Odysses Pg 3
A Wild-Goose Chase cont'd 

(j)  Period of self assessment and desperation

 

I was quite certain that my liver damage was the result of my consumption of Chinese medications for nearly two months. But I did not feel any pain or discomfort from my stomach and I could still play my usual golf without buggy or caddy, exercise in my gym and walk the usual distance in Bt Kiara. I had already stopped taking all medications except my normal vitamin, ginseng and gingko supplements. Now I also decided to drastically reduce my consumption of alcohol.

 

About twelve days after my self abstinence, I went to BP Lab in SS2 on 9th June to have my blood taken for Liver Function Test. The next day when I went the BP Lab to collect the test report, the receptionist greeted me with a solemn face and gave me the report without saying a word. I looked at the report and was stunned to see that my level of ALT had shot up by another 100%!

 

I was at a complete loss of what to do next. But I had decided, based on my recent experience, not to seek consultation with any local liver specialist. Again I looked for one in Singapore and was pleased to locate one, via the Internet, which is the Asian Centre For Liver Diseases in Gleneagles Hospital and is next door to Eye Clinic Singapura.                     

 

Appointments were made to see the liver specialist, Dr Desmond Wai on 18th June and also eye specialist Prof Arthur Lim on 17th June on my next visit to the plantation in Pagoh. When I spoke to the receptionist at Asian Centre For Liver Diseases I explained briefly to her my liver problem and told her I would bring along all my medical test reports.

 

After the last blood test report, I decided to abstain from consuming all alcoholic drinks and all my normal supplements.

 

Before I departed for Pagoh/Singapore I went to BP Lab again to have my blood taken for another Liver Function Test. Below shows the summary of the series of my blood test results on SGOT/AST, SGPT/ALT and Gamma Glutamyl (GGT).

 

Dates

AST

(8-37)

ALT

(5-44)

GGT

(12-64)

Remarks

22/10/07

19

19

35

In the pink of health

 

27/05/08

124

245

52

1st discovery of liver damage. Stopped Chinese Med.

09/06/08

124

482

93

Two weeks after stopping Chinese medicines

14/06/08

73

284

93

5 days after stopping alcohol and supplements

17/06/08

67

211

85

Test taken in Singapore

 

 

I was really panic stricken when my ALT shot up to such a high level nearly two weeks after I stopped taking the Chinese medications. It led me to wonder whether it was due to the Chinese medications or something else. When it started to come down subsequently, I began to feel more at ease.

 

(k)  With Asian Centre for Liver Disease

 

I reached Singapore at noon on 16th June and after checking into the Traders Hotel, walked to the Gleneagles Hospital. As I would be seeing Dr Desmond Wai early the next morning, I went to his clinic to register. After registration, I handed to the receptionist all the medical reports I brought along including a little note I prepared on the recent history of my medical problem. I was asked to go to another clinic to have my blood taken for testing.

 

I went to see Dr Wai in his office the next morning. He was a young, friendly and energetic doctor who migrated from Hong Kong. It was obvious that he had browsed through all the medical records I had submitted the day before as, without any further examination, he categorically told me,

 

“Your liver problem was due to ingestion of Chinese medications. In other words, you have Drug-Induced Liver Injury or DILI.” He further said,

 

“According to a clinical study carried out recently, it had been established that many traditional complementary and alternative medicines (CAM) accounted for a major proportion of offending drugs in DILI in Asia.”

 

Without much hesitation, he handed to me a copy of the study carried out in 2006/7 by him and a few others entitled “Drug-induced liver injury at an Asian centre; a prospective study”. He said that among the 31 DILI patients under the study, Chinese traditional CAM was the most common medication type implicated. Many were tested to contain harmful adulterants.

 

I had brought along the latest (27th May) medicines prescribed by Ti - a small plastic bottle containing a dark coloured solution and two types of tablets. When I showed them to Dr Wai, of course he would not know what they were but he said these could be tested to find out the added adulterants. He told me that in his study, all CAM were tested without charge in Pharmaceutical Lab, Health Sciences Authority, Singapore. When I asked him whether the three types of Chinese medicines I brought along could be similarly tested by the Lab, he immediately called the person he knew in the Lab and made the enquiry. Yes, the Lab was prepared to carry the tests but I had to pay out of my own pocket. Each test would cost me S$1,000. I decided to go ahead with the tests and was prepared to pay because as I told Dr Wai, I wanted to know the truth and furthermore, it would be of public interest if the medicines were adulterated.

              

Before departing, Dr Wai advised me to do blood tests fortnightly and said that my liver would be fully restored in four weeks.

 

Before we parted, I asked him whether I could resume my alcohol consumption. He retrieved my blood test report of 27/10/07 and commented:

 

“According to the report of 27/10/07 you were a very healthy person; go ahead and do what you did to yourself during that period.”

 

When we parted I felt very much relieved and was happy that my trip to see Dr Wai was well worth my while.

 

No medication was prescribed for me; unlike my family GP and other medical practitioners who tried to prescribe some even though they were not aware of the root cause of my problem.

 

I went to BP Lab in SS2 to have my blood taken for liver function tests on 01/07 and 14/07. The results of these tests are shown below.

 

Date

AST

ALT

GGT

01/07

25

51

62

14/07

24

35

50

 

As predicted by Dr Wai, my damaged liver recovered progressively after I stopped consuming the prescribed Chinese medicines and was fully restored four weeks after I had resumed my normal activities, including my visits to the pubs with my friends!

 

On 15th July I received an email from Dr Wai. He informed me that the Chinese medicines I submitted to the Pharmaceutical Lab of Health Sciences Authority of Singapore were tested against about 140 known drugs and found none was contaminated or adulterated with any of them. But he said that though the results meant that the Chinese medicines I took were not adulterated with western medicines they could still be the cause of my liver damage.

 

What do I do next? More tests or forget about it? 

 

(l) Second visit to Eye Clinic Singapura                                                                  

 

My main purpose of coming to Singapore this time was to seek advice from the liver specialist. As Asian Centre for Liver Diseases and Eye Clinic Singapura were neighbours, I took the opportunity to see Prof Lim again to make some further enquiries about my eyes.

 

I was in the Eye Clinic Singapura in the afternoon of 16th June after my registration with the Asian Centre for Liver Diseases. Prof Lim’s assistant first did my vision tests and asked, “Where are your glasses?”

 

I replied, “I don’t have to read here and so I left my reading glasses in the hotel.”       

 

We gave you the prescription for your glasses last time you were here. We expect you to make the new glasses for all purposes and not just for reading,” she commented.

 

“Yes, I made two pairs, one for reading and one for distant vision and outdoor activities. But I found it difficult to adapt to the latter and so I discarded it,” I replied as a matter of fact.  

 

No, you must try to adapt to the new glasses; try to have one for all purposes. It may take a week or two for you to adapt to your new glasses,” she advised.

 

After completing all tests, I was ushered into Prof Lim’s office. The latter went through the test reports and commented, “Your eyes are in good health, particularly your implants. But you have astigmatism and you need to wear glasses.”

 

I realized my folly, but I tried to give an excuse by saying, “I am not used to wearing glasses, what about replacing my present eye implants with multi-focal ones?” This was one advice I wished to get from him when I decided to see him the second time.

 

“Yes, you can have two new multi-focal lens implants, but you have to consider two things.” Prof Lim replied and he continued, “Firstly, you already found it difficult to adapt to your distant vision glasses. With new multi-focal plastic lens implants, you may find it more difficult to adapt to them. Secondly, your present lens implants are in excellent condition, why do you want to get rid of them? Think about it and if you want to go ahead you’ve to see Dr Ong.”

 

My eyes were dilated and while waiting to see Dr Ong, my appointment to see Dr Choo for my eye-bag removal was due. Dr Choo explained in details the operational procedure to remove the eye bags. The operation had to be carried in the operation theater in the hospital to remove the excess fat in the eye bags. After the operation, the sutures would be removed after a week and during this period; one should refrain from driving and swimming. The operation would take an hour or an hour and a half. He further added,

 

“The removal of the eye bags will not improve your vision, but it will make you look younger!”

 

Prof Lim happened to walk by and interjected, “Lee Kwan Yew had his eye bags removed but he still looks the same!”

 

Instantly I told Dr Choo that I would consider it and let him know my decision later. But in my heart I had decided not to proceed.    

 

After I left Dr Choo’s office, I waited to see Dr Ong to seek his advice on my proposed multi-focal lens implants. I started to reflect on my recent episode with my medical problem.

 

Why do I need to remove my eye bags and replace my current lens implants? These are superfluous actions which may cause further complications. Don’t trouble trouble until trouble troubles me; so I told the nurse attending to me that I had decided not to go ahead with the removal of my eye bags and replacing my current lens with multi-focal lens implants.

 

THE END OF MY WILD-GOOSE CHASE?

I was happy when I thought I had finally reached the end of my long and tedious search for a remedy – a simple pair of multi-focal glasses! But I was advised by the eye specialist and optometrist that I had to adapt to wearing them. However, more than four months after I had obediently worn my new pair of multi-focal glasses I was  unable to adapt to them as I still had the dizzy sensation walking in the open, looking down to search for something I dropped or looking up at the durian tree in my garden to admire the many maturing fruits.

My vision deteriorated after my return from New Zealand. By the end of October, I decided to pay a visit to an optometrist to have my glasses and eyes checked. The results of the tests were shocking and I had to seek immediate treatment to my left eye. The rest is another story. 

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