Thoughts:
1) This is the first time in a few weeks in which I decided to drive back to Bangi, with the reason being that I've an A&E on-call this Sunday morning. I had a nice chuckle when Syafiq asked me if it would be tiring to go back today, and back to Kuantan on Saturday midnight.
But I finally have the opportunity again to listen to podcasts. I tend to doze off straight away taking the bus, and with the iPod gone, lonely drives like these are the only time to listen to them.
2) Abah has been recovering remarkably since being afflicted with the stroke. He can walk very independently, but with slower progress in his speech and slower still with his upper limb. This has made it very difficult for us to care for him, especially with his "depressive state". Imagine at 3 am he'd suddenly go from the lower floor bedroom to the living room, on his own, limping, without "telling us". And since he can't sleep, he'd also suddenly get up just as we'd doze in the living room to go back to the bedroom. And of course 1 family member needed to stay awake and keep an eye on him because of this. His walking ability is now so good that we went out to eat, with him walking. For all intents and purposes, the walking stick is probably the only assistance device we need.
As for the upper limb, only the hand is making progress, in which there's more finger movement but still no strength. The shoulder and elbow are still limp. This is not surprising as it's around that area of the motor cortex that is infarcted based on MRI. As for his speech, he can speak a few more words with coaching by my lil sis Sarah. But you can't expect good development when she coaches Abah to say "Sarah comel" (Sarah is cute). Drama queen.
But there has been a lot of improvement in less than 2 months from being completely dumb and hemiplegic.
Along with the experimental hyperbaric oxygen therapy (which hopefully can stimulate angiogenesis to the ischemic penumbra based on anecdotal evidence), let's see if intensive physio and speech coaching can show neuroplasticity in action. Each hyperbaric session costs RM 300 a session (for at least 10 total sessions). But if helps with Abah's recovery to the point that he can work again, the investment is more than worth it. I'm not too worried about him recovering independence at all.
3) Abah is now pretty sensitive to temperature, and the current hot weather isn't helping at all. Imagine this: we set the living room air conditioner to 26 degrees C with automatic fan speed, with all family members sleeping together. By morning, the A/C is still on full blast, as we can't reach even that temperature. Even the tap water is warm without the water heater.
4) I'm still coughing, though not as badly as 2 weeks ago. The bouts are still severe, but reduced in the frequency of episodes. But the crepitations (lower to mid zone anteriorly bilaterally, coarse) still persist. In a way, I'm still hopeful that it's just bronchitis with superimposed bacterial infection. But the fact that the CXR showed bilateral bronchiectatic changes is a bit depressing. If it is tuberculosis (unlikely due to the location of signs), I'm hoping that the sputum I sent for tests would show results straight away; I only sent AFB twice out of 3 times so far. Then I'll be able to get the whole ordeal dealt with straight away.
But at least other than the sometimes debilitating coughing, I'm doing very well. No fever, no shortness of breath, no loss of weight or appetite (okay, I lost 1 kg, but gained waist circumference, so that doesn't count). The RP showed slightly high creatinine (125), which was expected as I lifted the night before. Hyperuricemia was expected (strong paternal history of gout). LFT was normal. I'll trace the sputum results next week (ample time to have them all done).
Functionally, I'm so good that after lifting on Monday afternoon, I played futsal on that night as well, and felt relatively fine. I'm still aerobically fitter than the gasping sisters who chased after Dr Ng during his short case teaching (hehehe). Seriously though, it has been exercise that's kept my airways clear; I cough more (and it's drier) during the non-exercise days. After I work out, I cough less, but whenever I do, all of the phlegm comes out, making me feel better.
I'm a bit anxious to look at the HR CT when it's done on the 5th next month. But it's more because of the fact that the exact cause of the bronchiectasis is still unknown.
And I regret not taking the H1N1 vaccine when it was available. Oh well, when the 2nd wave erupts in Malaysia I'll have to start wearing a mask again.
5) I don't know why, but I like teaching juniors more than studying. Throughout this block, most of my revision comes from taking juniors during my on calls (yesterday I teached them for about an hour and a half) and doing short cases and discussions. I love teaching juniors (in my "mean sadistic" way, which many, especially sisters in the same batch, don't like). I really haven't touched the textbooks or CPG's yet, which is alarming as internal medicine is one field where you need to read a lot, a whole lot.
But with Abah sick and now me "sick", I really don't have the motivation to study; I'm just cruising through the motions. Meh. Sorry Dr Azarisman, but I don't think I can fulfill your request and earn another distinction.
6) Talking of the sick role, I'm still a bit confused as to how much of a sick role I should have. I mean, I have clinical signs of illness (my crepts are so clear that I could teach my mother to hear them; colleagues and juniors have been listening to them too). But I don't look sick; lay men wouldn't know it. I don't really "deserve" to be absolved of responsibilities. It's like a gray area.
Nevertheless, since Abah's illness, Fiza has taken over posting leader duties (I only handle the short cases, badly) and Iwan taken over full leadership of the AGD. And both have been doing well. Thanks.
7) I've also gotten more and more jealous of others lately. This has been especially since we had to postpone my engagement to another date. I hate seeing others having it so easy to get engaged and married. Hopefully the wedding itself won't be affected, as it's 4 months away. But Umi's dreams to have a "lavish" wedding for her first child has been shattered.
We've been in a relationship for almost 7 years now. And I'm seeing others in a relationship for less than that and are now married, or very soon to be. Yes I'm jealous. But at least my girlfriend is now very much a part of family. With approval of her family, she stayed with Umi at Bangi and helped out especially with sending Sarah to school, getting herself a red punchcard every time. She did this during the most critical time, at which Abah was still in the hospital. And she outstayed Tok and Tok Ki in helping out. Is there really any way to thank her?
8) I've always wondered about how we should respond to hearsay. Some people make conclusions straight away. Some wait until there's concrete evidence. Today was the first time I got burned big time for deciding not to act on it.
Confirming hearsay is time-consuming, and thus I tend to block it all out. I wonder how others deal with it and why.
9) One thing I don't like about TM Gym is the music played. Imagine yourself entering the gym and hearing:
Suck my d*ck
Suck my mother-fu*king d*ck
(Repeat x3)
Followed by bastardized Cascada songs..
But I really have to salute the cardio bunnies who continue to ignore the really offensive stuff played at the gym, loudly. These are the makciks and pakciks, including Dr Alik who has become a regular of the elliptical machine. The sight of him training really hard while "listening" to "Suck my d*ck..." is priceless. I can't warm up for a minute without laughing uncontrollably due to the "distracting" songs played at this gym.
Abe has suggested throwing away Abg Mat's (the manager) mix tapes. But then again, I don't want to go back to hearing Taylor Swift while benching or squatting. So keeping the gym only for those above 12 is a good idea.
10) Initially, doing this blog was just to write down thoughts to share with others. Never did I think that it'd turn more and more into a diary.
Training:
Nothing much, the wrist is better. Have resumed pullups, and hence almost back to normal training as pre-injury.
Monday:
Deadlifts - Up to 110 kg x 9
MP - Up to 40 kg x 9
Pullups - 5 sets of 3
Followed by an hour of futsal that night.
Wednesday. Based on the inverted rows, I need to get my core up to speed. Heavy core training will need to be done next week.
With the time constraints caused by Abah's illness, I really don't know how to prepare for the upcoming B-ball tourney in April. Conditioning targets may be barely achieved, but skill training is for all intents and purposes is impossible if I go back home every single week.
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