Hard Rock Hardly Rocks

The impressive fibre-optic lighted sign at the hotel entrance.

Jimbo has been staying at the spanking new Hard Rock Hotel in Batu Feringgi, Penang for the last couple of days.

At RM 490 per room per night (Seaview Deluxe), after 40% off, it’s pretty costly. Was the place worth the money spent?

Hardly (pardon the pun).

Allow Jimbo to list the ways:

1. On checking in, Jimbo (and everyone else behind him) was ignored at the check in counter for 25 minutes! Can you believe it, no one attended to him, despite him standing there! There were 3 staff members busy at the checking-out counter but none at the check in counter (which is just behind them!). One of the staff member repeated saw Jimbo standing there and yet did not open his mouth, either in greeting or in offering any kind of assistance.

When Jimbo finally asked him, he said, “Oh, sorry, we don’t have enough staff. So please line up at the check out counter!!!”

“WT*!!!!”

Jimbo told him off in no uncertain terms that the service sucks. He saw Jimbo and the rest waiting at the check-in counter and did not bother to inform them that they should go to the check-out counter.

To pacify Jimbo, his room was upgraded to SeaView Deluxe from Hillside Deluxe. (Great! Now he can watch the tsunami come, if any)

2. When Jimbo got to the room, he found the room to be small (really small for RM 490!) and the TV was not working. It took a few calls and 3 guys before the TV was finally fixed.

3. The shower’s water pressure was pathetic. There was no indicator on the shower tap as to which is hot and which is cold water.

4. The air conditioning is freezing cold, despite being set at the lowest fan speed and at 30 degree temperature.

5. Jimbo found the pool area adjacent to the beach to be quite cosy but very noisy, making it impossible to really relax. The noise came from the loud speakers blaring loud music the whole day as well as the noise from the numerous beach activities such as water scooter and paragliding. Definitely not tranquil.

6. There was no sauna/steam room.

7. The food was average only; slightly better than those offered by 3 star hotels in Port Dickson.

8. The restaurant had lots of flies!

9. The various staff were young and energetic,keeping to the simplistic style but also came across as raw and inexperienced, bordering on being uncouth.

10. The room has complimentary internet (LAN and wireless) which is good but the internet speed leaves a lot to be desire. (Jimbo thinks they haven’t CUT yet!)

So, all in all, Hard Rock just didn’t rock, at least not for Jimbo.

Fri, 041209 @ 0700

Yuletide!

It’s the Yuletide season and it’s snowing in my blog!

Woooo……hooooo!!!!!!!

Thurs, 031209 @ 1240; sitting by the beach in Penang!

Case #94: Suddenly breathless

This 24 year old woman felt an uneasy discomfort on the left side of her chest from morning which worsened progressively. By noon, she decided to go to the hospital. When she presented to the hospital, she was in distress, having suddenly developed acute breathlessness. She collapsed and was resuscitated requiring mechanical ventilation.

This Xray was taken a short while before she collapsed.

Click to enlarge.

Question:

1. What is the most likely diagnosis?

Mon, 301109 @ 0700

One Load of BullJit

For a year of “very hard work”, Jimbo’s ID boss is taking the entire team (people from MAC*, CERIA**, Researchers and doctors) to watch this stand up comedian perform today!

Hurrah!!!! Looking forward to side splitting laughter!

Sun, 291109 @ 0700

* Malaysian AIDS Council

**Centre of Excellence for Research in AIDS, University Malaya Medical Centre

Kellie’s Castle

Picture of Kellie’s Castle taken in 1986.

The first time that Jimbo visited Kellie’s Castle in Ipoh (actually nearer to Gopeng), was way back in 1986! Back then, the place was not well known and there was no proper access. Jimbo and friends had to strip down to their shorts, and wade across a river in waist deep water in order to reach the old abandoned mansion. The experience was memorable because the place was so spooky!

Back then, the entire area was overgrown with creepy crawlies and huge trees. The Kellas Mansion (the original home of Kellie Smith and family) was not seen when Jimbo went there back in 1986. Walking along the darkened and quiet corridors of the castle then was a spooky experience. There were underground tunnels and stairs leading up to nowhere!

Fast forward 23 years; Jimbo and family visited the castle last weekend. The castle and the area surrounding it has not been developed for tourism. A proper bridge has been built across the river, overgrown shrubs and trees have been cleared; the ruins of the Kellas mansion is easily seen behind the castle and the castle itself is all spic and span; losing much of its spookiness.

Here are some photos from the trip:

The parking lot in the foreground.

The river which Jimbo and friends crossed 26 years ago.

Now a nice bridge spans across the river.

The castle has been spruced up with window panes added.

The underground wine cellar. Graffiti abound on almost every wall in the castle – another testimony to the Ugly Malaysian.

The stair that used to lead to nowhere now leads upstairs!

The ceiling on the 2nd floor has been refurbished with white plaster. Those days, it was just bricks and there were holes in the bricks which allows one to peep from upstairs to downstairs.

On the roof (those days there was no roof that one could stand on), Ryan demonstrated that he inherited his mummy’s genes in not being afraid of height…

While Darlene evidently got Jimbo’s gene for severe fear of height!!!

The roof of Kellie’s castle.

View through a window.

Some of the chambers were still pretty spooky. One could almost imagine a ghostly figure on the bottom left – oh wait! It’s just little Ryan!

The sign indicating Kellas Mansion located behind Kellie’s Castle.

The remains of Kellas Mansion.

Apparently this chamber used to be the shower with exquisite Italian tiles on the walls.

Kellie’s Castle viewed from the back.

And of course, there were plenty of signage with very bad English telling people that the safety ‘expect’ of the castle is in doubt…

And that engaging in ‘obsene’ behaviour in the castle ground is strictly forbidden. Jimbo thinks that placing CCTVs in strategic places would be better than merely pasting a laminated paper signage.

While there, the loudspeaker suddenly came alive in the place and a very tired, lethargic and bored male voice came on, trying to narrate the history of Kellie’s Castle. Listening to him struggling to pronounce simple English words was a torture. Why can’t they just make a good and proper recording and play the recording at intermittent hours? For a brief background of Kellie’s Castle, click here.

The place has got great tourist potential but unfortunately, is not fully explored. For instance, the souvenir shop was merely a table placed under a large umbrella and on the table were a few sorry looking badges and fridge magnets with a few very uninteresting T-shirts  and caps as well.

Sigh…

Still, it was a good trip and it gratified Jimbo to fulfill one of his daughter’s wish.

Fri, 271109 @ 0700

Jimbo got his flu jab

Jimbo received his H1N1 vaccine yesterday – in his left deltoid. The injection itself was relatively painless as the white liquid (vaccine was manufactured by GSK) was pushed slowly into the muscle.

The pain came much much later….
Insidiously…
Progressively….
By late evening, he could hardly lift up his left arm!

OOOOOOWWWWWWWWWWWWWHHHHHH!!!!!!!!

And there’s the headache, pounding relentlessly.
And the generalize lethargy and what appears to be a low grade fever.
And the neck feels a little stiff.

All expected side effects of course.

Nothing serious or catastrophic (it wouldn’t do to have an ID physician die from a H1N1 vaccination – bad for business indeed!)

Anyway, just so you are aware, in Singapore, there are 27 cases of adverse reaction to the vaccine reported so far and in Canada, several cases of anaphylaxis have occurred.

So we wait and see.

Oh, on another note, those who have received the vaccine may give a false-positive HIV test, Hepatitis C and the HTLV-I as well using the ELISA!

This could be a potential problem when there is a needle-prick injury involving health care workers who have been vaccinated against the H1N1. However, a simple Western Blot test should lay the issue to rest (for HIV).

Thurs, 261109 @ 0700

Ipoh Mali

Over the weekend, Jimbo and family took a trip up North to Ipoh for a short break. Their host, a very good friend of the family was very kind to take them around the place sampling what Ipoh is best known for: FOOD!

After 3 days of feasting, here are some things that have left an impression on Jimbo:

1. Food

Jimbo has tried everything, from keuh teow soup with chicken bean sprout (a bit disappointed that the bean sprouts were not ‘fat’ enough), to fried kueh teow, to thinly sliced toasted bread with kaya and butter, to half-boiled egg perched on a thick toasted piece of bread spread with butter, to the ice cold Ipoh white coffee, to wan tan mee (with wan tan the size of atrophic testicles), to the various types of biscuits and delicacies and also a few sumptuous meals in various chinese restaurants.

And the verdict: Most of the food were heavenly! (though admittedly some were over hyped and over rated).

It’s hot, crampy, and noisy!

The only thing that got on Jimbo’s nerves was the crowd!!! It would seem that every single Ipoh-rian were out at every hour of the day to eat! Consequently, the restaurants were forever packed with people. You have to down your meal amidst the deafening cacophony and the presence of people standing behind you like vultures, waiting for you to vacate your seat as soon as you are done eating! It certainly took the ‘oomph’ out of eating all the delicious food.

2. Ipoh Drivers!!

Gosh! They really drive you up the wall! Jimbo met 2 recalcitrant drivers in Chemor (a small town near Ipoh) who refused to give way, in a narrow road, even though it was far easier for them to back out than for Jimbo to reverse his car. They simply refused to move!!! It really annoyed Jimbo. Even KL drivers have the courtesy to give way.

Others simply drive at 40 km an hour on the fast lane and would not move to the left lane at all. On the other extreme, youth barely out of puberty would drive their cars at break-neck speed. In just 2 days, Jimbo witnessed about half a dozen accidents on the road. The current wet spell didn’t help of course.

Overall, Jimbo would say Ipoh drivers are the worst drivers he has ever encountered, even surpassing the crazy drivers in Batu Pahat! (but people say Penang drivers are legendary in their notoriety)

Wed, 251109 @ 0800

Positive Living

Jimbo encountered a patient with an amazing attitude the other day.

At the end of the consultation, Jimbo asked the man, who has HIV and Hepatitis C who has been started on HAART, when he would like to be seen again:

Jimbo: When can I see you again? It’s a few months to the Chinese New Year and you may want to finish celebrating before you are seen again in the clinic.
Patient: It’s quite ok really, doctor, because everyday when I wake up in the morning, it’s a New Year for me! So it doesn’t matter when my next appointment is.

Amazing huh?

This man, who was brought back from the brink of death, now spends his time doing charity work here and abroad!

Simply amazing.

Friday, 201109 @ 0700

Management of Dengue Infection in Adults 2nd Edition

For those of you who are interested in the latest Clinical Practice Guideline for Management of Dengue Infection in Adults (2nd edition), you can download the Quick Guide here : (pdf format, 1.9 MB)

Thurs, 191109 @ 0700

Blackmail

Jimbo got to know about an incident which occurred a couple of weeks ago.

A 30-something man with HIV, Hepatitis B and C who was a drug addict and is now on Opioid Substitution Therapy with Methadone was attended to by a medical officer in the clinic.

Since he was started on HAART (Highly Active Antiretroviral Therapy), he found it difficult to sleep as one of the anti-HIV medicine was interfering with his Methadone dosage making it less effective. The sleeplessness was part of a withdrawal symptom. And since he could not sleep, he became dependent on Valium (a potent anxiolytic which makes a person very sleepy) which he obtained rather freely from clinics outside.

When he was at the clinic with the MO, he requested for Valium to be given to him. The MO being unsure, declined his request and referred the matter to the consultant. The latter, in turn, believe that problem is due to inadequate effect of Methadone and suggested an urgent psychiatry referral to sort out the Methadone dosage.

On learning that he will not be given Valium, the man allegedly got very angry and agitated.

He allegedly threatened to stop taking his HAART if the doctor did not give him Valium!

Jimbo saw the same patient in the clinic recently. He knew about the previous incident but did not mention it. He was cordial and was actually quite overjoyed to see Jimbo as he remembered was one of the very first doctors to see him back when he was in a terrible state.

Jimbo: How are you?
Patient: I am ok, putting on weight.
Jimbo: What about your sleep?
Patient: Not much better. I still can’t sleep (after that he narrated about what happened in clinic the last time; he omitted the part where he threatened to quit his medicine)
Jimbo: The psychiatrist are adjusting your methadone dose right?
Patient: Yes, but it’s not at a good level yet.
Jimbo: It will be, don’t worry.

When it was time to write out his prescription, Jimbo wrote, “T. Valium 10 mg ON/PRN” (10 mg of Valium to be taken at night as and when needed).

Whilst Jimbo felt it was wrong for him to threaten and blackmail his doctor, at the same time, Jimbo felt that his need for Valium at this point of time is very real and not an excuse to get a fix or high.

Wed, 181109 @ 0700