Terima Kasih, Nak.

April 30, 2020


Today morning, just before Subuh prayer, a patient came with complaint of generalised itchiness with periorbital edema (means - bengkak di sekitar mata) that made his eyes become so small, I barely can see.

HCW : dah berapa lama dah jadi macam ni pakcik?

Pakcik : masuk hari keempat ni, pakcik pun taktaw kat mana silapnya. Bangun-bangun tidur, terus jadi camtu, pastu pakcik pergi klinik, dia bagi ubat gatal, ubat allergik, ubat sapu. Tapi makin teruk pulak bengkak kat mata ni.

If you received medications like these (only tablets with label of symptoms), please kindly ask the clinic to write down the name at least. Is it piriton, prednisolone? It is tricky even for us to know the names of medications just from the tablets. 

Anaphylaxis - Wikipedia
Something like this. Wikipedia



Maybe there was some allergens on his bed, maybe some insects, or maybe some food he ate before. The patient denied any history of food allergy. Though he had some allergic to an analgesics - pain killer (unsure name), he denied any history of taking analgesics prior to symptoms.

At first I got confused if this is allergic reaction OR anaphylactic reaction (which the latter is worse), I quickly read back the notes shared by one of my favourite medical officer and found this.




Going through by systems:

Skin - yeah, pakcik got some itchiness all over body with periorbital edema.
Respiratory - he denied any problem with breathing - no shortness of breath / chest pain / wheezing etc. And the lung was okay, no wheezing (wheezing ni selalu jadi bila saluran nafas jadi sempit, macam orang kena serangan asma.
Gastrointestinal - he also denied any abdominal pain / vomit / diarrhea
Cardiovascular - no history of dizziness / shock / fainted
Neurological - none as well.



Diagnosis:
Allergic reaction secondary to ? cause.

Intravenous cannulation done, we decided to give these medications given:
- IV hydrocortisone 200mg stat
- IV piriton 10mg stat
- IV ranitidine 50mg stat

After discussing with senior about IM adrenaline, there is less harm than benefits to give... though this is allergic reaction (not anaphylactic) - so, IM adrenaline 0.5mg stat. 

We reaccessed patient about 30minutes later, the first thing he said "Nak, pakcik dah boleh nampak, terima kasih, nak." We can see the swelling around his eyes already improved much! He claimed the itchiness also had improved, hence we decided to allow him to go home with some medications.


A thing about this pakcik was he kept on smiling through out his visit in ED, soft spoken as well. Dah la mata tengah sepet, senyum senyum lagi la sepet pakcikkk. 

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I always feel anxious to work night shift in Emergency Department. With this current Covid situation, staffs are distributed to many teams, hence, I need to survive on my own feet managing the Non Respiratory cases (green zone, yellow zone and red zone). Every single night shift, I will always pray for smooth shifts and the senior MOs working on respi team will not be annoyed to share their opinions for management. Alhamdulillah. the senior MOs, staff nurses, medical assistants are helping a lot and HO colleagues are good as well :)

Till next story :)
Salam Ramadhan semua.

SM, Perak, Malaysia
200430

Self Reflection from Ebit Lew's Beautiful Words

April 26, 2020




After reading these tweets on Twitter, I decided to read more about Ebit Lew. I know his name was famous ever since the Movement Control Order (MCO), when he directly go from one hospital to another to support the preparation for Covid Screening. There were lots of posts flowing on my Facebook timeline at that time, which amazed me a lot. He spent huge amount of money to help those in need. 

But, I don't really understand the current issue when he decided to take a break till MCO to be lifted later.

Otherwise, he is an impressive Muslim, who makes me reflect how much have I done for the community. I pray hard that Allah blessed me with my job's contributions as I am not that active in social contribution like him.  -_-'







Here, he mentioned a lot about prayers. Yeah, solat tiang agama kan? Simple but most of us take it for granted T_T. I realised as Muslims, we tend to get farther from Allah, especially when we are blessed with ease, happiness, success at that time. But we forget that all those rizq are from Him. 

Every speech of him are very eye and heart opening. Sometimes, we tend to search for others' mistakes forgetting that we are human too, so we also make mistakes. Here, we need to practice to see good in others. 

Hidup kerana Allah, do things for the sake of Allah. 

I need to always renew my intention every time I treat patient with this mindset. For Allah, for Allah, for Allah. 

May Allah bless him and us :)
Ameen!

Salam Ramadhan everyone.

SM, Perak, Malaysia
200426

Tell Me Three Things by Julie Buxbaum | Book Review

April 14, 2020


I bought this book in Popular prior to previous BBW visit. Actually I separated books I bought from BBW and the rest so that I would like to make sure I read at least half of BBW books (just to feel it worth my money travelling to KL for them haha). But somehow this book look attractive though.




Title: Tell Me Three Things
Author: Julie Buxbaum
Pages: 325
Publisher: Delacorte Press
Publication Date: April 2016


Synopsis:

This book is about Jessie Holmes's life approximately 2 years after the death of her mother. His father got married to a woman he met online, subsequently lead to Jessie's moving to a brand new life in Los Angeles. Jessie knew no one there except her father, new stepmother and stepmother's son. 

Few earliest days there, Jessie got an email from anonymous, Somebody/Nobody (SN) who offer to navigate her around without meeting each other in real life. After Jessie slowly making friends there, she was still in contact with SN, while trying to find out who SN was (who seemed to be a guy).

There are about 3 guys in the novel, Ethan Marks - Jessie's partner in some literature project, Liam Sandler - son of a saleswoman who hired her to work in a bookstore, and Caleb - a guy she met in the wrong class, sharing about his summer vacation.

Who is SN? Why is he messaging her?


------------------


1. “Perfect days are for people with small, realizable dreams. Or maybe for all of us, they just happen in retrospect; they're only now perfect because they contain something irrevocably and irretrievably lost.”

Jessie lost her mother to cancer at the age of 14 (I guess), and that's approximately the age girls start to become teenagers and somehow mothers are to whom girls will turn, to get further life guidelines.

Through the novel, I can always feel that she missed her mother a lot. The way she counted the days her mother left her, it showed it was never easy for her to forget. And to be real, I believe it is really difficult to move on and live with the memories.

And I love the part where Rachel (Jessie's stepmom) bought flight tickets for her for a weekend trip to Chicago to meet her old friends and to enjoy her known, familiar neighborhood. Rachel is one of the stepmoms who are not... I mean, mean?


2. 


I love this part too!

Deep inside, I really hope SN is a good person for Jessie. You know, sometimes I can't help to think that there is someone around Jessie (maybe) planning to trick her on thing like this. T_T

But, I am glad, SN IS A GOOD ONEEEE! :D



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Maybe enough with two. All in all, the story is cute and adorable, though I found it tiring to know the mysterious SN, which was finally exposed at the few final pages of the novel. T_T The three guys are interesting too, I mean, the author somehow managed to trick me into doubting myself to guess which one is SN.

I am a slow reader currently, reading takes a lot of time, making a review as well. Haha.
Till then.

p/s - I can't help to read SN as Staff Nurse -_-'

My rating: ★★★★☆
SM, Perak, Malaysia
200414


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