Cord blood gives hope to adults

Transcription

EE
Nov/Dec 2007 \
A Singapore General Hospital Bi-monthly Publication
Issue 5
November/December 2007 MICA (P) 111/01/2007
I N S I D E
Computerassisted knee
replacement
surgery
Pg
5
Have you
washed
your
hands?
Pg
9
Cord blood gives
hope to adults
Chicken
Galantine
for X'mas
Pg
21
The world
through
his eyes
Pg
\ 1
23
Cut & Keep
General Enquiry
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Billing/ Medisave Enquiry
Medical Reports
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Outpatient Appointments
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www.sgh.com.sg
FR
Outram Campus gets new landmark
Two unrelated cord blood units can be used to treat
adults afflicted with leukaemia.
Stories by Hazel Yong and Karen Teng
editor@sgh.com.sg
A 19-year-old girl has successfully battled
leukaemia following a stem cell transplant
using umbilical cord blood from two
unrelated individuals. Polytechnic
student Candy Yeow underwent a novel
procedure known as double cord blood
transplant after there was no match for a
bone marrow transplant (see other story).
Leukaemia survivor Candy Yeow remained
optimistic even while she was undergoing
double cord blood transplant.
Singapore Genera l Hospita l ’s
consultant haematologist and Deputy
Director for the Centre for Transfusion
Medicine at Health Sciences Authority
Dr Mickey Koh (right) said double
cord blood transplant is an option for
Singaporean adult patients suffering
from leukaemia. This is because due to
small family size, many may have only
one sibling or none at all. Therefore a
patient may not have a suitable match.
Dr Koh explained, “Bone marrow
transplants work better if the donor is a
sibling. There’s a 25 per cent chance that
their cells make a perfect match with the
patient’s and this minimises side effects.
If the sibling is unsuitable, we can search
bone marrow registries worldwide for
unrelated donors. But the Asian registry
is under-represented and finding a match
is relatively more difficult. Moreover, this
process may also take considerable time.
Novel double cord blood transfusion
The alternative to a bone marrow
transplant is cord blood transplant.
Pioneered in France in 1998, the
procedure was then confined to a single
cord blood unit and initially used on
children age 12 and below. Cord blood
is collected at childbirth and donated to
public cord banks or stored by parents
with private cord blood companies.
Donated cord blood can be obtained from
an international network of healthcare
facilities including the Singapore
Cord Blood Bank at KK Women’s and
Children’s Hospital.
As a single unit of cord blood may
not contain sufficient stem cells needed
for an adult, a novel procedure would
be to combine two cord blood units to
increase the stem cell dose. However,
this initially raised the issue on whether
the two separate units would react with
one another or against the patient.
Dr Koh said, “A double cord blood
unit transplant is an innovative concept
which enables us to use cord blood in
adults. The best thing about cord blood
transplants is that differences in blood
group between recipient and donors do
not matter as much. The two units of
cord blood can also be of different blood
groups.”
Recipient rid of diseased cells
Before a cord blood transplant is
carried out, a recipient undergoes
By 2010, a brand new 13-storey building will rise above the familiar landscape of Outram
Campus, as part of ongoing parts to redevelop the area into an academic medical hub.
Full story on page 3.
chemotherapy and radiotherapy to clear
his bone marrow of leukaemic cells.
The donated two units of cord blood
are then transfused into the recipient.
“The stem
cel ls f rom t he
donors’ blood
interestingly
then migrates to
the recipient’s
‘empt y ’ bone
marrow. In time,
the cord blood
units would ‘engraft’ or grow in the
recipient’s bone marrow and produce
new platelets, white and red blood cells.
It is very much like waiting for a seed
to germinate.”
Blood disease specialists like Dr Koh
are currently doing research into the
post-transplantation process.
“Biologically speaking, there were
three ‘people’ flowing in one body after
the transfusion – Candy’s cells and the
two different cord blood units. But
invariably, we always see one of the
two cord units taking over, sometimes
as soon as six weeks so that eventually,
one cord predominates while the other
fades away. Candy’s blood type has
also changed from her original to that
of the new cord unit. Research is still
undergoing to understand more of this
process and to predict which of the two
units would eventually engraft”.
Possible new treatment option
SGH’s department of haematology
r u ns t he la rgest adu lt stem cel l
programme in Singapore. Since last
year, doctors have performed three
cases of double cord transplants. Candy
Yeow is the longest survivor with the
best results as she is in remission and
does not require any medication.
While double cord blood transplant
is still a relatively new procedure, Dr
Koh and the rest of the transplant team
are also embarking on a parent-child
bone marrow transplant programme
in a bid to increase treatment options.
“This does present with additional new
problems and risks as the match in such
instances is usually only about 50%. The
risks are therefore much higher. The
parent-child bone marrow transplant is a
possibility as the genetic match may reach
50 per cent.”
CONTINUED ON PAGE 2
Outram Now Nov-Dec.indd 1
10/25/07 1:25:32 PM
2 \
\Nov/Dec 2007
CONTINUED FROM PAGE 1
Her sweet victory over leukaemia
A year after undergoing double cord blood transplant, a young leukaemia suvivor
is back in school and off all medication.
All eyes were on Candy Yeow when the
19-year-old arrived at a conference room
packed with journalists gathered to hear
how she battled leukaemia successfully
with a double cord blood transplant.
Casually dressed in a grey top and
black pants with chunky black earrings,
she flashed an abashed smile before
girlishly covering her face with her hands,
overwhelmed by the media attention.
H e r y e a r-l o n g s t r u g g l e w i t h
Philadelphia positive acute lymphoblastic
leukaemia, a rare and aggressive form of
the cancer began early last year. “I don’t
fall sick easily. So I knew something
was not right when I felt faint, wheezed
while going up short flights of stairs and
red dots appeared on my body.”
A month later, Candy went for a check
and was found to have an increased
heartbeat of 120 beats per minute. That,
together with her symptoms, warranted
an immediate referral to a hospital. Test
results of her white blood cells showed
238,000 per microlitre of blood. The
normal results are between 4,000 and
10,000.
“I was admitted to SGH even though
it was near midnight. I didn’t realise its
significance then.”
while I was in the
toilet, I couldn’t see
or hear anything. I
pulled my pants up
and yelled. When
I came to, I was on
the bed with nurses
around me.”
Support from
family and friends
The effects of
treatment affected
Candy physically
and
emotionally.
Candy Yeow and her parents (second and fourth from left)
celebrated the first anniversary of her successful double cord blood She had to be shaved
transplant with Dr Mickey Koh and the SGH doctors and nurses who
bald to prevent her
looked after her.
hair from falling out
in clumps as a result of chemotherapy.
Intensive chemotherapy
The next day, a bone marrow test Her mother Jane shuttled between
was done and the results showed that hospital and home to watch over her
Candy had leukaemia. Fol lowing daughter. “Candy had beautiful hair
that she underwent her first course flowing to her chest. As her mother, I
of chemotherapy through a catheter felt the pain too.”
At that time, Candy’s father Eric
inserted into a vein in her chest. To
destroy as many leukaemia cells as was working in Australia. The oil
possible, the first phase of treatment was field engineer returned to Singapore
intensive and stretched over four days, every two months but remained on
tenterhooks when he was away. “My
leaving her faint and nauseous.
Candy shared, “On the second day, heart jumped each time the phone rang.
I couldn’t concentrate at work and felt
like a zombie. But I was comforted
that the SGH staff took good care of
my daughter. Some even came back
Acute leukaemia is a type of blood cancer which results in the overproduction of abnormal
white blood cells in the body. This suppresses the production of normal white and red
into her ward late at night to keep her
blood cells and platelets. This results in anaemia or low red blood cells, increases one’s risks
company.”
of infection and blood clotting problems.
Candy’s friends made her cards filled
Chances of recovery are now possible with intensive chemotherapy or transplantation.
with messages of encouragement and
Leukaemia can be chronic and acute, depending on its rate of progress and abnormal cell
hope which decorated the walls of her
maturity. Specific causes are unknown for most of the time and it is not hereditary.
hospital room. But when her friends
Treatment Options
came, it was the patient who ended up
Chemotherapy
Intravenous or oral methods to kill leukaemia cells.
consoling the visitors. “I believe I will
recover faster if I remain cheerful,” she
Bone marrow transplant
Chemotherapy and radiation therapy to destroy diseased
declared proudly.
cells before infusing healthy new ones from a suitable
Cancer of the white blood cells
donor.
Double cord blood transplant
Candy needed a bone marrow
transplant but her younger brother and
seven-year-old cousin were not suitable
matches. A search with bone marrow
registries here and overseas also failed
to find a suitable donor. During her
five-month wait for a bone marrow
Peripheral blood stem
cell transplant
Stem cells obtained from the patient’s circulating blood are
returned to the bone marrow after intensive chemotherapy
and radiotherapy.
Cord blood transplant
Umbilical cord blood rich in stem cells are infused into
the patient. Matching need not be as close as for the bone
marrow or peripheral blood transplants. Less risk of
contracting graft-versus-host disease.
PUBLISHER
PUBLISHING CONSULTANT AND MEDIA REPRESENTATIVE NTUC Media Co-operative Ltd
Singapore General Hospital
Outram Road
Singapore 169608
Tel 6222 3322 Fax 6222 1720
EDITORIAL TEAM
Tan Shee Lah
tanshl@ntucmedia.org.sg
DESIGN
• Sharon New • Charles Chong
• Kelvin Teo
Hazel Yong
hazelyong@ntucmedia.org.sg
MARKETING TEAM
Leong Wai Kit
leongwk@ntucmedia.org.sg
Joseph Loh (Head, Group Account)
josephloh@ntucmedia.org.sg
CONTRIBUTOR
• Constance Nonis
SGH is a JCI accredited hospital
Jimmy Lim (Group Account Mgr)
jimmylim@ntucmedia.org.sg
Mike Chew (Senior Account Mgr)
mikechew@ntucmedia.org.sg
Jonathan Chen (Account Mgr)
jonchen@ntucmedia.org.sg
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chrisseng@ntucmedia.org.sg
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Email: mktgmedia@ntucmedia.org.sg
For editorial content, email:
editor@sgh.com.sg
transplant, Candy under went f ive
courses of chemotherapy and took 50
tablets daily.
As her condition was deteriorating
and there was no suitable bone marrow
donor, Dr Mickey Koh decided Candy’s
only chance was in a double cord blood
transplant (see cover story). In July last
year, he found two units of cord blood
from a cord blood bank in the US.
Only one unit matched Candy’s blood
type of ‘A’ while the other was of blood
group ‘O’.
Double cord blood transplant is not
commonly practiced but for Candy, the
novel procedure paid off. “The risks of
contracting infections are high during
the engraftment period but I thought if
I can pass this ‘final exam’, I can get on
with life.”
The two units of cord blood were
transplanted into her body through an
intravenous drip. Candy remained in
hospital over the next few weeks as her
immune system was then very low and
susceptible to infection. After about 3
to 4 weeks, the cord blood started to
grow and engraft in her and her blood
tests results improved. She lost 7 kg
during this procedure.
From blood type ‘A’ to ‘O’
But the suffering was not in vain as
her body has fully accepted the ‘new’
blood. Candy now has type ‘O’ blood
coursing through her veins, courtesy
of one of the cord blood donors. Tests
results showed all leukaemia cells have
been eradicated. In April this year,
she resumed her second-year Business
Management st udies at Nanyang
Polytechnic. Eleven months after the
transplant, Candy no longer needs to be
on medication.
A year after her life-saving procedure,
Candy has held a party to thank the
medical and nursing staff of SGH
Ward 72 where she spent two months
battling leukaemia. Her experience is
meticulously recorded in an online diary
which can be accessed by the public.
“I am proud to win the battle and
want people to know that contracting
leukaemia is not the end of the world.”
Besides blogging, she’s catching up
on her studies and planning a longawaited trip to Perth to visit her father.
“I’ll be a very busy girl.”
And healthy, too.
SGH CONTENT ADVISORS
Tan-Huang Shuo Mei
Director, Communications & Service Quality (SGH)
Director, Corporate Communications
(Singapore Health Services)
Casey Chang
Deputy Director, Communications
SGH EDITOR
Karen Teng
Senior Executive, Communications
SGH CLINICAL ADVISORS
Associate Professor Tan Puay Hoon
Associate Professor Tan Seang Beng
Dr Roland Chieng
Dr Howe Tet Sen
Dr Mickey Koh
Dr Ling Moi Lin
Dr Tan Bien Soo
Dr Celia Tan
Dr Yeo Seng Jin
10/25/07 1:26:06 PM
Nov/Dec 2007 \
\ 3
DUKE-NUS GRADUATE MEDICAL SCHOOL
Pioneers begin journey to ignite
spirit of inquiry
College of Medicine Building which is
next to the site where the new DukeNUS GMS campus is being built.
Through its unique and rigorous
curriculum, Duke-NUS GMS will train
the students into a new generation of
physician-scientists who will evolve
healthcare to a high level through
rigorous medical and research training
w ith intense focus on hea lthca re
problems and issues of particular concern
to Singapore.
The faculty comprises 40 regular
faculty members and over 150 visiting
faculty members. Many are clinicians
with the Singapore General Hospital
and local healthcare institutions.
The first batch of students at the Duke-NUS Graduate Medical School reciting the Hippocratic
Oath after receiving their white coats.
THE Duke-NUS Graduate Medical
School Singapore welcomed its first
intake of 26 students this August. The
students received their white coats in an
event steeped in significance, marking
the first steps in their medical journey.
K now n as t he ‘ W hite Coat
Ceremony’, the event marks the rite of
passage for the student into the select
family of medical practitioners. The
white coat itself symbolises both the
special privileges and the exceptional
responsibilities that society grants to
and expects of, respectively, physicians.
Although introduced only in recent
years, the ceremony has already become a
noble tradition at many medical schools.
The ceremony was witnessed by
300 guests including Minister for
Community Development, Youth and
Sports Dr Vivian Balakrishnan who was
Guest-of-Honour. It was held at the
SingHealth clinicians
are faculty members
Duke-NUS GMS Education
Professor Ng Keng Yeen (SGH)
Associate Dean, Clinical & Faculty Affairs,
Duke-NUS GMS
2nd Year Clerkship Director
Associate Professor Pierce Chow (SGH)
1st Year Basic Sciences – Normal Body
(Course Director)
Associate Professor Lim Shih Hui (NNI)
1st Year Basic Sciences – Practice Course
(Course Director)
Associate Professor Ivan Ng (NNI)
1st Year Basic Sciences – Brain & Behaviour
(Course Director)
Associate Professor Janil Puthucheary
(KKH)
1st Year Basic Sciences –Body & Disease (Team
GMS Leader)
Associate Professor Tay Sook Muay (SGH)
1st Year Basic Sciences – Normal Body (Team
GMS Leader)
Associate Professor T Thirumoorthy (SGH)
1st Year Basic Sciences – Practice Course
(Course Director Year 2)
Duke-NUS GMS Cancer & Stem Cell
Biology Research Programme
Dr Charles Chuah (SGH)
Instructor
Dr William Hwang (SGH)
Assistant Professor
This listing of faculty members is not exhaustive.
Parents of students taking a closer look at
a model of the new Duke-NUS GMS campus.
New landmark on Outram Campus for
pathology, education and research
New SGH Pathology Building will be home to SingHealth education and research activities.
By Constance Nonis
Health Khaw Boon
Wan said, “In so
doing, it will enhance
integration, enable
effective deployment
of equipment and
manpower, and raise
workflow efficiency.
This will improve
turnaround times
and service delivery
for the benefit of the
patients.”
The new SGH
(from left) SingHealth DCEO Mrs Karen Koh, Minister for Health
Khaw Boon Wan, SingHealth Group CEO Professor Tan Ser Kiat and
Pathology
Building
SGH Chairman of Medical Board Professor Ng Han Seong at the
has twin 13-storeygroundbreaking ceremony for the new SGH Pathology Building.
blocks with a total
AFTER years of working in tight gross floor area of 57,600 square metres,
spaces under demanding conditions, half of which will be for pathology
pathologists at the Singapore General services. That is 75 percent more space
Hospital will move to a purpose-built than the current premises occupied by
new building come 2010. The new SGH the Department of Pathology.
Pathology Building will consolidate the
Also under the same roof will be
current multi-site and spatially tight new SingHealth research laboratories
laboratories within a single facility.
focused on disease-specific programmes.
At the groundbreaking ceremony Education and training facilities include
on 27 September 2007, Minister for a one-stop multi-disciplinary education
centre with simulated environments
for team-based learning to train future
generations of healthcare professionals.
The location of the $230-million
SGH Pathology Building along College
Road will put the new facility in close
proximity to clinical services at SGH,
the national specialty care centres and
the Duke-NUS Graduate Medical
School.
Group CEO of SingHealth and
CEO of SGH Professor Tan Ser Kiat
said, “The building brings to fruition
years of careful planning to create
capacity for pathology, education and
research. We aim to harness synergies
from the convergence of pathology,
research and education to ensure that we
progress and innovate to boost the high
standards of clinical service and care for
our patients. It is envisaged that this
will lead to products that can improve
the diagnosis, treatment and cure for
patients in addition to prevention
of diseases. Co-sharing of resources
common to pathology and research will
also maximise efficiencies.”
Minister for Health Khaw Boon Wan said SGH
pathologists could now realise their vision
of leading the region in diagnostic and
investigative medical sciences.
Over the past decade, clinical demand
for laboratory investigations has grown
by 24 percent. The new building will
allow the department’s laboratory
capacity to expand by 50 percent. Head
of SGH’s Department of Pathology
Associate Professor Tan Puay Hoon
said, “With the new facility, we will be
better equipped to meet the challenges
of medical globalisation and exponential
technological advances within the
changing healthcare landscape. We
look forward to the opportunity to
re-engineer our processes, improve
ourselves and do our best to serve
patient needs.”
The new SGH Pathology Building
is part of SingHealth’s overall plans to
develop Outram Campus and gear up
to meet Singapore’s future healthcare
needs.
10/25/07 1:26:23 PM
4 \
\Nov/Dec 2007
HealthBits
Attention to Eyes
Eye check ups
If you work with a computer for long stretches, get an
annual eye check up. Catch eye problems early to avoid
going blind.
To drive home the message, more than 500 staff from
SGX had their eyes checked recently. The event was
sponsored by Rotary International, a non-prof it service
recognised for the establishment of numerous health and
medical centres such as SATA, Cancer Foundation, Aged
Centre, Alzheimer’s foundation and the Dyslexia Society
in Singapore.
Rotary International would like more people to know
that early detection is the only way to prevent avoidable
blindness, the scourge of modern societies such as
Singapore.
Instant cash
for whatever.
Flexible repayments
whenever.
Problems as eyes age
An
aging
society
needs to brace itself for
eye-problems among its
seniors. In Singapore, the
number one eye concern
is age-related macular
degeneration (AMD), says
SingHealth.
In AMD, the cells
of the retina and its
underlying layers become
unhealthy
with
age
resulting in a gradual loss of central
vision. Caused by age, smoking and
sun exposure, AMD affects 27% of
Singaporean adults above the age
of 60.
Despite the problem being so large,
a telephone survey revealed that a
mere 7.3% of the 520 randomly selected
participants were aware of the term
AMD.
Eye workout
You lead a sedentary life with a lot
of time glued to either the computer or
TV, or reading? Your eyes need exercise.
To stimulate eye muscles and keep eyes
healthy, do the following exercise once
a day.
• Imagine you are looking at a very
large clock. Without moving your
head, look up at 12 o’clock.
• Slowly rotate your eyes around the
clock, clockwise. Repeat three times.
Then do it three times in the reverse
direction.
• Now go back to 12 o’clock and
quickly move your gaze down to 6
o’clock. Go to 3 o’clock and move
your gaze to 9 o’clock. Repeat this
sequence three times.
(From 5-minute Therapies: Natural
remedies for Body, Mind & Spirit by
Denise Rowley)
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The beauty of lemon
The name lemon has its origins in
the Persian word “limuun”. Today, the
fruit is widely used in cooking, beauty
and even alternative medicine. Lemon
is a good source Vitamin C. but it starts
losing nutrients as soon the fruit is left
exposed to air.
The trick to getting the most from
lemon is to cut and use the juice
immediately. Lemons are high in
potassium and rich in vitamin B1. Both
lemons and limes contain 5% to 6%
citric acid as compared with oranges,
which contain only 1% to 1.5%, or
grapefruit, which contain 1% to 2 %.
10/25/07 1:53:38 PM
Nov/Dec 2007 \
\ 5
Active and agile again
After over a decade of living with the debilitating pain of osteoarthritis, a 72-year-old finally regained his agility
after undergoing computer-assisted knee replacement surgery.
By Leong Wai Kit and Karen Teng
editor@sgh.com.sg
LIFE for marketing adviser Teddie
Tan Ah Liang changed at age 60 when
osteoarthritis struck. What started as
pain in his right knee due to a wornout cartilage gradually worsened over
the years.
Osteoarthritis is a degenerative joint
disease affecting the cartilage – a slippery
tissue that covers the ends of bones in
a joint. Healthy cartilage absorbs the
shock of movement. When cartilage
is worn out, the bones rub together
resulting in pain, swelling and reduced
motion. Although not life-threatening,
osteoarthritis affects the quality
of life.
So painful he couldn’t drive
Mr Tan recalled, “I used to take
about 10 minutes just to climb a flight
of stairs. Sometimes, the pain was so
bad that I couldn’t drive because it hurt
every time I stepped on the brake or
accelerator.”
His worn-out cartilage could be
replaced with artificial joints made of
metal or plastic in what is commonly
known as knee replacement surgery.
Mr Tan was initially hesitant.
“I didn’t consider knee replacement
surgery then because several friends
who had gone for it, still felt pain
in their knees. So, I didn’t have any
confidence in such surgery.” Instead,
he turned to painkillers, popping up to
12 pills a day. At one point, he opted
for steroid injections. But the pain relief
was short-lived.
New surgical technique gave him
hope
In early 2005, Mr Tan changed his
mind about surgical options. This was
after reading a newspaper report on
computer-assisted knee replacement
surgery.
Senior consultant in the
Department of Orthopaedic Surgery at
the Singapore General Hospital Dr Yeo
Seng Jin had introduced a new surgical
technique to place an implant in the
knee with computer-assisted precision
and via smaller incisions. Patients
benefit from reduced blood loss, shorter
hospital day, speedier recovery and most
importantly, potentially better longterm results. (see other story)
Mr Tan recalled, “I got my family
doctor to refer me to Dr Yeo. I wanted
to know if this surgery would enable me
to walk easily again. Dr Yeo assured me
that my chances were 99 percent, and
that made me confident enough to go
for it.”
He did not know it then but Mr
Tan’s decision to undergo computerassisted knee replacement surgery
turned out to be a true lifesaver. Presurgery tests revealed that Mr Tan
was also suffering from heart disease.
One of his arteries had a 40 percent
blockage.
He underwent balloon
angioplasty and recovered well enough
for his knee replacement surgery three
months later in September 2005.
No more pain going upstairs
Mr Tan was placed under spinal
anaesthesia when Dr Yeo and the
operating team worked on his knee.
“Although I could hear the clinking
of surgical instruments as I was
conscious, I wasn’t afraid because Dr
Yeo kept asking if I were okay. He
also told me what he was doing to my
knee.”
A day after having an implant placed
in his right knee, Mr Tan was able to
move around his ward using a walking
aid. He went home after just a threeday stay. “When I first climbed the
stairs after my surgery, I felt very happy.
I had forgotten how it felt to climb
stairs without pain.”
Until today, Mr Tan remains thankful
• SGH is one of few centres in this region to offer computer-assisted
knee replacement surgery.
• About 1,200 knee replacement surgeries are performed annually.
• The Department of Orthopaedic Surgery offers specialised training
for doctors in the region.
to have undergone the 90-minute knee
replacement surgery. “I must say the
surgical team and after-care service at
SGH are first class. I’m very grateful
for this surgery because it took away
pain in my knee and gave me back my
life. I used to be very active until my
knee started hurting. Now, I am full
of energy. I feel less burdened, more
confident and altogether, happier.”
Dual surgical techniques
give better results
T HE technique of
placing implants in knees
using the combined
techniques of Minimally
Invasive Surgery (MIS)
and Computer Assisted
Surger y (CAS) has
resulted in better results
for patients.
Senior consu lta nt
orthopaedic surgeon Dr Yeo Seng
Jin (photo) concluded this after
completing a study of 108 patients
who had knee replacement surgery
done at SGH in 2005. Half the
patients were operated on using the
new surgical technique of CASMIS while the remaining underwent
the standard method of knee
replacement.
Surgery. Dr Yeo said this
makes SGH one of the first
in the world to announce its
clinical outcomes of knee
replacement surgery using
the new technique.
Under MIS, incisions
made are smaller, thereby
minimising blood loss and
injury to surrounding tissues
in the knee region. With CAS,
surgeons can refer to detailed digital
images taken by infrared sensors to
help accurately position implants in
the knee and align the joint.
“MIS benefits all patients because
there is less pain involved, and
patients recover faster. Implants
using CAS also potentially last
longer because of the technique’s
Computerised image showing the optimal placement of an implant in a female
patient’s knee during surgery and her X-ray taken post surgery.
Dr Yeo found patients benefitted
more from the new combined
surgical technique. “These patients
had less blood loss, had quicker
recovery of their knee function,
and needed shorter hospital stays
of three days. In the past, patients
stayed 5 days. After one month,
more of these patients could walk
longer distances and many did not
need walking aids. But by the third
month, both groups of patients were
the same. More importantly, X-rays
of the patients with the combined
technique showed better placement
of the implants.”
Findings from the study will
soon be published in the prestigious
American Journal of Bone and Joint
precision.” At SGH, over 300
patients had undergone this
technique surgery since 2004.
Dr Yeo said, “The main aim
of knee replacement surgery is to
enhance quality of life.” Therefore,
it’s crucial that implants last a
long time. Misalignment of knee
implants has been shown to lead to
earlier failure, as early as a few years
after surgery.
He said that for patients under 65,
the failure rate of their knee implants
at 10 years was three times higher
than those over 75 because of the
increased use of their implants. This
new technique would benefit the
majority of people undergoing knee
surgery with an average age of 65.
10/25/07 1:26:44 PM
6 \
\Nov/Dec 2007
Did you know that a virus can cause
cervical cancer and other diseases?
”
.
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D
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t
i
“Ne
The Human Papillomavirus, or HPV, is a common virus that affects both females and males. There are more than
100 types of HPV, some of which can be present without symptoms. Although most infections clear on their own,
there are a few types of HPV you should really know about:
• Some types can cause abnormal cervical cells, cervical cancer and other cancers which can be devastating.
• Other types can cause genital warts and benign (abnormal, but non-cancerous) changes in the cervix.
Help protect your future, and the futures of those you love. Act now to learn more
A health message by:
OBSTETRICAL & GYNAECOLOGICAL
SOCIETY OF SINGAPORE
Untitled-3
Outram
Now1Nov-Dec.indd 6
06-08 GRD-2007-SG-3658-O
about HPV from your doctor or visit www.empoweredtoprotect.com today.
10/2/07 11:17:52
AM
10/25/07
1:26:54 PM
Nov/Dec 2007 \
\ 7
Safer and better spine surgery “
Since May, SGH spine surgeons have been implanting screws into patients
aided by a comprehensive scanning and navigational system making its first
appearance in Asia Pacific.
Safety in spine surgery
is pat ients’ pr incipa l
concern, and for surgeons,
it means we know that we
have done the best we can
for our patients before the
surgery is over.
”
editor@sgh.com.sg
- Associate Professor Tan Seang Beng
SINGAPORE General Hospital’s
newly acquired mobile 3D imaging
scanner with computerised surgical
navigation has improved the way
spine surgeons place implants in their
patients.
Head of the Department of
Or t hopaed ic Su rger y A ssoc iate
Professor Tan Seang Beng described
the ‘O-arm’ mobile 3D imaging scanner
and ‘Stealth’ computerised navigation as
akin to a Global Positioning System for
spinal surgeries. The senior consultant
who is also the Hospital’s Director of
the Spine Service said, “The ‘O-arm’
and ‘Stealth” systems represent a major
step forward in improving a surgeon’s
ability in performing complex spinal
surgery. This will lead to better outcome
for patients.”
There is no extra cost to patients
whose surgeries are carried out under
the guidance of this latest technology.
A/Prof Tan said, “Patients will
be charged the same price as for
conventional 2D fluoroscopic X-rays”.
Screws implanted into spine for
support
A/Prof Tan estimated that nine in
10 people suffer from spine-related
problems such as neck or back aches.
Surgery becomes necessary when their
conditions affect spinal nerves leading
to pain, numbness, weakness or paralysis
in parts of the body.
“About 10 to 15 per cent of those
aged between 18 and 80 who have
spinal problems will eventually require
surgery. Screws and other implants
scan later, we can check and adjust the
screw during surgery. This will reduce
the need for another correction surgery
and allows us to perform surgeries that
are even more technically demanding.”
Associate Professor Tan Seang Beng (left) now performs spinal surgeries under the guidance
of an advanced intra-operative imaging and computerised navigation system.
often need to be placed to support the
spine especially if it were unstable. We
perform over 800 spinal surgeries each
year, half of which require screw or
other implants to restore strength and
stability.”
In spine surgeries, precision of the
implantation and safety of the surgery
are of utmost importance in determining
the final outcome of the surgery.
A/Prof Tan said, “No margin of error
can be tolerated in spinal surgeries. The
screw must go into the bone and away
from the nerve canal. But some areas of
the bone especially in the mid and upper
back are small, and in some individuals,
the bone is even smaller than the
smallest screw available. The surgeon
then has to decide which areas of the
spine are suitable for screw fixation.”
Surgeons get real-time 3D images
during surgery
Traditionally,spine surgeons depended
on X-rays taken during the surgery to
determine the position of the implants.
But conventional X-rays are 2D and
might not detect up to 15 per cent of
inaccurately-placed screws. A/Prof Tan
said in extreme cases, a patient has to
return to the operating theatre to adjust
an improperly positioned screw. “Skills
are not enough especially in complex
situations. So we now get help during
the surgery itself from advanced intraoperative imaging techniques coupled
with computerised navigation.”
The ‘O-arm’ system comprises
a mobile doughnut-shaped gantry
which can take about 400 images, in
a 360-degree arc around the patient.
These images are then immediately
reconstructed in multiple planes,
allowing surgeons an unparalleled view
of the patient’s spinal anatomy. Images
can then be projected onto a flat screen
of the ‘Stealth’ computer navigation
system. This allows surgeons to place
the screw, determine its ideal length
and diameter. Rectification can be
done immediately so misalignment is
prevented.
“So instead of having to take a patient
out of the operating theatre and do a CT
Smaller cuts, shorter downtime
For patients, it means less invasive
surgeries, smaller incisions, quicker
recovery and better results. A/Prof Tan
said, “Safety in spine surgery is patients’
principal concern, and for surgeons, it
means we know that we have done the
best we can for our patients before the
surgery is over.”
In just six months, SGH spine
surgeons have used this new technology
on about 50 patients (see other story).
The specialists used the conventional
method to put in a total of 185 screws.
The positions of these implants were
checked using the ‘O-arm’ system.
Twelve screws were immediately
repositioned during surgery so that by
completion of the surgery, all implants
were optimally placed.
A/Prof Tan said, “The ‘O-arm’ system
is especially beneficial to Asian patients.
It’s definitely more difficult to operate
on the spine of an Asian because of his
smaller bone structure. Smaller bones
also mean a smaller margin of error when
implanting screws into the spine”.
The ‘O-arm’ navigational and
scanning system became available only
last year. SGH is the first in the Asia
Pacific region to acquire this latest
technology for spinal surgery, along with
13 hospitals in the US and Europe.
Back to the ski slopes after surgery
Ski instructor Nik Ang aims to whiz down
snow slopes this winter in Japan, just eight
months after undergoing spinal surgery for
a cracked bone. He has the blessings of his
orthopaedic surgeon Associate Professor
Tan Seang Beng. Mr Ang had four screws
implanted in his spine but is raring to return
to his active life.
The 35-year-old is typical of individuals
prone to serious spinal problems requiring
surgery. Mr Ang likes fast action sports
and has been giving skiing lessons for the
past seven years. Falling backwards is an
occupational hazard.
He suspected the new pain was related to a
nerve injury.
“I took painkillers, hoping for the pain to
subside but still, my calf felt as if a hot metal
plate was being pressed against it. After
sometime, the joints near my ankle also started
hurting,” said Mr Ang.
Due to the pain and discomfort, the
adrenaline junkie had to scale back on his
activities. His condition worsened until he was
not able to walk for more than 10 minutes. “I
stopped going to the gym and gave up running.
It was quite depressing because my life suddenly
became sedentary.”
Persistent pain in his leg
Surgery needed for a crack in the
spine
In March this year, Mr Ang experienced
a burning sensation in his right calf. The
feeling was familiar, as he had undergone
cervical spine disc replacement surgery
in 2005 for a whiplash injury to his neck.
He recovered fully after the first neck
operation and had returned to sports.
A month later, Mr Ang went to see A/Prof
Tan, the same spine specialist who repaired
his neck injury. MRI images showed that
one of the vertebral bones of Mr Ang’s spinal
column had cracked, a condition known as
spondylolisthesis.
treatment I would receive. I also did my
own research on what to expect. So I went
ahead without fear.”
The four screws were implanted into Mr
Ang’s lower back to support his damaged
bone and help the cracked bone heal. The
surgery was carried out with the aid of the
‘O-arm’ scanning and ‘Stealth’ navigation
system (see main story).
In hospital for only four days
Associate Professor Tan Seang Beng
explaining to Mr Nik Ang how the screws
were implanted into the spine using the
‘O-arm’ mobile 3D imaging scanner and
‘Stealth’ computerised navigation system.
“Dr Tan gave me a comprehensive
explanation on how the spine works and the
Mr Ang recalled, “After the surgery,
there wasn’t much pain except at the
operated site but I was able to walk
around the next day.” He was in hospital
for four days.
To regain his fitness level, Mr Ang
is currently running briskly and will
be starting physiotherapy sessions to
strengthen his spinal muscles. With a grin,
he revealed, “I’m resting as much as I can
now but I can’t wait for December – I’m
going skiing in Hokkaido!”
10/25/07 1:27:13 PM
8 \
\Nov/Dec 2007
10/25/07 3:08:21 PM
Nov/Dec 2007 \
Doctor, have you
washed your hands?
prevent the transmission of germs.”
The hospital has introduced various
measures to spread the importance of
hand hygiene among staff, patients
and visitors. This included constant
reminders in the form of badges, posters,
stickers on floors and around mirrors
in toilets of the wards. All washbasins
in patient care areas also have pictorial
guides on the steps of proper hand
washing.
Wash your hands after touching a patient to
prevent the transmission of germs.
IT may seem rude of patients to ask their
doctors this but at the Singapore General
Hospital, such questions welcomed
and encouraged. In fact, frontline
medical personnel like doctors including
infectious diseases specialist Dr Asok
Kurup (above) and nurses wear badges
inviting patients to ask them about hand
hygiene.
The move is part of hospital-wide
efforts to improve the practice of hand
hygiene among staff, patients and visitors.
The term ‘hand hygiene’ refers to the
practice of washing your hands with soap
and water or rubbing your hands with an
alcohol-based disinfectant liquid.
SGH Director of Infection Control
Dr Ling Moi Lin said studies have shown
that hospital-associated infections could
be prevented or reduced by improving
hand hygiene compliance among staff
and patients. “Washing or disinfecting
your hands is the most important step in
preventing the transmission of microorganisms that can be acquired by direct
contact. It only takes a lapse in the
hand hygiene practice to increase the
chances of transmission of germs among
patients.”
Dr Ling stressed that patients’
treatment or recovery may be influenced
by medical personnel washing their
hands often or using the alcohol-based
disinfectant liquid. “Hand hygiene is,
in fact a simple but effective way to
Pictorial guides on proper hand washing
serve as reminders to frontline staff like Head
of Physiotherapy Department Abdul Rashid
Jailani.
To reinforce the practice of hand
hygiene among hospital staff, SGH
has implemented e-learning via its
own webpage dedicated to infection
control. Those who diligently practise
hand hygiene are given due recognition.
Mystery audits have also been carried
out according to standards set by World
Health Organisation.
Dr Ling is urging patients and
visitors to help hospital staff reduce or
prevent the spread of infection. Bottles
of alcohol-based disinfectant liquid are
now placed at the foot of every bed and
just beside the lift lobbies leading to all
wards. To do your part, simply squirt
the liquid onto your palm, rub your
hands together and you’re done!
Before and after attending to you
Before the start of any procedure such as changing your dressing or feeding tube
After touching your body fluid such as blood or discharge
After touching your immediate surroundings such as bed railings
If you are a visitor, wash your hands with soap and water or rub hands together with an
alcohol-based disinfectant liquid:
Before touching the patient
After touching the patient even if it’s just patting them on the back
After touching anything around the patient such as bedside table, blanket or bed railings
SGH’s Digital Ward project was named the
winner in theTechnical Service Improvement
category during the recent Asian Hospital
Management Awards in Pattaya, Thailand.
The Digital Ward features Patient Bedside
Terminals for doctors to retrieve medical
records and X-rays electronically as well as
provide TV and video-on-demand access
for patients. The Awards are given annually
to recognise and promote best hospital
management practices in the region.
Three other projects received the
Excellence (runner-up) awards under the
following categories:
SGH Chief Operating Officer Foo
Hee Jug (right) receiving the
award for the digital ward project.
SGH medical social worker gets
nation’s top award
As a patient, you have a right to be looked after by staff with clean hands. Check if your doctor
or nurse practises hand hygiene:
•
•
•
Digital Ward
project receives top
regional award
• SGH Colorectal Cancer Awareness Outreach campaign (Community
Service)
• Time reduction in Monthly Bed Management Unit roster (Internal
Service)
• One Card (Internal Service)
Break the chain of infection with clean hands
•
•
•
•
\ 9
Senior Principal Medical Social
Worker Crystal Lim has been named
‘Outstanding Social Worker’ of the Year.
She received her award from President
S R Nathan during a ceremony at the
Istana in October. Crystal, who received
a scholarship for her studies in Masters
of Social Work said, “I am always grateful
to SGH for her investment in my training
and development.”
Siemens sponsors training
programmes
SIEMENS Pte Ltd has pledged its
commitment to sponsor fellowship
training programmes at Singapore
General Hospital for doctors from
the region over the next five years.
It will also fund SGH radiologists,
radiographers and physicist for
overseas conferences and attachments
at key US and Europe institutions
for training on high-end imaging
modalities such as MRI, CT and
ultrasound. Siemens will also provide
training facilities at the SGH Mr Hans Dieter Bott, Managing Director, Siemens
Department of Diagnostic Radiology and SingHealth Group CEO Professor Tan
Ser Kiat after signing the Memorandum of
and organise bi-annual workshops on Understanding on 1 Oct 2007.
digital radiography/ fluoroscopy.
Head of the SGH Department of Diagnostic Radiology Dr Tan Bien Soo said,
“This partnership will strengthen our efforts in providing high quality radiological
services, ranging from diagnosis to minimally invasive interventions and treatment.
It will also realise our goal to become a premier training centre.”
10/25/07 1:27:44 PM
10 \
\Nov/Dec 2007
New pre-admission testing
centre for surgical patients
AVALONLsgh(Path).eps
10/23/07
4:34:45 PM
Best Outcome. Best Experience:
Not letting up the pursuit of quality
SGH continuously strives for
improvement, innovation and reinventing the patient care delivery
systems while keeping healthcare
cost low.
Between June to August this year,
SGH put itself through 5 stringent
tests – ISO/OSHAS renewal audits,
SQC-PD integrated assessment,
MOH Pre-licensing Inspection
and Business Continuity Planning
certification audit; and a mock audit
by Joint Commission International
(JCI), and cleared them all. It is an
affirmation and validation of its care
delivery services.
These achievements are the
result of a deliberate long term
commitment to build a quality
culture conducive to patient-centric
care. The Hospital is committed to
ensuring high standards of safety in
healthcare services delivery through
a virtuous cycle of continuous quality
improvement.
When OutramNow asked how SGH
rally 6,000 staff to deliver the ‘best
outcome, best experience’, Mr Foo
Hee Jug, Chief Operating Office at
SGH said, “We help win hearts, shape
minds and inspire quality amongst
our staff and business partners.”
PAT IEN TS schedu led for
elective surgeries now undergo
pre-op evaluation at the newly
opened Pre-Admission Testing
Centre at Block 3 Level 1. It
has facilities for diagnostic
investigations such as ECG,
blood and urine tests as well as a
Pre-Operative Evaluation Clinic
for patients to be assessed by
anaesthetists.
Article contributed by Chua Ling Huey,
Senior Manager, Communications, SGH.
SGH file photos
10/25/07 2:00:00 PM
Nov/Dec 2007 \
\ 11
Blazing the trail for nurses
Get to know Tracy Carol Ayre and it’s easy to understand why she recently received the President’s Award for
Nurses, the top honour for the nursing profession. The SGH Deputy Director of Nursing has chalked up over two
decades of service, is active in research and will soon earn a doctorate degree.
By Hazel Yong
AS a child, Tracy Carol Ayre played with
a toy stethoscope and fed medicine to
her teddy bear while harbouring dreams
of becoming a medical doctor. That
changed when she was 15 and discovered
the nursing profession.
“My grandmother was admitted into
hospital for breathlessness. Her blood
pressure was high and there was fluid
in her lungs. My mother and I waited
anxiously outside the Intensive Care Unit.
Then the doctor told us my grandmother
had passed away. We were there for
many hours but no one updated us of her
condition. We only got to see her after
she was gone. I was bitter and decided
to become a nurse, so this
situation would not happen
to others.”
Tracy’s second brush
with death was during
her first week as a rookie
nurse undergoing on-thejob training in the ward.
She had barely gotten into
the groove of her routine
when an elderly patient
collapsed.
“I already felt very lost,
being thrown into working
life and this happened. I didn’t freeze in
fear but it was the first time I encountered
death at work. Our nursing supervisors
later taught us how to deal with such
incidences.”
Fast-forward 21 years and Tracy has
blossomed professionally and personally.
She is now a deputy director of nursing
at the Singapore General Hospital
overseeing ambulatory services and quality
management for nurses. She exudes
confidence when making ward rounds but
remains approachable and friendly.
“Don’t call me Dr Tracy”
After completing her basic training,
Where Doctors Learn
Tracy went on to advance her professional
qualifications. From a graduate diploma
on a scholarship from the World Health
Organisation to a Master’s in clinical
research management at the University
of California in San Francisco and soon,
a PhD in Nursing from the University
of Melbourne. By next year, she will be
Dr Tracy, making her the second SGH
nurse to earn a doctorate degree. She
laughed, “Some nurses teasingly asked
if they should address me as Dr but I
prefer to be called Tracy. It removes the
social barrier immediately.”
The 40-year-old encourages her
nurses to speak up and challenge existing
nursing practices. She wants to debunk
the perception that research conducted
by their foreign counterparts is better.
Overseeing the Nursing Research and
Evidence-Based Practice programme
at SGH, Tracy coordinates close to 20
studies and systematic reviews yearly.
She has published and presented papers
at international conferences in Taiwan,
Japan and the US. “Delegates like to
hear from Singapore because they don’t
know how advanced we are. We may
feel intimidated when we read their
papers but we have unique things to
offer too. We are selling Singapore as
an organisation.”
Self-deprecating high achiever
Tr a c y ’ s a c h i e v e m e n t s a n d
contributions put her in a good stead
for the nation’s highest accolade for
the nursing profession – the President’s
Award For Nurses.
“When my boss (Nursing Director
Lim Swee Hia) told me of my
nomination, I asked ‘why me?’ and she
countered ‘why not you?’ I don’t like
all this limelight but I’m very grateful
for whatever success I have achieved
together with my colleagues.”
It seems that the human dynamo
does not veer much from health-related
activities even on her days off. She
reads Robin Cook medical thrillers and
volunteers with her neighbourhood’s
nursing group to care for bedridden
residents.
So does Tracy regret becoming a
nurse with a doctorate degree instead
of a medical doctor? “No”, she replied
firmly. “Nurses are the ones who care
for the patients 24/7. They make the
most impact on the lives of other
people.”
US-based Sutter Health visits SGH
For Healthcare Professionals & Hospital Administrators
2nd International Conference of the Asia Pacific Society for Healthcare Quality
17 -19 Jan 2008
Grand Copthorne Waterfront
Pre-conference Workshop A: Clinical Incident Management
16 Jan 2008
KK Women’s & Children’s Hospital
The following workshops will be held at the SGH Postgraduate Medical
Institute at Block 6 Level 1.
Pre-conference Workshop B: Quality Improvement
16 Jan 2008
Post-conference Workshop: Root Cause Analysis
20 Jan 2008
Details: www.apshq08.com
For General Practitioners
The following courses will be held at the SGH Postgraduate Medical Institute,
Block 6 Level 1 from 1 pm – 4 pm.
Emergency Medicine GP Symposium
1 Dec 2007
Urology Update
19 Jan 2008
Details: www.pgmi.com.sg
Pre-registration is required for all programmes.
SingHealth Group CEO Professor
Tan Ser Kiat (second from left)
sharing the SGH experience with
Sutter Health’s Chief Medical
Officer Gordon Hunt (facing
camera third from right).
A group of hospital administrators from Sutter Health, one of the largest healthcare
networks in the US, visited Singapore General Hospital in October to explore the
emerging opportunities in medical tourism. Led by Chief Medical Officer Gordon
Hunt, the group was also keen to learn how SGH uses medical technology in the
delivery of care to local and international patients. Not-for-profit Sutter Health is
based in Northern Carolina and has a network of 26 hospitals and 3,500 doctors.
Public cord blood bank joins global network
The Singapore Cord Blood Bank (SCBB) has become first in this region to join
the National Marrow Donor Programme, an international network of cord blood
facilities. The membership, which was announced during the SCBB’s second
birthday, reaffirms its mission as a national resource to save lives. Two SingHealth
institutions – SGH and KK Women’s and Children’s Hospital – are participants in
the SCBB’s programme.
Organon gives $3,000 for books on Anaesthesia
Medical company Organon has donated $3,000 to the SGH Department of
Anaesthesia for the purchase of reference materials.
10/25/07 1:28:23 PM
12 \
\Nov/Dec 2007
AtHome
10 ways to protect your joints
There are simple steps you can take to preserve function of your joints, maintain their alignment and prevent any deformity
from worsening. Start by applying 10 simple rules to your daily routine.
1Avoid positions that foster deformity
Avoid tight pinching
• For writing, wrap your pen with foam for an easier grip.
Avoid prolonged static positions
• Avoid activities that hold your joints in a single position for long periods of time
as this can result in fatigue and pain. If you are typing, take frequent breaks.
2
Use proper body mechanics
Certain ways of lifting and holding will help avoid unnecessary stress on your joints
and thus prolong their healthy functioning.
• When carrying an item, hold it closer to the centre of your body and the joints
that supports it.
• When lifting objects from below your waist level, bend your knees and keep
your back straight.
• When opening packages, use appropriate tools such as scissors instead of
struggling with your fingers.
• Use electrical appliances whenever possible.
• For drinking, use a mug and wrap your hand around it for a larger, more stable
grip. Cups with dainty handles are difficult to hold.
• Don’t lift heavy objects over your head. Use stool to reach high places.
3Use the largest, most stable joint for a task
Avoid tight gripping
• When using a knife, choose one with a large handle. Keep your knuckles parallel
to the handle and move in a sawing motion.
• Choose kitchen utensils with large and soft handles as these are easier to grip.
• When rinsing a tablecloth, grip it to squeeze water out instead of twisting or
wringing it.
• When using a dishwashing sponge, remove water by flattening it against the
side of the sink with your palm.
• Lift objects with both hands.
• Use both forearms to carry an item close to your body instead of gripping its
handles or sides tightly with your fingers.
• Push objects with your weight rather than pulling them with your fingers.
4Organise to reduce work effort
• Use adaptive devices for difficult tasks you often do.
• Long handled versions of items such as dustpans and shoehorns can reduce
bending.
• Plan workspace for maximum efficiency.
• Keep frequently-used items handy.
5
Respect pain, recognise fatigue
• Stop an activity as soon as you notice signs of fatigue and pain.
• Get enough rest.
• When opening a jar, place your palm flat on the lid and turn it toward the
thumb side of your hand. Open it with your left hand and close with your right
hand.
6Prioritise all activities
• Develop realistic expectations of what you can accomplish and then prioritise
those tasks you must achieve.
7Plan
frequent rest periods and remove activities that cannot be stopped
if your joints get tired
• You may find relaxation useful.
• Use lightweight utensils and cookware.
• Whenever possible, move heavy or bulky objects using wheels.
Avoid positions that place excessive or constant pressure on joints
• When rising from a sitting position, use the base of your hand to assist you.
8Follow the medical programme recommended by your doctor
9Follow a programme of protective splinting if recommended
• Splinting helps to avoid deformities and preserve function. Your Occupational
Therapist will design and fabricate splints.
10 Exercise for muscle strength and range of motion
• Balance exercise with rest as it is important to maintain movement and strength.
Ask your Occupational Therapist for a programme.
Tips provided by the SGH Occupational Therapy Department.
11/7/07 6:08:07 PM
Nov/Dec 2007 \
HospitalBills101
In every issue of OutramNow, we highlight some
frequently asked questions many of our patients have
about hospital admissions, their bills and procedures.
If you have other queries and concerns, email
editor@sgh.com.sg and we will address them in this
newspaper.
No more money in
Medisave account
My Medisave account has been fully used up for all my hospitalisation bills. What
can I do?
When you do not have any more funds in your Medisave account, you have two other
ways to pay your hospital bill.
1. Draw on your future Medisave contributions
Before considering the use of your future Medisave contributions or what
is known as Medisave Overdraft, you should first discuss with your immediate
family members to settle your hospital bills using their Medisave accounts. It is
always advisable to have some savings in your Medisave as emergencies requiring
hospitalisation may occur anytime for you or your family.
Immediate family members refer to your spouse, parents or child above 21 years
old. Do note that the use of Medisave is still subject to the Medisave withdrawal
limits which is applied on each hospitalisation episode regardless of the number
of payers.
If after this, you still have outstanding bills, you or your immediate family members
may apply for the Medisave Overdraft facility. This is allowed provided that
your Medisave Account is still active with contributions received no more than
three months back. Also, you must be admitted to a Class B2 or C ward of a
Restructured Hospital.
Application for Medisave Overdraft must be made to the hospital before your
discharge. The Medisave Overdraft facility cannot be used for outpatient
treatment.
2. Use the Medisave accounts of your non-immediate family members
To use the Medisave funds of a non-immediate family member
(eg children-in-law, siblings)
• you must be a patient of a Class B2 or C ward in a restructured hospital and
• you have exhausted your own and your immediate family members' Medisave
accounts
‘Short-Stay’ ward cuts down
unnecessary admissions
Why are some patients admitted to the Emergency Observation Ward at the
Department of Emergency Medicine instead of a normal hospital ward? What is
the difference between these wards? How do the ward charges for EOW differ
from a normal ward? Can I use Medisave to pay EOW charges?
The Emergency Observation Ward (EOW) is a ‘short-stay’ ward for patients who
need up to 23 hours of closely supervised care. SGH Emergency Medicine doctors
have identified 14 clinical conditions for which most patients improve after a period
of observation, and do not require in-patient admission. EOW helps these patients
avoid unnecessary hospitalisation and save on medical expenses. Some of these
conditions include minor head injury, abdominal pain, asthma and urinary tract
infection.
If you are to be admitted to the EOW, our admitting clerk will advise you of the
charge during financial counselling. The average bill size for an EOW stay of up to
23 hours is $140. Your bill will show a charge for ‘Short-Stay Ward’. Medisave can
be used to pay for EOW charges if your stay in the EOW is more than 8 hours.
If you require further treatment after 24 hours of observation, you will be admitted to
a normal ward. Otherwise, you will be discharged from the EOW.
Replies provided by Admissions Office and Business Office, SGH.
\ 13
Rehabilitation services
now at three polyclinics
PEOPLE who need the services of a
physiotherapist or podiatrist can now
visit rehabilitation centres at three
SingHealth polyclinics – Geylang,
Tampines and Sengkang. This network
of centres is known as Rehabilitation
Associates and run by the Singapore
General Hospital.
Patients living in these areas welcome
this option as they no longer need to
travel to SGH for such services.
Deputy Director of Rehabilitation
Associates Dr Celia Tan from the SGH’s
Allied Health Division said there is
almost no waiting time at these satellite
centres. “Having our rehabilitation staff
in the community provides patients with
the convenience of reduced waiting time
for appointments, lower transportation
costs and travel time, coupled with high
quality care at affordable charges.”
The physiotherapy services, mostly
referred to by polyclinic doctors
and general practitioners, focus on
musculoskeletal conditions such as
back or neck pain, shoulder and knee
pain mainly from sports and arthritic
problems. Podiatry services are also
available to help manage diabetic foot,
Senior physiotherapist Yang Ming Xing
attending to a patient at Geylang Polyclinic.
skin and nail conditions. For patients
with neurological conditions, home
visits can be arranged.
The centre at Sengkang Polyclinic
comes with a small gymnasium which
offers exercise and fitness programmes.
Patients with diabetes and other
musculoskeletal problems such as
sports and flat or prontated feet can also
have foot insoles custom-made by the
podiatrist.
Patients pay between $25 and $50
per session. There is no subsidy for
services at these centres.
InTheKnow
About Magnetic Resonance
Imaging (MRI)
WHAT is MRI? It is a non-invasive
medical technology, which uses a strong
magnetic field and radiofrequency
waves to produce images of various
parts of your body. The images can be
obtained at almost any particular angle
including three-dimensional (3D).
MRI does not use radiation, unlike Xrays and CT scans.
What is it used for? MRI images are
used to help doctors make diagnosis
and manage diseases.
What happens during an MRI?
You will be asked to lie on a cushioned
examination table and then moved into
a tunnel containing part of the scanner.
Although the MRI machine may look
imposing, the examination is quite
simple and safe. Just relax and keep still
as any movement will result in blurry
images. During the scan, you will hear a
muffled thumping sound. For diagnosis
of certain conditions, you may be given
an injection.
How long will it take? About 30 to
45 minutes depending on the part of
your body to be scanned.
How do I prepare for it? When
scheduling for an appointment, let us
know if you had any previous surgery
or metallic implant in your body. There
is no restriction on food or fluid for
most MRI scans. You may continue
with your prescribed medication as
directed by your doctor. But do not use
hairspray or make-up especially mascara
as these might affect the MRI images.
Before entering the examination room,
you have to remove all metallic objects
including hearing aids.
Information provided by the SGH
Department of Diagnostic Radiology.
10/25/07 1:28:57 PM
14 \
\Nov/Dec 2007
Soft shoe
shuffle
Low arch
Those with low arches have their feet
rolling inward (pronating) excessively
to absorb the shock when walking or
running. Flat feet happens when the
arches collapse.
Normal arch
Pressure is evenly distributed
from the heel to the ball of the foot,
absorbing shock and preventing injuries
effectively.
High heels make the
calves look slimmer but
stop the feet abuse before
it’s too late.
High arch
The arch is too rigid, making it
difficult for the foot to roll inward to
absorb impact. This may lead to underpronation, causing pain in the heels,
knees and lower back.
By Hazel Yong
You enter a shoe shop with your
other half. It’s been a tough week and
you want some serious retail therapy. All
around you are gorgeous wedges, ballet
flats, stilettos, strappy heels, pointy skyhigh boots.
But before you go wild and give your
credit card a good workout, stop and
ask if you are doing justice to your feet.
An average person walks over 10,000
steps in 15 hours daily. This roughly
translates into 115,000 km in a lifetime,
over four times the circumference of our
planet. The force bearing on the feet
can reach several hundred tons during
that time, making them susceptible to
injuries from ill-fitting footwear.
Unsurprisingly, people who have
foot pain because of this are mainly
women.
“The men don’t get it. Why? You
know those pointy heels women
love wearing,” said Mr Peter Cave,
managing director and orthotist with
In-Step Footcare, pointing to the ones
worn by this journalist. “We call them
killer heels.” Oops.
With high heel shoes, feet are
Pain, pain and more pain
In the urban jungle we live in, it is easy to develop heel pain from walking
and standing on hard surfaces all the time.
Bunions: Swelling of the first joint of the big toe, causing it to misalign Can
worsen due to tight toe boxes.
Corns and calluses: Thick layers of dead skin cells, caused by friction
between shoes and skin, especially from narrow toe boxes or the foot sliding
forward in high heels. Corns occur on the top and sides of the toes while
calluses develop on the soles.
Heel pain: Caused by walking on hard surfaces, bad footwear, obesity and
other health conditions like gout or arthritis. Pain experienced after getting
out of bed in the morning may indicate plantar fasciitis, where the band of
tissue starting at the heel to the base of the toes is inflamed. Pain may also be
due to spurs, which are hook-like bone growths on the heel bone.
Morton’s neuromas: Growth of nerve tissue occurring usually between the
third and fourth toes, due to ill-fitting shoes. The numbness and prickling
pain in the ball of the foot intensify with movement while wearing the
shoes.
Stress fractures: Hairline cracks due to the wearing of improper footwear or
a sudden surge in physical activity. Fracture site may swell.
Metatarsalgia: Sharp, burning pain in the ball of the foot due to excessive
pressure over time from improper footwear. Athletes may suffer from
metatarsalgia more due to the high impact of jumping, sprinting or landing.
Ingrown toenails: When corners of nails dig into the skin causing nail
fungus or infection due to narrow toe boxes or poor toenail trimming. Can
cause toe inflammation and develop pus.
raised and slide towards the front. Toes
are thus squeezed into the narrow toe
box, leading to calluses, neuromas and
stress fractures (see box) over time, he
added.
Foot types
Each foot comprises 26 small bones,
33 joints and 107 ligaments, 31 tendons
besides a network of blood vessels and
nerves.
Foot types are based on high, normal
and low arch height. A person can have
a different type for each foot.
About 95 per cent of the population
worldwide experiences foot related
problems such as arch imbalances
between the left and right foot, said
Mr Cave. A person may not realise it
until external factors set in, like muscles
weakening from aging or strain, obesity
or walking for long periods in shoes
without adequate arch support.
“Pressure from walking is shifted
to other parts of the feet, leading to
bad posture and musculoskeletal pain
up to the spine and neck,” he added.
“Everything starts from the feet so we
must get this foundation right.”
Care for footsies
Inspect your feet once weekly using a mirror. Check the toenails for discoloration
and the soles for lesions, especially for diabetics.
Dust foot powder to keep feet dry and prevent fungal growth.
Do stretches like toe curls in the morning to warm up feet muscles for the day.
Remove calluses by soaking feet in warm water before rubbing a pumice stone on
it. Apply moisturizer and wear socks overnight.
Make sure shoe heels are not worn out and tilting inwards or outwards.This creates
pressure on other parts of the foot. If they are, discard or replace the heels at the
cobbler’s.
Women who have to wear high heels can do so, but in between switch to flats or
sneakers if possible.
Choose the right shoes
Rounded toe box which allows you to wriggle your toes.
Wear both shoes and walk around the shop to test if for comfort.
Don’t buy shoes that require a “break-in” period; get the size that allows you to
slide one adult finger in at the back.
Maximum heel height should be capped at two inches for ankle stability.
Have your feet measured every time you buy shoes as they get wider and longer
with age.
Good walking shoes are those that bend only at the ball of the foot. You can also
try twisting the shoes. It should not twist too much or too little.
Orthotics are…
… devices like insoles to prevent or alleviate foot problems by relieving pressure on
the “wrong” parts of the feet. This can lead to improvements in posture and minimise
pain in the heel, forefoot, knees and back.
Medical grade types are available from podiatrists and orthotists, which they prescribe
after observing how patients walk or via computerised foot analyses. Customised or
off-the-shelf products are available.
Orthotics should be worn all the time to maximise benefits. It can take the wearer
two weeks or longer to get used to them.
Visit www.sgh.com.sg for info on the hospital’s podiatry unit or call 6326 5325.
10/25/07 1:29:11 PM
Nov/Dec 2007 \
\ 15
Sole sisters
OutramNow
TWO
writers
with feet woes share
how they found shoes
made for walking.
Hazel Yong - FRANKLY, I’ve always
thought people who wear slippers at
home fuddy-duddies. What do you
mean the floor is too cold, too hard?
Floors are floors, they are made that
way.
Today, I’m suffering for my
ignorance. I shuffle around my pad
with medical grade insoles stuck on
my $5 flip flops with tiny Velcro
squares. They look ugly but hey,
when you feel inexplicable heel pain
after getting out of bed or burning
sensations after a long day, you know
you need help.
My woes started about two years
ago, with a pair of cheap flats that
felt hard, heavy and insecure on my
feet.
Being a journalist, the constant
running around for interviews
exacerbated the problem.
But being a woman, I endured
them daily for a year because they
went with everything – capris, jeans
and skirts.
Goody-two-shoes: Joanna Tan of Heel and Toe fitting Mary Janes on Hazel
The flats caused a stubborn swelling
on the side of my right foot, which I
countered with Chinese ointment. The
last straw came when I wore pointy,
stiletto boots. They were half a size too
small but the sales assistant convinced
me that they would expand in no time.
All it took was a seven-hour wearing
for the toe-box to cut blood circulation
to my toes. I kid you not; they stayed
semi-numb for a month.
The podiatrist I visited said illfitting footwear threatened to collapse
the already-low arch of my right foot
(I conveniently forgot to tell him of my
10 kg weight gain over the past year).
An orthotist later said my right foot is
screwed up because it overcompensated
Tan Shee Lah – I have so many foot problems, my feet can be used for case
studies. My feet are rebelling and who can blame them after years of bearing the
weight of baby, books, groceries, etc while clad in pretty, trendy, sexy footwear
that would make a podiatrist frown. The revolt started three years ago with
Morton’s neuroma. For me, the pain was smack in the centre of the forefoot. It
led to the chucking away of heels and hobbling to various Chinese physicians for
acupuncture and realignment because it was obvious my posture was unbalanced.
The orthopedic surgeon I saw made me hop onto some foamy material in a box.
My imprints confirmed I was leaning more on the right, hence pain on that side.
He called in the orthotist who used my imprints to customise insoles for me.
Now, the problem was finding shoes that could accommodate the chunky
orthotics. All the brands that are supposed to be foot-friendly are not made with
space for special insoles. The sales staff kept saying, “these are very comfortable.
You don’t need anything extra.” They obviously knew little about ‘real’ foot
problems.
So, the footpath led to Kumfs at Heel & Toe. At that time, the styles were
sturdy and no-nonsense. A nun or a nurse would have looked right at home in
Kumfs painstakingly made leather footwear with layers of protection, sensible
heels, non-slip soles, arch cushions – everything the foot needs for a hard life on
the road. I started with two pairs of Mary Janes – one brown, one black. Now
I have a pale pink pair and a pair of court shoes with heels even. My Morton’s
condition improved, but my klutziness continued.
In flip-flips one wet weekend I slipped and dislocated my ankle. This would
probably not have happened if I had been wearing my Kumfs which supports
the heel and ankle, but for goodness sake I was just going to the market. A few
months later, I got bowled over by my dogs after their bath, pitched forward and
broke a big toe. And even more recently, I missed a step and got a nasty sprain
– all in one year.
Over the years, I’ve noticed that my high arches (under pronation, the
opposite of Hazel’s problem) are causing my feet (the right especially) to curve
and ache. Then, there’s plantar fasciitis (heel pain) in the morning, and with age
and a loss of padding, my soles are more sensitive. All this is making me feel
that my feet are holding me to ransom – punishment for long term abuse, sob.
Fortunately, although there are limits, these days the Kumfs styles are catering a
little to our obsession with good looks. Hazel’s Kumfs shoes for instance, are so
mouthwateringly sleek, I am tempted to get me a pair.
for the pressure problems in my left.
Since there’s no way I can relax on
the beach for three months like the
podiatrist prescribed, I needed orthotics
and good walking shoes.
Enter comfort brand Kumfs from
New Zealand.
Asians generally have wider feet so
Kumfs caters with width measurements
of narrow, medium, wide and double
extra wide, said Ms Joanna Tan of shoe
boutique Heel and Toe.
The shoes may lack in aesthetics but
they are based on anatomical need, she
added. She noticed quickly that my right
foot is rather flat but listened to my rant
for five minutes before suggesting shoes
which suit my needs. That I can
sometimes dress casually for work
made our search easier.
I inched towards high heels
perched on the shelves but was
dissuaded for obvious reasons. So
out came covered wedges, Mary
Janes and sandals. They are chunkier
due to rocker soles, arch cushioning,
metatarsal support (little balls under
soles to prop arches) and steel shanks
but they are oh-so-comfy. Some have
removable inlays to accommodate
customized orthotics. I also love how
I was encouraged to walk out of the
carpeted store and onto the marble
flooring outside for test-tries.
I opted eventually for black leather
loafers. The heels are nearly two
inches high but its wide base, rounded
toe box and leather lining more than
makes up for the tilt. I found myself
striding confidently for hours in them
without the day-end aches. The thin
insoles are adequately cushioned so
I need not purchase an extra set of
medical orthotics as inserts.
What makes the vainpot in me
truly happy however, is how classy
my shoes look when worn with jeans
or pants. I wonder if Kumfs will come
up with knee-length boots in future?
I can only hope.
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10/25/07 1:29:28 PM
16 \
\Nov/Dec 2007
1
2
MONITORING
In the Digital Ward, the patient rests
without being disturbed as his vital signs are
monitored remotely and automatically recorded in
his Electronic Medical Records (EMR). A nurse
accesses Computer-on-Wheels to review and
monitor his vital signs.
3
DIAGNOSIS
The specialist-in-charge shows the patient
images of his scans at his bedside using the
Mobile Electronic X-Ray Computing (MERC)
and explains to him why he needs surgery.
ADMISSION
At the Accident and Emergency department,
the doctor uses the Mobile Clinical Assistant
(MCA) to access the patient’s medical records
and investigation results and capture images of his
injuries.
A
Patient’s
Journey
7
FOLLOW-UP TREATMENT
Once the patient’s condition stabilises, he
is referred for long-term follow-up at the
polyclinic. With access to the patient’s electronic
medical records, test results and scans, the polyclinic
doctor can provide appropriate assessment and longterm care to manage the patient’s healthcare needs
in the primary care setting.
Powered by IT innovations
at SingHealth
6
DISCHARGE
The patient’s diabetic condition is monitored
upon discharge using TeleCare. He uses text
messaging to update his doctor on his condition and
vital signs. If his condition is less than satisfactory
or not well controlled, he receives a text message
prompting him to make an appointment at the
Specialist Outpatient Clinic for review.
4
SURGERY
At the Digital Operating Theatre, the surgeons
can access and refer to the patient’s CT scans,
X-rays and medical records during surgery.
5
RECOVERY
Back in the ward after surgery, the patient
uses the Patient Bedside Terminal to
surf the Internet and send emails. He uses the
videoconferencing feature—Video-Nurse-Call—on
the same terminal to contact the nurses on duty.
Singapore Health
Services (SingHealth) is
the largest healthcare
group in Sing apore ,
offering a complete range
of multi- disciplinar y
and integrated medical
care. The group consists of three Hospitals, five
National Specialty Centres and a network of nine
primary healthcare polyclinics dedicated to providing
quality healthcare that is affordable and accessible to
patients. Through clinical excellence, commitment,
and collaboration, SingHealth aims to be the trusted
leader in healthcare.
10/25/07 1:29:47 PM
Nov/Dec 2007 \
\ 17
Drug expert provides
safety net for patients
editor@sgh.com.sg
TO patients and the public, dispensing
medicine is her most familiar role but
Singapore General Hospital’s Principal
Pharmacist Andrea Kwa’s responsibilities
go beyond fol low ing doctors’
prescriptions.
“A doctor’s training focuses strongly
on diagnosis and treatment, and perhaps
less on discerning the intricate details of
different drugs. Sometimes, a few drugs
within a prescription could reduce the
overall efficacy when taken together.
Pharmacists can step in to make sure this
does not happen,” said Dr Kwa on the
complementary role she plays in patient
care.
Armed with a PhD in Pharmacotherapy,
the 33-year-old is more than qualified for
her role. A hospital-based pharmacist
like her can be posted to frontline service
points to serve outpatients and visitors, or
assigned to oversee the medication needs
for inpatients in the hospital wards.
Dr Kwa started out as an inpatient
pharmacist with SGH a decade ago,
fresh from the National University of
Singapore. Back then, she spent her days
making ward rounds and examining the
medication records of up to 150 patients
daily. She would check the dosages of
drugs ordered and also review whether the
combination would affect their efficacy.
Looking out for side effects
Counter-checking prescriptions
before dispensing is all in a day’s job for
a pharmacist. Dr Kwa said, “Pharmacists
also check if a previous prescription is
still needed. For example, a painkiller is
prescribed for a patient with abdominal
pain. Five days later, is the painkiller still
needed?”
Of equal importance to highlight to
doctors are the side effects of drugs. As
Dr Kwa explained, “Doctors and nurses
may not be as rigorously trained as
pharmacists on the detailed side effects
of medicine, the combination of different
drugs and drug-food interactions”.
Pharmacists can advise whether the
benefits of certain drugs outweigh the
risks. “For example, a patient needs both
Drug A and Drug B for his medical
condition, but Drug B is known to reduce
Get specially priced skincare sets at the
SGH Block 4 Pharmacy this festive season!
the efficacy of Drug A. The pharmacist
can discuss with the doctor and
recommend how best to individualise the
patient’s dosage regimen of Drug A while
he is also taking Drug B, and maximise
the benefits of both”.
Inpatients ready for discharge will get
a bedside visit from their pharmacist to
learn more about the indications, dosages
and side effects of their medicines. This,
Dr Kwa shared, is not an easy task.
“Pharmacists are usually the last group
of caregivers that patients see before
discharge. While we’re dispensing their
medication and giving advice, pharmacists
need to be patient and reassuring,
especially if patients have questions about
their medical condition, or have other
concerns.”
Branching out to research for
individualised treatment
At SGH, there are three tracks in a
pharmacist’s career progression. The
clinical path means direct dealings
with doctors and patients, while the
administrative option sees the drug expert
branching into management.
The third career track is research, which
Dr Kwa is now pursuing. As one of two
full-time research pharmacists in SGH,
she is currently studying ways to deal
with hospital-acquired infection, which
long-stay patients are vulnerable to. Dr
Kwa said there is a need for individualised
therapy, as textbook recommendations
may not be suitable uniform treatment for
every patient.
“You can use a certain dosage of Drug
A on one patient and it may work for
him. But if you give the same dosage to
another patient, the outcome can be quite
different. My passion lies in research
because patients can directly benefit
from our research results. Simply put,
research creates therapeutic options out
of a situation of limited or no therapeutic
options.”
GiftOfLife
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A doctor will review your medical
history and check your vital signs.
This includes pulse and blood
pressure readings to ensure you are fit
to donate blood. In fact, you will get
a ‘mini medical checkup’ when you
donate blood.
Reply from the Singapore Red Cross
SGH file photo
Make your moments merrier
this festive season!
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mystery gift from SGH Pharmacy
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Redemption point: SGH Blk 4 Pharmacy
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10/25/07 1:29:57 PM
18 \
\Nov/Dec 2007
ElderShield lightens burden of severe disabilities
DID you know that one in four elderly persons above the age of 75 suffers from
severe disabilities? No one can predict the future but with alarming statistics like
this, you should be prepared. Picture this:
You are disabled and unable to do even simple tasks
such as walking, bathing, feeding, dressing, toileting and
moving from a bed to a wheelchair. You have lost your
income. Your family is already shouldering the burden
of meeting daily living expenses. Now they too, have to
foot the bill for your medical and daily expenses.
This situation can be cushioned with payouts
from ElderShield, an affordable severe disability
insurance scheme to help you cope with the costs of
long-term care.
•
•
4 New competitive premiums
•
•
•
New ElderShield
ElderShield was launched in 2002 as a severe disability insurance scheme to
help Singaporeans pay for their long-term step-down care should they become
severely disabled. Drawing on past experience and public feedback, the Ministry
of Health has introduced a new ElderShield framework to give you better benefits
and coverage.
What you can expect
1 Enhanced benefits
•
•
All Singaporeans turning 40 from September 2007 will be offered a new basic
ElderShield plan which gives a cash monthly payout of $400, for up to 6 years.
Policyholders will receive a maximum potential payout of $28,800. This is 60%
more than the previous basic ElderShield plan’s maximum payout of $18,000.
2 Three choices of insurers
•
•
Aviva Limited will join incumbents Great Eastern Life Assurance Company
and NTUC Income Insurance Co-operative to provide ElderShield insurance
plans.
Besides giving Singaporeans more choices, this will also help to improve services
and keep premiums competitive.
3 ElderShield supplements
•
To meet the varied needs of Singaporeans, the three insurers will be offering
ElderShield supplements such as higher payouts, longer benefit period or
lessened definition of claim eligibility.
Private insurers are free to design and promote their ElderShield Supplements
in accordance with their perceived market needs, subject to guidelines set by
MOH.
Medisave can be used to pay for part or all of the premiums for the ElderShield
Supplements. The annual withdrawal limit is $600 per person insured.
Premiums for the new basic ElderShield plan were determined via an open
competitive tender.
The increase in premium is about $2 per month compared to the previous
premium.
The premiums for 40-year-old policyholders are:
Gender
Male
Female
New annual premium
$164
$204
Previous annual premium
$142
$182
With the reform, existing policyholders can choose to stay with the previous
scheme at the old premium and payout rate, or switch to the new plan by paying an
adjustment fee and the new premiums.
In addition, if policyholders want more coverage, they can also choose to top up
with an ElderShield Supplement offered by their insurer.
Rebates for existing policyholders
In October 2007, rebates estimated to be above $60 million were given to about
770,000 ElderShield policyholders. This is part of the ElderShield contract where
Great Eastern Life and NTUC Income Insurance Co-operative are to return 50 %
of any accumulated claims surplus to existing policyholders.
Lifetime coverage
ElderShield coverage is for life and offers a helping hand should you become
severely disabled. With the various enhancements, ElderShield is now better able
to meet the diverse needs of Singaporeans.
For more information on the ElderShield reform, visit www.moh.gov.sg
FromTheHeart
‘Prof N Balachandran – My Jedi Master’
“
In the movie ‘Star Wars’ when
Luke Skywalker wanted to become a
Jedi Knight to fight the evil empire
he sought the services of a Jedi
master thought to be residing on the
planet, Hoth. There he found Yoda
a strange creature which he could
not recognise as a Jedi master. His
preconceptions blinded him from
recognising a true Jedi master.
When I first started orthopaedic
surgery, I was asked to go to the
planet “Orth” to seek a master
orthopaedic surgeon. Here, I met
Prof N Balachandran (then called
Mr Bala). I too failed to recognise
a master surgeon. My perceptions
of master surgeons were those who
drove the fastest sports cars, played
the best golf and stayed in the
biggest mansions. Mr Bala (photo)
was none of these. He was, however,
the consummate surgeon, quiet yet
firm, possessing excellent clinical
judgement but above all, always
putting his patients first.
The Master
Over the years that I had worked with
Mr Bala, I learned a great deal from him.
He peppered grand rounds with little
pearls of wisdom. ‘To have good results
in surgery you must lead a good life’, Mr
Bala would tell us. Many young surgeons
under him tried leading ‘good lives’ yet
none could achieve his clinical results. As
with all masters, he had kept a few secrets
to himself and it was only years later that
Mr Bala revealed to us the secret of his
success. On one auspicious grand round
he told us ‘life only begins at sixty!’
Doreen
Doreen was Singapore’s longest
surviving renal transplant patient.
Although she is no longer with us, I
know she would not mind me telling
her story. After 25 years living with a
cadaveric kidney and multiple operations
for steroid-induced avascular necrosis
of the hip she succumbed to sepsis and
multiple organ failure. She spent the
last few months of her life in Room
14, Ward 76. ‘Died of an orthopaedic
complication’ the newspapers declared.
Doreen however knew better. In her
obituary the first person named was Mr
Bala and the nursing staff of Ward 76.
The day after, for the first time I saw Prof
N Balachandran play truant. I know he
snuck off from work to attend Doreen’s
funeral because he had promised her he
would do so.
The Surgeon
Prof Bala was not your typical surgeon.
Indeed, he seemed hesitant to operate,
always adopting a slow cautious attitude
to new procedures, waiting for new
techniques to be tried before subjecting
his patients to them. To many this made
him seem ‘behind the times’ or perhaps
outdated. Often he would seek advice
from his juniors, always quietly listening to
and carefully weighing their opinions. He
would also not hesitate to ask his juniors
to help him in difficult cases. Pride was
never a problem. Prof Bala was perhaps
the only surgeon I know that would not
perform a procedure on his patient unless
he thought it was in the patient’s best
interest. This always seemed an easy
thing to do but the fact remains that few,
if any of us, have been able to do it.
A Gathering of Friends
Prof Bala has single-handedly moulded
and shaped orthopaedics in Singapore to
what it is today. He has been a father
figure to all of us. Many of us have
chosen to do orthopaedics largely because
of the camaraderie and the close ties all
orthopaedic surgeons have for each other
that was forged by Prof Bala.
”
Shared with OutramNow by Dr Howe Tet
Sen, Senior Consultant in the Department of
Orthopaedic Surgery and Director of Trauma
Service, SGH, a story he wrote more than 10
years ago when Prof Bala retired. Prof Bala
passed away in November 2000.
10/25/07 1:30:28 PM
Nov/Dec 2007 \
\ 19
CelebInPerson
Thrills
and
spills
By Hazel Yong
IF there’s a celeb who can be lauded
for keeping it real, it’d be actor Adam
Chen.
After all, you might walk past him at
places like VivoCity and not recognise
the 31-year-old because he’s togged
in slippers, berms, T-shirt and geeky
spectacles. Far from his best form but
it’s oh so charmingly disarming.
Chen has been part of the media
industry since his days at the National
University of Singapore. The civil
engineering undergraduate was
modeling at a school fashion show
when he was discovered by Diva
Models. Despite an average height of
1.73m, he snagged a slew of ad jobs
from companies including Giordano,
SingTel and Coca Cola.
It was in 2001 when he was limited
to join the now-defunct MediaWorks’
Channel U.
While Chen became popularly
known as actress Cynthia Koh’s squeeze
– and subsequently ex – for some time,
he has built up an impressive acting
portfolio. Besides local Mandarin
serials, he appeared in several China coproductions such as The Invincible Duo
opposite Nicholas Tse, Dicky Cheung,
and Fan Bing Bing, as well as TVB’s
Food For Life starring Charmaine Sheh
and Kevin Cheng. He also crossed over
to Channel 5 successfully with two
seasons of Singapore Civil Defence
drama Lifeline.
Outside of acting, Chen keeps
fit with extreme sports like Muay
Thai and wakeboarding. His athletic
physique earned him a longstanding
ambassadorship with Swatch S.E.A in
Singapore. Read on for more about the
62-kg boyish buffster.
From rock climbing to wakeboarding
and now Muay Thai. Why this love for
extreme sports?
And roller-hockey too. Somehow, I
can never seem to appreciate ball games
of any type. Maybe it’s because I simply
possess no talent with anything round
or perhaps I prefer sports that are a
little less crowded. But regular stuff
like cycling, jogging and badminton are
like, err, no… yawn, haha!
I dare say I was among the first few
into rollerblading when the craze started
here. Roller-hockey came along when a
university hostel friend was smacking
a puck around and invited me to play.
From then on, I was hooked.
I admit I flit from sport to sport but
the most enduring one is wakeboarding.
It’s been four years and Punggol Marina
is my fave venue for the activity. Acting
peers Jeff Wang and Vincent Ng are
also patrons of the sport.
Currently, Muay Thai ranks high
on my list. I’m currently training at
Combat Academy along Macpherson
Road.
What’s the next sport you would like
to try?
That’ll have to be mixed martial
arts. It’s not a new sport but it gained
a lot of attention since the broadcast
of Ultimate Fighting Championship on
cable TV. It’s very much like boxing
but you can punch, kick, grapple and
wrestle. The only guideline is not to
fight dirty. Personally, it seems like a
natural progression from Muay Thai.
You must have suffered quite a bit of
injuries for your interests.
Well, I minimise injuries by being
diligent and doing my warm-ups. I’ve
been pretty lucky so far and the worst
I ever got was four stitches to my chin
two years ago. I landed a bit too hard on
the water after attempting a back flip.
My knees came up to my chin and cut
it open.
As an actor, I’m scared that scars may
affect my career but we’ve got to take
a calculated risk doing the things we
like.
Speaking of acting, you probably have
a busy schedule 24/7. How do you find
time for these exercises?
The hours can be pretty long but like
all other jobs, it has to end at some point
or another. So I manage to squeeze
time for sports on a weekly basis. It’s
a blessing that Combat Academy is
flexible with their timing so I can just
go there after work for Muay Thai. As
for wakeboarding, I just pray very hard
that I’m not working on weekends.
You sound like you have a lot of fun
under the sun for long hours. How do
you take care of your skin?
Err, if you look at my back you will
probably have hours of uninterrupted
fun too joining the freckles on my
back, haha! I guess I just forget to apply
sunblock but I do make an effort not to
stay out when the sun shines harshest.
I make sure I slather moisturiser at
home and use aloe vera gel when I get
sunburnt.
We now know what you do for fitness
but what about emotional well-being?
I read before bedtime and to maintain
my sanity, I will numb myself from time
to time with B-grade frat-boy comedies
and action flicks. I also love those where
the underdog wins in the end. There’s
no particular show I always turn to
though.
All this reading and watching movies
sounds like a lot of strain to your
eyes…
… And that’s why I am bespectacled.
I am myopic -- about 450-degrees
in each eye. I became shortsighted
during my childhood by reading under
the blanket at night. I have seriously
considered Lasik but can’t accept the
fact that my lifestyle will have to change
during the recovery process – that
means no wakeboarding for at least two
months!
Tell us some beauty or health secrets
that you practice but have never told
the media before.
Well, I never thought I would
succumb to taking health supplements
but I started recently. It’s an age thing.
Stuff that I take includes detox pills
and multi-vitamins. I believe that
one has to be disciplined and finish
each supplement course just like any
other fitness regime. All my previous
attempts at taking supplements failed
miserably because I hate swallowing
pills and capsules and it’s troublesome
measuring powders. This time, I have
switched to gel types. All I need to do
is to rip the packaging and sip, like
drinking jello. And better yet, there are
different flavors.
Complete this sentence: Health is…
Wealth. Invest in it enough and you
will reap the benefits.
10/25/07 1:30:38 PM
20 \
\Nov/Dec 2007
FrontLine
TheDoctor'sIn
My wife lost interest in sex Serving with his heart
Q
My wife underwent
surgery for early stage
breast cancer three
months ago. She has
returned to work but we do not have
sex anymore. She rejected all my
attempts to get intimate. Once, she
broke down saying she no longer felt
attractive. What can I do to help her
regain her confidence? We are both in
our 30s.
Sexual difficulties after
breast cancer diagnosis
and treatment are very
common. An estimated
80% of sexually active couples, stop
having intercourse all together.
However, with good counselling and
efforts put in by both parties, nearly
all couples will regain their previous
level of sexual activities. Your wife had
gone through a difficult time. She had
to cope with the diagnosis, the harsh
effects of treatment including surgery,
chemotherapy and radiation therapy as
well as the stress and uncertainty of her
condition in the future. You will be the
key person to help her regain her sexual
confidence. Now that she has a scar,
her greatest fear will be your feelings
towards her. It is very important that
A
you reassure her with both words and
action. Keeping very quiet and not
addressing her concerns directly will
make her jump to the conclusion that
you are no longer attracted to her. Talk
about it openly. Allow her to express
her emotions and tell you what she
likes and dislikes. Apart from words,
frequent touching and hugging can be
more intimate than intercourse. This
will go further to reassure her that you
still love her. The breast cancer support
group has been found to be extremely
useful for sexual rehabilitation. Your
wife will benefit tremendously from
other patients’ experiences and different
coping strategies. Do encourage her to
attend the sessions. Contact her doctor
and find out more.
Dr Roland Chieng,
Consultant, Department
of Obstetrics and
Gynaecology, SGH.
Email your health-related question
to editor@sgh.com.sg. The reply
provided is for your general
information only. You should consult
a doctor or seek treatment for your
condition.
He is a familiar face at SGH for
patients and visitors. Full-time
volunteer Koh Kim Guan, 59, has
served 11 years at the hospital
where he underwent open heart
surgery.
How did you go from being a patient to SGH’s only fulltime volunteer?
Twelve years ago, I was referred to SGH to replace a damaged mitral valve in
my heart. It was a life-and-death situation and the doctors did their best to save
me. I went home after 60 days and spent a year recuperating. I stopped working
as a subcontractor and signed up as a volunteer with the National Council of Social
Services. I asked to be posted to SGH.
What are your responsibilities?
Initially, I helped in giving directions and transferring patients. A year later, I
started manning the retail cart which sells items to raise funds for needy patients.
Now I am in charge of the two retail carts at Blocks 3 and 5, supervising about 10
part-time volunteers. I work from 9.30 am to 6 pm Mondays to Fridays.
I understand that you are often called to provide another service.
Nurses would call me when they have Thai-speaking patients. I learnt the
language on my own as I make frequent trips to Thailand to buy items for sale. I
am happy to help anytime even if I am not on duty.
Any memorable encounters?
During the Sars outbreak, I befriended a 31-year-old Thai construction worker.
He was blinded in both eyes after an industrial accident and became very depressed.
For two months, I visited him often and took him for walks around the hospital
until he went home.
As a full-time volunteer, how do you support yourself?
I lead a simple life and have some savings. I am happy to do my bit for SGH as
her doctors gave me back my life. My heart is here and this is my second home.
New&News
Advertising Feature
Toothbrush hygiene
Get a walking workout
DAMP bathroom plus high humidity
– perfect breeding ground for bacteria
and mould growth. To keep your
toothbrush clean, you can soak the
head in a sterilizing solution, or go
hi-tech with the new in Singapore
VIOlight Toothbrush Sanitizer.
The Center for Disease Control (USA)
reported that “even after being rinsed visibly
clean, toothbrushes can remain contaminated
with potentially pathogenic organisms”. In
addition, brushes kept in a common holder
may cross-contaminate one another, spreading
bugs causing eg flu, colds, and Hand, Foot and
Mouth Disease among family members. The
VIOlight, an Industrial Design Excellence
Gold Award winner is listed as one of the top
products by BusinessWeek and one of the coolest
inventions of the year by Time magazine. It
looks like a pencil case and uses a Germicidal
UltraViolet bulb – the same technology used
Joint pain keeping you from jogging
or any high intensity exercise? Try brisk
walking. If you are already walking for
fitness and want to boost your workout, Dr
Ben Tan of Changi General Hospital (Head
and Senior Consultant Sports Physician,
Changi Sports Medicine Centre) suggests
you step up your programme.
“If you don’t want to jog or run, then you
are left only with increasing the
duration or frequency
of each workout.
Adding inclines
can help to
increase
the
in hospitals and dental clinics. Pop your
toothbrush in and forget about it. In just seven
minutes up to 99% of microorganisms are
killed, and the unit shuts off automatically,
keeping your toothbrush clean until
the next use. $66.90 each (including
GST) from Capital Marketing at
178 Paya Lebar Road. Buy two units
and get free delivery. Ring Carine,
6288 9190 to order.
intensity of the workout, but it would also
increase the stress on the joints.”
For aerobic exercise, you cannot stroll
and smell the flowers. You need to walk
more than 60 steps per minute and walk for
more than 10 minutes continuously (with
less than one minute of rest). The best way
to check that you’re doing it right is with a
step counter like Omron’s Pedometer HJ113, $40.66 (from pharmacies, electronic
and department stores, or ring Kingston
Medical Supplies, 6745 3922). Besides
counting steps, the display shows aerobic
walking time and distance, calories and
body fat burnt, time, and past 7-day
memory.
Fill the blank and you might win one of five Omron
Pedometers from Kingston Medical Supplies.
OutramNow/Omron Pedometer Giveaway
Win a VIOlight Toothbrush Sanitizer - Capital
Marketing has five units for OutramNow readers.
Aerobic exercise involves walking more than ___ steps per minute
continuously for at least 10 minutes.
OutramNow/VIOlight Giveaway
Name:
I.C. no (just last 4 digits, Sxxxx1234)
Address:
Name:
I.C. no (just last 4 digits, Sxxxx1234)
Address:
Email:
Tel:(h)
Closing date: 15 Dec, 2007
Email:
Tel:(h)
Closing date: 15 Dec, 2007
(mobile)
Mail to: Robinson Road Post Office, P.O. Box 189, Singapore 900339
(mobile)
Mail to: Kingston Medical Supplies 35 Tannery Road,
#11-01 Tannery Block, Ruby Industrial Complex,
Singapore 347740 Tel: 6745 3922
10/25/07 1:30:52 PM
Nov/Dec 2007 \
\ 21
EatWell
Chicken Galantine with Chestnut Stuffing
SERVES 4
1. Brown chicken bones in oven for 40
minutes.
2. Dust flour, put margarine and
pour tomato paste on the bones.
Add vegetables into this mix.
3. Continue roasting in oven for 20
minutes.
4. Transfer the browned bones and
mixture into a pot.
5. Add chicken stock and simmer for
an hour.
6. Strain the sauce and season.
500 gm boneless chicken leg
100 gm spinach leaves
5 gm salt
3 gm pepper
Chestnut stuffing
250gm minced chicken breast
1 egg white
50 gm chestnut
20 gm celery
20 gm carrot
20 gm onion
50 gm breadcrumbs
1 gm mixed herb
A pinch of salt & pepper
Chopped all ingredient and mix well
with minced chicken
CHEF’S TIP
To serve this dish during the festive
season, just use turkey instead of
chicken.
ESTIMATED NUTRIENT
CONTENT FOR CHICKEN
GALANTINE (PER SERVING)
METHOD
1. Use a meat mallet and flatten the
chicken leg to make it thinner.
2. Blanch spinach leaves and place on
the chicken.
3. Spread chestnut stuffing evenly on
the spinach.
4. Roll the chicken firmly and secure
with butcher string.
5. Place the rolled chicken in an oven
pre-heated at 180º C and bake for
30 minutes.
6. Serve with Demi Glace sauce.
Demi Glace Sauce
1 kg chicken bones
250 gm carrot
250 gm onion
250 gm celery
150 gm tomato paste
2 pieces of bay leaves
2 litres of chicken stock
90 gm flour
90 gm margarine
Energy
Carbohydrate
Protein
Fat
Sodium
Cholesterol
241 kcal
21 gm
28 gm
5 gm
732 mg
83 mg
DidYouKnow
Contest
380
Win an SGH 185th
anniversary limited
edition Dendrobium
orchid brooch!
The ‘Friends of SGH’ programme has
volunteers identifiable by their green vests.
Volunteers clocked
6,000
hours annually
Youngest volunteer is aged
13
Patients, staff and volunteers created
the wall mural of ‘paper cranes’ in Ward
46
The SGH 185th anniversary commemorative brooch
is named after the Dendrobium orchid. True/ False
Longest serving volunteer Koh Kim Guan has
clocked
Here’s a chance for you to win a Dendrobium orchid
brooch specially commissioned to commemorate
Singapore General Hospital’s 185th anniversary
celebration. Valued at $33, this 18K gold plated Risis
brooch is the perfect gift for you or your loved one
this festive season. To be one of 10 lucky winners, just
answer this question:
11 years
Email your reply, name, address and contact number to editor@sgh.com.sg
2,935
Closing date: 10 December 2007
SGH staff contribute to
Community Chest every month
ArtsFest@SGH 2007 featured
including handicraft sessions.
Nearly
35
programmes
150 packets of blood collected in double blood donation drives
500
people participated in SGH Charity
Haircut raising $7,000
1,000
patients received free haircuts
since service was introduced in August last year
* All correct entries will be entered into a lucky draw to be conducted at the SGH Communications Office
on 15 December 2007. * Ten winners will be picked and notified by email on the collection of their prizes.
* Their names will be published in the next issue of OutramNow. * All entries will be included in a mailing list for OutramNow.
Results of the ‘Five cookbooks up for grabs!’ contest in
OutramNow September/ October 2007 Issue 4.
The answer is TRUE. Chicken curry can be made healthier by
using low fat yoghurt instead of coconut milk.
The 5 winners of ‘Where is the Fat?’ cookbook worth $26.40 produced by Singapore
General Hospital’s Department of Dietetics & Nutrition Services are:
Angie Lee, Hougang Avenue 8
Lim Meng Wee, Bedok North Street 3
Lim Sai Im, Jurong East Street 32
Tan Ah Choo, West Coast Road
Alan Wee, Jurong East Street 32
All winners have been notified by email. Prizes must be claimed by 31 December 2007.
10/25/07 1:31:05 PM
22 \
\Nov/Dec 2007
WeHearYou
Bouquets
Why do some specialists see new
patients on certain days and see followup patients on other days? It’s difficult to
fathom why a doctor’s last appointment
is at 10am on a Monday. Also, this
same doctor happens to have his clinic
sessions only on alternate days of the
week and only during the mornings.
Chua Nency
Brown rice is rich in fibre, vitamins and
minerals. It reduces the risks of colon
cancer and Type 2 Diabetes, lowers
cholesterol levels and protects against
heart disease. I suggest that SGH serves
inpatients with brown rice instead of white
rice. When patients are discharged,
they may continue to eat brown rice.
Yap Soon Chia
Our specialists will usually work out
their schedule for clinic sessions based
on the type of patients they manage.
For example, a first-time patient
who requires investigations such as
X-rays or blood tests will usually be
scheduled for earlier appointments.
This is so that the patient can go for
any investigation after consultation and
then returns to see the doctor again.
Our specialists do not just see patients
at clinics. Our specialists conduct ward
rounds, perform surgeries, supervise
doctors undergoing training, teach at
the university, and conduct research
and studies. A specialist also has to
undertake additional tasks assigned by
his department or the hospital such as
giving talks at conferences.
Yeo Han Seng, Senior Manager,
Specialist Outpatient Clinic, SGH.
It is true that brown rice has its
benefits. However, serving brown rice
to patients who are accustomed to white
rice, can cause a taste bud rebellion.
Brown rice has a mild nutty flavour, is
chewier and an acquired taste for many
people. To the non-adventurous, brown
rice may taste weird. Rather than make
patients eat something they are not
used to and compromise their intake
and recovery, our dietitians would
advise patients (especially diabetics and
those with special needs) during oneto-one counselling to try brown rice
when they are at home. We have also
tried introducing wholemeal bread for
patients on therapeutic requirements.
But the acceptance rate is still not very
high as the preference is still for white
bread. As we have to prepare up to
1,400 inpatient meals on a daily basis,
we will serve food options preferred by
the general population.
Koay Saw Lan, Head of Dietetics and
Nutrition Services, SGH
Editor’s note: We would like to thank Ms
Chua with a $50 SGH Pharmacy voucher
for her letter which gave us the opportunity
to explain our work processes.
If you have a question about hospital processes, email editor@sgh.com.sg The best letter featured in each issue
wins a $50 voucher redeemable at the SGH Block 4 Pharmacy for non-prescription items only.
Stroke patient from Sydney sings praises of SGH staff
“
…I have never in my 60 years been hospitalised, but have seen too
many experiences in both Australia and the UK where people have waited
long periods of time to be attended to. I was only in the (Singapore
General Hospital) emergency department a matter of minutes before
my head was being cat-scanned.
I was taken to a ward and almost immediately seen by a professor of
neurology and his team…around 8 pm. …He was 90 percent certain I had suffered a minor
stroke but that in the morning I would have an MRI scan to confirm. The attention, care,
understanding and genuine concern for my welfare displayed by every single member of staff
that I encountered at your marvelous facility was inspiring and totally reassuring.
The next morning I had the MRI, the professor confirmed I had indeed suffered a stroke…I thank
everyone at Singapore General Hospital (and) congratulate Singapore and the administrators of
the hospital for such a marvelous and proficiently run (what an understatement!) facility.
”
Sir Kerry Jewel, a visitor from Sydney, Australia who was taken to SGH by ambulance after suffering
a stroke while alone in his hotel room.
What an efficient and reliable healthcare system we have
“
…I was very impressed with the healthcare system in Singapore because I
have been treated by a highly skilled and caring medical team led by Associate
Professor Christopher Goh (right), Head of the ENT Specialist Centre.
Throughout my 15-day stay at SGH, everything was very well coordinated. I
was able to have a speedy recovery after my surgery as the hospital planned
every detail for me. They helped me arrange for a physiotherapist when I was
discharged from the ICU to ensure that I could move my limbs. While I was on a feeding tube,
they got a nutritionist to manage my nutrition needs. When I was in pain, the nurses in Ward
55A responded within three seconds when I pressed the Call button.
Upon my discharge from the hospital, they arranged for the pharmacist to dispense the
medication to me in my ward. Having been through these, I couldn’t help but think that
I am very fortunate to be a Singaporean to enjoy such an efficient and reliable healthcare
system…
Kudos to SGH.
”
Madam Chan Wei Kien who underwent major surgery in September during her fourth admission to
SGH in six months.
The above compliments were extracted from letters to The Straits Times Online Forum Page on October 12.
HealthBits
Flexitarians?
Americans have a new term for people who moderate their vegetarianism with
some occasional fish and meat. They call them flexitarians, says (www.cnn.com)
Like vegetarians, “flexitarians” eat a primarily plant-based diet of grains,
vegetables, and fruit. For the protein they occasionally reac for lean meat, fish,
poultry or dairy.
As many as a quarter of Americans fit this description, consuming meatless
meals at least four days a week, says the American Dietetic Association.
Parched from air conditioning
When it’s hot outside, we run indoors
to a cool air-conditioned environment.
The air-conditioner extracts heat
from the environment and with it,
moisture from the air as well, says
(www.howstuffworks.com), quoting scientists in the industry.
All of us who work in an air-conditioned environment know that while it feels
great to escape from the heat, skin and even eyes feel drier. And if you sleep with
the air-con on, you really should replenish the lost moisture. Use a skin emollient,
and if eyes feel gritty, have eye drops ready before eyes itch and turn red.
In the interest of protecting the environment and also saving energy, you might
want to consider switching to fans or air coolers. They are cheaper and also allow
you to keep windows open for fresh air.
10/25/07 1:31:22 PM
Nov/Dec 2007 \
\ 23
ArtsForHealth
The world
through his eyes
HAPPENINGS
Ballet rendition
of a classic tale
Be mesmerised by the graceful and fluid
moves from Cheng Ballet dancers as
they bring you their version of wellknown children’s classic ‘Snow White &
the Seven Dwarfs’.
Date
Time
Venue
: 14 Dec 2007 (Friday)
: 7 pm – 7.45 pm
: SGH Fountain Garden
Block 7 Level 1
Admission : Free
Still a beautiful life
They may be physically disabled but four
members of the SGH Amputee Support
Group showed that life is still beautiful
through a photography showcase of their
visions of beauty.
Date
Venue
: 30 Sept – 2 Dec 2007
: Block 2 Level 1
Arts for Health aims to provide quality caring
environment and promote good health in SGH through
the arts. Patients, visitors, staff and the community
can participate in creative arts programmes such as
concerts, workshops and exhibitions that bring healing
to the body, mind and soul.
SGH is the first hospital to receive the National Arts
Council Supporter Awards 2005 in recognition of our
promotional artistic activities.
Amputee patient Leong Kwang Seng using a digital camera to capture images depicting
nature’s beauty.
IT was their first trip to the Botanic Gardens in many years but for four members
of the SGH Amputee Support Group, it was a day to remember. Each was handed
a digital camera to capture their interpretations of the park’s beauty. Enthused
84-year-old Leong Kwang Seng, “I have not taken photos for a long time. It’s
much easier now because you can see the images immediately.”
On hand to share tips on getting the best shot was award-winning photographer
Dr Tan Eng Loy, a registrar with the SGH Department of Obstetrics & Gynaecology
and 10 volunteer photo buffs.
Their efforts got the thumbs up from Mr Kalaiselvan, 46, who recently underwent
a heart transplant. “It was a very uplifting experience taking photographs of
nature with fellow amputees. My volunteer Mr Koh gave me many tips on
photography.”
The outing was part of ongoing therapeutic activities organised under the
Arts for Health programme. Dr Tan explained, “Photography allows us to view
the world around us in new ways and see seemingly mundane subjects in a new,
refreshing light. Similarly, viewing the world in refreshing new ways is what many
patients with chronic and debilitating illnesses need to do as part of their recovery
process.”
CalendarOfEvents
SGH Physiotherapy Health Fair
– Celebrating 60 Years of Community Service
Date
Time
Venue
Organised by
Event Description
:
:
:
:
:
17 November 2007, Saturday
11 am – 9 pm
The Plaza,VivoCity
SGH Physiotherapy Department
Find out how you can achieve a healthier lifestyle with various
activities and a balanced diet. There will be free health screenings
and tests, information kits as well as physiotherapists on site
to share tips on how to kickstart your journey to a fitter and
healthier you. The day-long event is held in conjunction with the
60th anniversary celebrations of the Department of Physiotherapy,
Singapore General Hospital.
Admission
: Free
Enquiries, call 6326 6673
All about Anaesthesia
‘Lily Pond’ by Yee Ming Kwan, ‘Shameetha’s Ice Cream’ by Nanju Jit and ‘Peace’ by Leong
Kwang Seng
Doing their part for other patients
Twenty-five photographs taken by the four amputee patients are now on display
at Arts Expression, a dedicated arts space at Block 2 Level 1. Each image has
been framed (above) and available for sale at $200. Proceeds will go towards the
SGH Orthopaedic Endowment Fund to improve care for patients including
amputees. For more details, email the photo number and your contact details to
sghendowment@sgh.com.sg or call 6326 6378.
Date
Time
Venue
Organised by
Event Description
:
:
:
:
:
12 January 2008, Saturday
2 pm – 5 pm
Toa Payoh HDB Hub
SGH Department of Anaesthesia & Surgical Intensive Care
Join our panel of consultant doctors who will be sharing
information on the various choices of anaesthesia available
for people undergoing surgery. Will multiple health problems stop
you from having an operation? Can you be awake, yet free from
pain, during an operation? Get our panel of experts to answer
your questions and allay your concerns.
Admission
: $5 per person.
Enquiries, call 6321 4220
For information on other SGH programmes and services, log on to www.sgh.com.sg
10/25/07 1:31:38 PM
24 \
\Nov/Dec 2007
10/25/07 1:32:01 PM

Cord blood gives hope to adults

Transcription

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