Saturday, December 25, 2010

Situation Update and Don't Let Your Blackberry Get You Down...

We have had a busy few weeks, what with the long anticipated visit by pals from Ponte Vedra (only three short days), meeting Lin's nephew and his family (for the first time!) and then his latest health assessment. 

His White Blood Count and Neutrophils were low again and so chemo has been postponed until Monday, December 27th.

In the meantime we met with the Prof. on Thursday to go through the reports of his CT Scan and lab work. Liver and kidneys profiles are fine although he still needs to drink more water.

He had a test for vitamin D (25-OH Vitamin D) which the Prof. says shows a higher level of vitamin D than he usually sees. 

But on looking at the report I see that he has 46.9 ug/L which is within the sufficient range of 30 - 100.

(EXPECTED RANGES:  <10 is deficient, 10 - 29 insufficient, 30 - 100 sufficient and > 100 indicates possible toxicity)

It certainly shows the Vitamin D3 he has been taking works!

His scans were more interesting and I learned some new things. 

CT of thorax, abdomen and pelvis:
There was  fatty change in his liver from last time (nothing to worry about), his two kidney stones are still in situ and not causing any problems. 

Mild gynaecomastia was noted.

If you are curious, it means development of male breast tissue. I had been pooh-poohing his complaints about his chest area being sensitive and painful; but for once he was not imagining things!

Apparently it is not uncommon in those who regularly imbibe alcohol - when they have chemotherapy which affects their testosterone levels. Age also plays a part in lowering testosterone levels in males.

So there you have it! A consequence of the male menopause.

CT Brain:
Lin does not have a previous brain scan with which to compare this one. 

However, it proves he has a normal brain for someone his age with the exception of "an 18mm extra-axial CSF density in the region of the right CP angle, which may represent an arachnoid cyst".

The Prof. discussed the scan with the radiologist and let us have a choice: to investigate further by undergoing an MRI or waiting and watching.

I did say to Prof. Wong that perhaps it was better to leave Lin's brain alone because Lin's balance is much better than mine (which I put down to ageing). Truly, he is better on his feet than many younger people.

Taking into account that Lin does not have headaches or symptoms such as problems with his balance, we decided to wait and see.

As for the 1.8cm possible arachnoid cyst, I suggested it might be a tiny reserve of red wine! (I did not think that was well received!)

In case you are interested:
extra-axial: off the axis; applied to intracerebral lesions that do not arise from the brain itself.

What are Arachnoid Cysts?

Arachnoid cysts are cerebrospinal fluid-filled sacs that are located between the brain or spinal cord and the arachnoid membrane, one of the three membranes that cover the brain and spinal cord.   Primary arachnoid cysts are present at birth and are the result of developmental abnormalities in the brain and spinal cord that arise during the early weeks of gestation.  Secondary arachnoid cysts are not as common as primary cysts and develop as a result of head injury, meningitis, or tumors, or as a complication of brain surgery.  The majority of arachnoid cysts form outside the temporal lobe of the brain in an area of the skull known as the middle cranial fossa.  Arachnoid cysts involving the spinal cord are rarer.  The location and size of the cyst determine the symptoms and when those symptoms begin.  Most individuals with arachnoid cysts develop symptoms before the age of 20, and especially during the first year of life, but some people with arachnoid cysts never have symptoms.  Males are four times more likely to have arachnoid cysts than females. 
Typical symptoms of an arachnoid cyst around the brain include headache, nausea and vomiting, seizures, hearing and visual disturbances, vertigo, and difficulties with balance and walking.  Arachnoid cysts around the spinal cord compress the spinal cord or nerve roots and cause symptoms such as progressive back and leg pain and tingling or numbness in the legs or arms.  Diagnosis usually involves a brain scan or spine scan using diffusion-weighted MRI (magnetic resonance imaging) which helps distinguish fluid-filled arachnoid cysts from other types of cysts.   

It's likely that this fluid has been there for some time - perhaps since he was a child. Or, maybe his head could have been knocked about playing rugby. But as long as it gives no trouble, there's no need to disturb its peace.
As I sit here before my computer to post this rather late update, it has just turned Christmas Day in Singapore.
A friend sent this video clip to me - watch it and tell me that you didn't like it!

Monday, December 6, 2010

We Are What We Eat and Help ID A Local Plant

We should have been finished by now, but the WBCs and the neutrophil counts still delay the chemotherapy sessions.

On the good side, the side effects have not been as debilitating or painful as he had expected. It is certainly better to expect the worse.

In two days' time another blood test to see if he will be getting his chemotherapy (delayed from last week).

Still trying to get him to eat properly at mid-day and to drink lots of water.

The newspapers have been 'debunking' high doses of vitamin D3; I am going to continue on 5000iU with iodine as I have felt so much better since taking it.

I have been reading a book by an old friend, Betty Khoo Kingsley, called CANCER CURED & PREVENTED NATURALLY.

Ordinary People with Extraordinary Courage

They defied doctors' prognoses. Some were given just weeks to live.
They all turned to Raw Vegetarian Diets & Herbs and Self-Help Strategies - Meditation, Creative Visualisation, Chigong, Yoga and, 10 - 25+ years on, are living full and productive lives.

Foreword by Dr Chris KH Teo, Botanist and Herbalist
Founder of CA Care with Herbs
Author of Cancer Yet They Live

Publisher and Author: Betty L Khoo-Kingsley
Copyright 2007
ISBN 97898 10 580476

Actually I go back to it from time to time. She has packed in rather a lot of information and I forget things I've read so I 'learn' it all again and again!

These three photos show a shrub which is called (in Cantonese) the 'Seven Needle Leaf'. The needles grow in clusters along the stem, hence the name. The leaves are used in de-toxing which the locals believe will help in the cure.

The leaves are cleaned, torn and eaten as a salad (five leaves a day). The detox regime includes the juice of one raw organic potato and one organic green apple a day.

This came from one of the stallholders at Tiong Bahru market.

Questions: does anyone know the plant? What is it also known as? What is its botanical name?

Saturday, November 27, 2010

Making progress

The good news is that we have made some progress albeit not quite as quickly as we would have liked. Two more cycles (four sessions) to go !

This makes December a busy month. In addition to the bi-weekly chemotherapy (if there are no delays due to neutrophil counts) Prof Wong has scheduled a CT Scan, blood tests and a test for levels of Vitamin D3. The latter is a new one to us and I am curious to know why the interest in Vitamin D3.

When I first mentioned D3 in May/June he was ambivalent about Vitamin D3 supplementation, so we'll see what he has to say about it when the test results come out.

About a month ago, Lin had headaches and was feeling rather nauseous. But we were prepared for this and had the panadol and anti-nausea pills at the ready. But it had not entered our heads that we should have gone to the Cancer Center to have the side effect checked out!

Prof Wong asked if we had come into the hospital and we told him it hadn't occurred to us that it was necessary!

It wasn't as if Lin was feeling dreadful or running a fever - and it seemed like pretty small stuff to bother the hospital about. But now we know - if it ever happens again we will be there.

My guess is that the study of cancer is very much a work in progress and the doctors want to see all the manifestations of side effects in various individuals since no one case is quite the same.

On a related topic, we are still working with BUPA Hong Kong on Lin's health insurance claims; this is taking time because we are dealing with a bureaucracy. 

Admittedly, we had been late with some of the early claims. They have a 90 day window in which claims must be filed and that window evaporates faster than alcohol in the presence of an alcoholic.

The days fast-forward when transplanting ourselves to another country and getting to terms with treatment and all things new in one's life because of the requirements of the illness. Emotionally too it is a fraught time and the last thing on one's mind is sitting down to interpret the arcane demands of the claim forms; and applying oneself to collecting, sorting and collating paperwork and filling in forms.

The last six weeks or so, we have been back and forth trying to sort out what they REALLY need because certified copies will not do (in case we are also making a claim against another insurer). 

Also they want a diagnosis from the Prof which includes details of the treatment; this will also have to substantiate anything else the Prof has had checked out - for example an, investigation of Lin's heart (a detail that first appeared in the pre-surgery report in Hong Kong and then in the report of his CT scan, done here a few months ago).

Dealing with a monolithic organisation is not easy at the best of times and it does not help to have the South China Sea in the way. 

I don't blame the clerk ticking the forms because he or she is going by the book. But at some point his supervisors will need to read all the material and information we sent - copies of the Prof's CV, etc - since they would not know him from Adam.

Also we have to explain Medisave, a component in one's Central Provident Fund which can be used towards approved medical expenses. Otherwise they will invariably interpret it as a contribution from another medical policy!

Sometimes I just wish insurance companies were as genial and prompt in handling claims as they are in selling a policy or receiving renewal payments!

But life could be worse.

Saturday, November 20, 2010

Long Time No See/Hear?

Little things crop up and life gets in the way of this blog, especially when one takes a couple of break in the last month or so.

Bloodwork, no chemotherapy, bloodwork, chemotherapy. That about sums up Lin's main activities of late. The good news being he was able to have his postponed chemotherapy on Thursday (a change from the usual Mondays) and will be going into NUH today to get shot of 'the brick' this afternoon.

He's in fine fettle and this week we had two friends from Hong Kong home to dins on separate occasions. Both said he looks a lot better as a  result of his change of lifestyle (no booze, eating properly - sometimes).

He's had nine holes of golf this week which he needs because he is accustomed to exercise. But it doesn't seem to have helped his expanding girth (at least, that is his complaint).

My suggestion is that he spend time in the club gym to tone all his muscles, not merely the legs and golf muscles.

When we came to Singapore for his adjuvant chemotherapy, the 'gold standard' was our experience with Lin's surgeon and the Baptist Hospital in Hong Kong.

Now that he has been treated at NUH (where I have met up with a few old friends who are also cancer patients) and a friend in Singapore has had her colorectal cancer treated at Singapore General Hospital, my horizons have been broadened.

So to answer a friend who recently asked me where I was going to breathe my last: Singapore. Very simple, thus far I can communicate with healthcare providers in English (until Singlish evolves further away from English) and we do have an excellent public health care system in place.

Hong Kong runs a close second, but there I am a Chinese who doesn't speak much Cantonese and no Mandarin! When one is old and gasping, it's going to be hard to be lucid in an unaccustomed tongue. And my pals will not be in the next beds interpreting for me!

Also, Hong Kong's public health, which is equally excellent, is already stretched in coping with current demand.

I will not comment on private health facilities as I have very limited experience of it in HK and no recent experience of it in Singapore. 

This has not stopped me from being inclined towards public health mainly because I know that the specialists are not going to send me for investigations and procedures to satisfy perceived gaps in information, or to show me they care.

On thing I will remark upon is that our GP in Singapore mentioned that healthcare providers in the USA recognise and accept the results of bloodwork tested in labs. in Singapore, which says quite a lot since most doctors and hospital around the world prefer to re-do the tests when a new patient arrives.

Also, I have read Lin's various test and pathology results from Hong Kong and more recently, I have read those of my friend's scans and various tests, including her pathology report. I have to say that apart from the standard of written English, the ones done at SGH do give more detail (margins, depth of penetration, etc).

I suppose it is like looking at a map that gives an overall picture of the terrain and then at a more detailed map of the same area.

Anyway, I don't know if this is going to be good or bad news for our government; probably a very mixed blessing if many other Singaporeans think as I do. They will have to beef up and increase our medical facilities as the 'silver tsunami' grows and more silver-haired Singaporeans come home to roost.

To Lasik or Not to Lasik?

As I am by nature curious, I asked several friends and relatives about their experiences with spectacles and sight correcting procedures. This was promoted by having to juggle sunglasses, reading and clear distance spectacles. It's purgatory not being able to read a menu!

It can be summed up in this one sentence: "why do you think most prominent eye surgeons/specialists still wear glasses".

By the time Lasik, PRK, Femto-whatsit and so on have been around 75 years I shall be long dead; in the meantime I shall put up with squinting, misplacing my specs. (and phone) and all that comes with relying on spectacles for clear vision.

Medical Tourism

When I was in HK, I tried to entice my pals to visit Singapore. 

One of the pretexts that I suggested they put forward to their husbands is having their annual medical checkups done here. Naturally I was delegated the task of doing further investigation.

So I trotted to various medical tourism sites and then to specific government hospital websites. 

My grouse is that not all the medical tourism websites I visited are up-to-date - which is not good considering how we pride ourselves at being at the leading edge of technology.

As for the hospitals' websites, they vary in quality and presentation. For example, I could not find good pictures of the hospitals in their settings - which would give visitors a good impression.

For example the brand new Khoo Teck Puat Hospital which is lauded for being in a garden-like setting seems to have only one small picture (the rest are indoors and of various dignitaries) and I am not sure if it is of an artist's impression or model (blame my eyesight if I am wrong!).

Mind you I just went back to their website and could not locate that picture - there is a nice one, however, of their shuttle bus. 

I lie, I lie! - I checked out their newsletters and their current issue has the new hospital in all its glory on the cover. I am now going to try to reproduce it for you.

I would have loved photos of the KTP hospital and gardens to send on. Tan Tock Seng Hospital is not bad looking either.

NUH is in a state of flux as it is being upgraded and a new block is being constructed so it has excuses for not being portrayed on the screen.

However when it comes to the information on the health screening or wellness packages, there really is no excuse for the paucity of information and the inelegance of their web page(s).

Tan Tock Seng's website sets out their checkups best but even then you have to sidestep their blurb about corporate packages to get to individual men's and women's health screening packages.

If I did not know where to go and had to choose on the basis of their websites, I would pick Tan Tock Seng Hospital. And my thirst for more information about KTPH would be left unslaked unless I emailed them for information.

Tuesday, October 26, 2010

Pillar To Post?

We seem to be going from pillar to post again. The headache and nausea have gone, but the WBC and Neutrophils are still low.

The Prof. is brilliant but he's such a busy person that his patients have to be patient and flexible. The Cancer Center staff and patients with low blood counts waited from his blood draw (8:45a) to almost 1:00pm to know whether he would sign off on a chemo session for them today.

Others on his schedule for consultations this morning were sent away with apologies and asked to come in at the same time tomorrow because he had been asked to make a presentation this morning!

Holding as many portfolios as he does and having to fly hither and yon every now and again, it is difficult for him to get much 'face time' with his patients. He is totally 'hands on' and makes all the important decisions, so we all pray for his good health and safety.

While waiting today, I met an old friend. I had heard she was also a patient of Prof. Wong and knew we would meet up in Cancer Canter 3 sooner or later so I was not surprised to see her there.

As one does in such situations we compared side effects and notes. And I learnt something new: she said that she had a lot of trouble with mucositis and that it helped her get some measure of relief to keep ice in her mouth during her chemo sessions . 

She also had been told that in India, chewing on grated coconut 'flesh' helped sufferers from mouth ulcers and she's now tried it to good effect.

So now not only are we going to have Lin on Prosure powder (Vanilla!) in coconut water, he gets to chew the nice white 'flesh' of the coconut too.

All this means that he will be going to the Cancer Center next Monday for another blood test and, again, to wait for an all clear for chemo.

Hasta La Vista as I am going to Hong Kong to get away from the haze in Singapore (our Indonesian neighbours are burning down their forests to clear land for cultivation) and to continue my "R&R". Lin will be in good hands.

But I am imparting some advice sent by a friend:












Monday, October 18, 2010

Sigh, no Chemo today

After a brief respite we are back to low WBC and Neutrophil count. Haemoglobin and platelet counts are not that great either.

Lin had his blood tested this morning and then we met with Prof John Wong in the afternoon when he gave us the disappointing news. So we try again on Monday, 25 October. Let's hope that the chemo drugs are wreaking the same havoc on the "bad guys" as they are on the good ones!

Time for some good news!

Since Lin started on the 5FU and Folinic Acid (without Oxaliplatin) his mouth seems to have been more sensitive and painful. But thanks to a tip from our friend, Christina, he's been using Biotene mouthwash and oral gel and they have alleviated some of the discomfort.

The topic of exercise came up again in our session with Prof. Wong and I added my two cents' worth to Lin's plea to be allowed to swing a golf club. The Prof. is not acquainted with golf and was concerned that Lin might slip and fall or hurt a muscle by swinging too hard.

I assured the Prof. that the range is surfaced with a composite floor covering that is quite safe and the golf course is covered in grass. So he cautioned us to be careful as he's had patient's who have fallen, been bitten by a dog, etc., during their courses of chemotherapy!

Another piece of good news is that one of our friends had surgery recently for colorectal cancer and is up and home after six days in Singapore General Hospital.

I first heard the news when I was in Hong Kong and was rather worried because she made the decision of have her operation without getting a second opinion from either National University Hospital (NUH which has a Cancer Center) or Singapore General Hospital (SGH in whose campus our National Cancer Centre is located).

Maybe the threat of my impending return got her moving, but once she met with the doctor at SGH she saw the light. She was admitted last Monday afternoon and had her laparoscopic surgery on Wednesday.

I visited on Thursday and she was a little tired but pain free and already raring to go home. Saturday saw the removal of her catheter, Sunday the drainage tube from her abdomen and today she got her marching orders from her doctor.

While she was there I had the chance to see how this hospital handled things. 

I attended a presentation for relatives, caregivers and interested people on colon cancer from pre-op to post-op. and it was very interesting especially when we listened to an ex-patient talk about his experience.

I learnt things that I only experienced (without the benefit of prior briefing) during Lin's procedure and hospital stay - and got to understand the whys and wherefores better.

As a result of our friend's illness I got to know a little more about colon cancer and its treatment and am more convinced than ever that the Singapore government hospitals are streets ahead of most - even private hospitals - and I would have no hesitation in being a patient or recommending any relative or friend to take that route when an illness calls for the most up-to-date treatment and care.

While I grumble about some aspects of life in Singapore and will continue to do so, I am appreciative of the public health organisation to which I have contributed as a tax payer.

I wonder if it is because the doctors and nurses are too busy curing patients that they have little time to play at being bureaucrats?

The Land Transport Authority (LTA) and Traffic Police (TP) could learn from the hospital clusters; as a matter of fact many other government and non-government organisations here would benefit from working rather than pontificating.

The National Environment Agency (NEA) for one agreed with the Management of our estate that the best times to fog for mosquitoes would be at dawn and dusk. And THEN, mindful of the pest control companies' business they also said that any time would be all right!

The Public Transport Commission (PTC) could do with being more in touch with the people who take public transport.

As you can see we are fond of acronyms here in Singapore. In my mind, I imagine a huddle of little gnome-like creatures beavering away at inventing new ones for all the new 'bodies' that spring up every now and again.

We are booming despite warnings that things may not be so rosy in the next two quarters, and we are dealing with new Singaporeans and a tide of foreign workers. So we are not likely to follow the British in their culling of quangos and public services anytime soon. But it is food for thought that growing like Topsy cannot be the formula for all seasons.

There have been enough gaffes that have surfaced in our rather tame newspapers to make anyone wonder if we know what we are doing. Some are called "scholars' moments" (mistakes made by bright scholars 'parachuted' into top posts without experience of the real world or their feet on the ground). Others are truly 'foot in mouth' incidents that do not deserve re-telling.

Rather than rant on, I am going to attempt to include a video that'll amuse you:

Monday, October 11, 2010

Back In The Saddle

Cut short my trip to Hong Kong but that is another tale; no it's nothing to do with Lin. As a matter of fact a friend who saw him while I was away remarked that he looked very well despite my absence. My retort was that he looked well BECAUSE of my absence!

Instant stress when I arrive to find that he had driven himself to the airport to meet me; it's not as if I am incapable of getting home from the airport. How does he think I manage in Hong Kong?

More stress: we are there with luggage cart and the car in the car park. To save time I go and get the car and we load it together, with me heaving the big case into the boot. I think I glanced over at the cart to make sure it is empty before we drive off.

To cap it off, as I am unpacking I look for my laptop to plug it in and cannot see it anywhere, so Lin gets a painful earful and goes down to check the car. I am on pins and needles as someone could have walked past him and taken the laptop off the cart without him noticing and just about everything is on the laptop even if I do have Time Machine backups.

Thank goodness they say that a change is as good as a holiday. I caught up with most of my friends which was refreshing and managed to squeeze in 2 golf lessons, 2 practice sessions and 3 games of golf in 9 days, as well as some rather good meals.

Our resident "Einstein" was still taxing my patience and understanding so no change there. As I was rushing to complete some errands and then to the Airport Express station, she announced that my sister and another friend had called when I was in my shower.

I called both, only to find that my sister hadn't called - after all she had called earlier and dropped of something for me to courier to her son in Singapore. Luckily I remembered our Caller Id and checked the handset - it was someone else altogether!

As my sister and I both have been away a lot in the past 12 months, Einstein was only giving in to her natural inclination to give a name to a voice rather than ask the caller for her name! I am so happy she gave us the boot and that she saved us the trouble of getting rid of her.

Lin is in good physical shape but a bit grumpy due to perceived neglect and my reaction to the rather Einstein-esque episode at Changi airport.

His only valid complaint is that the inside of his mouth hurts. Since Prof Wong took him off Oxaliplatin the side effects of the 5FU seem to be more pronounced.

We wait another week before seeing the Prof although I do not envisage an effective solution to the pain from the damage to his oral mucosa.

Sunday, October 3, 2010

Rest and Recreation

I am writing to you from sunny (blue skies) Hong Kong and it is Sunday morning. So good to look out of our windows and see blue skies and green hills.

In Singapore, although we are on a tiny hillock, we look out on condominiums and commercial buildings. And a building site - a portion of the Thai Embassy which is being torn down to make way for something new.

Whereas Singapore is relatively flat and development has spared few places, Hong Kong is hilly and 'civilisation' is concentrated in several spots. This means once out of those areas, there is much nature to be enjoyed.

Whilst children rarely have homes with gardens to play in, unlike Singapore, the government has provided and maintains walking trials, picnic and barbecue facilities in the country parks and at beaches.

Sounds a bit strange, but there it is - look at a Google map of Singapore and of Hong Kong. Aside from restricted areas, nature reserves, reservoir/catchment areas and golf courses development is fairly evenly spread in Singapore. This allows for some low rise homes with gardens. Of course we have made up by planting trees and such along our roads and now in vertical gardens.

Our trees are awesome, they stand majestically and spread their shade over many of our arterial roads. Unfortunately, tropical trees have a predilection for shedding branches in storms and cars and motorists have died as a consequence.

Like the flash floods that suddenly hit Singapore this year, they're deemed acts of God for insurance purposes.

Now look at a Google map of Hong Kong island (we are comparing island with island). All the built up areas are along the coast. The middle of the island is dominated by greenery in the form of hills (county parks and reservoirs).

So the chances of getting a green view are better in Hong Kong. Personally, I think the fabled harbour view is over rated.

On good days such as these Hong Kongers throng the beaches, creating traffic jams for those who live in Repulse Bay. And they stream up Tai Tam Reservoir Road to walk the many trials that emanate here.

The couch potato that I am, I only walked ONCE - just before we left HK for Singapore this time - in the Tai Tam Country Park. Although we have been living in this vicinity since 1989! But now I have done it, I can say it was thoroughly enjoyable. I just need someone to drag me out!

From not having bothered to touch a golf club since April, I had a lesson and then a round of golf in the two days I was here! Definitely a case of feast or famine! And I am playing today too!

When I went up to the golf club on Friday (a public holiday in Hong Kong), I saw a new dining room - it had been re-designed and renovated during the summer hiatus. Stunning - and done without the trials and travails that our Singapore club is going through.

Some of the men's locker rooms have been renovated too and should be finished by now and if not, soon. I was shown some photographs and they have selected a more traditional look with dark-stained lockers - what I call a rendition of what American designers think of as the English country club look!

So much of the renovation and construction work in Hong Kong (public or private) is done with little fuss and inconvenience to other people. 

For example, driving along the Tolo Highway to the golf club there are a few places where construction is taking place. There are warning signs of lane closures nice and early so one can be prepared, and when one is passing the work sites, the barriers are set in from the margin of the lane so that the passage of vehicles is not impinged.

In many other places the barriers, work vehicles, workers and building materials or debris sit on the lane dividing line between lanes so that motorists and other road users shy away. This effectively closes half that lane and you often find motorists straddling two lanes as a result. Thus a 3 lane road becomes a 1 1/2 lane road.

At HKGC we are building the great wall of China to fence off the front of our car park from the road, but even that has not caused much inconvenience. But then that's nothing compared to the new buildings that sprout almost as fast as mushrooms! 

Even though interest rates are low these days, there is still an incentive to build quickly - to achieve a revenue stream. Or to get the early completion bonus if it is a major public project.

Maybe Hong Kong should export its expertise in project management and construction? But then they are too busy building and making money to go and teach!

Aside from having the sun shine down on me since I arrived, the smiles and genuine greetings of everyone at the golf club warmed the cockles of my old heart. So nice to return to one's club and be made to feel welcome!

The wait staff are resplendent in their new uniforms (they put my sloppy golf outfits to shame!) which were designed by a HK designer, Barney Cheng. 

Incidentally the Cheng clan are great supporters of the club and we have had a few Cheng club captains with the likelihood of more in this and future generations. Other clans are well represented too, so be careful of whom you speak when at the golf club!

Well, I must run because I am cadging a lift today. Our car needs a service (scheduled for tomorrow) and we will be going out for dinner after golf so I thought I'd travel with my hosts. This means I won't be drinking and driving later!

(Written in haste so please excuse even more mistakes than usual!)

And, in case you don't know, I am here on my own! Lin is in Singapore as he's not allowed to travel (germs and such in aircraft and chemo on Monday). So I am here for a holiday - and maid hunting because our HK maid has given me notice.

Friends say she is not too bright to give up such a cushy job; maybe that's why my nickname for her is Einstein!

Wednesday, September 22, 2010

Mid-Autumn Festival (Moon Festival)

The Mid-Autumn Festival is held on the 15th day of the eighth month in the Chinese calendar, which is usually around late September or early October in the Gregorian calendar. It is a date that parallels the autumnal equinox of the solar calendar, when the moon is supposedly at its fullest and roundest. 

The traditional food of this festival is the mooncake, of which there are many different varieties. The original mooncakes were not elaborate or expensive, but nowadays restaurants and bakeries seem to be in a contest to see who can come up with the most exotic crusts and fillings.

And sometimes the boxes probably cost more than the contents!

We had a quiet dinner at home with my 89 year old aunt, my cousin and two close friends. Then, just like small children, we went downstairs to the koi pond and lit up our lanterns!

Monday, September 20, 2010

How Little Things Mean A Lot

First little thing:  a miniscule amount of blood drawn this morning meant the difference between Lin getting chemotherapy today - or not. Obviously Prof Wong made the right call in stopping Oxaliplatin because Lin "made the cut" for the 1:30 slot at the Cancer Center chemotherapy treatment room!

Another little thing: despite Abbot Labs' Singapore office's refusal to offer Vanilla flavoured powdered Prosure, Lin's weight is now a more respectable 70 kilograms (when he started chemotherapy in mid-June it was a puny 67 kilograms). I did some research, Prosure (in powder form) IS available in Malaysia, Hong Kong and the Philippines in Vanilla AND Orange.

It's a small thing for the head honchos at Abbott Labs Singapore (probably a savings in inventory cost), but a huge difference to someone taking Prosure to have a versatile flavour like Vanilla to which one can add flavouring. Otherwise it is orange day in and day out!

Will stop now to get the good news to you all; more later.

Monday, September 13, 2010

Twiddling Thumbs

Now that we have settled into a somewhat flexible routine, dictated by Lin's chemotherapy sessions or rather his WBC and Neutrophil counts, we have come up for some air.

However, we don't do anything particularly strenuous or adventurous.  Friends have offered to lend us DVDs but we've never been huge fans of watching the box. Summer sporting events on TV have filled in some time and provided some interest, and there have been some wonderful moments of tennis. I only wish that Roger Federer had done better at Wimbledon and the US Open.

Yet sometimes we turn on the TV and watch whatever is on, even if it is not particularly enthralling, such is the power of the medium. It seems easier to sit and watch and flick to other channels every now and again than to get up and do something more entertaining or rewarding. Maybe this form of inertia gave rise to the term "to veg. out".

On paper we have access to a wide range of programs and lots of channels, but in reality the fare leaves something to be desired. Not being an avid follower of any particular American or British TV series, we have no idea how far behind we lag when we watch. We work around what is available rather than make it a point to switch on in order to catch a film, an episode or a telecast of a match.

Sometime, I think, in July we realised that we needed Singtel MIO for Lin to watch some of the soccer leagues or series (whatever they are called). Yet most of the other channels that we were already familiar with were on Starhub.

It took us only 3 visits from a Singtel tech to get us up and running and we are considered fortunate. Some friends have had repeat visits and one even had a whole team in her flat - twice.

The tales of woe have somewhat abated, possibly because some potential subscribers have been put off by their friends' experiences and are sitting this round out.

I suppose it must be good for competition to have both cable tv providers bid for sports events, but in this case the combined offerings of both dominant players have not added better content to paying subscribers' viewing.

It means having two set top boxes, one connected via the telephone landline and the other via the cable tv/broadband co-axial cable. And just to rub a little salt into the wound, subscribers to Singtel MIO have to subscribe to additional landlines to watch MIO on a tv that's in another location within their homes.

Some bright spark must have thought this an excellent way to reverse the trend in landline demand (with the recent flood of immigrants and workers into Singapore demand for landlines may not have declined here)! Neat idea, but it does not endear Singtel to anyone and they have not done us any favours.

And it only means they will have to continue making winning bids for some sports channels or events to keep their subscribers - it doesn't take a brain to see that subscriptions are not going to be any more affordable in the future.

In America, AT&T has U-verse which uses fiber optics (for broadband, digital tv and home phones) and does not require additional phone line subscriptions. So alternatives which are not so troublesome to install and get running and more economical on phone subscriptions do exist.

Through this transition and having to get used to new remote controls makes me wish someone would invent a remote control that is really simple and easy to operate.

It would be an intelligent "remote control for dummies" and have only an ON/OFF button, and buttons for volume and the numerals 0-9. All one would need to do is enter the channel number.

Otherwise it would use voice recognition for more advanced requests such as 'Search', 'Search Sports' and so on - keeping these commands simple and featuring only the current 24 hours' programming.

Bye bye multiple remotes and all sorts of tiny buttons.

Thursday, September 9, 2010

Organic if possible

The Daily Green recommends eating the organic versions of these.

Bell Peppers
Leafy Greens

Staying focussed

Perhaps we have been lucky or, more likely,  NUH was well planned and executed. Lin and I have nothing but praise for the people we have chanced upon whenever we have gone for his consultations, chemotherapy sessions and other services.

Yesterday, Lin was given the all clear by Dr Teo, his new-found cardiologist. It would appear that despite the calcium deposits (not to be confused with plaque) the old ticker is still going strong - for someone his age. In fact, Dr Teo was pleased that Lin's good cholesterol is nice and high.

So it looks like he only lacks a decent White Blood Count which we hope that dropping Oxaliplatin will help.

This afternoon he goes in to return "the Pump". We are convinced that if  the manufacturer would make it smaller it would have a most beneficial effect on the mood and outlook of chemo patients - lugging that brick around and constantly being reminded of its presence has a depressing effect.

If you gave me one wish, it would be for NUH to improve  (or at least,  stay the same). 

This came to my mind because we were approached to participate in a service survey conducted for the organisation. After answering the questions, some of which I felt could have been better focussed, I wondered if positive comments might lead to complacency.

Will dealing with reality - life and death on a daily basis - keep the organisation soundly grounded? Or will the business and management whiz kids get their way and make it into a glitzy 'destination' spot for medical tourism?

Far from being altruistic in my wish for NUH, I am thinking of our future - especially mine! As sure as death and taxes I shall be needing to visit the hospital as a patient in the foreseeable future; not as a caregiver. And I would not like to see it expensive, overly business-minded and bottom line driven like some private hospitals,  government and government related organisations.

Going by what I have experienced on our buses and trains and reading the grouses of commuters I have no doubt that commuting is every bit as bad as they say. And I travel off peak when it's meant to be less crowded.

Stallkeepers at my favourite wet market say young people feel left out because they find it harder and harder to afford their first homes. 

But we also have our share of spoilt brats. True or not, I heard a that a young man doing his stint in National Service (NS) was given a Bentley by his indulgent father who thought that his son's Ferrari would be too ostentatious to drive to camp!

I have also heard of young people in the financial world who are earning the equivalent of ministers' salaries (highest in the world) in bonuses.

I wonder if this is going to give rise to a society that "knows the price of everything and the value of nothing".

Maybe not if their parents and peer groups have their heads screwed on right. People who are familiar with China say that there are the usual nouveaux riches whose children squander money, but also those who have groomed their children by sending them to the best  private schools and universities in the west and got them work for a living.

Even pre-1997 we were asked to recommend finishing schools in Europe which might be suitable for daughters of the 'establishment'. 

Many Singaporeans just do not realise that we have yet to reach a level of sophistication that the elite PRC Chinese  already had enjoyed pre-Mao (the pre-WW II Chinese ambassador's daughter to the court was a boarder at Cheltenham Ladies' College). So it was hardly surprising to read in the IHT not so long ago of Chinese debutants being presented at the Crillon Ball in Paris.

Continuing as we have done, we always will be the 'overseas Chinese', the rough diamonds. Which is fine because there is a place for everyone. 

But not if we have higher aspirations - or are so blinded by our own hype that we think we have arrived.

What kind of society are we that babies are not permitted to be fed on the Mass Rapid Transit (MRT) trains? That do not allow seeing eye dogs into shops, restaurants and offices? That does not have decent handicap access or lifts in all MRT stations. That does not have pedestrian underpasses which are fully accessible to those in wheelchairs or strollers?

Instead, we have Lamborghinis complete with blackout windows and windscreens parked - with total impunity - at the junction of busy roads (Claymore Hill/Claymore Rd behind the Thai Embassy and close to Shaw Centre). Approx 1pm on Tuesday, Sept 7th.

When they are not doing that they seem to be driving around showing off their fancy wheels and making an unholy din. More and more people are grumbling about the quiet of the night being disturbed by the irritating roar of loud (sometimes illegal) exhausts as they drive round and round certain roads.

Never mind exhaust and construction noise pollution, we also pay lip service to recycling and being eco friendly. 

Most of the businesses here use plastic bags, as ever, with gay abandon. Most homes do not recycle. Many homeowners rely on their domestic help, the majority of whom come from countries where recycling (as the developed western countries) know it does not exist.

This would not be so bad if we still had people going round buying old newspapers, bottles, etc  - 'karung guni' men. In HK and China recyclables are often removed from the public bins by scavengers who earn a little pocket money doing this so that there is minimal wastage.

Here, we are somewhere between the countries where people throw aluminium cans and plastic into the ponds, lakes, rivers and seas and the ecologically conscious countries where people break up cartons, bundle magazines and newspapers, separate recyclables from trash and dispose of them in public recycling and trash bins. 

Unfortunately we are closer to the ignorant end. 

According to the MSM (mainstream media) we are going to light up Singapore landmark buildings at night - I wonder how we are going set the city ablaze and still be ecologically responsible citizens of the world? 

Well, at least we can rejoice that our two polar bears are going to be provided quarters more suitable for their type than they have been housed in (hope they have not become too accustomed to the tropical heat).

Even though every country has its everyday travails, those that we seem to be experiencing lead one to wonder if our planning has been less than meticulous and the implementation subject to less than the most rigorous testing? In golf we call it 'taking the eye off the ball'.

Forget the very rich and very influential - they and theirs can live anywhere they please.