Day 9196 of life

Here’s an update for those who would like to keep up on my dull life (if the work of a doctor is ever dull in the first place!).

Tonight…

Tonight I have to pick up this textbook and start studying for an official Neonatal Resuscitation Program (NRP) exam which will be held this coming Thursday and Friday. It’s a 916 page book packed with information about the normal body changes when a fetus becomes a neonate and what to do when the wrong things happen. 916 pages before Thursday. I have no idea how I am going to finish reading the book.

This week…

This week marks the second of six weeks to which I am working in the Special Care Nursery (SCN) of the Paediatrics department. It’s the section where we deal with newborn infants from birth right up to four weeks old. Much to my surprise I am enjoying it so far. Well, perhaps it’s because I haven’t started the difficult bulk of it yet – being on call and having to resuscitate babies. Nope, won’t be doing that until after I’ve completed the NRP course. Being in the SCN actually opened me up to at least consider Paediatrics as a possibility for my future. Maybe. Just maybes. No strong calling yet. Still waiting.

Today…

Today I stood by and watch helplessly as a little baby battles withdrawal symptoms. My mind just could not comprehend how a mother could even think of loading herself with dangerous drugs knowing quite well that her child’s also getting some of it and what makes it worse is to have her high moments so close to giving birth. If a mother herself knows she cannot withstand these awful symptoms, how could she expect her little one to? It was painful to see. I’ve seen it happen in adults and it is way too much for a baby less than a day old to experience.

Right now…

Right now I feel like sipping some coffee. The apple cinnamon-y scent from my burning candle makes it just the right atmosphere for a good cuppa…

… and an NRP textbook.  (-_-)

PS: New deco for the new year.. thanks to my graphics girl. I love it!

1-1-10

I suppose it would be nice to post something up for the first day of the new year. Much have happened back in 2009 – a lot of ups and definitely a lot of downs. After hearing all the testimonies last night at our little church gathering, it encouraged me to know that God is truly at work. My head so often gets so self-centered about my own problems and what I am to do with my pitiful life.

My new year resolution? Yup. I’ve got one and I really want to encourage you to do the same too. There’s this great website which I felt would really help in doing so. Find out how by clicking the banner below.

I could only pray that things will get better this year. I will be leaving  housemanship behind in June (God willing) and that would be a whole different life then.

I can’t wait to see what God has in store for each and everyone of us for the year 2010.

Have a blessed new year, folks.

Exchange Transfusion

I came home late last night after witnessing and participating in a pretty uncommon treatment procedure for neonates – exchange transfusion. 

This unfortunate baby boy started to develop jaundice at 10 hours of life (that’s not normal) and his bilirubin levels started skyrocketing to levels where it shouldn’t be. The more bilirubin found in your body, the more jaundiced (yellow) you are, the more dangerous it becomes as bilirubin can eventually seep into your brain and cause a huge mess there.

Such is the case for this little baby boy. It’s probably caused by some abnormal interaction between his blood and his mother’s blood either when he was still in the womb or during the process of delivery.

His levels were so high that the safer phototherapy would not be able to break down the bilirubin in his body. He needed an urgent removal of all the accumulated bilirubin… thus the exchange transfusion.

Basically what’s being done is we try to exchange as much of the baby’s own blood with normal blood from a donor. A small volume is taken out from the baby and an equal small volume of donor’s blood is injected back into the baby. It’s a long tedious process requiring intensive monitoring and it usually takes up to a few hours. The amount exchanged is about twice the baby’s total blood volume – and that means we took out all of the baby’s blood twice and exchanged it.

I drove home thinking about the procedure and realized that all of us actually need exchange transfusion… of a different kind, of course. We are all born with sinful bad blood running through our system that would eventually lead to death – real eternal death. In order to be saved, we need blood that is safe and free from all that bad stuff that’s killing us. Blood from one who is different from us yet like us for exchange. It cost the Son of God, Jesus, His life so that He could ‘exchange’ our bad blood for His that is pure and clean. He died our death so that we can have life that should’ve been His. That’s not the end of it because Jesus rose from the dead and was victorious over it all.

As I sat by the baby’s side, helping to inject in 10-15mls of new blood every 3-4 minutes, it really reminded me of the ultimate cost Jesus gave by dying on the cross to exchange with me His blood so that I may have eternal life to spend with Him in heaven.

¹³The blood of goats and bulls and the ashes of a heifer sprinkled on those who are ceremonially unclean sanctify them so that they are outwardly clean. ¹⁴How much more, then, will the blood of Christ, who through the eternal Spirit offered himself unblemished to God, cleanse our consciences from acts that lead to death,^[a] so that we may serve the living God!

¹⁵For this reason Christ is the mediator of a new covenant, that those who are called may receive the promised eternal inheritance—now that he has died as a ransom to set them free from the sins committed under the first covenant.

Hebrews 9:13-15

Have a Merry Little Christmas

That’s my King

Wonderful video by Albert Martin

The Bible says my King is the King of the Jews. He’s the King of Israel. He’s the King of Righteousness. He’s the King of the Ages. He’s the King of Heaven. He’s the King of Glory. He’s the King of kings, and He’s the Lord of lords. That’s my King.

I wonder, do you know Him?

My King is a sovereign King. No means of measure can define His limitless love. He’s enduringly strong. He’s entirely sincere. He’s eternally steadfast. He’s immortally graceful. He’s imperially powerful. He’s impartially merciful.

Do you know Him?

He’s the greatest phenomenon that has ever crossed the horizon of this world. He’s God’s Son. He’s the sinner’s Saviour. He’s the centrepiece of civilization. He’s unparalleled. He’s unprecedented. He is the loftiest idea in literature. He’s the highest personality in philosophy. He’s the fundamental doctrine of true theology. He’s the only one qualified to be an all sufficient Saviour.

I wonder if you know Him today?

He supplies strength for the weak. He’s available for the tempted and the tried. He sympathizes and He saves. He strengthens and sustains. He guards and He guides. He heals the sick. He cleansed the lepers. He forgives sinners. He discharges debtors. He delivers the captive. He defends the feeble. He blesses the young. He serves the unfortunate. He regards the aged. He rewards the diligent. And He beautifies the meek.

I wonder if you know Him?

He’s the key to knowledge. He’s the wellspring of wisdom. He’s the doorway of deliverance. He’s the pathway of peace. He’s the roadway of righteousness. He’s the highway of holiness. He’s the gateway of glory.

Do you know Him? Well…

His life is matchless. His goodness is limitless. His mercy is everlasting. His love never changes. His Word is enough. His grace is sufficient. His reign is righteous. And His yoke is easy. And His burden is light.

I wish I could describe Him to you. Yes…

He’s indescribable! He’s incomprehensible. He’s invincible. He’s irresistible. You can’t get Him out of your mind. You can’t get Him off of your hand. You can’t outlive Him, and you can’t live without Him. Well, the Pharisees couldn’t stand Him, but they found out they couldn’t stop Him. Pilate couldn’t find any fault in Him. Herod couldn’t kill Him. Death couldn’t handle Him, and the grave couldn’t hold Him.

Yeah! That’s my King, that’s my King.

AMEN!

Sermon by the late SM Lockridge

Biscuit girl

That was what my colleagues and I fondly called her.

Our little biscuit girl. Whenever we visit the room where she is, we’d always find her with a biscuit in her hand. Sometimes nibbling a little bit of it but most of the time she’s just holding in between her fingers. Her mother said that she always insists on having a biscuit in her hand. Yes, and even when she falls asleep, you’d find that little biscuit piece.

An adorable one year old but the size of one no more than six months, we always find her either lying down or sitting up with a straight back posture. Her mother loves her dearly and she is a clever one. She could point to the various parts of the body when asked to. I especially enjoyed it when she imitates the wings of a duck or when she pretends to ride a bike or when she sticks out and wags her little finger when her mother calls out the infamous phase of “hor hor… tak tau..” or when she cutely smacks her forehead when her mother calls out “ayoyo”. She makes us laugh every time we stop by her room. She was initially admitted into the cubicle which I was looking after. She absolutely disliked being examined and whenever I try to come close to listen to her heart and her lungs, she’d make that “pppptt” sound with her lips… to me. After a few days of being with her, I would playfully “ppptt” her and she automatically “pppts” me back. It eventually became our little thing.

But there’s always a tired look on her face. Her lips dusky blue and her forehead wrinkled as she makes effort to take each breath to sustain her life. You can hear a gasp-like sound when she inhales and an irreversible wheeze as she exhales. You’d hardly hear her speak because it takes too much of effort to. Even her cries were short ones interspersed with the difficult breaths she makes. If she were stronger, she would have walked or stand… but she can’t because her heart won’t allow it.

She has a congenital heart disease that’s not simply correctable. The heart surgeons have seen her and decided that there was nothing they could do to improve her situation. She was just on medication to prevent her heart from failing.

But it eventually did.

I found out over the weekend about her passing. Her heart grew too tired of sustaining her body and inevitably gave way. It happened on the day when I was off-duty. I was told that she still had a fighting spirit even to the very last breath of her short life. That room at the end of the corridor isn’t the same without our little biscuit girl.

I’ve come to realize that we, as doctors are most impacted by the patients who have died than the ones who recovered and lived. We rewind and think again what we had done wrong that had cost these patients their lives – either because of our futile attempts of treatment or just the impossibility of treatment. Sometimes we engross ourselves so much in finding all kinds of ways to save a dying patient that we have forgotten that all lives must also come to an end… somehow, someway. That’s why we are all mortal beings. I remember a quote I once read which goes, “Death awaits all of us, it is just a matter of when.” Perhaps what is more important is what happens after death. Where did their souls go? Did we engross ourselves with making attempts (futile or not) in bringing the eternal-life saving gospel to those who are headed to eternal death… somehow, someway? Whoever who believes in the Son, he is given eternal life, for free.

…

On a much lighter note, I have redecorated my little home. As you can see the tree is up and that can only mean that Christmas is coming. I’d like thank Carmen C who graciously doodled on her program to blend this picture up for me. I love it.

Now that I’ve got my little iphone gadget, you’d think that I would blogging away much more than before… but sadly that isn’t quite happening so far. I will try to though. I know I’ve been lagging behind in trying to update this space. But do stay tuned, I will write… eventually.

This boy

Imagine not being able to walk from the age of 5 when you could run and skip before turning 2. Imagine losing your older brothers before you could even understand why they’re gone. Imagine breathing becoming more of a conscious effort than a natural automated process. Imagine that as you lose your ability to walk, you suddenly realize they’re slowly becoming deformed. Twisted. Hard. Joints no longer a smooth movement. Imagine that all you could really do is lie on your bed and sit up. Imagine your parents knowing you will face the same fate as your brothers in a few years. All by the age of 11.

He’s an adorable boy sadly inflicted with a horrible genetic disease. Duchenne muscular dystrophy. He only had two older brothers and both of them succumbed to the this disease’s fatal complications in the recent months. This boy was tested positive even before he showed any symptoms at all. Out of 7 children, 3 of them positive, 4 were negative of which 3 are daughters. 1 lucky younger brother. Negative. Safe. Their parents’ only surviving son. This boy had come in with simple pneumonia. Nothing big. Nothing too serious yet. Who knows when his respiratory system may give way. At least he’s not on oxygen support yet. But soon he will be. Soon he will pass on. Not yet, their parents hope. Give him a few more happy years.

My ward houses general paeds and is partially a specialized neuro ward. All kinds of neurological diseases. Meningitis. Encephalitis. Severe epilepsy. Dravet Syndrome – never even heard of it. It is a rather sad field to be in. Sometimes these are never curable. Sometimes the simple ones are. But most of the time, you’re seeing children lying on their beds with a tracheostomy. Neurologically different. But I guess that’s what life is. It’s a God purposed thing. It is through these things that we realize that He alone is perfect.

Not us.

We’re messed up human beings to which only Jesus can save.

Physical death awaits all of us – it’s just a matter of time. How one lives the life after can be changed. With one decision.

Got to head to work now. Will write more later..

What’s a century divided by four?

Blogging is such a great tool to quickly access the moments the writer has captured into words in one particular cross-section of time,
… very much like an online diary thing.

I knew I really wanted to write again in dedication to the moment to which my age technically/biologically/legally changes – present known number plus one.

Little had I realize upon looking back that I had actually penned birthday thoughts on my blog in a biennial pattern. Today would be the third post written in succession to the last one two years ago. You’ll find them in the archives (October 2005, November 2007).

Time flies. Literally. Soon enough it will be another two years.

I told myself not to sound sappy.

Yes. It’s the big 2-5. It is HUGE, isn’t it? No plans on hiding my age there, you would have known if you read my past birthday posts anyway… although the growing number is starting to make me shy and quite uncomfortable. Too many reasons behind that to get into.

Y’know what would be interesting? To write to future me and perhaps the Lydia-ten-years-older could get going on some answers.

Dear Future Lydia,

Hey. What’s up? Does that term still sound applicable in your time? Btw, you look great for your age. Keep it up.

I’ve got a ton of questions for you…

Are you still all into that must-keep-yourself-thin? What’s your weight now?

What about your hair? Is it still long? Did you radically make a change somewhere along the line?

Are you still afraid of lizards? It’s ok if you still are. What about cats? How do you feel about them now?

Please tell me that you’ve already learn to swim properly and maybe went scuba-diving at least once!

What about family? How’s mommy and daddy doing? I hope you’re taking good care of them and making sure they’re seeing a good doctor when they’re ill. Don’t pretend you’re all that smart y’know.

Are you married yet? Dating, at least? Seriously?

Are you wiser now? Making better life decisions?

Oh Oh! I hope by now you would have at least seen the Aurora lights and maybe the Grand Canyon? Do you travel a lot? Have you gone to more countries in the South East Asia region, other than Singapore? Did you make a trip to visit your adopted daughter? Have we adopted anymore children?

Please tell me you still dress up a little and that you’re physically fit to still wear heels on nice occasions.

How’s church? Still going on strong, I’m pretty sure. Nothing can be against it when God’s on her side!

Still baking occasionally? Has your cooking and baking skills improved? That’s great. I’m sure they’re all delicious stuff.

What’s been good in your life nowadays? What’s about the not-so-good ones? Are you still glorifying God in all that you do? I’m sure you’re finding Him more and more precious by the day.

I’d love to know how you’re doing. I’ll be waiting here for your reply.

oh… btw. Happy Birthday.

Love,
Present Lydia

It’s all for the kids

Yup. Here I am. Paediatrics.

So far.. so good. A wee bit more motivated than I was in O&G.

Don’t know why.

Although the poking children part isn’t that nice. But I guess it’s something we have to do to treat them.

Alrighty. Got to go to work now. Will write soon!

I’m through

It’s over! It’s over.. finally finally over.

What a relief! It’s all behind me and in the past. Yaaayy!

What’s next?