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

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

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

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

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

Jimbo hasn’t really tested the macro function of his Canon IXUS 80IS which he bought a while ago. Last weekend provided a good opportunity as the rain let up for a couple of hours, allowing Jimbo to venture out with his camera for some quickie shots. Here are some nicer ones:

Tues, 171109 @ 0700

Jimbo heard the other day, from a friend in church, that the Malay word ‘potong’, which means ‘cut’ has become a much vilified word lately, mainly due to an advertising blitz of a local wireless broadband provider.

Apparently now, it’s politically incorrect to use the ‘P’ word as its meaning is now associated with ‘circumcision’!!!

Some people have, apparently taken offense to the advertisement, saying it belittles women. How exactly, one does not quite comprehend. Personally Jimbo thought it was a pretty creative advertisement. It certainly got everybody’s attention!

And so the meaning of the word ‘potong’ has changed, almost overnight! Just like how the meaning for the word ‘gay’ has changed: now people look at you one kind if you should declare, “I am feeling so gay today!”.

Jimbo hopes Dewan Bahasa and Pustaka would come out with new words for these Malay sentences quickly since the meaning of the word ‘potong’ has changed:

1. Dia potong jalan saya. (He circumcised my way)
2. Potong gaji. (Circumcised salary)
3. Saya mahu potong rambut hari ini. (I want to circumcise my hair today)
4. Potong stim. (Circumcised steam)
5. Ais krim potong. (Circumcised ice cream)
6. Sepotong roti. (Circumcised bread)
7. Saya mendapat sepotong baju dari ayah saya. (I got a circumcised clothing from my dad)

By the way, just so you know, circumcision actually PROLONGS the act of coitus rather than hasten it, so Jimbo don’t see how people can misunderstand that advertisement since it says, once you “cut already, it becomes faster”!!

Mon, 161109 @ 0700

It’s confirmed.

It runs in the family.

First Darlene, Jimbo’s 10 year old kid, did it 2 years ago.

Now, Ryan, Jimbo’s 5 year old kid has done the same!

When asked by his sister if squirrels lay eggs or have babies, Ryan answered:

“SQUIRRELS LAY EGGS”!!!!

Jimbo and Mrs looked at each other in wide-eyed disbelief at what they had just heard before bursting into uncontrollable laughter!

*Stunned! Speechless! Pengsan! Double-pengsan!!!*

Must be some kind of genetic defect from Mrs Jimbo’s side! LOL!!!!!!

Sat, 141109 @ 0700

Jimbo and team’s research project which was published recently has attracted one local interest. Jimbo received the following email yesterday:

(Letter has been edited to erase names and institutions)

Hopefully, he could initiate changes in the medical landscape of this country (our Health Minister is too busy fighting over non-health related things to bother) since he has a title to his name!

Fri, 131109 @ 0700

The mind is an amazing thing. It is not limited by physical boundaries. Anything is possible, all you have to do is to imagine it.

Which is why, Jimbo takes delight in watching his son at play. The little fella can make a space ship out of a clothes peg, simply because his mind says it’s possible. And he would spend hours playing with a pair of clothes pegs, one chasing the other. In his little mind, they are 2 space ships hurtling through space, one in pursuit of the other!

The other day, Jimbo watched in fascination as Ryan build his mini ‘zoo’.

In his little head, he could not see why it is impossible to place giraffes and bears side by side on top of the zoo entrance. When told that it is probably not a good idea to place lions so close to the area where zebras are kept (after all, the latter are the former’s lunch and dinner!), he looked at his daddy with the look that says, “My daddy can be so dense sometimes”.

“The lions can’t cross over because there is an invisible electric fence around them!”, he replied flippantly.

Yup, there’s magic in the little fella’s head.

Thurs, 121109 @ 0800