Hiccups...

It's been ages since i had one episode...and it just happen to occur when i had an bad case of upper respiratory tract infection.Runny nose,sore throat,fever and hiccups...

Some info about hiccup which to share(taken from emedicine-the website you trust XD)

Hiccup,medical term= singultus.It serve no purpose except to irritate you.It just an embarassement when you are having it while listening to patient's problem(but it does make d kids laughed).Usually affect the left hemodiaphragm.It can occur 4-60 times per minute.

Exact cause of it?=Mystery

Brilliant people has been postulating:

Hypocrates and celcus=liver inflamation

Shortt 1833=phrenic nerve irritation

Bailey 1943 has come up with a hiccup relex arch,which consist of afferent limb,hiccup center,connections to other systems and efferent limbs.

It will ring a red flag if the hiccup has been persistent more than 48 hours,which required a very detail history and examinations.Basically everything can caused a persistent /intractable hiccup.

Respiratory :pneumonia,empyema,asthma,bronchitis,diaphragmatic injuries.
Cardiac :pericarditis,myocardial infarction,
Electrolyte :low sodium,potassium,calcium,uraemia,
GI Tract :peritonitis,abscess,gastroenteritis,esophagitis...and there's more to go...

Treatment options:
Conventional methods:breath holding,changing breathing pattern,stucking a catheter into nose/mouth,digital rectal stimulation(wow),carotid massage...etc etc

Medical:
haloperidol,metochlopramide...

It's just a simple hiccup,but it can mean so much more...thankfully mine has resolved...

Life = Beautiful

I come to a conclusion that life can be very simple,to gain,there's always giving/sharing.plus that little luck factor.

With painful legs/knees for 3 days,i have seen the most beautiful sunrise in my life,made really good memories with my friends,and see how truely wonderful Sabah can be.

With sacrifice of being near to home,i have seen the beautiful side of Sabahan,being polite,helpful and generous(Even if it means driving up the pedestrian walkway to make way for ambulance)

With lost of most of my "me-time",i have seen myself better.

With all those moments of life and death,it made me realize "you never know what will happen when the next second comes".

With alteration of my physiology after going into accident and emergency department,i have seen some really interesting cases..(eg a small thread like worm sticking on my gloved finger after per rectal examination,a man walked in with creatinine level of 2817,rat as big as a cat bitten a 2 year old child,how a jelly fish can sting....)

I am just grateful for who and where i am.........Life truely can be beautiful!

How To Save A Life-The Fray

This song always reminded me of the ones i've lost,of those regrets ,and of those moments where i dont dare to relive...I am just glad i am here,and all that are still with me....thank you :).It's is October again,and i just wana say i missed you !

Step one you said we need to talk

He walks you said sit down it's just a talk

He smiles politely back at you

You stare politely right on through

Some sort of window to your right

As he goes left you stay right

Between the line of fear and blame

You begin to wonder why you came

Where did i go wrong,i lost a friend

Somewhere along the bitterness

And i would stayed up with you all night

Had i known how to save a life

Holiday....where are you??

I cant wait to go on my holiday....days are getting a bit routine...but i made some new friends,gain lots of new experince,and finally found a posting which i fell in love with....still........i want holiday...............

I just have to say it

Power,authority corrupts people.Meeting a few of the seniors SP recently really reflect how true is the statement.

When they are in a higher authority and can manipulate things according to their wishes,it doesnt matter how it will affect others,the most important thing is wether they like it or not,regardless it is right or wrong.

When there's acheivement,when there's success,yes ,we must let the world know about it!Creating a fan club and forcing people to like it,wow....

When there's conflict in between departments,let just involve the HO in it,the more the merrier right?

The statement"houseman nowadays is a protected species,even SP afraid of letter of complaint by houseman to the DG" I was thinking:"If a good senior SP who knows how to teach well,doesnt really give a damn wether they are being complaint or not,because they are such excellent and sincere teachers."

Another statement who shocked me the most:"selectively we teach the housemans,only those who shows interest"Again thoughts are running in my head:"please say the things tht you do in reality,god please help us".

Im not a super best HO among the bunch,but seeing and listening to these kind of things,really made me wana laugh ,it's this the level we are at?

I am so sorry...

Life is so unpredictable,so is disease progression.Life always give me a lesson that i may never forget for the rest of my life.And people say im a Jonah now...Maybe i am

It happen within minutes....He was talking fine to me in high dependency unit minutes ago after the morning blood taking,suddenly collapsed and unresponsive the other minute.While doing the CPR,bagging the patient,my heart was racing.

"What went wrong?"

"Why a minute ago you were perfectly fine,now your pupils are fixed and dilated?"

"Why has you heart stopped beating ?"

"Are we missing something here?"

I tried to intubate but to no avail,i've called for help,i've given adrenaline,bagging and CPR....What else can i do???........

Eventually thing sorted out when help came.Difficult intubation but in the end he was more stable.

I cannot meet the gaze of her wife when i left HDU.

I cannot bear seeing the teary face of a 50's old lady,who wondering what had become of her beloved....

I cannot imagine her feeling of insecurity and worriness,of losing a person who been sharing years and years of love and companionship.

While walking out from the hospital,it was another beautiful day with clear sky and bright sunshine.Inside my mind was a different story...

Plan

Lesson kept on repeating,no matter how well you planned for the future,it may not always go accordingly...well....who cares,happiness matters right?