Thursday, May 28, 2009

Thoughts for the week so far.

  1. Alexandra Hospital is a resort masquerading as a hospital! The peaceful old colonial building is a perfect place to recuperate.
  2. The cafeteria food is bad, though. Loads of measures to induce people to eat healthily - eg veg dishes are much cheaper than meat, grilled chicken cheaper than fried chicken, etc. Too healthy food is not delicious.
  3. Was poked in the face (almost in the eyes) by an Ah Por today. Think it was her way of saying hi.
  4. Sat through an hour long lecture on incontinence, a common problem in the elderly.
  5. Am impressed with the efforts of the geriatric ward staff (doctors, nurses, physio, speech therapists, etc) to provide hollistic care for our patients.
  6. Bought a used copy of Jules Verne's book Journey to the Center of the Earth for $2. Twenty Thousand Leages under the Sea is one of my favourite novels.
  7. According to the valued opinion of my friend Marky Ong, if I carry a kid's backpack...

    in omnia paratus says:
    u will look like a mother holding her son's bag for him
    in omnia paratus says:
    ppl go for the "stay-over-at-bf's-house" look
    in omnia paratus says:
    but i have nvr heard of a "hold-my-son's-bag" look

    Bah. How cute are these?

Friday, May 22, 2009

Green Bean Hearts.

Green Hearts
Originally uploaded by B*_J

This whole week has been mad. Another system to study everyday. Trying my utmost to memorise anatomy, physiology, patho-physio and implications in anaesthesia. Failing mostly because of tiredness and poor understanding.

I've realised that respi is probably the hardest physio chapter. Think what I learnt in M1 barely scraped the surface. When I was reading it yesterday I kept losing all the concepts. Haha. JB West! Will read that book thoroughly one day.

Dr L has been a great teacher, encouraging me to think and taking the time to explain what was going on. Despite my extensive shortcomings.

Got to see some interesting things at SGH too, sat in for four ops that utilised cardiopulmonary bypass. Had the opportunity to see some of the cool new technology SGH OT has.

A good short posting it has been. Off to the last posting of these electives - AH Geriatrics. :)

Thursday, May 21, 2009

I tried to rock but you only roll.

Originally uploaded by
✈ Sean Marc Lee 李荆山

The promise of the weekend and getting some sleep.

And the surgeons and anaesthetists totally caught on to Tatol Thyroidectomy. I was right, it actually is funny!

Wednesday, May 20, 2009

Green Ballet Flats.

Green flats are a little different, and add a bit of fun! French Sole Harriot in Green Croc.

Lanvin Green Lambskin.

Beirn Light Green Snakeskin.

Reed Evins in Tie-Dye.


Tuesday, May 19, 2009

Tatol Thyroidectomy.

In my slightly sleepy afternoon, 2nd CABG of the day state today, I thought, that misspelling is actually quite funny. Lonely people posting meant no one to share it with though. And anaesthesia for cardiothoracic surgery is very interesting but too high level for me who has not grasped the basic concepts well enough yet.

Have to remember renal physiology for tomorrow... These are the electives' busiest two weeks yet.

Monday, May 18, 2009

Starling's Law of The Heart.

When heart rate is constant, cardiac output is directly proportional to left ventricular end-diastolic volume (preload) unless excessive volumes are reached.

Determinants of ventricular filling
  1. Venous return
  2. Blood volume
  3. Distribution of blood volume- Posture, intrathoracic pressure, pericardial pressure, venous tone
  4. Rhythm of atrial contraction
  5. Heart rate
As most of the other factors affecting venous return are fixed, the major determinant of right ventricular preload is venous tone. In the absence of significant pulmonary or right ventricular dysfunction, venous return (affected by venous tone, etc) is the major determinant of left ventricular preload. Normally, the end-diastolic volume of both ventricles is the same.

Ventricular end-diastolic volume (preload) is difficult to measure clinically. An estimation can be made with the left ventricular end-diastolic pressure only if the relationship between ventricular volume and pressure (compliance) is constant. However, ventricular compliance is usually nonlinear and many conditions may reduce ventricular compliance. However, measurements of LVEDP or pressures approximating it is the most common way of estimating preload. Central venous pressure can be used as a measure of preload in most healthy individuals.


Typical French Food
Originally uploaded by Bеn
I have bred mysteries in my mind.

Sunday, May 17, 2009

What will tomorrow bring?

Dr. Li at work
Originally uploaded by
foggy photography

In this (mostly trashy) reality show I watched, one of the characters was relating her experience taking care of her mother dying of cancer.

"Tomorrow is not promised," she said.

Thursday, May 14, 2009

Happy @ SGH.

We anaesthesized some young patients today at the National Dental Centre. When my mentor told she was working at NDC today, I immediately thought that we would be doing local nerve blocks/ GA for adults who needed oral reconstruction or something. Wasn't actually sure what.

It was a pleasant surprise to be working with children! Despite me not knowing all the answers about how a child's respiratory system differs from an adult's.

'Tis feeling like a good posting. :)

Tuesday, May 12, 2009

Everywhere you go.

Laughing In The Rain
Originally uploaded by Greything
You always take the weather with you!

Monday, May 11, 2009

To my friend.

Far From Home
Originally uploaded by acampm1
Wishing you luck and love always.
Yay. Back to the OT tmr!

Sunday, May 10, 2009


Sentosa Medness 023
Originally uploaded by nwxiang
Monday - getting roasted in the sun with the M4s.

Thursday, May 07, 2009

The Shy Rose.

Another Supper @ Thomson - Cheeky Chocolates.

Wednesday, May 06, 2009

Some days, this is how I feel.

Winter Train
Originally uploaded by Osvaldo_Zoom
Where am I going? Don't ask anymore.

Saturday, May 02, 2009

It's the end of Surg and start of...

... an unexpected, indefinite break as all of us are suspended from clinical postings due to the swine flu alert. TTSH Surgery was excellent. I learnt alot in the Vascular and Upper GIT Teams, tutors were nice, enthusiastic in teaching and our elective group was really fun.

Boo, was really looking forward to Anaesthesia at SGH. Nonetheless, a break is always good, whether we want/ need it now.