Download BIGDisease - Jurong Community Hospital

LIFE
AT ITS
BEST!
2014ISSUE
4
YOU R Q UA RT ER LY H EA LT H & WEL L N ES S J OU R N A L
We profile the
men and women
who support you
in your journey
to health
Battling
BIGDisease
Chronic disease
is on the rise, but
new healthcare
models are pushing
against the tide
• Senior / Associate Executive (Logistics)
Connecting with you through
our Employee Value Proposition…
• Senior / Assistant Technician
A. Central Sterile Supply Department
B. Operating Theatre
• Senior / Dental Assistant (AH/JMC)
• Senior / Ophthalmic Technician
• Administrative Assistant
A.
B.
C.
D.
Human Resource
Major Operating Theatre
Medical Records Office (JMC)
Referral Management and Evaluation (JCH)
• Associate Executive
A. Pharmacy
B. Procurement
•
•
•
•
•
•
•
Associate / Patient Service Coordinator
Clinical Coder
Engineering Assistant (Biomedical)
Logistic Associate
Patient Care Assistant (AH/JCH)
Patient Information Associate (Call Centre)
Patient Service Associate
A. Emergency Medicine
B. Specialist Outpatient Clinics (AH/JMC)
C. Wards (AH/JCH)
•
•
•
•
•
•
JurongHealth is Singapore's public healthcare cluster for the West.
JurongHealth is building the new integrated healthcare hub
comprising the 700-bed Ng Teng Fong General Hospital and
400-bed Jurong Community Hospital (JCH) to provide holistic
care for patients from 2014. JurongHealth is currently managing
Alexandra Hospital (AH) and Jurong Medical Centre (JMC) with a
comprehensive range of clinical services for the community.
Winner of:
• Leading CEO Award
• Leading HR Leader Award
• Leading HR Practices in Employee Relations & People Management (Special Mention) Award
• Leading HR Practices in Quality Work-Life, Physical & Mental Well-Being (Special Mention) Award
Pharmacy Assistant
Pharmacy Technician
Plaster Technician
Principal / Senior / Enrolled Nurse (AH/JCH)
Supervisor (Wards)
Triage Specialist (Call Centre)
Apply now at
www.juronghealth.com.sg/careers
Or email us at
[email protected]
Join us on Facebook
www.facebook.com/JurongHealthServices
Follow us on LinkedIn
www.linkedin.com/company/jurong-health-services
We regret to inform that only shortlisted candidates will be notified.
“ The good physician treats
t
h
e
d
i
s
e
a
s
e
;
t
h
e
g
r
e
a
t
p h y s i c i wa hn o t hr eaas t st hteh ed ips ae at iseen. t
”
- William Osler
Preventing chronic disease, detecting it early and ensuring patients live well despite
being afflicted is one of our key priorities. Chronic diseases if poorly managed, may result in
even more serious consequences, affecting not just well-being, but social, emotional and
financial health as well.
In this issue, we look at four of the top chronic diseases that affect Singaporeans today.
These diseases are of special concern because they can affect anyone, especially with our
lifestyle which increases the risk of getting them. The BattlingBigDisease special explores
some causes, risks and treatments for these conditions. It also looks at how innovations in
healthcare models and advancements in technology are helping to better manage these
conditions and offer better outcomes for patients.
At JurongHealth, we are looking at new holistic approaches to tackle the inevitable rise
of chronic diseases. One way has been to leverage the expertise of a multi-disciplinary
healthcare team in patient-centric care delivery. This issue, we showcase some of the people
who play a key role in these teams. The AlliedHealthSpecial introduces the dedicated men
and women who work to support every patient, their families and caregivers in attaining
their health goals.
Don’t forget to turn to our regular features for more. In HealthBUZZ, read about the progress
of Ng Teng Fong General Hospital; and in FOODforLIFE!, learn about healthy ways to dine
out, snack and prepare a yummy breakfast. Finally, turn to HealthBites for tips on how to be
prepared for the haze should it return!
T h e e dit oria l t e a m
ONE HE A LT H
O1
C NTENTS
P UBLISH ER
JURONG HEALTH SERVICES PTE LTD
EDITOR -IN-CH IEF
CASEY CHANG
DEPUTY EDITOR
AARON LOH
E D ITOR IA L A SSISTA NT
WU WANWEN
CO NTR IBUTING EXP ERTS
DR ERIC CHONG
DR ENG SOO KIANG
DR KURUMBIAN CHANDRAN
DR LUKE LOW
DR NANDAKUMAR RAMASAMI
DR NIKOLAS WANAHITA
DR SEOW CHOON SHEONG
ELISA MAK
PUBL I S H ING CONSULTA NT
THINKFARM PTE LTD
M ANAGING DIR ECTOR
CHRISTOPHER TAY
E DITOR IA L & DESIGN
SHERALYN TAY
AUDREY PERERA
SHARON HO
JOHNNY TAN
WANTENG TAN
DEWON SWEE PEI FOONG
WRI T I N G & P H OTOGR A P H Y
ADAM KOH
BELLA LIM
LOUISA FOO
JUSTIN LOH
CL I ENT R ELATIONSH IP
JESSIE KEK
HealthBUZZ
04 OF MILESTONES &
GREEN SPACES
A look at the building
progress and greenery of
the upcoming Ng Teng Fong
General Hospital
HealthSense
07 ASK THE EXPERTS
Health questions answered
The information in this publication is not meant
to take the place of healthcare or services you
may need. Please see your doctor or primary
healthcare provider about any personal health
concerns. All information is correct at time of print.
ONEHEALTH IS PUBLISHED QUARTERLY BY
JURONG HEALTH SERVICES PTE LTD.
COPYRIGHT IS HELD BY THE PUBLISHER.
REPRODUCTION IN PART OR WHOLE
WITHOUT PERSMISSION IS PROHIBITED.
ALL RIGHTS RESERVED. MCI (P) 090/06/2014
PRINTED BY KHL PRINTING CO PTE LTD.
For general enquiries, email
[email protected]
O2 ON
LTH
O N EHE
E HE A
ALT
H
WeCARE
10
We profile
the men and
women who
support you in
your journey
to health
ALLIED
HEALTH
SPECIAL
2014 • ISSUE 4
26
BATTLING
BIG DISEASE
The fight
for health
Chronic disease is
on the rise, but new
healthcare models are
pushing against the tide
30 HIGH PRESSURE
SITUATION
Understand your risk of
hypertension and learn
how to protect yourself
34 ALL CLOGGED UP
Learn about the good, the
bad and the deadly roles
of cholesterol
38 SUGAR CRISIS
Watch your weight
and diet to prevent
diabetes and a range
of serious problems
41 COLON
CANCER
RISING
Be vigilant for one of
Singapore’s top cancers
and learn about prevention
and detection
FOODforLIFE!
44 HEALTHY HAWKER EATS
Dining out? Make these
healthier meal choices
46
SNACKING SMART
48
A TOAST TO REMEMBER
HealthBites
49 HAZE AWARE
When smoke or
smog gets in your
eyes, be armed with
this handy guide
Nibble on these smarter,
more nutritious treats
Flip out for this tasty,
protein and fibre-filled
French toast recipe
ON
ONE
HE A LT HH
ONEHEALT
EHEALT
O3
O3
HealthBUZZ
THE FINAL CEMENT SLAB IS
RAISED TO TOP-OUT THE
BUILDING STRUCTURE
JURONG RESIDENTS SIGN THEIR WELL-WISHES
FOR NTFGH AND A HEALTHIER COMMUNITY
ALBIZIA SAMAN (RAINTREE)
will provide shade with
its broad leafy canopy
A construction milestone
From commemorating
the topping out construction
milestone to planting the
seeds for a green environment,
here’s a snapshot of the
progress of Ng Teng Fong
General Hospital (NTFGH)
The final one-tonne cement slab hoisted to the top
of NTFGH earlier this year marked the completion
of the building structure. This cement slab, now an
indelible part of the hospital’s physical infrastructure,
bears more than 4,000 signatures and well-wishes,
collected at a community event at JEM shopping
mall, a future neighbour to NTFGH and Jurong
Community Hospital (JCH). The capstone is a symbol
of the community that lies at the “heart” of NTFGH.
With the completion of this building milestone, the
900,000-strong community in the west will soon
be served by the new hospitals when NTFGH opens
from December this year, followed by JCH in 2015.
Of Milestones
& Green Spaces
O4 O N E HE ALT H
BAUHINIA BLAKEANA
(HONGKONG ORCHID)
adds beautiful
colour to the
gardens
ALSTONIA SCHOLARIS
will give screening
along the perimeter
and general areas
PLUMERIA RUBRA
(FRANGIPANI RED)
provides a
sweet scent
and hue
A healing sanctuary
With approximately 22,600 square metres of green
areas in NTFGH, landscaping will be one of the
hospital’s many unique architectural features. These
green sanctuaries, in the form of ward planters and
vertical greening to green roofs and community
gardens will add to the hospital’s healing environment.
According to Stella Khoo, Horticulturist, JurongHealth,
what makes the green spaces in NTFGH unique is its
choice of sustainable native plants. “The proposed
plant palette was referenced from local species
which are easy to source, procure, hardy and easy
to maintain. Careful design planning is built in to
make these green elements as sustainable without
compromising hospital operations.” Ensuring that its
greenery remains truly green in an ecological sense,
rain catchment systems have been designed. These
will be able to supplement half of the irrigation system
requirements for planting areas. Most importantly,
the creation of various healing gardens will help in
providing a comfortable and healing environment for
patients and their loved ones.
Know your greens
coming your way…
SOME OF THE LUSH BEAUTIES
THAT YOU WILL SEE AT NTFGH
BRACHICHYTON ACERITIFOLIUS
or Illawarra Flame Tree, blooms
vibrant red for a splash of colour
CHRYSOPHYLLUM CAINITO
also known as ‘star apple’, will
take root in the community garden
COCOLOBA UVIFERA
commonly called the ‘sea grape’,
will offer shade for common areas
DYERA COSTULATA
or ‘jelutong’, will provide large leaves
for vertical screening of noise
STERCULIA PARVIFOLIA
known as ‘kelumpang burung’, will
green the perimeter grounds
COLA GIGANTEAN
will provide shade for walkways and
common areas
ONE HE A LT H
O5
HealthSense
Q
Recently, I’ve been
feeling unhappy
and stressed out at my
workplace. Because of
this, I’ve been giving
excuses to skip work
and it’s affecting my work
performance. How do
I know if it is depression
and if I need to seek
help? Do I see a Family
Physician or Psychiatrist?
A
Most people may feel
unhappy in reaction to
stressors. However, when
such emotional responses are severe,
it results in depression. This form
of sadness affects daily function
and impedes activities which were
previously enjoyable. You may feel
fatigued and physically drained; have
difficulty focusing on simple tasks;
be more irritable, short-tempered,
aggressive or negative. Some people
may turn to excessive alcohol
intake. In the worst case scenario, a
depressed person may have thoughts
of suicide or self-harm. Do see a
family physician or psychiatrist if you
experience any of these signs.
Dr Luke Low,
FAMILY PHYSICIAN (ASSOCIATE CONSULTANT)
Q
Some of my friends swear by colon
cleansing. What is this procedure,
what are the benefits and is it safe?
Are there other ways to keep the colon
“clean” and healthy?
A
The colon has many types of bacteria (called gut
flora) that produce byproducts that contribute to
the health of the intestines. In some diseases, this
dynamic is disturbed. Colon cleansing is currently a topic of
intense scientific research and is thought to be beneficial by
some because it rids the gut of its bacteria, and presumably
unhealthy products. However, its use in the general population
has not been supported by the medical community due to a
lack of scientific evidence. There have been rare cases where
the procedure has led to the puncture of the colon, causing
harm. Generally, a healthy lifestyle – regular exercise; keeping
a healthy weight; cessation of smoking or alcohol; a diet high
in vegetables and fibre, low in salt, sugar, processed meat and
animal fat – is more useful in keeping the colon healthy.
Dr Seow Choon Sheong,
SENIOR CONSULTANT, GENERAL SURGERY
Q&A
O6 O N E HE ALT H
Ask the expert!
Have a burning health question?
Send your question, name
and contact number to
[email protected]
BE THE FIRST TO
MAKE A DIFFERENCE
TO OUR PATIENTS
VOLUNTEER WITH
NG TENG FONG
GENERAL HOSPITAL!
Be the first face to welcome and to guide our
visitors and patients around our new hospital
when we open our doors in December 2014! We
invite caring and out-going individuals to
volunteer with us as greeters and guiders.
ROLES OF GREETERS & GUIDERS
(Commencing December 2014)
• Help with way-finding
• Guide visitors / patients to their destinations
• Assist patients on / off wheelchairs
• Assist with patients and visitors registration
• Assist with hospital tour requests
REQUIREMEN TS
• Minimum Age: 16
• Shift Time: Mon to Sun, 9am to 1pm /
12pm to 4pm / 4pm to 8pm
• Best Suited for: Retirees, home-makers,
shift workers and students
VOLUNTEER RECRUITMENT
Meet our volunteer coordinators at Jurong Medical Centre to find out more!
60 Jurong West Central 3, S648346 (Opposite Jurong Point Mall / Boon Lay MRT)
DATE
TIME
17 July, Thu
10am to 2pm
18 July, Fri
2pm to 6pm
19 July, Sat
10am to 12pm
ENQUIRIES / REGISTRATION
Please contact our friendly volunteer coordinators at 6370 6827 / 6830 or email [email protected]
ONE HE A LT H
O7
AlliedHealthSpecial
Life
Best!
AT
ITS
They are there for you when you’re getting back on your feet,
looking for help or need a supporting hand. As a critical aspect of
your healthcare journey, allied health professionals support the
diverse range of your healthcare needs. Some work behindthe-scenes to aid your diagnosis and treatment, while others work
directly with you to offer advice or conduct therapy. In honour of
the significant role they play, we showcase some of the men and
women who make it their job, passion and life’s ambition to care
for, support and guide you to health and wellness
LIGHTING & PHOTOGRA P H Y DAVID LEE STEVEN FOO S TY L IN G, H AIR & M A K E- U P PHOEBE PONG ALEX HO JING LIM
CLOTHES, SHOES & ACC ES S ORIES ALDO BANANA REPUBLIC CELIO* DOCKERS GAP NEW LOOK ROBINSONS TM LEWIN UNIQLO
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ALT H
Soundcheck!
More than just diagnosing hearing
problems, Shijitha plays a
critical role in enabling people
to communicate and connect
with the world around them
Audiologist Shijitha Chenicheri
Shijitha diagnoses, treats and manages hearing and
speech disabilities to help people connect with their
loved ones. “Hearing impairment is a dual disability,” she
pointed out. It’s not just ‘hearing’ but communication.
“If we cannot hear, our ability to talk to someone else is
also affected.” There is also a lesser known side to the
job. “Not many people are aware that the primary
function of our ear is to assist with our balance. In my
work, I also assess balance to see if conditions such as
giddiness are caused by inner ear problems.”
A major part of her work is fitting hearing aids and
this is a favourite aspect of her job. But the satisfaction
goes beyond merely deploying technology, she said.
“There is a very human side to it. I believe audiology is a
perfect combination of science and human interaction.
Apart from hearing science and technologies, there is
‘heart’ involved. I listen to patients’ needs and concerns,
counsel them about different options, help them
choose a suitable hearing aid and overcome their
challenges in adapting to it.” Whether it is to help an
elderly person hear again or play a role in teaching a
hearing impaired child to speak his or her first words,
she finds great satisfaction in knowing her work
makes an impact. “Hearing is an essential part of
communication, safety and entertainment and it is
exciting to bring ‘sound’ back to life. The reactions of
patients’ eyes lighting up when wearing a hearing aid
for the first time and hearing their loved ones’ voices
more clearly is a fulfilling experience.”
–––––––––
AUDIOLOGISTS
are professionals
who diagnose, treat,
and manage hearing
loss or balance
problems in people
of all ages. When
needed, they refer
patients to doctors
should a problem
require medical or
surgical evaluation
or treatment.
––––––––
ONE HE A LT H
ONEHEALTH
O9
AlliedHealthSpecial
The science
of eating well
Food is an essential and pleasurable part
of life – and it is Elisa’s job to ensure that
eating is both healthy and enjoyable
for all Dietitian Elisa Mak
The study of dietetics is both science and art. It
involves specialised knowledge, but also the skills to
'translate' the complex science of nutrition into
easy-to-understand information. “I help people to
make appropriate lifestyle and food choices to help
them stay well and improve the current medical or
health problem,” explained Elisa. “Dietitians are trained
to work in a hospital setting to interpret nutritional
science and blood results, give practical dietary advice
and look out for any adverse food-drug interactions to
meet our patients’ nutritional needs while also
managing their chronic conditions.”
She plays detective, looking for clues in a
patient’s eating habits, acts as counsellor to give
tailored dietary advice and takes on the role of a menu
planner to develop specific diets for people based on
their needs. Her interest in healthy eating is exceeded
only by her love of empowering others with
knowledge of good nutrition. “What makes me most
passionate about my work is the encounters with
different people.” She added that “good communication
skills are a crucial aspect of my work.” Beyond this love
for nutritional sciences and interacting with people
is a simple and enduring love for all things delicious
and how she can integrate these into dietetics.
“Discovering different foods, food cultures, food
beliefs as well as nutrient benefits continuously fuel
my interest in the field.”
–––––––––
DIETITIANS are
qualified allied
health professionals
who assess, diagnose
and treat dietary
and nutritional
problems for those
with chronic conditions
or specific health needs.
They often work in
healthcare institutions
to provide medical
nutrition therapy or
consultations that
help prevent and/or
manage various
medical conditions.
–––––––––––
O10
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A helping hand
Providing the link to community services or assistance,
Krutika works to ensure patients and their families
find the help they need on their road to wellness
Medical Social Worker Krutika Menon
It takes more than a kind heart to be a medical
social worker. A combination of empathy, resourcefulness and the ability to tap on a multi-disciplinary
array of services are what make Krutika’s work both
rewarding and challenging. As a medical social
worker, she deals with patients who – because of their
illness and/or hospitalisation – experience emotional,
psychological, social and care difficulties. “My role is
to assess the psychosocial functioning of patients and
families and intervene as necessary,” she explained.
This may include connecting patients and families to
necessary resources and support in the community;
providing financial assistance; psychotherapy;
supportive counselling; or grief counselling.
Working in the field, she not only enjoys helping
people, but also thrives in the fast-paced and dynamic
sector of public healthcare. “The most interesting
aspect of my job is meeting diverse individuals and
learning more about their lives. Each patient has a
different story to tell and each one inspires me to
continue in this profession. Supporting them in times
of need further enhances the satisfaction I receive
from my job.”
One patient, an elderly gentleman who needed
major surgeries on his foot, was particularly memorable. “The process of recovery and rehabilitation was
an uphill task for him and I had to support him through
counselling, liaising with community organisations for
long-term support and also applying for financial
assistance.” This underscored the breadth of her work.
“Seeing him go home safely and happily reinforced in
me the passion for my job.”
–––––––––––––– – – –
MEDICAL SOCIAL WORKERS
work with patients and families
who face difficulties coping due
to ill health and hospitalisation.
They assess emotional, psychological,
social and care challenges and
offer support. This often means
connecting patients and families
to necessary resources and support
in the community; providing
financial assistance; psychotherapy;
supportive counselling;
or grief counselling.
–––––––––––
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ONE HE A LT H
ONEHEALTH
AlliedHealthSpecial
The lifeblood
of medicine
You may not ever get to meet Gloria
during your medical treatment, but
the medical technologist is the one
who unlocks the information that
is key to your diagnosis and cure
Medical Technologist Gloria Chen
She works behind-the-scenes in the clinical
laboratory, processing, testing and recording the
results of tests on blood, bodily fluids and tissue. Her
work supports doctors in detecting, analysing,
monitoring, and treating diseases and medical
conditions. “It was an interest in clinical sciences and
preference for hands-on work that steered me
towards this field,” Gloria shared.
She may not be on the frontline interacting
face-to-face with patients, but she gets to know
patients very well in other ways – through their
specimens. “As medical technologists, we play an
important role in patient care,” she said. “Laboratory
test results are vital in helping clinicians with their
diagnosis and treatment, and we are the ones
providing these test results.” In fact, nearly 70 per cent
of clinical decisions about a patient’s diagnosis and
treatment rely on laboratory test results.
Her area of specialty and interest is the life-saving
field of transfusion medicine. “Working in Blood
Transfusion Services requires one to be agile and to
multi-task, especially in situations like massive
transfusion protocol activation and emergency
transfusions,” she said. “I have always thought how
amazing it is that different components of a human
being can be transfused or transplanted into others
to save lives!”
––––––––––––––––
MEDICAL TECHNOLOGISTS
are qualified professionals
who perform technical and
scientific duties in a clinical
laboratory. They receive,
process, test and report the
results of different types of
specimens such as blood,
body fluids and tissues,
playing an essential
role in the detection,
analysis, monitoring,
and treatment of diseases
and medical conditions.
––––––––––––––
O12
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Empowering
everyday life
As an occupational therapist Nur Hafizah helps patients of
all ages regain the ability to tackle everyday tasks for themselves
– building not just independence, but quality of life
Occupational Therapist Nur Hafizah Mohd Amin
It’s only when we are injured or ill that we start to
miss our ability to do simple tasks independently –
whether it is bathing or cooking a meal. As an
occupational therapist, Nur Hafizah works with
people who – for different reasons – experience
difficulties in doing their daily activities. “My work
ranges from observing a patient’s ability to shower
safely and training domestic helpers to care for
patients at home, to ensuring a patient can
reintegrate into their community and teaching
them how to manage household chores. I may
also prescribe exercises or advise on suitable
safety/mobility aids for the home.” The goal, she
said, is to customise therapies so patients maintain,
restore and improve their independence in the
activities which are important to them. This is
important in maintaining or enhancing their health
and wellbeing.
Her particular passion is upper limb
rehabilitation for stroke patients because each one
faces unique challenges. Sometimes, all it takes is a
little creativity. She recalled the case of a patient
who was paralysed from the waist down. “We used
a paper punch holder to support his iPad cover at
the right angle so he could continue a favourite
activity – surfing the internet!” Experiencing the
resilience of the human spirit and the ability of the
brain to adapt inspires her. “Seeing patients
re-learn skills over time, persevering through the
tough times and moving forward in life never fail to
amaze me.”
–––––––––––––––––
OCCUPATIONAL THERAPISTS
work with people who experience
difficulty engaging in their daily
activities due to physical disability or
mental or developmental problems
resulting from an accident, illness
or ageing. They teach skills, offer
rehabilitation and give advice on
modifying behaviour or physical
surroundings to improve independence
and safety so people can engage
in purposeful activity.
–––––––––––––
O13
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ONE HE A LT H
ONEHEALTH
AlliedHealthSpecial
Looking out
for your eyes
In a world of digital cameras accessible
at a touch, optometrist Bee Fang
cares for the most precious ‘seeing’
device we have – our eyes
Optometrist Ng Bee Fang
When she began her studies in optometry it was a
relatively new course at Singapore Polytechnic.
Today, the field of optometry is a critical one for
ageing Singapore – with growing demands and
advancements. Bee Fang explained, “Optometrists
are primary eye care practitioners who provide a wide
range of primary eye care services.” This includes
checking visual acuity, prescribing prescription
glasses, performing eye tests and diagnosing eye
diseases. They are also the only trained and licensed
eye care practitioners who can assess and prescribe
spectacles for children below eight.
“I also work with other healthcare professionals
such as eye doctors and general practitioners in the
management of chronic disease. In fact, sometimes,
an eye examination can lead to the first diagnosis of a
disease. For instance, diabetes and hypertension can
affect the eye. Hence, regular eye screenings by a
trained optometrist can prevent or delay the onset of
eye diseases,” she pointed out. Bee Fang maintains
her passion for her work because of the people she
helps and the empowering information she imparts.
“The most interesting aspect of the job is that I get to
meet people and share my knowledge so they can
take charge of their eye health.”
–––––––––––
OPTOMETRISTS
provide primary eyecare
such as assessing the type
and levels of low vision.
Optometrists are also
the only licensed eye
care practitioners who
can determine visual
acuity or the degree of
low vision for children
below eight years old.
They play a role in
diagnosing eye diseases
such as conjunctivitis
(red eye), cataracts
and glaucoma.
––––––––––
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The power to move
Helping you regain your physical wellness on
the road to recovery, physiotherapists like
Mark play an important role in managing
pain and preventing future injuries
Physiotherapist Mark Anthony Chan
Physiotherapist Mark makes it his goal to empower,
educate and enable others to manage and reduce
their pain, regain their mobility and tackle life. “As a
physiotherapist, I help people affected by injury,
illness or disability,” he explained. This involves using
movement and exercise, manual therapy and education
on lifestyle changes to help people remain active.
Physiotherapy is often associated with musculoskeletal function, but there are other specialities, Mark
pointed out. “There are physiotherapists who
specialise in cardiorespiratory problems and work in
intensive care units with critically ill patients. They
offer therapies to minimise lung secretion retention,
maximise lung oxygenation, re-expand collapsed
lung tissue and help patients on ventilators to wean
off the machine.” Physiotherapists also work in
neurological and geriatric areas.
One memorable encounter for Mark was with a
90-year-old patient who suffered chronic knee pain
and required a walking aid. “Though most might have
considered that at her age, the goal of walking
without an aid to be unrealistic or unnecessary, my
experience had taught me that age should never be a
limiting factor. In fact, her tenacity and dedication to
her exercise programme saw her free from her
walking aid in three months.” It shows the body’s
amazing ability to adapt, he reflected. “Seeing the
resilience of people facing adversity, and how they –
despite stumbling blocks – are able to dig deep into
their reserves to find a way to get back on their feet, is
inspiring. It is a privilege to be able to guide them
through the recovery process.”
––––––––––––––
PHYSIOTHERAPISTS
help people affected by
injury, illness or disability
through therapies involving
movement and exercise, manual
manipulation, education and
advice. These therapies aim
to alleviate pain, facilitate
recovery, enhance physical
dexterity and maintain optimal
health. Apart from physical
rehabilitation, they also work in
areas such as cardiopulmonary,
respiratory, neurological
and geriatric health.
––––––––––––––
O15
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ONE HE A LT H
ONEHEALTH
AlliedHealthSpecial
The dose is right
He’s not just a face behind the counter. Pharmacist Javin
ensures you’re taking the right medicine in the
right dosage and in the most effective way
Pharmacist Javin Tang
If you’re ever confused about the pill you’re taking
for a certain condition, Javin’s job as a pharmacist is
not only to dispense it, but to give you the
information you need to take it safely and effectively.
While a large part of a pharmacist’s work is in
dispensing medicines, they play other critical roles
in the healthcare spectrum as well. “We serve as a
crucial drug information resource for other
healthcare professionals and we work closely in
multi-disciplinary teams, advising on the selection,
dosages, interactions, and side effects of
medications,” he explained. “We also place great
emphasis on medication safety. Did you know, a
single drug has to be checked thrice by three
different staff before it can be dispensed?”
The dynamism of his work and its
ever-changing challenges range from addressing
enquiries from patients, customers or doctors;
sourcing for substitute medications; community
outreach; and even planning and setting up of
systems for the upcoming Ng Teng Fong General
Hospital. It all keeps the job interesting. Pharmacists
also monitor the health and progress of patients and
review medications for safety, effectiveness and
efficacy; provide holistic advice on health and disease;
run clinics to monitor patients on certain medications;
and participate in outreach programmes for
home-bound patients. All this underscores what lies
at the heart of the job: ensuring the health and
wellness of people.
–––––––––––––––––––––
PHARMACISTS are healthcare
professionals with specialised
knowledge in the science and
clinical use of drugs. They deal
with every aspect of medicines,
including drug manufacture, drug
supply, drug therapy management
and monitoring, as well as research
and development of new drugs.
In hospitals, pharmacists work
closely in multi-disciplinary teams,
giving advice on the selection,
dosages, interactions, and
side effects of medications.
–––––––––––––––––––
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Minding your
emotional health
Psychology is not only the fascinating study of the
human mind and behaviour. To psychologist Hui Fang,
it is the key to personal growth and emotional wellness
Psychologist Sam Hui Fang
It was the drive to understand more about human
behaviour and to help promote positive change for
those in psychological distress that inspired Hui
Fang to develop a career in the field of psychology.
As a psychologist, she uses scientific methods to
study how people think, act, react, and interact and
deploys evidence-based treatments to help people
deal with their emotional problems.
Psychologists are distinct from psychiatrists,
who are medical doctors able to prescribe
medication. Rather, she said, psychologists often
use ‘talk therapy’ (also known as psychotherapy),
behavioural change methods and cognitive therapy
(changing perceptions) to help and empower
people to cope and find solutions. Seeking help
from a psychologist can be a good way to
overcome life’s challenges, she said, and should not
be perceived as a bad thing. “The stigma that having
a mental health problem equates to being crazy
makes people unwilling to seek help early.” But
psychological help can tackle many practical issues.
“We can help people who feel anxious, angry,
depressed, or those who suffer insomnia, stress or
grief. We can also help people manage chronic
illness or pain.
“The most interesting aspect of my job is the
unpredictable nature of our cases. The
multi-faceted nature of human thinking and
behaviour continues to puzzle me and engages me
in continuing education,” she reflected, “But it is the
recovery process and change in my clients that
motivates and keeps me passionate about my work.”
–––––––––––––––––––––
PSYCHOLOGISTS are experts
in human behaviour and use
scientific methods to study
how people think, act, react,
and interact. They assess, diagnose,
treat or prevent mental health
problems and play an important
role in helping people who feel
anxious, angry, or depressed.
They also play a role in assessing
brain function and diagnosing
neurological problems.
––––––––––––––––
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ONE HE A LT H
ONEHEALTH
AlliedHealthSpecial
Best foot forward
Dianne ensures that your faithful yet overlooked
feet are in prime condition to carry you
through life Podiatrist Dianne Yap
Dianne always wanted to be in the healthcare
profession because she wanted to help keep
people healthy and well. As a podiatrist, she literally
does so from the ground up! She explained, “Podiatrists are specialists in the management of foot and
ankle conditions. We assess, diagnose and treat
foot and ankle problems.” This may include the
management of skin and nail conditions of the feet;
assessment of the biomechanical function and
abnormalities of the foot; prescribing functional
orthoses for support, padding and strapping; and the
management/treatment of diabetic foot ulcers.
Podiatrists like Dianne play an especially
important role in the latter. “Diabetes, especially
when poorly controlled, can affect the blood
supply and the sensation of the foot, increasing the
risk of ulceration, infection, and amputation.
Dealing with high risk diabetic feet has always
fascinated me. The thin line between saving and
losing a limb is immensely crucial for these
patients,” she shared.
New treatment options keep the field
interesting and hold new hope for patients too, she
added. One of these is placing sterilised live
maggots into non-healing wounds. “The maggots
clean up the dead tissue so that the healing process
is improved.” This lowers the risk of infection and
gangrene. Treatment advancements aside, her
patients give Dianne a deep sense of fulfilment.
“Seeing them get better or improving in their foot
and general health never fails to encourage me.
Moreover, life as a podiatrist is never boring as no
two feet are the same. You never know what type of
feet can walk into the clinic.”
––––––––––––
PODIATRISTS are
specialists in the
management of foot
and ankle conditions.
They assess, diagnose,
and treat foot problems
such as foot pain;
walking/running
abnormalities; fungal
infections; painful
growths and in-grown
toenails. They also play
a critical role in the
management of
chronic diseases
such as diabetes.
––––––––––––
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X-ray vision
Joshua’s skill with advanced
machinery helps to capture
what goes on inside your
body – so that doctors can
make sense of, and find the
clarity in, that picture of you
Radiographer Joshua Yap
It is Joshua’s job as a radiographer to take ‘pictures’ of
your insides. These images are an important part of
the diagnosis and help doctors figure out what’s
underneath a patient’s skin – whether it is a broken
bone, a tumour or a foreign body. Using imaging
technologies such as x-ray, computed tomography
(CT), magnetic resonance imaging (MRI) or
ultrasound, radiographers obtain images of the
body’s internal structures – both bony and soft tissue.
“Apart from obtaining a clear readable image,
radiographers need sound knowledge of a body's
different anatomical structures,” said Joshua.
Advancements in medical technology mean
very little radiation is now needed to get clear images
and this is an area that holds great promise. In fact, the
amount of radiation in a common test like a chest
x-ray is only a fraction of that received during a
seven-hour flight. “It is also now possible to obtain
certain types of CT thorax scans with the same
amount of radiation used in a chest x-ray,” Joshua
enthused. “This is of great interest to me because we
are always looking to reduce dose while improving
image quality for the benefit of all our patients.” What
drives him is simple: a compliment or smile after a job
well done. “It is enough to make me feel that this
job is indeed fulfilling and meaningful, and reason
enough to want to improve myself to better serve.”
–––––––––
DIAGNOSTIC
RADIOGRAPHERS
work in the field of medical
imaging, using different
non-invasive devices such
as x-rays and ultrasound to
provide a view of what goes
on inside a patient’s body.
They combine technological
skill and clinical knowledge
to produce diagnostic
images of various organs
and body regions and play
a role in the diagnosis and
management of diseases.
–––––––––––––––––
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ONE HE A LT H
ONEHEALTH
AlliedHealthSpecial
Breathe easy
When the essential act of breathing
ceases or is impaired, respiratory
therapist Clariza steps in to
ensure you can breathe easy
Respiratory Therapist
Ma. Clariza Bandong
Clariza works daily to make sure that patients
suffering from respiratory disorders continue to find
comfort and relief in an act we take for granted –
breathing. She explained, “As a respiratory therapist, I
help patients who have difficulty breathing. They
range from those with a chronic disease to those
who are in critical condition and are in the intensive
care unit (ICU). We use various methods to make
sure oxygen can reach the lungs. This includes
treatment such as oxygen therapy, mechanical
ventilation, and non-invasive ventilation.” Respiratory
therapists are also specialists in cardiopulmonary
resuscitation (CPR) and play an important role in
emergency care.
Apart from these clinical aspects, Clariza is also
involved in patient education, educating family
members on how to take care of patients at home
and how to take care of respiratory equipment. It’s
an interesting mix of knowing her equipment and
communicating with people, she said. “I get the best
of both worlds. I enjoy the technical aspect of
working with the various machines. At the same
time, I also get to take care of people.” One of the
most interesting aspects of her work is its range,
from critically-ill patients in ICU to patients who are
stable enough to go home and manage their
condition. She’s also continuously learning new
things, such as new patient care modes and better
technologies, “I find it amazing how these machines
can help support or extend life.”
–––––––––––––––––––
RESPIRATORY THERAPISTS
specialise in respiratory care
and are qualified to perform
respiratory care modalities
such as oxygen therapy,
mechanical ventilation and CPR.
Respiratory therapists work
in acute as well as critical care
and are often part of a multidisciplinary team involved
in the management of the
critically ill in a hospital.
––––––––––––––––
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State of your heart
Your heartbeat may hold the clue
to a heart condition – and cardiac
technologist Pamela is the person who
records the ‘music’ of your beating
heart to identify any abnormalities
Cardiac Technologist Pamela Tan
The lines and squiggles we see on a monitor or
electrocardiogram (ECG) are not just keeping pace
with your heartbeat; they tell your doctor just how
well your heart is working. As a cardiac technologist,
Pamela is trained to perform diagnostic procedures
for patients with cardiac disease. “While a cardiac
technologist does not diagnose patients, we work
with physicians to do so and assist in a variety of
diagnostics for heart and blood vessel disorders,”
she explained. This includes working with
echo-cardiography, treadmill stress tests, 24-hour
ECG monitoring, and blood pressure monitoring. Her
area of speciality is in performing ECGs. The device
uses ultrasound waves to create a black and white
picture of the heart without the need for any invasive
surgery.
Reflecting on her role, Pamela said, “As a cardiac
technologist we can benefit the lives of people in
many ways, particularly in aiding early diagnosis, so
that treatment can start and help people live healthier,
more productive and independent lives.” One
important skillset apart from technical knowledge is
interpersonal communication, she explained. “We
have to convey relevant information to the doctors
and build excellent staff-patient relationships. I like
meeting patients with different backgrounds and
helping the physicians to diagnose their conditions.
The new and improving technologies that help in
diagnosing heart conditions are of great interest to
my learning needs.”
–––––––––––––––––––
CARDIAC TECHNOLOGISTS
are trained to perform different
diagnostic tests on the heart
and blood vessels to help
evaluate, diagnose, and treat
patients with cardiac disease.
They perform both invasive and
non-invasive procedures to
aid the early diagnosis and/or
treatment of heart diseases.
–––––––––––––––––––
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ONE HE A LT H
ONEHEALTH
AlliedHealthSpecial
Help to say ‘hello’
We take the simple act of saying hello or eating for
granted. For those who have lost these abilities, Aileen
works to help them communicate, eat, swallow
and regain their quality of life
Speech Therapist Aileen Kelly
Speech therapy isn’t just about helping children with
speech defects. “Speech therapy,” said Aileen, “also plays
a role in the rehabilitation of swallowing difficulties.” She
explained, “Speech therapists provide assessment,
diagnosis and therapy services for people of all ages
who suffer from problems in speech, language, voice
and swallowing.” Her work plays a big role in helping
people regain their quality of life. After all, communication and eating are important aspects of living well.
She shared an inspiring case, “I recently had a
young patient who was unable to eat or drink at all after
a stroke so he had to receive nutrition via a tube in his
stomach.” Working with him daily to improve his ability
to eat and drink, he was soon able to enjoy a regular
diet. “Patients who make a complete recovery in such a
short amount of time are rare,” she said. “Great things
can be achieved with the patient’s hard work at their
rehabilitation programme.” She added, “The most
interesting aspect of my job has to be the people that I
meet; not just patients but the healthcare team of
doctors,
nurses,
physiotherapists,
occupational
therapists, medical social workers, therapy assistants,
and administrative assistants.” Going forward, she hopes
to help develop more standardised assessments in
languages apart from English, so that the field can
adequately address the diversity of patients and offer
them better care.
–––––––––––––––
SPEECH THERAPISTS
are professionals who
assess and treat speech,
swallowing, language or
communication problems.
In infants and children,
they may deal with speech
and language disorders,
learning difficulties or
hearing impairment.
In adults, it is common
to tackle difficulties in
speech, language and/or
swallowing difficulties
due to stroke or brain
injury, brain/head/neck
tumours or degenerative
neurological diseases such
as Parkinson's disease.
–––––––––––––––
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Brain wave reader
Chee Chong taps the secrets of
the human brain with a wide array
of sophisticated equipment to
diagnose and ‘read’ what’s going
on in the body’s control centre
Neurodiagnostic Technologist
Ong Chee Chong
The brain, the seat of human knowledge, emotion,
thinking and individuality, is one of the most complex
organs in the body. It is also an electrochemical organ
that sends tiny charges of electricity via its synapses to
relay information. As a senior neurodiagnostic
technologist, Chee Chong can tap into and record
these messages. This provides valuable data to
physicians who analyse the data to determine the
cause and effect of brain disorders such as epilepsy,
stroke, neuromuscular, nerve and spinal cord disease.
“We record and study the electrical activity in the
brain and nervous system,” he explained. One of
most common tests is electroencephalography
(EEG), where Chee Chong attaches specialised
electrodes to the head in order to amplify and record
real-time electrical brain activity. He elaborated,
“These electrodes monitor brain activity and we read
the data to detect any abnormal firing of the brain
cells, which in turn may affect the functioning of the
brain.”
These diagnostic investigations help the
multi-disciplinary team of medical researchers,
clinicians and physicians to evaluate, diagnose and
treat neurological conditions. There is great
satisfaction in making sense of the complicated
looking wave readings on his screen. “It is through the
use of these modern technologies that early diagnosis
and/or prompt and timely treatment of brain diseases
are made possible so people can lead healthier,
productive and independent lives,” he reflected. “I’m
passionate about my work because I can provide
accurate clinical diagnosis for the physician, which
may in turn help in the right treatment of patients.”
–––––––––––––––––––––––––––
NEURODIAGNOSTIC TECHNOLOGISTS
record and study electrical activity in the
brain and nervous system. They use a range
of high-tech equipment to help doctors
in the evaluation, diagnosis and treatment
of brain disorders such as epilepsy,
stroke, neuromuscular, nerve
and spinal cord diseases.
–––––––––––––––––
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ONE HE A LT H
ONEHEALTH
AlliedHealthSpecial
Air supply
If you’re feeling breathless, Wai Chun can help find out why
– he’s trained to perform specialised respiratory diagnostic
procedures and tests to review the health of your lungs
Respiratory Technologist Wong Wai Chun
Working in one of the newest fields in medicine
today, Wai Chun is excited to be part of a growing
number of respiratory technologists to help tackle
the increase in respiratory conditions. He explained,
“A respiratory technologist is a professional who is
trained to perform specialised diagnostic
procedures and tests for respiratory disease.” Many
of these involve assessing how well your lungs
function and how much oxygen you are getting.
“We diagnose and monitor diseases that affect the
lungs and make breathing difficult, such as asthma
or cystic fibrosis. The tests also find out the cause of
shortness of breath, coughing or wheezing,
monitor treatment of respiratory problems and
evaluate lung functioning before surgery,” Wai Chun
said.
A common test is spirometry, where a patient
blows into a device called a spirometer to measure
his/her breathing ability. It is one of the main
diagnostic tests for chronic obstructive pulmonary
disease (COPD), a growing concern among
Singapore’s ageing population. Spirometry is also
used to diagnose or manage asthma and other
respiratory conditions. “The most interesting aspect
of my job is patient education,” he reflected. “Using
various equipment and techniques, we help
patients who have difficulty breathing. Being a part
of the healthcare team providing care to patients
drives my interest and passion for my work.”
––––––––––––––––––––––
RESPIRATORY TECHNOLOGISTS
perform specialised respiratory
diagnostic procedures and tests
to evaluate, diagnose, and treat
patients with breathing diseases.
They play a key role in the diagnosis
and monitoring of diseases such as
asthma, cystic fibrosis and COPD.
The tests they conduct can also
be used to find out the cause of
shortness of breath, coughing
or wheezing, and they also
evaluate lung function
before surgery.
––––––––––
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While you
are sleeping
Nothing beats a good night’s sleep.
Beating insomnia and other
energy-draining sleep disorders is
sleep lab technologist Victoria,
whose mission is to make your
rest count Sleep Lab Technologist
Ma. Victoria Parot
Victoria watches people while they sleep. The job description may
sound a little odd, but it is actually an important part of diagnosing
sleep disorders. A sleep lab technologist, explained Victoria, is a
healthcare professional who conducts diagnostic procedures for
people with suspected sleeping disorders and provides the
relevant therapies. “Everything about my job is interesting,” she
enthused. “For instance, one of the main diagnostic tests is a sleep
study, a sleep recording to measure how well a patient sleeps and
how his/her body responds to sleep problems. The data from
these tests is then used to diagnose and treat the problem.”
The most satisfying part of the job is seeing the impact and
positive outcomes from the right therapies, she added. “We often
see people suffering from severe sleep apnea, a condition where
the airway collapses during sleep cutting off oxygen flow. Once we
initiate therapy with a continuous positive airway pressure
machine that keeps the airway open, we can see the marked
difference in the results and in the benefit to patients.” Victoria is
also passionate about raising awareness of sleeping disorders.
“Many are not aware of the risk and hazards of having sleep
disorders, but sleep is a very essential part of health,” she said. “My
job is not only to help diagnose and treat sleep problems, but
promote health and wellness through better sleep.”
––––––––––––––––––––––––––
SLEEP LAB TECHNOLOGISTS work as
part of a team to assist in the education,
evaluation, treatment and follow-up
of sleep disorders. They are specially
trained to perform sleep studies to
measure the quality of sleep and
diagnose the presence and severity
of a sleep disorder. Apart from this,
sleep technologists play a key
role in patient education
about the importance
of sleep.
––––––
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ONE HE A LT H
ONEHEALTH
BattlingBigDisease
Battling
BIGDisease
Our modern lifestyle has brought us greater convenience, more
affluence and access to all manner of healthcare advancements.
Even so, many chronic diseases are on the rise. In this issue, we
look at the major illnesses that affect Singaporeans and what
is being done to win the fight By Adam Koh
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The
rise
of
chronic
disease
Here in Singapore, we enjoy a multitude of modern conveniences, a high
standard of living, growing affluence and ready access to technological
advancements, including medical care. But even as we benefit from these
privileges, there is also a negative side. The modern lifestyle, with its stresses,
long working hours, and hectic activity means that our general health may face
greater health risks despite improved access to healthcare.
As Dr Luke Low, Family Physician, Lakeside Family Medicine Clinic –
a healthcare collaboration with JurongHealth – pointed out, “Singapore has
become a first world country very successfully and our populace is now leading a
more sedentary lifestyle.” With many of us working in offices and air-conditioned,
comfortable environments, we do less physical activity compared to our
forefathers who worked the fields and farms, and this increases the risk of
health problems, he added. While healthcare advancements mean we are
able to live longer and more productive lives, it also means an increase in
age-related illnesses.
A changing landscape
In Singapore, the profile of diseases that affect us today is different from those
in the 1960s and 1970s, and this has shaped the way our healthcare landscape
has evolved, said Dr Low. “[Then], infectious diseases plagued our population.
The answer to that was to have a primary care model that was easily accessible,
and the polyclinics and general practitioners (GPs) did well to respond to such
needs.” Because infectious diseases usually took just one or two consultations
to cure, the model called for clinics to be open to the public and did not
require an appointment system. “Fast forward to our current climate. The
management of chronic diseases involve long-term, often hospital-based,
care with recurrent appointments involving a multi-disciplinary team of
doctors, nurses, dietitians, therapists, and pharmacists for every patient.”
This shift means the healthcare model has been transformed from ad hoc
treatments to a more long-term and holistic approach.
Said Dr Low, “Patients with long-term chronic diseases often have to adapt
their eating, lifestyle habits, and even comply with complicated medication
regimes on a permanent basis. Such a drastic change requires time to adapt
and understand on the part of the patients.” This call for robust patient
education and empowerment has resulted in a more multi-disciplinary
approach. This consultative model where our team becomes the patients’
partners in health takes the place of the previous paternalistic approach where
the doctors dictate and the patients merely follow orders.”
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ONE HE A LT H
ONEHEALTH
BattlingBigDisease
First world illnesses
There is an
overall increase
in chronic or
long-term
diseases.
For instance, the Ministry of
Health (MOH) records
hypertension, high cholesterol, diabetes and obesity
to be among the most
common diseases among
adults aged 18 to 69.
Cancer too is on the rise
and is responsible for the
largest number of deaths
in Singapore each year.
Around 50,000 cases of
cancer were diagnosed
between 2006 and 2010
compared to 12,000 cases
between 1968 and 1972.
As most cancers are more
likely to affect older people,
Singapore’s ageing population will inevitably register
an increase in cancer
incidence. Of the top
cancers, colon cancer is
the most prevalent cancer
among Singaporean men
and women and is among
the top three fatal cancers
for both gender groups.
Many of these diseases –
if not managed well – can
lead to complications, even
disability and death. They
also take a toll on the social
and emotional health of
patients and their loved
ones. Dealing with chronic
illness is a challenge almost
all first world economies
deal with, and Singapore is
no different.
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SINGAPORE’s
TOPILLNESSES
1
2
3
4
0
5
10
15
20
25
1992
1998
2004
Hypertension
2010
1992
1998
High
Cholesterol
2004
2010
1992
1998
2004
Diabetes
2010
1992
1998
2004
Obesity
2010
While early detection and medical intervention have helped to
improve the prevalence of some chronic diseases, the incidence of
these diseases remain high. Lifestyle diseases such as diabetes and
obesity are of critical concern as these increase the risk of many
other problems such as stroke, heart disease, kidney failure and cancer.
2003 - 2011
2003 - 2011
60% Breast
Colon
40%
Lung
39%
Prostate
27%
2003 - 2011
29% Colon
2003 - 2011
15% Lung
2003 - 2011
12% Uterine
2003 - 2011
4
2003 - 2011
2003 - 2011
Liver
17%
LEADING CANCERS IN SINGAPORE
(2007 – 2011)
A
community
to tackle
chronic disease
Dr Eng Soo Kiang, Family Physician, Lakeside Family Medicine Clinic, highlighted
the recent shift to focus on community care, an approach that will improve
chronic disease management and move it away from hospital-based care. “MOH
has recently reach out to untapped community resources such as GPs and retired
nurses. New Family Medicine Clinics such as the Lakeside Family Medicine Clinic
also provide solo-practitioners like GPs with more scale and resources. Patients
get to see the same few doctors, nurses and allied healthcare professionals
who help manage their illness.”
This model means that patients and caregivers can be more closely supported
in their healthcare and sick-care journey from home to specialist outpatient
clinics to hospitals and back home again, added Dr Eng. The shared care
programme between the Lakeside Family Medicine Clinic and JurongHealth means
patients seeing family physicians at the former will have their care parameters
tracked and reported back to specialist colleagues via care coordinators. In the
event that such patients need to return to JurongHealth as part of their annual
follow-up with specialists, or due to a deterioration in their condition, their medical
conditions and summaries are transmitted back to hospital specialists for timely
consultation and intervention, explained Dr Low. He went on, “This ensures that
our patients get optimal care, be it in the hospital or the community.”
The shift towards
more integrated
community care
will improve
chronic disease
management and
move it away
from hospitalbased care.
>
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ONE HE A LT H
ONEHEALTH
BattlingBigDisease
Push against something with
enough force and it is bound to
give way over time. In hypertension
or high blood pressure, the pressure
that the blood exerts on the blood
vessel walls is too high, causing
damage. Dr Nandakumar Ramasami,
Consultant, Department of
Medicine, JurongHealth,
elaborated, “High blood pressure
develops when the walls of the
large blood vessels (arteries)
become rigid as they lose their
elasticity with time and when the
smaller blood vessels become
narrower.” High blood pressure
affects almost a third of the adult
population of Singapore, added
Dr Nandakumar, but because there
are few overt symptoms, many do
not realise they suffer from it.
When
the pressure
is on
IN CONSULTATION WITH
DR NANDAKUMAR RAMASAMI,
CONSULTANT, DEPARTMENT
OF MEDICINE
When the pressure of blood flowing
through its pathways becomes too
intense, it can increase the risk of many
health problems By Adam Koh
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A silent killer
Though there are no symptoms in a vast majority of
people, high blood pressure is a deadly disease. “Having
high blood pressure greatly increases the risk of heart
attack or stroke. If untreated, high blood pressure can
lead to kidney failure and even damage your eyesight,”
said Dr Nandakumar. The condition can also make the
heart muscle become abnormally thick and stiff. In a
condition known as left ventricular hypertrophy, the heart
becomes enlarged and less able to pump blood around
the body, leading to heart failure. The only way to tell if
you have hypertension is to get your blood pressure
measured. There are, however, some factors that may
indicate that you are at risk, such as:
∞
∞
∞
∞
∞
Not getting regular physical activity
Being overweight
A diet high in sodium or alcohol
A family history of high blood pressure
Diseases of the kidney or adrenal gland
Taking certain medicines and herbal remedies may
also elevate blood pressure. Dr Nandakumar also
said that high levels of stress are known to be associated
with high blood pressure, although scientific evidence
has not established a clear link.
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ONE HE A LT H
ONEHEALTH
BattlingBigDisease
We all need a certain amount
of pressure in our arteries to
keep blood flowing through
the body. When the heart
contracts, it sends oxygenated
blood flowing through
the arteries; when the heart
muscles relax, the heart refills
with blood.
Making
sense of
BP 120
76
Blood pressure
Systolic pressure
pressure of blood in the arteries
when the heart contracts
is the measurement of
the blood’s pressure
in these two phases and is
recorded as two numbers:
Diastolic pressure
pressure of blood in the arteries
between heart beats
Blood Pressure
Systolic BP
Diastolic BP
Normal blood pressure
Under 130
Under 80
Borderline high blood pressure
130 to 139
80 to 89
High blood pressure
140 or higher
90 or higher
The unit of measurement for blood pressure
is mmHg (millimetres of mercury)
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There is no known cure
for high blood pressure,
but the good news is
that blood pressure
can be kept under control.
Apart from medicine,
blood pressure can be
managed and lowered
with lifestyle and diet
changes.
Tackling hypertension
Lose
weight
Physical
activity
The more
weight you carry,
the bigger a toll
it takes on the
body and the
higher the risk
of hypertension.
Ideally, keep your
weight within a
healthy BMI range
of 18 to 25.
Aim for
at least 30
minutes a day,
five times a
week. Regular
exercise helps
lower blood
pressure and
reduce the risk
of other chronic
diseases as well.
Cut
down
on salt
Sodium
contributes
to high blood
pressure. Keep
within a teaspoon
of salt a day, avoid
processed food,
and use herbs
and spices
instead of salt.
Reduce
alcohol,
stop
smoking
Both these
habits are
significant
contributors to
hypertension
and other
ailments.
This multi-faceted approach to managing high blood pressure is
important as it not only treats the condition, but addresses the risk
factors that lead to it. “In order to ensure adequate treatment for life,
it is important that patients and their medical team work as partners
in managing the condition,” noted Dr Nandakumar. To this end, JurongHealth is setting up a Hypertension Clinic which will offer the
full scope of assessment, counselling, investigations, and intervention
for hypertension. Here, patients with resistant high blood pressure
will be assessed to optimise their therapy, and may be considered
for a novel therapy known as renal denervation (see box story).
The team will also help patients understand the
disease process, progression, treatment plans and goals.
“This ensures compliance, which is crucial, especially in
a chronic disease which can be easily managed, but if
untreated can lead to significant morbidity and mortality.”
New hope
for stubborn
hypertension
Renal denervation (RDN)
is a new and promising
therapy for patients
who are resistant to
multiple drug therapy
for their hypertension.
It is a minimally invasive
procedure that uses
radiofrequency waves
to destroy one of the
nerves that runs along
the renal arteries. This
nerve, when overactive,
plays a role in causing
high blood pressure.
The procedure has
few side-effects and
only requires patients
to stay overnight in
the hospital. “The RDN
service is an excellent
example of a collaborative approach by a
multi-disciplinary
team consisting of
cardiologists, radiologists, nephrologists,
and specialist nursing
staff,” added Dr Nandakumar.
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33
ONE HE A LT H
ONEHEALTH
BattlingBigDisease
All
clogged
up
Not all cholesterol is bad for you but
when the bad outweighs the good, the
risk of heart attack and stroke increases.
Learn how to keep your blood vessels
and heart healthy By Sheralyn Tay
IN C ONSULTATION W ITH DR N I K OL A S WA N A H I T A & D R ER I C CH ON G ,
C O NSULTANTS, DEPARTM E N T O F M E DICIN E
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Imagine thick chunky sludge
travelling through a pipe and the
residue it will inevitably leave on
the inside surface – that’s a good
illustration of how ‘bad’ cholesterol
can affect the blood vessels, the
transport infrastructure of your
body. “Cholesterol consists of
many different particles,” explained
Dr Nikolas Wanahita, Consultant,
Department of Medicine, JurongHealth. “When our body has a
high level of low-density lipoproteins (LDL) cholesterol and a low
level of high-density lipoproteins
(HDL) cholesterol, this becomes
an important risk factor for
various diseases.”
This is because LDL particles
stick to the blood vessel walls
– causing it to become narrowed
– and become the precursor of
what we called plaque that blocks
our blood vessels. “When this
plaque became unstable and
eroded, it may detach from the
blood vessel wall and cause
complete blockages downstream
in our arteries.” High levels of LDL
can also cause inflammation and
hardening of the blood vessels,
a condition known as
atherosclerosis, added Dr Eric
Chong, Consultant, Department
of Medicine, JurongHealth.
“High cholesterol is
a significant problem
because it is the forefather
of many cardiovascular
diseases such as stroke,
heart attack, and
peripheral vascular
disease (blockages
in the leg arteries).”
STAGES OF ATHEROSCLEROSIS
Healthy
artery
Build up
of plaque
forms
Plaque
ruptures;
blood
clot
forms
The facts
about cholesterol
Cholesterol is a type of fat in the bloodstream that is essential to all
animal life. It is a vital component of our cell membranes and plays
a role in intracellular transport, signalling and nerve conduction.
In addition, cholesterol is an important part of the way our bodies
make steroid hormones, bile acids and vitamin D. Cholesterol
comes in two forms of proteins known as lipoproteins: low-density
lipoproteins (LDL) and high-density lipoproteins (HDL). High levels
of LDL cholesterol can lead to fatty deposits in the artery walls that
cause them to harden and narrow. This form of cholesterol is
sometimes referred to as ‘bad’ cholesterol. HDL cholesterol is
‘good’ cholesterol that helps remove excess cholesterol from
the body, reducing the risk of heart disease. In the right amounts,
cholesterol is normal and essential for good health. But if blood
cholesterol levels are too high, your risk of developing health issues
such as heart disease and stroke can increase.
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35
ONE HE A LT H
ONEHEALTH
BattlingBigDisease
Risk factors and detection
Cholesterol
levels are
determined by
inherent factors
as well as
lifestyle choices
Genetics determines the
amount of cholesterol you
naturally produce. A family
history of high cholesterol
is an indication that you
may be at higher risk of
developing high cholesterol
A diet high in
saturated fat,
trans fats and
high-cholesterol
foods may raise
your cholesterol
levels
Being
overweight
and inactive
contributes
to increased
LDL cholesterol
As Dr Wanahita noted, it
is important to focus on risk factors within our control
by eating a healthy diet high in fibre, avoiding diets high in saturated and
trans fats, and maintaining a routine of moderate exercise.
Early detection
can also play a
role in reversing
the problem.
Though it is not possible to tell from physical signs that your cholesterol
levels are too high, a simple blood test can determine your cholesterol levels.
Dr Wanahita recommends regular cholesterol screening for men aged 35
and above and women aged 45 and above. Anyone with a risk of coronary
heart disease should begin screening earlier at 25 years old. The risk factors
for heart disease include smoking, family history of heart disease,
hypertension, diabetes, history of stroke, and a sedentary lifestyle.
A holistic
approach
Like many other chronic illnesses, the treatment of high cholesterol is not just focused on taking medication. “We term it chronic disease management because we aim to address the root of the problem,” said
Dr Chong. At JurongHealth, the disease is managed as a partnership, added Dr Wanahita, with allied health
specialists educating patients on self-management, lifestyle/diet changes and the importance of complying
with their treatments. “This empowers patients and gives them ownership of their own well-being,” he said.
Ultimately, this is a more effective approach to reduce complications and improve the quality of life.
O36
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4
Tips for
cholesterol
control
A better diet and routine exercise
play important roles in lowering
cholesterol levels.
Move it, move it
Regular physical activity – even moderate
exercise such as brisk walking – can make a
dent in high cholesterol levels. This is because
exercise not only lowers bad cholesterol,
it also raises good cholesterol. It all makes
an impact, whether it is a 45-minute walk
after dinner, clocking 10,000 steps a day or
just getting up from your desk to walk for
5 minutes each hour.
Go green
Studies reveal that the antioxidants in green tea
called catechins can have a cholesterol-lowering
effect. When brewing your daily cup, don't use
boiling water as it may kill the catechins. For a
boost, add lemon as the vitamin C makes the
compounds easier to absorb.
Load up on fibre
Oatmeal, wholegrain bread, fruit and vegetables
have a reputation for being healthy for a reason
–they contain cholesterol-lowering dietary fibre.
Soluble fibre helps lower cholesterol because
it absorbs cholesterol in the digestive tract.
Eat the right fat
Dietary cholesterol (foods high in cholesterol)
is not the main culprit of high cholesterol,
but saturated animal fat is, so cut back on
meat and animal fats. Don’t avoid fats
altogether though — good fats from canola oil,
olive oil and oily fish such as salmon, tuna
and cod have omega-3, which is good for
lowering cholesterol.
O37
37
ONE HE A LT H
ONEHEALTH
BattlingBigDisease
When the body cannot
convert sugars into essential
energy, glucose concentrates
in the blood, wreaking havoc
on delicate tissues and organs
By Adam Koh
IN CONSULTATION WITH
DR KURUMBIAN CHANDRAN,
CONSULTANT & DIRECTOR,
DIABETOLOGY
Sugar
Crisis
Diabetes mellitus may have a sweet-sounding origin
to its name – diabetes is Greek for ‘to pass through’
and mellitus is Latin for ‘sweet as honey’ – but its
effect on the body can be deadly. According to
Dr Kurumbian Chandran, Consultant & Director,
Diabetology, JurongHealth, it is one of the top
chronic diseases of concern in Singapore.
“Singapore has one of the
highest rates of diabetes in the
developed world and the prevalence
has increased from 8.2 per cent in
2004 to 11.3 per cent in 2010.”
This condition is significant because it can lead to a
host of problems, explained Dr Kurumbian. “Diabetes is
associated with long-term complications that affect
almost every part of the body. Poorly controlled
diabetes may lead to blindness, heart and blood vessel
diseases, stroke, kidney failure, amputations, and nerve
damage. The impact of complications associated with
diabetes is more pronounced, especially if the diabetes
is uncontrolled.” In addition, diabetes reduces both a
person's quality of life as well as life expectancy and can
pose a large economic burden on caregivers and families.
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What
causes
diabetes?
Diabetes occurs when insulin
is insufficient or cannot be used
adequately. Insulin acts as a ‘key’
that binds with insulin receptors
found on every cell surface, telling
the cell to absorb any glucose that
is present in the bloodstream. Only
then can cells use glucose as fuel.
Diabetes occurs when there is a
problem with this process of
turning glucose into energy.
There are two types of diabetes.
A less common form is Type 1
diabetes when the body cannot
produce insulin at all. Patients –
who are typically diagnosed in
childhood – need insulin replacement for life. Type 2 diabetes,
a more common form of the
condition, accounts for 9 in 10
of all diabetes cases. “This type of
diabetes results from failure of
the body to use insulin effectively
combined with the inadequate
production of insulin,” explained
Dr Kurumbian. When cell receptors
are insulin resistant, they cannot
access glucose for fuel and they
starve. Glucose builds up in the
bloodstream and over time,
affects the blood vessels in the
whole body, especially in the
nerves, eyes, kidneys and heart.
HIGH
CHOLESTEROL
LEVELS
HIGH
BLOOD
PRESSURE
SMOKING
2
TYPE
DIABETES
SEDENTARY
LIFESTYLE
HIGH FAT
DIET
OBESITY
1 in 3 Singaporean
diabetics are over
70 years old
12.3%
10.4%
15%
7th
12—14 years
of Singaporean
men are diabetic
of Singaporean
women are diabetic
of Singaporeans are estimated
to have diabetes by 2015
leading cause of
death in Singapore
in shortened life expectancy
Source: Ministry of Health
SYMPTOMS
OF DIABETES
RISK FACTORS FOR
INSULIN RESISTANCE
• Frequent thirst
despite drinking water
• A family history
of diabetes
• Constant hunger
• A history of
gestational diabetes
• Constant tiredness
The dangerous aspect
of Type 2 diabetes is that
symptoms do not occur
until after many years of
onset. So it is important
to be screened regularly
for diabetes so it can be
detected and treated early.
• Itchy skin, especially
around the genital area
• Excessive passing
of urine
• Weight loss despite
good appetite
• Excess weight and/or
central obesity – fat that
collects around the torso
• A sedentary lifestyle
• High blood pressure
• High cholesterol
• Slow healing cuts
and wounds
O39
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ONE HE A LT H
ONEHEALTH
BattlingBigDisease
Living
well
with
diabetes
Though diabetes cannot be cured, it can be
well-managed with adjustments to lifestyle, diet
and regular screening for complications, said
Dr Kurumbian. Apart from tests to monitor blood
sugar, cholesterol and blood pressure levels,
annual foot screening is mandatory to check for
and treat foot ulcers or infections to prevent
future major amputation of the leg. “Annual eye
screening is also crucial to avoid permanent
visual loss,” he added.
To better manage the disease, JurongHealth has formed an
Integrated Care Pathway (ICP) for Diabetes. “The cornerstone
for the effective treatment of diabetes is a multi-disciplinary
approach,” noted Dr Kurumbian, who heads the multi-disciplinary
committee and works with a team of physicians, diabetes nurse
educators, dietitians, physiotherapists, and other allied health
professionals to right-site diabetes patients. “We strongly feel that
patients whose diabetes, blood pressure and cholesterol levels
are on target should be managed by family doctors located
close to their homes. We can then partner family doctors to help
co-manage patients who have difficulty achieving these targets.”
All these initiatives will translate into cost-savings for the patient
in the long run, while delaying the risk of complications so
patients can enjoy better outcomes, he added.
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BattlingBigDisease
Colon
Cancer
Rising
Lurking deep in the
bowels – often with no
clear symptoms – colon
cancer is one of the most
common and deadliest
cancers in Singapore
By Bella Lim
IN CONSULTATION WITH DR SEOW CHOON SHEONG,
SENIOR CONSULTANT, GENERAL SURGERY
O41
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ONE HE A LT H
ONEHEALTH
BattlingBigDisease
What
causes
diabetes?
For a cancer that is
one of the most
fatal in Singapore,
colon cancer
presents few signs
– especially in its earliest stages.
Yet the cancer is of particular
concern because it is the most
common in Singapore and is
hard to treat, especially if it is
discovered in its later stages,
said Dr Seow Choon Sheong,
Senior Consultant, General
Surgery, JurongHealth.
This underscores the importance
of early detection to discover the
presence of cancerous growths in
the colon.
Dr Seow explained, “The cancer
occurs when normal cells in the
large intestine transform into a
sinister, uncontrolled growing
mass capable of interfering with
the function of the colon. These
cells later invade nearby organs
and spread.” Each year, almost
1,200 new cases of colon cancer
are discovered. Numbers are
expected to rise as the population
ages because cancer risk, in general,
increases as one gets older.
Each year, almost
1,200 new cases
of colon cancer
are discovered.
O42
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42 ON
INFLAMMATORY BOWEL DISEASE
Healthy
Crohn’s disease
Ulcerative colitis
fat wrapping
Muscle
hypertrophy
Fissures
Cobblestone
appearance
Ulceration
within the
mucosa
Signs of change
While it is commonly believed that chronic constipation is a cause
of colon cancer, Dr Seow said this may not be the case. “There is no
evidence that chronic constipation leads to cancer. However, colon
cancer may result in a change in bowel habits and these may include
constipation or loose stools.” Most often the cancer does not present
any outward signs. In advanced stages though, the cancer can cause
acute bowel obstruction which results in symptoms similar to
constipation as well as other signs such as abdominal swelling,
pain, weight loss, nausea and vomiting.
Blood in the stool is also not necessarily a symptom of colon cancer,
Dr Seow said, although a history of persistent bloody stools in older
people, especially those over 50, warrants investigation. Keep in mind,
he added, that there are also other less threatening causes of bloody
stools such as infection, piles, diverticular disease and inflammation.
Detection and
treatment
COLORECTAL
CANCER
SYMPTOMS
• Change in bowel habits
• Bloody stool
• Chronic abdominal
discomfort/pain
• ‘Thin’ stools
• Pain while passing motion
• Unexplained weight loss
• Anaemia
Those at risk
• Adults above 50
• Those with a family
history of colon or
rectum cancer
• Those with a history
of colon polyps
• Those with a history
of ulcers in the lining
of the large intestine
or Crohn’s disease
OTHER RISK
FACTORS include
smoking, alcohol,
insufficient exercise,
a diet high in preserved
meat, processed sugar,
red meat and animal
fat as well as obesity.
Colon cancer is slightly
more common in men
but it is not clear why
this is so.
If you
are at risk
The best way to screen for colon cancer is a faecal occult test. This is a
simple, cheap and common screening that detects even the smallest traces
of blood in your stools. All you need to do is request for the test from your
general practitioner or a hospital to collect a sample of your stool. You may
also opt for colonoscopy, where a doctor uses a long flexible tube inserted
through the anus to study the colon for any dangerous growths.
If colon cancer is detected in its early stages, the good news, said Dr Seow,
is that it is potentially curable. “The cure of colon cancer is highest in
the early stages where the cancer is confined to the bowel wall only.
This has a cure rate of nearly 100 per cent.” The treatment options include
surgery, chemotherapy, and radiotherapy, and can be given in different
combinations, he explained. “Surgery to remove the colon remains the
mainstay of treatment as it offers the best chances of cure.”
While it remains a challenging cancer to treat, advancements in medical
research are making colon cancer easier to detect and treat. “This includes
using aspirin to prevent primary or secondary colon cancer; new special
chemotherapy drugs called 'biologics' that target the molecular pathways
of cancer growth and development; and innovative methods of colon
cancer surgery such as laparoscopic, robotic, and single port surgery,”
Dr Seow explained. “Many such advances are readily adopted into
our medical practice in Singapore once they have been shown to be
beneficial to patient care.”
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ONE HE A LT H
ONEHEALTH
FOODforLIFE!
One way to truly experience Singapore’s
multicultural diversity is to walk through
a hawker centre or food court. Here, you
are bound to find cuisine inspired by the
various ethnic groups: Chinese, Malay and
Indian. According to Elisa Mak, Dietitian,
JurongHealth, eating out often poses more
barriers to eating healthily because of 4 Cs:
Culture, Constraint, Convenience and Cost.
more protein
but less fat, have
For
skinless chicken breast
with plain rice or porridge
For one, many food vendors prepare foods
based on established tradition or routine
rather than the knowledge of healthy
nutrition. This may mean unconsciously
using more oil or seasoning, making
food higher in fat, salt and calories.
Another reason, said Ms Mak, is time
constraint, “When you are in a hurry,
fast food may be more convenient or
you may choose your meal based on
where the shortest queue is – not
necessarily the healthiest one. Busy
people may also skip meals and snack
on convenience food – often fried snacks or
sugary buns – leading to unwanted calories.”
Sometimes, our food options may also be
due to convenience. Having dry-style noodles
– an option higher in calories than the soup
version – is often preferred because the soupy
form is often more uncomfortable to eat in
our humid weather. Cost is the fourth issue.
“We all try to save money and go for the
cheapest options when eating out and
sometimes those options may not be the
healthiest,” Ms Mak added.
Healthy
hawker eats
In a food paradise like Singapore, with convenient
and affordable food options, eating out is a way of life
Here are some ways to make better choices By Louisa Foo
IN CONSULTATION WITH ELISA MAK, DIETITIAN
44
O44O N E HE ALT H
fibre-rich
Ditch roti prata for
chapatti or thosai. Ask for dhal and
tomato chutney instead of creamy curry
or coconut chutney
rice-based noodles in
clear soup rather than fried, dry or
Choose
gravy laden options. Fresh fish noodles,
wanton noodles or yong tau foo without
fried items are light, healthier choices
Instead of fried noodles, opt
for congee without fried shallots
for a
breakfast
low-fat, but
comforting
End your meal
with something
sweet,
but light.
Choose cheng tng
or soya bean curd
with less sugar syrup
Trim the fat
with a bowl of
mee soto instead
of mee rebus or
mee goreng
O45
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ONE HE A LT H
FOODforLIFE!
That tea-time treat to perk you
up and boost your energy levels
has a bad reputation – but not
all snacks are created equal.
Here’re some healthier treats
to tame the mid-day munchies!
By Louisa Foo
IN CONSULTATION WITH ELISA MAK, DIETITIAN
Snacking
smart
Snacking can be healthy as long as you choose
the right snack and if it helps you meet your nutrient
requirements without exceeding your total caloric
requirements for the day. Elisa Mak, Dietitian,
JurongHealth, explained, “Whether snacking is
unhealthy depends on the type of snacks you
choose, the amount you eat and if the snacks
add on to those excess calories that you require
for the day.”
In fact, it is common to feel a little peckish in-between
meals when our blood sugar dips. “During our hunger
pangs and our search for an energy fuel, we will
possibly grab the most convenient snack, and
that is likely to be an unhealthy one,” Ms Mak said.
“Convenience foods such as potato chips or curry
puffs may be an easy on-the-go food during
hunger pangs but these snacks are high in sodium,
high in fat and calorie dense. In the long run, these
do not provide much nutritional benefit and only
lead to potential weight gain.”
To snack smarter, plan ahead, she advised. “If you
notice a trend of a specific time of day when you
feel hungry, plan ahead to have a healthy snack
before encountering the hunger pangs.” Alternatively,
drink some water first as we often confuse the cue
for thirst with hunger. Snack only when you need
it and avoid mindless snacking due to boredom,
stress or habit. Resist urges to nibble when watching
television or working at your desk,” Ms Mak added.
“It’s also important to watch portion sizes when
snacking to avoid too much of a good thing.”
46
O46O N E HE ALT H
Have
low-fat
yoghurt
for a creamy
comforting
way to bump
up your
calcium
intake
Grab a handful of
unsalted roasted nuts
such as almonds
or cashews
Jazz up your fruit. Have a
small spoonful of low-fat peanut butter
with apple slices or celery sticks for a
flavourful protein boost!
wholemeal crackers
Pair
with low-fat cheese
small
steamed vegetarian pau or
all-veggie Nyonya popiah
Make it meatless; opt for a
with less sweet sauce
soy green tea latte
Prepare a
with a glass of reduced-sugar soy milk
and green tea powder
steamed
Have a handful of
They’re low in fat but
high in fibre, protein and vitamins
chickpeas.
soya bean curd
Reach for a bowl of
with less sugar syrup
Have a few slices of grilled lightlyseasoned chicken breasts
and eat with cucumber sticks
Prepare fresh vegetable
sticks and dip them into plain
yogurt mixed with herbs
O47
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ONE HE A LT H
FOODforLIFE!
Hearty
French
Toast
Preparation Time: 30min
Serves: 6
Nutrient value (2 slices)
Calories
Protein
Fat
Fibre
229 kcal
12g
4g
4g
Ingredients
3
Eggs
¼ cup
Plain flour
½ tsp
Ground cinnamon
1 tsp
Vanilla extract
¾ cup
Low fat milk
1 tbsp
White sugar
1 pinch
Salt
12 slices
Wholemeal bread
Method
1. In a large bowl, add flour and
slowly whisk in the milk
2. Add salt, eggs, cinnamon, vanilla
extract and sugar and whisk
until smooth
3. Heat a lightly oiled frying pan
over medium heat
4. Soak bread slices in the egg
mixture until saturated
5. Cook the bread on each side
until golden brown
6. Serve hot with a little honey
and fresh fruit
A toast to
remember
Easy to prepare and delicious to boot, this healthy
French toast recipe is perfect for a quick breakfast or brunch
CONTRIBUTED BY DIETETICS AND NUTRITION DEPARTMENT, JURONGHEALTH
48
O48O N E HE ALT H
HealthBites
Arm yourself with the proper protection
and knowledge to combat the haze if it strikes
Haze aware
With reports warning that the haze may return later in the year, Dr Luke Low,
Family Physician (Associate Consultant), JurongHealth, advises all individuals to reduce
their exposure. Fine haze particles may irritate the eyes, nose, throat, heart and lungs.
People with asthma, heart or lung conditions should take extra care and ensure
they have enough medication on hand.
healthy
adults
the elderly,
children and
expectant
women
people
with chronic
lung or heart
disease or
stroke
*minimise
*minimise
*avoid all
*minimise
*avoid
*avoid all
*minimise
*minimise
*avoid all
long periods
of active and/
or outdoor
activity
long periods
of active and/
or outdoor
activity
going
outdoors
long periods
of active and/
or outdoor
activity
outdoor
activity
where
possible
going
outdoors
outdoor
activity
outdoor
activity
outdoor
activity
HAZE
LEVEL
(24HR PSI)
101200
201300
*Use the
right mask
If you must be outdoors
during the haze, use a
respirator mask of N95
standard or equivalent.
N95 masks are at least 95%
efficient against super fine
particles. Seal your N95
mask against your face
so that air has to pass
through the filter. You
can re-use your N95 mask,
but remember to replace
it when it becomes soiled
or distorted in shape.
It should not be shared.
above
300
Remember,
surgical masks
do not effectively
filter fine haze
particles.
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ONE HE A LT H
Have you downloaded
the JurongHealth
Digital Library?
Download today and access
JurongHealth’s publications, including
ONEHealth and the Commemorative Report,
in an interactive and dynamic
e-magazine format.
CONGRATULATIONS to
our 'early bird' downloaders!
You've won an iPad Mini!
Koo Joon Ngien NRIC: SXXX4591D
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And thank you to the
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All winners are notified by email.
Prizes not collected before 30 June 2014
will be forfeited.
O50O N E HE ALT H