One week of the year

Hong Kong is classified as a 'sub-tropical' island. Which roughly translates to 3 months of stinking hot, humid weather, 3 months of moderately hot weather, 5 months of temperate weather, 1 month of cool weather during the winter. Occasionally, during winter you might experience one week of cold weather. Not biting cold, but moderately uncomfortable weather. During this time, it's not unusual to see an over-reaction to the cold from the local populace. This over-reaction rears its head in the form of down jackets, gloves, scarves and beanies. 

Last year's winter was so moderate I don't even think I used a jacket, did I? Whereas in 2016 it got numbingly cold as the mercury dropped below five degrees Celsius. Most people will say that this year's summer was not as 'hot' as previous years, or cooler, which brings me to this winter, it definitely feels cooler. It could also just be that my apartment feels colder and indirectly, I feel colder.

I have been fundamentally opposed to buying a heater that will be used for one week of the year, only for it to end up in storage. Especially in a country where abundance of storage is non-existent. However, now that I am an official Hong Kong Resident I am entitled to my very own winter over-reaction, a heater. 

I'm too old to be cold.

The Silly Season

Towards the end of August, I found myself on a short hike out in Ham Tin. The day finished with seafood and wine in Sai Kung town. The following day, I woke up with a very achy sore right foot second toe; at the time I attributed the soreness to walking 45 minutes (yes, it was a short hike) in thongs. The soreness lasted a couple of months. Fast forward to Christmas Day and once again I've woken up with an incredibly sore foot. Specifically, where the big toe meets the ball the right foot. Different toe, same achy pain. Curious situation. I didn't kick a cinder block, or walk any substantial distance, I wasn't wearing new shows. Two separate instances that I've woken up with a sore toe, with no obvious moment of trauma.

So me, being me, I do three things. The first thing. I try to identify shared commonalities with the lead up to both events. One day of walking, one day without much walking. One day with lots of wine, one day with lots of wine. One day of outdoor activities, one day of socialising. One day with lots of cheese and seafood, one day with lots of seafood and purine-rich foods (think: liver and red meat). The second thing. With the help of the internet I jump to conclusions. The third thing. I go to my doctor and tell him that I think I have gout. He seems skeptical about this non-medical diagnosis based purely on my symptoms and my previously low uric acid levels appeared to suggest that gout did not seem likely. He then refers me to a foot specialist.

The Orthopaedic surgeon - she also doesn't think it's gout. Overarching medical consensus is that I would not be able to walk and that I would be experiencing more pain, even with acute gout. One thing that I've realised with my year of interaction with the medical system is that it's a lot of trail and error, attempting to diagnosis the symptoms with the aide of scans and test to come to a conclusion. We take an X-ray and find that there's no fracture, however there is a bit of bone that is floating right above the big toe. Which although unusual is unlikely to be the cause of my sore right toe. 

Here's the report:

The patient complained of right big toe pain and second toe pain for a few days. There was no history of injury. There was no family history of gout. The pain was exacerbated on walking. There was no rest pain. He also complained of left ankle instability symptoms. There was history of recurrent sprain for years. He last sprained his left ankle in mid Nov 2020.

On physical examination, there was minimal hallux valgus and bunionette deformity. There was no claw toe. There was mild callosity over the right second metatarsal head. There was a 5mm mobile roundish bony swelling at the right foot dorsum at subcutaneous plane. It was non tender on palpation and the Tinel sign was negative. 

For the left ankle, there was tenderness along the anteromedial joint line; there was also tenderness over the anterior talo-fibular ligament (ATFL) and the calcaneo-fibular ligament (CFL). The posterior talo-fibular ligament was non tender. Lateral laxity was grade 2.

X-ray right foot showed a bony loose body around the first metatarso-phalangeal joint, and minimal hallux valgus deformity.

So the soreness is likely to be caused by mild Hallux Valgus, or poor foot stability. However, in the space of 24 hours, I've gone from thinking that I have a uric acid problem, to finding I have a free floating piece of bone in my right foot, to having to get an MRI on my left ankle. It really is the silly season.

Boxing Day

It's a weird feeling being grounded in one place for such a long time. Living in Europe and Asia has provided the ability to travel with very little planning, thought and even gratitude to having access to so many destinations; It's something that I had definitely taken for granted. As we draw towards the end of the year it is kind of nice to have everybody in town. Christmas and New Years in Hong Kong always feels like a partial affair, most of the group are away traveling, visiting family back home or just making the most of the winter holidays.

I like to think that this year's Boxing Day is an ode to previous Boxing Day's in Sydney. Me on the sofa, with little appetite from the Christmas Eve and Christmas day over eating. I'm watching the Boxing Day Cricket test, eating Tim Tams and Minties, while navigating the "virtual" Boxing Day sales with some online shopping.

Pranayama and Meditation

The Anahata Pranayama and Meditation course is held twice a year. The pace is noticeably slower compared to the foundational course that I attended earlier this year. The emphasis less on Asanas (poses) and (not surprisingly) more on Pranayama (breathing) and Meditation. There are 16 students enrolled in the December class which suggests that there is less interest in the topic compared to the Asanas, or potentially the effect of Covid. The start of the course coincided with the fourth wave in Hong Kong, and aside from two classes that were held in the studio, all the classwork was done online.

There is some overlap with the chakras, kriyas and bandhas but majority of the content was new. I particularly enjoyed the breath work content. Once again, there is a practical component, which requires the student to walk the class through a meditation technique as well as a pranayama technique. Three teachers, Anurag, Dhiraj as well as Yogananth guiding us through the practise. 

15,500 HKD (~2,000 USD) - lucked out as work paid for the course

High school Reunion: 20 years on

Earlier this year a group invitation popped up on my socials for a "Canterbury Boys' High School class of 2000 reunion". I remember being overseas for the previous 10 year student reunion and it looked that 10 years later I would also be in the same situation. High school reunions fall into the "nice to attend bucket", not something you would explicitly travel for, but definitely something worth attending if accessible. As I scrolled through the list of invitees, names popped up that looked familiar. Others names, not familiar to me, forced me to pause and think "who's that?". The class of 2000 was small, if memory serves me right there were around 60-70 students who went all the way to year 12 and not remembering these names was really no excuse.

Fast forward to December of this year and a collection of photos starts to populate my feed. An afternoon event held at an ex-student's food truck. I scroll through the photos, so many familiar faces as well as some that I don't recognise. The photos are all smiles. I see faces from my group, and the odd handful of friends that I still keep in touch with. There are also students who started and left our school through the years. Our old grade teacher, Ms Player also attended which looked to be a nice touch.

It's an odd feeling looking at these photos. Passing of time, these are the people that I shared some of my formative yers with, shared growth, laughter, adventure and was so competitive with, now they're settled back into suburban life. These are the events that break the flow get me in a strange odd mood. Birthdays, new years, it's a reminder that we are mortal and that time waits for nobody. I imagine the conversations that were exchanged. The proverbial answer to "What have you been up to since I last saw you?", or the more extreme "What have you been doing since 2000?". Which I guess is the equivalent to small chat, what I would have loved to be apart of all the memories and stories shared from those years at Canterbury Boys. The characters and the incidents that graced the halls of Canterbury Boys' High School from 1995 to 2000.

Week off

I had grand plans for twenty-twenty travel. It was 90% planned out, Hawaii and India in the first quarter. Sydney for Easter, Singapore end of April, New Orleans and Texas for May, New York and Chicago in September, Seoul and Bali in October, Sydney for Christmas. The weekends were scheduled and the annual leave was approved. Then, somebody ate a bat and all plans for twenty twenty were dashed. 

When annual leave cannot be accrued, it changes the way you use it. I have taken the odd day off from work to recover from big nights, or to study for exams, but for as long as I can remember, blocks of annual leave have been reserved for overseas travel. I realise as I type this, this sounds like the ramblings of a privileged douche bag, however the point is not to talk about travel, but to describe the relationship I have with annual leave as an expat living abroad. Given the current circumstances, work has granted employees the ability to carry over 10 days of annual leave, which means all remaining leave must be used, so here I am taking an entire week off purely because it's a use it, or lose it policy. So here I am with one week of no work to spend in Hong Kong.

Initially my plan was to rest and recover from the ablation, that coupled with the fact I had a sprained ankle (this ankle sprain will come back and get me, see future post) and a shoulder impingement meant no real exercise. So I had decided to treat myself to alarm-clock-free mornings, catching up with friends and some home cooked meals. However, the reality of spending an entire week at home during Covid doing nothing dawned on me and I ended up trying to find things to keep myself productive. 

Here's where I eventually landed. 100 Hour Meditation and Pranayama Teacher's Training Course, twelve mornings, 9:30 am -12:30 pm, I have also signed up for two Coursera online courses: An Introduction to Psychology and Portfolio and Risk Management.

Care Package

 Well timed Christmas hamper from Oz!

Currently reading: "Born a Crime" - Trevor Noah

Adventist Hospital - Room 505B

Covid19 Test

• SARS-CoV-2 PCR - 1,200 

Doctor Charges

• Anaesthetist Fee - 35,000
• Surgeon Fee - 150,000
• Hospital inpatient care - 5,600
• Total: 190,600

Hospital Charges 

• ACT Machine - 390
• Anaesthetic Machine (additional 30 minutes) x2 - 2,652
• BIS Machine+Sensor - 1,950
• CC-Radiofrequency Abalation-RFA - 29,427
• CCIC GA Pack (for 2 hours) - 8,190
• CCIC IC Cannnulation pack - 520
• CCIC IV Pack - 910
• J&J CSR Consumables - 1,695
• DINAMAP - 248
• Echo(TEE, No report) - 1,300
• EP/RFA Consumer Pac - 4,550
• I-STAT - 468
• I STAT Cartiage - 143
• Infusion Pump/ Feeding Pump - 428
• IV/Syringe Pump x2 - 780
• Oximeter Reading per time x3 - 534
• Oxygen (3 LPM/HR) x3 - 174
• Oxygen Setup - 210
• Patient Meal / Breakfast - 306
• Patient Meal / Dinner - 48
• Pharmacy - 4,390
• Portable O2 Per time use - 300
• Prolonged Exam Time per 15 mins x2 - 2,596
• Room Charge / U500 - 2,000
• Sheath Terumo F5/6/7/8 x3 - 984
• Total: 198,993

All in: 381,561 HKD - (~49K USD) Is that fair value?

Here's a photo of the entrance point:

The anaesthetic wears off

11 pm. Beep beep. I hear the beeping of the blood pressure monitor and groggily snap out of the stupor. My mouth is so dry, it is possibly the driest place on Earth right now, my throat is barren, I try to swallow and feel my tongue scrapping against the roof of my mouth. So thirsty. I scan the dimly-lit room, there's no water nearby. Why am I so dehydrated? One of the requirements is not to drink or eat anything leading up to the ablation. Water is allowed, but it is encouraged to be kept to a minimum. That plus the fact they were pumping pressurised oxygen into my body while I was under General anaesthesia. So groggy, so thirsty.

I had been sleeping with my mask on. I remove the mask and fumble for the buzzer and call for the nurse. I have the IV still hanging out of my left hand, that's annoying. Wrapped around right arm is a blood pressure monitor. Beep beep. The crease of my right groin is bandaged, there's some tenderness. Slowly the senses come back to me, body feels so fragile, and then I notice the immense tightness around my heart and a distinct weight on my chest.  

The nurse comes in, "How are you feeling? Are you hungry?" I ask if it's possible to stop the beeping sound and if I can have some water. I'm told that I have to remain laying down for 8 hours, to make sure the wound heals. He shows me the bed pan in case I need to use the toilet then hands me some water and gives me some pain killers. Water. Finally, liquid salvation. Later he comes back with a sandwich, checks my blood pressure and turns off the machine. 

It's a little past midnight, I take a couple of bites of the cold vegetarian ham and cheese sandwich. I'm not usually somebody who is sensitive to loneliness but there's something about being in a dimly lit hospital ward, eating a cold sandwich on a Friday night that tugs are the heart strings. I pop a Panadol and manage to drift back into sleep. Intermittent sleep.

The next morning, the nurse comes in at 9 am, and advises that I am good to walk around. I order breakfast, which is the one thing I have been looking forward to the entire time at Adventist. Dr Fung visits the room at 10:30 am, he checks the wound and explains that the procedure was not a success. Turns out the source of the PVCs is located around the papillary muscle, which is apparently rare in itself. The procedure was done with x-ray and he was not able to accurately ablate the muscle. There is mention of needing specialised equipment and a slightly different procedure, this news is both disappointing and frustrating, and the information takes a while to process. I can't wait to get out of this hospital.

My first in-patient experience

All locations have a certain energy, or vibe. There's the energy of the family home back in Earlwood. There's the energy of my apartment in Hong Kong. There's the office energy, which differs on a Monday compared to a Friday. Hospitals also have an energy, for me it's an emptiness intertwined with expectation and anxiousness. 

It's 1:00 pm, I've just returned from Clearwater Bay, I have a long shower and pack my overnight bag. Unsure of what to bring I pack a warm change of clothes, my kindle, my laptop and the preauthorisation form provided by my insurance company. At 1:30 I leave my apartment and make my way over to Adventist Hospital. It's a bright, warm fall day, unusually warm for this time of the year as I bag some last minute Vitamin D while I wait for the 23. 

I get to Adventist Hospital at 2:00 pm and proceed with the in-patient check in. I'm shown the semi-private room (505B) in which I will be staying overnight, it's basic, it reminds me of a 3-star business hotel except with a decked-out bed and what looks to be fairly dated medical apparatus above the bedrest. I wonder if I'll be sharing the room with somebody. I'm greeted by a Customer Service officer, Kristy introduces herself, gives me a wrist band and runs me through the details of my stay. I'm currently scheduled to go in at 4:45 pm, but that's dependent on the procedure in the operating theatre before me.  It's like being at a resort, except there's no warm towel or lemon grass tea to welcome me. 

Over the next couple of hours, various people stop by room 505 to introduce themselves to me. 

My Anaesthesiologist, Dr Chu comes in and explains to me in broken English what he will be doing. "I'll be p-p-putting you under local anaesthetic for the G-G-GPS mapping, and then will bring you under general for the actual procedure. You won't feel a thing, but you might feel t-t-tired the next day. Do you have any questions?". Straight forward enough. 

Nurse Wing comes in, she's Australian and after some small chat tells me that because the incision point will be on the right fermoral artery next to my groin she'll need to groom the area. ie. Shave my balls. Not known for my wild body hair, this seems to be more of a precautionary step as they'll be applying a compression bandage post-procedure and don't want any hair to be caught up when they eventually tear the bandage off. I've never had a Brazilian and this won't be my first. 

At 4:50 pm a nurse comes in, I'm told to lie on the bed as I'm shuttled off into the theatre. It's a little weird, as I could easily walk down, but they insist I lie on the bed as the push me through the hospital corridors. Along the way various medical staff check my identity: "What's your name and date of birth?" and ask me to explain the procedure that I will be undergoing (I can see why it's important to check these key points).

At 5:00 pm I'm pushed into the theatre room, shifted to the operating bed as an IV is inserted into left hand. The assisting staff all look so young, like graduates, they attach EKGs and various nodes to my body as the large displays bursts to life with realtime information. I can see my heart rate, my blood pressure as well as other bodily readings. Dr Fung, the Cardiologist and Dr Chu, the Anaesthesiologist both come in and run over the procedure once last time: Electrophysiology study, 3D Mapping and RFA to address symptomatic premature ventricular complexes. 

My glasses are removed, a barrier is erected to block my view from the surgeon as they proceed to slowly inject me full of painkillers, a wave of tiredness hits me. I touch my right and left forefinger against my thumb. "Derek, we're starting the GPS mapping". I can feel them wiping topical anaesthetic around my right groin, I feel a pinch and then I feel tubing being inserted. Around 45 minutes later, drifting in and out of sleep, Dr Fung tells me that they have identified the area of the PVCs and will be putting me under general and that I can go to sleep. I close my eyes and darkness comes.

At 7:40pm , I hear "Derek, how are you feeling? We're all done", I briefly open my eyes, bright theatre lights, my body is jostled about (most likely being shifted back onto the trolley) before I fall back into darkness.

Currently reading: "The Art of Living"

Degree collection

Personal time off from work. I love midweek days off, there's a sense of freedom and individualism, almost akin to being awake late in the evening knowing that you are not apart of the majority. My day starts with morning yoga, followed by one last visit to the HKUST campus to fetch my degree.

I hand them my HKID, they hand back an envelope with my degree and my transcript. There's no handshake, no congratulations, no break in stride in administrative workflow. So comes an end to my post graduate adventure. I spent the last final moments strolling around campus before making my way back to Hong Kong Island to address the other thing that I started in August 2017, my heart.

 

Covid test

Preparation for this week's procedure. My first Covid19 test, not the invasive one where they tickle your tonsils or attempt to clear the sinuses but the test where you spit into a cup (apparently this isn't as accurate?). Filling up a cup with saliva from the depths of your throat is actually quite challenging, especially if there's only saliva generating the bulk of the sample. Couple of loud hocks and we're done.

Cost: 1200 HKD (200 AUD)

Update: I'm Covid Negative

A "Virtual" Graduation

It's been almost an entire year since my last exam. Without labouring the point, the year has been nothing short of pedestrian and despite completing all the coursework I don't feel like I've actually graduated. Thankfully, there have been no nightmares of turning up to an exam unprepared. There has been a slight sense of lost knowledge, with the desire to apply what I studied and learnt to the real world. That in itself forms part of the larger question about what my next steps are.

Regardless, there are essentially two outstanding components that remain which lends to the fact that my graduation feels incomplete. One, well we haven't had the official graduation ceremony and two, I still have not received my physical degree. So today, 22nd November 2020, is the Virtual Ceremony. Each student has been asked to upload a photograph of themselves which then had a gown and hat superimposed for the purposes of the virtual degree conferment. 

The inevitable Fourth Wave

The much anticipated Hong Kong to Singapore travel bubble has been postponed, two days before launch as fears of a Fourth Wave grips Hong Kong. Each time Hong Kong feels like it's in the clear, a cluster emerges. Complacency combined with what appears to be a high contagious disease, results in the dance of social distancing rules being relaxed and tightened; and so the dance continues. The latest outbreak has been tied to the Starlight Dance club, which on face value looks to be a fairly innocuous establishment, until you research and see what was really happening at these meet ups.

So, as expected Hong Kong has re-implemented social distancing measures and will look to reduce venue capacities and operating hours in attempt to stem the latest outbreak. It's quite timely, as I was just saying to myself "It's time to get back into the social scene" - the introverted side of my had completely embraced covid and the pause that it had provided for my social life. In all honestly I'm surprised there hasn't been a cluster at bars or restaurants with many floating the social distancing and mask wearing requirements. 

As we draw towards the pointy end of the year, it is a known fact that most people have back-loaded their annual leave, hoping for a Christmas Miracle. However, with corporate looking to wrap up in early December suddenly the Christmas and New Years period is looking less appealing for taking annual leave. 2020 maye have one the strangest silly seasons to date.

Redeployment of capital

First dabble into cryptocurrencies - probably not the best time to enter the market, with the major coins trading at almost all time highs.

BTCUSD: 17,800 USD

ETHUSD: 480 USD

XRPUSD: 0.33 USD

GOLDUSD: 1780 USD

Close your eyes, buy and forget

Finally got a BBQ

A "Virtual" Wedding

In what seems to be the accepted norm, events are moving online. Everything from virtual graduations (more to come), to virtual dates, to virtual conferences, and now, virtual weddings. My living room, TV and laptop are becoming common place items in a sequence of virtual events. 2020, as somebody looking in, seems to be a great excuse to do things. By things I mean, we've seen the announcement of expecting parents, engagements and marriages. 

The couple who were planning to get married next year in Bali decided to move ahead and tie the knot virtually. Despite being all around the world, there was an element of celebration and seeing familiar faces in different timezones still made for a special occasion.

Currently reading: "The Happiness Hypothesis" 

An acquisition

After multiple IPO attempts and countless rumours about acquirers, we have been sold. The initial sentiment has been a mix of speculation and disappointment. Let's start with the disappointment, the acquisition price seems to have left a few shareholders slightly disappointed, I say this as it places a value per share well below the lofty highs of yesteryear. For me, this is less of an issue, my equity stake is so minimal that the return for myself is not going to be of any material difference. 

Speculation is the main sentiment running through the organisation. What is the intention of the parent company? What will the effect on the existing business lines and personnel? What does this mean for our push for market share?

We will have a clearer picture in early 2021, starting with headcount and renumeration talks.

Mooncake Season

Two good things about Mid-Autumn: (1) The change in temperature, and (2) Mooncakes!

Weekend Hikes