Well said

Good intention and good riddance ??

Good intention and good riddance , those four words do not always come together

There are moments in life... When u do something with purely good intention... But in end of the day... U end up in the courtroom. Worse case scenario... In jail.

That is life . It sucks but it is true

For example
Life as a doctor .
People expect u to save life
And we do.. All the time
No question about that
But then,
Nobody remember how many life we have saved
Nobody keep track on that
But once u screwed up..
It will be on ur record forever and
People will remember u as a doctor who screwed up.

I knew a few doctors who refuse to take or treat critical cases
Just to keep their record clean and clear
U can't blame him
We doctors have family as well to take care of
We need to keep our job safe

Plus, in this new SPBA system, we want high marks for our skt
Hence we will get higher salary every year

It is a normal human instinct
We want to be safe before others

No one to be blame for this

The system has made our life so rigid
Everything must be done accordingly

Rules comes first... Other people life comes second

Cruel...
But we all need to keep our periuk nasi right
How I wish all doctors could work
As freely as u seen on tv... House md for example...

HIV via tattoo???

is it possible to be infected with HIV via the tattoo's needle ?
well , that what happened to an australian tourist who went to Bali for a holiday , got a tattoo there
came back home and later on found out she/he got HIV
at least , that what he/she claimed

nonetheless...
clinically , is it possible?

let's go to the basic here. how does HIV transmitted? occay , easy as abc ...  number one.. blood to blood... mother to baby and the famous unprotected sex
then,
let's look at how tatoos being "tattooed" on human body..
they use a special needle to paint the artwork on the skin

when we talk about needle..
it's a nature of the needle to prick
and of course ,during the process of tattooing ...
the needle pricked the skin a lot..
contacted with the fat tissue.. and also small vessels
meaning.. anything from the needle.. could go inside the vessel

so , in this case..
one sunday morning..
a HIV person went to the tattoo shop
and got a tattoo on his ass..

and the next person came in into the same shop
let's say some australian tourist he is..
got a tattoo as well...

and apparently the tattoo master use the same needle as he used for the hiv infected customer
and he forgot to clean and wash the needle thoroughly ...

there was a big chance.. the second customer could get the HIV as well
easily infected from the unsterilized needle
the same one used on the HIV patient

well ,
if that the case
he's such an unfortunately guy

moral of the story , dont get any tattoo...

but then.. same scenario also could happen at the barber shop or the sallon
when the barber use the same blade for shaving...

something to think about...

HIV mother

 

had a busy oncall last night at work

i was in charge of the obstetric OT

giving spinal and general anaesthesia for c section operation..

a lot of emergency cases being posted after midnite

not something i was looking for

coz honestly ,

after midnite

half of our brain has already shut down

and people become a bit cranky when they stay awake after their usual sleeping hours

occay , nothing new there

just another day at work...

at 4 am , came a case of HIV mother  , already in labour

for my readers info ,

HIV mothers are not allowed to go thru normal delivery

because we want to reduce the risk of mother to baby infection

all HIV mothers must be operated to make sure there is some chance for the baby to be HIV free

plus , all HIV mother must not breastfeed their baby as well...

so my patient , still a teenager

already has one baby when she was 14 years old

and she came for her second baby with her second husband

she claimed she got the HIV from her first husband... when she was 13

since then she was on medication for her HIV

nevertheless , for her 1st baby 4 years ago.

the baby was delivered manually...

hence , we were not sure of the status of her 1st baby...

could be a HIV positive ... and hopefully not

it was a sad story ..

and crazy as well

not sure about her second husband HIV status

but her husband claimed to be HIV negative

which is impossible

then before the operation started

i popped the big question to the couple..

do u still want more children after this????

u are HIV positive... and giving birth to another children..

well .... not the best idea

since u are struggling with ur disease

how are u gonna take care of the baby

what if ur baby turned out to be HIV positive as well?

pity the baby right?

we gave all the meds available on earth to make sure the baby delivered last night not infected

but the risk is still there

and we would not know the result of the baby HIV status immediately...

it's such a complicated situation

SHOULD people who are HIV positive   conceived babies?

what will happened to their baby?

they cant breastfeed them

and when the baby grows up .. what would he or she felt , when he found out he got HIV from their parent...

God goodness..

this is beyond my imagination

nite2 guys

Vitamin c plus collagen

Anyone interested ? Do privately contact me via email or facebook occay :)

Nia got injected!

We went to the clinic yesterday for nia immunization .
My goodness, there were so many babies there..
The waiting line was agonizingly long..

Worse case scenario... The doctor was on leave as well... Can't blame her... She is the only doctor at the clinic and she needs rest as well

Luckily , I know the clinic very well as I was supposed to be transferred there previously, but one way or another... I decided not to go...
Long story short... The staffs also knows me very well..
In view of the long que, mommy herself injected nia while daddy was holding her tight

We took preventive measure to make sure that nia was pain free during the injection.... Remember that I am an anaesthetist...pretty good at dealing with pain...

Nia was hardly crying during the injection... Just one tiny scream and she was ok already.... Thank you Allah... After the injection... She was doing well... No crying.... And until this morning ... Alhamdulillah... No fever.....

owh mak cik , what have u done!

one of the challenge working as a doctor  ;
is dealing with patient who believe hospital is the last resort

many patients, mostly the malay ethnic
more commonly in kelantan
prefer to seek treatment from bomoh whenever they fall sick
or something happened to their body

case and point happened to me at the clinic today

a makcik brought her 4 month old baby
with impetigo , and infected wound all over the body
something like the photo above

me : mak cik , when does it started to become like this?
mak cik ; eh.... baru saje.... semalam baru makcik perasan..
me : mak cik , please dont lie to me , i am a doctor.. i know what i see
mak cik : dah lama dah sebenarnya... dah dekat sebulan... mula sket jer.. pastu makin teruk

me : then , why dont u come to the doctor earlier? x kesian kat anak u ke dah jadi mcm ni...
mak cik : mak cik pergi jumpe bomoh... bomoh kasi air tawar... lepas seminggu 2 makin teruk baru mak cik bawak datang sini...
me : kesian anak mak cik ni... dah teruk sgt. .. dah kene jumpe pakar kulit...  x tau bole pulih ke x nanti ...
mak cik ; tu la mak cik bawak dtg sini nak ambik ubat la...
me : apsal mak cik x pergi follow up dengan bomoh jer? bomoh pakar xde ke?

well, this is the attitude of our people
still believe in bomoh
still believe that bad health caused by the black spirit
for crying out loud

please come to the doctor first,
then if we cannot treat u ...
then go find ur bomoh
not otherwise

the best part of this cases..
when these people come to the doctors at the terminal stage of the disease
some of them , died at the hospital
then these people started to blame doctors for their relative ill fated.
ridiculous indeed!

Vitamin c injection

Dear readers,
What do think about vitamin c injection? Any of u have tried the injection ?


I am doing a research regarding the vitamin c injection.
Kindly share ur experience here please

It is a very common procedure nowadays ,
Nothing to be shame about
It's not against the law
And it is not against the religion as well.


Medically, the only reported side effect from the vitamin c injection was the infection from the injection site...
Which is caused by improper injection technique , not by the vitamin itself.


So please share the info here guys!

Thank you a lot in advance!

baby with colic

peanut said...
salam..
DR Hanan, i would like to refer to u and may i get ur opinion on my nephew's problem..

my nephew is only 28 days old..
he is active..
mom breastfed him well and he drink a lot..
sometimes he burp easily but sometimes it takes time for him to burp...
and he poo a lot too..
about 5 times a day...

the problem right now is he will cry damn loud in midnight untill 3/4 in the morning..

i ve saw I LOVE YOU massage and a few more technique to reduce the gas. but, it doesn't help a lot..


we had brought him to the clinic 2 days back..and the doctor said the baby is having COLIC.. a lot of gas in his stomach..
the dr gave a red colour liquid medicine to be taken 2.5 ml, 4 times a day..

as a result, the baby is soo sleepy..
is it fine for him?

and yesterday we try to reduce the dossage to only 1.5ml...but he cried out loud again in the midnight..

he is doing fine in the morning..

is it colic was caused by the antibiotic gaved to mother when the amnion liquid burst 24 hours before delivery?

i really hope that u can help me with this problem..
thank you! =)


Dear peanut

looks like ur nephew is about my princess nia age
and dont worry ,
u r not alone
Nia also has the same problem

she has colic as well ,
the abdomen become distended
and she is always awake after midnite until early morning
no new issue here
her mommy and granny are also busy trying to keep her calm and asleep

this issue is very common among infant
nothing new here
but it's very tiring for parent
and very frustrating as well

there are a few solution for this problem
first , u can go to the doctor
and they will prescribe u with GRIPE WATER
it's safe to use for infact to reduce gas
after taking this syrup ,
the baby will fart , a lot

hence reduce the gas inside the stomach

however, should ur child still having this issue despite this medication
u should bring ur child to the pediatrician for further assessment

in the market currently
there are also special feeding bottle that can avoid colic
nevertheless,  the effectiveness of these bottle are pretty much questionable

occay , those are my answer as a doctor

should u ask my mom.
she will advise u to "mendemah" ur baby

in the photo above is my princess hanania being "demah" by my mom
she put some sand inside a piece of cloth
warm up the sand
and use the sand inside the cloth to slowly massage nia's stomach
after that being done ,
nia does look a bit comfortable and sleepy
she was quite calm during the process
how effective does this method?
God's know

breast feeding...

people make babies everyday
million of babies are borned everyday
i work at the general hospital
when i was in charged of the labour room few years back..
the labour was busier than the bloody factory

bak kata my friend from terengganu who was my fellow houseman back then..
" kilang keropok pong tutup.... labour room ni dua puluh pat jang penuh... "

well , good for us
we need new generation
these new generation will lead the world someday
and we are the one responsible to produce future leader..

unfortunately ,
not all babies have the best care from the mother..

when i said best care , i am not talking about baby court made from gold..
best care from parent meaning... exclusive breast feeding  or breast milk , on time vaccination... and most important ... love and care from mom and dad...

nevertheless , most of the young parent nowadays already failed at the first part..
the breast feeding
i do understand not all young and new mother can produce enough milk for the babies
and some babies do have trouble with sucking
hence making breast feeding almost impossible

however , we live in the 21 th century with all kind of technology and endless list of drugs
there are so many medicine on the market that can increase lactation for those who produce little milk
for babies who has problem with sucking the nipple
the mother could just pump out the milk and feed the baby using the regular bottle
yes, the intimacy of breastfeeding may not be there but at least the baby is getting mother's milk

there is no excuse nowadays for not feeding ur babies
unless u are a HIV patients , then we understood why u r not giving ur milk to ur babies...


i am a father , and  i want my princess nia to be fed with breast milk
hence she will grow up and be as pretty and as smart as her mother
x nak jadi anak lembu plak kan ....

unfortunately nia is not a big fan of breast feeding hence my wife keep pumping the milk everyday..
as long as nia getting her mom milk everyday, it's more than enough :)

so yes . to all mother, please .... breast feed ur babies  :)
it's the best milk in the world
contained all the vitamins, mineral and antibiotic that ur babies need to grow up healthy and strong!

open letter to people up there

A doctor must work eighteen hours a day and seven days a week.  If you cannot console yourself to this, get out of the profession.  ~Martin H. Fischer

before i start my blabbering

i know i may not be the first doctor who is going to write about this

there were already so many open letter , articles 

written by medical officers, specialist 

regarding the current issue of the houseman'

also know as the internship .. or new doctors

the new rules implemented by the government says that houseman must not be overwork

they must not work more than 12 hour per day and must have 2 days off every week

no oncall for houseman

then , they also must not be scolded and must be pampered ( occay , i added this part )

well , good for them.

when i was a houseman not long ago , i work every day  .... maybe 4 days off in a month at most ,

everyday we work more than 12 hours ... if we were to be on call.. we work 36 hours non stop

yes .... if u compared the condition during my time and current condition ... it's a lot of different

in a way , it's an improvement

in a lot of way , it's bull shit and  a lot of crap

like the proverb above said.. doctor must work more than the current houseman rate

i dont know who decided to give this houseman such a ridiculous schedule

but in the end of the day , it is not a way to teach houseman to be a good doctor

to be a good doctor , we need a lot of training

to have a lot of training ... we need to spend a lot of time treating patient

to spend a lot of time treating patient

we need to stay extra hours at the hospital

12 hours per day is not enough

currently the houseman works in shift system , am is 8 am to 8 pm... pm is 8pm to 8am...

sound very systematic right...

yes ... if u work in the office dealing with document it's fine

but not for doctors

we doctors have CME everyday , a place and time where we learn new things every morning .. so , those who come in PM shift.. they will miss the CME... how do u expect houseman to learn?

then , for those AM shift houseman ... they supposed to work from 8 am , to 8 pm... but 

generally in hospital ( unless in the emergency department ) 

from 5 pm to 7 pm is visiting hours and during that time , doctors dont do round ...it's time for rest...  hence the houseman end up doing nothing from 5 pm till 8 pm....

might as well allow them to go back by 5 pm right?

this is logic thinking

then.. for those who work from 8 pm to 8 am...

they actually work from 8pm till 11 or 12 at most...

by midnite.. everyone fall asleep ...

eventually learn nothing for the rest of the shift

i wonder those who suggested the shift system ever work in the ward :p

i'm sorry to say  , but i strongly disagree with the shift system

it's such an disadvantage for those houseman who wants to learn more

for those who want to relax , it's a golden opportunity

with this kind of system.... anybody could be a bloody doctor nowdays

dear people out there...

do u want to be treated by doctor whom did not have a proper training during their houseman period ..

imagine ur family member being treated by these unskilled doctors?

seriously...

back in my time ... we got scolded by medical officer and specialist badly if we made mistake and being screw upside down if we do wrongly..

we learned for our mistake 

and came to work very early in the next morning to do better

it was a good way to teach as we will always be reminded of the consequences...

and eventually make us good and capable doctors...

nowadays... if u scold a blood houseman ...

the houseman wont even bother to turn up to work the next day

and u ll get a letter from the people up there

crap isnt  it?

but this is the fact

wondering ...

it irked me !

this is a real story
happened yesterday at my clinic
it really irked me
it pissed me off

tiada niat untuk memalukan sesiapa , tetapi  sebagai pengajaran kepada semua manusia di alam sejagat ini,,

one fine evening.. at the clinic..
business as usual.. patients came in and out..
mostly due to fever...

until , came this old granny ; holding a baby...
accompanied by a young boy
who apparently is the father...

me : salam... how may i help u mak cik...
granny : salam... this baby is not well , maybe having fever .... she is 3 month old..
me : owh occay.. let me take a look ....does she has running nose?
granny : yes.. that too..
me : very well ... how about feeding? where is the mother? does she breast feed her baby?
granny : the mother is away ... the baby was never breast fed ...
me : mmm.. that explain a lot... may i know where is the mother? is she working?
granny : no , the mother is not working.... she went to KL to attend some birthday party with frens.. hence leaving the baby with us to take care of...

owh my God... for crying out loud!  ( well, i didnt said this actually )

Me : mak cik... the baby need her mom milk... the milk which contain all the vitamin and antibiotic which will keep the baby healthy... no drugs can replace the mother's milk... why does the mother refuse to breast milk?

granny : die malas... die kata susah nak susu badan..

and.. that was it..
i was speechless
the baby was so cute
so innocent..
3 month old.. the baby knows nothing
and the mom did this to her...

kalau x pandai jaga anak,,, please dont make anak on the first place...
what kind of mother leave an infant to the old granny... just to and have fun with frens for a bloody week????

it is a hard and difficult situation

juliaismail said...
Sedih baca. :-( Dr i have a question to ask and hoping for ur advise. I ada close friend diagnose with a stage 2 brain canser just 3month after get married. Menurut Dr, tumor tu berada di bahagian paling penting otak and hardly can be remove. Cuma boleh keluarkan sebanyak mana yang mungkin. Dr bagi dia option sama ada kimo atau buat major operation to remove which can lead to lumpuh. Her husband ask me for opinion but seriously i pun tak tau. I felt sory for them. Inai masih ada kat jari kaki.

dear julia

i felt sorry for ur friend
to be diagnosed with brain cancer ,
some said - it would be the end of the world
some said " my life is over "
off all cancer , brain cancer would be considered as the most fearful
as it could easily effect our mind , emotion , feeling , rational thinking...
all those stuff that u need to get thru ur life in order

u mentioned that ur friend is already at the stage ll
it's still an early stage
but we both not sure about the severity of her condition right
usually at stage ll
a patient could still have an active daily life
but the symptom occurs quite oftenly
in her case , symptoms could be severe headache and mood swing

in many case , at stage ll of cancer,
combination of surgery and chemotheraphy do produced a good result
nevertheless , these two methods also come with bad side effect
in her case ,
if surgical to be done  , maybe a part of the brain need to be removed
and during chemotheraphy ...
other healthy brain cells will be dead as well resulting for the toxic effect of the chemo drugs
imagine if u only have half of ur brain
that's is one of the possibilities that could happen to her

we could treat the cancer ,
but her brain would be effected as well...

she could fight until the end... but it would be a difficult battle to win...

cancer always relapsed even if we defeated them once ....

electronic cigarette

BayuTimur said...

assalamualaikum dr hannan,

 

doctor i want to ask u about electronic cigarette,did it gives us the same effects as usual cigarettes as it stated there no nikotine?pls answer me doctor

Dear bayu timur ,

thank you for ur brilliant question

electronic cigarette has become very famous lately

the manufacturer claimed that electronic cigarette or also known as e-cigar is less dangerous compared to the normal cigarette and it's also a method to stop smoking.

well , that's what the manufacturer said they also firmly stated that their e-cigar does not contain the dangerous chemical such as the carcinogen which is found in the traditional cigarette 

again... that's what they claimed of course they are putting good word for it coz they want to make money

nevertheless... WHO said otherwise 

WHO said , e-cigar is harmful as the normal cigarette studies have been done and showed that e-cigar also contained carcinogen which can cause cancer

well , that should sum it up...

it's not a solution to smoking after all the only good thing about e-cigar is  , it's less smelly and less smoky

the rest - only bring more harm - it's more expensive and in a way , it does encourage people to start smoking as they said e-cigar is not a real cigarette

so, 

my advice say no to any kind of smoking  , e-cigarette , normal cigarette , shisha - all of there will only lead u to the palliative ward eventually

* palliative ward is ward for people with cancer which cant be treated!

Is it true? But it is not hazardous anyway

Many of us have received this SMS. It has been circulating around for the past few days.
Nobody knows how true is this rumors , who started it.... And if it is true , I still havent heard no official press conference by the manufacture yet.

Occay, some said , whether it is true or not... Why take the risk right? Plus carbonated drinks is not healthy anyway.

Clinically and physically, it is quite impossible to be infected with HIV via oral route.

Even if u had an oral sex with an infected person... U hardly get the virus... Just an example.

Technically, to able to infect everyone via oral route ; iin this case putting an infected blood into the drink... It require a large amount of blood ...
I don't think a person has that much blood to fool around with.
Unless he committed suicide by jumping into the water tank of the company... And the body rotted inside it...
That would raise a bit of concern.
Other than that...
This would not be an issue after all

Hence, that is the reason why, the company involved has not made any press conference to clarify this issue.
It is impossible to infect people with HIV via this method..


Yet and still...

Why take the risk...

Drink more plain water guys!