0 (Waiting to be) discharged

Last few moments in the hospital ward. Document procedures sure take long! Just had my last meal, again from the Western selection. "Cream of green pea soup; Slow braised minced chicken caccitore and vegetable." A wee salty overall and had the "canned" taste, from the tomato sauce to the pea soup. But lately salty food has been appealing to me (usually not the case). - baaad. The oatmeal this morning was slightly thicker, an improvement from the watery version I had a few days ago. Their "peach compote" ended up as half a canned peach, and the lemon ricotta was non-existent. But I can do without cheese in my oatmeal, thank you.

Anyhow, my latest weight is 33.3 kg, meaning I gained ~2.5 kg over 6 days, which averages 0.4-0.5 kg a day. Is that too fast a rate? But I'm happy and feel better. No more bak chang feet though now the swelling has decided to hit my abdomen - BIG TIME. I'm like an underaged 4 month pregnant woman. Hope this issue reverts back to normal soon and is not a symptom of another condition!

Happy to be outta here!

0 Discharged

I'm a free bird! No more drips and needles and radiation and cold air-con and unappetizing breakfasts and back to hot creamy oatmeals! Though I shudder and the thought of the state of my flies and horrendous amount of lab work that's piled up in just 6 days

Hospital meals today were exceptionally good. I had Western full diet for both lunch and dinner. Lunch was "Grilled Chicken with Orange Veloute, Mashed Potato and Steamed Vegetables." The grilled chicken was the chicken chop kind which means it was fatty in some areas. Nevertheless, there were enough lean parts to fill my tummy. The orange veloute was not so much of a veloute but a sauce, but still, it gave a nice citrusy kick to the dish. The mashed potato came in the form of wedges instead, with skins on. It was nice in a sinfully salty way, though I tried to just eat the fluffy insides and avoid the fried outer parts. Dinner was "Seared Snapper, Salad Nicoise with Citrus Vinaigrette and Butter Rice." The seared snapper was awesome. Their version of "salad nicoise" meant carrots, green beans and yellow zucchini, which I don't see in what way resembled the real mccoy. Nevertheless all forms of veggies are good and I'm not complaining. Tmr's breakfast offered the seemingly appetizing option of "Hot Oatmeal with Peach Compote and Lemon Ricotta". After two days of Rude Health's Spelt Oaty's and bites of Larabar's Chocolate Cherry Torte for breakfast, I decided to risk having watery oatmeal again. Let's see how it turns out.

0 Status update

Bad news. The results of the chest X-ray showed lung infiltrates which the Dr diagnosed as pneumonia. So I'm being quarantined here a couple more days - boo. There's some good news though; I'm off the vitamin IV drip so I'm more mobile now (no need to call nurse every time I need the loo). The morning and evening sessions of albumin and antibiotic drips continue though. I think another upside to being confined to hospital is that I am forced to finally start writing my thesis, because otherwise there's absolutely nothing else to do.

Food-wise, I'm starting to get sick of their food, already from the second day. There's this characteristic "salty" MSG-like taste in all their dishes. I thought the Western menu sounded appetizing when it was described as "poached white fish." I expected a slab of flaky fish like cod, or (lowering my expectations) dory or sutchi. Instead what came was a mound of hard, salty shredded flakes. How is this ever acceptable as hospital food - at a private one to boot? I was really thankful for Mum bringing the takeaway salmon seafood aglio olio for dinner last night. This morning's oatmeal was not only cooked in water (I'm still bearable with tasteless plain oats), but in way too much water such that it became a watery mess. I miss my thick, protein powder-creamified oats with a hundred toppings. Luckily I had Larabar (chocolate cherry torte) and Sunbutter to tide me through.

Feel a bit of chest pain and breathlessness even as I'm sitting down typing now, hooked up to antibiotic drip. Not sure if the condition is getting worse? Edema is now fluctuating on-off (with albumin administration)?

0 For the second time

I've been admitted to hospital again, 6 years later. A few days ago (since Saturday), edema of the feet and ascites decided to strike. It persisted a few days until it became sort of unbearable, so mum made an appointment with Dr. RC. A blood test revealed quite worrying results - hypoalbuminemia and a depressed RBC and haemoglobin. Now, I'm in G741 - a four-bedder ward, on an IV drip supplemented with vitamins, and intermittent doses of albumin. It's been about 1 hour since the albumin infusion, and already I feel an amelioration of the edema. I hope it's not placebo effect (I've yet to visually verify the edema symptoms).

I've been prescribed a "soft diet," which suits me just fine. In fact the dinner of double seaweed soup with silken tofu, fish slices and jasmine rice was a simple but tasty meal. If there's anything to complain about, it's the lack of veggies; a few strands of floating seaweed don't count as a serving of veggie! And I thought hospital food is supposed to be "balanced" and "healthy." Tsk. Fuji slices and a nice hot cuppa milo on the side.

It's peaceful here; the other patients are female with ages ranging from 30s-70s. The air-con is quite cold but their hospital robe is pretty large and warm. The only downside is that I have to call the nurse each time I go to the toilet, because I'm attached to the drip. And I pee rather frequently. I shan't make this a long post because I'm typing with one hand and it's slow and I have to do work too. More updates tomorrow.

0 The truth hurts

Today was quite an interesting day - medically. I had a chest X-ray and ultrasound scan for the liver at Gleneagles. It was my first experience with ultrasound and there is nothing frightening about it; not that I was apprehensive in the first place. The nurse would rub some gel on the body part that is to be scanned (the abdomen in my case). You'd lie down on the bed and she'll use a handheld device to roll over different areas, asking you to breath in and out. Since the nurse was rubbing the abdominal area, some instances provoked a ticklish sensation and I had to use my utmost restrain not to burst out laughing. The results for both the X-ray and ultrasound were good; no abnormal growths detected in both areas except for "mild scoliosis," a condition I had since secondary school.

The results for the blood test was also out and my vitals were mostly within the reference range, including glucose, HDL, LDL, protein, and the minerals such as calcium and haemoglobin. However, my potassium was slightly above normal, as was my polymorph count. Nothing too out of the range though, so no cause for worry.

I guess I should be happy and relieved that I have been given a clean bill of health - internally. However, the most significant problem remains, which is the condition of being grossly underweight. I shall not hide it any longer; as much as I hate to face it, I have to acknowledge that my present weight, 29.9 kg, is horrifyingly scary and in fact, I should actually be warded already. I don't know why the weight keeps dropping. It is evident that Ensure, calcium pills and protein powders, which I have been taking for years, have not help alleviate the decline. Sometimes I secretly and morbidly wish that I actually had a medical condition, maybe not so serious as cancer but an hitherto undiagnosed disease, which I can blame for my underweight condition. But no; as the results indicate, I'm okay and the issue likely lies with the diet and portion sizes.

No pain no gain. Success stories about how obese/overweight people shed those pounds by eliminating their favourite fatty foods with healthier alternatives. It was hard for them, but with determination and discipline, they did it. Does that mean I have to give up my favorite foods (incidentally low calorie-type like pumpkin, sweet potatoes, veggies, fruits) for for higher calorie "denser" foods? After all there's so much volume of food one can consume a day and it makes better sense in terms of comfort to consume less of something high-calorie, than a huge quantity of something low-calorie.

Which brings me no my next point. Should I do calorie counting? It's a pain-in-the-ass and time-consuming but at least it gives a precise, systematic approach in tracking my intake, perhaps vital at this point. Otherwise I'd rely on my [non-existent] appetite cues which makes it very vulnerable to relapse. Currently I'm not counting calories (to think of it I have never really done so), but rather weighing portions as a form of tracking, like 32g buckwheat flakes for breakfast. I suppose maybe this method is easier (as no need to convert to calories) and I should stick to it.

In short, I know I need to gain weight and I really want to gain weight. I think my fear is the discomfort experienced in the process - bloatedness, fullness, having to constantly eat 24/7. But I must remind myself that the end result of better health will be worth all the pain. What I need to do now is to create baby goals and start an action plan. So here goes:

Goal: +1 kg in 1 month

Action (to be reviewed in one week i.e. next Thurs):

Drink Ensure/Ensure Plus at least every alternate day

Do 35g oats for breakfast (up from 32g)

Do 95g brown rice for lunch/dinner (up from 90g)

Do larger portion of protein

Four feasible steps that I can manage. I'd better not set too many or I know I'd just end up not following any. Although the changes seem negligible, I cannot make stark changes or the refeeding syndrome may kick in (or am I just making excuses again).

Today I also made baba ghanoush/ghanouj (roasted eggplant dip) for the first time. I will be posting the recipe soon! And thoughts of Cambodian fish amok are swirling around in my mind as I think of ways to use up all that coconut flesh from the young coconuts.

0 Getting fixed... one more time

It's the beginning of another round of hospital visitations, this time at a GI clinic in Gleneagles. I don't know why I always end up weeping at the doctor, although there's no reason to. I think it's just the stressful environment and the traumatic history of being hospitalized. Anyway, I was glad I didn't have to take my stats today, for I know it's the worst ever, even below diagnosis 6 years ago. But I was not glad to have my blood taken (fine veins + low BP = multiple needle pckings) or having to give a urine sample (dirty job). I also had a vit B12 injection to my buttocks. As you know, vit B12 promotes nerve function, which kind of makes me feel superior considering I have a test tomorrow ;). Come December, I have an ultrasound scan lined up to check for liver function, chest x-ray as well as an appointment with the nutritionist (fourth nutritionist so far).

In short, I really do hope and will try to get things right this time. I want nothing more than to stop all these depressing hospitalization visits.

4 The big fall

Woo hoo! Just submitted my LONGEST essay ever! I think it's 4000+ words? Anyway, I shouldn't be too overjoyed because I still have ONE more 3000 remaining, which I havent absolutely not start on, and to be due in one week!

On a side note, today I had a major fall at the escalator landing of TTSH. It was partly my fault and partly the Malay woman's fault. As usual, I was trying to squeeze my way through the afternoon lunch crowds, including those inconsiderate pple who either don't keep left on the escalator, such as this Malay woman with her baby pram. As I got off the first escalator and walked towards the second one, my slippers (maybe I shouldnt have worn haviannas?) got caught in the wheels of her stupid pram and I couldnt react in time. I fell forward with a thunderous thud on the metal landing of the second escalator. Heads turned, whispers were passed. And most vivdly, an intense jolt of pain coursing through my myelinated A-delta fibres from the sensory neurons in my knee and elbow, to the dorsal root ganglion and then up to the ventroposteromedial (VPM) thalamus in my brain (applying my neuroscience here, heehee). I supposed it could have been much worse; I could have fallen against the sharp edges of the escalator steps or (touch wood) knock my head against the steps and have a concussion! On hindsight, maybe then I would be relieved of all my essays and exams and robbed of my memory and then have a new start in life. Okay that's going a bit to far now.

So I hobbled home, and the rain did not make it any better (I forgot my umbrella). So there, my unlucky day.

0 Another week gone by

Several interesting events happened this week.

First, met up with another potential FYP prof yesterday. I was quite taken aback - and somewhat disapointed - by the offerings. Due to resource constraints, he offered a "dry" bench project, actually two in fact: a computer animation one and a MRI analysis. I'm pinning my hopes on LKL now; otherwise I may consider Tang or Tan. It seems all my friends have secured their projects already. I'm so late in the race!

This morning I was woken up at 5 AM by an irritating engine that whirred and grooved non-stop. It's similar to those kind of inconsiderate motorcycles, except that there wasn't any Doppler effect, meaning the vehicle was stationary - and blaring. It was only 4 hours later that I realized why - a dark blue Mercedes car had rolled into the longkang. Oh, what bad luck he had. Seriously, I pity him. Only at 9 AM was the tow truck there to pull his car away.

During immuno lab today I got to test out my own saliva for IgG and IgA - an assay reflecting my oral health. S. mutans, the main bacteria for tooth decay, was the antigen. IgA is found in the mucosa and oral cavity, and so expected to be present in high amounts (though too high is also not a good indicator), but IgG is mainly in the blood so not expected to be in high amounts. However, there was 2.3 units/ml IgG detected (by indirect ELISA), compared to friend which had negligible amounts. Attributable to gum bleeding? Maybe.

This semester, if anything, has made me an essay churning machine.
Bye bye, more essays to write, although its Good Friday tomorrow.

5 Unwinding with durians

Finally, the end of a super long tiring week.

I didn't even know I had a doctor's appointment today, until I got home and Mum went, "You've got to go in 5 minutes." What a shocker. The appointment went almost as usual. Gained about 1 kg since pre-Cambodia, but that may have been due to water weight (I was kind of needing to go to the toilet when I took my weight). Doc said I needed to up my fats, either directly or through increasing carb (which will then convert into fats). But the latter is not a highly feasible option given that most carbs would be converted into proteins (more essential for the body) before fats. Anyhow, I got a new prescription - vit B compelx.

At Bugis Village, mum bought a $30 packet of mao shan wang. Was the price justified? You bet! I daresay was the most creamy, lightest and yet potent mao shan wang I had ever, almost like a souffle!

Hmmm... ideas coming to mind with durian recipes!

0 Through an algorithmic lens

Origami is addictive. At least I get an excuse to 'play.'

Work disguised as play. I like that.

2nd appointment with homeopathic today. The verdict? "No significant change at the physical level." Retest in 5 weeks (23 Feb).

0 Sock that eye!

Gross. I just found out today that I have pressure sores on my butt. And it's not just a minor sore; it's a flaking, discolored and large patch of dry skin, more serious on my left butt than on my right. I don't know why I only discovered it today and not earlier. I mean, although sometimes I do feel "butt pain" after sitting down for too long, I have never expected to develop a disgusting pressure sore! Initially it wasn't that painful, but after my itchy fingers tried to peel out all that flaking skin, the skin area now is quite tender, and a wee bit painful to sit. A sign of too much sitting and studying?

That horrid thing aside, I'm loving myself some wild Alaskan sockeye salmon, which I got 1/3 off from Waitrose. What's the difference between the premium sockeye and the regular pink salmon? First the observable differences - the flesh of the sockeye is a deep pink, bordering on red (hence also known as a 'red' salmon), while the flesh of the pink salmon is, well, a pale pink. The red coloration of sockeye (or red salmon in general) comes from its diet - krill, a type of small shrimp. Now comes the taste test. I've been mostly accustomed to having pink salmon, but now that I've tried the sockeye, I've realized how much I've missed out! The sockeye salmon has a richer, more assertive 'salmon' flavour, which explains its premium price. But really, it's so good!

Also, I've got heritage potatoes (fortyfold), and together with the salmon, I had my own version of "fish n chips" - baked salmon with hasselback potatoes and a side of roasted mushroom/veg mix. (The potato skin didn't crisp up as much as I would have liked to :(.) Also check out my wacky plate!

P.S. I might just do a spontaneous trip to Brighton tmr.

1 For the last first time

Today was a day of many firsts.

Black Cherry Chocolate Spirutein

I tried out my first Spirutein energy supplement in Black Cherry Chocolate in lieu of the usual Ensure Plus. I followed the instructions and added 3/4 of the packet of powder to a mix cold soy milk and ice-cold water, which I found weird because usually powders are added to hot liquids to aid dissolution. I stirred the mix vigorously, dubious as to whether the powder would dissolve. Surprisingly, it did, though only after quite a bit of stirring and not completely. To sum up the taste experience, it was blackforest cake packed into a drink - great flavour but overly sweet. The bits of dried cherries floating about was also kind of annoying as it interfered with the drinking process. On the plus side, Spirutein comes in an amazing range of 20 (!) flavours like Chocolate Peanut Butter Swirl, Double Fudge Crunch and Peaches & Cream. If I ever buy Spirutein again I would get those without the fruit pieces. Overall I still prefer Ensure/Ensure Plus for it being less sweet. Nutrition-wise, I would say Spirutein is more suitable for those looking for protein enrichment (110 kcal, 0 g fat, 15 g carb, 14 g protein) while Ensure Plus is a more balanced source of energy (300 kcal, 9.8 g fat, 40 g carb, 13 g protein).

First cookbooks!

I finally put the $50 worth of Kinokuniya gift vouchers I received a year ago to good use and bought my very first cookbooks: 500 mediterranean dishes and 500 vegan dishes of the 500 recipes collection. At first I considered buying cookbooks by well-known figures or even celebrity chefs, but then I decided that perhaps generic cookbooks would suffice, at least for me the novice cook (and I wouldn't have to pay for all the celebrity fluff too). The 500 recipes cookbooks boast plenty of pictures, easy-to-read texts and multiple variations for each recipe. For example, the basic squash & apricot tagine in 500 vegan dishes can be varied by using beans & apple or prunes. For $15.95 for each book, I think it is very worth it. Hopefully this will inspire me to cook more and expand my repertoire of recipes :) I also bought a small London travel guidebook by Time-Out for my upcoming exchange.

Then just outside Orchard Building, I had my first up-close encounter with models who were, I believe, part of an event for the launch of H&M. Okay, I wasn't that close to them, just about 5 m away, but it was the closest I'd ever seen a real-life model. Now I fully understand what is meant by being a "head-turner." The male and female models were mostly Caucasian, tall, slim, leggy, decked out in trendy (H&M) wear, and veiled under a layer of immaculate make-up. Many Singaporeans were inevitably gawking at them, and some of them stared back - they were simply standing outside Orchard Building as if waiting for something to happen. I felt so... small, so underdressed and so ugly next to them. They made me feel like I was from outer space and a total different breed from their species. I guess this is what it takes to be a model.

I met mum at Plaza Sing to get party decorations and run some other errands. The day culminated with dinner- a bowl of shrimp Ipoh hor fun (soup) - at Angel Kitchen at Cuppage Plaza which was simple and good. They are better known for their curry chicken, which mum had. I bought the last bowl of hor fun available!

3 I have wings

Not too long ago, I discovered I had grown wings. But there's nothing funny about it and it is, in fact, quite worrisome.

In medical parlance it's called winged scapula. For the layman, it is the condition where the shoulder bladebone sticks out unnaturally. Mum alerted me to it a few months back when she hung her arm across my shoulder and noticed that my right shoulder blade protruded more than my left one. I didn't pay much attention to this until recently, when I had more time to... examine my body. When I stand with my right side perpendicular to the mirror, the hump of the right shoulder blade is visible, but less so when I stand with my left side perpendicular to the mirror. It becomes more obvious when I use a face mirror to see the reflection of my back: the right shoulder blade is definitely more prominent than the left one.

I googled for information. The underlying cause of scapula winging is usually muscle weakness and/or imbalance. Some knowledge of anatomy will be useful here. Normally, the scapula is held in the correct position by two opposing muscle groups: the anterior deltoid and pectoral muscles in the front and the serratus anterior muscles and trapezius in the back.

When there is a weakness in the back muscles (serratus anterior & trapezius muscles) and/or overdevelopment of the front muscles (anterior deltoid & pectoral muscles), scapula winging may result. So apparently my front and back muscles are not developed equally. Moreover, those who spend long hours at the computer/sedentary work and do not participate in activities that engage fully the shoulder muscles are at higher risk of developing wings. Hmmm... I think I belong to this group. I'm wondering too whether the wings developed as a result of my scoliosis, or the other way round.

Fortunately, winging can be corrected by exercises that work the back muscles. Now I just need to read up more on the exercises and have the discipline to do them everyday. I don't know how long it will take to go away, or whether it will even go away (hopefully it does!). I just don't want it to deteriorate any further. Imagine a bone protruding out over your t-shirt. Eww. Why must I have so many physical problems?