Diabetes Krishnan Aren’T Letting This Illness Get in the Way of a Full Life

NOV/DEC 2012 ISSUE 42

BE SAFE, Altered NOT SORRY States Learn how STIs The many faces are spread of personality and the ways disorders to protect yourself ON A NEW FOOTING How prosthetists and orthotists rebuild lives

Turning The Tables on Chan Guan Xiong and Menaka Diabetes Krishnan aren’t letting this illness get in the way of a full life

FEASTING SMART • AQUA AEROBICS MADE EASY • HEALTHY HOUSE RULES

Lifewise NovDec2012 cover V2.indd 1 10/30/12 3:45 PM NAMs_Lifewise mag ad NOV_DEC_210mmX276mm_FA.pdf 1 8/17/12 5:47 PM Lifewise NOV-DEC ISSUE 42 CONTENTS features

10 COVER STORY KEEPING DIABETES IN CHECK Diabetes is a long-term condition, but with proper care it can be effectively managed.

17 A NEW CHARGE How the Department of Prosthetics and Orthotics at Tan Tock Seng Hospital rebuilds the lives of amputees. 10 20 STOP THE SPREAD What you need to know about sexually-transmitted infections such as chlamydia, gonorrhoea,, genital herpes and HIV/AIDS.

23 PERSONALITY DISORDERS UNCOVERED When is someone being eccentric or suffering from 17 borderline personality disorder?

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1-3 Contents NovDec12 V3.indd 1 10/31/12 4:52 PM Lifewise NOV-DEC ISSUE 42 CONTENTS

lifestyle

26 A LOVE FOR THE PEOPLE Fulfi llment for A/Prof Tham Kum Yin lies in doing voluntary work in far-fl ung places. 28 HOW TO AGE WELL Giving back to society has taught Judy Wee and Lee Poh Leng valuable lessons in ageing. 30 LIVING WELL Reap the physical and psychological benefi ts of reorganising your living space.

32 SPLASH AND GET FIT Stay cool and keep ﬁ t with aqua aerobics. 38 PACKING A PUNCH, NOT A PAUNCH How to eat well — and smart — this festive season. 30 32

regulars

EDITOR’S NOTE 03 NEWSROOM 04 ASK THE EXPERTS 35 SPOTLIGHT/NHG NEWS 40 38 SPOTLIGHT/NHG DIRECTORY 48

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BE SAFE, Altered NOT SORRY States Learn how STIs The many faces are spread of personality and the ways disorders to protect yourself ON A NEW FOOTING ON THE COVER: CHAN GUAN How prosthetists The Will and orthotists XIONG AND MENAKA KRISHNAN rebuild lives PHOTOGRAPHER HONG CHEE YAN ART DIRECTION AUGUSTINE TAN Turning The STYLING VERNA TAN Tables on GROOMING MANISA TAN Chan Guan Xiong CLOTHES GUAN XIONG: SPORTS To Live Well and Menaka Diabetes Krishnan aren’t JACKET, PRINTED T-SHIRT AND letting this illness get in the way of PANTS FROM PUMA. MENAKA: a full life COTTON JACKET, STRIPED T-SHIRT FEASTING SMART • AQUA AEROBICS MADE EASY • HEALTHY HOUSE RULES AND SWEAT PANTS FROM UNIQLO. FESTIVITIES ASIDE, THE END of the year is when many of us pause to take stock of the months past. Has it been a good year? Have we achieved the goals we set out to do? And perhaps, most importantly, have we been keeping in good shape? As experts will tell you, keeping healthy involves more than just eating well and exercising regularly — and this is especially true for those who are beset by a chronic NATIONAL HEALTHCARE GROUP illness like diabetes. In such cases, keeping well involves EDITORIAL more active choices. It requires vigilance, determination Wong Fong Tze, Lim Phay-Ling,Tania Tan, and most crucially, a positive mindset to manage the Liana Goh, Christopher Lam, Farren Fernandez, Praveen Nayago, Ng Si Jia, Sunanthar Lu condition, from watching what one eats to keeping to the daily routine of insulin injections or oral medication. LIFEWISE ADVISORY PANEL What must be realised is that while diabetes is a Professor Chng Hiok Hee, Dr Alex Su, long-term condition, it doesn’t have to be a death Professor Roy Chan sentence. Nor does it mean sufferers are deprived of a chance to lead normal lives (pg 10). In this issue of Lifewise, we speak to three people with diabetes who lead MEDIACORP PTE LTD full lives, thanks to a combination of treatment and their EDITORIAL & DESIGN will to not be defeated by the disease (pg 14). Senior Editor Agatha Koh Brazil This resilience is echoed in the examples of patients Editor Ronald Rajan of Tan Tock Seng Hospital’s Department of Prosthetics Associate Creative Director Augustine Tan Assistant Editor Jolene Limuco and Orthotics, who have been aided in their quest to Senior Designer Isabelle Yeoh lead fulfi lling lives by a team of experts and the latest in Chief Photographer Steve Zhu artifi cial limb technology. We go behind the scenes to fi nd Executive Photographer Ealbert Ho Senior Photographer Kelvin Chia out what it takes to rehabilitate those who have lost a limb Photographers Roy Lim and speak to a prosthetist — himself an amputee — who Hong Chee Yan has inspired patients through his positive attitude (pg 17).

CONTRIBUTORS A commitment to a healthy lifestyle can however Audrina Gan, Elisabeth Lee, Evelyn Mak, be impeded when there are threats to one’s cognitive Nirmala Sivanathan, Rosnah Ahmad functioning. And while emotional rollercoaster rides are BUSINESS DEVELOPMENT part and parcel of life, those who suffer from a personality Senior Business disorder may not be able to seek help by themselves. The Relationship Manager Michele Kho onus then is on loved ones and caregivers to take the lead. Learn about personality disorders, how to identify them For advertisement enquiries, please email: [email protected] and where to seek assistance in our feature on page 23. On a lighter note, fi nd out how you can enjoy the rest For subscription enquiries, please email: of the year in a healthy and fulfi lling way. It’s certainly the [email protected] time to indulge — but it doesn’t have to be in an unhealthy manner. Lifewise shows you how to enjoy your favourite festive foods without busting the calorie/cholesterol Every care has been taken in the production of this counter (pg 38). See also how you can ease yourself back magazine, but National Healthcare Group (NHG), the publisher, editor and employees assume no responsibility into a fi tness regime with aqua aerobics (pg 32). And in for any errors, inaccuracies or omission arising thereof. Opinions expressed by contributors and advertisers are the spirit of giving, get inspired by two individuals who, not necessarily those of NHG, the publisher or the editor. in helping the elderly, have picked up valuable lessons in The information produced is for reference and educational purposes only. As each person’s medical condition is ageing well (pg 28). unique, you should not rely on the information contained So as we cross into 2013, keep in mind the popular in this magazine as a substitute for personal medical attention, diagnosis or hands-on treatment. If you are adage that “the greatest wealth is health” and remember concerned about your health or that of your child, please consult your family physician or healthcare professional. that you will continue to reap the benefi ts yourself as you

Copyright © is held by the publishers. All rights reserved. keep Adding Years of Healthy Life. Reproduction in whole or in part without permission is prohibited. Printed in Singapore by Times Printers, www.timesprinters.com. MICA (P) 033/11/2011. THE EDITORIAL TEAM

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1-3 Contents NovDec12 V3.indd 3 10/31/12 4:52 PM (newsroom) SNIPPETS FROM THE HEALTHCARE WORLD // CALENDAR OF EVENTS

ONCOLOGY Sobering News

Some bad news for those who love to drink wine as they dine: Just one glass of that drink a day can trigger an increased risk of breast and other cancers. An international team of scientists who pooled data from previous studies involving more than 150,000 people observed detectable increases of cancer cases involving the mouth, throat, gullet and breast among those who drink a glass of alcohol daily, In just one year, light drinking caused 24,000 deaths from oesophageal cancer, 5,000 from oral and 5,000 from breast cancer worldwide, according to the study which was published in the Annals of Oncology. The study was carried out because most research has shown that alcohol intake, especially heavy drinking, increases the risk of a number of MENTAL HEALTH cancers in the upper digestive tract. Even drinking low to moderate levels of alcohol — defi ned as three drinks a PEDAL THAT ANXIETY AWAY day or fewer — is associated with an increase in the risk of breast cancer. eel anxious? Working those muscles may help However, the International chase away the butterfl ies in your stomach. Scientifi c Forum on Alcohol Research F In a recent study, participants engaged in either RESEARCH cautioned that the fi ndings should a 30-minute period of rest or 30 minutes of cycling not be taken as conclusive.conclus Among over two days. A survey designed to measure anxiety SUGGESTSU G ST THAT T A otherother things,things, thethe researchersresearc did not levels was given before and after each activity. Th ey EEXERCISEXERCISE HHELPS ELPS adadjustjust ttheir estimates were then given a series of pleasant pictures of babies TO BUFFER ttoo taktakee into account and puppies, unpleasant violent images, and neutral TTHEHE EEFFECTS FFECTS lifestyllifestylee habits, images including those of cups and furniture. Th eir iincludingncludin smoking. anxiety levels were then measured a fi nal time. OF EMOTIONAL ThThee FoForum also noted Th e researchers found that the 30 minutes of EXPOSUREEXPOSOSURE ththatat tthehe scientists exercise or quiet rest were equally eff ective at reducing ddidid nonott comment on anxiety levels. However, the anxiety levels of those who the hehealthya effects had rested rose back to their initial levels while those of light drinking who had exercised maintained their reduced levels. — such as a “If you exercise, you’ll be better able to maintain rereductiond in the that reduced anxiety when confronted with emotional rriskis of much events,” said researcher J. Carson Smith, Assistant momore common Professor at the Department of Kinesiology of the ddiseases,is University of Maryland School of Public Health in esespecially the United States. Th e fi ndings were published in the cacardiovascular journal Medicine and Science in Sports and Exercise. ddiseases,is and a lolongern lifespan.

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4-9 LW Newsroom NovDec12 V4.indd 4 10/31/12 4:53 PM EXERCISE THAT calendar DANGEROUS BOUNCE ... NOV/DEC IT may be a fun alternative to the TV couch but that trampoline can be bad for your child’s health. In the United States, a staggering 98,000 trampoline- LIVING RIGHT WITH DIABETES related injuries occurred in 2009 resulting in 3,100 hospitalisations. PUBLIC FORUM 2012 Diabetes is a serious chronic The most common trampoline medical condition and is a injuries include sprains, strains and growing concern in Singapore. bruises while the more dangerous Awareness is the key to the prevention of this disease. mishaps affect the head and spine. Join diabetes professionals in Certain moves such as somersaults understanding more about the and ﬂ ips can cause spinal injuries different types of diabetes and that can lead to permanent health how to manage them. Learn how to adopt healthy eating habits and problems, according to the American Academy of Pediatrics (AAP). be physically activeactive by Researchers say 75 per cent of all trampoline injuries happen when a group engaging in safeafef and d of people are jumping together. And the younger the child, the more serious suitable exercises.cicisesses. the injury is likely to be since the bones of children are softer. DATE “It’s the whole bouncy and fun aspect that makes parents think these 10 Nov 2012 devices are safe,” said Dr Michele Labotz, a sports medicine physician for TIME 12pm – 4pm InterMed in Portland, Maine, and lead author of an updated policy statement on VENUE the trampoline. “And they think because the trampoline has this soft mat, kids Tan Tock can’t feel the impact. But they do,” he said. The statement was published Seng Hospital, in Pediatrics, an AAP publication. Theatrette at Level 1 FEE $4.00 (with blood pressure, weight/height and glucose screening) or $6.00 (inclusive MEDICINE of cholesterol screening) Please call 6496 6914 to register. When Painkillers Hurt aking too much painkillers may give you a real SKIN CONCERNS headache, literally. ACROSS THE AGES PEOPLE CAN END T One in 50 people who suff er from headaches (conducted in mandarin) could be doing so because of painkiller overuse, according to a UP IN A “VICIOUS This Mandarin public forum will watchdog body in the United Kingdom. “Medication overuse provide a better understanding of CYCLE” WHERE headaches” can come from taking aspirin, paracetamol and the common skin problems that non-steroidal anti-infl ammatory drugs (such as ibuprofen) people of all ages face. Topics THEIR HEADACHES to be covered by NHG doctors GET WORSE, SO on more than 15 days a month; or opioids, ergots, triptans (a include eczema, allergy, hair loss group of anti-migraine medicines), or combination analgesic and tips for blemish-free skin. THEY TAKE MORE medications on at least 10 days per month, said the National DATE PAINKILLERS Institute for Health and Clinical Excellence (NICE). 17 Nov 2012 WHICH IN TURN Professor Martin Underwood of Warwick Medical School, TIME MAKE THE who led a NICE review panel, said people can end up in a 2.30pm “vicious cycle” where their headaches get worse, so they take VENUE HEADACHES EVEN NTUC Centre Auditorium, Level 7, more painkillers, which in turn make the headaches even 1 Marina Boulevard MORE SEVERE more severe. FEE Many of those who found themselves trapped in Free (includes goodie bag and light refreshments) this vicious cycle started out using painkillers to relieve Please visit http://www.nsc.gov. an everyday, tension-type headache or migraine. NICE sg/showcme.asp?id=136 or call recommends other options for treating headaches, including 6350 8437 to register. acupuncture for patients susceptible to migraine and tension headaches, reported the Medical News Today portal. PHOTOS: ISTOCKPHOTO, CORBIS IMAGES CORBIS ISTOCKPHOTO, PHOTOS:

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4-9 LW Newsroom NovDec12 V4.indd 5 10/31/12 4:53 PM NEUROLOGY

ORTHOPAEDICS ENOUGH TO MAKE YOUR JAW DROP Useless check your dental records to know whether you are likely to succumb to a bone-thinning disease as gingko? Cage catches up with you. Dentists at Manchester University in the United Taking gingko biloba supplements Kingdom are pioneering a technology called Osteodent does not improve memory, attention that can detect those at risk of osteoporosis by looking at spans or problem-solving ability in dental scans years before the condition develops, reports healthy individuals. the Daily Mail newspaper. Researchers from the University Osteoporosis is a disease in which the density of bones of Hertfordshire in the United is reduced, making them weak and more brittle. Currently, a Kingdom say they found “zero diagnosis of one’s susceptibility to the disease is only made impact” on cognitive function, after a bone fracture. However, a British study has shown regardless of the age of the people, that bone deterioration in the jaw — which is routinely the dose taken, or the length of time X-rayed prior to dental treatment — can also reveal if bone taking the supplements, reported deterioration is occurring in other parts of the body. the New York Daily News. Using the results of the study, dentists have developed DENTAL SCANS Gingko biloba — a Chinese herb software that can immediately assess an individual’s risk of CAN REVEAL — has long been marketed as a osteoporosis, which in turn alerts the patient to whether they dietary supplement to treat blood need to be referred to a specialist for further investigation. THE RISK OF disorders and more speciﬁ cally, to “Dentists are well-positioned to provide such a service OSTEOPOROSIS improve memory both for healthy as they see patients regularly and routinely perform X-ray YEARS BEFORE individuals and also for those trying examinations,” said Hugh Devlin, Professor of Restorative to ward off Alzheimer’s disease. Dentistry at Manchester University and co-developer of THE CONDITION It has been used extensively in the new technique. DEVELOPS traditional Chinese herbal medicine for thousands of years.

MENTAL HEALTH

more than a few minutes. Are You Nomophobic? To address this latest addiction, a drug and alcohol recovery centre ou just can’t bear to turn off your in California has founded the fi rst mobile phone even for a second. You recovery group for people suff ering Yworry about your mobile running from nomophobia. Th e group helps out of power. And you can’t even go to people recognise the symptoms, the loo without your handphone. explore the psychological roots If you display such phone- of their vulnerability and related anxiety, then you may master techniques to regain have “nomophobia” — anxiety control of their lives. that occurs when there is no “We want them to access to mobile technology. understand that people A study of 1,000 individuals won’t forget you just in the United Kingdom this year because you are not showed that the percentage reachable for a few days. PHOTOS: ISTOCKPHOTO, CORBIS IMAGES of people who feared losing You can get information their mobile phone had increased later and still live a happy from 53 per cent to 66 per cent. life,” said the group’s Th ose between the ages of 18 founder Dr Elizabeth and 24 were most dependent on Waterman of Morningside mobile technology, and 77 per cent Recovery Center, in an reported feeling uncomfortable interview with the Los when away from their devices for Angeles Times.

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4-9 LW Newsroom NovDec12 V4.indd 6 10/31/12 4:53 PM NUTRITION calendar FAST FOOD FEASTING NOV/DEC — THE FINE DINING WAY IF you want to “have your cake (or burger) and eat it too”, try having your meal at a fast-food restaurant which offers soft lighting and mellow jazz. Researchers from Cornell University and the Georgia Institute of Technology in the United States found that softening the lighting and music PROBLEM GAMBLING in fast-food restaurants didn’t change what people ordered, but it caused them to eat 18 per cent less — 775 calories instead of 949. According to their FORUM 2013 Do you wish to help someone fi ndings, which were published in the journal Psychological Reports, they also in your family with his or her rated the food as more enjoyable. Their study involved about 60 diners, who problem gambling? Learn how were made to sit randomly to reclaim your life and rebuild relationships in this forum by the within one of two sections National Addictions Management at a fast-food restaurant. Service (NAMS). The fi rst was left as is, with bright lights, colours and DATE 26 Jan 2013 loud music, while the second TIME area underwent a makeover 9.30am – 12.30pm that included soundproofi ng, VENUE Health Promotion Board, Level dimmed lights, plants, 7 Auditorium, 3 Second Hospital candles, white tablecloths Avenue, Singapore 168937 and jazz music. In addition (Nearest MRT: Outram) FEE to lingering a little longer, $8 diners in the second area Please visit www.nams.sg also left more food on their to register. trays and gave higher ratings to their meal.

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4-9 LW Newsroom NovDec12 V4.indd 7 10/31/12 4:54 PM WELLNESS Never on a Monday

THE infamous “Monday blues” is actually a myth. While we certainly feel happiest on Saturdays and Sundays, most of us don’t feel much bluer on Monday than we do on Tuesday, Wednesday or Thursday. A poll involving some 340,000 subjects showed that while most people ranked their Monday mood as being a bit blue, their mood actually wasn’t much worse on Monday than it was on the rest of the weekdays (excepting Friday). Even with Wednesday being touted as the “hump day” (after which the weekend is popularly regarded as imminent), there weren’t any spikes in good feelings midweek. And while people generally agreed that Friday seemed like a great day (to party), they still couldn’t wait for the arrival of Saturday and Sunday. “Friday is probably a day when you get a combination of work and positive stuff and it is not surprising that it came in somewhere between NUTRITION the levels of the weekend and Monday through Thursday,” said THUMBS UP FOR Professor Arthur Stone, vice-chair in the Department of Psychiatry LOW-CALORIE YOGHURT and Behavioral Science at Stony Brook University in New York. ow-calorie yoghurt is not just for weight-watchers; He is also the author of a study it may also lower your risk of high-blood pressure. about days of the week and the L Long-term yoghurt eaters have been found associated mood patterns in the to have a lower systolic blood pressure, as well as a Journal of Positive Psychology. diminished risk of developing high-blood pressure, Prof Stone also found that according to a 15-year study presented at the American married people like weekends Heart Association’s High Blood Pressure Research a bit more than their divorced 2012 Scientiﬁ c Sessions. Systolic blood pressure is counterparts, and that younger the measure of how powerful the blood is against the people feel a bigger boost in mood arterial walls when your heart is beating. It is the top over the weekend than older people. number in a blood pressure reading. Th e study followed more than 2,000 volunteers who consumed yoghurt regularly. Results showed that 31 per cent of volunteers were less likely to develop high-blood pressure when at least two per cent of LONG-TERM their daily caloric intake consisted of yoghurt. Th at YOGHURT EATERS amounted to at least one 175ml cup of low-fat yoghurt HAVE BEEN every three days. Th eir systolic blood pressure also rose FOUND TO HAVE A less than those who did not eat yoghurt. Th e results are in line with the conventional wisdom that low-fat dairy LOWER SYSTOLIC products reduce blood pressure. BLOOD PRESSURE

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4-9 LW Newsroom NovDec12 V4.indd 8 10/31/12 4:54 PM MEDICAL NEWS MENTAL HEALTH Suffer the second-hand smokers ‘Pin and person who is regularly exposed to second-hand Prick’ help smoke may have trouble remembering things. A A British study found that non-smokers who were THE DEFICITS Patients of Parkinson’s disease exposed to second-hand smoke fared 20 per cent worse in may beneﬁ t from acupuncture memory tests than another non-smoking group did. Smokers ASSOCIATED WITH treatment. performed the worst in memory tests. Th ey forgot 30 per SECOND-HAND Parkinson’s is a disorder of cent more than those who were not exposed to secondhand SMOKE EXPOSURE the brain that leads to shaking smoke, reported the journal Addiction. A person who has EXTEND TO EVERYDAY and difﬁ culty in coordination. problems with “prospective memory” may end up forgetting Researchers from the things such as a meeting with friends or having to take his/ COGNITIVE FUNCTION University of Seoul have found her medication. that acupuncture seems to While the study doesn’t prove reactivate parts of the brain that that smoke damages memory, it have become deactivated. Their is still a cause for concern, the study was reported in the CNS researchers say. “According to Neuroscience and Therapeutics recent reports by the World Journal in September. Health Organization, exposure In the study involving to second-hand smoke can have 12 healthy subjects and 12 serious consequences on the Parkinson’s patients, scientists health of people who have found that acupuncture never smoked themselves, encourages better neural but who are exposed to other responses in these brain people’s tobacco smoke,” said regions: the basal ganglia, Dr Tom Heff ernan, a researcher putamen, thalamus, caudate at the Collaboration for Drug and substantia nigra — all and Alcohol Research Group at associated with Parkinson’s. Northumbria University. “Our In a separate study fi ndings suggest that defi cits published in the Journal of the associated with second-hand American Medical Association, smoke exposure extend to scientists have found that everyday cognitive function.” acupuncture may help in the treatment of chronic pain.

DERMATOLOGY VIRUS TO ACNE RESCUE

A harmless skin virus may emerge as an effective weapon against acne. The virus, called a phage, is naturally built to target and kill bacteria that causes acne. Experts at the University of California, Los Angeles (UCLA) and the University of Pittsburgh in the United States found 11 different versions of the virus that had this power. Acne is caused when hair follicles become blocked with an oily substance called sebum, which the body produces to stop the hair and skin from drying out. Bacteria that live on the skin can then contaminate and infect the plugged follicles. Phages appear to help counteract this. And unlike antibiotics, which kill many types of bacteria including “good” ones that live in our gut, phages are programmed to target only speciﬁ c bacteria. Co-researcher Dr Jenny Kim, director of the UCLA Clinic for Acne, Rosacea and Aesthetics, said: “Antibiotics such as tetracycline are so widely used that many acne strains have developed resistance. Drugs like Accutane, while effective, can produce risky side effects, limiting their use.” Phages on the other hand could potentially offer a tailored therapy with fewer side effects, the experts told mBio, the open access journal of the American Society for Microbiology. PHOTOS: ISTOCKPHOTO, GETTY IMAGES ISTOCKPHOTO, PHOTOS:

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4-9 LW Newsroom NovDec12 V4.indd 9 10/31/12 4:54 PM ( TAKE CONTROL) Keeping DIABETES in check

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10-16 LW NovDec12 Diabetes V2.indd 10 10/31/12 4:55 PM BETTER TREATMENT PLANS AND MORE PATIENT EDUCATION MEAN DIABETICS CAN LEAD NORMAL LIVES. BUT THE NEED FOR THEM TO MANAGE THEIR CONDITION IS STILL PARAMOUNT, SAY DOCTORS. BY NIRMALA SIVANATHAN

IN CONSULTATION WITH DR LIEW HUI LING REGISTRAR // DEPARTMENT OF ENDOCRINOLOGY AND DR ABDUL SHAKOOR S K CONSULTANT // DEPARTMENT OF ENDOCRINOLOGY // TAN TOCK SENG HOSPITAL DR ROBERT ISAACS SENIOR RESIDENT PHYSICIAN // DEPARTMENT OF GENERAL PSYCHIATRY // INSTITUTE OF MENTAL HEALTH MS NG SOH MUI SENIOR NURSE CLINICIAN // JURONG POLYCLINIC AND MS WINNIE POH SIEW HUAY NURSE CLINICIAN (CARE MANAGEMENT) // HOUGANG POLYCLINIC

IN MANY COUNTRIES People with a family history of diabetes WORLDWIDE, the threat of are at a high risk of developing Type 2 diabetes is growing, and diabetes themselves. Other risk factors Singapore is no exception. According to the include obesity, age and a sedentary Yearbook of Statistics Singapore 2012, the lifestyle. Your ethnic background can also disease currently aff ects nearly 11.3 per play a part. According to Dr Shakoor, the cent of the population. And this number prevalence of Type 2 diabetes is higher could rise to 15 per cent — or one million among the Malay and Indian populations, adult diabetics — by 2050. Th e reason for as compared to the Chinese population. this? An ageing population and one that is A recent survey showed that 15.8 per cent getting increasingly overweight. of Indians, 11.3 per cent of Malays and Doctors both in Singapore and around 8 per cent of Chinese in Singapore have the world have also seen an increasing diabetes. “However, the prevalence of number of young adults and children diabetes among all ethnic groups including developing Type 2 diabetes, a form of the Chinese population is increasing due to the disease that is typically diagnosed in changes in lifestyle and increasing obesity,” older adults. Type 2 diabetes is caused by says Dr Shakoor. insulin resistance. A family history of diabetes and “What this means is that cells in the genetics are also risk factors for Type diabetic patient’s body are unable to 1 diabetes, which is diagnosed mostly utilise the insulin produced by the body in children and younger adults, but the effi ciently,” explains Dr Abdul Shakoor contribution of genetic factors resulting S K, Consultant with the Department of in Type 1 diabetes is much less compared Endocrinology at Tan Tock Seng Hospital to Type 2 diabetes. Type 1 diabetes is (TTSH). Insulin — a hormone produced by caused when the pancreas has completely the pancreas — helps to bring down blood stopped producing insulin. It is managed sugar levels after a meal by converting through the use of daily insulin injections. excess glucose into glycogen which can Although Types 1 and 2 diabetes both then be stored by the body. Insulin also develop due to the lack of insulin, the helps the body to use up this excess sugar. causes for the two kinds are diff erent. Type Both these processes may be impaired in 1 diabetes occurs when the pancreas stops people with Type 2 diabetes. producing insulin, while Type 2 diabetes occurs when the pancreas does not produce suffi cient amounts of insulin. Another type of diabetes — referred THE PREVALENCE OF DIABETES AMONG ALL to as gestational diabetes — can also occur in pregnant women who don’t ETHNIC GROUPS IS INCREASING DUE TO CHANGES have a history of the disease. Caused by pregnancy hormones that can block insulin IN LIFESTYLE AND INCREASING OBESITY from bringing down blood sugar levels, DR ABDUL SHAKOOR S K, CONSULTANT WITH TTSH’S DEPARTMENT OF ENDOCRINOLOGY gestational diabetes is referred to as a “pre- diabetic state”. Women who develop this PHOTO: CORBIS PHOTO:

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10-16 LW NovDec12 Diabetes V2.indd 11 10/31/12 4:55 PM ( TAKE CONTROL)

kind of diabetes are more likely to develop Dealing with the Diagnosis Type 2 diabetes at a later stage in life. At polyclinics, Care Managers help patients to manage their diabetes It’s Complicated depending on each patient’s needs. Diabetes itself is not fatal. However, the According to Ms Ng Soh Mui, a Senior complications caused by untreated diabetes Nurse Clinician at Jurong Polyclinic, this — when sugar levels are allowed to build begins when a person is newly diagnosed up in the blood over a period of time — with the disease. often are, says Dr Liew Hui Ling, Registrar “Th e Care Manager will start by assessing of the Department of Endocrinology at their emotional state and readiness to talk TTSH. Th ese complications include chronic about their health,” Ms Ng explains. kidney disease which is Care Managers when the kidneys stop also teach patients to working and gradually better manage their lose the ability to remove condition and make waste and excess water PATIENTS THEMSELVES informed decisions from the body. According about their treatment to the National Health PLAY A SIGNIFICANT plan. Patients are given Survey 2010, diabetes information about the is one of the top causes ROLE IN THE LIFELONG disease, the prevention of kidney failure and and management of accounts for about 60 per MANAGEMENT OF complications, exercise, cent of new kidney failure THEIR DIABETES BY diet and medication. cases requiring dialysis Th ey are also trained to in Singapore. TAKING CHARGE OF use devices such as blood Damage can also glucose meters and insulin be done to the heart, THEIR LIFESTYLE pens. Care Managers also blood vessels, eyes and DR LIEW HUI LING, REGISTRAR OF THE DEPARTMENT monitor the patients’ nerves, leading to heart OF ENDOCRINOLOGY health outcomes and attacks, strokes, and limb coordinate their care by In Type 1 diabetes and the later stages of amputations. “What is worrying is that ensuring that they undergo yearly screenings Type 2 diabetes, insulin injections might most of the complications do not produce for diabetes-related complications. be needed. Bariatric surgery, such as gastric any signs in the early stages in the diabetic “But ultimately, patients themselves band or gastric bypass procedures, might patient,” says Dr Liew. play a signifi cant role in the lifelong also be recommended to help severely Th e good news is that most of these management of their diabetes by taking obese patients control their weight. can be prevented with a comprehensive charge of their lifestyle and monitoring In dealing with the diagnosis mentally treatment plan. “All it takes is regular their blood sugar regularly,” says Dr Liew. and emotionally, Dr Robert Isaacs, a medication, blood sugar monitoring, an “Th ere is no cure for diabetes. But it can be Senior Resident Physician at the General active lifestyle, healthier food choices, managed eff ectively.” Psychiatry Department at the Institute of weight management, regular foot care, Managing the disease can be done Mental Health, says that the way to live regular eye screenings and regular visits to through lifestyle changes by eating right, well with diabetes is to understand what the doctor,” says Dr Liew. being active and practising weight control. it is, what it means and what needs to be done to monitor the condition. “Having diabetes is a signifi cant issue, stress the importance are keeping the blood but it certainly does not need to be a HOW TO of monitoring blood sugar in a healthy range. death sentence as some people think,” Dr sugar levels at home The optimal blood Isaacs says. “People who take control of MONITOR BLOOD to diabetics. sugar level for a their situation and who make positive, Fortunately, this non-pregnant diabetic eff ective changes will feel empowered.” SUGAR LEVELS is made easy by person ranges from

Illness and stress, in using a device called 6.1 to 8mmol/L (110 The Diabetic Diet PHOTOS: CORBIS, ISTOCKPHOTO addition to the food that a glucometer which – 144mg/dL) before One of the most common myths you eat, can affect blood measures the glucose meals. Optimal blood surrounding diabetes is that eating too sugar levels. This, in turn, level in the blood, and sugar levels two hours much sugar causes diabetes. “Th is is simply can affect a diabetes which provides essential after a meal range from not true,” says Dr Shakoor. “If you are management plan. information on whether 7.1 to 10mmol/L (128 – healthy and diabetes-free, you will not That is why doctors medication and lifestyle 180mg/dL). have a high blood sugar level, even if you have been taking in more sugar. However,

12 LIFEWISE NOV - DEC 2012

10-16 LW NovDec12 Diabetes V2.indd 12 10/31/12 4:55 PM unattended, low blood sugar FOOT SORES: levels can lead to fainting, WHAT’S THE seizures and even coma. According to Dr Shakoor, WORRY? people with diabetes should include starchy Poorly-controlled diabetes carbohydrates in each meal, can lead to a higher risk but limit the portion size. of infections, inadequate Th ey are also advised to wound healing and nerve switch to low glycemic index damage due to poor blood (GI) carbohydrates such circulation. In poor blood as brown rice, wholegrain circulation, less oxygen is bread and porridge. Low GI supplied to the skin; this carbohydrates have less of an means skin breakages and impact on blood sugar levels. lesions heal poorly. According to the Health If left untreated, limb Promotion Board, low GI amputation or death caused foods take a slower time to by systemic sepsis (blood raise blood glucose levels and poisoning) can occur. thus are healthier for diabetic patients to consume. TIPS ON FOOT CARE FROM Th e intake of foods high in HOUGANG POLYCLINIC’S saturated fat and salt — such NURSE CLINICIAN (CARE as butter, red meat, full fat MANAGEMENT) MS WINNIE milk and salty processed foods POH SIEW HUAY — should be reduced. Better choices include skimmed milk, Cultivate good low-fat yoghurt and oily fi sh hygiene. Wash your feet such as salmon or mackerel. daily and dry them well. diabetics should not consume an excessive Diabetics are also encouraged to limit Pay attention to the areas amount of sugar as this will worsen their alcohol intake to a maximum of two between the toes. Use this diabetes-related complications.” units a day for women and three units a day time to check your feet for Diabetics should avoid skipping meals for men. One unit of alcohol is 10ml. And if cuts, redness, blisters or any so as to keep their blood sugar levels stable. you think so-called diabetic foods can help, watery discharge. Not eating regularly alters the balance think again. “Th ese so-called diabetic foods between food intake and insulin production and sweets are expensive, off er no benefi ts, Use the right shoes. and utilisation, causing blood sugar levels and have a similar fat content to ordinary Never go barefoot, even to eventually drop. A plummeting blood food,” says Dr Shakoor. when you are at home. Wear sugar level can cause anxiety, confusion, a pair of cotton socks or dizziness, drowsiness, speech diffi culties, stockings with your shoes. sweating and tremors. And if left Socks and stockings should not be too tight. Avoid open- toed slippers.

Diet Guidelines Move your feet POINTERS ON A DIABETIC DIET FROM around. Perform simple foot DR ABDUL SHAKOOR S K, A CONSULTANT exercises daily by rotating WITH THE DEPARTMENT OF ENDOCRINOLOGYGY and ﬂ exing your feet up AT TAN TOCK SENG HOSPITAL and down.

GOOD BAD Take care. Do not soak } Wholegrain pasta and bread } Butter and other saturated fats your feet in very cold or hot } Porridge } Meat with the skin on water. Avoid acupuncture, } Low-fat milk and yoghurt } Full-fat milk massage machines and foot } Salmon } Fried food reflexology as these may } Mackerel } Carbonated drinks break your skin. Go for a } Grilled and/or steamed dishes } Red meat diabetic foot screening at } Fruits and vegetables } Creamy pasta sauces least once a year.

NOV - DEC 2012 LIFEWISE 13

10-16 LW NovDec12 Diabetes V2.indd 13 10/31/12 4:55 PM ( TAKE CONTROL) Changes for theBETTER LIFEWISE FINDS OUT HOW LIFESTYLE TWEAKS HAVE ENABLED THREE DIABETIC PATIENTS TO MANAGE THEIR CONDITIONS AND LEAD HEALTHIER LIVES. BY NIRMALA SIVANATHAN AND AUDRINA GAN

Chan Guan Xiong 19, STUDENT WHEN HE WAS 11 YEARS OLD, insulin injections which he would need to Guan Xiong’s parents noticed take after every meal. that their younger child was not Today, Guan Xiong’s diabetes is under being his usual self. He complained of being control, with his blood sugar level in frequently thirsty and needed to visit the the optimal range. He still has to self- washroom more often than usual. He was administer insulin shots three times daily, also less active then he had been previously. to regulate his blood sugar levels. He’s also Worried, his parents took him to careful to watch what he eats as skipping Kandang Kerbau Women’s and Children’s or delaying meals — or even changing Hospital. A battery of tests later, his the amount of food he eats — can cause doctors broke the unhappy news. problems with his blood sugar control. Guan Xiong had Type 1 “I’ve gotten used to diabetes. His pancreas — facing my diabetes every the organ responsible for day,” says the third-year producing insulin — had Accountancy student stopped functioning and I LEARNT TO ADAPT at a local polytechnic. his blood sugar levels “But it wasn’t always were at 17.3mmol/L, AND DEAL WITH MY this way.” more than double the He recalls a time normal level of 6 to DIABETES. I’VE LEARNT when he was in 7mmol/L for a healthy Secondary Two that he person. Insulin is the TO LIVE WITH IT grew resentful towards hormone responsible for his illness. “I remember regulating carbohydrate absorption. asking myself: Why can’t I be normal? Why Guan Xiong was immediately warded do I need injections every day?” he says. and the doctors tried to stabilise his blood “I was so sick of it.” So he started skipping sugar levels. Over the next month, the injections. Luckily, his doctors noticed the hospital conducted classes for his parents spike in his blood sugar levels and sent him so they would be able to look after him. for counselling. “I learnt to adapt and deal Th ey were taught to measure Guan Xiong’s with my diabetes. I’ve learnt to live with it.” blood sugar levels at home, monitor his Th ese days, Guan Xiong lives a carbohydrate intake and administer the relatively normal life. Other than the need

14 LIFEWISE NOV - DEC 2012

10-16 LW NovDec12 Diabetes V2.indd 14 10/31/12 4:55 PM Menaka d/o Krishnan 55, ASSISTANT NURSE

WHEN MENAKA D/O KRISHNAN WAS DIAGNOSED with Type 2 diabetes six years ago during a routine health screening, it underscored the need for her to start living healthier. She had already been diagnosed with hypertension and high cholesterol — and this was the fi nal straw. Th e hectic nature of her job meant that she didn’t get much time to exercise. “When I came home from work, I didn’t feel like doing anything,” says Menaka who is an Assistant Nurse at Tan Tock Seng Hospital. Her diagnosis changed that. Now, she tries to incorporate more exercise into her life. She goes for weekly walks around her neighbourhood. She also changed her diet by cutting down on carbohydrates and sugary foods. Today, Menaka has her diabetes under control with a blood sugar level of between 6 and 7mmol/L, down from 14mmol/L when she was fi rst diagnosed. Her cholesterol and blood pressure levels are also under control. Menaka herself isn’t quite sure what brought I DON’T BELIEVE on her diabetes. A family history of diabetes is DIABETES IS A DEATH one of the primary risk factors when it comes SENTENCE. WITH THE to the condition but neither of her parents RIGHT ACTIONS, YOU CAN suff ered from it. However, she has struggled with LEAD A NORMAL LIFE her weight most of her life — obesity can be a contributing factor to the development of diabetes. “My favourite food is chocolate,” Menaka admits. “But I eat it in moderation these days.” Instead, she has started eating for daily insulin shots, he is able to indulge healthier by switching to brown rice and in regular teenage pursuits such as playing increasing the amount of vegetables in computer games, listening to music and her diet. bowling. He even enjoys the occasional One vegetable she has started taking game of badminton with his family — more of is bittergourd. “I heard that it can though he takes care not to tire himself help with diabetes,” says Menaka, who is out. Too much strenuous activity will cause divorced. In fact, a 2008 study published in his blood sugar levels to drop, resulting the Journal of Chemistry and Biology found in light-headedness. And as long as these that compounds in bittergourd extract can simple rules are observed, the condition reduce blood sugar levels in humans. doesn’t interfere with his daily life. Having taken these measures, Menaka “I don’t feel restricted by my diabetes at has gotten back on track with regard to her all,” says Guan Xiong. “My advice to young health. “I don’t believe diabetes is a death diabetics is that if you take care, you can sentence,” says Menaka. “With the right live your life like any other person.” actions, you can lead a normal life.” : SPORTS JACKET, WHITE PRINTED T-SHIRT WHITE PRINTED T-SHIRT JACKET, XIONG : SPORTS ON GUAN CLOTHES: HONG CHEE YAN PHOTOS: FROM PUMA. JACKET FROM UNIQLO, T-SHIRT : POLO FROM PUMA. ON MENAKA AND PANTS

NOV - DEC 2012 LIFEWISE 15

10-16 LW NovDec12 Diabetes V2.indd 15 10/31/12 4:55 PM ( TAKE CONTROL)

Tan Hong Chee recalls Hong Chee. Fortunately, he did not or ice-cream once in a while. “When you 66, SECURITY GUARD need to be put on medication and took come to my age, you want to enjoy life the doctor’s advice to reduce his sugar and a little. It would be miserable if you cut WHEN TAN HONG CHEE WENT TO carbohydrate intake. out everything. I believe that we should THE POLYCLINIC for his regular Apart from encouraging him to eat everything in moderation,” says the health screening fi ve years ago, consume less rice, his wife also switched 66 year-old. Admitting that he doesn’t he was diagnosed with pre-diabetes. His to cooking brown rice when she prepares drink plain water “unless I need to take blood sugar level was 9.5mmol/L, which meals for the family on weekends. When my medicine”, he has at least made the exceeded normal levels of between 6 and they dine out on weekdays, Hong Chee compromise of cutting down his intake 7 mmol/L. opts for healthier dishes such as fi sh soup. of carbonated beverages and now solely Pre-diabetes is a condition in which Currently, he is also consumes fruit juice. blood glucose levels are higher than normal cutting down on his Another major lifestyle but lower than those with full-blown meat intake after his change was his decision diabetes. Th is condition is sometimes cholesterol level shot up to quit smoking in July called impaired fasting glucose (IFG). recently. He is also on I’M HAPPY THAT I this year. A heavy smoker People with pre-diabetes are at increased long-term medication since picking up the habit risk of developing Type 2 diabetes. But by for high blood pressure HAVE MADE SOME at 18, Hong Chee admits making a few lifestyle changes — such as and has managed to he sometimes smoked up eating well and exercising regularly — and keep his blood pressure PROGRESS IN COPING to two packets of cigarettes taking oral medication, the condition can levels under control. a day. He had tried to kick be managed eff ectively. Still, Hong Chee WITH MY CONDITION, the habit many times in “I did not experience giddiness, — who has a sweet the past without success. fatigue or other symptoms associated tooth — cannot resist AND WILL CONTINUE “Before, I never convinced with diabetes. I just took the news calmly,” indulging in chocolate myself to quit smoking. TO GO FOR REGULAR Many smokers come up with excuses to continue HEALTH SCREENINGS smoking,” he says. It was his consideration for his daughter that led him to stub out the habit for good. “I would always smoke in the living room and she found Life changes the smoke unbearable,” he says. Since he stopped smoking, Hong Chee says he feels Drink more refreshed and his breath and clothes

fruit juice doesn’t smell of nicotine anymore. Slowly but surely, he is also making other eff orts Stop smokin to maintain a healthy lifestyle. For example, g during his morning commute he will alight eat less from the bus at Th omson Road and take a cho seven-minute walk to Toa Payoh where he colates works as a security guard in a school. w alk to w So far, his hard work has paid off . ork Th is year, he has managed to bring eat hea his blood sugar level down to normal lthily (about 6mmol/L). “I’m happy that I have made some progress in coping with my condition,” he says. “I will continue to go for regular health screenings.”

16 LIFEWISE NOV - DEC 2012

10-16 LW NovDec12 Diabetes V2.indd 16 10/31/12 4:55 PM ( BODY RECONSTRUCTION)

A new CHARGE THE PROSTHETICS AND ORTHOTICS DEPARTMENT AT TTSH REBUILDS THE LIVES OF ITS PATIENTS — BOTH MENTALLY AND PHYSICALLY. BY NIRMALA SIVANATHAN IN CONSULTATION WITH MR TREVOR BINEDELL UNIT HEAD OF THE PROSTHETICS AND ORTHOTICS DEPARTMENT // TAN TOCK SENG HOSPITAL PHOTO: CORBIS PHOTO:

NOV - DEC 2012 LIFEWISE 17

17-19 LW NovDec12 Rebuilding lives V1.indd 17 10/31/12 4:56 PM ( BODY RECONSTRUCTION)

WHEN DESMOND TONG WAS 22 For the past 11 months, he has made Th e P&O Department at TTSH, which YEARS-OLD, he got into a road it his life’s work to help fellow amputees is the largest of its kind in Singapore, has accident that neccessitated seven regain their confi dence and return to doing its own workshop where these high-tech surgeries. His right leg had to be amputated the activities they used to enjoy. components are used to build custom- from the knee down. “Adjusting to the idea Th anks to made artifi cial limbs for that I had lost my leg was incredibly painful advanced aids, its patients. at fi rst,” recalls Desmond, now 35. “I felt amputees are helpless and depressed.” now able to cycle, Support But thankfully for Desmond, he was swim and even AMPUTEES ARE NOW ABLE Network not alone on the road to recovery. “I play basketball. Besides artifi cial limbs, was blessed to have supportive parents, Th e world’s most TO CYCLE, SWIM AND EVEN the P&O Department siblings, relatives and friends,” he says. famous example — established in 1981 “I was also lucky to have a very good of this is probably PLAY BASKETBALL — fabricates and fi ts prosthetist at Tan Tock Seng Hospital Oscar Pistorius, orthoses, mobility aids, (TTSH) who helped me to literally get back a double amputee from South Africa who wheelchairs and custom-made shoes. on my feet.” competed in the men’s 400 metres race at Orthoses refer to supportive devices or A former real estate agent, Desmond is the recent 2012 Summer Olympics. braces that help to control biomechanical now back at TTSH, not as a patient but as a His remarkable feat is possible because alignment, prevent injury, provide support Prosthetist/Orthotist with the Prosthetics manufacturers now off er lighter, more following injury and assist rehabilitation and Orthotics (P&O) Department, and durable prosthetic parts fabricated from after injury. helping others get a new lease of life — just materials that are better able to mimic Th e department comprises a team of as he had been helped 13 years ago. human walking. Prosthetists/Orthotists who construct

“I M POSSIBLE”

Desmond Tong (left) He is also able to is testament to the drive with the leg, even Prosthetics and Orthotics though he needed to get (P&O) Department’s approval from the Land excellent work in and Transport Authority to rebuilding lives. have the accelerator pedal Of his presence as changed to the left side of an amputee at the P&O the car. Department, he says, “I Desmond says his own believe that patients see injury helps him relate to me as a living example the patients he sees. “As of what is possible as their prosthetist, I am able an amputee. Through to better understand the me, they are able to see pain and frustrations that for themselves that it is they are going through. possible for people with “It is never easy artifi cial limbs to run, play being disabled even sports and do anything just as a prosthetist,” adds like everybody else.” Desmond who is married. Desmond currently uses “Simple tasks like a hydraulic ankle energy squatting down to take return response foot fi tting a measurement can be with a carbon fi bre socket diffi cult for me due to the and a silicon liner. The leg, constraints of my artifi cial which is made of light and limb. But as I like to tell durable materials such as my patients, nothing is titanium and carbon fi bre, impossible. In fact, if you allows him to indulge in take the word ‘impossible’ sports such as swimming, and break it up, you get basketball and badminton. ‘I M Possible’.” PHOTO OF DESMOND STEVE ZHU OTHER PHOTO CORBIS

18 LIFEWISE NOV - DEC 2012

17-19 LW NovDec12 Rebuilding lives V1.indd 18 10/31/12 4:56 PM braces and artifi cial limbs, as well as The Road To Inclusivity podiatrists. Th e department also works Singaporeans today with rehabilitative doctors, medical social are more accepting of workers and physiotherapists to get people with disabilities patients back on their feet again. in the community. This “We see a wide range of patients of all is according to a 2011 ages,” says Mr Trevor Binedell, the Unit study conducted by Head of the P&O Department. “Amputees the Society for the account for about half the cases while the Physically Disabled other half is made up of orthopaedic cases.” (SPD) in Singapore Orthopaedic cases include drop foot caused to determine public by stroke, fracture management, cerebral perception towards palsy management, fl at feet and scoliosis, people with disabilities. which is an abnormal curving of the spine. The study found that: To join the team of specialised staff , Desmond had to fi rst pursue a four- } 13.4 per cent of year honours degree in Prosthetics and people feel that Orthotics in the United Kingdom. “I felt a the disabled calling to join the department,” he explains. are dependent or in need of sympathy, visually- and hearing- “After my surgery, I felt that I needed on others — a says Ms Marissa Lee- impaired. to help others go through what I went significant decrease Medjeral, Executive Employment through — and am still currently going from 47 per cent Director of the Disabled opportunities for through — as an amputee.” in 2009, when a People’s Association people with disabilities similar survey was (Singapore). “Although have also improved Getting Fitted conducted. having a disability can over the last few years, For amputees such as Desmond, the } 93.1 per cent of make it more difﬁ cult due in part to the P&O Department provides custom-made those surveyed for a person to fully efforts of organisations artifi cial limbs that help them regain agreed that more participate in society, such as Bizlink, the mobility and improve their quality of can be done to this does not mean that SPD, Movement for the life. Th ese can include artifi cial limbs for help people with they should be pitied,” Intellectually Disabled below- and above-knee amputations, disabilities on public she says. “Instead more of Singapore, as well hip disarticulations and upper limb transportation in should be done to as the Autism Resource amputations as well as “running legs” and Singapore. remove barriers they Centre. These welfare “water legs” for swimming. } More Singaporeans might face in trying to organisations receive For a patient, the process begins with see people with a consultation and assessment. “When a disabilities as patient is referred to us, he or she will be contributing HAVING A DISABILITY CAN seen by a team of professionals who will members of society assess the patient and his or her needs,” with only 8.8 per MAKE IT DIFFICULT FOR A PERSON explains Mr Binedell. “Th e patient will then cent of respondents be casted, or where appropriate, a mould saying that people TO FULLY PARTICIPATE IN SOCIETY, will be taken. Approximately two weeks with disabilities are later, the patient will have a fi rst fi tting.” unable to perform BUT THIS DOES NOT MEAN THAT After fi ttings are completed, a patient as well as the non- then begins gait training, which is the act disabled at work. THEY SHOULD BE PITIED of relearning how to walk with an artifi cial } 80.3 per cent of 61 limb. Th is process involves the P&O respondents, who be active members of partial funding from the Department as well as TTSH’s Department are in a position to the community.” Government to conduct of Physiotherapy. Th e latter is involved for hire, are open to Ms Lee-Medjeral vocational assessments continued and advanced training. During employing people says that although and job placements. advanced training, patients use equipment with physical Singapore has made “We have actually such as wobble boards, treadmills and disabilities. accommodation seen a trend of trampolines to prepare them for activities for people who use employers wanting to such as running and cycling — but the However, there is wheelchairs or mobility employ more persons process doesn’t end there. room for more public aids, there is still more with disabilities. It is “Our patients don’t ever leave us,” says education campaigns that can be done to supply that cannot Mr Binedell. “Th eir artifi cial limbs will to change the improve accessibilty meet the demand, require servicing for the rest of their lives. perception that persons for those with other rather than the other Th erefore, we usually get to see patients with disabilities are physical disabilities, way round,” adds grow up, get married, have kids and even as somehow less fortunate such as those who are Ms Lee-Medjeral.

PHOTO OF DESMOND: STEVE ZHU OTHER PHOTO: CORBIS CORBIS PHOTO: ZHU OTHER OF DESMOND: STEVE PHOTO retirees. We become a part of their lives.”

NOV - DEC 2012 LIFEWISE 19

17-19 LW NovDec12 Rebuilding lives V1.indd 19 10/31/12 4:56 PM ( STIs) Stop The SPREAD

FROM HOW THEY ARE TRANSMITTED TO HOW THEY CAN BE TREATED AND WHERE YOU CAN GET TESTED, HERE’S WHAT YOU NEED TO KNOW ABOUT SEXUALLY-TRANSMITTED INFECTIONS. BY NIRMALA SIVANATHAN

IN CONSULTATION WITH DR PRIYA SEN HEAD OF DEPARTMENT OF STI CONTROL AND SENIOR CONSULTANT DERMATOLOGIST // NATIONAL SKIN CENTRE AND DR GAVIN ONG ASSOCIATE CONSULTANT DERMATOLOGIST // NATIONAL SKIN CENTRE PHOTOS GETTY IMAGES

20 LIFEWISE NOV - DEC 2012

20-22 LW NovDec12 STIs V4.indd 20 10/31/12 4:57 PM CHLAMYDIA, GONORRHOEA, are also available for certain STIs such as Most STIs can be treated successfully GENITAL HERPES, HIV/AIDS the Human Papilloma Virus (HPV) which through the use of antibiotics, antiviral, — the mere mention of these causes genital warts and the Hepatitis or anti-fungal medication. Parasitic diseases invariably brings on a shudder. B virus. Th ese vaccinations can help infections such as pubic lice can be Ironically, it is this aversion that hinders prevent infections. treated using insecticide creams and eff orts to stop the spread of such sexually- shampoos. Additional medication such transmitted infections (STIs). as hydrocortisone cream and painkillers What are STIs? As the name suggests, might also be prescribed to treat symptoms they refer to a host of conditions that can and relieve discomfort. However, not all be spread by sexual contact. Th ese can take STIs can be treated and cured. Th at is the form of bacterial, viral, fungal or why prevention is key when it comes to parasitic infections. STIs CANNOT BE incurable STIs such as HIV. Bacterial infections such as chlamydia TRANSMITTED THROUGH and gonorrhoea, and viral infections such The HIV Situation as genital herpes are the most common CASUAL SOCIAL ACTIVITIES In 2008, the reported rate of HIV infections in Singapore, according to Dr Priya Sen, in Singapore reached an all-time high Head of Department of STI Control and LIKE SHAKING HANDS AND with 125.2 new cases reported per million Senior Consultant Dermatologist with the people. Th is number has dipped slightly to National Skin Centre (NSC). HUGGING, USING PUBLIC 121.7 reported cases per million people in Other types of STIs such as vaginal 2011 — but that doesn’t mean that HIV thrush — a fungal infection — and TOILET SEATS OR THE is any less of a concern than it used to be. parasites like pubic lice or scabies are It is also not confi ned exclusively to men also common. Th ese are usually passed SHARING OF MEALS who indulge in homosexual sex either. from one infected person to another through unprotected oral, vaginal or anal sex. “STIs are spread through intimate contact with infected urethral or vaginal secretions,” says Dr Sen who adds that anal sex carries a higher risk of spreading STIs than other types of intercourse. “Th is is because the lining of the anus is thin and can easily be damaged, making it more vulnerable to infection.” STIs like the human immunodefi ciency virus (HIV) can also be spread through blood transfusions or the sharing of infected needles. Th ey can also be transmitted from an infected mother to her baby during childbirth. Contrary to popular belief, STIs cannot be transmitted through casual activities like shaking hands and hugging, using public toilet seats or the sharing of meals. In Singapore, all blood products are thoroughly screened for HIV and STIs prior to administration. Prevention is Key According to Dr Sen, three groups of people have a higher chance of contracting STIs — those who frequent sex workers, men who have sex with other men and those who engage in casual sex without using condoms. “If you belong to one of these groups, have had unprotected sex, or have multiple sexual partners, you should go for a regular sexual health screening,” advises Dr Sen. Using a condom will also lower your chances of contracting STIs. Dr Sen says the correct and consistent use of latex condoms can signifi cantly reduce the risk of most STI transmissions. Vaccinations PHOTOS: GETTY IMAGES GETTY IMAGES PHOTOS:

NOV - DEC 2012 LIFEWISE 21

20-22 LW NovDec12 STIs V4.indd 21 10/31/12 4:57 PM ( STIs)

According to Dr Gavin Ong, Associate Consultant Dermatologist with the NSC, heterosexual sex (between a man and THE TRUTH woman) accounts for most of the new HIV cases in Singapore. Th ere has however been ABOUT STIs a rise in the number of new infections Many people are in the acquired through homosexual and bisexual dark about such infections. sex. “Also of concern is that a signifi cant Dr Priya Sen, Head of proportion of new cases diagnosed are Department of STI Control late-stage infections. Th is shows that many and Senior Consultant are still not coming forward for voluntary Dermatologist with the testing early,” he says. NSC, sheds light on three Early testing can lead to timely care common misconceptions and treatment. Without testing, people people have about STIs. who have HIV and don’t know it face a greater risk for serious health problems “I had a workplace and early death. Th ey might health check recently, so also spread the virus to I’m completely clean.” others unknowingly. A 2011 EARLY DETECTION, AND THUS Not all medical screenings study also found that early EARLY TREATMENT, CAN REDUCE include a comprehensive detection — and thus early STI test. Some screenings treatment — can reduce THE RISK OF HIV BEING SPREAD include syphilis and HIV the risk of HIV being spread testing while others don’t. from pregnant HIV-positive FROM PREGNANT HIV-POSITIVE You should ask your doctor women to their children. which tests are included, In Singapore, it is an WOMEN TO THEIR CHILDREN and which are not. Your best off ence under the Infectious option is to visit a sexual Diseases Act for people who health clinic. The doctors know they are infected with HIV not to high-risk individuals, a HIV screening is there will be able to screen inform their sex partners of their status recommended once every six months. you for your risks and advise before sexual intercourse. Th e Act also To date, HIV remains incurable but you on which tests you requires those who have reason to believe it can be treated. Many new drugs have should get. that they might be exposed to HIV to take been made available for people with HIV precautions to protect their sexual partners infections. Th ese drugs are normally “I can tell if by using condoms. Th is is applicable even taken in combination and are eff ective someone has a sexually- if they are ignorant of their HIV status. in suppressing the infection. However, transmitted infection.” Getting tested for HIV will ensure that you Dr Ong says currently there is no eff ective Many people who have an are not breaking the law by unwittingly vaccine against HIV despite clinical trials infection often do not show infecting your partners. conducted worldwide. If left untreated, any signs or symptoms. They Th e best time to screen for HIV HIV can progress to AIDS (acquired can look healthy and live infection is during the fi rst and third immunodefi ciency syndrome) that is the normally. A sexual healthalthatlt month from the last sexual contact as last and most severe stage of the infection. check-up will give a it can take up to three months for the People with AIDS suff er from a weakened deﬁ nitive answer. virus to manifest. If an individual goes immune system and are more likely to for a screening too early, he or she may develop certain cancers and diseases such “I should use twowowo have a false negative screen result. For as pneumonia. condoms to doublee the protection against STIs.” or blood test. These } Specialist STI Do not ever use two GET TESTED! tests are available at: consultation condoms at the same If you fall into a high-risk THE DSC CLINIC } Vaccinations time. Condoms providede group or suspect you Block 31 Kelantan Lane } Counselling a good protective barrierrieri have an STI, you should Singapore 200031 The DSC Clinic also when used correctly, butbut get tested. Any delay in Tel: 6293 9648 operates separate clinics using two condoms at the

getting tested means a for men and women. The same time will not only PHOTOS: GETTY IMAGES, delay in treatment, and Services offered: DSC assures that your increase friction, but also this can lead to serious } Affordable, medical information will increase the risk of condom ISTOCKPHOTO health complications. conﬁ dential and not be divulged to a breakage. Broken condoms Many STIs can be easily comprehensive third party without can lead to infections. tested with a swab, urine STI screening your consent.

22 LIFEWISE NOV - DEC 2012

20-22 LW NovDec12 STIs V4.indd 22 10/31/12 4:57 PM ( WELLNESS) Personality DISORDERS uncovered THERE ARE PERSONALITIES OF ALL KINDS IN THIS WORLD, BUT ARE THERE SOME THAT ARE CONSIDERED MEDICALLY ABNORMAL?BNORMAL? BY EVELYN MAK IN CONSULTATION WITH DR JAYDIP SARKAR CONSULTANT // DEPARTMENT OF GENERAL AND FORENSIC PSYCHIATRY // INSTITUTE OF MENTAL HEALTH PHOTO: GETTY IMAGES PHOTO:

NOV - DEC 2012 LIFEWISE 23

23-25 LW NovDec12 Wellness V2.indd 23 10/31/12 4:58 PM ( WELLNESS)

EVERYONE HAS A UNIQUE PERSONALITY — characteristics and traits that, in essence, are what defi ne us as individuals. Our personalities determine how we act, think, feel and relate to the world around us. And while there are external factors — such as behavioural, cultural and societal norms — that regulate most people’s personalities, there are occasions when an individual’s behaviour, emotions and thoughts stand out from what is considered acceptable in the wider social context. If extreme enough, these “out of the ordinary” personalities can be classifi ed as personality disorders. A diagnosis of personality disorder is made with utmost care and after extensive assessment, and not as a throw-away label that one attaches to behaviours. According to Dr Jaydip Sarkar, Consultant, Department of General and Forensic Psychiatry at the Institute of Mental Health, many patients with personality disorders face diffi culties in dealing with daily life. “Such patients can fi nd it diffi cult to get along with others, whether they are friends, family or colleagues. Th ey also fi nd it hard to keep out of trouble and have diffi culty controlling their feelings and behaviour,” says Dr Sarkar. As a result of these diffi culties, they tend to be “unhappy or distressed, and find that they often upset or harm others”. The Root of the Problem While there is no clear answer what causes these disorders, doctors have found that just as with other mental disorders, a mix of nature (genes) and nurture (upbringing) can play a part. “Th e causes lie largely in how children were dealt with in their early lives, and the amount of stress they may have had to face while still too young to be able to deal with it,” Dr Sarkar says.

Personality Disorder Types — 3 Broad Clusters

ECCENTRIC DRAMATIC, Histrionic personality personality disorder: “Patients THINKING AND EMOTIONAL AND disorder: Patients tend to are perfectionists and can be BEHAVIOUR ERRATIC BEHAVIOUR over-dramatise events and very rigid, overly cautious and Paranoid personality Antisocial personality exhibit strong emotions that preoccupied with detail. They disorder: Patients tend to disorder: Patients are easily change in an instant. They worry about doing the wrong have a deep mistrust of frustrated, often becoming worry about their appearance thing, and ﬁ nd it hard to adapt others. They feel that others aggressive or committing incessantly and constantly to new situations,” says are being nasty to them, crimes, and don’t seem to crave new excitement. Dr Sarkar. Patients also have often feel rejected and tend care about the feelings of Narcissistic personality high moral standards, while to hold grudges. others. They also tend not disorder: “An extreme sense being very judgmental. Schizoid personality to feel guilty or learn from of self-importance and a Avoidant personality disorder: A lack of interest negative experiences. craving for success, power disorder: Frequently anxious in relationships and muted Borderline personality and intellectual brilliance and tense, such personalities emotional expressions are disorder: This manifests as set these patients apart,” are very sensitive to criticism core features. a lack of self-control, both in says Dr Sarkar. “They crave and tend to suffer from Schizotypal personality actions and emotions. Patients attention but don’t show warm feelings of inferiority. To avoid disorder: “Odd ideas, a form relationships very quickly feelings in return. They also being criticised, they just lack of warm emotions and — but also lose them quickly exploit others by asking for avoid doing things. inappropriate emotional as well. When stressed, they favours and not reciprocating.” Dependent personality responses are the basic can become paranoid and disorder: These patients symptoms,” states Dr Sarkar. hear voices. They tend to ANXIOUS AND tend to be very passive and These symptoms can also be harm themselves by cutting, FEARFUL have no initiative, relying on related to schizophrenia, a overdosing or engaging in PERSONALITIES others to make decisions or just more serious mental illness. risky sexual behaviours. Obsessive-compulsive do what others want them to.

24 LIFEWISE NOV - DEC 2012

23-25 LW NovDec12 Wellness V2.indd 24 10/31/12 4:58 PM For example, if parents were very strict In addition, such disorders are most obvious disorders can lead full lives with support,” about a child’s performance in school and disabling during early adulthood, Dr Sarkar adds. “Th e help given can be and behaviour, this could cause the child tending to stabilise in middle age years. emotional, by talking to suff erers; or to become obsessive and a perfectionist. Even without treatment, the severity practical, where assistance is off ered in “If those who took care of them were of disorders tends to reduce by itself as the tasks like sorting bills out.” Caregivers unpredictable and the child experienced patient grows older. Research suggests that who need support can approach Family intense emotional reactions from them, people develop better coping mechanisms Service Centres which are equipped to or if they were sexually abused, borderline as they age. provide assistance. personality disorder could develop,” he adds. At present, treatment plans usually Caregivers should try to be non-critical In addition, research has found that include psychological (talking therapies) when talking to patients. “Be non- there are specifi c genes that can make and physical (medication) aspects. “Th e judgemental and avoid imposing your own people more impulsive or aggressive — cornerstone of treatment is psychotherapy. values on the patient. Don’t force him or this makes them diffi cult to bring up as Th ere are diff erent ways of talking with a her to conform,” Dr Sarkar says. “A quiet children. Th e combination suff erer. Short-term chat about what is going on can help to of their genetic therapies may last look into deeper issues that your loved one dispositions and diffi cult several weeks while is struggling with.” childhood can then lead longer-term therapies to the development of a WITH PROPER HELP can even last years,” personality disorder. Dr Sarkar explains. While symptoms of the HOWEVER, MANY Medication can also BEING WATCHFUL disorders tend to become be used. “Antipsychotic While the experiences faced by evident in adolescence, PEOPLE CAN START TO drugs in a low dosage each patient is different, there doctors try to refrain can reduce feelings are some common triggers from making a diagnosis LEAD MORE NORMAL of suspiciousness that can cause a sufferer to until a patient is 18 years and help those who behave unusually or erratically. old. “It is believed that AND FULFILLING LIVES are ‘hearing voices’. Caregivers should look out for personalities are not fully Antidepressants and the following: formed before then,” explains Dr Sarkar. mood stabilisers are also used to reduce Alcohol or drug use “While doctors may note that symptoms impulsiveness, anxiety and aggression,” Problems getting on with partners or family members

PHOTO: GETTY IMAGES PHOTO: are present in very young patients, it is says Dr Sarkar. “But medications are never recommended that a formal diagnosis is used alone in a treatment regime. Instead, Financial difficulties not made until after they have passed their they are used hand-in-hand with a form of Anxiety, depression or other teenage years.” psychological therapy.” mental health problems Caregivers who form a support system Important events or Road to Recovery for patients are also very important in the anniversaries Personality disorders are actually more treatment. “Many people with personality Stressful situations common than most of us realise. According to Dr Sarker, it has been found that about one in 20 people globally suff er from a sort of personality disorder. No research Help Yourself evidence on personality disorders is available in Singapore but based on the If you’re facing a rough } Exercise regularly. } If you feel you clinical experience of psychiatrists, the emotional patch, there } Give yourself a are losing a grip on more common of these are the obsessive- are things you can do treat when things are things, try calling a compulsive, borderline, narcissistic and to help yourself get diffi cult, or as a reward local helpline like the anti-social personality disorders. through the turmoil. for coping through a Samaritans of Singapore Although such conditions can cause Here are some activities stressful time. (1800-221 4444), the much disruption to a suff erer’s everyday that could prove useful. } Take up an interest IMH Helpline (6389 life, these are not impossible to live with, or hobby to give you 2222) or the Singapore in milder form. “Suff erers with milder } Try to unwind if the opportunity to meet Association for Mental forms can lead relatively normal lives with you are feeling stressed. like-minded individuals Health (1800-283 7019). some diffi culty during periods of stress. Have a hot shower or and take your mind off } Admit that you With moderate levels of the disorder, it go for a walk. You could daily stressors. need help, and fi nd could start to become diffi cult to maintain also do yoga, go for a } Talk to someone people you can trust relationships, or hold down jobs, and massage, or even make about how you are and confi de in to help suff erers may become unpredictable in use of aromatherapy feeling, whether it is you. Seek professional how they feel and behave,” Dr Sarkar says. to unwind. a friend, loved one, a help, and avoid high-risk “However, with proper help, many people } Avoid drinking too therapist or counsellor. behaviour such as self- can start to lead more normal and fulfi lling much alcohol and refrain Your GP could also be harm, unsafe sex, drugs lives, and most can better cope with the from using illegal drugs. of help. or violence. diffi culties caused by their condition.”

NOV - DEC 2012 LIFEWISE 25

23-25 LW NovDec12 Wellness V2.indd 25 10/31/12 4:58 PM IN PERSON A Love for the People LIFEWISE SPEAKS TO ASSOCIATE PROFESSOR THAM KUM YING, 48, SENIOR CONSULTANT AT TAN TOCK SENG HOSPITAL AND ASSISTANT DEAN AT THE LEE KONG CHIAN SCHOOL OF MEDICINE ABOUT HER LOVE FOR IMPROVING THE LIVES OF OTHERS. INTERVIEW EVELYN MAK

“MY LOVE FOR MEDICINE began in my secondary school days as a member of the Red Cross Society, when I learnt how to do cardiopulmonary resuscitation (CPR) and rudimentary fi rst-aid. I had classmates who would faint at the sight of blood but that never aff ected me. It was of no surprise to my parents and four siblings that I decided on a career in medicine. I specialise in emergency medicine, and working in the Emergency Department of Tan Tock Seng Hospital is defi nitely challenging. But while some people fi nd stress overwoverwhelming,helming, I aactuallyc fi nd it a positive source of energy. I likelike hhowow tthehe cases that I get to see are so varied. NothingNothing is predictablepre and nothing is routine. MyMy careecareer has also given me the opportunity to helphelp othersothe as a volunteer doctor overseas. My fi rst vovolunteerlun project was in Malang, Indonesia in 1997. InI that project, we helped to develop the city’scity’s emergencyem department and pre-hospital serviceservic and tie those in with their current hospitalhosp system. In the same year, I began workingwor with Medical Services International, a ChristianCh non-governmental organisation, to develop training in resuscitation and emergencye medicine. For the last 13 years, I’ve travelled with a team of Singaporean medical professionals to the Huili county hospital in Sichuan, China twice a year to helph improve their medical capabilities. My work in China has reinforced theth importance of my clinical skills. In Singapore,S ordering blood tests, X-rays or scanss is as simple as clicking a button. But theth technology in Huili is less sophisticated soso interviewing patients and learning to listenli and ask the right questions is much morem important. Working there reminds mem of the importance of basic skills and not A/PROF THAM KUM YING relyingre on technology. FINDS A SOURCE OF POSITIVE Th e biggest lesson I’ve learnt is how to ENERGY WORKING IN TTSH’S EMERGENCY DEPARTMENT beb content. Th ere are many doctors who workw harder than me, who are better than mem but who earn less than I do and receive fewerfe benefi ts. My time in China makes mem grateful for what I have, and also for what the Singapore healthcare system has achieved.”

26 LIFEWISE NOV - DEC 2012

26 LW NovDec12 InPerson-Prof Tham V2.indd 26 10/31/12 5:07 PM Home Gym Full Page.pdf 1 10/11/2012 1:27:09 PM

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“As I go on my rounds, I meet people both older and younger than myself,” Judy says. “Some are so alert despite their advanced age. Some suff er from memory loss and other problems despite being relatively AGE younger. When you meet people like these, you know which category you would want to JUDY WEE AND LEE POH LENG SHARE THE fall into when you get advanced in years.” To this end, Judy has become more IMPORTANT LESSONS ON AGEING THEY HAVE conscientious about monitoring her own health. Th ree years ago, she was diagnosed PICKED UP AS VOLUNTEERS. BY NIRMALA SIVANATHAN with a degenerative spinal condition so she has been exercising regularly to strengthen her back. Luckily for Judy, keeping fi t is not a Keeping Active chore. Together with her retired 61-year- JUDY WEE, 60 old husband, she attends jazz dance and LIONS BEFRIENDERS Zumba classes once a week, and plays golf VOLUNTEER INSTEAD OF BEING twice a week. An important lesson she has picked up IN 2002, JUDY WEE — THEN A NEGATIVE ABOUT AGEING, from her time volunteering is to approach HOUSING AGENT — was nearing ageing with an open mind. “You can’t just retirement age when she decided I TELL MYSELF THAT THIS IS stay at home. You need to get out there, to sign up as a volunteer with Lions keep active and learn new things,” she says. Befrienders. “I would be having more AN OPPORTUNITY FOR ME “Instead of being negative about ageing, I time on my hands, and I thought why tell myself that this is an opportunity for me not spend it meaningfully?” the sprightly TO DO MORE to do more, and to keep up with my children sexagenarian says. by teaching myself to become IT-literate.” “Since then, I have found that volunteering with the elderly is very fulfi lling. As a Lions Befriender, I visit seniors in their homes, interact with them and make sure they are eating well and taking their medicine regularly.” PHOTO OF JUDY: STEVE ZHU, PHOTO OF POH LENG: WILSON PANG Th e Lions Befrienders Service Association (Singapore) is a voluntary welfare organisation which aims to help improve the social, psycho-emotional and physical well-being of lonely seniors in the community. JUDY WEE Judy started volunteering with the SIGNED UP AS organisation 10 years ago. Once a week, A VOLUNTEER she visits seniors with limited or no family WITH LIONS BEFRIENDERS support, and who are at risk of isolation. WHEN SHE Th e mother of a son aged 35 and a daughter REALISED aged 32, and grandmother of three even THAT SHE goes beyond the call of duty to visit the WOULD HAVE MORE FREE seniors when they are hospitalised. Judy TIME IN HER also helps the staff of Lions Befrienders RETIREMENT deliver items to the homes of the elderly. YEARS

28 LIFEWISE NOV - DEC 2012

28-29 LW NovDec12 Silverglow V2.indd 28 10/31/12 5:07 PM POH LENG DEVOTES FOUR DAYS A WEEK AT IMH, INTERACTING WITH MENTAL PATIENTS SUFFERING FROM ILLNESSES SUCH Rewarding AS DEPRESSION AND Pursuits SCHIZOPHRENIA LEE POH LENG, 57 INSTITUTE OF MENTAL HEALTH VOLUNTEER

FOUR TIMES EVERY WEEK, LEE In 2010, Poh Leng POH LENG leaves his home in joined the IMH as a part- Jurong West at 6.30am and time volunteer coordinator. travels to the Institute of Mental Health Th ese days, he works (IMH) in Buangkok Drive, a journey that two days a week on an takes him one and a half hours by public offi cial basis and comes transport. He has made the trip religiously in for an additional two for the past 13 years since becoming a days as a volunteer. As a volunteer with IMH. volunteer coordinator, he Th e retiree fi rst started volunteering has initiated programmes after he had attended an Open House at such as the Volunteers- the institute. Poh Leng was then a Human Recruit-Volunteers scheme Resource manager with an IT company. and planned outings and Th e Open House invited members of the activities for patients. public to visit IMH and understand its work. In his free time, Poh “Signing up as a volunteer was a chance Leng also volunteers with grassroots Development Council and helps out at the to do something diff erent. I wanted to activities in the South West Community National Library Board with community challenge the stigma surrounding mental outreach programmes. illness,” Poh Leng says. “I also felt the need Working with patients at IMH has to give something back to society since I defi nitely changed his outlook on ageing. have been so blessed in my own life.” “I don’t want to become a burden to my He helps out at the long-stay wards I DON’T WANT TO BECOME children in my old age,” he says. “So I try to which include some adult, children and spend within my means, exercise more and geriatric wards. Patients at these wards A BURDEN TO MY CHILDREN control my diet.” suff er from mental illnesses such as Having seen the eff ects of dementia depression, schizophrenia and psychosis. IN MY OLD AGE, SO I TRY TO on some of the geriatric patients he “We sing along with them, play games works with, Poh Leng also understands and give them a chance to interact with SPEND WITHIN MY MEANS, the importance of staying mentally active others,” says Poh Leng, who has two sons after retirement. “If you are retired, fi nd aged 35 and 29. “Th e patients are here for EXERCISE MORE, AND something to do,” he says. “Don’t just sit extended periods of time so you get the around at home. Get out. Do volunteer chance to get to build a rapport with them.” CONTROL MY DIET work. Read. Move about.”

INTERESTED IN the polyclinics. For details, rehabilitative activities Support Groups. Volunteer visit www.nhgp.com.sg/ such as grooming and Support Programmes VOLUNTEER WORK? volunteer. basic social skills and include the Community Here are some providing a listening ear Health Engagement programmes to } IMH VOLUNTEER to patients. More details at Programme that aims consider. PROGRAMME www.imh.com.sg. to encourage seniors Volunteers at the Institute to embark on a healthy } GUIDING HANDS of Mental Health play a } TTSH VOLUNTEER and active lifestyle; the VOLUNTEER vital role in normalising AND PATIENT Stroke Support Group that PROGRAMME the lives of mental health SUPPORT GROUPS provides psycho-social This programme under patients by helping them Tan Tock Seng Hospital support and counselling to the National Healthcare to feel that they are not offers volunteers of stroke survivors; and the Group Polyclinics offers forsaken by society. Some all stripes diverse Night Sitters Programme a range of volunteering of the work IMH volunteers opportunities to provide to keep watch over fall-risk opportunities for you do include planning and support in more ways patients. More information to offer assistance and organising recreational than one. TTSH has 16 at www.ttsh.com.sg/ guidance to patients of activities, helping in Volunteer and Patient about-us.

NOV - DEC 2012 LIFEWISE 29

28-29 LW NovDec12 Silverglow V2.indd 29 10/31/12 5:08 PM ( LIFESPACES)

Living FEELING UNDER

THE WEATHER? TRY CORBIS GETTY IMAGES, PHOTOS: TRANSFORMING YOUR LIVING SPACE TO WELL IMPROVE YOUR WELL-BEING. BY ELISABETH LEE

STRESSED OUT AND FEELING ON EDGE? Th e reason might not be your boss, job or the usual things that cause you to feel on edge. It could be your living space. Some research has shown that the environment plays a large part in inﬂ uencing a person’s mental and physical health.

Go with the Flow Th e design of your living space can aﬀ ect your mood. John Eberhard, co-founder of the Academy of Neuroscience for Architecture, believes that an appropriately-scaled room — where the dimensions and layout of furnishings complement the overall size of the room to avoid congestion — leads to feelings of calm and reduced stress, thus promoting a sense

of security and increased competence W N AT AI and productivity. ER FOUNT Maximise your living space by getting rid of unneccessary stuff , and then streamlining the layout to improve traffi c fl ow and air movement. And it’s not about feng shui, but simple common sense — experts suggest high ceilings, clean lines (instead of jagged and irregular walls) and open spaces to ensure better ventilation. Another tip is to introduce an element of water into your living environment. Consider

adding a pond or fountain if you have a garden GA D RDEN PON or outdoor space, or a small indoor water feature if you don’t — the gentle burble of a fountain can generate just enough white noise to be soothing.

30 LIFEWISE NOV - DEC 2012

30-31 LW NovDec12 Lifespaces V3.indd 30 10/31/12 5:09 PM Go Green Clear the Air We all know going green Th e air quality of your home can also is good for health, but this aff ect how you feel. Th e United States means much more than just Centre for Disease Control says bacteria choosing eco-friendly cleaning and mould can build up in clogged products with low levels of air-conditioner fi lters, and excessive harmful VOCs. A two-year exposure can result in allergies, asthma study done in the late 1980s P and other adverse eff ects. EACE LILY by the National Aeronautics Other lesser-known pollutants and Space Administration are volatile organic compounds (NASA), a United States agency

PHOTOS: GETTY IMAGES, CORBIS GETTY IMAGES, PHOTOS: MIN CHONG ILLUSTRATIONS: (VOCs) emitted by household cleaning that conducts aeronautics and supplies, paints, building materials and aerospace research, showed varnishes. Th e indoor concentration that common household plants of VOCs can be up to 10 times higher can remove major indoor than outdoors, according to the United pollutants such as benzene and C States Environmental Protection H M formaldehyde commonly found RY MU Agency, and can have many short- and SANTHE in everything from carpeting to long-term adverse health eff ects. adhesives. So pick up an air purifi er, clean your So try adding a pot or two air conditioner fi lters regularly and of peace lily, chrysanthemum or choose household products that have mother-in-law’s tongue — not low levels of VOCs. Look for paints that only will they help fi lter the air, are labelled ‘non-toxic’ and free of extra these plants will also add to

M E O solvents or additives — 5g per litre or U the oxygen levels and beautify T H G N less of VOCs is preferable. E O your living space too. Th e NASA R- T IN-LAW’S study recommends at least one potted plant per 10 sq m of space, for tangible results. Colours that Calm In 2000, the Scottish city of Glasgow discovered that blue street lights resulted in reduced crime rates. American police stations often have pink holding rooms — all in the hope that a pink Cut the Clutter environment would soothe off enders. While A house chock-a-block with evidence is mostly anecdotal, scientists believe uneccessary things can have a that a room’s colour can have a huge impact on negative impact on its occupants. a person’s mood. Bright primary colours — red, Robin Zasio, therapist on the popular yellow and blue — can overwhelm and distract, cable television show Hoarders, so go for soothing shades such as pastels or believes that too much physical neutrals in your living space. clutter creates emotional clutter. Interior designer Carolyn Feder, who “Every time you walk into your home, specialises in creating rooms for special needs that clutter brings you down. Th ere’s children, suggests tranquil hues of blue, green a sense of not feeling comfortable and violet. “I tend to use these colours because and emotionally free in your own they are calming, as opposed to the louder house,” she told the Today show. primary colours,” she says. “Th e brain registers Decluttering is a process that’s these soothing eff ects on a subconcious level and best begun gradually. Get started this really helps to improve behaviour.” by setting aside an hour every day or once a week to target a specifi c area or room. Sort out what stays and what goes — store or box items that you seldom use and get rid of things you don’t need. Charities such as the Salvation Army and Pass It On (www.passiton.org.sg) can help ensure that your unwanted items go to someone who needs them more.

NOV - DEC 2012 LIFEWISE 31

30-31 LW NovDec12 Lifespaces V3.indd 31 10/31/12 5:09 PM ( WORKOUT) SPLASH and get fit AQUA AEROBICS LETS YOU STAY COOL WHILE WORKING TOWARDS A TRIM AND FIT BODY. BY EVELYN MAK

LOOKING FOR A WAY to get a “jog” through water, compared fi t and toned physique without to eight calories pounding having to sweat it out? Or the ground, according to a maybe you want to start a regular exercise report published in the British programme but joint problems are keeping newspaper Th e Independent. you away from the gym? Th en aqua aerobics may be the perfect workout solution. Beneﬁ ts Keeping Aﬂ oat for All Aqua aerobics is basically an exercise Th e unique benefi ts of aqua conducted in a pool with your body exercise have made it a partially submerged in water. While in the sport that is benefi cial to water, actions like kicks, squats, jumps and senior citizens or anyone other dance movements are performed to with joint problems. Th is is get your blood pumping. because being in the pool According to Dr Jason Chia, Head of negates the risk of falls, says Sports Medicine and Surgery Clinic at Tan Dr Chia. It is also a popular Tock Seng Hospital, one of the benefi ts of exercise option for expectant aqua aerobics is the lesser amount of stress mothers — the water helps placed on joints compared to conventional to prevent a rise in internal aerobics exercises. “Aqua aerobics trains the body temperature which can cardiovascular system while the buoyancy be common in pregnancies. of the water decreases impact on the joints. Aqua aerobics is especially Rather than working against gravity, you suitable for pregnant women are working against the resistance of water,” in the advanced stages of a he says. pregnancy when they have Water also supports much of your limited mobility. training while you are laid off your usual weight and acts as a cushion, resulting in You don’t even need to be a skilled workout routine and helps preserve your less strain even while you are strengthening swimmer as lessons are held in shallow or fi tness even as you recover your strength,” muscles and improving cardiovascular chest-high water and usually don’t involve says Dr Chia. fi tness. In fact, aqua aerobics can be more putting the head under water. Besides, your However, he advises anyone with eff ective than conventional workouts feet will always be touching the bottom of active infections and exposed skin lesions at the gym. Water is denser than air, so the pool. to avoid aqua aerobics until they are fully more eff ort is needed to move through Aqua aerobics can also be practised by recovered. Th is is to prevent other pool water. With this resistance added to your people who are recovering from injuries users from getting infected. And as is the workout, the eff ectiveness and eff ects of such as sprained ankles as it allows a safe usual precaution, you should always check the session are amplifi ed. Apparently you environment to exercise in without much with your doctor before starting a new burn 11.5 calories per minute when you pain. “It also acts as adjunct cardiovascular exercise routine.

32 LIFEWISE NOV - DEC 2012

32-33 Workout aquarobics V1.indd 32 10/31/12 5:10 PM Straight Leg Stretch THE RIGHT HELPS TO STRENGTHEN THE HIPS, GLUTES AND MOVES INNER THIGHS Ms Eunice Ler, a certifi ed } Hold on to the edge Federation of International of the pool wall with your Sports, Aerobics and Fitness hands outstretched. (FISAF) aqua aerobics } Stretch one leg out instructor holds aqua until your leg touches the aerobics classes at the YMCA pool wall, lifting it as high and private condominiums. as you can. Her 60-minute classes } Jump to switch legs usually begin with a short and repeat. warm-up with simple exercises to get the body Push-ups limbered up. This is followed TONES THE UPPER ARMS by a routine which can AND SHOULDERS incorporate movements from Place your hands on step aerobics, kickboxing, tai } the edge of the pool wall. qi, and Zumba. The pool wall Pull the weight of your and swimming noodles — } body onto your arms until foam tubes that can be bent your arms are straight. and used in different ways to Bend your legs back at keep you afl oat — are also } the knees and cross your used to add variety to the ankles. exercises. Lessons usually Hold the position for end with fi ve to 10 minutes of } three seconds and repeat. cooling down and stretching exercises. “When done correctly, Underwater Crunches your body will be fatigued by TONES THE ABDOMINALS the end of an aqua aerobic } Curl a swimming workout as the water’s noodle around your resistance will make your shoulders to support your muscles work harder than back as you lie back in the you realise,” Eunice says. water. If you don’t want to } Bend your legs and join a formal aqua aerobics bring your knees to your lesson, or if you can’t fi nd shoulders while holding lessons offered in your tightly to the noodle. Your neighbourhood, it is possible ankles should be crossed. to incorporate aqua exercises } Inhale as you in your normal pool routine. straighten your legs and Walking or jogging in the repeat. pool, doing squats Underwater Lunge and lunges, or just TONES AND doing punches STRENGTHENS in the water QUADRICEPS (THIGHS) are all simple } With your hands exercises that outstretched and you can do shoulders submerged, after your hold on to the pooll wall.wall. usual swim. } Bend your frontt leg On the at a 90-degree anglegle and right, Eunice straighten your backck leg. shares some } Switch legs and repeatrepeat.. simple moves you can do at your own time at the pool. PHOTOS: GETTY IMAGES, CORBIS CORBIS GETTY IMAGES, PHOTOS: MIN CHONG ILLUSTRATION:

NOV - DEC 2012 LIFEWISE 33

32-33 Workout aquarobics V1.indd 33 10/31/12 5:10 PM FREE! Subscribe to Lifewise (6 bimonthly issues for only $24) today and get a Home Gym AbsWheel worth $29.99 absolutely FREE! This tiny and portable equipment will help you get that NOV/DEC 2012 ISSUE 42 much-coveted washboard abs or flat, sexy tummy. BE SAFE, Altered ZANFIT ABStrimmer™ NOT SORRY States Provides Learn how STIs The many faces Non-slip foam of personality the ultimate Compact Dual wheels for are spread abdominals and portable greater stability handles for a and the ways disorders comfortable grip to protect workout yourself ON A 1 234 NEW FOR MORE DETAILS ON ABSTRIMMER, PLEASE VISIT WWW.NUTRITIONPARK.COM FOOTING Yes! Please send me my subscription of Lifewise! How prosthetists To subscribe, fill in the form below and send it back to us. and orthotists rebuild lives FAX 6481-5286 (for payment by credit card only) MAIL MediaCorp Pte Ltd (Subscription Division) 10 Ang Mo Kio St 65, #01-06 TechPoint, Singapore 569059 ENQUIRIES [email protected] Turning The TELEPHONE 6483-1555 (Mon – Fri, 9am – 5pm) 6 ISSUES @ $24.00 (PRICE INCLUSIVE OF GST) Tables on MR/MRS/MS Chan Guan Xiong and Menaka Diabetes Krishnan aren’t ADDRESS letting this illness POSTAL CODE get in the way of a full life TELEPHONE HOME

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34 LW Subscription NovDec12 V2.indd 34 10/31/12 5:14 PM ASK THE (Q&A) EXPERTS YOUR MEDICAL QUESTIONS ANSWERED

Q2)The Heart Truth

My 68 year-old husband was diagnosed with heart failure after he had shortness of breath. His doctor has not recommended surgery, but what should he be more careful of now that he has been diagnosed, and what symptoms should we be on the lookout for?

Th ere are many causes of heart failure and thus the treatment for individual cases may be diff erent. Th e fi rst priority is for your husband to see a heart specialist (ie. cardiologist) who will be able to recommend the appropriate tests to determine the cause and the right treatment. In general, one should take the prescribed Q1) Nature’s Calling Too Often medication and attend follow-up appointments regularly. Signs to watch out for include shortness I am a 45 year-old requent urination at night is called nocturia, of breath, leg or body swelling, woman. On most and it is a common symptom experienced chest pain, giddiness and by men and women especially from middle palpitations. Watching one’s diet nights, I wake up age onwards. In both sexes, it is important to is important as eating salty food to urinate at least F or drinking too much fl uids can fi rst see your GP to rule out a urinary tract infection twice. This has and diabetes. Th is can be achieved by a simple urine result in the swelling of the legs been happening test and where necessary, a fasting blood sugar level and even water in the lungs. Th is for about a month check. In addition, nocturia in men may be associated will worsen the shortness of now. Should I be with enlargement of the prostate gland. For women, breath which suff erers tend concerned? Is nocturia may be related to having an overactive to experience. Your husband’s this a symptom bladder. When these are suspected, your GP can heart specialist would be able of something initiate treatment for you. If the symptoms do not to provide individualised advice more serious like improve or if the GP suspects further investigations which is appropriate for him. are needed, a urologist will be able to help. an urinary tract DR DANIEL YEO infection? DR CHONG YEW LAM CONSULTANT // HEART FAILURE CONSULTANT AND HEAD, DEPARTMENT OF UROLOGY SERVICE // DEPARTMENT OF // ASSISTANT CHAIRMAN (CLINICAL DEVELOPMENT) // CARDIOLOGY // TAN TOCK SENG

PHOTO: GETTY IMAGES PHOTO: MEDICAL BOARD // TAN TOCK SENG HOSPITAL HOSPITAL

NOV - DEC 2012 LIFEWISE 35

35-37 LW NovDec12 Q&A V4.indd 35 10/31/12 5:11 PM Q3)Getting Back on Track

I was told by my doctor that I am borderline obese. I’m now 34 and have not exercised since I was in the army. What exercises or sports should I start with? And what kind of programme should I embark on so that I won’t be discouraged and give up after a short while?

Th e most important forms of exercise for weight management are aerobic and resistance training. Th ere are many forms of aerobic activities and it’s best to identify those that you enjoy doing, for Q4)In the Red example outdoor jogging or brisk walking in parks if you like nature. For a start, it is recommended that I am a woman in my 20s who is you do 30 minutes of aerobic activity per day for concerned about my rosacea. I’m keen fi ve days a week. If you have any pre-existing pain or to seek medical help but am concerned injury which may be aggravated by certain forms of about the risk factors. What treatments exercise, consult a doctor or physiotherapist. are there for rosacea? For resistance training, try to work on major muscle groups two to three days per week. You may want to start with calisthenics (body-weighted exercise) Rosacea is characterised by redness of the cheeks, such as wall push-ups, half crunches, half squats and chin and forehead with prominent fi ne blood vessels lunges (three sets of 10 repetitions); alternatively, gym and occasional pimples. However, there are other exercises such as chest press, leg press, leg extensions conditions which can appear similar and you should and leg curls (three sets of 10 repetitions). Again, to fi rst see a dermatologist to confi rm the diagnosis. motivate yourself, choose an exercise that you are Th e specifi c factors which aggravate your condition interested in. It is also important to exercise safely have to be fi rst identifi ed. Th ese include heat, with the correct techniques to avoid injuries. Finally, sunlight, spicy food and alcohol. For skin care, you watch what you eat. If you need dietary advice, you can should only use gentle, non-abrasive facial cleansers consult a dietitian. and avoid applications which have the potential to irritate your skin. Treatment options include topical MR KWOK BOON CHONG creams such as metronidazole gel, clindamycin SENIOR PHYSIOTHERAPIST // NATIONAL HEALTHCARE GROUP gel or erythromycin gel. Lasers such as pulsed dye POLYCLINICS laser can also be used to reduce the appearance of redness. In severe cases, oral antibiotics may also be required. In cases which are diffi cult to treat, oral isotretinoin may be used. Side eff ects include skin dryness and cracked lips, elevated cholesterol levels and abnormal liver function. Female patients must avoid getting pregnant while on isotretinoin as it can aff ect the development of the foetus.

DR HENG YEE KIAT ASSOCIATE CONSULTANT DERMATOLOGIST // NATIONAL SKIN CENTRE Q5)Detox Warning

Are detox diets medically proven to be beneﬁ cial to health? How should I go about a detox diet?

36 LIFEWISE NOV - DEC 2012

35-37 LW NovDec12 Q&A V4.indd 36 10/31/12 5:11 PM Detox diets are not scientifi cally Viewing pornography is, by itself, not an addiction. proven to be benefi cial to health. A sexual activity becomes an addiction when there are Th ere is little evidence that detox three or more of the following signs, as assessed by a diets actually eradicate toxins from doctor or trained counsellor: our body — our kidneys and liver aree } Th e activity gets more intensive over a six-month capable of fi ltering and eliminating period, either in terms of the time spent on it or toxins effi ciently. Furthermore, there the frequency. are no specifi c fruits or vegetables thatat } Th e behaviour causes problems to the person’s are especially powerful in removing functioning in social, work and relationship areas toxins. It is more likely a person may seesee } Even after the individual experiences major benefi ts from a so-called detox diet whenhen consequences (e.g. breakdown of marriage) due to his/her diet was originally unhealthy, and the activity, he/she continues to engage in it. the avoidance of unhealthy food choicesces } Th e individual progressively gets more pain and makes him/her feel better. distress rather than pleasure from the activity. A word of caution: some detox dietsets } Th e individual has made many attempts to stop or may lead to inadequate nutrition intake.ke. control the behaviour but was unsuccessful. It is wiser to eat a balanced diet basedd on } Th e individual uses the behaviour to regulate fruits and vegetables, whole grains anddl lean moods, escape from unresolved psychological and sources of protein; avoid foods that are high in fat, emotional issues, or to fi ll a void in their life. especially saturated fat, refi ned sugars and foods } Th e individual avoids or neglects important high in sodium such as processed foods; abstain from activities in order to engage in the behaviour. alcohol and drugs; and drink six to eight glasses of If a professional has assessed that your husband does water a day. not have an addiction, you may wish to see a family therapist to work out your relationship issues. MR WON TIN CHIANG SENIOR DIETITIAN-CLINICAL SERVICES // NATIONAL MR VIKNESAN SB HEALTHCARE GROUP POLYCLINICS SENIOR COUNSELLOR // NATIONAL ADDICTIONS MANAGEMENT SERVICE (NAMS) // INSTITUTE OF MENTAL HEALTH ASK THE Q6)Cellulite Woes SEXPERTS

I am a 27 year-old woman and I recently noticed visible cellulite on my legs and HERPES upper arms. My BMI is 23 and I exercise regularly. What causes cellulite? How can ALERT its appearance be reduced? I am a 30 year-old man with genital herpes. How should Cellulite is characterised by dimpling of the skin, I manage the either spontaneously or after provoking manoeuvres recurrence of the like pinching the skin. It is a physiological condition? And phenomenon, meaning that it is normal to have what should I do if cellulite. It has a multi-causal origin, with genetic I would like to have and hormonal factors, and the connective tissue sex with my partner? architecture and changes in vascular tissue all playing a role. Treatments include lymphatic drainage, Genital herpes is a sexually-transmitted infection that may topical phosphatidylcholine-based anticellulite gel, recur from time to time, expecially in the fi rst two years. radiofrequency and laser and light-based procedures. Triggers include stress and concurrent illness which may lower one’s immunity. DR TAN WEE PING If genital herpes recurs, seek treatment as soon as CONSULTANT DERMATOLOGIST // NATIONAL SKIN CENTRE possible as the medication works best when taken early. Some individuals may experience repeated fl are-ups which may be debilitating. In this situation, they may be put on long-term medication to suppress the infection. Q7)Porn Problem It is strongly advised to avoid sexual activity during a fl are-up as one is then highly infectious and may pass the I recently found links to pornographic infection to others. Even at other times, it is advisable to sites on my husband’s computer. What engage in safe sex such as being monogamous and using are the consequences of an online porn condoms as the herpes virus may be present in genital fl uids. addiction? Should he seek help? DR GAVIN ONG ASSOCIATE CONSULTANT DERMATOLOGIST // NATIONAL SKIN CENTRE PHOTOS: GETTY IMAGES, CORBIS GETTY IMAGES, PHOTOS:

NOV - DEC 2012 LIFEWISE 37

35-37 LW NovDec12 Q&A V4.indd 37 10/31/12 5:11 PM ( EAT SMART) Packing a PUNCH, not paunch BEING MINDFUL OF WHAT YOU EAT THIS FESTIVE SEASON MEANS YOU WON’T NEED TO GO ON A DIET IN THE NEW YEAR! BY AUDRINA GAN

IT IS EASY TO OVEREAT, especially during the festive season. With Christmas and Deepavali just round the corner, it pays to practice portion control to keep those unwanted kilos at bay. How to go about doing so? For starters, avoid house visiting on an empty stomach as this is a surefi re way to overeat when faced with a spread of goodies or a host urging you to “go on, have another slice of cake”. Before heading out, fi ll yourself up with low-calorie snacks such as fruits, vegetables or plain crackers. “Vegetables are generally lower in calories while high in fi bre, and can help to fi ll you up and reduce the urge to reach out for second servings or calorie-laden dishes,” says dietitian, Ms Ong Hui Wen, from Tan Tock Seng Hospital. It is especially important too, that you be conscious of portion sizes of calorie-dense foods such as beef rendang and ice-cream. A smart way is to share a portion with someone else; in this way you are limiting what you eat, but will still be able to enjoy a large variety of food. You can also use a smaller plate. Larger plates make the same serving size of food appear smaller, increasing the likelihood of piling on more food, and eating more. One particular study concluded that people provided with a larger bowl and serving spoon consumed 57 per cent more compared to those with a smaller bowl and spoon. If possible, choose a blue plate as well as it has been shown that the colour blue is an appetite suppressant. Th is is because we seldom get naturally blue food, and as a result, our appetites are not whetted by anything in this colour. If you are the host, feasting smart also means off ering your guests healthier alternatives. Instead of deep-frying, you can steam, grill, boil, roast, broil, bake or air-fry food. Saturated oils

38 LIFEWISE NOV - DEC 2012

38-39 LW Gourmet NovDec12 V5.indd 38 10/31/12 5:13 PM TRIM OFF EXCESS FAT FROM CHICKEN, BEEF OR such as ghee, lard Trim off excess fat from chicken, beef PORK BEFORE ROASTING and palm oil can or pork before before roasting and serve clog arteries so opt the gravy separately. Remember too, to AND SERVE THE GRAVY for canola, corn, skim off the layer of oil. sunfl ower or olive SEPARATELY oil. If you have to Reduce Deep-frying use butter, choose During Chinese New Year, steam your unsalted butter, says nian gao (glutinous rice cake) instead Ms Ong, and reduce the amount required of deep-frying it in oil. Or you could by half. Substitute the rest with apple pan-fry it sandwiched in between sweet sauce or canola oil. potato and yam pieces coated with Instead of using large amounts of salt batter for a tasty alternative. Substitute or doses of soy sauce, why not not dress some of the usual tidbits with raw up your food with fresh or dried herbs almonds, sunfl ower seeds or other nuts. and spices? Basil, black pepper, chilli padi, But avoid honey-roasted, sugar-coated coriander, chinese fi ve-spice powder, curry or salted varieties. spices, fresh mint, garlic, ginger, rosemary Dishes like butter prawns and roast and thyme are great alternatives. duck may be delicious but not all that Curry is a mainstay during the festive good for the heart. For main meals, season, and Ms Ong has a healthy tip consider feasting steamboat-style instead, for cooking it. “You can use low-fat as the food is then boiled and not fried. evaporated milk, skim milk, low- fat plain Add more vegetables and fresh fi sh yoghurt or soy milk with no sugar added,” slices to your steamboat for a healthy she suggests. and fi lling meal. Provide fresh fruit Turkey is generally known to be lower for dessert instead of the usual sugar- in sodium and cholesterol than chicken, laden options. If you do serve sweetened but serve a piece of turkey meat with a desserts, use natural sweeteners like generous dollop of gravy and you get a dried longans, dates or persimmon. meal that is high in fat. Th e same goes for Serving a dessert warm can also help to ham. When cured with salt and glazed enhance the sweetness without the need with honey, a 170g serving contains for extra sugar. 2,000mg of sodium, which is already With these smart tips on hand, you equivalent to the recommended daily can have a merry feast without putting intake of sodium. on a paunch!

KEEPING COUNT Here’s a chart of how some of your favourite festive foods stack up

FOOD SERVING SIZE ENERGY FAT (KCALS) (G) Roast turkey with skin 2 slices (90g) 170 6.7

Mixed vegetables, boiled, ½ mug (70g) 138 11.7 with added butter

Beef Rendang 267g 596 12.9

Ketupat (rice dumpling) 95g 88 0

Muruku 22g (per piece) 110 30.1

Gulab Jamun 225g 774 12.7

Nasi Briyani with chicken 488g 922 7.5

Pineapple Tarts 2 pcs (50g) 164 17.8

Ba kwa (pork) 1 pc (57g) 229 13.7

Yu Sheng (raw ﬁ sh salad) 1 serving (100g) 145 10.9 PHOTO: GETTY IMAGES PHOTO:

Drunken Prawn 6 large prawns (186g) 195 1.9 BOARD PROMOTION SOURCE: HEALTH

NOV - DEC 2012 LIFEWISE 39

38-39 LW Gourmet NovDec12 V5.indd 39 10/31/12 5:13 PM CORPORATE NEWS + CALENDAR OF EVENTS + FORUMS

Clockwise from left: Prof Jill Thistlethwaite; Prof Chee Yam Cheng hands out the Singapore Primary Care Research Award (Gold) to Dr David Tan Hsien Yung from the National Healthcare Group Polyclinics. TEAMWORK — THE KEY TO BETTER HEALTHCARE OUTCOMES

PROVIDING MORE COHESIVE TEAM-BASED CARE AND THE Th emed “Reshaping Healthcare: Deepening the CHALLENGES OF AN AGEING SOCIETY WERE THE FOCAL POINTS Foundation for Quality and Safety, Igniting the AT THIS YEAR’S SINGAPORE HEALTH AND BIOMEDICAL CONGRESS. Engine for Education and Innovation”, this year’s conference zoomed in on ways to improve healthcare education and communication. In his opening speech, Professor Chee Yam Cheng, ith Singapore’s ageing society, the CEO of the National Healthcare Group (NHG), said dynamics of patient care will only get the Congress would allow healthcare professionals to more complex. What that means for examine and share ways to enhance clinical quality and Whealthcare professionals is the need to safety, together with more cost-eff ective patient care. communicate more eff ectively with one another to cope Keynote speaker Professor Jill Th istlethwaite with changing needs. noted that communication between healthcare Th is was one of the key takeaways from this year’s professionals is still lacking. Prof Th istlethwaite is Singapore Health and Biomedical Congress (SHBC), one of the world’s leading authorities on team-based which was held on 28 and 29 September at the Max Atria care. She highlighted the need to train healthcare @ Singapore Expo. Now into its 11th year, the Congress professionals to communicate more eff ectively with — whose Guest-of-Honour was Singapore’s Minister one another. for Health Gan Kim Yong — drew more than 2,200 “It’s about harnessing the skill mix, recognising medical professionals from local and regional healthcare that none of us have all the skills we need to deal institutions from around the world. with complex patient needs,” said Prof Th istlewaite,

40 LIFEWISE NOV - DEC 2012

40-48 LW NovDec12 Spotlight V2.indd 40 10/31/12 5:40 PM our education and innovation. Focus GERIATRIC CARE research capabilities areas of clinical, in geriatric care at epidemiological and GETS A BOOST the same time,” he health services will be To meet the healthcare explained. targeted at new care needs of a rapidly- The establishment models for Singapore’s ageing population, of IGA is to meet the rapidly-ageing Tan Tock Seng Hospital’s current and future population over the Division of Integrative demands of geriatric next 20 to 30 years. and Community Care medicine in Singapore At the same time, has set up the Institute through the pillars IGA will work with of Geriatrics and of Research and Singapore’s medical Active Ageing. Innovation, Training schools to improve the

NHG Chairman, Mdm Kay Kuok, gives and Education, as well prominence of geriatric out the Young Investigator Award To establish new as Quality and Safety. education. Other than (Silver) to Ms Anusha Govinder Raj directions for geriatric “Our focus is very much being an entity to from the National Healthcare Group. care in Singapore, the in keeping ourselves attract, train and retain National Healthcare rooted in research and doctors to specialise in who is the Director of the Centre Group (NHG) has new innovative ideas, geriatrics, the Institute for Medical Education Research and announced the launch developing a pool of will also be a focal Scholarship at the University of of the Institute of geriatric professionals resource point for local Queensland in Australia. Geriatrics and Active who can ignite and and regional healthcare Research done by Mr Issac Lim, Ageing (IGA) at SHBC. propel new care models professionals. It from the Health Outcomes and Medical Set up by Tan Tock and programmes into will also serve as a Education Research department of Seng Hospital (TTSH)’s the community,” added platform for medical NHG, helped quantify the lack of Division of Integrative A/Prof Chin. professionals and communication. He found that while and Community Care doctors and nurses interacted well with (DICC), the institute — their peers, interaction between doctors which is located within THE EXISTING CARE MODELS HAVE WORKED and nurses was much lower. Th is in turn the hospital’s premises WELL THUS FAR, BUT TO MEET FUTURE may mean poorer quality of patients’ — aims to enable the healthcare experiences and health delivery of holistic care NEEDS, GERIATRICS HAS TO CONSTANTLY outcomes. Mr Lim’s research won him to improve the health, EVOLVE, INNOVATE AND IMPROVE independence, safety the top Medical Teacher Poster Prize at A/PROF CHIN JING JIH, TTSH’S DIVISIONAL CHAIRMAN OF DICC the 2012 AMEE Conference in Lyon in and quality of life of August (see page 43). older persons through Other plenary speakers at the innovation and public “The existing elder care providers Congress included Mr Göran Henriks, education. care models have in the community to Chief Executive of Learning and Associate Professor worked well thus far, share knowledge and Innovation at Qulturum in Jönköping Chin Jing Jih, TTSH’s but to meet future exchange ideas on County Council, Sweden. Jönköping is Divisional Chairman of needs, geriatrics has ageing research and noted globally for its successful execution DICC, explained that to constantly evolve, education. of a Regional Health System, something the rapidly-ageing innovate and improve. Part of the IGA’s that Singapore is striving towards. population and a There is a need to mission is to extend Two satellite conferences were disproportionately high bridge ourselves to the its services, research also held in conjunction with the main rate of admissions and elderly out there so and educational Congress — the Primary Care Forum lengths of stay have led that we can educate, programmes beyond and the NHG Quality Convention 2012. to a need to improve prepare and equip the current frail elderly Th e SHBC also formed the backdrop for the continuum of care both them and their to younger seniors the announcement of 47 winners for the through research and caregivers with ways who are still active annual Scientifi c Competition, which innovation. NHG CEO to embrace active and independent. drew 270 submissions. Dr Edwin Seet, Professor Chee Yam ageing — healthily, This will involve a consultant from the Department of Cheng said the setting independently and setting up educational Anaesthesia at Khoo Teck Puat Hospital up of the IGA is timely. positively,” he adds. programmes aimed at clinched top honours — the Gold “This Institute will A structured preparing the elderly Clinical Investigator Award — for his enable us to provide platform for healthcare for ageing, maintaining research on the clinical use of various an even more holistic professionals will be their health and quality laryngoscopes. Th e National University suite of services to established at IGA to of life, and postponing Hospital and the Institute of Mental Singapore’s senior conduct research and the onset of illnesses Health were the top-scoring institutions, citizens and develop work on technological and disabilities. with fi ve and three golds respectively.

NOV - DEC 2012 LIFEWISE 41

40-48 LW NovDec12 Spotlight V2.indd 41 10/31/12 5:40 PM Signing of the Collaborative Agreement between IMH and Galya Rajanagarindra Institute in Bangkok (right); villagers like these from the ﬂ ood-prone Pachi District of Thailand’s Ayutthaya Province will beneﬁ t from IMH’s training programme (below) MENTAL HEALTH: GOING BEYOND BORDERS THE INSTITUTE OF MENTAL HEALTH WILL TRAIN 840 MENTAL HEALTH PROFESSIONALS IN THAILAND, CHINA AND INDONESIA TO SUPPORT THE MENTAL WELL-BEING OF THOSE LIVING IN DISASTER-PRONE AREAS.

he damage infl icted by natural calamities often IMH will equip 120 offi cers from the goes beyond the physical. To survivors, the government and healthcare sectors from the three trauma can also have a psychological dimension countries with skills to develop policies and plans for Twhich can aff ect them for years. In view of disaster preparedness. this, a training programme to help disaster-aff ected An additional 120 mental health professionals communities in Asia has been set up by the Institute comprising of psychiatrists, nurses and social of Mental Health (IMH) with the aid of the Temasek workers will be trained as master trainers. Th ey will Foundation. Th e two organisations are collaborating then pass their skills to another 600 community- with tertiary healthcare based professionals organisations in Th ailand, through post-training China and Indonesia IN LEARNING ABOUT COMMUNITY MENTAL workshops. Towards to develop a capacity- HEALTH SUPPORT IN THESE THREE these ends, IMH has building programme in COUNTRIES, THE EXPERIENCE WILL ENHANCE signed a Collaboration mental well-being and Agreement with Galya resilience to support OUR ABILITY TO PROVIDE PSYCHOLOGICAL Rajanagarindra Institute disaster-preparedness and SUPPORT IN RESPONSE TO CRISES in Th ailand and West recovery of communities China Hospital in aff ected by disasters. NATIONALLY AND INTERNATIONALLY Sichuan Province in Th e $2.38 million A/PROF CHUA HONG CHOON, CHIEF EXECUTIVE OFFICER OF IMH China. A third agreement programme will improve will be signed with an the delivery of integrated mental health services in Indonesian healthcare partner by the end of this year. the respective communities by enhancing the skills of According to Associate Professor Chua Hong mental health professionals residing in these areas. Choon, Chief Executive Offi cer of IMH, this training Temasek Foundation funded more than two-thirds of the programme provides a win-win situation for all the programme by providing a $1.96 million grant to IMH. parties involved. “In learning about community Th e programme includes training mental health mental health support in these three countries, professionals to plan, develop and implement integrated the experience will enhance our ability to provide mental health services in disaster-aff ected communities psychological support in response to crises nationally and equipping them with skills in post-disaster recovery. and internationally,” he said.

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40-48 LW NovDec12 Spotlight V2.indd 42 10/31/12 5:40 PM BETTER COMMUNICATION = BETTER PATIENT CARE A SINGAPORE STUDY ON INTER- PROFESSIONAL COMMUNICATION IN A MEDICAL SETTING WINS THE TOP PRIZE AT AN INTERNATIONAL MEDICAL EDUCATION RESEARCH CONFERENCE.

he need to enhance patient care and safety proved to be the driving force behind Mr Issac Lim’s winning entry at Tthe Association for Medical Education in Europe (AMEE) Conference 2012. Mr Lim, a sociologist who manages the National Healthcare Group’s Health Outcomes and Medical Education Research (HOMER) unit, competed against 780 entries from around the world to clinch the top Medical Teacher Poster Prize at the premier global medical education research conference held in Lyon, France in August this year. Th is is the fi rst time a Singaporean has been awarded the top prize for medical education research awarded by an international organisation. Titled Making Birds of Diﬀ erent Feathers Flock Together: Common Skies for Inter-Professionalism, Mr Lim’s study is based on inter-professional collaboration between doctors and nurses. While similar research has been conducted in the United States and United Kingdom, this study was the fi rst to quantify doctor and nurse interactions, complete with visuals to convey the diff ering patterns of communication in a variety of clinical settings. For his study, Mr Lim clocked over 100 hours On how inter-professional observing doctor-nurse A MULTI-PRONGED APPROACH communication can be interactions in three enhanced, he says, “A diff erent settings at Tan SHOULD BE TAKEN, WHEREIN WE FIRST multi-pronged approach Tock Seng Hospital — in REDESIGN SOME OF THE WORKFLOWS should be taken, wherein the Intensive Care Unit, we fi rst redesign some of the General Internal AND SOCIAL ORGANISATION IN the workfl ows and social Medicine and the General CLINICAL SETTINGS organisation in clinical Surgery Departments. His MR ISSAC LIM, SOCIOLOGIST WITH NHG’S HEALTH OUTCOMES settings. Secondly, we need observations showed that AND MEDICAL EDUCATION RESEARCH (HOMER) UNIT to create shared learning communication patterns experiences for healthcare of participants are largely workers through sustained computer-mediated and intra-professional — that inter-professional learning.” is, between doctors or between nurses. Th is is due to Inter-professional collaboration is one of the factors such as the larger organisational environment, key areas recognised by global medical institutions organisational culture and structure. Mr Lim says as a means to enhance patient care. It is a model that his fi ndings are the fi rst step in improving inter- used by hospitals around the world to deliver professional communication in a hospital, which will enhanced healthcare to patients with long-term ultimately benefi t patients’ experience. chronic conditions.

NOV - DEC 2012 LIFEWISE 43

40-48 LW NovDec12 Spotlight V2.indd 43 10/31/12 5:40 PM Clockwise from left: Showcase by Tan Chee Keong on ‘Freedom and Peace of Heart’; Aileen Kang’s showcase of ‘Ordinary Things in Life’; ‘Choosing Triumph and Purity’ by Melody C HEALING THROUGH PHOTOGRAPHY MENTAL HEALTH PATIENTS EXPRESS THEIR THOUGHTS AND FEELINGS VISUALLY IN A PHOTOGRAPHY EXHIBITION.

hey say that a picture paints a thousand words using these skills to create a photo project. and this wisdom couldn’t ring more true than Th e result of this programme can be viewed by at the Picture My World Exhibition organised the public in an exhibition, which will be held at Tby the Institute of Mental Health (IMH). Th is various locations between October 2012 and April photography showcase is the result of a two-month long 2013, including School of the Arts, Jurong Regional eff ort that showcases how 14 individuals — recovering Library and Tan Tock Seng Hospital. In addition, or who have recovered from mental illness — use members of the public can sign up for free talks photography to communicate their feelings. on mental health. Two sessions are conducted by a Th e project and exhibition is based on an senior occupational therapist from IMH, and these organisation called Photovoice in the United Kingdom will cover topics such as emotional mindfulness which uses photography as a tool for empowerment and self-acceptance. Th e third session is led by for disadvantaged and marginalised communities. Th e a photographer, an arts manager and a senior organisation believes that a visual diary can serve as a occupational therapist from IMH who will talk about way to help a person document and refl ect on events photography as a tool for visual story-telling for happening in their lives. individuals recovering from mental illness. For people living with mental illness, social inclusion plays a Buangkok Green Tampines Regional central role in their recovery. PICTURE MY WORLD Medical Park Library However, a lack of understanding EXHIBITION SCHEDULE 10 Buangkok View, 31, Tampines Ave 7 about mental illness often adds Singapore 539747 Singapore 529620 13 Oct – 21 Nov 2012 to the marginalisation of such Talks and workshops 10am – 9pm daily 16 – 30 Jan 2013 a group. 12pm – 8pm daily will be held on 4 and Jurong Regional Library 18 November 2012 at Contributors to the exhibition 21 Jurong East Central 1, Tan Tock Seng Jurong Regional Library. Singapore 609732 Hospital, Atrium attended a series of workshops For schedules and at visual arts centre Objectifs, 11 Jalan Tan Tock Seng, Singapore 3084332 registration details, visit during which they learnt about 23 Nov – 13 Jan 2013 www.imh.com.sg/event. picture composition and exposure 8am – 6pm daily For more information on Institute of Mental 2 – 15 Apr 2013 Picture My World, visit from professional lensmen. Th e Health, Main Lobby 10am – 9pm daily www.picturemyworld.sg. participants were then guided on

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40-48 LW NovDec12 Spotlight V2.indd 44 10/31/12 5:40 PM AWARD-WINNING SOLUTION NATIONAL HEALTHCARE GROUP PHARMACY WINS AN AWARD FOR ITS INNOVATIVE SERVICE THAT PACKS VARIOUS MEDICATIONS INTO CONVENIENT SACHETS.

ational Healthcare Group (NHG) NHG CEO Prof Chee Yam Pharmacy and healthcare IT consultant, Cheng, third from the Integrated Health Information Systems left, with the award N(IHIS), clinched an award — for winners ConviDose — at the recent Singapore Infocomm Technology Federation (SITF) Awards in August. TEACHING NHG Pharmacy’s ConviDose: Safer, Easier Meds is a Multi-dose Medication Management System that packs the various medicines a patient needs HAS ITS to take at prescribed times into handy single sachets. NHG Pharmacy won the SITF Infocomm PAYOFFS Productivity Bronze Award for the service TEACHING MEDICAL PROFESSIONALS WERE THE MULTI-DOSE MEDICATION which now benefi ts RECOGNISED FOR THEIR EDUCATIONAL MANAGEMENT SYSTEM some 3,100 patients in CONTRIBUTIONS AT THE INAUGURAL 16 nursing homes and NATIONAL HEALTHCARE GROUP TEACHING PACKS VARIOUS MEDICINES four long-stay wards at the Institute of EXCELLENCE AWARDS. A PATIENT NEEDS TO TAKE Mental Health. A pilot AT PRESCRIBED TIMES INTO is underway to extend this convenient service SINGLE SACHETS to patients at the nine he learning journey is all part and parcel NHG Polyclinics. of the medical profession. And for most clinicians, teaching plays a crucial part in Ttheir practice as well. To honour medical educators, the National Healthcare Group (NHG) held the inaugural Teaching Excellence Awards on 1 September at Tan Tock Seng Hospital (TTSH). A total of 25 winners — 20 of whom are doctors — across four categories were honoured for their contributions. Th e other winners included nurses, pharmacists and a laboratory specialist. Th e Teaching Excellence Awards included categories for Junior Clinicians, Non-Physicians and Education Partners from non-NHG institutions. Th ree doctors were also given the NHG Education Leaders Award for their contributions to teaching over the years. Th ey are Associate Professor Vijayan Appasamy, Programme Director for NHG General Surgery residency programme and Senior Consultant at TTSH’s General Surgery Department; A/Prof Koh Nien Yue, Senior Consultant at TTSH’s General Medicine Department; and A/Prof Swapna Verma, Senior Consultant at the Institute of Mental Health’s Early Psychosis Intervention Programme. NHG clinicians are actively involved in the Residency programmes of tertiary institutions for their postgraduate medical education. In two years, the number of NHG clinician teachers has quadrupled — from 39 educators in 2010 to 157 in 2012. NOV - DEC 2012 LIFEWISE 45

40-48 LW NovDec12 Spotlight V2.indd 45 10/31/12 5:40 PM MOVING @ A HEALTHY VELOCITY A NEW PARTNERSHIP MARRIES HEALTH EDCUATION AND A SPORTY LIFESTYLE.

eading a sporty lifestyle is unquestionably a good thing — but at the same time there are safeguards that enthusiasts should be aware Lof in order to pursue their passion in a safe and benefi cial manner. To this end, Tan Tock Seng Hospital (TTSH) and sports lifestyle mall Velocity have joined hands to promote education on health and safety for sports enthusiasts in Singapore. Both organisations will leverage on their synergetic relationship and close proximity to each THE JOY other in the Novena area to launch a series of free monthly lunchtime talks themed “Moving @ A Healthy Velocity”. Th ese talks will be conducted by OF MUSIC TTSH doctors, nutritionists and other health-related specialists, and are being rolled out over a period TAN TOCK SENG HOSPITAL STAFF MEMBERS of 12 months from 17 September 2012. Th ese will LEND THEIR VOICES TO A CHRISTMAS CD FOR subsequently be held on the fi rst Monday of every A GOOD CAUSE. month from 12.45 pm to 1.15pm at the Velocity Atrium. Under the collaboration, TTSH’s team of multi- disciplinary healthcare professionals will provide information on subjects such as Sports Safety, Proper usic brings people together. And the Nutrition, Marathon Running and more. TTSH will production of Tan Tock Seng (TTSH’s) also contribute articles on these topics on Velocity’s Art of Healing Christmas Collection CD social media platforms. Th e partnership was sealed in Mis helping to foster closer relationships a Memorandum of Understanding (MOU) which was among the hospital’s staff . signed on 4 September 2012 and witnessed by Guest Th is project is part of the hospital’s Art of Healing Guest of Honour Dr Amy of Honour Minister of State, Ministry of Health and Programme, a TTSH initiative that uses the arts to Khor (left) looks on as Ministry of Manpower, Dr Amy Khor. create a warm, welcoming and uplifting environment Mr Liam Wee Sin, President (Property), UOL Group Ltd, Both TTSH and Velocity share a common goal of for patients, families, staff and visitors. Th e CD will Velocity and Chairman encouraging more Singaporeans to take up sports to also serve as a form of therapy to soothe patients Medical Board (CMB) A/Prof Thomas Lew, TTSH improve their health, but to do so in a safe manner. mentally and emotionally, and help them on their formalise the partnership To drive home that point, Velocity and TTSH staff path to recovery especially during the festive season. during the Memorandum of Understanding signing competed in a friendly fi ve-aside Human Foosball Past projects under the Art of Healing Programme ceremony on 4 September match on the day of the MOU signing.ng.g include a sing-a-long session where staff took the stage with the NUSS choir to entertain patients and their visitors at the TTSH atrium, and a piano performance by doctors from the Department of General Surgery. Th rough music, TTSH hopes to connect with the public in the true spirit of Christmas by bringing together the voices of its staff members in this CD. Th e collaborative eff ort also brought staff of all levels together to cultivate a culture of unity and care. All proceeds from the sales of the CDs will be donated to the TTSH Community Development Fund for needy patients. Th e Art of Healing Christmas Collection CDs will be released in the fi rst week of November and is priced at $15 (for staff ) and $18 (for the public). Grab a copy at the TTSH Heritage Gift Shop.

46 LIFEWISE NOV - DEC 2012

40-48 LW NovDec12 Spotlight V2.indd 46 10/31/12 5:40 PM NHGP Chief Operating Ofﬁ cer Ms Grace Chiang shows off some of the clinic’s new facilities

Also, registration and payment counters have been designed at a lower height to accommodate patients in wheelchairs. About 11 per cent of the polyclinic’s patients are between 65 and 79 years old. Instead of being placed across three fl oors — as was the case in the previous polyclinic — services are now concentrated on one level and clustered by colour zones. According to Ms Chiang, the clustering of services using colour zones and alphabets will help patients — who are classifi ed by chronic, acute and minor conditions — to identify service areas more easily. Clustering also promotes smoother patient fl ow. For instance, a patient with hypertension YISHUN can self-register, proceed to the chronic condition cluster, do a health screening, consult a doctor, obtain POLYCLINIC’S medication and make payment within a single zone. During their visits to the polyclinic, patients with infl uenza symptoms or other upper respiratory tract NEW HOME infections (URTI) are triaged and sent to see the doctor, and can collect their medication and make SURROUNDED BY LUSH GREENERY AND LOCATED NEAR payment all in the same area. Th e segregation of the A MAJOR HOSPITAL, THE NEW POLYCLINIC HAS BEEN URTI cluster helps to minimise the risk of infections DESIGNED TO BETTER MEET THE NEEDS OF PATIENTS. should an outbreak occur. Th is area is also set apart from the chronic patient cluster, where older patients with weaker immune systems tend to congregate. Height and weight stations have also been hen Yishun Polyclinic relocates to its designed to provide greater privacy as patients new premises at 30A Yishun Central 1 might not want their details to be visible to others. on 26 November, patients can expect Furthermore, visitors will have more legroom the Wa healthcare facility whose design is next time they sip a cup of coff ee, thanks to a more nothing short of cutting-edge. Not only is the polyclinic spacious café. nestled next to Yishun Reservoir, it also boasts higher To cater to higher patient volume, the new ceilings with skylights and more windows to allow natural clinic will have 25 nursing rooms compared to 13 light to fi lter through. previously, as well as three more consultation rooms. “We hope that exposure to the green surroundings Over the years, patient numbers have been on the rise will be calming and provide a healing element for our with annual percentage growth of patient attendance patients,” says Ms Grace Chiang, Chief Operating Offi cer at 19.4 per cent from 2007 to 2011. It received of National Healthcare Group Polyclinics (NHGP). 232,773 patients from January to August this year. Th e single-storey 4,440sqm building is a 10-minute Yishun resident Eric Tay, 49, welcomes the walk from Yishun MRT station and bus interchange. polyclinic’s move. “I’m happy to learn that the new Previously, it took a patient about 15 minutes to get to clinic will be a single-storey building and colour-coded the polyclinic from these two locations. into diff erent zones as it makes fi nding my way around Apart from an accessible location, NHGP has also easier,” he says. Mr Tay and his family have been visiting incorporated more elderly-friendly features into the Yishun Polyclinic for more than 20 years. polyclinic’s design. Th ese include handrails along all the Yishun Polyclinic will be closed from 22 to 24 walkways and chairs with armrests. To minimise the risk November to facilitate the move, during which of fall hazards, hydraulic couches which can be raised patients will be directed to Woodlands Polyclinic for or lowered will also be set up in all the consultation treatment. During the closure, a free shuttle service and treatment rooms. Previously, patients needed to will be provided to ferry patients to and from the walk up a step before they could get onto the couches. Yishun and Woodlands Polyclinics.

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40-48 LW NovDec12 Spotlight V2.indd 47 10/31/12 5:40 PM BUKIT BATOK POLYCLINIC and ISO 15189 which is under 50 Bukit Batok West Ave 3 the Singapore Accreditation Fax: 6566-2208 Council-Singapore Laboratory CHOA CHU KANG POLYCLINIC Accreditation Scheme (SAC- DIRECTORY 2 Teck Whye Crescent SINGLAS). In 2012, NHG WE’VE MADE IT EASY FOR YOU TO CONTACT OR LOCATE US. Fax: 6765-0851 Diagnostics joined efforts CLEMENTI POLYCLINIC with the nine NHG Polyclinics Blk 451 Clementi Ave 3 #02-307 to attain the JCI or Joint Fax: 6775-7594 Commission International HOUGANG POLYCLINIC (Primary Care Standard) NATIONAL INSTITUTE OF 89 Hougang Ave 4 accreditation. HEALTHCARE GROUP MENTAL HEALTH Fax: 6386-3783 CORPORATE OFFICE Buangkok Green Medical Park JURONG POLYCLINIC 190 Jurong East Ave 1 6 Commonwealth Lane 10 Buangkok View NHG PHARMACY Singapore 539747 Fax: 6562-0244 Level 6, GMTI Building Tel: 6478-2478 Tel: 6389-2000 / Fax: 6385-1050 TOA PAYOH POLYCLINIC Singapore 149547 www.pharmacy.nhg.com.sg 2003 Toa Payoh Lor 8 Tel: 6496-6000 / Fax: 6496- www.imh.com.sg NHG Pharmacy runs retail General and specialised Fax: 6259-4731 6870 pharmacies in NHG Polyclinics, services are provided WOODLANDS POLYCLINIC www.nhg.com.sg which include over-the-counter to meet the special 10 Woodlands St 31 The National Healthcare medicines, health supplements, needs of children and Fax: 6367-4964 Group (NHG) was created in and surgical and medical adolescents, adults and YISHUN POLYCLINIC 2000 as part of a national equipment at affordable prices. 100 Yishun Central (until 23/11/12) restructuring of Singapore’s the elderly. There are sub- 30A Yishun Central 1 (from public healthcare delivery speciality clinics such as 26/11/12) system into two operative the Psychogeriatric Clinic, Fax: 6852-1637 clusters. Neuro-Behavioural Clinic, PRIMARY CARE As a leader in public Early Psychosis Intervention Programme and National ACADEMY healthcare in Singapore, Tel: 6496-6681 / Fax: 6496-6669 NHG is recognised at home Addictions Management Service (NAMS). Within NHG COLLEGE www.pca.sg and abroad for the quality Tel: 6478-2446 / Fax: 6259-6423 The Primary Care Academy corporate settings, IMH of its outstanding medical www.nhg.com.sg/college (PCA), a member of NHG, was offers a comprehensive expertise and state-of-the- The unit develops healthcare set up to meet the professional Workplace Emotional Health art facilities. Care is provided professionals to their maximum training needs of primary Programme. It also provides through an integrated potential so that they will healthcare professionals in a 24-hour Psychiatric network of primary provide quality, cost-effective Singapore and the region. Emergency Service. healthcare polyclinics, acute and safe evidence-based care PCA aims to be a platform for sharing of expertise and care hospitals, national to patients. specialty centres, innovative capacity building among and business divisions. NATIONAL SKIN CENTRE community healthcare leaders Together, they bring a legacy and practitioners in ASEAN 1 Mandalay Road and the surrounding region. of 340 years of medical Tel: 6253-4455 / Fax: 6253-3225 NHG DIAGNOSTICS expertise to our patient- www.nsc.gov.sg Call centre: 6275-6443 centric care philosophy. The centre has a team of (6-ASK-NHGD) / Fax: 6496-6625 trained dermatologists to www.diagnostics.nhg.com.sg JOHNS HOPKINS treat patients with various NHG Diagnostics is a business SINGAPORE skin problems. To serve division of NHG. Founded in TAN TOCK SENG patients better, there are 2000, NHG Diagnostics is INTERNATIONAL HOSPITAL sub-specialty clinics for the currently the leading provider MEDICAL CENTRE 11 Jalan Tan Tock Seng different skin disorders and of one-stop laboratory and 11 Jalan Tan Tock Seng Tel: 6256-6011 / Fax: 6252-7282 laser surgeries. radiography services in primary Tel: 6880-2222 / Fax: 6880-2233 www.ttsh.com.sg healthcare, with an extensive www.imc.jhmi.edu The second largest acute network of teleradiology and Johns Hopkins Singapore care general hospital in professional service for imaging International Medical Centre Singapore with specialty NHG POLYCLINICS centres in Singapore, Indonesia (JHSIMC) is a licensed centres in Endoscopy, Contact centre: 6355-3000 and Vietnam. 30-bed medical oncology Foot Care & Limb Design, www.nhgp.com.sg Aligned with NHG cluster’s facility located in Singapore, a Rehabilitation Medicine and Apart from managing vision of “Adding years of joint venture between the NHG Communicable Diseases. It medical conditions, NHG healthy life”, NHG Diagnostics and Johns Hopkins Medicine covers 27 clinical specialties, Polyclinics also provide provides services that are International (JHMI). It is the including cardiology, health education, childhood accessible, cost-effective, only fully-branded Johns geriatric medicine, immunisation, treatment for seamless, timely and accurate. Hopkins facility outside of infectious diseases, diabetes, health screening, NHG Diagnostics is committed the United States, providing rheumatology, allergy, family planning service, to achieving excellence in inpatient and outpatient immunology, diagnostic antenatal and postnatal care, quality. The quality framework medical oncology care, medical radiology, emergency, as well as laboratory and is driven by a set of quality intensive care, laboratory gastroenterology, medicine, X-ray tests. principles and exists within services, hospital and retail otorhinolaryngology, an environment of continuous pharmacy, general internal orthopaedic surgery and ANG MO KIO POLYCLINIC improvement and business medicine and health screenings. general surgery. Blk 723 Ang Mo Kio Ave 8 excellence. NHG Diagnostics #01-4136 Fax: 6458-5664 is certiﬁ ed under ISO 9001

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40-48 LW NovDec12 Spotlight V2.indd 48 10/31/12 5:40 PM

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