Photos from recent events (2)

Sugiyama Meats - Japanese-Canadian owned and operated. My mom insists that their beef is flown in from Japan. I disagree because their prices are too low to sustain that kind of business. Uncle Gabe did say that Sugiyama supplies some major Japanese hot pot restaurants.
A plate of sliced pork leg in Swiss Sauce I enjoyed at Kingspark.
Look, I'm about to chow down.
Dimsum at "Nan Hai Yu Cun" (Southern Ocean Fishing Village)

Photos from recent events (1)

Mom and I were planning on having lunch @ Elephant and Castle

We were greeted by a cute looking oriental hostess. However, we were not happy with the environment. There was a really noisy table behind us. The view from our table wasn't that great. Also, the furnishings appear to be worn out. So, we decided to leave.

We were impressed with the new T-shirt my aunt sent me.

On a separate day, we went to Ikea for their world famous Swedish Meatballs

Unfortunately, they were closed early on Saturday! I wanted a photo with the food anyways!

"Two prisoners look out the window..."

Today I feel overwhlemed by homesickness. It feels like I'm drifting further and further from my goal of returning to Hong Kong. I'm worried, dead worried, about being stuck in this hellhole forever. Damn, how I miss Hong Kong. How I miss her skyscrappers in Central. How I miss her masses of people in Causeway Bay.

How I miss the feeling of entering the cool and metallic car of the MTR. How I miss lying on the edge of the waterfront in Tsim Sha Tsui and viewing the beautiful neon lights emitted by the IFC and China Bank buildings. How I miss looking at the young lasses in their hot pants and miniskirts. I even miss the food at Cafe de Coral.

But in order to move back to HK, I'll need to have an adequate income. At this point, there seem to be very few opportnities for pharmacists in Hong Kong. So my plan is to get a degree in medicine and try to practice med in Hong Kong with a Canadian MD degree. But even that route would be tough. Even if I were *lucky* enough to be accepted, how will I handle the physical and financial toll of being a med student?

After I do the mental accounting, the situation seems even more dire. I'll likely be pulling in 4000 a month as a pharmacist. 1000 will go towards rent. 300 will go towards my outstanding student loan. 400 will go towards a car, leaving me with about 2000 dollars. Actually, I suppose it is okay.

"Two prisoners look out the window. One sees mud, the other sees stars." - Oscar Wilde

One voice in my head is telling me: "Stephen, why bother trying so hard? It looks like you're going to be stuck in Vancouver for good."
Another voice from my heart says: "Stephen, it is because you love Hong Kong that you have to work hard. If you give up now, you'll never be in Hong Kong."

Let's hope I heed the voice in my heart.

Lesson 1 - The Power of the Business Cycle

Young man, when I was your age... (I am starting to sound like a 60 year old already)... I did not appreciate what a business cycle was.

Life Lessons Series - Introduction

Last night, as I rolled around in my bed, I thought about what I read in Get Smarter - Life and Business Lessons from a Billionaire.
What motivated him to write this book, explained Mr. Seymour Schulich, is a desire to make a difference in a young person's life. This makes sense - Mr. Schulich has already made billions of dollars from his mining business. He does not HAVE do anything for money anymore.

I thought about what I should do, what I should leave for my children. What are the words of wisdom that I can pass on to them? Perhaps, I could start with some life lessons of my own.

Table of Contents (which will continually expand with successes and blunders)

1. Business Cycle
2. Career Choice

Donald Tsang

Tomorrow at 8:30 PM, I will be having dinner with Donald and a couple of his friends. I met Donald in electronics class at London High School. At that time I was in grade 9 and he was in grade 11. We hadn't talked for years until he contacted me via facebook about 2 months ago. His enthusiasm caught my attention immediately. He definitely is interested in learning more about pharmacy as his girlfriend (aparently one he's hopelessly in love with) is a pharmacy technician. Perhaps she wants to apply for pharmacy school and he'd like to gather some information from me.

Donald's 26 this year. He is working at a student-rate at an engineering firm in Whistler. He lives in a 3 bedroom condo (all by himself) and greyhounds back to the city over the weekends. Apparently he's in the final year of a civil engineering degree at Lakehead University in Thunder Bay.

Donald has the impression that pharmacists make a lot of money. He quotes his girlfriend that pharmacists make $100,000 a year. He considers this to be a lot better than the average salary of an engineer at $70,000 to $ 90,000 annually.

I discussed a bit of investing with him. I stated my belief that any young man with a college degree can amass a great deal of fortune (in the millions) if he has financial discipline and makes wise investments. Donald disagrees. He brings in his own experience as a new grad with an environmental studies degree. Aparently, he had such difficulty finding employment that he chose to pursue a second degree. This explains why he has another year or school left.

So I'll be seeing him and his friends. Aparently one of his biochem friend was recently laid off and can use some advice regarding pharmacy as an option. I suppose I look forward to meeting new people.

Alright, back to blogging

The book I am reading is called "hou ke xue". It is a psychology book written by a Chinese scholar. The title literally translates to "the art of thickness and darkness." What does this mean? Thickness refers to overcome self-consciousness. Darkness refers to being ambitious and sometimes ruthless. The author believes that it is through mastering these two skills can one become successful.

Unfortunately, the book is quite boring. I don't think I will be reading too much of it.

When is it necessary to combine Plavix and Aspirin for vascular protection

Is it necessary to add Plavix (clopidrogel) to a baby dose aspirin for vascular protection?

If you need aspirin for cardiovascular protection only, you will not gain additional benefit by adding a clopidrogel.

If you need aspirin for established cardiovascular disease, you will not gain additional benefit by adding clopidrogel.

If you are suffering from acute coronary syndrome (aka a heart attack) or have a stent, then the additional of clopidrogel to baby aspirin is benefiticial.

Rules of thumb for use during pregnancy

Here are a few rules to abide with when using drugs during pregnancy:

1. Avoid drug therapy during the first trimester

2. Use older drugs from a class with the most fetal experience data

3. Avoid extended-release, controlled-release drugs and products containing alcohol

Acetaminophen
ASA - ASA-induced fetal or neonatal toxicity has not been observed with ASA dosed between 40-150 mg per day for the prevention of gestational hypertension, pre-eclampsia and eclapsia

More on this topic after...

Should I take a baby aspirin a day to prevent a heart attack?

If you've had a heart attack, there is no doubt that a baby aspirin per day will reduce your risk of getting a second heart attack.

If you have not had a heart attack previously, the answer really depends on your risk of getting coronary heart disease in the next 5 years. Your risk of CAD over the next 5 years is determined from your individualized Framingham score.

While a baby aspirin for day may decrease one's risk of CAD, it can also cause undesirable outcomes such as a hemorrhagic stroke, or, more commonly, stomach bleeding.

The balance between benefits and risks is most favorable in patients at high risk of CHD (5 year>3%)

Medications not to use while breastfeeding

Taking medications while breastfeeding is generally safe. There are issues which warrant attention:

1. Infants of less than 2 months old are most likely to experience adverse effects due to drug exposure from breastmilk

2. Some drugs are contraindicated during breastfeeding because they directly cause harm to the baby

3. Other drugs are contraindicated during breastfeeding because they can inhibit lactation

A simple measure to reduce drug exposure to a breastfed infant is to take the medication immediately after breastfeeding or just before the baby's longest sleeping period.

Here's a list of drugs which are commonly used and whether or not they are safe during pregnancy:

Acetaminophen
ASA - may cause Reye's syndrome and bleeding in the infant
Ibuprofen
Naproxen
Ketoprofen
First Generation Antihistamines - Low dose occasssional use is safe; may reduce milk supply and cause drowsiness, irritability, colickiness in child
Second Generation Antihistamines (Loratidine considered DOC)
DM and Guaifenesin
Pseudoephedrine, Phenylephrine - Reduces milk flow; also may cause irritability in babies
Cromolyn Sodium
Aluminum Hydroxide, Magnesium Hydroxide, Calcium Carbonate
Cimetidine, Ranitidine, Famotidine, Nizatidine - Famotidine and Nitazidine preferred because of lower drug concentration in breastmilk
Omeprazole - safe at 20mg/day
Bismuth Subsalicylate - link between salicylates and Reye's syndrome
Attapulgite
Loperamide
Simethicone
Psyllium
Bisacodyl
Cascara
Docusate
Castor Oil
Mineral Oil
Topical Antibiotics
Topical Antifungals - may be applied to the breast and nipple, wipe off excess
Topical Hydrocortisone - may be applied to the breast and nipple, wipe off excess
Iodine, Povidone Iodine, Iodide - Concentrated in breastmilk and can cause thyroid problems in infant
Large amounts of Alcohol - Can cause drowsiness, decreased linear growth and abnormal weight gain in babies
2 cups of Caffeine per day - May cause irritability in baby if more is ingested
Echinacea - Not enough data
Melatonin - May reduce prolacting and oxytocin to decrease milk production, avoid

Drugs that can make you fat

Weight gain is a possible side effect with medications. Which medications cause enough weight gain to warrant detailed counselling and possible intervention?

Drugs that cause substantial weight gain include some members of the following classes: antipsychotics, mood stabilizers, antiepileptics, antidepressants, oral contraceptives, antihistamines, and corticosteroids.

Olanzapine and Clozapine are major causes of weight gain. About 3/4ths of patients using olanzapine will gain ~ 4.5 kg during the first 10 weeks of therapy. Chronic use may be associated with even more weight gain. If either olanzapine or clozapine cause weight gain exceeding 5% of baseline weight, switching to an alternative drug or the addition of metformin may be considered. The weight gain associated with clozapine and olanzapine places patients at increased risk of diabetes and heart disease.

20% of patients using lithium gain greater than 9 kg in weight.

About half of those who take valproic acid will experience a 10% weight gain. If weight gain is an issue, swiching to lamotrigine or carbamazepam are valid options.

The antidepressants MAO-Inhibitors, tricyclic antidepressants and mirtazapine are associated with substantial weight gain. SSRIs are okay in the short run. Taken for longer than 6 months, SSRIs are associated with weight gain. If weight gain is an issue with these antidepressants, switching to venlafaxine, duloxetine or bupropion may be good options.

Oral contraceptives may cause a transient weight gain due to increased fluid retention. The weight gained initially is usually lost with time. Depo-Provera is associated with weight gain of 5kg over 5 years.

Antihistamines and corticosteroids will cause some weight gain as well. Thus, inhaled or intranasal corticosteroids are preferred.

Some bad habits to get rid of...

1. Stop disappearing on people (answer your cellphone!)
2. Stop being a perfectionist (do more!)

Lunch with Julian

Sometimes, I'm like an ostrich. I tend to cycle between a what I call an anti-social mode and a normal mode. When I'm in the anti-social mode, I refuse to log on to MSN or answer my cellphone. So I hid from some friends for a couple of days. Finally, I was forced to come out of my shell when my mom passed the phone to me on Saturday. It was a phone call from my good friend Julian. He has been working at Safeway for 2 weeks and would like to share share his experiences with me. He also wants to discuss with me his financial plan and wanted some advice.

So on Sunday, I met up with Julian at Tri-Ty. I'd call it a posh Taiwanese restaurant. When it comes to Taiwanese food, I do trust Julian. His girlfriend Jess is from Taiwan.

*I'm noticing that I ramble on extensively and sound like a broken record - I will get straight to the details.*

So here's what we ordered:

*Shit, blogger's upload tool isn't working - I will fix this later*



Here's Julian's "three cups of alcohol pig's knuckle's" for about $8.95. His order comes with 4 side dishes - a small squid with chili sauce, a piece of tamago egg, a slice of pickled cucumber and an additional item

Notice the half-liter glass of orange liquid to his left. It's a glass of refreshing CYP inhibition. Cost - $5.00.

Here's my Unagi on rice at $9.50. To be honest, the dish of reheated vacuum-packed eel looks better than it tastes. Suffering from a chronic eel-addiction - I suckered for this dish.

Our total before tips came to $20.00.

Two hours later, we were at the personal finance/investing section in the Chapter's across the street. Julian chuckled as he skimmed through on my recommendations - Lies about your first job. He must have identified with a lot of the lies mentioned in the book.

I flipped through Andy Sham's recommendation - the Wealthy Barber. While imparting his wealth-building wisdom upon a young couple, the Barber shares a story of his own. Back when he was young, the barber had no problems managing the finances of his shop. However, he was frustrated with his personal finances. Later on, a mentor provided the barber with good advice. The barber was able to manage his store's successfully because his shop only had needs. However, the barber failed utterly in his own finances because he has both needs and wants. The barber, he said, must only spend on his needs (goods and services he actually requires to survive) and not his wants (goods and services he desires).

These questions immediately came to my mind:
"I drive a corolla, but do I really need a better car?"
"I will need a girlfriend/wife eventually, but do I really need her to be hot?"

15 minutes later, the two of us wandered to the classics section. A helpful employee pointed us to where the Iliad was held. Julian liked the Penguin version of the Iliad. Unfrotunately, the price - 26.90 - was out of his budget. I grabbed a novelty minibook titled "the Quotable Oscar Wilde". Interestingly enough, the first quote I flip to said:

~ Oscar on Life: "It is better to have a permanent income than to be fascinating." ~

I was somewhat tempted to buy this book, until I flipped to a second page which read:

~ On the Importance of Being Oscar: "I can resist anything except temptation." ~

I had a good laugh at myself, then put down the $6.95 item.

Julian and I ended our stroll shortly. I asked him for a CD of our grad photos and also the Canadian Business Textbook I lent him. I guess he must've been stressed out (having been home alone for the past week and under a lot of stress from at his workplace). Anyhow, I'll get those things from him next time.

Return of the Blogger

It's been a long time since my last blog entry. I must admit it's difficult to pick up the pen... ahem... keyboard once again. I admit that I'm a perfectionist-turned-lazy man. Perfectionism has been the curse of my life. I aspire to do my very best in all endeavors. Unfortunately, I shy away from many activities or projects because of fear of failing.

As I make my transition into adulthood, I must shed this terrible philosophy. I would like to embrace challenges. I'm sure I'll run into many obstacles and make many mistakes of the way, but who doesn't?

I'd like to bring up a quote from a wise investor. He said something to the effects of: "We all make mistakes when it comes to investing. Even stock-deity Warren Buffett makes mistakes. What separates the winners from the losers is this: the winners make mistakes on somethings, but is correct when things matter."

Blogging is really trivial when compared with other challenges in life. So let's go!