2024 1st fight final leg part 2.

 

The flight arrived at CKS in the afternoon and we had picked up our car at the carpark. We headed north and the traffic was smooth as most of residents were travelling south back to their hometown for CNY eve. We managed to check into the hotel without hazard and after a brief rest we had roved around the street of T city heading to YiLan Ramen for our CNY eve dinner. The plan was smacked when we saw the door shut with a notice in front of the gate. Nothing to curse as it was CNY, a family day. We had to walk back with the thought of getting something from the convenience shop. Along the road, we came across Yoshioya (donburi shop) which was still operating. The shop was filled with foreigner, Asian and Caucasian…. Stomach was fed and we walked back toward the hotel.

The next morning, we had a late start as the event would be starting around noon. We woke up had grabbed some food along a coffee shop. It was CNY D1 and we had to take whatever was there. We travelled to the venue with MRT and met other church member before we entered the main hall. The event ended late in the evening and I had prebooked a table at a steak house nearby the hotel.

The Tex-Mex joint offered great food and we retreated to the hotel later.

The second day event started early with the holy communion. It ended later at noon and we arrived back to the hotel by 1pm. We had meal at the Kurai sushi shop next door before we headed down south.

It was a long journey; we encountered heavy traffic as it was D2 of CNY aka wife go back home day.

We reached home after 8 hours of driving; double the time than usual.

It was grace for me…. everything was properly arranged; I couldn’t bare to think the deep sxxx that I would be in should anything go wrong.

I praised the great one again…  

CNY...inter trip

 

I had told Ving that there would be no harm if we gathered with our parents during the CNY prior to departure of my 1^st flight. The meaning was different and we could enjoy festival time which was different in nature.

The plan was however altered as Ving had found out that there was this Global Chinese Conference organized by the church this year during CNY. Ving asked me if we could go back and attended this gathering during the CNY.

Yun was still stuck with her study and it would be a trio journey for us again. Ving would take the early start with Xian pushing from K city to KLIA 4 days before I head north for a flight to the Lion country. Xian and Ving would later take a flight down south with the Firefly and we would fly back together to CKS at CNY eve. We would then participate the global conference in T-city and headed back south on D2 of CNY.

4 flights for me to book and I need to worry about another trip up north from Kulai to KLIA2 via land(apparently fully booked of flight) on CNY eve -1 days. The 3D2N lodging in T city around the CNY was another challenge as it was very close to the venue and the option leftover was limited.  

All the booking was done within a five days window after multiple loops of checking and rechecking.

Makan tak kenyang , tidur tak nyenyak was best description of my life after my return from the 1^st flight.

There was this case I met 5 days before the journey. A middle-aged handicapped man was run over by a car and sent into the ED by EMT. I was complaining to the Great one about unfairness treatment to the patient. He was a patient with CP and walking difficulty. Apart from that, he was also deaf and had to read lips for communication. I was expecting internal bleeding secondary for pelvic fracture while doing the FAST echography. However everything was negative, he had only sustained some pulmonary contusion on the CT. I had asked the young police chap who came for investigation about the mechanism of injury. The video clip extracted from the nearby CCTV was stunning. The patient was crushed under the wheel of an SUV while heading to the train station after his work.

I did further inquiry after the patient’s father came. They did not have any specific religious belief though. I knew only the Great one could show such grace and I was curious why he had done so…..

I shared the case few days later with Yun and during the conversation, I finally realized that the miracle was actually directed toward me; The Great one just wanted to tell me, he is always along my side. A strange way to present himself, but It was the response from him that pacified me.

I felt peace afterward and stopped to worry about the journey. 4 days after Ving and Xian arrived at KLIA2. I started my drive up north. It was a warm morning and I managed to secure everything in the house and double check all the windows and doors before I hit the road. I stopped by at clear water R&R and bought some biscuit/snack. The temperature had dropped below 20C and I had put on my jacket while I wandered around the R&R. It was a brief stop, I continued my journey and reached DaYuan by noon. I had stopped by a food joint hoping to get some bread so that I could eat during the flight but all I could only settled with Taiwanese bread which I did not favor of.

I parked my car at a private parking lot nearby the airport as I had failed to book a lot at the airport parking area. It was winter holiday then and peak season for travelling.

I had arrived early and the counter of Scootair was still closed. I was lucky enough to find a corner around waiting area and taken a good nap before the counter checkin begun. The security check and document check was smooth and I was still able to find a seat at the dining area for a quick lunch. The red wine beef stew with rice was up to the standard but yet my anxiety prevailed.

Scoot was considered as low cost carrier and the menu offer nothing special and it was very expensive so I decided to skip the meal at 30000ft (reason that I bought the bread). The flight was a smooth one and I landed at T3 on time. 

My sis in law and mother was waiting for me and it took us about 1.5 hrs to arrive back home.

As I promised myself during my last trip for a nice BKT; I had brought my parents down south to JB to have a trial at the Hockien style BKT at Skudai. Sub-par to my standard but yet still acceptable, no fish prawn also ok la .

Ving and Xian arrived the same night and we spent 2 uneventful days around Kulai. The Trip to Kota Tinggi was postponed due to flood and rain. It was a place that I had fantasied for a long time. I wandered if I would I have a chance to visit the place in the future…

During the stay, we had visited a Malay night market nearby and I found that Malay food providers had greatly improved since my day in KK. Apart from the traditional food/cake, I had seen many new type of food added to their sale. I was lucky to lay my hand on the famous coconut shake and lots of goodies...

One thing that haven’t change; Chinese were still unable to mixed with Malays around the southern part of the peninsular; we were the finger countable Chinese that patronized the market

It was a short stay for us and we had a pre CNY eve family dinner at a Teocheow restaurant before we left; special food but yet not my cup of tea. It was the first time I had eaten such dishes and I thank my bro for setting it.

My sis in law had booked a minivan for us that evening and we left Kulai at 4pm.

The driver sprinted the Granvia like it was it’s last cruise. We managed to arrive at KLIA2 Tune hotel by 8pm even with the jam and 2 stop at R&R during the journey. One of the most expensive ride I had paid(incl the surcharge for CNY) but yet it was the only option that I had as no flight was available on that day.

After check-in to Tune hotel; we had wandered to KLIA2 seeking for dinner.  We had stopped by the food court and I had ordered mee mamak goreng from the food stall manned by Indonesian. I can assured you that it was the best mee goreng mamak that I had for the last few years.

The Tune hotel breakfast was a satisfying one and we managed to have a last tap of Malaysia yummy before we headed for the check-in. The first part of the daring trip ended when we boarded the flight….the next thrilling part awaits us at the other side of the world.

2024 1st fight final leg part 1..

 

The stay in the Boleh land was a slow one for me. My primary duty was to serve as Ving’s driver. Ving had several errands to run; accompanied her parent and visiting her aunts and uncles.

I had used up the some of the time upgrading my bro in law’s wifi. The internet service provider and supplied him with an entry level router and the connection sucks! I had toured around the shopping mall nearby and bought a DECO MESH combo.

I had upgraded my house with similar system few months ago and the connection was excellent and easy to install. The ASUS router was actually my favorite as it provides great tunning capability for NAS and CCTV setting. However the ASUS’s MESH was something that one need to live with it….

The DECO had proven to be a more convenient system and cheaper to implement. I had acquired a WIFI6 2 pcs MESH system and started the installation. It was more than 20 hours later with many trials and errors before I get the green light permanently light up. There was no instruction with the setting of parameter regarding the TM and DECO combo.

The result was exceptionally satisfying as the connection was markedly improved after the installation.

During this period I had visited the book tunnel bookstore near Setia Alam. A great bookstore located in a visitor lacking shopping mall. I hoped that it would still be there during my next visit.

Xian and I had discussed a lot regarding his plan in the future and he had evolved and it would not be a problem for him to attend any graduate school. Every stage of his learning process was a struggle to us; we had hesitated to send him to a normal kindergarten initially. After that, we had discussed the option of delaying his entry to grade 1. After the first few years as an initiate we enjoyed a few smoothly going year until the stage college selection. With grace from the great one, he had gotten what his wished for. Finally the solo ride in the college begun and he is now staying alone in a hostel and being a valuable asset to his team in the college…. Every step was crossing the limit and boundary that beyond our imagination.

I had patroned a few food joints and most of them were not compatible with my tongue; 2 of them were chain BKT.

I sworn I would try my best to lay my hand on a decent taste BKT on my next visit.

It was raining season and I had met a few flash flood during my drive. Heart pumping session for me but it was norm for the locals according to my in law….

It was a satisfied journey for Ving though, we completed most of the errands and the seniors of the family were happy about the arrangement.

The cashless life was another gained during this trip. I had installed the TNG e-wallet app and started my scanning and paying life after seeing my bro in law using it to buy goreng pisang at the local afternoon bazaar. Well, it was a great experience and I did not increase my load of syiling after this trip.

The trip ended 6 days later; it was an afternoon flight where we enjoyed an afternoon tea break at the Ya Kun with my in law. Frankly said, KLIA1 is improving but KLIA2 was still top notch for travelers.

The flight with China airlines was smooth and we reached CKS late in the evening followed by a safe trip back to K city with some hiccup.

We reached home by 11 and I headed to work next day after a short nap.

Our next trip was scheduled 2 weeks later and it would be a complicated one for all of us….. It had haunted me for the next 10 days until I realized about what was waiting for me….

The 1st fight of 2024 - the start

 

The return of Dragoncat to the Great one’s embrace had alter our plan during January.

I had decided to join Ving and Xian for the trip returning to Bolehland during mid of January. My joining would lift the burden of travelling for them.

We had to settled with the flight departing up north as the double A flight departing from K city was fully booked.

I had booked an afternoon flight so that we could travel up north with the HSR early in the morning.

The journey preceded with a night shift in the ward; K had agreed to cover for me in the ward for 2hours so that I could leave by 6am.

I reached home and picked up Ving and Xian by 7and headed toward HSR station. We managed to park the car at the train station which situated next to the HSR station. The parking fee is 3 times cheaper than the HSR station parking. It was a simple journey as I had trailed down this route few months ago with Yun to Bangkok for an IDPA shooting event.

We reached TPE airport by 10+ and I was shocked when I saw the big screen at the departure hall. The MH367 would be delayed to 9pm. I scanned over my phone and found that an email was sent to my mailbox at 4am informing the delay and I had ignored it. While 3 of us was discussing where should we spend the 7 hours, the counter had however opened as scheduled allowing us to check in our luggage. The counter staff had also announced that they would arrange a hotel for us to rest while waiting for the departure. It was not the best news of the day though. We had checked in our baggage and headed for our lunch. I had to called up the car rental company informing my delay and rental company had however to me that they would be closing by 10pm and I could only pick up my car the next day. I instantly cancelled the booking but however I received another mail from HAWK stating that my booking for a BRV was approved and asking if I wish to proceed with the booking. I called up HAWK and told them my situation and they told me that they had tracked my flight and would wait for me with a surcharge. Definitely the best news of the day under such hazard situation. After our lunch, we had gathered back to the MH counter and were directed to a coach. We were ferried to the Hotel Orchard Park nearby the airport. A voucher of 500 for each person was provided for dinner. The hotel was 4 stars grade with great bed and facility. We take a good nap and awaking up by 5pm. The flight was however delayed again till 9:40pm when we arrived at the airport by 7pm. It was supposed to be relaxing path but the airport was packed. We were urged to hurry to the security check point and it took us 2 hours to complete the task. It was 9pm when we reached the gate just before last call of the flight was announced.

We had used the vouchers to buy cakes/gifts instead of buying any lunch/dinner.

The flight took off at 10:30pm with our empty stomach.

I swept through what I gathered from the net and found that the MH366 was delayed due to unknown reason. The original flight from Jeddah to KL had reached KL 3pm and its next flight under the flight MH366 was scheduled the next day at 9:20am. It did not take off though.

The red eye flight was uneventful and we reached KL by 5+am. The airport was emptied and the connecting train to the satellite building was still out of service(it had been more than 1 year and it would take 3 years for a replacement)

I picked up the BRV and headed to my in law’ house. The early morning drive was smooth and the feeling of driving to work from Klang to Tg Malim early in the morning had stormed me again. It sucks really driving a underpower car with poor maneuverability (yeh, I am spoiled by Fefe after all those years).

It was the first time I had met such delayed of flight; however MAS had provided an excellent service to arrange hotel for us to rest. If we had been flying with AA, we would be on our own during the delay.

HAWK rent a car was another great service provider; they were the only rental company who provide BRV. BRV is a great car even though with its poor control and noisy engine setting; it’s spacious luggage and 7 seaters capability was definitely a plus for traveler.

It was not an easy start but it was smooth thereafter…

The end and start of journey

 I had always been a pet lover; raising pets were like raising kids to our family. Losing each of them had been a big pain for us. The leaving of Fatty and Titi was two major event during our life. I knew that it would be intolerable when the Dragoncat’s day come.

For the past 3 years, Dragoncat condition had deteriorated slowly. Her spine problem had become worst and slowly she lost her ambulatory ability. We would bring her around in a cage initially and later as her back condition become worst, we would carry her in our arms whole day.

Ving had given up the chance of going back to Malaysia during CNY and we had tried our best of staying with her, comforting her. She could no longer feed herself and we had to spoon fed her. She was in no pain and no fear as her appetite was good. She had been tamed like a domestic pet instead of being a prey. I knew that the day would come sooner and later and Ving had hoped that she would returned to the land peacefully in her sleep.

As my in law condition was fluctuating, Ving had however decided to pay a visit back to Boleh land earlier this year. I had arranged a window of 1 weeks so that Ving could go back for a visit. I would look after Dragoncat with the assistance of Yun during the period while Ving is gone. 10 days before the departure, Dragoncat had started to show sign of shortness of breath. The visit to the Vet had confirmed my suspicion, she had probably pulmonary malignancy leading to her respiratory failure. I knew before the consultation but yet at the time the Vet broke the news, I was still unable to control my tears….. We had to put her to sleep as only in the ICU box, she could maintain her O2 saturation. There was no way we could carrying her in our arm while giving any oxygen supplement. The decision was simple and straight forward then…

On our way back, we bough a few oxygen can for use on the returning journey and rented an oxygen machine. We decided to keep her one more night and summoned the kids to share the last night with her. At the grace of the great one, it was the last day for the school final. We picked up Yun and Xian on our way home.

I held her in my arm with the oxygen tube beside her nose that whole night. She slept well with all of us gathering in the living room with her that night.

The next day, we had taken her to the Vet as scheduled. We gathered around her during the final journey. She slept peacefully after the intramuscular sedation was given. We bid farewell to her and completed the final prayer thanking the Great one for his Grace. The sadness was beyond description for all of us…

We headed to the crematorium and the ritual was completed later that evening.

We had been through many events with Dragoncat. I complete level 100 as sorcerer in D4 during the last season with her in my arm. Ving had been pampering her whole day for the last 1 year and we had treated her as our third child. We had traveled with her thousands of kilometer during the 2 years; we had taken her north and south visiting Yun in her university and other places. She would show a smile after she had a good meal and we shared her joyfulness with her. She had been the longest living rabbit with the most travelling mileage in the island….

She did not leave us as in the way we had hope for however the Great one had arranged everything to pacify ours grieve in another way.

We had the chance to gather around her for her last journey; if what had gone as we hope for, she would had left us suddenly and the pain would be much intolerable…..

Crow mouth....

 

 

After years of practice, most of the physician would have some instinct/experience guessing diagnosis with only a small piece of history of findings. Most of the time you would be happy that you have gotten the correct diagnosis….

K was sitting with me at the desk and a 10 years old girl had sent to his side by the local rescue service. The complaint was right thigh deformity after fall during a basket ball game.

While the patient being sent for imaging, I had chatted with K and told him that most probably it would be cancer(osteosarcoma most probably) as the impact during a basket ball game is not strong enough to break a 10 years child’s femur.
Well, I regretted what I had said instantly and loaded the film once it showed up at the imaging list… Crow mouth I had…

K notified the orthopedic surgeon and after reviewing the image, the surgeon had told K to refer the patient as she would need to be managed by a multidiscipline team in a tertiary medical facility.

No one wanted to break the bad news, K had to tell the mother that the fracture is complicated and need to be managed by orthopedic surgeon who is specialized in that field.

I had regretted sharing my spot diagnosis….10 years old girl with a total hip amputation and a long course of chemotherapy waiting for her; even with such aggressive treatment she is still facing a 30% 5 years survival rate….

The incident had haunted me and I had paid my price during the level 3 IDPA competition 2 days later....

Trust no one.....

 

The central line insertion was definitely a heart pounding procedure for a medical trainee during the first few years of their training. The localization of the central vein is the most challenging part especially for patient with thick adipose tissue.

The introduction of ultrasound into ED practice had eased the process and raised the successful rate of central line catheterization.

Most of my young colleagues practice the actual ultrasound guided method, but I usually used the ultrasound to confirmed the position of vein and proceed with the procedure using the traditional method. We got a small amount of incentive if we use ultrasound to guide our catheterization. I am more confident during the venous puncture part as the imaging had given me a rough idea of the position and size of the vein. 

The catheterization was always a one man show until recent few years, the head of department had wanted the surgical aide to assist in the procedure as someone would need to hold the probe during the puncture. Well, as I did not use the probe during the puncture, frankly said, I am not very particular about having an assistant. However with an assistant, the secure with stitches part would usually be done by the aide and I would left the scenario early after fully insertion of the catheter.

I did remember in the past that one of my senior had told me that when the catheter is inserted down the guide wire, we would need to make sure that the tail of the wire is visualized and properly grabbed hold on so that the wire is not fully inserted into the center vein which might need a vascular surgery to extract out the wire.

I had always being cautious and would teach my staff that the tail of the wire needed to be secured by the operator before the catheter is fully inserted.

All of our surgical aides knew the rules as I had always insisted that part is clearly done.

However, few months ago, one of our junior colleague had met the worst case scenario above mentioned.

It was an easy femoral puncture and our junior colleague had left the table prematurely after the guide wire was being inserted. The insertion of catheter was left alone to our senior surgical aide. The wire was not secured before the catheter was inserted. When the aide noted the wire is not seen at the tail of the catheter; he got panic and removed the catheter immediately; the act had left the wire fully inside the femoral vein. What he should have done is to clamp the catheter with a forceps and remove the catheter hoping the wire would be removed with the catheter.

When notified, our junior colleague however was bold enough to do a small cut down with the aid from the senior surgical aide. The wire was noted and removed from the femoral vein without complication.

It was a heart pumping scenario which was compensated without a scratch.

When my junior colleague told me about the incident, both of us sighed and agreed that it was an narrow escape.

The surgical aide was senior enough and capable enough to perform many procedures ….but yet accident do happens..

My conclusion -----“Trust no one”