Mari Mengumpat

Mai mai sini Cik Kunang-Kunang nak habaq hangpa semua. Tadi kan, ada la patient ni datang dengan laki dia. Depa ni asalnya from Afghanistan. Laki dia tu drebar teksi, so pepaham je la kalau drebar teksi ni, pendapatan dia ala kadar jer.. *matilahhhhh~

So, nak dijadikan cerita masa aku tengah dok scan perut bini dia ni, si jantan bingai ni dengan selambanya dok mengumpat dok bercerita pasal bini dia ni dekat aku. Sejak bila pulak aku bawak watak Cik Sri Siantan ni eh?? Mentang-mentang la bini dia tu tak tahu bahasa Inggeris kannnnn??

Jantan Bingai: You know, my wife is such a useless woman.

Cik Kunang-Kunang: Why do you say so??

JB: Well, I am a cab driver. I don't earn much. All the money that I've earned gone very quick to her and the kids. She is useless and she keep getting pregnant. 6 kids you know!!

Boleh?? Selamba je cakap depan bini dia!

CKK: Well, it is not entirely her fault. If you can't afford to have babies, then stop having babies. She's not miraculously conceiving on her own does she?

JB: She is suppose to stop from getting pregnant.

CKK: (Dalam hati: Awat la hang ni bodo sangat!!). It takes two to tango Mister. You are the one who made her pregnant.

JB: She is still useless. I never like her anyway. My family arrange our marriage. She does nothing but to get pregnant. I am going to get a new wife.

CKK: You can't even afford one wife, and now you want to have another wife??

JB: Yes. We are allowed to have 4.

Jantan bodoh macam ni pun boleh wujud dalam dunia ni eh?? Dalam-dalam tak suka tu, sempat la kan kerjakan bini kau tu sampai dapat 6 anak. Tu dalam tak suka, kalau suka?? Kau ingat perempuan tu boleh je suka-suki mengandung tanpa sebab??

Laki ni kan kalau nak mencari akal nak berpoligami laju je kan?? sampai sanggup sujud dgn Salih Yaacob mintak ilmu 'menundukkan' isteri. Apekah?? Engkau kalau setakat kerja kerani yang nak makan breakfast pun kena kuis-kuis, lagi mau nak pasang lagi satu eh?? Tolong la malu sikit!! Salih Yaacob tu pun sebelum nak kawin lagi satu, dia dah siap bagi rumah kereta semua kat bakal isteri dia. Takdenya cakap-cakap kosong 'kan ku bina mahligai cinta kita di atas awan sana'. Awan lah sangat!! Awan taik kau!

Aku rasa, tak perlu la aku elaborate peel laki-laki dari belah-belah Afghanistan tu. Mostly yang aku jumpa semuanya macam taik. Baik geng taliban or bukan geng taliban, sama jer. Depa je la yang betul. Cakap depa je la yang kita kena ikut. Kita ni salah belaka. Cakap berapi-rapi pasal orang Islam ditindas la, diskriminasi lah, tapi perangai sekor-sekor macam syaitonnnnirrajim!! Cuba la tunjuk contoh tauladan yang elok sikit.

Ishhhhhh!!

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Official Result

Ok lah. 55 minit je yang mampu. The last one I did was 56 minutes. So seminit awal.

Itu pun macam nak pengsan ok. This time around rasa macam sangat tak larat and I'm almost giving up. Baru masuk 2km dah semput!! Rasa macam nak jalan je sampai garisan penamat.

Tapi bila difikirkan balik, macam tak berbaloi. So I slowed down my running pattern and pecut towards the end.

Next time, I nak strive for 50 minutes. InsyaAllah.

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Get set and GO!!!

Ok fella, wish me luck for the run. I'm all ready!!









Those are the t-shirt, the starting point and the timing chip. Sila abaikan kaki bervulus ittew!!

Cheers!!

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Thorpe Park

I went to Thorpe Park in Chertsey, Surrey today. Since I got coupon 2 for 1 from WHSmith, so tidak la kena pay a fortune. Just split one adult price of £40 to two.



Thorpe park is the second most visited park in the UK after Alton Tower. Seriously I had so much fun!! The rides yang ada kat situ sangat la best. Kalau setakat Sunway Lagoon or Genting Theme Park tu, celah-celah gigi je ok!



Two of the ride kat situ, Stealth and Saw, one part of their track tu vertically 90 degree ke atas dan ke bawah!! Memang macam nak tercabut jantung especially kalau duduk kat front row.

Roller coaster pulak ada macam-macam jenis. Ada yang spiral, ada yang backward, ada yang ala kadar, pendek kata macam-macam ada. I was like a kid in the candy bar!!!

So overall, aku bagi 10 out of 10. Sangat puas hati, worth for the money. Sapa-sapa yang datang London, daripada korang membuang masa dan duit naik London Eye tu, baik korang datang sini!! *matilahhhhh~

Satu je my advice if you guys datang sini, sila bawak baju hujan or poncho. Sebab ada few rides tu boleh buat korang kuyup. Kang rosak pulak korang punya cashmere jumper tu!!

Anyway, I'm doing this 10k charity run tomorrow at Clapham Common Park. This event is for starfish charity. This starfish charity is a programme that aiming to bring life, hope and opportunity to children with HIV positive in Southern Africa.

Wish me luck guys!!!

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Update!!

Okey, ni nak update la konon pasal perempuan SOM-SOM yang INGKAR dengan suggestion weols untuk induce. Alhamdulillah, selepas melalui fasa-fasa in denial dan KU BERSERAH, maka baby dia selamat dilahirkan yesterday melalui c-section sebab baby dah distress.

Baby sihat walaupun kulit baby sedikit mengelupas due to reduced liquor and menjeruk dalam perut mak dia for a month. Mak dia pun doing ok. Everything went well.

Walaupun, mulut puaka aku ni asalnya memang nak menyangsang, tapi bila difikirkan balik, at least at one point Allah buka pintu hati dia nak terima suggestion weols. Yang penting, kedua-dua dia selamat. Tak macam kes yang sebelum ni, yang baby dah distress, the doctor dah suggest untuk buat c-section, TETAPI laki bengong perempuan tu pulak tak izinkan. Dia nak bersalin normal jugak. Eh?? Ni sapa yang mengandung sebenarnya??? Kau ingat best ke kerja mengandung-beranak ni??

So apa yang berlaku??

Since, jantan JEBON tu tak izinkan doktor yang bertugas at that time buat c-section to his wife, all they can do was monitoring the baby's heart beat lah, to the point that the heart beat no longer exist. That was the worst of the worst...to listen to the baby's heart beat dari ada sampai takde. The next thing you heard was perempuan tu meraung meroyan and screaming to his husband, "YOU KILLED MY BABY!! YOU KILLED MY BABY!!"

Pernah ada satu jantan bahalul ni, aku kata kat dia, what if kalau bini kau tu dah desperate nak terberanak and only the male doctor je yang available, so macam mana. Kau tahu apa dia reply? Dia kata kat aku, he rather let the baby dead than let her wife being seen by a male doctor. Sampai macam tu ok!

Seriously, aku kadang-kadang rasa macam nak kakikan je orang-orang macam ni. Sorry to say, most of them adalah muslim. Masing-masing feeling ilmu agama tinggi melangit sampai nak mengharamkan semua benda. Tapi dok tipu council untuk dapatkan benefit tu boleh la pulak. Bukan ke tu duit haram?? Allah suruh korang tu berusaha mencari rezeki. Takde rezeki yang datang bergolek-golek ke kaki korang tu.

Yang preference baby's gender tu pun satu hal la jugak. Dok get me started lah. Bukan main lagi nak sekolah aku kata laki tak boleh tengok perempuan sebab haram and so on as if aku ni buta agama. Macam la aku ni kebulur kat bini kau yang tak semegah tu?? Tapi bila dapat tau kata baby perempuan, serta merta stress. KAU KENAPA?? Kau tak tau ke yang kufur nikmat tu salah satu dosa besar??

Lepas tu, bini kau, kau sibuk-sibuk suruh pakai niqab bagai. Tapi kau boleh la pulak pakai seluar pendek? Tu belum part mencarut kat one of the admin staff and called her stupid bitch sebab she booked the wife's medical appointment with male doctor. Islam ada ke ajar kita berperangai macam syaitonnnnnn???

Lebih menyakitkan hati bila orang-orang macam ni la yang menyebabkan orang pandang serong to Muslim. Everytime ada patient yang Muslim, sure akan ada masalah. Most of my colleague will give this stereotypical look everytime they have to deal with Muslim patient. Malu pun ada. Sakit hati tu jangan cakap la.

Sometime I wonder lah jugak, what this people expect anyway?? Dah sah-sah la you are in a foreign country yang majoritinya beragama Kristian. So, off course la kau tak boleh ikut kepala kau all the time kan??

For example, if kantin tempat kerja kau tak sediakan makanan halal, perlu ke nak hantar petition mintak kantin makanan halal sedangkan pekerja Muslim ada 3 ekor je?? Walaupun you have the right to request, tapi bukankah lebih mudah kalau kau bawak bekal sendiri?? Bersyukur la at least boss kau bagi kau break 15 minit untuk semayang, break satu jam pada hari jumaat supaya kau tak miss semayang jumaat and sediakan bilik untuk kau semayang. Lagi mau demand kan??

Orang yang tak bersyukur macam ni memang patut dijolok dengan chopstik!!!

44 Weeks and Counting..

Apa yang 44 weeks and counting tu??? Mai mai mai sini aku nak habaq kat hangpa semua.

Ada la sorang patient aku tu kan. Dia ni adalah muslim from the country yang sangat tak aman dan lagi huru hara kat dunia ni. This is her first pregnancy and was referred to me at her 44 weeks of pregnancy. 44 bloody weeks!!! Dah 4 minggu due tu! Aku pun terpikir la jugak kenapa la doktornya bingai sangat tak induce the baby. Bila aku baca record, rupanya perempuan ni refused induced. She want everything in normal natural way dan menyerahkan segala kepada ketentuan Allah (it was wrote in the record macam tu yer!!).

Aku tepuk dahi aku dua tiga kali.

Aku panggil patient tu masuk. Check baby's heart beat, ok positive. Liquor volume ok. Doppler wave pun ok. Dah siap semua, aku panggil dia duduk tepi aku sambil aku sedia hujah-hujah nak bagi ceramah free.

Aku tanya dia, "Ni dah masuk sebulan due ni, dok tunggu apa lagi? Bila doctor suruh induce kenapa you refused?"

Dia kata, "Saya nak beranak baby ni in normal and natural way. Tak nak c-section".

Pastu aku kata balik, "Bila masa kami suruh hang buat c-section? Doctor cuma induce je. Hang still kena push baby tu keluaq like normal delivery.."

Dia kata, "Takpa, saya nak tunggu. I left it to Allah to decide".

Hamboihhhhh pandai la hang. Aku dengan hidung kembang kempis ni pun pi la kata kat dia lagu ni,

"Puan, there is a reason why God gave us brain...for us to use it. As much as we want to left everything in God's hand, but at the same time we have to try our best to achieve what we want to achieve. Do you think God will give you money to buy food if you didn't find a way to get the money? If you fell sick at home and you need to get to the hospital, do you think the god will send you to the hospital if you didn't get the ambulance. No madam. That is what brain for. To think and do something wiseful. At this point, your baby is overdue for quite long time already. The longer you keep it, you just increase the risk for the baby to die. I don't want you to lose the baby. And I don't think you want it to happen either. We only left everything to Allah when there is no option whatsoever. Right now, you have an option and I beg you to accept it. Now, take this notes and go back upstairs and see your doctor and please please consider his or her opinion".

I somehow don't understand why people bother to go to the doctor if they end up throwing all the medical opinions out of the window?? Lain la kalau kau tu gila or have a learning difficulties. This sort of people really need to get their head check!!!

UPDATE: Setelah diberi nasihat oleh pelbagai pihak, patient tu masih dengan her decision. Dia tetap kata, "Allah knows best". So there's nothing we can do about it unless the mother is in life threatening condition. I hope at one point she will think this is not about her and her devotion anymore. This is about the baby!!

Hanya Hitung Masa

First of all, thanks to Bro Hazrey sebab informed me about this piece of article. Maklum la, saya ni memang la tak rajin nak membaca sokabar Malaysia. Nak nak pulak Harian Metro, memang la HARAM kannnn??? *matilahhhhhhhhhh~

Anyway, here is the story.

HANYA HITUNG MASA
Oleh Siti Nadirah Hafidzin
nadirah@hmetro.com.my



JOHOR BAHRU: Kegembiraan sepasang suami isteri dikurniakan anak selepas menanti hampir enam tahun bertukar duka apabila bayi itu yang lahir pada tarikh keramat 31 Ogos lalu mengalami kecacatan otak berada di luar tempurung kepalanya.

Lebih menyedihkan, bayi lelaki itu disahkan doktor menunggu masa untuk pergi buat selama-lamanya kini ditempatkan di bawah kawalan doktor pakar Hospital Sultanah Aminah (HSA), di sini.

Bapa bayi yang diberi nama Eyrshah Elman itu, Erywan Yaacob, 32, menyifatkan akur nasib menimpa bayinya, namun dia dan isteri, Noraishah Alaby, 32, kesal dengan kegagalan petugas sebuah klinik kesihatan berhampiran rumahnya di Gelang Petah yang tidak dapat mengenal pasti masalah kandungan isterinya sejak awal.

“Setiap kali menjalankan pemeriksaan, doktor dan jururawat di klinik itu menyatakan isteri dan bayi di dalam kandungan sihat dan selamat.

“Sehingga seminggu sebelum kelahirannya, doktor di klinik kesihatan terbabit menghantar isteri ke HSA kerana menurutnya kandungan mengalami masalah dan memerlukan pengawasan doktor pakar,” katanya ketika ditemui di sini, semalam.

Erywan yang juga pembantu jurutera berkata, doktor di HSA memberitahu, keadaan bayi itu di luar jangkaan kerana kes berkenaan yang pertama berlaku di negeri ini dan antara kes terawal di negara.

“Tetapi, saya kesal doktor dan jururawat di klinik kesihatan terbabit tidak dapat mengenal pasti punca masalah kandungan isteri, sedangkan menurut doktor di HSA, masalah seperti itu sepatutnya boleh dikesan ketika kandungan berusia empat atau lima bulan.

“Hancur dan hiba hati terutama isteri sebaik melihat cahaya mata pertama kami yang dinantikan hampir enam tahun dilahirkan dalam keadaan sungguh menyedihkan.

“Menitis air mata kami setiap kali memandangnya yang kelihatan amat menderita dengan keadaan otaknya di bahagian luar. “Jika doktor dan jururawat klinik kesihatan itu dapat mengesan masalah ini dari awal, anak saya mungkin tidak menderita. “Kini, kami berserah ke hadrat Ilahi dengan apa juga ketentuan, namun saya merayu mana-mana pihak terutama yang mempunyai maklumat berkaitan kes ini untuk membantu,” katanya.

Menurut Erywan, tiga hari lalu dia cuba menghubungi beberapa pakar perubatan untuk bertanyakan mengenai masalah anaknya, namun semuanya memberi jawapan menghampakan.

“Doktor mengatakan kes seperti ini amat jarang terjadi dan masih menjalankan kajian berhubung cara atau kaedah terbaik bagi menyelamatkannya,” katanya.

Sesiapa yang ingin memberi bantuan atau mempunyai maklumat yang boleh membantu Eyrshah Elman boleh menghubungi Erywan di talian 017-7746696.

Ok. Aku ada few issues with this article.

1. Kes pertama dan terawal?? Tu sangat tak masuk akal. Based on the picture, ia kelihatan seperti sac-like protrusions of the brain with a membrane seen covered the herniated part which consistent with one of the neural tube defect called encephalocele. So, judging on the head shape and forehead, seems like the cranial vault is present which differenciate it well compare to anencephaly. The protrusion commonly appear back at the head or front of the head between nose and forehead (macam elephant trunk).



There's nothing new about encephalocele. I've seen it few times in HUKM, betul tak Kak Fahya? Most of the time, it was associated abnormality. Encephalocele occur rarely at one in every 5000 births and the country that is frequently to get this, surprise surprise....it is Malaysia, Indonesia, Russia, Africa and most of south asian countries.



Lepas tu, encephalocele ni ada few catogeries and severities. Kalau the bulging part tu hanya mengandungi cerebrospinal fluid, ia dipanggil meningocele. Kalau ada brain tissues, ia dipanggil encephalomeningocele.

There are actually corrective surgery for encephalocele by the way. Unlike anencephaly yang brain dia tu totally expose (without skull). So, bila Bro Hazrey bagitau kata otak kat luar, saya terus ingatkan it is anencephaly. Encephalocele have better prognosis, but we have to find out the source of the problem first. Is there any brain tissues exist?? Is it associate with hydrocephalus or not? The less brain tissue present, the less risky it will be.

2. I really feel sorry for the couple yang sikit pun tak menjangka pasal benda ni. Dah la susah nak conceive, bila concived, abnormal pulak. Walaupun saya percaya pada Tuhan serta qada' dan qadarNya, I put the blame totally on the doctor. This is a serious patient negligence. So since aku tak tau background doctor tu, susah la aku nak counter attack. Is he/she just a GP or a specialist?? What sort of examination he/she did or gave to the patient during antenatal visit?? Does he/she have a proper equipment or good knowledge in obstetric??

3. Encephalocele, with proper equipment and proper person with a very good knowledge in feto-maternal (like me!! *matilahhhhh riak angkat bakul~), can be easily detected as early as 12 weeks by ultrasound scan. Ultrasound scan, ultrasound skill and ultrasound knowledge are MUST if you are in obstetric field!! Ultrasound scan is a PRIMER screening for obstetric!!! You cannot suka-suka buka klinik and jemput semua mak-mak buyung ni mai klinik hangpa if you have no idea about those three!!!



Kalau buat ultrasound scan pulak, ia tidak terhad setakat nak measure saiz baby sahaja, because you will end up with misdiagnosed anyway!!! You HAVE to do a proper early pregnancy scan at 12 weeks and the most important part is ANOMALY scan at 20 weeks!!!

4. I think it is time for KKM to introduce a compulsory early pregnancy scan and 20 weeks detail scan. It can make a lot of difference in managing obstetric case. For instance in this case, at least if we found it earlier, we can refer them to pakar earlier and planned what could they do regarding the baby condition. Come on la, kalau UK yang ada 62.3 millions population with high birth rate boleh buat, kenapa Malaysia with 28 millions population and lower birth rate tak boleh buat?? Kalau boleh make sure antenatal visit tu kena buat appoinment in advance, because sistem walk in yang diguna pakai sekarang ni boleh buat all medical practitioner sakit jantung!!

5. Please please please introduce sonographer and make it as a legitimate post in KKM. Australia, NZ, UK, US, Singapore and even India dah lama introduce sonographer dalam organisasi masing-masing. Korang bila lagi?? Tak ke rugi bila eligible sonographer yang lagi bijak pandai ni pergi kerja kat UK and Aussie?? At the moment, Vision College kat Kelana Jaya tu produced roughly 20 sonigraphers yearly, why do we have to let them to work in private hospital and overseas?? Kat Malaysia ni, KKM yang aku rasa ada proper sonographer with proper qualification and experience probably HUKM/PPUKM and PPUM. Tu pun kesian diorang sebab gaji seciput taraf-taraf U29 atau C41. Padahal kalau kau kerja kat UK, gaji ko sama dengan MO dan yang penting, it is in pound ok!!! Sori lah, aku memang mata duitan and high maintainance. But then again, isn't it the best feeling in the world when you can earn lots, spend as much as you want and at the same time ko boleh tanggung parent ko and adik ko yang masih belajar kat kolej?? Isn't it the greatest feeling in the world??

Ada setengah hospital tu, sonographer dia bukannya ada qualification pun. Setakat training 2-3 bulan dengan specialist atau consultant, dah diberi kepercayaan pegang patient. Nasib la diorang kerja dengan consultant, apa-apa hal ada back up dengan consultant. Tu pun, consultant bukan selalunya available. Meeting la, surgery la and so on. If pateint sue you, tidakkah kau ternganga di situ?? Kat sini, you work independant. Nothing to worry sebab all of us have a decent qualification with decent experience. The specialist and consultant will use sonographer's report in order to proceed with further assessment. It is really a big deal. We were taught to be independent and confident at the same time. If were are not sure with what we are looking for, then we are not sure and we can always refer them to second opinion. What harm it could do?? At the same time, we have to register with the ultrasound body or organization. This organization will protect us in many ways.

6. It is time to this matter seriously. I think regular antenatal visit yang just nak measure fundal height, ambik tekanan darah and so on boleh dibuat kat klinik bidan atau klinik-klinik biasa yang ada certified nurse or midwife. But at some point like for early scan and 20 weeks scan, they have to be referred to medical centre or hospital yang provide proper ultrasound scan with qualified sonographer or specialist. Jangan nak tunggu bila patient kencing manis atau darah tinggi baru nak refer!!!

Everyone makes mistake. True. The difference is how we overcome it and make it right.

Bear in mind that I am not some doktor pakar yang super duper bijak. Those are just my opinion based on my knowledge and experience yang seciput ibarat kuih siput.

To En. Erywan and Pn. Noraishah, Malaysia have lots of experienced peadiatric neurosurgeon. Even kat HUKM pun ada kalau tak silap. How I wish I am more resourceful. Jadi, jangan putus asa or putus harapan. Semoga Allah panjangkan usia bayi kalian and all the best.

Sekian.

Update: After a discussion with my colleague, she said it can be something different from encephalocele. Thing is we don't have enough picture, history to figure out what is the actual problem of the baby. She also suggest postnatal karyotyping to see whether it is related with any genetic syndrome. The prognosis and treatment is all down to the severity of the herniation and how much brain tissue presented in that herniation.

Update Ketika Berak

Haiyohhhh tajuk!!!

Al-kisahnya uols, aku ni baru balik dari beraya sakan from south Germany. Korang ado?? Aku yakin sangat hatta Itamrazali pun tak pernah beraya kat selatan German.. *matilahhhhhmak~

Anyway, nothing much pun uols sebab aku pergi duduk kat country side yang terpencil. What is the best thing you can do selain memetik buah epal dan buah pear serta feeding the chickens sambil feeling-feeling jadi Julie Andrews beryolande and singing Sounds of Music?? Takdenya aku nak berjimba berjoli katak bagai. Lagipun, mak dah asar nyehhhh!! *kilat sabung menyabung~

Lepas tu, balik ke London yang sejuk kejung macam syaitonnn ni, tup-tup terus tak sihat. Sabo jelah. Bila aku sihat kang, aku upate la yer.

Tu jer. Daaaaaaaa!!! *matilahlagi~

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