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Dr K.K.Tan Specialist Clinic, 6, Lorong Tembikai 1, Bukit Mertajam (2026)

09/05/2026

《为什么我还不退休?》
《Why Am I Still Not Retiring?》

行医四十年，常有人问我：
“医生，您为什么还不退休？”
这是一个很合理的问题。

照理说，我的听诊器大概早该进博物馆了；我的医生字迹，也许可以交给考古学家研究；连诊所那张椅子，恐怕都可以申请列入历史文物。

退休听起来当然很美好：睡到自然醒，慢慢喝咖啡，悠闲旅行，打打高尔夫，然后假装自己已经不会到处留意别人的血压器。

可是，行医四十年，医生的脑袋并不容易“退休”。医生不只是一份职业；做久了，它会成为生命的一部分。

几十年来，我聆听病人、检查病人、为他们担心、给他们建议、替他们治疗。这些岁月带给我的，不只是医学知识，更是丰富而宝贵的临床经验 —— 一种能帮助我察觉细微病征、更理解病人、并作出更成熟判断的经验。

当然，今天行医的挑战比过去更多。医生面对的不只是病人多、病情复杂，还包括人工智能的崛起、医疗科技的快速进步、政府新条例、越来越严格的合规要求、电子系统，以及似乎永远做不完的文书工作。

过去，病人问：“医生，我会没事吗？”今天，病人可能会说：“医生，AI 说我可能有十种病。”

然而，无论科技如何进步，制度如何改变，医学的核心始终没有变。病人需要的，不只是资料和答案；他们更需要一个愿意倾听、能够判断、懂得安慰、并且负责任的人。

人工智能可以提供数据，却不能握住病人的手。
电脑可储存病历，却不能真正理解病人的恐惧。
条例可以规范医疗，却不能取代医生的良知。

所以，为什么我还不退休？
也许，因为医学仍然给我意义。

它让我的头脑保持清醒，让我的心保持热度，也让我的脚步继续向前。也许，因为我的经验仍然可以帮助病人，而这种帮助，是课本、电脑或算法无法完全取代的。也许，因为病人仍然需要我；而在内心深处，我也仍然需要他们。

退休，总有一天会到来。
但在那一天之前，只要我的手还稳，头脑还清楚，心还愿意，诊所的门还继续打开。

我想，这位老医生仍会继续做他一直在做的事：
倾听、治疗、劝勉，然后偶尔提醒大家——
“请多喝水……不过，如果有肾衰竭，就不要喝太多。”

~~~~~~~~~~~~~~~~~~~~~~~~~~~

《Why Am I Still Not Retiring》

After 40 years in medicine, people often ask me, “Doctor, why are you still not retiring?”
It is a fair question.

By now, my stethoscope probably deserves a place in a museum, my handwriting should be studied by archaeologists, and my clinic chair may qualify as a historical monument.

Retirement sounds wonderful: waking up late, sipping coffee slowly, travelling, playing golf, and pretending not to check blood pressure machines everywhere I go.

But after 40 years, a doctor’s mind does not retire so easily. Being a doctor is not just a profession; it becomes part of one’s identity.

Decades of listening, examining, worrying, advising, and treating have given me not only knowledge, but also vast experience — the kind that helps me recognise subtle signs, understand patients better, and make wiser clinical judgments.

Of course, medicine today is more challenging than ever. Doctors now face artificial intelligence, rapid medical advances, new government regulations, stricter compliance requirements, digital systems, and endless paperwork.

In the past, patients asked, “Doctor, will I be all right?” Today, they may say, “Doctor, AI says I might have ten different diseases.”

Yet the core of medicine has not changed. Patients do not merely need information; they need someone who can listen, judge wisely, reassure them, and take responsibility.

Artificial intelligence can provide data, but it cannot hold a patient’s hand.
A computer can store medical records, but it cannot understand patient’s fear.
Regulations can guide medical practice, but they cannot replace a doctor’s conscience.

So why am I still not retiring?

Perhaps because medicine still gives me meaning. It keeps the mind alert, the heart engaged, and the legs moving.

Perhaps because my experience can still help patients in ways no textbook, computer, or algorithm can fully replace. Perhaps because my patients still need me—and deep inside, I still need them too.

Retirement will come one day.
But for now, as long as my hands are steady, my mind is clear, my heart is willing, and the clinic door still opens, this old doctor will continue to listen, heal, advise, and occasionally remind everyone:
“Please drink more water… but not too much if you have kidney failure.”

#医生 #老医生 #退休

03/05/2026

《为什么我不是素食者》
《Why I Am Not a Vegetarian》
许多人认为，吃素就一定代表健康。
其实，这并不完全正确。

素食饮食如果安排妥当，当然可以非常健康；但如果天天吃油炸食物、甜食、精制淀粉和过度加工的素肉，也未必比一般饮食更健康。

对我而言，我选择不做严格的素食者，并不是因为宗教因素，也不是因为我反对素食。这只是基于医学营养、实际生活和个人健康管理上的考虑。

这也不表示我不喜欢蔬菜或植物性食物。
相反，蔬菜、水果、豆类、豆腐、坚果、种子和全谷类，应该是健康饮食的重要基础。我的看法很简单：以植物性食物为主，同时适量摄取鱼类,瘦肉和鸡蛋。

鱼类，瘦肉和鸡蛋都是很有营养价值的食物。
鱼类含有优质蛋白质、Omega-3 脂肪酸、维生素 B12、维生素 D、碘和硒。鸡蛋则提供蛋白质、维生素 B12、胆碱，以及有助于眼睛健康的营养素。只要摄取适量，并采用较健康的烹调方式，鱼，瘦肉和蛋都可以成为健康饮食的一部分。

严格素食也可以很健康，但必须更用心规划。
一些营养素如维生素 B12、铁、锌、钙、维生素 D、碘、Omega-3 和蛋白质，都需要特别注意。尤其是维生素 B12，非常重要；一旦缺乏，可能影响神经、血液、记忆力和体力。

真正的问题，并不在于一个人是素食者还是非素食者。更重要的问题是：每天到底吃进去的是什么食物？

如果一个素食者每天主要吃炒面、白饭、甜饮料、饼干和油炸素料，他未必会比一个常吃清蒸鱼、鸡蛋、豆腐、蔬菜、水果和全谷类的人更健康。同样地，一个非素食者如果经常吃加工肉类、炸鸡、香肠、培根、甜饮料，却很少吃蔬菜，那也绝对不是健康饮食。

从医学角度来看，最理想的饮食模式，通常是以植物性食物为主、高纤维、低糖、少加工食品，并且含有足够优质蛋白质。

这也是为什么地中海饮食(Mediterranean Diet)常被推荐。它主要包含蔬菜、水果、豆类、扁豆、坚果、全谷类和橄榄油，同时适量摄取鱼类和鸡蛋。

因此，我不是素食者，并不是因为我反对素食，也不是宗教上的选择，而是因为我相信健康不在于一个标签，而在于均衡、食物质量和长期坚持。

我尊重素食者，尤其是那些认真规划饮食的人。但对我自己而言，我更倾向于一种实际而均衡的饮食方式：多吃蔬菜、水果、豆类和豆腐，摄取足够蛋白质，少吃油炸食物，少糖，少加工肉类，并控制适当分量。

简单来说，我不一定要成为严格素食者，才能拥有健康。我们真正需要的，是吃得明智。

当然，我还是会吃蔬菜——
只是有时候，会和鱼一起吃。

～～～～～～～～～～～～～～～～～～～～

《Why I Am Not a Vegetarian》

Many people believe that being vegetarian automatically means being healthy.
In reality, this is not always true.

A well-planned vegetarian diet can certainly be very healthy, but if it consists mainly of fried foods, sugary items, refined carbohydrates and heavily processed mock meats, it may not be healthier than an ordinary diet.

For me, choosing not to be a strict vegetarian is not due to religious reasons, nor is it because I am against vegetarianism. It is simply a decision based on medical nutrition, practical living and personal health management.

This also does not mean that I dislike vegetables or plant-based foods. On the contrary, vegetables, fruits, beans, tofu, nuts, seeds and whole grains should form the foundation of a healthy diet.

My view is simple: eat mainly plant-based foods, while including fish, some lean meat and eggs in moderation.

Fish, lean meat and eggs are both nutritious foods. Fish provides high-quality protein, omega-3 fatty acids, vitamin B12, vitamin D, iodine and selenium. Eggs provide protein, vitamin B12, choline, and nutrients that support eye health. When eaten in appropriate amounts and prepared in healthier ways, fish and eggs can be part of a healthy diet.

A strict vegetarian diet can also be healthy, but it requires more careful planning. Nutrients such as vitamin B12, iron, zinc, calcium, vitamin D, iodine, omega-3 and protein need special attention. Vitamin B12 is especially important; deficiency may affect the nerves, blood, memory and energy levels.

The real issue is not whether a person is vegetarian or non-vegetarian. The more important question is: what does the person actually eat every day?

A vegetarian who mainly eats fried noodles, white rice, sweet drinks, biscuits and deep-fried vegetarian products may not be healthier than someone who regularly eats steamed fish, eggs, tofu, vegetables, fruits and whole grains.

Likewise, a non-vegetarian who frequently eats processed meats, fried chicken, sausages, bacon, sugary drinks and very few vegetables is clearly not following a healthy diet.

From a medical point of view, the most ideal eating pattern is usually one that is mainly plant-based, high in fibre, low in sugar, low in processed foods, and provides enough high-quality protein.

This is why the Mediterranean diet is often recommended. It is based mainly on vegetables, fruits, beans, lentils, nuts, whole grains and olive oil, with fish, lean meat and eggs taken in moderation.

Therefore, I am not a vegetarian not because I oppose vegetarianism, nor because of religion, but because I believe health is not defined by a dietary label. It is defined by balance, food quality and long-term consistency.

I respect vegetarians, especially those who plan their diet carefully. However, for myself, I prefer a practical and balanced approach: more vegetables, fruits, beans and tofu; enough protein; less fried food; less sugar; less processed meat; and sensible portions.

In short, I do not need to become a strict vegetarian in order to be healthy.
What I truly need is to eat wisely.
And yes, I will still eat my vegetables — sometimes with fish.

#素食 #素食者

29/04/2026

《Seafood & Hidden Toxins》
《海鲜、与隐藏毒素》
(and the Microplastic Surprise)
（再加微塑料的惊喜）

海鲜一直享有“健康食品”的美名。
鱼类有益心脏，鲜虾让一餐显得更丰富，生蚝更神奇，竟然让全世界相信它既是美食，也是浪漫。

多年来，医生都建议人们多吃鱼，因为海鲜含有优质蛋白质、Omega-3 脂肪酸、碘、硒、维生素 D，以及许多对心脏、大脑、甲状腺、肌肉和免疫系统有益的营养素。

不过，现代科学也加上了一个重要提醒：
“鱼可以吃，但要懂得选择；因为有些海鲜除了营养，也可能带有汞(mercury)、镉(cadmium)、铅(lead)、工业化学物质、藻类毒素，以及一点免费的微塑料(microplastic)。”

于是，海鲜不再只是健康食品，也变成了一场餐桌上的“健康侦探故事”。

以前到菜市场买鱼，大家问的问题很简单：
“新鲜吗？”“多少钱？”“可以便宜一点吗？”
今天，讲究健康的阿叔站在鱼摊前，认真地问：“老板，这条鱼有汞(mercury)吗？”
卖鱼三十年的鱼贩回答：
“阿叔，这条只有鱼鳞。”
两个人看着那条鱼，心里都明白：
原来无知，以前也是一种简单的幸福。

从医学角度看，主要问题在于“累积”。
大型、长寿、掠食性的鱼类，就像海洋里的“大老板”，站在食物链顶端。它们多年吃下许多小鱼，体内也可能慢慢累积更多汞。
鲨鱼、剑鱼、旗鱼、马鲛王和大型金枪鱼，看起来很有气派，但从营养安全来看，有时就像背着太多有毒包袱的高级主管。

汞(mercury)之所以值得注意，是因为过量接触可能影响神经系统、记忆力、协调能力，也可能影响胎儿脑部发育。因此，孕妇、儿童和经常吃海鲜的人，更要小心选择。问题不是鱼不好，而是有些鱼‘’太成功、太长寿‘’、在海洋里的职位太高了(所以累积更多的垃圾）。

相比之下，小型鱼通常是比较安全、也比较谦虚的选择。沙丁鱼、江鱼仔、鲱鱼、小型鲭鱼等，就像海洋里的老实员工：没有那么华丽，也没有那么贵，却含有 Omega-3、蛋白质和矿物质，而且比较少带着一份“重金属履历表”上桌。

贝壳类海鲜则需要多一分谨慎。
生蚝、青口、蛤蜊、血蚶和扇贝都是滤食性生物。听起来好像很干净，但别忘了，它们过滤的正是海水里的各种东西。一只青口一生仿佛都在说：“别担心，我来净化海水。”
同时也默默收藏了海水想隐藏的东西。
贝壳类可以很有营养，但如果来自受污染的水域，就可能带有细菌、病毒、寄生虫、重金属或藻类毒素。因此，来源不明的生血蚶，不是“勇于尝鲜”，而像是一场肠胃道赌博。

微塑料，则是现代海鲜故事里的新角色。
这些很小的塑料颗粒，如今可在海洋、河流、食盐、瓶装水、食品包装中发现，甚至可能藏在那支陪伴年轻人度过低潮的“情绪支持珍珠奶茶吸管”里。

海鲜也可能含有微塑料，特别是贝壳类，以及整条连内脏一起吃的小鱼。较大型鱼类的好消息是，许多微塑料通常在内脏里，而我们一般会把内脏去掉。坏消息是，人类制造了太多塑料污染，结果海洋现在也开始“自己加料”。

不过，恐慌不是答案。
微塑料对人体长期健康的影响仍在研究中，而适量吃海鲜的好处则比较明确。因为担心微塑料就完全不吃海鲜，就像因为路上有灰尘就决定不走路。更好的做法，不是和海鲜“离婚”，而是改善这段关系。

实用的医学建议很简单：
适量吃海鲜；
多选小型鱼；
少吃大型掠食性鱼类；
向信誉好的商家购买；
避免来源不明的贝壳类；
去除鱼内脏；
并把海鲜彻底煮熟。

多样化也很重要——不要天天吃同一种鱼，吃到它几乎可以认你做亲戚。

总的来说，海鲜仍然是好食物，只是不再是完全天真无邪的食物。聪明的海鲜爱好者不必害怕，只要懂得选择：选小、选鲜、选干净、选多样，并且煮熟。

正如菜市场一位谨慎的阿姨所说：
“吃鱼，是为了 Omega-3，不是为了 Mercury-24。若那条鱼看起来比你还老、还成功，最好让它继续在海里退休。”

~~~~~~~~~~~~~~~~~~~~~~~~~~~~
《Seafood & Hidden Toxins》
《海鲜、与隐藏毒素》
(and the Microplastic Surprise)
（再加微塑料的惊喜）

Seafood has long enjoyed a saintly reputation.
Fish is good for the heart, prawns make dinner feel luxurious, and oysters somehow convinced the world they are both exotic food and romance.

For generations, doctors have advised patients to eat more fish because seafood provides high-quality protein, omega-3 fatty acids, iodine, selenium, vitamin D, and other nutrients important for the heart, brain, thyroid, muscles, and immune system.

Then modern science added a small but important footnote: “Yes, eat fish — but choose carefully, because some seafood may also come with mercury, cadmium, lead, industrial chemicals, algal toxins, and a complimentary sprinkle of microplastic.”

This is how seafood became both a health food and a clinical detective story on dining table. .

At the wet market, customers once asked simple questions:
“Is it fresh?” “How much?” “Can discount?”
Today, the health-conscious uncle stands before the fish stall and asks:
“Boss, this fish got mercury or not?”
The fishmonger, after thirty years in business, replies: “Uncle, this one got scales only.”
Both stare at the fish, silently agreeing that ignorance was once a much simple happiness.

The main medical concern is accumulation.
Large, long-living predatory fish — the ocean’s CEOs — sit at the top of the food chain. They eat many smaller fish over many years and gradually collect more mercury.
Shark, swordfish, marlin, king mackerel, and large tuna may look impressive on the plate, but nutritionally they can behave like senior managers carrying too much toxic baggage.

Mercury matters because excessive exposure may affect the nervous system, memory, coordination, and fetal brain development. This is why pregnant women, children, and frequent seafood eaters should be more selective.

The problem is not fish itself; the problem is some fish are ‘’too successful, too old, and too high-ranking‘’ in the ocean (hence accumulated more ocean toxic).

Smaller fish are usually the safer, humbler choice. Sardines, anchovies, herring, small mackerel, and similar fish are the honest workers of the sea: less glamorous, less expensive, rich in omega-3, protein, minerals, and less likely to arrive with a heavy-metal résumé.

Shellfish deserve "extra respect" too.
Oysters, mussels, clams, cockles, and scallops are filter feeders. That sounds clean — until we remember what they are filtering.
A mussel spends its life saying, “Don’t worry, I’ll clean the water,” while quietly collecting whatever the ocean was trying to hide.
Shellfish can be nutritious, but if harvested from contaminated waters, they may carry bacteria, viruses, parasites, heavy metals, or algal toxins.
Raw cockles from mysterious origins are therefore not “adventurous dining”; they are like betting in a gastrointestinal lottery.

Microplastics add the modern twist.
These tiny plastic particles are now found in oceans, rivers, salt, bottled water, food packaging, and probably somewhere in the cute little bubble tea straw.

Seafood may contain microplastics, especially shellfish and small fish eaten whole. In larger fish, much of the microplastic burden is usually in the gut, which we remove. Unfortunately, humanity has been so generous with plastic pollution that the ocean is now "seasoning" itself with it.

Still, panic is not the solution.
The health effects of microplastics are still being studied, while the benefits of moderate seafood intake are well recognized. Avoiding all seafood because of microplastics is like refusing to walk because the road has dust. The better answer is not to divorce seafood, but to improve the relationship.

The practical medical advice is simple:
eat seafood in moderation,
choose smaller fish more often,
limit large predatory fish,
buy from reputable suppliers,
avoid unknown shellfish sources,
remove fish guts,
and cook seafood properly.

Variety also matters — do not eat the same fish every day until it recognizes you as family member.

In the end, seafood is still good food — just no longer innocent food. The wise seafood eater is not fearful, only selective: choose small, choose fresh, choose clean, choose variety, and cook it well.

As one cautious auntie at the market wisely said:
“Eat fish for omega-3, not for mercury-24. And if the fish looks older and richer than you, better let it retire in the sea.”

26/04/2026

《Alzheimer’s Disease: The Long Goodbye》
《阿尔茨海默病：漫长的告别》
(and the New Hope of pTau-217)
(与 pTau-217 带来的新曙光)

阿尔茨海默病走进一个家庭时，往往不是一声惊雷，而是一阵轻轻的风。

起初，可能只是一些小事。
一位退休教师忘了把老花眼镜放在哪里，最后竟在冰箱里找到。
一位祖父在晚餐桌上，把同一个问题问了三遍；家人也温柔地回答了三遍，假装没有察觉。
一位向来细心的商人开始忘记缴账单，却坚称一定是银行出了错。

一开始，大家或许只是笑笑：“年纪大了嘛。”
可是，有时候，在这些看似平常的小插曲背后，正悄悄展开一场更深层的脑部退化。

阿尔茨海默病并不是普通的健忘。它是一种进行性的脑部疾病，脑内会逐渐累积异常蛋白，尤其是淀粉样蛋白与 tau 蛋白，进而伤害神经细胞，慢慢影响记忆、语言、判断力、行为表现，以及日常生活的独立能力。

在早期，病人可能外表依然整齐，谈吐也还正常，甚至还能与人高谈阔论时事政治。因此，家属常常感到困惑：“医生，他还能聊天、还能讲道理，可是他就是记不得自己有没有吃过午餐。”

这正是阿尔茨海默病治疗上最大的挑战之一：当症状变得明显时，疾病其实可能已经在脑中酝酿多年。治疗阿尔茨海默病，有点像发现白蚁时，木屋的梁柱已经被蛀空了一部分。我们仍然可以帮助，但修补永远比及早发现更困难。

目前的药物治疗，可以在某些病人身上改善或稳定症状一段时间。近年来，一些针对淀粉样蛋白的新型药物，也能在特定早期病人中减缓退化速度。然而，它们并不是神奇解药，不能让病人完全恢复到从前，也不能真正治愈疾病。这类治疗也涉及费用、适应症筛选、定期监测，以及潜在副作用等现实问题。

诊断本身也并不简单。现实生活中，记忆力下降可能由许多原因造成：忧郁、睡眠不足、药物副作用、维生素 B12 缺乏、甲状腺功能异常、中风、酒精影响，或其他类型的失智症。并不是每一个健忘的人，都患有阿尔茨海默病。

我常半开玩笑地说：
忘记车子停在哪里，未必可怕；
忘记自己有一辆车，那就比较令人担心了。

也正因为如此，pTau-217 检测的价值日益受到重视。

pTau-217 是一种与阿尔茨海默病病理变化密切相关的血液生物标志物，尤其能反映与淀粉样蛋白沉积相关的异常 tau 蛋白变化。

过去，要确认脑内是否存在阿尔茨海默病相关病理，往往需要昂贵的 PET 扫描，或通过腰椎穿刺检查脑脊液。这些检查当然有其价值，但并非每位病人都方便、负担得起，或愿意接受。坦白说，也没有多少病人会高高兴兴排队等着做腰椎穿刺。

相比之下，pTau-217 这类血液检测，为临床诊断提供了一个更实际、更容易接受的辅助工具，尤其适用于已经出现认知退化症状的病人。

它可以帮助医生判断病人是否更可能存在阿尔茨海默病相关的脑部变化，是否需要进一步确诊检查，以及是否适合及早接受特定治疗或进入更积极的管理计划。

不过，pTau-217 并不是“算命式”的检测。它不能单独决定一个人的命运。它必须结合病史、认知功能评估、身体检查、必要的脑部影像，以及其他血液检查，才能作出全面判断。

pTau-217 真正的价值，在于它能带来更早的清晰答案。
对病人而言，它可以减少不确定感。
对家属而言，它有助于及早作出医疗、财务与生活安排。
对医生而言，它提供了一个重要的生物学线索，让一种过去常躲在模糊症状背后的疾病，逐渐显露出轮廓。

我曾听过一位女儿说：“医生，我觉得很内疚，因为以前我一直以为妈妈只是固执。”

这句话，道出了失智症家庭最深的痛。许多病人在被理解之前，先被责备；许多家庭在知道真相之前，已经承受了太多挫折与误会。

阿尔茨海默病，是医学上最令人心酸、也最艰难的旅程之一。它不是突然夺走一个人，而是一点一点地带走记忆、能力与熟悉的性格；而承受这一切的，往往是最爱他的人。

然而，随着大众意识提高、诊断工具进步，以及 pTau-217 这类生物标志物的发展，我们正从“太迟才怀疑”，逐步走向“更早能识别”。

我们或许还没有真正的治愈方法，但我们已经能够给予一些非常重要的东西：更早的答案、更好的规划，以及更有同理心的照护。

在失智症这条幽暗而漫长的走廊里，哪怕只是一盏小灯，也值得我们紧紧握住。

~~~~~~~~~~~~~~~~~~~~~~~~~~~~
《Alzheimer’s Disease: The Long Goodbye》 ..(and the New Hope of pTau-217)

Alzheimer’s disease often enters a family not with a thunderclap, but with a whisper.

At first, it may be small things.
A retired schoolteacher forgets where she kept her reading glasses, only to find them in the refrigerator.
A grandfather asks the same question three times during dinner, while the family politely answers three times, pretending not to notice.
A usually meticulous businessman begins missing bill payments, then insists the bank must have made a mistake.

Everyone laughs gently at first. “Old age lah,” we say. But sometimes, behind these little stories, a more serious process is unfolding.

Alzheimer’s disease is not just ordinary forgetfulness. It is a progressive brain disease in which abnormal proteins — especially amyloid and tau — accumulate in the brain, damaging nerve cells and slowly affecting memory, language, judgement, behaviour, and independence.

In the early stage, the patient may still look well, dress well, and chat normally. That is why families are often confused: “Doctor, he can still talk politics, but he cannot remember whether he has eaten lunch.”

This is one of the great challenges of Alzheimer’s treatment. By the time symptoms become obvious, the disease may already have been present for many years.

Treating Alzheimer’s is a little like arriving at a house after termites have already weakened the wooden beams. We can still help, but repair is much harder than prevention or early action.
Current treatments can help symptoms to some extent. Some medicines may modestly improve memory or daily function for a period of time.

Newer disease-modifying treatments that target amyloid may slow decline in selected patients with early Alzheimer’s disease, but they are not magic bullets. They do not restore a person to their former self. They are also costly, require careful selection, repeated monitoring, and carry potential risks.

Another difficulty is diagnosis. In real life, memory problems may be due to many causes: depression, poor sleep, medication side effects, vitamin B12 deficiency, thyroid disease, stroke, alcohol, or other types of dementia. Not every forgetful person has Alzheimer’s. As I often say, forgetting where you parked your car may be normal; forgetting that you own a car is more worrying.

This is where pTau-217 testing becomes valuable.

pTau-217 is a blood biomarker linked closely to Alzheimer’s disease pathology, especially abnormal tau changes associated with amyloid accumulation. In the past, confirming Alzheimer’s biology often required expensive PET scans or lumbar puncture to test cerebrospinal fluid. These tests are useful, but not always convenient, affordable, or acceptable to patients. Many patients are not exactly queuing up happily for a spinal tap.

A blood test such as pTau-217 offers a more practical way to support diagnosis, especially in patients who already have symptoms of cognitive decline. It can help doctors identify who is more likely to have Alzheimer’s-type brain changes, who may need further confirmatory testing, and who may be suitable for early intervention or newer therapies.

But pTau-217 should not be misunderstood. It is not a fortune-telling test. It must be interpreted together with clinical history, cognitive assessment, physical examination, brain imaging when needed, and other laboratory tests.

The real value of pTau-217 lies in giving earlier clarity. For the patient, it may reduce uncertainty. For the family, it may allow earlier planning — medically, financially, emotionally. For the doctor, it offers a biological clue in a disease that used to hide behind vague symptoms and family disagreements.

One daughter once said, “Doctor, I feel guilty because I thought my mother was being stubborn.” That sentence captures the emotional burden of dementia. Many patients are scolded before they are understood. Many families become frustrated before they realise the brain is failing, not the character.

Alzheimer’s disease remains one of medicine’s most painful and difficult journeys. It steals slowly, and often from the people who love us most. Yet with better awareness, earlier diagnosis, and biomarkers such as pTau-217, we are moving from late suspicion to earlier recognition.

We may not yet have a cure, but we can offer something important: earlier answers, better planning, and more compassionate care. In dementia, even a small lamp in a dark corridor is worth holding.

#阿尔茨海默病

18/04/2026

《中国白酒真的有健康好处吗》?
《Does Chinese Baijiu Really Have Health Benefits?》

饭桌之间，偶尔会有人认真地问我：
“医生，中国白酒是不是对身体比较好？”

每次听见这样的问题，我总会先停顿片刻。并不是因为问题荒谬，而是因为它太贴近日常，也太合乎人情。

人对自己熟悉的事物，往往多一分亲近；对自己喜爱的东西，也总愿意往好的方向去理解。甜食可以被称作慰藉，宵夜可以被视为犒赏，熬夜有时也能被解释成夜深人静时效率分外清明。

至于白酒，在不少人的印象里，似乎也不只是酒，而是一种带着传统气息与生活温度的饮品。

有人说它暖身，有人说它活血，也有人因为它“纯粮酿造”，“窖藏多年”，便在心中替它添上一层养生的意味。

这样的说法听来并不突兀，甚至十分符合饭桌上的语言逻辑。

只是，医学终究较少迁就气氛。它不看情怀，不看酒香，也不看这一杯酒背后承载的是乡情、友情，还是盛意。

它所注视的，是更直接的事实：酒精浓度、摄取多少、饮用频率，以及身体为此所承担多少的代谢代价。

说到底，白酒首先是一种高浓度酒精饮品。无论名字如何雅致，包装如何讲究，它进入人体之后，最核心的成分依旧是53度的酒精。

它不会因为“纯粮酿造”而自动化作补品，也不会因为“陈年老酒”而忽然具有护肝之功。

若肝脏能够言语，它大概不会像品酒师那样赞叹“这一杯层次丰富，回味悠长”，反而更可能轻轻叹一句：
“今晚又得加班了。”

白酒真正令人顾虑的，不只是它属于酒，更在于它常常使人不知不觉喝得过量。它度数较高，入口较快，又往往出现在敬酒、回敬、再来一杯的场合之中。

你原本只想浅尝，最后却往往不是自己在决定节奏，而是饭桌上的气氛替人作了主。等到酒意渐起，身体早已默默承受了那一份不动声色的负担。

很多人喜欢拿一种经验来为白酒添上几分“可信度”：
“我喝白酒，隔天很清醒，没头痛，也没什么事。”

这句话听来颇有说服力，却未必能够证明白酒更健康。因为隔天是否宿醉、会不会头晕、口干、恶心或疲倦，其实与许多因素有关：前一晚喝得快不快、有没有配食物、有没有补水、睡眠是否被打乱、身体是否脱水，以及个人分解酒精的能力如何。

有些人隔天症状明显，有些人却仿佛若无其事，这更多反映的是体质差异、代谢速度和饮用方式不同，而不是白酒因此便拥有了健康上的益处。

说得更直白一些，隔天舒服，只代表症状较轻；却不代表身体昨夜没有加班。

许多酒精带来的影响，并不会立刻轰轰烈烈地显现出来。它更像一种安静而漫长的累积：今天一点，明天一点；应酬一点，节庆一点；高兴时一点，疲倦时也一点。时日久了，脂肪肝、肝酵素偏高、三酸甘油脂上升，乃至血压、血糖与尿酸的问题，便可能一一浮现。

这时候，有些人仍会说：“可是我从来没有喝醉。”然而，没醉，从来不等于没伤。

所以，若问中国白酒是否真有健康好处，较为诚实的答案恐怕仍是：它可以有文化上的位置，却未必因此拥有医学上的光环。

只是，文化归文化，医学归医学。一个东西可以有历史的厚度、情感的分量，却不表示它自然拥有健康上的益处。

说到底，真正对身体有益的东西，往往不必费力辩护。白开水如此，蔬果如此，规律作息与适度运动亦如此。只有酒，总让人忍不住替它补上一句“适量就好”，仿佛这样一来，便能为它添上几分安心的注脚。

也许，白酒最适合被摆放的位置，终究不是“健康饮料”的行列，而是生活与文化的一角。它可以被懂得，可以被欣赏，可以在某些时刻浅浅举杯，却不必被赋予它原本承担不起的美名。

毕竟，身体从来比饭桌更诚实。
而真正的健康，也从来不在杯中回甘，
而在日复一日、细水长流的自我珍惜之中。

《Does Chinese Baijiu Really Have Health Benefits?》

This is not a question I usually hear in my clinic. It tends to appear at dinner tables, somewhere between the second toast and the third insistence that I “drink just a little.”

Someone lifts a glass and asks, quite sincerely:
“Doctor, is baijiu actually good for health?”

I never laugh at that question. It is too human. We are always generous toward the things we love. If something has accompanied our family dinners, festive nights, old friendships, and business banquets for years, we do not like to think badly of it.

We prefer to imagine that what brings warmth to the table must surely bring some kindness to the body as well.

So baijiu becomes more than liquor.
It becomes tradition.
It becomes atmosphere.
It becomes “good for blood circulation.”

Given enough affection, almost anything can become health food.
But the body is not sentimental.
The liver, in particular, is not known for its appreciation of heritage, craftsmanship, or cultural symbolism. It does not pause respectfully because the spirit is grain-fermented, cellar-aged, or poured with great sincerity. It simply rolls up its sleeves and gets to work.

If the liver could speak, it would probably not say,
“Ah, what elegance, what depth, what a refined aroma.”
It would say, more likely,
“Really? This again?”

That is the difficulty with baijiu. It is not merely alcohol; it is alcohol wrapped in hospitality. It arrives in tiny cups and large emotions.

One drinks for courtesy, for friendship, for celebration, for not disappointing the host, for not appearing rude, and before long one is no longer drinking by decision but by atmosphere.

People often defend it with lived experience.
“But I feel perfectly fine the next morning,” they say.

Perhaps. But a quiet morning is not a medical certificate. Some bodies complain loudly; others suffer with better manners. The absence of a headache does not mean the absence of strain. It may simply mean your metabolism is efficient, you ate enough, drank enough water, or got lucky.

In medicine, “I felt okay” is not quite the same thing as “it was good for me.”

And that, I think, is the real point.
Baijiu may have cultural value. It may have emotional value. It may even have ceremonial value. But those are not the same as health benefits.

A thing can be meaningful without being medicinal.
It can be beloved without being beneficial.
It can be traditional without becoming a tonic.

So no—baijiu is probably best understood not as a health drink, but as a cultural one.

Enjoyed, perhaps.
Appreciated, certainly.
Romanticized—inevitably.
But prescribed? Never.

Because in the end, the body is always less poetic than the banquet.
And true health is usually found not in what burns warmly in a small cup,
but in what quietly does no harm to our body and liver at all.

#白酒 #白酒推薦 #中国文化 #中国白酒

10/04/2026

《Is lard / pork crackling actually healthy?》
《猪油/渣是不是其实很健康？》

Every time I hear this question, I know it is no longer just about nutrition and medicine.

It becomes a full-blown debate involving nostalgia, childhood memories, and the irresistible smell of grandma’s kitchen.

Let us be honest: "lard is delicious."

Pork crackling is even more dangerous — crispy, fragrant, and able to make people say things like,
“Surely this must be good for the body.”

Well… good for the soul, perhaps.
Good for the arteries? That is another story.

Yes, lard contains some monounsaturated fat.
But that does not make it a health food.
It still contains plenty of saturated fat, and that is exactly why it should not be glorified as some secret superfood.

The classic line is:
“My grandfather ate lard every day and lived to 90.”

True. But your grandfather also walked more, worked harder, ate less processed food, drank less bubble tea, and probably did not have food delivery arriving at midnight.

So no — he did not live long because of lard. He lived long while eating lard in a very different lifestyle.

The truth is simple:
lard is not poison, but it is not a health food either.

Same goes for pork crackling.
They are wonderful traditional foods,
but they are not heart-protective foods.

They are best enjoyed occasionally, not promoted or consumed daily.

Nevertheless we also need to be careful with heavily processed and repeatedly heated vegetable oils. But saying all seed oils are “bad,” “inflammatory,” or proven to cause heart disease is an overstatement.

The often-quoted University of Toronto article from 2013 does not prove that all vegetable oils are harmful though.

The bigger issue is ultra-processed foods, deep-frying, and excess calories — not simply the existence of canola, soybean, corn, or sunflower oil in the diet.

So the sensible view is: avoid overuse, avoid rancid and repeatedly heated oils, reduce fried junk food, and keep a better balance of fats overall. That is very different from saying every vegetable oil is dangerous.

Lard may be stable for cooking — resists oxidation better than polyunsaturated oils (e.g., soybean, canola). As it has high smoke point (approx. 190°C/374°F): Suitable for frying, searing, and roasting without breaking down into harmful compounds.

However for cooking and health, olive oil is generally better; but for aroma and indulgence, lard tastes better.

A mature attitude to the issue is this:
admit that lard tastes fantastic, and has no artificial trans fats (unlike hydrogenated vegetable shortening)
— just do not force it into the “healthy” category.

Also be reminded that, some processed lard (supermarket hydrogenated lard) does contain trans fats — so quality matters.

In short:
Lard comforts your taste buds.
It does not automatically comfort your cholesterol/cardiovascular report.

After all, life is already oily/油腻 enough.
Let us not make the arteries join the party too.

~~~~~~~~~~~~~~~~~~~~~~~~~~~

《猪油/渣是不是其实很健康？》

每次听到这句话，我都知道，接下来通常不是医学讨论，而是一场夹杂着乡愁、香气、童年回忆和一点点不服气的辩论赛。

说到猪油，很多人的眼神会立刻柔和下来。
一碗热腾腾的白粥，滴几滴猪油，香。
一盘青菜，用猪油爆一爆，香。
一碗猪油拌饭，再加一点酱油，
那个香，简直可以让人原谅昨天的不开心。

可惜，人体不是用“香气指数”来评估健康的。
血管也不会因为你吃得很感动，就自动变得通畅。

至于猪油渣，那更是“危险分子”，是“浓缩版的诱惑”。本来脂肪已经不少了，经过高温一炸，水分退场，香味登基，口感封神。平时看起来平平无奇，一旦炸得金黄酥脆，立刻从厨房配角晋升成 “人间精品”。

一口下去，嘴巴说：“太棒了！”
胆固醇可能在旁边小声说：“你先别高兴得太早。”
有人一边咬得咔嚓响，一边还很认真地说：
“这个很补的。”
我每次听到这句话，都会忍不住想：
它补的，可能不是身体，是快乐。

很多人对猪油有一种误会，主要因为这几年网上常常流传一些听起来很振奋人心的说法，
例如：
“猪油比植物油天然！”
“以前的人天天吃猪油，也活到八九十岁！”
“猪油有单元不饱和脂肪，比你想象中健康！”

这些话，不能说完全错。
但问题是，它们只说了一半。

猪油的确不是纯粹的坏脂肪，它也含有一部分单元不饱和脂肪。
这就像某位平时不太靠谱的朋友，偶尔也会帮你买一次咖啡。你不能因为他买过你咖啡，就把他封为“年度最佳人生导师”。

很多人对猪油有一种特殊感情。因为它代表着一种“以前的人都这样吃，也活得好好的”的集体记忆。很多人说：“我阿公以前天天吃猪油，也活很久。” 这句话我在门诊听过无数次。

我通常心里会想：
你阿公那个年代，走路多、劳动多、吃得少、外卖少、奶茶少、宵夜少。
他不是靠猪油活到老，他可能是在一整个高活动量、低加工饮食、低总热量的生活方式里，顺便吃了猪油。

小时候，猪油拌饭是宝；猪油炒菜是香；猪油渣拌酱油，是能让小孩多扒两碗饭的秘密武器。所以猪油在很多人的心中，不只是油，它还是一种乡愁。

但问题来了：
香，不等于健康；传统，不等于适合天天吃。
猪油的确又不是“十恶不赦”的东西。它不是化学武器，也不是吃一口血管就当场拉警报。

最有趣的是，猪油常常拥有一种“民间健康光环”。有人说：“猪油是天然的，比植物油好。”
也有人说：“以前农村的人天天吃，也没见怎样。”

还有人很有自信地总结：“猪油养人。”
这句话听起来很温暖，像一位慈祥的阿嬷。
但医学上通常会比较冷静一点：
猪油也许养香味，不一定养血管。

“天然”这两个字，本身并不自动等于“健康”。
老实说，糖很天然，吃多了也不行；盐很天然，吃过头血压照样抗议；猪油当然也天然，但天然不代表可以无限续碗。

其实，猪油最适合的位置，不是被捧成“超级健康食物”，而是老老实实地待在“偶尔享受”的名单里。

尤其是以下几类朋友，更要跟猪油保持一点“礼貌距离”：
有高胆固醇的，
有高血压的，
有糖尿病的，
肚腩已经很有存在感的，
或者曾经装过支架、血管已经表达过不满的。

当然，也不必从此见到猪油就神情凝重，仿佛它是厨房里的头号通缉犯。我也不是主张从此把猪油当成厨房公敌。医生不是来没收幸福的。

如果你偶尔吃一点猪油炒菜，偶尔吃几块猪油渣，身体通常不会因此立刻召开紧急会议。

问题从来不是“偶尔”，问题是很多人对“偶尔”的定义很有弹性。
有人说自己“偶尔”吃，结果是一周四次；
有人说“只是加一点点”，那一点点已经足够让锅里的青菜产生人生转折。

说到底，猪油和猪油渣最真实及最大的优点，是香；最大的风险，是让你因为太香而忘记分寸。

所以，猪油能不能吃？能。
猪油渣能不能吃？也能。

但如果你问：
“它真的是健康食物吗？”

那答案大概是：
它是个很会哄你开心的食物，
但不是一个会默默保护你心血管的食物。
适合偶尔吃，不适合天天吹捧。

作为医生，我比较赞成一个成熟的饮食态度：
承认猪油很好吃，但不要硬把它说成健康食品。

结论：
猪油和猪油渣，不是什么毒药，但也绝对不是什么健康食物。猪油适合怀念，猪油渣适合解馋，但真正适合天天相处的，还是清淡一点的饮食习惯。

毕竟，人生已经够油腻了，
血管这边，就别再加码了。
（谢谢）

#猪油 #猪油渣 #心脏病

04/04/2026

《清明，不只是扫墓，也是心灵门诊》
《Qingming: The Soul’s Annual Check-Up》
“树欲静而风不止，子欲养而亲不待”

清明节一到，华人社会就会自动进入一种很特别的状态：
有人忙着买祭品，有人忙着约兄弟姐妹回乡，有人忙着除草扫墓，还有人一边烧纸，一边在心里默默做人生检讨。

表面上看，清明是祭祖；说得医学一点，它其实很像一年一度的心灵回诊日。

尤其当我们想到那句古人名言：
“树欲静而风不止，子欲养而亲不待。”

这句话之所以千百年来一直有效，不是因为古人特别会写，而是因为它精准击中了人类最常见、也最难治疗的一种情绪——“来不及综合征”。

父母或爱人在的时候，我们总觉得他们会一直在。
今天忙，明天再陪；
这个月忙，下个月再带他们吃顿饭；
等有空一点，再陪他们看医生、散步、聊天、喝茶。

结果人生最不讲武德的地方，就是它常常不给你“等有空一点”这个机会。

所以很多人到了清明，站在墓前，情绪就会突然复杂起来。

一开始只是来扫墓，后来扫着扫着，扫出了眼泪，扫出了愧疚，扫出了满脑子的“早知道”。

从心理学来说，这很正常。
因为思念本身并不可怕，可怕的是思念里面还混着后悔。
那种感觉就像一种慢性的心理发炎，平时潜伏着，清明一到，准时复发。

有些人不一定会哭，反而会出现“临床表现”：
睡不好、胃口差、胸口闷、整个人提不起劲。
这就是医学上常见的现象：心里有事，身体先挂号。

所以，清明这个节日，其实很有智慧。

它不像现代人那样整天喊“放下、释怀、往前看”，
它允许你想念，允许你内疚，允许你在祖先面前承认——
对，我以前真的陪得不够。

某个角度来说，扫墓其实是一种很古老的心理治疗。
你去除草、上香、摆祭品、双手合十，表面是在祭拜先人，实际上也是在整理自己。

把平日讲不出口的话，趁着烟火缭绕，慢慢说给风听。当然，古人留这句话，不是为了让大家每年清明哭到血压不稳。

它真正的意思，是提醒活着的人：
别总把爱及孝顺留到“改天”。
父母或爱人要的，很多时候不是你多有钱，
也不是多隆重的补偿，
而是你愿不愿意在他们还听得见的时候，多说几句温和的话；
在他们还走得动的时候，多陪几段路；
在他们还坐在饭桌前的时候，好好吃一顿饭。

因为等到墓碑会回答你时，通常已经太迟了。

清明最深的意义，从来不只是怀念逝者，
更是提醒生者：
有些爱和关怀，要趁对方还在的时候投药，别等病情发展成“永远的遗憾”。

所以，清明扫墓，扫的从来也不只是草。
很多时候，扫的也是心里的灰，旧年的愧疚，以及那些一直没说出口的“谢谢”和“对不起”。

愿我们纪念先人，也珍惜眼前人。
毕竟人生最痛的事，不是父母或爱人离开，
而是你终于想好好孝顺或陪伴时，
门诊已经结束，
而且——永不复诊。

~~~~~~~~~~~~~~~~~~~~~~~~~

《Qingming: The Soul’s Annual Check-Up》

When Qingming arrives, Chinese families do more than sweep tombs.

They buy offerings, clear weeds, burn incense — and, quite often, conduct an unplanned emotional audit.

On the surface, it is ancestor remembrance.
In psychological terms, it is closer to an annual follow-up at the soul’s outpatient clinic.

Nothing captures this better than the old saying:
“树欲静而风不止，子欲养而亲不待。”
“The tree longs for stillness, but the wind does not cease; the child wishes to care for the parent, but the parent is no longer there.”

Its power lies in one brutal diagnosis: too late.

When loved ones or parents are alive, we assume time is eternally renewable.

Today is busy. Next month will be better.
When work settles down, we will visit more, talk more, care more.

Unfortunately, life does not run on our calendar.
It has a rude habit of cancelling appointments without notice.

So people arrive at Qingming thinking they are just there to sweep a grave.
Then suddenly, somewhere between the incense and the overgrown grass, they find themselves face to face with regret.

And regret is a stubborn condition.
Missing someone is painful enough.
Missing them with guilt attached, is a different disease altogether.

That is why grief often turns physical:
poor sleep, low appetite, chest tightness, unexplained fatigue.

In medicine, we see this all the time — when the heart is heavy, the body files the complaint first.

Qingming, in that sense, is remarkably wise.

It does not force people to “move on” with motivational slogans.

Instead, it allows them to remember, to ache, and to admit the uncomfortable truth:
Yes, I thought there would be more time.

Tomb-sweeping, then, is not only ritual.
It is ancient psychotherapy with incense.

You clear the weeds outside, and sometimes you also clear a little of the emotional overgrowth inside as well.

But the real lesson of Qingming is not about the dead. It is about the living.

Parents or loved ones usually do not want grand gestures.
They want dinner before the funeral menu.
They want conversation before the eulogy.
They want your presence before your guilt becomes eloquent.

Because once the gravestone is the only thing that answering back, the consultation is over.

So yes, Qingming is about remembrance.
But it is also a warning:
Do not postpone love until it becomes ancestral.

For in the end, the saddest part is not merely that our parents or loved ones are gone, but that when we are finally ready to care better,
the clinic has closed —
permanently.

#清明節 #清明节 #清明

Dr K.K.Tan Specialist Clinic

09/05/2026

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