Monday, June 20, 2016

Cloud in the house

Few weeks ago, Yun had asked me about our internet service; why we still subscript to a fixed line data plan as both Ving and I subscribed to an unlimited 4G data plan?  I explained to her about the need of a fixed line as we are currently running a cloud service in our house. I was using Dropbox for over a period of 2 years and when the compliment data space expired; I was forced to move 100G+ of photo and movie from Ving’s storage to a mobile hard drive. The downloading process took me over 20+ hours… a strenuous process and I decided to host my own cloud service. The searching process was simple, either synlogy or qnap? No much to compare as I had a budget to follow…. There was a promotion going on for the TS231+; although I am not satisfy with the ARM processor, I have to compromise for it.
Installing the machine was simple; but setting it up was a pain. I am not unfamiliar with the port forwarding part and the system was up running in less than 30 min. Everything was ok for the first day but my “cloud” had disappeared on D2. The machine was running but I was unable to locate and logon to it. Rebooting the machine is simple solution but yet the cloud disappeared after a day later. It took me a week to modify the setting and finally I found the culprit – my dlink ip cam recorder DNR 202L…..
The removal of the recorder solved the problem. The rest of the learning process was simple and I am happy with it.
A simple UPS was added later on and as long as the power failure is less than 1 hours, the system is good.
I had wanted to upgrade the fixed line to 300m/100m when I set up my cloud, but I was disappointed when I found out that my area was not eligible for the service. My 100m/30m data plan at that moment was running on a double VDSL line basis instead of optic cable.
When Yun brought up the question, I ran a check over the net and found that an upgrade to 1G/600M was available…..My eye shinned but yet the fee was way out of my budget; the fare was RM400/month and the 500M/250M was RM300/month. I opted for the 300M/100M which cost RM100 less and submitted the application.
The contractor came 3 days ago and the FTTH was installed. The upgrading of the speed was noticeable but I lost the convenient of having a fixed IP. I had to rely on the DDNS service provided by the router.
I later found out that a 100M/50M data plan provided by TMnet cost RM300/month; same price with 1/5 of the speed. No wander when I in law visit me, they were amazed by the surfing speed....
Well, the price of a 100M/50M in Sri Lanka is RM 75(limited to 100G, additional 1G = RM4). Water fish price by TM.
I considered myself lucky, but felt sorrow as I am so far away from home...

Thursday, June 9, 2016

Referral blue

Boss had approached me after my long break. He had related the case that he had encountered 2 days ago during his ward call.
Our neurologist had submitted her resignation 1 month ago and after some serious discussion and compromised; she had agreed to stay with the condition of waiving Sunday ward call. The immediate “lobang” were filled by Boss as usual.
A 7 y/o boy with abdominal pain was admitted to the pediatric service on Saturday. He was seen on the next day where the pain had worsened. Clinically the symptom favor acute appendicitis; but boss had chosen to do a CT for confirmation. The radiologist was consulted for final decision and a report ruling out of acute appendicitis was done. Boss had informed the family about the report but on Monday, when the surgeon saw the kid and CT. He had concluded that he favored acute appendicitis and with the diverted result, the family had asked for transferred to a tertiary facility immediately.
Acute appendicitis had been one of the “notable” diseases in my memory. One of my elder cousin had been mis-diagnosed at the age of 6 and ended up with a long HORIZANTAL laparotomy scar over his belly….
We were told not to jump nor run after meal as it may lead to acute appendicitis( a myth of coz) by our parents during our childhood.
I was cautious with this disease from D1 of my practice. Our new surgeon had wanted a CT scan for confirmation and he had ruled out 10-20 percents of the clinically favored acute appendicitis. He performs appendectomy only during office hour; cases who presented after office hour would be admitted and given parenteral antibiotic and surgery would be delayed to the next morning.
I learnt to differential diagnosis acute appendicitis on CT after his arrival.
I do not blame the radiologist for the report but yet our consultation system is the major culprit.
In the standard version of referral consult, a the relevant physician/surgeon should see the patient personally but yet some of the them do the consultation over phone or via communication app.
We had complaint multiple times regarding the setting and now finally our Boss had it….Hopefully some change will be done in the future..