Attack of the Aedes Mosquitoes

Just like that, Singapore becomes a Zika hub. The si lang Aedes mozzies one up us; even before we can hoot dengue, they hoot us with Zika.

Actually Dr Og (and possibly all other doctors) have been wondering why it took so long for Zika to reach our shores. After all, Aedes the mosquito IS endemic in Singapore and it IS more local than most homo sapiens in Singapore. And mebbe hor, the Zika virus is also more local and Singaporean than we think. Dr Og not anyhow say one; I have evidences Zika virus may be local.

1. Zika tries to be elitist.
Like all kiasu Singaporean, Zika cluster also must cluster around high class place like Elite Terrace wor!

2. JB custom will kar cheow (disturb)
You know we go JB, always kennah custom issues. Long wait.. oops thats our side problem...  Anyway, now JB custom officers will make life difficult for Zika virus like they do for Singaporeans.

3. Zika in Southeast Asia since long time liao
You can read this paper yourself.  It is more likely than not that there has been Zika outbreaks in Singapore for long long time liao. But since its self limiting and of little harm, like the other one thousand and one viruses, people and doctors just bochap.

But now with the scare in Brazil, Zika become famous and since Singapore epidemiological surveillance is so tekong, we are picking up loads of cases. Dr Og do agree that vector control is very important, even more so now than ever. Last time, we fight the Aedes only prevent Dengue. Now if we whack Aedes, we one stone two birds ar! So more worth it...

The mozzie wipeout however is not very the sucessful leh (obviously doesn't work since dengue and Zika is on the rise), It is always hard to get people to do the right things. Like in Hospital, ask lokuns to wash hands is harder than anything. Touch cadavers, various body secretions, do PR, don't wash hands also can eat lunch.

So Dr Og think we need new campaigns to kill the Aedes. I suggest recruiting the Hougang Horde to help. They are those people who swarmed the road in Hougang Ave 10, like zombies, just to catch a Snorlax for Pokemon Go. These people sibei wu eng, don't mind risking limb and life to catch things and damn thick skin don't even leave when scolded by residents and horned by cars (thick skin prevents mosquitoes bites mah).

But if everyone can contribute, will be even better right. Now the mozzie wipe out got five steps...

Just add step 6 lor. Step 6- if see mosquito, KILL with bare hands

Don't be lazy and soft la Singaporeans, see one mosquito, kill one and if we all just kill one per week, with our rapidly growing population, soon Aedes extinct liao!

Whoa Gold Medal!

08:45hrs - Came early to the clinic, patient is early too! Woohoo

09:00hrs - Seeing second patient.

09:10hrs - Done with second patient. Tried loading OKTO on PC. Cannot! Simi update to latest web browser???????

09:12hrs - Heng can watch on handphone! Just starting...

09:14hrs - Lun lun lun.... Ai yar liao

Some milliseconds before 09:15hrs - GOLD!!!!!!!!!!!!!!! Whatsapp whatsapp whatsapp

09:16hrs - Wipe off tears. Compose self. "Next patient!"

Congratulations Joseph Schooling! You have done us proud! 

The High Cost of Living (Actually Staying Healthy)?

Recently, a patient got dulan (henceforth DL) when his doctor billed her for two illnesses at the same setting instead of one consult. The case of the angry patient caught the attention of a reporter who seems perpetually DL with doctors. She then managed to get MOH and many doctors DL when she wrote that:

"The Ministry of Health (MOH) said there is nothing wrong with the way Dr Wee charges." 

MOH wrote back that they never say "nothing wrong" so don't anyhow say hor. Wait, MOH didn't really say that. They said this. SO PLEASE DON"T DL ME CAN?

Moral of the story? Singapore everyone also DL?

This issue of rising medical cost is of course a real issue. Dr Og and family also get sick and sometimes going to see real doctors can be sibei heart pain, so I can liao kai when you see a doctor you want to get the most out of it. Come for flu, also better get stomach checked coz like abit pain pain liddat. Wait, better also check the heart, coz later see bill confirm heart pain.

But from the other perspective, life also not easy for doctors la. In public hospital when your department lose money, your CEO start looking at the HOD eyes big big. In public still can hide here, siam there. After all is ah gong footing the bill.

In private, its your own problemo liao. Who call you hiao, want to go to the dark side tio boh? Got one day, a private specialist complain to me. He say someone complain he overcharge and never follow the price guidelines provided by SMA. Wah, the guidelines are so ancient Dr Og also almost forget liao (actually Dr Og never received the guidelines coz I always default membership payment for SMA until they DL me hahahaha).

But hor, if you do a simple google search, some jokers still putting up the price guideline online! Even as recent as June 2016. See this and this! For your info, the price guideline was found to be contravening competition law. Its all too cheem for Dr Og to explain so please read yourself la.

So what does this all mean? It means that since 2007 after they withdrew this price guideline, it has not been updated. Should doctors follow a 2007 price guide? I don't know about you but the bak chor mee I always eat was at most $3.50 in 2007. Last month, the owner just raised the price to $6.00. I don't blame him given how inflation has been in Singapore.

As for my private specialist friend, it turns out that the price he charged was within the range of the price guideline. The complainant obviously didn't bother to do his homework properly. When the specialist found out he told me, "wah, I'm charging 2007 rates ar?"

He so DL he decided to raise his charges.

National Day Parade 2016

Wah, time flies. SG50 came and go and we have celebrated yet another NDP., SG51 liao A new citizen recently asked me excitedly if I would be going to the national stadium to support the NDP. I can understand that having just obtained his red i/c, he was excited about NDP, but having watched the same routine every year for as far as I can remember, Dr Og was just not going to get all gaga about it.

The last time Dr Og actually went to a NDP was many many (many x many)  years ago. We were providing medical coverage and even simulated the worse case scenario of carrying an injured VVIP on a stretcher from the VVIP box down the stadium steps to the evacuation point. At the end of the day, the exercise proved to be futile as the NDP that year (like every year) was uneventful.

The only injuries incurred where likely the ones sustained by the poor medics who had to carry the 0.1 ton kilo medical officer (simulating the heaviest VVIP there possibly could be) on the stretcher. Trust me it was hard and dangerous work! I'm sure some of the medics can still feel the stretcher slipping out of their hands and the aches and pains sustained that day every year when they watch the NDP.

Yesterday's NDP took place at the new stadium and Dr Og heard that now stadium got to pay alot of money then can use. This is also same like hospitals, programs upgrade liao, patient gotta pay extra. Patients always complain, why need to pay more? Come on leh, you get new stadium, sibei solid new grass for the soccer pitch and stadium roof can open and shut like Transformer, of course pay more right? Same thing mah, new program, new admin staff (sorry always no chiobu one, if you need to know), protocols so complicated that reads like the inner circuitry of  a Transformer, so pay more lor... Even though the end results to end users still the same end of the day, the stadium seat still looks hard and uncomfortable like before...

Sadly, Dr Og missed most of the NDP yesterday and cannot give you a good review of it. I was celebrating NDP by wearing red and white, walking along the streets and throwing red and white pokeballs at virtual monsters. I'm sure Niantic like very pro Singapore gahmen and launch Pokemon Go over national day weekend for all to celebrate!

Also, actually Dr Og hasn't gotten over the Post Traumatic Stress Disorder of falling over the stretcher from on top the stadium steps that faithful day!!!!!! Darn, those medics!!!!

Jiak Kin Jio

When you are a Dr, people expect you to know everything!

Whether traditional medicine is good for them. 

Er, wait ar, Dr Og go call my mother first and ask.

Whether going to work will aggravate their BP... 

ok la, ok la take MC la.

Whether the medicine can take with supplements. 

Wah lau, why you don't ask the G@C salesman who sold you your protein shake whether can take medicine or not?

Whether your son's girlfriend is good for him. 

Ok, aunty I saw your family for a long time now but don't drag me into your family politics leh. Plus, must maintain patient confidentiality and cannot tell your son all the naughty things his girlfriend (whom happen to also see moi the friendly neighbourhood dr) done before right? But thumbs up for the good intuition!

But lately... and strangely... people have been asking me about bananas.

Patient: Lokun, I heard bananas can treat my condition!
Dr Og: Is it? You read from internet is it?
Patient: Wah, you lokun, you don't know ar... I thought lokun should know everything! But its possible right? Banana can cure me.
Dr Og: Er, the only case of banana I have encountered was when this guy thought it was funny to shaft a banana down the wrong end of his digestive tract, hahahha...
Patient looking disturbed. 
Dr Og: Ok, I digress but look here, I really don't know if banana is good for your condition. If you like, eat lor. But please also eat your meds ok?
Patient leaves looking disappointed.

The reality is that a doctor doesn't know everything. We only know what science can tell us. Most of the time the science tells us "maybe" or "it depends (on so many factors that there is no way you can understand what I am about to explain so lets not waste each other's time)". Anyway, before I forget, better take a note to check bloods for this patient next visit, in case he takes banana qds and end up with hyperkalemia!