Eggs

Some people's favourite food is lobster, crab or some oyster.

But my favourite food is the simple egg, especially sunny side up. cheap and tasty.

When I was dirt-poor, back in my undergraduate days, I would go to the mamak, order plain rice and only an egg. damage RM1.00.

And those arts of egg really keep me very happy indeed. Not my own creation, but I found them.
My favorite is the 4th with the green bunny, which one is your favourite?

Keeping abreast of things

Grateful to: Dr. R for more solo flights on Lap BTL, and first Lap & dye. I bloody addicted to laparoscopy. Probably it’s not an addiction, more of peer pressure over here.

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Definitely, I had to thank Palmdoc, for the update on Breast Cancer screening. If you’re too busy to read through the whole long article, let me spare you the agony and cut the chase. The main point is

1 pushing mammogram screening age from 40years old to 50years old, and less mammogram repeats, probably 2-yearly rather than annually.

2 self-breast examination is NOT, yes, NOOOOOOOOOT recommended, as it doesn’t reduce the harm, but increase anxiety and unnecessary insults to the breast.

After breaking few sweats over few games of table tennis over lunch break, I rushed back to the clinic. As usual, the bulk of patients after lunch break usually aren’t many, usually in multiple small crowds, won’t even make an illegal gathering counts.

I sat down in my comfy chair, absorbing the lyrical ambience of low-volumed Jason Mrez’s wonderful vocal creations, waiting for my first patient to scroll in, err… I mean stroll in. Too much of computering is really getting me pretty confused, at times.

An elderly Indian auntie made small steps into the room. I welcomed her with a smile (yes, I guess sports-induced endorphin is a good thing), and showed her the seat.

She doesn’t look too happy to me. It is not like she is unhappy, nor ill or depressed, but her face seemed to show some sense of helplessness, with a hint of shyness. Yes, by right, elderly people should be indulging in any shyness, even in the slightest degree.

Gently and slowly, I flip opened the blue ‘gynaecological’ card on my table, which is slightly yellowish at the sides, probably being eaten up by its age.

conversation ensued...

- You’d been us since 1999, are you coming with a new problem. I hope we can help you.

- Not really, actually I removed all my uterus and ovaries and already stopped hormone replacement treatment years back and I am very comfortable

- Ok, and so today, you’re here… (I finally found the referral letter for today)

- My last mammogram done was 3 years back, when I stopped my follow up in HRT clinic. I would like to repeat one for screening. And I called many people, and asked the health clinic, and after few roundabouts, they referred me here since I was previously follow up here and can get mammogram appointment here.

- Huh? (Total disbelief) Oh, so actually you came today to get us to get the mammogram screening from my radiology colleague?

- Yes.

- Ok, don’t worry, let me sort out with my colleagues at health clinic, I don’t think O&G clinic on an Antenatal Clinic day should be for getting mammogram appointment. Somemore, so much time and effort being wasted.

I called the person of which the John Hancock was on the referral letter. She answered the phone, probably thinking at the receiving end, I was going into fit and start scolding her with lots of harsh words.

telephone dialogue...

- Hi, I’m xx from xx. You’re xx from xx

- Ya.

- I called regarding patient wanting to get mammogram screening and …

- Oh, I called the Radiology department, and they won’t give us the mammogram forms, so we can’t order it from health clinic. So they asked us to refer to O&G clinic to get it since she was previous from there.

- Err.. (Disbelief X infinity) even for health promotion, normal health clinic can’t order it?

- Yes, I will talk to my FMS (family medicine specialist) about this.

- Ok. Thanks for the wonderful info.

Health promotion, the frontline of prevention of diseases, definitely failed miserably in the Bolehland. Probably, we’ll need an 1malaysia clinic that can order the mammogram for screening.

Hopefully, it won’t take a million years for the health clinic seriously given enough power and jurisdiction in running health promotion.

I blinked in disbelief, mainly because the health clinic manned by doctors led by a specialist unable to do things right, will the 1malaysia clinic able to do it better only with health assistants?

climategate | fake global warmers exposed !!

Grateful to: Mopiko for providing me soothing cooling temporary relief for my itchy rashes

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With the follow up from the 2012 disaster film, I guess global warming and all the climate change is a pretty worrying thing.

mindblowing evidence...

Thanks to a hacker, and wattsupwiththat, somehow manipulation of data had been exposed.

From emails hacked out of the Climactic Research Unit of the University of East Anglia:

From: Phil Jones

I’ve just completed Mike’s Nature trick of adding in the real temps to each series for the last 20 years (ie from 1981 onwards) amd from 1961 for Keith’s to hide the decline. Mike’s series got the annual land and marine values while the other two got April-Sept for NH land N of 20N. The latter two are real for 1999,

while the estimate for 1999 for NH combined is +0.44C wrt 61-90.

To which is replied to by one guilty (or self-protecting and nervous) soul:

I’m not too comfortable with this, and would rather not sign — at least not without some real time to think it through and debate the issue. It is unprecedented and political, and that worries me.

And there is this long list of collection rebuttal of global warming. Pretty impressive.

I guess perhaps, there's no point in worrying about global warming right now, but still, being environmentally-friendly should be all the way starting right from now. Maybe when global warming is real, there's really no turning back.

P.S. Damn. So i can't really blame the hot sun for my rashes. Maybe I am just allergic to @#$#$*&. Yeah, I meant to swear. Relieved - but not completely.

pathophysiology of twisted news

Stumbled upon this piece of news

GOPENG: V. Divyashree, who died in the bridge collapse incident at SK Kuala Dipang in Jeram on Oct 26, had wanted to be a doctor and her UPSR results were testament to what might have been.

The SJK (T) Gopeng pupil scored four As and three Bs in the exam. Her father, K. Vasudevan, 34, said Divyashree had wanted to become an orthopaedic surgeon so that she could determine why he was so skinny.

“It was one of the reasons she tried to do well in her studies,” said Vasudevan when met at his home in Taman Changkat Golf after obtaining Divyashree’s UPSR results on Thursday.

”She was very competitive and wanted to succeed in everything she did,” he added.

Divyashree, 12, and two other pupils, N. Dina Deve and M. Devatharshini, both 11, drowned when a suspension bridge they were on collapsed. All three were attending a 1Malaysia camp.

Vasudevan, who works as a technician in Kuala Lumpur, said the family was proud of his daughter’s achievement.

and i posted it in facebook and I got several comments.

"Divyashree had wanted to become an orthopaedic surgeon so that she could determine why she was so skinny." Interesting...

Yew Shiong Shiong

er... orthopedic causes for cachexia? er... osteosarcoma? Paget's? Ehler's Danlos? some sort of syndrome?... crap, i'm stumped...

Chow Kar Meng

hmm... every1 has a dream, i guess such trivia issue would gain readership ? I can find more heart wreaking stories around net/blog than this.

Poongundran Pannerselvan

For god's sake. It's a twelve year old girl. Can you tell all these diseases when you are tweve years old of course not. So what's the great harm to have such an ambition. Now that she's gone just let her rest in peace no need to torment on her ambition

Poongundran Pannerselvan

And I'm sure this orthopaedics thingy was told by her parents and not her as she's no longer around. For a parent who have just lost their child even the most utter nonsense could mean a gem of an issue to them. So if you guys can't sympatise and show some empathy, the least that you can do is not to post crappy messages like this

Seriously, i think the one who is truly ridiculing the unfortunate girl is the one who contributes to that twisted statement. The best bet is on the journalist, to spice up the news piece.

As much as I sympathize (I couldn't empathize yet) all the victims, I also sympathized the ridiculous progress of this incident. I really couldn't believe it when I read about the news about YB Ngeh filing a motion in Parliament to cut RM 10 (YES!! RM 10) from the salary of Ministry of Education because of this incident.

1. what does education have to do with this incident? the bridge is open for public,right?
   are you saying asking students to cross a bridge a potential dangerous activity?
   you expect the students to sit down, indulge in DOTA and call it a valid extra-curricular?
   
2. the person who are evidently involved in the construction should be charged in court for murder, or at least manslaughter. There is no use shutting down the company, and let the individual start another company, and start killing people and cut another 10 bucks off some minister's pay.
3. RM10. Wow! Like that's going to make a big difference - for a minister.
   

The fact that someone need to grow up to be not just any doctor, but to be an orthopaedic surgeon to determine why she is skinny, perhaps does tell us how pathetic the state of healthcare now.

Why can't she go to see a doctor and find the solution to her being skinny or underweight immediately, and not wait till she all grown up?
Or was her family being marginalized in the past when seeking treatment and health advice for being skinny?

Speaking of healthcare, I read in awe of the pekeliling on 1malaysia clinic.

Some of the contents I brought up here just to state my personal opinion.
If I am wrong (yes, bumi mana yang tidak ditimpa hujan), do correct me. Thank you.

Dengan wujudnya perkhidmatan ini ianya dijangka dapat membantu
mengurangkan beban pesakit di klinik kesihatan di kawasan Bandar sedia ada .
Dalam hal ini akses masyarakat untuk mendapatkan rawatan ringan
terutamanya di kawasan bandar dapat ditingkatkan

The city or the suburban areas is crowded with hospital and clinics with abundance of health care facility, while the kampongs and rural places were less equipped, most defaulted follow up because they couldn't rake up enough money to pay the taxi man to take them from their house to the hospital near the 'kawasan Bandar'. Tragically, some even succumb to their death on the journey to the 'kawasan Bandar'. I do not have valid solid stats, but I think my colleagues at Sabah or Sarawak have lots of those tragic tales of real citizen of 1malaysia dying or suffering because that bloody1hospital/clinic is so bloody far1. Or maybe, they had stopped telling those tales, because it had became a norm and nobody listened to them anyway.
1malaysia (tetapi tidak termasuk kawasan kampung dan pedalaman)?

Secara amnya skop yang dicadangkan adalah skop perkhidmatan yang boleh
dikendalikan oleh Penolong Pegawai Perubatan dan Jururawat Terlatih. Ianya
meliputi:
• Perkhidmatan rawatan ringan
• Susulan kes penyakit kronik
• Melakukan prosedur rawatan ringan
• Membuat notifikasi bagi penyakit berjangkit
• Menstabilkan pesakit sebelum dirujuk ke hospital berdekatan bagi kes kecemasan
• Perkhidmatan makmal menggunakan point of care test
• Pendispesan ubat
• Khidmat nasihat / promosi kesihatan kepada pesakit

The public don't even trust the some doctors nowadays, would you expect them to seek treatment to a clinic manned by Medical Assistants and Nurses?
Besides, if they can't dispense MCs, majority won't be interested, anyway.
If they can dispense MC, I think it would be an instant hit, no matter how unethical it would be.
Chronic illnesses have a higher risk of complications to arise.
Are the MAs and nurses well-equipped with the knowledge to detect those complications, when even the typical average-hardworking doctor may miss them?
To dispense medication? Any pharmacist commenting on this?

Kes yang diluar bidang Penolong Pegawai Perubatan akan dirujuk ke klinik
kesihatan atau hospital berdekatan dimana perkhidmatan disediakan oleh
Pegawai Perubatan. Bagi rawatan kecemasan, perkhidmatan yang disediakan
ialah menstabilkan pesakit sebelum dirujuk ke hospital berdekatan

Failure to recognize impending calamity, this flow of medical referral might probably cause delay in commencing early treatment to reduce morbidity or mortality. Putting a 'safety net' clause of a doctor is somewhere readily available ain't that convincing.

Kerajaan telah meluluskan peruntukan sebanyak RM 10 juta untuk operasi 50

klinik di seluruh negara setahun.

That's RM 0.2 million of taxpayer's money per clinic, probably wasted. Although, nurses are already in shortage in hospital, even there were rumours about taking in foreign nurses, and now, a good number of them had to be sent out to this clinic.

V. Divyashree, you had passed away, trying to enlighten us all the sorry state of civil engineering and healthcare in our country.

I hope someone is listening.
I hope everyone is listening.
I hope you rest in peace.

anatomy of modern woman

Whatever you give a woman, she will make greater.

If you give her sperm, she’ll give you a baby.

If you give her a house, she’ll give you a home.

If you give her groceries, she’ll give you a meal.

If you give her a smile, she’ll give you her heart.

She multiplies and enlarges what is given to her.

So, if you give her any crap, be ready to receive a tonnes of shit.