study sket...

dulu ms stud xdela kesah sgt cmne diz op was done..it is too specialty for me..tp since all diz happened aku jadik kesah nak tau..
juz to share...pengalaman live and theoritically
Tuesday ~23/11/10 @ 12 noon 
Abah ditolak masuk dewan bedah..sebak aku tgk mcm mane abah menunjukkan kegagahan diri..dia tersenyum malah siap put thumbs up...huhu...he is strong!
Angiogram was done by Dr. Yang Chin-Huat, Ngeyu
He was once in HSA...
He is soo nice...nampak tegas yet friendly
After telling me the diagnosis we can stil having conversation...he is among those with noble heart..


Surgery was done by Dr. Patrick Leong Kin Seng
He is a person with noble heart 
Penuh dengan kerendahan hati
1st time jumpe dia aku cume kenalkan diri as a houseman...
penuh dgn rasa rendah diri...
tapi dengan harta,pangkat dan kedudukan dia..die xbongkak dan lupa diri
He called me Dr Aishah
sangatla terharu..ssh nak jmp org seperti die di zaman sekarang...
In fact he actually considering to let me in for surgery..
Although it is a chance for me but i dare not to..
it is unethical..i'll b to emotion..


Usual procedure done
Anaesthesia given..
As expected once sedation given BP crash...really crash..
they had to rush for surgery ... 
Pre-op has been decided that the graft will be taken at bilateral saphenous vein since it is tripple vessels disease.and if to take internal mammary aryry wud b difficult in a rush situation like diz..
the surgery was done conventionally -Open heart surgery..
Abah's chest was open with incision over the sternum
Simultaneously, thegreater saphenous vein from abah's leg was harvested bilaterally
Then his heart was connected to the heart lung machine
One by one bypass was done...
He was bleeding...more than usual..as expected coz on admission they hav to give ticlodipine...and he keep on bleeding
prior to surgery 2 pint autologous blood has been taken and reserved
After all the bypass completed, the heart is restarted
Abah's chest was closed
Drainage was also inserted
Noted continous bleeding
Although not as heavy as before but still underrunning
the sternum was stabilized with stainless steel wire suture, and the chest and leg wounds are closed with sutures Surgery finished at ~ 5oopm
When he was sent to ICU -Ventilated and sedated drain still increasing
but diz time slowly...
Sebak menyelubungi suasana...
aku tau mereka semua mengharapkan abah bangun dan bercakap seperti biasa....
Not ventilated and sedated
satu per satu anak2 dan saudara mara dtg menjenguk...aku jelaskan satu persatu...yang mane perlu...
hiba melihat emak teresak2 menangis...
mungkin terlalu terkejut melihat kenyataan...
BP monitor ku lihat decreasing from 99/60 to 80/56....
PR mula tacy...140-150
aku mula risau
He is damn pale
sudah 3rd pint PC masuk
DIVC regime pending...
Dr Patrick juga ade di situ...
tenang sedikit hati ku
die menrangkan aim to keep bp between 80-100 SBP...
Lega sekejap tp ku tahu dia gusar jua andai pendarahan tidak berhenti
Melihat kepada PR yang bertambah tinggi aku tau it is a repond due to blood loss
Ku lihat ade Dopa, Norad, GTN...


Di dalam hati doa ku panjatkan agar semuanya lancar


Alhamdulillah D1 post op bleeding minimally only
Total 6 pint PC, 2 Autologous blood and 1 cycle DIVC regime...


Thank you Allah
Thank you for granting nur and strength to Dr Patrick atau nama islamnya Dr Iskandar...

sekarang ni menunggu abah pulih dan sehat sepenuhnya..
aku tahu abah kuat semnagat...
GANBATE!

HeArTy hEaRTy!!

i had a hectic week...Alhamdulillah I sail thru it..
a week full of emotion
an expected diagnosis but came along unexpected finding
unbearable sadness
most difficult decision
fighting with wat u know and wat u expect wud be
hiding ur true emotion...
miraclelous operation

Syukran jazillah Ya Illahi...
U hav granted us the best..
U lead us to it...

Abah was admitted to Pantai Hospital for stable angina..postcall and i came back noted ECG in hospital Extensive anterolateral MI..He was admitted to ICU..Next day we agreed for angiogram KIV proceed in Pantai Melaka..Hoping it will end there although i do know from ECG it is not that simple..thats for sure..true enuff noted Angiogram severe stenonsis of Right coronary branch, Complete blocked of LAD and stenosis Left main branch and Left circumflex artery..in short heart only recieve <10% blood supply...and the only solution is BYPASS!!
CXR shows pulmonary congestion
I wud say a beautiful xray for final year medical stud exam...very typical!
It is juz like a timebomb..either we loose it later or take the risk for op now and probablity of complicated surgery leading to death as worst outcome..but if we neva try we wud neva know...at least we hav done sumthing..
When the surgery was done i can feel my heart pumping very hard..and at last i cry...after all people calm...i've been keeping it...sbb aku rase kalo aku menangis di saat sumenya bersedih pasti mereka akan lg sedih kerana kenyataan yg sebenar aku lebih mengetahui kebenarannya...aku xmahu mereka mengetahui the worst situation
Alhamdulillah now day 4 in ICU post surgery...abah dah stat soft diet...dah sitting by chair..cume yang merisaukan aku still on IV Dopa 3ml..Nampak abah cengkung...kalo bole aku nak duduk sane je...sampai die sembuh and kua...tp aku jua punye tanggungjawab...doaku sentiasa dipanjatkan untuk kesihatannya...amin!