The Star Online
Tuesday April 22, 2008 MYT 7:16:12 PM
Star fruit can be toxic for kidney patients

KUALA LUMPUR: All it takes is one fruit or 100ml of juice and the ordinarily harmless star fruit becomes poison in a matter of hours for kidney patients.

University Malaya Medical Centre (UMMC) consultant nephrologist Prof Dr Tan Si-Yen said this was what happened to Tang Gon Seang, who has been suffering a kidney ailment.

The 66-year-old Malaysian was in Shenzhen visiting his son when he passed out on March 29 after eating star fruits and was rushed to the Shenzhen General Hospital where he fell into a coma.

“Star fruits contain a neurotoxin, which is not present in other fruits, affecting the brain and nerves. In healthy persons, the kidneys filter it out. In kidney patients, it cannot be removed and worsens their condition,” he said.

More than 10 other patients in the hospital suffered the same condition after consuming star fruits. Two of them died.

After discovering the star fruit connection, Tang has been undergoing dialysis.

His brother-in-law Teoh Thian Lye, 55, confirmed that Tang had been on medication for kidney problems for three years.

The family sought the help of MCA Public Complaints and Services Department head Datuk Michael Chong to transfer Tang back to Malaysia as the family could not afford the hospital bill of RM1, 000-RM2, 000 a day in intensive care.

According to Dr Tan, there was little awareness of this relatively new discovery and no local cases yet.

“The public must be alert to reactions to star fruit. Look out for initial symptoms including hiccups, numbness and weakness and neurological symptoms including confusion, agitation and epileptic fits,” he said.

“The risk of death is high and immediate aggressive treatment of daily haemodialysis is necessary,” he added.

Dr Tan said UMMC was prepared to admit Tang, when he was transferred back to Malaysia.

Related link:
Starfruit can kill

Woke up extra early and went to SJMC to consult a hematologist regarding my anemia. I have been breathless and feeling lethargic for a while now. It is no fun waking up after 12 hours of sleep feeling like I need another 12 hours more. At the same time, had the lump in the scrotum checked by a urologist. Apparently it is an infection of the epididymis caused by constant catheterisation. I am on a 2-week dose of Zinnat, an antibiotic, that hopefully will clear up the lump by then. He also scheduled me for a urodynamic testing to check on the pressure in my bladder.

In the 24 years since my spinal cord injury, I have never undergone any. UMMC had scheduled to urodynamic tests but both we called off - once because the doctor was away and the other because the lab was being renovated. These appointments are usually scheduled 6 months prior. Although the procedure is done free of charge at UMMC and costs RM1,500 at UMMC, I decided that I wanted to know if the pressure in my bladder is the cause of my renal failure and what can be done to prevent further damage.

After that, Wuan and I went all the way to the Palace of Golden Horse at Seri Kembangan for a buffet lunch with some good friends. One will be leaving Malaysia with his family in July. And then we drove all the way back to Damansara Mutiara for a meeting with the good people from the Malaysia Association of Standards Users at The Curve. We talked about the standards of accessibility which, although in existence since the last decade, are seldom adhered to by the local governments.

To sum it all up, I had to pull down my pants twice to have my testicles examined, drove all over Kuala Lumpur and Selangor to meet friends and make new friends, were extremely late for both appointments, and came back all fired up for no apparent reason and only fell asleep at 3am. It had been a tiring day but worth the effort.

I also have this one thing to say about SJMC. Although it is a hospital, there were no accessible parkings and I was made to circle the buildings twice before I found an empty standard-sized lot near to the entrance. The hospital management should really take note of this. They should not expect wheelchair users to park their cars at the open space which is a long distance from the entrance and down a steep slope. Of all places, I expect hospitals to be the most accessible place but this seldom the case. That is one of the reasons why I dislike going to hospitals.

It was by chance that I felt a firm lump in my right scrotum while performing catheterisation yesterday. It is firmer to the touch as compared to the left testes. It is the size of a small grape. There is no pain or perhaps my poor sensation is masking it. I need to get a doctor to have a look at it.

Wuan and I collected the two albums for our bridal photo shoot some time last month. We were impressed by the images in the sample albums that were displayed by De Paris Image at the wedding fair at Mid Valley Megamall. We had gone there for our dinner after having our marriage solemnised at Registrar of Marriage at Thean Hou Temple earlier in the day.

When we placed the deposit for the shoot, we had specifically indicated that we wanted natural skin tone with very little retouching of the images and plain background. Never mind that our complexion were not flawless. We wanted to look natural. The package came with one large album and one smaller album of twenty images each and three framed images.

When we were called back to view and select the images after the 12-hour photo shoot, we were rather delighted with the results. The skin tone was nice. We threw out most of the images that did not have plain background. At the end, we settled for an extra five images that cost us RM600 more. We liked the photos and it was not something that we would be doing often.

Imagine our disappointment when we went to collect the albums and discovered that some of the images were extensively touched up. We did not look natural. The skin tone was not natural. I looked like I had too much powder on my face. Looking at the images of myself reminded me of the touched up portrait of my father when he was young. In those days, if one wanted colour portraits, the studio would take a black and white photo and coloured it.

I will not recommend De Paris Image to couples shopping for a bridal studio for their photo shoot. Shop around more. I am sure there are studios that understand what minimum retouching is or ensure that the touched up images look natural. Make sure all the charges are stipulated up front. Some devious studios will not tell you that make-up, hairdo, fake eye lashes and the ampoules for make-up are not included in the package. Brides should bring their own free bra which can be bought from other places for a fraction of what the studios charge. The bridal photo shoot may be a once in a lifetime event for most couples but that should not be an excuse to allow these unscrupulous studios to take us for a ride.

No serious itching today, well, at least not to the extent of having to take anti-histamines, apply Beprosalic ointment or scratching like a monkey till the skin breaks. William will be dropping by in a short while to take me to the bank. I told him to give me one hour to get ready. I need that much time because of my new wheelchair.

I like my new wheelchair very much. It is compact, comfortable, gives me a good posture, easy to propel and has a very short turning radius. Considering the fact that it cost me a few thousand, it is still money well spent. The only problem I have with this chair is dressing myself up. In my previous chair, I could dress myself up in 10 to 15 minutes. In this, I need at least 20 to 30 minutes. Its compactness restricts some of the limb movements I need to wear trousers. You win some you lose some. I just need to get used to doing things in this chair.