Monday, January 26, 2009

The ever so demanding essay - Diabetes!

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I have a 2500-word case study which is due this coming Wednesday. The case study is on a 63 year old widowed man, presented with ulcer, and has not been prescribed with antibiotics by the GP... and the story continues.... up until the lab results, and diagnostic findings. Sigh... all I have to do is to plan out a holistic assessment, management plan, so on and so forth! But the problem is, it's bloody broad! I'm at the moment stuck at the assessment of his Neurological status as he's neuropathic! I've been reading one of the papers and it's 34 pages long, talking about Aldose reductase, the c-reactive proteins, the TNF's, and other inflammatory markers! Ouch! yes.... why must this bloody essay so ever difficult! I had a chat with few other colleagues on this, and everyone seems to be put off by this essay. What's making it worse, there's no specific criteria or guidelines. Hence, how much detail should we venture... Only Alistair knows!

And so, to supplement my needs of clever ideas, I have to feed my brains with sugar! That's why the chocolate pudding! Bless!!! I'm up and running now like a headless chicken trying to get it done!

Oh a short entry on this one. I was in bed as it was Sunday - the usual lazy me. Just before noon got a text from Haslina. A Malaysian friend of her's invited me over for a get together. Without hesitation, I jumped, agreed and got ready. Without breakfast, I headed town (it was terribly raining and windy), got myself a latte to keep me warm. Met up with them in town, and soon we got to this lovely house not far away from town. Apparently, she's a Malaysian whom I saw on my few weeks of stay here in Eastbourne. So my guess was right indeed.

She served us with Laksa (yummy), nasi goreng... and dessert! Phew... my tummy went all bloated. I didn't even think of dinner. So it was all good. Guilty as charged for not doing work, but it was all worth it. Thanks to them all. I had a good time with the kids too. I made them to sit still and actively listening to my story telling. Hahaha...

Anyhow, gotta get back to work! tick tock tick tock... placement soon! Accommodation sorted, Day 1 rota sorted. What else?

Saturday, January 24, 2009

End of Semester 1 - Year 3 / Orthotics error!

As always, I struggled again in making this particular casted insoles. They were so complicated (well, it was then) but I made it in the end with perfection and everyone was impressed including the tutors. However, as a good clinician, one should never ever be complacent. Hence, at 2am, I realised something was not right. I remember palpating and concentrated so much on the patient's left foot rather than the right as that was the problem. I looked for my picture files, the temporary insoles I had given the patient earlier. DAMN ! I said to myself. I got it the other way round!! Made my night sleepless and I rushed to the Leaf 2 hours earlier before my rota so I could get it rectified and sorted. Here they are...

This is the wrongly manufactured! Gosh, I can't even differentiate left and right!?? This orthotics are made to put the rearfoot into neutral at the subtalar joint and which should help with the patient's forefoot varus which caused him to pronate. With the forefoot extension 2nd to 5th post to sulci, this helps to reduce the functional pain that the patient experiences on the lesser MTPJ's during gait as a result of hallux limitus. Hence the 1st MTPJ cut out.
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Took ages to think, prescribe and understand the biomechanics.
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Now this is the correct one!
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Today's my last day of the semester. Next semester will be our very last semester. I have exams coming up and essays to submit. Currently working on a ever so difficult case study that requires so much thinking. Anyway, clinic caseload was great this afternoon and it went smoothly. In the evening, we gathered at the student common room for Irish coffee at Maura's farewell. She was with us for a semester for re-registration as a Podiatrist after she left the profession for quite sometime, and now she's returning to practice. She's from Ireland, and such a lovely lady. Her presence will certainly be missed.

My Irish coffee and cupcake.
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Chinese New Year tomorrow, year of the Ox! ehehe... Happy Chinese New Year everyone!!

Oh oh... placement soon!! yites..

Saturday, January 17, 2009

Hibernating.... NOT!

Wish it was summer already!! Sorry... can't help it, I'm a podiatrist, hence the pictures of shoes everywhere!

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I've been away and people have been complaining that I did not reply their MSN messages and all. Well, don't be disheartened people. I've been up and running about. Blame those busy assignments and essay that have kept me occupied since USA.

Last week was dreadful. My life only evolved around work, the Literature Review for my research proposal. Alhamdulillah, got the email today to say that the Ethics approval has been approved but needs some minor changes. So no biggie, will proceed with the data collection soon!

I think my life is all over the place (mind the exaggeration), but literally I sometimes can't even remember my schedule and all. Like today, I was supposed to be in orthotics, and I thought I was in surgery. Luckily I didn't prepare early and change into scrub suit. And I have so many things to think - patients' appointment, patients' orthotics.. arrgh! Time is so limited! And don't know if I had mentioned this before, I HATE ORTHOTICS MANUFACTURING!

For the past 2 weeks, I fed myself with loads of..... not food (well I had good food to be fair) but research papers. If those papers were the sea, I probably could cross the English channel already! I was in the library in an attempt to escape the comfort of my bed and the distractions at home. Thanks to Shahin who kept me company and making sure I work as I tend to get distracted by myself quite easily.

Shahin sneaking donuts into the library!
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Photography wise, I have not taken much pictures lately. Instead, my camera has been my very best friend in the library taking pictures of journals rather than photocopying them. Hehhe.

On the way to the library - The Meads town. Very quiet innit? And this is on a Wednesday morning.
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Me busy working, critiquing and typing my work.
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Stress has taken its toll - and this happens!
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My food highlight for the week I reckon?
Honey curry glazed chicken drumsticks with sweetcorn, french beans, wedges and onion rings.
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And this is what I had hours ago (12.40am) - breakfast, lunch and dinner.
Rice, boiled sausage, cucumber sticks and crabsticks - dip with wasabi and soy! ahah
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Saturday, January 03, 2009

I am so in need of Caffeine fix!

I just wanna hang out and sink in a couch and not thinking about work! A nice frappa would be nice!! Sigh...

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This was taken in New York after a long tiring day.

I'm craving for a good salmon fillet.

I'm craving for panfried salmon fillet with simple preparation, and sauteed or braised vegetables.

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I'll probably make it one of these days.

Friday, January 02, 2009

Christmas 2008 Holidays - New York

The beginning.

It all started when the three (Nurul, Hazim and myself) of us met for the taklimat with the Permanent Secretary of MOE in Brunei. It was random that the three of us had the same idea -USA for X'mas holidays!! Then, the plan went on until the real day came!

On the 22/12/2008 we all set to meet up in Paddington, each from Cardiff, Manchester and Eastbourne. It was ironic that Nurul and I stepped foot at Paddington station same time same spot! That's what I call -A PLAN! We arrived far earlier than Hazim, so we wasted the time over lunch and roam around London. The delays were all due to signal failure with the underground. Hours later, Hazim appeared and we took off for 2nd round of lunch, although it was a good time for tea already. After that, we spent few hours in London showing Hazim's friends around London.

The London Eye at night.

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The start of the journey, on the train to Heathrow.
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Our flight to New York JFK was on the early flight the next day, and the crazy idea was to stay up and hang around at Heathrow. Gosh, I had never imagined such a situation! It was such a wreck that we were so desperate to find any edible things for sale! Arriving at Terminal 4 was such a funny feeling. The check-in area was so small, and few seating places only available. Based on my depleting knowledge on flying, Terminal 3 should have more to offer and more people in comparison as it's a major terminal for international flights and airlines. Off we went to Terminal 3 without a second thought. There, we loiter around the arrival area, and took a nap for a bit. Hazim was dozing off and slept away comfrotably already and he didn't even realise that there were police roaming around questioning people. Nurul and I stayed wide awake, and perhaps we got so used to it from working night shifts. The feeling, environment and sigh-ness were all the same when we had to do our night shifts as nurses back then. I guess that's when experience comes handy!

Look at them..
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Back to the desperation of foods, we were so dead bored that Nurul and I decided to walk around outside to breathe some fresh air. We followed our instincts. The moment we stepped into Terminal 3 Departures, there were more people there. We could sniff aroma of coffee brewing, and our thoughts ran wild. However, the cafe we thought was open, was actually closed. We wander about somemore and slowly we saw light at the end of the tunnel!!! COSTA was open!!! We bought tons of foods and hot drinks! We went back to Hazim immediately to tell him we got food! Now you tell me, don't you think that was desperate?!?! Such a wreck right!? After we had our tummy filled, little did we know, there was also another cafe open just few steps away from us, BUGGER! But we spreaded the love as people nearby could smell our coffee too and they asked us with such interest.

our looks after the coffee boost!
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At 4am, we proceeded to Terminal 4 after a long wait for the transfer bus in the extreme cold weather. We checked in on time, and proceeded to the departure hall. Nurul and I now had gone weak and we slept until there was the flight call that made us literally jump! On board, we slept all the way through, and 8 hours later.... WELCOME TO NEW YORK!!!!
The New York experience.

We landed safely at JFK airport with anxiety and anticipation of the interrogation that people had been telling us. Fortunately, none of those scary stories we heard had happened. We went through immigration and customs breezely, in fact, we were welcomed and bid off with nice happy holiday greetings. Off customs, a tall man stood before us asking where we heading to. We replied Manhattan, and he made us wait in with another group of people. We were clueless, but I saw in his hands were leaflets of taxi service of some sort. Being anxious and puzzled, we didn't know if he was an official there, or was he working for someone, or worst, a MAFIA?!?! We were then led to the open car park where it was cold and ice from the snow storm the night before was still around in bulk. There were 2 limos waiting, one was a hummer and the other was the usual limo. It turned out to be a limo taxi service! our anxiety immediately gone and we captured the moments of joy! Off we went to Manhattan in a limo!

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An hour journey later, we arrived at the UN plaza where we stayed for the week. Hazim's aunt and uncle were very kind enough to offer us a place to stay for the three of us. We were literally at the Brunei Embassy as it's just next door and opposite the United Nations building. A very convenient place to stay as it's in the heart of Manhattan, within walking distance to Times Square, the Grand Central station, 5th Avenue and of course the UN headquarters. But the best has to be the hospitality offered by Auntie Wan and Uncle Karim. They were the most kind-hearted people and very accommodating and they made us feel so home. Upon arrival onwards, they never failed to make sure that we've eaten, and we have our needs catered for. We could never thank them enough, may Allah bless them and family, Amin. To start the New York experience, Hazim's cousins took us out to Bryant park for ice skating. That was so much fun!! hehehe We also went to Grand Central station, Times Square and the National library (the main focus of Day after tomorrow). It was so magical and felt like a dream!

At Grand Central Station
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National library and ice skating.

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The first night at Times Square.

Billboards..

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DAY 2.

We got up not too early as we had to overcome the jetlag and the fatigue after having to through such a long journey. The plan for the day was to go to the Empire State building and try our luck to go to the Statue of Liberty. Weather wise, it was foggy and cold but lucky enough it wasn't raining. The queue to the Empire State was surprisingly almost none, and the security check was very quick. Got our tickets, mins later, we were on what used to be the tallest building in New York until the late Twin Towers were built. It was such an indescribable feeling on the top, and the winds were very strong, strong enough to push us forward. I was so scared of losing my camera!!! But for the sake of sharing, I took the chance of taking pictures.. ehhehe Here's the bird's eyes view of Manhattan from the Empire State Building.

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After the Empire State building, we decided to go to Ground Zero, where it used to be the Twin Tower until the September 11 attack. The place is now nothing but what looks like a construction site. However, there was such an indescribable emotion as we walked through the sites. It was more of a development piece of land after a war destruction in a third world country. To get there, we took the subway for the very first time. I was not as easy the tube, but we finally managed it! eheh I feel so proud that I could figure it out! ehhe

The views whilst walking towards a subway station.


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On the subway train, me trying to figure out the route.

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At Ground Zero and Wall Street financial district with New York Stock Exchange X'mas Tree.

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Tribute and well-wishers outside the New York Fire Department.

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After a quick meal, the journey continued. We had to decide between places to go, Brooklyn Bridge, NYSE, Statue of Liberty? We ended up goin to NYSE then followed by the Staten Island Ferry Terminal.

The famous Wall St.

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After that, we tried our luck if we could cross over to the Statue of Liberty, and too bad the ferry service was already closed. We walked around and continued our way to Times Square. This time, to Rockefeller Centre where they displayed a famous large christmas tree and ice skating rink, the Plaza where Home Alone was filmed and along the way we saw Trump tower and all the designers stores.

Staten Island Ferry, next to the immigrant entry point during the history period.

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At Rockefeller

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Trying out the ubiquitous trolley service selling pretzels, meat skewers (lamb/chicken), hot dogs and many more. There were also many Halal and Kosher ones to be found, they're everywhere. It's impossible to go hungry in NYC as long you have the Kaching's in your wallet.

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As you can tell from this entry alone, I had seen quite alot in just 2 days of my stay, and I am so excited to share the stories. Perhaps I've bored you enough, will continue in the next entry.