Never Trust a Fat Dietitian, Never Trust a Skinny Cook!

Irfan having his pizza at Marche - Does he need a dietitian?

I hate Mondays! Most of us do, unless their job include mingling around supermodels (the one without attitudes, rare ones) or their job have an obscenely huge amount of money as incentive, such as playing football for ManYoo. Driving in on Mondays to work usually put me in a right strop, but not today. It's school holidays week here. It usually takes me around an hour to get from Gombak to UMMC, setting off just after 6.30 am. If I am lucky, I may just arrive for my cup of Nescafe and some kuih just before 7.30. Driving in, I usually put on my usual Podcast to listen. It was 'The Chris Moyles Show', from the BBC this morning. I used to listen to him a lot while in the UK. I also contemplated what I did during the weekend. We had lunch at Marche yesterday. The picture at top is of Irfan muching away at his pizza. Before that, Idlan had his sports day on Saturday, and we had our brunch at Delicious, that was nice. Hmmmm ... a diet theme is forming.

Today, it was 7.05 when I pulled into the parking lot. The day is going to be ace.

One of my patient complained that she is losing weight. Not often that a SHE is concerned about weight loss, because it is usually the opposite. I asked her if she having problem with appetite etc. She said she was doing OK before when she stuck to the hospital dietitian plans, but lately, as she is getting healthier, she decided that the supplements were too yucky. She also had another complaint, "dia senang saja cakap sebab dia sudah kurus". (it's easy for her (the dietitian) to say as she is so skinny). Hmmm! An interesting observation. I remember reading an article some years back, in Reader's Digest of all places about a survey they did in Italy. Skinny cooks are never as good as their chubbier counterpart. Does that apply to fat dietitians as well?

Going back from memory, she is right. I can't remember a fat dietitian working with us. The one attached to my ward for example. I remember her being pregnant a couple of years back, and even with the baby I was sure she only weigh around 45kg. She was really skinny. She must have saved a fortune after delivery from not having to spend money in the gym. As for a cook, not terribly sure. So, my assignment for the semester, try to contact the dietitian school and see if they need a Haematologist to give them lectures. If so, I can see first hand if the theory is true or not. I will keep you guys updated!

The rest of the day was spend hearing the moaning from my Final Year Medical Students. They have their exam starting next week. A lot of them complaining about not getting much revision done .... in Facebook! So stop facebooking and get some reading done. To be honest, in the last week before my final exam, I was also having problem concentrating. I remembered watching a lot of TV. I don't think any last minute scrambling would have made much difference. The illusive distinction and book prizes would have still be beyond me! For the boys and girls, I wish them all the best. Yes, I will try to squeeze in another session of short case before the week ends. I must say that the current crop is pretty decent and I am sure they will do well. All the best you all! Now STOP FACEBOOKING!

Note to self - things to do, 1) enquire if the dietitian school need a lecture about chemotherapy, 2) try some of my patients food supplements ..... are they really yucky?

Irfan and Idlan outside Marche

Should we keep UMMC Astro-free?

It's Sunday, but since one of my colleague is away in Taiwan, I covered him for the weekend duties. I came in for my morning ward round and late morning, I met one of the Medical Officers in the Common Room. While waiting for her, I came across a piece of note on the wall. I snapped a picture of it on my mobile, but for some reason I can't transfer it to my laptop. It was a simple feedback form from the committee asking what they would like to have in the room for the future. One of the reply was to have Astro, the satellite TV company here in Malaysia. Some body wanted a subscription to include the sport channels. The request was promptly rejected and the reason being it may jeopardise patient's well being. Hmm... seems far fetched? Let me tell you my experience.

Wednesday, 7th June 2002. World Cup, Japan. England playing Argentina. I was working in Manchester then. Everyone was watching the match in the doctor's common room. It was just before 11 am due to the time difference. Score was nil-nil. 42 minutes gone in the first half. Every one was still glued in their seat. I can count there were about 50 of us in the small space.

It has been a tense game, mainly played in midfield, but in term of technique, the Argentinean were clearly superior. After 19 minutes, Owen Hargreaves was injured, and was replaced by Trevor Sinclair. England lost what ever left of their midfield superiority. A stray pass, and Owen got through towards goal, but took a heavy touch. From nowhere the keeper came in and upended him. Pierluigi Collina, the referree, has no choice but to point to the penalty spot. Beckham had the penalty duty, not only to score a goal, but to bury the memory of France 98 when he was sent off in the quarter finals for kicking Diego Simeone, an Argentinean midfielder. Everyone remember that infamous incident right?

The room was quiet. Becks put the ball on the spot. Took five steps back. It seemed an eternity. Suddenly all our bleeps went off in synchrony, "CARDIAC ARREST, CORONARY CARE UNIT; CARDIAC ARREST, CORONARY CARE UNIT". Argh! Luckily I was not on call. The anesthetist shouted, "whoever that is, he deserves to die!". Beckham scored seconds later.

Hmm! I wonder if you are watching such a tense match, with the bleep going off, what would you do? I suggest no Astro in the MO common room. The UMMC website should also say, "please come to UMMC, where the doctor will be on hand 24 hours a day and their common room is Astro-free!" Long live UMMC! Would you sent your relatives into a hospital with Astro installed?

Update on Monday, March 16, 2009 at 10:10PM by Haris Abdul Rahman

Managed to upload the said image

ManYoo 1 - Liverpool 4, and my pre-game rituals proven right ... ish

Oh dear! Vidic really got spooked tonight. Turned into an ordinary defender by Torres who had an excellent week, a stormer in the midweek game against Madrid the other night. I am optimistic still about winning the League. It is the consistency that counts over a period of many month. It is not about just having a good week, and getting beat later by the likes of Middlesborough.

Not only that I am a football fanatic, I am also born superstitious. I always put on my right shoe before the left. Enters a room with my right foot. Always stepping into a vehicle with my right peg, hence Malaysia being a right-hand drive country prove tricky when I enter into the driver's seat. Recently Manchester United has had a good run. Winning all and sundry, not always in style, but winning none the less. I would like to think I have put in my contribution in the winning streak. Every weekend game since Xmas, I always go out to a Mamak joint near my place and buy myself Mee Ladna, tandoori chicken and naan bread. I then don my 2001 long-sleeved home kit, with the number 4 and name 'Veron' printed on the back. ManYoo won every game, van der Sar went on to break the British record etc etc.

I was going through the ritual again today. But shock horror! My red replica shirt is in the washer! Therefore, I wore my 2003 shirt with 7 Ronaldo instead! At least that would be worth half the luck. Oh no! It's definitely not working. Or as Randy Jackson said it best' "I'm not feeling it, dawg!". I supposed it is only a game, but I am sure the phrase, "Sports is not about the winning, but about the taking part" was coined by a loser. I suppose if we were going to mess up, let's do it well and proper. Take it with the chin up. There are other games to be won, and I can bet Liverpool will lose their next league match. Watch this space.

But first things first. Have to call Alex Ferguson and apologise on behalf of my maid for not washing my shirt in time for the match.

Friggatriskaidekaphobia

Hmmm ... that was I am sure a mouthful. Google the above term, and you'll come to its definition. It is the fear of Friday the 13th. And this year alone, there are 3 Friday the 13ths, today, last month and on the coming November. Why are people friggatriskaidekaphobic? If you count all the months in the last 400 years (that is 4800 months), the majority of 13th of the months actually are Fridays - 688 of them, with Sunday and Wednesdays close second at 687! So Friday the 13th are more common than we think and they should stop making frigging movies out of it!

This Friday the 13th also marked a milestone for me. My first ever day on call as a Consultant. Yes .... after tomorrow 8 am, I can say, been there, done that and worn the T shirt, providing everything runs smoothly till then. When I was a houseman, doing 56 straight hours on duty for the NHS I was complaining of too much work, and that my senior not doing much to help out. Then a year later, being a Senior House Officer (equivalent to Medical Officers in Malaysia), I complained that the Casualty Officers giving me incomplete referrals. Cursing them for not doing this and that!

Promoted to Registrar come with a different job description, and the one I hated most, taking on other specialty referrals! The Surgical Houseman found a lady with low blood sugar, what does he do? Call his SHO, and guess what he says? Call the Medical Registrar. So your job is reduced to taking referrals from other Housemans! Argh! When you turn up at their ward, they did not even bother coming up to you to tell you about the case. They were too busy setting lines etc!

Hey! I am now doing Consultant calls. So what had happened today? 10 am, call from Department. You have a referral, an 83-year-old with a broken hip in the Orthopaedic ward. They were planning to take her to theatre but noticed that her blood pressure a bit high. Had to get a medical consult prior. Presto, that's where I come in. Saw the lady. She was known to have high blood pressure and she was writhing in agony with her hip pain! Imagine how high my blood pressure went when all that needed giving was some painkiller meds ... and may be a slap on the face of who ever decided to call me! Ha!

Time to hit the Casualty floor to see what's cooking then. Wish me luck! And may your Friday the 13th be a lucky one!

United 2 - Inter 0

Woke up early to catch the last 10 minutes of the Champions League matches. United was cruising away, while Arsenal were preparing themselves for the extra time at Roma. Vidic and Ronaldo scored that night. Arsenal went on to win the penalty shoot-out and might play United after the draw on the 20th. Spend the morning perfecting the CRF for the Febrile Neutropenia studies while sorting out other issues, amongst them setting out tinyurl for my future links.

Grand rounds and Day Care followed suit. The afternoon CME today was prepared by Dr Iqbal. He spend 30 minutes talking about Multiple Myeloma. The talk was preceded by a overview of Imipenem by MSD, who also provided some nice Turkish salad for my lunch. Spend the rest of the afternoon going through some Myeloma cases that might be published in a local pharmaceutical bulletin, followed by a short case session with the final year medical students, who are anxious with their upcoming Final MBBS in two weeks.

Currently stuck in the office waiting for the rain to stop, before going home to the kids and Anita. Had a handful of papers to mark later. 

Update on Thursday, March 12, 2009 at 10:24PM by Haris Abdul Rahman

Finally reached home at around 8. Completed the alteration for the CRF on Filemaker Pro. Have to catch some rest as I will be on call tomorrow. Might be able to complete all the paperwork in time for the weekend. Spent some time updating Idlan's page - link posted on the right!