Hello? Is it Swine?

Tonsilitis... unable to swallow properly... strepsils never work... tot it will just get better after one or two days... but... no... new symptoms coming... blocked nose, stomachache, runny nose, headache, fever, rigors, chills... all come at once... spending time hiding under the blanket with lots of paracetamol and decongestant.... Just flown back from Malaysia a week ago... working in hospital... looks like i am in the high risk group for getting the infamous swine flu....

Access the NHS Swine flu service... done the questionaire and given the authorisation code for Tamiflu.... to take or not to take?? What should i do?? Is it swine flu? or is it just common flu... what should i do?? Done a bit of research online realise tamiflu not helpful but just something to help to make the recovery process slightly faster... and i have already have the symptoms for more than 48 hrs.. so tamiflu not for me then.... hopefully i will survive....

together with all the worries i have at the moment.... not helping... making the recovery process harder... no one will be able to help... hopefully things will get better... the light at the end of the tunnel is never ending... now another tiny dimmer light at another end.... going for that light seems like a better option now to make things slightly better... hopefully things will finally settled... hope to put an end to all these nonsense.... Hopefully God created this other light for a better future for us... Pray for me and my family... hopefully things will start to settle and things will get better sooon..... Father lord...

What would you do...

Potassium of 7.5 Doc... in a very haemolysed sample.... but with urea of 68 and creatinine of 450.... what do u wanna do doc.... Previously all normal blood.... (EXTREMELY DIFFICULT TO BLEED.... SEVERE DEHYDRATED)

(For those non medic out there... high potassium meaning bad... dammm bad.... can die one ... well... and this post might be extremely boring for you... can stop reading now.... )

-_-'''

That's exactly my expression when i received that call from the ward....

What would you do?
(A) Call For Help
(B) Ignore it
(C) Go and see the patient while ask for an ECG
(D) Continue flirting with A&E Nurse

For those who knows me well... my answer obviously is (D).... :-þ

No... i did not.... (C) was what i did.... that's what we all do anyway.... get a ECG and normally it's normal so just ignore it then repeat another sample... and pray hard it's just because of the haemolysed sample...

BUT... this time round.... ECG showed stonking Tall tented T wave V2-V3... Flatenned P Wave... just the type of ECG u will see when u flip open the ALS book... So the next question is... to TREAT or not ??

(A) Give Calcium Gluconate and rpt sample
(B) Give Insulin+Dex and Salbutamol Nebs
(C) Ignore it

(A) that what i did... it did not get better.... K+ came back 8.9 -_-'''''''''' Steady and calm... gave (B) now.... done Blood Gas.... pH 7.25, PCO2 3.8, PaO2 13.8, HCO3 17, BE -9.5... what else can i do now??? Having just done ALS... Sodium Bicarb the next step??? if not she will just get Cardiac arrest because i did not manage to reverse the reversible cause... Ppl... what would u do?? let me know....

What have i being doing?? Pictures tell it all

Reviving!!

Lots of thing happening since my last entry... firstly... I am no more FY1 Doc... i'm now FY2... haha... what's the diff?? Nothing really... other than changing how i introduce over the phone when i answer my bleep... no more surgical house officer... but SENIOR House Officer...!!!
No more attached to Vascular... nightmare team over... now to ENT.... Still couldn't believe i got over it... not entirely smooth sail... lots of bumpy rides and unforgettable one... without forgetting Mrs. A's surprise visit... which grant me 2 weeks off... The day after we swap over... Lagy still pulls me away from my new team asking me how all his patient doing... without realising we have already changed over.... Bumped into him on the corridor with his new houseofficer who happened to be the hottest Fy1... The only comment he could give to me was '' Hey Teck, Look now... we have a better looking bunch then u lots'' bitter... -_-''

So how is it like being a SHO? Running the surgical side of the Hospital as the most senior Dr sometime is again not for the faint hearted... One Important tips for every junior Drs, next time always get hold of your registrar mobile no... cause the bloody bleep will never be loud enough to drag your registrar out from the cozy bed to help you... The first set of nights where Mr. W the consultant surgeon, with a reputation that i shall not disclose here,whom i met for the very first time, caught me eating pizza in the mess before the working hours is deeem unacceptable. Not a very good first impression... :( I am actually not allow to be in the mess before my working hours, i am suppose to be working the minute i step into the hospital... and his comment about me when he first saw me.... " SO, you are the famous TECK '', left me and the rest of the team puzzled about what is the factor that have made me famous... the other comment that Mr. W said to the surgical directorate director (N.V)

Mr. W: How can the night team not consist of a SHO?
N.V : Hold on, you are wrong... you did have a SHO... that's Teck....
Mr. W: Oh no... Teck is not a SHO, he is pretending to be a SHO...

(His comment above was not unfair... because the day before, i was still a FY1, the next day i am already a FY2 )

Covering orthopaedics was not great experience... accepting too many inappropriate referrals have made my registrar annoyed... and me having to discharge them myself hopefully to keep him happy really not the ideal way of practicing medicine... putting my GMC registration hanging on a very thin string... So far... all the ortho cases have not been repeating... until now... i have not got a single case which is similar to the other... amazing what ppl could do especially on a bright sunny days.... instead of keeping themself safe when doing the good outdoor activities fun... they rather live life the dangerous way by presenting themself to Emergency Dept with broken humerus, radius, ulnar, femur, hips, tibia, fibula, clavicles, ribs, maxilla, jaw, skull or torn biceps, triceps, achilles tendon etc. So far the most bizzare injury i have attended was lifted off ground playing kite surfing and fall from 10m high... sustained no major injury other than 2 broken incisor teeth... Being the only Orthopaedics specialist in the hospital at night is really . ridiculous when ED is only staffed by two other fellow FY2s who have not done orthopaedics before... My conversation with an A&E sister about the state of the A&E at night.... :

Me: Don't you think it's absolutely a joke when the A&E is only managed by two Fy2 doctors... who in fact none of them are trained neither in ALS, ATLS nor APLS...
S/N: Well... that's not true... we have been through all this before... our consultants have got this planned....
Me: Oh, really... tell me about it...
S/N: Well, you see... although there's no senior drs down in A&E at night... there are still senior Drs of all specialties up there that shall be called immediately if have troubles...
Me: True... that's true... in the ideal world.... BUT... just consider tonight... do u know who is around tonight? It's ME... and me alone... covering General Surgery, Urology, ENT, Orthopaedics... my registrar's sleeping at home 5 minutes away.... Paeds SHO is again another Fy2... The medical SHO who happened to be my friend... another FY2... well ya.. medical SpR is around... SO to be honest... the only senior Dr. in the hospital tonight... is the medical SpR.... I am sure your consultant did thought about it... but i bet he/she forgot to tell the department their great plan
S/N: ..... Ooops...



I bet all the non doctors outside who happen to reading this entry must be thinking...
(OMG, I better make sure myself not getting admitted to that hospital)
(What kind of Hospital is this guy working in ???)
(Hmmm.... OH NO... how can we give our life and our love ones to all these people... )
To be FAIR ppl... your life will be fine... coming to hospitals at night... similar things are happening throughout the UK... especially in the district general hospital... we might not be able to help you the time you admit urself to the hospital.... but we and the nurses are definitely capable of prolong your life till the bosses come in... SO NOT TO WORRY!!!

Well... here i am starting my nights again tomolo... so ppl .... please take care of yourself... dun come to hospital at night... if you happen to pick up by the ambulance (touch wood) ask them to divert you to poole or bournemouth... don come to Dorset County... Although i doubt it would be much better on that side of the world...

Being blame again

*Sigh Sigh* To add on... Friday did not get better....

New patient not being seen during ward round when i was busy in other ward yesterday because my colleague did not bring the consultant to see him... turned out to be my whole team fault...

Patients not handed over to the juniors after being reviewed by our registrar without our presence turned out to be our fault again because of the absent minded registrar... and his poor communication...

Blood got stucked in the pod system in the system that delay the surgery happen to be our fault as well... get a grilling and cold and hard slam on the door by the consultant...

Patient refusing to be cannulated and being aggresive and deemed not safe for us to approach...thus bloods not taken for 2 days... turned out to our incompetency as well....

"Team!!! I expect a higher level of care for my patient in my team!!! " said the boss...

And just being woken up by a fast phone call today from night house officer... telling me that another houseofficer deleted our one and only list from the computer accidentally but refused to admit her mistake.... thus a new list is created based on a random piece of old list dated few days ago... when there were such high turnover and at least 7 new patients lying in the hospital which might be missed during today round...

Oh GOd... i really do not want to go in and work this monday!!!