Treat prolonged pain before it becomes a disease

F IRV E R S
1
ST
IS
SU
E
Mar/Apr 2008 \
N
AN
A Singapore General Hospital Bi-monthly Publication
Issue 7
Pg
5
Helping
patients
regain
function
Pg
11
Goodbye
Housemen's
Canteen
Pg
Treat prolonged
pain before it
becomes a disease
Pain affects a person’s well being and if left
untreated, can lead to serious health problems
By Hazel Yong and Karen Teng
editor@sgh.com.sg
INDIVIDUALS who complain of
persistent pain that lasts beyond three
months despite medication should be
taken seriously and treated before it leads
to serious complications. This warning
comes from Director of the Singapore
General Hospital’s Pain Management
Centre Dr Yeo Sow Nam.
Dr Yeo is the first doctor in Singapore
to obtain accreditation in the specialty
of pain management offered by the
Australian and New Zealand College
of Pain Medicine. He describes pain
as a sensation that causes suffering and
points out that unfair labelling of the
affected person would prevent him from
seeking proper treatment to address the
root cause.
“Such
individuals
are
often
misunderstood and labelled as suffering
from psychological pain when the pain
is actually very real. Once labelled, they
are not taken seriously and continue to
suffer.”
Dr Yeo notes that sometimes
a patient’s complaints of pain are
dismissed, especially when results of
diagnostic tests are inconclusive. “This
unfair labelling occurs when X-rays,
scans and other diagnostic tools do not
give a clear cause behind the patient’s
agony. It is seen in patients from all
medical disciplines.”
Suffering beyond three months
At SGH, pain is known as the fifth
Wall
mural of
inspirations
28
Pg
32
pages
\ 1
March/April 2008 MICA (P) 028/01/2008
I N S I D E
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kidneys
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E EA R Y
ONE
Dear Reader
It has been a year since we launched Outram Now - the first newspaper to be
launched by a Singapore hospital. This bi-monthly publication was produced
specially to help meet our patients’ need for information on our services,
hospital procedures and processes as well as healthcare financing.
Since our inaugural issue, we have received very encouraging and appreciative
responses from you. Many of our Outram Now newspaper stands all over
Outram Campus are emptied out within three weeks. Those who missed
previous issues, have also asked for Outram Now to be delivered to your
home.
So from now, we will increase our print run to 35,000 copies per issue.
We have started a mailing list for those of you who don’t want to miss a
single issue. To be included in our mailing list, just email your personal details
to editor@sgh.com.sg
We believe that health information has an impact on the quality of healthcare
and in the decision-making by our patients. In the year ahead, we want to
continue improving our health communication for all patients and their nextof-kin.
To help us do better, do participate in our readership survey. Your inputs
and suggestions will help us improve the content of Outram Now and meet
overall healthcare information needs of those we serve.
Thank you for your support.
Yours sincerely
Professor Tan Ser Kiat
GCEO, SingHealth & CEO, SGH
Li Wai Sum, 54, learnt non-surgical methods
to tackle her back pain, putting an end to
over three decades of suffering. Details on
page 2.
vital sign and recognised as an indicator
of the patient’s well being. Vital signs
are measurements for healthcare
professionals to assess an individual’s
basic body functions. The other vital
signs are temperature, pulse or heart
rate, blood pressure and respiratory
rate.
Dr Yeo says SGH is the first hospital
in South East Asia to recognise pain as
a vital sign and subsequently, developed
a common pain scale. Patients are asked
to express their level of pain on a scale
of 0 to 10. Zero means no pain while
10 refers to worst pain imaginable for
the patient.
Of great concern to him is chronic
pain which refers to discomfort lasting
over three months, beyond the typical
recovery period for an injury or illness.
This is because prolonged suffering can
affect the patient’s life drastically.
“People always ask what’s the big
deal about pain. Well, chronic pain is
a significant, unrecognised problem,
which can happen in any part of the
body to anyone. Many medical experts
“
Pain has a huge impact
on a person’s life. So don’t
ignore it.
”
- Dr Yeo Sow Nam
Director of Pain Management Centre,
SGH
who work with international bodies
like the World Health Organisation
recognise pain as a disease as it can
cause depression. In fact, about 45 to
50 per cent of sufferers develop major
depression and some even have suicidal
tendencies.”
One in 10 suffer from chronic pain
Local data shows that some people
do suffer from prolonged pain. Dr Yeo
who is President of the Pain Association
of Singapore shares findings of a
population-based survey completed last
year.
“Of the sample pool of 500 people,
about 10 percent said they have
experienced chronic pain. That’s across
all age groups. But for those above age
65, chronic pain affected nearly half of
them. And their pain were so severe that
they either try to treat it themselves
CONTINUED ON PAGE 2
2 \
\Mar/Apr 2008
CONTINUED FROM PAGE 1
or seek treatment. So clearly that’s not
just psychological pain. And with our
ageing population, we know the number
of patients suffering from chronic pain
will only go up, not down.”
Ignoring or suppressing pain with
painkillers increases the risk of insomnia
and loss of productivity, he cautions.
Over time, this poses a significant
psychosocial impact on both the affected
individual’s health and the community.
Rarer forms of chronic pain include
Trigeminal Neuralgia, as Dr Yeo
elaborates. “This is a condition where
the individual’s facial nerves transmit
abnormal ‘firing’ sensation for no
apparent reason, making it impossible
for him to eat or drink. Patients
have described it as ‘hellish pain’ and
said they are better off dying. This
condition can be treated if they come
in early.”
Not just the older folks
Chronic pain is often associated with
the elderly due to the ageing process.
But the profiles of patients seen at SGH
show otherwise. Dr Yeo (photo) notes
that more and more younger people
suffer from long-term pain which are
severe enough to have an impact in their
lives. Their complaints are often related
to the neck or back.
“We see a larger number of younger
patients below 65 years old because of
long hours at the desk or sport-related
injuries. They make up approximately 40
per cent of our patients now, compared
to 20 per cent about six years ago.”
Even cancer patients have options
The pain management expert says
advances in technology mean that those
who have chronic pain including cancer
patients, need not suffer in silence.
“There are enough options in this
day and age for
us to dare say
that although the
diseases involved
are not always
treatable, 99 per
cent of pain can
be managed very
well,
including
cancer pain. In
Non-surgical methods
eased her suffering
The weight of five apples used to be unbearable
for this homemaker but now she can even carry a
5kg pack of rice
Li Wai Sum is troubled each time she
spots schoolchildren with shoulders
weighed down by heavy schoolbags.
“Youngsters should be careful about
the weight of their bags to avoid back
trouble.That’s what I’ve been nagging
my two kids about since they were
young.”
The 54-year-old speaks from
experience. As a teenager, she
accidentally knocked her back
against a sharp corner of an amplifier,
injuring her tail bone. That moment
of carelessness resulted in 38 years
of agony.
Just 16 then, Madam Li was too
shy to seek help from male Tui Na
physicians. Also, her family could not
afford it. “I applied ointment but the
pain didn’t go away. It got so bad that
on buses, I avoided sitting. I took such
a long time to stand up and alight that it
was embarrassing.”
When she started working as a
salesgirl, the long hours on her feet
coupled with having to stock up items
at a duty-free store, exacerbated her
pain.
Madam Li was 24 when she consulted
an acupuncturist. “I was about to get
married and wanted to ensure a smooth
pregnancy.”
But the pain remained even after
she quit her job. When she rejoined
the workforce a few years later,
Madam Li saw a physiotherapist and an
acupuncturist. Relief was temporary.
One day, her physiotherapist told her
“not to come anymore”.
By then, her condition has progressed
to severe pain. She stopped working
again and felt the full impact of her
PUBLISHER
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Singapore General Hospital
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Tel 6222 3322 Fax 6222 1720
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fact, studies show that cancer pain
management can potentially prolong
patients’ lifespan.”
Multidisciplinary approach to manage
pain
At the SGH Pain Management Centre,
relief of pain is not just a simple case of
prescribing painkillers. One of its key
emphasis is to help patients self-manage
their pain and participate in their own
rehabilitation, via the Centre’s cognitive
and behavioural therapy programme.
Dr Yeo explains, “We discourage
long-term use of painkillers due to side
effects unless patients need them badly
to continue their lifestyle and functions.
The medications we prescribe are more
towards nerve or muscle stabilisers,
aided by advanced interventional pain
therapies and cognitive bahavioural
therapies.”
After a detailed history taking and
physical examination including analysis
of his degree and nature of pain, the
patient will be prescribed a customised
treatment plan based on his condition. It
is a multi disciplinary approach involving
the pain specialists, physiotherapists
and psychologists to provide long term
solutions that work.
As Dr Yeo sums it up, “Pain has a
huge impact on a person’s life. So don’t
ignore it.”
About SGH Pain Management Centre
•
•
•
•
•
•
•
First one-stop treatment centre in Singapore and South East Asia
Nine consultation rooms and an operating theatre
Acupuncture services available
Staffed by internationally accredited pain specialists and nurses trained in pain
management
One of the few facilities in the region to offer advanced techniques such intrathecal
medication pump and spinal cord stimulator for management of intractable chronic
pain
Appointments can be made via your family doctor, specialist or self-referral
Appointment hotline: 6321 4377
suffering. “I felt dull twinges as I turned
in my sleep. The pain robbed me of my
rest, leaving me listless and with mood
swings. I couldn’t carry a bag of five
apples without aching. If I walked for
20 minutes, I needed 20 minutes of rest
before I could continue.”
Determined to put an end to
her misery, Madam Li saw a private
orthopaedic surgeon in 2000 and
underwent surgery on her lower back.
“The doctor removed three small bones
from my tailbone which were curved
inwards. It might have been due to that
accident when I was younger.”
The following months went well.
“I had a good time for one-and-a-half
years.”
In mid-2002, Madam Li strained her
back while shopping for groceries. This
time, she came to SGH, saw a specialist
and signed up for physiotherapy
sessions to strengthen her back and
thigh muscles.“The exercises helped
but I didn’t continue.”
By the time Madam Li was referred
to the SGH Pain Management team in
2006 under the care of Dr Yeo Sow
Nam, she already felt “hopeless”.
But the first consultation lifted her
spirits. “Dr Yeo did a very detailed
Mike Chew (Senior Account Mgr)
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Chris Seng (Account Mgr)
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check-up. He paid attention when I
described my pain. I was asked to
bend here and there so he could
assess my condition.”
An MRI scan showed that her
troubles are now with the L4 and L5
vertebrae near the end of her spine.
DrYeo prescribed a combined therapy
of injections and a customised twoweek pain management workshop to
learn stretching exercises, relaxation
and sleeping techniques.
Madam Li completed her
treatment late last year and is still
under follow-up. She is happy with
her progress. “I don’t need anymore
surgery. I’ve learnt the correct
stretching exercises to manage my
pain. About 50 per cent of my
discomfort had disappeared after
constant stretching.”
Medication is just an option. “I
take painkillers only when necessary.
So far, there were only five instances
when I had to pop pills. I swim three
times a week to strengthen my back
muscles and relax. I even put on
some weight, mostly muscles! Now
I can carry even a 5kg pack of rice
for a short period of time, let alone
five apples!”
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 Lina Choong
Associate Professor Chow Wan Cheng
Associate Professor Tan Seang Beng
Dr June Goh
Dr Peter Lim
Dr Ng Beng Yeong
Dr Yeo Sow Nam
Dr Yue Wai Mun
\ 3
Mar/Apr 2008 \
Outram Now celebrates 1st birthday
SGH makes headlines for producing own newspaper, a first for a Singapore hospital
Greeting from our readers
“
Happy Birthday Outram Now! Thank
you very much for delivering the bimonthly
newspaper to me regularly. Your articles
contain very useful health knowledge. I look
forward to reading about patients who have
recovered.
”
Lee Phek Khim, 54, senior technical executive
“
...I look forward to receiving your
newspaper and have even saved the copies
for future reference. Here’s wishing you
many more birthdays to come!
”
K Poonam, 61, former SGH patient
“
...Outram Now has come a long way and
definitely provided us with many insightful
stories of SGH. I have been reading Outram
Now since the first issue and will continue
to do so. Happy Birthday!
“
”
Seetoh Wai Kit, human resource manager
...It was a pleasant surprise to have
been added to the mailing list – it’s like a
gift for being a valued customer at SGH.
”
Veronica Lim-Lowe, 41, family life educator
“
“
”
...Keep up the good work and I look
forward to the next edition.
THE Singapore General Hospital’s
bimonthly newspaper Outram Now
received an early birthday present when
it was featured in The New Paper on 24
January.
This comes just ten months after the
free publication was launched on the
hospital’s birthday in March last year.
The 24-page newspaper was the
brainchild of SGH Director of
Communications and Service Quality
Mrs Tan-Huang Shuo Mei.
“The positive feedback we have
received since the first issue was
It’s our
birthday but
you get the
presents!
Take part in our first Readership
Survey and stand to win one of these
prizes:
Three OSIM
Sona anti-snore
pillows worth
$199 each.
Ten hampers with
KariHome health
foods worth $200
each.
profile stories - topics often requested by
readers. The usual edition has 24 pages.
All past issues of Outram Now are
available online at www.sgh.com.sg
Copies can also be found at all libraries.
The Hospital will hold a health fair
at the SGH Fountain Garden at Block
7 on March 28 and 29 to thank readers
and the public for their support.
Activities include health screening,
sales of healthcare products and free
public forums on common medical
conditions and diseases by SGH’s team
of specialists.
affirmation of our efforts in engaging and
empowering readers with information
which helps them understand not just
the Hospital’s service offerings and
processes, but also the healthcare system.
To meet increasing demand for copies of
our newspaper from various parties both
on and off Outram Campus, we will
increase the print run to 35,000 from
this issue.”
To commemorate Outram Now’s
birthday, the first anniversary issue is a
bumper 32-page special edition packed
with more healthcare articles and patient
1. The following topics are of
interest to me (please choose
as many as you like)
a. Patients’ stories on medical
conditions & treatment
b. SGH specialists, services & facilities
c. Hospital procedures & processes
such as Billings, Claims etc
d. Calendar of events & Arts for Health
activities
e. Techniques & tips on personal care
at home
2. Why I read Outram Now (please
choose as many as you like)
a. Easy-to-read & interesting content
b. While waiting to see doctor
c. Warded and need reading materials
d. Just happen to come across a copy
e. Am a regular reader
3.
a.
b.
c.
I am best described as
Current patient
Former patient
Family member/ relative of SGH
patient
d. Visitor
e. Healthcare professional
4. Your gender
a. Male
b. Female
5.
a.
b.
c.
d.
e.
Age group
Below 20
21 - 30
31 – 55
56 – 70
Above 71
6. My occupation falls within this
category
a. Professional, manager, executive or
businessman
b. Uniformed & service personnel
c. Salaried worker
d. Self-employed
e. Retiree / student
Hazizah A Jalal, 56, clerical officer
...I got to know Outram Now when
I was visiting my friend who was once a
patient of SGH. It provides me with insights
into important health issues. It’s a good
newspaper for the young who are healthconsicous! I wish Outram Now all the best
in its future endeavours!
“
”
George Lim, 21, NUS undergraduate
...May you grow from strength to
strength! Looking forward to more
interesting articles!
”
David Ang, 57, section head of warehouse
Jessie Mok, 55, former SGH patient
“
...May this signal the growth of a fine
newspaper which I find very interesting and
informative where our health is concerned.
I am sure that many more readers will soon
appreciate the wealth information that it
contains.
”
Dr Tan Eng Yoon, 80, National Heart Centre
patient and husband of breast cancer survivor
Join the Outram Now mailing list
Email your name, address and telephone number to editor@sgh.com.sg
You can also paste this completed entry form on a postcard or the back
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Closing date: 11 April 2008
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\Mar/Apr 2008
\Mar/Apr 2008
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Daylight danger
With the buzz about Chikungunya,
you’d think it was a new disease.
Actually, according to the World
Health Organization (WHO), this
disease that resembles dengue fever
and is also spread by the Aedes
mosquito, was first noted in 1824
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While
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by persistent joint pain. The worry
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often loss of income and long-term
physical discomfort.
After about a 20-year interval,
Chikungunya fever is back with a
vengeance with 1.25 million cases in
just India in 2006. Now that it’s made
its appearance in Singapore, and
knowing that there is no vaccine yet
available against this virus infection,
prevention is our best bet.
Heed the Ministry of Environment’s
exhortations to stop mosquito
breeding by draining any area or
container with stagnant water (even
a few drops).
The Aedes mosquito feeds by day,
so WHO advises:
• Using mosquito coils,repellents and
electric vapour mats during daylight
hours;
• Using mosquito nets to protect
babies and old people who may rest
during the day. The effectiveness of
such nets can be improved by
treating them with permethrin
(pyrethroid
insecticide). Net
curtains (cloth or bamboo) can also
be treated with insecticide and
hung at windows or doorways to
repel or kill mosquitoes.
A woman’s heart
Although it’s now known that
women are at risk of heart attacks
as much as men, most women and
even health care personnel might
miss the symptoms of a heart
attack when a woman is involved,
especially when the woman is young.
The Mayo Clinic’s Dr Sharonne
Hayes, a cardiologist, tells women
how they can help themselves.
Whether man or woman,
symptoms might be similar. Probably,
70 percent of people will feel
something in their chest, but it may
not be pain. They may experience it
as pressure or burning, and it may
radiate up to their shoulders, or jaw
or neck or back. Many people will
also get shortness of breath or nausea.
They might vomit and think they
have the stomach flu. They may
get real sweaty and clammy, have
palpitations or feel lightheaded.
Other patients will not have much
chest pain at all, just discomfort or
pressure in their back or between
their shoulder blades, so there’s a
wide range of symptoms people
have to be aware of. It’s not like
that Hollywood heart attack where
somebody clutches their chest, and
falls over in the street. That happens
in less than five percent of patients.
Better safe than sorry
A woman with any of these
symptoms should ask herself, is it a
new symptom she’s never experienced
before? Does it last more than a few
minutes? If she feels unwell, she can
call her doctor, and if she’s feeling
particularly unwell, she should call
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some kind of gut feeling instead of
dismissing new symptoms that are
either worsening, or waxing and
waning but not going away. It’s much
better to walk out of the emergency
room being told that you had a bad
case of indigestion than having a
heart attack without medical help.
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\ 5
Are your kidneys okay?
A 10-second urine test is your first defence against chronic kidney disease
By Karen Teng
editor@sgh.com.sg
A SIMPLE test using a ‘dipstick’ in your
urine sample can reveal the health of
your kidneys in just under 10 seconds.
This hassle-free screening is done using
a specially coded test panel on a plastic
strip.
Senior Consultant at the Singapore
General Hospital’s Department of Renal
Medicine Associate Professor Lina
Choong (photo) says,“The test will detect
if there is any protein in your urine. The
presence of protein means there could be
a problem in your kidney, which needs to
be looked at. Early detection means early
treatment and we can prevent potentially
serious kidney problems.”
This reminder comes as Singapore
commemorates the 3rd World Kidney
Day on March 13.
Kidney damage caused by disease is
irreversible
As the filtration system for the body,
kidneys remove waste and toxins. The
pair of bean-shaped organs also balances
fluid and many important substances
in the body. Located below the ribs
toward the middle of the back, a kidney
can be damaged through an accident or
a disease.
Professor
Choong who is the
Hospital’s Director
of Dialysis explains,
“Once your kidneys
are diseased for a
prolonged period,
irreversible damage
may occur. You
will be diagnosed with what’s known
as Chronic Kidney Disease or CKD.
Treating this in the early stages can
slow its progression. While there is a
proportion of cases where the disease is
minor and only observation is required,
CKD is often silent, meaning you will not
have any symptoms. An assessment will
need to be done to judge its severity.”
There are five stages in the progression
of CKD. “The various stages refer to
the kidney’s glomerular filtration rate.
This simply means how efficient your
kidney is in removing waste products.
At stages 1, 2 and 3, we can slow down
the disease progression. The patient will
need an appropriate diet, lose weight
if needed, cut down on his salt intake,
exercise regularly and be started on the
appropriate medication.”
The aim is to prevent his condition
from progressing to kidney failure, as
Professor Choong explains.
“If he reaches stage 4, we will have
to prepare him for dialysis. At stage 5
means his kidneys have none or very
little function where he will need to be on
dialysis or undergo a kidney transplant.”
High-risk individuals should be
screened
Local data shows that the majority of
CKD cases here are linked to diabetes
and high blood pressure. If not properly
treated and controlled with medication,
both conditions can lead to complications
in the kidney, says Professor Choong.
“Kidney disease leads to heart disease
as well. There is a 10 times higher
risk of getting heart disease compared
to others without CKD. So if you
currently have diabetes and high blood
pressure, you should be screened with
the simple urine dipstick test. You can
do this at any polyclinic or your family
doctor’s. Early detection and treatment
will reduce your risks of kidney failure
and heart disease.”
Youngest patient was just 13
Professor Choong cautions that CKD
does not just affect a selected population
although some may have higher risks.
“Anyone can get CKD and at any age
too. My youngest patient was just 13
when he was diagnosed with stage 1
CKD. A routine screening in school
detected protein in his urine.”
If CKD is treated early, the need
for dialysis can be delayed. “Disease
progression can be slowed. Untreated
kidney disease especially if associated
with high blood pressure has been shown
statistically in a local study to progress to
the need for dialysis in just three years.
When treated, many patients can go
SGH file photo
followed his advice but after a while, I
returned to my old habits.”
For Mr Ong, that meant having supper
every night and often indulging in his
favourite braised pork trotters, laksa
and fried Hokkien mee. Smoking 30
sticks of cigarettes a day was a must. He
continued living this way even after his
blood pressure shot up and he became
overweight by 20 kg.
The wake-up call came in March 2001.
“I started having heart problems. A scan
showed three arteries were blocked.
Are you at risk of getting
Chronic Kidney Disease?
See your doctor for a urine dipstick
test if you
•
•
•
•
•
are above 50 years
are a smoker
are overweight
have diabetes
have high blood pressure
Five stages of Chronic Kidney Disease
Stage
1
2
3
4
5
What to expect
Start medication
Watch your diet and cut down on salt intake
Exercise regularly
Lose weight if overweight
Prepare for dialysis
On dialysis / Undergo kidney transplant
Lifestyle changes kept him off dialysis machine
Programming analyst Jeffrey Ong
considers himself a lucky man. His
diabetes-related chronic kidney
disease is not serious enough for
him to be hooked up to a dialysis
machine, thanks to a strict diet
control and regular check-ups. It is
an achievement that the 68-year-old
is proud of, particularly when many in
similar situations have failed.
“It is already quite good that I
can still maintain my health. A friend
around my age also had diabetes. Like
me, his kidneys were also affected.
But his condition was so serious
that within a year, he already said
goodbye.”
When Mr Ong was first diagnosed
with diabetes three decades ago, he
paid little attention to his diet. “The
doctor gave me medicine and told me
to eat cut down on fatty food and take
less sugar and salt. In the beginning I
on for 10 to 20 years before needing
dialysis.”
As CKD is a ‘silent’ disease, Professor
Choong urges high-risk individuals to be
vigilant on their health of their kidneys.
“Early kidney problems do not present
any symptoms. So you may not even
know until it’s too late.”
As the damage was extensive, I had to
undergo a heart bypass. Fortunately, I
came out of that all right. The doctors
also said I had serious problems with my
kidneys. A blood test confirmed it.”
Mr Ong was referred to Associate
Professor Lina Choong, a Senior
Consultant in the SGH Department of
Renal Medicine. “Dr Choong told me
if I don’t control myself and change my
lifestyle, I would need dialysis. I need
long-term medication to prevent my
kidneys from worsening.”
To better understand his condition, Mr
Ong read and learnt all he could about
the topic. Armed with facts coupled
with sheer determination to stay away
from a dialysis machine, he made drastic
changes to his lifestyle. Through selfdiscipline and support from his family,
Mr Ong now weighs just 60 kg. His
diabetes and high blood pressure are
controlled with medicine.
“I had my last cigarette seven years
ago. These days, I eat mainly organic
food and fruits. At home, we have
steamed fish and vegetables. I can’t
remember the last time I had satay,
laksa or sweet desserts. So far I’ve lost
about 20 kg. Every morning, I meet
a group of 30 friends for 45 minutes’
of tai chi as a form of exercise. We
only take a break if it rains, otherwise
public holiday or not, I will join them.
Now every three months, I come to
SGH and see Dr Choong for a review,
a blood test and stock up on my
medicine.”
Having learnt the importance
of early intervention for chronic
conditions like diabetes and kidney
disease, Mr Ong hopes others can
learn from his experience.
“Don’t take your health for granted,
even if you are now young. Take care
of yourself. If you have diabetes, see
your doctor regularly and follow the
‘rules’. Early stage of kidney disease
has no symptoms so you must go for
regular check-ups.”
6 \
\Mar/Apr 2008
Debunking the myths of anaesthesia
By Leong Wai Kit and Karen Teng
editor@sgh.com.sg
ANAESTHESIA, an important but
seldom-discussed topic was discussed
at length during a recent public
forum held at the HDB Hub in Toa
Payoh.
For the first time, doctors
from the Singapore General Hospital’s
Department of Anaesthesia and
Surgical Intensive Care organised the
event to address public concerns and
allay their fears on being ‘put to sleep’
during surgery.
The word ‘anaesthesia’ refers to a
reversible lack of awareness or the
blocking of pain and other sensations.
Information to allay fears of pain
Consultant Anaesthetist Dr June
Goh says, “There is a need to inform
the public on how best they can prepare
themselves for an operation, educate
them on the various anaesthesia
options, and allay fears of postoperation pain, which can be relieved
in different ways.”
Aptly titled ‘Numbing the Pain’,
experts discussed issues such as the
various choices of anaesthesia and
the possibility of a patient regaining
consc iousness m idway t h rough
surgery.
As Dr Goh explains, “In major
trauma cases or during heart surgery
where there is bleeding or very low
blood pressure, anaesthesia has to be
Exhibition panels were put up for the public to learn more on the various options of
anaesthesia.
“
There is a need to inform
the public on how best they
can prepare themselves for
an operation, educate them
on the various anaesthesia
options, and allay fears of
post-operation pain, which
can be relieved in different
ways.
”
Forum participants were shown how various anaesthetic gases are given to patients
before surgery.
Where Doctors Learn
The following courses will be held at the SGH Postgraduate Medical Institute,
Block 6 Level 1 from 1 pm – 5 pm.
For General Practitioners
Functional Neurosurgery & Spine Disorders
15 March
Pain Management Workshop
29 March
- Dr June Goh
Consultant Anaesthetist
Participants were given complimentary
checks on their vitals signs including heart
rate and blood pressure.
Rigorous training to ensure safety
Another issue of interest was the
criteria to be an anaesthetist.
“We are fully qualified doctors
who go through a fairly rigorous
selection process before undergoing
post-graduate training. Because of
this training and a conscious effort to
always be careful, anaesthesia has an
incredible safety record,” says Dr Goh.
Forum participants received a
complimentary check of their blood
pressure and heart rate. They also
had the rare opportunity to see actual
equipment used by anaesthetists in
the operating theatre and had their
questions answered on-the-spot by
experts.
The Hospital’s latest community
outreach efforts got the thumbs up
from Ms Sheila Ong, 40. “I attended
the forum to broaden my knowledge
in this area. SGH is doing a lot
to reach out to the public through
awareness programmes and I find this
reassuring.”
The auditorium was packed with members
of the public keen to learn more about
anaesthesia.
The panel of speakers included (from
left) Associate Consultant Dr Ho Kok Yuen,
Consultant Dr Sharon Ong and Principal
Resident Physician Dr Kim Soo Joang from
the SGH Department of Anaesthesia and
Surgical Intensive Care.
lightened as it affects blood pressure.
But it is very, very rare for patients to
wake during surgery.”
Management of Arthritis
5 April
Update on Breast & Vascular Disease and Approach to Head & Neck Masses
10 May
Update on Upper GI & Hepatobiliary Disease
17 May
Details: www.pgmi.com.sg
Pre-registration is required for all programmes.
Mar/Apr 2008 \
\ 7
“SGH doctors gave me hope to live...”
Life is almost back to normal for a former secretary, just seven months after she suffered a stroke
By Karen Teng
editor@sgh.com.sg
IT IS hard to picture Madam Susila
Visvalingham as a victim of a stroke
that paralysed the right side of her body.
She walks without any help and speaks
clearly. She dresses and takes showers
on her own, standing up.
The retired secretary says her memory
is intact but what happened in June
last year remains hazy. “I was at home
on my bed. Suddenly I felt I couldn’t
control the muscles on the right side of
my face. My legs felt weak.”
Her husband Subramaniam was also
at home. Aware that his wife has high
blood pressure, he took one look at her
and immediately called an ambulance.
Doctors at the SGH Emergency
department delivered shocking news.
“When I heard the word ‘stroke’, I
thought I was finished! I couldn’t move
my limbs. I couldn’t speak properly.”
Emergency brain surgery
A CT scan showed that Madam
Susila had bleeding in her brain.
Mr Subramaniam shares, “Her
was down my throat. I couldn’t walk.
I was depressed. I thought when am I
going to regain my old life?”
After three weeks in Intensive Care
and High Dependency wards, Madam
Susila was transferred to Ward 74,
a dedicated rehabilitation ward for
patients like her.
Stroke victim Susila Visvalingham and her
husband Subramaniam credit the team
of Rehabilitation Medicine specialists for
helping her regain independence.
blood pressure kept fluctuating despite
medication. Four days after admission,
doctors performed emergency surgery
on her brain. They inserted a tubing in
her brain to relieve the pressure.”
Madam Susila woke up to a bandaged
head and with numerous tubings
attached to her body. “My shoulder
length hair was gone. A feeding tube
Rehabilitation can make a difference
Life does not come to an end when
one is afflicted with a disabling illness
or had been involved in a traumatic
accident resulting in the loss or
decreased function of the limbs and
body.
Head and Senior Consultant of
the Singapore General Hospital’s
Department of Rehabilitation Medicine
Dr Peter Lim says that a comprehensive
rehabilitation programme can help
restore the individual’s function and
mobility to optimal levels.
Dr Lim, who is also Clinical Associate
Professor at Baylor College of Medicine
in Texas, USA, explains, “Rehabilitation
is often a part of the continuum of
patient care. It focuses on optimising
the affected individual’s function and
independence, such as being able to
transfer from bed to toilet, get around
and look after his own daily needs.
This will not only reduce the level of
assistance needed from a caregiver but
may render it unnecessary altogether.
Being able to function better improves
one’s quality of life and allows the
individual to do more of the things he
enjoys despite the disability.”
Independence important in
ageing population
Helping the affected person regain
independence will become increasingly
important in a rapidly ageing population
like Singapore, as he explains.
“As we become older, we are more
prone to age-related ailments and
chronic conditions like high blood
pressure, diabetes and joint problems
such as arthritis. These in turn, predispose
to strokes, amputations or problems
with moving about easily and free of
pain. When an elderly person becomes
disabled, he may need to be looked after
but the reality of the situation is that
providing this is increasingly difficult
nowadays with fewer large extended
families living together.”
People who need to be rehabilitated
may include those with neurological
conditions affecting their ability to speak,
swallow or walk. Common conditions
are stroke, brain or spinal cord injury,
Parkinson’s and motor neuron disease.
Individuals who had undergone surgeries
for spinal injuries, bone fractures, joint
replacements or had limbs amputated
also need rehabilitation to learn how
best to function and cope with their
conditions.
Holistic approach to patient care
Dr Lim notes that the term
‘Rehabilitation Medicine’ may be
unfamiliar to many as it is a relatively
recent and small medical specialty in
Singapore. It has been in SGH in its
present form only since 2000.
“Doctors in the Department of
Rehabilitation Medicine are specialist
physicians who are trained to work with
patients having immobility and disability.
We take care of general medical problems
during the inpatient rehabilitation period
and manage complications that arise
from immobility and chronic illnesses.
These include spasms, contractures, pain
related to muscle and nerve, pressure
sores, difficulties with urination and bowel
Intensive rehabilitation programme
Under the care Dr Peter Lim and
his team, Madam Susila started a
customised therapy programme.
“I used a walking frame up and down
the ward twice a day. I learnt how to
swallow water again and how to hold
a cup. Very simple tasks but I had to
learn how to do them again.”
Besides her husband and two grownup children, Madam Susila says the
greatest motivation came from her
doctors.
“Dr Lim and his team played a special
role in my recovery. They listened and
made me feel that I wasn’t alone. When
I became restless due to side effects of a
medication, they changed it. Without
their treatment and encouragement, I
wouldn’t have survived this, let alone
recovered so quickly.”
After two months, Madam Susila
went home in a wheelchair. She
continued with occupational and
physiotherapy sessions at a community
hospital near her home. At home, she
exercised with a walking frame to build
up her strength.
In early January, she returned to SGH
for a follow-up appointment. “I walked
into the consultation room without any
help. Dr Lim was so surprised! He kept
joking, ‘what happened to my patient?’ I
knew he was as happy as I am with my
progress. The last time Dr Lim saw me,
I still needed help to move around.”
Today, life is almost back to normal
for Madam Susila who has just become
a grandmother for the third time. With
a laugh, she shares, “My hair is taking a
long time to grow back! But seriously, I
try not to indulge in self-pity. I am just
glad that I am still around.”
“As he improves, an important
focus will be on preparing him and his
caregivers for a reintegration home
and into society. In the case of a
patient whose leg has been amputated,
we take care of the newly amputated
residual limb, teach him to look after
his wound as well as ways to optimise
his strength and stamina. If needed,
we train him to use walking aids such
as crutches. Later on, he may be
custom-prescribed and fitted with an
artificial limb to further increase his
independence.”
The entire rehabilitation
programme may take weeks or even
months depending on
the patient’s remaining
and recovering
function.
After
discharge,
the patient is referred
Customised programme
to day rehabilitation
for optimal outcome
centres in his
Dr Lim says patients are
community while
referred to the Rehabilitation
continue to be on
team after they had undergone
long-term follow-up
surgery or while receiving
at the SGH’s specialist
care for medical problems.
outpatient clinic
For example, a person who
for
Rehabilitation
has had a stroke. Once his
Medicine.
condition has stabilised, his Dr Peter Lim keeps a
watchful eye over an elderly
“Yes, you may not
rehabilitation process may patient learning to walk
become the next priority.
again using the Partial Body regain the use of your
affected body parts
“We then chart out a Weight Support System.
completely. But with
customised
goal-oriented
comprehensive programme to help rehabilitation therapy and training
the patient regain as much function as coupled with patience, determination
possible. This includes determining the and effort on your part, you can regain
best location for rehabilitation to take some use of your affected limbs or learn
how best to function and cope with a
place.”
The type of therapy and its intensity disability. Your loved ones will better
is modified according to his condition be able to help you at home,” says
Dr Lim.
and needs.
movement as well as coping, depression
and other psychological issues.”
The role of a rehabilitation physician
includes that of an ‘orchestra conductor’
as Dr Lim puts it.
“We lead and guide a multidisciplinary
team that include nurses, physiotherapists,
occupational therapists, speech therapists
and social workers providing a holistic
approach for the patient’s rehabilitation
needs. The team may include orthotists
and prosthetists for patients who require
an artificial limb or a device to support or
control part of the body. As physicians,
we are able to provide critical medical
input for the team, as well as liaise and
communicate easily with
other doctors and surgeons
involved in care of the
patient.”
8 \
\Mar/Apr 2008
Mar/Apr 2008 \
About waist and
weight matters
SGH’s newly–opened LIFE Centre offers comprehensive
programmes that prescribe and encourage lifestyle
changes leading to better and more holistic health
management
By Leong Wai Kit
\ 9
No food please
“I studied 24/7. I slept very little, waking up
every 20 minutes to study.”
For eight months, this was Ms Tricia Tan’s
punishing O-Levels revision regime. Soon,
she started skipping meals, focusing solely on
her books. It did not help that the then-16
year-old also started feeling self-conscious
about her figure.
Her study notes, she reveals, were
“scary”. “I could squeeze three sentences
within one line,” she says, referring to her
notes-laden foolscap paper.
While her foolscap sheets were always
filled, her stomach often went empty – Ms
Tan ate only “one spoonful of rice, half a cup
of vegetables, and a small portion of fish”
every mealtime.
“I kept feeding my younger brother
(seven years her junior) and when he said he was full, I’d get upset,” she says. Feeding
others, Ms Tan explained, was part of the illness.
It was only after her O Levels that her mother realised her weight loss was more
than just exam stress.
After seeing a psychiatrist, Ms Tan was immediately admitted to the SGH Eating
Disorder Treatment Programme.
Now, 18, Ms Tan is determined to get back on track. With help from doctors and
psychiatrists – and most importantly, support from friends and family – she is eating
normally again.
“My younger brother recently told me, ‘Jie Jie, I love you more now, because you’ve
stopped over-feeding me.”
SGH file photo
PEOPLE with bad habits that
compromise their health, can now get
help at a new one-stop medical facility
at the Singapore General Hospital.
The SGH Lifestyle Improvement
& Fitness Enhancement or LIFE
Centre is the first hospital-based centre
in Singapore that integrates multidisciplinary treatments for lifestyle
related health conditions.
With this Centre, patients can
now seek treatment under one roof
from medical professionals trained
to inculcate healthy lifestyle practices
and change harmful behavioural
patterns. These specialists include
doctors, dietitians, physiotherapists,
psychologists, occupational therapists
and medical social workers.
Although the Centre mainly focuses
on creating lifestyle modifications, and
treating eating disorders and obesity, it
also provides services such as counselling
and hypnotherapy. Its public education
efforts include organising regular public
lectures and workshops to provide
information on the various aspects of
healthy living.
The Centre runs a fully equipped
gym staffed by physiotherapists and
sports trainers. Here, patients can get
exercise programmes specially tailored
for them.
The Centre was opened in February
by Minister of Health, Mr Khaw
Boon Wan.
I used to pant going up stairs
The SGH LIFE Centre is a hospital-based centre for the
promotion of integrated and holistic care for patients.
Opens weekdays, 8 am to 6 pm. For more information, visit
www.sgh.com.sg or call 6326 6697.
Piling on the kilos because of work stress
If not for her mother, Ms Caroline Wooi would still be relying
on crash diets to manage her weight. Worse, her health might
deteriorate further.
“I began gaining weight two years ago because of work
stress,” Ms Wooi says. Although she has always been on the
plump side, the 25-year-old engineer piled on more weight
because of long work hours, a fast-food diet and lack of
exercise.
“I kept falling sick and felt tired all the time. My blood
pressure was on the high side. I couldn’t buy many clothes and
I was diffident and very reserved,” she says.
Luckily, Ms Wooi’s mother “forced” her to join the SGH
LIFE Centre’s Obesity Management Programme after learning
about it through a talk at her work place.
Today, Ms Wooi’s blood pressure is under control, and she feels more confident.
Three months after she joined the programme, Ms Wooi lost 19 kg, thanks to her thrice
weekly exercise regime, proper eating and support from her programme mates.
But Ms Wooi is not in a hurry to change her wardrobe just yet. “My mom is altering
my loose clothes to fit me. She says there’s no point buying any new ones now because
I’m going to lose more weight anyway,” she says laughingly.
Well, as they say, mothers know best.
Mr Chia Soon Keng – or Papa Chia
as he is affectionately addressed by
staff at the SGH LIFE Centre – is
one of the oldest regulars at the
Centre’s gym.
The jolly 62-year-old began
exercising five years ago under
the SGH physio-programme for
diabetics but joined the Centre’s
gym last September – as soon as
the hospital consolidated its various
treatments for lifestyle-related
medical conditions with the setting
up of the LIFE Centre.
“I’ve been diabetic for about 30
years, and I wanted to make sure
that my sugar level is under control,
and that I continue to stay active,”
explains Mr Chia.
Before his retirement at 54, Mr
Chia, who used to be a deputy general
manager in a finance company, could
not find time to exercise.
“Before I started exercising, I used
to pant after taking a flight of stairs,
and if I sat on the toilet bowl for too
long, I’d feel dizzy. Now, I can easily
chat and jog on the treadmill at the
same time,” he says.
Mr Chia visits the Centre’s gym
thrice a week, spending about two
hours exercising in the presence of
the Centre’s physiotherapists and
sports trainers.
Says Mr Chia: “The service is
excellent and everyone is so friendly
that I sometimes end up spending
three hours here.”
10 \
\Mar/Apr 2008
HealthBits
Fat or not?
Gentlemen, the next time your other half asks if she’s fat, you can give
her a straight answer without worry. Go to a body fat calculator website
http://www.csgnetwork.com/bodyfatcalc.html, input data and deliver
the verdict with confidence. Men require less fat as body cushion than
women, says the American Council on Exercise. While men need just 2%
to 5%, women need 10% to 13% to support childbearing and hormonal
functions. The American Council on Exercise has categorised ranges
of body fat percentage as follows.
Description
Women
Men
Essential fat
Athletes
Fit
Acceptable
Obese
12–15%
16–20%
21–24%
25–31%
32%+
2–5%
6–13%
14–17%
18–25%
25%+
Asian menace
Cancer still causes 12 per cent of all deaths globally and is the leading cause of
death in many Asian countries. This rate will double by 2030, says the Asian Food
Information Service (AFIC). The types of cancer that are showing the most marked
increase in Asian countries are those that have been linked to poor lifestyle choices.
AFIC’s tip to beat cancer:
•
•
•
•
•
•
Don’t smoke – Smoking has been linked to many types of cancer.
Balance energy in and energy out – Burn up energy by being active.
Eat more fruits and vegetables – Aim for a minimum of five servings a day.
Go for grains – Choose high-fibre breads and cereals.
Choose lean meats – Also limit red meat intake to 3-4 servings of lean red meat.
Limit alcohol intake – No more than two drinks a day for men and one drink
daily for women.
• Watch the salt – Aim to have no more than 6g of salt (2.4g of sodium) a day.
Uplifting news about Vitamin K
Application of Vitamin K creams can
do wonders in terms of preventing
eye bags, says the American Academy
of Dermatologists. The vitamin
helps rebuild connective tissues and
prevent sagging skin around the eye.
But don’t overdo it. Just a little is
enough. Vitamin K is a fat-soluble
vitamin and may end up being stored
in the liver and fatty tissues, causing
toxic buildup. A good dietary source
of Vitamin K is broccoli and spinach.
Also, try to relax your eyes. Soak a
towel in water, squeeze-dry and use
it on eyes for about 15 minutes as
often as you can. Alternatively, use
a slice of chilled cucumber or iced
teabags.
Pacific Healthcare Nursing Home(Bukit Merah)
Red alert
The next time you get a blood test result, take a look at your haemoglobin count.
Haemoglobin is a protein in red blood cells that carries oxygen to other parts of
the body such as the muscles which
use the oxygen to function. A drop in
the haemoglobin count can lead to
symptoms of anemia, reports Medline
Plus, a US health information centre.
Normal results can vary, but generally
should keep within these bands for a
healthy person:
Male: 13.8 to 17.2 gm/dL
Female: 12.1 to 15.1 gm/dL
(Note: gm/dL = grams per deciliter)
\ 11
Mar/Apr 2008 \
Helping patients live independently
Occupational therapists have played important roles in patient care for 60 years in Singapore but public
misconception still persists
By Hazel Yong and Karen Teng
editor@sgh.com.sg
SINGAPORE General Hospital’s
Principal Occupational Therapist Leila
Nasron shares, “Some people think we
are job placement officers! I have patients
asking ‘Can you find a job for me?’ Others
think we only deal with work-related
injuries. From our profession’s perspective,
the word ‘occupation’ spans three domains
- work, self-care and leisure. So our
work focuses on helping patients with
various disabilities be as functional and
independent as possible in their daily lives.
Simply put, we train you to do what you
used to do.”
Retraining patients in daily tasks
SGH has 23 occupational therapists.
The team offers rehabilitation services to
patients of all ages afflicted with physical,
cognitive or mental disabilities due to
conditions affecting the brain, spine
or limbs.
“For example, a patient who had a stroke
affecting one side of his body. He used to
put on his shirt with both hands. Now he
has to learn to do this with his functional
hand,” Leila explains.
not helping her husband regain use of his
writing hand, costing him his job. But the
hand was just one of his issues. He also
needed to think quickly, express himself
and walk better. We try our best to make
them understand what can be achieved
based on the patient’s age, remaining bodily
functions and level of family support.”
The role of an occupational therapist
differs from that of a physiotherapist,
whose focus is on the patient’s limb
strength and joint movement.
Occupational therapy starts with an
assessment of the patient’s ability to carry
out his daily activities, taking into account
his physical strength, memory retention
and problem-solving capabilities. Goals
are discussed before training commences.
One of the biggest challenges is
managing patients’ expectations.
“Sometimes the goals of a patient and
his family can be unrealistic. They want
everything to be back to normal. Once,
the wife of a stroke patient blamed me for
Celebrating 60 years of
occupational therapy services
SINGAPORE
General Hospital
celebrated the 60th anniversary of its
Occupational Therapy department and
the 3rd Occupational Therapists’ Day
on January 11 with various community
outreach activities.
This included a public forum where
a multi-disciplinary team of experts
including occupational therapists, a
doctor and a physiotherapist shared tips
on managing chronic conditions such
as hypertension, diabetes and stroke.
About 250 people attended the event
for free advice on foot care, exercises,
healthy lifestyle management and poststroke rehabilitation.
Thematic healthy lifestyle booths were
also set up at the Hospital to educate the
Occupational therapists Claire Lim
and Regina Phang sharing tips on joint
protection and home safety at the public
education booths set at the lobby of
Block 2.
Home visits to prepare for discharge
Caregivers of patients scheduled for
discharge get personalised training and
advice on home modification. Three times
a week, she goes to patients’ homes, as part
of SGH’s home therapy programme.
“I visit the patient’s home and advise
family members how to modify the
patient’s surroundings. For example,
installing handrails in the bathroom or
place items within easy reach of the patient.
Caregivers also learn how to help the
patient move around safely, for example,
from the wheelchair to the sitting toilet.”
Elderly patients who live alone get
special treatment. Leila shares, “Before
or upon his discharge, I take the patient
home. If he has a routine of going to
the coffeeshop, we have a dry run on the
route and I point out what he should look
out for.”
Occupational therapists like Leila work
with other healthcare professionals such as
doctors,physiotherapists,speech therapists
and medical social workers. They form
a multidisciplinary rehabilitation team
to provide a customised comprehensive
therapy programme.
It has been a challenging yet fulfilling
10 years for Leila who obtained a
Masters degree in Clinical Science of
Gerontology from Curtin University
two years ago on an SGH scholarship.
She graduated with a Diploma in
Occupational Therapy from Nanyang
Polytechnic in 1993 and earned
her degree from Sydney University
shortly after.
The 34-year-old says, “I decided
against teaching as I used to take my
tuition students’ failures too personally.
But I love working in a people-oriented
environment. Occupational Therapy fits
the bill and its wide scope means I won’t
be bored.”
DidYouKnow
3
Singapore celebrates
rd
Occupational Therapists’ Day this year
SGH has
4
21,348
23 occupational therapists
are males
patients seen at the SGH
Occupational Therapy department last year
SGH Director of Allied Health division
Ang Hui Gek and Head of Occupational
Therapy department Patrick Ker put the
finishing touches on a wall mural depicting
the daily activities of people with various
disabilities.
public on issues related to Work, SelfCare and Leisure.
The highlight of the celebrations was
the unveiling of a wall mural created by
SGH’s occupational therapists together
with former and current patients.
Engaging patients in art activities is a
form of occupational therapy.
The mural depicts individuals with
various disabilities participating in
ordinary activities of daily living,reflecting
the Occupational Therapy department’s
philosophy of helping them to overcome
their illness or disability.
The wall mural is on display at Arts
Expression, a dedicated arts space at
Block 2 Level 1 until the end of March.
3
Besides clinical and therapy services,
Occupational Therapists are now active in
areas – research, education and consultancy
Occupational Therapy services was started in
by an occupational therapist from England
1948
First local occupational therapist Joyce Lim joined SGH in
1956
Singapore’s first male occupational therapist
Ho Meng Jang joined SGH in
1975
12
Singapore’s pioneer batch of
locally trained
occupational therapists graduated in 1995
More than
300
occupational therapists now work in Singapore
12 \
\Mar/Apr 2008
Mar/Apr 2008 \
NewsInBrief
\ 13
By Karen Teng
Beep! You have an SMS from SGH
IF
you
have
an
appointment at the
Specialist Outpatient
Clinic of Singapore
General Hospital, do
not be surprised if you
receive a reminder via
SMS five days before
your consultation.
On the day of
appointment after you
have
registered, an
SMS alert will be sent
to inform you on the
number of patients
ahead of you.
This
means you do not have
to physically wait in the
clinic area and can even
enjoy a meal before your
turn.
But if you do not turn up for
your appointment, another SMS
will be sent advising you to obtain
a new date to see your specialist.
SGH says this is to ensure patients’
medical conditions are properly
managed.
The Hospital introduced the SMS
service in 2002 as part of its SOC
queue management system and later,
expanded the service for outpatient
appointments. Last year, over 750,000
SMSes were sent out.
Plans are underway to cover other
outpatient services. This includes
the collection of medicine from the
Pharmacy, making SGH one of the first
hospitals to offer SMS alerts.
Information at your fingertips
•
•
•
•
Reminders for outpatient appointments
Queue-turn alerts so that patients know when their turn is
Advise those who do not turn up to get new appointment dates
Patients scheduled for admissions receive reminders on punctuality,
registration and payment procedures
• If there is a mass casualty or disease outbreak, elective patients are
alerted on deferment of elective admissions
SingHealth employees can work beyond 62
Healthcare employees can expect to
continue working beyond the official
retirement age of 62 if they are good
work performers and healthy – that’s
a policy SingHealth has implemented
ahead of a law expected to be passed in
2012.
As Singapore’s largest public
healthcare cluster, SingHealth is among
the first in this sector to offer reemployment to staff, either in the same
or different job, when they turn 62.
SingHealth Group CEO Professor
Tan Ser Kiat says older employees have
experience and expertise that are not
easily replaced. “We value our mature
staff who bring valuable experience
and wisdom, and are inspiring role
models for younger staff.
We consciously adjust our
employment practices so
that we can optimise on the
experience of our mature
staff while at the same time
help them find fulfillment as
they continue working.”
It is this mindset that
motivates Goh Ah Hock
(photo), assistant manager for client
services at the Pathology Laboratory of
Singapore General Hospital. The 63year-old is known as a one-stop human
directory on laboratory services after
spending his entire working life here.
Mr Goh helped set up the Hospital’s
satellite and polyclinic laboratories.
Two SGH projects win regional awards
Singapore General Hospital’s efforts
to improve patient care services have
been recognised by the Asia Pacific
Society of Healthcare Quality. Two
work improvement projects came out
tops in the Best Poster Award category
during the Society’s 2nd international
conference held in Singapore in
January.
The Specialist Outpatient Clinic’s
project
‘Service
Express@SOC’
received the first prize for its innovative
hassle-free checkout after consultation.
Introduced a year ago, the scheme was
modelled after the payment system
implemented in hotels.
‘Service Express@SOC’ lets patients
pre-authorise
cashless
payment
options such as credit card or GIRO
so that they do not have to queue to
settle their SOC bill or obtain a new
appointment. Clinic staff will process
both and mail the relevant documents
to the patients. This means they can
leave the clinic immediately after
consultation.
The new payment scheme drew over
6,000 patients in five months. For those
who prefer the conventional payment
option, they are now able to complete
their billing and reappointment process
in an average 19 minutes. Previously,
the average waiting time was nearly 27
minutes.
The other award-winning project was
by the Department of Renal Medicine.
Work practices were improved to
successfully cut down by at least half
the rate of infection among patients
who have dialysis catheters.
He oversees a team of
104, mainly technical and
operational staff.
“I have
been grooming my successor
for the past five years and
was looking forward to my
retirement but the hospital
asked me to stay on. I feel
valued and am happy that I
can still contribute.”
SGH has retained the services of
101 employees above age 62, including
nurses, doctors and support staff.
The oldest is 76-year-old Lee Wai
Sum, a Principal Radiographer at the
Department of Diagnostic Radiology.
Last September,SingHealth launched
a Silver Connection movement to engage
its mature staff and help enhance their
employability. Its programmes include
preparation for financial independence
beyond retirement.
To reduce the physical work
demands for mature staff, SingHealth
institutions have introduced automation
and invested in equipment, which also
enhance patient safety and care.
For support staff such as Patient Care
and Health Care Assistants, usually in
their 40s and 50s, advanced skills and
developmental training programmes
have been introduced to equip them for
additional responsibilities. They have
been trained to do Electrocardiogram
tests for patients, previously done by
doctors and nurses.
SGH staff share festive cheer
Patient Relation
Assistants Syed
Abdullah Mohamad
Abbas (right) and
Norhayati Binte
Awang Ali bringing
festive cheer to a
patient.
As part of Singapore General Hospital’s community outreach programme
during the Lunar New Year, staff from its operations department presented
patients at the Bright Vision Hospital with 250 money banks specially
designed and sponsored by corporate gift design company Xenith Solutions to
commemorate the Year of the Golden Rat.
14 \
\Mar/Apr 2008
A patient’s point of view
Medical breakthroughs. Technological advancements. Qualified and
trained staff. Very impressive, but what do they all mean to patients? STEVE
HOGAN found out when he was hospitalised for a week in Ward 45, SGH.
IT WAS a few weeks before Christmas
2007 and I had been congratulating
myself that it was almost six weeks
since I had quit smoking, and besides
feeling better, it looked like I would be
able to stay off tobacco for good.
Many other folks had done it so
why not me?
So it was just a bit worrying, that
during this period, I experienced a new
uncomfortable back pain for a whole
day. By evening it was around the lungs,
and hurt every time I inhaled deeply. It
got worse that night and I was not able
to find a comfortable position so I could
fall asleep.
There was a vague worry that this
might be the beginnings of a heart
attack. With that in mind I thought
that being driven by my wife to the
Singapore General Hospital would be
the best course of action. Never mind
that it was 3 am in the morning!
As these things go, I began to feel
a lot better with each mile nearer the
hospital, and when we were finally at
the Accident and Emergency driveway,
I sprang out feeling that the whole thing
would be a waste of time for the A&E
staff, and I would look like a nervous
time-waster.
Nevertheless, someone took my
temperature immediately and I was
ushered into one of the curtained booths
by staff who were alert and calm. There
was no waiting at all.
A nurse interviewed me about the
signs and symptoms of my condition,
immediately ordered a trolley and
I
was placed on it. The thought that
I would walk out of there in a few
minutes time, with suitable medication
was extinguished. These people were
into serious medical attention, and I
looked like being a real case!
I was wheeled into a room that
seemed to have more high tech
diagnostic equipment in it than I could
make sense of.
I had received training as a male
nurse once, at Thomson Road Hospital
(later renamed Toa Payoh Hospital)
way back in 1970, and despite moving
on to other things, have always looked
back with fondness on those days.
Hard to imagine that back then urine
tests were done by nurses using test
tubes and bunsen burners at the far
end of the wards! And reusable needles
had to be boiled in special stainless
steel containers!
But here I was, a patient, and it was
the next century! When they needed
to take an x-ray, equipment unfolded
from the wall. The radiographer
appeared, smiled and told me she was
taking a ray, and click, it was done. No
waiting in corridors for my turn to
come.
Then there were these sensors. Round
shaped electrode looking things that,
like plasters, stuck on to the chest and
relayed vital signs to monitors around
the room.
Doctors later informed me that a
blood clot had been detected and I was
to be admitted for further diagnostic
tests. All this was done in a cheerful,
reassuring way that put me at ease,
comfortable in the thought that
whatever it was I was suffering from
was under control. It was, to say the
least, therapeutically impressive!
The daily routine at SGH starts
at daylight with nurses checking the
patients’ conditions and the beginning
of various treatments like injections,
pills etc etc. But what I could not work
out totally, were the different uniforms
of the nursing and ancilliary staff. Some
green. Some white with blue piping.
There seemed to be different people
around all the time. Women who cleaned
the windows and smiled easily at us.
Porters who wheeled in equipment and
offered words of reassurance to patients.
Fellows who just appeared, looked
around and left mysteriously. And of
course, the visitors, who came in shifts
like the staff, and then drifted around
speaking to more interesting patients
than the one they came to see.
Perhaps it might have had to do
with the long periods of sleep that were
a side effect of the medication I was on.
But it seemed that every time I awoke a
new shift of genial people was there.
After a week of this, I was discharged,
and left feeling grateful that it had all
been so cheerful, efficient and that my
condition, now under control, was not
that serious after all.
And it was still a few days to
Christmas!
Steve Hogan is Singaporean, and
teaches English.
\ 15
Mar/Apr 2008 \
Too many pills can do you harm
Taking various medications at the same time can put your health at risk
“The term ‘polypharmacy’refers to the
use of various types of medication at the
same time including over-the-counter
products and self-initiated medications.
Problems related to polypharmacy are
mainly preventable.”
Are you at risk?
•
•
•
•
Above age 60
Non-compliance: If patients have complex medication regime, they may use the
medicine improperly or skip doses
Multiple medicine: The more drugs prescribed, the higher the chances of harmful
clashes between various drugs
Multiple doctors: Elderly people with several ailments may see various doctors and
specialists in different healthcare institutions
Prevent problems related to polypharmacy
SGH file photo
SIXTY-five-year-old M. Chan (not
her real name) thought she had all her
health problems covered - nine types
of medicine a day for various illnesses.
When she developed infection, her
doctor prescribed antibiotics. But the
more pills she popped, the more tired
she felt.
A referral to the Medicine
Management Service provided by
pharmacists at Singapore General
Hospital, solved her problem. It turned
out that the antibiotics had reacted with
Madam Chan’s anti-seizure medicine.
This combination affected the other
medicine, resulting in her drowsiness
and lethargy.
After consulting her doctor, Madam
Chan stopped taking the antibiotics.
She felt better in two days.
Elderly sick are most at risk
Senior Pharmacist Chang Wei Terk
points out that such problems could be
minimised if patients like Madam Chan
understands the risks of polypharmacy.
•
•
•
•
•
•
Avoid doctor-hopping. If you are seeing several doctors for different conditions,
try to have a primary physician as a coordinator to check that the treatment
prescribed is appropriate
Know your medication history and volunteer information on your medical
conditions, drug allergies and list of health supplements
Be proactive and ask questions about your medicine including the use and side effects
Seek advice from your pharmacist before self-medicating, including the use
of supplements as even plant-based health products can clash with ‘Western’
medicine
Do not self-medicate. If you find your current medication ineffective, see your
doctor again
If affordability is an issue, do not reduce or stop taking the medicine. Ask your
doctor or pharmacist for an alternative
For a referral to the SGH Medicine Management Service, call 6321 4110.
Congratulations
Outram Now
for your one year
anniversary
With the objective of positive patient outcomes,
we’re a global healthcare products leader focused
on helping medical professionals perform their
lifesaving work.
Tyco Healthcare Pte. Ltd
No. 26, Ang Mo Kio Industrial Park 2, #04-01, Singapore 569507
Tel: (65) 6482 0100 Fax: (65) 6482 0300 www.covidien.com
COVIDIEN, COVIDIEN with logo, “positive results for life“ and ™ marked brands are trademarks of Covidien AG or its affiliate.
© 2007 Covidien AG or its affiliate. All rigths reserved. S-P-Positive/GB
Outram Now Covidien02.indd 1
2/22/08 2:49:58 PM
16 \
\Mar/Apr 2008
Car park
makes way
for new SGH
Pathology
Building
Story and photos by Karen Teng
editor@sgh.com.sg
40
LOTS
MOTORISTS to Outram Campus might have experienced difficulties in parking
their vehicles following the closure of a public car park opposite the Singapore
National Eye Centre.
Singapore General Hospital’s Chief Operating Officer Foo Hee Jug explains that
the loss of public parking lots in Car Park H was unavoidable. He acknowledges
that many patients might have faced difficulties in finding parking space during
their recent visits.
“We had to close the car park to make way for the construction of the new
SGH Pathology Building. When completed in 2010, the new 13-storey building
will provide much needed capacity to cope with the rising demand for laboratory
investigations that will benefit patient care. We know that not getting a parking lot
have caused some of you to be late for your medical appointments. We are sorry
for the inconveniences caused.”
To address the lack of carpark space in Outram Campus, the Hospital has
implemented several measures.
Easing car park woes
Stack Parking
Free value-added service available at
• Car Park C near Block 7
• Car Park E near Block 3
SGH S
CAR P TAFF
ARK
* Motorists pay only normal parking charges
* Deployment of traffic attendants to re-direct
traffic to other car parks during peak hours
Alternative car parks in
Outram Campus
• Car Park A at Health Promotion Board
Building
• URA car park along Hospital Drive
Creating more parking lots
• Relocating surface diesel tanks to add 30
more lots at Car Park C
• Developing a multi-storey car park
Suggest how we can do better
To share your feedback and suggestions for improvement,
• Email: sgh-feedback@sgh.com.sg
• Fill a feedback form available at all SGH reception counters
N
How you can help
• Whenever possible, use public transport
(bus, MRT or taxi)
• Shuttle bus service is provided free from Outram
MRT station to SGH and other specialty centres in
Outram Campus
- from East West line, board shuttle bus along Outram Road
- from North West Line, board shuttle bus along Eu Tong Seng Street
• If you can, walk to the main Hospital building from the bus stop or MRT station
- 7-minutes’ walk from Outram Road
- 4-minutes’ walk from Eu Tong Sen Street
Getting around
Mar/Apr 2008 \
71
SH
UT
T
BU LE S
S S ERV
TO IC
P
E
SG
HP
A
DUKE-NUS
GRADUATE
MEDICAL
SCHOOL
( U BU THO
nd
er ILDI LO
Co
N GY
nst G
ruc
tio
n)
LOTS
BO
B L W YE
OC R
K
( Under Construction)
38
LOTS
256
HEALTH PROMOTION BOARD
LOTS
329
LOTS
E
IC
RV
SE OP
E T
TL S S
UT BU
SH
71
LOTS
11 12
CK K
O OC
L
B BL
&
178
LOTS
LEGEND
100
LOTS
HEALTH PROMOTION BOARD,
SINGHEALTH POLYCLINICS - IOH
HEALTH SCIENCES AUTHORITY
MORTUARY, BLOCK 9
NATIONAL CANCER CENTRE
NATIONAL DENTAL CENTRE
NATIONAL HEART CENTRE
SINGAPORE GENERAL HOSPITAL
SINGAPORE NATIONAL EYE CENTRE
DUKE-NUS GRADUATE MEDICAL SCHOOL
SGH PATHOLOGY BUILDING
BOWYER BLOCK
CAR PARKS
Outram Campus
SHUTTLE SERVICE BUS STOP
SHELTERED WALKWAY
\ 17
18 \
\Mar/Apr 2008
AtHome
Give your back a break
A common cause of lower back pain is poor standing posture. You can minimise your risks by learning to
stand tall. Stretching your spine regularly will also enhance the flexibility and fitness of your back.
Watch your back muscles
When you stand for prolonged periods, you
tend to allow your back muscles to relax due
to fatigue. In this position, your back tends to
slump forward and the small hollow in your
back gets bigger. Over time, your back will be
strained resulting in pain.
Stand tall
To protect your back, learn the correct posture
of standing and walking. Raise yourself up to
your full height with your chest up and stomach
muscles pulled in.
This helps to align your body and relieve the
strain on your lower back.
When you have to stand for prolonged periods
at the same spot, put one foot on a low step or
stool. This helps to decrease the small hollow in
your back. Remember to switch from one foot
to another to prevent backstrain.
Rise and bend backwards
If you have to sit in the same position or stand
bending forward for long periods, take breaks at
regular intervals. Stretch your back to prevent
any stiffness or pain from developing.
Before you feel any pain, stand up straight
and bend backwards three to five times. Once
you have finished stretching, walk about for a
few minutes before resuming what you were
doing.
When lifting objects …
Picking up heavy objects with an incorrect posture can be harmful to your back.
A common mistake is to bend at the lower back while keeping your knees straight.
As the entire weight of the load is lifted by your back, this can strain your back
muscles.
The correct technique is to use your hip and thigh muscles when lifting a heavy
object.
3
Get a good grip
and hold the
object as close
to you as possible.
5
4
1
Stand close to the object with
your feet apart. Place one foot
slightly ahead of the other.
2
Bend both knees and squat in
front of the object. Keep your
lower back straight.
Stand up by
straightening
your hips and
knees. Remember to
keep your lower back
straight.
When you want to lift a heavy
object, stand tall and bend
backwards five or six times
before you begin. If you are going to
do a lot of lifting, take regular breaks in
between and stretch your back. When
you have finished lifting, stretch again.
Tips provided by the
Physiotherapy Department.
SGH
Mar/Apr 2008 \
Latest spine
surgery system
improves outcome
By Elaine Young
BACK problems are on
the increase and we only
have ourselves to blame
because we spend hours sitting in
front of computers, have poor posture,
and indulge in improper exercise. Most
developed countries report that 80 per
cent of all adults will have an attack of
neck or back pain in their lives.
Five per cent of people will go on
to need surgery to correct their back
problems, which makes quite a sizeable
group, and the most susceptible are the
20-somethings to the 50-somethings.
The numbers are certainly rising in
the orthopaedic surgery department
at Singapore General Hospital. It has
seen a 50 per cent rise in spine surgeries
in the past five years and now perform
1,000 spine surgeries per year. It’s a
figure that will keep on increasing, even
with the number
of sufferers in
denial.
“People
in
Singapore usually
go to their GPs,
osteopaths,
chiropractors,
herba l ists and
sinsehs for
months or years before they come to a
specialist,” says Associate Professor Tan
Seang Beng (photo), who is director of
the hospital’s Spine Service.
When to see a spine surgeon
He says that there are “red flags” to
suggest a back problem is not going to
go away with rest and painkillers, and
that it is time to see a spine surgeon.
The red flags, he explains, are the
presence of neurological symptoms in
the form of pain radiating to the limbs,
numbness, pins and needs, weakness or a
lack of coordination for a few weeks or
more.
“Surgery is required when the nerves
are pinched because leaving them
unattended would lead to problems such
as nerve injury, persistent pain, weakness
and may cause bladder and bowel
dysfunction,” says Professor Tan.
Essentially there are two aims in spinal
surgery. One is to free or decompress
the spinal nerves which are pinched;
the other is to repair the structure of
the spine if it lacks support. Repair is
normally with spinal fusion using screws
and rods to maintain stability.
Traditional and minimally invasive
operations share the same objective,
but the patient benefits with minimally
invasive techniques in having a shorter
hospital stay, smaller scars, shorter
recovery periods and less post-operative
pain.
Better surgical outcome with specially
designed tools
“Medtronic is the largest company
in the world supplying us with highly
innovative products covering the whole
spectrum of spine operations,” says
Prof Tan. The company leads the way
in minimally invasive surgery and,
specifically, in spinal fusion with its CD
Horizon Sextant system.
Traditionally, implants are applied
to the spine through a large opening in
the back. Large bands of back muscles
are pulled back for visualization of the
spine and easy access. This can cause the
muscles to be permanently scarred and
damaged, and painful immediately after
the surgery.
Dr Yue Wai Mun, Spine Service
Consultant of Orthopaedic Surgery,
explains that the Sextant system uses
rods, screws and specially designed tools
in a keyhole surgery.
Shorter downtime for patients
Tubes create tunnels through the
muscle to be used for decompressing
the nerves if necessary. Smaller tubes
are then used to approach the screw
placement area, causing minimal damage
to the tissues. The screws and rods to
stabilise the spine are passed through
20-cent sized opening, leaving just four
or six small incision holes at the end of
the surgery.
“The superiority of the system comes
in the early phases of recovery. With
open surgery, it can take three to four
days just to get out of bed. Much longer
time is required before the patient is
able to return to full activities. With the
minimally invasive surgery, the patient
can be up the day after the operation,”
says Dr Yue.
After three years of performing the
Sextant procedure, Dr Yue doesn’t even
mention the open-surgery option to
patients any more. He says: “For suitable
patients, this, to me, is the standard
operation for spinal fusion.”
\ 19
Back to playing golf with rods and
screws in her spine
Corporate trainer Karen Lim is a golf addict. She often plays a round of 18
holes in the morning and another in the afternoon, but it wasn’t an overenthusiastic back swing on the golf course that resulted in spine surgery, it
was a fall at work.
The 39-year-old recalls that afternoon in mid-2006: “I was wearing high
heels and leaning against a foldable table. It collapsed and I fell at an awkward
angle. I couldn’t get up and was stretchered out to the ambulance.”
Madam Lim was hospitalised in Singapore General Hospital for a few days.
She discovered that her lumbar 4 and 5 discs had slipped.
She didn’t want to rush into an operation because she had a few relatives
who had gone through traditional open-backed surgery and it took them
months to get back on their feet again.
She tried acupuncture, physiotherapy, Traditional Chinese Medicine and a
lot of rest, but her back problem was having an impact on her life, with
painkillers the only respite.
“I couldn’t sleep in certain positions, I couldn’t carry
anything, I couldn’t stand too long or sit too long and life
wasn’t going anywhere,” she says.
She and her husband also wanted to start a family. She
returned to SGH and was seen by Spine Service Consultant
DrYue Wai Mun (photo). He advised her to have the minimally
invasive Medtronic Sextant system for spinal stabilisation.
“I wasn’t at all worried about the key-hole surgery because
I had faith in my doctor,” says Madam Lim.
So, on the October 10, 2006, she spent two hours in the operating theatre
as Dr Yue used the Sextant rods and screws to stabilise her spine. She was
left with six small scars that “are not that bad” to look at.
Madam Lim recalls seeing other patients in her B2 ward that had been
through the open-back surgery and took longer to get out of bed. She was
out of bed after a day in the ward.
She says, “I started walking very slowly, but it didn’t feel bad at all. I could
see others trying to walk and it was very painful for them.”
Although she was given a month off work, she said she could have gone
back a lot sooner, but she used the time to go swimming and see her
physiotherapist three times a week.
The most important thing for Madam Lim was getting back to her golf, so
she also took long walks, carried on swimming and feels her recovery went
very well, very quickly because she did everything that was asked of her postsurgery. She has even limited her high-heel wear.
Now, almost 18 months after her operation, she says she is “back to
normal” and can now start trying for a family, and playing even more golf.
SGH and Medtronic partnership benefits patients
Medtronic is the world’s leading medical technology company. Singapore
General Hospital has used Medtronic spinal and cranial surgery products to
mark many milestones in recent years, and the partnership translates into
faster recovery times and shorter hospital stays for patients.
2004 SGH performs the first minimally invasive spine decompression
(METRx) and the first spine instrumentation (Sextant) in Southeast Asia.
2005 SGH performs the first cervical disc replacement (Prestige LP) in
Asia Pacific.
2006 SGH organises the first disc replacement course using Medtronic
equipment in Asia Pacific.
2007 SGH is the first hospital in Southeast Asia to use demineralised bone
matrix (Osteofil) as a bone graft replacement.
SGH is the first hospital in Asia - and13th hospital in the world - to acquire
Medronic’s 3D Fluroscopy system (O-arm). The O-arm system provides
the high-resolution imaging needed for more accurate placement of spinal
implants and spinal surgery, especially when linked to the Stealth Spinal
Navigation System.
SGH performs the first minimally invasive spine
instrumentation (Sextant) with Stealth Navigation
and 3D Fluroscopy outside of the United States.
2008 To date, SGH has performed 500 minimally
invasive decompressions (METRx) and over 100
spine instrumentations (Sextant). These numbers
represent the highest figures in either procedure
in Southeast Asia.
20 \
\Mar/Apr 2008
Diets demystified
and mid-afternoon snack is a must
even if you are not hungry. For phase
two, the rate of weight loss slows
down as banned foods are gradually
reintroduced into the diet and eaten in
moderation. Phase three is for weight
maintenance purposes after attaining
target weight. The cycle repeats itself
if weight returns.
By Hazel Yong
Ate one too many lunar
new year goodies?
Before you try a fad diet,
we get one of SGH’s
dietitians, Ms Kanita
Kunaratnam, to shed
some weight – oops, light
– on some of them.
Will the cut in carbohydrates and
fruits for phase one affect health?
Generally, phase one aims to
restrict carbohydrates while increasing
protein intake. This sends the body
into a state of “ketosis”, where fats
are use as an energy source instead
of sugars. The low carbohydrate diet
rapidly depletes glycogen stores in
the muscles and liver. This facilitates
water loss, which accounts for the
initial rapid weight loss seen.
Fruits are good sources of fibre,
protective anti-oxidants and phytochemicals such as carotenoids and
flavanoids. These naturally-occurring
compounds have been shown to
protect against cancer and boost
the immunity. So while you may
substitute fruits with vitamin pills
or fibre drinks or even eat more
vegetables, these won’t give you the
South Beach Diet
What: Created by cardiologist Dr
Arthur Agatson, this diet comes in
three phases. Carbohydrates and fruits
are absent from the first phase. Instead,
dieters eat controlled portions of lean
meats, shellfish and low-glycaemic
index (GI) vegetables like broccoli and
celery for two weeks. A mid-morning
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same nutritional benefits as fruits.
Phase two focuses on low-glycaemic
index food. What are they and are they
healthy?
Low GI foods are those where
carbohydrates break down slowly,
releasing glucose into the bloodstream
gradually. As low GI foods are more
filling, it reduces one’s appetite and
therefore lowers insulin levels making
“fat-burning” easier and fat storage less
likely. Low GI diets have been associated
with a reduced risk of developing diabetes
and heart disease. However, some low GI
foods like chocolates, pizza and potato
chips are high in saturated fats, while
some high-GI foods may still be good
choices because they are nutritious and
relatively low in calories (e.g. watermelon
and pumpkin).It’s more important to
look at the nutrient content of a food
item, rather than just the GI.
The South Beach Diet advocates three
snacks daily, even when one is not
hungry. Is this good for the body?
Having three small meals and three
snacks a day prevents hunger pangs,
binges, provides consistent energy and
is one of the most effective ways to
maintain metabolism. However, it is
important that the snacks are healthy
and pre-portioned to prevent overeating,
and that meal sizes are reduced to
compensate for the additional calories.
Advantages
The diet is fairly balanced after the
initial strict phase.
It does not rely on high fat
intake,especially saturated fats,
unlike the Atkins diet.
It encourages regular meals and
snacks.
Disadvantages
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Initial phase involves high
amounts of protein foods and
omitting carbohydrates. High animal
protein intakes have been linked to
higher risks of coronary heart
disease, cancer and renal disease.
Much of the rapid weight loss in
phase one is due to water loss and
is unsustainable.
Can be expensive and time
consuming.
Low diet compliance, due to
numerous phases and restrictive
food list.
MCR No
Atkins Diet
What: Created by cardiologist Dr Robert
Atkins. He theorises that individuals
can lose more weight eating a highfat diet than with an equivalent energy
intake from a high carbohydrate diet.
Atkins advocates less than 20 grams of
carbohydrate intake daily to maintain a
state of ketosis, where the body burns its
fat for fuel. As much as 50 per cent of
daily calorie intake is contributed to fats,
unlike the national recommendation of
less than 30 per cent total daily calories.
How safe is it for a person to be in
a constant state of ketosis due to
restricted carbohydrate intake?
Ketosis is a metabolic process where
fat is burned as a source of energy when
glucose is unavailable. Glucose is regarded
as the preferred energy source for all body
cells with ketosis as a crisis reaction linked
with chronic starvation. In the long
term, ketosis may result in malnutrition.
Ketosis also puts a burden on the kidneys
with the formation of ketones.
A low carbohydrate diet doesn’t mean
low cholesterol or low fat. Is this good?
Low carbohydrate diets may be
accompanied with rapid weight loss due
to greater water loss. The rapid results
may contribute to the popularity of such
diets. But while this diet may promote
short-term weight loss, the high fat
content and potential hazards for heart
disease override the benefits. Every one
per cent change in blood cholesterol
levels is estimated to increase the risk of
coronary heart disease (CHD) by two to
three percent. According to a study by
Anderson et al, (1), long term use of the
Atkins diet could possibly increase one’s
blood cholesterol level by about 25 per
cent and CHD risk by about 50 per cent.
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\ 21
Mar/Apr 2008 \
Who is unsuitable for the Atkins diet?
People
with
heart
disease,
hypertension and diabetes. Those
with increased risks for cardiac or
kidney disease may be especially
vulnerable to the detrimental effects
of high fat and animal protein
intake.
Advantages
Promotes initial rapid weight loss.
Disadvantages
Restrictive food list, with a heavy
reliance of proteins from meat, fish
and dairy products.
Condones high consumption of
saturated fats and increases risk
of coronary heart disease. Unlike
the South Beach diet which still
promotes good fats over bad
fats, the Atkins diet generally has
no restrictions on fats and can be
unsafe in the long term.
Possible detrimental effects of high
protein intakes on vital organs such
as the kidneys.
Ornish Diet
What: Plant-based vegetarian diet
that is low in fat and high in complex
carbohydrates and fibre. Created by
cardiologist Dr Dean Ornish, he
suggests that individuals consume
less than 10 per cent of their energy
intake from fat as it is the culprit
for weight gain. It excludes dietary
cholesterol and saturated fat, animal
products (except egg whites and
non-fat dairy products), nuts, seeds,
avocados, chocolate, olive and
coconuts. Oils are eliminated except
for some canola oil for cooking, and oil
that supplies omega-3 essential fatty
acids. The Ornish diet also prohibits
caffeine but allows a moderate intake
of alcohol, sugar and salt. There is no
restriction on calorie intake, only on
food types.
Is meat essential to a person’s diet?
Meat isn’t essential. A wellplanned vegetarian diet has been
consistently found to provide the
full range of protein, essential fatty
acids, vitamins, minerals and fibre
necessary for optimal nutrition. Since
vegetarian diets are generally high in
fibre, low in cholesterol and saturated
fats, they may actually be healthier
than most meat-based diets, leading
to a lower risk of obesity, heart
disease, high blood pressure and
diabetes. Lacto-vegetarians (those
who consume dairy foods) and lactoovo vegetarians (those who take
dairy food and eggs) can get a lot of
essential nutrients from dairy and
milk products. Vegans (those who
exclude all foods of animal origin,
including eggs and dairy), however,
may lack several essential nutrients
in their diet like vitamin B12, iron,
zinc and calcium as they eat only
food of plant origin. They need foods
fortified with these nutrients.
Fat consumption is restricted to less
than 10 per cent of the daily calorie
intake. This is much lower than the
national recommendation of 30 per
cent.
Fats play a vital role in maintaining
healthy skin and hair, insulating body
organs against shock, maintaining
body temperature and promoting
healthy cell function. They also serve
as energy stores for the body. Fats are
also an essential source of fatty acids
and help our body absorb fat-soluble
vitamins A, D, E and K. The current
recommendation of less than 30 per
cent fat from daily caloric intake is
intended to meet basic essential fatty
acid (EFA) requirements which range
from three to five per cent of caloric
intake. It also includes an allowance
of 10 per cent of total calories from
saturated fat, 10 per cent from
monounsaturated fats and 10 per
cent from polyunsaturated fats.
Who are unsuitable for the Ornish
diet?
Elderly, pregnant women and
people with eating disorders should
not attempt a very low fat diet. Those
with insulin-dependent diabetes
mellitus, elevated triglyceride levels
and fat mal-absorption are also
unsuitable.
Meal replacement diets
What: Meal replacement products help
people control calorie intake without
having to count the calories themselves.
Meal replacement plans can range from
between 800 and 1,600 calories a day. It
can be in the form of a reduced calorie
food regimen, prepackaged foods and
snacks that are vitamin/mineral fortified,
or vitamin/mineral fortified liquid
meals.
Is it alright to replace one or two daily
meals with a meal replacements?
This low calorie diet strategy is
usually designed to lower calorie
intake by 500 to 1,000 calories a day.
While most programmes for weight
reduction demonstrate promising shortterm weight loss results, long-term
observations of one year or greater show
high rates of weight relapse probably due
to compliance issues.
Who is suitable for this diet?
It is more suitable for individuals who
are unsuccessful with first line therapies
of a healthy diet and regular physical
activity. Also, very low calorie diets
(VLCDs) of less than 800 calories a
day are typically prescribed for morbidly
obese individuals or those where rapid
weight loss is a medical necessity. Studies
indicate that VLCDs are safe when
used as recommended by health-care
providers.
Advantages
Very low on fat and high on complex
carbohydrates.
Generally follows healthy principles
of eating high fibre and low fat foods,
and adequate exercise to help burn
excess calories.
According to Anderson et al (1), one
could postulate that long-term
use of the Ornish diet is likely
to decrease serum cholesterol
concentrations by about 32 per cent
and hence decrease risk of coronary
heart disease by over 60 per cent.
Convenient, taking away the need
to count calories.
Strictly portion controlled,
designed to be filling and reduce
hunger pangs.
Unlike the South Beach, Atkins
and Ornish diets which are typically
classified as “fad” diets as they are
more
extreme,
the
meal
replacement diet is more practical.
It has been shown to be part of
a successful therapeutic approach
to weight loss, especially when
used in combination with lifestyle
and diet education, as well as
professional support.
Disadvantages
Disadvantages
Advantages
Restrictive due to extremely low fat
content. Difficult to adhere to unless
one’s a vegetarian.
Long term sustained weight loss is
unlikely as calorie intake is not
restricted. This makes it easy for a
person on this diet to consume even
more calories than needed.
Restrictive and poor compliance.
Limited variety available when
consuming whole foods.
Limited flavours and those who
are lactose-intolerant may find
that some meal replacement
sachets or shakes are milk-based.
Cost.
So what works?
Fad diets and quick methods like
slimming pills or herbal teas usually
have side effects and cannot be
sustained in the long term. The key to
successful weight management is to
eat fewer calories than you need and
increase physical activity. Keeping
track of your fat intake is a good way
to lose weight because fat provides
twice the calories per gram than
carbohydrates or protein. Set sensible
goals and try to exercise three to five
times a week, for at least an hour
each time. The recommended rate of
weight loss is between 0.5 and one
kilogramme a week.
Aim for a healthy Body Mass
Index rating (BMI) between 18.5 and
22.9. For someone with a BMI of over
23, losing five to 15 per cent of body
weight may help reduce the risk of
obesity-related diseases.
Sample diet menu
Weight (kg)
BMI =
Height(m) X Height(m)
Classification:Health Risk
BMI:
Risk of Nutritional Deficiencies
<18.5
Low Risk
18.5 - 22.9
Moderate Risk
23 – 27.4
High Risk
>27.5
(1,500 calorie diet)
Based on a 30 yr old female, with moderate
activity levels.
Ht: 1.6m, Wt: 75kg, BMI: 29.3
Aim: to lose ½ kg a week
Requirements : 2000kcal/day
(-500kcal for weight loss)
Breakfast:
2 slices of wholemeal bread with 1
teaspoon margarine
1 cup low-fat milk
Lunch:
1 bowl of slice fish (90gm) noodle
soup
1 small apple
1 glass Diet Coke
Afternoon tea:
3 plain soda crackers
1 cup of tea with low-fat milk + 1 tsp
sugar
Dinner:
¾ bowl of plain rice
90 gm roasted chicken (lean, without
skin) (with 2 tsp oil)
¾ mug stir-fried mixed vegetables
(with 1 tsp oil)
1 small pear
1 glass water
Reference:
1) Anderson, J., Konz, E., and Jenkins, D.,
Health Advantages and Disadvantages of
Weight- Reducing Diets: A Computer Analysis
and Critical Review. Journal of American
Clinical Nutrition, 19: 578-590, 2000.
22 \
\Mar/Apr 2008
CelebInPerson
From sickly child to movie star
He is well built and healthy; and plays the role of a famous kungfu master convincingly in The Legend of Huo
Yuan Jia. But Hong Kong superstar Ekin Cheng reveals he was quite the sickly child.
By Leong Wai Kit
PART of Ekin’s Chinese name means
good health. But growing up, Ekin
Cheng had little of that.
Like the character he played in The
Legend of Huo Yuan Jia, Cheng too,
suffered from health problems as a child.
While the legendary hero’s problem was
asthma, it was arthritis for the young
Cheng.
Arthritis, the inflammation of joints,
usually affects the elderly. Which was
why Cheng’s family was so concerned,
they took him to, “both traditional
Chinese and Western doctors because
my joints would hurt if the weather
was too cold,” the singer-actor said in
Cantonese accented Mandarin. “I was
told by the Chinese doctors that my ‘qi’
(or blood flow) was not smooth.”
Cheng added he used to have sensitive
skin as a child too. That might be why the
actor stands by his no makeup principle
during shoots, as far as possible.
Thankfully, both Cheng’s arthritis and
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skin condition went away as he grew
older. His worst health problem as
an adult was a back injury, sustained
during sports some time ago.
Fighting fit
The heartthrob – best known for
his gangster role in The Young and
Dangerous movie series (released
between 1996 and 1998) – was in
Singapore late last year to promote his
latest offering: The Legend of Huo Yuan
Jia, which is now available islandwide. Cheng plays the legendary
kungfu master, who was one of the
most famous fighters in China at the
turn of the 20th Century.
To prepare for the role, Cheng had
to sacrifice his famous manly mane – a
style he has been sporting since the
early 90s. “I was hesitant at first, but
after I shaved my hair off, I thought I
looked quite okay,” he said.
The 42-episode period drama was
filmed during winter in Beijing.
“Because of my bald head, I
got cold easily during filming,
sometimes, to a point where I couldn’t
concentrate.” To beat the cold, Cheng,
along with the crew and real-life buddy
Jordan Chan – who plays his disciple
in the series – would huddle to eat
hotpot almost every night.
The next challenge was of course,
for Cheng to hone his martial
arts moves. “Huo Yuan Jia’s main
weapons were his bare hands and
legs. There was only one scene where
he wielded the rod,” recalled Cheng.
“So I had to put in extra effort to
ensure my moves were convincing
during fight scenes because martial
arts is not one of my strengths.”
Fortunately, the 41-year-old is still
in shape, and has several swordsmen
characters under his belt, such as
the suave Whispering Wind in The
Storm Riders (1998) and Hero Hua in
A Man Called Hero (1999).
“Keeping fit is very important to
me. Basically, I try to make sure that
I do some exercise every day, regardless
of the duration. On certain days,
it’s skipping. On others, it’s simple
stretching exercises like head rotation or
shoulder stretching.
“Staying
active
is
especially
important for city dwellers like me. If
we’re inconsistent with exercise, we may
injure or over exert ourselves when we
do them.”
Food lover
Another of Cheng’s reasons to keep in
shape is his love for food.
“I travel a lot, and when you go to
different places, you’d naturally want to
try all their famous food,” Cheng said.
In Singapore for instance, Cheng never
fails to eat a bowl – sometimes even two
– of his favourite spicy noodles, laksa.
Among his other local favourites are
Hainanese chicken rice, “you tiao” (deep
fried fritters) and pandan cakes.
In Thailand, Bangkok, where he stayed
for four weeks in 2006 to film Ultraman
for a Thai TV series, Cheng had his fair
share of yummy Thai fare. But what he
loved most in the Land of Smiles was
really hamburgers, sold in one of the
delis at Siam Ocean World.
Sounds like Cheng really loves
to eat. “If you love food and still
want to be in shape, pace your eating
and exercise regularly,” he advises. “Eat
less in quantity so you can eat more in
variety.”
Mar/Apr 2008 \
\ 23
HospitalBills101
Why was fee levied for a medical report?
I recently paid about $80 for a
medical report from SGH to support
my application for insurance claims.
This medical report had only a twopage summary with information on
my condition and laboratory results.
Why must I pay for a medical report
which consists mainly results of
tests I paid for previously? Also, is it
possible for SGH to give the patient
a copy of all his blood and X-ray
results?
Upon discharge, every patient will be
given a Hospital Inpatient Discharge
Summary. There is NO charge for this.
This document provides a summary
of the patient’s medical condition,
investigations done and medication
given during a specific hospitalisation
episode. Patients who want to make
insurance claims or apply for financial
assistance from a Voluntary Welfare
Organisation (VWO), can check
with the insurance company or VWO
if the information in this document
is sufficient to support the claims or
applications.
If the insurance company or VWO
requires a specific medical report
and provides forms to be filled up,
the forms will be completed by an
experienced doctor. The practice is in
line with the terms of the insurance
company or VWO requirements.
The completion of an insurance
claim form or VWO application is not
done during the patient’s outpatient
visit. This is because the doctor needs
time to review the patient’s full medical
records and fill in the form with the
correct information as required.
The regular consultation and
hospitalisation fees paid do NOT
include cost for a medical report as not
every patient requires one. A fee has
to be levied for this additional service
of providing medical reports to cover
the hospital’s administrative costs and
the doctor’s professional input. This
is a standard practice across all the
Restructured Hospitals.
At SGH, patients may request
copies of their laboratory test results
and diagnostic radiology reports
during consultation at the Specialist
Outpatient Clinic. There is NO
charge for this.
Patient may also request for copies
of laboratory test results and radiology
reports from the Medical Report
section at Block 3 Level 1 beside the
Medical Social Services department.
There is an administrative charge
of $5.35 (inclusive of 7% GST)
regardless of the number of test results
requested.
A n n e G oh , M a n a g e r, He a l t h
Information Management Services, SGH.
Type of Document
Hospital Inpatient Discharge Summary
Ordinary Medical Report
• A summary of the patient’s medical condition, investigations done and
medication given
• For a specific hospitalisation episode only
• FREE
•
•
•
•
Laboratory test results and diagnostic radiology reports
Specialist Medical Report
• Laboratory tests done on blood, urine samples etc.
• Diagnostic radiology procedures such as X-ray, Ultrasound, CT scan etc.
• Given FREE to patients on request during consultation at the Specialist
Outpatient Clinic
• Administrative charge: $5.35 for unlimited number of test results and
radiology reports if request is made at Medical Report section at Block 3
Level 1 (next to Medical Social Services department)
A specialist provides a report
A report on a patient by his own doctor
Contains information on the patient’s current condition
Data can be gathered from the patient’s medical record
Administrative charge: $80.25 ( inclusive of 7% GST )
• In which he is asked to provide an opinion on his own patient or
• On another doctor’s patient in a Restructured Hospital
• Administrative charge: $160.50 ( inclusive of 7% GST )
In every issue of Outram Now, we highlight some frequently asked questions many of our patients have about hospital admissions, their bills and procedures. If you have any
queries and concerns, email editor@sgh.com.sg
24 \
\Mar/Apr 2008
MOH: Means testing will not
be mean or demeaning
to ensure fair distribution of limited
Class B2/C subsidies so that those
in the lower income group get more.
This means higher income patients
will pay more even if they choose
to stay in subsidised B2 or C class
ward.
BEING hospitalised can be worrying
– not only about your health, but also
about your hospital bill.
Fortunately, Singaporeans enjoy
heavy government subsidies in
restructured hospitals, especially for
lower class wards. Those who stay
in class C wards have their hospital
bills subsidised by 80% while class
B2 patients receive 65% in subsidies.
This means that a huge part of your
hospital bill is taken care of when
you are admitted into either class C
or B2. If you opt for a higher class
ward, you will need to pay more for
your medical expenses as the subsidies
will be reduced accordingly.
More resources for healthcare
Last year, direct patient subsidies
amounted to over $1.6 billion, up
from about $850 million in 2001.
The Ministry of Health projects
patient subsidies to exceed $2.2
billion by 2012. The government will
continue to allocate more resources
into healthcare as Singapore faces
an ageing population and rising
expectations in healthcare needs.
This means Singaporeans can be
assured that healthcare will remain
affordable to all, even with the
introduction of means testing. MOH
SGH file photo
says means testing will help focus
subsidies on the lower-income group
even as the government continues
to improve subsidised healthcare
services.
Means testing ensures fair
distribution of subsidies
Overall healthcare services have
improved for all Singaporeans leading
to the narrowing of differences
between class B2/ C and class A/B1
Five principles of Means Testing
1
2
Patients retain right to choose
Whether high or lower-income patients, they can continue to
opt for a ward they prefer, including class C and B2.
Different subsidy rates
All patients in class C and B2 wards will continue to be subsidised
but at different rates. Hospital bills will remain affordable although
higher income patients will receive smaller subsidies than the lowerincome group.
3
Subsidy rate based on eligibility
The amount of subsidy an individual receives will be based on his
eligibility. His financial status will be assessed automatically based
on income declared to the Inland Revenue Authority of Singapore
(IRAS) or the Central Provident Fund (CPF) Board. This is to keep
means testing simple and hassle-free.
4
5
Flexibility for those in need
The unemployed and retirees will receive flexibility and sensitivity
during means testing assessment. Deserving Singaporeans will
be given due consideration.
No citizen will be denied treatment
MOH is committed to ensure that no Singaporean will be denied
treatment just because he cannot afford it.
wards. As a result, higher income
patients who can afford higher class
wards have also been drawn to class
B2/C wards.
MOH says means testing is a way
Majority continues to get current
subsidies
The ministry points out that means
testing will only impact a minority of
the upper-middle and higher income
groups who choose Class B2/C. Even
then, they will continue to be heavily
subsidised. Overall, the majority of
class B2/C patients will continue to
enjoy the current subsidy rates.
Together with large government
subsidies and a comprehensive
healthcare
financing
scheme
comprising Medisave, MediShield
and Medifund, MOH says healthcare
will remain affordable for all.
For more information on means
testing, log on to www.moh.com.sg
InTheKnow
About
Ultrasound
scan
WHAT is Ultrasound scan? This is a
specialised procedure that uses sound
waves to obtain information about the
structure and functions of different
organs within the body. X-ray is not
used in this examination.
What is it used for? The doctor
may order an Ultrasound scan to help
evaluate the source of pain, swelling
or infection in many parts of the body
including neck, abdominal organs, blood
vessels and muscles. As an Ultrasound
scan provides real-time images, it can
also be used to guide procedures such
as needle biopsy, in which a needle is
used to take cells from the body for
laboratory tests.
W hat happens during an
Ultrasound scan? You will be asked to
lie on the examination couch. A thick
gel will be applied on your body over the
part to be scanned. The gel can be wiped
off easily and will not stain your clothes.
The gel helps a handheld probe known
as a transducer to transmit sound waves
through your body. The radiologist or
radiographer will move the transducer
over your body part to be scanned. There
should be no pain or discomfort during
the whole examination. For diagnosis
of certain conditions, you may be given
an injection.
How long will it take? An
Ultrasound scan may take between 15
and 60 minutes depending on the part
of your body to be scanned.
How do I prepare for it? Some parts
of the body can be scanned without any
preparation. But if some preparation is
required, you will need to co-operate to
ensure your Ultrasound scan is complete
and accurate. Depending on which
part of your body is to be scanned, you
may need to fast or keep your bladder
full until after the examination is
completed.
Information provided by the SGH
Department of Diagnostic Radiology.
Mar/Apr 2008 \
\ 25
26 \
\Mar/Apr 2008
TheDoctor'sIn
FrontLine
Turned off by his sexual habits Safety first
Q
My fiancé recently
revealed some bedroom
habits which include
role-play and dressing
up. I have obliged
although I am not really keen on
such sexual behaviour. On several
occasions, I have experienced an ‘outof-body’ sensation where I seem to be
observing the lovemaking between my
fiancé and my body rather than taking
part in it. I have also been having
flashbacks of an unpleasant encounter
with a pervert during my schooldays.
Am I just having pre-wedding jitters?
A
Many people have all kinds
of sexual fantasies. It is great
that you are sometimes
willing to help your fiancé
fulfill some of his. You may also wish to
share with him your fantasies and see if
this will further spice up your sex lives.
However, if your fiancé can only have
sex with you if you engage in role-play
and dressing up, then it will be good for
both of you to consult a sex therapist.
Having occasional episodes of
‘becoming an observer’ or what is
termed as ‘spectatoring’ in sex therapy,
may be considered normal. But if this
occurs very often and causes distress
to the individual or couple, it may be
useful to explore further. I suggest you
focus more on bodily sensations and
communicate more with your partner
during intimate times. Let each other
know what is needed to enhance both
your levels of enjoyment.
It is normal to be reminded of your
past now and then. However if it causes
you distress and affects your sexual
relations, you may wish to talk to a
counsellor or sex therapist to resolve
any negative feelings that you may still
have after all these years.
Getting married is a huge
commitment for all of us. So you may
just be having pre-wedding anxieties
and fears. The good news is that such
feelings will usually go away as you
learn to move on and cope with the
challenges ahead.
Dr Ng BengYeong,
Head & Senior
Consultant,
Department of
Psychiatry, SGH.
Email your health-related questions
to editor@sgh.com.sg The reply
provided is for your information
only. You should consult a doctor or
seek treatment for your condition.
He is a familiar face at SGH for patients
and visitors. Security Officer Adnan Bin
Hashim, 50, has received an Excellence
Service Silver award, after having
worked just over a year in the Hospital.
By Karen Teng
You chose to work in a hospital. Why?
I was a manufacturing specialist for 23 years. In 2006, I retrained to be a security
officer. I decided to work at SGH instead commercial buildings because my duties
here are more varied.
What is your typical day like?
During my patrols in the hospital premises, I look out for suspicious people and
activities. When I come across illegally parked vehicles or people who smoke, I will
advise them. Sometimes I am activated to deal with people who turn violent or
aggressive. During visits by VIPs, I ensure their clear passage and help with crowd
control. If the fire alarm goes off, I check and if necessary, proceed with evacuation
and cordoning off the affected area. In the morning, I can be in the Security Office
attending to phone calls, exchanging of work passes for contractors and issuing of
keys.
What do you like about your role?
I can be assigned to perform different duties throughout my 12-hour shift so I do
not get bored and time passes quickly. I am not desk-bound, unlike my previous
job where I had to sit still for long periods.
Less than two years here but you have already received a prestigious national
award for providing good service. What is your secret?
Getting the EXSA Silver award was my happiest and proudest moment. I
was recommended after a just short period of working here as I received many
compliments from those I have served. Yes, it can be challenging and stressful
when dealing with the public especially when they let go their frustrations on me.
The most important thing is to stay calm and firm, while performing my duties.
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Mar/Apr 2008 \
FromTheHeart
Paying it forward
“
I received as much, if not more than what I have given. From my mentors, I
acquired knowledge, the passion of teaching and the art of doctoring. I learned the
value of paying forward – the best way of showing my gratitude towards my teachers
for their tireless mentoring. By nurturing the next generation of capable and caring
doctors, I have indirectly extended my responsibility towards my patients, and paid
tribute to my teachers – perpetuating their professional values and good work.
Importantly, it was never what they said or preached, but
what they did that mattered. The current SGH Chairman of
Medical Board Professor Ng Han Seong (photo), to whom I
owe a lot, has been my role model as I mature professionally
over the years. Prof Ng and many members of the former
Medical Unit III had shown me that there is never anything,
with respect to patient welfare, too small for my action or
attention. There is always time for teaching no matter how
busy we are. We need more role models. We need to hold on dearly to some of these
timeless values in our modern era of hustle bustle and technological evolution.
I have also learned much from my patients who come from all walks of life.
Gaining insight about life, each encounter broadens my perspective and makes me
a little less dogmatic. These precious lessons are more than any textbook can offer,
enriching me and hopefully making me a better person for my next encounter, be it
with another patient or a colleague.
I am thankful for the years that I spent in SGH. I thank all whose paths I have
crossed. This would include my very helpful non-medical colleagues. Their roles
and contributions only emphasise the futility of medical know-how in the absence
of a comprehensive healthcare delivery system, which is particularly crucial in a
public hospital.
”
Associate Professor Chow Wan Cheng is Senior Consultant and Head of Department of
Gastroenterology and Hepatology, SGH.
Bringing festive cheer
to lonely elderly
SOME 200 elderly
Tiong Bahru and
Chinatown residents
celebrated the Lunar
New Year with a
group of SingHealth
nurses. The senior
citizens – many living
alone - were treated to
an evening of festive
celebration held on
the eve of Valentine’s
Day at the Kreta Ayer
Community Centre.
Guests tucked into
a sumptuous ninecourse Chinese
dinner, and were
entertained with a
repertoire of songs in
dialects performed by
the nurses and their
family members.
SingHealth’s Director of Nursing for Outram Campus Lim Swee
Hia giving out festive hampers, Mandarin oranges and red
packets.
SingHealth nurses serving
dinner to senior citizens
specially invited to share
the festive cheer.
AroundOutramCampus
TriedandTested
SNEC sets up eye clinic at
Balestier Road
Sona so good
A new eye clinic staffed by specialists
from the Singapore National Eye
Centre (SNEC) is now up and running
in Balestier Road.
Offering the same complete
range of eye care specialty services
as the SNEC, the clinic was set up
for patients’ convenience especially
those living in central and northern
Singapore. Waiting time is shorter and
their travelling time can be minimised
as there is no need to travel to the
FOR four consecutive nights, my
husband of 15 years willingly put his
head on an object that looks like a
bird in flight. Well, that was how he
described the anti-snore Sona pillow
which I got him to try out.
Anyone with a partner who snores,
knows that both are deprived of a good
night’s sleep. The non-snorer would be
kept awake by an awful din while the
snorer’s sleep would be interrupted as
his partner would constantly be poking
him to turn to his side. At least that was
what I used to do when I couldn’t get
my beauty sleep.
Osim says the Sona pillow is specially
designed to prevent snoring which
occurs when one lies on his back to sleep,
leading to tongue and throat muscles
falling backwards, thus narrowing
his airways. A vibration between air
pressure and tissues at the back of his
throat, results in a sound known to us
as snoring.
The Sona pillow aims to reduce
snoring, as it limits the user to sleep
either on his right or left side. Both sides
of the pillow have contours for him to
slip an arm upwards under the pillow.
main centre at Outram Road. Both
outpatient and day surgery services are
available at the new clinic.
Patients can look forward to shorter waiting
time for the same complete range of eye
care specialist services.
Singapore National Eye
Centre – Balestier Branch
The team of eye specialists at the new
SNEC Balestier branch includes Associate
Consultant Dr Jacob Cheng, seen here
examining the eyes of an elderly patient.
363 Balestier Road
(opposite Shaw Plaza)
ParkwayHealth Day Surgery and
Medical Centre
Appointments hotline: 6227 7266
\ 27
By Karen Teng
editor@sgh.com.sg
For people who suffer from mild
sleep apnoea – a condition characterised
by pauses in breathing during sleep
– Osim says the Sona pillow has also
been clinically proven to work and is
approved by the US Food and Drug
Administration.
The morning after the first night
of using the Sona pillow, hubby and I
woke up surprised that both of us slept
through the night undisturbed. The
following nights confirmed that hubby’s
side-sleeping position is good for us.
His only complaint – with an arm raised
above his head during sleep, our bed has
gotten a tad too short for his 1.78-metre
frame. Still, we consider this as minor
inconvenience in exchange for a good
night’s rest.
The Sona pillow costs $199 and is
available at all Osim outlets.
28 \
\Mar/Apr 2008
Goodbye Housemen’s Canteen
Well-loved 49 year-old eatery makes way for new Pathology Building and will be relocated
Story and photos by Karen Teng
editor@sgh.com.sg
SINGAPORE General Hospital’s
Housemen’s Canteen – popular among
staff, patients and visitors – served its last
cup of coffee and final bowl of mee pok on
22 February. The single storey landmark
eatery opposite Block 7 was just a stone’s
throw away from the new Pathology
Building now under construction.
SGH Chief Operating Officer Foo
Hee Jug says, “This Building, when
completed in 2010, will create the
much-needed capacity to cope with the
rising demand for clinical investigations
that will improve patient care. Due to
the large footprint of the new Building,
its basement walls will come in close
proximity. As such, the Housemen
Canteen will need to be relocated in the
interest of safety for all.”
for newly qualified doctors, then known
as housemen or in today’s politically
correct term, ‘House Officers’.
Over the years, Housemen’s Canteen
became known as the hangout for
generations of doctors, nurses and
other hospital staff as they bonded over
affordably priced meals and perfectly
brewed cups of coffee.
The eatery also has evolved into an
informal teaching ground where over
breakfast and coffee breaks, senior
doctors shared with juniors their medical
knowledge and years of experiences. This
was the routine for many departments
after their routine morning ward
rounds.
Farewell to a beloved SGH icon
Word of the eatery’s cheap and
good food spread and subsequently, its
patrons included patients, visitors and
those working in the various healthcare
facilities in Outram Campus.
On the eve of its closure, the Hospital
organised a farewell party for staff to say
farewell to the well-loved Housemen’s
Canteen.
Hundreds including doctors of entire
departments turned up to enjoy their
favourite kopi and fish ball noodles one
last time. They covered the walls of their
beloved hangout with messages of their
favourite memories.
As Senior Consultant of Orthopaedic
Surgery Dr Tan Mann Hong sums it up,
“Many generations of doctors have gone
through here. I remembered this place
as far back as 1980. Then I was a medical
student, houseman, then Medical Officer,
then Registrar…up to (now). This was
the place to be after ward rounds, after
a day’s work. It is cosy, convenient. The
coffee and tea are good, and price is
cheap. We’re going to miss all this… this
is part of history.”
Alternative dining options
The closure of Housemen’s Canteen
was unavoidable to make way for new
developments on Outram Campus.
But those craving for their daily
cuppa or regular fix of mee pok need
not suffer from withdrawal symptoms.
With six Food & Beverage outlets and
a 24-hour convenience store in the main
Hospital building, plus eateries in several
institutions on Outram Campus, be rest
assured that when it comes to food, there
are varieties galore.
Get your next meal or favourite cuppa from...
Kopi Café Blk 3 Level 1
Favourite hangout for SGH staff
Built in the early 1960s, the
Housemen’s Canteen has evolved from
its humble beginnings into a well-known
landmark on Outram Campus. The
eatery’s name was coined from its main
role decades ago. Housemen’s Canteen
was adjacent to the former living quarters
Kopitiam Food Court
Blk 6 Level 1
Delifrance Blk 4 Level 1
Prima Deli Bakery
Blk 4 Level 1
Crowd-pleaser Housemen’s Canteen
•
•
•
•
•
•
•
•
•
•
A cup of black coffee cost 60 cents
A plate of chicken rice was $2
250 bowls of mee pok sold daily
4,000 cans of condensed milk used monthly for freshly brewed beverages
A meal with two servings of vegetables and a portion of meat cost $2.30
40 cents for a slice of papaya
$1.50 for a large glass of carrot, apple and papaya juice
50 kgs of watermelon cut and sold daily
100 kgs of a variety of vegetables sold daily by the Chinese mixed rice stall
Starfruit juice was a favourite among doctors
Café 155
Blk 7 Level 8
Polar Puff & Cakes
Blk 7 Level 1
24-hour
convenience
store
Cheers
Blk 4 Level 1
Other eateries & snack outlets at Outram Campus
• beverages • chinese rice • juice • condensed milk • mee pok
•
•
•
•
•
National Cancer Centre – café outside main entrance
National Heart Centre – cafeteria and Ali’s convenience store at Level 1
Singapore National Eye Centre – snack vending machine near main entrance
Health Sciences Authority – café at main entrance beside BloodBank@HSA
Health Promotion Board – cafeteria at Level 1
Mar/Apr 2008 \
\ 29
EatWell
Mee Siam
4 SERVINGS
GRAVY
25 gm onion
⅓ thumbsize piece of ginger
1 clove garlic
50 ml water
2 tbsp oil
5 gm chilli paste
½ tbsp taucheo, mashed
1 tbsp peanuts, roasted and ground
½ tbsp dried prawns, ground finely
1 stalk lemon grass, bruised
15 gm tamarind pulp (mix with 1.5 litres
of water and strain for juice)
1½ tbsp sugar
¾ tsp salt
HEALTH TIP
The sodium in this dish comes not only
from the salt but also from the tamarind,
dried prawns and taucheo. Tamarind
contributes approximately 16 percent of
the sodium content of this dish. When
a recipe calls for tamarind, reduce the
salt in the recipe to cut down on the
sodium intake. You can also reduce the
salt in this dish by substituting tamarind
juice with lemon juice and still retain
the tangy flavour.
LOCAL INGREDIENTS
• Taucheo is preserved soybean paste
sold in jars
• Kucai is also known as Chinese chives
(Allium odorum)
BEE HOON
3½ tsp oil
25 gm onion, sliced
15 gm chilli paste
40 gm beansprouts
200 gm bee hoon, soaked in water
100 ml water
This recipe is from “Where is the Fat?”
cookbook, a compilation of healthier dishes
created by the SGH Dietetics & Nutrition
Services. The cookbook is sold at the SGH
Block 4 Pharmacy for $26.40.
comes through. Add taucheo paste,
peanuts and dried prawns.
4. Add lemon grass and fry for a few
minutes.
5. Finally, add tamarind juice, sugar
and salt. Bring to a boil and remove
from heat.
GARNISH
2 hardboiled eggs, sliced into wedges
small limes, halved
cooked prawns, shelled (optional)
2 gm kucai (cut into 2 cm strips)
GRAVY
1. Blend onion, ginger and garlic with
50 ml water.
2. In a large pot, heat oil and add the
blended onion mixture. Fry until
golden brown.
3. Add chilli paste and fry over
moderate heat till fragrant and oil
BEE HOON
6. Heat oil and fry sliced onion until
light brown.
7. Add chilli paste and fry well.
8. Add beansprouts and mix well.
Finally, add bee hoon and water. Fry
until dry.
Missed past issues of Outram Now? Now you can read
them online at www.sgh.com.sg or any library
Mar/Apr
\ 1
2007 \
FR
EE
Jul/Aug 2007 \
UE
May/Jun 2007
FRE
\ 1
\
ESTIMATED NUTRIENT
CONTENT PER SERVING
Energy
Carbohydrate
Protein
Fat
Sodium
Cholesterol
To donate or not?
E
FRE
E
E
RA
Hospital
Bills 101
Pg
23
Y
A Singapore General Hospital Bi-monthly Publication
Nov/Dec
Giving
for future
healthcare
needs
That pain
in your
neck
May/June
(P)
2007 MICA
Pg
111/01/2007
6
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A Singapore
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Bi-monthly
14
D E
I N S I
Publication
Family
Ties
Light
Weightnurses are
their
“Our
Club
nate about ble
passio
edgea
Pg
knowl
job,
They get
Pg
g and
and skilful.
trainin
how
09
11
Eat
Well
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21
Dinosaurs
Alive!
Pg
23
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Well
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Keeping
love and
hope alive
Pg
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De
rs
Dear Reade
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www.sgh.com.sg
Sept/Oct
A Singapo
re General
General
Hospital
I N S
I D E
SingHeal
President th sweeps
for Nurses's Award
Pg
3
By Hazel
Yong
hazelyong@ntu
cmedia.org.sg
New design
high both s score
in looks
functio
and
nality –
easier
making
for patien
it
public
to approats and the
right nurses
ch the
for assista
nce.
Hospital
I N S
I D E
Bi-monthl
y Publicatio
n
SingHea
SGH website
Minimally invasive
internal
Mui radiation therapy
a lot of
That’s
- Ho May
nition.
and
admitted
targets early prostate cancer cells with minimal
recog
patient
a
te them
a
ld female Hospital for
of getting
we motiva enjoy their
major complications.
chance and an SGH downtime and no
THE 56-year-o General increasingly
Liver Transplant
a better
e
help them attrition
the SGH
nt Act
seven
to the Singapore
was becoming a healthcar
now has
The
is
Transpla
Stories bySINCE
Hazel Yong set up in April 2005,
she was not realise
liver failure
throat ailment,
work. d with
hazelyong@ntucmedia.org.sg
transplants
Team was
Although
did
Human Organe-clock.
SGH nurseshas
g
had liver
donor
lethargic. al, the diabetic
diagnose
SGH d
amende
rate for
patients have May Mui.
round-th
have a living source
an impendin
and
to the
A person thanks
al
that is to
58,
sufferHo
from early prostate
conventional external radiotherapy.
profession suffering from or high blood
on standby
potential MEN who
t,
including
very low that’shospit
has expand
Madam Ho,
which is a
this
transplan
yearsa ago,
she was hyperglycaemia treated with
have
safer therapy
There is also less scarring involved
nt Teame the those April 2005, the team
programme, patients. We started cancer nowFive
and suffered
of
so, – internal radiation
lethargic
for
Since .”
episode condition is easily But if left
known
as she
compared to conventional surgery for
Liver Transpla becom
liver transplants of liver for our
last year andoption
Luckily,
felt extremely itching.
on.
a
nursesout seven Ho.
of choiceto becarried
programme
like
sugar. The
brachytherapy.
Treatment involves
the removal of prostate gland.
interventi elevated blood
live donor
one transplant
g
Kit
from persistent
on Madam
what seemed
six dead
Leong Wai
want to do
aspirin
ignore
ions.
including
early medical
Stories by
the implantation
some 80 She
to 100
.org.sg
That will really
consulted
we ideally
“We’ve done
did not of
d, the prolongedcomplicat
leongwk@ntucmedia
roll
Dr Tan said, live donor transplant. week or one a fortnight. rather thanradioactive
undetecte lead to serious
Early detection, more treatment
‘seeds’ symptoms.
into the and
prostate
discovered
harmless
liver
in the patient’s
rolling,
and one
live donor
doctorunder the options
A donor
sugar can ly, the change go unnoticed.
the wheels
gland via her
hollow
needles
family
9, 9pm:
liver donors have started on our
has keep
was the problem.not say
Fortunate
2006, May
support
did not
The SGH
And we
a live donor
The prostate is important to the male
ultrasound
the nurses
her liverimages.
and stop”.
demand to guidance ofthat
condition
history,
doctor could
drip. available.
myseeds
became
sugar
made an urgent programme because is more control,
on
general
There is growing down the waiting
reproductive
system for its production of
Once in the body,
these
- about But
“At first,
and insert
coordinator
of her medical her blood t was
so much.
cutting
from acute an advantage. There can have a date
of
transplant
specimens
aim
itching
the fluid. It may be a small walnutBecause
suffering
seminal
4mm long and
rice that
I was bigger than
Dr Tan’s
whyslightly
ely checked
assessmen
draw blood
timing. You
a woman
a
he noticed yellow.
whereas
call to
how to
immediat
in terms of
not available
sized gland tucked inconspicuously
grains – willmy
continue
to release shorttheir initial doctor and
third visit,
preparation,
to learn
were
had turned
at SGH. Tests of admission and
g training
liver failure.to allay
level. Whenthey called the averted.
and the bladder but prostate cancer is
below
range radiation
overof
sixmy
or eyes
seven months
both parties did her best Patient arrived
whites
undergoin
be liver disease,
10pm:
But as
rmed she was
crisis was Lim Swee SGH nurses
confirmed,
to kill cancerHe
cells.
General
said it could
time, Elena
out and confi
the role
medical
carried
nobody transplant surgery.
to Singapore
took on sensed at that
potential nursing director with obvious
me
anxiety. were
and
Implantation
takes
only
liver
Elena
for
referred
”
she
out,
the family’safter office fihours
who
SGH
patients.final preparations
t to undergo
carried This was after
this incident
two hours and
is confiimmediately.
ned
Hospital
madeas I
nurses and best
n of Madam
r.
that patient well- been
“It was
were anxious
Hia related all, she was
discolouratio obvious and
as
except the Surgeons
n.
only to the prostate
Hia
Thegland.
further,
of a counselloand relatives
into
nking and
around
less
queries
an
transplantatio
probed
Lim Swee
pride. Afterhow quick-thi difference for
getting Patient wheeled
also was I handled their thethem
eyeballs was
This minimises
Director
the patient When she
Ho’sradiation
with
of a damaged
see Midnight:
make a
So
family was
what to
witnessed
tell tale sign
I could
SGH Nursing
and anesthetised,
knewtheatre
.
exposure to common
surrounding
also cause
about dialysis. that the
And
may
they
nurses could
ease.
ld
as
at
could.
operating
discovered
trained
of treatment
them attendance.
Jaundice, which usually shows
worried
organs, unlike
2
is called
liver.external
their care.
on put
e of 28-year-o as Elena about the cost
58-yeardoctor while and less
surgeonsONinPAGE
c
those in
turn yellow,
experienc Six years ago
radiation.
There
is tono
The informatisixCONTINUED the patient
worried
her
the skin
plan
the patient’s
after non-specifi
expect.
Today,
Take the
resumed
Ayob.
looked
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later stage
Typically,
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successfulist
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liver
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cancer patient who has
who have waiting
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Lau X-rayan
be soon
kicks months.
was diagnosed
uncommon
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hy,
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men.
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body
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granddaughte
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Those at risk are usually over 55 years
the prostate and you
plan safety
liver can
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Now”.
moments Transplant Act.
n is produced
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I am pleased
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r -“Outram
h.com.sg Previously,
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e clerk’s
informed s on Outram Campus. s and processes
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kidneys if
ice urology referral centre
all, he works
where
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needs.
r were Yours sincerely
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the day
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dead donor
the home
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in Singapore attendances,
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Madam Ho
we get a
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and SGH registered 217
why we need
law now allows
your healthcare of this newspapeago.
department
in itching,
Singapore,
after the operation and
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cornea when
, and that’s
The amended
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liver
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editorial
patients
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naps
the liver,
packs to cope
cause unpredictableA liver transplantoccur any 40,000
suffering
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lunchtime
removal of of death from any
service.
can
were of people
as
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the seven-week treatment
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for was
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n. It is 24/7
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a dead donor
Kiat eventSGH
identity and how the
transplantatio t up to organ from cannot wait because
Tan Ser in the
CEO,
conditions.
office because and forearms were
of our
in news
needs a transplant
purpose of
th &the
we
Professor
of our uniqueat Outram
benefi
for
interest
quickly.”
time and
An individual as a result of liver
very AM
the responses
Her thighs her jaundice became
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that this would
a reflectionmedical hub
indicated
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cheer
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liver fails
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estimated
Now” is
cirrhosis
wn
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3/20/07
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transplant
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Tan,
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from alcohol
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specialist
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oughs,
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A large
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black,” she
this abuse.
about medical
Nine months
before liver or weeks is
ON PAGE 2
keen interest
“We anticipate
Singapore
because of
CONTINUED
is also
be damaged
days
effect, the
There
came into
the HOTA Rapid damage over
Liver Transplantis more livers available
have
we
2
set up its
that
ON PAGE
Now
Kiat, who
because
Hospital
CONTINUED
of new bill. do more transplants
Dr Tan Chee
to
Programme.
we can
So one way
in the Department
heads law,
of organs.
AM
a senior consultantand Hepatology,
5/9/07 10:51:18
of suitability
logy
Gastroentero
team.
1
Final.indd
the liver transplant
SGH Newspaper
Cut & Keep
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‘Cranes’ of hope take flight
Radioactive ‘seeds’
ns
kill early prostate
Clinicia
nt
cancer
cells
arers to
“Transpla
”
From C
lease of life saved me...
livering new
I D E
I N S
July/August 2007 MICA (P) 111/01/2007
I N S I D E
'Bloodles
s'
brain
surgery
Pg
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r/October
Digital
ward
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111/01/20
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ted
adults
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sg
afflicted cord blood
with leuka units can
be used
emia.
w look
Stories
by
editor@sg Hazel Yong
h.com.sg and Karen
Teng
5/6.indd
\
\ 1
\ 1
A Singapore
Issue
Chicken
Galantin
for X'mase
Pg
21
5
Novemb
er/Decem
ber 2007
MICA
Cut &
Keep
General
AccidentsEnquiry
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The world
through
his eyes
Pg
General
Hospital
Bi-monthly
Publication
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Enquiry
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Outpatient
Services
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ts
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l Medical
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Service
Service
SGH website Manager
Helpline
23
Outram
Campus
gets
Keep away,
the nurse
giving outis
medicine
Pg
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3
Pg
11
January/Feb
ruary 2008
30,000
more SOC
appointmen
ts
Fa Cai
Chap Chye
13
Donated
skin needed
help the sev
erely burneto
d
Pg
Pg
21
MICA (P)
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SGH website Manager Helpline
1800 223
0118
www.sgh.co
m.sg
new land
Potentia
mar
l donors
k need to
amende
d Human
to treat
Issue 6
All-in-one
digital
neuroscienc
(P) 111/01/2
e
centre
007 opens
make pledges
028/01/2008
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1800 223
0118
www.sgh.com.sg
The managem
ent and
Singapore
staff of
all readers General Hospital
wish
a Happy
New Year.
Organ Transpla
A 19-yearfor skin
donated his
By Leong
nt Act covers to be harveste
Wai Kit and
leukaemi old girl has
skin upon
editor@sgh.com
Karen Teng
2004 to
a following successfu
death. Between
d upon
only liver,
.sg
2006,
using
lly battled
a stem
umbilica
heart, corneadeath as the
hovered betweenthe number of
skin can
cell transplan
unrelated
l cord
unrelate
donors
cause death
two and
and kidneys
blood
figures are
t is under-redonors.
is no skin
TAIWAN
four. These
from
student d individu
a grim
But the
to act as as there
fi
als. Polytec two
Candy
public response reflection on
prevent infection.
Karthigaya ghter jet crash
barrier to
is relatively presented and Asian registry
the poor
procedur
Yeow underwe
survivor
hnic
and misconcepti
fi
e
the idea
The leading
cause of
might have n Ramakrish nan
transplan known as double nt a novel process maymore difficult. nding a match
of donating
death in
on to
IT’S a
(right) overwhelmin
succumbed
severe
Moreove
death.
t after
one’s skin
also take
fashion
it not been
to infection,
cord blood
bone marrow
there was
r, this
upon
would
update
g infection. burns is
for donated
consider
applaud.
Visitors to Ward 46 are now greeted by colourful paper cranes at the
sitting area
that patients
The Skin
as ‘natural
skin which had constant worry
able time.
Novel
It is our
transplan no match
Come
5,000
bandages’
double
Bank Unit’s
for a
bringing cheer to both patients and visitors. The wall mural
was put
together by
as bacteria
t (see other
Scientific
nurses
October,
for his injuries. acted on dead
24-year-old
cord blood
thrives
Principal
The alternativ
Offi
staff, patients and volunteers with artist Sandra Lee as part
of this year’s ArtsFest@SGH
from the
story).
skin. So
cluster
over
transfus
“It is hard cer Alvin Chua explained,
will start
we need
celebrations. Full story on page 22.
on his body suffered 45 percent The remove the
SingHeal
transplan
e to a
ion
for people
to
white ensembles
patient’s
donning
burns as
th
bone marrow
something
to imagine
May. His following the accident
soon as possible. burned skin
Pioneer t is cord
spiffy offsuperficial
with trimming
sleeves or
how
blood
injuries had
last
literally see
and what
transplan
with donated
bodice.
procedur ed in France
to be covered enough of the patient’sIf there isn’t
s on the
daily like
we
The change
t.
e was then
skin in the
in 1998,
our skin,
from the
own skin
weeks (see
cord blood
first few critical cover his wounds
successfully.
expected to rise in future although that patientsMooted
be
deceased.
confined
is not
the
other
then we use to
Donating taken
organs is
unit
about
next best
to a single
children
According story).
Dr Lau
said, and
“So designed
far, none of
the vanity.
is not necessarily a bad thing as Dr Lau
probably
By 2010,
thing – cadaveric
the
themselve
age 12 and initially
easier becauseinternal
to Singapore
cannot see
by the
buy time
Campus,a brand
Hospital’s
is collected
and below.
skin – to
used on
the corporate
patientstrimming
required s,external
radiotherapy
explained.
nurses
what has
new 13-storey
and
General
Senior Consultant
Full story as part
been taken people
at childbirt
Cord blood
for grafting.” culture his own skin
colours
public
of ongoing
the Plastic
building
on
implantst refl
or repeated
“Based on findings from our own to supplement
away.”
and
page
and the theplacemen
and
cord banks
Head of
Reconstruct
h and
will rise
parts
3.
Skin taken
ectmajor
institution
with
Surgery Department ive and Aesthetic
Using cadaveric
to redevelop
their ranks
above
no
departmental database, 50 to 60 per cent hospitalisation.
or stored donated to
only from
This helpsThere are also
private
the familiar
s they
skin
the area
chemoth
selected areas
or what
by parents
Contrary
Associate
Donated
cord
Colin Song,
hail from.
speedurinary
complications,
retention
of patients came to us with advanced rectalinternal
into an landscap
is termed as dressing,
Professor
up both
to
cord blood blood compani
cadaveric
academi e of Outram
popular
his bone erapy and radiothe
skin is
communi Some
promotes
as allograft,
external
an internati
skin, or skin
stages of prostate cancer over the past or seed migration.
can be obtained es.
not
c medical
belief,
cation. patients and
marrow
from temporary healing and
rapy
onal network
The donated
toe leaving taken from head
facilitie
hub.
deceased
Leukaem
of leukaem to clear
acts as Burns
15 to 20 years. The cancer cells have experienced
from
Cohesiveslight urinary or bowel
biologic
donors,
s
to
the
fades
optimistic ia survivor
includin
of
two
survivor
are then
Professor
donor
skin
patient. The
ic
Cord Blood
may be the
Karthigayan
Candy
Song
butcorporate
this is common
spread to the bones so doctors can only symptoms
even
‘ bare’.
g the healthcare
double
transfuse units of cord cells. also away. Candy’s
allograft can for the regularly as part
SingHeal
key to for
while
Yeow
Ramakrishna
identity after
Bank
cord
we take about explained, “On
Singapo
of his rehabilitation
Children
“T
changed
remained
d
a burns
stay on a patient
blood
up to three
th’s Nursing
blood she was
n works
average,
try to relieve the patients’ symptoms, radiation
treatments.”
for Outram
patient’s
out
’s Hospital at KK Women’ re cel h e s t e m into the recipient
transplan undergoi
0. 25m
from her blood type
of the
process.
in terms of
system starts weeks before his
ng
ls f rom
has survival.
t.
As a single
new cord
Director
.
s and
Singap
original
.
Dr
Lau saidCampus
that some
not prolong their longevity. But the
skin depth, m t o 0.4 mm
immune Insufficient supply
explained
undergo
t he
Lim overseas
donor
like the
of cadaveric
explained, rejecting it. Professor
not contain
unit of
“The aim fewer
Swee
consultan ore Genera
The use
Professor
ing to unit. Research to that
thighs and from flat surfaces
s
increase in public awareness and health data
also ,suggested
urinary
to project
“The cadaveric
skin
Song
of
process
understa
sufficient cord blood
i n t e r ’ blood
back. We
the changeHia
shaver-like
is still (left) who Song peeling and
for
as temporary cadaveric skin
a cohesive of linked
Director t haematologist l Hospit a
and
estin
may
screenings mean that more cancers and
with is
device called
nineimpotence
use
stem cells
allograft harvest
bacteria can skin will start
l ’s be an adult, a
is also But
units would to predict nd more of this Director
gly
SingHeal problemsidentity
biological
then migrates
and Deputy
dermatome a
Medicin for the Centre
start to invade. practised in
needed
to combine novel procedur
by then,
the skin.”
th institution
for the
that we detect today are in their early brachytherapy
compared
to surgery
it easier
eventual which of the
of the cultured
to
e
we would
many major dressing is
for Transfus
the
to
for patients
increase
two
As only the
s and
ly engraft”
e
two B u r n s
Dr Mickeyat Health Sciences
have already Burn Centres.
internationa
the patient’s
make
external beam
radiation.
Given
stages. The patients are also younger or
of different
Ce
ion
the stem cord blood would ‘ e m recipien t’s
Possible
to
.
l skin is removed,outer topmost layer
National
skin for
this initially
in 1998, after Singapore followed
cord blood Koh (right)
Authorit
explained, n t r e we are able to
units to
pt y
grades. Dridentify
cell dose.
new treatmen
nurses
outcome,
Lau believes
and healthier at about 55 to 60 years the
don’tpositive
of the
take the patient’sgrafting, or
Currently
the harvested
“Not from
SGH set
suit appear
know why
raised
marrow. ’ b o n e
SGH’s
Neuroscie Heart Centre,
transplan
said doubley the two
Howeve
Singapor
Unit.
having
up
,
the
t
slightly
patients
the
unburned
areas
option
some
departm
own
Skin
In
that
the
combination
of
brachytherapy
old compared to the median age of late to
nce
issue
sufficient
separate
r, the
will
answer
pale
skin
time,
National
r u ns
Bank of the
ean adult t is an option
‘nurses’
areas taken
ent of
one another
since these
their queries.”
from leukaem
t he
units wouldon whether
are unable National Eye Institute and
cord
In Singapore,
body where compared to the rest
for the new
previously
and external radiation
can potentially
60s in the past. This enables us to offer patients
patients
will have
for
Singapore
program la rgest adu haematology
Centre.
the skin is
units wouldblood
This
the demand
As the
react
sometime
healed over.”
KKH’s
small family ia. This
is far higher
Dr Koh or against the
suffering
me in
because
left intact.
about 75 uniforms.
lt stem
care
be used
to treat more
locallyisadvanced
them more treatment options.”
s mistake
Director
for skin with harvested areas
is because
year,
patient. with recipient
‘engraft’
or health
said, “A
than local
Heng
per cent oneMadam
size,said
can be
cel l
doctors Singapore.
the whole
clothing,
care cancer
due to unit transplan
many
supply.
and
or
double
sibling Lim
’s bone
of nurses
asstages
of prostate
as the
well.patient identity Pheng noted,of Nursing
assistants
they wear
of last year,
may
the donor’s concealed
For appearance
new platelets
cord blood
or none
t is an
Lee with a panel of nursing
which
Over
marrow grow in the cases of double have performSince last
responded
patient
have
only one
the
at CGH,
nurses
“A common
innovativ
physical
is especially
enables
only
at all.
would not
Making medical history
aresame
such
casesfor overseas
and produce Yeow
may
As“There
the vendor
person
directors
, white
ed three
uniforms.
It
the nation’s
the excitemen us to
nurses
adults.
be affected.
is the cord transplan
It has
even though
have a highTherefor
and red
worked
Dr Koh not
to produce
Shortliste
use cord e concept to is very much
The best
e a the
SGH was the first of two public group,
but because
we have
just started the sister go for clinicaluseful when
been a long
ts. Candy
largest
t runs
slated match.
like waiting blood cells. best results longest survivor
the uniform
explained suitable
transplan
germina
blood
CONTINUED
transplan the designs.
thing about
year-old
attachmen our communi d prototype
in
as she
for Januaryuniform
ON PAGE
te.”
ts isswitch
hospitals here to introduce brachytherapyimprove
programme
here, we’ll confihealthcare
ne treatment them institutions.
, “Bone only
s werets work
with theremains road to recover
for a seed does not
2
cord blood
cation sibling.
that is
t at
Blood
is in remissio
Patients
the corporate change will
shownbetter last
of SingHeal
marrow groupnext
require
sessions There’s
put to
between
disease
will identify
year – thedifferences
at if
to prostate cancer patients in July lastvocation’s
to low-risk
patients first and seealso
how itgroup as nurses from
optimis
y
any medicati
are currently
th’s
a
While
n and
specialis
notinstitution
recipient
in blood
donor
their cellswith nurses,
a 25 per so.theAccording
profession identity and
tic after for Third Sergean
matter
the SingHeal
double
managem vote and
ts like
the goes.”
is ato Director
the rather and be more
submitted
year. Since then, the SGH team has
and donors
on. I was
is
al image
to do
doing
public.
post-tran
his brush
at CGH
ent
cord blood assmuch.
chance
th
patient’s make the cent
accepting
nally discharged
research Dr Koh Kohstill a relativelycord blood
than be
among
SingHealCONTINUED
splantati
do
The two
ofcan
thatYen
institution
The result for approval. and toa perfect
with deatht (NS) Karthig
SGHtransplan
implanted radioactive seeds in 10
Nursing
ON PAGE uniforms
2
of them,
match Lee
confused
after two
change
Yen,
groups.”
th’s
also
“Biologi
new
and
from kept
on process. into the
If the sibling this minimise
units of
ayan Ramakr
– user-frien
with
t months.
uniforms
by the
designs
worn by
Hospital s are Singapore member
the three their efforts be of different
cally speaking
six weeks,
vigil throughout
are also the rest of the procedur
For nearly
three ‘people’
dly yetis unsuitab aborted.
s side effects.
institution
e, Dr
to
nurses from different grades: across four
bone marrow
I was unconsciou
ishan but
blood
transplan
stylish
embarki
“This change years ago
My dad said
my
Hospital (SGH), Changi General
, there
s.”
could actually
bone
different
major registries le,
the transfusi flowing
nursing
we can
were
the 24t team sense
s but
Recipien
when I was hospital stay. admitted
marrow ng on a parent-c
were
nursing nurses
director,
in
have
General
search
staff nurse
Children’s (CGH), KK
t rid as our
airlifted back
the presenceI from Taiwan,
worn the is timely
transplan of my family
worldwid
nurse manager, since
two differenton – Candy’sone body after in a bid
at the SGH
Women’s
Groundhild
my head
Before
1990.
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PAGE 2
1
Features include
• Safer and better spine surgery
• Donated skin needed for burnt
patients
8/24/07
•
•
•
5:29:56
Isn’t artificial blood available?
I N S I
D E
10/25/07
SGH Newspaper
Jan/Feb 2008
2007 \
\ 1
Bi-month
ly Publicati
on
Comput
assisted erreplacemknee
surgery ent
Why “big”
SOC
queue
numbers
Eat
Well
MENTAR
6222 3322
Keep
6321 4311
Cut &
Enquiry
6321 4388
General & Emergencies
6321 4322
Accidents
6321 4333
Enquiry
Admissions
Medisave
6321 4355
Billing/
Reports
6321 4377
Medical
Social Services
6321 4366
Medical
Appointments
6326 56560118
Outpatient
Service
1800 223
.sg
Pharmacy
Medical
Helpline
www.sgh.com
International Manager
Service
Quality
SGH website
n
ly Publicatio
Bi-month
COMPLI
E
Hospital
07 E
FR
(P) 111/01/20
e General
A Singapor
MICA
ril 2007
March/Ap
12/21/07
1:25:32
PM
10:35:37
AM
PM
‘Bloodless’ brain surgery
Radioactive seeds to treat early
prostate cancer
Round-the-clock liver transplant team
Contest Results
Results of the ‘Win an SGH 185th anniversary limited edition Dendrobium orchid
tie pin!’ contest in OutramNow Jan/ Feb 2008 Issue 6.
The answer is TRUE. The SGH 185th anniversary commemorative tie pin is named
after the Dendrobium Orchid.
SingHealth file photo
No. Blood cannot be manufactured or reproduced.
It can only come from people. Your gift could mean
life for a sick child, an accident victim or a patient
undergoing surgery.
Reply from Singapore Red Cross.
Lim Lay Choo, Tampines Street 21
Lim Xin Yi Cindy, Rowell Road
Linda Pilo, Kingswear Avenue
Neo Suping, Toa Payoh Lorong 1
Seto Ah Soo, Holland Avenue
All winners have been notified by email. Prizes must be claimed by 30 April 2008.
Redemption coupon
Get 2 FREE tubes of Aderma Epitheliale
Repair Cream 5ml
Redeemable at service counter,
SGH Block 4 Pharmacy
While stocks last
Name:
Address:
The following 10 lucky readers each win a Dendrobium orchid tie pin worth $33:
Bin Chin Yee, Punggol Field
Chew Fook Wing, Cassia Crescent
Chia Soon Keng, Kim Tian Place
Cristina Merin Terrenal, Outram Road
Koh Kim Eng, Whampoa Drive
Dried prawns are commonly used
throughout Asia but especially in China
and Thailand. During the manufacturing
process, prawns are boiled first before
being spread out in the sun to dry.
Dried prawns are very salty and have
a very sharp taste. One tablespoon of
dried prawns may contain 250 mg of
sodium or more. Dried prawns are
normally used as seasoning. Due to their
sodium content, it is advisable to use only
a small amount in cooking. To get rid of
some of the salt, soak the dried prawns
in water before use. Fresh prawns are
still the best.
GiftOfLife
GU
AU
IN
371 kcal
48 gm
11 gm
15 gm
615 mg
106 mg
Did you know?
\ 1
FRE
L ISS
9. Serve bee hoon with gravy, egg and
limes. Cooked prawns may be added
if preferred.
Contact no:
Date of Birth:
Email:
Brand of skin care product(s)
currently used:
This cream
contains essential
active ingredients
for soothing,
softening,
regenerating and
promoting good
skin repair in adults
and children.
* Limited to one redemption coupon per
customer.
* Incomplete coupons will not be
accepted.
* All participants will be included in the
mailing list for Outram Now.
30 \
\Mar/Apr 2008
“
Bouquets
“
I would like to express my heartfelt gratitude and
appreciation to Dr Lim Jit Fong from Department of
Colorectal Surgery (photo) who recently performed a
successful operation on me. Prior to this, I had undergone 7 surgeries by other
doctors but the outcomes were not as successful. I had intestinal problems
for about 20 years. … Dr Lim successfully treated my condition and kept
encouraging me not to give up hope. …I am now recovering well.
- Dinda Daud
”
The above compliment was translated from a letter published in the Forum page of
Berita Harian on January 16.
“
Not long ago, I came across a calligraphic painting in the
Urology Centre, which read ‘Everything is about the patient,
for the sake of the patient, for all the patients’. Subsequently
I discovered that it was Professor Foo Keong Tatt (photo)
who brought the painting back from China, to commemorate
the Singapore Urological Association’s 20th anniversary.
Prof Foo has been my doctor for the past 24 years. He is
very warm, kind and evidently loves his job. Over the years,
he has mentored many young doctors and treated countless
patients. Not only he has a compassionate heart, Prof Foo is an excellent
doctor.
I commend the government in sparing no effort to ensuring excellence in
healthcare standards. Singapore needs more doctors with such compassionate
heart and competent skills to ensure there is continued advancement in our
healthcare sector.
- Huang Shu Gu
”
The above compliment was translated and extracted from a letter published in the
Forum page of Lianhe Zaobao on January 22.
I am always impressed by the high service standard displayed by your team
c at the entrance of Block 3 and those who are manning
the shuttle bus queue.They were always prompt and pleasant while carrying out
their duties. Plus not forgetting the staff members who are assisting passengers
at various shuttle bus (stops around Outram Campus). Do keep up the excellent
work!
- Patricia Lee
“
”
During my recent appointment at
the Specialist Outpatient Clinic, I was
pleasantly surprised and impressed by
the SMS queue reminder service. I
didn’t have to remain in the clinic
and was able to enjoy a cup of coffee
while waiting. The shuttle bus service
was very good especially the very
cient staff. I heard the
non-Chinese staff speaking to elderly
patients in dialects. That is a very good
gesture as the older folks could understand them better. The shuttle bus waiting
area at Block 3 is very comfortable - there are seats, ceiling fans, lots of plants
and even a TV. The environment is painted in visually pleasing colours. Overall
it was a soothing and great experience. It lightened up my mood. Thank you for
your continuing efforts in improving the services and environment.
- Ho Seo Teck
”
“
I like the contents of Outram
Now Issue 5 (Nov/ Dec 07)
especially the article and pictures on
exercises (for joint health). There is
also detailed information on certain
health issues which I am interested
in.
- Alice Woon
”
Available @ selected
plus all other leading retail outlets, medical halls and provision stores.
Imported by: Orient Europharma Pte Ltd, 1 Sophia Road #04-12 Peace Centre S(228149) Tel: +65 6339 8820
Distributed by: Chin Seng Moh (Import & Export) Pte Ltd, 6 Chin Bee Drive S(619856) Tel: +65 6262 4262
Mar/Apr 2008 \
ArtsForHealth
HAPPENINGS
Catch these free performances on Friday evenings
Venue : SGH Fountain Garden at Block 7 Level 1
Time : 7 pm – 7.45 pm
\ 31
Wall mural reflects
their inspirations
Sing the Golden Oldies
Sit back and sing along to well-loved evergreen songs performed by talents
from the Tanjung Pagar Arts Centre.
Date
: 28 March
ITE Rocks!
Put on your dancing shoes and get into
the groove with young performers
from the ITE College East’s Centre
for Music and the Arts.
Date
: 25 April
Melodious Angklung
Enjoy a joget performance by the
award-winning Sri Warisan Som Said
artists and sway along to the familiar
tune of Rasa Sayang as presented on
the Angklung, a bamboo-framed
musical instrument.
Date
: 23 May
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.
CalendarOfEvents
Moving Forward with Parkinson’s Disease
Date
: 12 April 2008, Saturday
Time
: 2 pm – 4 pm
Venue
: SGH Block 6 Level 9 (Void Deck)
Event description : Learn about Parkinson’s Disease and treatment options from our team
of experts comprising a neurologist, a neurosurgeon, a physiotherapist and a pharmacist. Learn
how to cope with the side effects of treatment and understand why some patients experience
‘freezing’.
Admission
Registration
Enquiries
Email
:
:
:
:
The colourful images reinforce the need for disabled or illness-stricken patients to live
equally interesting lives.
A KALEIDOSCOPE of colourful
images lined up against a wall of dark
pink – a potent combination worth a
second look. And that is exactly what
visitors to the ground floor of Block 2
Singapore General Hospital have been
doing – slowing down to admire the
newly installed wall mural outside the
Department of Diagnostic Radiology.
The wall mural was created by the
Hospital’s occupational therapists and
their patients together with artist Sandra
Lee in celebration of the 60th anniversary
of Occupational Therapy services in
Singapore.
The art piece showcases images
of people with various disabilities
taking part in daily activities. This is a
reflection of the Occupational Therapy
department’s philosophy of helping
patients to overcome the effects of illness
or disability and regain independent
living.
Inpatients were roped in to help create the
wall mural.
Free
On-site from 1.30 pm
6357 7152
nni_secretariat@nni.com.sg
Fabulous from 40!
SingHealth Signature Women’s
Forum 2008
Date
Time
Venue
: 19 April 2008, Saturday
: 1 pm – 5.30 pm
: Sheraton Towers Ballroom,
Scotts Road.
Event description : Feel
empowered, inspired,
rejuvenated – ready, set, GLOW! Themed ‘Fabulous
at 40’, SingHealth’s annual event presents women with
opportunities to learn to take care of their total well-being. Gain insights and practical tips on
staying in shape and good health during this stage of your life.
Admission fee
Registration
Enquiries
Email
:
:
:
:
$18
Pre-registration required (closing date 16 April)
6323 8288
marcom@singhealth.com.sg
For information on other SGH programmes and services, log on to www.sgh.com.sg
Engaging patients in art activities is a form of occupational therapy.
32 \
\Mar/Apr 2008
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2/22/08 3:31:04 PM