
I dedicate this blog to the child in me, the creative part of me and me as a whole. Some stories written here may be true, some may be product of pure imagination. Some stories may reflect the many colors of my personality. Eitherway, hopefully other people may benefit from the contents of my writings.
I am a new woman, with renewed faith and dreams. I have found myself, after years of searching. I know now what I want in life. It is ironic how as kids we have dreams and we talk about the future, but in the process of growing up, we tend to forget that child in us, our dreams and aspirations. Then we start blaming life as being cruel, we become money-orientated and we lose sight of what really matters in life. We become selfish and forget the virtues we learnt as a child.
I dedicate this blog to the child in me, the creative part of me and me as a whole. Some stories written here may be true, some may be product of pure imagination. Some stories may reflect the many colors of my personality. Eitherway, hopefully other people may benefit from the contents of my writings.
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