OFFICIAL NEWSLETTER OF THE NATIONAL STROKE ASSOCIATION • MICA ( P ) 149/07/2013 • Sep - Dec 2013 Charity Gala – ‘Everything But The Brain’

SNSA was proud to partner theatre group Sight Lines Productions in holding a charity gala night on 11 August 2013 in presenting the play “Everything but the Brain”, where the entire Content proceeds were kindly donated to SNSA. Held 1-3 Charity Gala at the DBS Arts Centre in Robertson Quay, 4-5 Stroke Awareness 6 Nutritional Needs for Stroke the event was graced by the presence of our Patients Minister for Health Mr who kindly 7-8 Community Outreach accepted the donation cheque in the amount 8 Upcoming Events of $20,000 from our main sponsor Boehringer Ingelheim.

This touching play was written by award-winning playwright Jean Tay and superbly presented Editorial Board by a talented team of actors and actresses expertly directed by Derrick Chew. It told the Editor heart-wrenching story of a physics teacher whose father suffered a stroke, and described Dr N V Ramani how she coped with being the sole caregiver for a whole year as he experienced one stroke Members after another. She hoped that by using physics she could reverse time by taking a train ride Dr Deidre Anne De Silva with him to Malacca, but this sadly could not happen. Mr Wong Sow Wei Mr Anthony Quek

The comic touch by three delightful bears helped the audience keep pace with time while intertwined was an ill-fated romance between the daughter and the father’s doctor. This Singapore National classic combination of drama, tragedy, humour and romance kept the appreciative audience Stroke Association glued to their seats as they laughed and cried in the course of the play – many had tears 26 Dunearn Road, Level 1 streaming by the end of the evening. Singapore 309423 Tel: 6358 4138 Fax: 6358 4139 In her thank you speech, Dr Deidre De Email: [email protected] Silva, our President, highlighted SNSA’s Website http://www.snsa.org.sg three primary missions – to support stroke survivors and their caregivers,

to raise stroke awareness and to be All rights reserved. No part of this publication may be reproduced, stored an advocate for stroke in Singapore. in a retrieval system, or transmitted in She highlighted the need to recognise any form or by any means, electronics, mechanical, photocopying, recording or stroke symptoms early and to rush to otherwise, without prior permission of the the nearest hospital for treatment. She Copyright holder. asked for more volunteers to help with This issue of Stroke Watch is supported by Boehinger-Ingelheim Singapore Pte our activities and donations to fund our Ltd who kindly sponsored the layout and programs. She announced that one printing costs. of our committee members would be representing SNSA in a task-group which is drafting a Bill of Rights for stroke patients, an example of SNSA’s work on stroke advocacy.

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Appreciative comments from the audience included:

“Congratulations! “Great storyplot! Well Great production.” “A very entertaining play- done actors! Meaningful dealt with a serious and and touching.” potentially heart wrenching topic in an informative yet “Thought-provoking, “Epic! Intense, light-hearted way. Thoroughly endearing, delightful emotional with enjoyed it.” mix of science, airy light-hearted emotion and humour.” moments.”

Comments to encourage stroke survivors and caregivers:

“Stay strong and know that you are not alone. “May god bless and “The play made me Either as a patient/ give strength to all want to spend more caregiver. We are all stroke survivors.” time with my parents. behind you.” Thank you”

The cast too were very supportive: Overall, it was a momentous and memorable evening, with comments such as:

“Glad to have “We have become friends tonight, us onstage and “Great event to performed in support “Great job! Looking you offstage. Thank you increase stroke of SNSA. Best forward to more so much for allowing us to awareness! Join wishes.” events like this J” share this with you” the fight against STROKE!”

All of us who were there will always remember this memorable night, and the kindness we were shown and heartfelt support we received that evening.

02 Singapore National Stroke Association

snsa sep-dec 2013 NL-3.indd 2 1/11/13 11:44 AM Singapore National Stroke Association 03

snsa sep-dec 2013 NL-3.indd 3 1/11/13 11:44 AM Our study found that Singaporeans know STROKE WATCH very little about Stroke. The results of the study were Also, only 30% of the survey symptoms. In addition, people interesting. population could correctly who had family members with identify one risk factor, and medical conditions that More than half of all only 40% of them knew at least increased the risk for stroke, or participants could not identify 2 risk factors. About 1 in 11 who were caregivers of correctly a single symptom of someone with a chronic persons did not know any Did You Know? stroke and only approximately medical condition, did have symptoms at all. This study 5% of the participants knew all greater awareness of symptoms also found that only 60% of three major symptoms of and risk factors of stroke. participants knew that 995 was stroke (drooping of the face, the number to dial for an STROKE slurred speech, weakness of Overall, the study revealed a emergency ambulance, and one side of the body). general lack of awareness of The treatment of stroke is close to a fifth of participants stroke among Singaporeans, time-sensitive. It is very More than 10% of individuals did not know what number to thus suggesting that greater wrongly identified heart attack efforts to educate the general important to recognise dial. SOURCE: NATIONAL NEUROSCIENCE INSTITUTE symptoms like chest pain and public, and in particular Interestingly, people who had stroke symptoms and act breathlessness as stroke individuals who are at greater higher risks for stroke (older symptoms, suggesting that they risk of stroke, are necessary. A group of medical students from the Yong Loo Lin people, people with a pre- were confusing a stroke with a School of Medicine conducted a study on Singaporeans’ disposing condition such as F.A.S.T heart attack. high blood pressure or diabetes level of knowledge of stroke, and tells us more. mellitus) were not more aware by amanda lim and grace ler FACE about stroke risk factors and troke impacts our lives in Yet, in Singapore, 85% of patients Ask the person to smile. many ways. It is the second present to the hospital beyond this Does one side of the face S leading cause of death in the critical time window to be droop? KNOW YOUR RISK FACTORS world, and the fourth leading considered for this clot-busting cause of death in Singapore. Two- treatment. One of the main reasons thirds of stroke patients remain for this is that people are not aware ARMS disabled in the long term. enough of stroke, its risks factors Top 7 Risk Factors and symptoms. They do not realize Ask the person to raise both Many people are unaware that it is the severity of the condition, and arms. Does one arm drift important to recognize the early do not seek medical assistance downwards? “More than half of early enough, preferring to wait to signs and symptoms of stroke, and 1. Hypertension to call an ambulance immediately see if symptoms get better. SPEECH Singaporeans 5. Increasing Age if one has those signs and A team of students from National 2. High Cholesterol symptoms. Time is of the essence surveyed did not 6. Previous Heart University of Singapore Yong Loo Ask the person to repeat a when it comes to strokes, and Lin School of Medicine, under the phrase. Does the speech know a single 3. Smoking Attack going to a doctor early can result supervision of Dr Lim Wei-Yen sound slurred or strange? in better recovery. For example, if from Saw Swee Hock School of symptom of stroke.” 4. Diabetes 7. Previous Stroke someone with stroke due to a Public Health, conducted a study blocked artery comes to hospital, a recently to assess the level of TIME clot-busting drug called stroke awareness among If you observe or experience Singaporeans. A door-to-door recombinant tissue plasminogen any of these signs, call 995 activator can be an effective survey was conducted in Bishan and go to a hospital treatment if given within the first public housing estate, and a standardized questionnaire was immediately. few hours after stroke. administered to a total of 687 residents.

04 Singapore National Stroke Association

snsa sep-dec 2013 NL-3.indd 4 1/11/13 11:44 AM Our study found that Singaporeans know STROKE WATCH very little about Stroke. The results of the study were Also, only 30% of the survey symptoms. In addition, people interesting. population could correctly who had family members with identify one risk factor, and medical conditions that More than half of all only 40% of them knew at least increased the risk for stroke, or participants could not identify 2 risk factors. About 1 in 11 who were caregivers of correctly a single symptom of someone with a chronic persons did not know any Did You Know? stroke and only approximately medical condition, did have symptoms at all. This study 5% of the participants knew all greater awareness of symptoms also found that only 60% of three major symptoms of and risk factors of stroke. participants knew that 995 was stroke (drooping of the face, the number to dial for an STROKE slurred speech, weakness of Overall, the study revealed a emergency ambulance, and one side of the body). general lack of awareness of The treatment of stroke is close to a fifth of participants stroke among Singaporeans, time-sensitive. It is very More than 10% of individuals did not know what number to thus suggesting that greater wrongly identified heart attack efforts to educate the general important to recognise dial. SOURCE: NATIONAL NEUROSCIENCE INSTITUTE symptoms like chest pain and public, and in particular Interestingly, people who had stroke symptoms and act breathlessness as stroke individuals who are at greater higher risks for stroke (older symptoms, suggesting that they risk of stroke, are necessary. A group of medical students from the Yong Loo Lin people, people with a pre- were confusing a stroke with a School of Medicine conducted a study on Singaporeans’ disposing condition such as F.A.S.T heart attack. high blood pressure or diabetes level of knowledge of stroke, and tells us more. mellitus) were not more aware by amanda lim and grace ler FACE about stroke risk factors and troke impacts our lives in Yet, in Singapore, 85% of patients Ask the person to smile. many ways. It is the second present to the hospital beyond this Does one side of the face S leading cause of death in the critical time window to be droop? KNOW YOUR RISK FACTORS world, and the fourth leading considered for this clot-busting cause of death in Singapore. Two- treatment. One of the main reasons thirds of stroke patients remain for this is that people are not aware ARMS disabled in the long term. enough of stroke, its risks factors Top 7 Risk Factors and symptoms. They do not realize Ask the person to raise both Many people are unaware that it is the severity of the condition, and arms. Does one arm drift important to recognize the early do not seek medical assistance downwards? “More than half of early enough, preferring to wait to signs and symptoms of stroke, and 1. Hypertension to call an ambulance immediately see if symptoms get better. SPEECH Singaporeans 5. Increasing Age if one has those signs and A team of students from National 2. High Cholesterol symptoms. Time is of the essence surveyed did not 6. Previous Heart University of Singapore Yong Loo Ask the person to repeat a when it comes to strokes, and Lin School of Medicine, under the phrase. Does the speech know a single 3. Smoking Attack going to a doctor early can result supervision of Dr Lim Wei-Yen sound slurred or strange? in better recovery. For example, if from Saw Swee Hock School of symptom of stroke.” 4. Diabetes 7. Previous Stroke someone with stroke due to a Public Health, conducted a study blocked artery comes to hospital, a recently to assess the level of TIME clot-busting drug called stroke awareness among If you observe or experience Singaporeans. A door-to-door recombinant tissue plasminogen any of these signs, call 995 activator can be an effective survey was conducted in Bishan and go to a hospital treatment if given within the first public housing estate, and a standardized questionnaire was immediately. few hours after stroke. administered to a total of 687 residents.

Singapore National Stroke Association 05

snsa sep-dec 2013 NL-3.indd 5 1/11/13 11:44 AM Nutritional Needs for Stroke Patients - Eating Good & Eating Right (Part 1) By Chan Tin Ki Vicky, Dietitian, Tan Tock Seng Hospital

Stroke is common in Singapore. According to the Ministry It is recommended to decrease saturated fat, trans fat and of Health Singapore Health Statistics, stroke is the fourth dietary cholesterol intake in our diet to reduce the LDL leading cause of death and the fifth common reason for cholesterol (‘bad cholesterol’) and triglyceride levels, and hospitalization in 2009-2011(MOH 2012a, MOH 2012b). incorporate polyunsaturated fat and monounsaturated fat This article will address both stroke prevention and post dietary sources to promote HDL cholesterol levels (‘good stroke nutrition-related complications management. cholesterol’) in the blood.

Stroke and heart disease can occur when arteries are HDL cholesterol prevents fatty substances from building narrowed with the deposition of fatty substances. It is up in the arteries and lowers the risk of stroke and heart known that certain lifestyle and genetic factors increase disease. Sources of polyunsaturated fat include some the risk of stroke and heart disease. Modifiable risk factors vegetable oils (such as canola, soybean, corn, sunflower include high blood cholesterol, high blood pressure, being oil), seed and nuts. Monounsaturated fat sources include overweight or obesity, smoking and a sedentary lifestyle. some vegetable oils (such as olive, canola, peanut (100%), These risk factors can be modified by active lifestyle sesame oil), most nuts and avocados. changes including good nutrition. When eating in or out, we can decrease cholesterol, Choose and prepare food with less fat saturated and trans fat intake by removing visible fat or skin Excessive fat (especially saturated fat, trans fat and dietary from meat, choosing plain rice instead of flavoured rice, cholesterol) in one’s diet can increase the LDL cholesterol decreasing the amount of gravy added on rice, choosing (‘bad cholesterol’) in blood. High LDL cholesterol leads to soup based noodles instead of fried or dry, using healthy the deposit of fatty substances in the arteries and increases cooking method (grill, broil, roast, steam or boil) and using the risk of stroke and heart disease. Sources of saturated a minimal amount of unsaturated oil in cooking. fat include animal fat such as lard, ghee, meat fats and meat skin, products made from palm oil and coconut oil Choose and prepare food with less salt or or milk, butter and full fat dairy products. Trans fat usually sodium comes from commercial deep fried food, pastries, cakes, A diet that is high in salt or sodium can lead to high blood cookies and products made from vegetable shortening. pressure, which ultimately increases the risk of stroke. The Dietary cholesterol can only be found in animal sources, daily requirement of sodium is 2000mg, which is equivalent which include internal organs, egg yolk, squid, prawn head to 1 teaspoon of salt. Sodium or salt comes from processed and fish roe. food, seasonings added during cooking and at the table (include some local dishes), snacks, instant noodles and fast food. We can decrease salt intake by using fresh food instead of preserved products, enhancing the flavor of the dish by using natural ingredients, reducing gravy or stews on rice, asking for less sauces in food and drinking less soup after eating noodles.

*part 2 will continue in the next issue

06 Singapore National Stroke Association

snsa sep-dec 2013 NL-3.indd 6 1/11/13 11:44 AM Community Outreach – Sembawang GRC Healthy Lifestyle & Celebrate Wellness 2013

Date: 18 Aug 2013 Time: 9:00am-12:00pm Venue: Open Field beside Causeway Point Guest of Honour – Minister Special Guest – Minister Host MP – Ms Ellen Lee, PBM Organized by Sembawang GRC, Women Steering Committee

SNSA was honored to have been invited and involved in the mega community event organized by Sembawang GRC, Women’s Steering Committee. The purpose of the event was to engage community-wide participation in health and wellness. The organizing committee involved more than 15 organizations to be partners for the community event, including Khoo Teck Puat Hospital, Kandang Kerbau Hospital, Health Promotion Board, National Healthcare Group, National Environment Agency, North West Community Development Council, People Association, Silver Ribbon, Nam Hong Welfare Service Society, Tsao Foundation, Singapore Cancer Society, National Cancer Centre, Singapore Police Force and schools.

The Sembawang GRC Community had initially planned to have it on 23 June 2013, but it was postponed to 18 Aug 2013 due to the Haze. The SNSA was glad that we could participate to fulfill our commitment to help promote and raise the community’s awareness about stroke, and thus provided the full support for the event.

More than 4000 people turned up for the event. SNSA manned a booth with brochures, bookmarks, and educational materials to highlight issues of stroke while the DVD on Stroke Prevention in Atrial Fibrillation was played. SNSA also ran the ping-pong ball quiz game with 20 questions relating to stroke prevention and treatment to educate public about stroke. SNSA is grateful to Gardenia Bread Company for sponsoring 200 raisin buns and Nestle for sponsoring tote bags and pens for us to give away as tokens of appreciation for participants in the game.

It was overall a wonderful event, and SNSA is very proud to have been a part o it.

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snsa sep-dec 2013 NL-3.indd 7 1/11/13 11:44 AM Continue from page 2 Encouraging story of Sembawang Community Event – observed at SNSA Booth

During SNSA’s participation for the Sembawang GRC Healthy Lifestyle & Celebrate Wellness Event, the SNSA team was impressed by a young man named James from the Evergreen Secondary School NCC group.

On 18 Aug 13, when James was introduced and deployed to the booth allocated for SNSA, he offered to help and then set up the laptop with the DVD playing basic information on Stroke Prevention in Atrial Fibrillation. He personally watched the DVD fully to understand the subject matter. He noticed our donation box placed on the booth, without much hesitation, he dropped his $2 note without asking anybody (later, an SNSA team member saw that he was left with only few coins in his wallet). James was then briefed on the ping pong ball game and the 20 questions relating to stroke as an avenue to educate the public on stroke awareness besides watching the DVD. He helped manage the questions with the English-speaking crowd and later picked up on the Chinese translation of the questions. Throughout the 4 hours of voluntary work, he was conscientious and never left the booth. Near the end of event, as the booth ran out of the gifts for the ping pong ball game, James requested help from another friend (Eddrick) to join him. They then went around the event premises, which is an open field, to distribute the brochures on stroke prevention and also encouraged people to make a donation to SNSA through the donation box.

SNSA is grateful to James and his friend, Eddrick; they have distinctly demonstrated pure heart and authentic charity. It was refreshing and encouraging for SNSA’s team to witness this behaviour from the younger generation.

SNSA has informed the organising committee, the host MP (Ms Ellen Lee) and Evergreen Secondary School, that the committee would like to highlight such character strength and positive virtue in these young students and has written to the school’s principal (Ms Carol Lim) to compliment their behaviour and encourage others, and the decision to publish this good deed in our SNSA quarterly publication “Stroke Watch”.

Upcoming Events @ SNSA

Social Integration programme Outing to River Safari Singapore on 16th Nov 2013, 10am to 2:00pm Concession rate for ticket & meals (limit to 30 persons). For details, call SNSA at 6358 4138. Volunteer’s Appreciation Lunch on 23rd Nov 2013. For more information, call SNSA at 6358 4138

Singapore National Stroke Association 26 Dunearn Road, Level 1 Singapore 309423 Tel: 6358 4138 Fax: 6358 4139 Email: [email protected] Website http://www.snsa.org.sg

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