Life as a Housemen in Malaysia

1st posters

Assalamualaikum and what is up people..!

Im back to writing a blog after 5 years since my last entry? So guess what, Im currently in my last and final posting of my housemenship ( surgical ) training and boy do I have a lot to tell. This entry is specially written for those of you who are thinking of doing medicine, who is already a medical student, and most of all those who are awaiting their housemenship. Sit back, relax cause its gonna be a detail breakdown. 

A little bit of my background. I wasn't the brightest during UPSR got 3As 1B 1C ( sains for gods sake ) but that was because of a language barrier. See I didn't quite understand Bahasa initially as I was brought up with English being my mother tongue. So went on to PMR got 8As and SPM 9As. Decided that going to matrix wasn't an option as they have tight rules like curfew and can only go out on the weekends. My god..! I had enough of that so I went on to Asasi Puncak Alam for 1 year. If you are currently at this stage or A levels, try your best to score and get that 4.0 flat CGPA cause students now days are smart. But with that in mind a few of my friends still got into medical school despite not having a 4 pointer because your interview is EVERYTHING. So 5 years in medical school in USM Kubang Kerian Kelantan and it was awesome! Graduated and waited for almost 1 year before I got my HO placement.

1st posting medical - peritoneal tapping during post call

Housemenship
Placement
The question I get ask a lot is that whether one should do it near or far away from their family. Until now, I still do not have the answer and it really depends on you. My advice is try to get somewhere in between where your HOship will still be driving distance from your family because it will get tough.

Some say that if you do your HO ship in this state KKM will not allow you to be an MO in that same state however there is no black and white regarding this issue except for Klang. Do your research and ask your seniors. Some hospitals are more harsh/malignant and some are more benign but regardless even the most 'so called benign' hospitals here do get extended as well if you really have issues.

However with the new contract system we've been told that all house officers who finish their 6th posting will have to float at their same hospital until they get their permanent post..! That will mean maybe another 1 year max? Who knows.

Postings
Generally which ever hospital you choose, there are 6 compulsory departments that you will have to go through namely

• Medical ( medical based )
• Paediatrics ( medical based )
• Orthopedics ( surgical based )
• Surgical
• Obstetric & Gynecology
• Emergency / Anaethesiology / Psychiatric / Klinik Kesihatan ( choose 1 )

For the Emergency / Anaes postings some hospitals might send you there as early as you completed 1 medical based, 1 surgical based, and O&G. So you will be in those postings earliest by your 4th posting like me. Some hospitals might let you choose which posting you want to enroll 1st but most of the time they will do the choosing.

What are you expected to do as a housemen?

1. Clerk new cases
2. Am, Pm, On call reviews
3. Writing discharges
4. Referrals ( in and out patients )
5. Request for imaging ( ct brain, ultrasound, etc)
6. Set an IV line ( branula )
7. Blood taking ( veins, arterial, blood culture + senstivity )
8. Attend to a collapse patient
9. Assisting in operations especially O&G
10. Clinic duties

These are the top 10 that I could think of. Though no one is expecting you to know all this on your 1st day but be well prepared they will still ask you to do it. That is why your tagging period is crucial for you to learn all these skills for you to be a functioning HO.

Tagging

Usually depends on each posting but generally speaking its from 7am - 10pm everyday for 2 weeks or some even 1 month depends on your off tag assessment by your mentor. It is for you to be a safe doctor and prepare you for your on call later.

Know Your Priorities
Believe me that you will be able to function continuously for more then 24 hours without sleep whether you like it or not. This is the most crucial aspect of being a doctor. For example : you"re on your way to the bathroom after doing dozens of discharges and suddenly the nurse yelled " Dr..patient collapse..! should you continue with your business? Of course not.

A few other real examples that I saw recently was this new housemen came quite early to the medical ward, as he arrived the nurse noted to him " Dr katil 24 branula dislodge " so he attended the patient and attempted twice. That took him more then 1 hour..! Only then did he seek for a senior's help and it was 7.45am and he haven't even started reviewing his patients. Know your priorities. Was the branula URGENT? Simply ask the nurse why did that patient need the branula? If you think it can wait then do it after your rounds.

6th posting surgical - remember to remove your watch..!

CONCLUSION
Being a housemen is no joke. No one understands what its like unless one has endured the journey. Times will come where you wish you shouldn't have picked medicine or you wish to open a kedai runcit instead of being a Dr. But always always remember why you chose this path, do it for the sake of your patients, do it for yourself. Find the sincerity in your heart to do whats right.

BODYBUILDING for DUMMIES

"I'm not telling you it is going to be easy
I'm telling you it's going to be worth it "

Assalamualaikum (May Peace be upon you)

I'm sure everyone of us have stared in the mirror admiring those side fats or spare tires or even some nice flabby stomach action when you wear something tight and then you go saying something like 

" ITS TIME TO CHANGE MAN "

" ITS TIME TO TAKE MATTERS INTO OUR OWN HANDS "

" I WANT MY OLD HIGH SCHOOL PHYSIQUE BACK "

If you are anyone of the above, reading this article may just get you one step closer to your goals. I'm going to break it down as simple and as general as I can so you guys can have a clear cut about the basics of bodybuilding. Just so you know I am not a professional bodybuilder and everything is based on my experience and some reading. I find it quite easy to bring up or down my weight within a range of 8-10 kg's with my training program. No harm sharing the knowledge and ways that I have just for the sake of helping others.

First of all by definition bodybuilders are people who lift weights in order to build strength, endurance, shape their muscles and maintain a healthy lifestyle. So yeah my 6 year old niece at home picking up my dumbbell can also be considered a 'bodybuilder'.

Commonly when people talk about losing weight or fat, the first exercise that comes to their mind isss ?? JOGGING... jogging (cardio) is a great way to lose fat not to mention MUSCLE MASS too.

I personally don't want to end up like the guy on the left due to muscle catabolism ( breakdown ) because of too much cardio.

which body do you prefer?
Marathon runner or Sprinter?

Lifting weights have become something exclusive for muscular people with HD abs huge arms and stuff and this phenomenon somehow causes inferiority complex among those who are out of shape to hit the gym or even step inside one without feeling shy.

" If you know you're out of shape, all the more reason for you to be in the gym than anybody else "

PREPARE your MENTAL first before reading any further : 

• don't expect overnight miracles
• takes time, focus, and consistency
• set realistic goals
• consult your physician if you have a medical problem
• start off SLOWLY
• get ready to change your physique..!!

Now lets get down to business. Once you're mentally prepared you need to have an over view of your training style from A-Z and I'll walk you through it.

Body types

Generally there are 3 different body types :

Ectomorph  - extremely thin with a very fast metabolism

Endomorph - usually overweight with a slow metabolism
Mesomorph - athletically build and usually classified as an easy gainer

So which one are you?

The reason you need to know which category you fall in is because it will help you create a training program that is suitable for your body type and help you get closer to your goal.

Workouts

I'm no expert I can tell you that but I can share what i've been doing and what works best for me during this couple of years. So here is how I break it down

those CALVES...!!

• saturday - shoulder & calves
• sunday - biceps & triceps
• monday - national chest day 
• tuesday - back & forearm 
• wednesday - 
• thursday - don't skip leg day
• friday - rest

If you notice wednesday is empty and thats actually the day I work my other body parts which are lacking behind or i'll just have good quality rest day (lazyy)

Now off all the days listed, take a wild guess which day is the most important in my training program?

Its FRIDAY - REST DAY

Bare in mind that your muscle fibres ( micro ) are torn in the gym but grows when you're sleeping or resting. Its very important to have adequate rest to give a chance for your muscles to recover and become stronger.

Now for beginners I would recommend learning the form first of any exercise before hand whether through youtube ( I find it much useful ) or ask a friend who knows what he's doing in the gym to give some pointers. Secondly is to get the 'feel' of the movement that you're doing so that you're comfortable. 

What you MUSN'T do is go into the gym and lift as heavy as you can. This is what I often see in the gym. You will not gain anything from it rather you're risking yourself to injury. People tend to show off in the gym by lifting as heavy as they can with horrible form. Proper form and technique should be used to maximize your gains. 

It doesn't have to be SUPER heavy as long as you get 8-12 reps (repititions ). In this field you do not want to get injured AT ALL trust me cause once injured it will be nasty and takes some time to fully recover. So stay SAFE!

" Do Not Sacrifice Form and Technique at All Cost "

There are a few patterns of workout you could use for example :

• Pyramid set - start off with a fairly light weight get 8-12 reps in then rest for about 1 min then pick up a heavier weight. In this workout pattern, its best if you could get 3 sets whereby the last set will be your heaviest weight and rep out as much as you can ( muscle failure ). Pyramid set is usually beneficial to put on muscle mass first before you can shape it. 

•  Drop set - it is the opposite of a pyramid set. Usually I will use a combination of pyramid set + drop set. For example my heaviest weight would be 60 kg I would rep out as many as I can. Then i would take off 2 plates leaving 40 kg on the bar and rep it to the max. The same process continues until you're down to your last plate 10 kg or even 5 kg sometimes. The reason for this is to BURN OUT your muscles. Its like squeezing your wet towel after washing it real hard. You want your muscles to be drained off energy.

• Super set - its basically a back to back exercise without rest. For example a bench press straight to pull ups or dumbbell curls straight to barbell curls. It can save a lot of time and can cause muscle confusion which is a good thing so that your muscles won't get used to a certain exercise and stop growing.

But for beginners I would strongly recommend trying the pyramid set first then work your way up in weights get proper form & technique before you try any advance program.

Nutrition

Now to support your new and active lifestyle, you really need to review your daily nutritional intake. Find out you basal metabolic rate ( BMR ) online. It basically means how many calories your body burns at rest and from there you could adjust the amount of calories you consume depending on your goal but don't worry too much about your calories. A man's gotta eat right?

What you can do is

• Cut out the junk food and I mean all of it,snacks, potato chips, ice cream, FAST FOOD goreng pisang, ABC, cakes, sodas, candy, NASI LEMAK and the list goes on and on.

• PROTEIN - increase your protein intake from whole food like tilapia, chicken breast ( without the skin ), nuts not forgetting whole EGGS.

• CARBOHYDRATES - complex carbs are always preferable cause your body needs some time to digest it and you won't spike your insulin suddenly. Some examples are brown rice, white rice, oats ( yukk ), wheat, sweet potatoes 

• FATS - don't get your hopes up im talking about the good fats like omega 3 and 6 DHA and EPA. You can get these from oily fish like salmon, natural peanut butter or like me I get some fish oil supplements. The good fats are the HDL and stay away from saturated fats.

• FIBRES - eat your greens and your fruits to maintain a healthy gut and it keeps you full longer with much less calories not to mention the vitamins you get from them. Furthemore fruits are delicious.. thank you Allah..!!

• WATER - always drink plenty of water everyday especially when you're in the gym. Water will spike your metabolism in the morning when you wake  up for your subuh prayer and you feel wide awake. Its the most cheapest product and by far the most important one of them all.

Dieting doesn't mean starving yourself to death. It doesn't mean vomitting everything back out after you've had your meal but the key word of dieting is to CHOOSE your food wisely. 

NEVER starve yourself in order to lose weight because thats exactly the opposite of what you're supposed to do. When you stop eating your metabolism drops dreadfully its like an engine without gas. Our unique body that Allah has granted us will always try to adapt to a certain situation. In this case when you stop eating, your body starts thinking that you're out of food and you're really starving to death in the middle of the desert. So your body will hold on tight to your fats as a reserve fuel and energy for your body to survive. The best thing to do is to eat frequently 5-6 meals a day with the right proportion so that your engine has all the fuel it needs to burn all day long. One more important thing to know is that you can't target fat loss at specific area like tummy or side fats. The only way to get rid of those fats are to reduce your overall FAT PERCENTAGE.

" No More 3 Big Meals like Always  "

My roommate is so LUCKY..!!

 Rest

This is the last part of your training. Don't get me wrong but eating and resting is part of your training too. Have enough rest 6-8 hours of sleep but I get 10 which is not good and I miss my morning lectures =.='' 

Lastly never ever put an EXPIRY DATE on a journey like this for example i'd train for a year or let me go on a diet for a month. Ask yourself what will happen when you've reach your dateline ? Bodybuilding is My lifestyle and it can be yours too only if YOU choose it to be..GOODLUCK..!! 

WHY EGG IS A MUST IN YOUR DIET..?

You eat 40 whole eggs per week. 5 to 6 eggs daily at breakfast. You eat them with veggies, really like them and feel full of energy at the gym each time your day starts with an omelet. Well i wish my harmony cafe had omelets.

But everyone tells you you're crazy eating so many eggs. They tell you eggs are unhealthy because they're full of cholesterol. You'll clog your arteries and die if you continue. Sounds familiar? Truth or myth? Let's see.

Once demonised as bad for the heart, eggs have been repositioned as a health food in recent years as researchers have found that not only are they good for hearts, but can even help you to lose weight.

an Egg-ceptional Super Food...!!

Nutrition

Renowned for their high levels of protein and calcium, eggs contain a number of important vitamins and minerals as well. A single large hard-boiled egg has only 78 calories, but offers 6.29 g of protein, 200 mg of cholestrol, 25 mg of calcium, 0.59 mg of iron and 112.7 mcg of choline. It contains 22 mcg of folate, 260 IU of vitamin A, 44 IU of vitamin D and 176 mcg of lutein and zeaxanthin, as well as small amounts of many of the B-complex vitamins.  Yeah i know all this boring stuffs right but what you really want to be concerned is the amount of calories and not to mention the amount of protein!

Realize that much of the cholesterol is located in the yolk of the egg. The yolk holds the calories, fat, cholesterol, but unfortunately, the taste as well.

" Eat the yolks, they contain pretty much all the nutrients! "

Why People Say Eating Lots of Eggs is Unhealthy

The logic is that since eggs are high in cholesterol, a high egg consumption will increase your blood cholesterol. So by cutting eggs from your diet, your blood cholesterol will decrease. This, however, isn't how your body works.

Eggs contain high amounts of cholesterol. 1 large egg has about 200mg cholesterol and 5g of fat. Almost half of that fat is saturated fat. A few years ago, Bruce Griffin, professor of nutritional metabolism at the University of Surrey, analysed 30 egg studies carried out over 30 years and found eggs ‘have no clinically significant impact’ on cholesterol levels.

Facts on Cholesterol. You can find studies showing that high cholesterol levels will make you live longer and more immune to infections & diseases than low cholesterol levels. More facts:

• Your Body Makes Cholesterol. Your liver makes 3-6x more cholesterol than you can get eating eggs and other animal products.
• Cholesterol is Vital To Your Body. You need it for the production of steroid hormones like Testosterone and to build & repair cells.
• Dietary Cholesterol Isn't Bound to Blood Cholesterol. There's no relation to cholesterol & saturated fat intake to higher cholesterol levels.

However, thanks to more recent research, we now know the cholesterol in food has little effect on our blood cholesterol levels. What really affects blood cholesterol is the amount of saturated fat we eat. This means if you need to lower your cholesterol, the most important thing you can do is cut down on the amount of foods you eat that contain saturates, such as fatty meats, full-fat milk, butter, lard, cream, pastry, cakes and biscuits. Eating more fruit, vegetables and foods such as oats and pulses, which contain a type of fibre called soluble fibre can also help to lower cholesterol.Thanks to this newfound knowledge, the Food Standards Agency doesn’t recommend limiting the number of eggs you eat, unless your GP or a dietitian has specifically advised you to do this.

Aren’t They FATTENING?

In the Department of Health analysis it was found that eggs contain around 20 per cent less fat, 13 per cent fewer calories and 10 per cent less cholesterol than 30 years ago. 

In one study, overweight women had eggs or a bagel for breakfast. The egg eaters consumed fewer calories in the following 24 hours.

Effects of Eating Raw Eggs

Recently i accidentally ate somewhat 2 raw eggs and trust me it ain't pretty. Raw or uncooked eggs pose a potential health risk, especially if you consume them on a regular basis over long periods of time.Eating raw eggs can significantly increase your risk of developing salmonella poisoning, according to the United States Department of Agriculture, or USDA. Salmonella is one of the leading causes of food-borne illnesses in the United States and can cause stomach pain, diarrhea, vomiting, fever and chills. In some cases, salmonella poisoning can be fatal. The USDA recommends fully cooking eggs to kill any salmonella bacteria that may be present.

According to the Linus Pauling Institute, eating raw eggs can interfere with the absorption of the vitamin, biotin. Raw egg whites contain avidin, a protein which binds to biotin in your stomach, preventing it from being absorbed by your gastrointestinal tract. Cooking eggs destroys avidin, reducing the risk of developing a biotin deficiency. Biotin deficiencies are rare but can result in problems such as hair loss and skin rashes.

Cooking raw eggs increases the bioavailability of the protein in them. 51 percent of the protein found in raw eggs is bioavailable, meaning only about half of the protein in a raw egg can be absorbed by your body. In contrast, by cooking the egg, the bioavailability of egg protein increases to 91 percent, making cooked eggs a much better source of available protein than raw eggs.

BOTTOM LINE : " JUST COOK THE EGG MAN...! "

hey eat ENOUGH protiens and you might just end up like this guy..!!

For further reading check out the links below

http://stronglifts.com/cholesterol-saturated-fat-how-many-eggs-daily/

http://www.dailymail.co.uk/health/article-2184650/Eggs-Are-bad-cholesterol-I-have.html

http://www.livestrong.com/article/530941-how-many-eggs-can-i-eat-a-day-without-adverse-effects/

http://blogs.discovery.com/dfh-sara-novak/2012/10/how-many-eggs-should-you-eat-per-day.html

http://www.weightlossresources.co.uk/diet/healthy_eating/how_many_eggs.htm