Close call 失之毫厘，差以千厘

It is not easy to be a medical doctor; worse if one is a specialist.

As my other colleague said, s specialist is the last bastion for a patient with medical problem. If the diagnosis is missed, the suffering can be catastrophic sometimes.

I had a patient recently. I thought she had immune encephalitis initially. But by a stroke of luck, I happened to add a lab test to screen for remote possibility of MELAS, a neurometabolic/genetic disorder -> and it turned out to  positive. Further investigations point towards MELAS. 

Treatment for immune encephalitis and MELAS is different all together; worse of all, the latter is a neurodegenerative disease, shorten lifespan...

最近有位患者因为脑部疾病入院治疗。起初我以为是免疫性的脑炎，不过因为这是患者的第二次发病，我在检验时，额外检验患者的乳酸指数；结果误打误撞的发现她的乳酸指数蛮高的。后续的检验都指向线粒体疾病的可能性。最终，患者被转移去公立医院继续就医。

回想起来，如果我没有检验患者的乳酸指数，那便不可能诊断出线粒体病症，治疗方针便是个错位，无法对症下药。

有时医者的职责很大，容不得丝毫的疏忽。

Belated birthday meal 迟来的生日餐

CJ celebrated his birthday last week. We didn't buy any birthday cake, or go out for dinner to celebrate his birthday last week.

Instead, we went for a belated celebration yesterday - had our dinner at Yum Char restaurant in Changi Business Park. He (the birthday boy) paid for the meal first, and I reimbursed him later on via PayNow app. 

餐厅的布置

The Dim Sum variety was good. There were some SG60 promotion, and discount for seniors or those who were celebrating their birthday that month (month of July). The food was not bad at all!

After dinner, we went to an adjacent shopping mall @ Changi Point - CJ was looking for sport shoes for indoor games. He found what he wanted at the ASCICS store in the mall. Paid with cash + capital mall voucher and his NS LifeSG voucher.

向来某人庆生时，我们一家人都会在外面的餐馆进餐。

今年，靖捷的生日已过了一星期， 我们才于昨天傍晚到 Changi Business Park 的 饮茶餐厅去吃晚餐，庆祝那迟来的生日。

恰巧该餐厅也有庆祝新加坡60大寿的促销活动。除此之外，在这个月份庆生者还享有有额外折扣！

该餐厅的食品，选项蛮多； 食物也挺可口，价钱也实蕙。

Tuk Tuk - the iconic means of transport in Thailand

 

Upon seeing the photo of Tuk-tuk, the image of Thailand/Bangkok will inevitably appear in most people's mind. Well, it is one of the cheapest means of transport in Bangkok.

However, one has to be careful when engaging their services - sometimes, the unscrupulous drivers may "take you for a ride" literally!

But, this is one of the way to 'immerse oneself ' into the community!

Short "working" trip to Bangkok 曼谷3日行

Was offered sponsorship to attend a symposium on infant nutrition in Bangkok last week (3-5 July, 2025).

Symposium on nutrition (focusing on formula milk) usually not my "cup of tea". But this being a very short trip, and it is not too far away from Singapore (Bangkok), I took up the offer.

Took a morning SQ flight at 9.30am from Changi Airport - the flight arrived at Bangkok Airport about 2 hours later. Met some familiar faces (who were attending the same symposium) in the airport. Took transfer transport to Intercontinental Hotel. Since check-in time was after 2pm the earliest, we went our separate way to explore the vicinity. 

The hotel is conveniently located in the busy city district - surrounded by various shopping centres (City World, Big C etc), with the famous Erawan 4 faced-Buddha just round the corner (within 2-3min walking distance from hotel); I explored 4 faced-Buddha, City World (got lost there), Big C shopping centre... Then returned to the hotel - checked in at 2pm, and took a break there... Picked up at 6pm for dinner at Blue Elephant (the food was quite good, with a good variety of local delights, presented in fusion fashion). 

四面佛

the funfair/carnival in front of Central World

                                          

Big C

                             

Central World, and the "iconic traffic snarl" in Bangkok

The next day, I attended all the lectures for the symposium (an achievement by itself, as I saw some attendees left mid-day) - learning some new concepts along the way. 

Breakfast and lunch all catered by the hotel. 

The symposium ended by 4.50pm, took a quick break before departing at 5.45pm for dinner at a restaurant facing the Temple of Dawn (Watt Arun). The food was so-so, but the view was fantastic.

View along the street, not too far from the restaurant

Tuk-tuk ride

view from the rooftop of the restaurant of Chao Phraya River

By the time we reached our hotel, it was almost 9.30pm - retired early for the night.

3rd Day was also the last day of the journey. It's free and easy for all till 4.30pm (pick up time at hotel lobby, our flight departed at 8.10pm). 

After breakfast, I walked about 20min to Lumphini Park nearby - it is just a typical exercise park (akin to that of Botanical Garden) - many people, both young and old, exercised there. There was also hawker stalls right in front of one of the entrance to the park. 

The street food just outside one of the entrances to Lumphini Park

Lumphini Park

A monument at another entrance

         

                                          

Then I walked to a Buddhist temple nearby - Hualamphong Temple. This is a typical Buddhist temple, nothing too extraordinary.

Then I walked to (belief it or not) a Hindu temple (Sri Maha Mariamman Temple @ Wat Khaek). 

Fancy visiting a Hindu temple in Bangkok!

Typical garlands for prayers @ Hindu temples

Just before reaching the temple, I saw a long line of people queueing in front of a bakery shop - as the saying goes - this means the buns/bakery there must be good; so after visiting the temple, I took a queue ticket to buy some random buns from the store (queue number 81, while it was serving queue number 61 at that time)...

The stall

My next destination is Talat Noi (street art) -a favourite for youngsters, to take insta photos, but nothing to shout out for... 

Then I took one hour to walk back to my hotel - stopping for lunch in one of the food stall along the way. 

The whole morning walking routine covered 22k steps - my left ankle was aching by the time I reached my hotel. 

Went for a quick 1-hour body massage at at massage parlour nearby - then went back to my hotel for quick shower, and checked out at 2pm. After that, I went for another 1 hour foot massage from 2.30-3.30pm. Our airport transfer sent us off to the airport around 4.30pm (in case of traffic jam along the way to airport). 

View from my room...

我向来不喜欢参加与我主修专科没有关联的研讨会。这次却破例出席了在曼谷举办的已儿童营养为主题的研讨会。整个行程来回3天；研讨会是在第二天举行。第一与第三天是自由活动时间。

以往的产商津贴的研讨会，都会包含一些余兴节目， 如当地半日游等；这次却不然。很多时候都是自由活动，连第一天与最后一天的午餐也没有包办。

曼谷是一个朝气勃勃，喧闹的城市。行人熙熙攘攘，热闹非凡。感觉上比新加坡的乌节路更繁华热闹。高耸的购物中心，分别竖立在马路两旁，它那豪华的装饰，令人眼花缭乱。

Durians - king of fruits 万果之王 - 榴梿

It is durian season again. Apparently because of bumper crop this year, the cost of "good class" durians is expected to be low in coming months.

Went for early dinner in a hawker centre in Ang Mo Kio just now, and chanced upon a durian stall offering "discounted" price for the new crops of durians.

Durians are lauded as the King of all Fruits. The texture and smell evoke two extreme opposite emotions - you either crave it or hate it!

In Chinese culture, it is labelled as being "heaty" - apparently not good for people with hypertension, and can tip a person who is of "low immunity" to fall sick easily...

又是榴梿飘香的季节。开始有水果摊卸货拍卖榴梿了。

据说这次的榴梿产量过多，价格会很实蕙。

今天傍晚，不期而遇的碰到小贩中心附近的水果摊位在摆卖榴梿。标价确实比往常便宜一些。我老婆在不同的两个摊位，分别买了两盒猫山榴梿（新币50）及一粒猫山榴梿（新币12）；品尝后觉得比较贵的口感好些。

The dreaded jam @ Causeway 长堤堵车

 

The queue to the Malaysian custom

No inpatient to cover this weekend. Malaysia is going to enforce its long deferred VEP (Vehicle Entry Permit) come 1st July, 2025. A fine of RM 300 will be imposed on vehicle entering JB without a valid VEP. 

I have already activated my VEP since November last year. However, the RFID tagged to my new vehicle was apparently not detectable when I drove into JB last year. 

Hence, I thought it may be good for me to test out my RFID this week. 

But alas, New Straits Time reported that the jam across crossway was estimated to be 3 hours or more on Saturday (21 June). 

The intrepid me decided to drive into Johor Bahru despite the dire warning from the authority. Woke up early at 5.10am. Left our house by 5.45am, and began our drive to Johor Bahru today (Sunday morning).

And yes, there was some jam as expected. It took us slightly over half an hour to clear the custom on both ends of the causeway (which was not too bad, I reckoned). And yes, the RFID for my car worked well. We cleared the Malaysian immigration check point without any problem. 

However, while following the GPS guide to our destination in Skudai (a morning market which we haven't been to before), we drove back to the JB immigration check point unwittingly... Have to declare to the immigration officer, get clearance from another immigration officers housed in a hidden corridor (after submitting some written statement), then made a U turn through a tunnel. No... we were not the only car making the same mistake. There were two other cars being guided through the U-turn tunnel. 

Finally, we arrived at the morning market. My wife bought some local delicacies and vegetables there.

Parked out car near the morning market, this is a one way street with no exit....

Yong Tau Foo

Vegetable stall

We saw a shop house selling egg - bought 3 trays of Kampung eggs. Then walked to a nearby coffee shop for breakfast (curry noodles).

After breakfast, we drove about 20 minutes to Bestari Bestmarket (a supermarket cum wet market), and then another 15 minutes to Restaurant Triple One at Jalan Perkasa 3 (for Trengganu Curry Fish Noodle). After this, we drove to eat Foo Chew Noodles at Ah Ling Foo Chew Noodle (Jalan Mutiara 1/11). By then it was already 2pm, time to go home.

Inevitably, we were caught in the jam at JB causeway. It took us over 1 hour to clear the jam at both ends of the causeway.

The dreaded jam @ causeway

We finally reached home at 3.20pm. What a day!

在长堤上碰到堵车，是件令人揪心的事。再者便是成功过了移民关卡后，因为走错路而需重闯关卡，再有关当局的许可与见证下，於某个指定“隧道”来个U转弯，重新往新山闯，这种经历，更令人撕心。而我今天偏偏碰上了！