Born at just 29 weeks, our daughter almost didn't survive. Now she's thriving, but the journey isn't easy
I got admitted right away, but at the time we had no idea that this would turn out to be a four-day fight to keep our baby in my womb. The doctors tried everything, but our little one was in too much distress and needed to be delivered via an emergency C-section.
What followed was not the birth experience I had imagined it to be.
Our baby's tiny cry was barely audible in the operating theatre. The relief I felt hearing our little one's voice for the very first time was short-lived as the medical team quickly whisked her away – I did not even get to see or touch my child.
My husband, Immanuel, had to wait outside the operating theatre throughout the whole operation, not knowing how the both of us were doing.
Once our baby left the operating theatre, Immanuel immediately followed her to the Neonatal Intensive Care Unit. For those first few hours after giving birth, I couldn't see or be with them – all I could do was lay on the recovery bed, fearing the worst.
At just 29 weeks, our Laura entered the world far earlier than we had expected, her fragile lungs not yet ready for their first breath. She was red and raw, with tubes all around her. She weighed only 0.7kg, and was barely any bigger than my hand.
Words cannot describe the heartbreak we felt as we spent the next several days watching our baby lie helpless in an incubator, unsure when we would be able to touch her, much less carry her. We could only press our hands against the incubator's see-through cover, hoping the warmth of our hands could reach her.
FIGHTING FOR EVERY BREATH
In the very first week of Laura's life, there was no mincing of words – we were told that she was 'very sick' and 'might not overcome'.
She had severe cystic chronic lung disease, meaning she needed constant respiratory support. Her first days on Earth were filled with beeping monitors and the steady hum of ventilators, sounds that we would eventually get used to as she relied on these machines for the first few years of life.
The first time we held her, we were preparing to let her go. At only 20 days old, she had already undergone cardiopulmonary resuscitation (CPR) and intensive interventions. Her tiny body was just too sick and frail.
But against all odds, she pulled through that night. And the next. And many, many more tough nights after.
The next time we got to carry her was 50 days later. After nearly two months, we finally got to have the skin-to-skin contact with our baby that we'd been yearning for as new parents.
Most days, though, it was still too tough for her to be moved from her little bed. All we could do was watch as she gave her best fight, hoping and praying our presence and love were enough to strengthen her somehow.
Day after day, we kept turning up to be at Laura's side, determined to brave this perilous rollercoaster ride together. Even so, at times, we couldn't help but feel helpless, useless. The challenges just seemed endless – surgery after surgery, procedure after procedure.
THE LONGEST WAIT
For 14 months, the hospital was our second home.
Due to COVID-19 visitation restrictions, we didn't have our usual support system of friends and family. But like a real home, the doctors and nurses became like family, supporting us through every step of Laura's journey.
Our doctors delivered the facts of Laura's reality but always encouraged us to remain hopeful. Our nurses gave us regular updates on her quirks and antics; when Laura celebrated her first birthday in the hospital, they were right there with us, bearing witness.
Most importantly, Immanuel and I learnt to lean on each other more than ever before, finding strength we did not know we had in ourselves and each other.
After 429 arduous days in the hospital, Laura was finally discharged. Our hearts overflowed with joy – but also apprehension. After more than 14 months in the hospital, we knew bringing her home was going to be a monumental challenge.
LIFE AT HOME
For the first few months of being at home, we couldn't let our guard down. Laura's tracheostomy tube and tendency for reflux and vomiting meant nights of constant vigilance. She was always at high risk for choking, so we kept watch over her breathing every minute of every day, even as she slept.
Changing her tracheostomy tube and nasogastric tube was no easy feat; neither was managing the rest of her medical supplies and equipment. In the hardest moments, we felt renewed gratitude for the months of careful, thorough training by KKH's home care nurses.
As exhausting as it was, having our daughter home with us was everything we'd dreamed of during those long hospital months. Every gummy smile from her, every peaceful moment of rest we could enjoy together reminded us of how far we had come.
We'd joined a children's tracheostomy group to find support and community with other families going through similar experiences. Even before we got home, we were recommended a trolley setup for her medical equipment that would make caring for her easier.
As Laura grew bigger and more mobile, we sought advice from experienced parents in the group who gave us invaluable suggestions on how to tweak the trolley setup to better accommodate her movement.
We admired their resourcefulness in finding ways to support their children through trial and error, and how they freely shared their wisdom and experience to help other children just like Laura, who were growing in awareness of the tubes and machines as being part of their little lives.
SHARING OUR STORY
Early on, we had also found hope through another family's Instagram posts about navigating their child's struggles with the same condition. Soon, we began documenting our own journey on an Instagram account (@raising.rara), recording all the ways Laura was beginning to thrive at home despite her many challenges.
This helped us connect with other families facing similar challenges – and soon other parents began reaching out to us as well, with the same questions and fears we once had.
Whenever we go out in public, we often draw stares from strangers, bewildered or alarmed by Laura's many medical apparatus. Many parents in the same boat share similar stories of grief and frustration with us.
While we can't speak for every one of these parents, here's what we usually say when asked how we would like strangers to react: Smile at these children, even if your initial response is surprise. How we as adults respond and react to visible differences matters profoundly.
A simple 'hi' and a friendly wave is more appropriate than 'What happened to you?' when interacting with a child. What we say around and about children greatly affects how they perceive the world. It's not about manners or semantics; it's language that shapes us as a people.
Children with disabilities and medical needs are aware of their differences – but they're still children. Just like any other child, they're worthy of being treated kindly and gently.
Together, we can create a more compassionate Singapore − one that sees beyond the trappings of medical devices to the beautiful souls they support.
Hashtags
Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles
CNA
4 hours ago
- CNA
At her mother-in-law's bedside, dementia sparked an unexpected bond: 'I felt closer to her than before'
Whenever Teresa Teng's ballad The Moon Represents My Heart plays, Fortuna Tan thinks of, not her husband, but her mother-in-law Wong Ngun Siew. Wong died of pneumonia last year, at the age of 92. She had suffered from dementia for seven years. Tan accompanied her through the last four years of her life when she was bedridden after a stroke, assisting with feeding, bathing and diaper changes. They also spent hours listening to oldies together. It was during those long quiet afternoons that Wong opened up to her daughter-in-law, sharing poignant memories of her childhood, marriage, struggles and hopes – many of which she may not have mentioned to her own children. Through dementia's trials, their relationship blossomed. 'I saw her in a different light and felt closer to her,' said the 53-year-old Tan. 'That's probably why I was willing to care for her till the end.' WHEN STROKE STRUCK Wong had six children, and lived with her youngest son at her own home. One of her daughters took care of her medical needs. In 2017, after being diagnosed with vascular dementia, she also began attending daycare. However, in 2020, Wong suffered a stroke. 'After our regular Saturday family dinner, we watched TV together. Suddenly, she grabbed my daughter's hand and leaned on her. We thought she was going to sleep. But her face changed – one side drooped. That's when we realised she was having a stroke,' Tan recalled. At first, doctors thought Wong would not pull through. But her condition stabilised and she was eventually transferred to a community hospital. That was during the early days of the pandemic, and the hospital only allowed two visitors per patient. One of them had to be Wong's helper, who assisted her with daily needs. Tan's husband wanted to be the second caregiver, but he could not step away from work for extended periods. That was when Tan, a stay-at-home mother who had given up her career as a data analyst many years ago, stepped up. Her two children were then aged 18 and 21. 'I did it out of love for my husband,' Tan told CNA Women. 'I wanted to support him since I was more equipped in dementia care.' She had helped to care for her grandmother, also a dementia patient, from 2017 to 2019 when she died. A FOUR-YEAR CAREGIVING JOURNEY After the stroke, Wong could not move her left side. Bed-bound, she required diapers and had to be fed, changed, bathed, and transferred from bed to geriatric chair and back daily. Wong already had her helper to care for her, but it was often a two-person job. When the helper was cleaning Wong after she had passed motion for instance, she would wriggle a lot and Tan had to help hold her. She had to do the same when Wong had constipation, so that the helper could insert rectal suppositories to aid her bowel movement. Some may baulk at the stench but Tan said it did not bother her. Because dementia often requires round-the-clock care, Tan went to her mother-in-law's house from Mondays to Wednesdays, staying from lunchtime to around 10pm, to support the helper so that she could get much-needed rest. From Thursdays to Saturdays, Wong's other children would step in to support the helper, and on Sunday, Tan and her family would pop by to buy groceries, and check in briefly. To equip herself, Tan enrolled in a six-month course on dementia care by Peacehaven Jade Circle Acaredemy, an eldercare training centre. When she was taking care of her grandmother, Tan had watched her gradually lose the ability to speak Mandarin, and subsequently the Teochew dialect. She felt helpless to make her feel cared for and loved. This time around, she was determined to better equip herself with caregiving skills, communication skills and engagement strategies. With that knowledge, in 2021, she even started a support group, Caring You, Caring Me, for fellow caregivers in church. The group currently has 10 to 12 members who meet every three months to share knowledge, engage in self-care activities such as garden walks and art therapy, and support one another. A TAPESTRY OF MEMORIES One thing Tan's course taught her was how to engage Wong, as slowing down cognitive decline was a priority. Some days, the duo would simply count to 50, count backwards, then count in Mandarin and Malay. Tan also created a personalised playlist of Wong's favourite songs. The duo spent many quiet afternoons just sitting together and listening to the nostalgic tracks of Teresa Teng. Drifting through the corridors of memory, Wong often found herself lost in the past. Out of nowhere, she would ask, 'Where is my mother?' – forgetting that her mother had long since died. 'If I had told her that her mother had died, she might not accept it and would be upset, or she might accept it and be distressed,' Tan said. Instead, Tan would validate her thoughts by saying: 'You are thinking about your mum' and then distract her with further questions. 'I'd say, 'I don't know where your mum is, but can you tell me what she looks like? Why are you looking for her?' 'She said, 'My mum wants me to follow her to the market'. That was how I knew she was recalling the past. So I'll ask her how old she was,' Tan said. That was how Wong's life story unfolded to Tan one memory at a time. 'I found out that my mother-in-law had a hard life growing up. The second oldest among eight children, she had to take care of her younger siblings, and did not get a chance to study. 'She only had the opportunity to go to night school during the Japanese occupation. She later became a seamstress, sewing on-and-off to support the family. 'She met her husband, my father-in-law, during an arranged date with her mother's friend's son. After that one-day date, my father-in-law asked, 'What do you think? Can we be together?' That's how they got married without much dating. 'After marriage, she set up a laundry shop to help support the family. I finally understood why she is always concerned about money,' said Tan. THEIR FINAL JOURNEY TOGETHER With deeper understanding and empathy, the mother-and-daughter-in-law pair grew closer. But the final journey came with other struggles. 'The last year of her life was really a rollercoaster,' said Tan. Wong gradually lost the ability to eat, and Tan would help to feed her on the helper's day off. 'That's very challenging. It took me one hour just to feed her half a bowl of porridge. Sometimes, she would not even open her mouth. Sometimes, she would forget to swallow. I could not give her the second spoonful if she did not swallow, otherwise, she might choke. If the food goes into her lungs, she could develop an infection,' said Tan. Their chat sessions also ended when Wong lost her speech. 'Using the analogy of a library, for dementia, it's as if over time, one book after another disappears from memory,' Wong said. Medical issues such as digestive problems, severe constipation and infection also became more frequent, and Wong was hospitalised almost monthly. 'The phone was always beside me, and when the helper called me, I would try my best to tell her what to do, what medication to give and when to send my mother-in-law to the hospital,' said Tan. 'When the helper lacked rest and had a headache, I'd take over,' said Tan. 'I didn't have much social life because I had to be at the hospital most of the time.' On Dec 4, 2024, Wong made her final trip to the hospital. She was diagnosed with pneumonia. Doctors warned that she had likely come to the end of her journey. One by one, her children and grandchildren visited. Tan also said her final farewells. 'Whenever I had quiet moments with her, I thanked her for the privilege to develop a connection with her during this caregiving journey.' Her mother-in-law died 10 days later. Though Tan was at the hospital then, she did not go up to the ward, opting to give her husband and Wong's children more time with her in her final moments. 'Being there in her final moments was not so important to me. When she was living, I had already shown her care and love, and I knew she felt it,' said Tan. But whenever she hears The Moon Represents My Heart, Tan remembers their bittersweet journey together. 'I won't say it's a sad thing. It brings memories of the good moments I had with her,' she said wistfully.
CNA
10 hours ago
- CNA
South Korean medical students to return to school, urge education reforms
SEOUL: South Korean medical students who walked out of school last year in protest at a government plan to increase medical school admissions said on Saturday (Jul 12) that they would return to campus, calling on authorities to normalise academic schedules. The Korean Medical Association, the main lobby group for doctors, in a statement urged the government to take steps to restore the academic calendar and improve training conditions. 'We will place our trust in the government and parliament and commit to returning to school to help normalise medical education and the healthcare system,' the KMA said in the statement, issued jointly with parliament's education committee and lobby groups representing medical students. A specific timeline for the return was not provided. Thousands of medical students walked out of school in early 2024 in opposition to a plan by the previous administration to add thousands of new spots at medical schools. The trainee doctors had argued that the planned rise in admissions would lower the quality of medical education. They said that rather than just an increase in numbers of students, more reform was needed to attract doctors into essential care such as emergency or pediatrics. The KMA statement called on the president and the government to form a task force to address long-term reforms in medical education and training and to ensure the participation of all stakeholders, including students.
CNA
12 hours ago
- CNA
Laced and lethal: How 'Kpods' are hooking youths and exploiting legal grey areas
Warning: This story contains a reference to suicide. When David (not his real name) first tried an e-vaporiser offered by friends in January last year, he had no idea that the liquid inside it contained more than just nicotine. It was only when he felt lightheaded after taking a few puffs that the teenager, now aged 20, suspected it was not a regular vape, which in itself is illegal in Singapore. After he confronted them, they revealed it was a "Kpod" – a drug-laced vape that typically contains chemicals such as etomidate, a fast-acting anaesthetic used in medical procedures. However, he still continued using it. "I started at first using just my friend's vape at the clubs and then after that, I realised I was (getting) more addicted and I was looking for it more," David told CNA TODAY. "So I got the (seller's) contact from my friends and I bought my own 'Kpod'. I started using it almost every day at home. "I realised I was getting addicted on the fourth or fifth month of usage, but I still couldn't stop because of the feeling it gave me." Also known as "zombie vapes" or "space oil", "Kpods" have been gaining popularity in Singapore over the past year. The device is commonly known as a "Kpod" because they are sometimes also laced with ketamine, another anaesthetic that has hallucinogenic properties. In May, the Health Sciences Authority (HSA) said it was closely monitoring the trend, after detecting more than 20 cases involving etomidate this year – a four-fold increase from just five cases in all of last year. In a raid in April 2024, the authorities also seized 65 vapes suspected to contain tetrahydrocannabinol, the main psychoactive compound in cannabis. Social service agencies, healthcare professionals and legal experts said that a lack of awareness about "Kpods" and their long-term health effects, along with regulatory grey areas exploited by both sellers and users, may be fuelling their increasing use among the young. Indeed, David admitted that even though he knew the vape was laced, it did little to deter him. His friends claimed that the substances could not be detected in urine tests and assured him that he could enjoy the high without getting caught. He was also told that etomidate is classified as a poison under Singapore's Poisons Act and not a Class A controlled drug under the Misuse of Drugs Act, which carries heavier penalties. This was why he believed that, if caught, he would face a lesser charge under the Tobacco Act, which outlaws regular vapes, rather than the harsher consequences meted out under Singapore's anti-drug laws. He eventually stopped last July, after his mother discovered he had been using these drug-laced vapes and referred him to an addiction recovery facility. He struggled with the withdrawal symptoms he experienced as he tried to wean off the "Kpods". "When I stopped using the 'Kpods', I could feel very lethargic and my body would hurt a lot ... I just felt very uncomfortable in my own body without using (it)." Social service agencies counselling former youth addicts said that, like David, many of them held misconceptions about the harms of "Kpods", including the false belief that etomidate poses minimal health risks since it has a legitimate use as an anaesthetic in medical settings. Mr Wilson Tan, executive director at Youth Guidance Outreach Services, said that some young people hold liberal views towards such chemicals and they would say: "This is not drugs, this is medicine. It is used to save lives. If it comes into my body – if it's a moderate consumption – I don't think it will damage my body that much." Agreeing, Mr Alvin Seng, a counsellor at addiction recovery centre We Care Community Services, said that young people often underestimate the long-term neurological and organ damage caused by 'Kpods', believing that occasional, intermittent use is safe. However, that belief could not be further from the truth, healthcare and addiction experts said. While "Kpods" are a relatively new phenomenon and more research is needed into the exact long-term effects of repeated etomidate abuse via inhalation, experts warned that the risks are far more serious than many young people realise – which is why the anaesthetic is classified as a poison in the first place. Associate Professor Bibhas Chakraborty, interim director at the Centre for Quantitative Medicine at Duke-NUS Medical School, said sedatives such as etomidate can carry a risk of overdose, potentially leading to severe or life-threatening consequences almost immediately. "In contrast, regular vaping or smoking involves nicotine, which, though addictive, is not legally considered poisonous. Its side effects such as organ damage stem from long-term abuse and pose health hazards over time," he explained. "In short, these 'Kpods' can cause immediate fatal effects, while regular vaping and smoking primarily present long-term public health risks through chronic exposure." Dr Clare Anne Fong, a consultant at the Division of Respiratory and Critical Care Medicine within the National University Hospital (NUH), said that perhaps most insidious is the fact that users can never really know for sure the substances or precise chemical mix in "Kpods". This uncertainty raises the risk of accidental overdose, the experts said. Mr Bruce Mathieu, a motivational speaker and content creator who speaks out against "Kpod" use on social media, said the lack of transparency around what goes into the vapes makes them extra dangerous for the abuser. The 55-year-old reformed drug user said his decades-long struggle with substance abuse began when he first tried cannabis at the age of 13. He went on to spend more than 30 years in and out of prison for drug-related offences. "At the end of the day, drug traffickers want money and more money. They do not care about your health. They do not care about what they put inside the pods," he added. "They can tell you (it contains) etomidate or they can tell you it's 'Kpod' but … it could be just nicotine and caffeine. Or it can be other harder drugs, harder substances. There are no quality checks … you don't know what you're putting into your body." He also said: "If I had a choice – the lesser of two evils – (between) 'Kpods' and meth, I'd take meth." Meth, short for methamphetamine, is an illegal stimulant. "At least with meth, I know what I'm getting myself into. With 'Kpods', I don't know. What I consume right now could just be my last … and that is a very scary thought." A GROWING PROBLEM Social service agencies in Singapore told CNA TODAY that they have seen an uptick in clients seeking help for "Kpod" use over the past year. Most are youth – some as young as 13 – referred by parents, schools or family service centres. The agencies said that they are mainly older teenagers and young adults, aged between 15 and 29, because "Kpods" are more expensive than regular vapes and tend to be accessible to those with greater financial independence. The "Kpod" scourge is not confined to Singapore. Increasing numbers of drug-laced vape products have been seized across Southeast Asia and other parts of Asia in recent years, signalling a growing public health concern. In June, three Singaporeans were among four men charged in Malaysia with trafficking 9.42 litres of liquid cocaine stored in nearly 5,000 vape pods. Malaysian police recorded 119 drug-laced vape seizures last year – almost four times the 32 cases in 2023, The Star newspaper reported on Jan 3. In May last year, The Bangkok Post reported that four people, including two Singaporeans, were arrested in Thailand's capital city for selling vapes laced with methamphetamine and heroin. These cases reflect a troubling regional trend – the rising availability and misuse of drug-laced vapes, which pose serious health risks to users, particularly the young. Experts attribute the rise in "Kpod" use to several factors including cross-border trade, encrypted messaging platforms such as Telegram, rapidly evolving technologies and word-of-mouth among peers. These channels allow users to obtain modified vapes easily and anonymously, making it difficult for the authorities to monitor, curb or regulate the trend. Dr Fong from NUH said: "Unlike in Singapore, vapes – as compared to other 'hard' drugs – are still legal in many other countries and there is a lack of standardised regulation regarding their sale." Mr Shaneet Rai, Of Counsel at law firm Kalidass Law Corporation, noted that dealers turn to encrypted chat groups such as those on Telegram or Discord to advertise "Kpods". Thus, enforcement is complicated by anonymous user names, fast-disappearing channels and payments made via cryptocurrency or pay-later services, he said, adding that the pace at which dealers adapt to new technologies often outstrips the capabilities of current enforcement tools. Just like regular vapes, "Kpods" can come in a variety of sweetened flavours. However, unlike standard e-vaporisers, "Kpods" are laced with more than just nicotine. Etomidate is among the more commonly found drugs in these modified vapes, but it is far from the only one. Experts said "Kpods" are a new channel for drug pushers to distribute illicit substances. The liquid content of these products is virtually indistinguishable from regular vape juice without laboratory testing or toxicological analysis, making detection difficult. Mr Rai the lawyer said that "Kpods" are typically imported into Singapore and often concealed within black market vape shipments. They are usually manufactured in unregulated overseas labs, where there are minimal restrictions on adding psychoactive substances to e-liquids, he added. Indeed, dealers may exploit legal loopholes by filling e-vaporisers with compounds not classified as hard drugs, such as in the case of etomidate-laced vapes. These substances can be frequently modified, not only to evade legislation but also to cut manufacturing costs by mixing them with other chemicals. With these vapes remaining unregulated, there is no clear indication of what goes into them, including their exact chemical makeup. In some cases, even the sellers themselves are unaware of what the vapes contain. One such seller told CNA TODAY that he never know the original source of the "Kpods" that he sells. The 28-year-old, who is based in Malaysia and spoke on condition of anonymity, said he relies on the supplier's word that the product he is selling contains etomidate, but admitted he does not know what is inside the "Kpods" he sells. He believes they might also be laced with tetrahydrocannabinol, the main psychoactive compound in cannabis. He also said that different brands of "Kpods" could contain different chemical mixes and thus have "varying strengths". Other "Kpod" sellers contacted by CNA TODAY on Telegram shared listings featuring various "flavours" – mostly fruit-based such as mango or green apple – and a range of brands. They did not say how the contents of the vapes could be verified, offering only verbal assurances. Drug rehabilitation centre Addictions Recovery Singapore said: "It's important to highlight that etomidate is not the only risk. We have seen evidence that vape liquids can also be clandestinely laced with ketamine, cocaine, methamphetamine, heroin and synthetic cannabinoids. "This dramatically raises the stakes, as individuals may be entirely unaware of what they're inhaling, compounding the risk of unpredictable psychological reactions and multi-drug dependence." ETOMIDATE: A POTENTIAL HEALTHCARE CRISIS Healthcare and addiction experts said that the rise in "Kpod" use among the young is worrying, because etomidate can cause both short- and long-term harm – including potentially fatal consequences even after a single use. Associate Professor Bibhas Chakraborty, interim director of the Centre for Quantitative Medicine at Duke-NUS Medical School, described etomidate as a strong drug used in hospitals to sedate patients during procedures. It is meant to be administered only under close medical supervision and not for personal or long-term use. Inhaling etomidate can lead to short-term effects such as dizziness, confusion, shaking and breathing difficulties. Dr Sharad Haridas, a consultant psychiatrist at Promises Healthcare, a clinic that offers addiction therapy among other services, said the drug can also lower levels of gamma-aminobutyric acid in the brain, resulting in heightened anxiety, poor sleep quality, concentration difficulties and, in some cases, panic disorders. The Addictions Recovery Singapore said that although etomidate is not considered addictive under supervised medical use, recreational inhalation can quickly create psychological dependence, with users chasing its sedative effects. Even occasional use may disrupt sleep regulation and trigger rebound anxiety or irritability, which are early signs of withdrawal. The impact of "Kpod" use is especially serious for adolescents, whose brains are still developing. Exposure to substances at a young age may impair cognitive function, emotional regulation and memory over time. Young people also metabolise drugs differently than adults, which may lead to unpredictable side effects, Dr Fong from NUH said. Aside from that, "Kpods" might be laced with other undisclosed substances apart from etomidate. Early drug exposure increases the likelihood of future drug-seeking behaviour and long-term addiction, the experts said. Dr Melvyn Zhang, senior consultant at the Institute of Mental Health's National Addictions Management Service, said that adolescent brain development continues into the mid-20s. Any form of drug abuse during this stage can harm the brain's development, affect mental health or increase the risk of developing an addictive illness. "From a clinical perspective, there is a possibility that early substance experimentation may predispose individuals to other drug abuse. "However, the actual gateway hypothesis of 'Kpod' use leading to other drug abuse has not been scientifically tested," Dr Zhang added. Regardless, "Kpod" use goes beyond addiction risks. Dr Zhang cautioned that it may also lead to adrenal insufficiency, a serious health condition that affects cortisol production, which is critical to the body's stress response and various physiological functions. More research is needed into the recreational use of sedatives such as etomidate, particularly through inhalation, including their potential for dependence and withdrawal effects, especially since "Kpods" remain a relatively new phenomenon, the experts said. In the meantime, there are already signs of how drug-laced vapes are affecting individual users. For David, the effects included feeling "lightheaded" and "buzzed" – a high that lasted less than a minute each time he used a "Kpod". Although the sensation felt good at first, he began experiencing headaches and body aches. He also recalled feeling deeply "dissociated" from his body. On several occasions, this caused him to lose balance and fall. Once, he even hit his head, but refused medical treatment, fearing hospital workers might report him for suspected substance abuse. These dangers became devastatingly real for Mr Delfard Tay, who lost his 20-year-old daughter Shermaine Tay to suicide in September last year – a tragedy he believes could have been linked to her "Kpod" use. The 43-year-old logistics company manager said that his daughter had started using "Kpods" at the start of last year. Although he repeatedly tried to coax her out of it, their conversations often ended in arguments, followed by days of silence. Over the following months, Mr Tay began noticing significant changes in her behaviour. She spoke more, but often incoherently. She also became more aggressive and was easily agitated. In the week leading up to her death, she also experienced persistent vomiting, he recalled. The autopsy report did not offer conclusive answers, but after reviewing closed-circuit television footage from their home, Mr Tay saw that his daughter had been inhaling "Kpods" shortly before her death and he could see her visibly shaking in the footage. Social service agencies said they had counselled young people who reported similar symptoms after using "Kpods". The Addictions Recovery Singapore said that common immediate effects include shivering, "zombie-like" disorientation, aggression, unsteady gait and sudden collapse. Mr Tan from Youth Guidance Outreach Services said that users may engage in more risk-taking behaviour while on "Kpods". He noted that some users also refer to the vape by its street name "piao piao", a Chinese term to describe "floating" – indicating the light, detached sensation it induces. Dr Zhang from the National Addictions Management Service said that because the medical complications of "Kpod" use are still not well understood, a cautious approach to symptom management is needed. However, this is made more challenging because users often avoid seeking help for fear of being penalised by the authorities for drug use. TOYING WITH THE UNKNOWN The fact that there is so little awareness about "Kpods" and their harms is what is driving its rising popularity, experts said. The liquid inside a "Kpod" is virtually indistinguishable from regular vape juice to the naked eye, so it is easy for unsuspecting young users to be misled by ill-intentioned sellers into trying "Kpods", under the pretext that they are regular nicotine vapes. However, some users and social service agencies said that there are ways to tell the difference between a "Kpod" and a regular vape. Often, the devices look slightly different. One of the tell-tale signs is that a "Kpod" often has a small pod attachment fitted onto an e-vaporiser. It also tends to be significantly more expensive than regular vapes. Those who are knowingly using "Kpods" downplay the health risks of etomidate-laced vapes due to misinformation or gaps in existing research. A common misconception is that etomidate, even though it is a controlled substance, is safe or less harmful than traditional cigarettes, simply because it is used in medical settings. As a sedative, its fast and heavy effects can be particularly appealing to stressed or sleep-deprived youth, the Addictions Recovery Singapore said. "Without realising they are consuming controlled substances, they may develop patterns of self-medicating or escalate to other drugs like benzodiazepines or opioids," it warned. Sellers may also mislead users or manipulate regulatory loopholes to market "Kpods", claiming they are undetectable in urine tests and assuring users that substances such as etomidate are classified as poison under Singapore's Poisons Act, not as Class A controlled drugs under the Misuse of Drugs Act. However, some of these misconceptions have been dispelled by the authorities. In a written parliamentary reply on Jan 8, Health Minister Ong Ye Kung said that "individuals consuming such e-vaporisers may also have etomidate detected in their urine". Assoc Prof Chakraborty from Duke-NUS Medical School said: "Technically speaking, etomidate can be detected in urine, but only through specialised or targeted testing methods. These tests are highly sensitive and can detect etomidate and its metabolites for up to several days after use, despite its short half-life." He also said that the claim that etomidate is "undetectable" likely stems from it not being included in standard drug screening panels – not because it cannot be detected at all. In a statement earlier this year, the Central Narcotics Bureau (CNB) said that there had been "sporadic cases" where vapes were used to consume controlled drugs. It added that anyone whose urine tests positive for controlled substances, "regardless of the mode through which it was ingested", will be investigated under the Misuse of Drugs Act. "The possession of any apparatus or article, including vapes, for the consumption of controlled drugs is an offence under section 9 of the Misuse of Drugs Act," CNB warned. And even though some young users may believe that they face lighter penalties for using drug-laced "Kpods" – as opposed to being charged under the Misuse of Drugs Act – the consequences for using or selling "Kpods" are still more severe than those for regular vapes. Associate Professor Razwana Begum, head of the Public Safety and Security programme at the Singapore University of Social Sciences (SUSS), said that the possession or use of e-vaporisers may result in fines of up to S$2,000. However, involvement with "Kpods" containing controlled substances such as etomidate carries heavier penalties, including imprisonment and higher fines under the Poisons Act. Currently, "Kpod" suppliers are exploiting regulatory loopholes to market their illicit goods. Manufacturers, for instance, might introduce novel psychoactive substances into "Kpods" that are not yet scheduled under the Misuse of Drugs Act, Mr Rai from Kalidass Law Corporation said. The constantly evolving chemical compositions, coupled with potentially slow laboratory turnaround times for identifying controlled substances, can further hamper enforcement efforts. COMBATTING THE CRISIS To combat the rising threat of "Kpods", experts and social service agencies said that a range of targeted measures is needed. Further upstream, they stressed the importance of stronger "Kpod"-specific research and youth education. Mr Alvin Seng from We Care Community Services said that current anti-drug and anti-vape campaigns do not address "Kpod" use directly. "Anti-drug messaging typically focuses on Class A drugs such as cannabis and methamphetamine, but not 'Kpods'. "Anti-vape messaging also does not make any mention of 'Kpods' and only focuses on nicotine vapes," he added. Agreeing, Mr Narasimman Tivasiha Mani, executive director of youth-based non-profit organisation Impart, said that more effective anti-drug and anti-vaping messaging should clearly highlight the severe health risks of "Kpods", using specific case studies to drive home the message. He also said that the authorities could consider myth-busting campaigns that directly address and dispel misinformation surrounding the drug-laced vapes. Many young people genuinely do not understand the extent of harm the substances can inflict on their bodies and long-term health, he observed. "They need case studies, they need to be shown how bad it is." This would include addressing young people's false beliefs that "nothing wrong" can come from etomidate abuse since it is a "medical drug", he added, or that it offers the same high as ketamine without the same negative side effects. It is important to let the young know that people can die instantaneously from its abuse, he asserted. Beyond highlighting the dangers of "Kpods", educational campaigns should also underscore the importance of early reporting, to empower young people to come forward and seek help, Assoc Prof Razwana from SUSS said. School-based programmes that promote open dialogue and provide accessible support can further facilitate student reporting and enable early intervention. These efforts, when paired with confidential helplines or online reporting platforms, can help reduce the fear of repercussions and prompt more young people to report "Kpod"-related incidents, she added. She also stressed the importance of parental involvement. Raising awareness about "Kpods" and their symptoms, as well as equipping parents to be proactive and vigilant, is key to identifying early signs of use. Parents can also help reframe reporting as a step towards rehabilitation, supporting their children in breaking the habit and preventing long-term harm, Assoc Prof Razwana said. This was the case for David, who eventually turned sober with the support of his mother after she referred him to an addiction recovery facility in July last year. On the rehabilitative front, Dr Haridas from Promises Healthcare said: "As far as treatment approaches go, there is currently limited published data, but the general principles of substance use disorder apply. "The first is to adopt a non-judgmental approach and to provide a safe space to explore the underlying reasons behind substance use. "This is where counsellors come in. They can help individuals manage anxiety, depression and trauma – factors often exacerbated by etomidate misuse." Downstream, regulatory gaps must be addressed as well. This includes tightening controls and penalties, or possibly introducing broader analogue laws to ensure Singapore's drug legislation is agile enough to respond to fast-evolving threats such as "Kpods". Singapore has tried to address this by introducing generic listing provisions – such as Section 17C of the Misuse of Drugs Act – but Mr Rai the lawyer said that more flexible analogue laws could enhance enforcement agility. "A presumptive classification model or analogue provision, as seen in jurisdictions like the US (Federal Analogue Act) or Australia, could allow the authorities to treat chemical variants as controlled based on structure and effect, pending confirmatory analysis," he added. Such a move would help future-proof Singapore's laws against fast-evolving synthetic drugs, especially those distributed in digital or aerosol form, he suggested. For now, would reclassifying etomidate as a Class A controlled drug under the Misuse of Drugs Act be an effective next step? Dr Fong from NUH cautioned that reclassifying the drug would complicate its accessibility for use as an anaesthetic. "It would be subject to the same stringent regulations as other controlled substances such as fentanyl (a synthetic opioid), requiring dual sign-offs, strict dosage verification and meticulous documentation of any unused quantities," she said. Given that etomidate is frequently used for emergency intubations in resuscitation areas, such added regulatory burdens could hinder its timely administration, she added. Mr Rai said: "'Kpods' represent a perfect storm: youth-targeted marketing, chemical innovation, digital anonymity and cross-border trade." Addressing it would require a combination of stronger technology-enabled enforcement, real-time chemical surveillance, public education campaigns, clear prosecutorial guidelines on knowledge-based defences, as well as updated regulatory frameworks to classify substances faster. "This is not just a drug issue. It's a digital, social and public health issue – and the law must evolve in sync," Mr Rai urged. Tackling the knowledge gap is the first step in the right direction. This is also what Mr Mathieu, who is against "Kpod" use, hopes to do in speaking up on social media about its dangers. "I do not want others to be in my shoes, where we waste and rot in prison due to our drug addiction," he said, adding that many users start out thinking that they have a handle on their drug consumption, telling themselves that there is "no way drugs are going to get its claws into me". "But you know what? Everyone I met in prison, including myself, said the same thing. The oldest person I met during my last imprisonment for drugs was 82 years old ... at the age of 82, he was still in the bondage of drugs." David, too, admitted that he lacked awareness about the real effects of "Kpods" and this was partly why he was so easily drawn to them. "I feel like it would have helped me if there was more education about what 'Kpods' really are and what they would do to you in the long run, and all the side effects and the cons of it ... I could see the kind of person I was when I was on 'Kpods' and it was not the kind of person I wanted to be. "Because some of my friends had mutual (friends) who passed away because of 'Kpods', I try my best to let my friends know why I got sober ... and I'm slowly trying to keep them away from smoking 'Kpods' as well." WHERE TO GET HELP If you are facing mental health problems or having suicidal thoughts, you may reach out for help through the following hotlines. You may also find a list of international helplines here. If someone you know is at immediate risk, call 24-hour emergency medical services.
