The other side of my role at UMMC

It's a rather surreal day. One of my nephew was born with undescended testes, and since he has been complaining of pain in his tummy in the last couple of weeks. Initially his parents tried traditional massage, but clearly it has not worked - have faith, my son! I brought him to see the Paediatric Surgeon this morning expecting just a consultation. Instead, he identified a slot tomorrow morning for an op, and admitted the boy.

I spent the afternoon explaining to my nephew what to expect tomorrow. This poor boy really like his comic book and fast food. Had to buy him some then since he will be fasting from midnight tonight. As I was sorting out my stuff, I got a phonecall from my wife telling me that her auntie is also inpatient. It was however a planned one. She will have her angiogram tomorrow morning.

Hence I spend the day as a visitor and counsellor today ...

Told You This Stem Cell Thing Will Lead Somewhere Someday

Hello! Is it me you're looking for?Part of my work in UMMC involves stem cell transplant as part of the long term consolidation among my unfortunate leukaemia patients. Oftentimes, we never even got to it, either due to patient not having a good enough response to initial chemotherapy, patient being too old for the procedure, have problem with their internal organs or carrying infection that will render the transplant process too risky. However, all this are meaningless if they don't have potential donor in the first lace. As a rule, we look amongst their siblings to donate. Failing that, we may be looking at the various stem cell or cord blood registry.

I stumbled across this article yesterday which I found interesting enough to blog about. Conventional stem cell transplant are not alien to us. There are now new avenues being explored for it's use, from the conventional to the bizarre. The success of autologous (source being patient's own) stem cell infusion into Mr A Allagra's in September 2003 in IJN captured the public imagination. I was fortunate enough to be part of the team to perform the first adult unrelated transplant in Malaysia, although my boss my not be impressed to be quoted as a Medical Officer.

Now, breast augmentation from stem cell? Hmmmm! Now, that's a thought. I am not sure how to response should a member of public ask me about it - hey! I am a stem cell expert after all!. And for the students, should I ask you the indications for stem cell transplant, please don't mention to grow breasts!

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