1013. Travels broaden your mind if you know how
It is 8.42 am May 30, 2012. I have just returned from a 5day-4night packaged tour to Hong Kong, Shenzhen and Macau on May 29, 2012. Packaged tours are the least expensive way to travel and if you know how, the best way to broaden your mind if you know how to do it.
Shopping till you drop in air-conditioned comfort is a favourite of the Singaporean traveller. I will not be commenting on this retail therapy as I prefer not to visit the shopping malls of other countries if possible.
How to broaden your mind in your travels?
1. Listen more. Listen to your tour guide to gain knowledge of the world.
An experienced guide will provide much local information v. Singapore's situation. For example, my lady tour guide in Hong Kong mentioned that only 20% of the residents get public housing while 80% of Singaporeans get public housing. She was incorrect in the sense that the 20% of Hongkongers are renting public housing at very low subsidised rental rates while 80% of Singaporeans are "owners" of 99-year-leasehold HDB apartments. The statistics mean nothing to the average Singaporean but there is an economic significance. For example, the young Singaporean couple will find it better to buy the HDB flat rather than rent as rental flats, even in Hong Kong, are subject to long waiting lists and prices have had shot up recently.
2. The world is nowadays much more competitive. Speak to your tour guide and know how competitive her job and the travel industry has become over the last two years. Too many travel agencies have been set up and the more successful ones have grown big and can take away the business of the small ones. Success creates success. If you own a small business, like a solo veterinary practice you can see that you will be affected too as the bigger surgeries recruit more vet graduates and attract more Singaporean clientele. The new employees work a year or two and set up their own practices. So, there is an increase in competition for jobs, promotions and mates over the last few years, just like the travel industry has been forced to deal with direct internet bookings by prospective travellers and low budget airlines compete with established airlines like Singapore Airlines which has to compete in the premium business class with Emirates Airlines.
3. More IT-savvy younger generation. These are the ones that select their clients based on the lowest quotation and then the quality of service. In this tour, a group of "seven pretty girls" as the Macau tour guide referred to them in Cantonese, used their handphone to show the guide the itinerary. Not the usual printed paper but from the phone. When the tour guide gave her phone number to them to contact her for travel arrangements the next day, her phone rang immediately. One of the seven said she was the caller. This young generation knows what to do to verify the connection instantly.
4. Develop a sense of humour in life. Learn how the Macau tour guide has the sense of humour in reprimanding the client and yet get laughter. One example would be from paragraph 3. When the Macau tour guide answered her phone as it rang immediately when she gave her phone number, she said, "Shwai loi" in Cantonese. Ii can be translated to "naughty girl" and the group laughed. No ill feelings.
5. Be outstanding if you want attention. One of the seven ladies had a special hair cut. The Macau tour guide called her "Ma Been loi" in Cantonese. "Loi" refers to woman or lady in Cantonese.
"What is the meaning of "Ma Been"? Do you know Cantonese" I asked one of the other 7 ladies. "I am not Cantonese. It is the type of hair-style," her friend or sister said. The "seven pretty women" are sisters and cousins.
6. Ask if you don't know. Many young ones are afraid to ask as they may reveal their inadequacies and lack of knowledge. Obviously, a young one has less knowledge as the person is young. Don't be afraid to ask. I am 62 years old and though I understand and speak Cantonese, I still asked the tour guide what is the meaning of "Ma Been"? I would guess "Ma" refers to horses. "Been" refers to tail. The Macau tour guide told me the hair-style resembles the tail of the horse. As an ex-racehorse vet, I could see some resemblances. A picture is worth a thousand words and I will show you one.
I never had a chance to talk to the "Ma Been loi" though.
7. Learn to open up by replying with a sense of humour. The Macau tour guide said, "I have 22 female tourists today. You are the only male." I had not been observant of this fact. "Men work hard to make money," I said to her. "Women work hard to spend the money made by men." So, what was I doing as a thorn amongst roses?
8. Create a lasting impression by telling stories of your personal experiences. The Hong Kong and Macau tour guides are ladies and experienced. They could communicate very well and so created a good impression. That is because they don't stop chattering. Unfortunately, they use Cantonese often and for me, it was home ground as my mum spoke Cantonese to me while I was younger.
Singaporeans seldom speak Cantonese but Mandarin nowadays and so they feel left out, in my opinion. The guides do speak English and Mandarin but most of the time, it was Cantonese. No Tagalong for the two Filipino women joining the tour in Macau. However, the younger generation of Macau and Hong Kong residents learn more Mandarin but they prefer not to be tour guides. I guess the money is not there.
9. Walk the streets to know the real life of the residents. Hot and humid. Showers. Why not just stay in air-conditioning shopping malls?
Unfortunately, you will miss much gaining knowledge if you just prefer to be in air-conditioned places as the vast majority of residents in Hong Kong, Shenzhen and Macau don't have this luxury. Too smelly in wet markets. I went to one in Hong Kong and it was a street photographer's dream site. Will show some pictures. The blood, the gore and the foul smell puts off most of the younger Singaporeans. Our wet markets are well ventilated and all pork must be sold in air-conditioned fridges in wet markets. Our enforcement officers against pork sellers in this wet market will net them a gold mine as pork sellers display their trotters and ham hanging up in open air. Our bureaucrats think of ways of making food safe for the public and drafting more regulations to control the type of trade. Then they wonder why the cost of living goes up with the years. See my pictures of the vast competition in this wet market. It was like survival in the jungle as there are more fish sellers with live fishes seen in this market than any wet market in Singapore.
10. Don't put your backup discs in the same laptop bag. I left my laptop in Hong Kong International Airport as I was busy taking pictures inside the airport. Practice makes perfect pictures. I put the two back up discs in my camera bag, not the laptop bag. So, I don't lose my precious memories of my travel from May 26 - 29, 2012. I phoned Hong Kong Airport at 9.30 pm. "No such laptop," the reply came and I left my phone number. So, no hope. Fortunately I had my two backup hard discs with me.
11. Excellent Service Provider from Cathay Pacific. At 10.30 pm, the Hong Kong Airport officer phoned me to say they found it. I doubt any airport lost luggage will bother with me. On May 30, 2012, I phoned Cathay Pacific HK at 8.10 am thinking they have not started work (as like most offices in Singapore), I got a fast response from HK and I would get my laptop back from CX 739 reaching Singapore at 3 pm today. This is incredible service from Hong Kong and there is much my veterinary practice has to learn from them.
12. Survey to get feedback from customers. The HKIA (Hongkong International Airport) girl asked me to do a survey. When she checked that my last country of travel was Cambodia which was not on his survey list, she said thanks. On Cathay Pacific CX711, an Indian steward supervisor in red silk blouse asked me if I could fill up a survey form. Survey is always good to check on staff. Overall, I rated their services as No. 1 and that was before I discovered that I had left my laptop at the HKIA. Feedback surveys are important and keeps staff on their toes. I do my own direct survey of the performance of my vets and staff by asking about the case outcome and being at the reception table and answering phone calls some days. No other way to ensure a high standard of care and service nowadays.
13. Don't complain about inconveniences or mistakes of service providers. On May 26, I checked into L'Hotel at Lina Towers and was given a beautiful room 61-12 facing the lifts. I was surprised there was a wooden bench inside the bathroom and the toilet bowl was higher than usual. The sinks were much smaller than normal. The shower rail was lower. Why is there a bench inside a bathroom? I thought it was a sauna bathroom. You just sit on the bench and sweat it out. Since I was not into sauna baths, I did not bother. Actually, this was a handicapped room. The hotel receptionist phoned later to ask if I wanted a normal room but this was OK for one night. The 4th night I returned back to the hotel, I was much surprised to be given the suite room. This room was at least three times in floor area compared to the normal room, had a bath tub, separate shower and toilet bowl. There was a marble table for four, a big dressing table, a foyer. The view of the harbour was around 180 degrees from inside the room. I would not book such a room as it would be costly.
Updates at:
http://www.designtravelpl.com/Folder_3/20120529travel-broadens-your-mind-singapore-ToaPayohVets.htm
Pet health and care advices for pet owners and vet students, photography tips, travel stories, advices for young people
Wednesday, May 30, 2012
Thursday, May 24, 2012
Old dog lost 3 kg in 2 weeks.
The dog was treated by Dr V on May 1, 2012 for coughing. The cough had disappeared after 3 days of drugs and the dog stopped eating. Blood test was taken but he said that he was not told of the results. I apologised to him and reviewed his records. Liver enzymes were high and Dr V had prescribed heart medication and advised review in 14 days . However, he did not turn up and now it is May 24, 2012 and the dog is very thin and weak. A loss of 3 kg from May 1 to May 24 is too drastic.
Now it is very thin. The 62-year-old man came with his daughter. As he had white hair, I said incorrectly that his grand-daughter was accompanying him. I asked Dr Daniel to handle this case with me. Respiratory rate and pulse were normal.
SIGNIFICANT FINDINGS
1. Below normal rectal temp at 37.5
2. Weight loss
3. No appetite and does not drink water.
4. Periodontitis Stage 4 and painful throat area.
5. No abdominal pain or swelling of the liver which is good news.
6. Penile sheath was swollen.
7. Heart murmurs.
"This dog could be more than 15 years old," the father said. He remembered I did a tail amputation on a tail lump in 2007. "He had seizures in 2010," I saw the record but he could not remember. His daughter confirmed and said no more seizures.
What's the cause of this loss of appetite and painful throat? Blood test, urine test and IV drip done first.
Now it is very thin. The 62-year-old man came with his daughter. As he had white hair, I said incorrectly that his grand-daughter was accompanying him. I asked Dr Daniel to handle this case with me. Respiratory rate and pulse were normal.
SIGNIFICANT FINDINGS
1. Below normal rectal temp at 37.5
2. Weight loss
3. No appetite and does not drink water.
4. Periodontitis Stage 4 and painful throat area.
5. No abdominal pain or swelling of the liver which is good news.
6. Penile sheath was swollen.
7. Heart murmurs.
"This dog could be more than 15 years old," the father said. He remembered I did a tail amputation on a tail lump in 2007. "He had seizures in 2010," I saw the record but he could not remember. His daughter confirmed and said no more seizures.
What's the cause of this loss of appetite and painful throat? Blood test, urine test and IV drip done first.
Management meeting on May 23, 2012 8pm
Dr Vanessa and Mr Min were held back after the last case at 8 pm as I wanted to meet them to communicate their work performances to them. Frequent trust and audit meetings are necessary at this stage as workers and vets find it very hard to change their mindset and ways of working. This applies to all businesses.
I took out medical records done by Dr V yesterday to illustrate and to get improvements in standard of care.
Discussion centred on meticulous record keeping, evidence-based medicine to diagnose yeast infection and other skin diseases, in-patient recording to be kept for file, not just elsewhere, X-ray and other records to be kept in one file. Litigation prevention with proper records including consent forms and correct diagnosis.
Accounts to be properly filed. Interns to be guided and made sure they are gaining the experience and coming on time - a file to be started by them and Min to supervise. Min to speak out and reply when asked a question and to let me know if he has problems at work. "There are many graduates and vets in Myanmar out of job," I told Min. "Every year there are new graduates, even in Singapore. Therefore, wake up each day with happy feelings that you have a job you have been trained for as a vet in Myanmar and open your own clinic like Mr Saw at the end of the contract." Min was saying that Dr Saw in Yangon is doing very well.
These are old issues but need communications again as it is part of management. Change management is seldom effected without communications and explanations.
I took out medical records done by Dr V yesterday to illustrate and to get improvements in standard of care.
Discussion centred on meticulous record keeping, evidence-based medicine to diagnose yeast infection and other skin diseases, in-patient recording to be kept for file, not just elsewhere, X-ray and other records to be kept in one file. Litigation prevention with proper records including consent forms and correct diagnosis.
Accounts to be properly filed. Interns to be guided and made sure they are gaining the experience and coming on time - a file to be started by them and Min to supervise. Min to speak out and reply when asked a question and to let me know if he has problems at work. "There are many graduates and vets in Myanmar out of job," I told Min. "Every year there are new graduates, even in Singapore. Therefore, wake up each day with happy feelings that you have a job you have been trained for as a vet in Myanmar and open your own clinic like Mr Saw at the end of the contract." Min was saying that Dr Saw in Yangon is doing very well.
These are old issues but need communications again as it is part of management. Change management is seldom effected without communications and explanations.
1010. Westie puppy can't open his mouth - Craniomandibular Osteopathy
Yesterday, May 23, 2012, I answered a phone call. A lady wanted to speak to an experienced vet (Dr Sing) at Toa Payoh Vets. She had consulted another experienced vet (Vet 1) who had apparently diagnosed her Westie as having enlarged "lymph nodes" and prescribed antibiotics and medication. After that, the Westie puppy again had difficulty in opening her mouth.
"I know my Westie is suffering from an inherited disease called 'lion jaw'," she could not pronounced craniomandibular osteopathy and told me to surf the internet for 'Westie, lion jaw'. She was not happy with the breeder but would not return the puppy.
I identified myself and told her that I had not come across the disease in my 40 years of practice. "Singaporean breeders seldom breed Westies," I said. "This breed is not easy to breed for some reasons. This breed has a type of skin disease."
I advised her to go back to Vet 1 who is experienced and has X-rays facilities. Even experienced vets cannot be expected to know everything in every breed and in every system, but we are learning every day. The internet is a great help and many owners know more than the vets in specific disease conditions!
An image of a Westie with "lion jaw" is at:
http://www.flickr.com/groups/westie/discuss/72157622728730796/
"I know my Westie is suffering from an inherited disease called 'lion jaw'," she could not pronounced craniomandibular osteopathy and told me to surf the internet for 'Westie, lion jaw'. She was not happy with the breeder but would not return the puppy.
I identified myself and told her that I had not come across the disease in my 40 years of practice. "Singaporean breeders seldom breed Westies," I said. "This breed is not easy to breed for some reasons. This breed has a type of skin disease."
I advised her to go back to Vet 1 who is experienced and has X-rays facilities. Even experienced vets cannot be expected to know everything in every breed and in every system, but we are learning every day. The internet is a great help and many owners know more than the vets in specific disease conditions!
An image of a Westie with "lion jaw" is at:
http://www.flickr.com/groups/westie/discuss/72157622728730796/
Tuesday, May 22, 2012
Do-it-yourself (DIY) tail docking a Schnauzer X
"My puppy's tail is swollen and Vet 1 gave him an injection yesterday," the man with three 7-week-old puppies brought one to amputate the dead swollen tail. "I brought him to see Vet 1 yesterday and was told that tail docking is illegal in Singapore. But I see many dog breeders doing it."
"Tail docking of puppies are not banned in Singapore," I asked what material he used to do tail docking of his Schnauzer X as the puppy was already 7 weeks old and he started tying the tail at the first week of age
"I read in the internet that dental floss strings are the best," he replied.
"Most breeders either dock the tails at day 3 or use a rubber band," I said. "The rubber band strangulates the tail. The tail becomes gangrenous as it gets no blood supply and drop off after around one week. It is very painful for the puppy."
For this man, the tail was still around for the past 6 weeks. One puppy's tail had just dropped off. The other had a tail that still has feelings. Only this Schnauzer's tail was dead and swollen at the strangulated area. He wanted tail amputation.
ANAESTHESIA
Miniature Schnauzer X, 7 weeks, 1.6 kg.
What safe anaesthesia to use? The puppy is still not mature.
I used Domitor and Ketamine at 50% of the usual formula and add an equivalent 0.15 ml of saline, totalling 0.3 ml given IV by Dr Daniel
ELECTROSURGERY
"How will you amputate the tail?" I asked Dr Daniel.
"V-shaped incision," he said as that was what his professors had lectured. I asked him to sketch his plan.
"There is a big septic dead area and the V-shaped incision will comprise some of the gangrenous area," I said. "Use my surgical approach which consisted of two horizontal skin incisions on the dorsal and ventral aspect of the tail. The dorsal incision is further away from the anal area than the ventral but as far from the gangrenous strangulated wound as possible." Then the dorsal area will flap downwards covering the whole tail, giving a good cosmetic appearance."
I have never used the "V-shaped incision" method in tail amputation but it can be one of the alternatives.
"Tail docking of puppies are not banned in Singapore," I asked what material he used to do tail docking of his Schnauzer X as the puppy was already 7 weeks old and he started tying the tail at the first week of age
"I read in the internet that dental floss strings are the best," he replied.
"Most breeders either dock the tails at day 3 or use a rubber band," I said. "The rubber band strangulates the tail. The tail becomes gangrenous as it gets no blood supply and drop off after around one week. It is very painful for the puppy."
For this man, the tail was still around for the past 6 weeks. One puppy's tail had just dropped off. The other had a tail that still has feelings. Only this Schnauzer's tail was dead and swollen at the strangulated area. He wanted tail amputation.
ANAESTHESIA
Miniature Schnauzer X, 7 weeks, 1.6 kg.
What safe anaesthesia to use? The puppy is still not mature.
I used Domitor and Ketamine at 50% of the usual formula and add an equivalent 0.15 ml of saline, totalling 0.3 ml given IV by Dr Daniel
ELECTROSURGERY
"How will you amputate the tail?" I asked Dr Daniel.
"V-shaped incision," he said as that was what his professors had lectured. I asked him to sketch his plan.
"There is a big septic dead area and the V-shaped incision will comprise some of the gangrenous area," I said. "Use my surgical approach which consisted of two horizontal skin incisions on the dorsal and ventral aspect of the tail. The dorsal incision is further away from the anal area than the ventral but as far from the gangrenous strangulated wound as possible." Then the dorsal area will flap downwards covering the whole tail, giving a good cosmetic appearance."
I have never used the "V-shaped incision" method in tail amputation but it can be one of the alternatives.
Hypersexuality is hard to diagnose
Trust and Audit case
An interesting "skin disease" case
TP 42859
Pom White Male Born March 2012
(one year two months now as at May 22, 2012)
Born March 2011. Fluffy coat
Around 8 months, hair starts to drop from back area
1. Vet 1 in another practice attributed it to "puppy hair loss". Not much loss at that time.
2. Mar 18, 12 Vet 2. Complaint alopecia. Licks flanks, alopecia flanks and ventrum, no crusting, erythematous scaling Neoderm cream.
3. Apr 20, 12 Vet 3. Cream not better. Pustules. Hair around anus growing. Skin infection.
4. May 14, 2012. Vet 4. Bald, bilateral alopecia. I suspected hormonal imbalance, possibly testosterone. History important. Humping cats and people. I diagnosed hypersexualtiy. Castration.
5. May 22, 2012. I phoned. "More calm and less sex drive since castration."
Blood test slightly elevated enzymes.
How to squeeze the anal sacs? owner asked.
An interesting "skin disease" case
TP 42859
Pom White Male Born March 2012
(one year two months now as at May 22, 2012)
Born March 2011. Fluffy coat
Around 8 months, hair starts to drop from back area
1. Vet 1 in another practice attributed it to "puppy hair loss". Not much loss at that time.
2. Mar 18, 12 Vet 2. Complaint alopecia. Licks flanks, alopecia flanks and ventrum, no crusting, erythematous scaling Neoderm cream.
3. Apr 20, 12 Vet 3. Cream not better. Pustules. Hair around anus growing. Skin infection.
4. May 14, 2012. Vet 4. Bald, bilateral alopecia. I suspected hormonal imbalance, possibly testosterone. History important. Humping cats and people. I diagnosed hypersexualtiy. Castration.
5. May 22, 2012. I phoned. "More calm and less sex drive since castration."
Blood test slightly elevated enzymes.
How to squeeze the anal sacs? owner asked.
Monday, May 21, 2012
1007. Final report on "No Smoke Without Fire - No scabies without mites"
Webpage:
http://www.sinpets.com/dogs/20120522scabies-hard-to-find-singapore-ToaPayohVets.htm
http://www.sinpets.com/dogs/20120522scabies-hard-to-find-singapore-ToaPayohVets.htm
No Smoke Without Fire - No Scabies Without Mites?Dr Sing Kong Yuen, BVMS (Glasgow), MRCVS21 May, 2012 |
toapayohvets.com
Be Kind To Pets Veterinary Education Project 2010-0129 |
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