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Sempat la tengok sebentar tadi...

Hari Merdeka kali ke-56 pada 31 Ogos 2013

Bunga ni kembang menyambut kepulangan aku dan mama. Terus mama suh aku snap gambo bunga yang tengah berkembang mekar ni. Harum baunya. Orkid cathlya kami panggil. Susah nak bunga. Wangi baunya... Ada dua tangkai bunga yang keluar kali ini...

Cantik kan...

Tukar Durian.. Heeeee

Tak sampai dua jam beli mama start enjin keta dan angkut aku sekali. Tak lupa angkut sekali doyan yang mangko tu. dengan penuh harapan nak tukar durian yang tiga biji RM50 tu. biar puas hati. Time beli dia kata gerenti isi tebal dan kuning...

Sampai tempat jualan durian, mama turun dengan menjinjit sebiji durian. Syukurlah. Tanpa banyak soal, dia terus ambil durian di tangan mama, pilih yang baru dan terus bagi mama yang baru. Syukur Alhamdulillah...

Tak tangkap plak gambo doyan mangko tu. yang baru aku tak buka lagi. Biar dululah. Dah makan tiga ulas yang mula mula tadi dan batuk mula menggila. Doyan... Kau kah puncanya? Kesian kalau aku tuduh kau doyan ku sayang. Tapi mama kata makan doyan buat batuk. Betulkah???

Durian lagi????????

Dah tau demam makan durian Raja Musang aritu ada hati lagi nak makan doyan again... Hmmmm..

Hari Merdeka ke 56 tahun ni, mama drive lagi pulang ke kampung halaman yang tercinta... Cian mama. Drive lagi untuk anak dia... Sebelum jam 7 pagi lagi kami dah gerak menuju kampung. Syukur Alhamdulillah... 

Tiba jer kampung semangat nak makan doyan meluap-luap. Nafsu ni kan godaan syaitan. Huuuuuuuu syukurlah bila tiba pekan Sungai Besar syurga durian tu dah buka. Hua hua huaaaa... Mai sini Musang Kingggggg. Opssss kali nimtak nak dah Raja Musang tu. nak try D24 lah plak....huuuuuu

Ehemmm ehem...ehemmm.... Nielah isinya. RM50 tiga biji. Huhuhu yang ni isi untuk dua biji. Sebiji lagi nak kena lempar balik kat muka penjual doyan tu coz isinya mangko kata orang perak. Tu lah.. Dah suh pilih yang cantik cantik. Itu dibaginya kita. Mentang mentang lah aku n mama pompuan senang senang dia tipu. Kami ni cuma harapkan kepakaran dia jer. Ikhlas percaya. Tapi ini dapatnya... Tunggu aku datang ngan mama lagi. Nak tukar doyan tu...

Jom balik kampung di Hari Merdeka... 31 Ogos 2013

Biarkan gambar berbicara..

Pengorbanan seorang ibu...

Entri ini khusus buat mama. Mama kesayangan aku yang telah berumur 60 tahun tapi nampak macam 45 tahun. Yang semua orang akan terperanjat bila mengetahui aku anak mama.

Sepanjang aku sakit, mama banyak menolong aku. Mama telah menjadi bukan mama yang sebelum aku sakit. Semua keperluan aku mama uruskan.

- mama sanggup betulkan kasut aku

- mama ambilkan barang aku.. Sentiasa tolong aku hingga sekarang, mama masih mahu menolong walaupun aku cuba ambil sendiri menggunakan kaki

- mama pimpin aku setiap ketika berada di luar rumah

- mama sangat ambil berat pasal ubat, minyak sapuan, tongkat, luka pembedahan dan corset aku

- mama bantu aku pakai skirt yang melorot ke kaki atau apa sahaja yang melibatkan barang di bawah kuasa aku yang tidak boleh membongkok

- mama gagahkan diri bawa aku ke mana sahaja aku mahu. Tgk laut, beli barang, teringin nak makan durian, teringin mangga madu, teringin kfc, teringin pergi guardian dan lain lain. Padahal patutnya umur mama sebegitu aku yang jaga dia...

- mama tolong ambilkan barang aku yang terjatuh

- mama chargekan hp, ipad dan lain lain

Pendek kata sekarang aku bergantung pada mama. Ya Allah, panjangkan umur mama dan sihatkan kami berdua agar kami boleh saling mengharapkan antara satu sama lain. Aminnnnn

Sesi Bersama Miss Azlin@ Klinik Ortopedik, HKL

Sesi Q & A with Miss Azlin@22.8.2013

Pinggul kebas

------ ambil masa sikit coz ada letak alat apa tah sepanjang 12 jam pembedahan berjalan. 

Punggung x boleh angkat

------- beri masa sikit lagi

Nak berdiri dari duduk sakit 

-------- juga perlu sabar dan beri masa

Foot drop masih ada lagi

-------- part ni aku sedih sikit. Macam yang pernah diingatkan dulu, foot drop ni mungkin dah tak boleh sembuh coz dah lama terbiar. Sedihnyaaa...

Boleh drive tak?

------kalau dah ok cubalah... Tak sakit dah ker?

Kenapa operation ku lama?

------- macam yang saya cakap dulu, u dah pernah buat operation, sebab ada parut luka lama

Kena hati2... Parut kat dalm tu.

Cara pakai corset n bila perlu pakai?

-------3 bulan penuh pakai. Tiap masa kecuali baring jer.

Luka operation dah ok kan?.. Aku iyakan coz Miss Azlin tak check coz aku pakai corset

Nasihat tambahan:

-Jgn pusing pusing badan kuat kuat atau jangan pusing langsung

-Jangan sesekali tunduk 

-Jangan angkat barang berat

------ yang ni jer ingat. Mama masuk juga dengan aku kali ni. Kalu ingat alu update okay... Daaaaa

@HKL

Hari ini pergi HKL lagi sekali. Kali ini kes mama. Aku hanya temankan saja. Kebetulan kerap terjadi dalam hidup kita membuatkan Graf Hidup kita akan turun naik... 

Kali ini kami berada di Klinik Pembedahan Plastik dan Rekonstruktif, HKL.

Pokok Bunga Tenggek Burung

Ini satu lagi antara pokok kesayangan mama. Pokok bunga tenggek burung orang panggil. Kami ikut jer panggilan ni. Cari kat tenet pun sama panggilannya. Bunga dia akan mengeluarkan buah seperti burung lagaknya. Sebijik macam burung kecil yang sedang menghisap madu. Pokok ni aku hadiahkan mama awal tahun dulu. RM15 sepasu kot kalu tak silap aku. Time tu kecik jer. Sekarang dah besar dan banyak mengeluarkan burung burungnya huhuhu comel. Burung tu time muda kaler hijau. Dah tua kaler kuning dan akhirnya akan gugur sendiri. Unik kan ciptaan Allah nie. Subhanallah...

Ini dia pokoknya...

Selsema dan batuk datangggg jommm larikkkk

Petang ni nak tidur macam aktiviti biasa aku. Tapi tak dapat. Hidung mula sumbat dan batuk kerap datang. Baru jer kelmarin aku hupdet entri pasal batuk n bersin. Aikkkk tetiber hari ni, dah 5 kali bersin. Dan hikmahnya, baru aku tahu, kalu dalam posisi berbaring, bersin itu kurang sikit sakitnya... Batuk juga begitu. Amat kurang sakitnya.

Dua kali semasa aku berdiri dan duduk, tuhan je tau sakitnya. Beraduh juga lah menahan sakit. Tiga lagi time baring. Syukurlah. Camno ni.. Tiap kali nak batuk n bersin tak kan nak baring... Wallah...

Penangan Musang King

Hari ini gi temankan mama gi Guardian. Mama masih setia drive untuk aku. Kesiannn.. Mama masih tak benarkan aku drive. Time lalu kat tempat orang jual doyan aku cakap nak beli.. Tapi tiba tiba bila mama nak berhentikan kereta aku rasa tak nak la pulak. Bila mama nak balik, aku rasa nak pulak. Dan mama dengan setia berpatah balik. Huuuuu

Ini hasilnya. Orang kata lepas operation dan sakit tulang belakang tak boleh makan durian. Betul ker? Tapi aku dah lama teringin. Dari sebelum bulan puasa dulu. Mama pun tak bleh nak larang dah. Lastly aku terbeli juga. Sebiji Musang King. RM18.00 sekilo. Murah plak. Takut gak tak manis dan mangko. Tawakal jer. Sebiji RM26.00. Memang murah. Dalam hati berdoa agar buahnya manis. Dah la beli sebiji.

Balik, terus buka kat kerusi taman depan umah mama. Rasa seulas. Syukurlahhhh. Manis, lemak dan berkrim. Huuuuuu Alhamdulilah. Setakat petang ni tak rasa lain pulak badan aku. Cuma macam panas sikit badan. Tapi baru dua ulas jer. Huhuhu..

Kemboja Mama...

Di rumah mama ada banyak pokok bunga. Hari ini aku nak share pasal bunga kemboja kacukan yang mama tanam. Mulanya ada beberapa pokok sahaja. Arwah abah yang minat pokok ni. Tapi bila kami dah pandai biakkan pokok ni melalui biji benih, maka pokok kemboja kacuk mama bertambah bilangannya. Ini antara jenis yang ada.

Di bawah ini ada aku tunjukkan gambar biji benih pokok bunga kemboja ni. Kadang orang bela pokok ni tak kuar benih pun. Tapi dengan mama mesra dan rajin la plak dia berbuah. Huhuhu rezeki mama...

Buah ni kalau kering dan dah matang dia akan terbuka dengan sendiri dan biji benihnya akan terbang mengikut tiupan angin. huhuhuh Allah ciptakan biji benihnya tersebar dengan cara itu. Di kedua2 belah biji benih pokok ini ada sepasang bulu halus yang ringan untuk diterbangkan angin. Kerap kali juga buah ini terbuka tanpa mama sedari. Tahu tahu dah kosong buahnya. Biji benih dah lari. Huhuhuu. Jadi sebelum ianya terbuka penuh, baik di ambil, buangkan sayapnya dan semai. Jika ada rezeki nanti dah matang aku sharekan okehhhh...

Teringin nak yang kaler putih plak. Tapi lum beli lagi. Cantik gak kalo ada yang putih...

Salam 18 Syawal 2013

Hari ini aku nak citer pasal parut pembedahan. Parut luka sekarang dah semakin timbul. Parut yang lama aku memang tak reti nak sapu apa apa untuk hilangkan atau ratakn parut. So kali ni aku nak try krim atau gel untuk hilangkan/pudarkan kesan parut yang ada tu. dah la panjang kali ini. Dalam 20cm. So aku try la guna mulai semalam. Untuk 7gm harganya RM49.90 di Guardian.

Guna sikit sahaja. Sapukan di tempat parut, biarkan kering. Siap. Dua kali sehari. Moga berjaya.

Lumbar corset ku

Salam 17 Syawal 2013 kepada semua pembaca blog...

Malam ni sementara tunggu gel penghilang parut ni kering kat belakang, aku ambil gambar corset yang menjadi peneman aku sejak tarikh 23.7.2013 aritu. Hari aku keluar ward. Mulai saat itulah aku memakai corset ni tiap kali berjalan ke mana mana atau berjalan di dalam rumah. Tanggal ketika mandi, wuduk, pergi tandas, baring dan tidur sahaja. Lain dari itu kena pakai. Terpaksa pakai selama tiga bulan sepenuhnya.....

Family Bonding...

Entri kali ini aku nak ceritakan pasal ikatan kekeluargaan yang amat rapat dan tak akan terputus sampai bila2.

Semasa aku mendapat tarikh pembedahan aku ialah pada 17.7.2013, hanya mama sahaja yang mengetahui tarikh ini. Selagi tak muktamat mama tak bgitahu sapa sapa atas permintaaan aku. Kalau tahun 2006 dahulu tiga kali tarikh pembedahan aku ditunda, aku rasakan kali ini mungkin akan tunda selepas raya. Berat hati aku dan mama menyatakan yang doc tak akan jalankan pembedahan pada bulan Ramadhan.

Bibik yang kami nak upah untuk jaga aku di HKL sudah diberithu supaya bersedia. Kalau jadi kami ambil dia. Kalau tak jadi tak ambillah. Kebetulan, dewi namanya baru sahaja mendarat dari surabaya seminggu. Memang jalan dipermudahkan Allah.

Hati ku mula berdebar dan cuak hanya bermula setelah mendapat panggilan telefon dari salah seorang doc.. Lebih kurang macam ni lah perbualan kami pada hari ahad itu:

Dia: assalamualaikum... Boleh bercakap dengan....? Saya dr.... Dari HKL

Aku: waalaikumusalam... Yer saya..

Dia: tahu kan nanti nak buat TLIF surgery...

Aku: yer saya.. Naper doc???? Tunda ker???

Dia: ehhh... Tk lah. Jadi. Jumpa isnin nanti ya...

Aku: gulp.... Perasaan cuak, takut, sedih dan sedikit sedih bercampur baurrrr. Huhuhu sebelum ni steady coz kompom macam tunda kan... Haaaaaaa hamek kau..

Mamaaaaa doc call.... Dia cakap jadi rabu ni...............

Dan masa berjalan... Tanpa menunggu kita walau sesaat

Keluargaku

Seperti permulaan entri, walaupun dirahsiakan tarikh pembedahan dan juga kemasukan aku ke ward, keluarga aku tetap datang melawat. Adik beradik belah mama semua datang kecuali seorang sahaja yang tak datang. Yang kerja datang mencuri curi masa yang senggang lepas kerja. Aku tahu kesusahan mereka. Terutama di bulan Ramadhan. Letih, lapar, dahaga, penat, nak cari parking, tunggu shuttle dan lain2. Aku tahu sangat. Aku faham. Itu sebab tiada sorang pun dari pejabat aku yang aku bagi datang melawat. Bukan takat tak bagi melawat. Ward dan tarikh masuk juga hanya boss aku dan dua orang yang paling rapat dengan aku sahaja yang tahu.

Seorang makcik kesayangan aku juga datang menaiki bas. Sanggup naik bas dari kampung semata mata nak melawat aku. Sepupu sepupu tersayang juga datang tanpa jemu. 

Berbuka puasa di ward

Paling indah, bila saudara mara aku datang, belah petang dan sekaligus berbuka puasa di ward aku. Huhuhu tak akan berulang kembali saat saat indah ini. Walaupun sakit dengan adanya mereka, semangat aku meninggi. Ketawa ketawa dan gembira. Agaknya sebab itu aku cepat keluar ward.

Mereka berkumpul, bentang surat khabar dan berbuka puasa beramai-ramai. Bestttttt.... Aku tak dapat join. Hanya berbaring di katil sambil memerhatikan mereka dengan sayu. Huuuuu... Sanggup bersusah payah kerana aku...

Moga Allah merahmati kalian semua.... Aminnnnnnn

Mangga madu lagi...

Balik dari kl, mama singgah di ladang mangga madu tak jauh dari rumah mama, beli dari ladang. Mesti puas hati dapat yang masak pokok. Kalau muda pun boleh menyicah coz tak masam... Sedapnya... Manis dan lemak. Jarang jumpa yang jual di tepi jalan macam ni punya sedap dan manis. Selalu tu derang jual dah tak segar. Masak pun kulit buah dah berkedut kedut kering.

Yang dari ladang ni segar, bergetah dan masih berbau wangi sangat. Layannn....

Batuk, bersin dan nak muntah

Tiga perkara ini buat aku ngeri dan fobia. Ini kerana ketiga2 aktiviti luar kawal ini buat aku menjerit kesakitan. Tulang belakang aku seolah2 dipulas dan ditekan. Siksanya hnya Allah yang tahu.

Sejak operation aritu aku memang dah tak sentuh ais. No more ais... Sedih kerana sebelum ini aku tak bleh hidup tanpa minuman berais. Sekarang kena la pantang.

Aku boleh buat... Walaupun tak sentuh ais, tapi masih batuk. Hingga entri ini ditulis masih ada batuk nya. Kesan bius masih adakah????

Jadi nya aku amat amat menghindari dari tiga perkara ini untuk menyelamatkan tulang belakang aku. Moga selamat hendaknya....

Memakai Lumbar Corset

Pakar bedah di Spine Institute (University Hospitals of Cleveland) masih mencari bukti untuk mencadangkan pesakit memakai brace atau corset setelah pembedahan spinal fusion. Mereka hendak tahu adakah dengan memakai brace akan membantu menstabilkan tulang belakang dan kesan yang lebih baik.

Dalam kes aku, doktor memang suh pakai corset tu. aku tak dibenarkan keluar ward aritu selagi corset tu tak dapat. Harga RM190.00 jer. So dah dapat corset tu baru aku dibenarkan keluar.

Tiga bulan penuh aku kena pakai corset ni. Sepenuh masa kecuali time baring. Antara sebab aku kena pakai benda ni adalah untuk:

-Menjaga supaya aku tak bongkokkan tulang belakang. 

-Kurangkan sakit. 

-Support tulang belakang.

-Stabilkan kedudukan besi dalam tulang belakang.

-Kukuhkan rasa tulang belakang semasa berjalan

Ni antara bentuk corset lumbar.. Bahagian bawah tulang belakang. Aku punya lebih kurang yang coklat nombor satu tu.

 

Xray Tulang belakang

Filem xray spine aku diteliti oleh Miss Azlin. Syukur semua berada dalam keadaan baik sahaja. Tiada besi atau skru yang lari dari tempat asal. Syukur ya Allah.

Buat pertama kali aku ambil gambar xray tulang belakang aku. Selama ni buat derk jer. X ambil pun untuk simpanan. So kali ini aku ambil dan boleh dirujuk di sini macamana skru dan besi tu kelihatan.

Mama ikut sama dalam bilik Miss Azlin. So dia dengar penerangan dari Miss Azlin. Cuti sakit aku disambung lagi hingga bulan Oktober. Ubat tahan sakit 60 biji jika ambil sehari sebiji. Dalam jam 1.00 semuanya selesai. Syukur Alhamdulilah.

Hasil checkup hari ini...

Salam 15 Syawal 2013

7.30 pagi taxi yang ditempah sudah sedia menunggu depan umah mama. Awal sploh minit sebenarnya. Cuaca pagi ini Alhamdulillah.. Baik walaupun pagi tadi angin agak kuat bertiup. Ingat dah nak hujan tapi syukur. Cuaca baik mengiringi perjalanan aku dan mama ke HKL.

Jam 9.30 

Suasana di persekitaran HKL terutamanya di belakang ward aku dahulu ramai wartawan dan polis berkumpul. Semua nya menunggu dan memburu berita terkini berkaitan tragedi bas Genting terjunam ke dalam gaung semalam. Takziah kepada semua keluarga mangsa tragedi. Menitik juga air mata memikirkan azabnya dan traumanya mangsa saat bas tersebut jatuh dan terjunam. 

Tiba di Pusat Rawatan Pakar dan Harian HKL. Ambil no di klinik ortopedik aras bawah. Dudukkan mama di klinik ortopedik aras dua. Nasib baik aku teringat yang x- ray perlu dibuat sebelum berjumpa dr. Pakar. Mama duduk di situ dengan barang barang yang agak banyak. Then aku turun ke aras bawah dengan borang x-ray. 

Acara x-ray

Setelah siap x-ray di bilik no.6, aku menunggu diluar. Menantikan filem x- ray siap. Tetiba nama aku dipanggil lagi sekali dari bilik x-ray no. 6. Aik.. Apahal plak... Mesti kena x-ray lagi nih...

Betul dugaanlu.. Kena x-ray lagi skali coz yang first tak nampak besinya.. Hurmmm.. Jadi lagi. Aritu time aku di ward, kena x-ray lagi sekali juga. Time tu g x-ray dengan katil. Best jer ditolak atas katil g bilik xray. Huhuhuh. Dahh siap xray, baring tunggu nurse datang amik, juru xray datang carik aku dan tolak katik aku masuk bilik xray sekali lagi. Aduhyaiiii... Sib baik tak balik ward lagi.

So hari ini terjadi lagi. Tak perlah. Cuma lambat sikit aku nak bersiap coz pakai corset lagi. Nak pakai kain lagi susah. Maklumlah kaki kiri aku ni mana leh angkat. So salin baju lagi selali. Xray lagi sekali. Huuuuu

Mama masih setia menunggu. Dah dilem siap, naik atas semula dengan filem x ray di tangan. Syukur dah siap satu bab.

Menunggu doktor pakar di bilik no.23

Setelah selesai no dipanggil, aku dan mama menunggu di hadapan bilik no.23. Sempat ke tandas berhampiran bilik no.23. Bersih dan luas tandasnya. Selesa. Tisu juga banyak. Tahniah...

Bersambung lepas ini apa kata Miss Azlin...

Jom.. HKL

22 Ogos 2013... Checkup pertama kali selepas operation TLIF (17.7.2013)

Moga segalanya dipermudahkan Allah SWT. Amin.

Sebulan telah berlalu...

Genap sebulan aku dimasukkan ke hospital Kuala Lumpur. Syukur semuanya berjalan lancar dan sempurna walaupun ada harapan yang sedikit kecewa. Namun ianya telah diubati dengan redha dan sabar. Syukur Ya Allah....

Info pasal Foot Drop du Utusan Malaysia 2008

Kemalangan sebabkan kecederaan saraf

Doktor,

Tahun lepas, saya mengalami kemalangan jalan raya. Masalah yang saya hadapi ialah selepas pembedahan kali ketiga, doktor mengesahkan saya mengalami foot drop iaitu kaki saya terjatuh dan menyebabkan saya sukar berjalan kerana terpaksa mengangkat kaki lebih tinggi sedikit.

Selepas pemeriksaan awal doktor mengesah saya mengalami kecederaan saraf sebanyak 50/50. Tetapi maklumat lengkap belum diketahui.

Persoalannya bolehkah saya sihat seperti dahulu? Berapa lama tempoh untuk sembuh dan apakah rawatan terbaik selain pembedahan pembetulan saraf?

- OTE, Johor Bharu.

Jawapan,

Foot Drop adalah terma yang digunakan untuk pesakit yang mengalami kecederaan pada Common Peroneal Nerve iaitu saraf yang bermula dari kawasan lutut dan berfungsi mengawal pergerakan kaki dan pergelangan kaki agar boleh diangkat.

Dalam keadaan Foot Drop pesakit tidak dapat menggerakkan kaki dan pergelangan kaki ke atas. Ada banyak sebab bagaimana saraf tersebut boleh tercedera dan tahap kecederaan saraf juga memainkan peranan yang penting dalam rawatan dan pemulihan.

Klasifikasi kecederaan dibahagikan kepada Neuropraxia, Axonotmesis dan Neurotmesis.

Neuropraxia merupakan kerosakan saraf melibatkan gangguan konduksi arus saraf tersebut menyebabkan gangguan sementara yang mana pemulihan penuh boleh dilihat selepas enam hingga lapan minggu.

Axonotmesis merupakan kecederaan pada sel-sel fiber saraf tersebut (axon) tanpa kerosakan kepada kantung atau lapisan luar saraf (myelin sheath). Pemulihan kecederaan sebegini memakan masa yang agak lama, bergantung pada tahap kecederaan saraf dan juga kawasan kecederaan. Contohnya, kecederaan saraf pada bahagian lutut akan pulih lebih cepat daripada kecederaan saraf di bahagian pinggul. Akan tetapi, tidak semua pesakit dapat mencapai tahap pemulihan penuh.

Neurotmesis pula adalah kecederaan saraf sepenuhnya di mana saraf tersebut telah terputus sambungannya dan ini menyebabkan kelumpuhan sepenuhnya fungsi yang melibatkan saraf tersebut. Selalunya kecederaan sebegini memerlukan rawatan rapi termasuklah pembedahan mikro tetapi pemulihan tidak akan mencapai tahap 100 peratus atau kembali seperti asal.

Oleh itu, hendaklah dipastikan tahap kecederaan anda terlebih dahulu untuk mengetahui tahap pemulihan yang diharapkan. Kaedah pembedahan lain seperti pengalihan tendon (tendon transfers) merupakan pembedahan yang sedikit sebanyak untuk mendapatkan kembali fungsi pada anggota yang terlibat.

Artikel Penuh: http://www.utusan.com.my/utusan/info.asp?y=2008&dt=0217&pub=Utusan_Malaysia&sec=Kesihatan&pg=kn_05.htm#ixzz2dWFopxVD 

© Utusan Melayu (M) Bhd 

Teknik MIS TLIF...

Minimally-Invasive Surgical (MIS) TLIF

Transforaminal lumbar interbody fusion (TLIF) is a surgical procedure that removes a painful lumbar disc and replaces it with either a block of bone or a fusion device to allow bone to grow across the disc space creating a fusion. TLIF can be done through a traditional “open” approach, where a larger incision is made in the middle of your back, or through a minimally-invasive surgical (MIS) approach. With the MIS technique, two smaller incisions are made on each side of the back and special instruments called retractors are used to provide access to the spine with minimal disruption of the muscle tissue. The minimally-invasive TLIF technique has the benefit of smaller incisions, less blood loss, shorter hospital stays, and quicker recovery as compared to the traditional TLIF procedure.

Salam Syawal ke 4, 2013

Ini gambar siang hari di 3 Syawal 2013

Tengah malam tadi jam 1.15 pagi Syawal ke empat aku dikejutkan dengan siren bomba, ambulan dan kebisingan dari kejauhan. Masya Allah, ada kebakaran rupanya.

Kampung Puah Seberang, Sentul ranya yang terkena musibah n dugaan kali ini. Takziah kepada semua mangsa kebakaran.

Tulang Belakang

Vertebrae

Your spine is made up of 24 small bones, called vertebrae. The vertebrae protect and support the spinal cord. They also bear the majority of the weight put upon your spine. Vertebrae, like all bones, have an outer shell, called cortical bone, which is hard and strong. The inside is made of a soft, spongy type of bone, called cancellous bone.

The vertebral body is the large, round portion of bone. Each vertebra is attached to a bony ring. When the vertebrae arestacked one on top of the other, the rings create a hollow tube for the spinal cord to pass through. Each vertebra is held to the others by groups of ligaments. Ligaments connect bones to bones; tendons connect muscles to bones. There are also tendons that fasten muscles to the vertebrae.

The bony ring attached to the vertebral body consists of several parts. The laminae extend from the body to cover the spinal canal, which is the hole in the center of the vertebra. The spinous process is the bony portion opposite the body of the vertebra. You feel this part if you run your hand down a person's back. There are two transverse processes (little bony bumps), where the back muscles attach to the vertebrae. The pedicle is a bony projection that connects the laminae to the vertebral body.

Intervertebral Disc

Between each vertebra is a soft, gel-like cushion, called an intervertebral disc. These flat, round "cushions" act like shock absorbers by helping absorb pressure. The discs prevent the bones from rubbing against each other.

Each disc has a strong outer ring of fibers called the annulus, and a soft, jelly-like center called the nucleus pulposus. The annulus is the strongest area of the disc. It helps keep the disc's center intact. The annulus is actually a strong ligament that connects each vertebra together.

The mushy nucleus of the disc serves as the main shock absorber. The nucleus is made up of tissue that is very moist because it has high water content. The water content is what helps the disc act like a shock absorber-somewhat like a waterbed mattress.

Facet Joints

The spinal column has real joints (just like the knee, elbow, etc.) called facet joints. The facet joints link the vertebrae together and give them the flexibility to move against each other. The facets are the "bony knobs" that meet between each vertebra. There are two facet joints between each pair of vertebrae, one on each side. They extend and overlap each other to form a joint between the neighboring vertebra facet joint. The facet joints give the spine its flexibility.

The facet joints aresynovial joints, structures that allow movement between two bones. The ends of the bones that make up a synovial joint are covered with articular cartilage, a slick spongy material that allows the bones to glide against one another without much friction. Synovial fluid inside the joint keeps the joint surfaces lubricated, like oil lubricates the parts of a machine. This fluid is contained inside the joint by the joint capsule, a watertight sac of soft tissue and ligaments that fully surrounds and encloses the joint.

Neural Foraminae

The spinal cord branches off into 31 pairs of nerve roots, which exit the spine through small openings on each side of the vertebra called neural foraminae. The two nerve roots in each pair go in opposite directions when traveling through the foraminae. One goes out the left foramina; the other goes out through the right foramina. The nerve root allows nerve signals to travel to and from your brain to the rest of your body.

 

 

 

Spinal Cord

The spinal cord is a column of millions of nerve fibers that carries messages from your brain to the rest of your body. It extends from the brain to the area between the end of your first lumbar vertebra and top of your second lumbar vertebra. Each vertebra has a hole in the center, so when they stack on top of each other they form a hollow tube (spinal canal) that holds and protects the entire spinal cord and its nerve roots.

The spinal cord only goes down to the second lumbar vertebra. Below this level, the spinal canal contains a group of nerve fibers, called the caude equina. This group of nerves goes to the pelvis and lower limbs.

A protective membrane, called the dura mater covers the spinal cord. The dura mater forms a watertight sac around the spinal cord and the spinal nerves. Inside this sac, the spinal cord is surrounded by spinal fluid.

Nerve Roots

The nerve fibers in your spinal cord branch off to form pairs of nerve roots that travel through the small openings between your vertebrae. The nerves in each area of the spinal cord connect to specific parts of your body. This is why damage to the spinal cord can cause paralysis in certain areas and not others. It depends on which spinal nerves are affected. The nerves of the cervical spine go to the upper chest and arms. The nerves of the thoracic spine go to the chest and abdomen. The nerves of the lumbar spine reach to the legs, pelvis, bowel, and bladder. These nerves coordinate and control all the body's organs and parts, and allow you to control your muscles.

The nerves carry electrical signals back to the brain that allow you to feel sensations. If your body is being hurt in some way, your nerves signal the brain. Damage to the nerves themselves can cause pain, tingling, or numbness in the area where the nerve travels. Without nerve signals, your body would not be able to function.

Paraspinal Muscles

The muscles next to the spine are called the paraspinal muscles. They support the spine and provide the motor for movement of the spine. Joints allow flexibility, and muscles allow mobility. There are many small muscles in the back. Each controls some part of the totalmovement between the vertebrae and the rest of the skeleton. These muscles can be directly injured, such as when you have a pulled muscle or muscle strain. They can also cause problems indirectly, such as when they are in spasm after injury to other parts of the spine.

A muscle spasm is experienced when your muscle tightens up and will not relax. Spasms usually occur as a reflex (meaning that you cannot control the contraction). When any part of the spine is injured-including a disc, ligament, bone, or muscle-the muscles automatically go into spasm to reduce the motion around the area. This mechanism is designed to protect the injured area.

Muscles that are in spasm produce too much lactic acid, a waste product from the chemical reaction inside muscle cells. When muscles contract, the small blood vessels traveling through the muscles are pinched off (like a tube pinched between your thumb and finger), which causes a build up of lactic acid. If the muscle cells cannot relax and too much lactic acid builds up, it causes a painful burning sensation. The muscle relaxes as the blood vessels open up, and the lactic acid is eventually washed away by fresh blood flowing into the muscle.

Spinal Segments

Doctors sometimes look at a spinal segment to understand and explain how the whole spine works. A spinal segment is made up of two vertebrae attached together by ligaments, with a soft disc separating them. The facet joints fit between the two vertebrae, allowing for movement, and the neural foraminae between the vertebrae allow space for the nerve roots to travel freely from the spinal cord to the body. The spinal segment allows physicians to examine the repeating parts of the spinal column to understand what can go wrong with the various parts of the spine.

Ankylosing Spondylitis

Ankylosing spondylitis is a rare condition that can cause back and neck pain. It is a rheumatic inflammatory disease that affects the spine and sacroiliac joints. It usually begins in the spine (usually the low back first), but this chronic and painful disease may also attack other joints, tendons and ligaments, and the chest wall.

Over time, this disease can cause the vertebral bodies in the spine to fuse together. When this happens, patients with ankylosing spondylitis will have difficulty moving freely. Common symptoms for ankylosing spondylitis are gradually occurring back pain and stiffness (usually over a period of weeks or months). Early morning stiffness is often helped with a warm shower or light exercise. Symptoms last longer than three months.

In particularly severe cases, patients may be unable to look above the level of the horizon, or they may develop a significant amount of pain from having a hunched over posture. Ankylosing spondylitis is usually diagnosed using x-rays of the sacroiliac joints, looking for changes in the tissues caused by inflammation. However, tissue changes are not always visible.

 

Infection/ Discitis

Discitis is a low-grade infection that affects the disc space between two vertebrae. Although discitis is uncommon, children under ten are usually the ones affected by this condition which is the result of an inflammation caused by staphylococcus, viruses, or other inflammatory processes. Discitis is characterized by the slow onset of severe back pain and may or may not be associated with fever, chills, sweats, feeling tired, loss of appetite or other symptoms. The diagnosis is usually made by seeing narrowing of the disc space between two vertebrae and a bone scan that shows that the disc and adjacent vertebra are "hot" on the scan. A MRI scan with contrast may also be helpful as long as lab tests which may include a CBC ( complete blood count with differential), CRP (C reactive Protein), and ESR (Sedimentation rate). This condition can be very painful and is often aggravated by any movement of the spine. The pain often travels to other parts of the body including the abdomen, hip, leg, or groin. It usually occurs in the lower (lumbar) back and upper (thoracic) back. This is a medical urgency, and should be addressed promptly.

Young children with this condition are usually irritable and uncomfortable and refuse to sit up, stand or walk. The treatment of discitis generally involves antibiotics, rest, and a brace. Surgery is rarely needed.

Herniated / Ruptured Disc

The disks in your spine are your “shock absorbers” between the bones (vertebras). With forces too strong for the disk to support, such as, lifting an object that is too heavy or lifting it improperly, tears in the disk or a herniation of the disk may occur. A herniated disk is also called a bulging, protruding or “slipped” disk which may cause specific pain patterns from the back into the buttocks, hips, and/or legs. The ways in which a herniated disc causes different pain patterns and problems with your back is related to the location of the herniated disc along your spine, and also to the anatomy of your spinal column.

Osteoporosis

Osteoporosis is a disorder caused by a decrease in the amount of calcium in your bones, which can cause the bones in your spine to break because they are too weak to support the weight of the body. When this happens, people usually suffer from sharp back pain, and they often become shorter or have a "hunched over" posture. If you have these symptoms you could be suffering from osteoporosis.

Osteoporosis is a disease that affects more than eight million women and two million men. It's characterized by low bone mass and deterioration of bone tissue which can lead to fragile bones and increased risk in fractures of the spine, hip and wrist. More than 700,000 vertebral fractures every year are caused by osteoporosis.

Osteoporosis is some times called the "silent disease" because bone loss has no symptoms, and the disease usually remains painless until a bone breaks. Although the disease can affect any bone, spinal or vertebral compression fractures can have serious consequences including loss of height, severe back pain, and deformity, a curving of the shoulders and back, and a thickening waistline. Women in particular reach their maximum bone mass at about the age of 20. After that, they will gradually lose bone mass. In the 5-7 years immediately following menopause, women will lose up to 20% of their bone mass. When osteoporosis affects the spine, there is a gradual collapse of the vertebrae producing back pain, loss of overall height, and a stooped posture. The back pain at vertebral collapse may be severe at times.

Sciatica

Sciatica is the descriptive term for when pain runs from your back or buttocks down your leg and even into your foot. It is a condition caused by either compression or trauma of the sciatic nerve. Sciatica is made worse when you cough or if someone lifts your leg up while you are lying down. Symptoms may begin abruptly or gradually, are usually irritated by movement, and often grow worse at night. Sciatica implies that there is an irritation of your nerve root in the lower part of your spine. In some instances, this could be due to a ruptured or herniated disc in your lower back.

Spondylolisthesis

Early treatment usually involves rest and medication. Progressive spondylolisthesis may require surgical treatment.There are two common forms of Spondylolisthesis; isthmic and degenerative. Spondylolisthesis occurs when there is a weakening of the pars interarticularis. The condition may also be caused by degenerative disc disease. When the vertebra slips forward, it may press on nerves, and surgery may become necessary. Spondylolisthesis may also be caused by degenerative conditions that affect the vertebral facet joints.

Spondylolysis

Spondylolysis is a defect in the lamina of the vertebrae in the pars interarticularis, usually the fourth or the fifth lumbar vertebrae in the lower (lumbar) spine. Spondylolysis may occur as a congenital defect or be the result of repetitive trauma. Some physicians believe spondylolysis may be caused by genetics, and that someone could be born with thin vertebral bones causing them to be vulnerable to the condition. Spondylolysis is common in teenage gymnasts and football players, and presents with lower back pain that is worse with strenuous exercise or activity. Radiographic findings are subtle, but bone scans, MRI scans, or CT scans will usually detect the lesion. Activity modification, bracing, injections or surgical treatment may be indicated for persistent symptoms.

Sprains & Strains

Most acute pain in the back results from sustaining a mild strain in the back or back musculature. Sprains and strains in your lower back usually happen during a sudden and stressful injury, causing stretching or tearing of the muscles, tendons, or ligaments in your lower back. When you strain or sprain your lower back it causes a lot of stress on your spine, irritating it. If you have this condition you may also suffer from painful muscle spasms which can occur during your daily activities or at night while you're sleeping. The pain is usually limited to five or ten days.

Stenosis

Lumbar stenosis is a natural product of aging, and the wear and tear on the spine throughout our lives. As our bodies grow older, the ligaments and bones that make up the spine grow thicker and become stiffer. The spinal canal gradually narrows, and the spinal cord is slowly compressed. The lack of space interferes with the normal function of the spinal cord and the body becomes less able to function normally.Stenosis produces a dull, aching pain in the lower back when standing or walking. The pain usually radiates down into the buttocks and thighs, and can be relieved by sitting, or by using a walker or a shopping cart in the grocery store. These symptoms usually slowly get worse over time, and people who suffer from spinal stenosis will notice a slow decrease in their ability to walk shorter and shorter distances.

Trauma/Spinal Cord Injuries

It is impossible to predict how badly someone's spine has been injured before a doctor has evaluated them. Therefore, everyone who is involved in an accident that could have damaged their back is treated as if they do have an injury to their spine. Most people are familiar with the "backboards" that paramedics use to transport accident victims, but they are unaware of how important these devices are in keeping the spine stable while they are taken to the hospital.

Paramedics and emergency response teams treat accident victims according to strict protocols that have been developed in order to save lives. These protocols are designed to minimize the possibility that someone with a spine injury could be injured while moving him or her from the accident scene or while taking them to a hospital. With these protocols, cervical collars are placed on all accident victims. The patient is secured on a backboard, and then taken to a hospital for further evaluation.

Each year in the United States, there will be approximately 50,000 new spinal cord injuries caused by accidents. A spinal cord injury occurs when the cord itself is crushed, stretched, or torn by the accident.

Unfortunately, this is still an injury that cannot be reversed or cured by modern medicine. More than half of these injuries involve the cervical spine, and most of them happen to young men. These injuries are incredibly devastating to the patient, their families, and also to their communities.

Much research is being done on ways to minimize spine injuries by designing cars for better safety, improving protective gear like football helmets, and educating people about the dangers of certain activities. Other research is being done on improving immediate care after a spinal cord injury, and also in determining the most appropriate type of rehabilitation for each individual patient.

 

Tumors (Benign/Malignant)

Doctors use the term "benign" to indicate that a particular tumor is unlikely to spread to others parts of the body. Benign tumors can still be a significant problem however, depending upon their location, size, adjacent structures, blood supply, and other factors. Fortunately, most benign tumors can be treated successfully.Tumors of the spine and spinal cord are relatively uncommon. The most common initial symptom that patients with a spinal tumor have is pain. Because back pain is very common, it is also not a specific symptom of any one disease or medical condition. Spinal cord tumors can be either primary (originating in the spinal cord) or secondary (metastases of cancer that originated elsewhere in the body). Therefore, the challenge is to determine how to evaluate back pain with the goal of specifically excluding a tumor as the cause of the pain. Luckily, most back pain is not due to a tumor. However, if a cancer were discovered after a long period of "conservative" management of back pain, most patients would feel that their problem should have been investigated more thoroughly in the beginning.

Doctors use the term "malignant" to indicate that a particular tumor or a cancer often spreads to other parts of the body, and can be difficult to cure or treat. This is very different from "benign" cancers, which are much less likely to spread, are easier to treat and control.

Tulang Belakang- Pengenalan

Anatomy of the Lumbar Spine

What exactly is the spine?

The spine is made up of 24 bones, called vertebrae. Ligaments and muscles connect these bones together to form the spinal column. The spinal column gives the body form and function. The spinal column holds and protects the spinal cord, which is a bundle of nerves that sends signals to other parts of the body. The many muscles that connect to the spine help support the upright posture of the spine and move the spine.

The spinal column has three main sections-the cervical spine, the thoracic spine, and the lumbar spine. The first seven vertebrae form the cervical spine. The mid back, called the thoracic spine, consists of 12 vertebrae. The lower portion of the spine, called the lumbar spine, is usually made up of five vertebrae. However some people have a sixth lumbar vertebra.

The normal spine has an "S"-like curve when looking at it from the side. This allows for an even distribution of weight. The "S" curve helps a healthy spine withstand all kinds of stress. The cervical spine curves slightly inward, the thoracic slightly outward, and the lumbar slightly inward. Even though the lower portion of your spine holds most of the body's weight, each segment relies upon the strength of the others to function properly.

Cervical Spine (Neck)

The cervical spine is made up of the first seven vertebrae in the spine. It starts just below the skull and ends just above the thoracic spine. The cervical spine has a lordotic curve, a backward "C"-shape-just like the lumbar spine. The cervical spine is much more mobile than both of the other spinal regions. Think about all the directions and angles you can turn your neck.

Unlike the rest of the spine, there are special openings in each vertebra in the cervical spine for arteries (blood vessels that carry blood away from the heart). The arteries that run through these openings bring blood to the brain.

Two vertebrae in the cervical spine, the atlas and the axis, differ from the other vertebrae because they are designed specifically for rotation. These two vertebrae are the reason your neck can move in so many directions.

The atlas is the first cervical vertebra-the one that sits between the skull and the rest of the spine. The atlas does not have a vertebral body, but it does have a thick forward (anterior) arch and a thin back (posterior) arch with two prominent sideways masses.

The atlas sits on top of the second cervical vertebra, the axis. The axis has a bony knob called the odontoid process, which sticks up through the hole in the atlas. Special ligaments between the atlas and the axis allow for a great deal of rotation. It is this special arrangement that allows the head to turn from side to side as far as it can.

The cervical spine is very flexible, but it is also very much at risk for injury from strong, sudden movements, such as whiplash-type injuries. This high risk of harm is due to the limited muscle support that exists in the cervical area, and the fact that this part of the spine has to support the weight of the head-an average of 15 pounds. This is a lot of weight for a small, thin set of bones and soft tissues to bear. Sudden, strong head movements can cause damage.

Thoracic Spine (Mid Back)

The thoracic spine is made up of the middle 12 vertebrae. These vertebrae connect to your ribs and form part of the back wall of the thorax (the ribcage area between the neck and the diaphragm). The thoracic spine's curve is kyphotic, a "C"-shaped curve with the opening of the "C" in the front. This part of the spine has very narrow, thin intervertebral discs. Rib connections and smaller discs in the thoracic spine limit the amount of spinal movement in the mid back compared to the lumbar or cervical parts of the spine. There is also less space inside the spinal canal.

 

 

 

Lumbar Spine (Low Back)

The lowest part of the spine is called the lumbar spine. This area usually has five vertebrae. However, sometimes people are born with a sixth vertebra in the lumbar region. The base of your spine (called the sacrum) is a group of specialized vertebrae that connects the spine to the pelvis. When one of the bones forms as a vertebra rather than part of the sacrum, it is called a transitional (or sixth) vertebra. This occurrence is not dangerous and does not appear to have any serious side effects.

The lumbar spine's shape has a lordotic curve-shaped like a backward "C". If you think of the spine as having an "S"-like shape, the lumbar region would be the bottom of the "S". The vertebrae in the lumbar spine area are the largest of the entire spine. The lumbar spinal canal is also larger than in the cervical or thoracic parts of the spine. The size of the lumbar spine allows for more space for nerves to move about.

Low back pain is a very common complaint for a simple reason. Since the lumbar spine is connected to your pelvis, this is where most of your weight bearing and body movement takes place. Typically this is where people tend to place too much pressure, such as when lifting up a heavy box, twisting to move a heavy load, or carrying a heavy object. These activities can cause repetitive injuries that can lead to damage to the parts of the lumbar spine.

Thrombin... Apakah????

Thrombin is a protein produced by the body. It is a specific clotting factor that plays an important role in the blood clotting process.

Secara mudahnya... Thrombin adalah untuk menghentikan pendarahan... Namun aku tak pasti adakah semua pembedahan memerlukan "thrombin?????"... 

Pembedahan aku tahun 2006 takder plak quotation benda nie...

Harganya RM1,200 utk 5ml sahaja.. Kalo ikut slaid yang aku cari di Internet ada juga  thrombin yang dibuat dari haiwan.

Lagi info...

Thrombin is at the center of this process of blood clotting. Blood clotting starts with molecules that sense that something is wrong. For instance, the protein tissue factor is found on the surfaces of cells that are not normally in contact with the blood. If tissue is cut, the blood flows out of the blood vessels and encounter tissue factor. Then, a cascade of signaling starts, beginning with a few tissue factor molecules and amplifying, like a pyramid scheme, into a response large enough to cure the entire problem. Tissue factor activates a few molecules of Factor VII. These then activate a lot of Factor X. And finally, these activate even more thrombin. Thrombin, when activated, then translates this signal into action. It clips a little piece off of the large protein fibrinogen, causing it to assemble into large stringy networks. These networks then trap lots of blood cells, forming the dark red scab that blocks the damage.

Salam Syawal ke-2 2013

Salam Syawal ke dua semuaaaaaaaa....

Mood hari ini sedih kerana meninggalkan sanak saudara....

Syawal pertama sudah berlalu...

Mood gembira sekarang... Bahagia dan lega......

Cerita 1 Syawal lagi... Hari ke 22 selepas pembedahan TLIF

Ramadhan telah meninggalkan kami. Tidak usah bicara tentang sedihnya kehilangan Ramadhan jika tidak melayan Ramadhan dengan sebaiknya ketika Ramadhan berada di sisi... Semoga Allah menemukan aku lagi dengan Ramadhan yang mulia. Dengan orang orang yang aku sayang... Mama, abang, cu dan lain lain. Aminnnnnn..

Syawal ku sambut sederhana. Jadual family kami berubah tahun ini. Tak pernah pernah rendang dan ketupat dimasak malam raya. Tradisinya, buka puasa akhir sebelum raya biasanya ketupat dan rendang dijamu sekali. Aku , mama n cu bertungkus lumus memasak. Tapi kali ini berbeza. Berbeza coz aku sakit. Tak boleh tolong cu macam dulu dulu.

Jadi kami tak masak rendang petang akhir Ramadhan. Cu tak bagi aku tolong dia. Cu yang masak tengah malam raya sorang sorang. Ciannn cu. Pengorbanannya amat besar dalam keluarga kami.

Lagi satu lain dari tradisi, bilangan lauk yang dimasak. Hanya dua jenis sahaja. Kebiasaannya paling kurang tiga jenis. Lebih lagi... Tapi kali ini hanya dua sahaja. Jadilah. Raya ala kadar tetapi meriah. Tatkala mereka semua ahli keluargaku berada di bawah beramai ramai, aku seorang berada di meja makan. Huhuhuhu layanan istimewa. Semua disediakan. Bestttt... Rasa amat dihargai. Syukur aku punya saudara mara yang amat sporting.....

Luka pembedahan

Alhamdulillah. Luka makin sembuh. Walaupun mandi hari ini dan pakai corset sepanjang hari, luka hanya merah dan tidak berair atau berdarah. Syukurlah.... Aku hanya sapukan gel gamat luxor Jenama Gamat Healin yang dah terbukti keberkesanannya. Luka melecet di bahagian badan aku ketika pembedahan dilakukan telah sembuh sebaik aku keluar hospital dan disapukan gel yang mama beli.

Darah beku makin berkurangan dan tinggal parut sahaja. Namun kesan parut tu agak ngeri jugak dilihat. Bergaris. Macam boleh terbelah semula. Uiskhhhh hati hatilah aku. Moga tak berdarah atau dijangkiti kuman. Aminnnnn.

Kaki kiri (foot drop)

Kaki kiri aku masih berita sedih. Masih lemah dan tak berdaya nak angkat. Sedih sangat. Sedangkan harapan aku agar selepas pembedahan kaki kiri aku semakin pulih dan aku boleh berjalan seperti biasa. Mungkin perlu masa lagi? Mudah mudahan. Insyaallah jika tak okay lagi aku akan cuba cara dan alternatif lain. Insyaallah..

1Syawal 2013

Subuh ini buat pertama kali selepas pembedahan aku mandi keseluruhan air di badan. Takut juga luka di belakang ni. Tapi dah agak lama. Insyaallah tak apa apa rasanya dan aku mandi sunat Aidilfitri subuh ini sempena Hari Raya Aidilfitri 2013. 

Semoga kesihatan aku akan bertambah baik dan segala galanya dipermudahkan Allah SWT. Aminnnnnnn.

Selamat Hari Raya Aidilfitri 2013

Assalamualaikum WBT semua. Salam 1Syawal buat semua yang beragama Islam tak mengira bangsa.....

Cantik tarikh hari ini. 8.8.3013