So, This Is What It Feels Like to Be Old!
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WWW.SINGHEALTH.COM.SG • WWW.SGH.COM.SG MAR/APR 2020 MCI (P) 056/10/2019 THE FLAGSHIP IN FOCUS PUBLICATION OF THE SINGHEALTH DUKE-NUS ACADEMIC MEDICAL CENTRE Page 7 Healthy cells left alone in prostate cancer trial IN FOCUS Page 10 ECMO ups pneumonia So, this is survival chances what it HEALTHWATCH feels like to be old! Not a robot but old-age simulated by an “age suit”. It highlights how the loss of muscle strength makes the elderly more prone to falls Page 16 READ MORE ON PAGE 3 The real cause of back and neck pain 01 SingHealth Issue 58 Cover V1.indd 7 17/2/20 3:02 PM SGH200 PAGE 02 The history of Singapore General Hospital (SGH) is the history Counting of medicine in Singapore. The first general hospital for British troops was established in Singapore in 1819, but it was only in 1821 that it began serving the general populace — marking the down to PUBLISHERS true beginnings of SGH. As the countdown to SGH’s bicentennial begins, Singapore Health will present snapshots showing changes in 2021 medicine and its various disciplines in the past 200 years. Photo: SGH Photo: CO-PUBLISHERS The roots of orthopaedic Vernon Wong Photo: surgery ® Staffed by general CONTENT ADVISOR surgeons in the early Group Chief Communications Officer, SingHealth days, the discipline is now Audrey Lau highly specialised, with EDITORIAL TEAM surgeons operating in Lim Mui Khi, Ann Peters, Tina Nambiar, Lydia Ng seven areas, such as spine, sports medicine, and Read Singapore Health online at musculoskeletal tumours. A mock-up of a spine procedure using an advanced imaging system, known as the O-arm, to guide surgeons. www.sgh.com/ by Professor Andrew Tan singaporehealth Head and Senior Consultant charge of chronic ulcers and hand forefront of research and innovative Department of Orthopaedic Surgery deformities in leprosy. processes, harnessing technology Singapore General Hospital The department started to grow and partnering leading biomedical in stature and eminence after the companies to improve patient care. PUBLISHING AGENT he development of late Professor N Balachandran took The department’s specialists have ThinkFarm Pte Ltd orthopaedic surgery over in 1980. He spearheaded several been quick to introduce and adopt Managing Director in Singapore mirrors service improvements for people with new technologies in orthopaedics, Christopher Tay closely that of the disabilities, spinal injuries, chronic such as artificial intelligence and 3D Editor US and UK. Before World War II sickness, and congenital deformities. printing, scoring many firsts in the T Dang Hui Ling (1939-1945) and up to the early He was also involved in setting up country and region. Not surprisingly, 1950s, orthopaedic conditions were orthopaedic surgery departments in the department is recognised as the Head, Creative managed by general surgeons other hospitals, including Tan Tock leading centre for minimally invasive Sean Lee with an interest in musculoskeletal Seng Hospital, Alexandra Hospital, orthopaedic and robotic surgery. Art Director trauma and fractures. No systematic and the now-defunct Toa Payoh Indeed, given its size as well Lee Lily or structured programmes were Hospital, playing a crucial role in as the breadth and depth of its available, and equipment and improving the practice in Singapore. clinical services and experience, the Head, Client Relationship instruments were crude. department is well placed to lead in Jessie Kek It was only in 1951 that the using such technology responsibly. Teaching, research For advertising enquiries, practice was established as a Importantly, Prof Bala placed Through well-designed clinical please call 6831 1299 or email separate clinical entity, and great emphasis on teaching and pathways and care integration, [email protected] five years later in 1956 that the training the next generation of it is the only orthopaedic Department of Orthopaedic specialists so that patients could department internationally to Surgery came into being. The benefit from better care. That legacy offer a unique suite of clinically All rights reserved. Copyright by Singapore Health Services Pte Ltd (registration no.: first batch of local orthopaedic continues today. Not only is SGH’s audited presurgery, surgery, and 200002698Z). Opinions expressed in Singapore surgeons were trained in the Department of Orthopaedic Surgery post-surgery care programmes. Health are solely those of the writers and are 1950s, undergoing basic clinical the oldest in Singapore, it is today A recent initiative is the same-day not necessarily endorsed by SGH, SingHealth Group and/or Thinkfarm Pte Ltd (registration training before proceeding to the largest and most established discharge for some hip replacement no.: 201226362G), and their related companies. Britain for a postgraduate degree orthopaedic department in the patients, which cuts short a typically They are not responsible or liable in any way for the contents of any of the advertisements, in the discipline. country. It boasts seven orthopaedic three-to-four day hospital stay articles, photographs or illustrations contained In the 1950s, poliomyelitis was subspecialties, including spine, adult and lowers costs for patients. More in this publication. Editorial enquiries should be directed to the Editor, Singapore Health, rampant, affecting many young reconstruction, sports medicine, of such short-stay procedures are 168 Jalan Bukit Merah, #13-01 Surbana One, children. Orthopaedic surgeons were trauma, musculoskeletal tumour, expected to become available, Singapore 150168. Tel: +65 6222 3322. Email: [email protected]. Unsolicited material will involved in their rehabilitation, as foot and ankle, and acute care. Two benefitting patients undergoing not be returned unless accompanied by a doctors generally did not want to subspecialties have also been spun other orthopaedic procedures. self-addressed envelope and sufficient return be involved in treating the disease off into full departments in recent The department sees up to a postage. While every reasonable care will be taken by the Editor, no responsibility is and others such as tuberculosis, years — Hand and Reconstructive quarter of Singapore’s orthopaedic assumed for the return of unsolicited material. osteomyelitis, septic arthritis, and Microsurgery, and Plastic, patients, handles more than 126,000 ALL INFORMATION CORRECT AT TIME OF PRINTING. MCI (P) 056/10/2019. Printed in crippled children. In those days, Reconstruction and Aesthetic Surgery. outpatient visits a year, and performs Singapore by Times Printers Pte Ltd (registration orthopaedic surgeons also took The department is at the over 8,000 surgeries annually. no.: 196700328H). 02 SGH200 + Glory Box.indd 2 17/2/20 11:50 AM PAGE 03 COVER Dr Samuel Chew (right) putting a young Mr Nigel Chew through the moves in his “age suit”, which makes him feel like a frail old man. The straps stiffen his joints as in arthritis, a device under his feet creates a loss of sensation, and the goggles reduce his vision. If you have very good muscle health, you cannot have weak bones. But if you have strong bones, you could still have very poor muscle health. Dr Samuel Chew Adjunct Assistant Professor, Department of Geriatric Medicine, Changi General Hospital While sarcopenia is evident in the frail and old, a surprising finding in the study was that it can also affect healthy seniors, said the study’s principal investigator, Dr Samuel Chew, Adjunct Assistant Professor, Department of Geriatric Medicine, CGH. The study, called Strengthening Health in Elderly through Nutrition, was conducted by CGH, Photos: Justin Loh Photos: SingHealth Polyclinics, and Abbott to look at the impact of nutrition on the elderly. Phase 1 of this two-part study Can you future-proof looked at 400 healthy people in Singapore aged 65 and older, and found that despite their apparent health, one in five were at risk of low muscle strength. Women fared old age? worse, with 25 per cent of them r Nigel Chew, 27, can General Hospital (CGH), can now having low muscle mass compared Even healthy old usually bound up the seriously empathise with the aged. to 15.5 per cent of men. people who are stairs two or three But he is lucky to be forewarned More than half the participants steps at a go. But in a long way in advance, so he can did not have enough vitamin D, independent, eat well, Man “age suit”, he moves like a frail take steps to avoid some of the which is provided by sunlight, old man. health problems associated with and is important for muscle and have no diseases The suit makes him feel what it ageing. One of the main lessons function, immunity, and bone is like to be aged. he has learnt is the importance of health. The irony is that they can have low muscle Some 20kg to 30kg are piled building and maintaining muscle live in Singapore, where there is mass, which puts them on to simulate loss of muscle mass, which essentially means sunshine all year long, so they strength. Straps stiffen his joints muscle strength. should have been able to get at risk of falls. But this and restrict his movements to sufficient vitamin D easily. show him what arthritis feels like. Why muscle strength? The significance of the findings can often be reversed. A device covers the soles of his A recent local study has underlined is that the participants were by Suki Lor feet to simulate a loss of sensation the importance of having good not those usually at risk, such as in his feet (as in the case of muscle mass in old age. Low patients who were elderly, with diabetes) so that he can hardly muscle mass (sarcopenia) not only multiple chronic medical illnesses, feel the ground he walks on. affects overall health, but also or critically ill. Mr Chew, an executive with makes walking difficult and puts a “This was a very unique group the Office of Innovation, Changi person at risk of debilitating falls.