Monday, February 22, 2010

A present of flowers and a blade

February 22, 2010 (First Appointment in the Resale of an HDB apartment)

"Tonight, I will present my wife with a bouquet of flowers and a blade," the husband's first appointment at the Housing & Development Board's first appointment was aborted. The Housing & Development Board (HDB) officer had shown him a 2-page letter hand-written in big letters from his file across the table and said: "Your wife had written to object to the sale of the HDB flat. You have to engage a private lawyer or bring your wife to see me to withdraw her objection. I am sorry I can't proceed with the processing of the sale now."

This was a man in dire straits. Down and out. A bankrupt. "How do you expect him to engage the services of a private lawyer when he is a bankrupt and unemployed?" I asked the HDB official. I was helping Realtor Khin Khin in her first case and after a caveat lodged by a bank of this man's first buyer, I thought this first appointment was a formality. The racehorse had galloped past the turn and was in the straight heading towards the finishing post.

The Buyer's Agent, a slim serious looking housing agent who had just given the HDB officer the original letter from the Official Assignee (OA) approving the sale of this HDB flat said, "The private lawyer could be paid from the proceeds of the sale."

The HDB officer flashed the OA's letter at her: "I am sorry to say that there will no proceeds from the sale for the Seller." He meant that the OA would grab all the monies on completion of the sale. So, no money to pay a private lawyer's fees which would be at least $1,200 in cash. More if the case is complicated. This man in dire straits was hanging around a shopping mall according to Khin Khin who frequented the same place. Therefore he could not be gainfully employed.

"If the private lawyer is paid, is there a guarantee that the sale can proceed if the wife still objects?" I asked the HDB officer, a pale-faced trim man with reddish brown hair was sympathetic but he would not give any legal advices. Why should he take the risk?

However, he was a kind man as he gave this man in dire straits a second chance, during his lunch-time next week. He could just postpone the next appointment several weeks later if he exercised his powers. The HDB officials are very helpful in some of my experiences of dealing with them.

If this man in dire straits, at the pits could not sell his HDB apartment, the HDB would force sell at 90% of valuation. That meant he would lose at least 10% of the sales proceeds. Although he would not get any cash at the completion of sales, he still would get money returned to his Central Provident Fund (CPF). The OA would return all his CPF monies from the sales proceeds to the CPF before paying the other creditors. I calculated that the balance would be around $5,000 for the creditors.

With his wife's objection lodged without his knowledge 2 months ago, he was fixed. If the HDB forced sale his apartment, he would lose out a lot of money.

As we left the HDB, I knew that this man was pushed to his mental limits. Would he be committing murder? I asked him "Why do you want to present your wife the flowers and the blade together?"

"Well, she has to choose one or the other," the man in dire straits said. "It will be best if you can arrange a meeting with your wife and I together to talk over," I knew that this man had suppressed his emotions and his frustrations for many months. I was surprised that he was not involved with the loan sharks as his HDB apartment was spared the spraying of paint and vandalism. He and his wife were residing there in peace. If he could complete the sale of his HDB apartment, he could have some freedom to travel overseas to work. Now, the OA would not permit him to travel overseas as he did not "contribute" to return monies to the debtors.

It is not easy to contact this man by phone as his top-up card and phones keep being "lost". Now, there are 7 days to wait and see.

Tuesday, February 16, 2010

27. Chinese New Year 2010's interesting cases

Report written at Toa Payoh Vets: Feb 16, 2010. Chinese New Year (CNY) 3rd day. Still a holiday. I wrote the following since I was quite free.

CNY reviews of interesting cases.
During Chinese New Year, almost all Singapore small animal vets close. Feb 14, 2010 was Chinese New Year and also Valentine's Day. Toa Payoh Vets do open half days during Chinese New Year. During last Chinese New Year, I had no cases and so I thought the same would happen this time. However, there were a few cases. Vomiting and diarrhoea in dogs accounted for 3 cases. The following were some interesting cases for dog lovers.

Case 1. Hypersexuality in the male dog.
The career lady was in charge of a regional publishing operation and had no time to take leave. She planned one month ahead and took several days' leave to care for her Miniature Schnauzer after neutering as advised by me. Her dog had inflamed areas in his groin region due to humping and licking.

The dog was groomed first. Multiple rashes on his lower body. Treatment for 4 days. Then I neutered him and sent him home 4 hours after neutering. He would be given Tolfedine 60 mg at 1 tablet per day. I phoned the lady and she said that the dog felt no pain and was just normal. I told her that the urine analysis showed that the dog has no urinary crystals unlike the previous test in which some triple phosphate crystals were found. The dog had spermatozoa in the test, as in previous test. Why? This male dog had an anti-social habit of humping onto legs and pillows, injuring his groin area. I hope neutering would help as he is already 4 years old. Neutering before 1 year of age would be best. This owner slims her dog down now as she cooks for him. No more dry dog food. She takes good care of him and I expect this dog to live up to 20 years. He is only 4 years now and may outlive me as I am 15 times older than him.

"You can't shout at him," the gentle lady boss told me. When I commanded the Schnauzer in a firm voice to be still on the examination table, the dog suddenly turned around and opened his mouth to bite me. I just withdrew my fingers in time. No tough love for this dog. But no gentle kind words from me. I muzzle him instead.

Case 2. Medial Entropion. Shih Tzu, 7 kg, Male, Neutered, 1 year, 39deg C. Persistent eye tearing since puppyhood.

The Shih Tzu is well known for medial entropion causing life-long tearing and irritation but few owners are aware of a simple surgery to resolve the problem. Seldom does the owner bother to take the surgery. A case is recorded below for the benefit of vet undergraduates. Name of surgery: Nasal fold excision. I didn't know there is such a surgery.

Admitted: Feb 2, 2010
Surgery 1: Feb 5, 2010
Surgery 2 (left eyelid tearing on day 6, right eyelid has no tearing): Feb 11, 2010. Excised a bigger elliptical skin area below and lateral to the medial canthus. Rolled out the left eyelid more. Took out stitches of right eye area to review. Wound opens up as the area is under tension and has not healed firmly as it was 6 days only. Has not healed 100%. Re-stitch.

Tolfedine 60 mg (1/2 tab/day) x 10 days
Baytril 50 mg (1/2 tab/day) x 6 day
e-collar, eye drops
Daily cleaning of eyelid area is necessary for the next 10 days
Nylon 5/0 stitches to be taken out on Feb 25, 2010
Goes home on Feb 17, 2010 (pictures taken on Feb 16, 2010. Phoned owner at 10.30 am wakening him up.)

Case 3. Anal sacculitis or circum-anal tumour.
Miniature Pinscher, male, 5 years with hard lump on left anal sac area. Anal sacculitis/circum-anal tumour surgery. Heals well. Goes home on Feb 16, 2010. Is this a circum-anal tumour? Still Alive And Kicking - Circum-anal tumours. Should the dog get a second anti-androgenic injection and be neutered? Many owners are against neutering deeming it to be a cruel act. Or in this case, the dog is deemed too old and a anaesthetic risk. So I do not pursue the matter further as the owner may think that I am soliciting business from her and from the owner's point of view - this is patently obvious. Update: 2004 tips for young and older dogs

Case 4. Torticollis (head tilt) in a rabbit.
CNY 1st day. Rabbit, female, 2 years, 1.7kg
Feb 14, 2010 (Chinese New Year).
Left head tilt. Sudden onset at 1 am (loud noises heard). Left eyelid wide open. Nystagmus. Right eyelid injured as rabbit lies on right face. Keeps rolling to try to get up.
Ear canal - blood in cotton bud seen from deep inside the ear canal. Irrigate ears.
Prednisolone, Meloxicalm oral, Biolapis, Fiberplex. SC dextrose saline and baytril. Sent home the 2nd day as she could stand but with head tilted. Less Nystagmus. The lady owner to nurse and hand feed. No blood test or X-rays for the time being as this would increase vet costs.

CNY 2nd day.
Case 5. Suspected high fever in a hamster.
White dwarf hamster, Male, 14 m,
Eyelids closed. Not eating 2 days. Sleepy for 2 days
Young teenaged boy was upset that his pet became sick when he was in China for 9 days.
SC dextrose and Baytril and eye drops.
Day 2 - conjunctivitis and tearing esp. right eye (photography) and dehydration - will need electrolytes. Eating. Stools passed but only a few pieces. Not a good prognosis.
Owner to disinfect hamster cage, feed bowl and water bottle.

CNY 3rd day. Still a public holiday.
Case 6. Deep ulcerative keratitis in a Chihuahua.
Chihuahua, 2.6 kg, 38.8. adopted for 2 months. Abandoned. Eye cataracts. Possibly >8 years old. Male. 2.65 kg.
Right corneal eye ulcer very deep. Blood spots. Past 2 weeks. Why the delay? The owner thought it was a small matter.
Anaesthesia is high risk as dog has heart disease. Bad teeth. Eats only wet food. Big right flank abscess > 4cm x1 cm
Really eating? Owner asked to bring food to Surgery for me to check. 3rd eyelid flap on day 2.

Case 7. Poodle, Male, 2 years. Dental scaling. I was surprised that the lady owner made an appointment for dental scaling for a young dog. Rarely do Singapore owners bother at this age. Grooming 3-monthly and regularly yes. The external beauty is a priority.

But teeth check up once a year? No. This young dog eats home-cooked food and no dry food. So plaque and tartar form in the back teeth. Daily brushing will resolve all problems. Some dogs don't like teeth cleaning. This lady may be one of those more sophisticated ones who know the importance of dental health to enable her dog to live longer.

Case 8. A tele-conversation with a pet owner. One owner complained that his dog had been losing weight since being warded. His vet prescribed many types and sizes of capsules containing nutrients and vitamins for his old dog to "prolong his life". Yet the dog lost weight while he was warded. He said he was not given progress reports. The dog would not eat when brought home as he was force-fed. I don't make comments in this case as I only get one side of the story. Just provide a listening ear as I am sure that there will be owners with grievances against me as a vet.

Case 9. A tele-conversation with a new vet undergraduate. Young people prefer texting. I prefer phoning to thank Daphne for her help in producing 2 educational videos for vet students recently. Creating educational videos to bring veterinary surgery alive. She had been an intern at Toa Payoh Vets. I gave her my very best wishes for her new adventure as a veterinary undergraduate in Australia. She saw 5 beautiful Miniature Schnauzer puppies at a practice and was saying how cute they were. New-born puppies always tug's a lady's heart strings. I told her I did not perform the Caesarean section but was taking pictures. Oxytocin injection and wait or an elective Caesarean section?

This 2010 CNY was not a quiet day unlike 2009 CNY. My main lesson is from the feedback in Case 8. It is important that the vet does daily rounds of in-patients and check records of weight loss and appetite as a routine no matter how busy they are. Phone the owner to update and to phone the owner to visit the pet if the pet is dying. Before the pet dies so that the owner can pay the last visit. I wonder whether this is taught at veterinary schools for the 5th year students.