Healthy Healthy Life

A newsletter for patients
Oct - Dec 2011
MICA (P) 023/07/2011
A Publication By NHG Polyclinics
Ease the
Tension
...p7
BELLY TROUBLE...p8
HEALTHY HOLIDAY
RECIPES...pg9
Company
...p10
...p11
Brain Gym
Your chance
to win
VOUCHERS!
Healthy
LIVER
Healthy Life
This festive season, watching your diet not only means saving
your waistline but your liver too.
... turn over to page 3
02
Message
from the
Chairperson
Dear readers,
Seasons Greetings from the editorial committee of ‘What’s Up, Doc?’! We will be bidding
this year goodbye soon and I am sure that most of us are eagerly awaiting the start of next
year, and have lined up many year-end celebratory activities to welcome 2012.
While we share your joy and wonderful festive mood, we would like to also give you some
friendly health advice in this issue. Do refer to the articles and learn how to look after your
liver since it is one of the most hardworking organs within our bodies. Gain some tips on how
to ease that tension headache (if you find yourself too stressed while clearing up your work
before all the partying starts), and how to cope with common gastrointestinal symptoms.
In line with our tradition of encouraging you to eat healthily (even more so during the
festive periods), we have included some healthy recipes that you can try out at home
and impress your family members with. Take some time to read through the health
and drug questions which our readers have submitted, and if you have any other health
conditions you wish to read about, do drop us a line at whatsupdoc@nhgp.com.sg.
Lastly, we have included an updated list of treatments for the health conditions you can
use your Medisave to pay for. We encourage you to take note of these to ease your
out-of-pocket medical expenses.
Wishing you happy holidays and a healthy year ahead!
Dr David Tan
Chairperson
Editorial Team :
Chairperson
Editor Editorial Advisors
Dr David Tan,
Jurong Polyclinic Ms Annie Chua,
Corporate Communications
Ms Mariaman d/o Sukumaran, Toa Payoh Polyclinic
We welcome your suggestions on how to improve the newsletter. Write to whatsupdoc@nhgp.com.sg.
The information produced is for reference and educational purposes only.
As each person’s medical condition is unique, you should not rely on the information contained in this newsletter as
substitute for personal medical attention, diagnosis or hands-on treatment. If you are concerned about your health,
please consult a healthcare professional.
Reproduction of the articles in whole or part without permission is prohibited.
Ms Ainolmardziah Bte Yusof,
NHG Pharmacy
03
Healthy LIVER,
Healthy LIFE
Overindulging in rich foods and alcohol can take a toll on the body, causing
one to gain weight, risk high blood pressure and cholesterol problems. There
is also an added burden on the liver.
The liver is the largest internal organ and is responsible
for a wide range of duties. It takes care of more than 40
biochemical reactions in the body, making it one of the
hardest working organs as well. It metabolises sugar to
energy, converts protein to usable amino acids, breaks
down fat and even neutralises toxins. In fact, the liver
processes everything we eat and drink. After going
through the digestive system, the nutrient-rich blood is
filtered in the liver before travelling to the rest of the body.
This means that having too many sinful treats can
impact the liver other than adding on the kilograms to
your body. In particular, being overweight can lead to
a condition known as fatty liver or non-alcoholic fatty
liver disease. This occurs when there is an abnormal
accumulation of fat in the liver tissues. The liver – the
‘food factory’ of the body – not only converts starch to
energy-rich glucose but also stores the excess glucose as
a fuel reserve called glycogen. Glycogen is reconverted
to energy by the liver when needed, but is left to build
up if it remains unused. This causes the development of
a fatty liver ultimately. Excessive alcohol can also cause
fatty liver because alcohol contains high levels of sugar.
According to Dr Seet Lin Tze, senior family physician
at Clementi Polyclinic, conditions that put one at risk
of developing non-alcoholic fatty liver disease include
obesity, diabetes, high cholesterol, and rapid weight
loss/starvation.
In most cases, fatty liver can be treated and is reversible
with a healthy diet, exercise, safe and sustained weight
loss, good management of diabetes and cholesterol
levels, and limiting alcohol intake. However, about 10
per cent of fatty liver cases may progress to cirrhosis – a
hardening of the liver. This increases the risk of liver cancer
and liver failure.
Added Dr Seet, “Bearing in mind that cardiovascular
disease is the most common cause of illness and death
in people with non-alcoholic fatty liver disease, it must
be strongly emphasised that lifestyle changes in terms
of diet, exercise, weight loss and smoking cessation as
well as treating associated diabetes, hypertension and
hyperlipidemia are critical in maintaining the health of
the liver.”
04
健康肝脏，
健康生活
在节日期间，注意控制饮食不
仅是为了保持苗条的腰围，更
是为了保护您的肝脏。
暴饮暴食会对身体造成不良影响。这不但会导致体重增
大多数的脂肪肝病历其实是可以治疗的。只要通过健康饮
加、增加您患上高血压和高胆固醇疾病的风险，还会导致
食、运动、安全和持续的减轻体重、良好地控制糖尿病和
肝脏负担加重。
胆固醇水平、以及限制酒精的摄入，脂肪肝是可以逆转
的。不过，大约百分之十的脂肪肝病例可能会演变为肝硬
肝脏是人体中最大的内部器官，担负着许多不同的重任。
化（肝脏变硬), 这会增加患肝癌和肝脏衰竭的风险。
它负责人体中四十多种生化反应，因此可说是人体最辛勤
工作的器官之一。它将糖代谢成为能量、将蛋白质转化为
薛医生补充说:“切记，在因非酒精性脂肪性肝病而患病和
可使用的氨基酸、分解脂肪以及中和毒素。实际上，肝脏
死亡的人中，最常见的原因是心血管疾病。要特别强调的
坦任了一项重责，那就是处理我们所饮用的全部物质。在
是，通过控制饮食、运动、减轻体重和戒烟来改变生活方
经过消化系统之后，富含营养物的血液经肝脏过滤后才流
式，以及治疗相关的糖尿病、高血压和高脂血症，是对于
至身体的其它部分。
保持肝脏健康至关重要的。”
这就是说，吃得太多不仅使您的体重增加，也会影响您的
肝脏。超重可导致脂肪肝，即非酒精性脂肪性肝病。当脂
肪在肝脏组织中异常积累时，人就会产生这种疾病。肝脏
是人体的“食物加工厂”，不仅将淀粉转化为富含能量的
葡萄糖，还将多余的葡萄糖（以糖原的形式）储存起来，
作为能量储备。在需要时，糖原将被转化为能量，但是如
果置之不用，则会积聚最终导致脂肪肝。过多酒精也会导
致脂肪肝，原因是酒精含有很高的糖分。
金文泰综合诊疗所高级家庭医生薛灵芝说:“导致人们患上
非酒精性脂肪性肝病的风险因素包括，肥胖、糖尿病、高
胆固醇以及快速减轻体重／饥饿。”
05
Hati (Hepar) sihat,
Hidup pun sihat
Musim perayaan ini, memberi perhatian pada diet anda bukan sahaja dapat
menyelamatkan ukuran pinggang anda tetapi juga hati (hepar) anda.
Menikmati makanan berkhasiat tinggi dan alkohol
dengan keterlaluan boleh membebankan badan,
menyebabkan seseorang itu naik berat badan serta
mendatangkan masalah risiko tekanan darah tinggi
dan kolesterol. Selain itu, ia juga menambahkan beban
terhadap hati (hepar) anda.
Glikogen ditukar semula kepada tenaga oleh hati
(hepar) apabila diperlukan tetapi dibiar berkumpul jika
ia tidak digunakan. Ini akhirnya menyebabkan keadaan
hati (hepar) berlemak. Alkohol yang berlebihan juga
boleh menyebabkan hati (hepar) berlemak kerana
alkohol mengandungi kadar gula yang tinggi.
Hati (Hepar) adalah organ dalaman terbesar yang
melaksanakan pelbagai tugas. Ia menguruskan lebih
daripada 40 tindak balas biokimia dalam badan,
menjadikannya salah satu daripada organ-organ yang
sangat bekerja keras. Ia metabolises (memproseskan)
gula kepada tenaga, menukarkan protein kepada asid
amino yang boleh diguna untuk memecahkan lemak
dan juga meneutralkan toksin. Malah, hati (hepar)
memproses semua yang kita makan dan minum. Selepas
melalui sistem penghadaman, darah yang kaya dengan
nutrien ditapis di dalam hati (hepar) sebelum perjalanan
ke seluruh tubuh.
Menurut Dr Seet Lin Tze, doktor keluarga kanan di
Poliklinik Clementi, keadaan yang boleh membawa
risiko penyakit hati (hepar) berlemak bukan-alkohol
termasuk kegemukan, kencing manis, kolesterol tinggi
dan kehilangan berat badan yang cepat/kelaparan.
Ini bermakna bahawa menikmati terlalu banyak
makanan lazat boleh memberi kesan kepada hati
(hepar) selain menambahkan berat badan anda.
Khususnya, berat badan yang berlebihan boleh
membawa kepada keadaan yang dikenali sebagai hati
(hepar) berlemak atau penyakit hati (hepar) berlemak
bukan-alkohol. Ini berlaku apabila terdapat pengumpulan
lemak yang tidak normal dalam tisu hati (hepar).
Hati (Hepar) - ‘kilang makanan’ badan - bukan hanya
menukarkan kanji kepada glukosa yang kaya dengan
tenaga, tetapi juga menyimpan glukosa yang berlebihan
sebagai rizab bahan bakar yang dikenali sebagai glikogen.
Dalam kebanyakan kes, hati (hepar) berlemak boleh
dirawat dan boleh dipulihkan dengan amalan diet yang
sihat, senaman, penurunan berat badan secara selamat
dan berterusan, pengurusan penyakit kencing manis
dan paras kolesterol yang baik, serta menghadkan
pengambilan alkohol. Walau bagaimanapun, kira-kira
10 peratus kes-kes hati (hepar) berlemak boleh melarat
ke sirosis - tisu berserat di bahagian hati (hepar). Ini
meningkatkan risiko kanser hati (hepar) dan kerosakan
hati (hepar).
Tambah Dr Seet lagi, “Perlu diingatkan bahawa penyakit
jantung adalah punca utama penyakit dan kematian di
kalangan mereka yang berpenyakit hati (hepar) berlemak
bukan-alkohol, perlu ditegaskan bahawa perubahan
gaya hidup dari segi diet (pemakanan), senaman, berat
badan dan berhenti merokok serta merawat penyakit
kencing manis, darah tinggi dan hiperlipidemia adalah
kritikal dalam mengekalkan kesihatan hati (hepar). “
06
03
07
Ease the
Tension
Hectic lives, work schedules and the mad rush to clear up as
much work as possible before taking that well-deserved year-end
holiday may bring on the occasional bout of tension headache.
A tension headache - or medically known as a tension-type headache
- is the most common type of headache, often described as a
sensation of having a tight band around the head.
The exact cause for tension headache is unknown,
but the most common reason given is that it develops
after an individual had held his head in a fixed
position over a long period of time. Prolonged periods
of just sitting at the desk while working on the computer,
doing fine delicate work with the hands or using a
microscope are other known reasons.
Other triggers may include:
• Sleeping in a cold room or with the neck in an
abnormal position
• Stress
• Depression and anxiety
• Poor posture
• Working in awkward positions for a sustained
period of time
• Jaw clenching
• Alcohol/Caffeine
• Eye strain
• Fatigue
• Excessive smoking
Soothe the muscles
Soothe sore neck muscles with either a hot compress
or a cold pack, depending on your preference. A hot-water
bottle, a warm towel or a hot bath/shower may help in
easing out the aches. If you are using a cold pack, wrap
the ice pack/cubes in a towel to protect the skin. A
gentle massage to the muscles of your head, neck and
shoulders may also help to relieve muscle tension and
provide relief from headaches.
Stress management
Stress is a common trigger for tension headaches. Try
to reduce stress by planning ahead and organising
your day. A list of tasks for the day – written down in
order of priority – may help.
Another way is to adopt a positive attitude and regain
your sense of control by changing your expectations.
Reframe your problems and view your stressful
situations from a more positive perspective.
In addition, you can reduce stress in your life by nurturing
yourself. Set aside time for fun and relaxation either by
yourself or with others. This way, you will be in a better
position to handle stressful situations when they arise.
Use techniques such as deep breathing exercises and
stretching to relax. Regular exercise, a proper diet and
adequate sleep help you to maintain good health and
reduce stress.
Perfecting your posture
Good posture can prevent muscles from tensing up
and place minimal strain on your muscles, ligaments,
tendons and bones. When standing, hold your shoulders
back and keep your head high. Pull in your abdomen
and buttocks and tuck in your chin. When sitting, make
sure your thighs are parallel to the ground and your
head isn’t slumped forward. Get up and take a break
from your computer every few hours especially if long
hours at the desk triggers headaches.
08
The enjoyment of the festive season – feasting and merrymaking – can
take its toll on our tender tummies. We share with you some tips on
how to avoid the common stomach problems caused by enjoying
too much good food during the celebrations.
Heartburn
Diarrhoea
Characterised as a ‘burning’ sensation in your lower
chest, it may be accompanied with a sour or bitter taste
in the mouth. It is often experienced after a big meal or
while you are lying down after a meal.
Having to visit the toilet often is no fun. For some people,
this may even warrant medical attention, as it could be
a sign of more serious health conditions.
Causes: Stomach acid may sometimes escape up the
oesophagus (the tube that leads from your mouth to
your stomach). This occurs if you overeat, are pregnant
or have a condition where part of your stomach is
pushed up into the chest.
Avoid the ‘burn’:
• Avoid caffeine, smoking, alcohol and foods that are
too spicy, carbonated, acidic and oily.
Don’t lie down too soon after eating.
• Lose weight if you are overweight.
See a doctor: If you experience heartburn frequently, see a
doctor to avoid inflammation from occurring.
Bloated stomach (gas in the stomach)
The swollen discomfort of a bloated tummy can be very
unpleasant and inconvenient. It can disrupt your social
plans and sleep, and may even disrupt your daily activities.
Causes: This is a result of a build-up of gas in the
intestines during digestion. Certain foods produce gas
when they are broken down. It can also occur if you
swallow a lot of air during eating.
Dispel the gas:
• Avoid or cut down on ‘wind’-producing foods such as
cabbage, asparagus, cauliflower, potatoes and corn.
• Artificial sweeteners and carbonated drinks can also
cause gas to build up.
• If you are lactose intolerant, avoid dairy products.
• Chew well, eat slowly and avoid talking while
eating – these habits will help to reduce the amount
of air swallowed while eating.
See a doctor: If the sensation of a bloated stomach continues
for a long time, or if your abdomen has grown bigger and
is painful to the touch, please consult a doctor.
Sources: Health Promotion Board and www.familydoctor.org.
Causes: The loose watery stools that are a hallmark of
diarrhoea may be due to a viral or bacterial infection,
food poisoning, intolerance to food, medication or even
stress.
Taming the tummy:
• Drink plenty of clear fluids such as water, fruit juice
and clear soups to replenish lost fluids.
• Eat bland foods such as clear soup, rice porridge
and plain bread.
• Avoid meat, nuts, beans, dairy, oily food, coffee and
alcohol.
See a doctor: Babies, children, the elderly and anyone with
a chronic medical condition should always consult a doctor
when they experience diarrhoea. If there is vomiting,
severe pain and if stools are black or bloody, you should go
to the emergency department of the nearest hospital.
Constipation
Everyone moves their bowels at varying frequencies.
It may be daily or twice a day, but a disruption in your
‘daily motion’ can be an uncomfortable affair.
Causes: A lack of fibre, water or physical activity, certain
medications and piles can cause constipation.
Promote regularity:
• Ensure that you drink about 8 cups of water a day
and have fibre-rich foods in your diet (oatmeal,
whole wheat bread, fruits).
• Prunes and prune juice can help relieve constipation.
• Exercise three times a week. Walks, swims or bike
rides can help to promote regularity in your bowel
movements.
See a doctor: Frequent bouts of constipation, tummy pain
and swelling, thin stools and weight loss due to constipation
can be signs of a more serious illness.
Contributed by:
Dr Seah Chee Yong
Senior Family Doctor, Hougang Polyclinic
09
Thai chicken salad
Ingredients
•100g chicken breast
•A 1-inch knob of fresh ginger, peeled
•2 tbsp sugar
•2 chili padi (optional)
•½ cucumber, deseeded and thinly shredded
•10 coriander leaves, chopped
•3 cloves garlic
•2 tbsp fish sauce
•Juice of 1 lime
•1 medium carrot, shredded
•2 shallots, halved and thinly sliced
Method
• Grill, microwave, steam or poach the chicken breast
• Shred with a fork
• For the dressing, combine garlic, ginger, fish sauce, sugar, lime &
chillies in blender and puree until smooth
• In a large bowl, toss the shredded chicken meat & carrot with the
dressing, onion and coriander
Healthy Tip:
Replace chicken with pan fried tau kua (firm tofu) cut to small cubes.
Garlic chicken and basil sandwich
Ingredients
•1 tsp canola oil •1 clove garlic, crushed
•Salt & black pepper
•4 leaves fresh basil
•100g roast turkey or chicken meat, skin removed
•2 slices wholemeal bread
•15g (6 strips) marinated sun dried tomato
Method
• Heat a non-stick frying pan and add canola oil
• Slice a 5mm thick piece of chicken and rub with garlic
• Fry chicken on each side for 2 to 3 mins
• Season (if preferred)
• Assemble sandwich by stacking toasted bread, chicken, tomato strips and basil
Healthy Tip:
Use low fat yoghurt as a creamy spread. This is great with leftover chicken
or turkey. Tea-Scented Mandarins
Ingredients
•2 cups mandarin orange segments •½ cup hot black tea
•2 tablespoons honey •Pinch of ground cardamon
Method
• Place orange segments in a small bowl
• Pour tea over them
• Drizzle with honey
• Sprinkle with cardamom
• Serve
Healthy Tip:
You can replace mandarins with orange, pear or mango.
Healthy
Holiday
Recipes
Low in fat but high in flavour,
try these healthy recipes for a
cross-continental festive feast.
Grilled
Salmon with
•
balsamic vinegar
Ingredients
•2 pieces of 100g salmon fillets
•100g green beans, steamed or blanched
•100g cauliflower, steamed or blanched
•Salt & pepper to taste
•Olive oil
Sauce
•1 shallot, minced
•¼ cup balsamic vinegar
•2 tbsp groundnut or olive oil
•1½ tsp fresh thyme leave
Method
• Rub salmon with olive oil, salt and pepper
• Preheat grill pan and grill fish (skin
-side down) for 4 to 5 mins
• Turn fish over and cook for another
2 to 3 mins
• For the sauce, combine oil, balsamic
vinegar, shallot and thyme
• Serve the grilled fish with green beans
and cauliflower, drizzled with sauce
Healthy Tip:
Pan fry the fish instead of grill.
Recipes contributed by
Mr Won Tin Chiang
Dietitian
NHG Polyclinics
10
Brain
Gym
5
7
9
2
6
1
7
6
e
Sudoku Puzzl
9
4
5
2
4
5
9
2
6
8
5
8
7
1
4
7
1
5
Quiz Time!
9
2
6
Answer the simple question below and you could win for yourself
$30 worth of Takashimaya vouchers!
Hint: The answer can be found in this newsletter.
Question: You can lower your risk of developing a fatty liver by leading a healthy lifestyle.
True or False?
Answer
Full Name (as in NRIC) :
NRIC Number
:
Address
: Email Address
: Contact / Mobile No.
:
:
Simply email your answers in the format above to whatsupdoc@nhgp.com.sg by 15 December 2011. Three correct entries will be
selected to win the vouchers! Winners will be notified via email. Hardcopy submissions will not be accepted. Staff members of
NHG Polyclinics are not allowed to participate in this contest.
Last Issue’s Quiz Results
Question: Name one form of gum disease
Answer (either one is correct): Gingivitis or Periodontitis
1. Foo Wee Kiat, NRIC number: SXXXX151H
2. Thow Nan Yien, NRIC number: SXXXX968E
3. Nancy Toh, NRIC number: SXXXX861B
You will be notified via email on how to collect your $30 Takashimaya vouchers. The decision of NHG Polyclinics is final.
Company
New Services you can now use Medisave for!
•Since November 2010, females aged 9 to 27 years old can use Medisave if they wish to take the Human
Papillomavirus (HPV) Vaccine to guard against cervical cancer.
•Since July 2011, women over 50 can use Medisave for mammogram screenings.
You can also use Medisave for the following:
Treatment of chronic conditions:
•Diabetes Mellitus • Hypertension
•Lipid disorders
• Stroke
•Asthma • Chronic Obstructive Pulmonary Disease (COPD)
•Schizophrenia • Major depression
*Note: Patients can use their Medisave to pay for consultation, medication and
laboratory tests that are related to the chronic diseases mentioned above.
Vaccinations
•Hepatitis B
• Pneumococcal
Dental treatment
•Removal of roots • Bone graft surgery
•Implant surgery • Soft tissue graft
•Incision & drainage
•Dislocation, re-implantation and transplantation
11
Ask
THE
EXPERTS
Do you have a burning question on
health issues? Drop us an email at
whatsupdoc@nhgp.com.sg today!
Health QUESTION : Drug QUESTION :
I am a 29-year-old female and a frequent blood
donor. Recently at the blood donation screening
station, I was told for the first time that my blood
pressure was low and I was not allowed to donate
blood. What are the causes of low blood pressure?
Should I be concerned and how should I deal
with my condition?
The main causes of low blood pressure are:
1.Decreased intake of fluids, e.g. if a person is fasting or
not drinking enough water.
2.Excessive loss of water because of vomiting,
diarrhoea or fever.
3.Excessive loss of blood due to bleeding, heavy
menstrual flow, frequent blood donation without
supplementation of iron pills.
4. Sickness e.g. heart failure, anaemia.
5. Over-treatment of high blood pressure.
I am in my 30s and of an average weight but I would
like to prevent myself from gaining weight during
the end of the year festivities. Can I take Xenical to
prevent weight gain?
Xenical® is commonly used for people who are overweight.
You should consult your doctor for a full assessment
before embarking on any weight loss programme or diet.
The active ingredient in Xenical® is Orlistat, which targets
the enzymes that break down fat. This prevents up to
30 per cent of dietary fats from being digested. Xenical®
targets the digestion of fat rather than suppressing the
appetite and should be taken in conjunction with a wellbalanced, calorie-controlled diet that is rich in fruits and
vegetables. For a more holistic approach, this should be
coupled with regular exercise.
Common side effects of taking Xenical® include oily
discharge from the anus; abdominal pain or discomfort;
flatulence (wind) with or without discharge; oily, fatty or
loose stools; and/or an increased urge for bowel movement.
You should be concerned if the low blood pressure is
causing symptoms like shortness of breath, difficulty
in breathing when doing simple household chores or
giddiness. You should consult your doctor if the low
blood pressure is persistent and symptomatic.
These symptoms generally occur at the beginning of
treatment, or after an oily meal. They will generally subside
after some time. Other side effects that may occur in
some patients include headache, anxiety, irregular
menses or muscle pain. Stop the medication and see
a doctor if you experience severe side effects such as
difficulty in breathing, facial swelling, hives/itching/rashes,
stomach cramps or pain, or yellowing of the eyes or skin.
Contributed by Dr Yuen Soo Hwa
Senior Family Doctor
Woodlands Polyclinic
Contributed by Cheryl Char
Pharmacist
Hougang Polyclinic
. 12
“
On 16 June, I brought my daughters for a dental check-up at Ang Mo Kio Polyclinic
and was attended to by Dr Yeo Sze Lynn. I wish to highlight that Dr Yeo was very professional
and she used stories to explain the uses of the tools and equipment, so that my girls were not
so nervous. Even the dental drill sounded so harmless during this visit. I have had bad
experiences with dental visits since young but I must admit that I was also ‘coaxed’ into
a comfortable state during this session.
”
Thank you Dr Yeo for making our visit so enjoyable. We are looking forward to
my younger daughter’s next visit to fill her second decay! Mr Lai Sze Hai
*To enjoy the discounts, please present the coupons at the point of purchase.