Azim's 4th Day in Hospital

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Today has been the last day of my stay in Belfast. I am now back in Coventry due to work - tomorrow I'll be starting a week of nights.

This is the exterior appearance of Ulster Hospital, it looks small. Ulster Hospital is located around 15-20 minutes from Belfast City Centre by bus (buses 4B, 19 and 20 in case you want to get there too) and the bus fare is a mere £2.50, return.


Despite the small size, Ulster Hospital is the centre for plastics surgery in the whole of Northern Ireland. Some of the best (hand, plasctics and maxillo-facial) surgeons operate here. The nurses and doctors all seem friendly and helpful.


Azim was noticeably brighter today. He said that he has had a good sleep, good food and despite morphine and codeine he has finally managed to open his bowels for the first time after 3 days. He felt fresh after the nurse-assisted morning bath and the bandages on both his arms look ed fresh. However, his left arm appeared slightly swollen.


Here is how Azim spends most of his day; writing and answering text messages and phone calls (despite his bandaged hands). If you were wondering how he managed to type those messages I hope the above picture presents a clue.


Noon time, Azim was visited by the Consultant Surgeon and a nurse, who opened his bandages. The Consultant took a quick look at Azim's hands and asked Azim to flex his fingers, which he could to a limited extent, better with his left.


One look at Azim's right hand, and the Consultant instructed the nurse, "Prep him for theatre, nothing to eat and drink starting now. Aim for surgery at 6-10pm. Home tomorrow."

He then explained that they were going to attempt a skin transplant, and that after discharge Azim would be followed up in his clinic after 3-4 weeks, with regular plastics rehabilitation. Azim asked, "I'm a dentist and I really need my fingers to function fully ...". Before Azim could finish the sentence, the surgeon replied, "I'm a hand surgeon, and the skin graft is exactly what I would have in the same situation" ... and soon left.

A quick phonecall to inform everyone the change of events. Preparations were made if Azim was to be discharged tomorrow.


An SHO arrived to explain the procedure, the nurse rebandaged Azim's wounds.


Signing for consent before the procedure.
---

So from 12 noon, Azim was nil-by-mouth until 630pm, when a group of nurses approached Azim to bring him to theatre. It was then when I left Azim's side & Azim's friends kindly offered to drive me to the airport.

As soon as I arrived to Birmingham, I received a phonecall from Azim saying that the procedure was completed. Unfortunately, they discovered pus and infection inside the wound and instead of doing the skin graft, Azim had further debridement and cleaning of the wound of foreign objects ("grit", as written in the notes) and a drain has been inserted into his arm to drain the pus over the next few days.

Azim has been moved from a normal ward to a posh sideroom, complete with it's own TV, washroom and privacy and comfort. Probably because Azim is a fellow health professional (?). I remember when Puan Mama Sarah and Amar (PMS&A) was giving birth to Amar and she was whisked off to a posh side-room too, without us asking for one. At that time I was still just a humble junior SHO.

It is still up in the air on what's happening to Azim, but I suspect they would want to drain the pus fully and continue with strong intra-venous antibiotics before proceeding to doing the skin flap. Only after then would Azim be discharged.

A good news is that we are planning for Azim's wife and son to come to Belfast in the next 2 days. We feel that with Salamiah around, they would be someone to care for Azim after hospitalisation and also someone to always keep him company. Goodness knows how long he'll still have to remain here.

PS


Above is a picture of Azim's wound right after the accident and before any operations. Azim mentioned how, during the accident and after his car has stopped spinning he got out of the car through a smashed up window (a window that was probably smashed by his own flailing fist, causing his injury) and on remembering his valuables especially his passport, Azim opened his boot and carried his bags to safety with his injured arms.

As usual, larger (and more) pictures on my picasa web album.

Azim in Hospital Day 3

Today is Azim's 3rd day in Ulster Hospital, Northern Ireland. His day started with a consultant lead ward round. In the ward round, we learnt nothing new. The consultant re-confirmed that they were aiming to bring Azim back to theatre as early as tomorrow for reconstructive surgery including skin transplant. They were aiming to discharge Azim probably on Monday, and after discharge, Azim would require extensive plastics rehabilitation to bring his arms' functions as close as possible to normal.

Azim's left hand in bandage. His left hand is his only functional one at the moment. With it he is able to text message, and attend to some (but not all) personal hygiene. It is still difficult for him to for example, put clothes on by himself or flip pages of a magazine or feed himself.

Azim's right arm, in plaster of paris and elevated. He is able to move his right fingers to a limited extent but so far the arm is of limited function.



Azim is mostly pain free but occasionally complains of cramps and throbbing on his arms. He complains of eye pain too, but on inspection there are no obvious alien particles and the eyes do not appear red. He says today is the first day he could finally feel discomfort and cramps in his shoulders, back and arms. The sites where they inject intravenous antibiotics hurt too, but that is natural.


More than physical pain is, in my opinion, Azim's mental worry - bordering on distress. It is very obvious he misses his wife and three small children back in Malaysia and I always either try to avoid the subject of his family or tread the subject with extreme care. Apart from missing his family, he has many other problems to worry about too...

We try to reassure him to worry only about his present state, and to push everything else to the back of his mind, and worry about them when the time comes.

Seeing him, for someone who is severely burdened by problems, he always seems calm and collected. His expressions would only occasionally break to reveal the sea of worry underneath but mostly, would not even show a slight crease or grimace.


Another non-physical problem, and also a common one among patients is boredom. Who could blame him? 24 hours a day he lies in bed doing next to nothing, unable to watch TV (his glasses were lost in the smashed up car) and unable to read his magazines (difficult to flip the pages). I tried to entertain him with some DVDs I carried and they did seem to help, if only a little.


One thing that touched my heart to see was how much support Azim has received from his friends. Every day, droves and droves of Azim's friends come to visit and he receives torrents of calls from many others, from all around the world (apparently). People has brought him gifts, cards, books, magazines, clothes and plenty of food especially from Jas. Jas has brought food specially prepared from home (some cooked even by himself) daily, and even takes the trouble to feed Azim himself.

All of Azim's friends uttered prayers on Azim's behalf for him to get better quickly, and get over these troubling times.

Today, my jaw almost dropped to the floor when a social worker approached Azim to ask about whether Azim needs more help after being discharged from hospital. Basically, the social worker has offered for special carers to visit Azim at regular intervals daily and assist him with hygiene and any special needs. That is the amazing thing about this country; they think of everything. Care is excellent in hospital and they even provide care after discharge.

It is as if the government is saying; "don't worry, we know you have family and lots of friends but WE will look after you. You are OUR responsibility."

Amazing.

PS
As usual more pictures on my Picasa Web Album.

Azim in Hospital day 2

I'm in Ireland now, unfortunately time is limited for me tonight so here are some pictures.

Azim is okay, he's overcome the initial emotional and physical shock. He's had initial debridement of the wound and he seems much better. Further operations probably tomorrow or after.

-I've moved to a different location now, the place where I'm sleeping for the night-

What do you know, I have wifi access, alhamdulillah. So now I could write more before I go to bed.

Firstly about the journey; I set out relatively early this morning to catch my flight at Birmingham International scheduled for 11am. The journey to the airport was quick and uneventful, I felt noticeably more agile and swift (probably because I'm travelling free of the two little ones) despite having to carry a heavy knapsack and a backpack.

At the airport, security checks delayed the travel. Nowadays, people flying in/from the UK are bound with many new restrictions; one of them is that we could no longer carry fluids onto the airplane. Fluids include milk, drinks, toothpaste, hair gel, perfume etc2 - anything liquid really. However, with the new regulations apparently small amounts of liquids are allowed but heck, I tried to avoid the hassle by not carrying any.

Alhamdulillah, one of the things I am extremely grateful is that there were no limit to the kindness showed by Azim's friends here in Ireland. Azim's friend Jas offered to get me from the airport, take me to the hospital and even arranged for a place for me to stay. He momentarily went home but came back with fresh laundry and clothes, lots of food and essentials for Azim's stay in hospital.

We are all truly grateful for the kindness showed by ALL of Azim's friends. During his stay, many people have paid visits and many more offered kind words and prayers - thank you all.

Regarding Azim, he recounted the chilling details of the accident. He was driving along the motorway when at a split second he suddenly felt the car skidding and he lost control. He recalled how during the time when the car was spinning and everything was a blur it was as if everything felt like a dream, like his mind was looking at the event from outside his body. The few milliseconds of when the car was spinning he said felt as if he was "ready to die" and he said he was just waiting for death to take him ... when the spinning suddenly stopped, and he realised he was still alive. He felt his right hand hit the side window - smashing it (the window, hopefully not the hand) to pieces. When he came to, he realised he arms were both heavily bleeding.

Another car was involved, but thank goodness it was merely a scrape. Thank goodness too that the ambulance was swift to arrive taking him to hospital. I was much relieved to hear that the pain was not overwhelming.

The extent of the damage? Well, as far as I could assess Azim could walk freely and there are no other major injuries elsewhere. His face, shoulders, pelvis, body all are virtually unscathed. There is though a gash at the back of his head requiring 8 staples. His left hand is mobile and usable. His right hand less unfortunately less so - immobilised in plaster of paris.


I was relieved to see that Azim looked, apart from the hands, okay. I heard he was in a much worse state, both physically and emotionally, yesterday. Today, his appetite was strong, all the vital statistics were stable.

The surgeons are planning to explore the arms further tomorrow and plan for further surgeries in the coming few days.

Despite everything, he seemed to still be able to smile and crack jokes. Both arms are suspended to these two poles and Azim needed help with everything from eating, hygiene, even scratching his nose.

This is Jas, Azim's kind friend seen here feeding Azim food kindly prepared by Jas' wife.

It also seemed that Azim still has a very healthy appetite, which is excellent for recovery.

The nurses all seemed extremely helpful and friendly. Alhamdulillah, no one stated that they did not want me to stay with Azim despite being outside of visiting hours. I stayed by Azim most of the day today mostly just keeping him company.


And lastly, this is Azim on his high tech multi reclinable bed. Obs are all stable, don't worry. Looking forward to seeing him again tomorrow.

OK everyone, time for me to retire myself. I'm not at Azim's friends' house for the night, they are extremely hospitable and I am extremely grateful for a place to stay tonight. I'm extremely tired from the journey so I think this is the time I'll sign off ...

... for today.

More here: my picasa web albums

A misfortune

I wasn't joking when I mentioned in one of my posts way back about how my brother Azim's life has not really been easy sailing. To list all his cumulative trials and tribulations to this day would probably be more than I could stomach but enough for me to say that his life leading to his graduation has not been easy at all.

We thought that after he graduates things would get better, but unfortunately so far, things has become worse; his visa application to work in the UK has been declined and he has been forced to move back to Malaysia all in the past 3 weeks. In fact, his family are all back in Malaysia and he's here just to conclude the move.

I was shocked again to receive a phonecall from him this morning; a call I thought was for my birthday. Instead, Azim revealed that he had been in an accident on the motorway near Belfast.

Apparently, he lost control of the car as the car skidded over a patch of ice and he hit the road divider. He hit another car too, but according to him the other car appears virtually unscathed. Azim's car though was badly damaged and reality struck me when Azim said, "I thought I was going to die" ...

When he said that, my thoughts immediately went to his wife and 3 children back in Malaysia, awaiting his return - his flight back was booked only 4 days from now, on Thursday. A flight which now has to be postponed indefinitely.

We are all grateful Azim is still alive - though both his arms are injured. According to him, there'll be a debridement operation tonight and he has been put "nil by mouth" (fasting before an operation) since noon. On the phone he sounded extremely drained, or maybe it was the morphine to make him cope with the pain.

Insya Allah I will be making my way there early hours of this morning. Please pray for him.

Borakphoto Assignment: Culture

It took me awhile, and it's abit overdue but I've finally completed this months Borakphoto assignment (This month's task is Culture).

For "Culture" many ideas came to mind but first I had to research the definition: Culture is defined as a system of values, beliefs, customs and behaviour shared amongst individuals in a society and passed from generation to generation through learning.

Brainstorming had me thinking of the following:

1. Graffiti art, found in abundance in this city.
2. Food, I was thinking of making sushi. I abandoned this idea as I've submitted too many pictures of sushi in the past.
3. Clothes: I was thinking of shooting a pair of baju kurung or baju melayu drying in the morning sun, backlighted etc2.
4. Architecture: probably something from the Paris trip
5. Goth youths, loitering at the city centre. You guys know what "goth" mean right? It's the "culture" (heh heh) where one wears black, black make up etc2.

In the end, especially due to time constrains I thought of how in our culture we eat with our fingers - a practice generally frowned upon in Western society due to hygiene concerns. They don't know what they're missing; the tactile sensation we get eating with our fingers make food taste its best.

Thus concludes the behind-the-scenes of this month's Borakphoto assignment.

Take care all.

ps

Watashi no tanjoubi (My birthday)

24th November is my birthday. This year is kinda special, as it's the first birthday I've celebrated where I feel I'm part of a complete family (with Puan Mama Sarah, and the two little ones). Everything felt right in place today...

Anyway, while I was working today here is what Sarah and PMS were up to:

Sarah was sneakily baking a cake.

Chocolate ... Yum!

Signing the birthday card with crayons; lots of multi-coloured circles and lines.


PMS was busy preparing everything else - the various kinds of food (Ayam percik, tauhu sumbat, kuey tiaou [how to spell huh?] etc2222)

The birthday cake in it's final, ultimate form.



Sarah wanted to blow the candles too

Uncle De, Auntie De and family kindly came to join the party :)

Sarah enjoying the cake

For my birthday present, PMS generously got these: exactly what I want & need; running work shoes, without laces and black in colour. Exactly the kind of style I like. Comfortable to wear at work, semi-casual and perfect for running after cardiac arrests :D

Quite expensive too .... thanks Bie!

No doubt PMS and Amar were tired after the dust settled.

Thank you EVERYONE who wished me happy birthday, you've all made the day very special indeed. May Allah bless you all. Thank you for the kind wishes & the lovely thoughts. To O-K & KKL, hope you enjoyed the food on my behalf, it definitely seems like you guys did!

I had a great day both at work and at home. At work, we enjoyed an extended tea break, complete with various goodies & munchies - chocolates, biscuits, crisps ... even icecream (it's winter).

Excellent day, thank you everyone.

Blue Skies

Sony W800 - fixed focus - F2.8 - 1/1000 - ISO 100

Beautiful blue sky and cloud formations on the way to work today, I didn't have a proper camera so took the above picture of our hospital's library with my cameraphone and just as a joke I tried checking the picture's EXIF data - it turns out that the cameraphone actually makes EXIF data! (as written below the picture).

Hands up who says it's indistinguishable from my other cameras?

I have been wanting to watch Casino Royal, the latest Bond movie - rave reviews on the internet and all my friends have been recommending it. Some even say it's the best Bond ever. I had the chance the watch it several nights in a row now but, probably because I'm getting old, I feel that getting rest and spending time with the family much more desirable than going to the cinema (gasp!)*

I may still watch it in the end, probably this weekend. Anyone have seen the movie yet, recommendations?

*I also find myself HATING listening to the radio while driving to work. I find the contents of radio chatter empty in terms of content - the DJ talks empty nonsense interspersed with boring adverts. So instead, I gravitate towards putting on the news & radio discussions.

Man, now I understand Hiyoshi's growing pains.

Strangely, I always get like this this time of the year (reason will be clear in 2 days ... :p)

PS
I have been watching Mission Impossible III just now - the best Mission Impossible EVER! Highly recommended.

Flash Game: Grow Cube

I am so sorry everyone, I'm still busy at least until tomorrow. The reason is, I have a presentation due tomorrow on "Ventricular Tachycardia". The past one week I have been gathering articles and over the weekend I was supposed to prepare the slides on Powerpoint *glance at Auntie De* instead ... well you guys know what we were up to over the weekend. Despite lugging my trusty laptop, I didn't get to do any work at all.

So the past 2 nights I've been really busy preparing the slides - 100% done now, and I'm just reading the presentation over and over until everything sticks.

Anyway, in situations such as these, it's good to have release and mine is the free web based Flash game above called: Grow Cube. It's a really cute game, and as it's free there's no reason why you guys shouldn't try it as well (warning! it's addictive)

The rule of the game is simple: place each of the ten items on the cube to create chain reactions to solve the puzzle. ONLY the right sequence of placed item could solve the puzzle. If you're successful, you'll be treated with the ending sequence shown in the above picture.

Good luck finding out the sequence, I'll give hints tomorrow/the day after :p

Link to Grow Cube (or click the picture)

Please let me know how you guys get on with the game.

ps
still K-I-V ing replies to the blog (sorry everyone!!!). Insya Allah after tomorrow I'll have more free time. Later!

Our Weekend: From Birmingham to Nottingham

I have been extremely busy the past week and weekend, so just a quick update again today - unfortunately pictures & quick captions only this time, readers. Um, sorry for not replying to comments on the previous post guys but I promise I will - but maybe tomorrow or the day after. OK, on with the show:

We woke up from the weekend full of plans.

Sarah was extremely happy at the prospect of meeting her friends again.


Selfridges, The Bullring , Birmingham at Sunset.
This weekend, we had the utmost pleasure of planning a meeting in Birmingham. It was supposed to be a get together between our family, Uncle and Auntie De's family, Rosli & Mama Daniel's family as well as Arep & Dina. The children would have enjoyed chasing each other around the city centre, the women would have enjoyed drinking coffee together and the guys would have enjoyed another photography meet up. Alas, Rosli & family had to cancel and Arep & Dina was stuck in a massive traffic jam (one of the main junctions was closed).

The Bullring, Inside.
The last picture I managed to take inside before I was asked to stop by the security guards. In the UK it seems that in most shopping complexes, pictures are not allowed. Actually, even taking pictures of some buildings are restricted (for example, we were stopped by security guards while taking pictures of the Wales Millennium Centre too). Did you know that you could get into trouble if you photograph things like security cameras, bridges and power grids?

Anyway back to the story, Birmingham was jam packed with people. It was too crowded for our enjoyment to be honest. Especially with push-chairs and many little children to take along.

Beautiful Day.
Despite the gloomy weather forecast (huh!), the day was bright and sunny with blue skies. Don't let the clear day fool you though, it was freezing cold. Winter is coming!


Another lovely weekend travelling and photo-taking.


For lunch we made a stop at one of our favourite restaurants: Wagamama.

Sarah was showing off her mad chopstick skillsz.

Uncle De enjoying his Amai udon with gusto...

...and me enjoying mine.


Puan Mama Sarah ordered fried rice (which tasted almost exactly like Malaysian fried rice)


Heh heh do I have lurvely pictures of Auntie De enjoying her food, but I decided to post this sensible one, right Auntie De? *wink*

Our weekend was far from over after the Birmingham visit on Saturday. After Birmingham we entertained Arep & Dina at home (I finally got to try Arep's 70-200 L lens - wow!) and much later that night we travelled to Nottingham. But that's another story. I'm happiest with this picture from our Nottingham visit:

Radcliff(?) Power plant - these are the (?) cooling towers. Apparently the white clouds emanating from those cone-like grand structures are steam i.e. not pollution, according to our resident engineer; Uncle De. It was fun taking pictures with Rosli again, and thanks Uncle De for driving us here.

Over and Out. See you guys soon.

PS: More high-res pictures on my Picasa Web Albums. Best viewed with Firefox (because of the added functions e.g. slideshow & full screen view).