The heat is on

I’ve been at an exam prep course this past week.

How nice it was to sink back into a student-like life! I could walk around in scruffy jeans and a hoodie, no patients to see, no consultants to please, no theatre politics to deal with, and most importantly, NO DECISIONS to make! (well, at least not any that could possibly kill someone if not made wisely)

However, the 0830-1700 lectures from Monday to Friday have been very intense, and my brain now feels absolutely exhausted after I’d summoned the last of its remaining concentration and comprehension power yesterday. All I want now is a really good holiday (I’m missing Australia SO MUCH), or perhaps just to sit out in the sun on this lovely Spring day. But I know I can’t.

Whilst the course has been very useful in filling in certain gaps in my knowledge, it has also identified other areas that I need to work on. The weekends are now very precious for my revision, because I know my mind and body may not cope with excess studying after long, hard, weekdays at work. Studying is a priority at the moment, as getting these exams are so important not just for my professional confidence, but also for my career progression. The director of our Anaesthesia School warned us all yesterday that we should not attempt the exams if we do not feel like we deserve to pass- I certainly don’t at the moment, so I need to do something about it!

“If you don’t study for these exams, you definitely will not pass. If you study really hard for them, you may possibly pass. Remember: you either get an A* for the FRCA, or you fail- there are no acceptable grades in between.”

God, please help me pull my socks up and work hard these next 2 months.

Lord, please help me to pass.

Itch

I’ve developed hives somehow, probably from something in the lamb curry I had for lunch this afternoon.

My mast cells and basophils are in overdrive and this itch is driving me insane! And, the cetirizine is seriously taking its own sweet time to reach peak effect! I am struggling to stop myself from scratching…

Help!

 

p.s.

Being geeky (and in preparation for an exam), I shall write about chlorphenaramine– a drug used for the same purpose and that I prescribe a lot more commonly.

Use: Allergic rhinitis, Rash (urticaria), Pruritis, Anaphylaxis

Presentation: 4 mg tablets, 0.4mg/ml syrup, 10ml/ml colourless solution for injection

Dose: 4mg oral dose tds/qds, 10mg iv/im/sc dose

Mechanism of axn: Antihistamine (competitive antagonism of H1 receptors), Anticholinergic

Pharmacodynamics

– CVS: Inhibits histamine induced vasodilatation and capillary permeability.

– RS: Reduction of bronchial secretions, doesnt fully reverse anaphylactoid bronchospasm as leukotrienes are also involved in allergic bronchoconstriction.

– GI: N+V, other GI disturbances

– CNS:  Sedating, some LA properties

– Anticholinergic properties

Pharmacokinetics:

– Absorption: Slow absorption, 25-50% oral bioavailability (due to extensive first pass metabolism)

– Distribution: 70% plasma protein bound, Vd approx 7.5L/ kg

– Metabolism: Liver- oxidative deamination, demethylation

– Excretion: Urine, Cl 4.4-7.9ml/kg/min, elimination T1/2= 2-43hr. Not removed by dialysis.

 

Back in the rut

I’m back in the cold and dreary Kingdom for the United.

Slept since I got in at 11am yesterday, and woke up only at 1am this morning!!!

I have a sneaky suspicion that jet lag is going to hit me pretty hard this time around. Having a body clock adjusted to Australian time but actually physically living in the English timezone really doesn’t work. Thankfully, I will be on nights next week- which my body clock will hopefully be able to cope with.

Today marks the first day of my attempt to become a vision/revision machine. I have been studying since I got up at 1am, and will head off to my basic science course in a couple of hours. Hopefully, what little homework I have completed will be sufficient to help me in understanding all that will be taught today!

Random side note: Listening to Lee Hom in the quiet of the night as I plod on with work has been exceedingly calming. God has truly blessed him with hypnotic vocals that mesmerise me over and over and over again.

My thoughts on work

I am writing this post on board my flight from Sydney to Singapore.

Sigh. As the Chinese saying goes, 好花不常開,好景不常在。After a lovely holiday in Australia, it is finally time to say goodbye and go home. And tomorrow night, I will be flying back to the UK. I dread to think of all the work that awaits me when I get back. There will be more on-calls to do, more studying to go through, and a whole lot more stress to endure as I prepare for the primary FRCA (MCQ) that will torture me in June. For the coming 3 months, I am going to need to work like a machine. Oh dear, the thought of this has made me feel ready for another holiday already.

This leads me to think: how nice it would be if I never had to work! Being permanently on holiday would be absolutely amazing! If I had all the money in the world and can afford to go anywhere or had the freedom to do anything, I will lead the most enjoyable life!

Really? Perhaps not. Since the fall of Adam and Eve, man has been commanded to work; this is God’s plan for our lives- that we should toil for our livelihood. How can I expect to feel satisfied in my earthly life without doing what God has wired me up to do? I do not think that life can be fulfilling without hard work. Indeed, I doubt holidays would seem enjoyable if I did not have to earn them. Breaks are precious and refreshing only because there have been periods of labour and exhaustion to compare them with.

We are all like rechargeable batteries: we exhaust ourselves doing what we have been designed to do. Then, we spend a period of time at rest getting ourselves recharged for the next time we work again. What use is a rechargeable battery if it was never taken out of its charger to power up electronic equipment? In the same way, what use would our lives be if we only sat around doing nothing? Roads will not be built, houses will not be constructed, streets will not be swept, science and technology will not advance, sick people will be left to die, and no one will farm for food. In fact, our “permanent holidays” will really suck because nobody works. No one will be running hotels, no one will be flying the planes, there will be no chefs, no room service, no cleaners, no dive instructors, no tour guides, no nothing. Imagine a world with no work. I can just see in my mind’s eye that we will all just be disease-stricken, lazing around in our own dirt and grime with fleas buzzing around our smelly bodies. We have no roofs over our heads, and are hungry with no food to eat. We are bored to death with no TV to watch, no iphone/ipad/ipod/imac to play with. It will be awful.

Man are made to work.

Colossians 3:23. “Whatever you do, work at it with all your heart, as working for the Lord, not for men.”

Trip out to the Blue Mountains

AUD 99 bought me a trip to the Blue Mountains west of Sydney, so named because of the Eucalyptus oil produced by gum trees that line these mountains. The oil, mixed with water droplets and dust, refract sunlight in such a way that it painted the mountaintops a tinge of dreamy blue.

It was a lovely warm day, and it was nice to have my touring looked after by someone else after a long week in a foreign place.

The tour guide/ coach driver was an Australian man named Mark. It was nice to hear his Australian accent come through the speakers of the coach for a whole day. He was funny and friendly, and told us all kinds of random facts throughout the day. His ancestors, his old place of residence, the price of bottled water and petrol, the use of electronic tags to pay toll money in Australia…

It took us approximately 2 hours to arrive at Katoomba by coach. Katoomba is an Aboriginal word for “shining, tumbling waters,” how romantic. Our first stop was the echo point lookout, where we would view “The three sisters,” Mount Solitary and the Jamison Valley. It was quite a breathtaking sight to behold. From the lookout point, all I could see were cliffs, mountains, valleys, rivers, green trees and a vast cloudless blue sky.

The “three sisters” is a rock formation produced by many years of erosion by the elements. To the Australian Aborigines however, it is a sacred place from their Aboriginal dreamtime, where 3 sisters were cursed into becoming these astounding pillars of rock.

We headed off to “Skywalk” thereafter. This is essentially a cable car ride across the valley. From this cable car, we could see more of Mother Nature and her beauty. We could view the three sisters and the eternity waterfall. There was also a platform within the Skywalk ride that changed from being translucent to transparent right beneath our feet, enabling us to view the valley thousands of miles below us. Amazing, but scary at the same time.

After a short lunch, I proceeded to take the railway down to the bottom of the valley. Now, this is the world’s steepest railway, angling up to 52 degrees at its steepest point. I sat on the outside, where there was no barrier to stop me from falling out. In fact, there weren’t even any seatbelts or anything to tie me onto the carriage itself! It was mighty scary. I felt like the train was going almost vertically at some points, and had to hang on to a bar with one hand whilst my other hand grasped onto the wire fencing above our heads. The ride was a quick one thankfully- I don’t think I would have survived anything longer!

When we got into the Valley, I enjoyed a short board walk through it. It was really cool under the canopy of the rainforest trees. I looked around me and all I could see were tree trunks, leaves, vines… nature in all its glory. In fact, I felt like I had walked onto the set of “planet earth.” My geography lessons from secondary school flashed across my mind; sadly, I could not remember much.

The trip into the valley ended with a cable car ride back to the top. It was like any other cable car ride, except that it was going vertically rather than horizontally, and it ended with a (planned) swing.

After we got away from ScenicWorld, we spent some time browsing the shops at Leura mall. Following that, we headed back to Sydney where we were taken on a quick drive around the Olympic Park before being dropped back off at our respective hotels.

It was a lovely day out. Australia can be so beautiful.

Bondi Beach & Attractive Aussies

I went to Bondi beach today.

After 3 days of persistent rain, the cumulonimbus clouds finally relented and let the shy sun peek through. It was sunny and warm, perfect for a nice day out at the beach.

It was my first time at Bondi beach today, and I have to say that it was everything I expected it to be. Clear sapphire blue skies, emerald green waters, white waves washing ashore onto the long stretch of cream coloured sand. The sun was shining on my face and the cool sea breeze in my hair. Throngs of sun-worshippers had arrived, each person taking his or her own little spot on the sand to sunbathe, read, picnic, or simply just chill out. Others were building sandcastles, playing beach volleyball, or jogging along the coastline. Surfers rode the waves in the sea, yet others were swimming, or simply thrashing about playfully with their mates in the water.

It was a day for the young and old.

I joined in the fun too, and allowed myself to bake under the sun for about an hour. I then walked along the beach, people watching and getting all trigger-happy. I had a watermelon-flavoured snow cone today, and it was just the thing I needed to bring this hot day to perfection. Before I knew it, I had been out for almost 4 hours, and I was well and truly roasted (yes, my skin is all red and inflamed now, and I am starting to regret not putting any sunscreen on).

As I strolled along the beach, I could not help but notice how HOT Australian men are. There were so many of them out there today, all half naked and showing off their toned, sun-kissed bodies. They all seemed to have the necessary 6 pecs and classic V shaped body. Many have also been blessed with rather handsome, chiselled faces. These, together with tousled blonde or brown hair, a winning smile, and a sexy Aussie accent, made them unbelievably attractive. I found it very hard not to stare.

Aussie women are also not to be outdone. Toned abs and perky bums were seen everywhere- they make it seem as though it was easy and normal to attain a figure like theirs! I was completely and utterly put to shame when I tried to compare myself to their amazing bikini bodies. Many of the women were also a healthy bronze colour, which must have taken hours, days and months of sun-worshipping to attain. These women were quite obviously very confident and proud of their bodies, many of them choosing to display themselves in semi-nudity to the rest of us beach-goers.

All in all, it was a gorgeous day out at the beach. I haven’t been to one in the longest time ever, so it was nice for me to get my pasty looking self out in the sun again. I love people watching, and spending the day at Bondi was certainly a treat for me.

Meeting Wong Fu Productions

Wong Fu Productions swung by Singapore as part of their South East Asian tour two days ago and I got to see them! I feel so fortunate to be in Singapore at the same time they visited and am so happy that I managed to go to their event.

That day, I realised just how bad I am at being a “groupie.” The event was supposed to kick off at 7pm, and so, JX and I decided that we would meet outside the Rock Auditorium at 6.45pm. I mean, that sounds pretty reasonable right? WRONG. Apparently, the “true fans” had all gathered to queue up at 4pm! There was even one fan who had arrived at 12 noon! I truly cannot understand how anyone could willingly forgo such precious hours and minutes of their life to do nothing more than queue up. Also, many of the fans who were at the event were uncontrollably excited. The amount of screaming heard through the night could only be matched by the squealing and shrieking of  passionate school girls from my alma mater during a school sports day. There was cheering for every single joke the Wong Fu guys told, every single pose they struck, and every video they played. As for me and JX? We clapped and cheered when appropriate, but stayed mainly calm throughout all the raucous that was going on around us. I wouldn’t say that we were party poopers; I prefer to think that we were just (more) rational. I mean, at our age, it would be highly inappropriate to behave like 16 year old young punks right? Having said that though, adrenaline did surge and I squealed like said 16 yr old young punk when the music video they shot for Wang Lee Hom was screened. “That’s the man I have loved for the last 10 years!” I told JX.

Anyways. I really enjoyed myself that night. Phil and Wes had come, but Ted could not make it due to commitments back in the USA. Although they were one person down, it was still nice to see these guys in person. They are both so thin! But very well dressed. Wes looked especially attractive and has a skin complexion that would make many girls green with envy! The 2 guys were very eloquent, and funny. They spoke like we had been friends for years (“BFFs” as Phil would put it). And I absolutely adore their American accents. It was a real delight to hear them speak.

I came away feeling quite inspired. It was nice to hear how Wong Fu had met in University- Phil was apparently really impressed with Wes and Ted’s work in class and thus determined to befriend them, whilst the other guys knew him as the semi-famous lip-syncing and dancing guy on campus. They described how they started making their first videos together, and how they scrimped and saved to buy a good camera together. They told of how they struggled to make ends meet post-graduation whilst persisting in their passion for film-work. They spoke of how they used to film for weddings (and may sometimes not be fed) and work at nightclubs interviewing drunkards. And finally, they shared about how they eventually got the recognition that they deserved through Youtube.

Phil and Wes screened a number of their works, and emphasised how important it was for them to dabble in most genres (romantic, comedy, music videos etc), and to ensure that the quality of their work was up to the same standard irregardless of the budget or manpower that they had. The guys were obviously very proud of their achievements as a production company thus far, but also seemed very grounded and appreciative of all the support their fans have rendered them.

I thought the event went really well, and it far exceeded my expectations. I mean, what can you expect from a couple of guys who don’t sing or dance or play any musical instruments? As Phil said, it was one big Youtube video party, but this party was a lot more than I had imagined it would be and I was surprisingly a lot more engaged than I had expected to be. I do hope to see these guys again soon. Hopefully it won’t be too long more before then!

Wong Fu for Lyfe.

p.s. Really not quite sure why they decided to spell “lyfe” with a “y.”