Saturday, December 24, 2011

Oh What A Night!

This blog has been rather noticeable for its silence, not that nothing's been happening or that life is dull although in Singapore it's been a case of more of the same old, same old stuff. So rather than irritating myself I decided it wasn't worth mentioning.


In recent months the only few high spots have been a wedding (in Singapore) and a trip to India. Until tonight in Hong Kong.


Lin and I set out for dinner from Hong Kong Parkview (which almost every taxi driver in HK seems to know the way to) with our family at the venerable Hong Kong Club. In my haste to get out of the taxi and grappling with a puffy jacket and a bag of clean laundry for my brother, I left my handbag on the seat in the taxi which sped off as Hong Kong taxis are won't to do.


I realized this as soon as I had deposited the puffy jacket and laundry bag at the reception desk. Sheer panic set in and I told Lin about it. He dashed off into the cold night and dense traffic to peer into every passing taxi in case one of them held the errant handbag.


I mentioned this to one of the receptionists who did not have any bright ideas and so while I got on the house phone to call our helper and my brother went of in search of Lin, all I could do was fret and worry - and try to think of friends with a computer, preferably an Apple.


Of course, without my iPhone I could only remember a handful of numbers. Still I managed to get hold of a friend to go to 'Find My Phone' and there we got a bit of false hope because they discerned the phone to be at Parkview. So we patiently waited for our helper to get on to Security at Parkview for their list of taxi registration numbers which had passed through their gates between 7:00p and 8:00p.


Lin, by that time, had come back into the Club and spoken to the other receptionist, a very clued up lady. He gave her the Parkview number which was printed on the back of his bus schedule card and she called and asked for assistance in checking their list of taxi registrations with their cctv cameras.


More important she called the centralized hotline for the taxi companies' Lost and Found and put me on so that I could provide the details they needed.


Even then, hope seemed to be very distant and abstract.


While waiting for my sister and her family to arrive I was on the phone to home and again to friends. There was also a melee of people in the foyer of the Club.


But all of a sudden I saw the taxi driver come through the main doors and thrust my handbag at Lin. I jumped up and thanked him in my deficient Cantonese. Instead of acknowledging my thanks and Lin's too, he asked if I would like to check if anything was missing!


All I could think of and did was to get hold of my wallet and fish out some notes to hand to him, so relieved was I to be reunited with my handbag again. He thanked us and rushed off again into the cold night.


It was all so improbable that I am still stunned. I had almost resigned myself to canceling my credit cards, re-applying for my bank card, driving license and HK ID. It wasn't the money (there wasn't much in there) but the hassle and the cellphone that bothered me.


Even though in Hong Kong it is easier to obtain replacement documents such as our car registration book, driving license, HK ID and cards than in Singapore.


A few months ago I had to get a duplicate of the car registration document because it was nowhere to be found at home or anywhere else and we had been away most of the time between road tax renewals. I checked the internet and noted that I had to make a police report and tend that to the Road Transport Department.


The Happy Valley police station was very smart and the policemen were friendly and helpful and we had a little chat about Singapore since the one who assisted me had visited some years ago.


The Road Transport department were quick and efficient too.


I compare that with my two previous experiences at the Lavender Street head office of the ICA in Singapore - both times when I had to apply for replacement NRIC's (National Registration Identity Card, I presume, is what that acronym stands for).


First I had to get a queue number and when you lose documents or in some way are perceived to be causing them an inconvenience or being a "bad child" you wait longer than those in the queue for the straightforward, routine stuff. It's quite apparent when you sit and wait and watch the numbers being posted on the displays.


Anyway, in the case of a lost NRIC it costs Sin$100 (about HKD$600) for the first time you lose your IC and $300 for the next time. It takes a month when you lose your IC for the first time and then three months if you did not learn your lesson the first time around!


Since we used to bounce around between Florida, HK and Singapore I was bound to leave some documents behind somewhere. But mindful of the need for my IC for voting in the Presidential Elections, I decided not to risk being without my IC for more than 14 days and waiting until I got back to HK to check in my cupboards before applying for a replacement.


So I got the 'bad child' treatment of waiting lover and paying more (only to find out later it was safe and sound in HK - the same case as with my first 'lost' NRIC).


I don't know how long it takes to get a replacement in Hong Kong but I expect less than 3 months and it is much less expensive - HKD$335 each time (less than SIN$60). It's no wonder people say that in Singapore we Pay and Pay.


What happened tonight might never happen to me in Singapore because it is so hard to hail taxis, I am not laden with jackets and stuff because our weather is never cold and I suspect I would not get the cooperation of the staff at any of our clubs to contact various parties. Also the bureaucracy of public transport Lost and Found, if anything like my past experiences with Lost Luggage at Changi Airport, would make it a long and arduous chore (try calling them on the phone) to locate my bag.


Last but not least, I must be one of the luckiest people in the world to have met a honest and kind taxi driver. I cannot say that a Singapore taxi driver would not have taken the trouble to try and find the owner of the handbag, but I have a gut feel that all my sentiments about Hong Kong public transport and especially its taxi service are justified - even if it is only in my case. And when compared to Singapore's.


If in HK and you need the centralized taxi Lost and Found do call: 1872920.


And if you have an iPhone (even one set on silent, use Find My Phone - only after I got home did I find out that with access to a computer you can get your silenced iPhone to ring loudly).




But my wish for all of you for 2012 and beyond is that you won't need either.


Merry Christmas and a Happy, Fulfilling and Healthy New Year!







Saturday, September 17, 2011

Adding to my trove of hospital experiences


One thing is for sure, I could not write for a living because I cannot find the energy or motivation to sit down and write about all the things that I often think about or experience.

This blog, for example, has languished for some time. I could claim that there is a hiatus in Lin’s follow up care which is true because he is in between check ups (thankfully he gets his port-a-cath flushed without event).

We are thankful that he is in fine health.

More recently I got to know more about a different illness and treatment; this time it had to do with an abscess of the liver.

My brother called me one Friday evening to say that he was running a high fever, had chills and a bad headache but would wait until Monday to visit his GP.

He called me on Saturday afternoon to say that he was feeling worse and was going to the 24-hour clinic and Accident/Emergency department at Gleneagles, a nearby private hospital.

I insisted on driving him there and before too long the duty doctor examined him and suggested a blood test to check for malaria, dengue or something else. Rather than wait there for hours we went back to his apartment.

When the results came back the diagnosis was a bacterial infection and my brother decided to wait until Monday to see his regular GP – who also did some more tests.

In the meantime he was started on a course of antibiotics and felt a little better. But at my prodding he spoke to a friend at the National University Hospital (NUH) who happened to be flying out that night for a medical conference but urged him to go to the walk-in A&E, which we did after dinner on Wednesday night.

Until then I had no idea that Singapore’s government hospitals were overloaded. Not only were patients waiting to be examined, there were announcements over their public address system to say that they were experiencing a shortage of beds.

At about 3:30am we drove home – he had been examined, prodded and poked. Blood was extracted for testing and he was given medicine via IV. There was still 100 patients waiting to be seen by the two doctors on duty!

Perhaps that was why the doctor on duty that night was curt to the point of being rude. The first thing he said when we walked into his room was “name” and then he pointed at the only other chair in the room and said, “sit down”. I stood the whole time, trying to pretend I was an IV stand.

Being me, I waited until we were ready to return to the waiting room and asked him for his name. He gave me the shortened form and as I had not come across such a name I asked him to spell it. “J-O-C-E” he said. I later found out it was Jocelito.

Overworked or not, he had no excuse for being so rude and offhand with any patient, but I guess the patients were all too ill to notice.

Anyway, my brother was asked back the next day for a consultation with a gastroenterologist and the upshot was that he was asked to check in. But no beds were available so he went home to wait.

Later that Thursday night he was checked in and antibiotics were administered intravenously for his liver abscess and an infection.

However, what he at first thought was prickly heat from his rather warm, non-air-conditioned accommodation turned out to be a severe reaction to one of the antibiotics. By that time they had managed to find him an air-conditioned room and he was much happier.

Because of the allergy they pulled the IV and gave him oral doses of antibiotics instead. And decided to wait for some improvement in his skin condition before they introduced a needle through his abdominal wall to drain the abscess.

This meant more waiting and, finally, on Wednesday after the dermatologist had given the OK, the abscess was drained.

By the next day he felt much better. Three days later (Saturday)  I think he will be allowed home soon – after they have removed the drainage baggie.

Needless to say, every morning I would “WhatsApp” him and bombard him with questions, some of which he would ask the doctors - the doctors being fortunate not to have their visits coincide with mine!

The drug allergy is a mixed blessing. While he does not have to live with an IV for six weeks while antibiotics are pumped into him 24 hours a day, he still has to take six weeks’ worth of antibiotics at timed intervals even if it means waking up to take them.

After this, he will be quite healthy and bacteria-free. And he is going to be a teetotal purveyor of wines until the doctors give him the green light to resume imbibing wine!

What I have learnt from this is to suffer any headaches and fever combination until such time as the doctors have been able to take blood samples and culture them for bacteria.

This would enable them to target the type of bacterium and administer the appropriate antibiotic.

Otherwise they would have to throw the kitchen sink at the infection which could be caused by any or a combination of the usual suspects -including streptococcus and staphylococcus (real nasties).

Tuesday, August 2, 2011

Getting to the news that is fit to print


Spending portions of the year in different places may seem idyllic, but there are many big and little things to do to close down one household and get another up and running. Being married to an ex-newspaperman means that I have to suspend magazine and newspaper subscriptions in one place and get deliveries to resume in another.

You would think this is easy and seamless given that newspapers are in the business of communications. And you would also be forgiven for thinking that with the declining popularity of the printed word, the papers’ circulation departments would be on the ball.

In a way they have been on the ball, some promoting home delivery on their Web sites and others running circulation campaigns (selling subscriptions) with cars as prizes.

But lots of times things fall between the cracks.

In the USA, the WSJ could not find our subscription details and we had to set up home delivery all over again. The New York Times was a bit confused because we also have a subscription to the IHT which now calls itself the Global Edition of the New York Times.

The South China Morning Post fiddled with its delivery logistics and after that took days to get its act together to resume delivery. Unacceptable for a daily that gets delivered every morning. Hopefully they now have someone who knows more about newspapers than just reading them.

Of the magazines Businessweek is like a giant oil tanker and takes as long to stop or turn! As their mailing labels are prepared three weeks in advance they need three weeks notice to suspend or resume delivery, an age in today’s world.

Some require going online to use their web forms, others can be contacted by email.

The US newspapers usually try to get one to phone without realising there is a whole world outside of America that cannot avail themselves of their 1-800 toll free numbers and may not be in a convenient time zone. But then the USA still has not shed its parochial mentality, not surprising of a country that still measures in feet and inches, weighs in pounds and ounces, fills up in gallons and prints letters in Letter and Legal sizes.

But if booby prizes were awarded, our local giant Straits Times would win hands down.

For all their hype and full colour, full page bluster recently and revamps of their web version (STI), I have found the online ST cumbersome to navigate.

After months of always unsuccessful, intermittent attempts to log-in a certain way I gave up trying and resolved to get that solved.

To do that I had to try and replicate the steps and note down the circumstances which caused this error message to appear.

Finally I got my mind focused on troubleshooting the problem, always the hardest part of getting anywhere with computer related situations whether you call it inertia or fear.

The next hardest part is convincing the tech people you are not just inept or have a vivid imagination or computer phobia.

Anyway, I am happy to say that someone at STI managed to understand my gibberish and fixed the glitch that prevented me from logging in from the ‘outside’ (going to straitstimes.com) as opposed to what I think of as ‘inside’ (from reading an article in their daily newsletter and continuing from there).

However, the thought has since occurred to me that if I had that problem, maybe others have encountered it too. And unlike me they might have decided to call it a day with straitstimes.com.

Coming back to subscriptions, we now have a subscription to the print version (directly with SPH rather than via the vendor, an episode that calls for its own story) and a subscription to the ST online - aka STI. In addition, I also have an ST application on my iPhone – which I rarely accessed so cannot recall if it was free or paid. (Or, perhaps, linked to my ST online account.)

After ST launched their iPad/iPhone app in a blaze of colour in their print edition, I got curious and found that this app is an update to the iPhone app that’s been on my iPhone - and now includes the iPad too.

The catch is that a subscription is soon to be required as access expires August 31, 2011. More annoying, it contains lots of advertisements.

I don’t remember seeing any advertisements before – in the days when I seemed to get ST articles free.

To continue with my Alice in Wonderland experiences with the ST. After my brother got stuck on his Mac (and so did I trying to help him on my laptop) while attempting to subscribe to the ST online version (a month ago),
I grasped the nettle and emailed a friend at the ST.

I did this as a last resort because STI is one of the rare newspapers site which does not provide the Circulation department’s email anywhere obvious and when you call the number on the web site you get into a queue plus a warning that it could be a long time before your call can be attended to – the old “due to a large call volume” claim. Actually, the recorded voice warned of not being able to elicit a response for TWO days!

Long story short, they set my brother up with a subscription (and hopefully they sorted out the error which prevented Apple computers – or is it all makes – from dealing the subscription deal). Or so I thought until Sunday night when he mentioned in passing that it was only a two month subscription, which came as a surprise to me.

On further investigation, I discovered today that annual online subscriptions have been canned and only short term subscriptions  (for online access) are available until the new subscription scheme is rolled out!

The young lady I was speaking to at ST today must have been bemused by my ranting (I told her it wasn’t her that I was grumbling about but the shortsightedness of her management) on the topic of piecemeal subscription plans and not being able to use the web to subscribe or manage one’s account.

At one point I told her I was thoroughly confused and asked if I needed three accounts – one for print, one for ST online and one for the iPhone/iPad app.

Apparently not, but we will have to wait until the new scheme is (ta-dum, drum rolls please) revealed later this month.

What kind of ‘mickey mouse’ newspaper is this that changes subscription plans in fits and starts and not all in one smooth go?

All I can say is that it is a good that there isn’t much competition even we have a free press in Singapore.




Thursday, July 7, 2011

First Post Chemo Check Up

There hasn't been much to report - we made it to Ponte Vedra where I embarked on a frenzy of getting domestic things sorted out and Lin resumed his golfing days.


I did get away to Tallahassee the capital city of Florida, to play in a tournament with a friend and it was good to get a break as well as to see a different part of Florida.


In May the TPC 'circus' came to town for the week and people who did not leave town to avoid the crowds volunteered to help at the tournament (the annual Tournament Players Championship at Sawgrass). KJ Choi was the winner this year and a deserving one too.


We started our trek back to Singapore in early June, with Lin leaving almost a week ahead of me so that I could close down the house. I caught up with him in Hong Kong and we returned to Singapore at the end of June, in time for his pre-check up workup.


We met with Prof. Wong on Tuesday this week and he went through the lab and x-ray results in his usual thorough manner. In fact he asked for Lin's medication list, which he (the Prof.) insists his patients carry on them at all times.


Lin hadn't looked at his in simply ages and had left it in his travelling wallet so we quickly filled  out another one from memory. When you start to fall into an easy routine, the Prof. pops a curve ball and this is an example of one of them!


What must have triggered it off was Lin's continuing low White Blood Count and low Neutrophil count because he looked at the list and said that none of the things Lin was taking would cause a drop in the blood count. So the marrow must not have recovered sufficiently from the chemotherapy and therefore we have to be vigilant against any type of illness or infection.


Anyway the rest of the news was good, no unexpected lumps and bumps in the x-ray or ultrasound and the blood work (except for the WBC and Neutrophil counts) was normal.


So we are free until end September when Lin goes in for the pre-check up routine and then sees Prof. early October. The fly in the ointment is that the weather is not great anywhere else - it's hot in Florida which is in it's hurricane season.


Hong Kong is into the typhoon season with its torrential downpours, heat and humidity. So it looks like we will have to stay put for a while.


Three weeks back here and we are getting 'rock fever'! We'd got somewhat used to being in Singapore (we were here almost uninterrupted from May 2010 to April 2011) because we were so involved in Lin's treatment which was all new to us and anyway we HAD to be here for the duration of the treatment.


But having recently returned from Florida (clean, orderly, spacious, relaxed) and Hong Kong (vibrant, clean, attractive, courteous) we find today's Singapore a contrast.


The roads are chaotic and crowded, the standard of driving is appalling, the restaurants and retailers seem to just miss the spot and people are plain rude. Sure, there are rude, crude men and women elsewhere too, but there are more 'civilised' people to balance them out. True blue Singaporeans seem to be swamped and not taking it well.


As fr quality of life, we have three renovation/construction sites around us so we get a morning chorus of piling and other loud noises. At night we hear the rumble of the MRT (subway) trains although they are underground. And at various times of the night our sleep is shattered by the loud exhausts of car enthusiasts taking their expensive cars out for a 'throat clearing' exercise.


Sometimes it's just after midnight, sometimes around 4am, and sometimes between 6:30am to 7:00am. There are a few prancing horses, bulls or other loud cars living somewhere in this vicinity (or within a mile or two in radius) and they need to be exercised.


Surprisingly, or because our apartment in Hong Kong is on the edges of a country park, we only contend with daytime renovation noises like jackhammers. At least we get our measure of sleep. Not in this 24-hour casino city.


On a more pleasant note, I happened to be looking at some videos on TED.com and found this one:


http://video.ted.com/talk/podcast/2010X/None/DavedeBronkart_2010X.mp4


It's relevant to ALL of us - presented by a cancer patient who found help and support and is a big advocate of patients helping each other.


I cannot say how important it is to learn all you can about what ails you (be it cancer or something else) and seek help - sometimes patients know more than doctors and nurses. For sure they know what it is like to be a patient.


I had trouble getting to a Web site he suggested, acor.org but nowadays there is a bigger choice of authoritative and useful Web sites for you to chose from. 


And there are also apps for iPhones and iPads (I have an iPhone) which help you understand the body -  they have great graphics hence better on iPads are often offered only for this larger format.


But I am happy with my iMuscle iPhone edition by 3D4Medical.com (there's an iPad edition too).  The presenter of the talk has Visible Body (iPad only) which is in the iTunes Store. Or you can also use Google Body.





Monday, April 11, 2011

A Breath Of Fresh Air

I haven't posted an update since March 22. Hong Kong was a whirlwind but Lin got 18 holes of golf in and I played some golf too - in cool weather!

Then we dashed off to San Francisco where we spent the first two and a half days eating and sleeping; a combination of jet lag and plain tiredness. Fortunately we are blessed with very good friends who have lived in Asia and they went with our flow!

After that much needed pause we finally arrived in Ponte Vedra late on Sunday, April 3. It's now April 11 but it feels like forever because of the mountain (only a slight exaggeration) of accumulated things to do, opening up the house and getting the cars back on track.

Anyway we are making slow but steady progress and the fresh, clean air (except for copious quantities of pollen), clear blue skies and languorous pace is such a welcome change.

No matter how wonderful a city, it can never be as relaxing as being away from the buzz and energy that makes cities what they are.

If you grew up in Singapore or Malaya in the 50's and early 60's, you may remember and understand what I mean by pace. And yet when we were growing up it did not seem to be that slow except when we were waiting to open Christmas or birthday presents. Or to get my driving license!

Only the other day I was chided by a security guard at Sawgrass for being seemingly anxious to go through.

" How long you been in America Ms Anne? Take it slow now!" as I sat in my car fidgeting while she raised the gate for two fire trucks. I didn't know that my impatience was that obvious!

My friends from Hong Kong would simply die of boredom, friends from Singapore would find the pace here a little slow but the golf course more than adequate recompense.

But after coming from Hong Kong and Singapore where domestic help is a given, the most uplifting event of this trip so far is parting ways with our house cleaner-cum- care taker.

It was a case of the last straw that broke the camel's back - but rather than be overly concerned about cleaning house and who will keep an eye on things while we are gone, I have an overwhelming sense of relief.

Anyway it's high time I went through each nook and cranny and did a thorough sorting out - and throwing out of junk that we have accumulated since 1993!

Tuesday, March 22, 2011

We Are All Cleared For Take Off!

All's clear so we leave tomorrow for Hong Kong and then puddle jump from Hong Kong on March 30. We'll rest a few days with our friends Elizabeth and Martin in San Francisco before continuing on to Ponte Vedra.


Whew! It's been a bit of a rush and everything hinged on getting the final 'all clear' from the colonoscopy. I am not sure what I would have done if there was a hitch especially as all the flights to Hong Kong seem the be rather full.


I was wondering why as the (Singapore) school holidays have ended, but then I had forgotten about the Rugby 7s which is a jolly good excuse for a wild and wet weekend at Hong Kong Stadium.


So "see you later" to our friends in Singapore and "hello" to our friends in Hong Kong. And "see you soon" to our friends in Ponte Vedra.

Monday, March 21, 2011

Taking flight, we hope

A quick one this.


We went to NUH and Lin will be having his colonoscopy tomorrow as some of you (those in Singapore and the same time zone) will be enjoying lunch!


If you are not busy with chopsticks, forks, knives and spoons do keep your fingers crossed as I have bought tickets to fly to Hong Kong on Wednesday, March 23. 


Seats are very few and far between this week and these are the only ones I could secure at such notice.


We'd like to be able to spend a while in Hong Kong before we make the trip to San Francisco on March 30.


Have not got a back up plan so we are winging it for the next few days. Nothing like more excitement in our lives.


Will keep you all posted.

Saturday, March 19, 2011

Want to try pushing a rock uphill? (an even longer and more boring version of what appeared in 'Chewing The Cud'!)

Time flies, but it also drags. We've had some qualified good news in that Lin's white blood cells have recovered sufficiently for us to pack our bags.

But we're still in limbo because he's now scheduled for a consult with the endoscopy specialist (this coming Monday) and until he's had his colonoscopy his feet are still nailed to the floor here in Singapore.

Thus far I have made some flight bookings and the ETD from Hong Kong is March 30th, 2011, with arrival in Ponte Vedra early April! Unless something untoward happens we should be able to make that deadline. It's the Singapore-HKG leg that is the moveable feast.

Prof. Wong is quite pleased that Lin has put on some weight. Unfortunately for me, I too have put on some weight - about 4 kilos since September last year! Must be the stress and keeping him company coaxing him to eat!

I have not been good about keeping all of you posted in recent weeks and I have wondered why. Is this experience starting to become tiresome? Yes, somewhat. Look at it this way, sometimes pushing a rock uphill calls for short rests!

But it is probably more about battling health insurance bureaucracy, in this case BUPA HK and the beady-eyed bods in their Claims Department.

After a hectic few months I settled down enough to put together the bits of paper we had accumulated from hospitals and such and sent them off for reimbursement. And that marked the beginning of a long and tedious trek to fulfill their requirements; the list of supporting documents looks simple enough at first glance. But be forewarned - or as we learn the hard way, get yourself a decent insurance broker.

Their claims forms are confusing (starting with trying to decide WHICH form is the correct form)  and belie the amount of information that is needed - we have spent months shuffling from pillar to post to satisfy the Claims tartars.

Now I believe it when I read that doctors in some countries have quit practicing because of the amount of red tape they have to deal with in between treating the sick. That and the malpractice insurance premiums, no doubt.

In Hong Kong (and even in the USA) some doctors refuse to accept any form of health insurance - it's strictly cash, cheque, VISA or Mastercard. Or any combination of the foregoing. And I don't blame them having tried to walk the walk with the paperwork.

This saga began in September (about the time I started to put on weight so that puts the kibosh on me being fat when happy!). We had to appeal to have some claims accepted for review because some of our earlier bills missed the 90 day deadline for filing.

It seems most unfair that when one is least prepared to tackle (and has the least time for assembling and submitting) health insurance reimbursements is the time they must be in the clutches of the Claims Department. 90 days is too short a time when the family is dealing with a major illness or injury.

Anyway, getting hold of the same person at the end of the phone is like being in pursuit of the holy grail and Lin wasted much time recounting the situation to successive customer service personnel. In the end we managed (through divine intervention?) to transition to corresponding by email with the same person and that has been a help in recent months. What a relief!

I also discovered (who checks out these things when all is well?) that Lin's health insurance policy was being handled directly by one of Bupa HK's office sales staff with whom we had not exchanged a word with all this time (but probably earned a commission on having us on his books as a client), so long story short we switched to using an insurance broker recommended by a friend.

The only time we heard from this individual was when he emailed us to confirm whether if was Lin's intention to switch to a broker.

By the time that the switch was confirmed by Bupa the bulk of our claims were already in the pipeline so I continued rolling the rock uphill.

The system at the hospital means that we routinely obtained tax invoices and credit card charge slips. Having paid by Medisave and our credit card, we did not know to ask for the official receipts. Bupa would not accept the tax invoices accompanied by the credit card slips; they demanded receipts too.

And if we forgot or did not obtain an invoice when we left the hospital, we could ask for and were issued duplicate tax invoices at the next visit. These were not acceptable (Bupa seems to think that the presence of the word 'duplicate' means that their clients have tendered the originals to another insurance company!).

In the last month, the customer relations officer we have been liasing with at Bupa managed to contact the central finance and administration office at NUH and asked for receipts - that's how I learned where to go for them. What a revelation - it was the key log in easing that logjam!

Then, unknown to us, the Claims Department - a law unto itself - kept sending letters by snail mail to our Hong Kong address to ask for more details (despite us having spoken and written to Bupa to contact us in Singapore). These demands required that the submission be made within a month; not exactly easy when we do not receive our HK mail here in Singapore.

Anyway, another piece of mindless bureaucracy is the requirement that each claim must be accompanied by a letter from the doctor stating the diagnosis and the treatment! Surely any human being with a modicum of commonsense would accept that the diagnosis was made in April when the cancer was first detected - and had not changed.

As for treatment, surely that was obvious from the invoices and receipts which stated what was done. But no, the doctors have to provide covering letters.

In the end Prof. Wong wrote a letter summarising what had happened between May 24 and December, which he kindly provided. Thank goodness the Prof. has been most understanding.

Since then we have periodically submitted lists (signed by the Prof.) headed  with the description of the condition followed by the dates and treatment or diagnostic tests ordered (all this merely repeated what the other bits of paper had to say).

Matahari would have trouble trying to make sense of the information on the Bupa Active part of their Web site pertaining to claims submissions. Prior to submission we complete forms that are not numbered. When these forms arrive in HK they are allocated voucher numbers and we do not know what numbers they might be allocated.

When the statements of account and details of submissions appear on the web pages, they bear ONLY the Bupa voucher numbers. Work that one out.

Dates make a difference too, we discovered. There are visit dates and invoice dates; and woe betide the client who is not detail oriented. Anal even.

I am math-challenged (2+2=5) and if not for spreadsheets I would have 'holey' pages in any book in which I try to keep accounts. As it is I delete lines and columns with great aplomb only to grieve later for their disappearance.

I can only imagine what it might be like to have my nails pulled out with a pair of pliers, but I feel as if I went through the mental equivalent in this trial and error experience of assembling our information in a form that would record what we obtained (with the information that we have learnt, step-by-error prone step - that Bupa requires), and then record what we have sent off to HK.

In the meantime they continue writing to our HK mailing address. Never mind cross purposes, we aren't even on the same channel.

Being inclined to be lazy and too reliant on Bupa keeping track, I now find I have to obtain and send them 'missing' receipts and invoices that I had ticked off lists that I had kept on scraps of paper! Better late than never, I suppose.

Our single sheet printer-scanner has never had to work so hard. 

Thank goodness for the Bupa HK customer relations person who is caught between their Claims Department and us; while she is strictly a company person, she at least lends a human element to this whole farce. If not for her we wouldn't even have got this far in understanding how their bureaucracy works.

The 'war' is not over yet.

What still eludes me is the matter of which category in which to apply for reimbursements. There are subtle differences and I don't know enough to navigate through that maze.

Hopefully, our newly-appointed broker will bat for us in placing these where they are most likely to be considered.

In the meantime we appear to have surpassed the annual or total limits for some of the claims. Again it doesn't make sense because the benefit limit for diagnostics is really rather low so that when one has more than two or three scans and various tests, including blood tests, the budget's blown.

So how's the doctor going to monitor the progress of the treatment and to see if anything else is brewing?

If it's been boring and exhausting to read this, you can well imagine what it's been like to live it, all 4 kilos worth.

Saturday, March 12, 2011

Food We Should Eat

Flounder (sole)
Haddock
Halibut
Herring
Mackerel
Salmon
Sardines
Tuna

Apples
Blackberry
Blueberry
Cherries
Clementines
Cranberries
Grapefruit
Lemon
Nectarines
Oranges
Peaches
Pomegranate
Raspberries
Red grapes
Strawberries

Basil
Black pepper
Cinnamon
Flaxseed
Garlic
Ginger
Ginseng
Lavendar
Licorice root
Nutmeg
Oregano
Rosemary
Sesame seed
Tarragon  
Tumeric

Lentils
Lima beans
Soybean
Sword jackbean
Tofu (soft, firm, dried, fried), miso, natto
Enoki mushrooms
King oyster mushrooms
Maitake mushrooms
Matsutake mushrooms
Oyster mushrooms
Reishi mushrooms
Shiitake mushrooms

Cashews
Chestnut
Pine nuts
Sesame
Walnuts

Arame
Dulse
Kombu
Mozuku
Nori
Wakame

Cuttlefish
Oysters
Sea Cucumber
Shrimp and prawn
Squid and squid ink

Artichokes
Beets
Bok choy
Broccoli
Brussel sprouts
Cabbage  (red, savoy, white)
Carrots
Cauliflower
Chard
Endives
Kale
Mustard greens
Olives and olive oil
Onions
Parsley
Parsnip
Peppers
Pumpkin
Radishes
Salsify
Scallions
Shallots
Soybean sprouts
Spinach
String beans
Sweet potatoes and yams
Thistle
Tomatoes
Turnip and their tops
Watercress
Winter squashes

Dark Chocolate
Green Tea
Maple Syrup

Wednesday, February 16, 2011

Some Good News

Our eagerly and anxiously awaited appointment with Prof. John Wong took place yesterday! 


He congratulated Lin on completing his six cycles of chemotherapy, albeit this was completed on 31 January 2011 rather than the originally scheduled 18 November 2010 - an extension of two and a half months.


The main culprit was the ANC (NOT as some of you had jested, the African National Congress!).
ANC: The absolute neutrophil count, the number of white blood cells (WBCs) that are neutrophils.


Low/compromised immune levels invariably cause delays in administering chemotherapy and so it was with Lin.


Things improved slightly when the dosage of the chemotherapy drugs was reduced and then, again, after Oxaliplatin was dropped from the 'cocktail'.


In fact, his last two chemotherapy sessions  (16 January and 31 January 2011) were according to plan! Let's hope (and pray) that this is a good sign.


After Lin was pocked and prodded and offered up his palms for inspection, Prof. Wong talked us through a Survivorship Care Plan which you can find here:
http://www.asco.org/ASCOv2/Practice+%26+Guidelines/Quality+Care/Quality+Measurement+%26+Improvement/Chemotherapy+Treatment+Plan+and+Summary/Colon+Cancer+Treatment+Plan+and+Summary+Resources?cpsextcurrchannel=1


Lest I bore you, anyone who is interested should visit:
http://www.cancer.net/portal/site/patient


Another useful site for information about cancer:
http://www.macmillan.org.uk/Home.aspx
Both are clear, concise and easy to understand, a huge help when the last thing anyone (who is already anxious) wants to do is to be even more confused and befuddled.


Things decided: Lin will continue to have 3-monthly check ups / reviews with Prof. Wong, and he will keep his port-a-cath (saves having it taken out and then a new one implanted if the need should arise because of age and the effects of chemo drugs coursing through his veins - basically they become harder to find!). But we must have it flushed clean every four to six weeks.


Bottom line: we will visit Prof. Wong mid-March, and before then Lin will have his blood tested and a colonoscopy too. The latter being his least favourite diagnostic procedure!


Prof. Wong did mention that there is a CT Scan for signs of colon cancer but it does not show up all pre-cancerous growths (i.e. polyps). Also, the benefit of a colonoscopy is that when spotted during the colonoscopy the polyp(s) can be snipped off.


I did a bit of looking around. What the proponents of the virtual colonoscopy (CT colonography) don't tell you is that you still MUST perform the same bowel preparations! 


In addition to missing small polyps, a virtual colonoscopy can result in some false positive results and if any polyps or other abnormalities are noticed, a colonoscopy will be needed (source: cancer.org).


Why risk doing the horrid bowel preparation twice?



    In the meantime, Lin must wait for his neutrophils (the famous ANC) to recover and takes care not to let any infection or injury hamper his recovery.


We are both quietly elated (if one can be elated and quiet at the same time) and looking at our calendars to see when we can make that 'Great Escape' to Hong Kong and Florida!


Do keep your fingers and toes crossed.


PS: Prof. Wong said that yesterday's occasion is the time when he would report this milestone to the referring doctor. In this case, some of you know who was instrumental in Lin being able to become a patient of the most able and competent oncologist one is ever likely to meet. 


We owe a debt of gratitude, which can never be repaid, to this true friend in need.