Umbrella.....

Despite the continous flow of patients coming to AE today, nothing particularly interesting until the end of my shift when a young girl, accompanied by her mother and grandmother, came in with the hook of the handle of an umbrella stuck in her mouth. It was one of those cases that I would never see again in many years to come. Of course at the beginning nobody knew what exactly had happened. Obviously she was not able to give the details as the thing fully occupied her mouth. She could only cry. Apparently, her cry was heard in another room in her house, and the next thing the mother found her in that state. My consultant tried initially to remove the umbrella but it stuck firmly on her lower soft palate and there was a bit of bleeding. Worried that by removing it would cause more damage, my consultant contacted a paediatrician from another hospital. After much explanation they agreed for a transfer. An anaesthetist was also present and he was also worried about her airway. Later, a junior anaesthetist bravely attempted to remove the umbrella just before she was transferred to the children hospital. To everyone surprise he did it succesfully and there was no serious damage. I would never forget the relief that her grandmother showed.



Oh! Yes! I said yesteday I had a confession to make....well, not today....some other time

Another day off

This week I work morning shift, the first time for the past 6 weeks. It has not been bad at all. I haven't got time today to write down some of the interesting cases I saw like : bilateral broken arms, pancreatitis, anaphylactic reaction, CVA, pregnant woman with thrombosis and a heart attack. I will talk about them tomorrow.
I also have a confession to make but I will wait till tomorrow..see what happens.
Going to bed soon.

My week off.....

It was supposed to be a week off work, doing nothing, just relaxing.....well, that has not been the case. Usually, it would take 3 days to recover from a week night duty to get back to a day routine. Unfortunately, this time I didn't get a chance to recover that quickly as on Wednesday I had to attend basic paediatric life support course, which was a day course, being held at Children University Hospital, Temple Street about half an hour by Luas and a short distance of walking from the nearest Luas station.



It was an intensive course starting from 8am, finished at 6pm. There were about 20 of us from different specialities, whose job involving children, including nurses and doctors from emergency medicine, paediatric medicine, intensive care unit, orthopaedic and anaesthetic. We all were taught how to do a proper basic life support to a child in an emergency situation. Later that day after lunch each one of us had to perform in front of a small group of people, of what we had been taught. Although I deal with this nearly everyday with adult, it was quite nerve wrecking to lead the team when I was being judged and criticised. Overall, I enjoyed it, and I passed the practical test which was done at the end of the course. It was a simple test but I am proud with myself for being able to do it calmly and systematically. One of my principles in life is to enjoy every success, and to learn from each mistake, no matter how small it is. Having passed the test, I am in a better prospect to get a job in Jan 2009.



After the course, I went straight to the gym for nearly 2 hrs and by the time I got back, I was so exhausted that i went to bed early. The next day, thank god, I had the all day for myself, so I went to city centre and had my hair cut.



Friday, yesterday, I had to be at work starting at 8am. I was not supposed to but Samuel asked me to do his shift for a day as he had to go for a driving test. So there I was, got up early in the morning and drove for 1 hr to get there on time. The morning started with 2 hours teaching Session which occurs on friday morning only. Dr. Kelly, one of the AE consultant was there. Irene (a south african doctor), Esosa (a nigerian doctor) were also there. We were taught how to detect fractures or broken bones from xray. For adult, it can be quite easy, but in children, it can be quite tricky, because their bones are still developing, and certain fracture can be easly missed particularly on the hands, wrist or ankles/feet. At the end of the session we were shown by two representatives from a company which produces fibre layered backslab.



There are two common types of material used in AE to stabilise broken limbs before further review by the orthopaedic team. One is plaster of paris which application is quite messy and the other is fiber material which is much easier to apply. During the session we were taught how to apply the material properly.



It was fairly quiet afternoon in AE yesterday. Nothing interesting. One patient, he cut his upper lip after falling. The thing with a cut on the lips, I have to be careful in stitching it, otherwise it will leave a scar that could affect their social lives later. The wound needs to be closed precisely, and the patient needs to be warned about the comestic complications including the scar. With this young man I was quite happy with the result.



The other patient, came in with severe vertigo, which is a sensation that the room spinning around. It was so bad that she could not stand up or walk properly. Poor sod!. In vertigo, first of all we need to determine if there is a peripheral cause which is not that serious, or central cause, which means from the brain, which can be serious and needs urgent attention. With this lady, with previous similar episode and elevated lymphocytes, it seemed she had viral labyrinthitis, inflammation of the inner ear caused by a virus, which is self limiting. Considering the age and the severity i decided that she needed medical admission. Off she went under a medical team.



The last patient I saw yesterday was an elderly guy with non insulin dependent diabetes mellitus (NIDDM) or Diabetes type 2, came in referred by the hospital chiropodist, who is a person who is looking after toes and nails particularly in diabetic patients or in patients with peripheral neuropathy. The patient, apparently had developed peripheral neuropathy or loss of sensation, on his feet. It is quite common for a diabetic patient to have peripheral neuropathy as a late complication. The other complication is foot ulcer because of poor blood circulation. The combination of the two (peripheral neuropathy and foot ulcer) is disastrous. Because of he had loss sensation of the foot, he became less aware of the ulcer on the foot and he kept the pressure on the ulcer which made the ulcer worse. On examination the foot was swollen and red - signs of infection - and there was a small ulcer on the sole just near the big toe. It was oozing with pus, producing foul smelling. According to him, it had been there for 6 month. Just imagine how bad it was! It appeared that he had chronic ulcer with peripheral neuropathy and cellulitis which is infection of skin. I was worried about the bone which also might have been infected (osteomyelitis) and if so it is a serious condition. Regardless, he needed admission...



After work, I was rushing home with a plan to go to the gym and later to have a dinner with a group of friend to say goodbye to Liam who is moving to Australia. When I got back, I was too tired to go to the gym, but I managed to bring myself to the dinner. It was in Tante Zoe's restaurant, an american food restaurant in Temple Bar. It was ok. Nothing spectacular about the meal. Funny enough, Liam who is leaving, who organised the dinner had to leave the table even before the food was serve after he fell ill. We toasted, saying goodbye to Liam without his presence.

Finally......

Eventually, the 12 hrs night shift for 7 days in a row ended yesterday. Another 4 weeks before i have another one. Now, I have a week off work...well not really, I have to go back for 1 morning shift on Friday after swopping with Samuel, the other AE sho.

The whole week last week was an interesting week. Few interesting cases I had to deal with, each one with different level of difficulties. One of them was a case involving an elderly man with multiple medical problems, came in by an ambulance with acute onset severe abdominal pain. The pain was initially located centrally, and it was very severe that I had to give him a small dose of morphine, which relieved the pain partially. He was sweating profusely, looked clammy with drowsiness. Vital signs were stable at arrival. Immediately I moved him to the resus unit, a special room to deal with a very sick patient. At first I thought he had bowel obstruction because the abdomen was distended and he had colostomy bag for rectal removal few years ago. During further assessment, he complained that the pain now was more severe on his back. The blood pressure dropped below normal value. At this stage I knew that he had an abdominal aortic aneurism (also known as AAA, triple A) which may had been leaking. I expressed my concern immediately to my senior colleague, who organised an urgent CT scan of abdomen, which later showed as expected, a leaking AAA. Subsequently, he was tranferred to another hospital, 1 hour away for emergency surgery. Everyone congratulated me for the quick action.

Working in emergency medicine can be daunting sometimes. It is a stressfull job with so many things to do at the same time. Time is the essence, and as a medical officer in AE you are working against it. Anyhow, with a case like the one mentioned above, it is all worth it. I know I make a difference, and it is, of course, fulfilling.

Most of the cases I dealt with in Drogheda during last week were traumatic injuries, particularly after midnight. I don't know how many I saw with a head injury and most of them were drunk. I just don't understand this drinking behaviour in Ireland. It is their culture alright, but why on earth they go out drinking until they can't stand up on their feet. Some of them become very abusive and aggressive when they are drunk. I had several cases like that last week. One of them was assaulted with a hammer. He was so drunk that he couldn't remember what exactly had happened. He sustained mutilple lacerations on his bald head, and on one of his ears. He was quite abusive against us while we were trying to clean the wound. After calming him down, we continued to clean the wound. Unfortunately we found he was bleeding profusely from the injured ear, and we could not locate the site of bleeding source. Ct brain was arranged, and luckily it was normal. We planned to admit him for neuroobservation and for ENT review because the ear was still bleeding. Frustratingly, once he was more sober, he walked out from the department with a bleeding ear. In a case like this, we only could watch him walked away as he was an adult......stupid adult! This only one example of the many....and we have just to put up with it.

Another case was an anorexic lady, fell in her house, complaining of very severe back pain. She was given high dose morphine, later difene per rectal but the pain persisted. The initial xray show no broken vertebrae nor pelvis. I was puzzled initially. I suspected it was psychogenic pain as the pain was inconsitent to the injury. She looked so thin, like a ghost. She came in with full make-up on her face and this was 4 am. I couldn't take proper history from her because she was shouting, roaring and crying. She kept calling, like a child, for her mother, who was beside her. She was in her 40's but looked much older than her own mother who was also dressed immaculately. I decided to keep her in AE for further review by my senior colleague. The next day, I was told she created a drama in AE after MRI scan showed normal results. The orthopaedic team didn't want to do anything with her because there was no broken bone. Eventually my consultant organised physiotherapy for her. Initially she was resistance to the intervention. After much persuasion she was discharged home the next day.

The saddest case or most tragic case was a case involving an elderly lady who fell from stairs in her home. She was found by her husband. On arrival, she was already on intubation, still breathing on her own but both eyes widely opened with non-reactive, dilated pupils. At this stage I knew she had a brain injury- more specifically brain death. On arrival the trauma team had already been contacted. During the assessment she stopped breathing and resuscitation was initiated and she was brought back to breathing on her own again. Eventually my consultant decided, with consent from her understandably distraught family to end her misery by stopping the life support.....she died in the department surrounded by her large family. I cried a little later during my break, thinking about my mother who also died tragically 10 years ago.

Life is so short and yet it is so precious. Appreciate what you have in life no matter how little it is because you never know when you are going to lose it. Appreciate the love you have from your family, your friends and of course your partner. Live to the fullest, and that is what I am going to do.....

(ps: for confidentiality purposes, I deliberately omitted the name of patients, their exact age, and the exact nature of injury including the exact site)

work...work....work

Feel like a long time ago since the last time I wrote in this blog. I started my 12hrs shift a day for 7 nights straight on monday 11/8. It was not as bad as I thought before I started. The problem is it is totally an anti-social shift to do. I can not do anything else like going to gym, meeting friends, cooking, and of course writing something on the blog.

It takes me about 3 hrs driving back and forth, so in total it is 15 hrs off, 9 hrs left which are used for basic things like sleep, eat, clean. In fact, I just got up about an hour ago and now ready to go to work again....Am I complaining? Not really. Just finding an excuse on why I haven't up-dated this blog as frequent as it should be.

Ok.....have to go to work now. Tomorrow I will talk about AAA.

A great weekend...

I did 12 hours shift working from friday night till saturday morning. It was raining heavily the whole night. Unfortunately it didn't deter people to come to AE. It was a chaos. As I was the only AE doctor there, and it was my first time working at night shift, so it was crazy. Anyhow i manage to survive.

I got home around 10 am and forced myself to sleep because I had to wake up early to cook dinner for a group of friends. I woke up at 2pm and ready to cook. I cooked Indian mee goreng and sweet spiced chicken wings. The kitchen was a mess afterward but hey, I have andrew to clean it up......sorry andrew, not my intention! The dinner was planned by Haiyu and I to say goodbye to Cindy and Paul who are going to emigrate to New Zealand at the end of the month.

Syed collected us at around 7 to bring the food to Haiyu's apartment which was located at Aungier Street, city centre. We were already late. Haiyu had cooked beef rendang which was nice. Manu, Haiyu's french husband, and his french friend was also there. Others were Cindy, Iban sarawakian girl, Paul, Cindy's Irish fiancee, Syed, my dear malaysian friend, Nico, syed's jewish argentian-spanish friend, Andrew, and Mitch, my other malaysian friend.

I had a great time. Everyone seemed to enjoy our food. Great company, great food.

Later that night, I went to Jeff's apartment for a small party. I was so tired so I spent lying on the couch listening them talking shit until 8 am sunday morning.

Something is missing....

I feel completely worn out today. Don't know why, can't figure out what. I am tired. No motivation. Feel like I have to push myself hard to do anything. Can't sleep. Signs of depression? Don't know. Missing my family? Hate my job? Need a major change in my life in every way? Don't know. I also have a premonition that something bad is going to happen, and I am scared of the unknown. Feel like everything right that is happening right now is not right. I have a great job, good money comes with it, have my own place, have someone that I love dearly to share my life with, but I feel that all that is too good to be true. I feel that something bad is going to happen to screw everything up so that my entire life would make completely different turn to start a new journey...........

I feel like lately I am consumed with work again. It is in my head 24/7. I hate doing things half way but lately that is exactly what I have been doing. I want to be the best, and I have been quite competitive but I have lost the drive lately. Although I think I am good at work, considering the responds I got from my colleagues, but I still think I am not good enough because I have failed to carry out the goals that I have set up myself to achieve.

Emmmm....such a relief to be able to release the tension in my head by writing them here. I already feel a bit better now. I should do this more often. I don't care if people read this blog or not. I do this for me....

It was a very busy night at work last night. The department is too small for big population it has to provide. It is crazy, considering Ireland is a first world country but the hospital's condition is like a hospital in 3rd world countries. I was shocked when I first got there. Too much politic in Irish health system but too litlle being done.

Last night I saw a guy whose anal muscle was weak that he couldn't shit properly for 2 weeks. Sent to the surgical team and the SHO was complaining about the referral. What am I supposed to do? The patient had problem shitting!

Then there was another patient, young enough, complaining of chest discomfort consistently for 2 weeks. all investigations revealed nothing and she was informed about the results. Not surprisingly, because I got this type of patients every so often, she was not happy. It sounded like she wanted something bad to happen to her.

Then, I saw a middle aged woman with a lung disease who came in with shortness of breath. She was nasty and snappy. She was like 'who the hell are you asking me all these questions, just fix the problem'. I was boiling up inside but keeping it calm on the surface. Smiling and be nice. It appeared she still smoked and didn't take her medications as regular as it should be. She wanted me to fix the problem that she created........but hey, I am just a doctor.....I only can give advices...

Before I left and that was nearly midnight, I saw a patient, a foreign national, who took overdose of benzodiazepine after finding out her foetus didn't have a heart beat on the same day she found she was pregnant..basically she had a miscarriage. That was sad......

On getting ready to leave the hospital, I bumped into my consultant, and he reminded me to be here by 8am tomorrow to attend the tutorial. No word on how are you, how are things. Fun and exciting work huh? I dont think so. Ok, I should be there tomorrow because I have missed the tutorials a lot due to the shift hrs. I got home at 1am , went to bed by 2am, set the alarm at 630am to go to the tutorial but I had difficulties to sleep. The alarm went off and I was so exhausted. I couldn't even lift a muscle. As a result I missed the tutorial again.......That what pissed me off....

Anwar Ibrahim was charged yesterday. Olympic Game will start tomorrow

News from home...

I got a message from my baby brother, Amy, today at work looking for some financial help to get a new printer for his new laptop which I bought for him few months ago. I was busy at work to reply the text message, so the first thing I did when I got home at 1am was to call my baby sister , Midah, using Sykpe. She was already at the school where she was teaching, SM Teknik, Klang.

Apparently, Amy is in IKIM college in Kuantan at the moment, having registered last weekend to start his 3 years diploma course in accountancy under UTM. I am happy for him. He had a difficult childhood and teenhood having lost a mother who was very close to him at a tender age of 10. He was a lost soul for few years but he managed to pick himself up. I am proud of him for his strength and his fighting spirit. After SPM which he didnt do well enough to earn entrance to university, I sent him to politeknik to do Hospitality course which he seemed to enjoy. After obtaining his certificate, he decided to be independent and took a year off from his studies. With a help of my 2nd cousin, he got a job a sale assisstant which he extremely enjoyed that he decided to continue his studies in bussiness related course, hence, he is where he is now.

Another good news I received from Midah was, my other younger brother, Aboy, had just been accepted to start his training to be an inspector police. He will commence his training on September in Pulapol, KL. He had to undergo a long process of interview before being accepted. He has been recently engaged to a girl from the same village. I can't think a better job for him. Physically he is just perfect for the job. He is the most kind and honest member of the family. I wish him good luck with the 9 months training.

My granny, from my dad side is not well. She has dementia and physically she is getting weaker and weaker. We all don't know how old she actually is. In her ID card she has the same birthday as her first two children, and my Uncle is nealy 80 so she must be near 100. I can only pray for her wellness.....

This is what I sent to one of the NST editor last year. It was not published, and in a way I was glad because firstly, although the article had good points to ponder on, it was badly written in term of construction and grammar. I was in such a state at the time I was writing it, and I have no intention to reveal in what way. Secondly, some of the points were considered sensitive to many, and I am sure I would have trouble if it was published. Anyhow, the editor kindly replied the email.

"Hi yap,

I read your article (What's the point?: What maketh a Malaysian, anybody?) today with so many questions about myself, my race and my country and how frustrated I am with the current political views regarding racial interaction (relationship?) among Malaysians. It feels like we have moved backwards as a nation in terms of racial integration, and we as Malaysians have failed to progress mentally (and socially) in unity and in harmony.

I might be crucified to say what I am going to say next but I need to tell you personally how I am glad to have u around and challenge the mindset of the few (the many rather) in public (I assume they are from my race, the malays).

Let me tell you my story. I was from a small village. A malay village (very malay) somewhere very remote in negeri Sembilan. My family lived in proverty as rubber tappers. I was lucky (very indeed) that I was sponsored by yayasan sarawak to further my secondary education in Miri, Sarawak under student interchanges programme that my family didn't have to pay a dime for my education from that point. My mother let me go (out of our proverty) although it meant I could only see my family for one month a year. I have to tell you that I had one of the best years in my life. There I had the opportunity to know people from different races and religions but unfortunately it lasted only for 3 years before i was sponsored to study in a college which students were exclusively malay (namely MRSM) and had a chance to further my studies abroad under a government scholarship.

Having had a chance to visit many countries and learnt many different cultures in the world after my graduation, I have had difficulties to accept my position professionally in the name of fairness and justice. I had discussion with Malaysians (malay , Chinese, Indian) and my western friends about my background and how I end up to where and what i am now and it makes me wonder what if I were not malay. Would I be in the position where I am now if I am not a malay malaysian? Many would say you should be grateful, because you are malay and a malaysian, you have been given the 'special treatment'. Of course I am grateful but do I deserve it when probably (a fact likely) many Malaysians who are not malay and poor (but have the same potentials) continue to be at a low level of ladder of social hierarchy.

Live is about survival and only the fittest will survive but the situation (politically and socially) in Malaysia seems like its programmed based on who you know and what your race is. This is a social injustice and understandably (considering where I came from) I am propelled into dilemmas in trying to understand the whole situation. Am I proud to be Malaysian or should I be proud to be a malay? But what is a Malaysian when it is divided socially, economically, politically
(emm..sounds like in every sense) based on races? What is the meaning of being a malay? A muslim who is born in Malaysia and has chance better than the others to gain everything from the government? What do I know about a Malaysian? Malay, muslim and born in Malaysia? Doesn't sound right, does it, when you can physically see the varieties that exist in Malaysia? Why should the meaning of being Malaysian be divided by races and religions? Should not it be on how much you have contributed and want to contribute to your own country?

Young politicians today apparently haven't learned a lesson from history - May 1969 in Malaysia. I read with shame the recent news on the malay supremacy and why they think (the malay mainly- forget the other bumiputras!) are better than the others to deserve the 'special treatment'. They might incite the same racial confrontation but in a different context. The politicians are mainly to blame for all the fiasco. But again they are the product of an ideology that was established to purportedly correct the social injustice that existed just after the independence but is it (the ideology) relevant now? Should the definition of a Malaysian be changed now? But what is to change if we can't understand or accept what it is truly meant in the first place? Many more things I want to say but I will save them for the next time.
Terima kasih"

This is Mr Yap's reply:

"Hairi,

Thank you very much for sharing your story with me. I wish more people were as open. I too, have many Malay friends who ask me and themselves very similar questions. It truly is a shame that people have trouble accepting themselves and others for what they are - people like everyone else.

Thank you so much for taking the time to write and I'm glad that the piece touched you in such a manner. I was very nervous about the kind of response the piece was going to get because experience has taught me that not everyone likes addressing this issue.

Take care of yourself and sorry for the late reply."

Well, something to think today.........

Another day at work....

It was a hectic day for me yesterday....which was my last day off work for this week. Got up early...well, not that early, about 10am, and without breakfast went straight to city centre to my bank to get a bank draft. I need to send the cheque to Liverpool children hospital for Paediatric Emergency Course which is going to be held in October. When I sent an email to them last week, they replied telling me there were only few places left....so I had to send the application with the cheque ASAP. It costs me £279.....In addition to that I had to pay £250 for basic paediatric life support course which is going to be held at Temple Street Children hospital, Dublin on 21/8/08. I managed to post the letter to Liverpool but for the one in Dublin, I had to cancel the delivery because at the very last minute, I realised I forgot to enclose the application letter....damn! So I rush to get home before the post office closed. And you know what I did.....on the way back, I bought a new bicycle.....hahahahaha....typical me, so impulsive!
I need a bike anyway to make a trip to the city centre from my apartment. That bloody bike costs me £350 including the side bags, locks and a helmet. Once I got back to the apartment, it was just too late to post the second letter. To fill up my day, I decided to go to the gym with my new bike. Apparently, I quite enjoyed riding my bike. It is obviously faster than walking, and it's good for my health.....emmm.....I am gonna have good legs in a month time if I continue to use the bike.
My hectic day finally took a toll on me. By 9pm I was so exhausted,....and what did I do? Go to sleep....

A mess........

This is my comment that was published in malaysiakini portal (some important points surprisingly were edited): (the one in bracket with bold letters is the one that was edited)

"Dr Hlasim: As a medical practitioner myself, I am shocked by the publication of the medical report on Saiful, Anwar's accuser. It has violated a patient's confidentiality with is the fundamental right of a patient who is seeking treatment or assessment from a medical practitioner.(Saiful might be lying on the whole process but he still have the right to the unsaid agreement of confidentiality. When we take an oath to begin our career as a medical doctor, we agree to this agreement to respect the right of a patient. I believe he, Saiful, didn’t give his consent for the publication. It is unethical for the doctor involved to reveal his finding without Saiful’s consent. It is a gross professional misconduct if it is true that the doctor voluntarily allowed the medical report to be published. I haven’t read the report published myself and I have no attention to, but I was informed it was quite graphic and this is not acceptable).Even if the medical report is true, Anwar's legal team should use it in the court to squash the charge rather than using the media to win the war of public perception. I am not sure now if the report can be used in court if Anwar is charged because of this irresponsible publication.I really hope the doctor will come forward and reveal the truth. (Whether he provide the website voluntarily with the information ? If so he should be ready to be stripped off his medical licence for professional misconduct) If he didn't give his consent for the publication, then shame on the media that published the report. It is a disgrace to fight for the justice of one person but violate the rights of another person.If Anwar's team is talking about justice then an injustice has been committed by the publication of the medical report. I am not a government supporter nor an Anwar supporter.Yes, he was wrongly jailed for a crime he did not committ but he fought hard, and he gains my respect for that. This time, I am not sure if I am able to give him the same respect.He should fight the accusation in the court and if he believes there is conspiracy against him, then he should reveal it in the court. Berani kerana benar, takut kerana salah.The truth always prevails!"

This is what I sent to Oyin, my friend in malaysia, who commented on my comment above:
"well, as you can see, I am impartial. Not on either side which is fair. I sent the same comment to the star and NST. I am so sick with malaysian politic at present. I dont trust Anwar as much as I dont trust the government. What is left for me to support...DAP? PAS? no way! The pakatan wont work because of their completely different ideologies. People have made their choice...BN won. They are not perfect but they won. Wont win my heart though. We have to deal with it. That is democracy. Anwar is impatient. Insteads of rushing asking BN MP to cross over, if he want to be PM, he should have worked to strengthen Pakatan and show the public they can work together for the benefit of the people, to win the next election. By forming a government, with involvement of MPS who cross over, he will taint the name of democracy. If you want to win you need to win it fair and square. And with economy suffers globally, whatever happening in Malaysia now is not good. God helps us! In term of this sodomy thing, I also dont believe it happened involuntarily and I believe there is a personal vendetta by saiful for something only both of them know. Of course the government and police use the issue to their advantage which is wrong itself. However, the rights of both, Saiful and Anwar, should be protected, no matter who is right or wrong. I always believe that we should fight for the human right of any individual even though he is wrong."

I have just posted pictures from my recent trip to Lisbon in a new page. I discovered today that it would take a while to download photos and post them here. Insteads, I found it is much quicker to download the photos into my picasa web album. So, if anyone is interested to see what I saw and experienced during the 5 days trip, you are most welcome to visit the page (http://picasaweb.google.co.uk/hlasim74) or just click the url on link. I will download more within the next few days. Enjoy!

Today, my off day from work, has been quite unproductive. I had planned few activities but I only managed to execute small percentage of them. For the past few weeks I have been having trouble with my sleeps. I am not sure what, but part of the reason is my stomach. I continue to have epigastric pain, and every so often, if not every hour, I am awakened by the discomfort. I have got it checked with urea breath test to find out if I had H.pylori associated ulcer disease after being in trial with proton pump inhibitor, but the problem persists. It never bothers me during the day, only at night when I am in bed. I have started to take Zoton FT again to see if it would resolve the problem. If not, I guess I have to have OGD. As a consequence of this epigastric discomfort, I have not been able to have a proper sleep, hence, my energy level has been greatly affected. Instead of getting up at 9 pm as planned, I woke up late, nearly 12pm. It took a while for me to start doing anything.
When I woke up there was James in the second bedroom in his deep sleep. He met up with Andrew last night, and ended up at my place. He woke up soon after me and off he went again. Typical James.

Then, I had a chat with Rizal , my new buddy from KL, via the msn messenger. Small talk and he sounded like a nice guy.
After much contemplation, I decided to go to the new gym , Crunchfitness Gym, for the first time after signing up with it last week. I guess I had to do something productive, otherwise another day would be wasted which I hate.

The gym is marvelous but it was very busy. I couldn't use the equipment I wanted to use, and I had no patience just standing around to wait for my turn. It was quite frustrating. So I ended up trying my Yoga. While doing it, I realised how unfit I had become. I found it now quite difficult to do all the bending and stretching after abandoning the exercise for a while now. Somehow, I am glad that I have started doing it now. I also learn a lesson....do not go to a gym after office hour.

On the way back by walking which took me nearly half an hour, I decided to buy a whole chicken to cook. I miss malaysian food, and of course you wont get it unless you cook it yourself. Therefore, malaysia green curry played in my mind on the way back.

While waiting in front of a lift in my apartment block I bumped into Brian who happened to drop in to see andrew. Nice to see him again. Lately I have drifted away from most of my friends. Don't know why.....emmmm, something that I have to figure out in bed tonight. Brian was in a good form. He likes to travel. So far, he has been in nearly 40 countries. Only 3 weeks ago he was in madrid with the other lads, and he has already booked a flight to Barcelona next weekend to meet up with Stephen who I haven't seen for few months now. Miss him too.
After eating my green chicken curry which is also Andrew's favourite, I tried to study anatomy for my exam in december but my brain was not working. I dont know why....perhaps, I am getting old or I am just to tired with so many things going on in there. So many decisions to make, so many goals to achieve....hemmmmm..I am a dreamer..

Another day.....

Well, nothing interesting went on today. Just like a typical working person. Gets up, goes to work, comes back from work, eats and sleeps and the pattern repeats the next day. I felt like a robot....and the batteries were dying off...I am sure this is just another of those days that you feel numb. Everything goes around you doesn't not matter to you as everything has its own pace and no matter how fast you do thing, it still doesn't guarantee the result you want. Hopefully tomorrow will give a different story....

Back to Dublin

I was not looking forward to today....heading back to dublin. I managed to sleep only for 3 hrs after late night out. The flight was at 1035 so I had to woke up early......The Lisbon international Airport was a chaos....

Belem, Lisbon

Woke up pretty late today but somehow I managed to force myself to make a trip to Belem, another tourist spot about 30 minutes away from the city centre by underground and train. Again, the weather was fantastic, around 25c. I'll post more about the the trip and some pictures once i get back to dublin. What i need now is some rest. My calves are aching from too much walking...I am such a wimp!

Lisbon

Relaxing in the hotel at the moment after spending the whole afternoon at Cascias about 45 mins by train from Lisbon City Centre. It was beautiful despite cloudy wheather. I bought a lovely pair of short that I would be wearing tomorrow. I will try to post some pictures later. Going to have some rest.

A night with my beloved friends

I had a lovely dinner with my friend last night at Milano restaurant, an italian restaurant on Baggot Street. Lovely interior and I enjoyed the food. I love italian food particular the pasta dishes. The dinner was arranged by Hazel whom I haven't seen for many months and she looked pretty as always. I was also glad to see Liam after being missing from the scene for quite sometime. He just got back from a holiday in Thailand. I was also sad when he told me he was imigrating to Australia to be with his loved one. He will be leaving in a month time after a trip to Montreal with Jeff and to Las Vegas with Eamon. We will be missing him big time.

The other lads were Andrew, Brian, Paul and Eamon.

For the dinner I had Avacado with spinach and peppermint leaves with italian sauce. I had twisted pasta with mozarella chest as a main course which was delicious. Andrew couldn't help himself to tuck in some of the pasta. My favurite part of the meal, as always, was the desert. I am a desert person. No matter how full I am there is always a place for desert. For me a bad restaurant is the one that serves deserts without

any thought in them. I had strawberry fruits top with honey mixed with yogurt and nuts. Delicious!

2nd day of annual leave. As planned I got up early, well, at 11am (I am not a morning person, ok!). So many things to do before the trip to Lisboa (Lisbon), Portugal tomorrow. First of all, I have to fix the car. The exhaust was just hanging down there, ready to hit the ground. Don't know what happenned but for the past week or two , the car has been making odd sound. Andrew checked it yesterday and found out what was wrong. The exhaust has become loose and it needs to be fixed. I will be returning from Lisbon on dublin so I would have no time to fix it and I need the car to go to work on Sunday. That bloody car.....need a new one!
I send it to Fast Fix Car Shop....and they are really fast. It appeared that a rear box (don't ask me what it is called) attached to the exhaust also leaked and needed to be changed. Whatever.....costs me £80 (bloody car!).
After having my lunch, a green chicken curry which i cooked last night (yummy! yummy! love it) I went to town to:
1. have a look at Crunchfitness centre (www.crunchfitness.ie ) at Aston Quay. I was so impressed by it cleanliness, high tech equipments and large swimming pool, I signed up right away. The entrance is so grand, so camp! The fee is reasonabe. £100 for registration, 1 month free membership and the £64 permonth, significantly cheaper than Iveagh Fitness Centre (in term of grandeur, Crunchfitness is so much better). Now the challenge is to have self discipline....The last time I signed up for Gym, I went there in binges....two months intensive ttraining 4 months nothing. No wonder I didn't get any benefit.

2. send a form for Insurance renewal. I had to send ASAP before they increase the premium. I had a car accident last week and now I am awaiting the paperwork to b completed for the claim. So I hope they would receive the renewal form and proceed with it before I complete my claim. Smart move huh!

3. Get contact lenses. So much cheaper in Specsaver than the last place, nearly half the price. Cekik darah punya company (bloodsucking company!)

Looking forward to dinner with Hazel and the gang tonight.

Awake!

Dan, Brian, Steven, Chris
Sergei, Jeff
Steven, Chris
Sergei, Paul, Jeff

I finished my night shift yesterday at 8 am. Hooray! No more night shift for St. James Hospital. Now, I have the whole weekend off till Tuesday. It's now 5:10 am, I still couldn't sleep. Well, I went to bed yesterday at 10am and sleep through till 7 pm, had my dinner and went to bed again at 11 pm. Big Mistake!

I woke up at 3am, and here I am, fully awake, wondering what I should do. After surfing in the internet, reading all the online malaysian newspapers ( http://www.hmetro.com.my/, http://www.bharian.com.my/, http://www.utusan.com.my/, http://www.bernama.com/, http://www.malaysiakini.com/), then I remembered I had signed up to start my own blog. Hence, here I am, looking for ideas on what I should write.

Perhaps, I should write about my plan today........God! Only now I realise I actually have a boring life. My work has consumed me greatly.

Recently, I started to learn spanish through an online website (http://www.rosettastone.co.uk/). It uses immersion method which I find quite interesting. Its aim is to allow the language to be assimilated into your mind naturally like a child learning a language without thinking too much about the grammar. It has been few months now since the first day I signed up but due to the constraint of time I hasn't done it regularly as it suggests. So I think I should plan everyday on how much time I should spend to learn the language. A little time daily but I believe consistence is the key.

One may wonder why spanish. Ahak! I will tell you a secret. I have a dream. My dream is to retire early in a small village in Spain looking after animals and growing my own food. I love Spain. I like the weather, the food and the people. Well, that is the dream anyway.

Sitting here on my own alone gets me thinking that I haven't been out for a long time. The last time I met my friends (Jeff, Brian, Steven) probably nearly 2 months ago. So, I think I should go out tonight to meet them.

I haven't seen a movie in a cinema for few months now. So, I should see a movie tonight. Which one? Indiana jones, Sex in the city, Priceless or Mongol?