Sunday, February 26, 2012 @ 9:50 PM
因为他是信实 永远长存不变
i know every time when it comes to this day...
a sunday rest day for me, i'll start to "complain"
i'd go to church but i'm kind of dragging myself there.
i'll give hundred and one reasons to skip DG (Disciple group)
- i need more sleep
- i want to sleep
- it takes 1 hr to reach church on public transport
- i can't get a cab on sunday!
- i didn't attend the previous sessions in DG so therefore i'll feel puzzled or lost.
- usually i'm daydreaming during DG, either too tired, or it just doesn't get into my head.
- going to lishi service should be good enough, because both usually speak the same message (general message)
true enough, today i skipped DG and was late for service.
i couldn't really concentrate during service, be it worship, listening to the sermon
i just can't sit still and listen. after service i have a mentoring training to go for
and when i heard that some mentorees doesn't have to attend i was like "YAY!"
so i called L and she said... well because you're 1735 chairperson so its also good for you to go.
back to that one day when Lena asked me "hey have your heard about mentoring?"
i was like... yah... and deep inside my heart was
"you better not ask me to mentor someone. because i don't want to."
so i asked her "am i going to be a mentoree or mentor?"
" mentoree." (i was smiling inside.. phew!)
i dreaded going for the talk or rather lecture today... it was 4 hours for goodness sake.
4 hours! i can have lunch with church friends (probably Dingyue only, because she's the only one who can lunch with me after church.) then go home built my doll house in the garden, go for a jog.
but then... i dragged myself to the mentoring lecture.
i won't say... "WOW! THANK GOD I WENT FOR THE MENTORING LECTURE!!" in caps, in excitement, in a revitalizing way.
but really i thank God for His faithful reminder to me, the fruit of the Spirit that i have yet to bear,
and i am (or should be) misfit in this fallen world (because I'm actually fitting myself in...).
Wednesday, February 22, 2012 @ 6:08 PM
It’s Not Like the Rest of Us, But It Should Be
http://zocalopublicsquare.org/thepublicsquare/2011/11/30/how-doctors-die/read/nexus/
came across this article (above link) via the hospital intranet
and thought it was pretty much well written
very close to the context that i'm in every single day
many people especially chinese won't talk about death.
they think its a taboo. but working in the ICU these years, i realized that it is actually really important to talk about it with your family members, like all the what ifs.
what if i met a road traffic accident and my brain actually bleeds
and I'm being supported by the breathing machine for a couple of days
unable to wean off from it. do i still want to continue living?
what if i gets a very bad pneumonia, my lungs are stiffen and i need a tracheostomy
(an incision made on your throat and a tube is shuffed in and you need to breath using it for a very long time) and at the same time u need a tube to be inserted into your nostril leading to the stomach for feeding purposes. do i still want to continue living?
with our current sedentary lifestyle we're having, awesome high calories diet
diabetes mellitus, hypertension, hyperlipidemia will usually comes in a package for almost everyone of us.
so if one day, knowing the facts that when i grow old, i'll may have such co-morbid conditions that increases mortality rate. do i still want to continue living?
many family members i've come across doesn't know how we work, how the treatment goes
should they request for a DNR and terminate treatment or should they go all the way and give chances to the patient. I'll always tell them... please put yourself in their shoes... if all of you are the one lying there, will you want to die or try your very best to walk out of the hospital alive.
and the answers i get were all.. what ifs... there's a chance but i let it go?
i'll be feeling guilty.
in this article i've shared, what the writer wrote was very real.
when someone collapsed and gotten themselves admitted into the icu
eg. a patient with very bad pneumonia, they usually can't breathe properly, CO2 building up in their lungs
therefore in the A&E the Drs will intubate(shuf a tube into the throat and connect it to the ventilator and send the patient to the ICU)
next in the ICU, the Dr will insert this catheter called Central Venous Catheter (CVC) through your neck, purpose is to monitor the overall fluid status and also to administer drugs(usually, 4-5 types)
that are so toxic it can't be run through a normal IV cannula because it will burn the veins.
next the dr will insert an Arterial catheter (IA) over the radial artery (the part where u feel for pulse on ur wrist) for continuous blood pressure monitoring purpose and withdrawing of bloods for lab specimens
also a urine cathether will be inserted to monitor the urine output, making sure that the patient is not fluid overloaded.
let's go to the simple stuffs like airway first.
with the tube in your mouth, you can't talk. you can't drink, you can't eat. so you'll have a nasogastric tube inserted via nose to stomach for milk feeds. because you can't swallow, your saliva will be kept in your mouth, your phlegm will be building up in your respiratory tract so that you will need suctioning. and each suctioning is very traumatic. a small catheter being put through your breathing tube (ETT) and a suction pressure is applied to suck it out. (usually my patient's face will turn red, coughing and tearing even they are comatose, so imagine how traumatic it can be. per day you get at least 10 suctions for those very minimal phlegm patients like asthma)
then the CVC and IA line
the antibiotics treatment used in our patients are usually very very strong antibiotics, and when family members hear strong they think of it as good. in fact it's bad. to think that you need very strong antibiotics cover, it just shows how sick you are. how bad the infection is. (keep that in mind)
and we don't usually run antibiotics only (usually a 2-3 types of antibiotics up do 5-6 doses per day in total) we also run sedative IV medications to make you sleep (that's y sometimes patients are not comatose, they are just sleeping.. you can speak louder and wake them up, they can hear you.)
and if your blood pressure became low, so low that we will start medications (Inotropics) to bring the blood pressure up. the drugs we usually use are Noradrenaline (causes your fingers and toes vessels to contract and therefore high doses causes blue cyanosed fingers that can be irreversible) Dopamine, a drug that in high doses, it causes very fast heart rate of like 120-150s can be even higher that it may triggers off a lethal heart rhythm that requires the patient to be shocked. and many other more...
whatever examples i've mentioned above are the very very very common basic stuffs that the Drs will do.
like for almost 95% of the patients who admits into the ICU.
for very serious cases, there will be dialysis for the kidneys, balloon pump for the heart, and other machines or devices that will be hooked onto you for supportive measures. keep in mind for a machine to hook up to you, is not like pasting it onto your skin, its inserting a catheter into your body most of the time.
so, when u get a terminal disease, do you want full treatment when you collapsed or do you want quality time with your family? to die at home or in the hospital?
if it's me, i'll choose to die at home and spend quality time with my family and friends.
and i believe my family members too.
so, really, talk about death with your loved ones. it's really important. that when one day, you have to make a decision, you know what's best and what they want.
don't spend a bomb (really big bomb like 50k-100k for total hospital bills) for futile medical treatment.
spend those money with your loved ones on a holiday, a good meal or give it to charity and do good.
Tuesday, February 21, 2012 @ 11:17 AM
cardiology,
had an eventful night
the patient i nursed yesterday passed away.
he had multiple non sustain ventricular tachycardias (VT)
and subsequently went into VT, followed by torsades de pointes
and then ventricular fibrillation (VF)
started resuscitating, CPR, drug, shock
but he went into VF storm.
for my very first time. i seen someone being shocked 35times
with 38 doses of adrenaline and all the other medications like lignocaine, amiodarone, magnesium sulphate all whacked into the body at one short.
we tried our best, resuscitated for about 1.5hours, going 2..
before our con said stop. yea.. our con actually came down in the middle of the night.
i don't really fancy cardiology.
i prefer medical, respiratory cases, liver failure cases etc.
but for the past few days, i've been assigned to take care of those very sick cardio patient
mainly those on IABP, and i realized cardio is really pretty interesting.
and my past few days experiences that are totally shocking enough.
1. IAB cath migrated
2. ?stent thrombosis triggers VF
3. torsades de pointes
4. this recent resuscitation.
it's not an easy resuscitation, because the patient's heart just can't be restarted back
can't resolved the VF and VT such that the down times is way too long
and there isn't enough time to save the patient.
cardio is actually really... fascinating
Friday, February 17, 2012 @ 11:59 PM
and it ended with sparkles in the sky!
dolled up early in the morning and went to lakeside for a self retreat and had a quiet time with God.
it was great. and the thing i learnt today was " to feed on the right food and note your diet progression."
food are basic needs in life
and there's many kinds
we all know that we need to feed on good healthy food and we know what they are.
but because its not nice, not easy to make, so troublesome to get them from organic stores
so we don't usually feed on them. only take those once in a while
where else on the other hand, high calories food are much easily accessible,
cheap, tasty yummy and makes us feel happy.
adding on to the healthy lifestyle,
we need to exercise (recommended at least 30mins x3days per week) but to many of us, its a chore.
it goes the same to our spiritual life
we know what's healthy for us but we just take them once in a while
and those easily accessible high calories stuffs like world's philosophies, quotes, negative influences all over the internet we usually feed on them much and it made us feel emotionally better at times.
and probably to some of us(like myself) doing QT can be a chore.
as a nurse, i know even better about all these steps to healthy lifestyle, healthy living
exercise, have a balance diet, what to eat what not to eat, what should you avoid and the list goes on.
but knowing and not practicing it myself can't really convince others to do the same.
in comparison, not living a healthy spiritual life, also can't convince others that i'm a living testimony.
agree?
life. many say it's complicated
life to me, simple. i've made it complicated because i don't comply.
nway, on a brighter note
had an impromptu day out with vivian
went vivo and then realized the weather was perfect so decided to go sentosa
it's pretty awesome to once again be near to "nature"
the beach, the sea, the sunset. (i dunno when's the last time i stayed throughout the sunsets)
we also chatted (after so long) and cam whore as usual
and i really thank God for this day.
He ended it with free mini fireworks in the sky
to brighten our hearts as we took a walk at the sentosa broadway back to vivo to home!
great day i'd say. AWESOME!
Thursday, February 16, 2012 @ 11:03 PM
away from the ICU
i'm having a total of 4 days away from the ICU this week
and it's day 2 today. somehow made me realized that i really like to work in the ICU.
just completed a 2 days advanced wound and stoma management course
the gonna be off for the next two days ahead.
recently i've developed these rashes and again self-diagnosed it myself as Pityriasis Rosea
and started my very own treatment
firstly i started off with hydrocortisone 1% cream, cuz usually when u get a bit of rashes these are pretty commonly used and commonly prescribed creams by Drs. so i thought i'll just get it over the counter.
used it for about 1week, my rashes got worsen and i know that this skin condition is going to last long, and hydrocortisone are not well recommended to use for long term... so i need another alternative..
then i thought of NAPPY RASHES! google about using Desitin cream for pityriasis rosea
and realized that people are using it! SEE. being in medical line as well as having technology work wonders.. save my $$ for a visit to the Dr.
DESITIN CREAM - i really love this cream despite its stinky smell, i usually intro them to patient's family when my patient developed excoriation over their buttocks due to non stop diarrhea.
it contains 40% zinc oxide thus heals rashes fast! so remember, if u ever get nappy rashes or what forms of rashes. ZINC OXIDE is what u need.
then...also,
because of not having to work in the ward, therefore i'm less tired
i started to google and research about skincare products (like again...)
i realized that my skin tends to become oily and fine lines are appearing!!
dark eye rings too!! =(
so what i've gotten myself recently
Sukin Night renewal moisturizer.. it's 100% organic and even though i have oily skin,
U STILL NEED TO MOISTURIZE THE SKIN.
Renew's Rose Hip Oil 100% organic
for wrinkles and fine lines, scars etc
Revlon Colorstay Foundation in Nude
check out a lot of reviews for oily skin makeup stuffs
i realized this is the best, tried it out at watsons, it's really good
doesn't feel sticky on my hands at all
so now... for people who are interested.. here's my skin routine!
Day:
Avene's cleanser for sensitive skin
Avene's toner for sensitive skin
(Both comes in green bottle)
Avene's moisturizing lotion (clear liquid)
Avene's fluid mattifying moisturizer (put this if i'm putting on make up)
or Avene's Exfoliating moisturizer (put this if i'm home and or not putting make up)
Avene's sunblock for face and body
khiel's spf 15 lipbalm (if i'm going out)
lip-smackers skittles favor / palmers cocoa butter
(usually at work, cuz when i'm hungry and can't eat still, i'll just have these tasty lip balms to ease my hunger)
Night: if i put face mask
Biore's makeup remover (if got make up)
Avene's cleanser for sensitive skin (put a bit to remove the oily feeling from the remover then i'll shower)
(after shower...)
Avene's cleanser for sensitive skin (wash it properly this time round)
Face mask for 15mins (i'm currently using faceshop vit C skin brightening face mask)
pat my face with fingers then i'll apply
bio-essence bird nest anti dark rings essence around my eyes
2 drops of Renew's rose hip oil (rub it over palm and pat over face and neck)
Sukin's night renewal moisturizer
bodyshop watermelon lipbalm (still hungry at night you know!!)
Night: if i put my sleeping pack
wash my face with my usual cleanser
toner with avene's toner for sensitive skin
smack my sleeping face mask straight away
currently using
Laneige water sleeping pack
Faceshop Raspberry firming mask
bodyshop watermelon lipbalm
depends on my mood which sleeping mask i'll put.
oh well.. this is my new skin routine
hope my skin is better! cuz i'm out from that drug!
Sunday, February 12, 2012 @ 11:43 PM
未来美在 忽然， 成功来自 我要
在这一年头， 自己发觉到 我的 思想 稍微往 比较坏的 方面。
整天埋怨， 喊累 ， 脾气也不是很好， 样子也变得 憔悴。
pretty low morale too.
真的很不像自己， 也渐渐觉得 不怎么认识 自己了
totally confused.
是时后 花一些时间 去思考 自己到底 想要 什么
什么才是 最重要 ，什么才是 荣耀神的。
真的好久 好久 没有 好好的 与上帝 联系了。
Friday, February 10, 2012 @ 12:28 AM
maybe it's for the better
suddenly felt frustrated with the new management of my workplace.
all the stresses are being added onto the overall in charge nurse
such that now i really hate being an overall charge nurse or u can call it boss nurse.
damn it.
it's the PAY FINE system.
they are totally abusing it such that everything also must pay fines.
sighs...
now i have a new job to do...
besides being a fall auditor,
SCD compressor trainer
inservice i/c
resus drill team
bedside clinical education
i'm now arrowed to do statistics of the ICU on deaths, admissions, long stayer etc.
honestly they are all good.. i mean it benefits me a lot
will look good on my resume.
bite and bite i'll just pass through bah!
咬一咬 一切就会 过去！
