Hello!

Hello world :)

Felt like it's been awhile. Been busy with the move.

Just wanna drop by and say hello :)

I have been well.

God's been gracious to me :)

Amen :)

A TULIP for you :)

For a greater meaning underneath..

Facing the Giants

Do you know what's the giant within you?

Do you know what's the giant that you're facing?

Lately, I was being reminded of a good movie I watched a few years back. It's a Christian movie (Same producer as Fireproof) which I will highly recommend to anyone.

I was reminded of this show because for 4 consecutive weeks, my church sermons have been heavily focussing on the matters of the Spirit and knowing the Giant within us.

Coincidentally, I am also facing a giant and there's a giant of fear come crushing down me lately. I tried dealing with the giant initially, but later I realized that I might not really know who's my giant...

How can one win a battle without knowing who's the enemy or the giant she's fighting against?

So I have to find the giant, and to really face the giant.

Oh yea, maybe I should share with you some quotes from the movie 'Facing the Giants' which touched me, and still do :)

When coach Grant Taylor trying to rebuild his football team, a conversation with his young captain:

Brock Kelley: You don't want us to win games?

Grant Taylor: No. Not if that's our main goal. Winning football games is too small a thing to live for. And I love football as much as anybody. But even championship trophies will collect dust and one day be forgotten. It's just that so far this has all been about us; how we can look good, how we can get the glory. The more I read this book, the more I realize that life's not about us. We're not here to get glory, make money, and die. The Bible says that God put us here for Him. To honour Him. Jesus said that the most important thing you can do with your life is to love God with everything you are, to love others and yourself. So if we win every game and we miss that, we've done nothing. Football then means nothing. So I'm here to present you a new team philosophy. I think that football is just one of the tools we use to honor God.

Brock Kelley: So you think that God does care about football?

Grant Taylor: I think He cares about your faith. He cares about where your heart is. And if you can live your faith out on the football field then yes, God cares about football because He cares about you. He sent His son Jesus to die for us so we could live for Him. That's why we're here. But see, it's not just on the football field; we've got to honor Him in our relationships, our respect for authority, in the classroom, and when you're at home alone surfing the internet. I want God to bless this team so much that people talk about what He did. But it means we got to give Him our best in every area. If we win, we praise Him. And if we loose, we praise Him. Either way, we honour Him with our actions and our attitudes. So I'm asking you: what are you living for? I've resolved to give God everything I've got. Then I'll leave the results up to Him. I want to know if you'll join me?

And one of my favorites:

Grant Taylor: God can do whatever He wants to do, however He wants to do it. And He chooses to work in our lives because He loves us. He's good. Hope today's a milestone for what He can do for the rest of your life if you trust Him.

Today, I felt ministered during prayer meeting when pastor read a scripture from 2 Corinthians, especially when it came to this verse:

"Therefore, we do not lose heart. Though outwardly we are wasting away, yet inwardly we are being renewed day by day. For our light and momentary troubles are achieving for us an eternal glory that far outweighs them all. So we fix our eyes not on what is seen, but on what is unseen. For what is seen is temporary, but what is unseen is eternal". 2 Cor 4:16

Shouldn't fear the giant.

Everything is transient except Him, including the giant.

Rain on Me

AND

Embrace the Rain.

I would like to share something that I read with you :)

So many times people approach us and tell us how strong we are... how brave we must be to take on all that we have, I never really thought we were brave, and most of the time we are not strong. What options do we have? We could either wallow in the heartache or we can praise Him through the storms.

Christ took on so much more than we could ever imagine. He never promised us that this life would be easy. He never promised that we would never experience pain or heartache.

"I have told you these things, so that in me you may have peace. In this world you will have trouble. But take heart! I have overcome the world." John 16:33

I feel Him gently nudge me and quietly say "I am still here." If I let Him, He will guide my footsteps and guard my heart. So I choose to face my days with hope. I know that in every circumstance in my life, He is already there."

Must be wondering why I have the urge to share this. I dont know.

But it reminds me of the existence of the greater me despite the many situations.

And how many times when it rains, how many of us can embrace the rain with willing hearts?

Can it come from practising?

The FIRST shift

My pharmacy assistant Siling told me these:

"If you are going back to interchange, take either bus 800 on this side or 804 on the opposite side of the road"

I was jaded after the entire thing and unknowingly, I crossed the road, waited for 804 to leave the bus stop and boarded bus 800 which came after it. It was supposed to be 2 stops away from the interchange but I ended up spending almost half an hour on the feeder bus because I boarded the wrong. Initially I felt so stupid and contemplated whether I should just alight at any stop and take a cab home. But I was just too tired to even move my butt away from the seat. So I decided to take a long ride back to the interchange.

Due to some reasons, a medication error happened today and I had to go to the patient's house to take back the medicine before things could become worse. Don't ask me why this kind of things actually happened. When your workload and patient load increased by 93% from the old days (but the number of staff remained the same and sometimes less), things do happen and you just cannot help it.

Don't worry, I didn't make that error. But I have to admit that I committed a fair share of medication errors too. When I made an error, the team supported me and helped me. So when my teammate made an error, I had to support too. The situation in the pharmacy is really bad - this is the 2nd medication error that necessitated me to go to the patient's house to explain and do service recovery. 1.5 weeks ago, a patient was discharged to a community hospital and I too made a trip to St Luke Hospital for another medication error.

But as I was taking the long bus ride just now, a tinge of blissfulness actually dawn upon me. I have a lot to tell God and I always feel as if I don't have time to talk to Him.

It felt as if so much had happened over a short span of 2 months. Have I told you lately that I have 3 major shifts in my life this year.

The first shift - My hospital had shifted from the old Alexandra Road to Yishun and is now called Khoo Teck Puat Hospital (KTPH).

Since the opening of this new hospital, I have been put in charged of 3 wards - 2 of which are Geriatric Medicine wards (老人科), the 3rd one is called Isolation ward (Infectious Disease ward).

How should I describe it? It felt as if I was running on a flat road (the old AH days) and suddenly the steepness of the road has increased tremendously and it's taking so much of me. The people that we see in Yishun are generally more sick, and the conditions are usually more acute. It felt as if God has brought me out of my comfort zone - and coincidentally, He brought me out of the comfort zone when I started turning lukewarm towards Him.

Before my principal clinical pharmacist left the hospital for PharmD, she told me something that I could never forget. She told me that I have the aptitude in clinical pharmacy and I should never give up on this path no matter how hard situations are going to be. She said there are certain things in this world is something that you can only see ONE in a decade kind, and I am one of them. Honestly, when she said that, I felt the pressure. At the same time, being a 1.5 month-old pharmacist then, I felt relieved because someone of that credentials actually validated me.

I am telling you these now not to boast about the praises she gave me, but I want to tell you that man's words can poison one's senses and numb one's direction in life.

When the hospital just started operating, the patient load was manageable and I was still managing well between these wards. As the patient load started picking up within 2 weeks of opening, the challenges that came to me also increased exponentially.

Not only myself, the whole pharmacy has practically plunged into a mess as we are understaffed and the staff-workload ratio is really an imbalance. And when there is chaos, there is also medication error. And when there is medication error, there is also complaints from both nursing and patients. When there is error and where safety is concerned, there is also a fair component of fear and people start giving up and leaving.

And you realize that you are not protecting the people you need to protect, especially the junior ones. They are living in fear - fear of making mistakes and made responsible for the harm inflicted on patients, albeit not intentional.

At the same time, I feel that coping with the ward load is a struggle. The patient conditions are so acute and sometimes it's beyond my limited knowledge and I feel fearful too. As I was reviewing the patients, I realized that there's a lot of things that I do not know and I feel that I'm so lousy, and I add no value in the care of the patient.The sense of incompetency overwhelmed me so much in the beginning that it made me quite sorrowful.

So many first time-s...

1st time facing so many mortalities within such a short time frame.

1st time feeling that I could have done something more than just accepting the things the way are, and the patient may still survive today.

1st time feeling so demoralized by certain physicians

1st time for me to experience the validation and trust from the physician and also to lose it immediately, due to some situations that is beyond my capability to prevent.

1st time hating seeing DIL (dangerously ill) and DNR (DO not resuscitate) so many times in the wards. Because I am losing them and no matter how aggressive I want to escalate the treatment, it will be a No from the physician.

1st time having my colleague's grandma admitted into my ward and she said "I know she's in safe hands because you are in charge of this ward". I feared.

1st time doing training plan to train the staff so that they can be upgraded to face the storms.

1st time feeling that I've not heard God's voice for the longest time ever and I have been so alone in this storm..

It is also the first time for having to carry the black pot and feeling so embarrassed. I was very angry with God why did I have to face such situation despite my commitment to maintain my attendance at church. What's more the black pot incidence came to me immediately after I returned from discipleship training. Such an irony - I was so spirit-filled yet the news came and I couldn't sleep the whole night. It felt as if the renewed strength that I got from DT vanished into the thin air in such a matter of seconds.

It is also the first time that I felt so powerless and sorry for not being

able to protect my pharmacy technicians and I so wanted to reverse their fear but I couldn't. I saw them losing hope and I felt sorry for the way situations are.

1st time feeling so so so weary of something that I am so fond of.

But on Monday boss talked to me and she said she wanted to rotate me to other discipline like General Surgery.

It is true that you don't know what you have had until you are about to lose it.

Today as I was doing ward rounds with the consultant and medical officer, I felt so blessed. I realized that I learnt a lot from the team of doctors. The consultant was examining the patient and explaining to me why is he doing certain things. We discussed a lot on our patients and the medication parts and I was trying my best to help to optimize the medication part. I checked the labs and recommend the antibiotics etc and answered their queries regarding the medication according to what I know. And we moved from one patient to another patient. Just ward round, something very routine.

I noticed that we learned from each other. Sometimes when I really don't know, I told them that I don't know and will get back to them. I realized that I am no longer embarrassed by the fact that I don't know the stuff. I feel relieved when I said I don't know and will check it out.

I loved following ward rounds because we can exchange perspective. A lot of times, I do interventions based on my knowledge on the drugs and the patient. Sometimes it gets rejected. sometimes accepted. I cannot follow every team's rounds because I am doing 3 wards and all doctors review patients in the morning. I can only follow one team every day.

Everyone wants to make sure the patient gets the best care just that we are coming from different groundsBut as I follow the rounds, I tell them why I would like certain medication be dosed in certain ways, and I explained why I preferred one over another, they started to see where I am coming from and accepted my recommendation. Sometimes, after hearing the team's opinions and plan, I decided to respect the team decision and support it. It's the communication that God has slowly built over time that makes it what it is today.

I feel that I am a really silly girl. I keep seeing what I don't have, and have long forgotten what I have.

I have been really foolish. A foolish pharmacist thinking she can save the whole world and use her paper knowledge to help patients only to find herself doing more harm.

I am a stupid girl for I have been dwelling in the low self-esteem for too long and didn't realize that even the low self-esteem and inadequacy is part of God's plan in making me a better person, a greater vessel, a wiser pharmacist. I should have stopped eroding in my self-insufficiency and start discovering how He's leading me through all this while.

I forgot that I am only a 4 month-old pharmacist and God has already placed me in the best place on earth that no one could be EXCEPT ME,so that I get the best learning experience. He exposed me to the myriad of illnesses and conditions that I have not seen before and today my clinical knowledge has increased from baseline and for the things that once I didn't know, I know better now.

I realized that I can be kinder to myself and not force myself to live up to people's expectations of me. I do not need to get people's validation and it's okay that people reject my recommendations. I do not need to be fearful of rejections and therefore stop making the necessary interventions for my patients because the fact is God has given me the literature and evidence-based drug knowledge to back my interventions and whether the interventions get accepted or not, it's still part of His perfect will. I just need to face Him in all that I do, with clear conscience.

God taught me a huge lesson about myself these 2 months. To many, I appear to be a capable person but only God knows the inferiority complexes hidden beneath this brave front. But I realized that all God wants from me is to admit that I have this problem and I do not need to feel shameful about it. When I hear the voice of the enemy telling me that what He has made me to be is not enough, I just need to draw strength from God to resist it with the truth. For I have been made lukewarm, He now wants to turn up the temperature. A journey of faith He's teaching me. Learning to rely God in greater faith and not be tossed up and down like a ship in a storm. Finding the anchor in all kinds of weather and eventually found it.

All in all, I need to turn my eyes upon Jesus and not man's words, I need to tune into His words for His words is a lamp to my feet and a light for my path.

Today, I saw the doctor's entry - await pharmacist input on vancomycin monitoring.

As I was following the rounds today, I saw the patient gasping and blood pressure dropping very low. It was a DIL, DNR case and the doctor withdrew all treatment - for maximal ward comfort measures. And I realized I wasn't angry or upset. For I know exactly it's an end of life issue and I am losing the patient already - I should let her go. True enough, she passed away 2 hours later. First time realizing sometimes doing nothing is the best for the patient. First time, seeing it so physically, that the end of a man is the beginning of God in her. I can't describe exactly how I felt at that point of time - I felt that God was just telling me that how fragile human can be and as human, we are so powerless against many many things on earth. Like all we once held so dear and built our lives upon can be NOTHING in just a twinkling of an eye. Why holding onto them so tightly and burden ourselves with so much sorrows?

In the same day, the doctor whom I thought have lost trust in me called me for some other stuff. Today, my colleague needed an answer about a drug urgently and I provided it immediately.

Suddenly I felt a sense of restored justice and righteousness from God. It might not be today only, but my radar is more sensitive today I guess. I wonder when was the last time I counted my blessings and goodness in life.

Strangely, my manager wanted to meet up with me this morning, after my ward rounds.

She chatted with me for awhile and once again she said "You know, hooi ching, your seniors are singing praises about you for what you are as a young pharmacist. You have the potential and I hope you see it". Something along this line.

To hear the same thing from a different person. However, this time, the conviction is different too.

It does not matter to me anymore whether anyone thinks highly or lowly of me. It does not matter to me anymore, whether the seniors or the doctors think I have what it takes and they value my inputs. It also does not matter to me anymore if people think I make stupid interventions and get more rejections.

What matters to me most, right now, and for the rest of my life, is that God thinks highly of me and thus for every situation that He puts me in, is one that He has already overcome and I too, will overcome victoriously because He is the pillar of my strength. I should not regard it as something bad for it's an opportunity for me to grow spiritually. All I need to do is to remember this, and bite on it, chew on this promise and carve it in my heart.

I know I'm not done, He's not done with me yet.

I know the process is still on-going.

But I am no longer upset.

Neither am I happy.

I am just thankful. :)

I really hope that in future, even when my soul is heavy, God will put a song in my heart that rises out of me and sends away the dark clouds.

This is what the Lord says:

Let not the wise man boast of his wisdom

or the strong man boast of his strength

or the rich man boast of his riches,

but let him boast about this:

that he understands and knows me,

that I am the Lord, who exercises kindness,

justice and righteousness on earth,

for in these I delight,"

declares the Lord.

- Jeremiah 9:23-24-

Turn your eyes upon Jesus

Hello there.

I feel so drained lately. Physically, mentally and emotionally.

Feel like taking a really long break and just leave where I am.

Yet it feels like another escapism when I say things like that.

How good it'll be if I can wake up in heaven tomorrow.

Yet it won't be the case because I have a journey that I need to walk through.

Do you feel the same way too?

I kept playing this song again and again.

You know, sometimes fixing your eyes upon Jesus is the antidote to the weariness.

The half-life of this antidote is short so you have to keep doing it again and again. Because as the antidote effect wean off, you feel the weariness again.

I really cannot think of a better solution for now. So I need to keep turning my eyes upon Him, if not I might not be able to make it to the end of this journey.

I really do feel like waking up in heaven :)

Turn your eyes upon Jesus

Look full in His wonderful face

And the things of earth will grow strangely dim

In the light of His glory and grace

Lord I am dry, so please fill my cup :)

What we don't know can, and does, hurt us

Knowing one's weight is very important in healthcare.

I always know my weight. There are many drugs in this world are dosed by body weight.

Vancomycin, a potent antibiotic that kills a multidrug resistant bug, is dosed by actual body weight. If one day i am infected by this bug, I always know what kinda dosing i will give myself because calculating by 15mg/kg 12hrly dosing, the dose is ard there.

Sometimes, I think it's a healthcare-acquired disease - that subconsciously, when you are dosing your patients certain dangerous but life-saving drugs, you tend to help yourself calculating the doses that you need too - just in case you might need them in future. And no one knows how to dose it better than you do.

Eptifibatide - another drug that is used in acute cardiac events, is also dosed by body weight. Ask me next time and I will tell you the dose. This drug costs a bomb too. So the heavier you are, the more expensive it gets.

If you have followed by blog before, I once briefly touched on TB regimen. When one's diagnosed with TB, they will be started on 4 drugs, all dosed by their body weights. In general, it's > 10 pills a day for just TB treatment and for a minimal duration of 6 months. Next time you should tell me your weight, so that I can calculate for you. Have that figures stored in your head just in case... touch wood!

Anyways, if you have known me well enough, perhaps you have heard me talking much about TB.

My eldest brother, a houseman officer in Hospital KL, is recently hospitalized and the primary diagnosis to date is pleural TB. TB is an infection caused by a bug called Mycobacterium tuberculosis. [If you have watched tv, sometimes you will see people in the past got sicked and coughed out blood - that's a TB representation, sort of]

It started with episodes of cold and cough which didn't resolve despite antibiotics (for cough and cold), and when he went for a Chest X ray, it was realized that there's fluid accumulation in his lung. I asked him the presenting symptoms - no shortness of breath, no fever.

Because of the fluid in lung (which is very uncommon), he was hospitalized. A series of test include blood and sputum culture showed negative so far. To put things in perspective, it's extremely hard to grow TB bugs and may take4-8 weeks before any result could be seen. The skin test (Mantoux), another diagnostic test, however told us otherwise.

Some information about The Mantoux test: a small amount of a substance called PPD tuberculin is injected just below the skin of your inside forearm. You should feel only a slight needle prick. Within 48 to 72 hours, a health care professional will check your arm for swelling at the injection site, indicating a reaction to the injected material. A hard, raised red bump (induration) means you're likely to have TB infection. The size of the bump determines whether the test results are significant, based on your risk factors for TB.

My brother has that raised bump.

Because of the fluid in his lung, today he had some painful procedures. The fluid in his lung needed to be drained away so a chest tube was inserted from the back to the lung to drain the fluid away - 1.5L(can u imagine??) of fluid was drained out. At the same time, he had a lung biopsy.

My dad kept asking us that we should call my brother and check on him more often. Daddy said I should talk to brother more cos I am the only one in the family knows what's going on due to the complexity of medical information which can be at times, and after I got the information I can update them so that they understand the whole picture. I guess me and my brother are spiritually-sicked. We always thought that we need to be accountable for our own affairs, bear our own responsibilities without needing to tell people, not even our own family, about the good and bad going on in us.

My sister gave me a serious talk on saturday which really touched me. She mentioned, we(my brother and I) often being too "independent", always think that we are living by ourselves alone out there, often don't care enough to update and communicate to our own family about our own lives. When shit happens to us, we deal with them most of the time ourselves; when we could have shared, leaned on our own family members who really want to care for us, whether we ask for it or not.

I know. I hate being like this, yet I am still like this.

Anyways, I only told them that the hospitals do all these test on my brother so that they can try to grow the TB bugs and if the TB bugs really can't grow much later, that's means he's not actively infected with TB. If it grows then it's TB.

But I didn't tell them that the lung biopsy and lung fluid test were done also to rule out the possibility of cancer. Because one of the reason of fluid accumulation in lung can be malignancy and lung biopsy can tell us if it is. I kept saying it's darn hard to get a TB because we are all immunized since young, unlike the older generation. But if it's not TB it has to be something else. The skin (Mantoux) test can be false positive under some situations, and given the negative results for the rest, honestly, I am worried.

Yet how am I supposed to convey these information to the already so darn worried parents. A simple word like 'maybe' can send them down with a few sleepless night. I wonder if I am too rationale, too healthcare professional-liked, to digest all the information myself.

People asked me if I am afraid of TB.

I said no. Because it can be treated, and it should be treated with properly dosed TB drugs (no under-dosing please!). The course is tedious and painful, with side effects etc, but it can be treated. I will not be worried if it's TB.

What if it's not? I wonder if this is going through in his brain right now.

On a positive note, I don't think it can be cancerous stuff. For he's too young for that, and I know that there's so much in him that God wants to use and will definitely use. I guess he must have created a legacy in his hospital - a houseman down with ?TB - off duty for ? months. It's an atypical path that God is already subjecting him to, and I know that He is in charge of his life. But if it happens, I really hope to be able to see the good out of the difficult things that my brother and my family will have to go through.

Wonder if you ever encountered things that you've never thought will ever occur to you? I did have a fair share of them, including this. I must say, what we don't know can, and does, hurt us. It hurts people who doesn't know Christ even more significantly. I feel that so strongly from my parents.

Dad has been coughing and unwell for near a month.

All I can say is, I can only release the burden of all the difficult things that are on my heart into His hands, cos He is the only One who can lift it off and carry it for me. I hope things go well, really. And if things have to happened, I pray that the timetable of this family is therefore hastened.

He made the burden light :)

Hello! :) How are you?

This week I am working late shift, ie from 930-7pm. Coincidentally, Linqun is also working the same shift, just that she's in outpatient I'm in inpatient.

As I was walking to mrt from hospital yesterday, this tree caught my attention and I thought - wow, it was quite scary hahaha :)

How have you been? This week has been fine for me, and I really thank God for keeping me safe and at peace. Somehow, He made my burden light. If it's the HC 3 months ago, I am sure I will be darn frustrated with things.

Yesterday, I walked into my ward feeling very "Strange". From the entrance, I could heard someone playing songs very loudly from the laptop. The song that the patient played was also

another thing that surprised me. Not sure if you know it, but he's playing "万君之耶和华" from Stream of Praise. To put it more explicitly, he was basically playing the whole album throughout the day.

To me, I think it's quite exciting cos it's really refreshing that someone is blasting the songs I like early in the morning. But as I saw how the other patients in the same cubicle is reacting silently, I felt a little "oops" kinda thing.

Sorry for the randomness. All in all, I am good :)

Perhaps a little updates from me. I have officially started my work in Khoo Teck Puat Hospital. The wards are very new and beautiful but we are still coping with the "newness" as everything has to start from 0 again.

The population in the north is quite different from what we have in AH last time. The people here are younger and with more acute conditions. I was quite overwhelmed these 2 weeks because I find it quite challenging to manage my patient's medical conditions and their therapies. At the same time, I am excited - because I know God is training me clinically. I am really thankful because things have not been that bad, and I have good people whom I can seek inputs from when I need people to throw me insights as to how to manage my patients.

All in all, I'm very grateful of God's timely providence and grace. Amen :)

Because my shift starts later, I have more time in the morning. I have ample time to quiet down myself before starting my day and I really like it :) And I can stay up late the night before to do and dig whatever I like, how good is that!

I have been eating dinner with lin qun lately. It's weird that I often tell myself that I should not eat dinner because I exercise less lately and my metabolism is slowing down, so I should reduce on my intake. But at the end of the day, when me and Linqun left work, we are incredibly hungry and we often resolved to a big feast for dinner. It has been like that for the entire week and I just had KFC with her how bad is that? Today has been mentally challenging for me actually - cos I encountered things that I haven't come into before and more drug questions are coming from doctors too. I think I'm a lucky girl because I have a chance to deal with these issues and I am starting to like psycho-geriatric wards :D Yea so at the end of the day, I was really really tired and hungry and I need to binge. :D

There's this eating place in yishun which I wanted to tell John and Huijun badly last saturday but I forgot. It is founded by this ex-drug addict and he continues taking in such kind of people to work here. The food is really nice and affordable and the people there are okay too. Yea, it's me and linqun feasting again :D

ACCP conference is starting this friday. It is a 3-day conference so I was quite sian about it hahaha. I am presenting on Sunday 5pm. The slides are done, I hope it's well done though. Wish me luck :)

Some pics here:

Obesity doesn't come from one time Binging

Hello, how are you?

I have not been writing. There's a lot of apprehension when I am about to blog. I questioned myself many times, who are you? Who are you and why are you here reading what I'm writing? Did you come here because you've nothing better to do and would like to get gossip topics about hooi ching? Or do you come because you know me. You really know me, and would like to know what's going on in me and how has my life been?

Honestly, I did think about ending this blog because it reveals a lot of weaknesses in me that I cannot extricate myself from, yet. I was then reminded how painful it was to shut down a blog because it meant closing down the stories - be it your own or those you shared with other people. I felt a sharp pain in the heart and was awakened. You must be wondering, why am I so free reflecting on this not-so-important issue like whether I should end a blog or not? I guess it's because I feel so rotten inside out already, and my perceptions towards things and people have been quite skewed of late.

Today I did start reading the book of Psalm. If you're also doing your quiet time with God, I encourage you to start at this book too. It's a gem :) Are you now starting to wonder why someone as rotten as me will think book of Psalm is a gem? Instinctively, I have an answer to it -- It's because this book exists for people like me - rotten, helpless, praying for hope and strength, and the perspective towards many things.

I am a nobody. I cannot flaunt about myself being a faithful Christian despite attending church and listening to sermons regularly. Because many times I feel that i'm like a sink with an open drain - nothing gets retained.

I have a confession.

I haven't met God in the longest time ever. I can now tell you that this is the worst method to live your life. It gives a downward spiraling effect that only engulfs you more and more to the point of utter hatred towards life. Why?

Because life is simple. There are only 2 ways to live your life:

ONE: "Blessed is the man who does not walk in the counsel of wicked or stand in the way of sinners or sit in the seat of mockers. But his delight is in the law of the Lord, and on his law he meditates day and night." The way of righteous.

TWO: "... They are like chaff and the wind blows away. Therefore the wicked will not stand in the judgment

, nor sinners in the assembly of the righteous.".The way of wicked.

My compass must have been under-construction, if not why do I feel that I'm the foolish one walking towards the 2nd path? Fortunately, I know I am fine despite I don't feel fine right now. Whatever happened, I just want to walk with God and meet Him now.

Today, I have another confession. (Yeah again!)

I want to re-discover myself before the Lord once again. I want to stop judging myself outside of Christ and start seeing myself in the realm of Christ. I need to stop hating myself for not doing what's supposedly right. Today, I need to present the accumulated bitterness to God and ask for forgiveness.

All in all, I need to really wake up. :( I have to stop feeling lousy and ashamed of myself because I don't need to. I don't need to because I am God's precious child, all I need to do is answer to Him and not others. I don't need to feel lousy because

any incompleteness in me is to be and can only be made complete in Him, only if I welcome Him into my life again. I should stop getting angry with myself for keep doing the wrong things because He knows my inert inability to do so and I will one day overcome them when I start praying and not rely on my limited wisdom.

Today I am also one step closer to letting go.

I should have done so long time ago, for it is taking too much of me, and making me too unhappy. Slowly but surely I promise You. I should let myself go and stop living

life using the myriad solutions that the world can offer, only to realize that I ended up on the 2nd path. I ought to start practising on how to let go of them and get reformatted all over again. I

know one day, You will make me strong like a tree planted by the river... and the leaves don't wither.

Sometimes people just need to start getting serious. Throughout the church camp that just passed, I realized one thing - that is the people on the stage --> they are dead serious about God and His words. They are dead SERIOUS you know? I got electrocuted for a moment actually - must be I have not been serious! And that life had been okay then and there and the accumulated grace from the past seemed to be STILL sustaining me through.

But then, the only change I need to make in order to get back to the right track again is to be serious first!

I know after saying all these, I will still make mistakes, still get into things that make me and people miserable in one way or another. But I shall let You give me a bolus of hope now. Show me that obesity really doesn't come from one time Binging!

ps: sorry for the incoherent thoughts. I can't explain myself actually :(

A Change

Blogger told me that there are new template designs so I decided to take a look. Was quite amazed by their selections and honestly, I love them :) I have been resistant to changes all these while. I meant to my blog. I love the white and simple background. I wanted to name this blog simplicity in the beginning. In fact, it was named this way when it got started.

Simplicity. Something that I yearn to attain and still striving to attain, and maintain. However, along the way, things happened, I grew up, and I felt like naming this blog 'Living By Grace'. Because these 3 words remind me how I have been living my life all these while.

But today, I am gonna change my blog background. I hope I will grow to like it. Hee. Was feeling quite weird when I look at the colorful blog that still says 'Living By Grace' hahaha! But oh well, sometimes people just have to change to enjoy new stuff :)

I just got back from Church camp. It had been a tiring journey, the bus driver drove really slowly. However, having the brothers and sisters throughout the journey was indeed great. I love their presence, really.

How have you been? Hope life has been great for you. :)

Today, there's actually a lot of things running through my head. Perhaps just reflections of what happened over the past few days in Malacca. I enjoyed my stay in Malacca, and I really have to thank Miki for bulk of it because she is such an adorable sister and roomie. And I got a lot of songs from her :P I don't think I will blog much about the church camp, because most of them are something very intimate that can only be revealed in the heart when you are alone with God. I anticipate them :)

Was just looking at a bible verse and thought of sharing it here:

This is the covenant that I will make.. says the Lord: I will put My laws in their mind and write them on their hearts; and I will be their God, and they shall be My people.

- Hebrews 8:10

It happened to be my verse of the day :)

I have a lot of outstanding tasks to do. Yeah, my mind is running fast already.

1. Powerpoint slides for ACCP presentation

2. I need to hunt some people down about my inpatient set up in KTPH

3. I need to read certain stuff about anticoagulation, antibiotics, and many many more

4. I need to do laundry and clean my room

But actually, above all, I need to pray. I need to pray that I can not only see Him in all things that I do, but also to enjoy His perfect blessings in all that I do.

Hope you have a good Friday :)

You and Me

Dear you,

I have a lot of things that I needed to tell you badly. But each time, as I was about to start pouring out, there was a strong force that held me back from telling you everything. In the end, I kept everything inside me again.

Have we drifted apart? If we haven't, why is it so hard for me to feel convinced that you are still here with me. I feel so alone. Yet I feel that I am still alright living alone thus far.

Last friday, my good friend asked me over msn how has my life been. I said fine. Normal. You know, sometimes it just seems to the whole world that my concern is on my job and my job seems to be stressful. And people like to ask me how's my job etc etc... But really, there is no problem with the job, it can be intensive but I love my job. I look tired because it's not easy to wake up at 6 plus every day and always standing and running around throughout the day. But it just seems to people that my world evolves around pharmacy now and it's easier do conversations about job now that you are a working adult.

But seriously?! Job is perfectly ok.

It's you that I am concerned of. I feel that I might have lost you. Could it be possible? We have been through so much together. When I was down, desperate, totally crushed, you stood by me and held me in your arms. You told me that endurance for the acute pain would save me from the impending everlasting agony. I listened to you, because you were all that I had, you were all that I could rely on at that point of time. We were so much closer then. Everytime when I cried, I knew you were there for me wiping away all my tears. Despite the bitterness overwhelming me, I really really knew you were there. Your love was so real then that I could never had missed.

But why is it that I am missing your love so much lately.

No trials, no bitterness or what so ever, ideally, we should be nurturing our relationship. But why is it that I find it harder to hear your voice, feel your touch of love? Must we be bound together by hardships?

Will we make it through the days after the trough? I am scared, getting very frightened that soon I will never be able to get back to where we were. You are always the strongest, the smartest, tell me you will mend it back can you?

Dear you, my heart feels very very heavy. There isn't problems too grave that engulf me, have I taken for granted that you will settle them all nicely and there's no need to worry about anything anymore? I think so. I think I have taken you for granted that you will not let anything, or anyone to harm me. But through this, I am getting more and more complacent.

Remember you told me many months back in November, when I was still a pre-reg, that "giving is always better than receiving" through my encounter with the TB uncle. I still remember him vividly, and I think I love him much. He really had all of my heart. But ever since I dispensed to him at bedside that day, he readmitted twice, and passed away. Do you know why I am telling you this? I really want to remind you the emotions and things we had shared in the past. I wanted to tell you that I so wanna go back to who we were then, because I want to start giving more because I have you, and thus everything.

I know I shouldn't use our Sundays together to gauge how close we are. But I have not been talking to you. Sometimes, I don't even want to talk to you because I cannot seem to feel your presence. Everyday passes by like it's just another normal day, like a solo-me playing the solo piece. They said you are still with me, I know. But I so wish that you make your presence felt. It seems to me that the chance of getting closer to you is higher on Sunday and I know it's wrong. But I cannot help it. :( I have missed 2 sundays - 1 cos I went back to KL, 1 cos I was on duty. I am missing another one cos dad is in town. Sucks do you know? Not that I am the happy person in church, it just feels very suppressing to not be able to do my routine on Sunday.

That day, when people messaged me to check out the good news in my inbox, I had already known it. I know my pre-reg project abstract got accepted by ACCP(

Asian Conference on Clinical Pharmacy 2010)

and I had to do an oral presentation for it on the first Sunday of July. Do you know it sucks totally when people say I should feel honoured and happy because it's a great chance and ACCP is a big event? It really pissed me off then because yet another sunday that I have to miss and really, I didn't want to get accepted and present on the stage. I dislike the idea of competition involved in this. I know I sounded very against the idea of me presenting on ACCP in front of my boss, and people don't get it. I also don't get it. I just don't want, and don't want another sunday missed. Who cares if the hospital is gonna sponsor the registration fees. I know I sound like the president of people with distorted thinkings but seriously?! No.

I know your grace still amazes me. I really know. Dear, it was your grace that pulled me out of my trough. Because of your grace, I can be the most independent girl in most people's eyes now. I know your love and grace have never left me, but i can no longer be dependent on them to live day by day do you understand? They have to become something bigger. They have to transform into a kind of strength that make me able to do more, for you, and for others. Let me live with purpose again will you?

I am sorry. I know I shouldn't get mad at you. But can we start all over again? Must we wait till the camp for this seemingly lukewarm relationship to be rectified? What if it doesn't?

Can you fall afresh on me all over again?

From,

Me

Mistakes

"Everybody makes mistakes. When they do, they will need to have a chance to say sorry, without the fear of retribution."

- Dr Burke, Grey's anatomy

Hello! If you have known me well enough, you should know that I am very into Grey's lately. It's trashy but you get absorbed into it quite easily. I like it, probably because it's all about surgeries and I am dealing with a lot of surgery cases now. Yep I am doing surgical wards. All the cuttings, amputations and weird cuttings are here. Can't say that it's my favorite, it's a lot to learn but they are really interesting! :)

The above quote is from Grey's too. When he said that, it really sinks deep into my heart. Very well said, so applicable in the fictional and non-fictional world.

I want to bear that in mind :) For myself, and others!

p/s: do you have Grey's all seasons? care to lend me? :D

Fireproof Again

I just finished watching Fireproof on HBO. This is my 4th time watching this movie. Surprisingly, I am not at least disinterested or bored despite watching it so many times. Each time the movie touches me differently, or changes a subtle thing in me towards another direction.

I think I can remember almost all conversations in the movie already. It feels weird sometimes to re-watch a movie when you know what are they gonna say the next minute. I must say the actors and actresses in the Fireproof movie are amateurs. Not professionals definitely, but I really appreciate the teachings and messages conveyed through this movie.

I first watched this movie when I was waiting at the Perth Airport. That time, only God knew how troubled and emotionally shaken I were. I used to be always wanting for certain outcomes. People always say what they want to see is the end-product, the outcomes! Often, we want good results. That's the outcome that we yearn for. We want good marriages - that's another outcome that we hope to attain. We want good life - another outcome.

But over the past few years, God has taught me a lot about it's NOT all about outcomes.

If I look into the core of my being, the bottom of my heart, I must humbly admit that I do wish for good outcome too, for certain things at least. Sometimes, I feel as if God is playing a big game with me. Things that I do not wish to have good outcomes turn out the other way round. Yet the things that I wish so badly to have the GOOD outcomes I dreamed about didn't turn out to be so.

But now I realize why the good outcomes didn't come. I had under-looked my process. Each process there's a You in it, each outcome has Your grace in it too. Now that I think about it - No regrets. At least I recall the processes of the not-so-good outcomes and the oh-too-good outcomes. And I also remember that nothing fosters courage like a clear grasp of grace.

Bleah, where were I? Randomness again. Anyways, back to fireproof - it's really a nice movie :)

I first blogged about it in May 2009 when I was in Perth. There's this song (While I'm waiting) in the movie that really touched me a lot.

It's now May 2010..

I think I have at least fireproof-ed myself :)

Running Inspiration :)

Hello world, how are you?

Lately, I feel that I am aging. I get tired easily, feel sleepy easily and get lazy easily too. And I realized that I haven't been exercising regularly.

I did a lot of sports when I was in university but I didn't feel sleepy easily during the lectures. And I could stay up late to finish many many tasks - be it school or non-school related. I then noticed that it's these running/ touch rugby then had unknowingly transformed into a kind of constant infusion of adrenaline, sustaining me through my study years.

But ever since I started working, I exercise less.

I always counsel my patients who have diabetes, high blood pressure, and high cholesterol to exercise because it is one of the ways to reduce their risk factors of developing more complications. How much should they exercise? Studies said exercise 3 times a week, each time more than 1/2 an hour. It's easier said than done - TRUE!

They often say it is difficult because of works and other stuff etc etc.

Hence ever since then, I told myself that I should exercise 3x a week . If I can do so despite my busy schedule, then I will have sufficient reasons to convince my patients that if I can do so, why not you?

Time and again, I failed.

But today's gonna be different!

I want to practise what I preach from today. So I will make an effort to exercise 3x a week. I know I will feel less tired if I commit to regular exercise routine because my infusion of adrenaline will come back to me again.

Today I went running at the sports complex. As usual, a mp3 playing the nice christian songs that never fail to keep me going while running. I like the feeling of running and listening to heavenly songs. And it has always been the best time to talk to God while running because I need someone to talk or else I will be bored. However I don't have energy to verbalize my conversation because it will then waste away my energy and make running very strenuous. Talking to God at heart is the best. :)

Many decisions made after every run.

Many blockages became unblocked after each heart-to-heart talk.

That's why I will never think exercising is a waste of time.

It's good for health and good for heart - physically and spiritually :)

I hope you can start exercising and enjoy the simple sweet moments with God through it too :)

Wounded

I really cannot take it anymore. This week has been over-eventful.

Why things have to turn out this way? Why things with good intention will be interpreted as risk and harm?

I really don’t care about what people will think of me. I really did it with good intention.

But it feels so darn awful when things get shot back in the most unexpected manner, and it’s no longer about whether you care what others think of you. Because YOU is now an understatement. It’s the identity you carry along with your name that’s involved now.

I feel really upset God L

I know I shouldn't but I really feel more awful when such things happen, You didn’t leave me alone, neither is Your grace. You once again has proven to me that I am in the right place where You can make me stronger. My heart is wounded, self-esteem crushed, confidence plunged to the bottomless pit - yet the team backed me up as if there's tonnes of spirit backing them up too. The bitter and sweet taste. And warmth.

Thank you for the thoughtful voice.

Thank you for the angry voice scolding me that you'll slap me if I really shed a tear for that matter or person.

Yet when strings of things come to me one after another, is it really not me?

And if it’s me, what could I have done better?

God have you planned all these before hand? If you haven’t then why I have to leave this country at this point of time?

God, if you could, can You ensure that I won’t get into situations that can terrorize people again?I am sufficiently frightened.

The Only Good Inside Your Heart is the Good that Jesus Brings

Good evening folks! Lately, I had the habit of listening to some old christian songs I used to have. Suddenly I came across this song and thought of sharing it here. It's really uplifting.

I think I haven't shared this with you before. I am thinking of signing up medical missionary trip sometime soon. Got this link from sharon, call it escapism perhaps, but I really hope to step out of Singapore to see how God can use me in this field. You might not know, sometimes, it's really hard to reach out when you're a healthcare professionals. A big part of your profession requires you to use drugs judiciously, and find the best treatment for your patients - if the patient wants to be treated. Of course, there will be patients who want to be treated conservatively - ie, DNR (do not resuscitate) when emergency happens.

But when you are a healthcare professional needing to treat your patients with the best therapies you can think of, have you ever thought that you're playing God? At some point of my career (3 weeks only!), I kept asking me if I really am playing God. At some other times when I am really trying very hard, making very vigorous interventions to the doctors to escalate certain therapies, I cannot see God in what I am doing but I can see myself doing what I am doing.But at times, when I really don't know what else can I give to the patient, my heart tells me to commit into our Saviour's hand.

So, being good is just a fable. Even in healthcare.

I have decided,

I'm gonna live like a believer,

Turn my back on the deceiver,

I'm gonna live what I believe.

I have decided,

Being good is just a fable,

I just can't 'cause I'm not able.

I'm gonna leave it to the Lord.

There's a wealth of things that I profess,

I said that I believed,

But deep inside I never changed;

I guess I'd been deceived.

'Cause a voice inside kept telling me,

That I'd change by and by,

But the Spirit made it clear to me,

That kind of life's a lie.

I have decided,

I'm gonna live like a believer,

Turn my back on the deciver,

I'm gonna live what I believe.

I have decided,

Being good is just a fable,

I just can't 'cause I'm not able.

I'm gonna leave it to the Lord.

So forget the game of being good,

And your self-righteous pain.

'Cause the only good inside your heart

Is the good that Jesus brings.

And when the world begins to see you change,

Don't expect them to applaud.

Just keep your eyes on Him and tell yourself,

I've become the work of God.

I have decided,

I'm gonna live like a believer,

Turn my back on the deceiver,

I'm gonna live what I believe.

I have decided,

Being good is just a fable,

I just can't 'cause I'm not able.

I'm gonna leave it to the Lord.

I have decided,

I'm gonna live like a believer,

Turn my back on the deceiver,

I'm gonna live what I believe.

I have decided,

Being good is just a fable,

I just can't 'cause I'm not able.

I'm gonna leave it to the Lord.

I have decided,

I'm gonna live like a believer,

Turn my back on the deceiver,

I'm gonna live what I believe.

When the world laughs at you 2

Hello world, how have you been?

Truthfully, things have not been that good for me in the past 2 weeks. Just wondering, do you find it harder to find God’s grace in the midst of trials or when your life is “smooth-sailing” and monotonously stable?

Anyways, this is already my 3^rd week as an inpatient pharmacist. Today while I was taking train home, I was quite astonished to see my reflection on the MRT train windows. Such a haggard me. Suddenly, I feel as if I’ve blend into the working world. I used to think that I’m different from the other working adults who have been working for years, BUT I realized that I was wrong, I look exactly like any of them, and I dislike it.

Since last week, my ward load has increased from 1 to 2. I have been handling 2 wards and just yesterday, I hit the highest number of beds. Just to put things in perspective, there is no correlation between the number of beds I am handling with the competency or what so ever. It is just natural for inpatient pharmacist to handle an average of 2 wards.

But I think I have not been handling my life well. Last Friday, a sister in my fellowship group shared something that happened in her life lately and a statement she made then really brought me back to reality. She said “when the spirit is right, everything will become just so right”. I guess I am just experiencing the absolute opposite of this statement, that is when the spirit is not right, everything will become so wrong.

Things have been so wrong lately. I don’t know why. Guess which pharmacist had to report 2 e-HOR in 3 weeks? ME! Yeaps, 2 medication-related errors happened in my ward these 2 weeks and even though I wasn’t the one doing it, I am the one who has to face the score when such things happen because I am the ward pharmacist. Actually I didn’t feel things were so wrong even when the e-HOR took place, because I know that errors happened and one happened during a public holidays when the discharges at the main pharmacy was like horribly enormous; and another one happened just to remind us to be more alert to the multiple strengths medication in the pharmacy. Didn’t blame anyone, just that, I am so wow-ed by the frequency of such things.

And I also don’t know why, I seem to have an intrinsic mechanism that attracts all the weird cases to my wards. One Bangladesh patient came in because of fits and it was found that there’s worms in his brain. Rare case for AH but I got it man. Bought in the medicine for him because AH doesn’t keep so many of such medication and in the end, before he’s even completely healed, the employer wanted him to be discharged because of the bills. It took me a couple of phone calls just to persuade the employer to agree to pay for the treatment for this patient and to come down to collect the medicine. Not cheap I have to acknowledge, but it’s necessary. At least he’s willing to buy 2 weeks supply of the medicine, instead of 1 month as prescribed by the doctors.

One day, suddenly I received a call from the ward saying my consultant wanted to PERSONALLY administer IV tensilon to this patient. Tensilon is a medicine used to diagnose myasthenia gravis. It’s an exemption drug, ie not registered in Singapore, hence no hospitals will stock up this item in their pharmacies.. We only kept 1 vial but it was used up the day before, for the same patient -_- SO SO wasted. Wilson helped me to call TTSH, SGH, NUH – ALL of them had 0 stock. I was darn panic that morning, I shouldn’t be. L

Another case - patient needed midodrine for orthostatic hypotension. Again, this is not a usual drug and hence we don’t keep in AH. Oh, first time in my life to come across EBA –Epidermolysis bullosa acquisita also.

Imagine doing all these and reviewing the patients in your wards at the same time. It is so so difficult L It shouldn’t be, if I have time. But it seems like everyday I get to encounter this kinda weird weird stuff and at the end of each day, I really get a real big mental block.

Many times, it felt as if the weight of the whole world is on me. I have been asking myself, why am I so jaded these days? Why do I always look so tired and I seem to have lost the joy that I used to enjoy?

And it’s until Friday that I realized why I am the way I am.

You know, the spirit is not right from the beginning. I have been handling things myself and my mind has always been running too quickly, or trying to think about solutions or how to carry my points to this doctor or that doctor. Things have not been mad. But the severity of the un-mad things has been magnified when the spirit is wrong.

I have been so occupied with things that I forget that He is with me and I can draw strength and wisdom from Him. And why do I have to make myself so tired and worried when He is the one in control and things have not been bad for me, not in the past, not now, and it won’t be in future. The only thing that’s changed is the intensity and frequency of matters that I have to deal with – seems to have increased. But I realized that actually, I don’t need God to give me wisdom to handle them.

Above all these, I really need to seek God and have the right Spirit first before I even start thinking about the problems/ situations. Why is it so hard fix my eyes on the unchanging ONE when I am surrounded with so many things that are changing?

Sigh.