Mountain Climbing Gear 8

When I blogged about the balaclava being the last essential piece of attire for the coming Mount KK Climb (in less than 48 hours!), I was wrong!

Most of the climbers in the team met over dinner last Saturday (it was a ‘pre-climb dinner’ ~ we are big into eating, you know, as any decent Malaysian is). The dinner was for us to share any last minute briefing and basically to chat and motivate one another.

At the dinner, I was passed the T-shirt made specially for the climb. Yellow isn’t my favourite color (give me blue or black anytime) but I guess it makes sense to wear yellow deep inside the Borneo jungle, in case we got lost and need to highlight our plight or wandering hungry tigers may think we are part of their species and thus leave us alone.

I do like what is printed on the T-shirt.

The front of the T-shirt. The figure is printed a little too low so if I tuck in my shirt (which I do not!) it would be half-hidden.

The back has this map drawn on it. We will be ascending via the Mersilau trail and descending via the Timpohon trail.

What I see on cloth now, I shall see in person soon!

The target is of course, Low’s Peak (I wonder why they call it Low’s Peak when it is anything but low?!!!). There’s a peak I’d rather avoid: Ugly Sister Peak!

And so, I spent the better part of Sunday packing all my stuff for the challenge which will begin in less than 48 hours. I hear the weather over there is pretty foul!

Do keep us (all 20 of us) in your prayers ya.

This blog shall go on autopilot from tomorrow onwards until Jimbo comes back.

Mon,300608 @ 1500; desperately praying for good weather, strong knees, strong back , good sleep and victory on the mountain. And ya, also desperately praying for some kind of internet connection up there too so I can update via Mo.Blog on my Palm Treo 680. And hot aromatic coffee. And nice warm water for shower. And… and…and…., think I’ll stop here.

Mountain Climbing Gear 9
Mountain Climbing Gear 8
Mountain Climbing Gear 7
Mountain Climbing Gear 6
Mountain Climbing Gear 5
Mountain Climbing Gear 4
Mountain Climbing Gear 3
Mountain Climbing Gear 2
Mountain Climbing Gear

Case #43: The man with SOB

This 43-year-old man who is HIV+ was diagnosed with pulmonary tuberculosis 6 months ago. He was started on anti-TB. Unfortunately, he developed allergy to Rifampicin and it was replaced with i/m Streptomycin. However, he developed severe tinnitus and Streptomycin had to be stopped. He was then continued on just 3 anti-TB agents without either Rifampicin or Streptomycin.

At the time of diagnosis, an ECHO was performed and his EF was merely 35%. Four months into his therapy, he presents with shortness of breath on exertion. He was treated as congestive cardiac failure. An ECHO was done and a procedure was performed on him. He felt better at the time. HAART was started at this time.

Two months later, he presents again with shortness of breath on exertion. This is his CXR:

An ECHO was performed and this is the image:

A procedure was performed and a repeat CXR was done after that:

Questions:

1. Describe the first CXR.
2. What procedure was performed on him?
3. Describe the post-procedure CXR.

Mon, 300608 @ 0700

Note: The answers to this case will only be released next Tuesday (or later) as Jimbo will be away.

Spider Orchid

Let me share with you my latest orchid plant, which I purchased for RM 30 when I went to Cameron Highland last month for the family camp. It’s called a ‘spider orchid’ which is not surprising since the flower petals are long and tendril-like. Real nice.

Sun, 290608 @ 0700

Hunting for NGV

Jimbo and family went hunting for NGV this morning.

Not the gas.

We were looking for a dealer to install a NGV system in our family car. Since the petrol price hike early this month, the expenses of Jimbo et al has drastically climbed to an unbearable level!

We did a bit of research before we set off this morning. We called our favorite taxi driver regarding where the dealers are, since he uses NGV himself.

Apparently, according to him, there are 3 dealers in Seremban. Two Chinese shops and one belonging to a Malay. He has no idea where the latter’s shop is.

After breakfast we set out to find the 2 Chinese dealers. Here’s a summary of what we encountered.

1. Workshop number 1.

Location: Temiang, near the Eon Service Centre in the industrial park.
Owner: Chinese man.
Attitude of owner: More sour than amniotic fluid. Wouldn’t even greet nor look at you. Treats you worst than a lump of protoplasm. Total paralysis of all muscles involved in smiling. Has severe God-like complex.
Price quoted: RM 4,500 (caveat: not sure actual price. not sure when can be done. “you wait”)

2. Workshop number 2.

Location: Rahang, opposite BP Station.
Owner: Chinese man.
Attitude of owner: a little less sour than amniotic fluid, probably same pH as stale urine. Looks at you for about 5 seconds. Treats you like an amphibian. Twitches of facial muscles seen. Has severe take-it-or-get-lost complex.
Price quoted: RM 6,500. Non-negotiable. Conversation over.

Jimbo knew the location of another workshop because he spotted a sign a few weeks earlier.

3. Workshop number 3.

Location: Near Taman Permai, opposite food court.
Owner: Chinese couple.
Attitude of owners: Friendly. Looks at you all the time (probably wondering how much Jimbo has in his pockets). Smiles once in a while. Workers (though a bit clueless) are friendly.
Price quoted: Initially RM 4,700 (2 weeks ago) has risen to RM 5,000 (today) and then to RM 6,000 (after 20 minutes, because instead of a metal tank, they will use a semi-fibre glass tank). Installation can start immediately.

Jimbo’s gonna get himself some NGV, but from who…..?

Sat, 280608 @ 1412

The mummy was here

Took this picture some time ago.
It’s the male toilet.
It’s the staff male toilet!

I wonder whatever possessed the last user to discard toilet paper all over the place. I have a few theories:

1. He suffers from prostatism ~ hence will continue to tear piece after piece of toilet paper to ‘clean up’ after each insufferable dribble.

2. He has bowel/bladder incontinence.

3. He is severely short sighted, and therefore kept missing the toilet bowl when he throws the soiled paper.

4. He simply has a bad aim.

5. He has a good aim but the darn wet and sticky toilet paper held on to his fingers tenaciously. Severe flinging actions resulted in toilet paper being strewn all over.

6. He’s into toilet interior (re)decoration.

7. He’s actually an ancient Egyptian mummy who was just awoken (by the constant irritating drilling that has been going on in campus because of the CCTVs installation project) and he unwrapped himself in this very cubicle. Unfortunately he left some evidence behind. He is now roaming around in campus.

Be afraid.

Be very afraid.

Sat, 280608 @ 0700

Pre-release publicity

Just a short publicity stunt: The latest installment of Ugly Betty Script (detailing the less-than-exciting life of the fictional and imaginary Ugly Betty character inside the deep recesses of Jimbo’s overactive muddled brain) shall be released tomorrow next Tuesday!

Fri, 270608 @ 1600; post call and so tired, hence the frequency of blog-orrhoea.

Meeting an icon

I met John Bartlett when I attended the conference last week.

“John who?” You will say.

I doubt there is anyone in the ID world who doesn’t know who is John Bartlett. For those who don’t you can take a read here:HOPKINS RESEARCHER JOHN BARTLETT HONORED BY NATIONAL FOUNDATION FOR INFECTIOUS DISEASES

I practically grew up on a staple of Bartlett’s books and articles.

So, like I said earlier, I met Bartlett. Well, I kinda met him anyway. He was the speaker for one of those early morning session and he was speaking on ‘Recurrent Infections’. The session started at 7.15 am but my shuttle from the hotel to the venue was late and I reached there only at 7.45 am, by which time the hall was packed and I was not allowed in.

So, I peeped through the window and watch this iconic person deliver his talk.

Sigh…

But as fate would have it, I managed to catch him giving this very interesting talk later that day!

Fri, 270608 @ 1200; Jimbo’s in KL attending a workshop on Microsoft Power Point. Don’t ask…

Giant Feather

Jimbo is in an area called Phileo-Damansara in Section 16, Petaling Jaya for a course on Microsoft Power-Point. In the middle of the high rise buildings is this oasis of calm ~ a man made fountain with giant feathers (made of metal) resting serenely on the water surface.

I like it very much. It’s a little surreal.

Fri, 270608 @ 0700

Eating Sh*t!!!

When I attended the conference last week, one particular talk stood out. I do not think it will ever be erased from my mind! I attended a symposium on the management of Clostridium difficile infection (the bug that cause Pseudomembranous colitis as a result of prolonged antibiotic use).

Nothing has changed with regards to its management. Vancomycin (oral) or Metronidazole are still the mainstay of therapy for the last 2-3 decades as drug companies are reluctant to invest more time and money into this unpleasant adverse effect.

One therapy, according to the speaker, however, works like a charm! Its success rate is well documented to be over 97%!

However, the means of this therapy is anything but desirable! Here is what I mean, take a look:

Here’s the step-by-step on how to perform a fecal transplant!

1. Get a donor (I do not think it will be too difficult ~ it’s pretty ‘crappy’ actually).

2. Screen the donor for C. difficile.

3. Harvest his stool (Eeewwww….gross!). We need 30 g in < 6 hours (that’s a lot of crap)

4. Add 50 ml of 0.9% NS to the above.

5. Blend it in a blender and filter using a coffee filter (preferably not from your kitchen). This reminds of a scene from one of the Austin Powers movie!

6. As for the patient (or victim!), give oral vancomycin and omeprazole.

7. Insert an NG tube into the poor victim above (via the mouth or nostril).

8. Pour item 5 down the tube. (I am about to puke!!!)

9. Cure rate is > 90%.

That’s it! Easy-peasy!

Who says ID conferences are boring?!!!

Thurs, 260608 @ 0700; on call today.

Typo

Last Monday I attended a meeting attended by people representing the ID team in UMMC (including yours truly), the PT Foundation, amFAR, the Health Ministry, a freelance biostatistician, University Malaya Public Health and Biostatistics department, and a few notable foreign speakers from the recently concluded ICID 2008.

Our mission was to sit and brain storm and identify research opportunities on HIV and the MSM population in Malaysia.

It was a long but fruitful meeting. It also served as an eye opener for me on various issues and I came away having some ideas on some areas which I might go into.

Anyway, the picture above was taken on that day. Can you identify the typo? It took a lot of will power not to go to the board and correct the mistake!

Wed, 250608 @ 1200