RAMADHAN KAREEM

Bismillahirrahmanirrahim. 

Assalamualaikum.

wahai orang-orang yang beriman, puasa diwajibkan ke atas kamu sebagaimana ia telah diwajibkan ke atas umat sebelummu, agar (dengan puasa itu) kamu menjadi insan yang bertakwa. (Al-Baqarah 2:185)

Alhamdulillah. Ramadhan insya Allah bakal tiba lagi untuk tahun ini. Semoga kita semua mendapat keberkatan dan rahmat daripada Allah. Selamat berpuasa kepada semua.  Semoga tahun ini lebih baik dari tahun sebelumnya. 

kenangan berbuka allied sisters di padang mpk sebelah masjid sultan ahmad shah kuantan

kenangan ramadhan berbuka di rumah hazirah aka nek guru aka kaklong di kerteh. sedapnya bubur lambuk emak kamu babe.

kenangan ramadhan allied health sc final year 2010 troop di sate zul kuantan

kenangan malam ihya' ramadhan allied sisters di musolla sister

she is one of the regular imamah di musolla blok g. selamat menempuh ramadhan di perantauan kakak.

 Ramadhan kareem.

Allahu Akram. 

THE STORY OF MY DIETETIC COUNSELING

It’s the world hepatitis day peringkat Hospital Selayang last Friday. And of course, they ask dietitians to open up a dietetic consultation booth. Its only been about 2 months I’ve been working in Selayang Hospital, and they have organized several events that involved diet consultation. Last month was for Hari Tanpa Tembakau.

me and cik elly diet consultation for hari tanpa tembakau hosp selayang June 2011 -pix taken from ben's fb

Personally, I did enjoy give diet consultation to people, for I always love community programme. Perhaps for some people it seems lame or boring or tiring, but from my point of view, it is one of the best ways to convey and disseminate the message to the public –healthy eating. Ever since study time, whenever there is health exhibition programme, diet booth always win –I mean it always has the longest queue, and the same happened here. Sorry pharmacy booth ;) And I love seeing how eager ppl are to learn about diet yeay! ;)

long queue for diet consultation. see counseling kat sorang, yang lain pon nak dgr -pix taken from ben's fb

Looking back to the first person I ever counseled, I think it was during Medex’07 (Medical and Allied Health Sciences Exhibition in conjunction of Convest 2007 at IIUM Gombak). That was our very first community programme. We were in our second year. At first I was avoiding myself from counseling work, only did screening part (measure weight ht body fat bla2). I was not yet ready to give diet consultation. But witnessing few of my friends who were very good at counseling did trigger me. So I tried one –and yup I like it! And Diet booth won the best booth for the programme. Yeay again!!

When we started our clinical year, my group was first posted at Klinik Kesihatan Bandar Kuantan Bukit Sekilau. Bukit Sekilau Kuantan is a Chinese community (I think so, because there are lots of Chinese pt there). Thing about Chinese ppl in Kuantan is most of them speak Cantonese, neither Malay nor English. Hence diet counseling there is quite challenging. You have to simplify ur words but at the same time not to forgo important part of ur counseling. Its always funny to see how enthusiastic we became to ensure pt understand what we are saying. One of my friend when counseled those type of pt, she will transformed into a kindergarten teacher, as in counseled the pt like he/she is a kid. And yes I have flaws too. When I happened to have Chinese pt who doesn’t really understand Malay or English, I always speak loudly. Yup it’s a habit. Haha. Funneyh because my friends said they can hear my voice across the hall, and excuse me Ija they don’t understand Malay not deaf ;) Well among the so many patients that we’ve seen there, there is this uncle that I still remember clearly. Here goes:

Me: Uncle, bile ade kencing manis, buah pon kena hati2 makan. Sbb buah pon ade gula. Kita sarankan makan buah 2 kali sehari, tapi kena ikut saiz hidangan (yadda yadda and tell d pt serving size of fruits)

Uncle: Ooo itu mcm ya. Itu buah cempelak pon boleh makan lorr?

Me: Cempelak??? (after few seconds I got it –CEMPEDAK!). Oh itu cempelak pon boleh makan uncle, tp kalau nak makan sekali makan boleh makan 4 ulas saje, x boleh lebih nanti gula darah naik.

Uncle: 4 kecik itu??? Itu lekat kat tekak saja mehhh!!! ~and then we both laugh~

Haha incident uncle cempelak will be a story that I’ll remember forever… 

at KKBK Bukit sekilau, Kuantan. tp ni gmbr grp community, bkn clinical. -pix taken from mazu's fb

Anyway, giving diet consultation gives us a mixed of feeling, depending on the patient. There are ppl who really eager to listen to our advice and ask question, hence will bring smile to our face. There are ppl who don’t even bother to listen, thus we’ll be demotivated (hey u don’t want to help urself in the 1^st place so why shud we bother?). Sometimes there is pt that share secrets and ask for opinion. Tough huh, kena jadi counselor pulak. There are also arrogant ppl, that  are so full of themselves, think that they know everything, and question our qualification  to advice. These ppl? Increase BP mehh (attn: pt kakzam ;)).. There are also flirtatious, funny, sad, problematic, etc. Ada yang bila kita buat public diet consultation, kite consult sorang, yg lain berkerumun nak dgr sekali. Ada jugak  yg nak jodohkan kita dgn anak dia (lol), and many many more. 

But regardless of what type of patient they are, we, as dietitian, will try our best to give diet consultation appropriate to their health condition. Diet consultation is very individual, thus there is no exact script that we can memorize. Of course the guidelines is there, but still we have to build rapport and make sure the dietary changes that we want them to implement suit their life, not just syok2 sendiri. Because we want the dietary changes to be implemented for life, not only for few weeks prior to counseling and boom, relapse! 

Well, to end this story, a funny story during diet consultation Hari Tanpa Tembakau last month:

Miss A: Dik, akak ni, ada problem ni tau. Bila akak ketawa je, akak rase mcm semput. Rasa nak putus urat. Ada diet yang sesuai x dik untuk elak putus urat?

Me: Huhhh???? (monolog dalaman: what the hell diet putus urat???)

kite ngn kak elly hari tanpa tembakau -pix taken from kak elly's fb

 So fellow dietitian friends, if u read this, ada diet untuk putus urat x? lol!

MENSYUKURI NIKMAT SAKIT

Assalamualaikum.

Hello all.

CERITA SAKIT

I’ve been sick for about a month. On and off. Nausea, vomiting, headache, cough. And being me, I am not a big fan of seeing doctor. So it took me a good 3 weeks of sakit-tak sakit-sakit balik cycle to see one. Yesterday my sister brought me to a GP. The diagnosis? Quite a lot I tell u. 

1.      Left eye conjunctivitis –I believed I got infected from a pt. I did diabetic counseling to him on Friday. And he happily opened his eye protective gear to listen to me and looking at the pamphlet. Aissh laaa..In my 24 years of living, this is the first time I got sakit mata. Thank god its not itchy or watery or what not. Just feel like there is a layer on my eyes. And its not that comfy. Anyway as I am staying at my sister’s place at the moment (sori sis sakit je dtg umah awak L), I bought this nerd spectacles to protect little syauqi from being infected. Pretty cool huh? Hehe.

muka budak sakit cuba jadi nerd. see my infected  left eye?

2.       Gastritis. –the GP said that it is acute. But still, no more spicy and oily foods in the meantime. This is so heartbreaking, u know, being a big fan of spicy foods. A friend of mine already predicted this before, based on the sign and sx –vomit after eating. I think the peak of this problem is when I have a dose of caffeine last Thursday. Its been quite a while since I drink coffee, but I was really sleepy that day. So I bought a can of coffee that morning. Caffeine, as you know, is a stimulant. It could increase production of stomach acid, hence can worsen symptoms of gastritis. Right after I finish the good 1 can, I felt dizzy, my hand trembled, and of course, nausea. Then on the afternoon, off we went to get lunch at Selayang Baru. I tried to ignore the nausea feeling, ordered Maggi goreng. It was delicious, but of course I cudnt finish it. Still, I ate few chilies ;) And then, boom! As soon as I arrived office I vomit out all my stomach content. Rase nak mati masa tu, sakit.

3.       GERD –Got this secondary to gastritis. So adik2, how it happens? Lets recall the pathophysiology. Gastroesophageal reflux disease (GERD) is a condition in which the stomach contents (food or liquid) leak backwards from the stomach into the esophagus. This action can irritate the esophagus, causing heartburn and other symptoms like vomiting. Eh akak x hafal pon copy paste dr pubmed health je ;). So in my case, I really did vomit a lot this month. Vomiting sucks! U’ll experience heartburn, sore throat and not to mention the exhaustion that u feel after such episode.  It took a lot of your energy. At the moment I cudnt tolerate much food at a time. Has to eat small and frequent meal. Anyway I am LOA now, so I don’t really eat pon. Mute point kan. Hehe. But I did force eat now, for the purpose of taking all the meds. Aigoo..

4.       Throat inflammation and fever –ye la, since eat very little, sakit2 lagi, immune system pon compromise la. But the sore throat is killing me. Its hard to swallow foods. It just make the other problem worst. Dah la x selera makan, nak paksa makan pon tekak sakit. Haii laa.. 

CERITA PENGAJARAN DARIPADA SAKIT

Anyway, we hear people said about remember 5 things before 5 all the time. In fact we remember them well: sihat sebelum sakit, muda sebelum tua, kaya sebelum miskin, lapang sebelum sempit, dan hidup sebelum mati. But it is always easier for us to remember those magical reminders when we already experience the later things.

Dah sakit baru ingat nikmat sihat. Dah sakit baru nak ingat Allah banyak-banyak. Dah sakit baru nak memohon kat Allah sungguh-sungguh. Tapi itu adalah pengajaran daripada sakit ini yang perlu kita fahami. Sakit itu nikmat. Bila sakit kita lagi banyak beristighfar, mintak ampun kat Allah. Bila sakit kita jadi lagi dekat dgn Al-Muhaimin. Bila sakit kita lagi banyak berdoa kepada Ar-Rahim.  Dan kerana itu, saya mensyukuri nikmat sakit ini.

"Dan kami menguji kamu dengan kesusahan dan kesenangan sebagai cubaan; dan kepada Kamilah kamu semua akan dikembalikan" (Surah al-Anbiya’ ayat 35)

Mohon doa dari semua, untuk kesejahteraan dan kesihatan kita bersama. Amin. 

Ija,
Menulis di kala sakit...dan lapar...

p/s: always adviced pt who are LOA to always try to eat, as u hv to hv enough energy and protein to combat ur illness. But when u are in their shoes, u’ll know how much they suffer. Another lesson learnt from this sickness.

WORDLESS WEDNESDAY: YESTERDAY

es soda gembira. mmg gembira meminumnya *happy2*-image google

favorite saya adalah nimrod. die senget dan haywire dan x stabil asyik langgar org je. supercute!

p/s i still wanna put some words on the pix hehe ;)

MAY THEY REST IN PEACE

Assalamualaikum.

One of my patient was dead over the weekend.

it sucks. not a good way to start a new week.

He had multiple problems and complications -ESRF, HPT, DM with micro/macrovascular complications, cancer, and CVA.  i planned an enteral regime for him with Nepro.

over the time i saw this pt, his children were always around. but this one son, probably 1 or 2 years younger than me, lets call him M, was the one who is always there most of the time.

in one of my follow up visit, his face was tight. the father keep on asking M to remove 'his shoes' because he felt numb. truth is there were no shoes. M told me that his dad has been requesting that since last night. and he keep on telling his father that there were no shoes. i cud sense that he is trying so hard to control his patience. the voice was slightly raised, but he keep on aswering to his father's request. i told M, his father might feel numb bcos of microvascular complications of DM, or probably bcos of the edema. and then he sighed. a long, tired, sad sigh. it was slow, but i cud hear him clearly. 'bawak byk2 bersabar'. i told him, slowly. he looked at me for several seconds, took a deep breath, turn to his father, look deeply at him, and slowly said 'abah tak pakai kasut. dari semalam lagi abah tak pakai kasut. takpe biar M picit ya' and then slowly he rubbed his father's feet. standing there, watching that very short father-son moment, i almost cried. i really cudnt stand situation like this. call me hati tisu. call me x professional. i dont care.

he was already in terminal care the last time i saw him on friday. the family members has gather around to recite Quran a few days back. he was pronounced dead on Saturday due to complications of esrf.

i reviewed this pt several times, and i am aware of his deteriorating condition. but i cudnt help myself from being emotionally drawn. it is not good, being attached to ur pt that way, i know...

Semoga rohnya dicucuri rahmat dan ditempatkan di kalangan orang beriman.

Al-Fatihah.

Al-fatihah juga utk allahyarhamah Dr Lo' Lo'. Smg rohnya dicucuri rahmat dan ditempatkan di kalangan orang beriman.

p/s Kullu nafsin dza iqatul maut. Setiap yang bernafas itu pasti akan mati. Peringatan untuk saya dan kita semua. 

A POEM TO A FRIEND

with wawa on my 22nd and her 23rd birthday

She is a very lovely lady

For so many years she has been with me

Coming back from class, she always comes to my room

We share story, happy or gloom

Lying on my bed, we have a little chat

About our future, what we gonna be, things we gonna get

She’s the hardworking ant, I’m the lazy cat

She helps me through hardships, and helps me decide

She is the beautiful rose, I am the bubbly lily

She was born on 12, and I am on 22 February

She wakes up early, only to later on wake me

She is skinny, and I’m the fatty (~sigh~)

She got lots of advices, and the one who listened is me

She looked serious, but always laughed to my comedy

Though we seems different, but that’s made us a ‘we’

For you Nawwarul Huda Zulkefli,

Don’t be sad don’t be gloomy

Because all this is a destiny

For Allah knows better than you and me

I am wishing u all the best, take this as a test

Lastly my dear wawa,

Remember, sabar itu syurga…

Love,

Ija

p/s smg menjadi pn dietitian yg hebat. smg dpt transfer cepat ;)

DIABETIC MX WORKSHOP AT HKL

Assalamualaikum

Hello all.

Its been a gloomy week for me this week, not sure why. Maybe because am not feeling so good with the flu and cough and headache and homesick. Yeah maybe that. And for the past couple of week I’ve been sick –nausea and vomit after eat, could not finish up meal, LOA. Mazuin’s diagnosis? Stress related to just restart working. The only thing positive about it is I’ve shed a couple of kilos. Haha. Ya I know its not a good way of losing wt, but I did anyway lol!

Well I started this week with a diabetic management workshop in HKL. Went there with Cik Jun (housemate cum colleague).  Met great dietitians/teachers in HKL (I did my professional clinical attachment there) –Dr Romzi (yup she got her PHD now  ~so inspiring smpai rase goose bump), Datin Sharita, Pn Marlina, Pn Maryam, Pn Amilia etc. Also a few familiar faces, mazuin (a dear friend from uia, dietitian at pusrawi but soon to work in hukm p/s jgn marah aku reveal kat sini ek mazu nway ramai yg dah tau kan), alip (senior uia, dietitian serdang), khairil (or khairul, I always confused -ex besta dietitian now works in PPUM).

Nway back to the workshop, the 1^st talk was by Dr Ronald Ma, Assoc Prof Dept of Medicine & Theraputics Chinese University of Hong Kong. He talked about management of DM pt with obesity/overwt problem. The new generation drug for DM. But sorry I cudnt share much. I was pening2 lalat at that time (not well + hypo –skip breakfast), cudnt concentrate. Perhaps boleh tny Mazu she was busy jotting down notes (as expected from best student hehe). Tetapi di dalam kepeningan I got few ideas of what he’s talking –it’s important for obese diabetic pt to lose some wt, for it really contributes to help in glycemic control. I believed that is what we preached to our obese diabetic pt, but sometimes we (or at least me) tend to forget to emphasize on that sole fact to the pt, lebih focus pd diabetic diet mx je. Its true that if pt practice diabetic diet, it could help them to lose wt, but a little emphasis on the importance of wt loss to help control blood sugar, blood pressure and lipid profile wont do any harm no? 

After revitalized with morning tea, the session continues with a talk on MNT for DM by Miss Yeo, HKL dietitian. Well not much update, pretty much the same as the 2004 MNT. The discussion afterwards was on non-nutritive sweetener.  What is our stand on the recently popular stevia? As it is plant-based, it is safe to consume, including by diabetic pregnant woman. But more study should be done on stevia –long term effect, etc. Hey perhaps I could discuss this issue on next entry. Found a journal and review papers on this but x baca lg (biase la malas  *tampar muka sendiri laju2*). The last session was a case study presented by Ms Khalilah. Nothing much to share here, just the same diabetic mx as we always encounter in medical ward. 

Well the workshop ends with us (me mazu and jun) catching up with alip and kairil and get to know other new dietitian. And of course greeting HKL dietitians that have thought us a lot. Surprisingly ada antara mereka masih ingat kami yg hina ini hehe. Mazu sgt impressed dgn ke’dhobitan HKL dietitian. I pray that I can be great people like them one day. Mntk tlg amin ye.. macih.

us with hkl dietitian special unit posting

kami dgn tn hj ridzoni on our very last day there

p/s: on tuesday I cover kakzam for her endocrine clinic with ilman. 1^st pt adalah makcik yg sgt cute, 76 yo.

cikdietitian: makcik duk mane cik?

Makcik: duk batu kep (batu cave). Tp makcik org noghori (ilman kat dpn dah jeling2 dah), hari2 masak lomak nak oii, pakcik ko tanak makan bnd lain.

Alahaiii makcik, comel betol.. u really made my day ;)

p/s 2 hohoho balik kampongg!!

TA'ARUF

Bismillahirrahmanirrahim.

The name is Nor Syahiza bt Abd Kadir. But most people close to me call me Ija. Some call me Iza. Some Nor. Doesn’t matter anyway. And I am to start blogging today, finally. I used to blogged before (Friendster blog –assyahiz.blog.friendster.com), but stop for no reason. I love blog hopping, for the reason I love reading other’s stories –to take lesson from, to smile, to laugh, to cry with, or simply to get information. 

The motivation to write? I was browsing through some old pictures the other day, and it hit me. Many of the memories were really precious and important to me back then, but it started to fade away. And I don’t want that to happen. So I need to keep them in a journal. And no, that is not the only reason. There are lots of writer out there inspired me, for their passion of sharing knowledge and experience with others. So that’s what (or that’s what I hope) I am about to do. 

I graduated last year, on April 2010 from the Garden on Knowledge and Virtue in Bachelor of Dietetics (hons).  I am a dietitian who is still looking for a permanent job, who is still torn between so many important decision to be made, who is still confuse between her passion and her needs, who is still unsure of her future. But at the moment, I am grateful for being a part time dietitian in Selayang Hospital. 

cik dietitian with her mak

Oh before I forget, I am 24 years old woman, was born in Temerloh Pahang (in my nek’s beloved house –yup I was born in the house), but my family resides in Bandar Jengka. The type of person I am -A serious person….(I believed that my friends who read this will be like wth ija haha!). Gotcha! Hey it’s not my call to describe myself, so u tell me. And one last important information about me; I am single haha ;)

Anyway, welcome to my blog, I am praying and hoping that it will benefits others.

Chow!

Assalamualaikum.