How My iPhone Survived Water Damage

It was just another normal night shift in the pediatric ward. Until I noticed that my iPhone wasn't in my pocket, just as I wanted to take a nap (somewhere around 1 am). Looked everywhere. Called the phone. Woke my wife up in the middle of the night to use Try My iPhone. Even tried to call up one of the patient's parent, who for some circumstances requested for discharge at midnight. No use. After close to 2 hours of searching, I gave up and went to bed.

Apparently what had happened was that the iPhone fell from my pants pocket in the bathroom and fell onto the floor without me noticing it. And when I opened the door, the phone was pushed to the bathroom wall, with a leaking shower head right above it. It was ledger just nice; every time I'd search the room it'd be between the door and wall.

So when I woke up and showered before clerking a new admission, imagine the horror when I saw the phone when the door was closed, the leaking shower right above with water dripping onto it. The screen was black, and I pressed the unlock button once with no response. Water was seeping out of the speaker holes at the bottom. At the instant I removed the case and wiped the phone clean. After I showered, I put the phone in my shirt pocket with a plan.

Water damage occurs from the electronics getting short-circuited. So there are 2 main steps to salvaging a wet electronics equipment: turn off the power, and remove the conductivity of the wet intruder.

1) Turning off the power - not easy when using an iPhone, which doesn't have a removable battery. And the phone was already unresponsive, so it wasn't something I could control.

2) Reducing conductivity - the most important factor is removing the free ions first. Ideally this means washing the salts that may have entered the phone with distilled water. This is more important if the phone got wet from seawater or pool water (and in some respects HKL water does apply) but it is a scary idea so I scrapped that. This is where the idea of disassembling a phone and cleaning the electronics with a soft brush and/or alcohol to remove salts for stuff with water damage comes from.

The next step is drying the phone. After I wiped the phone clean I kept it in my shirt pocket with hope that the body heat would evaporate some of the water while allowing an outlet for the evaporated water to come out. My plan for definitive drying was getting a calcium chloride based desiccant (ala Thirsty Hippo) to suck out the water inside.

I called my wife to send an airtight tub while coming to work and send Muiz to the creche, with the hope that the Hospimart in HKL sells such a desiccant product. Apparently it wasn't sold. So after 10 hours of discovering the phone I finally got a tub of calcium chloride from the nearby Guardian pharmacy. I put the desiccant container in an airtight tub and closed it with the iPhone inside.

44 hours later, I recharged the phone. 76% battery left, turned on as usual, and it was back to business as if nothing happened.

From searching the internet, there are other alternatives to calcium chloride (which in all respects pretty cost effective as it is):
1) silica gels - you'd need a shit ton, and who keeps these in their house anyway?
2) uncooked rice - you might want to keep it for 72 hours instead of the 2 days I used.
3) hot air - use with care as you might cook the electronics. And ventilation is more important than the heat itself with this method

So remember the steps:
1) don't allow your expensive phone to get wet.
2) dry your phone's insides ASAP, and don't turn the phone at all until it's already dry.
3) if you dare, clean the insides. You've probably voided your warranty already anyway, so it could be a reasonable step if you're desperate.

Most important resource (among others): Andy Ihnatko

Couple Random Thoughts - March 11 2012

1) Since the Share Sheet feature in future OS X Mountain Lion includes Vimeo and not Youtube, I'm considering returning there for my video hosting needs.

2) The takeaway note from the recent hospital lecture in conjunction with World Kidney Day: you can't expect to receive if you're not willing to give. The Malaysian organ donor rates are really appalling such that the majority of recipients get their surgeries in China/India. I agree that we need an opt out instead of the opt in system in place currently.

3) The worst thing about being in the strength sports (powerlifting/strongman/Oly lifting/bodybuiling)? Your thigh size determines your pant size, not your waist. The belt *is* mandatory.

4) It's cool to have passed the anaest/ICU posting assessment without studying at all (the exam came as a surprise). Maybe I should return here. After all, being an intensivist is one of my interests along with (paradoxically) sports medicine/rehab.

Heh. Some Random Thoughts.

1) WWDC starts in an hour. It's now 12.30 am. Damn it.

2) For good or bad, the fact that my wife and newly born kid are both in Melaka means that I'm able to train with a much higher frequency. I'm currently training every other day in between EOD calls. It might eventually be a stupid idea in retrospect but life is boring alone otherwise. And spending RM140 for training only at most 8 times per month (usually ends up at only 4 times per week there) is fucking expensive compared to when I was in Kuantan. Hell, if I trained at Bangi exclusively with the per entry rates it would be only RM80 per month!

3) 5/3/1 by Jim Wendler is probably the best training program ever for a general strength enthusiast. You can train 4 a week, 3 a week, and even 2 a week and still make progress. Let's just run the numbers:
Mid 2009 - My 1 rep maxes were:
Deadlift - 120 kg
Squat - never tested. 3RM front squat was 85-ish kg
Bench - 60 kg
Military press - 40 or 50 kg. I think. I didn't log my original 1RM.

Let's run the numbers now. Do note that I've not tested my 1RM's in more than a year. My best lifts are:
Deadlift - 145 kg for 6 reps
Bench - 75 kg for 10 reps. No spotters for racking/unracking.
Squat - 115 kg for 10 reps. No spotters for racking/unracking.
Military press - 57 kg for 6 reps.

And this progress is made even with on calls and real life stuff that make me lift only 2 times a week for the most part. Get the program here.

He doesn't even use the spotters in "just for fun" competition!

4) This is an extremely good read. From a man who's an accomplished powerlifter, head athletics coach, physical therapist, and a well of knowledge.

5) June 6 was the birthday of late Abah. Too bad he isn't around to see his grandson. Shit, not being able to see your father's last breath as you're stuck in your first on call as a junior doctor is a big blow. Sigh. No abuse from a consultant/specialist/medical officer can break my resolve in continuing as a doctor more than the circumstances and implications of Abah's death. Nothing can make you feel more like a failure. Al-Fatihah.

Things to Aim for in 2011

Training:
1) I want to reach that theoretical 100 kg bench. And since I already can and have deadlifted 140 kg for a single, I'm now aiming for at least 180 estimated 1RM. Since I'm not training to compete, I'll stick with the basic Jim Wendler 5/3/1 "2 a week" template without focusing on singles; as long as the estimated 1RM reaches the goals, I'm happy. I've already recovered from the temporary hiatus from training due to starting housemanship and training at full speed (considering the circumstances). Here's where I'm at now, with the estimated 1RM and previous best (right before starting housemanship):
Deadlift - 123 kg x 9 (159 kg, best 166)
Bench - 68 kg x 10 (90 kg, best 94)
Squat - 117 kg x 5 (136 kg, best 140)
Press - 52 kg x 6 (62 kg, best 63)

2) Keep the weight down, without the expense of losing strength. This is a bit difficult as I'm training 2/week. If I've more time, I'll do more resistance-type of cardio. Dietary restriction will only be secondary. As long as I'm not bloated up I'm happy. But...

3) Being heavy inhibits my pullups. I want to get stronger at pullups again. Currently I'm training my back in every lifting session. But that won't do much if my weight remains at 90. Last session, I could only 2 7 sets of 2. Pitiful. But hey, that's at a BMI of what, 34?

Career:
I want to further set my sights on the path that suits me. In general, this is how I am as a doctor:
1) I hate history taking
2) I don't hate examinations
3) I love difficult procedures, and am relatively good at them. I always get "referrals" from colleagues for difficult lines, difficult ABG's or blood taking. I'll do those over boring reviews. If you can memorize your cases, and monitor them well enough, writing everything down again and again with small changes is dead boring.
4) I love resuscitations, making sense of investigations results stat, and tense moments.

So far the 2 career paths I'm keen for are surgery and anesthesiology/critical care. Mr Zainal (HOD) has already said (via MO's I know) that I'd be welcome back once I finish my housemanship. Prof Faisal (UPM) has also said that I'd have his full support to enter UPM as a trainee lecturer in surgery. But I want to taste the anaesth posting first if I can.

Another issue is whether I want to stay in KL/return to IIUM Kuantan. My first choice would be Kuantan; but since my wife has a good career development path by staying in HKL, the obvious choice would be to stay within the Klang Valley.

Exams? I'm seriously considering to take the MRCS part 1 this year, and maybe even the MRCP part 1 even thought I hate medical; after all, a strong medical background is needed regardless of your clinical specialty later on.

Life:
Aim for a nice balance between training/work/family/personal stuff. Duh? I still want to read my comics, and I wonder if Rhye will produce a Rhye's and Fall of Civilization version for Civ V...

I know that resuming life as a Wesnoth online player is more or less impossible. But watching the developments as a silent_obs (hint to the MP community) is fun, especially as regards to the tremendous art development going on.

When my late father asked me to enter boarding school, I initially refused on the grounds that I don't want to become a robot living with a fixed schedule. As a doctor, I refuse to be limited by my long hours.

Valedictory Speech, Full Version

I've just finished my training session for the upcoming convocation with the IIUM Senate Committee. They said that it had good content and a good flow, but was far too long for the 10 minute limit. I'm posting it up, as I feel that the summarized version will never be as good. Note that I've not yet finished it, as the Arabicized stuff wasn't done yet, and the BM needs a lot of corrections. Done in like 2 hours before the training session, haha (!). We doctors do lack time you know (you know the typical doctor excuses).

Assalamualaikum and good afternoon to all.

It is a great pleasure and honor for me to speak in front of an accomplished audience. For today I am speaking not to an ordinary group of graduates; today I am speaking to a group whom can now be called professionals. I must take this opportunity to first thank my parents, my other family members and friends, my teachers of past and present, and as a doctor, my patients. Without all of them, I would not be as successful as I am today, nor selected to speak to address such a special group of graduates. For who I am today is a product of all those I mentioned above.

For you are a special kind of audience. You are an audience of whom standards are not just set by your teachers; the standards of your proficiency of practice is also set by your senior professionals, who have set high standards upon themselves. To graduate as a doctor, an allied health professional, or a lawyer means that there is no question regarding your qualification.

I still remember 7 years ago, when all of us were a group of students who had just finished the SPM examination, and were just about to begin a new phase as students in the Matriculation Center. At that moment many of the faces I saw were a mixture of excitement and anxiousness. We thought that SPM was hard. Would we survive the next 5-7 years of education? An education that is more specialized, yet harder. Nevertheless at the time there was always those moments of youthfulness. Late nights, last-minute studies, and of course the obligatory sleeping in class. This was the same regardless of the course undertaken by the students. Even Medicine.

Now fast forward to the moments right before the graduation. At that time you can also see the same mixture of excitement and anxiousness. But now it was for a different reason: We were preparing for the professional exams. An exam where you are judged not just by your regular teachers; but judged by professionals who are going to see you for the first time, and probably the last time. And this is what I mean to speak to a special group of graduates. You are graduates who are trusted not just by your own lecturers, but also by other professionals who have never met you before; who are convinced by your knowledge and skills the only time they saw you. You have achieved success, surely to be envied by others.

Kejayaan itu adalah sesuatu yang patut diraikan. Ini adalah kerana sesuatu kejayaan akan membawa kepada kejayaan yang seterusnya. Akan tetapi kejayaan kamu pada hari ini adalah hasil campuran pelbagai elemen. Ia bukan sahaja hasil daripada titik peluh usaha tuan-tuan dan puan-puan graduan. Kejayaan kamu pada hari ini juga adalah hasil daripada pengorbanan tenaga dan wang ibu bapa dan ahli keluarga kamu, daripada pengorbanan guru-guru, dorongan dan kerjasama rakan-rakan, sama ada rakan sepelajaran mahupun yang bukan, dan yang penting untuk diingati, para pesakit, pelanggan, dan sejarah atau pengalaman orang lain seperti kes-kes mahkamah yang terdahulu. Oleh itu, adalah penting buat diri saya bagi mengambil kesempatan ini bagi mengucapkan penghargaan terbesar bagi mendiang bapa saya sendiri di atas pentas ini, bagi Allahyharham Prof Madya Ayub bin Mohd Yatim yang meninggal ketika bulan Ramadhan al-Mubarak yang lepas.

It is only fitting to pay tribute to my father, who has given unlimited support in my endeavors to achieve excellence in IIUM. It was a rarity for him to ever say no to giving financial support for my efforts in buying all of However, my late father fell ill during my final year of studies with stroke, making life extremely hard for my family as a whole. He then was afflicted with a heart infection, which required heart surgery - on the day of my final professional exams. And yet my family and I persevered, and I passed my exams which I personally viewed as with flying colors considering the circumstances surrounding the end of my undergraduate life. But 1 month ago, ironically on the first day I was on call, my father passed away due to complications of his illnesses. It instantly had made the hardship of work, and the rigors of studying before that, pale in its emotional stress. The scolding of senior doctors and specialists, and the fatigue of long hours at work, felt tolerable with the death of my father.

The emotional burden of personal family illness, yet with the coincidence of becoming a successful graduate has taught me one thing, something that I wish to impress on you today: your success as a graduate today is to be cherished, but its elements are never to be forgotten. The success you achieve will thus protect you from arrogance, and keep you humbled.

And your humbleness in remembering your roots will keep our parents safe once they leave us, which they will. It is with this humbleness that we will remember to pray for them. To pray that they will be rewarded with Paradise, and saved from Hell. As the prophet once said, “One does not bring but 3 things to the Hereafter: beneficial knowledge, charity, and prayers of a good son.” But before we go further, I would like to remind everyone of a verse in the Qur’an”... I want to create a khalifah on earth...” To fulfill the principles mentioned in the above verse, we muslims must rediscover what it takes to become political and professional leaders. And the effort must be exemplified by none other than the IIUM graduates themselves.

It is important for IIUM graduates to not only be humble as I have mentioned above. IIUM graduates are bred in its system to be more than mere certification holders. We have to, and are educated to, to be more than followers. We have to be leaders. And the leadership displayed by IIUM graduates is not limited to our muslim ummah only, but also to the general public, or in terms of lofty standards befitting an IIUM graduate, leadership of present mankind itself. And better yet, the principles required to lead the ummah in the 21st century are easily derived from the Triple I-CE vision introduced by IIUM, that is internationalization, integration, islamicization and comprehensive excellence. By living the principles above, doctors, allied health professionals, and lawyers from IIUM will not be mere professionals; we will be professionals with leadership, who will unite the muslim populace and lead the world via the various avenues, whether it be academics, practice, or politics.

Internationalization is an important principle to be upheld if we are to achieve our ambition of being khalifah on earth. Muslims in the modern era are now segregated by nationalities and race. In the political sense, muslims are characterized by divisions, infighting, selfishness. And in the professional sense, muslim professionals are slow to not only develop, but to adapt new revised and better standards as regards to our professional development. Instead, we have left it to our Western colleagues, of whom the majority are non-muslim, to develop new ideas, practices, and guidelines which have increased the quality of the work of their profession.

In a different aspect, muslims now still stuck by sometimes questionable traditions. We have refused to see outside of our bubble, thinking that we are superior simply because of our religious faith as being muslim, or by misguided notions that some aspects of culture and tradition have their roots in religion when they are not.

Muslim professionals must be the spearhead of efforts to finally bring muslims to the forefront of the international arena. Muslim doctors, allied health professionals, and even lawyers must learn to be at the forefront of research and development, and to quickly explore new avenues of ideas that may help us improve the standard of healthcare care and legal systems. We should not hesitate to seek knowledge from non-muslims if it means improving ourselves. After all, best practice is best practice. And we must make example of muslim professionals who are among the leaders in their fields, but ply their trade in the western world, and thriving in it.

Muslims professionals from IIUM must also be at the forefront of efforts to educate the general public and modernize its thinking. The muslim professionals should make effort to educate the general public, to teach them than modern development does not have to, and should not lead astray from religious principles. Muslim professionals must teach the public to differentiate culture and religion; the latter is permanent, the former can and must change according to its suitability in modern practice. Muslim professionals from IIUM should be exactly that: excellent professionals, and faithful muslims. We must equal the accomplishments of the various muslim professionals of whom their names we keep on hearing as regards to the Islamic Golden Era.

To become a leader in the modern era, it is not enough to simply be a doctor, an allied health specialist, or a lawyer. The certificate that we have received today, despite of its significance, is not enough to allow us to lead the muslim world and the general ummah as a whole. We must seek out further knowledge, more than the knowledge of our practicing field. And all of this various knowledge needs to be united into one. Muslim professionals from IIUM must live the principle of integration.

A good example of this is seen in medical education. For clinicians of the modern era, it is not enough for them to simply be a highly qualified clinician in practice, or to simply be a Masters holder in a specialist field. Clinicians must now be proficient at research to become leaders of their field, that is to become research clinicians, to search for better practices and develop better technologies. To do so the clinicians must not just deepen the depth of their knowledge; these clinicians now have to broaden the scope of knowledge to the basic sciences of mathematics, the truly basic medical sciences: biology, chemistry and physics. But mastery of these fields is not sufficient; the knowledge must be turned into one, that is integrated.

Integration can also be seen in another light: that is integration of the general ummah. Muslims, exemplified by muslim professionals from IIUM, must be the example of integrating the ummah as a whole. In IIUM, we are blessed with a mixture of muslims originating from various countries. We even have non-muslims studying in this garden of knowledge and virtue. Our experiences and abilities to integrate with various peoples must be extrapolated to leading the muslim professionals and muslim populace as a whole, and then on to becoming political leaders of integration for the general mankind. Muslims professionals from IIUM must be at the forefront of education and goodwill to peoples of other faiths.

Muslim professionals from IIUM must not shun themselves and segregate into their own group. Instead, we must reach out to peoples of other faiths. We should provide service and education to muslims and non-muslims alike. And the responsibility is double-fold for us: to provide as a professional, and to provide as a muslim. During our practice is an excellent opportunity to preach regarding Islam to our clients and patients. And this preaching may not be direct; the character that we portray may sometimes be enough preaching in itself.

Integration and internationalization are interrelated with the next principle of Islamicization. IIUM graduates are ingrained with the principle that all worldly and religious knowledge is interrelated with each other. Secularization is the exact opposite of the what is taught in IIUM. Muslim professionals must change the current practice of their fields to reflect on basic Islamic principles. A good example of this is the field of shariah law, which combines the principles of modern law with basic Islamic rules and regulations into one field, which is already established by lawyers and led by IIUM. Other good examples are the halal food business and Islamic banking. And there are many avenues for muslim health care professionals to contribute to health care. The most obvious of this is medical ethics which I want to talk about.

Medical ethics is currently led by the Western world, based on mostly ethics based on human thinking, which can be wrong. And the western world is itself segmented, with those who believe and those who do not believe in divine concepts. This is where muslims have a great avenue to contribute. This is because Islamic principles of the world and law are based on permanent concepts: the revelation via the Holy Qur’an and teachings based on the Hadith of our beloved prophet Muhammad s.a.w. Because of this, medical ethics based on Islamic teachings would thus have more permanence and acceptance, as basic Islamic principles are true regardless of the passage of time. By improving our practice by integrating fields of professional practice with religious teachings, we will be following in the footsteps of the Golden Era researchers who pursued knowledge of Graeco-Roman origin and related it with Islamic principles to develop new fields of knowledge for which the muslims were the leaders and not mere followers.

To live by the previous 3 principles stated earlier, muslim professionals from IIUM would be living by another principle of IIUM needed to lead the muslim ummah and mankind in general for 21st century and beyond: comprehensive excellence. For to be leaders in an age with increasing populace, increasing political dynamics, increasing numbers of specialized academical and professional fields, and increasing technological advances, there is no other way other than to make effort to be the best: to be the best doctor, the best husband, the best father, the best son, the best neighbor and the best leader. This is because your deficiency in one area may ultimately hinder your role in another. And if you are deficient even slightly in a very competitive era, your leadership role will be taken by another. It sounds hard; no mission ever is easy.

But IIUM has taught you well. You have been taught to become excellent professionals in your field. You have been taught to become excellent muslims, who integrate knowledge of the islamic teachings and modern fields to develop knowledge more than the sum of its parts. You are taught to become one who integrates with the populace and others of your profession. You are taught to become one who seeks to be excellent in all aspects of life. You are a professional, an IIUM graduate.

Now go and make us proud.

Thank you. Assalamualaikum wbt.

Thoughts (July 24 2010)

1. It's back to reality pretty soon. But then again, the post exams was never a holiday for me. No honeymoon, no traveling, none of the stuff people do before starting work as a houseman. Every day, it was 4-7 hours of driving. If you think driving is not tiring by itself even though it burns no calories and chronically breaks people's backs, I'd love to have you as a personal driver.

I had to survive on pretty high doses of caffeine. There were several times when I had to just sleep in the car because of severe fatigue. Once my wife and I had dinner at 1.30 AM with work on the next day (I cooked of course, she was already fried from work and slept until food was ready). The day was spent helping my mother with errands/Abah's health issues. The only thing keeping me sane was the progress in the gym, which I could only go at night and ended up with coming home late, exacerbating my caffeine super-dependence. For references, to survive the induction I drank almost 6 cups/day of coffee/tea. That equaled 2 strong cups of coffee from Dunkin Donuts every day. I also kept my typically high levels of reading during the holidays, which at least kept my mind a little bit sharp. No studying though.

The recently ended induction program for housemen was supposed to be a holiday. But then I ended up as the participant leader. Luckily, other than an incident of a "lost" laptop and handling money-collecting duties, it wasn't too hard. But the chance for a mental break was lost. And housemanship starts next week.

I really envy the people who have been having fun during the holidays.

2. Next week I'll start work at HKL. Will it be that hard? I'm really not sure, after feeling exhausted already before starting work. Maybe it'll be the same level of tiring life as now, but in different ways. After all, I did say that the medical exams were harder and more stressful than the akad nikah (wedding vows).

What's really getting into me is the need to find a house. It's no longer feasible to go to KL every day from Bangi, especially if the aim is to reach there by 7 AM. The preferred places are Sentul/Ampang/Cheras as there are LRT stations there. A sleepy houseman is a dangerous houseman. But Sentul is super expensive, and the other two are jam centers on days that we drive. Other choices are Keramat & Gombak, but those options mean that driving is the only option to work. But as it stands, going to work from Bangi has been hell for both of us.

3. Will need to find another gym when I move. I'll make sure I get a lift, even during housemanship. But nothing will be as cheap as Kaki Gym/TLS/Try My Gym in KL. And it's utopian to get as many sessions as I could before, even during the peak of Abah's ills, when I did two a week, combing days into long sessions, sparing the weekends. Being strong has been quite useful and I don't want it to go away.

4. I'm a bit torn as regards to my future. My plan has been to go to a government clinic after housemanship, followed by pursuing studies in sports medicine. But there are several issues. With whom do I want to work? KKM, MSN, or MoHE? Do I want to be attached to a sport, or in a clinic setting? When the time comes, do I want to open what I have in mind: a comprehensive physical/sports rehab clinic, catering for sports and general public needs? I really would like answers.

But if all that fails, emergency medicine and internal medicine are fallbacks.

5. Lastly, Abah is back in the wards, this time for overwarfarinization, bleeding gums, INR of 8. Unsure of the cause though. Sigh.

The Professional Exam

Thank you to all the lecturers, staff, patients, seniors and juniors (my teaching subjects, a source of study), study group mates (Abe, Aiman, Ammaar, Coax, Hafiz, Nadhir, and even Zaim for a short while), batch-mates. Thank you for tolerating my extroverted, cynical, nasty, narcissistic and mean tendencies.

Looking back, I am still sad that the memories of SPM haunted me again, consistently scoring among the top, but failed to deliver on the big day (1 B, in BM). And considering how hard I tried to achieve it, more than my SPM efforts, it hurt even more. Considering the potential I knew I had, the result was an underachievement, a failure of sorts in the objective point of view. Even as I type I am still having periodic episodes of tears welling up.

How I hate the effort-results curve (my imagination, and it's sigmoidal in shape). To get a higher result, you need extraordinary effort after a certain level. And when you fail to achieve the objective, you feel as though all of that effort was just, "lost".

Long story short, it wasn't composure that failed me in the clinicals, but my mental stamina. My mental energy ran out at the wrong time.

Long case - Hemophilia B. Never seen 1 in my life prior to Pro. I clerked according to logic.

Short cases - Twin pregnancy, acromegaly, ACL tear. Those who remember my luck with the Lachman test might be interested to know that again, I failed to notice a really obvious positive Lachman test while lecturers already saw it. Just like in year 4 revision. Only when I repeated the test did I notice it, a complete tear.

But subjectively, it was probably not a failure. None of the study group members had to re-sit their exams. Truthfully, when I heard every one of those names mentioned, I smiled in my heart.

And I did well for the Pro considering that Abah fell sick since the 3rd posting with stroke. Almost every week since December if I remember correctly I went back home during the weekends. It was extremely tiring, regardless of whether I travelled by bus or car. 70% of my knowledge of internal medicine was based on my year 3 knowledge, as there was a lack of time to read. Teaching juniors helped tremendously.

And right before the exams, Abah would again be readmitted, with an aortic valve replacement during my clinicals. The original planned surgery was to include an ascending aortic replacement with coronary reimplantation, and cardiac bypass; I only knew that the simplest was to be done well after the exams. And yet I remained composed enough, I blocked out any worries about Abah and focused on the exams. I did well enough that I called Umi right after the exams to tell her I passed before waiting for the results, the confident being I am. I knew a distinction was out of reach, but yet I remained hopeful until yesterday noon. I haven't told her yet the exact results. But Abah is now alert.

Inspired by the performance of Liyana Mazli, Mastura and Fatin of the previous batch, I tried to emulate their excellence. During that year I was disheartened by the fact that I was not considered for Ortho distinction due to failing an easy PMP on sports injury which I was confused by the manner of the questions. I vowed to keep myself average and sane, until the AGD, listening to the posting awards. I wanted to be at par with them. Since then I worked hard, getting distinctions in the first 2 postings, and good marks in the latter 3

Alas, the handicap I had probably hindered me, but to me this was probably an excuse. But yet I hope that Umi and Abah would be proud of their son, excelling in difficult physical, emotional and mental circumstances, although the true definition of excellence would have been the D. I cannot thank them enough, Umi for teaching me the alphabet at 3, and nurturing my competitive self, never settling for mediocrity. Is there any mother that scolds her child for not getting a distinction when it was in reach? She was the one who cared for Abah since his illness, and told me to focus on studying and performing. And for Abah, who never stopped helping me financially in living comfortably to excel, and for teaching me to work hard, even when you are a bright person. And thanks to my fiancee as well, who had to tolerate me ignoring her for weeks focusing on the exams. I've done what I could, but I guess second best is the highest I can ever achieve, until proven otherwise.

With that, thank you. Alhamdulillah. The pain may persist for months, but at least the "educational" ride is over. Now into the world as a working doctor, a different animal.

P.S. Mr Hafiz on me never seeing a hemophilia patient, "You don't need to see cases, you only need to know it!" I hope that he was proud seeing me present and discuss a case I have never seen outside of a textbook.

Thoughts, Training (May 16, 2010)

Thoughts (It's been a while):

1) The LPT stretch from Gambang to Kuantan is dangerous in the presence of rain: T-Rex was skidding almost every 3-5 minutes.

2) An interesting quote from Harry Selkow to me:

"The quickest way to get strong is to be the weakest guy in the gym." I've learned to create my own ways to avoid a "jaguh kampung (big fish in a small pond)" mentality. For example, I always look at lift videos in the Internet, not really to humble me, but to motivate me.

MJ used to lie to the media that opponents smack talked with him, and admitted that he lied when he retired, with the intent of firing himself up.

3) An even more interesting quote from Michael Jordan when he was told to emphasize teamwork:

"There's no "I" in team, but there's an "I" in win."

4) People need to have a winning mentality. Standards must be individualized. You don't tell Federer to be grateful whenever he became second best to Nadal; hey at least he got into the finals. You don't tell the same to LeBron James when the Cavs just lost to the Celtics. When your potential is much more, why settle for less?

When I told Umi that I was close to getting a D for O&G, her response was to actually scold me (and my fiancee) for going back every weekend!

5) I've been feeling that I am very lax in preparing for the Professional Exam this Friday. Not spending much time studying, and more relaxing. No pressure for the most part.

This reminds me of SPM, a time in which Abah and I got into a very heated (understatement) argument, and a time in which I was even more hot-headed than I am now. Abah was pressuring me to study while I was home in between papers. I wanted to relax and take my time to read in the middle of a stressful exam period. The trigger was when he kept pestering me to come back after prayers while I was talking with friends. Hm...

6) Speaking of Abah, he and Umi are currently back to the general ward. Atrial fibrillation secondary to CAP. The neurologist said that there's probably new recent stroke(s), although there's no functional signs other than generalized lethargy. I guess the echo tomorrow is for that. Thanks for the wishes from everyone.

7) I'm finding that everyone loves my massaging skills. Maybe I should learn Active Release Technique (ART) or Graston (gasp!).

8) Hm, I can no longer borrow Abah's pants: my thighs have become too big.

9) I don't understand why casual gym goers waste their money with single joint, isolation exercises and getting no visible changes after even 1 year. Unless you can bench 100 kg (I can't), squat 140 kg (not tested yet), or deadlift 140 kg (yes), you have no idea imitating routines of people who spend at least 2 hours every day for 6 days a week with the help of assistance and are already fucking strong in the first place.

Sure, it's your choice, but money and time is precious for those of whom going to the gym isn't no 1 in their lives.

Training:

Since I'll be getting married soon (27 June, Bangi Golf resort - bookmark that date, invites will be sent out when they're ready), I'm going to start fat loss. It's time to dial in the diet 100%. I'm aiming for (generally) normal strength training via 5/3/1 3 days a week, with heavy conditioning on the same days + one. Every other day except 1 day per week will be filled in with general "light" conditioning, probably with Turkish get-ups.

Diet will be carb cycling. Previously I still took carbs on off days. Now it'll be carbs in morning and pre-training only on days with heavy conditioning, and no digestible carbs on off days. The aim is 1-2 kilos a week.

Soon I will also be going back to Bangi, with no lifting partners. At that time I'll have to reduce again my lifting maxes for the bench, which is my weakest lift relatively.

In the mean time, I did have a good deadlift session last week: 131 kg kg for 7 reps.

Thoughts, Training Log Until March 21 2010

I haven't written in a while; not enough time.

Thoughts:

1) Living in the fast lane, stress can either bounce off of you like a slab of concrete, or deliver blast through you, like a slab of concrete. Usually for me it was more of the former, but yesterday it as certainly like the latter, due to multiple stressors finally getting into me.

I need to keep my legendary temper in check: I think I punched the wall almost 10 times yesterday, hard enough to make people notice. The skin at my knuckles aren't hyperpigmented because of hemochromatosis, you know.

2) My aunt got operated for a "ruptured" appendicitis, but the operation was laparoscopic, so it shouldn't have been too bad. Get a good rest Umi Dah.

3) So far I'm finding that I need to do a lot more to get myself ready for Pro, especially now that the date has been pushed forward. And I can't enter the wards to boot. But with the current schedule and stress levels, I'm not sure how I'll manage to fill the hours in. With my current "intellectual abilities" I'm guessing that just 1 hour to study O&G and another to study for Pro consistently every day would suffice. Another would be to study 1 1/2 hours for Pro (which I've not started on my own yet, only group study), and depend 100% on bedside teachings and other "classes" (including on call sessions with 3rd years) to prepare for O&G (which was exactly what I did for internal medicine, and still got me no 2 in the group). We'll see which path I follow, which depends a lot on how well I cope with the stress.

But I want another distinction, for O&G and Pro. I want the money from the MMA award (though I haven't registered as an MMA member. 1K will help out a lot, especially with the internal drama in the family (not just Abah's illness).

4) Speaking of Abah, he has been talking a lot more, which is good. This morning he also started trying to regularly walk without his walking stick. But there's a lot more training required especially regarding his speech, and dealing with his upper limb spasms while doing ROM exercises are very difficult: too soft and you won't be able to extend the elbows & fingers at all, and too hard and Abah will be in pain. But he's laughing more, and interacting better with guests, who are still coming non-stop during the weekends.

Thanks for the support.

5) Next week is Naufal's wedding, the wedding of a person I can truly refer to as a best friend. Congratulations. Hopefully I'll be able to come over, unlike the so many I've missed lately.

6) Some people have it so easy: you'd God damned better be grateful.

Training (writer's block setting in):

The b-ball underground tourney is less than a month away, and what is hopefully going to be a special day is another 3 months away. It's probably time to reel in the diet, get a good more cardio in, and hopefully still increase if not maintain strength while shedding some fat. People don't care how healthy you actually are, just as long as you meet others' interpretations.

Videos are up on my Youtube page. But one thing is for certain: my pullup strength sucks, and I'm very unhappy about it.

Hm, Next Step: Re-Correlate Previous X-Ray with HRCT and Clinical

HRCT Thorax this morning came up completely normal (already discussed with radiologist, awaiting full reporting), and there goes how many years of radiation into my chest. No bronchiectasis/bronchial thickening/consolidation/cavitation/calcification/enlarged lymph nodes. Considering that kind of result, I was then "grilled" by the radiologist to rethink whether one was warranted. Maybe Dr Haida was right in that a CT wasn't indicated.

Still coughing with whitish sputum, at most localized occasional crepts at right anterior lower zone (which was also normal on CT). Yesterday, my chest felt a bit heavy, and I auscultated myself. I could hear the crepts through my breathing, and "confirmed" it with friends. Today was much better though, since any kind of "physio" would bring the sputum out, including simple joking and laughing. Similarly the breathing "exercise" associated with a chest CT did make some reasonable amounts of sputum come out.

AFB results never returned, so I might have to consider retaking them. I doubt I want to expend the effort to produce enough sputum for another C&S and Gram stain.

Me wonders if it's asthma. Or malingering haha. In any case, I accidentally left the X-Ray film at home (so I'll have to bring it next week), which I of course didn't tell the radiologist. Radiologists are well known for their strictness. Hehe, hopefully none will read this.

On the bright side, I'm radiologically healthy!

Ugh, Don't Be a Doctor Like This

My friend recently went to the doctor with a complaint of symptoms suggestive of exercise induced asthma and night cough with wheezing, with a history of eczema and allergic rhinitis and a strong family history of asthma. The doctor was adamant on not prescribing medications (even for pre-exercise), and not to diagnose asthma as he was not having an acute exacerbation during the time of consultation. Instead, she told him to stop exercising at night for avoidance of exacerbations. The friend then told her that exercising at night is the only usual time, as there is usually no time to do so in the morning or evening.

Then came the hammer (I'm paraphrasing here from memory):

"As a medical student, you need to make some sacrifices. If it means not exercising to prevent an attack, then do so. This is because we are very busy blablabla..."

WTF, that is complete bullsh*t. Just because you are in a busy field like medical does not mean that you should not exercise. And when a person has obstacles to achieving a healthy lifestyle, you help him/her to do so. When a child has exercise induced asthma, do we ever tell the mother to stop the child from exercise instead of prescribing reliever medications to use before physical activities? Do you tell the swimmer to stop swimming because swimming can lead to shoulder impingement? Do you tell the blind to give up on education because he can't "read"?

What happened was completely stupid and fu*king irresponsible. At least she cared enough for this friend of mine:

"Let me prescribe you with vit B complex, as it can help you concentrate."

Talk about not treating the complaint at all. If he's not going to buy for himself the oral salbutamol for prophylaxis pre-exercise, I'll buy it for him.

What an absurd ordeal.

Thoughts, Training Log Until Feb 7 2009

I had no internet last week, so all this are two weeks' thoughts into 1. The first "set" was what was supposed to be the blog for 2 weeks before (already typed halfway but not finished then). The second "set" will be for last week.

Chapter 1
Thoughts:
1. Abah has just been discharged from the ward. Turned out that he had hospital-acquired pneumonia (which Umi didn't know) and just a normal stress reaction (after we asked for a referral to rule out depression). He can only say a few words, most consistently Allah (just upgraded to Allah Akbar yesterday), Sarah once, Aida (ex-student) once. Not once did he say Ah (Umi) or Amir/Adib. Maybe some torture can get the words out, hehe.

Upper limbs are 1-2/5 for power, lower limbs are 2-4 (depending on the joint). We've managed to get him to walk with a stick from the car into the house, with support to prevent him from falling. But at the fastest, it's a 15 minute trip, with help. The problem though is with upper limb exercises, which is not as easy to stimulate than the lower limb exercises.

2. He has also been having problems with urinary retention. He is currently passing urine only once a day, about 700 mls. His bladder was definitely palpable. Tactile stimulation failed, and only long-term heat stimulation with warm water worked. Unfortunately, Abah hates the thermal stimulation, and would scold us because of the "temperature shock". The anger is more evident when bathing him. Fortunately there's no constipation.

3. Taking care of Abah has been very difficult for the whole family. As of last week Umi still couldn't work, taking care of Abah with Adib. She is now on half salary. My girlfriend still had to send my lil sis to and from school. Last week my grandparents stayed at home, alleviating much of the domestic stress. We are now going to try hyperbaric oxygen therapy for about 10 sessions. Each session costs about RM200, with the costs divided among Abah's siblings.


Nevertheless, logistics at the moment is still a nightmare. Umi needs to work, but without me around, there's no one who can help Abah move about the house alone (who weighs almost 80 kg). I was also strong enough to handle supporting Abah in the bathroom, and pick him up to standing position after he slipped from the sofa and sat on the floor. To move him around requires 2 people otherwise (Umi and Adib). The same number is also required to get him into the car, as unfortunately the two cars at home have high seats (Harrier and Rav-4). 1 person to pull Abah onto the seat, another to lift up his knees. My "suggestion" to use the Iswara was quickly shot down (a joke of course). Abah's colloeagues are planning on aksing UKM what can be done to help with the situation.


4. It is still cruicial to get him independent as fast as possible, which is why I've been millitaristic with his lower limb physio. At home, I've been forcing Abah to stand up despite his protests, and walk to and fro when possible. Abah tends to ignore Umi's suggestions to stand, and Adib is more of an enabler, keeping Abah in the "sick role". With him independent, there'll be no problems for Umi to resume working. But without intensive training, when that can happen is unclear. Speech therapy at home is also a big problem, as I don't know how to force him to keep on trying to speak.


5. I have a jinx with the HUKM elevators, always breaking down when I want to use them. And so I was forced to climb up 7 flights of stairs to bring the wheelchair to Abah when he was discharged, a challenge I relished and had no problems. It was unfortunate for the little 8 year old kid who tagged along to help bring the belongings to the car. He was wobbly from the 5th floor onwards.


Conclusion: I may be fat, but I'm fatter than a skinny 8-year old. And those who ridiculed my aims to be stronger (rather than purely bodybuilding purposes), now you have an answer as to its advantages.


Training:
Max week.

Good mornings - up to 66 kg x 16
Back squats - up to 78 kg x 16
Weighted pushups - up to BW+20 kg x 17
Standing DB presses - up to 40 lb x 16


My wrist has been getting better, with 50%1RM for deadlifts, bench and military press (empty bar) all painless. Penlay rows up to sets with 95 lb also went well. This week I'll try progressing and retesting the state of my wrists, working to hopefully 95%1RM.


Cardio last week consisted of barbell complexes, followed by sprints and light treadmill intervals. They were, um, killer. It was needed, considering that there'll be an underground b-ball tourney involving the old IIUM team. Think 4 games a day.

Chapter 2
Thoughts:
1) Abah can walk a bit faster now, but his hands are only flickering, still. I'm trying to aggressively train his hands, but it's difficult as it requires him to move and hold on to objects. You can't train the upper limbs properly while on the sofa. Otherwise I've kept with the grip training using a cup to give him sensory feedback about his movements. Due to the lead-pipe rigidity of his elbow, I've been pushing to have mobility work in his arms as frequent as possible to prevent a fixed flexion deformity. He can lift his legs up onto the bed now, and the headaches are less frequent. He'd still have giddiness on standing though. "Medically", there's no ankle clonus, although there's some "toe clonus" when I extend and dorsiflex the toes/ankle.

As regards to his speech, there has been no improvement, except when he accidentally pee'd in his pants (he couldn't go quick enough to the toilet, and he couldn't tell us he wanted to go). He mentioned "kain" (referring to the sarong) when he wanted us to help get him to the toilet in a different manner. Other than for that ordeal, the wheelchair is not used at home, as I was adamant on getting him to walk.

He no longer has urinary retention (no more need to use temperature stimulation), but he's consitipated, with no bowel opening in a week. Since tactile stimuli didn't work, we've started trying small amounts of laxatives. So far still no improvement. The amount probably needs to be increased further. I'm not too worried (yet) as he doesn't complain of abdominal pain/fever.

2) Despite cutting my training to only 3 days at most of trainining I still can't cope with the fatigue of going back home every week, even when taking the bus. In fact taking the bus probably makes it worse, as it gives me sacral pain. I leave the bus feeling more tired than before entering it. And since I have no small luggage bags, I end up having to lift the bag wherever I go to. At best I look clumsy doing that. The only advantage of taking the bus is that it's cheaper, and there's no danger if I doze off.

Even though before this I was also someone who wakes up late, it's even worse now. Either I feel fucking miserable when I wake up, or I wake up severely late. Both not a fun option. And the fatigue lasts the whole week. I hate mental fatigue.

It's now 10 weekends straight of going back home (interrupted by the weekend before exams) and counting. I still haven't started studying for internal medicine, depending on just the knowledge gained during year 3. And let's not get started on the issue of assignments...

3) I had 2 what the fuck moments with the telco's last week.

The first was with Celcom for my mobile internet, when it took a fucking 20 minutes call and another 40 minutes consultation at their shop just to figure out that my SIM card was defect. Come on, when I told you it worked before, the problem is not with using the wrong settings on my computer, morons. Okay, so the differential was a problem with the modem, but 40 minutes? Seriously? At the very least you could've made free the RM5 replacement fee to repay for the insane unproductivity and horrible problem solving.

The second was with DiGi, as regards to my old mobile internet account. When I terminated my old account, they did not bring up the fees due for the half month when I did terminate it. And so what did they do? They decided to ask for the fee via an annoying call (in the middle of Dr Zain's class) with a menacing tone and threats. All for RM58. Take the money and shove it in your throat DiGi.

4) I find that stupidity has a bimodal distribution: high among the poor, but also very high among the rich. After the Bollywood love saga last week, there's no denying the truth.

5) On another note, how come I only knew about it when the pot was literally boiling? I guess I've become more and more detached with my surroundings.

6) Added with with my problems with my car (battery is now officially RIP'd) and family finances (Abah's credit bills still need to be paid, which I have to do as Umi needs to care for Abah), there's reallly too much in my head. At least Abah still has full salary while Umi has to request for half pay. No offense to Wahida (all the best for her therapy), but I think I need a "long-term" break just as well just to get a hold on my bearings, at least mentally.

Training:
I had a severe lack of time last week. My wrists feels better. But I broke my old PR's. Enough said. With a just recently injured wrist (2 months is recent in the soft tissue calendar). And so 1 gym session (strength) and 1 at home was all I could muster.

Deadlift - 140 kg x 1 (10 kg PR)
MP - 60 kg x 1 (6 kg PR)
Fat-man pullups - Back to the lowermost level, but pain at rep 5. If there is no pain this week with 5 reps, I'll retry inverted rows, with the stability ball, and see if there's pain.

Since I couldn't go to the gym again, I tested my wrist by doing pushups at home:
5 x 10 puhsups, back to back with 5 x 10 bodyweight pushups, using the palms instead of the fists as before. No pain. More of a conditioning than strength type of work.

If things go right I'll reduce the weight and up the weights again. But I'm not sure when I'll restart doing pullups. Maybe I'll try negatives once inverted rows with the stability ball becomes painless for at least 8 reps, or if I'm able to do again Penlay rows up to 165 lb x 10 as before.