Calculi (Stone)

A lot of people might have experienced the most painful sort of pain in the abdomen other than constipation pain LOL...

Almost every 2 hours we receive patients complaining severe lower abdominal pain that starts from the back and radiates downwards to the groin area. It is quite characteristic of a "ureteric calculi". Calculi means stone. In our urinary tract we have the kidneys, down to our ureters, then to the bladder and then out through the urethra.

When there is a stone in the urinary tract it is a normal mechanism of our body to get rid of it. So our body tries to expel it through our urine. What makes it painful is that the stone have sharp edges and as it tries to get its way out through the small ureters and urethra it has to be squeezed out by peristaltic movements and hence causing the pain. And mind you, even men have trouble bearing this pain, some would faint.

The bad news is the pain will only resolve after the stone comes out and it might take days. Look at the X-ray above, that stone on the left has a long way to go before it gets out. More bad news for men, your urethras are much longer then in females :P And even more bad news...It can recur.

To avoid getting stones in your urinary tract, drink plenty of water every day of at least 2L of water in healthy young adults unless if prohibited by your physicians for your other medical conditions. Eat plenty of green vegetables and fruits everyday and urinate regularly. Do not hold it in for a long time everyday. Also avoid beer and cigarettes.

Some stones may be very big, probably too big for it to come out but that is quite rare. That would require other surgical or laser interventions.

So make sure you get good healthy diet and drink clean water every day for the rest of your life. Believe me, you wouldn't want to experience this pain at all, ever.

Domestic Violence. Is it worth it?

Working in the Emergency Department in Malaysia we receive cases like domestic violence, child abuse and rape as well. I don't know about other countries though. It's heart breaking when we listen to their experiences first hand especially by the beaten and battered ones. However when it comes to rape cases, we don't really entertain all of their emotions well since most of the time they are not really genuine rape cases. Most of the time they are just annoying little kids who prefer to come half naked to the hospital (even though they were not recently raped) and heavy make up with no guilt on their faces and have been having that sort of fun sex even at young age as early as 11 years old with kids their age or whoever they want and probably have done it a thousand times or more and who are actually proud of what they did. Yeah we know, we do perform the examinations so we know. But don't get me wrong. Of course we have empathy and sympathy towards girls who were actually raped like real real rape. Not just by definition rape.

Domestic violence don't just happen among the poor, the uneducated couples or the problem gambling. Some couples went through tough times especially when there are no more love between them and no more respect towards each other. It's scary to even start thinking about building a family of my own after seeing the real picture here in the hospital. A woman who have been married for 3-5 years came to me one day and told me she was beaten by her husband and his friend in public one night. I asked her why did that happen? What was she doing? What was causing the aggravation? Her story was something like this. She's a working lady. Probably careered by the way she dressed up. Her husband has told her that she cannot socialize with her friends too late at night and at that time she was out with her friends until 2 am in the morning. And she was out with some guy friends and a girlfriend. I guess the husband had some doubt about her honesty and loyalty so he beat her up right there and then.

I guess we can never predict the future. You might be in love one day and the next day you may wake up next to a serial killer! (hehe..maybe that only happen in movies - i sure hope its only in movies and not in real life) Building a life is hard. To build a family is harder. But it's just a cycle of life that has been going on since the day Adam and Eve were sent to earth. And it must go on. Being in love is beautiful. The thing that holds everything together is even more beautiful and i think that thing is trust.

I wish all the best when it comes to love and life. I know some people have to experience rough patch one after the other in their life. But success isn't a destination. It's a journey.

Conviction

It's my day off today and I got to watch a few movies at home. I got to watch Harry Potter and The Deathly Hallows, Saw 7, Devil, and Conviction. Maybe I'll be watching some more tonight.

Have any of you watched Conviction? If you are the kind of person who loves movies based on true stories or the kind of movies that touch your heart and soul then this is the one for you. At least it is for me. Conviction was based on a true story about 2 siblings, an elder brother (Kenny Waters) who was wrongly accused of murder and sentenced to lifelong imprisonment while his younger sister (Betty Anne Waters) who was a single mother of 2 sacrificed whatever she had to prove that her brother was innocent.

They came from a poor family. These 2 siblings were so close together since they were at very young age. They have strong love for each other even when their parents went through tough times together. They lived in a broken home. When they grew up and both got married and started having children, Kenny was arrested and sent to prison. Betty Anne had unconditional love for her brother and she strongly believed that her brother was innocent. She was in desperate move to free her brother. The big problem was money and after 6-8 years of Kenny's imprisonment, Betty Anne decided that she would go through law school and become her brother's attorney and reopens the case.

Just imagine how a 30+ year old lady with poor educational background and children to look after would give up her life and sacrificed so much to free her innocent brother that she loved dearly. I wonder how many of us have that kind of love towards his or her siblings. I wonder how many of us would do the same. I don't even know if I would have the courage and strength to do so. Especially when it involves me going back to school for something that I know nothing about.

It was a good story with high moral values put into it. That is why I enjoy this kind of movies. It is always good to see things differently at various angles and different perspectives. It teaches me to appreciate life more and be content with what I have :)

My Artworks :)

I love paintings and I wish I am an artist. I can't remember when was the last time I painted something. My mediums are very simple. I use normal watercolour papers and acrylic colours. I have never used other papers and colours. Probably because I don't really have time to search for the different kinds of materials available and also because I don't know where to get them :(

I rarely paint because now I hardly get any extra time to do what I love to do. But when I get a sudden epiphany only then I will be in the mood to start painting and will not stop until my artwork is done. I think its fun to paint because since I'm an amateur I get to experiment different strokes, techniques and create different colours.

Somehow I noticed that most of my "good enough" paintings are mostly blue in colour hehehe... I don't know why. Maybe if I am a real artist I think people will nickname me Bluey :P

I envy the real artist to have been so gifted with skills and passion for art. As for me, my passion is so limited thanks to my "unconditional love" for my work...Puhlease... Somehow I think I need a long long long break away from the hospital and restart my hobbies. Don't we all.

Maybe one of these days I will make some time to paint. But its rainy season here at this moment. I need a good shiny day to paint. I usually wake up early to paint and start at sunrise and try to get it done before sunset. If I don't get to finish it by then, I'll definitely won't be able to complete it at all :P

I wonder what am I going to paint next. I always have this problem before I start painting because it seems that there are so many things to paint but I don't know which one to start with.

These are some of my work I've done over 2 years period :P Hope you enjoy looking at them as much as I have enjoyed creating them :)

Save Lives

I've received some questions before like "what do I do to help an accident victim?" or "how do I perform CPR?"

1. First of all before you help others you need to first protect yourself and make sure you are away from any dangers. Example when you are at the accident area and you never know if the vehicles might burst into flames, etc.

2. Call for help! Call for ambulance.

3. When theres a major accident, what you should do first is help out those who you think have better chance at surviving, ie victims who can walk out or crawl out. Lead them to a safe spot. Then only attend to those who need to be rescued like those stuck in the vehicles or the unconscious ones.

4. For those who have any bleeding areas you should try to control the bleed. You only need a piece of cloth and gently apply pressure on the affected area. If you want to tie the area ie the leg, you don't actually need to tie it too tightly as to tie one end of the cloth to a tree and the other end to another tree :P

5. If you see an unresponsive victim, you may need to start CPR. It would be good if you can perform CPR well. There are CPR courses available if you are interested to learn and will get a certificate at the end of it. Otherwise theres a good video here on youtube /http://www.youtube.com/watch?v=O9T25SMyz3A

Have fun learning. Oh and yeah, don't practice it on a real person because CPR is painful to a conscious person :)

Malaysian Music Talents

I used to post in this online forum called Asiafinest. And I recently started to post again in there and texting some old friends I met before. There's a thread in the forum about some of Malaysia's very own bands from the 70's and I think they were awesome. I wonder what happened to these talents and what are they doing now. It would have been nice if more people know about them and other Malaysian talents such as these to be built and reborn.

The Strollers:

http://www.youtube.com/watch?v=qrTYsVsZiyg&feature=related

http://www.youtube.com/watch?v=A0Dp8UQkHIE

And how I miss all of the P.Ramlee movies. Love his movies, love his work. Recently I got to know that he actually didn't play all of those instruments that we all thought he was good at. He only knew a few. I forgot which one. Here are some of my favourite :)

P. Ramlee:

http://www.youtube.com/watch?v=GlaPiPv9wMA

http://www.youtube.com/watch?v=8PdoelbBKi8

Personally I don't think the new age Malaysian music scene isn't that bad either. Only that I wish that they can be more internationally recognised for their talents because I think it is only fair that they are well known for the efforts and talents they have been gifted with. Enjoy the videos. I sure enjoy them :)

Yummy yummy

I don't know why but I have this passion for spaghetti. I love spaghetti so much that I just have to eat it once or twice a week and that actually takes a lot from me since I have to prepare, cook and clean inspite of my busy schedule when most of my colleagues will just say no to.

I think what I love most about spaghetti is how spongy and how smooth they can be. I've been trying on some new recipes lately. I bought a book on spaghetti and now I feel like I can start my own spaghetti bussiness, hehehe. It's interesting learning different styles of spaghetti/pasta recipes. I'm so enjoying cooking now and loving it. Only that I don't like to mess up the kitchen because at the end of the day I need a lot of cleaning to do.

In my fridge I always have tomatoes of different colours and types, lemon, any kind of fresh herb, cheese, mushroom, onion, capcicum. Those are the must haves so that I can make spaghetti any time I like. And at the moment I love this new recipe that I've tried. It has fresh basil, grape tomatoes, black pepper and lemon juice, and oooohhh..how it gives me food orgasm. Hehehe.

Dengue Fever - New Beginning

Happy new year everyone :)

I was on call in the emergency department last night and I had quite a good call. Yesterday wasn’t as busy as I expected since it’s the holiday season and all. I’ve been wanting to write on Dengue Fever for quite sometime but always have forgotten about it soon afterwards. Somehow it feels like dengue season is all the year round in Malaysia. Probably shouldn’t be called “season” since it really does affect a lot of lives all through out the year.

Dengue fever is caused by transmission on dengue viruses through a vector (something that carries and transfers the virus) very well know to all of us, that’s the mosquito. Not just any mosquitoes. It’s the Aedes aegypti mosquitoes. We recognize it for having black and white stripes over its legs. These little buggers also transmits other viruses causing Chikungunya and yellow fever. As we all know they like living and breeding in clean stagnant water. So if you haven’t washed your used glass of water with probably some water in it somewhere in your sink or under your bed, please get to it. Wash it off and you might save yourself from being bitten by what you have cultured in there.

How do we look out for symptoms of dengue fever?

1. As the article said it, we usually suspect dengue fever if your fever persist until day 3 of fever.
2. Muscle and joint pains. This is quite common even in other normal viral fever (the not-so-dangerous kind of fever)
3. Headache.
4. Vomiting and diarrhea (watery stool). Do not hesitate to go to the hospital for check up for thinking that it might be a regular food poisoning symptoms. Severe vomiting and diarrhea may make you very dehydrated so do not wait any longer!
5. Bleeding tendencies, such as gum bleeding when you brush your teeth. Or nose bleed. Sometimes some patients present with rashes. You might not be able to understand the pattern of the rash that you see, so whenever you see your skin gets red you should probably get it checked instead of trying to be a doctor of your own.

How dengue kills? Many would ask this question as to how a simple mosquito bite kills a human being or to be exact, dengue fever claimed up to tens of thousands of lives per year in Malaysia (alone). To simplify the effect that brought about the severity of this illness is by the fact that it causes the water level in your body to reduce drastically and significantly leaving you all dried up and hence if treatment is late that person may go into a shock (not a shocking-scary-shock but a term used to describe reduction in perfusion and oxygenation in your tissues) and that causes death. So in short, when having any fever at all you need to drink a lot of water. However, I’m not suggesting you to stay at home and drink 5L of water per day because it will only cause you more harm then good. What you really need is to get yourself treated in hospitals.

You may neglect the facts that this mosquito business is a serious matter. Until you have lost someone you know or love who succumb to dengue fever. Only then you may open up your eyes and try to do something about it when you know it is already too late for the damage has been done. I have seen so many of young, well built fellows who suddenly collapse from dengue fever and in an instant die in front of my eyes. I know life and death is a fate and we can’t run away from it. But let’s just try to create a better and healthier living environment for ourselves and those whom we care for so much.

Let us start cleaning what we have left so to kick off a brighter future ahead of us on this new year :)

The Green Mile 25/12/2010

I remember watching a movie called The Green Mile somewhen in the year 2000 (I think) and it was one of the most memorable movie I've watched in my life (apart from old Disney animations). I could actually recall few bits here and there even though I've only watched it once (which was practically 10 years ago). I guess it was because of the intensity of the movie brought to life by Tom Hanks (acted as Paul Edgecomb) and Michael Clarke Duncan (acted as John Coffey).

This movie was an adaptation of a book by Stephen King published in 1996. It was about Paul Edgecomb who was a security guard in a prison who had some faith in supernatural incidents brought by John Coffey (an inmate who was to face death penalty for murder). But it wasn't about the supernatural-myterious-terrifying plots that caught my attention. I wasn't really sure why I remembered the movie bits quite well. Then I remembered that I was actually so happy I watched the movie and I bought that book 3 years after I watched the movie and boo-hoo... I've only got to read it now :P which probably means that the book has been quite dusty having being kept on my bookcase for a long long time :P.

Now that I finally get to spare some time to read while doing locum in one of the nearby clinics I feel only too happy to get back to my old hobby...reading. I used to read a lot of novels back then. Used to be so happy to be going to bookshops and I got to pick and chose any books I wanted and didn't have to pay them (my parents paid for them of course). But now I don't remember when was the last time I've stepped into a bookshop..Hmm..Or maybe perhaps I did get into one a year ago and that was to buy some pen hehe.

Now I'm already on the last quarter of the book and it feels good to almost finishing it because obviously I havent read a novel in the past umm..6-7 years? One thing that I enjoy most about this book is how people should always be given a second chance. Not just for people to reflect back on what crimes they have done in the past, but also for us to be more patient towards anyone at all for whatever kind of attitude they have showed to you and made you upset, etc etc. As I believe being patient and kind may lead to one good thing and the other.

I am now in my last posting of housemanship year and I'm in the emergency department. I don't quite enjoy my time here. Most of it because my patience has really been tested to the core as we are the first liner doctors in the hospital who will be attending to all patients before being coursed to the wards so we are dealing with all sorts of attitude and expectations and bullshit to be exact. There has been many challenges from not just responsibility point of view but my tolerance level too. I'm trying to wake up every morning reminding myself to have a good day at work because if I feel good my work will go smoothly as I'd hoped it to be (maybe not as often as it should).

Working in the emergency department is fun because I get to test my knowledge and recall on my previous encounters of the cases I've seen before. Something to brush up on my old piece of brain (where ever that piece is). The only thing that isn't fun in here is...well...don't think I want to blog about it in here because one day when I grow old and I read back on my old blogs, I don't think I want to be remembered of these ill memories.

So Green Mile, here I come back to your browning pages and hopefuly get to finish reading it before end of this 2010 to mark your 10th year since the time I watched you on tv :P

Housemanship bla-bla-bla

I think we have all read or heard enough of the current issues revolving around the lack of competency of young doctors going through housemanship years. I realised that this subject has been made generalised making the entire Malaysian community perceive that all young doctors are unreliable and unprofessional. Some patients or their relatives would not even consider being polite to the young doctors because they keep in their minds that the junior doctors are not fit to be one. This might sting a little if not a lot to those doctors who have dedicated their hearts into performing at their best while at work.

It is undeniably true that there are a few under trained young doctors all over the place, be it in capital cities or those trained in peripheral hospitals in Malaysia.

From my observation having gone through the housemanship course it really was a good 2 years of practice. In my view, I think it was a good first step because we were exposed to so many departments like general surgery, obstetrics and gynaecology, medicine, paediatrics, orthopaedics, trauma and emergency and anaesthesiology. I think the duration of each posting to be of 4 months is perfect if not too long or too short a duration. If this is cut short, one may not have enough exposure to encounter different cases since there has been a marked increase in the number of young doctors. If this is to be prolonged, I think there will only be more complaints not from the young doctors (they don't have a say at anything) but from the team they are working with, their colleagues and specialists in-charge. Why is that so? Lengthening their comfort zone as being a houseman will not make them a better team player as they will be left behind since they will not be carrying any responsibilities towards their patients and there are no contributions towards the team.

It is true as a houseman one will not be held responsible for whatever mishaps because they are still in training "under supervision". However, some might take advantage of this situation taking refuge behind this quote and running away from his or her responsibilities. Mind you, there are eyes and ears all around monitoring these doctors' every move in the respective departments and the hospitals. Sadly, what stays in always stays in. When senior doctors were enquired about these problematic doctors, their answers would be they have no rights to take actions towards these doctors and the only available punishment to date is to extend the duration of his or her stay in the department. Hence the problems only get worse as the problem is still unsettled and they still will not be able to learn to be reponsible for their patients or actions. This in time turns into a vicious cycle.

Regarding the increasing number of freshly gradtuated young doctors, I wouldn't even think of it as a problem. Do not only judge something based on what is seen in hospitals in Klang Valley and Kuala Lumpur. I don't know the real number of young doctors in each department in those hospitals but after seeing Reggie Lee's comic on the ratio of young doctors to a patient, I think we can have a bit of an idea of what the situation is like over there. There are other hospitals which have very less number of houseman in their departments comparatively (please do not compare to what it was like 10 years ago to what it is like now, we know in the old times there used to be only one houseman taking care of 30 patients a day). Maybe what we need is a better system at dividing the appropriate number of houseman into each hospitals which is critical to ensure no decline in the experiences gained by the junior doctors.

We have understood the expectations of Malaysian Medical Council and what their concerns are. Maybe it is also time to look deeper into the issues and understand why the problems occured in the first place. I'm sure there are many controversies of what is really happening. This blog is not for me to leak our the dark secrets or fall up of the system but only to enlighten some dim corners that might have been overlooked.

I will start writing again :)

I'm so touched some of you are still reading my blog :) I feel so happy I want to give lots of hugs and kisses to all of you reading and many many many SUPER THANKS :)

PURSUIT OF HAPPYNESS

It has been a very long long time since I opened up my own blog to start writing something again. I've been very busy with work since I've started working for about 9 months now. But I think the reason to have gotten me back to blogging is because of what I feel now.

My parents have just left to perform their Hajj few days ago. I wasn't sad that they were leaving at first because I'm used to being far apart from them and I'm used to the part when they went away for holidays in other countries or something. So I went back home to see them and sent them to the airport. My mom started crying which was I thought a usual thing for her knowing how emotional she can be. But when my dad too started to cry it just hit me with a bang!

He hugged me and said to me he only wishes that God would accept him and he would ask for nothing more. But when one of the religious teacher heard that she said that we should not think that way, that we still do need to ask what we want because even our Great Prophet Mohammed asked for something when he was performing his Hajj. I think I understand what my dad meant when he said he doesn't want to ask for more. I think that's because he has realized that he has been blessed and been showered with so much of everything that he has ever wished for, that he is just too greatful for every single thing.

The next couple of days after that I was at home taking care of my 2 little sisters. They are now 12 and 13 years old. I was sick at that time but they were very responsible and they took care of me and made me soup and brought me my medicine and cleaned up the house for me too :) Then I realized how lucky my parents are because their children are very obedient, responsible and we are all good children to them.

I believe that our family has been blessed with so much. We have each other and we love each other so much. Not only that, we have really cute pets too and I feel that there is so much of love in our family. Of course there are rough patches every now and then here and there. It hasn't been all blooming flowers everytime but I guess that's what makes life more challenging and fun :)

I hope I will be as lucky as my parents are one day. Some people believe that happyness is something that you can pursuit but you can never get.

I don't know if happyness is something that we can only pursuit but never achieve. Maybe we can't always get whatever we want but that doesn't mean we cant be happy. And maybe by being sad lets you accomplish something, something worth going through for, maybe something that teaches you about the beauty of life.

Breast Cancer Q&A

"I don't know how to start to ask my mum to check her breast. I just feel weird to ask that.

Anyway, for guys do I need to go for medical check up for my breast? I don't think they examine my breast during my last medical check up."

That is a good question. How do you ask someone to get a private part checked especially when you are the opposite sex because it feels weird.

It does feel awkward to do so since you are the son but because of your good intention and your concern towards your mother's well being then you very much have to raise the topic to her. Here is an easy way to hint her about breast cancer and breast examination. First you look up for a newspaper article or a brochure about breast cancer and ask her to read. Then maybe you can casually ask her if she has gone for breast examination anytime of her life before. Most Malaysian women are too shy to go for it. And then you point out to her that she can do it at home on her own. It helps if you can remind her of someone she knows or someone in the family who have or had breast cancer since that is a high risk factor and she doesn't want to be diagnosed late.

Men are also at risk of having breast cancer. Even though it is quite rare but it is important to examine yourself too. The self examination doesn't take long and it is very easy. So you should encourage yourself to do it once in a while.

Thanks for posting some good questions so other readers can benefit from these too. :) Enjoy reading.

Suicide? Think Again!

I'm so beat today. I am now posted in Emergency Department. Today is my 7th day here. It's quite fun to be working here because us in the emergency department is the first line of people taking care of cases that comes in.

Today, it's sad to see a few people who came in with poisoning. They tried to become suicidal by consuming poison and excessive paracetamol (panadol). I hope none of you will ever fall into these category of patients. You see, people who attempted suicide really do not care about their life anymore as to have decided to drink up pesticide or do something stupid, like stab themselves. But us in the hospital try so hard to help them come back to life.

When I saw a girl who came in today unconscious after drinking pesticide, I was so angry. I don't really know why I was angry at her, maybe because of what she did to herself. And we tried so hard to bring her back. We did so much to revive her, but it felt ironic and I felt stupid too. I can't really explain how I felt that time. I do understand that as a doctor I have to try my level best to counter her condition, but I was mad at the same time because she did something really stupid.

If you think that drinking poison and try to kill yourself is an easy job, you are wrong. In fact, it can be the most painful thing to do ever. You won't just get knocked out instantaneously like how you see in movies or TV shows. When you consume poison, depending on the nature of the poison, you can ulcerate your mouth all the way down to your stomach, or you might get the most painful burning sensation and you start throwing up in a very painful way. And because you start throwing up, you might even aspirate (the vomit might enter your lungs) the vomit and poison and then you will start having difficulty in breathing, that you are gasping for air but your lungs are burning and the airways constricting disabling you to breathe. We definitely don't want that do we?

So choose to seek help rather than attempting suicide. There are many ways you can try to let your heart and emotions out. Get someone to talk to. Get anyone, you can even talk to a pet if you want to. As long as you don't decide on doing something stupid. And know this, people do care about you. Somethings in your life may not go the way you want it to be but there are people who want you to continue your life's journey and strive in any challenges you may face.

Take Good Care of Your Teeth

Many of us do not bother much to go for yearly dental check up. But I do hope you do take good care of your teeth. Some of us might not give much attention to how our teeth look like, if it has started to get black with caries or some even start to decay.

We should all start looking into the mirror and get a closer look at your teeth inside and out and in between. It is important to take good care of your teeth because not only it makes your smile more impressive but also it helps to prevent heart diseases.

Any teeth with caries or those which are decaying are good site for infection to sets in. And as we all know, if there is infection present, that means there are bad micro organism around. So these micro organism can travel inside your teeth and gets into the blood and at the end the blood will be carried into your heart. When the micro organism gets into your blood it can cause some dangerous heart diseases and damages your heart. It will slowly and silently causes you problems and you might not even be aware of it until your heart and your body cannot decompensate(correct) whatever that have been going on with your heart.

So start brushing and flossing and gargling. Do not brush too hard till u bleed, because that is wrong. Just brush lightly and make sure you don't miss out any areas especially at the back and in between the roots and hopefully we all can be proud of our teeth and smile from ear to ear everyday! :)

Touching the Void

Until now I have never understood why people would even enjoy climbing humongous cold icy and rocky mountains for days and as I and most of us see it, we would swear never to set foot in that kind of place because it is hauntingly dangerous. Today I watched a very real documentary film about 2 friends, Joe Simpson and Simon Yates. They were 2 very ambitious mountaineers whose aim was to conquer an unclimbed West face of a notorious 21,000 feet peak called 'Siula Grande' in Peru in 1985. And something went really really really wrong.

The movie started off by showing the beautiful scenery God created of the mountains. When I saw the scene where there was nothing else but whites of the snow and the thick clouds, and the blue sky together with strong sound of wind blowing every now and then, it was gorgeous. I was telling myself I would love to experience that, just to stand in front of it and enjoy the view.

The movie went on with the 2 of them climbing to the top of the mountain. Simon was the leading guy and Joe follows about 100 feet behind him. They were connected with a rope and the rule is, if one of them fall,the other will have the same fate. They took 3 days to just get on top of the mountain. Everything seemed to be going on well. Until they were on their way down.

Joe happened to be the unlucky one in this expedition because he broke his right leg on the way down and he fell off a deep hole inside the mountain that made Simon thought he was dead. So Simon continued his journey back and left Joe in the mountain.

Joe's determination and courage was tested on how he would survive to get out of the inside of a mountain with a broken leg. At this point I was thinking to myself. What is it that I would do given the same situation as Joe had. But I think it is too easy to plan now that I'm watching it in a movie. Something is now swirling in my thought. What would I do now to survive in my own world. The world I'm living in. The daily life I have now and tomorrow's. Joe never gave up in spite of having a broken leg, probably shattered into pieces, alone, cold, with no food or water and most of all, he was getting nowhere. With his condition and his state of mind, he formulated a strategy. Pure survivor instinct. He made his aims little by little, and he gave some time to accomplish his aim. He pushed himself to gain what he aimed for, what he craved for, his safety. He crawled, he hoped with his good leg and fell every time he hopped but even with his excruciating pain he still went on, and on, and on. Until he reached his goal he refused to stop. He gained his strength, for what ever was left, to keep going. It touched me deeply. For one person to be able to help himself to win his own challenges and never stops until he gains more and more, to me that feeling is overwhelming. I want to be able to do that. I want to be able to challenge myself to see how far I can go.

Being alone doesn't mean you are weaker. It means you are stronger. Because being alone means you are independent and that you are ready to commit to life's great challenges without other's help or sympathy. Being hurt doesn't mean you are a loser. It means you are a winner. Because you achieve when others think you would falter. When Joe was alone, he thought of 2 things, either he would die from pathetically waiting for someone to come and get him when nobody knew where he was or he could die on his way out trying to survive. And he decided he would rather die trying. But as he was on his way to get out of the mountain, he realized he was stronger and smarter than he thought he was. So now I feel good about being alone. It makes me feel impressed with myself that for all this time I have won my life because I am independent.

I am looking forward to be able to experience new things in life and I am excited to get to know what is waiting for me in the future. And I hope in every challenges I am to face, I can make it through and come out stronger every time. To be able to do that, and perhaps if I became successful one day, I would be more than pleased to tell my life's story might have been sparked after watching this beautiful true story based movie called 'Touching the Void'

Diabetes

It rained the whole day today. Feeling quite cold but rather cozy because i get to enjoy hot soup and hot tea. I hope it rains tonight too so i can sleep like a baby kitten (as I always do) :P

Today in the hospital I met a patient who is in her 60 who have been a diabetic and hypertensive for over 25 years. She came because of palpitation (her own awareness of the feeling that the heart is beating fast and hard) and breathlessness.

I won't blog about heart condition today, instead I'll talk about Diabetes. Diabetes is defined as high blood glucose (sugar) level in the blood.

Diabetes affects over 1.5 million people in Malaysia alone. It is one of the most dangerous disease because it creates multiple complications(bad outcome) to those who are suffering from diabetes. There are 2 types of diabetes. The type 1 affect children or younger age people because there is a defect in producing a substance called insulin to take up glucose while type 2 affects the adult due to their bad eating habits.

Some people might say "so what if I have diabetes? It's just high sugar in my blood. It won't harm my health at all."

Diabetes is frightening in spite of just high blood glucose level. Because of this high glucose level in the blood it creates many complications that can affect your entire body from your brain and down to your feet. Due to high glucose level in the blood, your body tissues are more prone to infections. The bacterias love to be around tissues and environment rich with glucose. And once infection sets in it is very difficult to treat unless if the person can control their blood glucose level. That is why some of you might have seen your elderly who have been having diabetes for a long time who had infection of their feet which did not improved and at the end had to go for an operation to amputate(operate and remove) some part of their leg.

Diabetics are also at risk in developing kidney failure. These patients undergo a complication called nephropathy which means that the kidneys are dying. Hence they need a treatment to replace their kidneys either by kidney transplant or hemodialysis. A transplant sounds easy but how many people do you know now who are willing to donate their organs for others? Hemodialysis is a good substitute because it works as an artificial kidney but it is expensive. One cycle of treatment of 3 times a week can cost up to RM300 and these people need to go for hemodialysis for the rest of their lives.

Other complications can be blindness, loss of sensation and hence you wont even feel that your feet are badly cut and that becomes a good source of infection. Uncontrolled diabetics can also develop heart failure, coma and stroke.

So don't give excuses not to care about your blood glucose level. You can get your blood glucose level checked in a clinic or if your diabetic parents have got a device called 'glucometer' like the picture up there you can test your glucose level yourself at home.

STOP SMOKING

Hello everyone. It has been a very long time since I last blogged (I think I've said that too many times too). But it was for a good reason (I think). I've been busy with studies and also elective programme where I was working with my dad.

I have quite a lot of things I want to share with you but today I've decided to talk a bit on smoking.

I know some of you smokers might roll up your eyes and ignore this but I'm still going to pin out to you the effects of smoking you are creating not only to yourself but also people around you, especially your loved ones.

Lets see how much of harm have you caused to your lungs since your lungs act as your air filters. Most of the smokers will have occasional cough which may be severe and may prolong and worsen as time past by. Still they refuse to quit smoking because they have an excuse by saying that others who don't smoke gets cough too. That is true but people who doesn't smoke gets cough due to infection that spread from one person to another by air. In case of chronic smokers, they develop cough because of their lungs have undergone desruction and abnormality hence you are more succeptible to infection and other diseases.

Few of the most diseases that affect chronic smokers are : Chronic Obstructive Airway Disease (where the patient frequently gets attacks of breathlessness), Lung cancer, Bronchiectasis. These conditions are most grieved because they are the difficult illnesses to be treated and chances to return to normal is very minimal.

The smokers might even deny that they smoke a lot of cigarettes a day and claim that they only smoke occasionally so they think that they are safe from dangerous illnesses but hear me out, once you have smoked, it takes 6 years to clear your lungs from the harmful toxins you have inhaled and only afterwards your lungs can be healthy again.

The harm done isn't contained only in your lungs, your bad habit also affects your heart and your blood vessels. Your poor over worked heart muscle gets weaken and since you have also caused damage to your heart's artery bringing the blood supply, your heart gets weaker and weaker and it might undergone a disease called 'coronary artery stenosis'. Stenosis means the artery (a vessel bringing blood supply) gets smaller. Coronary artery is the name of the artery bringing blood supply to your heart muscle. When this happen your heart muscle can die and you get something called as Myocardial Infarction or Myocardial Ischemia. These 2 are Malaysian 2nd cause of death compared to other morbid illnesses that kill our population.

So lets do our parts to either stop smoking (to those who smoke) and to those who don't smoke you should play your role by advising people to stop smoking.

There are ways on how you can stop smoking. You can seek medical help where you may be prescibed with nicotine patch, or counseling session but most importantly you should believe in our own ability to make yourself stop smoking. Do not hesitate to seek help or other's supports. And as far as possible, try to stop in just one day and don't try to reduce is because usually you fail to totally quit smoking if you think you should first reduce the number of cigarettes you smoke daily.

VARICOSE VEIN

It has been a tiring week. Though I think it has also been a boring one too. I didn't go to hospital the whole week because the final year students were having their exams in the hospital so other students are banned to enter the hospital, unless if you are sick of course :P

Today I was called by the lecturer to talk on Deep Vein Thrombosis(DVT) but before I can tell you what it is I have to write about VARICOSE VEINS first then maybe next time if at all I remember I'll write about DVT.

Varicose veins are actually quite common. It actually means that there is presence of abnormal vein anywhere in the body that is more elongated,tortuous and dilated. It can occur anywhere in the body but the one that concerns doctors more is the one affecting the legs. Usually patient will not complaint much on pain as they are usually dull type. But it might not be acceptable to the patients cosmetically.

Normally, there are valves in the veins of the legs that help the veins to bring back blood towards our heart. But what happens here in varicos veins, the valves will be damaged and then it causes blood to pool in the legs and causes the veins to be dilated and tortuous. And if patients don't seek medical help then it might progresses and he or she can develop complications, such as an ulcer or bleeding from the varicose vein.

There are certain risk factors as to why it develops, like smoking, standing for a long time-like policeman or guards or surgeon too(my dad has one too),and it can also happen in pregnancy. But there are also ways how you can prevent this from happening. You should exercise regularly,STOP SMOKING!,and learn to stretch your legs and contract the calf muscle every now and then even if you are sitting down.

If you have developed a varicose vein(or someone you know has varicose vein) you should seek medical help and the doctors can try to deal with your problem. Certain varicosity need only conservative treatment but the later stages, you might need to undergo operations to remove the diseased veins. Usually the doctors will give you a compression bandage like the picture I posted up there. At home, whenever you are sitting down you should put your feet on another chair or when you are sleeping you should elevate your legs over 2pillows. This will help the blood to stop pooling in the veins and can be circulated back to the heart.

Friday 20/04/07

I had a terrible morning today. As soon as I got back into my room I sat on the chair and was admiring my new fish. Then I scrolled my phone picture gallery and found some old pictures of my pets. I've lost my dearest cat Tom and only got to know about it few months after that since my family kept it a secret from me until I came back home and was calling his name but he never showed up. So today I'll show you my dearest cuddly best friends and I'm missing them dearly. I wish I get to see them again one day :(

PEPTIC ULCER

It was a long long week for me this week. I was in so much stress that my body and brain refused to do anything I was supposed to do. I just couldn't be bothered with what was happening around me and my room was a big mess. Nowadays every time I get down from the bus from Muar I came back to my room to shower and I left it just how it was in the morning and went out till 10 and got back to knock myself out till the next morning. That was what happened the whole week and nothing else.

I had my surgery end of posting examination on Monday. It was a terrible one for me because I had a case which I had never seen and discussed before. I had a case of Hemorrhoid or also known as Piles. In Malay it is called Buasir.

But I don't feel like talking about Hemorrhoid today. I'm thinking of writing about Peptic Ulcer. Patients always term this illness as 'gastric'. I'm sure you have probably had one yourself or someone else you know have one.

This is actually an ulceration of the food tract, that is the stomach and small intestine. This condition is quite commonly seen among Malaysian. Usually when asked, the patients will tell us that they love consuming carbonated drinks especially Coke. And they love spicy food and also they love asam ( a kind of preserved snack ) which I love too :(

As to why the ulceration happens, there's a lot of theories and reasons why. A major causative agent is microorganism called H Pylori. This bad microorganism have the ability to make our stomach release excessive gastric acid. Normally we all do secrete gastric acid to digest food but in excessive amount, the acid can erode the food tract and then cause pain to the patients.

Patient always complaint of pain in the area close to the centre of rib cage. The pain may be of gripping or burning in nature. And is usually associated to food. Some may vomit after taking food due to this pain but some may experiance the pain when he or she is hungry. This depends on the site on which the ulcer develop because our stomach and small intestine is about 41 feet! Some worse or acute condition, patient may have vomiting of blood or they tell the doctor that they are passing tarry black,sticky stool (feces).

Gastritis is usually well treated with medicine and if the patient can try to reduce or stop their habit of drinking carbonated drinks,spicy food and asam.
In some patients, Gastric Cancer can occur too. Because due to the acid irritation, the lining cells transform themselves into canceros cells. This is what worries all. So do try your level best to stop your carbonated drinks and etc.

I had a 40years old patient last week who was diagnosed to have gastric cancer. He came with a hard lump in his abdomen which was painless. He had gastric ulcer when he was younger. He was offered to get the lump removed by surgery 3 months ago but he refused it and seeked treatment from a local bomoh. And when he came back last week to the hospital his cancer growth has spread to his liver. He died a few days after that. It was really sad to have lost a young patient of that age and it was very sad too that he was not being followed up even though he had refused his treatment.

So I do beg you to please be more alert of whats happening in your body. The problem with patients are that they only come when they cannot tolerate pain. And cancer growth is painless.
Maybe on my next blog i'll talk about cancer. Since it is just too commonly seen and misunderstood by most people.

Oh and yes, today I bought 5 guppies and put them in a lovely long vase. I'm admiring their beautiful colours and how they keep swimming. I wanted to take their pictures but they just can't stop swimming! But they are gorgeous :)

BREAST CANCER

Again, I've forgotten about my blog. Well, actually I didn't forget. Only that I just couldn't find the time to sit down and blog about what I saw in the wards.

I just got to know that quite a number of people have been reading my blog. I didn't really expect that. And thank you for your support. From now on I will try to blog a little more often and blog on the more interesting cases I saw in the hospitals.

I'm now in the final year of my M.B.B.S course and hopefuly in another 1 and 1/2 year I will graduate and start working then. I am now posted in one of the specialist hospital in Muar, Johor. It's quite a busy hospital but work hasn't been at it's hectic peak yet. I've gained few good experiances here by seeing more cases now that I'm in surgery ward.

Almost everyday there are new cases of breast cancer patients need to be admitted in the hospital to undergo treatments. Sadly, most of these women seek medical help too late. Few of these women have a huge cancerous lump in their breast and a number of them have developed ulcers on the breast skin too.

I got to talk to the patients and asked them what was the reason that they came too late to the hospital. Some told me that they wanted to try for alternative medicine and some had seek help from a medicine man. Sadly but true, some of them have went to see a doctor in some private clinics and these unfortunate ladies were just treated with antibiotics and panadol! For a simple yet unforgiveable reason that these doctors didn't examine their breasts and didn't even have a suspicion of something dangerous even though breast cancer is at rise in Malaysia. I hope I will never forget this and will never ever do the same to my patients once I start practicing.

There are a few simple steps of how women can examine their own breasts at home and if at all they have felt any abnormality in their breasts they should immediately come to the doctors to be checked. Here is a good link to have a look at on how to do Breast Self Examination. Click on it.

Oh and yes, breast cancer although occur mostly in women, men are still in danger of it too. There are a number of causes as to why it develops. The strongest causative factor is the inherited gene called BRCA1. In those families where there have been a member who have been diagnosed with breast cancer before, you should be more cautious and should be more alert of any changes in your breast since you are at a high risk of developing it.

For men out there, do encourage your loved ones (not forgetting your dearest mother) to do breast self examination and push them if at all they hesitate to get their breasts checked by doctors. Though previously this disease attack the aged women, nowadays there have been cases reported among women who are as young as 30 years old.

Friday 20/10/06

I'm coming home tonight! Yeay! I'm so happy I just can't wait!

I'm a bit sad that I'm the only one here now. I have to wait for my parents to come pick me up tonight. All my friends have left and some were already home yesterday!

Anyway, I'm just so happy now. It's my first Hari Raya I'm celebrating with my family after 3 years celebrating Hari Raya in India. To everybody I wish a colourful and bright Diwali. And to all, Selamat Hari Raya!

LETS DONATE BLOOD

I had my end of posting exam today for ENT. Can't believe one month is over! I think I did OK today. My clinical evaluations and my practice was OK. But I'm still worried. I don't know.

Anyway, few days back there was blood donation drive in the college. Out of minimum of 400 students, only 80-90 came up to donate blood! That's quite surprisingly not very good. Since we all are in a medical team and well, not many of us are interested in donating blood. I wanted to donate blood so badly and I was so happy that they finally came to our college for the drive. But when I got there and got my blood checked, my Hemoglobin is low. Well, it's not that low, only that they wanted a minimum of 12.5 and mine was 12.4!

I got so sad that I couldn't take part in it :( so I tried my luck again that night just in case if I could make it and well, not my day I guess, the second time I had it checked, it came down to 11.8 :(

Well, in case if any of you see a blood donation activity taking place nearby, you might want to take part too. Everyday someone depends on blood for life. They are needed for surgery, accident victims, or to help treat people with LEUKEMIA, cancer, heart and liver diseases and even HEMOPHILIA. Your contribution could help save a life!

Only about 450ml of blood will be withdrawn from you. Our total blood volume is about 5L. And 450 is less than 10%. So this will not make you feel different without the blood you donated. Most people feel great after donating blood too. You just have to be sure that you have had good meal before donating and that you have had enough rest the day before. Having enough rest and food makes a big difference in how you will feel afterwards.

It takes about 24 hours for your body to replace the blood volume. You should drink extra 4 glasses of water or non alcoholic fluid. Do not carry heavy liftings with your arm for 5 hours. And your body needs 4-8 weeks to replace the red blood cells before you can donate again.

So why don't we all lift up the spirit of helping others by taking part in a blood donation drive. I had fun the first time I donated. I'm just going to wait a little more till I can correct my hemoglobin level higher and then I'll look forward into donating blood again :)

Monday 16/10/06

Bad haze today. Been a month like this. Some burning in the Indonesian land (again) for the umpteenth time :( and I'm feeling lazy and sick. And I've got ulcer in my mouth :( hurts when I eat this Indian cracker like thing called "muruku". It's pretty nice but I think I'm having this ulcer also because its fasting month my mouth gets dry and it got ulcer easily.

I skipped class today. But I went for afternoon session. We learned how to study X-Rays of the head and neck. It wasn't so bad. But I couldn't really concentrate because I was having headache too. But now I'm just in the room drinking hot mushroom soup. Think I'll drink more soup tonight at least I get a bit more liquid in.

And found out Hoppy is pregnant again. The last time she delivered to a few babies. 4 I think. Can't quite recall. They died one by one, one day after another :( But anyway, I hope this time the babies will survive. Can't wait to see them coming out :P Then I can be grandmum. Hehe.

Just a minute

I feel so tired. Feeling lazy to go to class as usual. But I better not skip today's group discussion. I think it'll be so nice if I can become hamsters every now and then. To sleep and sleep and sleep till my owner pick me up and bullies me :P

Talking about hamsters, one of them ran away last 2 nights. That got me so very worried. He never did that before but now I will have to be more careful. Have to make sure he wont run out again whenever I open the room door. Now they are sleeping. Guess thats what they do best. That picture or a slimmer hamster is Hoppy, a female. And the other is Happy, a male hamster, the one that tried to run away :(

Hope tonight I get to go out and buy some movies to watch or maybe some pc games. I can't wait to go home for eid. Mom have been calling me again and again asking when am I coming home. And last night she told me that I'm going to have to bake 2 types of cookies a day once I'm home. Cant wait :P

TONSILLITIS

Had a long day in the clinic today. The teaching doctor went on and on and on. But at least I learned well today. It was my turn to present a case today and I had a patient who came with sore throat. My patient was an 18year old boy who have been having recurrent sore throat since childhood and he was diagnosed to have TONSILLITIS of chronic type.

Tonsils are lymphoid tissues in the oral cavity that have a protective role in the mouth. There are 6 in number and the ones you see in the picture are called palatine tonsil. The normal tonsils are small and the colour maybe not so red. It should have the same colour like your mouth. See the smaller picture, here it shows that the tonsils are enlarged and are red.

People with tonsillitis usually complain of sore throat, difficulty in swallowing, fever, and probably change in voice too. Tonsillitis is common among us. This is because our mouth gets infected easily if hygiene is not maintained, or because we frequently get cold or cough. This common infection maybe infecting us again and again and again and weaken our system and infects the tonsils next.

It isnt a dangerous disease, but it may cause harm to children because their respiratory tract is small and this enlarged tonsils may obstruct the air passage and may cause complications.

So if you want to know more about your tonsils, have a look in front of the mirror. You might need to use torchlight and observe the tonsils when you are having cough or cold. If you think your tonsils are enlarged and you need better treatment than just rest and homemade remedies than you should go see a doctor for it. :P

SINUSITIS

Wow. I think I haven't been blogging for months. Sorry about that. I didn't forget or anything. I always tell myself whenever I learn or read about something new I would go back to my room and blog. But nowadays life here in Melaka is too busy and I have other extra curricular things to do too :P

Now I'm in ENT posting (Ear Nose & Throat). This field is quite fun. And I think it is a bit relaxing. I've always wanted to let people know a bit more about this normal disease that people often talk about, which is called SINUSITIS.

Sinusitis is different from normal cold or flu that we often come across. So not all flu and cold that we get is known as sinusitis. And if your doctor diagnose you with sinusitis you will have to come for regular check up since it is a little bit more serious than normal cold.

Sinus are air filled cavities in your skull. There are 4 in numbers on each side and are named. These spaces are normally empty only to be filled by air. These sinuses help to maintain our head light and provide resonance to our voice.

Sinusitis is the inflammation of the sinus lining on the inside, we call mucosa. This inflammation may be caused by nasal discharge or phlegm that enters these sinus cavities. And as we know, these phlegm has microorganism like bacteria or virus. So when these microorganism enter the sinus they may cause damage in the sinus. And the patient complains of heaviness in the face, facial pain together with profuse nasal discharge which is thick, and also there may be fever, headache, bodyache, etc.

The facial pain may be occuring at different sites depending on which sinus cavity is infected. Sometimes they maybe only at the forehead close to the eyebrow, or maybe in between the eyes, or sometimes on the upper jaw or gums and teeth.

It is very important to try to keep your sinus clear of phlegm whenever you get cold or flu. Someone told me once that you need to keep your head upside down for few minutes. This enables the sinus to be emptied since we are helping the phlegm to drain out. That is just my theory behind it. :)

Monday 8/06/07

I went to Jasin Hospital today. I spent the whole morning in OPD with the specialist and got to do a few stuffs. O&G posting is relaxing but I dont quite like it because the lecturer doesn't finish the class early and just now we only had 20 minutes for lunch break :(

Today I got to do the 4 Obstetric grips oa pregnant woman in the OPD. That was the first time ever that I managed to feel for the fetal parts. It was a good experiance. And I'm having the feeling I might be very interested in taking this field especially because the women are always easy with me.

When I was doing the 4 Obstetric grips I got to know where the baby's body parts are. Like where is his head, his limbs, and his back andbuttocks. After knowing the baby's position in the womb I got to listen to his heart beat using this Fetal Doppler. Their normal heart rate is much faster than us adults. Theirs are around 160beats per minute.

And I also saw pap smear procedure. This procedure is done to detect any cancerous growth in the cervix. Cervical cancer is easily detected by doing pap smear and women who are sexually active and who are in post menopausal age should do this pap smear once a year at least. This if done can help reduce the mortality caused by cervical cancer a lot lot more because cervical cancer is easily curable if it is detected at early stage.

Sunday 7/05/06

Finally, I'm done with Smallville. I never again will watch that dumb series. But I have a feeling I might be watching the 5th season soon enough :P

I can't help it. I keep watching it and everytime I do I'll condemn all the actors and actresses (Lana especially) and I just hate it hate it hate it :(

HEART ATTACK

I'm up early this morning,because I had a weird dream. Hehe. I've been getting these weird dreams ever since I was addicted to watching Smallville. This is bad. Want it to stop :P

Yesterday I learnt about Coronary Artery Disease. Coronory artery is the artery that supplies blood to the heart and if this artery is diseased or if it is blocked then we all are in deep trouble. We need the blood supply to the heart so that the heart tissues can be oxygenated and the heart can work properly to pump blood to all the other tissues in the body. If the coronary artery is diseased,we have high risk of HEART ATTACK and we can die instantly. I'm sorry if this sounds scary but if preventive measures are taken then I can assure you that we all can live happily without this problem. So cheer up :)

There are factors causing problems to coronary artery and the most important and the most common one is ATHEROSCLEROSIS. It simply means the thickening of blood vessels. This thickening happens due to deposition of fatty plaque in the blood vessel walls. Well,the word fatty plaque already tells you that this is because there's high level of lipid or fat in the blood and this is the reason why these lipid or fat gets stored inside the vessel walls. But this doesn't just happen in obese people,even thin people get this deposition because they eat too much fatty food and somehow their body automatically stores these fats into the blood vessels and not their body tissues and that's why they look thin and slim all the time. So becareful. This fatty plaque what it will do to our blood vessel is that it will grow and grow and as it grows it makes the blood vessel lumen smaller and smaller. This causes the blood flow in the vessel wall gets disturbed and one day when it is big enough it might occlude the vessel wall, (in this case the coronary artery) and this stops the blood supply to the heart.

Atherosclerosis used to be a disease of the old age. But recently there has been post mortem report of children having these atherosclerotic plaques. And this is very pitiful. That's why it is very important not to feed them too much. Nowadays there are many round babies and round children all over and I feel bad seeing them like that. They do look cute I must say but we can't see whats happening inside their body. How their body system is acting and stuff.

We cannot treat this atherosclerosis plaque, I mean once the plaque grows,we cannot remove it with drugs or surgery. But there are ways to prevent this. Like try avoiding fatty food mostly and we believe that Vitamin E and Vitamin C is needed to help us conteract with the fats that we eat. And also there is fish oil that contain Omega 3 which contain high level of PUFA (poly unsaturated fatty acid). PUFA helps in raising the 'good cholesterol' level in blood and this reduces the risk of heart problem. And the most important thing is, STOP SMOKING :) and don't say i didn't warn you.

PROSTATE CANCER

I'm so tired now. My back is aching because I was carrying 18L of water into my room. This is what I do once a week. It's my water supply to drink. I'm so used to drinking reversed osmosis water and now I just can't drink normal tap water anymore because it taste so different from RO water.

I went to hospital today and was alloted a case as usual. Today the patient was a male patient of 73 years old. He was educated by the way he talked to me. He was diagnosed to have prostate cancer since 4 years back. And sadly the cancer cells has spread to other organs in his body including his bones. Now he's having severe pain whenever he moves. He was telling me that he is ready to go. But he wants to leave this world peacefuly. It was sad to know that his body is being eaten up by the cancer cells slowly but surely. He was being very strong. And he kept repeating that he is willing to die anytime at all.

Prostate is a gland found only in males. Most of the prostate enlargements are of benign type. Easier way to describe it is that it is nothing to be worried about. But if you are unlucky, it might be a malignant (something to be very worried about).

This problem can affect any men. Mosly of age 50 and above. Early detetction is important. The first symptom that you should be aware is increased in frequency of micturition especially at night. There are other symptoms such as when you feel urgency in micturition and that you are not very satisfied with the urination that when you feel there are still more urine in your bladder only that it is not coming out. Also poor ejaculation. If this happens to you then you will have to go straight away to the doctor.