Blessed

It has to be one of the most mundane birthday I have ever had. Started my day in Community Rehab Clinic seeing primary students with learning disabilities. As much as I love helping the students with learning problems, it drains the energy out of me. So many factors, so many ways to help. It can also be frustrating looking at how our rotting education policies are not helping out children in the rural places at all. Life is unfair.

Saw 8 patients through the morning, had lunch with boss and ward rounds which ended at 4.30pm with some discussion on coming courses and paediatrics related activities. Working with my current boss give makes us pushing ourselves to the limit. Her unlimited energy shows us what human is capable of doing. Planning after planning, project after project. Trying my very best to achieve a quarter of what she does.

Brought my camera out when I went for my routine jog hoping to shoot some dramatic sky but was gloomy. Went home after 8 laps, cook myself a nice filling dinner and studied.

As mundane as it could be, still took the time to reflect and count my blessing. Grew up with a super mom who brought me to this world 28 years ago, married the love of my life and now a father of a boy. Despite the future uncertainties with our current state of economy and politics in our country (heard that Mr Prime Minister? Citizens are suffering), I believe God will pull us through and bless us more than we can contain.


Recently inspired by the lyrics of this song by Hillsongs. Word of the season indeed.

If my heart has grown coldThere Your love will unfold
As You open my eyes to the work of Your hand
When I'm blind to my way
There Your Spirit will pray
As You open my eyes to the work of Your hand
As You open my eyes to the work of Your hand

Oceans will part nations comeAt the whisper of Your call
Hope will rise glory shown
In my life Your will be done

Present suffering may pass
Lord Your mercy will last
As You open my eyes to the work of Your hand
And my heart will find praise
I'll delight in Your way
As You open my eyes to the work of Your hand
As You open my eyes to the work of Your hand

https://www.youtube.com/watch?v=j7Uj_B0KNgU

Wedding and Mini Family Getaway

After a long and stressful weekend, I couldn't wait to leave Kapit albeit with a heavy heart because of the unstable patients I left behind.

Took Ethan on his 9th express boat ride out of Kapit, 9th AirAsia flight from Sibu to KL and his first ERL ride back home. He was an angel throughout the flight. He slept without making a big huha, eats his own food and played with us before he fell asleep again. Well, happy mood during day time comes with bad mood at night. He cried to sleep and woke up a few times throughout the first night back in KL.

One of the things I secretly anticipating for was durian. I know well enough that my father in law will definitely get durian to eat with us when we are back. True enough, we had so much durian that we had to forgo our dinner. Like father like son, Ethan devoured the durian we offered him and he really liked it a lot. So much that when we removed the durian from his mouth, he started crying. A true Malaysian is born!

The main reason we were back in KL was for Wai Kit and Carine's wedding.

Solemnisation and Exchange of Vows, IN CHINESE. Well done Carine!

No love story has touched me as much as Wai Kit and Carine's. I teared a lil when Wai Kit told his part of the story how Carine took care of him when he was in the ICU and how Carine was asking people to pray for Wai Kit when he was badly injured from a motorcycle accident. A walking miracle and faith. Had a great time catching up with Inn Shan and Yee Ling together with the ex-Kapit people during the wedding dinner.

Attended DUMC live at home on Sunday as Ps Daniel preached on Acts 2. The rest of the day was just resting at home and did some windows shopping in MV before having dinner with mom.

The most painful part of this trip is to leave behind Angel and Ethan in KL as I travelled back to Kapit alone. I alway enjoy travelling alone. But this time I miss Ethan moving about in my arms during the flight. I miss him putting his slimy finger all around my face before wiping his face full of saliva on my shirt. I miss hugging him.

As I will be back in Kapit alone preparing for my exams in September, I can rest assure that Angel will take really good care of Ethan. Cannot ask for a more capable wife like Angel.

Counting my blessings.

Cases come in THREE

There is always a myth in our medical fraternity that when you see a complicated or interesting case, 2 similar cases will come knocking on your ER/clinic door soon after. I do not buy it. But I saw 3 cardiac cases of different severity just last week. Good cases come in three - Myth or truth?

It all started off with a school going girl coming in for some dyspnoea and chest pain. My ER colleague thought she looked pale and suggested to order an ECG to look for anaemia-induced strained pattern of the ECG like adults. Coincidentally I was reading the ECG chapter for my exams. So why not.

Though not commonly diagnosed with ECG, but I had the gut feeling that the ECG shows pericardial effusion with variable voltages. They called it electrical alternans where the R waves shows different heights within the same leads recording. True enough CXR showed a huge globular heart and pericardial effusion was confirmed with our ECHO.

Symptomatic pericardial effusion, there is not much choice in Kapit. Send out of Kapit or tap in Kapit. With permission from our paediatrics cardiologist, patient was wheeled into OT on the same day for a diagnostic pericardiocentesis under GA.

Being a first timer for this procedure, I held my breath from the insertion of the needle to the placement of the catheter with Saldinger method . It was a success. Patient was so much better the day after. But we still do not know what causes the pericardial effusion. Glad to have such opportunity to tap a heart before I leave Kapit.

While seeing the girl with pericardial effusion, out second case came the same afternoon from Poly Clinic, with an incidental finding of a likely heart block for paediatrics input. A school going girl planned for dental extraction noted to have irregular pulses but otherwise stable. Fortunately our cardiologist was due coming for visiting cardiac clinic 3 days later, so we gave an appointment to see again during cardiac clinic.

With all the rights of freedom of speech, my paediatrician declared, "So there will be a third case coming soon, probably during my absence when Nickson is alone"

This is another myth that we believe - DO NOT jinx yourself by inviting completed cases because they will actually come. I don't buy that either. But the 3rd cardio-pulmonary case came 2 days after my paediatrician left for a meeting.  T_T

It was the most complicated case that I have ever managed. It was a newborn with birth asphyxia complicated with persistent pulmonary hypertension of newborn. Unfortunately we lost the baby at day 3-4 of life. Wasn't a good experience but I learned a lot throughout the whole process. Thank God for Angel who understood and supported me all along. Told her I had never felt that stressful in my life before which was true.

Thank God everything is over. Had a nice weekend spending time with Angel and Ethan in KL. Nothing comforts me more than home after a long and stressful week.

So cases come in three?