A not so long distance relationship

My husband’s specialist placement is in Johor, a state that has its weekends on a Friday and Saturday. They don’t even have a public holiday on the 1st of January to celebrate New Year. My husband was unaware of that including myself. I am sure most Malaysians are not aware of it too. He nearly did not turn up for work that day!

Johor is very expensive to live in. It was quite difficult to find a studio that’ll fit his budget and at an appropriate distance to his workplace. I have kind of decided not to follow him there as it would be a hassle to move between states and bring the kids with us. After all, we already have a home and good social support here. We are just a few hours drive away if he misses us. Indeed, the husband has been coming home on a weekly basis to see us. So, it ain’t really a legit long distance relationship (LDR).

Photo by Krivec Ales on Pexels.com

In Johor, he has been putting himself up in budget hotel rooms switching in between his options of about 3-4 hotels. These rooms price range are at RM30 – RM50 per night. It is convenient for him so far since these hotels are not only air-conditioned, they have FREE WIFI, breakfast options (if the husband wants too) and are usually at good locations near malls or restaurants. He only books them for 4 nights as he’s usually at our gate by Thursday evening. That will amount to roughly between RM150 – RM200 per week. Sometimes he gets cashback on his app or vouchers from Agoda (being a platinum member and all) and his expenditures can drop to as low as RM100 per week. Which is way cheaper than renting a room or studio for the month. Unlike me, he doesn’t need a lot of accessories to life. He is a nomad by heart. He is fine with having a roof on his head and food in his belly at a bare minimum. He needs that humble abode to only rest, eat, shower and sleep. I am not quite sure how long he will be able to live like that because this placement is not for just a few months. It may take up to years therefore I am curious as to how his living strategies and preference will change.

As of now my routine at home is still pretty much relaxed. My son’s school has not been fully opened yet for face to face teaching due to the rise in Covid-19 cases. So, there is no rush in the morning to get everyone to school although I still send my youngest to daycare. The son on the other hand is dropped off at the grandmothers’ house together with his cousins where I will pick him up after work. I just need to prepare for breakfast and dinner at home. Lunch is sorted for the kids at daycare and at grandma’s house.

When the husband returns home, I find that he is more alert of what’s in the fridge and our pantry. He has been very helpful in getting the dry groceries nowadays (thank god, jimat duit sis) Also, the things that needs fixing like the toilet flush and all. Other than that, everything else is just fine. As for my part, I am less lazy to prepare breakfast for the kids, getting more obsessive with house cleaning and organizing, fairly motivated to get more study stuff done promptly as opposed to last minute work. I feel that I could do better though. I am still waiting for my transfer to a different health facility soon.

TB Chapter – Part 1

I have Latent TB. This is my story.

The investigation and diagnosis

It started off with a new colleague at my workplace being diagnosed with active pulmonary tuberculosis (PTB). Which consequently led to all her close contacts being screened for it as well. It was normal practice for every new staff to have themselves checked for PTB, a similar process I went through about 2 years ago, with a negative result.

The screening process involved going through the symptoms and sending a sputum sample (if present), doing a chest XRAY and a Mantoux test.

I had no symptoms, my chest XRAY was normal BUT my Mantoux test was glaringly positive this time around. Even I was shocked because I never had this response during my previous Mantoux tests done in my previous workplace and upon entering this new premise.

This was between 24 – 48 hours

Since we had a blood test called IGRA to further confirm the diagnosis, I took the test. Lo and behold, it was POSITIVE. There is no denying of the TB organism in my body- only that it is asleep. It does not have the capacity to give me an infection that manifests the classic symptoms of TB. Now it is my choice of whether I would want to be treated for it or otherwise. Of course in medicine there is no 100% guarantee that it will wipe away the TB and prevent reactivation but it is worth trying.

Initiating Treatment

I first had to do a baseline blood test for my liver function. I ended up screening for my cholesterol and diabetes all. Since my blood works are fine, my doc discussed with me of a few treatment regimes. There are monotherapy treatments which can take up to 6 months and a combination therapy for 3 months. I missed the trial period for a study using a drug called Rifapentine which is to be taken weekly for 6 weeks. Therefore, my choices are limited. My attending Dr and I agreed upon the combination therapy.

My regime is Akurit-2 (rifampicin + isoniazide) 4 tabs daily & pyridoxine 10mg once daily for 90 days. If my weight was less than 55kg, I would have been given 3 tabs instead. It is weight dependent. ha ha ha.

Expected major reactions would be a red-orange hue in my body secretions (tears, urine, sweat) and a degree of peripheral neuropathy. Perhaps also bodily ache and gastrointestinal symptoms. My liver functions will be monitored on intervals and I will personally look out for a tinge of jaundice on myself.

Will update later on how soon I turn orange-red.

Vaccine Survey among healthcare workers

We are currently riding the god-knows-how-many-wave of the Covid-19 virus. It seemed only yesterday we gave ourselves a pat on the back for winning the fight. However, as soon as we let our guard down – the virus strikes again. There are rumours of implementing the MCO again but at the expense of the economy which is a pain because we have just kick started the wheel.

Vaccine has been THE NEWS in the country lately. Malaysia with its slightly smaller budget will be securing the purchase of vaccines from various suppliers. The top two being Pfizer and Astra Zeneca. Healthcare workers will be among those to be vaccinated first. Hence, a survey was done in my clinic to see how many would want to be vaccinated with no WHY’s if they choose not to. It was a short questionnaire – basically one that just asks for your personal details. An interesting thing I find about the survey is of how we need to enter our postcodes. According to a friend, the data would be useful to see how much coverage the vaccine will have in the community within a given time. An epidemiologist would explain this better I guess.

It is understandably a decision that requires a huge leap of faith. The vaccine is new. Anything new freaks people out despite the amount of scrutiny it undergoes. What more with testimonials and conspiracy theories cropping up in mass media. I too have my concerns as to whether it will interact with my TB meds. However, I have faith that the MOH council which did a good job in not bringing in the dengue vaccine into the country will have also analyzed enough evidence to support their decision to purchase the Covid-19 vaccines.

I am sure we will get more information soon as the vaccines will start rolling out to HCW and the public by March 2021. Until then, life must go on within SOP.

10th Wedding Anniversary at Casa Bonita Hotel

Prior to the pandemic, I’ve already planned out my 10th wedding anniversary celebration . We were both going to lose weight, organize a kenduri at our house and wear matching batik outfits for our photos. However, things happened. COVID-19 rules our lives. Mr Husband was busy with his public health activities whilst I was busy on the clinical side of things. We managed to squeeze some family time interim but honestly, it could have been better.

10 years living with another human being is not a small feat. Have I ever thought of separation during this relationship? Of course. Especially on my period. But Patience and Sanity usually pulls me away from it. Covid-19 or not, a decade of love needs to be celebrated. If he is not going to be the first to utter those words , wishes or gestures, then I will be the one to do so and sprinkle some romance in the air. It’s tiring having to kick it off every time but someone’s gotta keep the wheel of marriage running.

I started with the watsapp wish in the morning. Sending him a snapshot of my wedding anniversary gift to him. This is to also hint him to get me a present if he hadn’t thought of doing so. (insert annoyed face here) If he is not getting me a flower bouquet, then he’d better get me a present for my 10th wedding anniversary. Then just like an excellent PA, I laid out the plans for the day.

Me working half day –> fetch kids from grandma –> check into hotel , also in Melaka –> husband will drive from JB and reach hotel with whatever transport he wants —> husband will arrange for dinner

I chose Casa Bonita Hotel for our staycation for new years weekend.

CASA BONITA HOTEL is located strategically at where all the viral eateries are. It is at Limbongan where the famous keria is. The keria man is also selling laksa at his shop. Other famous stuff nearby is the avocado drinks, soursop drink, the asam pedas lady, the mee bodo at tengkera. All this within walking distance to each other. We had wanted to do that but the exhaustion from work got the better of us that we practically just enjoyed the room and the food delivered to us.

Our room is the family suite. It has 2 double beds, a living room with a mini dining table, a fridge and a bath tub. At least my kids can enjoy that whilst being stuck in the room. I booked our stay via Agoda of course at RM225/night for 2 nights. The total came up to RM551.57 including tax and service fees.

I had wanted to book dinner at the in house restaurant but in view of us being health care workers, I thought we’d better stay in our rooms and reduce the risk of contracting the virus. This is because if a HCW gets ill, it may cause inconvenience to the work schedule if the HCW needs to get MC and such. Mr Husband instead arranged for dinner in our room by ordering this meal box from another hotel, Bayview hotel. At RM88, we get a selection of food that make up a meal for our little family.

This promotion is seasonal. I enjoyed the chicken the most followed by its Xmas crepe. The cornish pie was a bit bland but passable for a hungry tribe. It was a meal worth the money.

As for presents, I got my husband a portable massage machine for his back. He got me a Samsung Tablet A 8″ 2019. Lovely, I had always wanted one. I think it could be useful for my studies. I am still exploring its features and scrolling through apps that might be useful for my side responsibility as a student. Do recommend me good ones.

I have already made a staycation booking for the upcoming Chinese New Year celebration. I just hope nothing major will happen on that day.

Minci, the results came back positive

Apart from a positive UPT, the last thing you want to hear as a patient is that you are positive of something. (for the record, I am not pregnant). Especially now in this pandemic when it is dreadful to be positive of Covid-19. This is because the pathway upon diagnosis here in Malaysia is such that you would be whisked to the hospital and isolated for at least 10-14 days with monitoring in between. It is ugly if you have small children that are dependent on you and that you will have to be separated from them for a while. So yeah, now is not a good time to get Covid-19 eventhough you feel fine.

Anyway, I did the Covid-antibody test a few weeks ago. It was negative. So this entry is not about Covid-19.

The only positive investigation that is pinning on me now is my IGRA test. At the end of last month, a colleague was tested positive for pulmonary tuberculosis (PTB). It was initially just a screening test everyone had to do upon reporting themselves to a new workplace and this colleague coincidentally had symptoms as well. Once the colleague learned of the diagnosis, naturally, all close contacts at the workplace have to be tested including me since we share the same small room for prayers, eating and gossiping during lunch hours.

All the girls did the Mantoux test and chest Xray. Out of 8 girls who did this test, 2 of us had a positive Mantoux test (one of them is me of course) but we are asymptomatic of TB meaning we have no cough whatsoever. In fact, both of us have a really good appetite and a big waistline to begin with. We don’t look like the typical patient with active TB. Or maybe we are atypical? lols.. we could be.

Anyway, all 8 of us were asked to proceed with IGRA – an Interferon Gamma Release Assay blood test. I think both of us were kind of prepared to accept that the results might be positive. Indeed it was.

So, what is next?

Despite being asymptomatic, we still need to make sure that we have no active TB going on. That means reviewing the Chest Xray again with an extra pair of eyes to look for cavitation and taking a sputum AFB sample (if we have sputum to give- which we don’t). Once that has been excluded, then I would need to make a decision on whether I would agree to start on treatment for latent TB.

Latent TB is not infectious.

It means that at one point in life I was exposed to the bacteria which did not have enough capacity (gosh) to launch a full attack on my body to exhibit the TB disease. It’s like I caught the bug and it decided to go to sleep somewhere in my body. Waiting for the time to wake up and become powerful and active. So it will be up to me to try and kill it now before it decides to become evil and create havoc in my body. Anyway, I will only decide once my colleague in charge of TB review my Xray again later. We really need to make sure of this because the type of medicine and length of treatment regime differs.

This TB ball will start rolling next week into the new year. I guess this is the first chapter of my interesting 2021. I guess my WORD for 2021 has a big purpose this year. My word is RESILIENCE. My word for 2020 is THRIVE. Maybe that’s why the bacteria is thriving. lols.

I will give this chapter in my blog a hashtag. It will be #MinciBerTB