Wednesday, January 31, 2007

5 days 4 nights

That's how long I have been in Pantai Medical Centre children's ward C525.

Amin's been purging for 6 days from Saturday 20th January 2007. We have gone to 2 different clinics to seek for medication and in the end, on the morning of 25th January, I took Amin to see Dr. Rasool here at the clinic at my workplace and without wasting any more time and medicine, he referred us to Dr. Azam, Paediatrician Specialist at Pantai Hospital, who then immediately warded us.

Amin had actually been on and off purging and experiencing high fever especially at nights, for the past few weeks, since early January, but have been able to recover after 2 to 3 days. I have visited the doctors at two of our local clinics at home where they gave him antibiotics and fever medication. All the medicines have finished but the fever and purging came back the following week but this time, it got worse. The purging continued constantly almost after 3 hours of meal intake and on 24th Jan, the fever came back and stayed for good, despite how much medicine I gave Amin. That's when I knew that I had to take Amin to a different clinic, to seek for another opinion, and hooray to Dr. Rasool for immediately able to diagnose Amin with viral infection of Gastroenteritis and identified that Amin was already dehydrated.

I have never seek treatment at Pantai Hospital before and neither did any of my family members, hence, we were new to absolutely everything. I was in for a surprise. It's so unbelievably efficient. The admission registration and General Letter (GL) acquiring process were carried out flawlessly by the staffs there and within 15 minutes, we were already in our room and several nurses and lab technicians were ready to take a few samples of Amin's blood for analysis. The lab technician prick one of Amin's finger and squeezed a few drops of blood from it. I knew that it didn't hurt so much but Amin was crying out loud, most probably due to the surprised of the sudden needle prick.

Dr. Azam came in a few minutes later to put the Intravenous (IV) Access Device in Amin. He inserted a tube into Amin's veil located on his right hand. And this time Amin cried helplessly on and on and on even long after the process ended. It must have hurt him so much although Dr. Azam had successfully found the large vein and only inserted the needle in one attempt.

Throughout 5 days and 4 nights, Amin was fed with 4 bottles of salt/glucose, 3 doses of 2 types of antibiotics through IV drip, and I lost count of the number of medicines he had to swallow every 4 hours. His urine and stools sample were taken for analysis and his diapers outcome were recorded each time. Dr. Azam also identified that there was redness in Amin's throat and phlegm in his lungs, hence he also assigned nebulizer treatment be done three times a day.

There's no words that can express how I felt at this moment. I just kept praying to Allah for things to get better. I'm very grateful that Amin was very understanding, patient and tolerable. It was as if he had grown out of his age. He was such a good boy. He didn't even attempted to take the IV tube off, although he did told the nurse to do so (in his own language- of course). He refused to swallow the medicine, hence we had to force them into his throat (mommy so sorry baby! but we had to do it, or else, how will you ever get any better?) Anyway, it was a miracle that he was able to sleep with such minimal movements and able to control his hand from pressing the IV tube.

His fever subsided only on the third day and that was after the doctor gave him his 3rd and final doses of antibiotics. His purging getting less on the fourth day and Dr. Azam stopped all medications, including the IV drip and put him under observation on the 5th day. A few drops of blood was taken early in the morning and by 6pm Dr. Azam gave us the green light to go home. Syukur Alhamdulillah..

Million thanks to both of my parents for accompanying me day and night without failure. I couldn't have made it without your support, especially with my husband out station during this period. Thanks to all my relatives and family friends who came to visit and thank you for the doa'. May Allah bless you always.

p/s: I made a nazar to fast for one day as Amin got better.


What is Gastroenteritis?

Definition from, Gastroenteritis is a catchall term for infection or irritation of the digestive tract, particularly the stomach and intestine. It is frequently referred to as the stomach or intestinal flu, although the influenza virus is not associated with this illness. Major symptoms include nausea and vomiting, diarrhea, and abdominal cramps. These symptoms are sometimes also accompanied by fever and overall weakness. Gastroenteritis typically lasts about three days. Adults usually recover without problem, but children, the elderly, and anyone with an underlying disease are more vulnerable to complications such as dehydration.
Gastroenteritis usually consists of mild to severe diarrhea that may be accompanied by loss of appetite, nausea, vomiting, cramps, and discomfort in the abdomen. Although gastroenteritis usually is not serious in a healthy adult, causing only discomfort and inconvenience, it can cause life-threatening dehydration and electrolyte imbalance in the very ill, the very young, and the very old.
Typically, children are more vulnerable to rotaviruses, the most significant cause of acute watery diarrhea. Annually, worldwide, rotaviruses are estimated to cause 800,000 deaths in children below age five. For this reason, much research has gone into developing a vaccine to protect children from this virus. Adults can be infected with rotaviruses, but these infections typically have minimal or no symptoms.
Children are also susceptible to adenoviruses and astroviruses, which are minor causes of childhood gastroenteritis. Adults experience illness from astroviruses as well, but the major causes of adult viral gastroenteritis are the caliciviruses and SRSVs. These viruses also cause illness in children. The SRSVs are a type of calicivirus and include the Norwalk, Southhampton, and Lonsdale viruses. These viruses are the most likely to produce vomiting as a major symptom.
Bacterial gastroenteritis is frequently a result of poor sanitation, the lack of safe drinking water, or contaminated food--conditions common in developing nations. Natural or man-made disasters can make underlying problems in sanitation and food safety worse. In developed nations, the modern food production system potentially exposes millions of people to disease-causing bacteria through its intensive production and distribution methods. Common types of bacterial gastroenteritis can be linked to Salmonella and Campylobacter bacteria; however, Escherichia coli 0157 and Listeria monocytogenes are creating increased concern in developed nations. Cholera and Shigella remain two diseases of great concern in developing countries, and research to develop long-term vaccines against them is underway.

What causes Gastroenteritis?

Summary from, the most common cause of gastroenteritis is viral infection. Viruses such as rotavirus, adenovirus, astrovirus, and calicivirus and small round-structured viruses (SRSVs) are found all over the world. Exposure typically occurs through the fecal-oral route, such as by consuming foods contaminated by fecal material related to poor sanitation. However, the infective dose can be very low (approximately 100 virus particles), so other routes of transmission are quite probable.
Gastroenteritis arises from ingestion of viruses, certain bacteria, or parasites. Food that has spoiled may also cause illness. Certain medications and excessive alcohol can irritate the digestive tract to the point of inducing gastroenteritis. Regardless of the cause, the symptoms of gastroenteritis include diarrhea, nausea and vomiting, and abdominal pain and cramps. Sufferers may also experience bloating, low fever, and overall tiredness. Typically, the symptoms last only two to three days, but some viruses may last up to a week.
A usual bout of gastroenteritis shouldn't require a visit to the doctor. However, medical treatment is essential if symptoms worsen or if there are complications. Infants, young children, the elderly, and persons with underlying disease require special attention in this regard.
Besides bacteria, several types of viruses, such as rotaviruses and the Norwalk virus, cause gastroenteritis. During the winter in temperate climates, rotaviruses cause most cases of diarrhea that are serious enough to send infants and toddlers to the hospital.
Certain intestinal parasites, particularly Giardia lamblia, stick to or invade the lining of the intestine and cause nausea, vomiting, diarrhea, and a general sick feeling. The resulting infection, called giardiasis, is more common in cold climates but occurs in every region of the United States and throughout the world. If the disease becomes persistent (chronic), it can keep the body from absorbing nutrients, a condition known as a malabsorption syndrome. Another intestinal parasite, called Cryptosporidium, causes watery diarrhea that is sometimes accompanied by abdominal cramps, nausea, and vomiting. The resulting infection, called cryptosporidiosis, is usually mild in otherwise healthy people, but it may be severe or even fatal in people with a weakened immune system. Both Giardia and Cryptosporidium are most commonly acquired by drinking contaminated water.
The greatest danger presented by gastroenteritis is dehydration. The loss of fluids through diarrhea and vomiting can upset the body's electrolyte balance, leading to potentially life-threatening problems such as heart beat abnormalities (arrhythmia). The risk of dehydration increases as symptoms are prolonged. Dehydration should be suspected if a dry mouth, increased or excessive thirst, or scanty urination is experienced.

What is stomach flu (viral gastroenteritis) ?

Concluded from, Stomach flu is a viral infection that affects the stomach and small intestine. It is also called viral gastroenteritis. Viral gastroenteritis is a common infection of the stomach and intestines that results in vomiting and diarrhoea. It can be caused by a number of different viruses, such as Rotavirus and Norovirus (previously known as Norwalk-like virus). There are many other causes of non-viral gastroenteritis including bacteria, toxins, parasites, and some non-infectious diseases.
Viral gastroenteritis is a highly contagious leading cause of illness, but it seldom lasts for longer than 72 hours. It is characterized by a sudden onset of loose, watery bowel movements, which may or may not be accompanied by fever, chills, weakness, muscles aching, stomach or abdominal pain, nausea, vomiting or gas.
Many types of viruses can cause gastroenteritis but the most common are Rotavirus and Norwalk virus. Rotavirus is the leading cause of gastroenteritis in children and can also occur in adults exposed to children with the virus. Norwalk virus causes group-related or institutional diarrhea with peak frequency during the winter. Norwalk-like viruses are common in school-age children. These viruses are often found in contaminated food or drinking water. The viruses cause about 40% of group-related diarrheal illnesses. They affect older children and adults and are more frequent during the winter months. Symptoms appear within 4 to 48 hours after exposure to the contaminated food or water. The viruses are usually spread by the fecal-oral route. Rotavirus causes severe gastroenteritis in infants and young children. Severe dehydration and death can occur in the young age group. It is responsible for up to 50% of the hospitalizations of children with diarrhea. Outbreaks may also occur in geriatric settings such as nursing homes. Usually, by the age of 3, most children have acquired an antibody to the virus.
The main symptoms of viral gastroenteritis are vomiting and watery diarrhoea. Other symptoms may include nausea, fever, abdominal pain, headache, and muscle aches. Dehydration can follow. Symptoms can take between one and three days to develop and usually last between one and two days, sometimes longer.
The objective of treatment is to replace fluids and electrolytes (salt and minerals) lost by diarrhea. Antibiotic therapy is not effective in viral illness. Antidiarrheal medications are generally not given, as they may prolong the infectious process. Self-care measures to avoid dehydration include drinking electrolyte solutions (available over-the-counter) to replace fluids lost by diarrhea. People with diarrhea who are unable to take fluids by mouth because of nausea may need intravenous fluids, especially in small children. People taking diuretics need to be cautious with diarrhea, and may need to stop taking the diuretic during the acute episode. (Always consult with the health care provider before stopping a prescribed medication!)
Do not give anti-diarrheal medications to children unless directed to do so by a health care provider. Since the risk of dehydration is greater in infants and young children, parents should closely monitor the number of wet diapers changed per day when the child is sick. Electrolyte and fluid replacement solutions for children are available in food and drug stores. Jell-O water, soda and plain water do not replace electrolytes the child needs when dehydrated from vomiting or diarrhea. Children with diarrhea often benefit from dietary modifications until the diarrhea subsides.

Monday, January 08, 2007

1st day @ work

My 2 weeks vacation was a blessing. No internet, no workload, no phonecalls from the office.. yeah, right! huh.. except for that one, of course.. We spent the first few days here at home, launging around, watching dvd, sleeping until noon (Amin too, no kidding!) and I even managed to cook breakfast and lunch a couple of times. Then we spent a week in Penang for the Raya Aidiladha and the remaining days back here in KL. Oh how I love the holidays.

And today, I'm feeling good. Feeling fresh. Feels great to be back in the office. To sit in this absolutely freaking cold server room. To assist my staff in answering calls pertaining to broadband problems. To surf this reporting application and checking it one by one to see if any frontliner failed to update the reports from time to time. Oh my god.. who am I kidding? I hate this job. Seriously, I do. I can do better than this, dammit. I deserve better. My IQ is dropping by the second here. Huwaaaa... I want to get out of here.. Help me pleaseee..

Oh well, enough said.


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