january rant

- bismillah -

Alhamdulillah, January has been nice to me. 

Changed my portfolio at work, that is from being in charge at maternal child health clinic to regular outpatient department clinic. I have to hold TB, HIV portfolio, pain clinic as well as hypertension audit. 

So far, i have 'recruited' 2 newly diagnosed PTB patients 😂 i saw them prior sputum afb, but somehow after the results were out they were 'destined' to meet other doctors... hehe hence i have no direct experience yet to initiate tab akurit-4 to ptb patient despite being mo tb hewhew.

I am grateful that my colleagues have been nice and supportive, hardworking, doing our best in seeing patients... basically we were all new to each other hence no deep attachment or heart feeling if we had ever done something unexpected. I dont know if it was only me or everyone feeling the same, we only met at work and most of the time we were talking only about work. I feel good about it, but yeah, things are just great like this. 

Usually we will get a new planner by KKM, but until now (final week of January 2023) we still haven't get it yet. It's quite disappointing though. I really appreciate the planner given by kkm since previous years, that no empty page left as the year ended 😂

Anyway, bought my own..but still waiting for the courier to deliver it.

I think i have undiagnosed ADHD, but somehow i started to see everyone around me struggling the same/ similar symptoms but living fine undiagnosed. Well, so far i give myself time and kind of watchful waiting, if things are getting worse or disturbing then i will seek professional medical attention to confirm my self-doubt. 

So far i need to write everything in places i can see.

Avoid multitasking without written to-do list.

Reply messages now or never.

Listen more in conversation.

Drive slower and farther from the front vehicles.

But today i blurted my thoughts to a patient. "Do you smoke? I can smell a very strong odour from you," i told a patient. Rupa2nya the cleaning staff tengah bakar sampah dekat tepi klinik 😭 i minta maaf dgn the patient and lucky enough he is very supportive and just laugh with my sudden reaction. #impulsiveme

Today i managed to complete a mortality report (after 1 week of procrastination), that is only i have listed step by step of what and how to do things. Thanks to my colleagues who are very helpful (both mo and ma are kind alhamdulillah).

I also managed to run errands for my ngo i'm participating. Things are so smooth if we took care of our niat on why we're doing things. Alhamdulillah. Went to 3 shops before i get to have my task done (potostat ja pun), the 3rd shop baru berjaya.

Lepas kuar dari kedai, i sat long in the car before driving back home. Cabut pin betulkan my shawl yg dah ke belakang nampak dahi jendul, wear my lipbalm and sprayed perfume. Then i drive happily back home sambil makan kinder bueno.

These small things help me to be insane and mindful, less stress and be happy with today's achievement, because, my adhd brain dont easily feel happy unless i do something to feel happy. The brain just didnt give enough happiness signal eventho i did things amazingly at work today. 

Oh yeah i forgot to mention that i refered a maternal case to ED at 450pm. Haha. That is an achievement u know, to punch out 5pm without dragging time haha.

Today also jadi mo standby waktu lunch hour, so by 2-3 pm keluar pergi zus coffee, pkul 3pm masuk kerja semula. Good day alhamdulillah.

Esok jumaat, semoga lebih murah rezeki. Amiin.

Ps. Nampak tak ideas are unorganized in this post hahahaha #rant

2022 recap

Alhamdulillah

The year 2022 has been a rollercoaster of emotions in my career, specifically.

At the beginning of the year, i was assigned as the MO in charge for the maternal child clinic department in my KK. I see antenatal cases every morning, with postnatal follow ups, well child examinations as well as covering growth monitoring for children until 6y/o. Besides getting along with nurses and staffs from mch clinic, i also worked with my fellow staff nurses from 4 other klinik desa (community clinics).

In mch, i have to master the scan, contraceptives counseling and insertion, as well as tackling infants and childrens developmental assessment.

I joined a 3-month-duration attachment program with specialists from O&G department in the state hospital to master basic gyne and antenatal ultrasound skill.

I went to various courses and meetings related to mch issues, such as 20-hour lactation course, perinatal and under 5 mortality meetings, being baby-friendly clinic auditor, being chief investigator for aefi incident in another clinic, delivered cmes to fellow mos and nurses, doing monthly reten, etc. I also managed to join volunteer program under papisma on weekends. Alhamdulillah. The last course that i attended was implanon removal course hehehe.

My personal achievements - what i mean by personal is only i celebrate it haha - were 1) getting anemia rate lowest among other clinics during jan-sept meeting hehe, 2) successfully removed an implanon of a patient for the first time hahaha (dec 2022), 3) took medex and ace it alhamdulillah (nov-dec 2022), 4) drive by myself to airport and left my car there for 'a business trip' flight - which i never thought i would do such before, well, i used to have my parents sending and fetching me everywhere i go previously during school/studying days.

There was a sad moment though, which when i was not offered for permanent post in my career. I was sad because i had compared with my fellow friends. There would be discrepancy in salary, time of service, etc. I think i was at least equal to them, if not any lower. But then i realised this is a matter of rezeki. There were lots more persons with better quality, skills and achievements but also didnt get the offer. Well, we just dont find faults in ourselves, will ya?

It was after that sorrow period that i braced myself and challenged to take medex exam. I have my worth, and being offered permanent or contract is not going to downgrade my 'worth'.

I have to keep going. I have to find ways to further study. Taking medex is one small step for the beginning.

Anyway, i had a blast on my last days of working. I remembered there was one afternoon, when i finished seeing a patient but still documenting the findings, a child came walking alone into the room and wandered around. I greeted him but there was no reply heard. He looked at me, and then i remembered that he was one of my patients with adhd and speech delay. The child took a sit near me, watching me writing, he was listening to my questions but he was silent. Later, he waves his hands to me and went outside the room. I was stunned. 'oh, he was trying to talk with me! he was saying goodbye just now' and i can feel my eyes became teary. He remembered me, myb during the first time i met him. Hopefully all the efforts done to make him converse are fruitful.

Besides that, i jaga fever clinic on the last friday of 2022. Surprisingly, there was only 1 patient came in the afternoon session after friday prayer hahaha. So i spent the rest of my time with sudoku and freecell hahahaha.

When i was walking with other staffs, there were times when miscommunication and errors happened. There was one session when i had to call them face to face explaining where and whose the fault was, later offering solutions (and punishment hehe). Types of punishment would be the head nurse should deliver cme in their respective klinik desa if they had ever messed with any case management.

I hope i had resolved interpersonal issues with them, i lanjer starbucks (bancuh sendiri hahaha) as token of appreciations and token minta maaf berleter banyak dkt diorang 😂 (pray may Allah accept the deed amiin)

Most difficult patient would be one lady from anti-everything side. Lets not talk more about that. 

Most beloved moment was on my last day working when suddenly a kakak nurse came to me and handed me a gift from her recent umrah trip. Alhamdulillah. I feel appreciated hehe

Anyway, that's all (part of) recaps, written in hurry few minutes prior 12 midnight 31/12/22, but somehow i terlajak jugak. So nanti post ni jadi 1st post for 2023 lol.

There were no cheezy drama relationship thingy moment in my 2022, i am just simply grateful for everything and everyone around me.

Apart from career, in 2022 my car had its first kemek at back door after being hit by another car while i was changing the lane (or myb i hit that another car lol), alhamdulillah it was a smooth process and solved. Since then i invested in 70mai dashcam set (so my 1st 70mai is in 2022, after 4 years loyalty to yicam front-dashcam only)

Travel-wise, alhamdulillah done recap in my ig.

Anyway, this is it. Alhamdulillah for everything. I thank Allah for everything. 

لا حول ولا قوّة الّا بالله

There is no will and strength except for what Allah has decreed upon us

May Allah bless every moment with barakah,

Semoga 2022 diberkati,

Semoga 2023 dipermudahkan segala urusan kebaikan.

Alhamdulillah utk 2022,

Bismillah utk 2023.

Dengan nama Allah yg dengannya tiada mudarat pada segala sesuatu di langit dan di bumi 🤍✨

business trip

- bismillah -

Alhamdulillah. Allah granted me a trip after a long time. It was all started when seeing a friend's IG story, i pray for such moment too.

And He granted me the best way, subhanallah alhamdulillah.

Allah maha mendengar, maha dekat.

I started my trip with istikharah.

It was to accompany a few friends for a meeting. I wasnt really involved in the meeting in the first place.

I prayed that if it is good, then may Allah make it easy for me before, during and after the trip.

It was a blast. It was full of blessing. Alhamdulillah.

...

May Allah bless me, for what i can tell and what i cant, for what i want and what i dont, for what i have and what i dont.

I dont know i can challenge myself to be independent, until i did it.

Allah has always been with me.

I may feel alone, but no, i was never alone. And i will never be alone. Amiin.

"Thank u for ur participation, may it be counted as ways of obtaining Faith and Guidances from Allah, and be a blessing for your life."

Amiin2.

finding the grip then when life is not a race, but u are left behind...

- bismillah -

Untuk diri ini, it is okay, what ever the struggle you are facing, Allah takkan biar sia-sia.

Allah ada. You are not insignificant dalam pemerhatian dan jagaan Allah. Buat jahat ke, buat baik ke, buruk ke bagus ke, semua Allah tahu dan ada rekod, ada balasan. Nothing insignificant. You lelaki ke you perempuan ke, Allah tak pernah double standard.

Bertaqwa lah kepada Allah.

Yes, the sadness was real and it really is.

However it is, remain bertaqwa kepada Allah.

May Allah bless me.

May Allah guide me.

May Allah make me among the righteous and people who belong to His Jannah under His endless mercy. Amiin.

اللهمّ اكفني بحلالك عن حرامك واغنني بفضلك عن من سواك 

وَالَّذِينَ جَاءُوا مِن بَعْدِهِمْ يَقُولُونَ رَبَّنَا اغْفِرْ لَنَا وَلِإِخْوَانِنَا الَّذِينَ سَبَقُونَا بِالْإِيمَانِ وَلَا تَجْعَلْ فِي قُلُوبِنَا غِلًّا لِّلَّذِينَ آمَنُوا رَبَّنَا إِنَّكَ رَءُوفٌ رَّحِيمٌ 

(سورة الحشر : ١٠)

 لا تجعل في قلوبنا غلا لأحد من أهل الإيمان بك يا ربنا

Semoga yg tengah melalui perasaan yang sama juga terpujuk dengan ayat2 Allah.

🤍💕

kursus trauma dan attended trauma

- bismillah -

Alhamdulillah.

Pada masa tulisan ini dicatatkan, covid 19 di malaysia dan di seluruh dunia terkawal, sudahpun diisytihar endemik (sebelum ini pandemik dunia). 

Alhamdulillah saya dan keluarga terdekat tidak terlibat dengan kes covid yang teruk. Alhamdulillah. Kami mendapat jangkitan covid ketika sudah menjadi endemik hehe. Saya, kakak, abang, kakak ipar, telah disusun dlm perancangan Allah utk dapat covid pada masa yang sama. Alhamdulillah, cat2b saja. Semoga Allah lindung dari long covid. Kami mendapat booster sebelum itu lagi.

Kenapa saya kata disusun takdir? Kerana kakak saya tinggal di negeri berlainan, namun disusun takdir untuk berjumpa dan menjadi kontak rapat saya. Hehe. Sori kakak. Sementara abang dan kakak ipar saya memang ahli rumah.

Ibu dan ayah? SubhanAllah. Moga Allah sentiasa jaga dan lindung mereka selalu. Mereka test negative walaupun duduk serumah dan demam. Besar hikmah dan kuasa Allah melebihi pengetahuan kita.

Semoga Allah ampuni dosa2 dan diangkat darjat mereka yg meninggal dalam wabak ini. Toksu saya yg hanya duduk di dalam rumah tidak ke mana2 juga diuji dengan covid ini hingga ke hujung nyawa. Innalillah.

Anyway, 

Banyak perubahan bila keadaan sudah kembali endemik.

Dulu, semasa pandemik dan PKP dilaksanakan, kendaraan tidak banyak di atas jalan raya. Sekolah ditutup dan bermula sesi persekolahan dari rumah. Saya pergi kerja naik kereta dengan sangat lancar dan lapang, iaitu lebih kurang 15minit saja. Sekarang, apabila keadaan sudah kembali 'asal', 25-30minit juga masa diambil utk ke tempat kerja.

Selain itu, ketika pandemik dan pkp, saya merasa lebih selesa apabila semua menjaga jarak, tidak bersembang dan duduk dekat2. Sekarang, terasa janggal bila ke tempat sesak, dan apabila ada orang duduk di kerusi sebelah! Lebih janggal apabila perlu membuka mask kerana rasa hidung tiada filter lol hahaha.

Di klinik pula, jumlah kedatangan pesakit menurun ketika pandemik dan pkp. Sekarang, bilangan pesakit meningkat 10 kali ganda sehari. Ke mana manusia2 yang sihat semasa pkp dulu? Haha

Sekarang, apabila dibenarkan keluar rumah, ramai yang diserang demam batuk selsema, disengat tebuan, ditimpa kemalangan dan lain2. Betapa selamatnya keadaan apabila ramai hanya duduk di rumah!

Sebenarnya, pandemik ini mengajar kita, utk mengembalikan urusan kepada Allah. Dia berkuasa mentadbir segala sesuatu. Di awal apa2 permulaan, Allah telah mengetahui pengakhirannya utk sesuatu keadaan dan kejadian. Dulu, tak terbayang bagaimana keadaan pandemik ini akan berakhir!

Allah tahu keadaan kita bagaimana bermula, dan Allah tahu bagaimana keadaan kita di pengakhiran. Semoga Allah berkati hidup ini dan diberikan kematian yang baik (husnul khatimah) kepada kita semua.

Jadi, always doa dan doa.

Kebetulan hari ni dan kemarin kursus Trauma Life Support utk dr2 dari klinik kesihatan anjuran pej kesihatan daerah. Teringat kembali kenangan dan pendedahan yang saya dapat dari ED dulu. Beruntung saya menjadi houseman di ED ketika sebelum pandemik. Pengalaman cpr dan resus almost every patient semasa housemen (jonah kan). Rupa2nya saya tidak mencatat di dlm blog ini satu event yang besar yg berlaku.

Ketika itu, hari pertama saya ditugaskan di shift redzone sebagai houseman (kerja siang bukan oncall), bersama2 dengan seorang lagi rakan houseman yang lagi parah penjonahannya (sebenarnya, lebih banyak pengalaman dia dengan pendedahan kepada kes yg lebih byk / complicated).

Kami mendapat panggilan akan menerima kes seorang kanak2 separa sedar, yg terlibat dalam kemalangan motosikal dengan kereta. Daripada 3 orang penunggang motorsikal itu, 1 orang kanak2 lagi telah meninggal di tempat kejadian, manakala seorang penunggang dewasa dan kanak2 tersebut cedera parah.

Kanak2 itu dimasukkan ke redzone, manakala lelaki dewasa itu dibawa ke yellow zone.

Ketika di redzone, kami bersedia dengan memakai glove dan mask. Rakan saya yg cekap itu segera menyediakan alatan2 resus, seperti ET tube saiz kanak2 dan lain2. Saya bersedia dengan troli ambil darah.

Apabila pesakit sampai, mo yg bertugas ketika itu attend the patient. Pesakit sedar dan diberikan bantuan oksigen. Pasukan pediatrik dirujuk. Ibu kanak2 itu pun sampai. Lega. Kanak2 ini boleh dimonitor tanpa perlu intubate.

Namun, selang beberapa minit, mangsa kemalangan dewasa tadi (ayah kepada kanak2 itu) ditolak masuk dari yellow zone ke redzone. Open book fracture!, beritahu seorang mo lain dari yellow. Dia yg melakukan pelvic spring ke atas patient itu lalu segera dapat detect kecederaan yg teruk itu. Open book fracture jika lambat di detect boleh mengancam nyawa pesakit. Nauzubillah.

Benarlah, high impact injury, terutama apabila ada mangsa kemalangan yang meninggal di tempat kejadian, maka pesakit yg terlibat tidak mungkin cedera sikit2 saja. Kena ada high index of suspicion utk critical injury / life threatening injury.

Protokol resus dijalankan. Saya sebagai houseman terfunction dengan rakan saya, menjadi runner untuk bekalan darah dan lain2. Massive transfusion protocol diaktifkan. Ulang-alik dari ED ke blood bank dengan ice box, double check blood identity dengan patient identity. Kawan saya accompany patient itu utk ct scan dan xray. 

Semua orang bekerja keras sehingga pesakit stabil, pasukan ortho dan anaesth pun turun ke ED. Sehinggalah kami berhenti apabila pesakit sudah dimasukkan ke icu. Lega.

Tidak dilupakan, amik ample history dari si ibu (yang juga isteri pesakit) yang mukanya pucat, pasrah, sedih dan blur. Dia sedih tapi tenang, dia menangis namun bukan meraung. Si anak awalnya kritikal di red zone, kemudian si suami pula rupa2nya lebih kritikal daripada si anak! Keadaan bagai telur di hujung tanduk! 

Keesokan harinya, atau beberapa hari selepas itu, mo yellow saya yg attend case tu beritahu patient survived dan selamat. Alhamdulillah. Tak ingat pula berapa litre darah, yg pasti byk kali ulang amik darah hehehehe. Mo saya ucapkan terima kasih dan tahniah atas teamwork semua.

Waktu tu baru saya faham, begitu rasanya apabila usaha kita menyelamatkan patient berjaya. Begitu rupanya rasa dihargai dan menghargai. Dan begitu rupanya rasa syukur apabila mendapat pendedahan dan pengajaran dari Allah melalui kejadian ini...

Allah beri ujian dalam keadaan yg kita mampu, dengan teamwork, facility, knowledge, resources etc.

SubhanAllah. Cantik aturan Allah.

Sebab sekarang, sy takmau dah jumpa kes pelik2 ni 😂 sebab keadaan tak sesuai hahahaha

Cukuplah utk pengalaman yg boleh diceritakan dan disyukuri. Moga dicatat dlm amal soleh yg Allah terima. Ilmu2 yg diajar senior2 dan rakan2 juga merupakan amal soleh jika ikhlas diberikan.

Sekian kaitan cerita kursus trauma life support hari ni dengan alkisah polytrauma with open book fracture suata masa dulu sebagai houseman.

Alhamdulillah utk segalanya.

Ps. Rindu pula attend patients mva di yellow zones.. hehehe jumpa finding lain macam cepat2 escalate ke red zone #penjonahan

MCH experience

- bismillah -

Just for a quick brain dump.

Currently i am in MCH, maternal child health clinic, taking care of antenatal and postnatal ladies, and children below 5 years old.

It has been 6 months.

I have the opportunity and exposure to meet with different interesting cases. One of them that i remember the most was, a case of single mother with unwanted pregnancy with her partner. She is para 2, so that was her third pregnancy. She came for booking late, at 2nd trimester of pregnanc. Her booking Hb was 10.0mg/dL. Her serum feritin level was 9 (severe iron deficient). She didnt take any oral iron supplements given from clinic. As expected, the Hb trends dropping. Nurses and JM have been telling her about compliance of oral hematinics in pregnancy. I met her and talked about the situation. I counselled her for IV parenteral iron, the need for faster anemia correction at third trimester, the importance of preparing for safe delivery, of which surprisingly she agreed. Guess what was her Hb at 36/52 gestation after receiving IV cosmofer? Was the anemia corrected prior delivery? 

Haha.

Alhamdulillah.

Alhamdulillah. 

Alhamdulillah.

From this situation, i learnt about boundaries and capabilities. A mother is responsible for her baby and children, but we, as health practitioners can only guide them and help them how to, not forcing them. And the end result should be a win-win situation for both parties; which is when the mother is informed and not forced with her decisions, and the doctor able to prepare her for safe delivery with lower risk of bleeding.

SubhanAllah.

We cannot bring harm to others, indeed we are also incapable of doing any good or harm, as we also believe all the goodness and everything that occurs to a person are all under Allah's will.

May Allah bless me and everyone around me.

#psowarrior

My skin flares up again.

May Allah forgive me.