1. health and fitness
2. disease
3. diabetes

WINNER
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LIFEWISE
MAR
A P R
2 01 5
ISSUE
no.56
WINNER
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NEW LOOK
BE LABELSAVVY
DOES ZERO FATŸ=
FEWER CALORIES?
CAFFEINE
CAUTION
How much coǺee
is too much?
VACCINES
ARE VITAL
TO HEALTH
p12
PROFESSOR PHILIP CHOO >
GROUP CHIEF EXECUTIVE OFFICER
NATIONAL HEALTHCARE GROUP
Turning
to Art
building on
NHG’s
How one man
heals through
painting p18
TO ADD YEARS OF HEALTHY LIFE
SILVERGLOW > KEEPING SENIORS ABREAST OF TECHNOLOGY p26
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2/26/15 5:18 PM
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CONTENTS
M A R - A P R 2 0 1 5 I S S U E no . 5 6
features
10 COVER STORY
PASSING THE BATON
Meet the new chiefs of the
National Healthcare Group.
12
CALLING THE SHOTS
10
Why vaccination is a
vital course of action.
16 ANXIETY WOES
Understanding the
anxious feelings of
terminally-ill patients.
12
22
18 PAINTING TO HEAL
A patient with schizophrenia
seeks solace in art.
20 THE RIGHT MOVES
Reap the benefits of dancing
without inflicting permanent
damage to your body.
22 READ THE FINE PRINT
20
Learn to decipher nutrition labels.
NHG IS THE REGIONAL HEALTH SYSTEM FOR CENTRAL SINGAPORE
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Lifewise
CONTENTS
M A R - A P R 2 015 I SS U E no . 5 6
24 IN PERSON
Be inspired by Ms Chan Soo Chung
of NHG Pharmacy and Dr Wong
Hon Tym of the NHG Eye Institute.
26 APP-SOLUTELY
SENIOR-FRIENDLY
Smartphone applications to
assist technophobic seniors.
28 CABIN FEVER
Could sitting in your car
be making you ill?
30 SETTING THE RIGHT TONE
Exercises that address
uniquely feminine concerns.
30
34 WHAT DID YOU SAY?
A local study explores
the issues surrounding
hearing impairment.
28
regulars
26
2
Lifewise
EDITOR’S NOTE
NEWSROOM
ASK THE EXPERTS
SPOTLIGHT/NHG NEWS
NHG DIRECTORY
03
04
36
41
48
MAR-APR 2015
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WINNER
AWARD OF EXCELLENCE
APEX 2014
LIFEWISE
MAR
A P R
2 01 5
ISSUE
no.56
WINNER
AWARD OF EXCELLENCE
APEX 2014
NHG CORPORATE YEARBOOK 2012/2013
Lifewise
NEW LOOK
BE LABELSAVVY
DOES ZERO FATŸ=
FEWER CALORIES?
CAFFEINE
CAUTION
How much coǺee
is too much?
VACCINES
ARE VITAL
TO HEALTH
p12
PROFESSOR PHILIP CHOO >
GROUP CHIEF EXECUTIVE OFFICER
NATIONAL HEALTHCARE GROUP
Turning
to Art
building on
NHG’s
How one man
heals through
painting p18
TO ADD YEARS OF HEALTHY LIFE
PHOTOGRAPHER KELVIN CHIA
HAIR & MAKEUP MANISA TAN
SILVERGLOW > KEEPING SENIORS ABREAST OF TECHNOLOGY p26
Cover_V11a.indd C1
ON THE COVER:
PROFESSOR PHILIP CHOO,
GROUP CHIEF EXECUTIVE OFFICER,
NATIONAL HEALTHCARE GROUP
2/26/15 5:19 PM
Learn a
thing or two
about health
N
NATIONAL HEALTHCARE GROUP
EDITORIAL
Wong Fong Tze, Tania Tan, Lydia Soh,
Hamidah Aidillah, Praveen Nayago, Ng Si Jia,
Nathalie Ng, Elizabeth Sim, Clara Poh, Clara Lim
LIFEWIS E ADV IS OR Y PA NE L
A/Prof Lim Tock Han, A/Prof Thomas Lew,
A/Prof Chua Hong Choon,
A/Prof Chong Phui-Nah, Prof Roy Chan
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CONTRIBUTOR S
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Eve r y c a re h a s b e e n t a ke n i n t h e p ro d u c t i o n o f t h i s
magazine, but National Healthcare Group (NHG), the
publisher, editor and employees assume no responsibility
for any errors, inaccuracies or omission arising thereof.
Opinions expressed by contributors and advertisers are
not necessarily those of NHG, the publisher or the editor.
OW THAT THE DUST HAS SETTLED
on another festive season, it might be a
good time to take stock of your health and wellness.
As the year progresses, ask yourself: how closer are
you to achieving the goals you set at the beginning
of 2015?
For many of us, resolving to make a lifestyle
change starts by paying attention to nutrition, and
this is where food labels come in. If you have ever
wondered how to decipher nutritional information,
read our Eat Well feature on page 22.
If you are a senior citizen out of your depth
where iPhones or Android gadgets are concerned,
turn to page 26 to discover what tech can do for you,
and how to go about mastering it.
For those interested in dance, you might be
interested to know that Tan Tock Seng Hospital
(TTSH) is working with the National Arts Council to
develop Dance Medicine in Singapore. Professional
and prolific dancers will be familiar with some of
the injuries sustained through long-time pursuit of
that perfect pirouette or grand jeté. As you will read
on page 20, workshops are being held to educate
dancers on avoiding such injuries.
You might have heard of the ongoing debate in
other parts of the world over vaccination. For those
who need a little more convincing, turn to page 12
to learn why vaccination is so vital.
Lastly, the National Healthcare Group (NHG)
welcomes a new Group Chief Executive Officer,
Professor Philip Choo who continues to actualise the
Group’s vision of adding years of healthy life with the
support of the NHG Board, Management and staff
from all its institutions.
THE EDITORIAL TEAM
The information produced is for reference and educational
purposes only. As each person’s medical condition is
unique, you should not rely on the information contained
in this magazine as a substitute for personal medical
attention, diagnosis or hands-on treatment. If you are
concerned about your health or that of your child, please
consult your family physician or healthcare professional.
Copyright © is held by the publishers. All rights reserved.
Reproduction in whole or in part without permission is prohibited.
Printed in Singapore by KHL Printing, www.khlprint.com.sg.
MCI (P) 058/11/2014.
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SNIPPETS FROM THE HEALTHCARE WORLD // CALENDAR OF EVENTS
ONCOLOGY
Good news
about coffee
and cancer
That cup of java may lower the
risk of developing skin cancer,
according to results of a recent
American study — the first of
its kind to specifically examine
malignant melanoma.
According to the report
published in the Journal of the
National Cancer Institute, an
analysis of more than 447,000
non-Hispanic Caucasians, who
generally have a higher risk
of skin cancer, showed that
those who consumed more
PHARMACOLOGY
NEW ‘SUPER’
ANTIBIOTIC
DISCOVERED
A
n antibiotic called teixobactin could be a new weapon in the
fight against “superbugs” such as MRSA (methicillin-resistant
staphylococcus aureus) and drug-resistant tuberculosis, according
to a study published in Nature. The drug is still a few years way from
human trials but if it does see the light of day, this new antibiotic could
be a game-changer, say scientists.
Professor Kim Lewis of Northeastern
University in the United States and biotech
startup NovaBiotic Pharmaceuticals discovered
teixobactin through a novel technique that
cultures microbes on soil sandwiched between
two semi-permeable membranes. Of the
discovery, Prof Lewis said, “Here is a new
molecule that hits bacterial cells, does not hit
mammalian cells, and is free of resistance.”
IT POTENTIALLY
OPENS THE DOOR TO
FURTHER DISCOVERIES
THAT COULD BOOST
THE WORLD’S
ANTIBIOTIC ARSENAL
4
Lifewise
than four cups of coffee a
day had a 20 per cent lower
risk of developing malignant
melanoma. Decaffeinated
coffee consumption did not
have the same effect.
Previous studies have shown
that coffee may have other
health-protective effects.
Regular coffee consumption
may help reduce the risk
of other serious conditions
including diabetes, liver disease,
depression, Alzheimer’s disease
and Parkinson’s disease.
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VITAMINOLOGY
VITAMIN D,
WONDER DRUG?
ENDOCRINOLOGY
It’s women
who are at
bigger risk
of dying
R
esearchers have found that
high levels of vitamin D
— found in fatty fish like
salmon or obtained through sun
exposure — are associated with
better odds of surviving advanced
colorectal cancers, according to
a study of about 1,000 colorectal
cancer patients published in
the journal Gut.
Meanwhile, an international
study of 1,658 adults found that
vitamin D deficiency was linked
to a sharp increase in the risk
of developing dementia and
Alzheimer’s disease, according to
a report in the journal Neurology.
“Clinical trials are now needed
to establish whether eating
foods such as oily fish or taking
vitamin D supplements can delay
or even prevent Alzheimer’s
disease and dementia,” said
author Dr David Llewellyn of
the University of Exeter Medical
School in the United Kingdom.
KINESIOLOGY
GET FITTER WITH A PARTNER
PHOTOS: GETTY IMAGES, SHUTTERSTOCK
University College London researchers in the United Kingdom have found
that you are more likely to succeed at being healthy if your partner makes
similar efforts to do so.
According to a study published in Jama Internal Medicine, research on
more than 3,000 couples who were either married or cohabiting found
their efforts to quit smoking, exercise more or lose weight were three
times as successful if their partner followed suit. This effect even extended
to partners of those who underwent weight-loss surgery.
Dr Sarah Jackson told the BBC, “This shows that if you can target
couples or encourage people to involve their partners they may be more
likely to succeed. Having the support of someone close seems to help.”
INDIVIDUALS’
EFFORTS TO
BE HEALTHIER
WERE MORE
SUCCESSFUL IF
THEIR PARTNER
FOLLOWED SUIT
Women with type 1
diabetes face a greater risk
of dying from a range of
diseases, especially heart
disease. According to the
BBC, scientists from the
University of Queensland
in Australia analysed data
from more than 200,000
with type 1 diabetes and
found that women had a
40-per-cent higher risk of
death by any cause.
Women also faced a
greater risk of stroke than
men, and faced a higher
chance of dying from
kidney disease.
Type 1 diabetes
usually manifests during
childhood. Nobody is
sure why the disease
causes women more likely
than men to die early,
but Mr Simon O’Neill of
Diabetes UK says there has
been evidence to suggest
that physiological changes
to girls at puberty could
make it more difficult for
them to get their diabetes
under control.
However, Mr O’Neill
added, “With the right
care and support in
place there is no reason
why people with type 1
diabetes — both men and
women — can’t live long,
healthy lives.”
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NUTRITION
BE MINDFUL BEYOND
CALORIE COUNTS
M
aking healthy eating choices is easy if you just follow the
calorie counts printed on food labels, right? Not so. While
labels do show the calories contained, the actual amount of
calories your body can absorb depends on how processed the food is,
according to a report published on The Conversation portal.
The processing of food — whether by cooking, grinding or
mashing — can have a big effect on how your body digests it.
Experiments conducted on animals have shown that the greater
the processing, the more energy is absorbed, no matter the energy
source. Conversely, up to two-thirds of the total calories available
in raw carbohydrates pass through the body undigested.
Texture also matters. Highly-processed
foods tend to be softer — which means your
body has to expend less energy to digest
it. Research has shown that lab rats that
consumed softer food gained more weight
and became fatter than their counterparts
who ate solid food. So, ultimately, when
shopping for food, don’t just look at the total
amount of calories. Cook from scratch as
much as possible and avoid processed foods.
LAB RATS THAT
CONSUMED SOFTER
FOOD GAINED
MORE WEIGHT
THAN THOSE THAT
ATE SOLID FOODS
6
Lifewise
NEUROLOGY
Smartphone
use is rewiring
your brain
Swiss researchers have found
distinct differences between
smartphone users and
conventional mobile phone
users, according to a study
published in Current Biology.
Electroencephalography
(EEG) scans — which detect
electrical activity in the brain
— of 37 volunteers found that
smartphone users had higher
levels of brain activity in response
to stimulation of their thumbs
and fingers. The increase was also
correlated with how often the
smartphone was used.
This is similar to the brain
changes found in classical
musicians — violinists, for
example, have a larger brain
area representing the fingers
that are used to play the
instrument. Thus, researchers
think that the same could be
true for smartphone users. Study
author Dr Arko Ghosh, from the
Institute of Neuroinformatics of
the University of Zurich, told the
BBC: “I was really surprised by the
scale of the changes introduced
by the use of smartphones.”
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CARDIOLOGY
TRICHOLOGY
New heart test could
save the lives of women
British researchers say doctors could spot twice as many
heart attacks in women if they used a newer, more sensitive
blood test, according to study published in the BMJ
(formerly known as the British Medical Journal) and funded
by the British Heart Foundation. The standard troponin test,
it seems, misses many cases of heart attacks in women. And
while the newer test would detect twice as many heart attacks
in women, it would identify only a handful more cases in men.
Researcher Dr Anoop Shah said women are less
likely to be diagnosed with a heart attack when
complaining of chest pains, compared to
men. He told the BBC, “One reason for
this difference in diagnosis rates of men
and women is that we, as doctors,
may have been using a threshold
for troponin testing that is too
high in women.”
A further trial is underway
to see whether using different
thresholds for troponin testing
for men and women will lead to
more accurate diagnoses and
save lives.
STEM CELLS
USED TO
GROW HAIR
Researchers at the SanfordBurnham Medical Research
Institute in the United States
have used human stem cells
to generate new hair, science
portal EurekAlert! has reported.
According to Associate Professor
Alexey Terskikh, the method
is a “marked improvement”
over current hair transplant
technology. “Our stem cell
method provides an unlimited
source of cells from the patient
for transplantation and isn’t
limited by availability of existing
hair follicles.” The next step is to
transplant these dermal papilla
cells, which initiate hair growth,
back into human subjects.
SMOKING
A BLOOD TEST TO HELP YOU QUIT
PHOTOS: GETTY IMAGES, SHUTTERSTOCK
U
niversity of Pennsylvania
researchers in the
United States say that
a blood test could help people
choose the best method to
quit smoking, according to a
study published in the Lancet
Respiratory Medicine journal.
Researchers studying 1,240
people on smoking cessation
programmes found that
those whose bodies
break down nicotine
at a normal rate had better
odds of quitting successfully
by using the prescription drug
vernicline instead of nicotine
replacement patches.
Both methods worked
MORE PEOPLE COULD
NOW HAVE A SIZEABLE
CHANCE OF SUCCESS
AT GIVING UP SMOKING
equally well for those whose
bodies break down nicotine more
slowly, though there were more
side effects with the prescription
drug. Lead researcher Professor
Caryn Lerman told the BBC:
“If these tests are used, people
could have a sizeable chance
of success.”
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NUTRITION
PERSONALISED
DIETS CAN MAKE
A DIFFERENCE
A
re you a feaster, constant craver or emotional eater? According to
BBC Science, this distinction matters in weight management. In a
study conducted by Oxford and Cambridge researchers in the United
Kingdom, picking the right diet can make a huge difference in outcomes.
The researchers found that “feasters” — people who find it tough to stop
once they start eating — should eat a high-protein, low-glycaemic index diet,
because they tend to have a hormonal imbalance that results in them not
feeling full as quickly as the average person. On the other hand, “constant
cravers” — who have genes that make them feel hungry most of the time —
should try intermittent fasting, and “emotional eaters” who turn to food when
stressed do best on a combination of a healthier diet along with group support.
KINESIOLOGY
WHEN DOING
NOTHING COULD
BE LETHAL
8
Lifewise
ENDOCRINOLOGY
Pain-free blood
sugar testing
on its way
University of California San
Diego scientists in the United
States have developed a novel
way of testing blood glucose
levels by using a temporary
sticker, according to a report
in Analytical Chemistry. The
new method is painless, cheap
and works just as well as
conventional finger prick tests.
The device has electrodes
that sense glucose levels by
using a small electric current.
While the gadget cannot show
a numerical readout for now,
researchers are working on a
Bluetooth reader that can relay
the data to a smart device.
If successful, the invention
would revolutionise the daily
lives of millions of diabetic
people around the world.
University of Cambridge researchers in Britain suggest that a
lack of activity could be more lethal than obesity, according
to a study published in the American Journal of Clinical
Nutrition. According to the results of a 12-year study of more
than 300,000 people, the number of deaths due to inactivity
was almost double that of deaths due to being overweight.
Researchers concluded that 20 minutes of brisk-walking
a day would be enough to reduce this risk. Professor Ulf
Ekelund told the BBC that eliminating inactivity in Europe
would reduce mortality rates by nearly 7.5 per cent, but
eliminating obesity would reduce rates by just 3.6 per cent.
He added: “It’s not a case of one or the other. We should
strive to reduce obesity, but physical activity needs to be
recognised as a very important public health strategy.”
PHOTO: GETTY IMAGES, ISTOCKPHOTO
PEOPLE WHO
FIND IT TOUGH
TO STOP EATING
SHOULD OPT FOR
A HIGH-PROTEIN,
LOW-GLYCAEMIC
INDEX DIET
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IMMUNOLOGY
VIROLOGY
DRINKING AFFECTS YOUR
IMMUNE SYSTEM IN JUST
20 MINUTES
J
ust one night out on
the town can affect
your immune system,
according to a study published
in the journal Alcohol. While
previous studies showed that
alcohol consumption affects
the immune system several
hours or days after exposure,
Loyola University Health
Systems researchers in the
United States found that
effects on the immune system
can be measured just 20
minutes after the first drink.
Researchers isolated
immune cells from blood
samples collected from
volunteers before and after
they became intoxicated. They
found a pre-inflammatory
response after just 20 minutes
post-exposure. However, the
immune response decreased
after a period of time, and
volunteers’ immune systems
became more sluggish than
when they were sober.
Avoiding colds
According to a study published in the
Proceedings of the National Academy of
Sciences, you really can catch a cold from
being cold — something many have long
since convinced themselves is untrue.
Yale University researchers in the United
States have found that the human immune
system is weaker in cooler temperatures,
allowing cold viruses to thrive.
Rhinoviruses replicated better in
a colder nose. The researchers tested
rhinoviruses at 33°C and 37°C, and found
both the natural sensors that detect
infection and the immune response were
less effective at the cooler temperature.
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NEW LEADERSHIP
C
HANGES TO
KEY LEADERSHIP
appointments within the
National Healthcare Group (NHG)
were announced in early January
2015, in line with the Group’s
vision of improving integrated care
for Singaporeans.
Professor Chee Yam Cheng
stepped down as the Group
Chief Executive Officer (GCEO) on
10 January 2015, after four years
at the helm. Taking his place is
Professor Philip Choo, 56, who
concurrently was the Deputy Group
CEO (Regional Health) and CEO,
Tan Tock Seng Hospital (TTSH). In
turn, Prof Choo has been succeeded
by Dr Eugene Fidelis Soh, formerly
Chief Operating Officer, TTSH.
On the leadership changes,
Prof Chee, 65, said, “When the
time comes, the younger ones
should have the opportunity to
move up while we step down and
continue to provide guidance
and mentorship.”
A New Model Of Care
As the CEO of TTSH from 2011
to 2014, incoming Group CEO
Prof Choo reshaped its operations
and infrastructure to better deliver
integrated and interdisciplinary
care to patients. He also oversaw
the inauguration of the hospital’s
Centre for Geriatric Medicine,
Singapore’s largest of its type,
in July 2014.
NHG welcomes his experience
in geriatrics and is confident
that he will be able to face the
challenges of Singapore’s evolving
healthcare needs. Prof Choo had
chosen to specialise in geriatrics
— a field that was little-known in
the 1980s — after foreseeing the
importance of healthcare for the
elderly in the future.
Through relationship-based
community healthcare, Prof Choo
10
Lifewise
hopes to ease the strain on acute
hospitals, while improving
proactive and preventive care.
“If you can change systems and
mindsets, you broaden your reach
a lot more,” he said.
“By developing leadership in
our people, and enhancing their
skills and capabilities, we seek
to deliver healthcare that creates
value for Singaporeans.”
“It is not unusual for him to
ask after staff and know their
names — from frontline healthcare
assistants to nurses and fellow
doctors,” said Madam Kay Kuok,
Chairman of the NHG Board, who
also noted Prof Chee’s intellect,
dedication, compassion, wit
and humility.
Under his leadership, NHG
evolved into the Regional Health
PASSING
NEW CHIEFS AT THE NATIONAL HEALTHCARE GROUP.
BY ASHUTOSH RAVIKRISHNAN
An Affable Leader
During his tenure as GCEO,
Prof Chee steered NHG towards
excellence through new
initiatives and partnerships while
maintaining a personal and caring
touch with staff.
System (RHS) for Central Singapore.
In 2013, the Central RHS Advisory
Council was launched to facilitate
the enhancement of integrated
care while also promoting health
services and literacy, and improving
access to care.
Other achievements include
the establishment of four new
research institutes — the Institute
of Geriatrics and Active Ageing, the
Institute of Infectious Diseases and
Epidemiology, the Skin Research
Institute of Singapore, and the
Rehabilitation Research Institute
of Singapore.
With 40 years of experience
in public healthcare under his
Prof Chee Yam Cheng (left) was
Group CEO, NHG, 2011-2014. He has been
succeeded by Prof Philip Choo (right).
MAR-APR 2015
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With Singapore’s rapidly
ageing population and
growing chronic disease
burden, delivering affordable
quality care is vital to
NHG’s role as a public
healthcare service provider.
We are confident that
Professor Philip Choo will take
on the leadership of NHG very
ably to face these challenges.
belt, Prof Chee will continue to
inspire and contribute in his
new appointments as Emeritus
Consultant at TTSH and
Senior Advisor to the NHG Board.
A Community Of Trust
Dr Eugene Fidelis Soh was
appointed TTSH’s Chief Operating
Officer and Quality Service Manager
in 2008 to ensure the efficient and
seamless running of the hospital.
MADAM KAY KUOK, NHG BOARD CHAIRMAN (LEFT)
THE BATON
He was also instrumental in the
automation of its pharmaceutical
system and spearheaded its master
plans for wards of the future.
A firm believer in trust between
patients, caregivers and healthcare
professionals, Dr Soh, 40, founded
the annual Singapore Patient
Conference to bring together the
community at large to discuss
healthcare issues.
He is also NHG’s Lead for the
Health City Novena Master Plan,
a major integrated healthcare
development which is set to
connect and create better models
of care for the medical community.
“Through forging close
relationships, we collaboratively
deliver value to Singaporeans,”
Dr Soh said. “It is indeed humbling
to serve a pioneering hospital that
is a pillar in our community.” Dr Eugene Fidelis Soh has
taken over as CEO of
Tan Tock Seng Hospital.
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VACCINATION
CALLING
MANKIND NEEDS VACCINES MORE THAN
BY ELISABETH LEE IN CONSULTATION WITH
ASSOCIATE PROFESSOR LIM POH LIAN HEAD //
SENIOR CONSULTANT // DEPARTMENT OF INFECTIOUS DISEASES //
TRAVELLERS’ HEALTH AND VACCINATION CLINIC //
TAN TOCK SENG HOSPITAL
12
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MAR-APR 2015
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THE S H OTS
EVER, AS A RECENT MEASLES OUTBREAK IN DISNEYLAND PROVES.
PHOTOS: SHUTTERSTOCK
F
IFTEEN YEARS AGO, in 2000,
the United States was declared
measles-free. And yet, by the
end of January 2015, more than 84 people
across the country had contracted the
potentially-lethal virus after an infected child
visited Disneyland.
This is not the first outbreak of measles
the US has seen since the country declared
it eradicated. Similar outbreaks occurred in
2008, 2011 and 2014, and worryingly, each
outbreak has been progressively larger — in
2014, the US Centers for Disease Control and
Prevention reported a whopping 644 cases.
How did this resurgence happen? Measles
is a highly-contagious disease that spreads
rapidly through communities with groups of
unvaccinated people — the majority of cases
in the Disneyland outbreak had not been
vaccinated, according to the CDC.
California, where Disneyland is located,
was at the centre of the outbreak. Vaccination
rates among kindergarten-aged children in
the state have been dropping since 2008, and
experts attribute this decline to worries that
vaccines may cause autism — a theory (since
proven false) that came to prominence no
thanks to vocal anti-vaccination activists.
“Unfortunately, this theory continues
to live on as urban myth, and some
parents refuse to have their children
vaccinated because of autism concerns,”
says Associate Professor Lim Poh Lian,
Senior Consultant and Head of Tan Tock Seng
Hospital (TTSH)’s Department of Infectious
Diseases. This is despite the World Health
Organization — which celebrates World
Immunization Week 2015 from 24 to 30 April
— calling the eradication of smallpox through
years of vaccination “one of the greatest
achievements in public health”.
This has not stopped anti-vaxxers — as
the vocal minority of parents against vaccines
have come to be known — from gaining
traction particularly in parts of America.
“Tragically, such misinformation can cost
lives and result in preventable outbreaks if not
challenged with the truth about vaccines,”
says A/Prof Lim, who also heads TTSH’s
Travellers’ Health and Vaccination Clinic.
Meanwhile, other experts think that
the decline in vaccination rates has arisen
because vaccination has simply become a
victim of its own success. Developed countries
are now free from polio, smallpox and
diphtheria, while rates of infection of other
vaccine-preventable diseases are a fraction
of what they used to be. Thus, fewer
people these days are aware of the horrors
that infectious diseases used to wreak on
unvaccinated populations.
It All Started With A Pox...
What anti-vaxxers do not realise is that failing
to vaccinate hurts more than just their own
child. To better understand this, first we have
to understand how vaccinations work.
Vaccinations have come a long way from
when doctors smeared smallpox-infected
pus into broken skin to spur an immune
response, but the principle remains the same.
A fragment of the bacterial or viral protein is
introduced into the body, which stimulates the
immune system to produce antibodies to fight
the germ. Think of it as a training exercise —
and if the body comes into contact with the
real disease in the future, the antibodies are
ready to fight off the infection.
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VACCINATION
NOT ALL VACCINES
HAVE TO BE
INJECTED. SOME
ARE TAKEN ORALLY,
WHILE OTHERS
MAY BE INHALED.
In some instances, the vaccine comprises
the whole live virus in a weakened form.
These include the vaccines for shingles,
chickenpox and the trio of measles/mumps/
rubella. “These live vaccines are safe for
the majority of individuals but are usually
inadvisable for pregnant women and severely
immuno-compromised patients whose
immune response is weakened or absent,”
says A/Prof Lim.
Vaccination is the provision of immunity
so that a person is protected from infection
by a specific bacteria or virus. “It is called
‘active’ immunisation because your body
actively develops immunity, which is usually
long-lasting,” says A/Prof Lim. However,
if someone has already been exposed
to infection, for diseases such as rabies
passive immunisation can be provided with
immunoglobulins. In most of these cases,
protection lasts only several months.
Not all vaccinations have to be injected.
Some vaccines such as the polio vaccine are
taken orally, while others can be administered
through the nose, such as some inhalable
forms of influenza vaccine.
There aren’t many drawbacks to being
immunised. Common side effects include a
sore arm or occasional redness at the injection
site, as well as fatigue, body- or headaches.
In less than 1 in 10,000 to 1 in 50,000 patients,
the bigger risk is of a severe allergic reaction
to the vaccine, depending on the vaccine
components and the individual patient.
In specific rare cases, seizures can occur
in those receiving whole-cell pertussis
vaccines — but this risk has been made
very low with the newer acellular pertussis
vaccine, A/Prof Lim says.
For those who fear vaccinating their child
because they worry about the infant’s ability
to withstand more than one inoculation, rest
14
Lifewise
What about Ebola?
The first large-scale trials of two
vaccines against the Ebola virus have
begun in Liberia. As of press time, there
have been more than 8,500 deaths
in the latest outbreak in West Africa.
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assured that modern vaccines use only a tiny
amount of antigens. This is a tiny fraction
of the number of germs a typical child, who
constantly touches and puts everything in its
mouth, is exposed to every day.
PHOTOS: SHUTTERSTOCK
Safety In Numbers
Most importantly, vaccinations also help to
develop what is known as ‘herd immunity’.
This occurs when vaccination rates in a
community are high enough to slow the
spread of the disease, thus providing an extra
level of protection for those who have yet to
develop immunity. Herd immunity is crucial
to protecting those who cannot be vaccinated,
such as newborn babies (who are too young)
and those who are too ill or weak (such as
some cancer patients).
In Singapore, thanks to the National
Childhood Immunisation Programme (NCIP),
vaccination rates remain high — indeed,
diphtheria and measles vaccinations are
mandated by law. According to the authors
of a 2010 study on childhood immunisation
in Singapore, the NCIP has been successfully
implemented. This is evidenced by the
disappearance of most childhood diseases;
excellent immunisation coverage rates in
infants, preschool and school children;
and the high level of herd immunity of the
childhood population protected.
The most important child vaccines
include tetanus, diphtheria, pertussis
(whooping cough), polio, HIB (a bacterial
infection), pneumococcal, chickenpox,
measles, mumps, rubella, hepatitis B
and rotavirus.
Any family clinic, polyclinic (such as
the National Healthcare Group Polyclinics)
or paediatric clinic will be able to provide
these vaccinations. All recommended
immunisations under the NCIP are fully
subsidised by the Government and provided
free-of-charge at all polyclinics for children
who are Singapore Citizens. Enhanced/
optional vaccines can be paid for via Baby
Bonus cash gift or Child Development
Account savings.
Adults may assume that childhood
vaccines are all they need, but this is not
necessarily true, according to the US CDC.
GOING ON
A HOLIDAY?
What travel shots you require depend on
where you are going. One way to find out
is to have a pre-travel evaluation at TTSH’s
Travellers’ Health and Vaccination Clinic.
“For developing countries, hepatitis A
and typhoid vaccine are recommended to
protect against infections from what you
eat and drink,” says A/Prof Lim. Yellow fever
vaccine is needed when travelling to certain
countries in South America and sub-Saharan
Africa. Meningococcal vaccine is required
for pilgrimages to Saudi Arabia, and also for
travel to the meningitis belt of Africa.
“We try to ensure people are up-to-date
for routine vaccines like influenza, tetanus and
hepatitis B vaccines,” she adds. A/Prof Lim
also recommends a one-time pneumococcal
vaccine for travellers older than 65.
You might still require vaccination as an
adult for the following reasons:
You were not vaccinated as a child.
N
ewer vaccinations may not have been
available when you were young.
Immunity can fade over time.
A
ge can compromise your resilience to
diseases such as seasonal influenza.
Adults should consider having hepatitis A
and B, meningococcal and seasonal flu
vaccines as well, especially if travelling. Other
vaccines may be necessary depending on the
destination (see sidebar, above).
Women between nine and 26 should
consider the HPV vaccine that helps confer
protection against cervical cancer. Older folk
should also consider the shingles vaccine to
guard against the painful condition.
While getting immunised is commendable,
do not forget that it is just the first step in
protecting yourself and your loved ones —
some vaccines require booster shots. “Tetanus
requires a booster every 10 years, usually
given with diphtheria and pertussis as the
Td or Tdap vaccine,” says A/Prof Lim. Some
travel vaccinations, such as typhoid, Japanese
encephalitis and meningococcal vaccine also
require booster shots. NHG IS THE REGIONAL HEALTH SYSTEM FOR CENTRAL SINGAPORE
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END
D OF LIF
FE ISSUES
A
LL OF US have been
anxious. The nervousness,
clammy hands, dry mouth and
pounding heart are familiar to
anyone who’s taken an examination
or been to a job interview.
But while it may be temporary
for most, anxiety can cause
ongoing distress for some
terminally-ill patients. In fact,
Dr Kwan Yunxin, Consultant
at Tan Tock Seng Hospital’s
Psychological Medicine Clinic, says
that significant anxiety symptoms
are found in about 25 per cent of
cancer patients.
A mix of worry, fear and
apprehension, anxiety presents
itself through a combination of
cognitive and physical symptoms,
such as breathing difficulties and
nausea. Sufferers also harbour an
intense fear of the future.
These symptoms and feelings
can worsen if patients have a
stubborn illness that refuses to go
into remission, which leaves them
worrying about their impending
death, and its potential impact on
their loved ones.
An anxiety disorder is defined
as an intense feeling of anxiousness
experienced for a duration that
significantly impacts the sufferer’s
life. These disorders can severely
worsen a terminally-ill patient’s
life by exacerbating the nausea,
vomiting and fatigue he or she is
already facing as a result of their
illness or treatment.
Indeed, it is common for anxiety
to exist alongside another mental
illness, depression, in terminally-ill
patients. It is therefore important
for patients and their families to
recognise the symptoms of anxiety
in order for it to be promptly
diagnosed and treated.
traumatic stress disorder (PTSD).
A generalised anxiety disorder
is characterised by a patient’s
persistent and excessive anxiety
and worry, usually about their
prognosis and side effects of
treatment, which can result in
fatigue and restlessness.
Conversely, panic attacks are
often unexpected, and episodic.
These are characterised by sudden
bouts of fear or discomfort, with
attacks ending as quickly as they
appear. Symptoms include profuse
sweating, trembling, choking
sensations and a fear of dying.
Recurrent and unexpected panic
attacks combined with a fear of yet
another attack are diagnosed as a
panic disorder. Such a disorder is
Know The Disorder
Four anxiety disorders are common
among palliative care patients:
generalised anxiety disorder, panic
attacks, panic disorder, and post-
woes
TERMINALLY-ILL PATIENTS
CAN BE STRICKEN BY
ANXIETY — MAKING THEM
MORE UNWELL THAN THEY
OTHERWISE WOULD BE.
BY ASHUTOSH RAVIKRISHNAN
IN CONSULTATION WITH
DR KWAN YUNXIN CONSULTANT //
PSYCHOLOGICAL MEDICINE CLINIC //
TAN TOCK SENG HOSPITAL
16
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accompanied by significant changes
in the patient’s behaviour — they
are often afraid to be left alone and
require constant company.
PTSD, meanwhile, is the result
of a particularly traumatic event
which in turn leads to flashbacks
and nightmares. These experiences
are accompanied by irritability,
insomnia and an avoidance of
places and people associated
with the trauma. According to
Dr Kwan, patients in palliative care
may experience PTSD relating to
frightening events associated with
their diagnosis or treatment.
Treatment Options
PHOTOS: GETTY IMAGES
Determining the cause of a
patient’s anxiety can help in
its treatment. It is important to
first rule out any medical causes
that can contribute to increased
anxiety such as the consumption
of medication like steroids and
agonists — commonly used to
treat symptoms of Parkinson’s
disease — and withdrawal from
substances such as alcohol, opioids
and benzodiazepines. Opioids
include illegal drugs such as heroin
and opium while benzodiazepines
include Valium and Xanax,
restricted drugs that are used to
treat mental illnesses.
Once medical causes for a
patient’s anxiety are excluded,
treatment can begin. This treatment
can be either non-pharmacological
or pharmacological, Dr Kwan
explains. The former depends on
psychological interventions while
the latter relies on medication.
Non-pharmacological
treatments tackle the root cause of
the patient’s anxiety — the patient
is encouraged to be frank about his
or her worries and discuss fears
about their disease or death. Such
fears should not be dismissed
as irrational, but accepted and
gently allayed.
Spiritual needs should also be
addressed adequately. If necessary,
arrangements should be made for
patients to speak to their spiritual
and religious leaders.
Indeed, some patients can
soothe their anxiety themselves
for example, by learning relaxation
skills such as deep breathing and
progressive muscle relaxation.
A pharmacological approach
is dependent on medication
such as anti-depressants or
benzodiazepines to ease anxiety.
These prescribed drugs offer quick
relief, making them suitable for
more severe cases.
If pharmacological methods
are to be used, however, care
should be taken to ensure that
administered drugs do not have
an adverse effect on a patient’s
physical condition. For example,
benzodiazepines should be used
with caution as they may worsen
cognitive impairment or delirium.
Such drugs may also have a
sedative effect and even lead
to slow, incomplete breathing.
Chronic use of benzodiazepines
can lead to dependency, which can
also lead to increased anxiety. This article was adapted from
The Bedside Palliative
Medicine Handbook (2013),
edited by Dr Allyn Hum and
Dr Mervyn Koh. The book
comprises contributions from
multi-disciplinary team
members at the Tan Tock Seng
Hospital Palliative Care Service
and its community partner,
Dover Park Hospice.
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WELLNESS
PAINTING
to heal
FOR ONE MAN DIAGNOSED WITH
SCHIZOPHRENIA, THERAPY COMES
IN THE FORM OF A PAINTBRUSH.
BY ASHUTOSH RAVIKRISHNAN IN CONSULTATION WITH
DR JIMMY LEE CONSULTANT // INSTITUTE OF MENTAL HEALTH AND
MS WAN SAU PENG PRINCIPAL OCCUPATIONAL THERAPIST //
INSTITUTE OF MENTAL HEALTH
18
Lifewise
I
T IS MIDDAY ON A SUNNY
Wednesday when Sim
Kah Lim, 47, enters his art studio.
On the door hangs a no-entry sign,
which effectively reserves the room
for Mr Sim for the next two hours.
From ceiling to floor, the
walls are adorned with paintings
reminiscent of Singapore in a
bygone era — old cars along the
road outside the then-Convent
of the Holy Infant Jesus (now
CHIJMES), and food vendors
in Chinatown.
But this is no ordinary art
studio, and Mr Sim is no ordinary
artist. He has schizophrenia — a
mental disorder characterised by
profound disruptions in thought
— and his studio is a room in a
ward of the Institute of Mental
Health (IMH). Mr Sim has been an
in-and-out patient there since he
was young.
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PHOTOS: MARK LEE
An Early Start
It was thanks to his father that
Mr Sim developed a passion and
skill for art. The oldest of three
children, he would join his father
in painting landscapes by the
Singapore River. “My father
was a carpenter who also sculpted
Chinese idols and painted cinema
posters,” Mr Sim says in a mix of
English and Mandarin.
When he was 12, he began to
hear “voices in his head”. He would
scribble what he heard in jotter
books, filling them up with phrases
that, to laymen, were gibberish.
His parents brought him to the
then-Woodbridge Hospital’s Child
Psychiatry In-Patient Unit where he
was diagnosed with schizophrenia.
Mr Sim’s frequent relapses
during his teenage years entailed
periodic admittance to Woodbridge
Hospital (now known as IMH).
As his family could not manage
the fluctuations in his condition,
Mr Sim had to remain in hospital,
although he has occasionally gone
home to visit his elderly parents.
THROUGH
PRACTISING
ART, PATIENTS
CAN TRANSLATE
INDESCRIBABLE
FEELINGS INTO
TANGIBLE FORMS
from drawing to clay-making.
Occupational therapists carried out
such sessions until 2010, when IMH
began its art therapy programme
led by an art psychotherapist.
To ensure Mr Sim always has an
outlet for his emotions, his sister,
who visits him once every two to
three weeks, provides him with art
supplies. She sometimes sells his
work to family and friends.
The Years Ahead
An acrylic cityscape of bumboats
floating near Boat Quay is so
detailed, it is hard to believe that
Mr Sim, the artist, has not been
free to explore the outside world
for more than 20 years.
Mr Sim admits that he would
like to return to live at home but
clarifies, “I don’t want to be a
burden to anyone.”
Art As Therapy
Art has been Mr Sim’s constant
companion. In particular, he
enjoys painting portraits of fellow
patients and staff, often from
memory. “It calms me,” he says.
His work reflects his mood.
When he has a relapse and hears
voices, Mr Sim begins to paint
darker images depicting demons
and mythical creatures, rather than
his usual cheerful, dreamy works.
Ms Wan Sau Peng, Principal
Occupational Therapist at IMH,
explains, “Through art, patients
can translate their ‘difficult-todescribe’ feelings into tangible
forms — we can then understand
their inner struggles.”
Through art therapy, as this
process is known, patients express
themselves through anything
Dr Jimmy Lee, a Consultant
at IMH’s Department of
General Psychiatry, encourages
collaboration between caregivers
and family. “Engagement with
the team — sharing concerns and
progress — helps to develop an
individualised treatment plan,”
he says.
However, Dr Lee adds that the
management of schizophrenia
is multi-disciplinary and cannot
replace the role of medication in
some cases.
Mr Sim has modest hopes
for his art but the people caring
for him believe it is good enough
to be exhibited. IMH presents
framed pieces by Mr Sim to
visiting dignitaries, and hopes to
exhibit his work as well as that
of his fellow patients.
Though Mr Sim is unsure of
what the future holds, he can be
assured of one thing — when the
going gets tough, he can always
count on his trusty paintbrush
for that healing touch. NHG IS THE REGIONAL HEALTH SYSTEM FOR CENTRAL SINGAPORE
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LET’S DANCE
Everybody Hurts Sometimes
L
ET’S DANCE!” urges British singersongwriter David Bowie in his aptly-titled hit
song from 1983. “Sure,” you say, and why not? After
all, the benefits of dancing have long been identified as
a way for people of all ages, shapes and sizes to stay fit.
Besides being a creative outlet and a way to
socialise, dancing has a wide range of physical health
and mental benefits — such as improved heart and
lung function, muscular strength and endurance,
stronger bones, improved mental function, a reduced
risk of osteoporosis as well as better flexibility.
Dance is also great for weight management. In
some schools in the United States for example, the
video game Dance Dance Revolution is used
as part of a physical education curriculum to
try and prevent childhoodobesity.
It must be noted however that dancing
is physically demanding — especially when
done in a professional capacity — to the
point that it can cause serious injuries.
Some of these injuries require months of
rehabilitation, and it is the feet and ankles
that suffer most, says Dr Jason Chia who
heads the Sports Medicine and Surgery
Clinic at Tan Tock Seng Hospital (TTSH).
Common afflictions include tendinopathy
(a degenerative condition of the tendon causing pain
and swelling) and plantar fasciiitis (a degenerative
condition causing pain in the heel) as well as stress
injuries of the foot. In addition, dancers tend to
experience knee and lower back pain caused by muscle
strain and stress fractures of the spine.
The severity of such overuse injuries, as they
are known, depends on the degree of overuse.
Some can be traced to an individual’s technique, or
predisposing factors such as anatomical anomalies
(like an abnormally curved spine, known as scoliosis)
or fatigue. “But if these are addressed prior to training
season, the risk of developing overuse injuries can be
reduced,” says Dr Chia.
THE
RIGHT
REAP THE BENEFITS OF
DANCING WITHOUT INFLICTING
IRREVERSIBLE OR CHRONIC
PAIN TO YOUR BODY.
BY FAIROZA MANSOR
IN CONSULTATION WITH
DR JASON CHIA HEAD //
SENIOR CONSULTANT // SPORTS
MEDICINE & SURGERY CLINIC //
TAN TOCK SENG HOSPITAL
20
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PHOTOS: ISTOCKPHOTO, SHUTTERSTOCK
MOVES
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ONE CANNOT ACCOMPLISH
ARTISTIC ENDEAVOURS
IF ONE IS CONSTANTLY
DEALING WITH PAIN.
“Besides warming up before stretching the
muscles, it is also good to devote some time
at the end of the training session for static
stretches which focus on improving flexibility.”
Dr Chia recommends stopping when pain is
felt, and administering immediate first aid
Participants at the first dance injury workshop.
to prevent recurrent or persistent injuries.
attended. Full-time professional dancer Ms Christina
It is therefore important for dancers to have some
Chan lauded the move to organise such workshops.
knowledge of common injuries and their presentation.
“Knowing the body and how to take care of it is
If a joint is painful and swollen to the point of
integral to having a career in dance. This knowledge
obstructing joint movement, for example, the dancer
can be considered part of the basic skillset of
should seek medical attention.
professional dancers and is important to the general
health of those dancing recreationally if they wish to
To help educate healthcare professionals and dancers
continue enjoying dance,” says Ms Chan. “One cannot
on injury management, prevention and rehabilitation,
hope to accomplish any artistic endeavours if
TTSH is working with the National Arts Council (NAC)
he or she has to constantly deal with pain.”
to develop Dance Medicine in Singapore through
Dr Chia agrees. “Having a good
a series of pilot workshops. The first workshop,
knowledge of the ‘how’ of dance
“Managing Dance Injuries”, was held on 29 November
movement and its impact will help
2014. Professional dancers, sports physicians and
us as healthcare practitioners better
physiotherapists came together to educate dancers on
understand the causes of dance injuries
how to better manage dance injuries.
and ensure more effective treatment to
The lectures and rehabilitation exercise
make an injured dancer’s return to and
demonstrations were well-received by the dancers who
continuation of dance possible.” Introducing Dance Medicine
FOOTLOOSE?
A quick look at the survey results
conducted by TTSH in 2012 of
the prevalence and pattern of
dance injuries in Singapore.
53%
had dance related injuries,
out of which most
were overuse-related cases
ONE
IN THREE
365
respondents,
comprising professionals,
semi-professionals and
recreational dancers
58%
OF THOSE INJURED
CONTINUED TO HAVE
RECURRENT INJURIES
of the respondents sought medical attention,
while the rest resorted to self-treatment or
sought alternative care treatment such as TCM
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EAT WELL
More than
just
PAY ATTENTION TO FOOD LABELS
FOR HEALTHIER EATING CHOICES.
BY FAIROZA MANSOR IN CONSULTATION WITH
MS LYNETTE GOH SENIOR DIETITIAN //
NATIONAL HEALTHCARE GROUP POLYCLINICS
Fine Print
HEN GROCERY SHOPPING, how can you be
W sure
that the food item you’ve just picked up
is ‘healthy’ as claimed? How do you make sense of
nutritional information data? Also, do claims such as
“low fat” or “no sugar added” necessarily mean an
item is healthy? With advice from National Healthcare
Group Polyclinics Senior Dietitian Ms Lynette Goh,
Lifewise finds out what these terms really mean.
What Do Labels Mean
Most packaged food items have a date printed on them:
EXPIRY The cut-off date for a food to be eaten
}
Always check for spoilage
such as odour or bulges
in the packaging
before eating.
22
Lifewise
PHOTOS: GETTY IMAGES, CORBIS, ISTOCKPHOTO
Tip!
or used, provided it is stored according to the
manufacturer’s recommendations. Food that is past
its expiry date may not be of optimal quality, but it
does not mean it is not safe. However, you consume
it at your own risk.
}
BEST BEFORE The cut-off date a manufacturer
can guarantee quality and freshness of the product,
but not whether it is spoiled or safe.
SELL-BY
The date indicating the latest the store
}
should be selling the product before removing it
from the shelf. The product may still be eaten for
some time after, but may not be at its highest level
of quality.
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Sugar claims
NO ADDED SUGAR OR
UNSWEETENED No sugar
NUTRIENTS UNDER
from any source has been
added. Product may still
contain a lot of natural sugar
and DOES NOT mean it is low
in sugar or calories.
SUGAR-FREE Product
contains 0.5g of sugar or less
per 100g or 100ml.
SCRUTINY
Calorie claims
CALORIE OR ENERGY-FREE
Product contains 5kcal or less
per serving or 1kcal or less
per 100g/100ml.
LOW CALORIE Contains less than
40kcal per serving or 8kcal or less per
100ml for ready-to-drink beverages.
Tip!
Average adult’s daily calorie intake:
Man = 2,000 to 2,200kcal
Woman = 1,800 to 2,000kcal
Salt claims
LOW SALT OR SODIUM
Product has 120mg or 0.12g or
less of sodium per 100g.
Fat claims
FAT-FREE Product contains
0.15g or less per 100g or 100ml.
LOW-FAT Product has 3g or less
of total fat per 100g OR
1.5g or less of fat per 100ml.
LOWER OR REDUCED FAT
Product has at least 25% less fat
than the regular product, but it
DOES NOT mean it is low in fat.
LIGHT OR LITE Product is
lightly salted or light in taste
or colour. It DOES NOT mean the
product is low in fat or calories.
REDUCED SALT OR SODIUM
Product has at least 25% less
sodium than the regular
product, but it DOES NOT
mean it is low in salt
or sodium.
LESS OR REDUCED SUGAR
Tip!
Product contains at least 25%
less sugar than the regular
product, but label DOES NOT
mean the product is
low in sugar.
Be wary of products that
list sugar among the first
four ingredients.
Tip!
Calcium claims
HIGH CALCIUM
Product contains at least 50%
of an average adult’s daily
recommended calcium intake.
The recommended daily calcium
intake is 800mg a day for an adult.
Fibre claims
Tip!
HIGH FIBRE Product has
6g of fibre or more per 100g,
OR 4g of fibre or
more per serving.
The recommended salt intake is
5g a day, about a teaspoonful.
The recommended fibre
intake is 20g to 35g a day.
Tip!
When In Doubt
Look out for the
Healthier Choice Symbol
on food packaging. Items
displaying this logo are
generally lower in fat,
saturated fat, sodium
and sugar. Some are
also higher in dietary
fibre and calcium
compared to similar items
within the food category.
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IN PERSON
Better Literacy,
Better Lives
MS CHAN SOO CHUNG WANTS TO IMPROVE
LITERACY — HEALTH-WISE AND OTHERWISE.
INTERVIEW WANDA TAN
READING HAS LONG BEEN A PASSION
of mine. When I was young, I read voraciously and
my parents would give me books as a reward for
doing well in school. My favourite authors are
Mitch Albom and Malcolm Gladwell; their books are
very inspirational and a great tool for learning and
self-improvement.
I’ve tried to promote the reading habit in other
people. For example, I give books to my colleagues
as gifts, and we have set up a small library in
our office so that everyone can share in the joy
of reading. I also used to read to my three children
— aged 14 to 18 — when they were younger.
Nowadays they prefer to do other things such as
watching TV, but I still encourage them to cultivate
reading as a hobby.
PRECAUTIONS
FOR
PRESCRIPTIONS
READ UP ON
the medicines you are
taking and understand
why you have to do so.
PAIR YOUR
MEDICATION
with a routine activity such as
eating breakfast to help you
remember to take your pills.
among the bulk of the population is very low.
As a result, errors in medication-taking often
occur — especially with the elderly patients who
have memory lapses and/or multiple chronic
health problems. They either forget to take their
medicines or take the wrong dosage. To minimise
such errors, National Healthcare Group Pharmacy
launched a Multi-dose Medication Management
(MMM) system called ConviDose™ in 2012.
ConviDose™ uses a machine to automatically
dispense the various medications for each patient
into ready-to-administer sachets, along with
labels indicating when and how the pills should be
consumed. Initially introduced at nursing homes
to lessen the nurses’ workload, this personalised
service is now also available at National Healthcare
Group (NHG) Polyclinics. By subscribing to the
system, patients are thus empowered to take care
of themselves at home. BE UP-TO-DATE
and regularly check that your
medication is not expired.
24
Lifewise
Ms Chan Soo Chung has been the Executive Director
of National Healthcare Group Pharmacy since 2000.
PHOTO: CHEE YAN
THE HEALTH LITERACY LEVEL
MAR-APR 2015
24-25 In Person.indd 24
2/26/15 5:38 PM
IN PERSON
E
PHOTO: CHEE YAN
VER THE GOOD BOY, when my
parents prodded me to become a
doctor, I got on board with little resistance.
Besides, when I was in Primary 3, I won a
book prize and chose to take home a book on
biology as my reward. The book jumpstarted my interest in the human anatomy.
A family friend who is a General Practitioner
also allowed me to sit in on some of his
sessions — this was before the patientdoctor confidentiality clause was properly
practised — and that further motivated me.
I contemplated pursuing gynaecology
and plastic surgery but eventually decided
on ophthalmology. I find the study and
treatment of the eye to be a meticulous
art and one that is ‘clean’. Very few eye
Eyes Wide Open
WHEN DR WONG HON TYM, 46, ISN’T SEEING
PATIENTS, HE’S SEEING THE WORLD.
INTERVIEW FAIROZA MANSOR
surgeries, for example, are bloody affairs.
Also, the results of most treatments —
even surgery — are almost immediate.
The patient is usually thrilled afterwards,
and I too partake in their joy.
After nearly eight years as Head of
Tan Tock Seng Hospital’s Department
of Ophthalmology, I’ve never once
felt despondent or moved to throw in
the towel — the 31 consultants in the
department are great to work with and are
incredibly supportive.
SHEDDING SOME LIGHT
I love travelling and I believe that it is
important to be exposed to and appreciate
various cultures. Seeing the world has
enabled me to be more understanding
and open in my dealings with patients
and colleagues.
I am also passionate about advocating
the use of guide dogs for the blind. I’ve been
on the board of directors for the Guide Dogs
Association of the Blind for over two years
now. We believe that guide dogs can help the
visually-impaired enhance their quality of
life by achieving better mobility. Our society
still has some way to go to being receptive
to having guide dogs in common areas, but
I am seeing some improvement. There are
now four active guide dogs in Singapore
which, with the help of the association, were
trained in, and imported from, Australia
mostly. In time, I hope there will be more. Dr Wong Hon Tym is the Medical Director
of Singapore’s National Healthcare Group
Eye Institute, Singapore; and Senior Consultant
and Head of the Department of Ophthalmology,
Tan Tock Seng Hospital.
KEEP AN EYE ON IT
AS A CHILD... Listen to your parents. It is true —
playing computer games for too long can increase the
risk of myopia.
AS AN ADULT... Don’t look at your computer or
phone screen for too long. Take regular breaks and get your
eyes checked at least once in your 20s, 30s and 40s. Some
regeneration diseases can be traced at an early stage and you
can arrest the problem through simple preventive treatment.
AS A SENIOR CITIZEN... Go for check-ups every
one to two years to maintain healthy eyes in your silver years.
NHG IS THE REGIONAL HEALTH SYSTEM FOR CENTRAL SINGAPORE
24-25 In Person.indd 25
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2/26/15 5:38 PM
SILVERGLOW
M
OST PEOPLE IN SINGAPORE
enjoy instant connectivity thanks to
technology. But while some seniors are
keeping up with these advancements, many
others fear to embrace them. In doing so, these
technophobic elders not only risk feeling
alienated but may also deny themselves the
convenience and instantaneous information
that technology offers.
These seniors’ concerns are very real,
though. “Studies report that issues such
as low vision and the fear of learning
a new electronic tool may contribute
towards the barrier of using gadgets,” says
Ms Madeleine Tay, Principal Occupational
Therapist at Tan Tock Seng Hospital (TTSH)’s
Occupational Therapy Department.
Other prohibitive factors include language
barriers — many smartphone features are best
experienced in English — as well as a lack of
tech-support from family members. The cost
of the devices can also be prohibitive.
Seniors who use gadgets, meanwhile, often
barely scratch the surface of what they can
offer. These seniors could thus be missing out
on relevant apps that can help them find their
car, for example, or those that enable them to
make video calls to faraway loved ones. They
even miss out on apps that make managing
health and medication that much easier.
Getting Help
To help 21st century seniors become more
tech-savvy, the Infocomm Development
Authority (IDA) has set up the Silver
Infocomm Initiative. As part of the initiative,
the IDA offers classes — priced between
$5 and $10 per training hour — for seniors to
increase their technological literacy.
During the foundational iBegin course,
participants are taught basic skills such as
Internet usage and typing skills.
At the advanced iLive stage, participants
go one step further and learn how to integrate
technology with their lives — they learn about
booking airline tickets, blogging, watching
video clips and online banking.
Seniors can approach any of the nine
senior-friendly
BY ASHUTOSH RAVIKRISHNAN
IN CONSULTATION WITH
PRINCIPAL OCCUPATIONAL
THERAPIST // OCCUPATIONAL THERAPY DEPARTMENT //
TAN TOCK SENG HOSPITAL AND
MS CARMEL TSO PRINCIPAL OCCUPATIONAL
THERAPIST // OCCUPATIONAL THERAPY DEPARTMENT //
INSTITUTE OF MENTAL HEALTH
MS MADELEINE TAY
26
Lifewise
PHOTOS: ISTOCKPHOTO, SHUTTERSTOCK
BRINGING SENIORS
UP
UP-TO-DATE
WITH TECH
CAN IMPROVE THE
QUALITY OF THEIR LIVES.
MAR-APR 2015
26-27 Silverglow V5.indd 26
2/26/15 5:39 PM
NHGP App
Need to easily manage
your medical appointments at
a National Healthcare Group
Polyclinic? Simply download
the free National Healthcare
Group Polyclinics (NHGP) app
on either an Apple or Android
device — search “miHealthcare”
in the respective app store and
you can manage your medical
appointments in just three steps.
Simply enter your NRIC number
to make, reschedule or cancel
appointments, but be sure to register
your mobile number with NHGP first.
Silver Infocomm Junctions islandwide
at locations such as Woodlands
Regional Library and Kampong
Kembangan Community Club to sign up for
classes. Since its inception in 2007, more than
73,000 participants have attended. Visit
www.ida.gov.sg for more information.
If you’d like to get involved in
bringing the silver generation into
the tech world, you can donate
an old iPhone and its charger to
SingTel, who will refurbish and
gift them to a senior citizen. For
every iPhone donated, SingTel
will sponsor the talktime and data
plan for the beneficiary for a year.
iPhones were specifically chosen for
their ease of use. Visit info.singtel.
com/personal/silverline for information.
Apps As Therapy Tools
Besides bringing convenience to people
of all ages, personal IT is also being used
as treatments in the medical context —
institutions such as TTSH, Institute of Mental
Health (IMH) and National Healthcare Group
Polyclinics (NHGP) have all incorporated apps
and devices into their treatment programmes
(see sidebar on the NHGP App).
“At IMH, occupational therapists use
an app called the Cognitive Stimulation
Programme, or CSP, designed for older adults
with mild/moderate cognitive impairment,”
says Ms Carmel Tso, Principal Occupational
Therapist at IMH’s Occupational Therapy
Department. CSP was a collaborative effort
between IMH’s occupational therapists and
psychologists, and the Institute of Technical
Technophobic seniors
might be missing out
on wearable tech like
“smart” watches.
Education’s multimedia department.
CSP comprises a suite of cognitive training
games that are played on a touchscreen device.
“The games are designed to be culturally
and contextually relevant to older adults in
Singapore, and feature images and games that
relate to everyday life,” says Ms Tso.
For instance, one of the games — designed
to improve attention span — requires users
match a particular fruit from a selection
of pictures of local fruits. Another
game, designed to improve memory,
requires the user to recall arrangements
of pictures and uses local scenes like
Chinese opera and lion dances.
TTSH’s occupational therapists
use video game systems with motionsensing inputs, such as the Nintendo Wii and
Microsoft Kinect, as part of its CSP. Ms Tay
says that studies have shown that such gadgets
can act as a “therapeutic medium” that can
help to improve coordination, sitting balance
and the senior’s desire to participate. Other Useful Apps For Seniors
People who forget to take their medication on time can
download the MediSafe Meds & Pill Reminder. The app
can also be linked among family members to update
consumption — useful in reminding a forgetful family
member or reassuring a concerned soul.
Also handy is EyeReader which acts as a virtual
magnifying glass. Users simply point their
phone’s camera at a section of text and it
appears larger — say goodbye to squinting at
menus the next time you are out for dinner!
NHG IS THE REGIONAL HEALTH SYSTEM FOR CENTRAL SINGAPORE
26-27 Silverglow V5.indd 27
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2/26/15 5:39 PM
LIFESPACES
CABIN
FEVER
CAN SITTING IN A CAR BE A HEALTH HAZARD?
BY NIRMALA SIVANATHAN IN CONSULTATION WITH
DR SUZANNE CHENG WEI NA CONSULTANT DERMATOLOGIST //
NATIONAL SKIN CENTRE AND
FAMILY PHYSICIAN // ASSOCIATE CONSULTANT //
NATIONAL HEALTHCARE GROUP POLYCLINICS
DR LEE KWANG HOW
W
E ALL KNOW THERE IS AN ELEMENT
of risk to travelling in an automobile.
But what you might not know is that, aside from the
danger inherent to hurtling along centimetres
above the ground inside a metal-plastic-and-glass
box at considerable speed, sitting in a motor
vehicle can pose other health hazards.
Relatively Safe To Touch
28
Lifewise
KEEP IT CLEAN
Drivers sometimes neglect
to replace their car’s air
conditioning filter (right) —
this should be done annually.
chemicals found in pretty much every plastic-based
product, from your car’s steering wheel to vinyl car
seats — affecting human skin directly.
Every Breath You Take
Compared to skin irritation, respiratory irritation due
to gaseous emissions is much more pertinent. Until
zero-emissions vehicles are the norm, the pollutant
known as Particulate Matter (PM) will continue to
pose health risks.
PHOTOS: ISTOCKPHOTO, SHUTTERSTOCK
Dr Suzanne Cheng, Consultant Dermatologist at
the National Skin Centre points out that the
chemicals responsible for that heady ‘new car smell’
can have adverse physical effects. These volatile
organic compounds (VOCs) can cause temporary
irritation of the eyes, nose, throat and skin. In
large doses they can also cause headaches, nausea,
dizziness and shortness of breath.
According to a United States study, VOC levels
in new cars — being found in various interior
plastics, glues and sealants — are higher than those
recommended for indoor environments. And while
VOC levels in new cars diminish over time, the
offending compounds are also present in everyday
items — from air-fresheners to leather treatments.
However, it is uncommon for VOCs to irritate the
skin, as the primary route of exposure to VOCs is by
breathing in these gases. Indeed, it is uncommon
to pick up a contact allergy. According to Dr Cheng,
there are no published reports of phthalates — the
MAR-APR 2015
28-29 Lifespaces V3.indd 28
2/26/15 5:40 PM
IN THE HOT SEAT
While cabin plastics generally
pose little risk, the air in
your car often does.
GROWING MOULD
G
Mould thrives in warm and humid
countries, says Dr Lee Kwang How, and
can also affect our respiratory system.
Those sensitive to mould might develop
an allergic reaction with symptoms such
as a runny nose, wheezing and shortness
of breath. A person with an impaired
immune system and who is exposed
to mould faces a heightened risk of
developing a fungal infection of the
lungs. Mould under certain conditions
may also produce cancer-causing toxins,
says Dr Lee.
However, there are several things
you can do to reduce the growth of
mould in enclosed environments such
as your car. One would be to keep
the humidity low by running the air
conditioner. You should also clean the
interior of the car regularly with mouldkilling products, as well as remove
damp carpeting.
PM consists of solid and liquid particles of toxic
chemicals, heavy metals, dirt, soil and pollen. Of
particular concern are PM2.5 fine particles that are
2.5 micrometres or smaller in diameter — which can
come from a car’s tailpipe. They can enter the lungs
and cause serious health effects.
According to Dr Lee Kwang How, Family Physician,
Associate Consultant at the National Healthcare Group
Polyclinics, “Inhalable coarse particles (PM10) and
fine particles (PM2.5) alike can affect the respiratory
system in the short and long term”. Exposure to PM2.5
INHALABLE PARTICLES
LIKE PM10 AND PM2.5
CAN AFFECT THE
RESPIRATORY SYSTEM
has been shown to have a greater negative effect on
respiratory health than PM10.
Short-term effects include coughing, wheezing
and other breathing difficulties. People with asthma
might also experience an aggravation of their
condition. Long-term effects of exposure to PM include
decreased lung function as well as premature death in
individuals with existing heart or lung disease.
In order to reduce the amount of airborne
pollutants entering your car, the US Environmental
Protection Agency advises drivers to wind up their
windows while driving in urban areas.
This practice, however, works only provided your
cabin air filter is in good condition and not mouldy
or choked with tobacco smoke. Thus, make sure
the cabin air filter of your car’s air conditioner is
changed regularly. NHG IS THE REGIONAL HEALTH SYSTEM FOR CENTRAL SINGAPORE
28-29 Lifespaces V3.indd 29
29
2/26/15 5:40 PM
WORKOUT
SETTING
THE
RIGHT
TONE
WHILE THERE IS TECHNICALLY NO
SUCH THING AS A ‘FOR-WOMEN-ONLY’
WORKOUT, THERE ARE EXERCISES
THAT ADDRESS SOME UNIQUELY
FEMININE CONCERNS.
BY FAIROZA MANSOR IN CONSULTATION WITH
DR DESMOND ONG LUAN SENG
FAMILY PHYSICIAN // ASSOCIATE CONSULTANT //
NATIONAL HEALTHCARE GROUP POLYCLINICS
MR RAY LOH EXERCISE PHYSIOLOGIST //
SPORTS MEDICINE AND SURGERY CLINIC //
TAN TOCK SENG HOSPITAL AND
DR TEY HONG LIANG CONSULTANT //
NATIONAL SKIN CENTRE
30
Lifewise
MAR-APR 2015
30-32 Workout V4.indd 30
2/26/15 5:41 PM
B
E IT WEIGHTLIFTING OR BALLET,
women these days have the choice
to participate in whatever fitness
activity they desire or enjoy.
But that being said, there do exist exerciseor sport-related conditions that affect women
in particular. Female athletes who participate
in strenuous exercise and physical training may
experience symptoms such as amenorrhoea (the
absence of menstrual periods), osteoporosis
(reduced bone density) and eating disorder
(resulting in a lack of nutrition), explains Family
Physician and Associate Consultant at the
National Healthcare Polyclinics, Dr Desmond Ong.
This trio of interrelated symptoms is known
as the Female Athlete Triad, which affects female
athletes in varying degrees. This is especially so
for those who take part in competitive endurance
sports like cross-country running, or aesthetic
sports like gymnastics — disciplines that favour
low body weight and leanness.
That Time Of The Month
PHOTOS: CORBIS
Symptoms of the Triad develop when an active
female goes to extremes in dieting or exercise.
Being interrelated, each symptom then leads to
the other: Abnormal eating habits arising from the
desire to keep a light body weight, coupled with
excessive exercise, prevents the body from getting
enough nutrition.
Poor nutrition, low caloric intake, high-energy
demands, or a low percentage of body fat then lead
to hormonal changes. This results in menstrual
dysfunctions which include delayed menarche
(the start of having menstrual cycles in one’s life),
irregular menstruation or amenorrhoea.
“These hormonal changes also cause the
THE KEY TO BUILDING
STRONG BONES AND
AVOIDING MENSTRUAL
PROBLEMS IS EASY
— SIMPLY CONSUME
ENOUGH CALORIES TO
FUEL YOUR BODY.
stimulation of the ovaries to be suppressed,
resulting in infertility,” Dr Ong warns. However,
this exercise-associated infertility is generally
reversible and usually resolves itself with weight
gain or a reduction in exercise. It is important to
note that if these symptoms occur, other medical
conditions should be excluded before attributing
them to exercise, he says.
Finally, the lack of menstruation disrupts the
body’s bone-building processes and weakens the
skeletal system. As a result, bones become brittle,
leading to premature osteoporosis. Should this
happen during adolescence, the female athlete
may not be able to achieve optimal bone density
during years which are critical, Dr Ong says.
Luckily, avoiding menstrual problems and
building strong bones is easy, according to Brown
University in the United States. Consume enough
calories to fuel your body during exercise and at
rest, and be sure to include several servings a day of
calcium-rich foods like milk and soy products.
NHG IS THE REGIONAL HEALTH SYSTEM FOR CENTRAL SINGAPORE
30-32 Workout V4.indd 31
31
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WORKOUT
Some of us are not inclined to
working up a sweat. But, perspiration
from rigorous exercise isn’t all bad.
While perspiring has no significantly
positive effect on the skin, says
Dr Tey Hong Liang, a Consultant at
the National Skin Centre, it is essential
for lowering body temperature — the
failure of which leads to heat injuries.
Sweating also helps to clear the
body of toxins. For example, certain
bodily waste products such as urea and
lactate are excreted in sweat, explains
Dr Tey. Some ingested food — especially
those from the onion family such as
leeks, garlic and chives, as well as
chemicals such as certain sulphur-based
medications, are also excreted in sweat.
SWEAT
OUT THE TOXINS
Toning Tips
32
Lifewise
Specifically, he recommends engaging in
resistance training at twice a week until you get
to the point of “mild fatigue”. Combine this
with cardiovascular exercises while keeping to
a low-calorie diet. Mild muscle fatigue, Mr Loh
points out, is achieved by doing either a high
number of repetitions of weightlifting exercise
with light weights, or fewer repetitions with
heavier weights. PHOTOS: CORBIS, GETTY IMAGES
The various symptoms of the Triad can be
prevented by keeping a healthy attitude towards
food and exercise. Just remember that proper
nutrition is crucial for good health, which in turn
leads to good athletic performance. Besides,
exercise has many well-documented benefits,
such as improving cardiovascular fitness,
increasing muscle mass and strength, reducing
adiposity (or obesity), improving cognitive
function and generally, as a result of these
benefits, improving quality of life, advises Dr Ong.
On the topic of exercise, many women tend
to avoid doing strength training at the gym,
preferring exercises that they think won’t make
them look bulky. For instance, many would
prefer the toned, sinewy frame of pop star Taylor
Swift over a more powerful build like tennis pro
Serena Williams.
Mr Ray Loh, Exercise Physiologist in the
Sports Medicine & Surgery Clinic at Tan Tock
Seng Hospital, says it is important to combine
strengthening with cardiovascular exercises
in order to get into the shape that you want.
Mr Loh explains, “Basic weightlifting should be
incorporated in your weight-loss regime to help
you improve metabolism and retain lean muscle
mass.” Having added muscle means that the
body burns more calories even while resting.
MAR-APR 2015
30-32 Workout V4.indd 32
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LifeWise Mar-April 2015.indd 33
2/26/15 5:44 PM
WHAT
A LOCAL STUDY IS
aiming to uncover
more information on
the prevalence and attitudes
towards treatment of hearing
impairment in Singapore.
Spearheaded by Dr Ho Eu Chin,
an Ear, Nose and Throat (ENT)
consultant at Tan Tock Seng
Hospital (TTSH), the study is funded
by the National Healthcare Group’s
Clinician Scientist Career Scheme.
Hearing impairment is defined
as a loss of hearing. It can be
further classified by its severity —
mild, moderate, severe or total.
These can be a result of ageing,
occupational hazards or lifestyles.
It is a degenerative condition that
worsens as time goes by.
Lack Of Information
“Most of the data we have on
hearing impairment are obtained
from Western countries. This is
not very effective as there are
many differences between the
34
Lifewise
did you say?
A NEW STUDY EXPLORES THE ISSUES SURROUNDING
HEARING IMPAIRMENT IN SINGAPORE.
BY ASHUTOSH RAVIKRISHNAN
Singaporean population and others
— from ethnicities to societal
norms and attitudes. We need to
better understand the situation in
Singapore, not other countries,”
Dr Ho tells Lifewise.
Dr Ho’s team comprises a
full-time research assistant,
Ms Agnes Chew, and audiologists.
Together, they laid the groundwork
for the study in late 2013 and began
collecting data in March last year.
Since then, the team has
screened nearly 1,400 patients, all
of whom are patients of TTSH’s
ENT Department. Patients who
visit the department for any
condition, even those unrelated
to hearing, are also invited to
participate. Participants undergo
a hearing test conducted by
an audiologist.
Currently, while the
demographics of the participants
accurately reflect the differences
in age, socioeconomic groups
and sex of the population, the
study is, however, limited by its
under-representation of certain
ethnic groups.
“We have to take this into
consideration when extrapolating
the information to the larger
community,” says Dr Ho.
MAR-APR 2015
34-35 Catalyst V5.indd 34
2/26/15 5:45 PM
Action films in a cinema
A jackhammer
at 15m
80dB-100dB
100dB
A heavy truck at 15m
Late To Seek Help
The study confirmed suspicions
that patients who visited the clinic
for hearing impairments were often
already in the later stages of the
disorder. This suggests that they
had been living with the problem
for some time — several decades in
some cases — before seeking help.
Dr Ho attributes this late
treatment to the gradual nature of
most hearing impairments. People
who face a sudden or drastic loss in
hearing — which can be a result of
injuries — will almost always seek
treatment immediately.
However, people whose hearing
worsens over a longer period —
some up to 30 years — may be
unaware of this gradual loss.
This notion was supported by
research conducted on patients who
were visiting the department for
conditions unrelated to hearing.
Thirty to 40 per cent of patients
in this group had unknowingly
experienced at least mild hearing
loss. Their impairment only came to
light after the test, proving just how
unnoticeable the condition can be.
Dr Ho believes such patients
lose one to two per cent of their
hearing per year. The first sounds to
Normal
conversation
at 1m
60dB
PHOTO: ISTOCKPHOTO, SHUTTERSTOCK
DR HO EU CHIN; CONSULTANT; EAR, NOSE AND
THROAT DEPARTMENT; TAN TOCK SENG HOSPITAL
1112dB
40dB
120dB
Rock concert
conce
A soft whisper
at 2m
140dB
Threshold
of pain
Dangerous Decibels
Hearing
aring protection iis
s recommended
beyond
decibels.
yond volume levels above 85 decibels
For reference, here are some common
sounds and their decibel levels.
SOURCE: NATIONAL HEALTH SERVICE (UNITED KINGDOM), OCCUPATIONAL SAFETY
AND HEALTH ADMINISTRATION (UNITED STATES)
fade are usually background noises
that people ordinarily ignore; such
as the hum of an air conditioner.
At the mild to moderate stages,
patients often ask people to repeat
themselves, making the problem
noticeable to everyone but the
patient, who often is in denial.
Most patients thus seek help
only at the severe stage when the
problem is noticeable to them.
Attitudes towards hearing loss are
to blame for this phenomenon —
many people assume that hearing
impairment can be left alone until
it becomes unbearable, at which
point the problem can be easily
corrected with a hearing aid.
This is not untrue, but most
people fail to realise that the
brain needs time to adapt to a
hearing aid — at an early stage,
the brain can adapt in as quickly
as a day or two. If hearing loss is
long-standing, adaptation can
take weeks or months. As such, it
is advisable to wear a hearing aid
SOURCE: NATIONAL
SOURCE:
SOURCE
NATI
NATIONA
ONAL
L HEALTH
HEAL
HEALTH
TH SERVICE
SERVIC
SER
VICE
E (UNITED
(UNI
(UNITED
TED
KINGDOM), OCCUPATIONAL SAFETY AND HEALTH
ADMINISTRATION (UNITED STATES)
34-35 Catalyst V5.indd 35
Nightclub
110dB
MMP3 player on ‘loud’
Changing Attitudes
WE NEED TO
UNDERSTAND
THE SITUATION
IN SINGAPORE,
NOT OTHER
COUNTRIES.
85dB
earlier, rather than later.
Fortunately, the study suggests
that such attitudes are also
changing. Younger people are
coming forward to get screened for
hearing impairment and are willing
to use a hearing aid if necessary.
“Twenty years ago, the
youngest patient with a hearing
aid would be in his early 40s. Now,
we have users in their mid-20s.
This is probably a result of greater
awareness,” explains Dr Ho.
Rising affluence has also led to
more patients wearing two hearing
aids, instead of the usual single ear
piece. Dr Ho believes this is ideal as
hearing impairment almost always
happens in both ears.
The team aims to wrap up the
study after collecting data from
3,000 participants, which it is
confident of doing by the end of the
year. The final results of the study
will be published in both local and
international medical journals. For issues of Catalyst, visit
www.research.nhg.com.sg.
NHG IS THE REGIONAL HEALTH SYSTEM FOR CENTRAL SINGAPORE
35
2/26/15 5:45 PM
&
QA
YO U R
ASK
THE
EXPERTS
M E D I CAL Q U E STI O N S AN SWE R E D
Q1
Surgery for Obesity
I have always struggled to keep the weight
off — my body mass index is now above 38.
My blood glucose levels are normal, but
I am worried about getting type 2 diabetes
due to my weight. I am about 40 years old.
I am keen to have a stomach bypass or gastric
sleeve operation as these surgeries can
change the way the body processes glucose.
Are these surgeries elective, or must they
be recommended by a doctor first?
36
Lifewise
36-39 QnA V3.indd 36
Asians with a body mass index
(BMI) higher than 30 are at risk
of developing serious medical
problems. The treatment is
multi-disciplinary, involving diet
modification, lifestyle changes,
exercise and metabolic surgery.
Bariatric or weightloss surgery is done to
treat or decrease metabolic
complications such as type
2 diabetes, hypertension,
hyperelipidemia, obstructive
sleep apnoea, osteoarthritis,
gastro-esophageal reflux disease
and more.
Currently, people with a
BMI of over 32.5 with any one
co-morbidity, or a BMI above 37.5
even without any co-morbidity,
are suitable for bariatric surgery
after undergoing assessment
by a multi-disciplinary team
comprising a bariatric surgeon,
dietitian and endocrinologist
before choosing the procedure.
The options include
laparoscopic banding, sleeve
gastrectomy or Roux-En-Y
gastric bypass. The choice of
surgery depends on age, type of
diet and co-morbidity, if any.
If you have no diabetes and
if you are a volume eater, you
may be suitable for a sleeve
gastrectomy. On the other
hand, if you are a snacker or
consume large amount of sweets,
milkshakes and ice-cream, then
you may benefit from a bypass.
DR JAIDEEPRAJ RAO
SENIOR CONSULTANT & DIRECTOR OF
THE BARIATRIC SURGERY PROGRAMME //
DEPARTMENT OF GENERAL SURGERY //
TAN TOCK SENG HOSPITAL
MAR-APR 2015
2/26/15 5:47 PM
Q3
Smoke Break
I used to smoke a pack of
cigarettes a day for two
decades but recently kicked
the habit. However, I do not
feel much different from
when I was smoking. I also
do not have any nicotine
cravings. Is it normal to
not feel any difference, or
should I expect withdrawal
symptoms to kick in later?
Q2
Too Much Coffee?
PHOTOS: GETTY IMAGES, SHUTTERSTOCK
I drink a lot of coffee from the moment
I wake up until late at night — usually a
mix of espresso as well as coffeeshop kopi.
In total, I have about four such drinks
every day. Is that too much? What is the
recommended daily dose of caffeine for
an average adult male?
There is no recommended daily dose of caffeine; a safe
caffeine limit is defined as the amount of caffeine a
person can consume without experiencing any negative
caffeine overdose symptoms such as insomnia,
nervousness, restlessness, stomach upsets, a quickened
heartbeat, muscle tremors or irritability. Different
people have sensitivities or reactions to caffeine based
on personal tolerance, age and medical history.
Generally, up to 400mg of caffeine a day appears
to be safe for most healthy adults. This is equivalent to
about four to five cups of brewed coffee or coffeeshop
kopi, or five espresso shots. However, the caffeine
content in a cup of each type of coffee varies. Factors
affecting caffeine content include serving size, the type
of coffee bean used, the fineness of the coffee powder is,
how the coffee is brewed, and how much coffee is used.
Besides coffee, caffeine is also found in tea,
energy drinks, some soft drinks, chocolate and
certain medication. For example, two servings
of five-hour energy shots, for example, provide
about 400mg of caffeine and a 250ml can of
regular energy drink contains 80mg of caffeine.
The caffeine content in some soft drinks varies
from about 20mg to 50mg per can.
As a guide, keep caffeine intake to less
than 400mg daily to prevent any symptoms
from overdosing.
Congratulations on quitting
smoking. The changes that one
experiences after quitting may vary,
and may be subtle in the shortterm. The most acute symptoms
of nicotine withdrawal — such as
headache, nausea, sweating and
cramps — wear off within 72 hours.
However, it is common to have
occasional cravings for nicotine
for months or even years after you
quit smoking.
The longer-lasting effects are
more due to psychological or social
withdrawal rather than physiological
withdrawal. These cravings are
often triggered by events or social
situations when you would have
enjoyed smoking, so you should try
to be on guard to avoid returning to
the habit. Many people are unable
to quit the first time around due to
these reasons.
DR LEE LAY TIN
SENIOR CONSULTANT //
OCCUPATIONAL HEALTH DEPARTMENT //
TAN TOCK SENG HOSPITAL
MS TEOH SOH SUAN
DIETITIAN // NATIONAL HEALTHCARE GROUP POLYCLINICS
NHG IS THE REGIONAL HEALTH SYSTEM FOR CENTRAL SINGAPORE
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2/26/15 5:47 PM
Q&A
Q5
I’m Losing It
I read that hair fall is a
normal daily occurrence.
Is there an average number
of strands we lose per day,
and when should one start
worrying about hair loss?
What can we do to prevent
or delay it?
Q4
Stubborn Fats, Begone!
Is it true that when you get older, some fats
just won’t go away no matter how much you
exercise or watch what you eat? For example,
is it possible to get rid of the ‘muffin top’
around my waist after I pass 30?
Our body metabolism starts to decline after about age 26.
We become less efficient at burning calories and our
total body fat increases as we get older. In some areas of
the body, particularly the abdomen, fats are more “stubborn”
— that is, resistant to being utilised. In addition, fat cells
do not disappear with weight loss, they shrink in size.
This means that with excess calorie intake, those fat cells
will re-expand.
We cannot dictate fat loss in specific areas of the body.
It takes more than just regular exercise and diet;
we need the right amount of exercise and a lifelong effort
in weight maintenance.
The American College of Sports Medicine recommends
performing moderate-intensity physical activity for at least
150 minutes per week for weight maintenance and more
than 250 minutes per week for significant weight loss.
It is essential to practise a combination of both resistance
and aerobic training. Start your warm-up with light-intensity
exercises and cool down after by lowering the intensity.
Also, don’t forget to stretch at the end of the workout.
On top of exercise, it is important to watch our diet —
the saying “we are what we eat” holds some truth so enjoy
food in moderation. In conclusion, persevere and stay active!
MR JUSTIN LIM XUAN LI
PHYSIOTHERAPIST // NATIONAL HEALTHCARE GROUP POLYCLINICS
38
Lifewise
36-39 QnA V3.indd 38
Normal hair grows in cycles and
goes through three stages:
1 Growing phase (anagen)
2 Resting phase (catagen)
3 Falling phase (telogen)
At any time, it may be normal
for a person to lose as many as
50 to 100 strands of hair a day.
Your hair loss may be abnormal
if you are losing more than 100
strands a day. This may result in
general hair thinning or patchy
hair loss over the scalp.
There are many different kinds
of hair loss, such as:
Androgenetic alopecia — the
most common type of hair loss
in both men and women which
may occur due to a combination
of factors such as genetics,
age, and the male hormone
(dihydrotestosterone).
Alopecia areata — usually
results in patchy hair loss on the
scalp or other hair-bearing areas
such as the beard or eyebrows.
Telogen effluvium — diffuse
hair loss which may occur two to
four months following stressful
MAR-APR 2015
2/26/15 5:47 PM
Q6
events such as childbirth,
high fever, acute illness,
physical or emotional stress or
crash dieting.
Chronic illness — if one has
underlying iron deficiency due
to anaemia or thyroid disorders.
Drug-induced — the use of
certain medications such as
chemotherapy drugs may cause
hair loss.
Scarring alopecia — hair loss
may occur due to underlying
scalp diseases that may need
further investigations such as
scalp biopsy.
If you feel that your hair loss is
excessive, you should consult your
doctor or a dermatologist to find
out the cause of the hair loss and to
receive appropriate treatment. Use
a wider-toothed comb and avoid
hairbrushes, curlers and excessive
traction to your hair. Keep your
hair short and avoid perming
your hair.
DR CHUAH SAI YEE
ASSOCIATE CONSULTANT //
NATIONAL SKIN CENTRE
Under Pressure
How do I avoid ear congestion on planes? During
take-off, my ears hurt from the pressure and I can’t
seem to equalise. Is there any way to prevent this?
The space behind the eardrum or middle ear (ME) contains air. The
Eustachian Tube (ET) opens into the back of the nose and allows the
equalisation of ME air pressure. Nasal congestion can impair ventilation
of the ME. ET dysfunction can be temporary — during a cold for example,
or long-standing in individuals with allergic rhinitis (an inflammation
of the nasal passage). While flying, ET dysfunction can prevent the
equalisation of ear pressure during changes in cabin air pressure.
Affected individuals usually suffer discomfort during flight descent
rather than ascent — as the plane goes up the ME air pressure is higher
than cabin pressure, facilitating the escape of air through the ET.
During descent, cabin pressure increases but ME pressure remains low.
Equalisation of ME pressure often fails as it is easier for air to escape
from the ME than to enter it. Failure to equalise causes the eardrum
to be pushed inwards, causing discomfort.
To minimise this, swallowing and
yawning can encourage ME pressure
equalisation. If you have a cold, overthe-counter nasal decongestant helps
but should not be taken long-term.
For individuals with allergic rhinitis,
prescribed intranasal steroids would be
more effective — but these work better
if started several days prior to flying.
DR HO EU CHIN
CONSULTANT // DEPARTMENT OF
OTORHINOLARYNGOLOGY //
TAN TOCK SENG HOSPITAL
ASK THE
SEXPERTS
PHOTOS: GETTY IMAGES, SHUTTERSTOCK
GETTING
USED TO A
BIG CHANGE
Do women suffer sexual dysfunction like men do?
Sexual dysfunction in women can be divided into disorders of
sexual desire, arousal, orgasm and/or sexual pain. As a woman
approaches mid-life, defined as 40-60 years of age, she nears
menopause which results in a drop in sex hormones. The woman
experiences decreased sex drive, lethargy and vaginal dryness.
She also has to deal with decreased reproductive abilities as well
as a physical change in her body image (which can contribute to
decreased desire), reduced arousal or difficulty reaching orgasm.
Diabetic women are also at higher risk of sexual dysfunction.
Other causes include neurological diseases, pelvic surgery or
radiotherapy, as well long-term anti-depressant use.
Female sexual dysfunction can be treated with hormone
replacement therapy. It can also be prevented by leading a healthy
lifestyle by exercising (which can improve blood circulation to the
pelvic organs), not smoking, avoiding excessive alcohol intake and
being open with one’s partner about one’s sexual needs.
DR RONNY TAN
CONSULTANT // DEPT OF UROLOGY // TAN TOCK SENG HOSPITAL
NHG IS THE REGIONAL HEALTH SYSTEM FOR CENTRAL SINGAPORE
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Q&A
ALL ABOUT
ACNE
CONTRARY TO POPULAR BELIEF,
THIS COMMON SKIN CONDITION
IS NOT CAUSED BY BEING ‘DIRTY’.
BY DR SUZANNE CHENG WEI NA
CONSULTANT DERMATOLOGIST //
NATIONAL SKIN CENTRE
Acne is a disease of the pilosebaceous unit
(hair follicles and oil glands, commonly
known as ‘oily pores’). Development of acne
usually begins at puberty when hormones
influence the skin’s lubricating sebaceous
glands to secrete more oil. Besides
hormones, stress also plays a part.
Some believe that acne is caused by
being “dirty” but this isn’t entirely true.
Washing your face too often may actually
cause more oil to be produced. Consuming
certain foods such as chocolate and dairy
products is often believed to stimulate the
development of acne. However, data linking
the foods to the condition are inconclusive.
There is, however, some weak evidence
showing that high glycaemic index foods
(like white rice and sugary foods) as well as a
high fat intake may worsen acne.
This cross-section model of skin tissue
shows conditions (from left): whitehead,
blackhead and an acne pustule/cyst.
The development of acne comprises
four processes:
1 The hair follicle lining over-grows,
plugging the follicle
2 Excess sebum (oil) production
3 The presence and activity of the
Propionbacterium acnes bacteria,
which is found on the skin
4 Inflammation
WHAT ARE THE SYMPTOMS?
The first two processes result in whiteheads
and blackheads, otherwise known as
comedones. Processes 3 and 4 result in
painful inflammatory lesions such as
pimples, blemishes and acne cysts.
HOW IS ACNE TREATED?
Affected individuals with comedonal
non-inflammatory lesions —
whiteheads and blackheads — should
cleanse the face twice daily and apply
topical retinoids. They should avoid applying
heavy make-up and oily facial products.
For individuals with a few inflammatory
lesions, topical antibiotics may suffice.
Individuals with more severe inflammatory
acne are usually prescribed oral antibiotics.
Other conventional treatments include
oral contraceptive pills (for women with
acne) and oral retinoids.
HOW TO AVOID ACNE?
Acne can be difficult to avoid because
the degree of sebaceous gland activity is
genetically determined. However, early
treatment is advised to prevent the formation
of large inflamed acne lesions which leave
deep scars that are harder to treat.
40
Lifewise
Early treatment
of acne is
recommended
in order to
avoid lesions
that leave
permanent
scars.
PHOTOS: ISTOCKPHOTO, SHUTTERSTOCK
WHAT IS IT?
MAR-APR 2015
40 AllAbout Acne V3.indd 40
2/26/15 5:48 PM
CORPORATE NEWS + EVENTS
+ FORUMS
CLOSER TO THE COMMUNITY
NHG’S MOBILE COMMUNITY HEALTH CENTRE BRINGS
HEALTHCARE CLOSER TO THOSE WHO NEED IT.
a strong primary care foundation and community
partnerships are critical. The Mobile CHC is a key
initiative in our efforts to boost primary care which
T
forms the foundation of our regional health system.”
Mobile Community Health Centre (CHC). The CHC will
The CHC provides diabetic eye and foot screening, and
support some 300 general practitioners (GPs) in Central
personalised nurse counselling services for conditions
Singapore who in turn help to manage a growing number
like hypertension and high cholesterol. Patients can
of chronic disease patients in the community.
also get advice on self-care, nutrition and exercise.
o provide greater support to primary care partners
and patients with chronic conditions, the National
Healthcare Group (NHG) has launched its first
The launch was held in conjunction with the inaugural
ONE-STOP SERVICE
In addition to faster test results for patients, the
People’s Association Aljunied Cluster & NHG Community
mobile service enables patients — who must be referred
Health Carnival 2015 on 7 February at Kovan Hub, where
by GPs or clinics — to be screened closer to home.
Health Minister Mr Gan Kim Yong was the Guest-of-
It reduces patients’ need for additional trips to a
Honour. “Today’s launch of the first Mobile Community
hospital or polyclinic. It also encourages early diagnosis
Health Centre by NHG will take us another step closer to
and preventive treatment.
the community in providing primary care that is easily
accessible,” said Mr Gan.
The NHG Mobile CHC is a retrofitted 24-seater bus.
It will be parked in Community Clubs and HDB carparks
“With regular checks, and a more holistic approach in
at various locations
managing patient care, GPs would be better able to help
including Bishan-
their patients manage chronic diseases.”
Toa Payoh, Hougang
Professor Philip Choo, NHG’s Group Chief Executive
Officer, said, “To provide integrated care for patients,
Left: Health Minister
Mr Gan Kim Yong
(in red shirt) at the
launch of the NHG
Mobile Community
Health Centre.
and Whampoa, at
predetermined times.
The NHG Mobile CHC operates from
Monday to Friday, 9am to 5pm.
It is closed on weekends and
public holidays. For a schedule
of its planned locations, visit
https://corp.nhg.com.sg/RHS/Pages/
Our-Locations-and-Schedules.aspx.
Left: Ms Chang Xiaopei,
Senior Nurse Counsellor
and Centre Manager for the
NHG Mobile CHC, tending to
a patient, Mdm Sarasvathy.
NHG IS THE REGIONAL HEALTH SYSTEM FOR CENTRAL SINGAPORE
41-48 Spotlight V4.indd 41
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2/26/15 5:49 PM
Below: A/Prof Wong
Wei Chin led the
two-day event to bring
cheer to patients.
Above: In all, nearly
1,000 oranges were
distributed during
the two-day event.
SPIRIT OF
THE SEASON
Left: Ms Loh Shu Ching,
CEO of Ren Ci
Community Hospital
with Professor
Chee Yam Cheng,
Emeritus Consultant,
TTSH, doing their part
for patients.
NHG STAFF AND STUDENTS FROM
TWO MEDICAL SCHOOLS BROUGHT
CHEER AND ORANGES TO PATIENTS.
I
n the spirit of Chinese New Year, staff from the
National Healthcare Group (NHG) and medical
students brought holiday cheer to patients of the
Tan Tock Seng and Ren Ci Community hospitals.
In all, some 90 people — comprising NHG and
hospital staff, as well as students from the Lee Kong
Chian School of Medicine (LKCMedicine) and Yong
Loo Lin School of Medicine (YLLSoM) — took part in
the event held on 11 and 12 February 2015.
This is the third year that such an event
has been held as part of NHG’s Corporate
Social Responsibility programme. Led by Associate
Professor Wong Wei Chin, Lead for Geriatric Medicine at
LKCMedicine; and Ren Ci Community Hospital’s Director
of Nursing Mdm Mak Ngai Khan, the team packed goodie
bags with oranges and other treats. In all, nearly 1,000
oranges were distributed to more than 480 patients in
the two hospitals. The participants also livened the mood
with musical performances.
A/Prof Wong was heartened to see both staff and
42
I am heartened to see NHG staff and medical
students working together to lift the spirits
of our patients. These students display such
enthusiasm in serving our older patients.
ASSOCIATE PROFESSOR WONG WEI CHIN
Ms Stephanie Goh, a first-year student at YLLSoM,
said, “I had a lot of fun bringing joy to the patients.
medical students working together to lift the spirits
I realised that it means a lot to them and their families
of patients during the lunar new year season. Said
to have someone to talk to. It was also enriching to hear
A/Prof Wong, “These students display such enthusiasm
their life stories. I found the programme to be a very
in serving our older patients.”
meaningful experience indeed.”
Lifewise
MAR-APR 2015
41-48 Spotlight V4.indd 42
2/26/15 5:49 PM
TRAINING FOR
EMERGENCIES
TEMASEK FOUNDATION AND TTSH
SET UP A TRAINING PROGRAMME FOR
OUR FRIENDS ACROSS THE JAVA SEA.
E
ast Java in Indonesia is often exposed to
natural disasters such as volcanic eruptions, earthquakes
and floods. To help enhance emergency care preparedness,
Tan Tock Seng Hospital (TTSH) and Temasek Foundation are
partnering to train healthcare professionals from that region.
Over the next three years, TTSH will develop a dedicated life support
resuscitation training programme to build the capability
of 480 healthcare professionals from six hospitals in East Java.
A Memorandum of Understanding was signed on 11 November
2014 to pave the way for the programme. Temasek Foundation’s
grant of about $700,000 will go towards training, certification and
equipment costs — one practice dummy alone can cost up to $8,000,
for example. TTSH will help to set up a Life Support Training Centre
at Lamongan Muhammadiyah Organisation.
According to Dr Tay Seow Yian, Head and Senior Consultant in TTSH’s Emergency
Department, prompt cardiac life support can increase the chances of survival of a
Staff of Tan Tock Seng Hospital
training delegates from East Java
in January 2015.
heart attack. “Early access to ambulance services and thereafter, to continue the
resuscitation chain in hospital, are also critical factors in survival,” he said.
The first batch of 50 delegates from Indonesia was at TTSH for training from 28 to
30 January 2015, following a two-day theory training course conducted in East Java.
Allied Health gets a revamp at TTSH
NEW STRUCTURE IS ANOTHER STEP TOWARDS PROVIDING TEAM-BASED CARE.
I
nstitutions like Tan Tock Seng Hospital
The Clinical Board is chaired by Associate
(TTSH) are gearing up for team-based care
Professor Thomas Lew.
and as such, since 8 December 2014, TTSH
“The restructure allows better
has redesignated its therapists, pharmacists,
coordination and communications across
dietitians, social workers, podiatrists,
different professional domains,”
prosthetists, psychologists, radiographers and
said A/Prof Lew.This will translate
laboratory technologists as clinicians. They
into more timely and effective
now come under the new Allied Health Services
care for patients, delivered in a
and Pharmacy (AHS&P) Clinical Family Group,
more holistic and empathetic
headed by Ms Susan Niam who was formerly
manner by a team of providers.
Director of Allied Health Services at TTSH.
The hospital’s Medical Board has also
A/Prof Thomas Lew (left)
and Ms Susan Niam head
the TTSH Clinical Board and
Allied Health Services and
Pharmacy, respectively.
Ms Susan Niam,
Chairperson, Allied Health
been superseded with the formation of a
Services and Pharmacy
new Clinical Board. This will provide unified
(AHS&P), said, “The goal
clinical governance and a collective leadership
of this change is to grow
structure to foster the development of multi-
the team towards team-
disciplinary, patient-centric clinical care for
based, patient centric
the Medical, Nursing and AH&P family groups.
clinical goals.”
NHG IS THE REGIONAL HEALTH SYSTEM FOR CENTRAL SINGAPORE
41-48 Spotlight V4.indd 43
43
2/26/15 5:50 PM
Executive Director of NHG
Pharmacy, Ms Chan Soo Chung,
receiving the award from
Health Minister Mr Gan Kim Yong.
BRINGING HEALTHCARE
INTO THE FUTURE
THE MINISTRY OF HEALTH’S IT EXCELLENCE AWARDS
RECOGNISE INNOVATIONS THAT IMPROVE PATIENTS’ LIVES.
T
he Ministry of Health (MOH) Information Technology Excellence
Awards 2014 were presented for the first time at the National Health IT
Summit 2015. The awards recognise public healthcare institutions
that have achieved outstanding business outcomes through effective and
innovative use of IT. The judging panel of eight members was chaired by
Mrs Tan Ching Yee, Permanent Secretary, MOH, and awards were given in
four categories. Here are the winners from the National Healthcare Group
CATEGORY A: IT Excellence in
Increasing Access to Care
CATEGORY B: IT Excellence in
Delivery of Affordable Care
This category recognises projects and
initiatives that increase healthcare
delivery capacity through effective
demand management and preventive
care, productivity improvements or
healthcare experiences that promote
convenience for citizens.
The National Healthcare Group
Polyclinics (NHGP) Telecare Programme
for Diabetes, Hypertension and
Dyslipidaemia, available at all nine NHGP
polyclinics, allows patients with stable
diabetes, hypertension or abnormal
cholesterol levels to self-monitor their
condition at home, with the supervision
of a trained Care Manager.
This acknowledges projects and
initiatives that drive significant cost
reductions in healthcare operations,
cost-avoidance in patient care delivery
services or deliver timely and effective
health finance support to citizens.
This award was shared among the
major public healthcare institutions
under MOH, including Tan Tock Seng
Hospital, Institute of Mental Health,
National Healthcare Group Polyclinics
and National Skin Centre — all NHG
institutions. The award was given for
the outpatient subsidy enhancements
and Pioneer Generation benefits that
were rolled out on 1 September 2014.
These have since allowed
many Singaporeans
to enjoy enhanced
outpatient subsidies and
Pioneer Generation benefits.
NHGP Chief Executive
Officer A/Prof Chong
Phui-Nah receiving
the award from
Health Minister
Mr Gan Kim Yong.
44
Lifewise
CATEGORY C: IT Excellence in
Providing Quality of Care
This rewards projects and initiatives
that contributed significant
improvements to advancing patient
safety, patient centricity, care quality
and continuity of care for citizens.
The Outpatient Pharmacy
Automation System (OPAS) halves the
waiting time for medication by using
robot arms, automated conveyors and
other technologies to fill patients’
prescriptions accurately. OPAS was
implemented at Tan Tock Seng
Hospital and National Healthcare
Group Pharmacy outlets. Also jointly
awarded for implementing OPAS
were National University Hospital and
Integrated Health Information Systems.
CATEGORY D: Champion for
Health IT Excellence
This recognises individuals whose
contributions have been pivotal in
advancing the use of health IT for the
betterment of healthcare.
Dr Jonathan Phang of NHGP
was one of four winners of this
award. Dr Phang, who is a Family
Physician, Consultant and Deputy
Director of Clinical Services at NHGP,
is a proponent for the use of IT in
providing efficient, high-quality
healthcare. Dr Phang led the planning
and implementation of the clinical IT/
Electronic Medical Records systems
at NHGP. He was also key to NHGP
transforming into a “paperless”
organisation and fulfilling its vision of
a “one patient – one registration –
one bill” system.
MAR-APR 2015
41-48 Spotlight V4.indd 44
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A DAY OF FUN
AND TRIBUTE
NHG HQ STAFF CAME TOGETHER
FOR ITS ANNUAL CHARITY CARNIVAL.
O
n 9 January 2015, the National Healthcare Group
(NHG) held its annual NHG HQ Charity Carnival, an
event with delicious food, exquisite handicrafts and
fun-filled staff performances, all in the name of a good cause.
Extending his support and recognising the efforts of
staff on the day was Professor Philip Choo, incoming NHG
Group Chief Executive Officer (GCEO). In all, some $9,000
was raised with all proceeds donated to the Ang Mo Kio
Family Service Centre — COMNET Elderly Services,
a charity organisation that was selected
Above: Professor Chee
Yam Cheng (left) with
carnival participants.
Left: Staff sportingly
took to the stage
to perform at
the carnival.
by popular vote during the event.
The lively afternoon was
capped off with a video tribute,
produced by NHG’s Group Corporate
Communications, dedicated to
Professor Chee Yam Cheng who
had recently stepped down as NHG
GCEO. Prof Choo weighed in too, by
recounting what he had learnt from his
predecessor over 30 years of working
together. Prof Chee has since been
appointed President of NHG College
and Senior Advisor to the NHG Board.
A New Chapter
THE LEE KONG CHIAN SCHOOL OF MEDICINE MARKS THE
FOUNDATION LAYING OF NEW CAMPUS BUILDINGS.
T
he Lee Kong Chian School of Medicine (LKCMedicine)
— Singapore latest medical school, jointly set up by
Nanyang Technological University (NTU) and Imperial
College London (ICL) — will have new facilities coming up
at NTU’s main campus in western Singapore and another at
Health City Novena.
On 8 January 2015, some 180 guests, staff and students
from LKCMedicine — for which the National Healthcare Group
(NHG) is the primary clinical training partner — as well as
representatives from NTU and ICL witnessed the laying of
the foundation stone of LKCMedicine’s two new buildings by
Guest-of-Honour and President of Singapore, Dr Tony Tan
Keng Yam. The seven-storey Experimental Medicine Building
at NTU’s main campus is set for completion in July 2015,
while the 20-storey Clinical Sciences Building at Novena will
open its doors to students next year.
From left: NTU President Professor Bertil Andersson; President of Singapore
Dr Tony Tan Keng Yam; LKCMedicine Governing Board Chairman Mr Lim Chuan Poh
and Imperial College President Professor Alice Gast at the ceremony held at NTU.
NHG IS THE REGIONAL HEALTH SYSTEM FOR CENTRAL SINGAPORE
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2/26/15 5:50 PM
(Not) Going Viral
NHG DIAGNOSTICS CELEBRATED THE NEW YEAR
BY DOING ITS PART FOR A GOOD CAUSE.
N
HG Diagnostics ushered in 2015 with a corporate
MASTERING
CLINICAL
PHARMACY
MORE OPPORTUNITIES FOR CLINICAL
PHARMACISTS TO FURTHER THEIR STUDIES.
social responsibility (CSR) activity at Thye Hua
Kwan Home for Disabled @ Eunos. Putting
the funds raised from last year’s sale of mooncakes to
good use, NHG Diagnostics organised its first influenza
vaccination session for more than 75 residents and staff
on 7 January 2015.
The CSR committee, known as GLOW (Giving Laughter
with Our Work), conducted the vaccination exercise at that
time as flu season usually occurs between December to
February and May to July each year. The vaccines will help
residents guard against the flu and other complications
S
ince 2005, pharmacists from the National
such as pneumonia, by stimulating the immune system
Healthcare Group (NHG) and other
to produce antibodies.
institutions have been able to enroll in the
Dr Tyrone Goh, Executive Director of NHG Diagnostics,
Master of Clinical Pharmacy (MCP) programme,
presented the vaccines to Mr Ardi Hardjoe, Superintendent
run by NHG College in collaboration with the
of the Thye Hua Kwan Home. They were subsequently
University of South Australia (UniSA).
administered by the home’s nurses to the residents.
The two-and-a-half year part-time
programme aims to develop clinical pharmacists’
ability to provide specialist pharmaceutical services
CSR committee members also distributed bags of festive
goodies and art packs after the exercise.
In view of the positive feedback from the participating
in hospitals and other clinical environments,
staff, NHG Diagnostics and its GLOW committee look
which will ultimately optimise the quality use of
forward to planning more such CSR activities in the
medication. To date, 68 pharmacists have enrolled
near future.
in the programme, and 28 of them have graduated.
Pharmacists must complete a series of
lectures, tutorials and clinical scenarios,
held at NHG College at Nexus@one-north.
Lectures are conducted by Mr Stefan Kowalski,
Programme Director, of UniSA’s School of
Dr Tyrone Goh (far right)
presenting vaccines to
Mr Ardi Hardjoe (left),
Superintendent of
the Thye Hua Kwan Home
for Disabled @ Eunos.
Pharmacy and Medical Sciences.
The programme’s flexibility is beneficial to
students who have to juggle their coursework
with their pharmaceutical work. Mr Ng Boon Tat,
Principal Pharmacist at the Institute of Mental
Health who graduated in 2011, said he was pleased
with the skills he picked up during the course,
which allowed him to learn at his own pace.
46
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HOPE IN SIGHT
OCCUPATIONAL THERAPISTS’ DAY
HIGHLIGHTED HOW THOSE
WITH VISUAL IMPAIRMENT CAN
LEAD PRODUCTIVE LIVES.
T
o celebrate the 11th Singapore
Occupational Therapists’ Day
on 11 January 2015, a week-
long event with the theme “EnvisiOn
PossibiliTies” was organised by the
Occupational Therapy department at
Tan Tock Seng Hospital (TTSH). The event
aimed to broaden perspectives on how people
with low vision — in which one’s eyesight
is irreparably impaired — are able to lead
productive lives, with occupational therapists
An exhibition was
held to highlight
the challenges
people with low
vision face, as well
as technologies
to assist their
everyday life.
as partners in the rehabilitative journey.
An awareness exhibition was held on
13 January 2015 at the TTSH Atrium, where
the public had an insight to the challenges
faced by those with low vision through
simulator goggles. Visitors were also engaged
give talks on their services, thereby giving the
at interactive booths where they could
public and staff access to various resources via a
learn about home modifications, adaptive
common platform. Highlights included talks by
devices and assistive technology to facilitate
the Singapore Art Museum on how the museum
their independence.
provides an inclusive art experience for everyone,
Community partners were also invited to
and a talk by Soundball Singapore, a non-profit
organisation that promotes tennis-playing for
The event aimed to broaden perspectives
on how people with low vision are
able to lead productive lives, with
occupational therapists as partners
in the rehabilitative journey.
the blind, on how people with low vision can be
empowered to keep fit through sports.
In addition, the department’s occupational
therapists shared on how to improve care
of patients with low vision to help create an
accessible hospital environment.
NHG IS THE REGIONAL HEALTH SYSTEM FOR CENTRAL SINGAPORE
41-48 Spotlight V4.indd 47
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DIRECTORY
AN EASY GUIDE FOR YOU TO CONTACT OR LOCATE US
NATIONAL
HEALTHCARE GROUP
CORPORATE OFFICE
3 Fusionopolis Link
#03-08, Nexus @
one-north
Singapore 138543
Tel: 6496-6000 /
Fax: 6496-6870
www.nhg.com.sg
The National Healthcare
Group (NHG) is a leader in
public healthcare in Singapore,
providing care through our
integrated network of nine
primary care polyclinics, acute
care hospital, national specialty
centres and business divisions.
NHG’s vision of “Adding Years
of Healthy Life” is more than
just about healing the sick.
It encompasses the more
difficult but more rewarding
task of preventing illness and
preserving health and quality
of life. As the Regional Health
System (RHS) for Central
Singapore, it is vital for NHG to
partner and collaborate with
other stakeholders, community
advisers, volunteer welfare
organisations and others in
this Care Network together
with our patients, their families
and caregivers to deliver
integrated healthcare services
and programmes that help in
“Adding Years of Healthy Life”
to all concerned.
Specialist mental health
services are provided to meet
the special needs of children
and adolescents, adults and
the elderly. There are subspecialty clinics such as the
Neuro-Behavioural Clinic,
Psychogeriatric Clinic, Mood
Disorder Unit and an Addiction
Medicine Department. The
treatment at IMH integrates
evidence-based therapies,
supported by the departments
of Clinical Psychology, Nursing,
Occupational Therapy and
Medical Social Work, to provide
holistic care for patients.
IMH also provides a 24-hour
Psychiatric Emergency Service.
11 Jalan Tan Tock Seng
Tel: 6256-6011 /
Fax: 6252-7282
www.ttsh.com.sg
The second largest acute care
general hospital in Singapore
with specialty centres in
Endoscopy, Foot Care &
Limb Design, Rehabilitation
Medicine and Communicable
Diseases. It covers 27
clinical specialties, including
cardiology, geriatric
medicine, infectious diseases,
rheumatology, allergy and
immunology, diagnostic
radiology, emergency
medicine, gastroenterology,
otorhinolaryngology,
orthopaedic surgery,
ophthalmology and
general surgery.
INSTITUTE OF
MENTAL HEALTH
Buangkok Green Medical Park,
10 Buangkok View
Singapore 539747
Tel: 6389-2000 /
Fax: 6385-1050
www.imh.com.sg
48
Lifewise
2 Teck Whye Crescent
Fax: 6765-0851
CLEMENTI POLYCLINIC
Blk 451 Clementi Ave 3
#02-307 Fax: 6775-7594
HOUGANG POLYCLINIC
89 Hougang Ave 4
Fax: 6386-3783
JURONG POLYCLINIC
190 Jurong East Ave 1
Fax: 6562-0244
TOA PAYOH POLYCLINIC
2003 Toa Payoh Lor 8
Fax: 6259-4731
WOODLANDS POLYCLINIC
10 Woodlands St 31
Fax: 6367-4964
YISHUN POLYCLINIC
NATIONAL
SKIN CENTRE
1 Mandalay Road
Tel: 6253-4455 /
Fax: 6253-3225
www.nsc.com.sg
The centre has a team of
trained dermatologists to
treat patients with various skin
problems. To serve patients
better, there are sub-specialty
clinics for the different skin
disorders and laser surgeries.
NATIONAL HEALTHCARE
GROUP POLYCLINICS
Contact centre: 6355-3000
www.nhgp.com.sg
TAN TOCK SENG
HOSPITAL
CHOA CHU KANG POLYCLINIC
National Healthcare Group
Polyclinics (NHGP) forms
NHG's primary healthcare arm.
NHGP's nine polyclinics serve
a significant proportion of
the population in the central,
northern and western parts
of Singapore. NHGP's onestop health centres provide
treatment for acute medical
conditions, management of
chronic diseases, womenand-child health services
and dental care. NHGP also
enhances the field of family
medicine through research
and teaching. NHGP has also
been awarded the prestigious
Joint Commission International
(JCI) accreditation under
the Primary Care Standards.
Through the Family Medicine
Academy and the NHG
Family Medicine Residency
Programme, NHGP plays an
integral role in the delivery
of primary care training at
medical undergraduate and
post-graduate levels.
30A Yishun Central 1
Fax: 6852-1637
NHG COLLEGE
Tel: 6340-2362 /
Fax: 6340-3275
www.nhg.com.sg/college
The unit develops healthcare
professionals to their maximum
potential so that they will
provide quality, cost-effective
and safe evidence-based care
to patients.
NHG DIAGNOSTICS
Call centre: 6275-6443
(6-ASK-NHGD) /
Fax: 6496-6625
www.diagnostics.nhg.com.sg
National Healthcare Group
Diagnostics (NHG Diagnostics)
is a business division of NHG.
It is the leading provider
in primary healthcare for
one-stop imaging and
laboratory services that is
accessible, cost effective,
seamless, timely and accurate.
NHG Diagnostics supports
polyclinics, community
hospitals, nursing homes,
general practitioners and
the community at large via
its extensive network in
Singapore, Indonesia and
Vietnam. Its services are
available in static and mobile
centres. Mobile services
include general X-ray,
mammogram, ultrasound,
bone mineral densitometry,
and medical courier. It also
provides tele-radiology service,
laboratory and radiology
management, and professional
consultancy services in setting
up of imaging centres and
clinical laboratories.
ANG MO KIO POLYCLINIC
Blk 723 Ang Mo Kio Ave 8
#01-4136 Fax: 6458-5664
BUKIT BATOK POLYCLINIC
50 Bukit Batok West Ave 3
Fax: 6566-2208
NHG PHARMACY
Tel: 6340-2300
Fill your prescription online:
www.pharmacy.nhg.com.sg
NHG Pharmacy manages
the dispensary and retail
pharmacies at all nine
NHG Polyclinics. Services
include Smoking Cessation
Clinics, pharmacist-led
Anti-Coagulation Clinics
and Hypertension-DiabetesLipidemia Clinics, where
pharmacists monitor and
help patients optimise their
medication. Patients may also
consult our pharmacists for
treatment of minor ailments
or for travel or nutritional
advice. NHG Pharmacy also
provides comprehensive
medicationmanagement
services to Intermediate Long
Term Care facilities (ILTCs)
such as nursing homes. Under
the ConviDose™ programme,
medication is conveniently
packed into individual sachets
for patients according
to the stipulated quantity
and time the pills need to
be consumed.
PRIMARY
CARE ACADEMY
Tel: 6496-6681 /
Fax: 6496-6669
www.pca.sg
The Primary Care Academy
(PCA), a member of NHG,
was set up to meet the
professional training needs
of primary healthcare
professionals in Singapore
and the region. PCA aims to
be a platform for sharing of
expertise and capacity building
among community healthcare
leaders and practitioners in
and around ASEAN.
JOHNS HOPKINS
SINGAPORE
INTERNATIONAL
MEDICAL CENTRE
11 Jalan Tan Tock Seng
Tel: 6880-2222 /
Fax: 6880-2233
www.imc.jhmi.edu
Johns Hopkins Singapore
International Medical Centre
(JHSIMC) is a licensed
30-bed medical oncology
facility located in Singapore,
a joint venture between the
NHG and Johns Hopkins
Medicine International (JHMI).
It is the only fully-branded
Johns Hopkins facility
outside the United States,
providing inpatient and
outpatient medical oncology
care, medical intensive
care, laboratory services,
hospital and retail pharmacy,
general internal medicine
and health screenings.
MAR-APR 2015
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