counting days

... expendable labor

Being on call after a long journey away packed with latest updates after updates drilled into my head and some kind of wild adventures soon after, can be really taxing.

I was having on and off epigastric pain and bloatedness, even though I am having regular meals. I got myself hysterically suspecting myself having possibly some myocardial infarct due to the fact that (sadly) had increased my weight another 2kgs and was loading my guts with pretty awesome cholesterol-laden, tasty seafood from that beautiful land up north of Borneo.

Nah. Probably gastritis. Hopefully.

And speaking about being hysterical, I got into a conversation with one of my colleagues being on call.

She is a soon-to-be mother, sitting around lazing waiting for her next duty calls. 'The Star' newspaper on her lap, with a black ball pen, scribbling some numbers over on the page of advertisement. I was contemplating that she's counting when her child going to come to this world, or probably counting her period of gestation, or possibly the baby's kick.

"Hi, what are you counting?"
"Days."
"Days?"
"Yeah, days. How many days I am alive."
"Oh."
"I already lived for almost 10,000 days, yet I don't have much achievement." (force a smile)
"Don't worry, once you deliver your baby, that would be the greatest achievement in your life!"
"Really?"
"Of course. Of course."

And I rushed to do my op.

Come to think of it. Maybe that's probably one (of the major) reason I'm in OB - to be there for the ladies when their reaching out for their achievement and making sure they survived through it all.

What better achievement can top carrying another lifeform in the abdomen for 40weeks and at the end endure the most horrendous unspeakable pain known the humankind, just to bring a life and joy to everyone?

aedan's mystery of Tee Ya

Baby talk.

All the coos and the babbles. That was 1 year before. Perhaps even John Langdon wouldn't have enough skill to decipher any of the baby talk.

Aedan is fascinated or maybe hilariously love to repeat the word:

Tee Ya... Tee Ya... Tee Ya...
then follows by neverending baby laughters.

Tee Ya. Is it english? hokkien? chinese?

He mispronounced Tee Knia - small plate in Hokkien?

After 1 year of mysterious Tee Ya and Tee Ya, finally mystery unfold - he was mimicking me.

Copying how I always call my dearest: 'Dear' with a long drag.

OUCH!!

OUCH!!

I swear this is the shortest entry... ever...

flying mothers

Now everyone can fly... Not true for some pregnant ladies...

Some time ago, my colleague, C sitting opposite me in clinic was asked by the patient for a memo for flying, i mean, going on a ride on airplane back to her hometown at the other side of south china sea.

C looked at me, and I looked back at her.

"Probably she'll just need a memo,C. You think she is safe to fly?"
"I think she's safe. I will just write a memo."

Just two days ago, on flight, enroute to the land below the winds for OGSM (read carefully: not orgasm) conference, the onboard mag travel3sixty had a rather nice article shedding lights upon some technical procedures and rules for pregnant mothers going on an aircraft.

that article was nicely written by Captain Lim. Captain Lim got his own site, and probably you can ask just about anything about flying.

the article in summary:

if the gestation of the baby is

• less than 28weeks: the mother has to sign release and indemnity form.
• 28 to 34weeks: the mother has to present a medical certificate (within 1 week of validity) stating the due date and the fitness, and to sign the release and indemnity form.
  
• more than 34weeks: not allow to fly.
  

as for on board delivery

• place of birth = place of disembark for the airplane
  
• nationality = place of registered for the airplane
• but no true consensus, therefore technically easier if nationality follows the mother.
• as for the free for life flying for the 'plane baby', it is completely just a rumor and though there are instances of such with Thai Airways and Asia Pacific Airways, but those are purely at discretion of the flight company if the baby brings good luck or fortune within their culture.
  

Therefore, not everyone can fly, not if you gotta 35weeker solid passenger within you.

back in the line of fire

after countless months of training the JMOs, finally, I am getting some first calls this month.

I was on first call yesterday.

first call, manages all wards, all admission, all referrals all day long and after 12midnight, runs the OT as well. basically running left and right, centre and out, front and back, up and down while the second call relieves all procedures, mainly C-Section in the op theater. Perks of being first call - entitles to AM off next morning. Even if it doesn't, we'll basically drop dead in clinic or have intermittent petit mal running the clinics.

when i started my first call, it was like ground zero battleground, fighting for more time, fighting for more energy, but mainly fighting for more wisdom to prioritize everything towards a safe management of patients transiting through my department.

now, it is still a battleground, but with first call, I get to talk and communicate with my colleagues in other department, basically referral in and out.

Referrals within good colleagues is always great. Here's a reason why.

NK: Hi
Me: Yep
NK: Ey, why am I helping you to resuscitate this patient?
M: Where is it? I will come, but I bet you're pulling my legs.
NK: Can't fool you. Wanna introduce a 17 years old 'leng lui' to you?
M: Is the 'leng lui' stable?
NK: 'Leng lui' of course stable.
M: What's the 'leng lui's problem?
NK: Huge abdominal mass. UPT negative.
M: Send her up to my ward, will assess and scan her from there.
NK: Now?
M: Yep.

And of course, there will always be DHs that accept referrals like it is the end of the world, even though it was within office hours and the DHs are not on call on that day. DH basically is synonym to the statement "men thinks with their penis". Take a wild guess.

Here's why i think DH is befitting to their egoistic primitive behavior.

M: Hi, have your lunch already? (Trying to be nice. But i think DH doesn't deserve it)
DH: No lar, why? You disturbing me, where got time to eat?
M: Are you in charge of this ward?
DH: Yeah, the other MO also in charge of that ward. Why you didn't call him?
M: I got your name first, and the operator connects me to you.
DH: Really ar? I already went to your ward earlier, you want me to go back again mer?
M: (you think our hospy is so bloody big ar?) Well, here's the patient that I would like to refer to you... admit for xx, noted BP high... (interrupted)
DH: how high is it?
M: 160/90
DH: how many readings? high since when?
M: slightly high since last night.
DH: why didn't refer last night?
M: I wasn't on call last night. (I'll be glad to refer you in the middle of the night next time you're on call. mental note to myself)
DH: you guys got serve her medication or not?
M: she's newly diagnosed.
DH: aiya, you guys must have frightened her till BP shoots up high.
M: Ya, may be. (Frighten, my ass!).
DH: What's her Urea/Creat?
M: Normal.
DH: Got do X-ray and ECG or not?
M: Yep, normal.
DH: Start her on stat dose of x first. So, can I come see her tomorrow?
M: Up to you. (No problem, by that time, my specialist would have referred to your specialist)

I guess a simple case of newly diagnosed hypertension with hypertensive urgency can be managed easily by starting oral medication as per guidelines, but it is always best to refer to the expert not only for the current problem, but also for future follow up and end-organ damage monitoring.

Anyway, bottom line is, I been to Medical posting before.
Surely, DH been to O&G posting before.

Therefore, since I am being scrutinized harshly on BP, ECG, CXR, Urea, Creat which I am prepared to present and interpret adequately, the next time DH is going to refer me some O&G cases, I hope that DH will be ready to tell me the LMP, VE and speculum findings, basic menses, sexual and obstetric history and Pap smear, or else my sarcasm will slice the D off his egoistic DH...

... provided that he actually have a D.