'Mampir UGD'

Iseng banget orang mampir ke UGD ya? Tapi jangan salah... di musim kurang jelas seperti sekarang-sekarang ini UGD lumayan jd tempat yg sering dikunjungi orang-orang. Seperti juga yang terjadi pada saya tadi malam. Mampir UGD demi mendapat sehembusan napas :p . Apa pasal? begini ceritanya:
Saya dan pasangan menghadiri sebuah resepsi pernikahan di TMII, sekitar jam 20.50 kami beranjak pulang. Baruuuu saja keluar dr gerbang TMII saya mulai merasakan sulit bernapas (serangan asma yang memang sudah 1 bln ini kambuhnya kurang ajar)...saya pikir kali ini kemungkinan krn agak kedinginan (sempat sedikit berhujan2an td mnuju resepsi) plus beberapa bapak2 yang kurang pemahaman terhadap peraturan pemerintah "Dilarang merokok di tempat umum" dan dgn santai nya merokok di dalam ruang resepsi (biasa kan cari tempat di luar) sehingga saya mau tidak mau terpapar.

Sialnya lagi, saat serangan mulai bertambah parah, ketika saya merogoh tas utk mencari inhaler (obat hirup asma) yang seharusnya senantiasa saya bawa, kok ya gak ada... baru saya ingat sepertinya saya tidak bawa :( . Serangan asma mulai dibumbui dengan sedikit kepanikan krn tdk ada inhaler. Untunga saja pasangan saya tidak menunjukan kepanika nya, dia menenangkan saya sambil menambah laju mobil. Jarak yang harus kami tempuh masih lumayan jauh (TMII-mayestik).

Menjelang keluar tol di kuningan, sesaknya semakin parah, hingga sudah tidak mampu mengeluarkan sepatah katapun... berkeringat..dan badan melemas. Melihat hal itu pasangan saya langsung menawarkan utk k UGD, krn msh terlalu jauh utk sampai rumah. Walhasil kami mnuju ke sebuah RS di warung buncit (Jakarta Medical Center).

Akhirnya.. sampai juga, sebelum saya benar2 kehabisan oksigen... sesampainya di ugd, setelah dijelaskan masalahnya, seorang dokter jaga dan suster mulai sibuk2 menyiapkan peralatan utk perawatan. Yang agak lucu adalah sebelum sang dokter menengok ke arah saya (dia sambil mengomabdikan kepada suster apa saja yang harus disiapkan... dia mengajak saya ngobrol, menanyakan keadaan dan mulai kapan serangannya. Hehehe saya yang sudah tidak mampu bersuara kecuali suara 'mengi' yang kadang ada kandang tdk dr saluran napas... hanya bisa mengangkat alis sebelah, berharap sang dokter menengok dan melihat keadaan saya yg bisa dibilang sudah parah :P . Ketika akhirnya dia menengok, baru raut mukanya berubah melihat saya yang sudah amat sangat sulit mengatur lalu lintas udara ke saluran napas. Langsung dia meminta suster utk mempercepat menyiapkan.

Lalu, apa saja yang diberikan? obat inhalasi melalui nebulizer (lumayan efektif utk serangan asma akut krn dalam keadaan yang sudah sulit sekali menarik napas, obat akan masuk dgn sendirinya ke saluran napas), dan suntikan. Lumayan lama saya harus menghirup dr alat nebulizer itu, menurut dokter 15 kemudian diberi oksigen murni. 15 mnt kemudian sang dokter memeriksa lagi ternyata sesak nya masih berat, sehingga setelah nanti diberi oksigen saya menghirup nebulizer lg, setelah diberiksa lagi ternyata masih agak berat, walhasil saya diberi 3x pengulangan nebulizer-oksigen-nebulizer-oksigen-nebulizer-oksigen. Jadi total2 sekitar 2 jam sana di UGD.

Saat saya sudah mulai bisa berbicara sang dokter mulai mengajak ngobrol...menanyakan kenapa bisa parah sekali serangannya, ketika saya bilang "inhaler nya ketinggalan dok" baru dia mengerti kalau asma saya memang agak berat. Dia bercerita bulan2 ini memang banyak sekali yang datang malam karena serangan asma, maklum cuaca lagi gak jelas, dalam satu malam paling sedikit ada 4 pasien UGD yang terserang asma, tapi semua nya rata2 asma ringan sehingga cukup diberi satu 'ronde' nebulizer-oksigen saja sudah langsung membaik.
Sekitar jam 24.00 sayapun diperbolehkan pulang dengan dibekali beberapa obat (lagi), dan nasihat2 agar lain kali jgn sampai lupa bawa inhaler dan menggunakan nya secara teratur selain saat serangan (obat hirup yang saya gunakan saat ini adalah Symbicort Turbuhaler, yg selain sebagai 'rescue inhaler' juga untuk treatment pencegahan serangan2 akut).

Ya nasib memang..penderita asma, apalagi di kota besar seperti Jakarta, selain faktor alam yaitu cuaca yang gak jelas, juga banyak faktor pencetus.. polusi, asap rokok, dan debu rumah biasanya pencetus yang peling sering ditemukan di kota2 besar.
Jadi pelajaran kali ini:

1. Jangan sampai ketinggalan inhaler.
2. Lebih siap dgn berbagai tindakan preventif
3. Para perokok tolong..kasihanilah sekitarmu!!!

Gambar Nebulizer (pengobatan dgn penguapan 2 jenis obat, yg diberikan ketika saya d UGD)

Nebulizer. (gambar diambil dr: www.mercurymed.com )

CoolNeb
Nebulizer utk terapi.. (hehehe the visually cool side of medication :p )



Sekian... terimakasih!!!!

Singing in the Rain

A really fun to watch video... enjoy it!!

Jakarta Fight Hunger: Walk the World 2007

Ikutan yuuukk...




http://www.fighthunger.org/en/wtw07/id/jakarta

Kabar Baru untuk Penderita Asma

Asma, penyakit menahun yang berupa penyempitan saluran napas (ketika kambuh) ini memang merupakan penyakit yang banyak kita jumpai, terutama di kota besar, di Indonesia sendiri dari beberapa sumber yang pernah saya baca ada sekitar 7-8% orang yang menderita asma dan terus meningkat setiap tahunnya. Ini diakibatkan antara lain karena semakin buruknya kualitas udara yang kita hirup sehari-hari. Ketika saya kecil saya mengenal asma sebagai suatu penyakit turunan yang kita derita sejak kanak-kanak, namun beberapa tahun terakhir ini ternyata banyak juga penderita asma yang mendapatkan serangan pertamanya saat sudah dewasa. Asma ini bisa kambuh dikarenakan berbagai faktor pencetus seperti alergen, atau kelelahan saat melakukan kegiatan fisik, perubahan cuaca, sakit flu, emosi, bahkan bisa juga karena luapan kegembiraan. Tingkat dan jenis sensitivitasnya berbeda pada tiap orang, saya sendiri memiliki sensitifitas berlebih (alergi bahasa bakunya...) thd asap rokok, debu, polusi udara (sehingga jika sudah terlalu lama berdiam diri di Jakarta serangan akan sering sekali timbul), beberapa obat2an (aspirin), MSG (hehehe hidup sehat judulnya), dan lain lain. Nah, kalau kita bisa menghindari faktor-faktor pencetus ini, tentu serangan asma pun bisa dikendalikan.

Bagi anda yang memderita asma juga, tentu mengerti bagaimana rasanya bila terjadi serangan, atau bagi anda yang memiliki buah hati yg menderita asma, saya sendiri kadang tdk tega melihat anak-anak yang sedang terserang asma (hahaha walaupun itu juga terjadi pada saya :P ). Sementara jika anda bukan penderita asma dan penasaran seperti apa rasanya, kira-kira begini (ini lagi-lagi saya baca dari sebuah jurnal kedokteran):
1. Coba anda lari2 selama 3 menit, sampai napas terengah-engah
2. Ambil sebuah sedotan dan bernapaslah hanya dari mulut menggunakan sedotan itu
3. Terakhir, ketika bernapas tekan bagian tengah sedotan sehingga hanya sekitar 30% bagian yang terbuka dan bisa dilewati udara (ingat bernapas hanya melalui mulut).
Untuk mengurangi seranganpun terdapat berbagai obat-obatan dari mulai yang diminum, dihirup, hingga suntikan. Bagi mereka yang cenderung terserang secara berkala (sering) obat hirup (inhaller) kadang menjadi pilihan terbaik, obat jenis ini mampu melebarkan saluran napas dengan cepat namun seidkit sekali efek sampingnya terhadap organ-organ lain karena reaksinya langsung kepada sasaran, tidak seeperti obat-obatan yang diminum.

Nah, sebuah berita yang saya baca di www.sciencedaily.com , di Amerika sedang diadakan sebuah penelitian tentang asma yaitu "Bronchial Thermoplasty", sebuah percobaan untuk mengatasi asma tanpa penggunaan obat-obatan, melainkan dengan penggunaan panas untuk membakar "otot-otot halus" yang biasa berkontraksi ketika serangan asma. Suatu frekuensi radio tingkat rendah atau energi thermal akan melalui otot-otot saluran bronchial kita, dan akan 'merusak' otot-otot halus ini, dokter sendiri akan bisa mengontrol sebesar apa 'kerusakan' yang diperlukan. Percobaan yang sudah dilakukan adalah dengan menggunakan metode ini terhadap beberapa penderita asma 1 jam setiap harinya selama 3 minggu, hasil yang didapat adalah penurunan signifikan terhadap penggunaan obat-obatan seperti inhaler oleh para penderita itu.

Hal ini memang bukan merupakan penyembuhan, tetapi sepertinya cara yang cukup menjanjikan bagi penderita asma untuk bisa lebih mengendalikan penyakitnya. Sebab saya yakin bagi para penderita asma dimanapun, sekedar untuk mengurangi serangan saja sudah merupakan suatu hal yang amat berarti. Kita cuma bisa berharap, percobaan ini berjalan lancar dan berhasil, dan bisa kita nikmati di Indonesia ;)

Nemu di Blog Tetangga... ;)

Ini kartu saya, katanya...

You are The High Priestess

Science, Wisdom, Knowledge, Education.

The High Priestess is the card of knowledge, instinctual, supernatural, secret knowledge. She holds scrolls of arcane information that she might, or might not reveal to you. The moon crown on her head as well as the crescent by her foot indicates her willingness to illuminate what you otherwise might not see, reveal the secrets you need to know. The High Priestess is also associated with the moon however and can also indicate change or fluxuation, particularily when it comes to your moods.

What Tarot Card are You?
Take the Test to Find Out.

Ketika Steve Jobs Angkat Bicara

Awal Februari lalu Om Steve angkat bicara mengenai iPod, DRM (Digital Rights Management), dan 4 perusahaan musik terbesar (Universal, Sony BMG, Warner and EMI), intinya sih pendapat dia mengenai teknologi hak cipta, hak copy, dll.
Mari kita simak apa saja yang dia bahas ;)


Thoughts on Music

Steve Jobs
February 6, 2007

With the stunning global success of Apple’s iPod music player and iTunes online music store, some have called for Apple to “open” the digital rights management (DRM) system that Apple uses to protect its music against theft, so that music purchased from iTunes can be played on digital devices purchased from other companies, and protected music purchased from other online music stores can play on iPods. Let’s examine the current situation and how we got here, then look at three possible alternatives for the future.

To begin, it is useful to remember that all iPods play music that is free of any DRM and encoded in “open” licensable formats such as MP3 and AAC. iPod users can and do acquire their music from many sources, including CDs they own. Music on CDs can be easily imported into the freely-downloadable iTunes jukebox software which runs on both Macs and Windows PCs, and is automatically encoded into the open AAC or MP3 formats without any DRM. This music can be played on iPods or any other music players that play these open formats.

The rub comes from the music Apple sells on its online iTunes Store. Since Apple does not own or control any music itself, it must license the rights to distribute music from others, primarily the “big four” music companies: Universal, Sony BMG, Warner and EMI. These four companies control the distribution of over 70% of the world’s music. When Apple approached these companies to license their music to distribute legally over the Internet, they were extremely cautious and required Apple to protect their music from being illegally copied. The solution was to create a DRM system, which envelopes each song purchased from the iTunes store in special and secret software so that it cannot be played on unauthorized devices.

Apple was able to negotiate landmark usage rights at the time, which include allowing users to play their DRM protected music on up to 5 computers and on an unlimited number of iPods. Obtaining such rights from the music companies was unprecedented at the time, and even today is unmatched by most other digital music services. However, a key provision of our agreements with the music companies is that if our DRM system is compromised and their music becomes playable on unauthorized devices, we have only a small number of weeks to fix the problem or they can withdraw their entire music catalog from our iTunes store.

To prevent illegal copies, DRM systems must allow only authorized devices to play the protected music. If a copy of a DRM protected song is posted on the Internet, it should not be able to play on a downloader’s computer or portable music device. To achieve this, a DRM system employs secrets. There is no theory of protecting content other than keeping secrets. In other words, even if one uses the most sophisticated cryptographic locks to protect the actual music, one must still “hide” the keys which unlock the music on the user’s computer or portable music player. No one has ever implemented a DRM system that does not depend on such secrets for its operation.

The problem, of course, is that there are many smart people in the world, some with a lot of time on their hands, who love to discover such secrets and publish a way for everyone to get free (and stolen) music. They are often successful in doing just that, so any company trying to protect content using a DRM must frequently update it with new and harder to discover secrets. It is a cat-and-mouse game. Apple’s DRM system is called FairPlay. While we have had a few breaches in FairPlay, we have been able to successfully repair them through updating the iTunes store software, the iTunes jukebox software and software in the iPods themselves. So far we have met our commitments to the music companies to protect their music, and we have given users the most liberal usage rights available in the industry for legally downloaded music.

With this background, let’s now explore three different alternatives for the future.

The first alternative is to continue on the current course, with each manufacturer competing freely with their own “top to bottom” proprietary systems for selling, playing and protecting music. It is a very competitive market, with major global companies making large investments to develop new music players and online music stores. Apple, Microsoft and Sony all compete with proprietary systems. Music purchased from Microsoft’s Zune store will only play on Zune players; music purchased from Sony’s Connect store will only play on Sony’s players; and music purchased from Apple’s iTunes store will only play on iPods. This is the current state of affairs in the industry, and customers are being well served with a continuing stream of innovative products and a wide variety of choices.

Some have argued that once a consumer purchases a body of music from one of the proprietary music stores, they are forever locked into only using music players from that one company. Or, if they buy a specific player, they are locked into buying music only from that company’s music store. Is this true? Let’s look at the data for iPods and the iTunes store – they are the industry’s most popular products and we have accurate data for them. Through the end of 2006, customers purchased a total of 90 million iPods and 2 billion songs from the iTunes store. On average, that’s 22 songs purchased from the iTunes store for each iPod ever sold.

Today’s most popular iPod holds 1000 songs, and research tells us that the average iPod is nearly full. This means that only 22 out of 1000 songs, or under 3% of the music on the average iPod, is purchased from the iTunes store and protected with a DRM. The remaining 97% of the music is unprotected and playable on any player that can play the open formats. It’s hard to believe that just 3% of the music on the average iPod is enough to lock users into buying only iPods in the future. And since 97% of the music on the average iPod was not purchased from the iTunes store, iPod users are clearly not locked into the iTunes store to acquire their music.

The second alternative is for Apple to license its FairPlay DRM technology to current and future competitors with the goal of achieving interoperability between different company’s players and music stores. On the surface, this seems like a good idea since it might offer customers increased choice now and in the future. And Apple might benefit by charging a small licensing fee for its FairPlay DRM. However, when we look a bit deeper, problems begin to emerge. The most serious problem is that licensing a DRM involves disclosing some of its secrets to many people in many companies, and history tells us that inevitably these secrets will leak. The Internet has made such leaks far more damaging, since a single leak can be spread worldwide in less than a minute. Such leaks can rapidly result in software programs available as free downloads on the Internet which will disable the DRM protection so that formerly protected songs can be played on unauthorized players.

An equally serious problem is how to quickly repair the damage caused by such a leak. A successful repair will likely involve enhancing the music store software, the music jukebox software, and the software in the players with new secrets, then transferring this updated software into the tens (or hundreds) of millions of Macs, Windows PCs and players already in use. This must all be done quickly and in a very coordinated way. Such an undertaking is very difficult when just one company controls all of the pieces. It is near impossible if multiple companies control separate pieces of the puzzle, and all of them must quickly act in concert to repair the damage from a leak.

Apple has concluded that if it licenses FairPlay to others, it can no longer guarantee to protect the music it licenses from the big four music companies. Perhaps this same conclusion contributed to Microsoft’s recent decision to switch their emphasis from an “open” model of licensing their DRM to others to a “closed” model of offering a proprietary music store, proprietary jukebox software and proprietary players.

The third alternative is to abolish DRMs entirely. Imagine a world where every online store sells DRM-free music encoded in open licensable formats. In such a world, any player can play music purchased from any store, and any store can sell music which is playable on all players. This is clearly the best alternative for consumers, and Apple would embrace it in a heartbeat. If the big four music companies would license Apple their music without the requirement that it be protected with a DRM, we would switch to selling only DRM-free music on our iTunes store. Every iPod ever made will play this DRM-free music.

Why would the big four music companies agree to let Apple and others distribute their music without using DRM systems to protect it? The simplest answer is because DRMs haven’t worked, and may never work, to halt music piracy. Though the big four music companies require that all their music sold online be protected with DRMs, these same music companies continue to sell billions of CDs a year which contain completely unprotected music. That’s right! No DRM system was ever developed for the CD, so all the music distributed on CDs can be easily uploaded to the Internet, then (illegally) downloaded and played on any computer or player.

In 2006, under 2 billion DRM-protected songs were sold worldwide by online stores, while over 20 billion songs were sold completely DRM-free and unprotected on CDs by the music companies themselves. The music companies sell the vast majority of their music DRM-free, and show no signs of changing this behavior, since the overwhelming majority of their revenues depend on selling CDs which must play in CD players that support no DRM system.

So if the music companies are selling over 90 percent of their music DRM-free, what benefits do they get from selling the remaining small percentage of their music encumbered with a DRM system? There appear to be none. If anything, the technical expertise and overhead required to create, operate and update a DRM system has limited the number of participants selling DRM protected music. If such requirements were removed, the music industry might experience an influx of new companies willing to invest in innovative new stores and players. This can only be seen as a positive by the music companies.

Much of the concern over DRM systems has arisen in European countries. Perhaps those unhappy with the current situation should redirect their energies towards persuading the music companies to sell their music DRM-free. For Europeans, two and a half of the big four music companies are located right in their backyard. The largest, Universal, is 100% owned by Vivendi, a French company. EMI is a British company, and Sony BMG is 50% owned by Bertelsmann, a German company. Convincing them to license their music to Apple and others DRM-free will create a truly interoperable music marketplace. Apple will embrace this wholeheartedly.

Sumber: http://www.apple.com/hotnews/thoughtsonmusic/

A Sight for Sore Eyes

Mudah-mudahan lumayan menghibur, sementara orang-orang memasang foto-foto dokumentasi banjir, saya mau memperlihatkan foto-foto indahnya jakarta beberapa minggu sebelumnya, disaat kita bisa menikmati birunya langit Jakarta selama kurang lebih 2 minggu :)


Point of view dr jendela kamar ;)


Benar-benar 'Sunday' dari Pasaraya Grande Theater Building Lt.7


Magic Hour di Balkon...