Greetings from Bangkok! 2nd Annual Echo ASE-ASEAN Conference

By James Thomas posted 10-25-2016 14:07

  

Monday, October 24, 2016:  Greetings, ASE, from the other side of the world!  We have been in Bangkok over the past few days for the 2nd annual Echo ASE-ASEAN conference, and it’s been another great success.  We had over 250 attendees registered from 22 countries, mostly from Southeast Asia (Thailand, Malaysia, Singapore, Indonesia, Vietnam, Philippines, Laos, Cambodia, and Myanmar), but also places as far flung as Australia, Pakistan, Nepal, United States, UAE and Turkey!

The meeting this year took place with a touch of sadness in the air, as the Thai people had lost their King one week earlier, and the entire country was in a state of mourning for one year.  King Bhumibol was the longest ruling monarch in the world at over 70 years, and he was incredibly beloved by his people.  Interestingly, he was the only monarch ever to be born in the United States, having been born in Boston 88 years ago, as his father was in medical school there at the time.  In solidarity with the Thai people, the ASE faculty followed their example and dressed mostly in black and white clothes.  The many public ceremonies occurring daily around Bangkok necessarily limited our attendance somewhat from last year, but there still was great enthusiasm for echo education in the room.

As you may recall from last year, the idea for this meeting grew out of several converging ideas.  First, Southeast Asia is a populous and sophisticated region for echocardiography but with limited educational opportunities.  Second, at a meeting three years ago in Jakarta, Indonesia, the ASEAN echo leaders came together to discuss forming a regional echo society, which ASE hoped to be able to foster along. Finally, after last year’s highly successful inaugural meeting, it was hoped to continue this tradition with annual (or so) conferences that would increasingly take on the character of a society meeting but with strong ASE presence.  I am very pleased to report that since last year, the leaders of the national echo societies in the region have come together to formally inaugurate the ASEAN Society of Echocardiography, with Edwin Tucay of the Philippines as President. 

For this second meeting, we returned to the Conrad Hotel just across the street from the American Embassy in the heart of Bangkok, a vibrant city of 15,000,000.  Faculty this year included from the ASE our President Allan Klein (Cleveland Clinic), Craig Broberg (Oregon Health Sciences University, OHSU), Roberto Lang (University of Chicago), Jae Oh (Mayo Clinic), along with meeting chair Jonathan Lindner (OHSU) and co-chair Jim Thomas (Northwestern University). Twelve regional faculty from Thailand, Indonesia, Singapore, and Philippines rounded out our speakers.  As for ASE staffing, we really brought the A-team with CEO Robin Wiegerink and COO Hilary Lamb manning the registration desk, occasionally assisted by my wife Yngvil in the role of unpaid intern!

The first day’s lectures focused on the assessment of systolic function in the morning (including important topics of cardio-oncology, the athlete’s heart, and diabetes), with valvular heart disease discussed in the afternoon.  We tried to leave plenty of time for panel discussions and presented much of the educational content through case presentations, with Q&A continuing through the refreshment breaks. After a solid day of lecturing, we felt it appropriate to reward our speakers with an outstanding faculty dinner at Nahm, named the number one restaurant in Asia last year and recently declared (by those who declare such things…) the #37 restaurant in the world! It was truly on of the best meals of my life, exploring all the vibrant flavors of the Thai kitchen with incredibly fresh produce arranged in unimaginably inventive ways.

Saturday, October 22, 2016 dawned bright and beautiful in Bangkok.  Soon we were back at it, tackling the thorny topics of adult congenital heart disease (with Craig Broberg and Ju-Le Tan tag teaming masterfully for several lectures), diastolic function, endocarditis, aortic disease, and multimodality imaging.  We are also grateful to our exhibitors: the National Board of Echocardiography Siemens, TomTec, and especially Philips and GE, who also presented lunchtime seminars at the meeting.  We also wish to thank Lantheus for providing an unrestricted educational grant for the meeting.

That evening, the ASE faculty (plus our adopted irrepressible child KK Poh from Singapore) returned to dine together at Sala Rim Naam, the Thai restaurant at the Mandarin Oriental Hotel, one of the iconic hotels of the world.  It also happens to be where Yngvil and I spent the first three nights of our honeymoon over ten years ago, so it is always a real walk down memory lane to take the boat ride across the Phraya River to dine there. The food is surprisingly affordable (as was Nahm for that matter), and we finished the evening with a drink at the classic Bamboo Bar, an amazing watering hole that has hosted great writers through the years from Rudyard Kipling to Norman Mailer.

Finally, on Sunday, October 21, 2016, we were up bright and early for a packed morning of echo in systemic diseases as well as providing interventional guidance for all the amazing procedures that have come on the scene in the past two decades.  The afternoon was given over to live demonstrations, including several patients provided by our Thai faculty. It was a wonderful opportunity to show how advanced echocardiography, such as 3D and strain imaging, can be done in complex patients, and the crowd responded very positively.

Over the lunch hour, we met with the leadership of the nascent ASEAN Society of Echocardiography to discuss our next steps, in particular when and where we might want to hold our next meeting.  There was strong enthusiasm to continue this effort with the hopes of really lifting this society and improving echo quality throughout the region.  Although no final decisions have been made for the next meeting, Edwin Tucay and his colleagues from the Philippines Society of Echocardiography made a strong pitch to hold our next meeting in Manila in the first quarter of 2018 (fall is typhoon season in Manila and we hope to avoid that completely by coming in the dry season). We will be reviewing the situation closely and hope to finalize dates and locale shortly.

I’ll close this blog with a strong plea to our members from America and throughout the world to consider coming for the next ASE-ASEAN meeting.  Not only will it provide outstanding echo and cardiology education, it is a wonderful opportunity to see this fascinating part of the world.  Though SE Asia is a looooooong way from America (plan on about 24 hours of travel to get over), once you’re here, it’s really very easy to get around the region and see some fascinating cultures, beautiful beaches, and cities exploding with excitement. For example, this year Yngvil and I came a few days early to spend the weekend in Singapore, truly one of the great cities of the world (and home to two Michelin-starred “hawker stands” where you can get a full meal for under $10; try doing that at Le Bernadin!), followed by 3 days in Siem Reap, Cambodia, where we toured the awe-inspiring Angkor Wat and enjoyed incredible Khmer cuisine (and cheap: a twelve course tasting menu for two at the best restaurant in Cambodia for $56!). Last year we paired a few days in Chiang Mai before the meeting with some beach time in the south of Thailand afterwards. These meetings truly give the chance to break out and explore some of the most fascinating cultures on the planet.

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 All signs point to Echo ASE ASEAN!

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One of the many memorials to King Bhumibol, beloved leader of Thailand for over 70 years.

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Many of us wore these black ribbons in sympathy with the Thai people.

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Hilary Lamb and Robin Wiegerink manning (or should that be womaning?) the registration desk.

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One of the panel discussions on the first day, featuring (L to R) Allan Klein, Jim Thomas, Rungsrit Kanjanavanit from Chiang Mai, Thailand, Kian-Keong (but everybody calls him KK) Poh from Singapore, Roberto Lang, and two of my former fellows who helped out so very much with this meeting, Teerapat Yingchoncharoen and Sarinya Puwanant, both from Bangkok.

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That’s Farhan Latif from Lahore Pakistan, on the left, one of my oldest friends in the echo world, along with several of his Pakistani and Nepalese colleagues.

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The three Musketeers, KK Poh, Jim Thomas, and Jonathan Lindner.

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Another panel discussion with (L to R) Nathima Ratanasit from Bangkok, Ju-Le Tan from Singapore, Jonathan Lindner, Allan Klein, and Ario Kuncoro from Jakarta, Indonesia.

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 The audience enjoying the panel.

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ASE “headquarters” with Jonathan, Hilary, Robin, Jim, and ace unpaid intern Yngvil Thomas

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Approaching the incredible Nahm restaurant, #37 in the world.

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Make your reservations early.  This place is not to be missed!

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Roberto and Lily Lang with Smonporn Boonyaratevej from Bangkok.

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Teerapat Yingchoncharoen (Bangkok), Edgar Tay  (Singapore), and ASE CEO Robin Wiegerink.

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Ario Kuncoro (Jakarta, Indonesia), Loewe Go (Manila, Philappines), Hilary Lamb, and Jonathan Lindner.

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Craig Broberg, Ju-Le Tan (Singapore), Wendy Ruan (Singapore) and Rungsrit Kanjanavanit (Thailand).

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 Terry and Jae Oh with Allan Klein.

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Yngvil and Jim Thomas.

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Jonathan with Ju-Le, Wendy, and Rungsrit.

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Again, the Three Musketeers, Jim, Jonathan, and KK.

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Let the feasting begin!  An amuse bouche of pineapple with Thai-spiced cashew butter.

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Crab wafers with coconut, galangal, and coriander.

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Egg nets with prawns, wild almonds, and kaffir lime.

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Pork and lobster with shredded ginger and Thai citron.

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 Steamed red curry of scallops with Thai basil and coconut.

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Scallop salad with coconut and lemongrass.

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Penaeng curry of wagyu beef with peanuts, shallots and Thai basil.

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Chiang Mai chilli relish with grilled river prawns and crunchy pork crackling.

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The Chiang Mai chilli relish to go with the previous picture.

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Whole fried fish with lemongrass fish sauce

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Clear soup of fresh water crayfish, pork, and ivy gourd leaves.

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Wonderful Thai fruit to cleanse the palate.

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Some other amazing Thai fruit, whose name I can’t remember.

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Yes, that’s corn off the cob for dessert!

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And just to complete the effect, the notorious durian fruit, the odor of which is said to stop armies in their tracks.  I actually thought it was tasty, but I think that was a minority opinion…

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Sweet rice cakes.

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Some petit fours to complete the meal.

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Oh, what the heck, how about some more petit fours!  Although this may seem to have been an incredibly extravagant meal, the cost was only $75 per person. 

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Here’s the crowd after a very satisfying meal.

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And the view from the other end.

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Second night out, with this incredible flower piece in the lobby of the Mandarin Oriental.  It’s something completely different every time I see it!

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Crossing the Phraya River by boat to get to the restaurant with Sherry Barrow (CEO of NBE and former ASE staff person), Allan Klein, KK Poh, Hilary Lamb, Jonathan Lindner, and the Thomases, reliving our honeymoon ten years ago.

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Langs and Ohs enjoying the ride.

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Robin Wiegerink

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An (appropriately) out of focus picture of the Sky Bar, famous from Hangover II.

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Ready for our meal at Sala Rim Naam.

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No better way to finish the evening than at the Bamboo Bar at the Mandarin. 

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Allan Klein and I with two former fellows, Sarinya Puwanant and Teerapat Yingchoncharoen.  It’s so gratifying to see former trainees doing so well!  On the right is Decho Jakrapanichakul

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Presenting challenging interventional cases (L to R): Edgar Tay, KK Poh, Jonathan Lindner, Roberto Lang, and Edwin Tucay.

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Live demonstration with Decho Jakrapanichakul scanning and Roberto Lang providing expert commentary.

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No better way to learn advanced echo than with the experts scanning and working the machine!

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Meeting with the leadership of the ASEAN Society of Echocardiography and the Philippines Society of Echocardiography to begin planning the next meeting. L to R Jim Thomas, Edwin Tucay, Joyce Jumangit , Hilary Lamb, Jonathan Lindner, KK Poh, Mary Ong-Go, and Eleanor Lopez.

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Don’t let your wife go out with Terri Oh in Bangkok.  She’s liable to end up buying a painting like this one! 

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