dear anonymous,

you made my day.

thank you. ;')

13 june II

terima kasih cinta hati

mission failed

1st attempt to do blood donation (in egypt, i already did twice in malaysia before) was few months ago when life hayah organize a campaign to donate blood at muassah & miri. went to academic building and did the check up. unfortunately my Hb level was 11, so im not a fit candidate to donate blood.

and yesterday, saw the advertisement for blood donation day at blood bank, shatby hospital.

go there, repeat the same check up. blood pressure: 110/80, check. visible vein, check. Hb level: 12, check. 

it is normal. but they didn't allowed me because they said it is borderline normal. this is my 2nd attempt, and i still did get the chance to donate my blood here.  i think sumthing wrong with the machine. 

unsatisfied with the result so i do CBC.  go to the lab to take blood tube, withdraw my own blood. and send the back blood to the lab.

and I've got the result on the spot. 

so that's it, the machine was wrong! it's not 12.

tsk. -.-

i eat a lot. and i really mean, a lot!
how come im still anemic? 

13 june

1st wish i've got from my dearest parent.
although few hours early.


terharu.

thank you. i love you.

open heart surgery

random sequelae of the operation:

1. we come a little bit late. the operation was start at 9. and we come at 10. the surgeon already open the thorasic and on that moment they're preparing circulatory bypass by inserting canulae at ascending aorta, SVC and IVC.
   it was breath taking saw heart directly, beating in the thorasic cage for the 1st time.  subhanallah.
2. start cardiapulmonary bypass. important of communication between the cardiac surgeon, perfusionist & anaesthetetic to make sure everything is working. they reply each other sentence in every order given.
3. put clamp on ascending aorta. and the anaesthetic insert cardioplegic solution every 20-30min by high pump pressure; to prevent emboli. as the pt received heparin, must monitor the ACT (activating clotting time) between 480-600s all the time.
4. the heart stop beating. senior surgeon come and he cut open the heart through right atrium, tricuspic valve, interatrial septum to reach mitral valve. im not sure when did they remove the stenotic valve, just aware they start suturing the metallic cardiac mitral valve to the heart. 
5. it took about >20 suture for the valve. insert the thread 1 by 1 first, along the diameter of the valve to the cardiac (as shown in the pict).
6. and here's the moment the where the dr ask the most precious question. 'you want to do the suture?'  oh faint! and i replied in shock, can I? dr hand to me the needle holder, and step aside let me took his place. ohhh my. i did it!
7. then they did surgical knot for every single thread separately in the valve to the heart.
8. finished placing the metallic cardiac mitral valve, try the valve function my moving it with forcep. and alhmdulillah its working.
9. repair the tricuspid valve by autologos tissue from pt's pericardium. and close the heart.
10. senior surgeon finished his work and leave. then they off cardiopulmonary bypass and re-perfuse the pt's blood by remove the canulae from rt atrium.
11. the heart start beating again. unfortunately they detect 2nd degree heart block.
12. insert 2 pace maker, at right atrium & lf ventricle. suture the pacemaker wire to the heart & another metal part outside the skin connecting to the machine.  im not sure how does it work and is't temporary or permanent.
13. the heart beat become normal. then remove cannula at the ascending aorta. the systolic BP must be around 100 to prevent aortic dissection.
14. control the bleeding, cautery any bleeding point, continuous suction, and put gauze around the heart.
15. put 2 drainage in the pericardium at the midline just below the last ICS.
16. remove rib spreader, put bone wax at sternum for hemostatis. 
17. put again rib spreader, remove and pack another gauze inside. check any bleeding and put organic hemostatic gauze around suture in the heart.
    the surgeon not suture the pericardium to avoid cardiac tamponade.
18. again remove rib spreader and suture the sternum by wire. wow it really need full of energy to insert the wire and suture it to sternum. they did continuous suture 1st then cut it by wire cutter to be separate stitch. 
19. remove the gauze around the heart and close the sternum. there are about 6-7 wire stitch and they knot all the stitch at the same time. every end of wire are hold by artery forceps and they do it simultaneously. 
20. close the skin. finished the operation around 2pm++.

unfortunately i didnt know the name of the senior surgeon who did the operation. only know the name of the residents; dr osama and dr karim. 

it was priceless experience.!

 :)

*guilty

alhamdulillah.

got a chance to scrub in 4hours open heart surgery for mitral valve replacement & tricuspid valve repair today and I did 1 stitch for the valve. cool~

it was awesome. but i think this feeling will be much better if no guilt feeling inside. there is an awkward moment when u got opportunity to do something that not everyone get and they just watching you at the side. i.e scrubbed in with ur colleague around. everybody want it. kn? who doesn't?

lg rase bersalah, sbb org lain yg ajak pergi tgk operation in the 1st place. and actually im not really in a good mood so just remain silent and keep the distance away from the ppl im not engaging. sounds emo. huh. kot. *lg2 la rase bersalah*

when dr said, 1 of you can scrub in with me, I look at my colleague who invite me and made eye contact asking 'you want to do it?' and she replied and I interpret it as 'go ahead if u want'. 
so then I volunteer myself and go scrub in with scrub nurse

tiba2 rase awkward. rase bersalah. I should insist her to scrub in.

I think mayb sbb mcm serik for certain somebody yg cuma selalu ambil kesempatan saje. im the one who alwys ask dr to do somthing, any procedure, etc. and usually I ask and let my colleague if they wnt to do it. but there are some rare opportunity and when i've got the chance, somebody crossed the line and took advantage of it. rase geram kot.
if you to do it, ask for it by urself. volunteer urself. go in front and brave urself. dont take advantage on others. chances and exposures are everywhere if u're hardworking.

ohmmo. i dont like ppl do this to me. so now i really feel guilty thinking that im taking my dearest colleague chance, i think she deserve more because she's the one who invited me in the 1st place.

hmmm i hope i can made up something to overcome this guilt feeling. hoping for another chance, and for sure will let her do it next time.

im sorry. :(