Jan 28, 2012

been reading...

Anne had been married about a year when one day the she came running up to her husband jumping for joy.
Not knowing how to react, the husband started jumping up and down along with
her. "Why are we so happy?" he asked.
She said, "Honey, I have some really great news for you!"

"Great" he said, "tell me what you're so happy about."

She stopped breathless from all the jumping up and down. "I'm pregnant!" she gasped.

The husband was ecstatic as they had been trying for a while. He grabbed her, kissed her, and started telling her how wonderful it was, and that he couldn't be happier.

Then she said "Oh, honey there's more."

"What do you mean more?", he asked.
"Well we are not having just one baby, we are going to have TWINS!"
Amazed at how she could know so soon after getting pregnant, he asked her how she knew.

"It was easy" she said,
"I went to the pharmacy and bought the 2 pack home pregnancy test kit and both tests came out positive!"

Here's the real guideline for Management of Twin Pregnancy by RCOG.

Jan 24, 2012

surgical small talk

There are many reasons for any medical practitioner to fall in love with the practice of surgery. Subconsciously, the short period of time when you have the patient’s internal organs on your finger tips – it is almost god-like. This could just be the main raison d'être for anyone to fall in love with surgery. Conversely, the fear of screwing up with all those bloody live human organs on your hands is partly the reason why others fell out of love with surgery.

The other small, tiny perk of surgery is that little small talk while one operates. Rarely, the patient would be awake to hold a conversation with you, ie conscious brain surgery or when patient only on local or regional anaesthesia.

If you are planning to undergo a surgery soon, make sure that you only go to a surgical clinic with staff who had attended surgical tech schools.

Here’s a small talk that I recently had, while assisting, inspired by the Chinese New Year song heard from the radio in OT.

Surgeon: So, the next year is Dragon Year, right?

Me: Yup. This year is Rabbit.

S: So fast came back to Dragon, I used to remember that the millennium was Dragon year.

M: Yup, luckily it’s Dragon, and not Dog,Rat or Rabbit. Like this year Rabbit, a lot of people bought rabbits, mainly for good luck, and then do not properly take care of the animals.

S: Hmmn. That’s bad. Good that it’s Dragon. They can’t buy Dragon, right?

M: Yup, they don’t exist to be bought.

S: How about other years?

M: There are Cow, Tiger, Snake, Horse… I doubt anyone would keep Cow or Horse.

S: So, what do they do during Tiger Year? They go for tiger show?

(Taken aback. Almost speechless. 2 minutes of pause)

M: Haha, no, they go to touch Tiger in open zoo or some temple in Thailand.

And that was the last surgery that I had taken part in before the year of the Dragon.

Happy Chinese New Year!!! Hope everyone have high-flying, wonderful Dragon year!!

Jan 6, 2012

holiday: boon or bane?

It is rather not surprising that one third of our days of year are being spent on leave. Yet, out of this holiday, I believe strongly that I will probably be on call on 2/3 of it and actually on leave on the other 1/3 out of those holiday.

Thus, my actual holiday is 1/9 (1/3 X 1/3) of the whole year. Bad deal, right?

Dr Ng brought up the issue of how destructive holidays can be.

Although, I totally agreed with the disastrous standpoint of having an emergency public holiday, I do not stand with him on the fatality of fixed, scheduled holiday.

The main reason for me to be skeptical is that what he had proposed, what everyone projected, what theoretical logic suggested, may not be the evidence-based conclusion that one should simply adopt without seeing a validated figures.

The actual fact that western countries with 4 seasons have more holidays but better healthcare outcome endpoints than Malaysia appear to antagonize the 'hazardous over-holiday' theory. Of course, there are abundance of other confounding factors to be taken into consideration.

Holiday being synonym to the absence of formal clinic and elective operation list may lead to unintended procrastination in treating the patients.

Nevertheless, the positive implications of holiday to public health should not be discounted. Of course, by continuing to read further, please be reminded that those implications are also theoretical reasoning, without supportive evidence-based figure.

Holiday can reduce psychological or psychiatric morbidity as everyone take a break from work, except for doctors who have to 'hold the fort' while others go for holiday.

Holiday opens up more time for family bonding moments, healthy sporting adventures and mind-relaxing retreats. Festive holiday also pushed everyone to start to tidy and clean our residence more aggresively, leading to more hygienic and organized, less accident-prone home.

On the downside, too much time out of work may lead to overindulgence in bad habits like heavy drinking, heavy eating, heavy gambling, heavy driving and heavy everything. The drinking part leads to more liver diseases, the eating part leads to hypercholesterolemia, obesity and diabetes, the gambling part lead to poverty, the driving part lead to motor vehicle accidents. Contrary to belief, festive seasons can be very stressful for some. Some people depressed looking at the big hole in their wallet after spending for festive preparation. Some people stressed up looking at the potential being questioned about their persistent failure to find a life partner, recent disastrous family disharmony or recent sudden descent in their career climb.

Well, I wouldn't conclude whether holiday is good or bad, but possibly the government of Malaysia could take a year and cut down half of the holiday (probably the State holidays) and study its actual health implications based on several key representative endpoints.

Either that or declare more holidays!!!

Jan 4, 2012

happy birthday, dad!


happy birthday, dad.

you'd done a whole more than protecting your balls.

i love you so much!!