The Great Singapore Sale '07

Weekend's here, Mummy's here, & so is the Great Singapore Downpour Sale!

My first time out properly for shopping since I came a week ago.

Mom arrived at 5.30a.m. although I had expected her to arrive 1 1/2 hours earlier. Though that I would stay up waiting for her to arrive, but gave in to my sleepiness halfway through lol.

Re-slept from around 7.30am til 11.30am.

Went to Chinatown first. Lotsa quaint little shops selling all sorts around the area.

Bought some chilli pork bak kwa for dad (mmm yumm!) from Bee Cheng Hiang.

Bought a sweet little top, Sha too, and mom bought the skirt. All for SGD60 after quite a bit of haggling. Sha & my mom are pro bargainers la lol. Mom bought a few souvenir tees, and we bought a few trinkets too. Cheap cheap (relatively)!

Ate at Da Dong restaurant for lunch. Dim sum stuff. Not bad la. Quite big portions. Ate one zhong (zhang) too. The dumpling festival is just round the corner, I just found out! Then ate fried carrot cake with egg and dried prawns...tasty! (We went back later at night to ta-pau some back for my dad lolz)

Started raining :P

Then we went to VivoCity (MRT stop at HarbourFront), which is a huge new-ish shopping complex not dissimilar to Midvalley.

So big, dunno where to start lolz. Randomly walked into Tangs first. Bought a new ring (courtesy of mom and her credit card lol, well, she bought two!). Quite like it. Dainty rose-coloured ring with a few dainty diamond-like swarovski crystals on it. 40% off!

Walked around the whole mall. Realised there were tons and tons of UK brands here. Nice...but some didn't have sales though (like Zara and MNG...may not be UK-origin brands, but you get them in the UK too lar).

Went for lunch at the food court upstairs. Very nicely decorated to make it look hawker-ish. Food was decent, normal kinda food court price la. But there was definitely lots and lots of varieties though. Mouth-watering ones too!

In the evening, went out to the top floor's outside of the building, where it's literally overlooking the harbour front. You can see Sentosa island from here, and all the cable cars and ferries heading towards/from it.

We actually didn't over-buy or over-spend, me thinks! Not bad not bad. Very disciplined, I must say lol.

On our way back, stopped at Chinatown again where we went to get the carrot cake.

It was pouring. Not even dogs and cats ar. It was raining elephants and rhinos I think! Serious downpour of rain man. Really bad for the people doing business there me thinks.

In the end, we also ta-pau-ed the peanut soup that was mentioned in the Wikitravel article. It wasn't peanut-cream soup as we had imagined, but literally peanuts boiled in sweet soup with tong yuen (glutinous rice balls with filling). Quite nice!!

Came back half soaked. Rain rain heavy rain! One umbrella definitely not complete coverage for two people! On the bright side, at least it's not freezing cold.

Feet are achingggggggggggggggg now. Quite sleepy dy, but still have to go shower :P

More shopping and walking tomorrow! Woo hoo + groan altogether lolz.

Lost in time and place? Lol...

Where to go, where to go la?

Our dear ice-cream man! >.<

Oh, learnt about Argyll-Robertson pupils from Dipz while chatting to him just now. ARP = PRA, or prostitute pupils, apparently. Lol. Accomodating but not reactive! Hah!! With regards to the neurosyphillis that I had mentioned earlier.

Eyes half closed now. Soooo sleepy. Will try update more pics tomorrow lah! In the meanwhile, my facebook seems quite quiet and lonely. Poor thing!

Day 5 and the weekend's here!

It's da weekeeeeeeeeeeeeeend now!! Woohoo! I survived week 1 of my electives!

No more snoozing man. No more lying in bed after I turn off the alarm. Damnit. Woke up the LATEST today out of the whole week. Didn't even have time to shower. Only managed to wash my face and brush teeth. Darn!

Still managed to get to the CDC before 8am. Not bad not bad. Lol.

Ward round this morning as usual. Got asked about transaminases which I knew shit about. So read THAT up during the 'free time' that I had around lunch time. Ask me all about it now lah!!!! Muahahahah.. I can probably answer, erm, 50% of your questions...?*sungguh memalukan la* :P

Went for research meeting at 11am. Gawd I so cannot do lunch-ish time meetings la. Everytime also soooooooooooooooo bloody sleepy. Tak leh tahan!

Ate a Fuji apple for lunch coz it's the only thing I sempat grab this morning while I was rushing rushing rushing. No time to prepare bread. Oh well. Still filling anyway.

Sat in on another consultant's outpatient clinic in the afternoon. (wow i'm too rajin la here. could have gone back but i didn't! so proud of myself lolz. Must be the Sporean spirit! hahahaaha) Was really good to see another consultant's consultation style.

Saw a variety of cases, although all were HIV patients la. Just that everyone had different issues to bring up.

One was about terminal care (and making sure the relatives were prepared to some extent, but the irony was that this particular patient had a very very good CD4 count, and would die in the near future not because of HIV/AIDS but due to severe damage that his lungs had taken from previous TB infections and bronchiectasis), another was about getting pregnant with HIV (and that was coz the mother-in-law who doesn't know about this patient's HIV status wanted a grandson eventhough she already had a granddaughter), yet another was about syphillis and the possibility of being infected in the CNS (with issues of informing other people that you are HIV +ve before having sex with them, and the possibility of being sued and jailed if you did not), and there are the usual lot with financial problems la.

Learnt about MediSave, MediShield, & MediFund.

Learnt about various options for getting pregnant and giving birth when you're HIV +ve.

Stayed til 6pm. OMG. 8am til 6pm. i.e. leave the house at 7.25am and arrive home at nearly 7pm. Wish I was that rajin in Newcastle man. Have to learn how to be this rajin in 5th year! Lol. Have been inspired by my housemates to attain their achievements in final year man! Pressure!!!!!

Had instant noodles and a slice of kaya bread for dinner. Lolz. Then went out with Sharon to the salsa club we went the other day.

Ladies nite tonight. We got in free w/o having to pay cover charge, then from 9.15pm til 1.30am we had this whole list of drinks that we could get free (although the cocktails and mixers were pretty much quite watered down, but still!). Had a couple of really 'light' mojitos, which was okla, but since it was free, I'm not complaining ;P

Finally tried a teensy bit of dancing tonight. Simple cha cha, but pai seh lah. I cannot dance also lolz. But still it was quite fun la. And the guy had good patience :P Sha had a pretty good time though, from the looks of it ;)

Left just before midnight (like Cinderella lol) coz our 'pumpkin carriage' (i.e. the MRT)'s last train back runs at 12.05am. So was back home by 12.30am dy. So 'kuai' huh lolz.

Mom's on the bus now on her way to Singapore. Shopping time this weekend!! Woohoo!!! >.<

Elective Day 4

Day 4

Lesson of the day - I shall never ever ever ever forget that loin-to-groin pain = renal stones. How stupid of me to forget. Damnit.

Anyway...woke up a wee bit earlier today, so left about 3 minutes earlier than the last 2 days. Whole lotta difference that made *note the sarcasm*

Still, was lucky enough to catch the train immediately when I arrived at the station so saved about 5 minutes there.

Damn, need to get in around 7.50-7.55am la. The MO always start ward round before 8am. Damn Singaporeans so rajin have to be 'cepat dan cekap' (fast & effective) all the time.

Consultant joined us halfway through. So basically all the patients have to be poked and prodded and woken up twice within an hour at 8.30 in the morning. *sweatdrops*

Had few more new dengue admissions. One girl who had been in the last couple of days was now classified as DHF instead of DF (re: dengue haemorrhagic fever vs just dengue fever) 'coz she was a lot more poorly and fever lasted a lot longer (plus other criteria which I should know but can't recall now. Die. Memory soooo gone. Dementia liao). She had SOB last night (that's shortness of breath for all you non-medical-terms-inclined readers, not son-of-a-b**** fyi) and was given some O2, but was doing a lot better today. Her CXR showed a right pleural effusion and ?bilat consolidation. Most interesting case in the dengue side of the ward.

Other half of the ward was as usual la. 5 chronic HIV patients.

Followed the MOs and Reg out to McDs for a drink (and their breakfast) after that. Asked and learnt abit more about Spore healthcare system compared to NHS.

Also asked and learnt about Spore med students' lifestyle. It's literally not a life. Lol. UK med students will sooooooo die if they have to live the life of a Spore med student. No Friday nights free out drinking, no Saturdays to do as they wish, no Wednesday half days, no starting after 8am (as everyday starts as 8!), no skiving if you don't wish to fail out of med school...tak boleh tahan! Lol ;P

Came back at 11-ish. Had nothing to do til 11am so parked my ass in the air-conditioned doctor's room (which became abit like a freezer after a while) and tried to read the Infectious Diseases chapter in the Oxford Handbook. Yeah, right. "Read". IF reading meant glancing at the page with eyes three quarters closed and mind in dreamland already. Yup, I did some 'reading'. For 1 1/2 hours til 1pm. Lol. Oh well, ate my gooberPB sandwich in an effort to try and stay awake. Stayed awake alright, for about a whole 5 minutes. Bollocks.

Went for the MO's teaching session then. They had free lunch which was pizza but I didn't dare take any in case there wasn't enough to go round between them. Better not lah, in case they resent me later for eating THEIR barely-enough lunch. At least I didn't fall asleep this lunchtime. Must be the 'reading' I did earlier.

Went for clinic at 2pm with my consultant. A pure HIV clinic la. Quite interesting actually.

Showed me how different the HIV community is here compared to in the UK. Here, people of all sorts of races, ages, sexual orientation, background, & socioeconomic status could be infected with HIV. Which basically means any random normal-looking person on the street could be HIV-infected. You would've never guessed. Whereas in the UK, the HIV community that we see in clinics are generally either African refugees/asylum seekers, or gay.

Nevertheless, patients in the UK have it good la. Patients here have to scrape money everywhere to pay for the cost of their anti-retroviral drugs. At least the doctors give them alternative places to get cheaper versions of the same drugs from Thailand (re: not bootleg drugs, but merely the generic drugs w/o having to pay for expensive drug-company names). UK patients only need to pay a standard prescription fee, and there they go complaining about how expensive everything is. Bollocks la. Wait til you have to fork out all your savings to pay for your medication, til you have to declare bankruptcy. See if you wanna complain somemore.

Clinic finished at 4.30pm which wasn't too bad. Got more reading materials which I have to look through later (should I take a nap first? and wake up at 6am to read? Lol).

Went to the Novena shopping mall, bought some sushi and bread. Back by 5.30pm, ate sushi and showered. Everyday come back hot sweaty and sticky. Gross.

Ate a slice of bread with kaya. Ate a packet of the mini cup instant noodle. Ate a pear. Ate a Fuji apple. Lots of random stuff huh lol.

Watched a few vid clips from SYTYCD season 3 which were posted on Rickey.org...I like Hok & Lacey!

Feeling so sleepy dy now. And it's only 8.30pm. Not good.

Still so happy for the final years new F1 doctors! Hope they'll enjoy their last holiday as a student before venturing into the work force...and hope I can do as well as they did next year. Finger & toes (& eyes) crossed!! ;D

Must go and catch up on the last 2 weeks of bleach and naruto. Toodles~ (=^.^=)

Midweek

It's Thursday already! Looking forward to the weekend when mom's coming down to Spore...some serious shopping time! Yeay!!

Great Singapore Sale, here we come (in a few days time! lol) !!!

Day 3 of electives

First of all, before anything else, a BIG CONGRATULATIONS to all our official F1 doctors now!!! YEaY!!! Congrats Charles, Dipak, Luke & Chia Ying!! Double congrats on the Distinctions and Merits. YOu guys are good lah!! Celebrationnnnnnnnnnnnnnn time..!! >.<

Back to today's highlights...

Woke up LATER than I wanted to, AGAIN. Luckily lunch was packed before I went to sleep the night before (or rather, a few hours before at 3am). Rush rush rush, still managed to arrive at CDC before 8am lah. But realised that I forgot my white coat whilst at the MRT station. Damnit. Always have to forget to bring something.

Went for ward round which started at 7.55am. No sane NHS doctor starts medical ward round that early la. But was joined by my consultant supervisor, Dr Lee, a bit later. There were another 4 new dengue admissions the previous night. All staying in dengue hotspots. All foreign workers (from China/Bangladesh). Learnt about Chikungunya virus (which is quite similar to dengue and even spread by the same vector, the Aedes Aegypti mosquito, but is usually not fatal), felt a few cervical lymph nodes, and felt a systolic thrill in a HIV patient. Wow. 1st time feeling a thrill.

11am - MDT meeting. Went on to some case presentations and later talked about any deaths for that week past. Then had presentation on Medical Writing by an invited speaker. Tried very very hard not to doze off somewhere in the middle. Really need more than 3-4 hours sleep at night lol. Finished at 2.30pm. Had free buffet lunch though. Definitely nicer than sandwiches :D

Left after that and skived the afternoon. Lol. UK habits coming into play here. Went home and found out that Sharon was back too. Haha. Took a cold shower coz was soooooooooo sweaty. Not even funny the humidity here (and in Msia for that matter). Read a little bit of the reading material that I had (been asked to) photocopy earlier, then went to snooze-land for a good 3 hours!

Had goober PB sandwich for dinner (which I didn't eat for lunch) and went out with Sha to meet her cousin at a salsa club in Tanjong Pagar. Personally I don't dance, but it was quite nice doing some people watching. Everyone seemed to be having loads of fun. Guys were queueing up to dance with Sha and Jac lol. But there were a lot of people dancing salsa, merengue, bachata, rueda etc. Had a few drinks (gin lime soda of which the klutz part of me spilled half of it :P, long island, mango delight) and took a few pictures and vids of Sha n Jac dancing with different guys. Fun!! Although a bit intimidating for beginners though I think. Lol. Everyone seemed to know how to dance pretty well already. Definitely more difficult for guys, coz they have to know how to lead.

Nearly 2am now. Have to go sleep! But CONGRATS again to all the 5th years-now officially doctors!! So proud of you guys! Hugz all round >.<

Day 2 of electives

Shit. Y am I such a slacker? Was meant to wake up at 6 smthg this morning so that I had ample time to shower, eat breakfast, pack lunch, n maybe have a glance through the oxford handbook on HIV or something. Damn you snooze button. You are too evil. Woke up at 7.10am when I wanted to leave the house at 7.20am! Left at 7.25am with a packed goober peanut butter sandwich lol. It's 2.30am now and I have to wake up before 7am again. I'm so dead. So gonna sleep at the 11am-2pm meeting later. Gone lah. Lol.

On the other hand, ward round in wd71 was good. Met the best medical officer around lah. So friendly and chatty. Good good!! The medical officer was very fast and pretty efficient lol. Half the ward were dengue patients, the other half consisted of 'uncles' who were HIV-infected. It's a Class C ward, so the government subsidises 80% of the hospital bills. But you only get fans, and 'natural ventilation'. No air-cons, no carpet, no 5-choices on your breakfast menu. That's only for Class A1 patients.

There's a 'check-list' for patients admitted with (suspected) dengue. Rash? Tick Yes or No. Bleeding? Tick Yes or No. Fever? Tick Yes or No. Day # what of fever? What is the platelet count? What is the haematocrit %? What is the TPR? (temperature, pulse, respiration, although no one does respi rate la). What is the blood pressure? sitting vs lying, any postural hypotension? Got abdo/back pain? Pain anywhere else? Bleeding anywhere, especially from gums/nose? Got nausea/vomiting/diarrhoea/dizziness/difficulty breathing/cough/appetite? Classified into dengue fever (DF), dengue haemorrhagic fever (DHF), and dengue shock syndrome (DSS). Make sure no 3rd space leakage - pleural effusion, ascites, hepatomegaly, transaminitis. What do you work as? Where do you stay? Anyone else around you ill? Travelled anywhere recently? Can walk can eat? Serology/PCR only done after day5 or 6 of illness when fever breaks and platelet increases/haematocrit decreases. Severity of rash not an indication of severity of illness. Management plan - rehydration, monitoring, symptomatic treatment. Simple basic stuff. Inform ministry. Post-viral syndrome lasts for 4-6 weeks. Malaise, tiredness, weakness.

Went for part of my supervisor's outpatient clinic. Haven't even discussed properly with him what my elective outcomes are lol. He really 'sayang' his patients la, although he can be quite moody/temperamental with his staff, apparently, from what I heard. His special interest is in HIV. Shit have to read up about it loads. Will be good for final year though. Took pic of PPE - Pruritic Papular Eruption (learnt something new!) Compliance to medication can be checked through viral load. You can get Kaletra (a kind of protease inhibitor) via Thailand for 1/10th the price you get it normally (in Spore). There are 2 patients who were infected by HIV through blood transfusion (about 10 years ago). Ministry of Health pays for their treatment now. However, ART (anti-retroviral treatment, i.e. drugs for suppresing HIV) is not subsidised by the government, so all the other unfortunate patients have to fork out every single dime and penny to pay for these expensive drugs.

Pruritic Papular Eruption in HIV patient - caused by insect bites/staph infection

Attended and observed a family conference in the afternoon. Talked about limitations to active medical care (for a end stage-ish HIV patient), and discussed palliative care. DNR. End-of-life issues. Very realistic and pragmatic, I think. What to do, when to do it, what NOT to do, who will do what. Picking up lots of mandarin words here and there, fast!

Got off at 4.30pm. Nothing to do and damn sleepy. Went out at 7.30pm with Sha to meet up with her cousin for dinner. Wandered around for awhile whereby everyplace was full! S'poreans really love to eat out huh. Lol. Finally ate at Crystal Jade Restaurant. The aubergine (egg plant) with mince pork was nice, so was the fried prawn with salad sauce! Yummy. Thx Jackie for the treat! >.< Then met up with her colleagues (they are all SIA air stewardess). 'Toured' the east side of Singapore in Jacqueline's car (i.e. missed a turning and ended up on the CTE and then the PIE, reached Bukit Timah before finally heading back towards Orchard Rd) and had some drinks near where we are staying...lychee margarita...sedap! Thx Vanessa for the treat! Meeting the girls again tmr nite to go to a salsa club...Sarah will be envious! Lolz...

Vanessa, Tammy (gomen ne if i spelled ur name wrongly), meself, Jacqueline & Sharon

Anyway, got to go sleep now. Got my fingers, toes, eyes, hair crossed for the final years for their result tomorrow...but I'm sure they'll all pass with flying colours! I have faith in you guys! >.<

Electives in Singapore

1st day of Elective

in Singapore

doing 4 wks of Infectious Diseases

at the Communicable Diseases Centre (CDC) near Tan Tock Seng Hospital (TTSH)

MRT is 3 stops away from where I'm currently staying (Somerset - Novena)

staying near Orchard Rd...woohoo!

ppl at CDC are very nice, so far so good!

went for outpatients clinic today, 95% HIV patients.

mostly sexually transmitted

15 patients seen today, 3 DNA...and that was from 2-6pm!

languages used - Chinese (about 2/3rds), English, Malay

amazingly interesting to see how doctor breaks bad news +/- try to explain what HIV is in Malay

patient was more amusing. seriously in denial. had to bite my lips to keep from laughing. totally unprofessional, but couldn't help it LOL...I'll try better to be more understanding nxt time

quite sad to see some of the young people affected with HIV. One guy was just 19. and the biggest fears young people have is how to hide the news from their parents. Especially those who are being heaped with high expectations.

British people who are patients are so lucky lah. no need to fork out a fortune for hospital bills. antiretroviral drugs cost anything from SGD 100 - SGD 1500 per prescription!

earlier in the day...met other students starting their electives in S'pore today - including 3 ppl from Newcastle too (OMG how small is this world!), 1 from Cambridge & 1 ABC dude from Virginia Uni (NOT Virginia tech which is 100miles away!). cool & chatty ppl :) probably won't have a chance to see any of them again though during this elective. oh well.

Sharon & her cousin & his wife have been very hospitable.

Really nice house.

Very close to Orchard Rd, & near MRT station.

Survived on 3 pcs of sushi + 2 pcs of bread with goober + 1 can of guilingao + 1 small pear for dinner LOL

Tomorrow nite going out for dinner with Sha & another of her cousin.

Spent SGD 15 on EZ-Link card, of which only SGD7 worth of travelling money was given. !"£^&*(%

Bought a prepaid sim card too.

Bought notepad too.

Going to sleep soon...ward round at 8am tomorrow. Have to leave the house latest 7.20am. Groan.

Hope tomorrow will be as good and interesting as today!

Fingers crossed (=^.^=)

Good luck for the OSLERs you final year peeps! Gambatte ne!