Sep 15, 2015
He is 80 years old but still works. His 3 children of over 30 years, 2 single and 1 married, wanted him to stop. They bought him a small car.
"One goes to NUS, one goes to NTI and the other one studies ACCA," he said to me today. "I did not even pass my primary school and so had to work very hard to educate them!"
He had to tolerate the bad tempers of his boss who was demanding. The boss lived up to 90 years of age and was a tough task master. He learnt the trade from him, from finding the best glue for the binding at least cost. In 1952, he imported his paper machine from Italy, a Priano which had two small bulbs and is still working. He had wired a short longer fluroescent lighting tube now.
Last year, an agent offered him $500 to get someone to assign the lease for $60,000. The deal fell through as the HDB disallowed any assignment for the new tenant. "At least I have till 2019," he told me. Many commercial shops have till 2016 to find an assignee if they want to quit. This is a policy to prevent rental hikes due to assignment fees increasing over the years. The HDB will police the trade and make sure that the tenant is really at work and not subletting. So there is no incentive to take over and the old book-binder now works half a day.
"I can't tender for the business," he emphasized. "I don't even know my ABC!". He is the subcontractor.
"Did you print and bind the condolence book for Mr Lee Kuan Yew?" I asked.
"Yes," he showed me a page. He also showed me a cover for the Anaesthetic Record book of a local hospital.
"How do you manage all by yourself?" I asked as his wife of over 70 years of age had not turned up. She is ill.
"I don't accept more than I can handle," he said. "I will ask for part-time help if I need it."
A much loved father and a loving husband. Mentally sharp at 80 years of age. Cluttered shop full of left over papers and 3X5" cards.
"No use for such cards," I said. "Now, the records are computerised."
"The government forces the people to computerise," he said."Or they will lose their operating licence.. Even for btothels as I print their visitors' book."
"For brohels in Geylang?" I was surprised.
"Yes, yes. However, the old workers do not want to touch the computer. And it is hard to find young Singaporeans to work in brothels to use computers to keep visitors' records. The government wants it so that they can come in and grab the whole computer in cases of investigation! The owner had to learn how to computerise but the workers are aged and do not want to do it!"
Tuesday, September 15, 2015
2294. 2nd visit: A lovable dwarf hamster keeps losing weight - sand bath allergy?
Sep 15, 2015
This dwarf hamster, around one year old, is very active but he scratches his sides and bites his bely. His chest hairs have dropped by 50% and he has actually lost weight.
In Aug 30, 2015, the daughter owner consulted me saying he keeps losing weight. He keeps scratching his left ear when I saw him. He weighed 46 g, a ball of action. A big abscess in his scent gland was drained and his longer lower incisor teeth were trimmed.
In Sep 7, the owner took him to another vet as the hamster had not put on weight. A skin test on the chest showed no skin mites. Anti-fungal, appetite stimulant, baytril antibiotics and anti-histamine oral were prescribed. Yet the hamster did not put on weight. So the mother consulted me as the hamster was not putting on weight.
Findings: A large nose pimple (digging into pelleted bedding and sand?).
Hair loss on both sides of the cheek pouch (sharp seeds stored inside the pouches?)
Hair loss on chest and top half of lower body (sand bath of different fragrances used daily, according to the mother).
What is the solution to the continuous body scratching and biting?
An allergy is suspected but the cause is unknown. It could be the fragrant sand.
"A change of lifestyle is needed," I advised not giving the daily fragrant sand bath and switch to paper litter. I would get the hairs clipped bald. The lower front teeth were OK and the hamster is hyperactive and much loved. But he just did not put on weight as all his litter food intake had been burnt out by his continuous scratching. (VIDEO).
Will need to follow up.
This dwarf hamster, around one year old, is very active but he scratches his sides and bites his bely. His chest hairs have dropped by 50% and he has actually lost weight.
In Aug 30, 2015, the daughter owner consulted me saying he keeps losing weight. He keeps scratching his left ear when I saw him. He weighed 46 g, a ball of action. A big abscess in his scent gland was drained and his longer lower incisor teeth were trimmed.
In Sep 7, the owner took him to another vet as the hamster had not put on weight. A skin test on the chest showed no skin mites. Anti-fungal, appetite stimulant, baytril antibiotics and anti-histamine oral were prescribed. Yet the hamster did not put on weight. So the mother consulted me as the hamster was not putting on weight.
Findings: A large nose pimple (digging into pelleted bedding and sand?).
Hair loss on both sides of the cheek pouch (sharp seeds stored inside the pouches?)
Hair loss on chest and top half of lower body (sand bath of different fragrances used daily, according to the mother).
What is the solution to the continuous body scratching and biting?
An allergy is suspected but the cause is unknown. It could be the fragrant sand.
"A change of lifestyle is needed," I advised not giving the daily fragrant sand bath and switch to paper litter. I would get the hairs clipped bald. The lower front teeth were OK and the hamster is hyperactive and much loved. But he just did not put on weight as all his litter food intake had been burnt out by his continuous scratching. (VIDEO).
Will need to follow up.
Monday, September 14, 2015
2293. 2 days after the General Election
Sep 13, 2015
It seems that the bookies had forecasted more opposition wins as all 89 seats were contested. The large crowds at rallies held by the opposition supported the forecast. The PAP would lose more seats as it had lost to the opposition in by-election due to a PAP MP resignation from an affair around 2011. There was a pattern of favouring the opposition to check the powers of a dominant party. Some high-handed civil servants caused much unhappiness and these have had impact on the ruling party.
But the PAP won with a bigger share of the votes. The PAP had more concern with the problems of the ordinary people, like job competition from foreigners, subway train breakdowns and high cost of housing. These were bread and butter issues brought up by the opposition in 2011. These issues were tackled well and shown to be caring.
So, there was a general increase in PAP's votes across the 83 seats and now it has the majority, it has the support of over 70% of the population. The bookies may have lost money. As for me, I have always voted for the PAP as it has a record of good governance as evident by the progress seen in infrastructure and economy.
For example, in Potong Pasir. It looks much brighter under the PAP which won the seat only in 2011 when Mr Chiam See Tong left to campaign in Bishan-Toa Payoh, leaving his wife to rally the residents to vote for her in the 2011. She lost by around 118 votes. This time, she around 30% as the residents are happy with the hard working and persevering PAP MP whom I have not met. The election success speaks for his efforts. I predicted he would win in a video 7 days before the election as he had the advantage of being an incumbent and had worked hard. I am not in his constituency but I could see the improvements.
Where other countries have high employment, here in Singapore, the unemployment is probably 5%. Therefore Singaporean employees are like kings as they are in great demand and many do not want weekend work. A work-life balance for them. So, who does the weekend and evening jobs in the private sector? Some employers need to close their operations. In 4 years' time, there may be a higher unemployment rate and the government gets the blame. Will the civil servants become more high-handed since they can't be corrupted with money?
Many Singaporeans including myself have had suffered from some of these high-handed unsympathetic civil servants in the regulatory authorities. I gave two examples:
1. A friend who used to vote for the PAP told me he voted for the opposition to check the powers of the PAP. He had seen many financial hardship cases. In one case, the woman asked for financial help to treat her husband's cancer. The bureaucrat said she did not qualify as her son was working. By the time the government gave her the check, she told the officer to present it to the coffin where her husband was in. This friend said that the government has lots of money and in this case, could have helped out. So he stopped voting for the PAP.
2. Some years ago, I did not meet the deadline for 100% completion of re-building of my veterinary premises.
The only fittings I did not have were no wooden cabinets and a receptionist table. There were the airconditioners, the water, electricity, the drugs, the anaesthetic machines, the lighting, the crates. The AVA officer, Dr Lau E K came to inspect and pointed to the absence of these items. He said I could sue the contractor for the delays. In any case, he would not license me to practise till I had these two items. He had the power and he exercise his power absolutely. Mine would be the first veterinary clinic that would not be licensed for lacking in wooden cabinets and a receptionist counter. Never mind that I had mobile cabinets and a table and chairs for the receptionist and clients. There was no mercy. Bad luck to me. He said no to my appeal to him to re-consider and walked out to go home after the inspection.
I just can't believe his lack of concern whereas the HDB officers tried their best to expedite my construction at all times and these HDB officers were also regulatory government officers. I appealed to the Director of Primary Production, Dr Ngiam and he could see that my clinic was operational. He permitted my licence renewal.
It is a hard to believe story but it is a true life experience I share with readers as regards the high-handedness of some regulatory officers.
It seems that the bookies had forecasted more opposition wins as all 89 seats were contested. The large crowds at rallies held by the opposition supported the forecast. The PAP would lose more seats as it had lost to the opposition in by-election due to a PAP MP resignation from an affair around 2011. There was a pattern of favouring the opposition to check the powers of a dominant party. Some high-handed civil servants caused much unhappiness and these have had impact on the ruling party.
But the PAP won with a bigger share of the votes. The PAP had more concern with the problems of the ordinary people, like job competition from foreigners, subway train breakdowns and high cost of housing. These were bread and butter issues brought up by the opposition in 2011. These issues were tackled well and shown to be caring.
So, there was a general increase in PAP's votes across the 83 seats and now it has the majority, it has the support of over 70% of the population. The bookies may have lost money. As for me, I have always voted for the PAP as it has a record of good governance as evident by the progress seen in infrastructure and economy.
For example, in Potong Pasir. It looks much brighter under the PAP which won the seat only in 2011 when Mr Chiam See Tong left to campaign in Bishan-Toa Payoh, leaving his wife to rally the residents to vote for her in the 2011. She lost by around 118 votes. This time, she around 30% as the residents are happy with the hard working and persevering PAP MP whom I have not met. The election success speaks for his efforts. I predicted he would win in a video 7 days before the election as he had the advantage of being an incumbent and had worked hard. I am not in his constituency but I could see the improvements.
Where other countries have high employment, here in Singapore, the unemployment is probably 5%. Therefore Singaporean employees are like kings as they are in great demand and many do not want weekend work. A work-life balance for them. So, who does the weekend and evening jobs in the private sector? Some employers need to close their operations. In 4 years' time, there may be a higher unemployment rate and the government gets the blame. Will the civil servants become more high-handed since they can't be corrupted with money?
Many Singaporeans including myself have had suffered from some of these high-handed unsympathetic civil servants in the regulatory authorities. I gave two examples:
1. A friend who used to vote for the PAP told me he voted for the opposition to check the powers of the PAP. He had seen many financial hardship cases. In one case, the woman asked for financial help to treat her husband's cancer. The bureaucrat said she did not qualify as her son was working. By the time the government gave her the check, she told the officer to present it to the coffin where her husband was in. This friend said that the government has lots of money and in this case, could have helped out. So he stopped voting for the PAP.
2. Some years ago, I did not meet the deadline for 100% completion of re-building of my veterinary premises.
The only fittings I did not have were no wooden cabinets and a receptionist table. There were the airconditioners, the water, electricity, the drugs, the anaesthetic machines, the lighting, the crates. The AVA officer, Dr Lau E K came to inspect and pointed to the absence of these items. He said I could sue the contractor for the delays. In any case, he would not license me to practise till I had these two items. He had the power and he exercise his power absolutely. Mine would be the first veterinary clinic that would not be licensed for lacking in wooden cabinets and a receptionist counter. Never mind that I had mobile cabinets and a table and chairs for the receptionist and clients. There was no mercy. Bad luck to me. He said no to my appeal to him to re-consider and walked out to go home after the inspection.
I just can't believe his lack of concern whereas the HDB officers tried their best to expedite my construction at all times and these HDB officers were also regulatory government officers. I appealed to the Director of Primary Production, Dr Ngiam and he could see that my clinic was operational. He permitted my licence renewal.
It is a hard to believe story but it is a true life experience I share with readers as regards the high-handedness of some regulatory officers.
2292. The commercial palm tree sucked out all water
Sunday Sep 13, 2015
After more than 10 years in my small plot of back garden, the palm tree had grown in girth to over 3 feet in diameter. Centipedes nested inside the trunk and crawl into the kitchen. All the cow grass had withered and the soil is exposed.
I got a contractor to uproot and take it away before it cracks the retaining wall of my back garden. I just can't believe this palm tree could be so water thirsty and large as Singapore does not have palm plantations. The other type of palm tree you see in Singapore grows slim and tall.
After more than 10 years in my small plot of back garden, the palm tree had grown in girth to over 3 feet in diameter. Centipedes nested inside the trunk and crawl into the kitchen. All the cow grass had withered and the soil is exposed.
I got a contractor to uproot and take it away before it cracks the retaining wall of my back garden. I just can't believe this palm tree could be so water thirsty and large as Singapore does not have palm plantations. The other type of palm tree you see in Singapore grows slim and tall.
2991. Titan the cat has difficulty peeing
Sunday Sep 13, 2015
I have known Titan the neutered male cat for many years. He had difficulty peeing many years ago. The problem was the high litter tray lined with newspapers. Every time he gets into the litter tray, he bruised his lower belly and penile area leading to pain. I discovered this by querying the owner as I did not see the litter tray. No more problems.
Then today, he came in with difficulty in peeing. He had also been rubbing his backside on the floor, Mr Thiru, the father had said.
"Has he been to the groomer?" I asked.
"Yes, last week." the Primary School teacher daughter said. Her father had sprained his left ankle and would wait outside the consultation room while I examined the fat Titan.
"Was he OK after grooming?" I noted that this lady groomer referred by me had done a great job (video).
"Yes," the daughter said. "He looked forward to grooming, but he is quiet when he sees the vet."
Titan was like a statute and did not claw or growl at me. Visiting a vet was not pleasant for him as he remembers me for giving him injections.
"He has stained anal areas as he had been licking it,": I expressed brown oil from the left anal sac. "He probably has an itchy backside, licking it to relieve his anal sac impaction. He needs to reduce weight as it is difficult to express his anal sacs with so much perianal fat tissues.
"His inflamed prepuce is swollen now and it is not possible to protrude his penis as in normal slim cats," I said. "That could be one reason he had difficulty in peeing. The reason I asked about a recent grooming visit is that the groomer may have had accidentally clipped his preputial area. This is unlikely as Clara is very experienced and the cat was OK for the past week after grooming."
"Titan loves the dry feline W/D food," the father said. "He would ask for more and my parents would pity him and give him."
"Give him a certain amount to achieve his weight of 6 kg," I referred the owners to a table of amount to be fed on the W/D bag to attain 6 kg.
"He will claw when he asks and no food is given," the father said. "I will let my parents know."
Titan is 12 years old but he is as fit as a young cat, dashing after birds and lizards. However, the daughter could not film him in action.
I prescribed antibiotics and painkillers for the next 5 days. No urine was available. The bladder was not swollen but painful on palpation. So, I could not do urine test. No X-ray for the time being.
I have a video of him for readers to appreciate his vitality and health.
.
I have known Titan the neutered male cat for many years. He had difficulty peeing many years ago. The problem was the high litter tray lined with newspapers. Every time he gets into the litter tray, he bruised his lower belly and penile area leading to pain. I discovered this by querying the owner as I did not see the litter tray. No more problems.
Then today, he came in with difficulty in peeing. He had also been rubbing his backside on the floor, Mr Thiru, the father had said.
"Has he been to the groomer?" I asked.
"Yes, last week." the Primary School teacher daughter said. Her father had sprained his left ankle and would wait outside the consultation room while I examined the fat Titan.
"Was he OK after grooming?" I noted that this lady groomer referred by me had done a great job (video).
"Yes," the daughter said. "He looked forward to grooming, but he is quiet when he sees the vet."
Titan was like a statute and did not claw or growl at me. Visiting a vet was not pleasant for him as he remembers me for giving him injections.
"He has stained anal areas as he had been licking it,": I expressed brown oil from the left anal sac. "He probably has an itchy backside, licking it to relieve his anal sac impaction. He needs to reduce weight as it is difficult to express his anal sacs with so much perianal fat tissues.
"His inflamed prepuce is swollen now and it is not possible to protrude his penis as in normal slim cats," I said. "That could be one reason he had difficulty in peeing. The reason I asked about a recent grooming visit is that the groomer may have had accidentally clipped his preputial area. This is unlikely as Clara is very experienced and the cat was OK for the past week after grooming."
"Titan loves the dry feline W/D food," the father said. "He would ask for more and my parents would pity him and give him."
"Give him a certain amount to achieve his weight of 6 kg," I referred the owners to a table of amount to be fed on the W/D bag to attain 6 kg.
"He will claw when he asks and no food is given," the father said. "I will let my parents know."
Titan is 12 years old but he is as fit as a young cat, dashing after birds and lizards. However, the daughter could not film him in action.
I prescribed antibiotics and painkillers for the next 5 days. No urine was available. The bladder was not swollen but painful on palpation. So, I could not do urine test. No X-ray for the time being.
I have a video of him for readers to appreciate his vitality and health.
.
Friday, September 11, 2015
Thursday, September 10, 2015
2989. INTERN VIDEO. Z-plasty in a very large wound
Sep 9, 2015
HOOK
BKTP
On Sep 8, 2015, the dog owner WhatsApp me an image of her bleeding 14-year-old Shih Tzu and asked whether she could treat the bleeding herself using the cream I had prescribed for the skin disease some 2 months ago.
"It is very difficult to advise you based on your smartphone image," I said. "It is best you bring in the dog for examination." Phone diagnosis can lead to a misdiagnosis. There are owners who lodge a complaint with the authorities if the dog develops sepsis and dies from bacterial infections of the blood due to a phone image mis-diagnosis.
The next morning on Sep 9, 2015, the owner brought in the dog. Thick dark red blood oozed out from below the armpit. This was not a simple case of bleeding. It was a large shoulder abscess. The dog turned his head to bite me when I tried to touch his painful right shoulder.
This is a very old dog. Sedation with anaesthesia is risky but the dog would bite or die from the stress of treating the abscess without anaesthesia. The owner reluctantly accepted the risk of anaesthestic death.
Sedation with IV domitor and ketamine at 0.15ml + 0.15 ml permitted my assistant to clip the wound area.
What are the other treatment options after debridement?
1. Let the wound heal by granulation. This wound is very big and the muscles below would become badly infected, causing pain and licking for months. The owner will need to clean the wound daily for many weeks. The dog cannot walk normally.
2. Stitching a large wound is best practice.
After debridement, the wound is gigantic. How to close this skin wound without the stitches breaking down 3 days later?
2. Z-plasty. It is best to close the wound to protect the muscles.
The procedure is described by me in:
One case done for removal of large skin tumour
https://www.youtube.com/watch?v=k_xgdWNKCi0
2. Then hydrogen peroxide was poured in to clean the wound further.
3. This wound was so large and under high tension. Simply stitching the ends together would not lead to healing as the stitches will break down in 3 days.
4. The solution was to use Z-plasty surgery and give painkillers and antibiotics.
See video footage.
As at Sep 10, 2015, the dog had been tightly bandaged to stop the subcutaneous bleeding. Antibiotics and painkillers are given.
Video dog standing with bandages on Day 2 post-op.
CONCLUSION
1. Early veteirnary attention by the owner prevented sepsis and death of the dog as bacteria would have travelled to the blood stream and infect the whole body. Blood test results.
2. Z-plasty takes a long time as compared to simple suturing of the two ends of the wound. In this case, there would be poor outcome making the owner very stressed out and unhappy. .
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