Yang goes camping!

My Yang Yang went camping last week!

Before he went, he said he didn't like it coz of what he heard from Kai - dirty toilets and milo which was like water with brown colouring *.*

We told him to go with an open mind. After all, Kai also enjoyed his P5 camp in the end. And be safe - listen to the teachers and instructors!

But a week or so before the camp, we got bad news from the school - due to higher levels of bacteria in the waters where they were supposed to go kayaking, this batch would not have kayaking :(

I still pack his wet shoes in case his old shoes - from last year and worn to Japan! - gave up during the camp. These wet shoes were from the grands who bought the wrong size or something. 

Ready for camp with his barang barang on Wednesday

The week or so before LNY, I stopped sending Yang and Yu to the bus stop. So when I realised it was raining, I changed quickly and chased after these two. I always shelter them up the bus if it rains. More important this time in case Yang gets wet and falls ill during the camp!

Yu was sad to see him go to camp, awww... Missed this sweet boy, especially at night...

Sito had to fetch Yu on Wednesday and Thursday as Kai would be late. And Kai helped send Yu to school on Thursday - he usually leaves before his brothers but this time, he was so patient and even asked me where he should drop him off! It was HBL for Yu on Friday so no ferry duty.

I kept checking the parents' chat group near noon as they were supposed to return from camp to school by noon. Happy to see that his class was one of the first two classes to go back! He reached home about 12.45 pm, coming in all smiley with a cap on his head - super cute but I didn't have free hands to grab the camera..

So yes, the toilets were gross. He said he held his poop but thankfully, he managed to poop a lot that day and the next couple of days! Guess the school made them guzzle lots of water...

But the milo was great! He even told Kai that it wasn't water with brown colouring haha! But his fave was the breakfast - char kway teow one day and bee hoon the next. He couldn't have a second serving for the former but he had three servings of the latter! He also brought back a lot of banana-flavoured cake and Khong Guan biscuits. 

A funny thing - I found a pack of Khong Guan biscuits in the washing machine after washing his bag. Oops, must have missed that... But it was still crunchy! Fantastic packaging, I say!

Anyway, he also enjoyed the campfire. He said he was shy but he put on his cap to overcome his shyness and managed to do the campfire dance. The campfire was top of his list :)

He also happened to be in the same tent as his BFF ET, for which he was very happy. At one point, there was some mix-up in the sleeping bag coz one kid kept pulling other bags somehow - the kids probably all had the same one from Decathlon! But luckily he brought the right one home. The second night was spent on a bed in a dormitory.

There was also outdoor cooking, amazing race and low element activities. But they were not allowed to eat their pizza, and for good measure, I guess - who knows how hygiene the process had been?! :p

So even though his first response to me was that the camp was meh, it seemed like he had a good time :)

But he seemed to have caught a bug from the camp, just like Kai who had to miss LNY celebrations in school due to a cough. 

On Saturday, he didn't feel well after lunch - which happened to be hotpot like for Kai's P5 camp. We were supposed to go to Macs for dinner, his choice as Kai chose Macs when he returned from his S1 camp. But they returned from the playground just as we were about to go pick them up, and Yang looked pale and felt dizzy.

In the end, Sito brought Kai and Yu for dinner downstairs while I stayed home with Yang. I brought him to wash hands and sat him down in front of the basin while I went to change out of my street clothes.

I regret not handing him the vomit pail. I heard him puke as I went back to him. Sighs... Let him vomit it out on the floor ba... When he felt better, he took a shower while I cleaned up the mess. I used up a lot of old cloths and a mid-sized bag. Gross. But I managed to clean up before he came out of the shower. 

But before he managed to pull on his pyjamas pants, he had to puke. This time, he got to the toilet in time, yeah! And this time, he really felt better coz he agreed to having some food. Sito packed ban mian for him - this boy likes it after having it a couple of times during the recent raining weekends.

When we were at AhMa's place the next day, he declined Ferrero Rocher coz he thought he might have eaten too many on Saturday before he puked - he had six. These kids had no control over snacks if we turned our head...

He didn't go to school ytd coz he said his tummy still felt weird after breakfast and he was afraid he might vomit on his way into school like last time - can't remember when though. So Sito and I took turns to go through all his subjects. At the end of the day, he said it was worse than going to school haha!

Today, he said his tummy felt worse. But he didn't say he would stay home. I gave him a bigger pair of pants coz his old ones were pressing on his belly, and a plastic bag. So far, no phone call. So ok, I guess he's fine!

Hope my sweet boy gets well soon!

Update on the new school year

After a week plus of orientation, Kai's lessons finally started on 13 January. How pleasantly surprised we were to hear that he likes secondary school! Coz the teacher taught fast and the classmates didn't talk all the time. Hmmm...

Unlike in primary school, he seems to have more homework these days. He's quite independent and can do his own work until he faces difficulties. Then it's "Papa! Papa!" or "Mama! Mama!" from his room, regardless of where we are...

His first major assignment was a writeup for LNY, in preparation for Chinese WA. It was a nightmare in general knowledge, organisation and expression. Told him he couldn't just copy whole passages from his research. So he translated that into English, and back-translated into Chinese instead of using his own words! Must applaud his ingenuity but please, really work on expressing yourself in Chinese!

Kai also started having English tuition after a trial on Saturday, 11 January. It was at Bishan Central but in the end, we chose the Monday evening slot at the Junction 8 branch instead. It turned out that we had to change to Saturdays for two weeks in January due to his camp and a reunion dinner...

Happy with a kabab roll from pasar malam after tuition

The brothers had their usual "Care Week" and started lessons same day as Kai. But I think they started on some lessons here and there before that...

This year, they come home on their own Monday to Wednesday as Kai's day ends at 2.30 pm for those days. So I also cook less lunch coz Kai would have lunch in school at 2.30 pm. I wonder why they don't give a lunch break and end school later. The lunch timing is really bad... In fact, with such a late lunch and with recess also late at 11 am, I started making breakfast for Kai. Then his brothers wanted breakfast too so I think I end up cooking way more *.*

They sent me a photo taken with the smart watch while waiting for the bus home one day

We started drilling working with Yang every day after school. Sito would go through all subjects except Chinese, to reinforce what he has learnt that day. I was pleasantly surprised that he took all this in his stride. I mean, he complained a great deal last year when doing papers... But for the past few weeks, he has been listening to Papa and doing his work. 

As for Chinese, he really doesn't like it... But no choice, especially when he just came back yesterday with 10/40 for a compo! We went through the relevant topic and he even told me the whole story based on the pictures one day before the class assignment. But he hardly wrote beyond the first two pictures in the end. He said he was thinking what to write until he ran out of time. 

Sito told him to describe each picture again before doing his correction, which was to copy out a model compo. Wasn't well done. I think he didn't know how to write the words and couldn't express himself properly in the language... He's away at camp now. Will work with him later...

Yang also started English tuition yesterday evening. After our experience with Kai, we decided to take the plunge and start Yang early. Hope this can help improve his English - he still has a spelling issue but at least need to nail his grammar and S&T and compre etc.

Sito sent him and waited for him there. The tutor said he was very active in class! When I asked him about it, he said he couldn't sit for two hours, Jialat! But this social butterfly had already spoken with all six or seven boys, but not the two girls... So free in class?! 

Good big brother to his only DiDi

As for Yu, he had his first HCL extra class on 9 January. Then he regretted taking HCL coz more time in school, haha! Too late, my dear. Must take whole year before I allow you to drop!

As we focus more on Yang, Yu hasn't had much to do so far. Anyway, he is more like Kai, can do his work independently. So when he has nothing to do, he sleeps or plays with soft toys or helps me with housework.

Bia-ing homework at AhMa's place on Sunday coz he forgot to do earlier

Washing grapes

They all need to choose their CCA. More on Kai's separately as trials are still ongoing...

Yang wanted to join badminton again so that he could be with his best friend but we knew from his P3 experience that it was too crowded so we dissuaded him. He wanted art then but we had then learnt more about secondary school CCAs so we encouraged / persuaded / psycho-ed / convinced him to pick something that he could continue in secondary school. 

But we let art be his second choice, after track and field. Next two choices are basketball and robotics but art would definitely have a slot if he didn't get into track. When we received notification that he got into track and told him, he wasn't happy. He said he chose it coz of us :( Just try and see how...

During our recent fortnightly Sunday visits, Yang and Yu played badminton with AhYe downstairs. So Yu also wanted badminton. But too late :p And for the same crowdedness reason, we rather he didn't. He put robotics as his first choice. As a P3 CCA first timer, he had a good chance to get in. Next are track, chess and art. Indeed, he got into his first choice and was very happy to hear about it.

Both Yang and Yu will start their CCA next Wednesday. All the best!

Navigating Singapore's health sector

Apart from giving birth and the many A&E trips (see list in annex :p), I have not used our health services much, thankfully, until lately.

As a kid, we mostly went to a GP for common childhood fevers, colds and coughs. The middle age doc nearby who gave bright green strange tasting syrup, the old Yoda-lookalike doc near Grams who wore a tie and gave bitter powder, and from my teens onwards, the two pretty docs nearer Yan's place (but still near me) who gave me much comfort.

We went to the polyclinic too. All I could remember was waiting, waiting and waiting! Probably went there for baby wellness coz YQ's childhood glaucoma was first diagnosed there.

So I never went back to polyclinic as an adult. It was always GP.

But now the polyclinics are so good. Ok, I don't know about Singhealth or NHG but my area is under NUHS, and all I need to do is to click a few buttons to make an appointment, check in for my visit, check number of patients before me, check where to go next, pay and retrieve bills and reports. The wait time is very acceptable and sometimes surprisingly short.

How do I know? How do I know indeed!

We started using the polyclinic coz a new one opened in Bukit Panjang, but more for injuries etc, in case need referrals for further treatment. Like Yang fell and hurt his shin in school. I think we still went to Raffles at the mall downstairs for regular illnesses and to grab MC for work purpose. 

But I never found a GP I'm comfortable with while staying at BP. The doctors at Raffles are all on rotation. Once I even had one who spilled my blood on the floor when drawing blood, goodness! So I went back to Dr Gill at HV for health checkup and PAP - not having a random doctor for the latter!

Guess it's good that we're making home at HV again?!

Anyway, polyclinic. We went to the polyclinic even more after moving to HV. Sito cut his toe on the metal gate and went for a tetanus shot. I also had a tetanus shot given my frequent brushes with the kitchen knife...! I had a skin issue on a toe - forgot the name - and had to go burn it off with silver nitrate. Yang had a rash on his face and got a referral to the Skin Centre. And of course my intestinal issue.

This intestinal issues opened my eyes to our healthcare sector. Here are some thoughts:

First - how do things work?

Hint: Not everything is automated

I was referred to a specialist at Alexander Hospital who sent me for a CT scan and then scopes. I paid for the CT scan using Medisave and cash.

But I have been paying for an Integrated Shield Plan (ISP) with Great Eastern (GE) since 2014/2015. Even if Medishield doesn't cover outpatient CT scans, wouldn't the GE portion cover? 

I asked the staff at the CT scan. They said only Medisave, and were not sure about the ISP. So I went back to ask my agent. He advised me to ask the hospital staff to do e-file at my next visit since I was going back for more stuff.

However, the financial counsellor for my scopes said over the phone that she couldn't do e-file for CT scan. I tried again at my next physical visit to the hospital, which was for the gynae consultation. The registration counter said they did not do e-file there and told me to pay first and then claim from insurance.

*.*

After my first scopes in June, I still had to pay using Medisave due to deductible and co-payment. There was no ISP payout as I hadn't met the deductible. After my second scope in September, Medishield kicked in and I paid a little for the co-payment using Medisave. The GE portion did not kick in.

I wondered why so I did some digging - coz I forgot details told to me when I signed up! - and found that:

• Medishield does not cover pre- and post-hospitalisation. So the CT scan and all the consultations were outpatient, not hospitalisation = not covered.
• GE (or whatever insurer you have) kicks in only when the hospitalisation exceeds Medishield limits and when Medishield does not cover the specific procedure.
• GE also covers pre and post relating to the hospitalisation. So I found out how to claim pre- and post-hospitalisation bills. 

After my final visit in October, I put together all my receipts and relevant reports from the hospital, and sent them in. I was pleasantly surprised that I got $1,259 in claims within two weeks, largely cash and some Medisave, from the GE portion of the ISP. 

Recently, I put together all the expenses in an Excel sheet, with details from CPF statement, hospital bills and GE statements. Of my total bill of $3,675, I paid $1,798 using Medisave and $56 using cash, the remainder of $1,820 was covered by the ISP, of which only $560 was via auto e-file at the hospital. 

The amount is more than what I had paid for the GE portion in the past 10 years ✌ Later, I discovered I should have included the polyclinic bills too but too late, gone from the system + much smaller amount.

Point is - now imagine if someone less savvy didn't know about pre and post claims. That's good money out of pocket!

Next - time:

When we talk healthcare, we often think money. But there's also time. By the time I was done with my final consultation with the gastro specialist, it was almost a year since I went to the polyclinic. 

There was a lot of time between appointments. I think it was because I opted for subsidised treatment and I didn't have a nasty prognosis.

Now that's scary if I had something nasty! 

But while researching the ISPs recently, we found that in the case of critical illnesses, the wait time for subsidised treatment should not kill you, haha! Indeed, a friend went to polyclinic which told her to go straight to A&E as they suspected meningitis. It was ruled out at A&E but she had a blood culture taken. Next thing she knew, the hospital called her back to be warded immediately for a bacteria infection.

Third - of course, finances:

Cost of healthcare depends on the individual, e.g. type of ward, public or private hospital. But it also depends on the healthcare provider.

I have already chosen subsidised care to minimise my costs as covered in my first point. But does the healthcare provider think about minimising cost to patients as well, besides providing financial counselling?

I recall in previous conversations with XY, she mentioned over treatment in the US. I don't think it's an issue here. Or at least I have not witnessed it. Our polyclinics also kind of make sure that we get a referral to a specialist only if they can't handle - I mean, I went to the polyclinic twice before I got referred to gastro! Same for Yang's rash.

But I have this other issue - over the years, I get prescribed the same types of medicine for my colds etc. Those little packs accumulate in the medicine cabinet and expire, some nearly untouched. After clearing up my medicine cabinet one day some years ago, I've learnt to say no to the usual paracetamol and lozenges. But it is usually at the point of getting medicine, just before paying. 

I remember only one instance where the GP told me exactly what he would prescribe for me - I was surprised but very happy as I was able to ask questions and say no to some before they started packing the medicine. Other times, I was probably too ill to think until the medicine was placed in front of me.

For other ailments, the doctors would generally say this cream or that coz must explain how to apply etc. Anyway, for Yang's recent pus-in-toe (not ingrown in the end), I brought along my own antibiotic cream to ask the doctor if he could use that coz those tend to accumulate too!

Knowing my medicines, I save money and clutter and waste.

But this may not be the case for other patients, especially those with very good insurance coverage - insurance will pay, so just consume max. And this begs the question of whether healthcare providers think the same - insurance will pay so just provide/charge max.

Raffles and even my old GP in later years would ask at the point of registration if the fees would be covered by insurance. And my delivery fees went from $2k for Kai to $4k for Yang - for Yang, I had to ask the doctor to sign some documents for Sito's company insurance. I changed to another OBGYN for Yu.

So....

Years back, I wrote about healthcare costs in SG vs. Evanston. I don't know with all this insurance business, whether our healthcare costs will remain affordable in the long run. 

Fourth - healthcare for all

I only had three points until I learnt of an incident lately which got me wondering... This is not my personal experience but I thought I should highlight it too.

I mentioned above that a friend was admitted for a bacteria infection. She was supposed to stay for five days for IV antibiotics. Due to bed crunch, the hospital wanted to send her home before the five days were up, for home care for 14 days, during which she would not be allowed to leave home. 

When she wanted to just stay in hospital for 14 days instead, the hospital changed its mind and discharged her anyway but she had to return daily for four days of IV and then take seven days of oral antibiotics. 

Maths tells me that the number of IV + oral antibiotics days has been reduced. Was her healthcare compromised? At the end of it, she did recover. But the process, to me at least, wasn't very pleasant.

I understand the need to cater to everyone. All the talk about our ageing population taking a toll on the healthcare system isn't just talk. It is understandable to ask less critical cases - or cases that are no longer critical - to make way for critical cases. But it should be done with finesse, no? I think bedside manner is just about as important as the treatment itself, if only to seek greater understanding from patients and their family.

Aftermath

Anyway, after going through the bills and GE statements, Sito and I dug deeper into ISPs. So besides what I mentioned above, our A/B1-type ISP was meant for (a) non-subsidised components such as choosing a doctor, and (b) A/B1 ward stays with less/no subsidies.

Now that Medishield has increased its coverage, and we are going for subsidised treatments and ward stays, we figured there was no need for our A/B1-type ISP. So we downgraded our ISP to the standard one, covering B2 and below ward stays - we are ok with no aircon.

The delta in premiums between these two is not much at this point, as the bulk is still Medishield itself. But with age, the GE part will increase a lot. So it makes sense for us to just switch based on our needs. Seriously, I also don't know why we took the more expensive plan last time - Sito's was from eons ago whereas mine was a copycat of his. Ya I know, I didn't do my research...

But it's never too late!

And we just got ISPs for the kids as well, since we're already paying for Medishield. They're young and the premiums are low. The Medisave interest will take care of everything.

*** *** ***

Annex

Sep 2005: my tummy

Jan 2007: my thumb

Jan 2013: Kai's fever

Feb 2013: Kai's fever

Jun 2013: Kai's HFMD

Jul 2013: Kai's fever

(Ya, first-time parents... No more A&E for fevers for the brothers!)

Jul 2015: Yang's fall

Jan 2016: Yang's febrile fit 1

Jun 2016: Yang's febrile fit 2

Jul 2016: Yang's febrile fit 3

Nov 2016: Sito's tummy

Mar 2019: Yu's eye

Apr 2019: Sito's ribs

May 2019: Yu's scalp

Aug 2021: Yang's tummy

Jan 2022: my head

Feb 2023: Yang's tummy