ORAL sex can lead to throat cancer

New Paper
11 April 2009


Sex act linked to throat cancer

ORAL sex can lead to throat cancer, say US scientists.

A study conducted by Johns Hopkins University has revealed that the human papilloma virus (HPV) poses a greater risk in contracting cancer than smoking or alcohol.

Oral sex is the main mode of HPV transmission.

And those who had already experienced a previous oral HPV infection were 32 times more likely to develop cancer.

The American study of 300 people also found that that those with more than six partners were almost nine times at greater risk of contracting the disease.

During the study, men and women who had been recently diagnosed with oropharyngeal cancer had blood and saliva samples taken and were also asked about their sexual practices and family history.

They found HPV16 - one of the most common cancer-causing strains of the virus - was present in the tumours of 72 per cent of cancer patients, reported the Daily Mail.

Scientists said the majority of HPV infections had no symptoms and often did not require treatment.

But they also said a small percentage of those who contracted high-risk strains may go on to develop cancer.

Study author Dr Gypsyamber D'Souza told the BBC: 'It is important for health care providers to know that people without the traditional risk factors of tobacco and alcohol use can nevertheless be at risk of oropharyngeal cancer.'

Co-researcher Dr Maura Gillison said that oropharyngeal cancer is still relatively uncommon and that most people who contracted HPV probably wouldn't develop throat cancer.

Dr Julie Sharp, science information officer at Cancer Research UK, said: 'As this was a small study, further research is needed to confirm these observations.

'We know that after age, the main causes of mouth cancer are smoking or chewing tobacco or betel nut, and drinking too much alcohol.'

Hmm...I think I have Dissociative Disorder

When I was in my teens, I was diagnosed with some form of personality disorder. I went for counselling and therapy, which I thought was pretty useless. They just wanted the patients to open up and talk. And talk and talk. Frankly, I dun see that any helping my condition.

I did not know what kind of personality disorder I had, cos I was not allowed to see my own medical files and also the psychologist and psychiatrist did not informed me.

Over the years, I got better. And I have not seek medical help since those few times in teenage years.

I do think I have dissociative disorder. I did have some of the symptoms. I am dissociated from the society and my environment.

Even SO said that I am living in my own world. And in a way, I am. My world is rather small. And mostly involves around SO and me. And the dogs.

As for external social and leisure activities outside the home...there is hardly any. I am almost like a hermit most times.

But frankly, it's not that bad. I could still function in normal society rather well, most of the time. I am no raving lunatic. I have proper trains of thoughts. And read my blog, they dun sounded too crazy, do they?

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The Straits Times
15 Aug 2008

Dissociative disorder often lasts

NEW YORK - DISSOCIATIVE disorder that begins in childhood or adolescence frequently persists into adulthood and is often followed by other psychiatric disorders, according to a report published online in the journal Child and Adolescent Psychiatry and Mental Health.

Dr Thomas Jan from the University of Wuerzburg, Germany and colleagues analyzed the long-term clinical outcomes of 27 former patients with juvenile dissociative disorder (two of whom had committed suicide). The average age at onset of dissociative disorder was 12 years old.

According to the researchers, 89 per cent of these patients had 'recovered or had markedly reduced symptoms' after treatment during childhood.

However, at follow-up an average of 12.4 years after the initial diagnosis, 83 per cent of the patients 'met the criteria for some form of psychiatric disorder'.

Dissociative disorder is characterised by psychiatric symptoms such as the disruption of consciousness, identity, memory, behavior or awareness of the environment, according to the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision.

Dissociative disorder may take the form of altered consciousness as a reaction to overwhelming psychological trauma.

Psychiatrists suggest these memories are encoded in the mind, but have been repressed.

Review of the follow-up data revealed that more than one quarter of patients (26 per cent) still suffered from a dissociative disorder, the report indicates, and 48 per cent had a personality disorder.

Compared with a control group, the patients previously diagnosed with dissociative disorder were less likely to have financial and emotional independence from their parents, more likely to still be living with their parents, and less likely to have social leisure activities outside the home, the researchers note.

Only 8 per cent of patients, however, had serious impairment of social, occupational, and psychological functioning, and only 4 per cent were unable to function in all these areas, the investigators say.

'Treatment strategies have to consider that in a significant portion of young patients, initial recovery may not be stable over time', the authors conclude.

Even after patients are stabilised, they recommend that these patients see a mental health provider periodically to detect recurrence of dissociative or other psychopathological symptoms. -- REUTERS

Organ trading model in next 1 to 3 years

The New Paper
14 Aug 2008

Organ trading model in next 1 to 3 years

But Health Minister Khaw Boon Wan proposes that the model, only for kidneys, be managed by independent body using strict screening.

By Ng Wan Ching

SINGAPORE may have an acceptable model of organ trading in the next one to three years. While it may not be an ideal solution to the shortage of donor organs here, it cannot be ignored either.

That was how Health Minister Khaw Boon Wan characterised his dilemma in a closed-door dialogue held last month with 30 professionals. The dialogue, organised by the People's Action Party's (PAP) Women's Wing, was reported in the July/August issue of Petir, the PAP magazine.

Mr Khaw said that while the debate rages on, patients are dying and the poor are being exploited to part with their kidneys at a low price. Hence, he cannot ignore it.

'If we don't do anything about it, we will be guilty ourselves,' he said.

STOPPING EXPLOITATION

In the clearest picture yet of how an organ trading system might work here, Mr Khaw said this was how he would do it:

1. Restrict trading to kidneys only, as trading in other organs creates other problems or involves a higher transplant risk to donors.

2. Eliminate a direct transaction between the donor and the patient by letting an independent, professionally-run third party, the kidney bank, manage the donor pool and match the transplants.

3. Require stringent screening, full risk disclosure and communication with donors and their families, to ensure that only healthy donors are selected and their decisions fully informed.

The third party (the kidney bank) will also safeguard the welfare, health and interests of donors by providing pre- and post-surgery care.

Petir reported Mr Khaw as saying that this would be the greatest value of legalising kidney trading - to stop the exploitation of the poor and ignorant, who do not know the full value of their kidneys. For the best possible outcome, he added that matching should be based only on clinical criteria, not dollars and cents.

He suggested that a way to subsidise poor patients' access to kidneys is by requiring those who can afford it to pay the international price to the kidney bank - 'the Robin Hood principle where one rich patient can possibly support transplants for five poor patients'.

'This will address the current problem of black market trading where the poor can only be donors but not possible recipients,' he said.

The audience asked if more could be done to promote altruistic donations.

Mr Khaw said that compared to Sweden, where family members will readily offer their kidneys for transplants to their loved ones, Singapore's altruistic transplant rate is 'shameful'. There are hundreds of patients on the waiting list, but altruistic donations from family members number only in the dozens.

Mr Khaw said that currently, each year, about 200 Singaporeans join the pool of patients who can potentially benefit from a kidney transplant.

Of these, 50 will get one from deceased donors under the Human Organ Transplant Act (Hota); another 30 will receive a donation from a relative and 20 will go abroad for a transplant. To help the remaining 100, the Ministry of Health will propose that Parliament remove the Hota age limit for deceased donors, now set at 60 years.

The MOH will also explore matching a donor whose tissue is incompatible with the intended recipient's with another donor-patient pair in a similar situation.

These initiatives will raise the kidney transplant rate by another 30 to 40 patients a year. But that still leaves about 60 patients without a transplant option.

While altruistic donation is the way to go, he said that the door should also be kept ajar for some limited transactions to take place. His estimated time frame is to have an acceptable model of organ trading in the next one to three years.

Dentist charged $7 for Consumables

I was walking past a dentist in a mall when I did a double take.

There was a notice on the door that said that from a certain date onwards, the dental clinic would charge an extra $7 for consumables used per visit.

Consumables are those disposal dental stuff/products that dentists used during consultation.

That's inflation talking. Prices are going up. Now even dental clinics are charging for consumables.
I heard of some clinics charging about $2-4 for such consumables but $7?

Why can't they incorporate that in their usual fee?

Personally, in order to slash expenses, I have changed my dentist from that of a private clinic to a dental clinic in a public hospital. And my savings have been quite significant.

For patients to really accept $7 extra in dental consumables, that dentist had better be freakingly good! Otherwise patients would just like me migrate to other dental clinics with cheaper fees and zero charge for consumables.

Long wait at hospital

SO accompanied his mother to the hospital this morning for an eye consultation. The appointment time was supposed to be 9.45 am. But she had to arrive 30 mins early for an eye check up.

SO and mother were on time. In fact, they were early. And they finished the check up by 9.30 am and started waiting to consult with the eye doctor.

They waited and waited and waited. And they just sat there and waited.

The eye specialist finally saw her on 1:10 pm! They waited for about 3 and a half hours just to see the doctor for less than 10 mins!

The doc said her eyes were okay. There's nothing wrong with her eyes. Just old age. No cataracts, nothing. That lucky bitch. Here, I am, prime of my age and already I had mild cataracts.

Okay, back to bitching about the doc. 3.5 hours!! Her appointment was at 9.45 am and it took so long just to see the doc. What did the doc do in between?

If the doc see a patient she was suppose to see at 9.45am only at 1.10pm. Then the patient at 11am would have to wait till 3.30pm?

Did the docs have any concept of time? Did they know the very purpose of making appointments? What's the use of setting up appointments to see doctors when the doctors did not fulfill that part of their obligations?

Frankly, how would you think the docs would react if the patients arrive 4 hours late? The nurses would screamed!

But it's not as if the doc dun see any other patients during the time. SO said there were patients in and out of the door every 10-15 mins. Where did all these patients came from? Were they patients of the day before? A few days old?

Where's the use of the appointment time schedule? It's hardly accurate!

I knew a doc who previously worked in these public hospitals. He said there was no urgency, no incentives to see as many patients. The docs have a number of quota of patients to see per day, but that quota was pitiful low!

These docs dun make extra money for seeing extra patients. They could thus afford to make patients sit and wait for hours. It's not as if the patients would run away or complain. What's the use of complaining? The nurses would said the docs were busy. Please wait.

For private doctors overseeing their own business or clinics, time is money. Every min counts. Every min is a dollar. Hence, there is this urgency to speed up seeing the patients. The greater the patients turnover rate, the greater the revenue.

But doctors at these general hospitals were given a fixed range of salary. They dun get special incentives, bonuses or money for seeing extra patients. There's no extra push!

This friend further confided in me that most docs there were jaded. With no incentives, hardly any competitions, they tended to slag in seeing patients. Some even like to sms, call friends and family, chit chat, flirt with nurses etc. These very docs lacked motivation!

Poor us patients. What can we do except to be at the mercy of these spiteful doctors?

How I wish I could clone my Gin

Reading this nearly made me cry. How I wish I could clone my Gin.

But US$150k or even US$50K is beyond my reach.

There is hope. Maybe in a few years time, when prices go down, I may be able to clone my Gin again. That's why I am still keeping parts of her fur and claws.

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The Straits Times
06 Aug 2008

Dog lover sells house to pay for 5 clones of beloved pet

Commercial cloning of pet dogs in South Korea takes off; camels may be next

SEOUL - THE loss of Booger the pit bull terrier was almost more than Ms Bernann McKinney could bear.

Now she is the happy owner of five cloned Booger puppies, minus US$50,000 (S$68,600) and her house.

'This is a miracle,' said Ms McKinney at a news conference in the South Korean capital. 'I was able to smile again, laugh again and just feel alive again,' she said, blinking back tears of joy as she cuddled the five black puppies - all of whose names include the word Booger.

The puppies were born to two surrogate mothers on July 28, said RNL Bio, the company which arranged for the re-creation of Booger through his refrigerated ear tissue.

Ms McKinney, 58, a movie scriptwriter in California, sold her house to raise the US$50,000 to pay for the cloning. 'I had to make sacrifices and I dream of the day, some day, when everyone can afford to clone his pet because losing a pet is a terrible, terrible loss to anyone.'

She said she would consider training some of the puppies as service dogs for the handicapped or elderly when they arrive at her home next month.

RNL chief executive Ra Jeong Chan hailed the event as the world's first commercial cloning of a pet dog.

The operation was launched in May by a Seoul National University team led by Professor Lee Byeong Chun. He played a key role in creating the world's first cloned dog, an Afghan hound named Snuppy, on a non-commercial basis in 2005.

RNL originally charged US$150,000 to clone Booger. But it agreed to reduce the price to US$50,000 to celebrate what it calls the first commercial deal for a pet dog. The company has said it expects the price to drop as technology improves.

Mr Ra said Booger's case opens the way for global commercial cloning services for pet lovers since the success rate for dogs is high. Up to 300 dogs could be cloned next year for wealthy animal lovers in the United States and elsewhere, he added.

RNL will contest claims by a US dog-cloning firm - BioArts International - that it is infringing on its patent, Mr Ra said. The university would also undertake an ethical review of his firm's business to prevent indiscreet cloning.

'For my next project, I will consider cloning camels for rich people in the Middle East,' he said.

AGENCE FRANCE-PRESSE, REUTERS

New rules for Beauty

Everyone wants to look beautiful. Beauty comes with a price and now new rules.

I suppose that these rules are created to protect the consumers. I have personally underwent a few aesthetic treatments for my skin.

I have done chemical peels, micro-needling, sub-ablative laser etc

The doctors I went to are aesthetic doctors or doctors who practise aesthetic treatments full time. They dun do other forms of medical practices, in other words, they dun see patients for other ailments like cold, fever, flu etc.

I have known people who underwent aesthetic treatments under GPs who also has a family practice. Treatments are definitely cheaper, but the the quality of treatments is not really there. The doctors are always busy in between treatments, seeing other patients for other common ailments.

Obviously such GPs are in it for the money. A common medical consultation cost about $20 to $30 per patient per session. An aesthetic treatment cost anything from $100 for a single session of chemical peel to $300-$500 for IPL or laser treatments. Do your maths.

Frankly, the best aesthetic doctor I have seen is Dr Yeak. She was formerly from Raffles Medical Group. She is now with Singapore Aesthetic Center in Novena, #08-12. She is warm, very friendly and not pushy!

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The Straits Times
25 July 2008

Doctors face tighter rules on aesthetic treatments

Such procedures to be offered only as a last resort from Nov 1

By Jessica Jaganathan

THE days of the 'cowboy practice' are numbered. From Nov 1, doctors will have to get permission before they can offer a range of controversial aesthetic treatments.

The Singapore Medical Council's (SMC) newly established Aesthetic Practice Oversight Committee will decide who will be allowed to offer these treatments that are not backed by strong scientific evidence.

Promising weight loss and fairer skin among other results, they should be offered only as a last resort, after all conventional methods have been exhausted. No advertisements of these treatments are allowed too.

Doctors will be also have to get written consent from patients and record every detail of the treatment and the results, just as in a clinical trial for a new drug. This regime will apply to seven aesthetic treatments, including fat-busting mesotherapy, where drugs are injected into the body.

Aesthetic treatments have been the subject of much debate over the last three months, after the health authorities raised concerns about the number of doctors branching out into lucrative beauty treatments, some of which are banned in other countries.

Yesterday, details were released about how the profession plans to regulate some 30 aesthetic procedures, within a week of the Health Ministry coming out with stricter rules for liposuction.

Professor Ho Lai Yun from the Academy of Medicine said: 'At the moment, it's a cowboy type of practice.' With the guidelines, he added: 'Patients will know who they can go to, what are the procedures available to them, what they can expect...So, to a greater extent, they are protected.'

For instance, filler injections to plump up lips can be done by plastic surgeons and GPs in a clinic. More invasive procedures, like breast enhancement surgery, can only be done by a plastic surgeon in an operating theatre.

Although general practitioners are allowed to do most of the less invasive aesthetic procedures, they will need proper credentials - they must attend an accredited course recognised by SMC and attain a certificate of competence.

Doctors who flout these guidelines may be referred to the SMC for disciplinary hearing, where, depending on the case, they could be fined or even suspended.

The profession's watchdog is already investigating the aesthetic medicine practices of six doctors, including a specialist.

Madam Halimah Yacob, chairman of the Government Parliamentary Committee for Health, said the guidelines were a good start to enhance patient safety but cautioned that consumers may be driven to beauty salons instead. She said: 'These treatments if not done properly can lead to serious complications...it does not make sense to insist that only doctors be subject to these guidelines while beauty salons are free to operate without any rules even for invasive procedures.'

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The Straits Times
25 July 2008

AESTHETIC TREATMENTS CARRIED OUT BY GPs

New rules' impact merely skin-deep?

New guidelines still being debated but most GPs taking them in their stride

By Jessica Jaganathan

THERE is unlikely to be any major shake-up in the aesthetic treatment business because of the new rules released by the profession and the Ministry of Health (MOH), say doctors.

The guidelines covering about 30 aesthetic treatments give both the specialist and the general practitioner (GP) sufficient room to continue to make a living.

Some signboards will have to be changed, though - as doctors were reminded yesterday that they cannot refer to themselves as 'aesthetic' doctors or surgeons, as it is not a recognised specialty.

There will also be clear benefits for patients with the new guidelines. They can be confident that the doctor is properly trained to offer the treatment if it has been tried and tested. And if it is experimental, then the doctor will be watched closely and the results monitored as well, regardless of whether he is a specialist or a GP.

The two camps have, for the most part, been on opposite ends of the aesthetic treatment debate for the past three months.

Some plastic surgeons were portrayed as viewing regulation as a way to protect their turf, while GPs were said to prefer minimal oversight so that they could muscle in on the lucrative $200-million-a-year market.

With the new guidelines out yesterday, plastic surgeons are happy that most invasive treatments must be carried out in an operation theatre, a requirement which would effectively rule out GPs.

Dr Colin Tham, honorary secretary of the Singapore Association of Plastic Surgeons, welcomed the restriction on GPs doing invasive procedures, and said the impact of the new guidelines on plastic surgeons was minimal. He did speak up on behalf of GPs, questioning the need for a certificate of competence for GPs to perform some of the non-invasive procedures, describing the requirement as being 'over the top'.

But other plastic surgeons did caution that the institutions awarding the certificates should be scrutinised carefully.

GPs who have been offering some of the less scientifically proven treatments such as mesotherapy and carboxytherapy said they would have to study the clinical trial requirements closely before deciding if they will apply to offer these treatments after Nov 1, when the new guidelines kick in.

The Society of Aesthetic Medicine, which comprises mainly GPs, plans to write in to MOH to appeal against requiring seven 'controversial' treatments to be offered only as a clinical trial. The society's spokesman, Dr Benjamin Yim, a GP who has been offering endermologie for four years, said patients might be more sceptical of the treatment when told that it is experimental, and this might drive them away. Endermologie is a non-invasive technique for reducing the appearance of cellulite

As a clinical trial, doctors have to document in detail patient results and, usually, a large pool of patients is needed - typically about 200.

Associate Professor Goh Lee Gan, president of the College of Family Physicians, said the cumbersome process might discourage some doctors from doing them. 'Research will show us if the treatment is useful or not for the patients,' said Prof Goh.

However, Dr Roy Chio, a GP who offers endermologie and micro-needling, said there already exists evidence that these treatments work and they are well-documented in medical journals overseas.

A marketing executive, who wanted to be known only as Cynthia, said having proper guidelines now will make it easier for patients like her to know what is allowed and what is not. But the 26-year-old, who had micro-needling treatment about five months ago, said it had been effective in reducing her acne marks.

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Treatments that need clinical trials

Fat reduction

# Mesotherapy: A drug cocktail is injected into the skin. It is believed to melt fat.

# Carboxytherapy: A non-surgical procedure like mesotherapy, in which carbon dioxide is shot through a needle to 'kill' fat cells and stimulate blood flow.

# Mechanised massage: This is a non-invasive deep-tissue massage performed with a machine to reduce cellulite.

Skin treatments

# Microneedling dermaroller: This device uses a series of pins on a hand-held roller to make microscopic punctures in the skin. It supposedly encourages collagen to form and reduces scars and wrinkles.

# Stem-cell activator proteins: Patients consume a protein extract that 'regenerates ageing tissue' by using protein or chemical messengers to send signals to cells to 'teach' them to regenerate.

# Skin-whitening injections: These jabs are supposed to reduce blemishes such as acne and chicken pox scars and wrinkles.

Miscellaneous treatments

# Negative pressure procedures: In vacustyler sessions, for example, a patient's lower body is placed in a chamber where a machine stimulates the lymphatic system. This is believed to improve circulation in the lower body.

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THEATRE WORKS
With the new guidelines out yesterday, plastic surgeons are happy that most invasive treatments must be carried out in an operation theatre, a requirement which would effectively rule out GPs.

APPEAL PLAN
The Society of Aesthetic Medicine, which comprises mainly GPs, plans to write in to MOH to appeal against requiring seven 'controversial' treatments to be offered only as a clinical trial.

Skin patch to reduce paranoid

I did a double take as I read this news article. Is this real? Has medical technology advanced to such a state that only a skin patch is used to treat paranoid?

Maybe I should get one for my mother? She has been paranoid for years!

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The New Paper
25 July 2008

Skin patch helps reduce woman's affair paranoia

The Exelon Patch improves mental functions such as memory and thinking in Alzheimer's patients

By Ng Wan Ching

THE 80-year-old woman was severely paranoid that her husband was having an affair. So much so that her husband made sure all the caregivers in their household in Jakarta were men.

Paranoia can be a symptom of Alzheimer's disease, which was what she was suffering from. Her condition was progressively getting worse. It was also a challenge to get her to take her medicine - she was paranoid that people were poisoning her, so she refused all oral medication.

A few months ago, the elderly woman came to Singapore to see Dr Sitoh Yih Yiow, consultant geriatrician from Age-Link Specialist Clinic for Older Persons.

He prescribed a medicated patch (Exelon Patch), the only skin patch approved for the treatment of mild to moderately severe Alzheimer's dementia here. Dr Sitoh said: 'This mode of delivery of the medication helps both patient and caregiver by providing an easier way to manage their therapy.'

He told the woman's husband to put a patch on her lower back once a day. The drug on the patch is absorbed into her body through the skin. Two months later, when the doctor assessed her, she had improved a little. She was no longer as agitated and paranoid and was a little more amenable to being treated medically.

The patch that Dr Sitoh prescribed is the world's first skin patch to be used in treating Alzheimer's.

The medication (rivastigmine) is not new. It has been available in capsule and liquid formulations since 1997. It improves mental function (such as memory and thinking) by increasing the amount of a certain natural substance in the brain. It also improves the patient's ability to perform everyday activities.

It is the delivery method that is new. Researchers found that the once-daily skin patch provides smoother and more continuous delivery of the drug over a 24-hour period compared to pills. A study of 1,200 patients from 21 countries who were given the patch daily showed that the patch was as effective as the capsules. The study also showed that the side effects were three times less than those for the pills.

One in four patients reported the side effect of nausea with the pill, while one in 14 reported nausea with the patch. Other side effects include vomiting and diarrhoea.

There was also a study done with the caregivers. It showed that 70 per cent preferred the patch because of ease of use and an easy-to-follow schedule.

Dr Sitoh cited another patient who was a good candidate for the patch. The man, an 83-year-old Singaporean, suffers from Lewy Body disease, which is a cause of dementia very similar to Alzheimer's disease. He had difficulty swallowing. He also suffers from diabetes and high blood pressure. His family were resistant to having him take more medication.

'Earlier this year, I suggested the patch. He's now more alert,' Dr Sitoh said.

The patch was approved for use here by the Health Sciences Authority in April. Dr Sitoh has prescribed the patch to five patients. In Singapore, there are about 200 patients using it.

Dr Ang Guan Lee, medical head of Novartis (Singapore), manufacturers of the patch, said: 'The cost of similar drugs used to treat Alzheimer's disease here is between $210 and $280 a month.'

The patch will cost a patient about $250 a month.

What price Altruism?

The New Paper
23 July 2008

What price Altruism?

Should there be financial compensation for organ trading?

By Low Ching Ling

IT is an issue that has divided patients, their families, doctors, lawmakers, ethicists and just about anyone who feels strongly about it.

Supporters of legalising organ trading say it is a no-brainer: Why not do it if it can save more lives?

Please, get real, no one is going to give a stranger his or her kidney for free, they argue.

Critics decry organ trading as unethical. They insist donors should do it out of the goodness of their heart.

Which way should Singapore go?

But does it always have to be narrowed to a zero-sum game - either pure altruism or financial reward?

Perhaps not, Health Minister Khaw Boon Wan revealed in Parliament yesterday. He said he would sometimes get requests from charities and religious bodies who want to offer 'some compensation, in kind and in cash' to organ donors and their families to 'acknowledge their altruistic act'.

But the organisations would worry that their gestures might be seen as organ trading.

Mr Khaw said: 'My view is that we should encourage third parties, especially those from the charity and religious sector, to help promote altruistic organ donations, and that we should consider how they can be allowed to provide some financial compensation to the donors and their families after the transplants have taken place.'

Yes, push altruistic organ donations to their 'maximum potential', and let living-related kidney donations and those done under the Human Organ Transplant Act to still be the 'predominant sources' of kidney transplants.

But don't rule out organ trading, Mr Khaw added.

'If altruistic organ donations cannot fully meet the demand, we should continue to search for good complementary solutions,' he said.

'We should not reject any idea just because it is radical or controversial.'

Can legalising organ trading be the answer to our kidney donation woes?

Mr Khaw said: 'By forcing ourselves to think about unconventional approaches, we may be able to find an acceptable way to allow a meaningful compensation for some living-unrelated kidney donors, without breaching ethical principles and hurting the sensitivities of others.'

And perhaps it is time we get real, he said. After all, there are desperate patients out there who want to live, and also desperately poor people willing to exchange a kidney for a better life. 'This is the reality and the human dilemma confronted by many in such desperate situations,' Mr Khaw said.

'Criminalising organ trading does not eliminate it. But it merely breeds a black market with the middle man creaming off the bulk of the compensation which the grateful patient is willing to offer the donor.'

WHAT PRICE ALTRUISM?

So, will putting a price on altruism work in Singapore?

It may still take some time before the Government reaches a decision. For now, the Health Ministry will push to amend some other existing laws on organ transplants.

First, by removing the age limit of 60 years old on cadaveric donors.

Mr Khaw said: 'Many countries, including Spain, do not set such an age limit. The suitability of the organ depends on its condition, rather than the age of the donor.'

Second, by allowing pair-matched donations here.

This means that if patient A's donor does not match A and patient B's donor does not match B, they can switch donors if there is a match that way. A live donor registry will be set up to facilitate this.

With the two initiatives, Singapore can aim to raise its kidney sufficiency level from 50 to 70 per cent in the medium term.

What about those who have broken the law?

Mr Khaw said: 'Even as we take action against those involved in illicit organ trading and unscrupulously exploiting the desperate and the vulnerable, we will take a sympathetic approach to the plight of the exploited donors and the basic instinct of kidney failure patients to try to live.'

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The New Paper
23 July 2008

Want fairness? Let kidney bank handle it

By Ng Wan Ching

THROWING money at donors is not the solution to the kidney shortage facing kidney failure patients here. If it is, then those who need money the most will be the first to give. And those who have the most money will be the first to get.

That situation, as so many have pointed out, will exploit the poorest among us and it will favour the richest. The amount of money given, directly or indirectly, to the donor, will influence who might donate a kidney.

At $20,000 to $50,000 a kidney, perhaps the lowest earning segment of society will feel compelled to give.

For up to $300,000, perhaps the next higher segment of society will feel the push.

For up to $500,000, perhaps even well-heeled professionals might be induced to donate.

The amount has to be carefully calibrated so as to be meaningful and yet not glaringly so that it becomes a rare consumer item.

Idealistic as this sounds, there should still be room for altruism, albeit not so pure. (None of this prevents those who want to give for nothing in return.)

So how can the sums paid to donors be regulated?

The money could come from a common pool managed by a governing body rather than individuals paying for their donor organ in a free market. On top of managing the money, the governing body overseeing the kidney bank will have to come up with policies that address various issues.

Such as, what will happen to their family members if they happen to need a kidney in the future? Once someone has given up one of their kidneys, they won't be able to help their loved ones in their time of need.

One solution is to put kidney donors' family members at the top of the transplant list if they do need a transplant. And while money might encourage more people to give, there will still be those who baulk because of health considerations.

Many US hospitals say donation does not increase a donor's risk for kidney failure or put him at more risk for future health complications.

But the 'what if's' linger.

Studies have been done to show that donors are at no more increased risk of heart attacks. Further study is needed to determine whether the apparent increase in the risk of high blood pressure is truly an effect of living kidney donation.

The long-term monitoring of donors' health calls for more research.

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The New Paper
23 July 2008

Allow organ trading, says Noble Prize laureate

Attitudes towards compensating kidney donors are changing. Health Minister Khaw Boon Wan spoke about a recent article by Dr Gary Becker, of the Hoover Institution, who won the 1992 Nobel Prize in Economics.

In an article titled 'Should the purchase and sale of organs for transplant surgery be permitted?', Dr Becker used economic principles to argue for organ trading. Here are some excerpts.

AN ECONOMIST'S PERSPECTIVE

'To an economist, the major reason for the imbalance between demand and supply of organs is that the US and practically all other countries forbid the purchase and sale of organs.'

WON'T REDUCE NUMBER OF DONORS

'Some critics simply dismiss organ markets as immoral 'commodification' of body parts. More thoughtful critics suggest that allowing organs to be bought and sold might actually reduce the total number of organs available for transplants because they claim it would sufficiently lower the number of organs donated from altruistic motives to dominate the increase due to those sold commercially.

'That scenario, however, is extremely unlikely since presently only a small fraction of potentially useable organs are available for transplants.'

LIMITS TO OPT-OUT SYSTEM

'A PhD thesis in progress by Sebastien Gay at Chicago shows that opt-out systems may yield somewhat more organs for transplants than the opt-in systems used by the US and many other nations, but they do not eliminate the long queues for transplants.'

CHARITY NOT ENOUGH

'If altruism were sufficiently powerful, the supply of organs would be large enough to satisfy demand, and there would be no need to change the present system.'

EQUILIBRIUM PRICE

'In a paper on the potential of markets for live organ donations, Julio Elias of the University of Buffalo and I estimate that the going price for live transplants would be about US$15,000 ($20,280) for kidneys and about US$35,000 for livers.'

Current costs for transplants in the US are in the range of US$100,000 for kidney and US$175,000 for liver.

POOR NOT EXPLOITED

'... why would poor donors be better off if this option (of selling their organs) was taken away from them?

'... Many of the organs used for liver or kidney transplants are still likely to be supplied by relatives. In addition, many middle class persons would be willing to have their organs sold after they died if the proceeds went to children, parents, and other relatives.'

DETERRING IMPULSIVE SELLERS LOOKING FOR SHORT-TERM GAIN

'(We can have) a month or longer cooling-off waiting period between the time someone agrees to supply an organ and the time it can be used.

'They would be allowed to change their mind during the interim.'

The morning after

The Straits Times
13 July 2008

The 'morning after' HIV drug cocktail

It may keep virus at bay if taken in time but does not always work

By Braema Mathi

The 30-year-old businessman was on a working trip in Bangkok. He visited a male prostitute on his last night in the city. Against his better judgment, they had unprotected sex. But the next morning, he was seized by panic with the sudden realisation he might have exposed himself to HIV - the retrovirus that can lead to Aids.

Upon landing in Singapore that afternoon, he headed straight for the Department of Sexually Transmitted Infections Control (DSC). Not only did he get an Aids test, but he also asked to be prescribed post-exposure prophylaxis (PEP).

He had read that the cocktail of antiretroviral drugs with Zidovudine works like a 'morning after' HIV prevention course and may keep the virus at bay. He paid a hefty $1,230 for a 28-day course of PEP, put up with the side effects, including severe diarrhoea, and saw the doctor weekly. He breathed a sigh of relief when another HIV test three months later pronounced him clean.

PEP was first administered in 1998 to health-care staff working with HIV patients in San Francisco, who risked infection from needlestick injuries. It was also used for health-care workers in Singapore around the same time.

Dr Tan Hiok Hee, head of the DSC clinic and senior consultant at the National Skin Centre, told The Sunday Times that the centre made PEP available to the public in 2004. It can also be prescribed by doctors in private practice here.

Since then, Dr Tan has treated 22 people with the drug cocktail. Dr Lin Li from the Communicable Diseases Centre has treated three. The patients - educated, mostly professionals and all males save one - sought treatment after unsafe sex. All tested negative after completing their treatments although it is not known if their sex partners were HIV positive in the first place.

Doctors interviewed by The Sunday Times took great pains to emphasise that PEP does not always work and cannot replace safe-sex practices. 'Studies have shown that PEP is not 100 per cent foolproof against HIV. Its efficacy is around 81 per cent,' said Dr Tan. There have also been reported studies, he added, of at least 20 health-care workers overseas succumbing to HIV despite being treated with PEP.

Dr Lin explained that upon exposure, it takes less than two hours for the HIV virus to start coursing through the body of a person or to lodge itself in the cells. She said the cocktail is best taken as early as possible - not beyond the window period of 72 hours after exposure to the virus.

Only then is there a chance that the drug cocktail can 'wipe out the HIV from the blood, not allowing it to infect another cell even if the first one in which it is lodged dies''. 'It is a race against time - PEP versus the virus - to see which gets into the blood stream first,' added Dr Lin.

'Once the HIV gets established in the brain, the lymph nodes or the testes, it has found its sanctuary in the human body and drugs will find it harder to reach the virus.'' Dr Tan noted that PEP comes with a price - side effects, costs and clinical management. Patients often experience nausea, diarrhoea, anorexia, rash, hair loss, headaches, insomnia and pigmentation on nails. They also need consultations and tests at intervals of between three and six months.

This is important as PEP can, in the course of 28 days, suppress the formation of antibodies to the HIV, reflecting a negative result. A positive HIV result is achieved through the presence of antibodies in the blood. Also, an all-clear does not mean that the person is free of HIV. The virus can remain in the body without converting cells into infected ones.

Dr Tan said it is important to complete the PEP regimen and not forgo it after the initial HIV tests come back negative. 'Taking PEP will also involve loss of days at work to cope with the side effects and consultations.

Then there is the constant anxiety. It is better any day to wear a condom, be safe, than to go through this.' Still PEP, combined with other drugs, has been useful in preventing mother-to-child transmission of the HIV virus, as well as protecting victims of sexual assaults.

Rape victims often end up with lacerations on the anal and vaginal walls, leaving them more vulnerable to HIV and other sexually transmitted diseases. In Singapore, emergency department doctors will prescribe PEP to rape victims if necessary.

Doctors and Aids workers said that the drug cocktail is not a substitute for ABC, the cardinal rules of safe sex: abstain, be faithful to partners, and use condoms. Counselling and education are also important.

Dr Lin said: 'As human beings, we always like to think that it will not happen to us. That is why people still take the risk.' Indeed, the number of reported HIV/Aids cases in Singapore has been rising - from 0.8 cases per million in 1985 to 98.9 infections per million in 2006. The main mode of transmission is sexual contact.

There were 422 new HIV infections last year, the highest number in a single year since records started in 1985. As of the end of last year, 3,482 persons in Singapore had contracted HIV/Aids, of whom 1,144 died. Said Dr Tan: 'PEP is not a panacea given by doctors. The drug plays a small role.

What is more important is for people to choose their partners carefully, be faithful and/or practise safe sex.'

My nose guy??

I am planning to get a nose job later this year. The plastic surgeon at the top of my list is Dr Hong. Now I am also considering Dr JJ Chua. His name has been coming up in the media as one of THE plastic surgeons to go to.

I dun know how true his claims are, that he has done a lot of celebrities' surgeries. But there are few rare reviews of him online by people in the street. Maybe they are too poor to be his clients?

His website is virtually blank and I heard he charge rather high prices.

http://www.jjchua.com/

One factor for consideration for me is not the skills of the surgeon but also where the clinic is located. Dr Chua 's clinic is in Orchard. I dun drive, and taking cabs there back can be a problem. Especially when the nose is bandaged and raw.

Hmmm......still under consideration. Maybe I should email him for a quotation and if his fees are beyond my price range, I should seek other just as qualified surgeons.

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The New Paper
07 July 2008

Meet Caldecott's NIP TUCK guy

Doc claims to be the plastic surgeon local celebs seek out. But he's not saying who has had what done

By Jeanmarie Tan

HE claims to have done plastic surgery on a number of celebrities in Singapore. And no, his name isn't Woffles Wu or Martin Huang. He is Dr J J Chua.

The plastic surgeon runs his private practice, the JJ Chua Rejuvenative Cosmetic & Laser Surgery, at Mount Elizabeth Hospital. He is also the consultant on a new TV serial about plastic surgery.

Dr Chua claims to have 'enhanced' several MediaCorp stars. And that doesn't include other local showbiz denizens like models, beauty queens, deejays, singers, comperes, fashion designers and stylists, as well as artistes who have retired or resigned from MediaCorp.

Some of them have even become good friends, said the chatty 42-year-old, who has 10 years' experience in the aesthetics field. He estimates that about half of local showbiz celebrities have undergone cosmetic enhancements.

BOLD CLAIM

On his bold claim that he's the go-to guy for most of the Channel 8 and Channel U crowd seeking a little nip and tuck, Dr Chua said: 'I cannot verify in numbers (and compare with other plastic surgeons) because patients' identities are confidential, but I know I've done a lot. 'Because if you talk about common obvious surgeries like breast enlargement, and say the industry talks about five celebs out there who've done it, they all happen to be my patients!'

Of course, he can't reveal names. Dr Wu and Dr Huang, who have worked on their fair share of foreign and local celebs, declined to comment on the veracity of Dr Chua's claims. Dr Huang said: 'I prefer not to comment on celebrity patients as these patients greatly value their privacy and confidentiality and I feel that it is important to respect and protect that.'

According to Dr Chua, the common procedures he performs on his famous female clients range from non-invasive ones like botox, fillers and lasers to nose jobs, lip plumping, double eyelids, breast enlargement and liposuction.

The men also undergo operations, including Thermage skin tightening and chest reduction. Dr Chua lives in a condominium penthouse in the eastern part of Singapore and drives a dark grey Lexus SC430:

Contrary to popular opinion, DrChua reveals that most of his celebrity patients are 'not shy' and walk into his clinic 'tall, loud and proud'. 'But a few are still very scared, kancheong (Hokkien for panicky) and worried, so they'll wear sunglasses and caps and make sure nobody notices them. Or they want to avoid the crowds and so I will open at special hours to accommodate them.' But when Dr Chua meets his clients outside of the office, it's a different story. He recalled how he has attended several events where familiar faces would be present, but both parties would avoid the other. 'Or sometimes we'd walk past and recognise each other and just smile. It feels weird, but I don't go up to them unless they come up to me first.'

Still, Dr Chua - whose hobbies include 'things to do with my hands' like drawing, painting and sculpting - says he enjoys working with celebs because they are 'not difficult or picky, are friendly, honest, no-holds-barred and don't complain'. 'They know exactly what they want and have a good knowledge of the treatments so I don't bullsh*t them. 'And I know artistes don't make as much money as people think, so I give them discounts and special care.'

The major downside is the time constraints and hectic schedules that artistes work under. The second eldest of four children who hails from a poor family, Dr Chua is an old boy of Raffles Institution and Raffles Junior College. He earned his MBBS from the National University of Singapore before getting his fellowship from the Royal College of Surgeons at Edinburgh and Glasgow.

In 2000, he trained in laser surgery and face reconstruction at Taipei's Chang Gung Memorial Hospital. A year later, he did his cosmetic surgery training at London's Wellington Hospital. In 2002, he returned to Singapore and became head of cosmetic surgery at Singapore General Hospital's department of plastic surgery. He opened his own practice in 2004.

An actress in her early 30s told The New Paper on Sunday that she knows 'many people from the entertainment industry' who go to Dr Chua for cosmetic help because he's effectively bilingual 'and not every plastic surgeon is'. She added: 'It helps that he's very friendly and approachable too.'

Other actresses we spoke to added that MediaCorp hairstylists recommend him to the artistes because he's 'good at what he does' and he's 'one of the few qualified plastic surgeons in Singapore'.

A deejay-turned-compere in his mid-30s speculated that Dr Chua's profile was raised after he appeared on the popular Channel U talk show Shoot in 2006, as a guest. He said: 'After the episode aired, quite a few celebs, especially the younger batch, wanted to get in touch with him. And then it was just one after another.'

Crazy Sexy Cancer

Saw this on Oprah also. Well, it is a film, book and blog about cancer, celebration of life and death. A life style and attitude revolved around living with cancer and death.



http://www.crazysexycancer.com/

http://crazysexycancer.blogspot.com/

Dying Professor last lecture

Saw this on Oprah. Did a search and posted the video of the lecture.

Carnegie Mellon Professor Randy Pausch, who is dying from pancreatic cancer, gave his last lecture at the university Sept. 18, 2007. The topic is "Achieving Your Childhood Dreams".

The lecture is interesting, humorous, peppered with his personal life stories and photos, and yet it is also sad and teary.

And yes, he is still alive and his recent updates is at http://download.srv.cs.cmu.edu/~pausch/news/

4 min lecture


There is a longer 76 min version of the lecture. I could not embed that video cos it's size is too big and crashes this blog.
http://www.youtube.com/watch?v=ji5_MqicxSo&watch_response

Eye for an eye

Would you buy a Kidney? Would you sell your kidney?

To be continued

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The New Paper
30 June 2008

KIDNEY QUESTION: ALLOW SALE, OR... ...BAN SALE?

Aussie doc: SELL ORGANS TO GOVT, SAVE LIVES

IT is the first case of its kind in Singapore, where two Indonesian men have pleaded guilty to organ trading. And it throws open the door for debate again, on the issue of legalising organ trading.

Organ trading is banned in Singapore for a variety of reasons, including ethical ones. But some have argued that lifting such bans could save lives. Last month, an Australian kidney specialist sparked national debate by suggesting the government should pay up to A$50,000 ($65,450) for kidney donations to overcome a chronic shortage.

Dr Gavin Carney said eliminating a law that prohibits the selling of organs would save thousands of lives and billions of dollars (euros) in care for patients on organ waiting lists. He also said it would stop people from going to Third World countries and paying for black-market organs and risky, unregulated surgeries.

FEW DONORS Australia has one of the lowest rates of organ donation in the developed world, about 10 donors per 1 million people, according to a federal health task force. 'We've tried everything to drum up support for organ donation and the rates have not risen in 10 years,' Dr Carney was quoted as saying in Fairfax newspapers. 'People just don't seem to be willing to give their organs away for free... 'Let's pay people some money for a new car or a house deposit and those waiting lists will be halved within about five years.'

Dr Carney, a professor at the Australian National University, could not immediately be reached by The Associated Press. Dr Carney's proposal was immediately criticised by transplant groups, who fear it would exploit poor people.

QUASHED

The idea was quashed by Health Minister Nicola Roxon, who said Australians would not be allowed to market their organs. 'But we do know that we need urgent action in this area of organ donation,' Ms Roxon told Australia Broadcasting Corp. radio. Rather than paying people for organs, Ms Roxon said her ministry would act on some of the recommendations of a federal task force that recently completed a review of the organ donation system.

The task force attributed Australia's low organ donor rate to a decrease in road accidents and strokes, lack of public awareness, and poor identification of donors in hospitals, among other factors. In comparison, Germany has 15 donors per 1million people, the Netherlands has25, the United States has 27, and Spain has 35, it said.

Selling or buying organs is illegal in Australia, as in most countries, and carries a penalty of six months in jail and a fine of up to A$4,400. More than 1,800 people are waiting for kidney transplants in the country but only 343 kidneys were donated last year, Fairfax reported. Transplant Australia said the average wait for a kidney transplant is four years.

Transplant Australia chief executive Chris Thomas said his organization rejects paying for organs and instead is working with the government to change the donation system. He said Dr Carney's proposal would leave poor people vulnerable. 'It really focuses on the poor and people who are least able to pay for things in society. They get attracted to these types of things,' he told ABC Radio. 'We'd reject that.' Kidney Health Australia also rejected Dr Carney's proposal, saying it would be open to 'many ethical issues and abuse.' - AP

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The New Paper
30 June 2008

TIME FOR S'PORE TO RETHINK ISSUE

By Ng Wan Ching

WOULD I pay for a kidney if I were dying, there were no donor kidneys available and there was a willing seller?

At this point in my life, I want to see my children grow up. And I want to live this sweet life a little longer. So my answer would be yes, with certain caveats.

First, the seller must be informed of the risks of the procedure and be educated on what it means to be a kidney donor. He must undergo careful medical and psychological evaluation and receive follow-up care. That said, the reality is still that such a course is illegal here. But might we not examine the feasibility of a kidney market?

The way the Iranian government does it is to provide a fixed compensation to the seller of about $1,500 as well as limited health insurance coverage. Second, he also receives separate remuneration either from the recipient or, if the recipient is poor, from a designated charitable organisation; this amount is usually between $3,000 and $6,000. In Iran, there is no longer a queue for donor kidneys.

One idea, which has been mooted elsewhere, is to take the money spent to provide dialysis and use it to fund programmes aimed at helping lower-income people buy kidneys. The rich will be able to take care of themselves.

It was reported last December that Singapore's National Kidney Foundation had spent $17.5 million on dialysis and kidney failure prevention services for about 2,000 kidney patients in 18 months. If this money were used to set up a kidney bank, which would buy kidneys, at $20,000 a kidney, 875patients every 18 months would be freed from the need for dialysis. Over time, the numbers would get better, as kidney patients here wait an average of seven years before they get a donor kidney.

What about the risk of surgery to the donor? Doctors I spoke to said that the most significant risks were those associated with anaesthesia and surgery which, at 0.03 per cent mortality, was comparable to any other operation. Long-term risks are also low. A 1997 study from Norway that followed 1,332 kidney donors for an average of 32 years found no difference in mortality rates between kidney donors and the general population.

A 25-year follow-up of 70donors conducted by the Cleveland Clinic found that the renal function is 'well-preserved' and that the overall incidence of hypertension was comparable to that of non-donors.

EXPLOITATION

But the potential for exploiting donors - especially low-income ones - is always there, for they will be the ones most likely to find monetary incentives attractive. Protecting them is of utmost importance. That is why any plan for compensation should be regulated by the government.

Legal scholar Richard Epstein puts it in his own special way (The Wall Street Journal, May 2006): 'Only a bioethicist could prefer a world in which we have 1,000altruists per annum and over 6,500 excess deaths over one in which we have no altruists and no excess deaths.'

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The New Paper
30 June 2008

Health Minister: It won't be legal any time soon because...

UNDER the Human Organ Transplant Act (Hota) here, it is a criminal offence for any person to 'enter into a contract or arrangement under which a person agrees, for valuable consideration, to the sale or supply of any organ or blood'.

The penalties are a jail term of up to a year, or a fine of up to $10,000, or both. Health Minister Khaw Boon Wan has said that there was no possibility of legalising organ trading any time soon. He has argued that such a move raises difficult ethical problems, and would also encourage the wrong types of people to become donors, such as the poor.

It is also an idea that many here and elsewhere find 'degrading' and 'repulsive', he was reported to have said last year. Efforts to increase the supply of organs for transplant should focus on greater public education instead.

Mr Khaw noted that countries which have tried organ trading attracted the 'wrong' type of donors - drug addicts, for example. Apart from the moral issues, ophthalmologist Lam Pin Min, now deputy chairman of the Government Parliamentary Committee for Health, also pointed out the medical risks to donors in a report last year.

Kidney donors face less than 0.1per cent risk of death, but it is more dangerous for liver donors who have a 1-3 per cent chance of dying and a 25per cent chance of problems from surgery.

There has been one kidney donor-death in Singapore. A woman who donated her kidney to her husband died shortly after the surgery in 2005. The cause of her death is still not known.

Going numb and blind

Today I had two scheduled medical tests at AH. I had complained to the doctor on my previous visit 2 weeks back that my last three little fingers on my left hand were numb. I also told her about the grey black spots that appeared in my vision under bright sunlight.

We arrived bright and early at AH's Clinical Measurement Unit for my nerve tests. There were a few people sitting around waiting their turn. I had arrived earlier than my scheduled appointment and was surprised that when the actual appointment time came, I was shown into a room punctually.

I was greeted by this rather petite lady, whom I later found out to be a medical technologist. Her duties was to perform a series of electrode tests on all my fingers on both my hands to test their nerve functions.

The technologist was quite friendly but eh...there was a certain smell about her. At first, I thought she had body odour, but then later, I realised the smell was coming from her shirt. It was a sourish sweat smell, which took me a while to get used to.

Frankly, I did considered telling her about the smell but I did not cos I really dun know her and she might constitute such frankness as rudeness. Besides, she might feel embarrassed and that could maybe spoilt her day.

If it was someone I know, yeah, I would tell them about their sweat smell or BO or certain smell, so that they could take note and do something about it.

I remembered when I was working as a temp many years back. There was this young girl in the accounts department who had really bad BO. I really hated entering the accounts room cos the room reeked of her sour BO. I asked around why no one told her and how they could have worked in such an environment. The accounts people said that they were used to it and they thought it was rude to tell her she got BO. So no one did. They just held their breath until they got used to it. That was so kind and yet so stupid!

People with BO could not smell their own foul smell. Someone need to tell them so that they are aware of their problem and do something about it. If I have BO, I want to know, so I can do whatever to treat it. So yeah, I will tell most people tactfully, unless I think they cannot handle knowing. Maybe then, I would drop heavy hints.

I am digressing. Anyway, the nerve test took about 3o mins. The medical technologists attached electrodes to each finger and test the nerve reactions as she ran a minor electrical current through them.

I asked her if the results were normal. She said most of my fingers nerves were normal except for the last 2-3 fingers on my left hand. She repeated certain tests on those fingers to verify her results. She told me she could not give me a detailed report. She would submit her findings and her superior would generate a report, which a doctor would explain to me on my next medical appointment.

-----------------------------------

My next appointment was at the Ophthalmology and visual science clinic for my eye test. This clinic was crowded and most of the patients were old folks in their 50s. I felt out of place. Had my eye condition gone so bad that it is similar to those of senior citizens? Am I going blind?

After registering and waiting for 15 mins or so, they called my name for an eye test. There I was lead to a darkened room, where a nurse checked my eye sight. There was a series of rows of numbers a certain distance away, and she made me read certain rows to check my eye sight. She checked the right eye first and then the left eye. And then she repeat the test with this dotted glasses. With the dotted glass, some of the rows which I could not read initially, I could see. I ought to get myself a pair of these glasses, which I know is available in some pharmacy.

Then she led me to this eye examine machine where she asked me to look into. The inner of the machine was this bright photographic picture of a long straight road with blue skies on both sides of the road. She then told me she is going to spray something into my eyes and asked me to focus looking into the machine.

After the eye test was completed, I was next asked to wait outside for a eye doctor.

After waiting for what seemed to be ages, a young doctor came out of his room to call my name.
He introduced himself as Dr EC and sat me down. Dr EC was this stocky hairy fellow with short hair and bouncy butt. His voice was rather high pitch whiny tone but not feminine.

He then started to ask me a series of questions like when i noticed the dark spots in my vision, if I had any eye trauma or fall or whatever etc. Then he asked me to stare and focus into his machine lenses as he examined my eyes. He directed me to look right, look left and look straight.

Frankly, it has been a long time since another man except SO stared so intently into my eyes.
Gosh, he must be staring for more than 15 mins.

Maybe cos due to his age....late 20s?, I dun really think he was that experienced. Frankly, I wondered if he found the real cause about my eye condition? All he could said was it did not seemed to be retina detachment. And these dark spots also sometimes known as floaters and flashers are signs of aging. He said that people just have to live with it cos it is not something that can be treated with medication, eye drops or surgery.

Sigh...I was a bit depressed on hearing this. I had read up all on floaters and flashes before this, but this verbal confirmation of my eyes made me realised that my eyes are failing. I always had perfect eyesight. While a lot of my classmates were struggling with glasses, I have always been glasses free and now I am young and my vision are showing these signs of aging. By a certain age, I would probably go blind!

While checking my eye sight, our thighs and knees were pressed against each other. And yeah, as I told SO later (who called me a slut!, that bitch), it has has a long time since I pressed my knees against another man's thighs or had my thighs pressed against by someone's knee.

Gosh, I sounded so desperate and deprived. Ha! It was a certain intimate moment that was mostly corny and very awkward.

Anyway, Dr EC told me to wait a while and that he would get a senior doctor to confirm his diagnosis. Sigh...that shows that he is as inexperienced as I thought he was.

The senior doctor, Dr S arrived and directed me to look into the lens of the machine as he examined my eyes. He was quick in his diagnosis. He was able to detect in less than 5 mins that I have floaters and that I also have the beginning of cataracts in my left eye. He explained that that would account for the bright flashes as I watched TV.

This was something that the young Dr EC could not detect despite staring at my eyeballs for ages. Anyway, Dr EC told me that I have to check into the hospital immediately should my vision worsen drastically in a short time. He gave me a follow up appointment in one month time.

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Frankly, eye sight is the most important to me. I would rather go deaf or mute than be blind. I got this great fear of darkness. I would rather die than live a life in darkness. I can survive without hearing, without speaking but seriously I dun think I can function without seeing.

Let's see how this goes in one month time.

Turning yellow

Fingers still numb!

My fingers are still numb. The numbing sensation is less and I am also getting quite used to it.
The first two days were the worst. I was so conscious of the numbness that my fingers felt so uncomfortable.

Now, they are still numb but I can block out some of the feeling. They are constantly numb, not numb in flashes. Could the fever burn out some nerves to cause such numbness? Are they temporary, semi-permanent or permanent?

Frankly, before they were numb, I was not so conscious of my fingers. They were my fingers and just there. Now the tingling numbing sensation is a constant reminder of the existence of my fingers.

SO wanted to bring me to the doctor nearby. But what can they do? Do they have the necessary equipment to run tests or would they just refer me to the hospital or specialist? I refused to go. I told SO I would rather wait for my medical appointment at AH on 24th May.

This AH medical appointment is my regular medical appointments which I have been doing for years. Every three months, I had a series of blood tests to test my uric acid, blood pressure, blood sugar, cholesterols, liver and kidney functions. And each session, I paid about less than $100 for blood test and medication. And if I have additional medical problem, I just have to tell the doctor and they would referred me to a specialist within their hospital clinics. Just like the time, I had bloody stools and was referred to a doctor who checked my colon and gave me a colonscopy. He found out I had piles and I had a minor day surgery to cut off my those protruding blood vessels.

SO agreed reluctantly but wanted me to go see a doctor or hospital, should the numbing spreads or become worse.

Fingers Numb!

I had just recovered from my high fever over the weekend and was watching TV last night when I realised that my three last fingers on the left hand going numb. There was a sharp tingling and numbing sensation. Frankly, I thought I was having a heart attack or having a stroke. I really thought that my fever yesterday had triggered a stroke.

SO was sleeping as usual but I did not wake him, though I was close to panicking. But rather than checking in the hospital and staging a false alarm, I surfed the net and googled for numb fingers. I was not having any heart palpitations, nor was i having difficulty breathing just that my fingers were numb.

I found out online that for a stroke to happen, your left side would be totally numb, that means including the whole arm, and maybe the face. Since my was only 3 fingers, the cause could be neurological caused by the high fever, or pinched nerve or carpal tunnel syndrome.

Such conditions are quite common and reading these lessen my fears to a great extent.

I did told SO the condition as I was preparing for bed. He told me that if the numbness persisted longer, he would accompanied me to a doctor the next day.