How would you feel?

If you get this elderly dude who comments that Asians doesn't have good pronouciations everytime when they talk.

If he just kept on asking you questions despite the fact you said you had the mask on/raising your voice/speaking in a loud and clear tone , and yet he still claimed he can't hear anything from you.

If he growls at you saying that you got a sense of arrogant because you told him that you would talk after the treatment and taking off the mask of course.

Fug you old man. Now I am glad to pass him over to my 'beloved' boss for his next visit.

Back from Adelaide -Part 2

The conference had an early kick start at 8am. At the end of the conference, we were given feedback forms. Besides given the opportunity to rate the talks by different guest speakers, I've also indicated that the chairs provided should be at least be more comfortable for our butt especially it's a full 2 day thingy. At the end of the day, my butt ached more than anything. The organiser may consider to bring in those chairs like the ones in Chinese resturant. In addition, I can't believe the biscults were all snapped up within seconds at the tea time. Poor me only managed to grab two. Well, it's better than nothing.

7.55am

I get to tour around wine centre where the conference is held.

Quite interesting set up that you are able to press the button to smell the shiraz, chardonnay, savignon..etc

so many bottles of wine....

Wine tasting tours + bar (i wanted to drink but no one drink with me ;(

Walking out of wine centre

I met up with J - the German babe who is currently touring Australia by herself. We went pub crawling from having Hahn's light beer to Stella Artois to Vodka cruiser. We both love shopping and she even offered to pay for my coffee earlier on coz she felt bad to make me wait for awhile.

I look forward to many travels in Oz this year such as Lord Howe Island, Darwin, Alice Springs.

So many places, so little time.

Back from Adelaide - Part 1

I've just attended a wonderful diabetic foot conference in Adelaide. Now I feel those 'stuffs' I've learnt from uni gradually 'reflux' back into my brain. heh heh.
The conference was well organized with a variety of guest speakers such as endocrinologists/vascular/orthopaedic surgeons/ radiologist/ staff scientist- who actually provide an excellent insight on hyperbaric (concentrate oxygen) treatment.
See, it's not fun getting diabetes as it is often regarded as a systemic disease. You do not get diabetes from eating too much sugary food. What happens is your pancreas (behind your stomach) is not able to produce enough insulin -which is needed to control your blood sugar level. SO, when the insulin level is reduced, people will get high blood sugar level.
Most of the time, diabetes is associated with lack of sensation (neuropathy) on the sole of feet and thus, leading to unknown cuts/ulcers that result without patients' knowing. Neuropathy doesn't give out any signal and it can happen any time any day. The only way to keep your feet alive is to have good prevent measures (for instance, check your feet 2 times daily so that nothing get caught underneath the feet..etc).
However, patients with painful neuropathy (eg, painful when touched and worst with ulcers) complicates their quality of life. There are many suggestions of why patients do feel a lot pain on their feet (eg, anatomical variations /abnormal nerves dennervations?). This symptom can be controlled using such as anti-depressants, tricyclic drugs that can produce some awful side effects.
Diabetes is often linked with the word 'amputation'. In reality, amputation is the last resort to keeping the patient 'alive' rather than putting up with gangrenous limbs or sepsis.
How much the bone (orthopadic) surgeon would need to chop the foot/leg depending on the blood flow to the lower extremities. That's where the vascular surgeon would come in and assess. And ooo yeah, they are the people who do strip off the veins for varicosities sufferers too.
Diabetes requires multidisciplinary management- drs, diabetic nurse educatiors, dieticians, optometrist, physiotherapist..etc.
If you do have diabetes, make sure you have adequate follow up with your docs, watch what you eat on your diet, exercise, and lastly, maintain a positive outlook of the disease.

* this blog has been written in its simplest form so that non-med readers will have a better understanding of what diabetes is in general. The blogger will not be responsible for any medical advice/notes as stated here.
Bye Adelaide!Had so much fun with the Fringe festival going on at the same time! This is my 2nd visit and I've met quite a nice German girl whom I hang out on my last day there. That will be my part 2 of blog.I took this pic at the Adelaide airport. I wish I will be sitting in that flight instead of Virgin Blue back to Sydney..I miss home lorrr....

Say 'Cheesecake'

I've decided to spend my Sunday making this one and only cheesecake which I would only eat from Trobolone chocolate.
Since I've got no grinder and mixer, I have to breakdown those biscults for crust base -manually -_-.Followed by the 'rubbing in' method using low salt butter, bring the crust to chill 10mins in the freezer. On the other hand, mix well with Philadelphia (less fat ones) cheese , melted trobolone chocolates, sugar and bit of hot water to a creamy texture. Pour the cream to the top of the chilled crust and put it back into the fridge overnight.
*puff*
Just in time for dessert after dinner.

Preparation shot ..heh heh

Getting the crust ready to be chuck into the freezer

Ready to be set overnight

My Aussie gf came over to pick up the cheesecakes which she is gonna share with her hubby. I've invited Dentist Rachel over to my place so that I can let her taste some of my 'FA BU LOUS' sweets. Sorry dar, I'm sure you're able to churn off the calories faster than I expected.Just start taking Magic (dog) for more walkies ;p

SHE is a beech

She is the mother of two who presented with this massive chronic ingrown nail for several MONTHS. Seen a GP sometime ago and only told to apply some antiseptic cream.For the past few weeks, the problem has worsened with inflammation, swelling, redness, pus bits...heh.
The bottomline is mom is into alternative medicine. She is totally against the use of any medications. So in order to have a nail surgery done, my colleague have suggested to have a pre dose of meds to settle down the inflammation first. Subsequently, a post operative dose for follow up.
Pt even threatened that if after the post op dose of med and yet she has suffered from infection, who will be liable for that.
Gosh, she sounds as if she wants the practitioner to pledge that she will be infection free after operation.
She is truly a freak.
She went on slamming against my colleague that she is abusing the medication (ABs) and went on rattling about her having poor understanding of alternative medicine.
As my mate tried to explain the necessity of the meds, she (patient) rebuke that she felt as though like an idoit listening to her explainations.
Here my dear colleague is trying to provide all necessary information and yet if she is so against it , I wonder why SHE should be in the clinic for a start.
What she expect was to have the surgery done and that's it.
No medications/drugs involved.

Maybe my mate should omit the use of anasthetic and just tear off her toenail.

Exchange program

Got to the hospital early in the morning. Saw an email stuck to the board.
It is a local hospital from UK seeking for 1 or 2 staffs on an exchange program. Woohoo! So I've applied for it. If I'm being selected for it, I'll be off in September for a couple of weeks. Si beh exciting.
That's what I called happily single. Hurhur!
'Enjoy the carefree single lifestyle while it lasts'-quoted by my accountant.

************************************
I've just read one of the news back home stating that SMU (a university in singapore) is increasing the school fees by 15%. And that means, a fee up to SGD$7500 is to be paid per semester.
Scary thought of having a kid/kids in near future. I reckon by the time my kid grows up, I'm not exactly sure will I still be working my a** off in order to pay for his education. And that's really sad because I wanna be a 'tai tai' (professional homemaker) by the age of 50+.
After all, I have slogged a lot throughout my teens , uni days, and now still striving hard to acheive what I can for my career path.

No, I'm not being clucky ;p

Says who?

My ex-nursing friend, Dan, has sent me a post Xmas gift: It is none other than what I wanted but a clinque blusher in Smoldering Plum colour! I am sooooo touched and happy. And it is the same color which I've been using for the past 10years. Thanks to Dan's recommendation and I simply refused to swap it for another brand.
My boss saw my package and asked out of curiousity where the present is from. I told him it is one of my best guy friends who bought something for me which I've wanted.
Da boss (being a real 'weirdo') claimed that there's no such thing as best male friends. He believed Dan is keen on me.
"Well, it doesn't work that way for me. I do have quite a far number of good good guy friends- in regardless they are married or single or attached, we have no problems catching up or have dinner together," as I commented.

I am a firm believer in platonic relationship. And I'll still insist on keeping in touch with my dudes even though after married. After all, most girls and guys see things in different perspectives. Therefore, it will be good to have a good guy friend around if I ever need to ask for advice coming from a man's perspective.
Sigh* Too bad, Boss seems to prefer to be controlled under the thumb of wifey. Hence sometimes, whenever we are just having a casual chat, I feel that I had to draw not a line but two lines between us. He just appeared to be quite uncomfortable....

Snapper dish!

Haven't had curry food for ages. Instead having a typical curry chicken dish, I've marinated a snapper with soya sauce, ginger mince, salt, pepper, garlic mince, paprika and added some broccoli into it.

As for the sauce, I've got a pinch of flour, salt, pepper,osyter sauce, one teaspoon of premium grade Mandras curry power with water. Add fried onion as garnish to the dish. Viola! The taste comes out really well. I was thinking of saving half of the dish for tomorrow's lunch but it was that good that I've gobbled down the whole pot instead.

Ooooooo, saw that little omelette there. That's my lunch. I'm gonna made ham omelette with chopped lettuce mayo sandwich. Eating out can be expensive in Australia especially for a single person. I am talking like having a decent meal which can cost you an average of AUD$10. So imagine one week, you are able to save $50 bucks. In a month you will able to save $200 bling!heh heh.

*******************************

Business at the clinic has been rather slow lately. For the past few weeks, I've been working only half a day everyday but still earning quite ok income. I've checked that today I'm supposed to have my first patient in the morning at 9am. However, the patient's name was removed ??(dunno which date) and it turned out my first client will be at 1.30pm. Bascially I've made a fruitless trip to the clinic for nothing. I was rather pissed as I don't understand why the receptionist can't be 'bothered' to make a call and let me know the changes of appointments. At least I could have slept in till late......

I was rather annoyed as this has been the second time it happened.

I've brushed him aside

I am supposed to send a message to him yesterday that I am not interested in coming for the dinner today.
I (being a twit?) forgotten to message him after watching the Emmys till late yesterday night.
And today, I'm off for a swim and caught the movie -memoir of Geisha in the later afternoon.

It was only at the dinner's time, I've realised I've yet sending him a SMS.

Sigh* Looks like I am spoiling my own' image' ;p And maybe that's why I haven't being so lucky to celebrate V-day.
And this year, it is no exception.


However, is there anyone keen to send me some tulips ( as i insist!) to my practice on Vday?
That would be a nice consolation.

How to brush (unwanted) boys aside?

Remember the semi-baldie guy I've mentioned earlier on? He rang and invited me for dinner at his place this Saturday. I asked if he will be inviting other people as just in case I can bring some food stuffs over too. He replied that maybe just 2 more peeps but yet to be confirmed.
On my mind I was thinking " eeeks, what if it ended up me and him? At his place? No good!"
Trying to be on my most humble mode, I told him that I'll check out with my gf first as most likely we'll be going out on Saturday night (yes you can sense it why I am saying this).

The feeling I get from him is he wants to be my friend for a different reason.....not based on just friendship. Now you see why I am so hesistant to keep in contact with him.
Just not comfortable.

(Scones for Devonshire tea)

Jog/Ice-cream

OK, so I went for a jog.Came back home 20minutes later because the files were bugging me like crazy. After cooling down, I had a violet crumble ice-cream which I can't resist it.
Sigh* How can I put back on those calories?? So da KNN! #*%()*$^

********************************************
One of my regular patients requested for a home visit.He is terminally ill and his toenails are getting long and thick. I don't usually conduct home visits unless I am super free plus the distance to the house are not far from the clinic. Home visits are generally too time consuming which no doubt the cost per home visit range from 65-85 bucks.
He once told me at the clinic that "dying never occur as a problem to me. If it's time to go, gotta go then."
Certainly he has my admiration on his bravery battling against cancer . Additionally,not everyone can view death as a positive sight.
I've informed his wife that should he needs another home visit, I am quite happy to do so.

Life and death, what do we know?

Don't Chaaaa

Talking about shake my booty, I can't wait.... I can't wait to go back good ole Singapore!
I've checked the air flight avalibility in late May, all I have to do is to wait for the leave approval! Woohoo! To me, staying in Sydney is pretty much like a nun spending most of her time on a mountainous top chanting sutra.Ouhmmmmmm.....I've told Callie that once I get back to SG, we'll go Zouk Mambo and confirm that we shall have our stands on the platforms.
I would love to sing a long songs by Spagna, Duran Duran, Rick Astley (my favourite all time!),Belinda Carlise.....yes! Callie you hear me, I 'chopped' you liao.
I wanted to do Cheerleading (are you laughing at me?)here to kill my spare times but come to think of it, the chances of meeting new friends are slim. Most likely I would make friends with the kiddos instead.
*************************
Got a patient today with multi-complex problems on her lower limbs.

I'll summarized the case scenerio to avoid long winded details as below:

Visit 1:
History:
22 yo female. Occupation: Teacher

Referred by GP to pod. Complained of right heel pain. Had NSAIDS, physiotherapy but still didn't resolve the heel pain. Took NSAIDS which cut down the pain level for a while only.
Pain increased with weightbearing and prolonged standing/running. Complained on occasional calf muscle stiffness.
Currently wearing Nike trainers.

Examination
Subtalar/midtarsal joints within normal range. Subtalar pronation on weightbearing.
Ankle equinus bilaterally. Pain on medical tubercle of calcaneus.

Diagnosis: Plantar fasiciitis

Tx: Icing, physiotherapy, calf muscle stretching exercises, custom made orthotics

Visit 2

Hx:' Left foot minimal swelling as one of the veins 'burst' recently'. Precribed antibiotics by GP and that settled down the swelling. Felt stiff on her left calf muscle. Nil abnormal findings noted on lower limb. Right heel pain still present.

Examination: Casting for orthotics done. Pulses on doral pedis and posterior tibialis palpable and bounding.

Visit 3

Hx:Wanted see a pod urgently. Swelling of ankle and distal one third of left leg. Left calf muscle very tight. Another pod diagnosed as cellulitis or possible posterior compartmental syndrome. Suggested to GP for venous and arterial doppler study.
Capillary filling time <>
Skin colour intact/nil pallor;
Hair distribution on feet- intact
Nil suggestive findings on venous insufficiency.

Note: I find that it's abit extreme to send patients for such investigations. Since Doppler ultrasound (which was performed earlier on) demonstrated a good vascular flow on both DP and PT with triphasic phase, is it a real necessity then?

Tx: Letter to GP and oral antibiotics if necessary

Visit 4:

Came in to collect orthotics. Left ankle swelling settling down except for stiffness. Walking into the clinic with a limp on left foot. Currently seeing a physiotherapist and it does help a little with calf stiffness

Tx: orthotics issued. Fitted well in shoes. Walked with no limping seen. Kept on complaining stiffness on left calf. *sigh*

Pt said she will limp only without shoes on.

Currently her GP is putting her on Mobic once daily and some blood investigations.

Why does a young lady like her is suffering from such bad calf muscle tightness??

She will be reviewed in 3 weeks' time with blood test results.

( taken from www.zappo.com)

Who has got a tight arse?

Yeap, that's me. I bought a smiliar tote bag for just $10 bucks and obviously,talking about quality wise, the zipper starts to fail on me after using about less than ten times. Being a al cheapo (with a good reason though) doesn't help much. Spent some time online on this lazing sunday looking for a decent tote bag. *Unfortunately Sydney malls do not have a wide range of DKNY products. What a shame indeed.
I've always wanted something like that (in the pic as shown) and that's definitely gonna be my number one on the shopping list.

Or any sugardaddy likes to sponsor? Hurhur!

Sms and men

There are a few men whom I just got to know have been trying to sms me (or rather creating a communication route between me and them) recently.
The problem is I am just not interested.
Sometimes I wonder will I end up being in 'lesbianism'.....-_-

Summary of the sms messages:

Mr P - from Italy. About in his mid 30s. Doesn't look like the presentable type. He even messaged me from Italy and ended with 'kisses'. Errrr, so cheesy. I don't mind if it's someone whom I am keen on.Muhahaha.

Mr J- Got to know him from friend's friend. Age 30 and semi blad (maybe like uglybaldie). Works in a local engineering firm. He started messaging me by using the free smspup service. (al cheapo?- not impressed). He also emailed me a few times and asked if I got MSN...can't be bothered to reply. When we went out as a group, he didn't even bother to wait for the late night bus with me as no doubt both of us were walking in the same direction. Yeah there is no obligation but definitely a big minus point on his lack of gentlemanly manner.

Mr M- And again, knew him from a friend's friend. Very poor sense of humour. Not funny. Very slow in understanding my explaination too. Each time when I asked him a question, he will stare at me a few seconds before answering -not properly also. Plus he is into ciggies. Yucks. I can't imagine myself kissing an ashtray.
*ptooi*

I hate Valentine's day.

That's life

Take a look at the bus stop outside my home. Oz bus stops are seriously crap. No shelters from rain or shine. Just stand near the yellow post or a sign board nailed onto a lamp post, all you have to do is to signal the driver as the bus approaches. If not, I am afraid you have to wait for another 30mins to 1 hour for the next bus to come. See, this is how I've learnt to salute to Singapore's highly efficient transport system. Otherwise, Oz people do Q-up when getting onto the bus. The communters here would often say 'Hi' to bus drivers and get off with a 'thank you' to bus drivers. Actually, if only singaporeans would be a bit more polite, I am sure the
'uncles ' or aunties' (bus drivers) will feel their services are very much appreciated.



**********************************
I love to have students in the clinic. That made my work so much easier. All I have to do is to make them work harder of course ;p




*********************************
Oh I got a new fringe! Dan said I look like a typical Jap girl. Phil said it looked nice on me. Boss said I looked like a little girl (what the fug??). Receptionist said I looked younger. (that's much better.)

By the way, my bro kept on playing this song by BlackEyed Peas's " Don't phunk with my heart."
This is how my non-speaking English mom trying to imitate this song:" Ma ma ma maha, don't fuck with my haaart?!?"
By the way, she sang this to me while we are shopping in a store where the song was played.