Saturday, February 20, 2010

LEA- final comments

Thought of giving my last few cents of worth towards the end of the block- but too much honesty may be perceived as a person-targetting exercise, which I would like to do, and I do do, openly. Maybe this will be an overkill- therefore better for public viewing. Hopefully, third time lucky. It's terribly watered down now..

LEA: Other comments:

'I have initially explained more on the presentations etc. However thinking back of the need to comply to the school’s assessment needs and what nots, that had to be scaled down as well. On hindsight, I feel that might be slightly counter-productive as having an LEA should ideally serve as a learning reflection resource for students which would aid in their future revision/consolidation. Or not it should not have been termed LEA in the first place, better to be 'i want you to LEA my way!' It should be accessible and flexible enough, targeted to what a student wants to get out of it.'

Thursday, February 18, 2010

More LEA complains... it ain't gonna be the last of it!

REFLECTION ON THIS EVENT
As I said before, there has been mixed reviews of physiotherapist so far, but now, having observed them working their magic, I realize that physiotherapist play an integral role in complementing the medical aspect of treatment. According to NHSCareers, physiotherapy is a healthcare profession which sees human movements as central to the health and wellbeing of individuals. In general, concentrate on problems that affect muscles, bones, the heart, circulation and lungs. The range of services provided includes manual therapy, therapeutic exercises, application of electri-physical modalities, hydrotherapy and acupuncture (for musculoskeletal complains). They help people to improve their ability to use parts of the body that have been affected by disease or injury, keeping joints mobile and strengthening surrounding muscles, therefore allowing many to live more independently. Some physiotherapist may have to work outside the normal working hours of 9-5 and during weekends, especially those in the sport and leisure sector.
Given another chance, I would have enjoyed spending more time with the physios early on in our medical education as it is embarrassing that only until now that I’ve managed to have an opportunity with them!
In the future event whereby medical treatment might not suffice for a musculoskeletal presentation, I would be more than willing to refer a patient to the physios for the necessary therapy. I think their contribution to general healthcare is somewhat still under-appreciated.

---> Fella said that this is controversial. Can't always compare 'us' vs 'them'. But, isnt this my own reflection? Can there be a 'right' and 'wrong' reflection'?? You can't even be honest with comments there days. Med school is forcing us to think one - dimensional!
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Not as if that we are not learning anything at all everyday - else what do we students do when we get back? Learn on what we saw! Now with this unnecessary duplication of work, how are we going to get more productive work done?
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and this was the email to eportfolio for their toothless system!!

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To whom this may concern,

I feel that the LEA template is a bit difficult to work with, especially with the system always crashing and its inability to take text from MSWord directly (tables/diagrams).

Other problmes encountered:

1. Interface is poorly structured. Once you click on 'edit post' --> maximize view : most times it gets lost in the screen. and one therefore can save the document. This has happened time and again. Using other computers instead, it even does not appear (the maximise view option) in the web browser (explorer)

2. System logs off by itself. Dont know if it's peculiar to me or not, but it does that every now and again.Again, whilst on different computers and internet connections too.

I feel that the school should make the learning input experience more seamless by ensuring ease and stability of system before launching it- it is frustrating indeed having worked your way through the document for it to only then say that it’s unsavable at the last minute. Worse is that, you can’t even log in the system once it ‘hangs’! I’ve been trying my best to log into the system the whole night to no avail. And this has not been the first time anyway. I finally had to resort to provide my GP Tutor the word copy instead- whichc defeats the purpose of having an eportfolio in the first place. Even during the DSSM period, both my consultants werent able to log in to the invites- i had to manually print off those write ups for them!

I hope this teething problmes, as trivial as it may sound to you, could be sorted asap. It is not that we are not supportive of the online shift of assesment, but having an assesment/eportfolio tool which is not user friendly is stifling all the other task which you expect us to achieve. More constructive time could be spent on consolidating clinical skills rather than wasted on fiddling around with some dodgy implementation!

--> Updates: Such a pain the tutor was: Meskipun tuan besar mengakui betapa payahnya hasil keringat yang telah dicurahkan buat beberapa malam sebelumnya, namun tuan besar secara tidak langsung masih sekeras-kerasnya ingin lea-lea sedemikian saya mengikut tanggapan tetap nya, termasuk refleksi-refleksi saya! Masakan saya tidak dibenarkan untuk berfikiran sendiri! Memang tiada belas kasihan langsung! Baik jadi robot sahaja!

Monday, February 15, 2010

LEAs- note to self

Turns out that constructive criticisms are not welcomed, even in community medicine practice! Well, so i shall stick to boring clinical cases then..
Additional paperwork (even for med students!) is a waste of time, when more teaching sessions could instead be spent on consolidating essential clinical skills, the bread and butter of medicine (not writing good/great reports!)

Sunday, February 14, 2010

Billy's 2010: One to watch

I'm starting to get excited about the new drift season kicking off. There's some really good looking events planned for this year here in the UK, and the car I've got my eye on for this season is Tony's KE70.


It was kicking ass at events and practice days for last year or so with a 20v under the bonnet. But the boys went back to the spanners over the winter and it's re-emerged with a new heart in the shape of a F20C!


A lot of fine work has gone into this cars build from the very beginning, with attention spent in all the right places.


Just look how much bloody lock it has!





With this years BDC licensing day already under his belt Tony is all set to be chasing down and scaring the crap out of all the bigger toys that will be out to play. I can't wait to see it in action. Good luck for the season Tony! You're already winning on cool points.

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p/s: Any seats available for a co-driver? :P

Thursday, February 11, 2010

the national anthem

I do notice time and again, even at sporting events, ceremonies, and a more recent one- an ys steddfod celebration in a local high school nearby - seems to bring out much warmth and full-hearted singing from the crowd, be it parents or the children, when the national anthem comes into play. I don't know if this is peculiar to the welsh only (who are very proud to be Cymraeg and not seasneg, mind you) but we seem a bit 'inhibited' or insipid when it comes to displaying our affection through this simple yet profound act of nationalism. Well, at least i wasn't the only one scratching my head, having another fellow-countryman along side who also seemed baffled and at the same time , amazed by their displayed solidarity, makes a non-coincidental two curious minds. Maybe, the indifference and apathy is a sign of the underlying greater social and political malaise afflicting our current society. . which as bananas-in-pajamas always say, 'are you thinking what i'm thinking?'.

Thursday, February 04, 2010

One for the LEA... if this makes the grade

One patient today, said that,
"..I've worked in the hospital before a long time ago, and i've seen many of you go through the system then and you were all so nice and caring and thoughtful of us oldies here, but it's when you become a doctor, and even higher then you start forgetting about the patients. I know patients are the worst people to deal with- we are always whining and miserable when we come by and meet you- I really don't envy your job, to be honest. But do bear in mind that we are all humans here who need a little time off yourself from the many many patients you encounter through the day: we come with all sorts of problems no doubt; we all do truly appreciate if a doctor spends a mere extra few minutes finding out what our main concerns are, really, and not focused on the disease itself... you students tend to do that (the former) a lot, I notice. Which is good. Always remember not to loose your human touch once you are a doctor, young man.."

She was so ever polite this 67 year old lady, even with her grossly inflammed and painful right knee due to osteoarthritis (which ironically wasn't severe enough for a knee-replacement). She did'nt want to upset 'her regular GP' as she felt it was best if she were to see the orthopaedics but she didn't want to say it outwardly to the doctor, worrying that it may offend him, thinking that his opinion was'nt the best she could've had: I told her why not i then take it up to him and see what he says? In the balance of what's best for her, I told him in the end. I thought she was fine with it. But her profound words made me think of how many doctors become disillusioned after working for the system for couple of years, putting up with all those targets, QoFs and other political implementations, when it was the noble intention of serving the patients needs which originally signifies a docs' community niche.

Monday, February 01, 2010

Battle of the brawns

Doc Hisham Salleh
This is my race report for the Ironman Langkawi 2006.


Background:
Triathlon is a sport which consists of 3 discipline which includes swimming, biking and running. The normal olympic distance consists of a 1.5km swim which is usually done in a lake or in the ocean, followed by 40km of road biking around a race course and finally ending with a 10km run.In malaysia there is a religous following of pros who do it for the money, kids who take part because its fun, weekend warrior amateurs who just want to prove that their still not over the hill yet and the average Joe like me.I have seen kids as young as 8 in the races (though in the shorter sprint races) to the veterans like my friends Patsy the 69 year old grandmother and Francis my 72 year old friend. You see people from all walks of life be it students, profesionals like lawyers, pilots, engineers, business people, rich people with expensive bikes, overweight people who insist on wearing the triathlon suits with their bulges protruding, guys with scantily clad girlfriends, mothers with husband and kids looking bored at the sidelines..... 31 year old karaoke loving average Joe doctor like me among others.
The completion of a triathlon is a sense of accomplishment for most, however for some there is always the challenge of going the extra mile, going for the ultimate goal.... the Ironman Triathlon.

Historical background:
Like a lot of silly things in life, it all started after a few rounds of drinks.In 1978 (If I remember correctly) a US naval officer John Collins based in Hawaii was debating with his chums who was the fittest athlete ever. Some say it was Eddie Mercx ( a multiple tour de France champion- Before Lance Armstrong, Mercx was god to the cycling buff), others claim it was the swimmer and others say the marathon runner. Despite the free flowing drinks, Collins and friends could not come to a conclusion. He formulated a challenge. He surmised it was possible to tie a well known local event of Waikiki open water swim, with a perimeter bike ride of the island and the Honolulu marathon. He also suggested to call the winner...an Ironman.In february of that year 15 individuals including Collins raced in what was to become a future cult following.....The Ironman Triathlon. Over the years the Ironman Triathlon has grown to include venues all over the world, from Hungary, UK and France in Europe, To Perth, Lake Taupo New Zealand, to a few cities in the US and Canada and even Asian destinations like Korea and Japan. 2006 is the seventh edition of Ironman Langkawi.
The race has been standardised and is now managed and run by the World Triathlon Corporation with prize money being offered to the Pros and for the amateurs (age grouper as they call it) the chance to compete in the Ironman World Championships in Kona Hawaii, to some the holy grail of Triathlon. Usually 2 to 3 places or slots are offered to the top 3 finishers in each age group category, in each race around the world.

SWIM 3.6Km (2.4 miles)
BIKE 180.2Km (112 miles)
RUN 42.2Km (26.2 miles) marathon


Thats the challenge that I had accepted to take on roughly 6 months ago in attempting to complete the course in the cut off time of 17hours. 26 February2006 became a much awaited landmark.
I have done a few Olympic distance Triathlons before, entered a few adventure races, ran the marathon,biked 220km with my OP and KOP's(kawan OP) friends from KL to Lumut, swam 2km open water in Desaru at last year's Half Ironman race, abseiled 16 storeys down Berjaya Times Square in last years AXN KL race and a few other gila things ...so why not do the Ironman? And since we are lucky to have the race in our own backyard (homeground), the cost, transportation and preparation was a little bit easier. Imagine the Mat Sallehs who fly half way around the world after training like mad for a year, spends a small fortune in accomodation and food,acclimatise a week to the local weather and terrain and finally ended up getting sick in a hospital far away from home. So for us to have an event here was a great blessing actually.
So why not? yeah, why not? that has been the reply for me and my Lite and Easy Gang whenever a race or event or challenge pops up. So it was with this Gung Ho Kamikaze attitude that me, my friend Steve(canadian bear) and Zabil (Mas pilot) signed up for the race last year not knowing what to expect. A few Lite and Easy members pulled out due to personal reasons.

Training:
Training? In reality I really didnt have a specific training regime, nor did I have any diet regime (Im 52kg BMI of 20-thats borderline cachexic) that I followed. I know many people spend absolute long hours and time and money in researching the best ways to train and trying to implement it. Things like endurance training, weight training, race tapering, lactic acid threshold was greek to me (and still is!) as I read about stories from Ironman finishers, winners, wannabes,Triathlon websites, conversation with friends and the lot. Life went along just fine with no drastic changes in life style. The usual routine of running 5 to 7 km once or twice a week, swim once a week, bike once a week on Thursday nite in Putrajaya continued without stepping up a gear.The weekend was as usual filled with mountain biking, lite and easy road rides, terribly non hard core rock climbing at Batu Caves....the usual stuff. Oh yeah, sometimes I do have to work on weekends if Im On call at the hospital...duhh!! resulting in me missing my fun.In between we continued participating in runs, races and other events thats happening arround.Swimming has always been my weakest link, having "learnt" how to swim barely a year ago and attempting the Kenyir Triathlon (with 1.5km swim in it) only a few weeks after learning how to swim.I came out of the water 3rd last then, with me, Patsy and Francis fighting for the rear honour. I have never been able to improve much since then and have always relied on my mediocre biking and running to help. So to attempt 3.8km of open water was a real challenge for me. The longest that I have done was 2km in Desaru. Im not a fan of swimming especially at sea though I've gone diving before. My choice of style was breast stroke with speed options of slow, and extra slow. My weekly excursions at the Kelana Jaya pool doesnt seem to have made any impact. Not surprising really when at times I have to 'tuang' the swim due to work, and also when most swim sessions was spent on 'cuci mata' at the pool. So when February 2006 came and all i could manage was 2.5km, I started to have second doubts. I frantically became a bit more regular at the pool in order to complete the 3.8km swim in the cut off time of 2hours 20mins as per the rules. By mid February I finally managed 4km in the pool in slightly over 2 hours. I felt ecstatic! Normally due to the sea water buoyancy, and absence of any stoppages for laps, swimming in the ocean is a bit faster. I found this out in Port Dickson where I came at a blistering pace of 45minutes for 1.5km. The top guys complete it in 20 minutes. (I was 5th last out of the water in PD). I felt confident of completing the 3.8km swim in less than 2hrs 20min.
Biking: I have never been a fan of road racing, Im more of a mountain biker. But for the Ironman, a bit of racing mentality has to adopted. I had always assumed that my cheap road bike could bring me along for 180km, but how fast? The rule states that you should finish biking after 10and a half hours from the start of the race. With my estimation that my swim would take 2 hours, that gave me 8and half hours.I planned to do it in 8 thus giving me more time for the run. 7 hours left for the marathon....hmmm I think I could do it if I took it easy and paced myself well.
Running: As stated earlier, I have completed the marathon so there is no doubt that I could run it, but after 3.8km swim and a hard 180km bike ride? Usually the butt hurts like mad by then and what about my energy reserves? I have been known to 'bonk' after a longish bike ride. Perhaps being small and petite with no body fat and less muscle mass makes my Glycogen reserve inadequate to maintain such long distance. The 220km ride to Lumut was a fine example where I basically 'lost it' after the 150km mark. Despite riding then at such a slow pace, touring mode as bikers call it, I felt quite low on energy and felt sick then. To counter this, I started to force myself to eat more often during long rides. The food of choice for athletes on the go would be Power bars and gels and electrolyte drinks. I however remained loyal to the roti canai and nescafe o at the bike rides consumed at stops and breaks along the ride. I have been criticised by friends for not looking after my hydration and carbohydrate intake thus explaining my 'small tank" situation. I should be more diligent in what i eat and drink more before and during rides. Somehow that line of management doesnt seem to be compatible with me. I do exercise for fun. If it gets serious and get complicated by rules regarding diet and such, the fun I think is taken away. I have never had any control at all of what i eat. I eat anything that I fancy. Someone warned me that that may be my downfall. It could be. But it all became irrelevant as the date approached nearer. Work constraints and trouble with the purchase of my new house along with some other events made my last minute preparation go hay wire. Too late now. It was time to go.
Some people prepare for a race like its all out war with plannings, race day simulation etc . Some people are too ignorant, not knowing what to bring, where to go and register, what to to etc etc.Some depend on friends to handle their gear. Some bring their loved ones. Well for me its a bit of all of the above. Im not much of a 'gear head' with my cheap road bike and all but I did make the effort to get my bike pre serviced and packed by the bike shop a few days pre departure. I left the logistical affairs to Steve ie: flight bookings and such. And I did have my so called support crew in Azmar and Karoline my Lite and Easy gang. We were to fly in on the Thursday week of the race, register and do other pre race stuff Friday and Saturday. Race Sunday 26/2/2006 from 0700hrs and hopefully end by 0000hrs 27/2/2006 (monday). Fly back to KL on 28/2/2006. Zabil as usual brought his whole family with lovely wife azah, daughter Aiman and Fauziah the maid. Very big support crew. Azmar flew on Friday to Penang and did his solo bike touring from Penang to Kuala Kedah 160km plus I think and took the ferry to Langkawi to join us.(another long story on its own). Karoline flew in Saturday evening. I had great company

Thursday: I woke up expecting everything would go smoothly before my 2pm flight. Everything became haywire! I for once sent my daughter Farah to school as I was on leave that day. She's usually a lovely well behaved girl but sensing that I was going away started crying and not letting go of me at the kingergarden gates. She had to be pulled away by her teachers. I then received a call from the hospital and I had to rush to the hospital for some things that need to be done. Rushed back home to go to the bank and rushed to my parents house for some errands. My mum chose the exact moment to have an allergic skin reaction and being the only fool in the family who chose to do medicine and not law, I had to go out again and get her some medicines. Then rushed back to fetch Farah. I thought it was over, then Wendy called. She was already in Langkawi and apparently left a wheel rim and a pair of gloves at the bike shop in Taman Tun. "Would u mind bringing them along pleaseee" Frantic calls and smsing and finally had Steve pick them up. But my bike box was already full and packed by then, so I had no choice but to carry the rims with me on board! Steve asked what would he get in return for helping out the'chick'. I told him that he can watch.
Friday: Me and Steve got our bikes set up and went riding. What was meant to be a lite and easy reconaissance ride turned out to be a 90km torture in the hot blazing sun! We toured the course and explored parts of the island. Generally had fun but I think we over did it a bit I. I felt a bit of pain in my calf and Steve got sunburnt. What a way to start your Ironman week! It is recommended that you arrive a week early to acclamatise and prepare but we only arrived 2 days before. A lot of things need to be done. Register, medical check up, payment, gear check. Oh yes, did I tell you how much I had to pay as entry fee? RM 760 or USD340 for foreigners as race fee which most normal people would say a high price to pay for pain in return. A lot of pain may I say. I had to register for Steve so that he gets the local price. " Steve Lee 36 -40 category...hmmm "Im paying for my chinese friend who is yet to arrive from KL" as I bluffed my way at the registeration counter.

Checking in:
The first thing that impressed me upon arriving was the abundance of well toned and fit looking bodies around me in the race hotel lobby. This was definitely not the usual Triathlon where you see average, overweight people minggling around with the Pros. Almost everyone there had done multiple Triathlons with I suspect minimum of fuss. You can see from the T shirts worn that these guys are no fool. Ironman California Finisher. New York Marathon. Boston Marathon. Kona Ironman Finisher.....and the list goes on showing the impressive resume these triathletes have. Another thing that impressed was the gear that these people have brought. Some of the bikes have names that I have never even heard off, with high end components and all the latest gadgetry. Me and Steve was really out of place. There we were a short thin guy and an overweight Mat salleh mixing with the elite. When we lined up at the racing registration, the girl at the counter asked frankly in surprise I would presume "Are you here for the race?" No, Im here for the free buffet. I wanted to reply, but decided against it. " First attempt sir? " she asked with a wide grin.
The medical check up was next. They measure your pulse, BP, Height, weight and finally the tired doctor pretended to listen to your lungs. Weight 52kg. "what? " asked the nurse and they rechecked my weight as if it was of national security. My pulse was also a bit tacycardic (high) since we just came back from riding. The Chinese doctor who was almost asleep earlier immediately payed extra attention to me. I dont know if it was courtesy to another doctor or perhaps he was just plain worried about me.Anyhow Steve's weight of 100kg also caused a stir. It was official, we won the award for most average, lightest and heaviest triathlete.
Race briefing was next. It was given by Ross, a sunburnt heavily accented aussie dude. The rules went on and on.I found that the technicality was a bit too much. Most people there understood though what was going on. Even Ross knew what the questions were before the question was even completed. " I know what you mean" he often intercepts in the midddle of each question. "Yeah dude" I hissed under my breath " You know what they mean but not me!" In the end the briefing was barely required for the regulars, but was a nightmare for average amateurs like me. Back in the room I had to reread the 10page rule book. One section attracted my eye on finishing, "You are advised to make sure that you are able to stand up unaided, eat without vomitting and being giddy after the race before leaving......" I sure dont want that to happen to me.
That's a big swimming pool you have there!
We went to the jetty to view the swim course. It was a point to point swim on a 950 metres long course marked by buoys. Do it 4 times or 2 loops and you have 3.8km. Easy. As of my usual pre race practice, I began to make friends with the rescue people, just in case you know. Since the race was the next day, I just swam for 500metres to get used to the water. The water then was calm but very murky. You cant see beyond 5 metres in the water.That worried me a bit. well too late now.We checked in our bikes at the transition area and did a final gear check.
After that me and Azmar went around town to have a look around. Out of a sudden I met OP Azudin who was there to visit his daughter studying in the local MRSM.He wished me well and promised to be at the race tomorrow. By the way OP Azudin has now become more of an active cyclist. He has progressed to being able to ride 40km on his mountain bike. Quite a feat if you take that he has only started to bike a few months. I also received calls and SMSs from fellow OPs, some I know some I dont,all wishing me luck. How on earth did they know Im attempting this event? Apparently OP Stupes posted it on the mailing list and also on his blog site. I felt like a star. I hope I wont let my fans down.
The night we had a heavy dinner and again met OP Azudin.Tried to sleep early but was too excited.
Woke up 0400hrs raceday and headed down for breakfast. Must eat! I reminded myself repetedly.Went back to the room to see Karoline still asleep. Final gear check and stretch.....Yawn. The pain in my calf was still there! I hope it wont get worse. I gave Azmar my wife's number just in case. People do get sick and land in hospital during and after Ironman races. In fact there has been reported cases of death...thats another story. I felt nauseated after the full breakfast and vomitted out my breakfast. Not a good omen. But I did feel better after that.
Race: The jetty was well lit with music blazing. All the Pros were stretching and hovering around. Final bike check. Final visit to the toilet. A short dip in the water for a quick warm up. The water was warm but it was still dark at this point. The race was postponed to 0730hrs because of this. I couldnt see a thing. "Athletes on the pontoon...!" came the anouncement. I guess that's me.
0730: BANG! and we were off. I started at the back of the pack. No use getting kicked in the face. After a few minutes the non swimmers were separated from the main pack. I was in the middle of the rear end fighters. Francis was ahead of me...Duhh! Swam faster and got into a good rhytmn. Somehow I noticed it was a bit more choppy today. Since it was dark and I couldnt see, I wasnt worried. 35 minutes to reach the first lap. Oh no! I should have covered that in less than 30 minutes. Turned around for the next 950 metres. Kept a steady pace.I had to avoid some fellow strugglers and continued on. It was halfway during the second lap that I got lapped by the PROs. Not to worry, this was expected. The PROs are usually well behaved in a way that they would swim away from the buoy to avoid the slower guys. It was the main group that I was worried about. They basically clambered on top of you and kicked you in the face. Bloody hell Give way la! Reached the u turn 20 minutes. It sure was faster. Later on I was told that it was high tide and swimming away from the jetty was against current and back with it. The return leg was easier but we got blinded by the rising sun. I could not see the bouy! I went off course and was finally stopped by a kayak. "That way sir" he pointed. I craned my neck to see that I had gone adrift almost 50 metres away! Shit! This happened during the 2nd loop though and I wasnt worried since I was on time to complete the swim in 1 hour 50 min. By now I was feeling good but felt like the waves were higher.The sea got choppier than ever. My 50kg lean athletic body was tossed about like a pancake. I could not see where I was going. Then the inevitable happened. I got sea sick. I felt nauseated. my vision was blurred. I hang on to a bouy to check my goggles, no they were fine. Oh dear. 1Hr 35min and I was at 3.2km. Almost there. Dont screw up boy! I swam slowly to the next bouy. Out of a sudden I felt my bowels giving up on me. The retching and the acidic smell was familiar. Vomitus, here they come! My vomit came out like an angry volcano. The vomitus thankfully went away from my face with the water. I stopped and struggled for air, with my head bobbing up and down. In a concerted unison,as I struggled up for air my vomit was washed with the tide all over my face. Aduiii! Shit!
I wanted to laugh but it wasnt funny.
I wanted to shout and curse but was out of air.
I wanted to cry but my eyes were dry from dehydration.
Here I was the Ironman wannabe, struggling in the middle of the ocean.I clang on to the bouy as if my life depended on it. My race has ended.
A kayak appeared and the marshall asked me if I was in trouble. "Am i last?" I asked. "No uncle, many more behind you" said the girl. (I think it was a girl). Dah la muntah, kena panggil pakcik pulak tu....!
I held on there for a few minutes, trying to think.I know my preparation was adequate, I know I could do it. But I also know that I have a lovely wife, my daughters Farah and Yasmin waiting for my safe return. My parents. My Gang. Images of the pakcik that had a recurrence of Nasopharyngeal Carcinoma (cancer nose)that I had just a few days spoke to flashed trough my mind.
Deciding to quit is the most difficult thing to do in any situation, but here it was easy. I was just too sick to continue. By now there was a waterjet ski with 2 Fire Dept officials near me.
Unlike the pakcik with cancer, I had another day to live.
The fireman asked if I could pull myself up onto the jetski. Off course I can! Watch out for the step, sir...and with a heave ho effort I missed my step and landed face flat in the water! The fireman got his hand out and with a single pull I was on the jetski. Aduhh...malunya! I was transferred to the officials boat where they told me the news that I had already knew. I was disqualified (DQ)."A participant will be disqualified if he or she requires medical or non medical assistance at any time in the race" This was the first time I was DQed from a race. I have had a few DNF (did not finish) before, but this was a first. We stayed on and I saw a few people behind me struggling past. The current was really strong now. I could sense that there would be a lot of DNFs and was a bit cheered by the fact. But I also felt pity for them, after all the effort and time spent. I felt pity for myself too. I have ended my race very early on. I felt angry. Back at the shore, I was greeted by azmar, Karoline and OP Azudin. I could tell that Azmar was worried sick not seeing me arriving. At the 2hr 20 mark , all the swimmers left was picked up by rescue boats. By now I was already down and out. Out of a sudden,with a rush of blood to the head, I approached the race swim director, a chinese guy named Wong. "Sir, I want to continue with the race..".With a grin on his face, " No sir, you are disqualified and CANNOT continue with the race". I wanted to give him the finger but walked away. My 3 fans gathered around me to console me and as usual OP Azudin remained as optimistic as ever "Hang masuk diam diam kat belakang mana depa tau doc...go go!" With that I sneaked in the back door of the tent and collected my gear and changed. Some of the junior officials in the tent knew what I was up to and quietly gave me the thumbs up. I met this guy Soon whom I later found out to be a Mas pilot, who DNFed due to cramps. Lets do it buddy.Yeah! Lets! We walked slowly to our bikes as if nothing happened. The bike racks was almost empty now. I pretented to walk the bike to the hotel but instead headed to the start line. Mr Wong was looking from far, but I swear I could see the grin from the corner of his mouth. At approximately 11am,3 and half hours after the start of the race, Soon and I left for the "unofficial" bike leg of our respective Ironman race.
I felt good! I was on my bike and speeding on. Reached a comfortable tempo and cadence. Just as we were passing the hotel where the crowd was gathered at the U turn for the bike and run leg, the MC my friend Razlan saw us..".From MAlaysiaaaa Dr Hisyam Salleh!!" The crowd went wild. Obviously they realised that I was LAST!

Definitely not in front!
The biking leg consists of 3 rounds on a 60km loop. The loop went 30km away from Kuah toward the Northern part of the island heading in a NorthWesterly direction on a generally flat road,and headed back to the start. The weather was HOT and sunny.It must have been 38 to 40deg C out there. I pedalled on. The calf pain was gone. A quick mental calculation and I realised that I had to complete the course before 1800hr. Bike in 7 hours .I've never gone fast that far ever. Second doubts began to creep in. I was at least 70 km behind the leaders and 30 to 40km behind the main pack. If I pushed myself, I may be able to reach home by 6pm but could I run after that? Haiyaa.
At the 20km mark I was lapped by the PROs. That meant that I was way way behind. From then onwards I was being overtaken repeatedly by fast guys. But I was also overtaking some people on my own. Some people who pushed themselves too hard on the swim and too hard on the bikes were now slowing down. I felt better.Then I saw Steve on the other side of the road. We exchanged news and I found that he was on his 2nd lap! That meant the PROs were on their last! At this point some people were already stopping and vommiting by the road side. I felt sorry for them, but i knew exactly how they feel. Then I saw Zabil on his Specialised S bike. He was in trouble. Normally hunched down in the aerobar position, he was upright and not looking too good. I knew if I pushed hard I might be able to catch up in the run.I felt optimistic again. The race was lined with aid station every 10km. They gave out bananas, water, sports drink and the likes. I set my timer to beep every 8 mins to remind me to drink. I dont want to bonk now that I have gone this far. I also kept a close watch on the speedometer on my bike. I had earlier planned on an average speed of 27km/h to enable me in reaching 180km in 7 hours. For the first lap my speed was 30 to 32km/h. Much to my amusement, it went down drastically at the second lap to 25km/h. The weather was taking its toll on everyone. I was taking on board litres of fluids and countless bananas and still dehydration set in. I could feel that the muscle was not responding to my commands anymore. I did manage to stop 3 times to pee, twice in the mobile toilet and once open air roadside. Dark coloured urine, meaning that the kidneys was preserving water by concentrating urine by reabsorbing it more via the loops of Henle and Collecting ducts.(structures in the kidneys). I was thinking about medical cases to gauge if I could think straight. Hypoglycemia (lack of sugar in blood) causes you to lose focus and sometimes you make silly mistakes like forgetting to drink, pushing too hard etc..or worse still crash! Each time I passed the transition, I would be greeted by Razlan "From Subang Jaya Malayyssiaaaaa Doc Hisyam!!" Not only was I carrying the malaysian hopes but now the whole of Subang Jaya was counting on me. Sigh.
From Subang Jaya.....! Doc!(Razlan)

By the third lap, the course was almost empty with majority of people already running.It was 330pm and I had 60km to go. 25km/h. Thats all man. On normal days I could do that with ease, not today though. I was slowing down like a tourist enjoying the sights. My Gluteus maximus(butt) was sore. My left Quadriceps (thigh) was feeling like its been bitten by ants. And worse of all I could not feel my private parts. This happens to cyclist when they sit on the saddle too long. The compression on the sit bone (ischial tuberosity) somehow blocks the arterial circulation to the penile and scrotum region. This is componded further by compression of the IlioInguanal Nerve which supplies that area. You feel numb and that thing aint there anymore. However its temporary though. I dont have to take Viagra after the race. For most of the last lap I was accompanied by a marshall riding on a motor bike. Talked a bit to distract me from the pain with my marshall encik Samsudin. Samsudin is a maintainence crew from UUM Sintok. Apparently he has been coming every year to volunteer in the races. He has seen it all, people vomitting, collapsing even those throwing their bikes in the drain. He says he is still amazed to see people like me going on despite the struggle. He can understand the Pros, they do it for the money but average Joes like me? For a 5ringgit's worth of finisher's Medal? I found it difficult to explain to him. Maybe another day, cik Din as I called him.
The last 19km was the hardest. I just could not maintain any cadence and rhytmn at all.I was really slow and 6pm was approaching.Cik Din became from a marshall to a fan who cheered me on. Even when Azmar offered me water from his rented motorbike, Din said it was Ok. Its not that Im going to win and go to Kona anyway. I had to stand up most of the time to wriggle away the accumulated lactic acid in my legs. As I neared the end, I began to feel a bit better and was looking forward to the run. A marathon in 6hours in my state was impossible, but azmar urged me to carry on. "Do your own race la doc" . With that I realised that I was only in the race for 9 hours! I swam almost 2 hours and started biking at 11am. That meant I was still in the 9th hour of racing....unofficially. Unofficially my race should end at 2am! I was resolute then. Rain or shine Im going to go the whole distance! F*%K the finisher's medal and Certificate. This is my own challenge.
As I hobbled across the bike finish at 1810hrs I could hear Mazlan announcing at the finish line "your an Ironman!!" as he greets the finishers. I sneaked again into the tent and was thinking aloud, someone out there has finished and here I am about to run a marathon. Ha Ha Ha! I burst out laughing. The girls assisting me in the tent was worried. Uncle ni sakit ke? I changed to my running gear. My old running T shirt and my OPA rugby shorts donated by OP Bandit because he cant fit into them anymore and my trustworthy adidas was to be my last gear for the day. I hobbled out of the tent and started the marathon. No one cheered as people were at the finisher's line mostly now. The run basically went trough the same biking route with the U turn at Km 5. 4 loops will do it, thats all.
Normally in a marathon, my knee starts to hurt at the 30km mark. Today it was km 2! Bloody hell! Why am I dumb enough to endure this? I could just stop now and go to my hotel room. Being the Dumb ass that I am, I soldiered on. The race course was littered with people walking, lying by the road side with ambulance screaming up and down. A lot of unhappy people. At Km 8, I caught up with Zabil. He was at the roadside with the medical crew putting ice all over him. He was in bad shape. "Cramps all over my body la doc" he said, the dissapointment evident in his voice. Poor guy, he had trained so hard. I felt his pulse and it was galloping. He was red all over. I knew it was over. He requires an IV line. "Can you give me something for the pain doc?". Yeah I could. I asked the medical assistant(MA) if they had Voltaren Injections (Diclofenac Na) which I offered to administer to Zabil. The MA said yes but he need to call the doctor first. Ok you do that. Meanwhile Zabil sensing that he was slowing me down told me to continue. " Okay bro, I'll run till the U turn and give you the injections..." I told the MA to set up an IV line for Zabil and that I will be back. I hobbled on. By the time I reached the U turn and heading back I could hear the siren blazing and Zabil was off. I hope the MA did what I told them to. As I ran, I observed the many faces that passed. Some of anguish knowing they were about to DNF, some smiling knowing they were going to make it. It was already dark now and we were given flourescent sticks to carry during the run. The local people came out in force now that the heat is out of the way. Go Go Ironman! I felt like a star.
Encountered Steve a few times as we passed each other. He was going to make it Im sure. I told him I will finish at 2 am and he grinned . Go Doc! At the turning point of the 2nd lap, I was stopped by Ross.He was carrying a piece of paper which I suspect had the list of DNFs and DQs. In his thick aussie slang he told me that I was disqualified and shouldnt be on the road. The conversation went something like this.


Ross: I strongly advise you sir to get off the course, you are disqualified. You have a long way to go. You are not going to make it before the cut off. Just give up.
Me: I know what you mean.
Ross: You will hamper and obstruct other people and endangering others.
Me: I know what you mean.....But Im not stopping.
Ross:Then you will be doing it at your own risk! Please take off your race number. You are out of the race! You are not in the race anymore
Me:I know what you mean.
With that I took off my number and gave it to him. I wanted to throw it at him but decided against it. I continued on.
Ross: And we wont let you cross the finishers line. You will be barred from the finisher's area!
Shit! He really wants to have the last word! Go to hell! I screamed to myself.
I had been running for the last 20km now and my knees were really starting to hurt. I began to walk.It was 2200hrs. 22km till my "unofficial" cut off time of 0200hrs. That meant 5km/hr. Slightly faster than walking pace off 3-4km/hr. I was going to make it despite of old man Ross. I decided to skip the finishing line to avoid any trouble. I dont have anything to prove to that loser and the entire Triathlon Coorporation. I am an ironman on my own right! No, I was just joking. I felt so mad, yet so low being humiliated like that. I really didnt care now. I was hurting bad. Azmar, who later on in the week was attempting his first half marathon at the KL International Marathon 21K race, saw me struggling and decided to accompany me. A bit of training la doc. I told him it was a walkathon now. He insisted to come along. In hind sight, Im glad he followed me. I was one of the only few people on the course after 11pm. Most of the runners had already finished or wisely quit. Those on the course had their loved oned accompanying on bikes. My 'loved one " was Azmar. We talked and I thank him for the support he gave me. Meanwhile Karoline accompanied Steve on his last 5km and he crossed the finish an official Ironman. Well done man! 14hr45min
I told Azmar how to run his first half marathon. Also encouraged him to enter the A Famosa Triathlon the following week. In my mind i was also trying to figure out how I would be running the KL marathon less than a week from now. It was already Monday. Would my wife want to come along to the A Famosa Triathlon 2 weeks from now? You can call me crazy, but there I was DQed from a race and planning for the next one already. Not enough pain ke doc?

The water stations were being closed down now. But they still gave me water to drink. After 0030hrs they were gone though. It was only me, Azmar and a few others who refused to be taken off the course by Ross. I noticed no one was wearing race numbers by now. The streets were now empty. At the last stretch home we were looking around to see if there were any food stalls still open. Luckily Karoline had bought something for me and Azmar to eat. Another loved one.
My wife called me asking if i was safe in the hotel room. I said no and that i was still on the road and expecting to finish at 2am. I could almost hear her laughing her guts out back in USJ." Dont worry dear, to me you are an Ironman", with that I think she went to bed smiling.
Me and Azmar hobbled into the hotel lobby to be greeted by Karoline. It was 145am. The sleepy girl at the reception looked at me with wide eyes. I was expecting her to announce loudly: "You are An Ironman!! Welcome home".
Instead all that she could muster was, "room number, sir?".
I was in a bad state.16hr 45mins "unofficially".
Am I an Ironman?



PS:Technically Im a DQed non Ironman. But to me the whole experience was amazing. I have reached my very limits and even gone beyond. The feeling of satisfaction completing the course can never be summed up with a finisher's medal or a lousy certificate. The sense of accomplishment is what motivates me to outdo myself. I hope my story will encourage my friends to follow suit . Just go out there and outdo yourself! You will be amazed at what you can achieve. See you at this week's marathon!
Cheers.Warm Regards.

OP Doc Hisyam
A87-91


Since then, a lot of my friends began to train for races. Azmar and Karoline did their Ironmans this year along with so many others. Im an optimist. I believe that nothing is beyond reach if you try hard enough. I also enjoy motivating my friends to outdo themselves. I hope this story will do the same to you too.