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02 singapore health JUL⁄ AUG 2011
News
One-stop centre for
women’s problems
A multidisciplinary team comes under one roof to serve
endometriosis patients at KKH
BY Thava Rani
Thirty-three-year-old Andrea
Lim (not her real name) went to
KK women’s and children’s hospital
(kkh) with severe menstrual
cramps and bowel problems. After
assessing her condition, the gynaecologist
referred her to the colorectal surgeon,
who did a colonscopy.
With the results and their combined
experience, the doctors discussed the
options with her. She chose to undergo
surgery, where scar tissue distorting her
uterus and large bowel, was removed.
After the operation, she received counselling
from the nurse coordinator, and also
completed a questionnaire which helped
the team better understand the impact
the condition had on her daily life.
Andrea is one of an increasing number
of women in Singapore suffering from
endometriosis, a gynaecological condi-
tion that affects up to one in 10 women.
KKH alone saw 1,200 women who underwent
surgery related to endometriosis
last year.
This and the severe impact the condition
has on the lives of women, plus the
high chance of recurrence, prompted the
hospital to set up the one-stop KK Endometriosis
Centre that offers a comprehensive
range of services and adopts a
patient-centred approach.
“As the combination of symptoms,
severity and specific needs of these
patients is diverse, we felt that the availability
of a multidisciplinary team of doctors
and medical support staff will be
optimal to provide holistic care to such
patients,” said Dr Cynthia Kew, Associate
Consultant, Minimally Invasive Surgery
Unit, Department of Obstetrics and
Gynaecology, KKH.
For more information, call the Endometriosis Centre’s
coordinator hotline at 9834-8034.
About endometriosis
Dr Cynthia Kew, Associate
Consultant, Minimally Invasive
Surgery Unit, Department of
Obstetrics and Gynaecology, KK
Women’s and Children’s Hospital,
answers some typical questions
patients have about endometriosis.
What is endometriosis?
A condition where the lining of
the uterus, or the endometrium,
is found outside the uterus, such
as in the ovaries, fallopian tubes,
pelvis or lower abdominal cavity
What are the symptoms?
Severe menstrual pain, chronic
pain in the lower abdomen or
pelvic region, painful sexual
intercourse, infertility
Other symptoms unrelated to
periods or none at all
What types of surgery can help?
Ablating (burning off) or excising
(removing) endometriosis lesions
Ovarian cystectomy (removal of a
cyst from the ovary)
Complete removal of the uterus
and ovaries, which means
immediate menopause. Therefore,
it is reserved for women nearing
menopausal age or with very
severe symptoms
The above are usually
accomplished through
laparoscopic (keyhole) surgery
Are there non-surgical methods of
treating the pain?
Painkillers
Hormonal therapies
- First line (fewer side effects):
oral contraceptives, progestogens
- Second line (more side effects):
GnRH analogue, danazol
- Levonorgestrel intrauterine
system
Other alternative therapies:
counselling, thiamine, vitamin E,
high frequency transcutaneous
nerve stimulation, local heat and
herbal remedies
Can endometriosis affect my
chances of pregnancy?
Yes, about 25 to 50 per cent
of subfertile women have
endometriosis, making it a
significant cause of subfertility
Besides surgery, assisted
reproduction like intrauterine
insemination (IUI) and in-vitro
fertilisation (IVF) may help
Round-the-clock drug therapy
A new computer system allows more thorough review of patient prescriptions
during the night
A pharmacist does more than
just dispense the medicines
the doctor ordered. With
the expert and up-to-date
knowledge of drugs, pharmacists
serve as an important
link in the treatment chain
to ensure that the drugs and
dosage which doctors have
ordered are appropriate.
They look out for known
allergies and other details in a
patient’s medical history and condition
that might affect the effectiveness
of the medication, or that might
react with the drugs he is already taking.
Working hand in hand with doctors
and nurses, pharmacists can – and
do – intervene if they deem a medicine
being prescribed to be unsuitable for the
patient, and suggest more appropriate
alternatives. At the pharmacies – both
outpatient and inpatient – pharmacists
check and review prescriptions received
every day. Inpatient pharmacies serve
patients during their hospital stay as well
as when they are discharged.
Pharmacists – usually clinical pharmacists
who hold higher or postgraduate
degrees in pharmacology and related
PHOTOS: ELLEN LIM
Pharmacists review doctors’ prescriptions and offer patients advice and recommendations
round the clock.
disciplines – also regularly accompany
doctors on ward rounds. They share their
expert knowledge in the use of medication
and provide advice on usage.
At Singapore General Hospital (SGH),
the review of all patients’ prescriptions is
now round the clock, with a small number
of pharmacy staff working at night since
December 2010. According to Mr Lim Mun
Moon, Deputy Director, Department of
Pharmacy, SGH, the review of patients’
orders became possible after the implementation
of an electronic management
system. The system puts drug administration,
including records of patients’ medication,
online.
“With the electronic system, we can
deploy just a few pharmacists on night
duty and they are able to review all orders
online,” said Mr Lim.
“With the previous paper-based
records, it was difficult to have enough
pharmacists physically going around the
wards to check on medication orders.”
Pharmacists, added Ms Lim Ching
Hui, Principal Clinical Pharmacist, SGH,
are able to review orders “remotely” from
the pharmacy, instead of physically going
to the wards or having the wards send
patients’ records to them. There are 28
wards in SGH.
Having a night pharmacy with two
pharmacists and three pharmacy technicians,
who assist the pharmacists in
supplying medicines to the wards, helps
to provide “a consistent level of care to
patients at all hours of the day, improving
patient safety”, Ms Lim said.
Previously, a pharmacist was assigned
to be on call over the night, and pharmacy-related
services were provided by
pharmacy technicians specially trained
to review medication under supervision.
Doctors and nurses could dispense medication,
but only from stocks kept in the
wards. Urgent requests were relayed to
the on-call pharmacists.
SGH, like other healthcare institutions,
is increasingly using IT to enhance
safety and make it more convenient for
patients, as part of a national objective
to create a single health record for each
patient. This allows his medical history
to be accessed easily.

JUL⁄ AUG 2011 singapore health 03
News
Root cause
National Dental Centre of Singapore cuts waiting time for
patients with braces
Stacey Chia
It should have few emergencies,
but National Dental Centre
(NDC) of Singapore’s Department
of Orthodontics, where its specialists
correct misaligned teeth or jaws, was
seeing unusually high numbers of patients
walking in without an appointment.
Puzzled by the number of unscheduled
appointments, Dr Chan Feng Yi, Registrar,
Department of Orthodontics, NDC, led a
team to tackle the problem. “We wanted
to improve the quality of care by finding
out why patients came for unscheduled
visits,” she said.
Most of the department’s patients are
seen for misaligned or irregular teeth,
and are fitted with braces to correct the
fault. The team discovered that although
patients came back for their scheduled
visits every six to eight weeks to have
their braces reviewed and adjusted, many
also made impromptu visits because of
problems such as rubber bands breaking,
wires poking their gums as well as other
small discomforts.
Braces are fitted to correct crooked or
gap teeth as well as over- or underbites.
Metal brackets are fitted to each tooth
and are connected by a wire, held in place
by elastic bands. The dentist will tighten
the wire gradually to force the teeth into
the right position.
Rubber bands are also used for some
patients to apply additional pressure to
move jaws in directions that the braces
alone can’t. The rubber bands are hooked
around specially created hooks, which
form part of the braces.
As the braces force the teeth to
straighten, the wire may work itself
Soft wax can dull sharp wire
edges and provide relief from
the braces rubbing against
the cheeks.
out of the back
bracket, or get
bent so it rubs or
pokes into gums
or cheeks at the
back of the mouth,
causing discomfort.
The rubber bands
can also snap.
“Most patients who
walked in were not in pain,
but unsure about what to do. By explaining
how braces work and the problems
they might have during the first appointment,
we let them know that their problems
can wait and be addressed during
their scheduled visits,” said Dr Chan.
The problem of the rubber band breaking
was solved by discarding the orangecoloured
bands, which were found to be
weaker than bands in other colours.
As for wires poking into gums and
cheeks, Dr Chan said: “As teeth shift, it’s
normal for the wire to start poking the
gums. We started to give all our patients
wax, which can cover the sharp parts of
any wires poking out, to ease the discomfort.
Sometimes, we take it for granted
that patients who start using braces are
fully aware of the changes that will take
place and can take the discomfort. Now,
we routinely give them wax,” she said.
But walk-in visits are sometimes necessary,
such as when retainers (worn to keep
teeth straight after braces are discarded) are
lost. “If this happens, we ask them to come
in to see us, as patients cannot do without
their retainers for long,” said Dr Chan.
PHOTOS: 101TEAMWORK
Patients with braces saw their waiting time reduced, thanks to an initiative by NDC that
halved the number of walk-in appointments.
In focus
Digital dental care with
Electronic Medical Records
Better dental care is not just limited
to patients receiving orthodontic
treatment.
The new $3.7 million electronic
dental record system at National
Dental Centre (NDC) of Singapore
is the first custom-built solution
that seamlessly integrates all major
aspects of patient management in a
large-scale dental institution.
The system is also linked to the
larger SingHealth Electronic Medical
Records, which give dentists easy
access to a patient’s medical history,
lab test results and drug allergy alerts.
With quick and timely access to a
patient’s updated dental history and
preexisting medical conditions, dentists
can now provide more thorough
assessments within a shorter period
of time.
NDC, the first dental specialty
centre in Asia to receive Joint Commission
International’s accreditation,
sees more than 150,000 patients a
year. Prior to this, physical records
were kept in a 440 sq m room, a space
which can now be converted into 15
consultation rooms.
Then Health Minister Khaw Boon
Wan wrote in his blog that patients
stand to benefit the most from this
upgrade to the electronic system, and
can expect better services and more
accurate treatment.
Noting the space saved due to the
reduction of paperwork and storage
needed, he said: “Less is truly more.”
PHOTO: ALECIA NEO
Can you guess what this is?
See page 26 for the answer.

06 singapore health Jul⁄ Aug 2011
News
At ground level
An improved, spring-loaded ankle brace helps patients with neurological conditions,
such as stroke or cerebral palsy, walk easier
BY Angeline Neo
Walking is such an easy, natural
movement that few of us give it a
second thought. But before 25-yearold
Janice Ng is able to take a few steps,
she has to mentally map the distance
she wants to go first, even if it’s just to
cross the room. Every step is deliberate,
never random.
Ms Ng has cerebral palsy, a walking
and motion disorder caused by damage to
the motor control centres of the developing
brain. Cerebral palsy may affect one
limb, all four, or a combination, making
movements abrupt, jerky, uncontrolled
and uncoordinated. In Ms Ng’s case, she
suffers from “toe-walking” – a condition
where her heel and toes don’t rest flat on
the ground when she is standing, resulting
in her being balanced precariously
on her toes. When walking, her feet
aren’t able to perform the full range of
movements that most people are able to.
Not surprisingly, she is prone to tripping
and falling.
A brace, known as an ankle foot orthosis,
worn on the lower leg and foot to support
the ankle, can help people like Ms
Ng walk more normally by holding the
foot and ankle in the correct position.
However, conventional devices can be
rigid, preventing the “up-down motion
in a natural walking movement”, said Ms
Celia Tan, Senior Principal
Physiotherapist,
Singapore
General Hospital
(SGH),
and Deputy
Director of its
Allied Health
Division.
Every step for Ms Janice Ng, 25, has to be deliberate and well-thought through to
prevent falls, as cerebral palsy has caused her to have a condition known as toe-walking.
To address this shortcoming, SGH
physiotherapists and a team of Ngee Ann
Polytechnic final-year mechanical
engineering students worked
together to develop an improved
device, one which has a moveable
ankle joint and a spring at
the back. According to Ms Dawn
Tan, Principal Physiotherapist,
SGH, the device “enables the
patient to lift the foot, clear
it off the ground and land on
his heel”.
The result is a more
natural walk and easier
mobility. The device gives
patients better control of
their ankles, which are often
weak because muscles in
the area lack exercise. With
improved control, patients
have a lower risk of tripping or falling.
The project, a winner at SingHealth’s
Allied Health Innovative Practice Award
2010, was among the many innovations
churned out by Ngee Ann Polytechnic’s
aspiring engineers. Under an SGH-Ngee
Ann Polytechnic programme, in place
since 2004, final-year students and hospital
staff work to develop devices to
improve care and therapy for patients. In
the last seven years that Ms Celia Tan has
helmed the programme, the hospital has
patented three new devices.
“The arrangement allows us to combine
our medical experience with the
technical expertise that the students
have acquired. We give the ideas, they
build the prototypes and, together,
we create something that is currently
unavailable in the market, or construct
a better device that can be more efficient
PHOTOs: Alvinn Lim
in aiding patients’ therapy,” she said.
Building a prototype for a medical
device usually takes about nine months.
During this time, Ms Tan or a therapist
works closely with each group of four
to six students. The students sometimes
visit the hospital to see therapists at
work and speak to patients to understand
their requirements.
It took the team 18 months and
two attempts to build the improved leg
brace. The first model was bulky with a
side-loaded spring – functional but not
perfect. With fine-tuning, a second prototype
was produced – this time, it was
lighter, more wearable and effective. It is
still undergoing changes, and the team
is looking next at ensuring a proper fit.
“If the fit is not right, the patient may
suffer blisters and discomfort, which
may deter him from using the brace, and
stop him from benefiting from proper
physiotherapy. An improper fit will also
affect control of the ankle, causing more
trips or falls,” said Ms Tan.
I’m actually starting to
make a little progress
and walk better. I hope
that in the long run,
I won’t have to hunch
and can have a proper,
upright posture when
I walk.
Ms Janice Ng, a cerebral palsy patient
The foot brace brings hope to patients
like Ms Ng, who is testing the device.
“I’m actually starting to make a little
progress and walk better. I know once we
get the fit right, it will help me tackle the
problems I have. I hope that in the long
run, I won’t have to hunch and can have
a proper, upright posture when I walk,”
she said.
Ms Ng, who will graduate from university
this year, said: “People always tell
me that after I graduate, I should get a
desk job. But I love to meet and talk to
people. I want to move around and see
new places. With this leg brace, I’ll be
able to move around and experience
things I’ve never tried before.”
Above: The improved
ankle foot brace
features a movable
ankle joint and a spring
at the back.
Right: The ankle foot
brace is slim and
unobstrusive, and easily
fits into shoes.

Jul⁄ Aug 2011 singapore health 07
News
Just a minute
Heart attack patients stand a better chance of
survival with an on-site check run by paramedics
PHOTOs: alecia Neo
tion of many others has been preserved.
“The aim is to reduce the door-toballoon
time, for patients needing acute
angioplasty, as much as possible,” said
Assoc Prof Ong, referring to the time
taken from the moment patients enter
the doors of the hospital to the moment
they get the angioplasty.
On-site ECG transmission by paramedics
has done just that, cropping an
average of 37 minutes off the door-to-balloon
time for public hospitals, according
to a study that was presented at SGH’s
Annual Scientific Meeting in April this
year. Assoc Prof Ong was the principal
investigator of the nationwide study,
which involved all restructured hospitals,
National Heart Centre Singapore
and SCDF.
Before this study,
an ECG was done
Dos and don’ts
Do
Call 995 for an ambulance. The paramedics
are trained to stabilise the
patient’s condition with medication,
and the ambulance is equipped with a
defibrillator to resuscitate the patient
should the heart stop en route
Give clear instructions to the paramedics
on finding the patient’s home,
have someone wait at a visible location
to guide the paramedics and hold
the lift open if the patient lives in a
high-rise building, so as to save time
Get ready the patient’s personal
effects such as personal identification,
medical benefit identification,
insurance and other documents for
admission
Have the patient seated in a
location where he can be transferred
easily to a stretcher
Give a clear account of what
happened. Let the paramedics know
about any drug allergies or past
medical history
Don’t
More lives have been saved after Associate Professor
Marcus Ong introduced a system to prepare A&E staff for
heart attack victims who are en route to the hospital.
BY Thava Rani
All it takes is a minute. But that extra
minute – for paramedics to run an electrocardiogram
(ECG) on a person suspected
of having a heart attack – could mean life
or death.
Running an ECG at the patient’s
home, instead of at the hospital, allows
the results to be transmitted to Accident
and Emergency (A&E) quickly. This, in
turn, enables A&E doctors to begin preparations
for treatment, including activating
the procedure for opening a blocked
artery, while the patient is in the ambulance
en route to the hospital.
“The sooner the artery is unblocked,
the less the damage, and the better the
patient’s chances of survival,” said Associate
Professor Marcus Ong, Senior Consultant,
Department of Emergency Medicine,
Singapore General Hospital (SGH).
In a heart attack, a blockage or clot
in an artery cuts off oxygen supply to
the heart, damaging the muscles. A
person whose heart muscles are badly
damaged can eventually suffer heart
failure. He also has a high risk of dying
from complications, such as abnormal
heart rhythms. Depending on the type
of heart attack, doctors may perform an
angioplasty where a catheter is inserted
and a balloon is inflated in the coronary
artery to open it up, restoring blood flow
and oxygen to the heart. A stent can also
be placed to keep the artery open. About
half of the 3,000 heart attack patients
who seek treatment at public hospitals
every year require acute angioplasty.
The sooner the heart
artery is unblocked, the
less the damage, and the
better the patient’s
chances of survival.
Associate Professor Marcus Ong, Senior
Consultant, Department of Emergency
Medicine, Singapore General Hospital
In the past two years, an estimated 30
additional lives have been saved each year
by Singapore Civil Defence Force (SCDF)
paramedics, who perform this check on
suspected heart attack patients at their
homes. In addition, the heart muscle func-
only after the patient arrived at the hospital.
Activation of the angioplasty team
and other preparations could take place
only then.
Now, with some 250 paramedics
trained and 46 SCDF ambulances
upgraded, on-site ECG has become routine.
All preparations at the hospital are
made while the ambulance, carrying the
patient, is en route. When the ambulance
arrives, everything is ready and waiting
for the patient.
A revision of workflow processes also
contributed to bringing down the median
door-to-balloon time from 88 minutes to
51 minutes. At SGH, for instance, a mass
paging system was put in place to activate
the angioplasty team, which is particularly
crucial at night when doctors need
to be recalled from home to the hospital.
To further improve a patient’s chance
of survival, a greater understanding and
awareness about dealing with a heart
attack, such as recognising the signs
and symptoms as well as the appropriate
response, are needed, Assoc Prof Ong
said. “So far, we’ve only been looking at
door-to-balloon time, but what is more
important is the symptom-to-balloon
time (the time when the patient first
starts having severe chest pain).
“We hope public education can make
a difference here.”
Drive or take public transport to the
hospital, even if the patient lives
nearby. The patient’s condition may
deteriorate en route, and it is safer to
wait for an ambulance. Ambulances
also get priority on arriving at A&E
Ignore the pain
Get anxious about time wasted when
the paramedics perform an on-site
ECG
Maybe it’s a
heart attack
Severe chest pain and a combination
of the following symptoms
can mean a person is having an
acute heart attack, said Associate
Professor Marcus Ong, Senior
Consultant, Department of
Emergency Medicine, Singapore
General Hospital.
1 Severe chest pain is often
described by patients as the worst
pain of their lives and likened to
something very heavy pressing on
the chest
2 Pain that appears to spread up to
the neck or down to the left arm
3 Breathlessness
4 Sweating
5 Feeling faint and/or nausea
6 A history of heart problems
7 Patient is elderly, smokes or suffers
from diabetes, high blood pressure
and high cholesterol

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10 singapore health JUL⁄ AUG 2011
News
> Continued from page 1
At death’s door and back
team – two perfusionists who operate the
machine, a cardiac surgeon and a doctor
– is activated. They rush to hospital in
ambulances, taxis or their own cars.
Still, he gave it a try
Dr Su Jang Wen, Consultant, Department
of Cardiothoracic Surgery, NHCS, was the
first to arrive. “Fortunately for Cherie, the
medical officers and nurses were already
doing CPR before the ECMO team arrived.
They were very efficient,” he said, adding
that despite CPR, in most cases of heart failure,
the outcomes from using the ECMO
machine are poor. There is also a high risk
of organ damage, even if patients survive.
Since 2003, the machine has been used on
205 patients with heart failure.
Dr Su Jang Wen used the ECMO machine
to keep Cherie’s heart ticking even as she
went into a coma after the heart attack.
Doctors decided to use the ECMO
machine on Cherie because she was
very young. “Her life was about to start.
We thought – let’s give her every single
chance we can. We asked her parents and
they said ‘go ahead’,” Dr Su said.
The ECMO machine works through
two tubes inserted into the body at the
patient’s groin. A pump in the ECMO
machine draws deoxygenated blood
through one tube. The artificial lung in
the machine removes the carbon dioxide
Her life was about to start.
We thought – let’s give her
every single chance we
can. We asked her parents
and they said ‘go ahead’.
Dr Su Jang Wen, Consultant, Department
of Cardiothoracic Surgery, National
Heart Centre Singapore
and puts oxygen in the blood, before sending
the blood back into the body through
the other tube. “The pump acts like a
heart with enough pressure to send blood
throughout the body to support the other
organs. There are no gaps in pumping. It
works continuously,” Dr Su said.
The prognosis was unclear
While the machine kept Cherie’s heart
ticking, she was in a coma. Her family was
told to prepare for the worst – that even if
she survived, she could be paralysed due
to brain damage. Dr Su wrestled with the
possibility that she might be permanently
in a wheelchair or suffer from cerebral
palsy if she survived.
After seven days, with her heart function
back, she was taken off the machine.
Cherie said that Dr Su’s face was the first
she saw after regaining consciousness.
The love of parents
But Cherie couldn’t move her legs or hands
much and could only whisper. Dr Su credits
much of her recovery to the devotion
of her parents. “Every morning on my
rounds, I’d see both parents. They were
there 24 hours.
“Her father stopped working to take
care of her. He would carry her from the
bed to the chair, and move her fingers
and legs as instructed by the physiotherapists.
He was hopeful, smiling and
optimistic. Her mother helped look after
her, as the nurses could not be there
every minute.
“Her parents really helped with her
mobility, to prevent her body from getting
stiff. It was very touching. They really
cared for her,” he said.
When she left the hospital, she still had
difficulty walking and could only speak in
a whisper. She was asked to return immediately
if she felt even the minutest chest
pain. The quiet teenager proved to be
a fighter.
Less than two months after Cherie’s
discharge, Dr Su got a phone call to say she
was in the hospital to see him. She literally
skipped into his room. “I just couldn’t
believe it. When she left, she could walk
but with some assistance, and was still
unable to move her limbs easily.”
Cherie had come to see him not for
chest pains, but to be certified fit to return
to school. A keen student who is No. 2 in
her class, she turned down an offer by her
school principal to take a year off school
PHOTOS: ALVINN LIM
Ms Angeline Chern Suan Choo, Senior
Perfusionist, Perfusion Unit, NHCS,
pushes one of the six life-saving ECMO
machines in Singapore down the corridor
of the Intensive Care Unit. All six
machines are kept at NHCS and are ready
for use at a moment’s notice.
after her recovery. She wanted to make up
for the time away, excel in her exams and
be a teacher one day.
The experience has taught her that life
isn’t all about academic achievement.
“My friends say I’m now a much happier
person. I won’t be overly concerned
about school and studies, but will focus
more on my family and friends. There are
a lot of people my age who think if they
don’t score well at school, it’s over. I want
to let them know it isn’t.
“Life can be unpredictable. You have to
treasure every minute.”
Staying alive
Another patient saved by the Extra
Corporeal Membrane Oxygenator
(ECMO) team was health industry
executive, Mr Foo, 42, who had a
heart attack while driving back to his
office after lunch.
He was reduced to driving at a
crawl, but made it back. “I was trying
to catch my breath. I was sweating.
I felt nauseated and giddy. I knew I
was having a heart attack,” he said.
When the pain subsided, he called
a meeting and told startled colleagues:
“I need to go off, I am having
a heart attack.” A colleague drove
him home and later to the Accident
and Emergency (A&E) department of
the nearest hospital, where he was
admitted in stable condition. The
next day, when doctors were putting
a stent in his left main artery, his
heart failed. They gave him cardiopulmonary
resuscitation (CPR) and
used a defibrillator, but after an hour,
they called in the ECMO team.
Dr Tan Teing Ee, Senior Consul-
Dr Tan Teing Ee (left) and his team used the ECMO to support Mr Foo, a heart attack
victim, while they reopened his blocked artery.
tant, Department of Cardiothoracic
Surgery, National Heart Centre Singapore
(NHCS), who dashed down to the
hospital with the ECMO team, said: “It
was touch and go.”
Mr Foo was promptly supported
with the ECMO machine and transferred
to NHCS for further management. As
his right main artery was blocked too,
doctors put in another stent to reopen
that artery while he was supported by
the machine.
After five days on the ECMO machine
and under sedation, Mr Foo regained full
consciousness. “Coming out of sedation,
I heard the familiar voice of my
boss. I was very cold and disoriented,
but she reassured me and calmed
me down.”
Three months after his discharge
from hospital, he went for a heart
bypass surgery to correct the blockage
in another artery.
Mr Foo, who has familial hypercholesterolemia,
a genetic condition
which resulted in him having high
cholesterol from childhood, said
he has always studiously checked
his blood pressure and cholesterol
every year, exercised regularly and
watched his diet.
The attack caught him by surprise,
although two months before
it, he experienced chest pains, which
went away after resting. He said: “In
hindsight, I should have seen to it
immediately.”
These days, he is mindful of
maintaining his sense of wellbeing
and calm. He takes medication to
manage his cholesterol levels and
continues to exercise regularly. “I am
learning to take it slow and be more
conscious of my wellbeing. That’s my
priority now.”

Jul⁄ Aug 2011 singapore health 11
News
A joyful giver
Mdm Theresa Yip shows that age is no barrier
to a charitable heart
BY Ruth Loh
Many people give to charity, but
few have dedicated as much of their
time, effort and money to the less
fortunate as Mdm Theresa Yip. Every
month, the 81-year-old drops by Singapore
General Hospital (SGH) to donate $100 to
the SGH Needy Patients Fund. If she isn’t
able to make it one month, she makes up
for it by giving $200 the month after.
Behind this humble act has been a
lifelong journey of charity that started in
the 1950s when Mdm Yip began giving to
charities, homes and the less fortunate in
many ways. An excellent dressmaker who
learned her skills in school, she put them
to good use supplementing her income as
a nurse.
“I had two children to raise,” the feisty
Mdm Yip, who now has five grandchildren
aged 16 to 30, said matter-of-factly. “Sewing
and knitting baby clothes, toys and other
things helped me earn extra money.”
When I cooked for
charity once a month,
I spent about $100 each
time on ingredients. Now
that I no longer cook,
I want to continue to
donate the same amount.
Lions Befrienders.
Between 2007 and
2009, she was director of
the club’s Bendemeer branch.
As a Befriender, she looked after
elderly people living in one-bedroom flats
and on government welfare. She distributed
household necessities door-to-door
– meat and vegetables at one home, laundry
powder and washing detergent at the
next – making friends along the way.
Mdm Yip’s love and care for the less
fortunate was recognised by the Minis-
try of Health, which honoured her with
a Merit Award in 1978 and a Long Service
Award in 1985 for dedicating 30 years to
nursing. In 1999, the Lions Befrienders
Section gave her an Outstanding Award.
Nowadays, her knees won’t allow her
to continue with her gruelling pace of
work supporting elderly people, but they
can’t keep her away from her mission of
love. Each month, as she has since
mid-2010, Mdm Yip pops into SGH
to hand over a gift of $100.
When asked why she chose to give
$100 a month, she said: “When I cooked
for charity once a month, I spent about
$100 each time on ingredients. Now that
I no longer cook, I want to continue to
donate the same amount.”
PHOTOs: Allen tan
Far left: Mdm Theresa
Yip regularly knits
baby mittens,
booties and even
dolls for charity
sales. Although she
no longer cooks
for old folks at
community clubs,
Mdm Yip continues to
donate the monthly
$100 amount which
she used to spend
on ingredients.
Left: Every month,
she comes to SGH to
contribute the sum
to the SGH Needy
Patients Fund.
Mdm theresa yip
Noted for her fine needlework and the
beautiful clothes she made, Mdm Yip later
turned her skills to benefit the needy.
Then a midwife at Kandang Kerbau Hospital
– her first and only employer – she
volunteered to teach handicraft skills to
elderly people.
For nearly 30 years, Mdm Yip was a
familiar – and welcome – presence at
many homes for elderly folks. On her regular
visits, she brought household items
to the residents. “I took biscuits, powder,
soap, toothpaste – all those daily necessities,”
she said.
She cooked meals for old folks at community
clubs in Kallang, Kolam Ayer,
Kreta Ayer and the like. Not only did she
volunteer her time, Mdm Yip also contributed
ingredients for the meals she
cooked. In 2003, Mdm Yip joined the
Funding medical research
Without funds, many good ideas remain ideas, with no possibility
of being turned into treatments that improve patients’ lives, or
even offering a cure from disease
The discovery of penicillin in
1928 revolutionised medicine and
marked the start of modern antibiotics,
without which people would
have continued to die from what are
now known to be easy-to-cure infections.
Although Sir Alexander Fleming
discovered penicillin by chance, he had
been actively searching for anti-bacterial
agents after seeing many soldiers
with infected wounds die from sepsis
during World War I.
Research – and the important role
it plays in medical treatment – is a key
component of the work staff at Singapore
General Hospital (SGH) do. Many
clinicians involved in research at SGH
have made discoveries and innovated
care delivery benefitting patients.
But medical research is a lengthy
process that requires many rounds of
studies, including large human trials in
the later stages, before an idea becomes
an established treatment. Besides
taking years to complete, research is
also often highly expensive.
Research is mostly self-funded in Singapore,
and money for many of the projects
undertaken comes from donations.
With limited funds, some promising
research projects remain just good ideas
without a chance to benefit patients.
Help where it
is needed most
Singapore General Hospital’s
Fundraising and Development Office
collects donations that help needy
patients. Every year, some $600,000 is
paid out to help needy patients receive
medical treatment and other services.
Many of these patients are often the
sole breadwinners of their families,
supporting young children and sick
parents or family members.
For more information about how
to make a donation, call SGH
Fundraising and Development Office
at 6321-3736 or 6321-6378,
or email giftstosgh@sgh.com.sg.

14 singapore health JUL⁄ AUG 2011
Tell us
This letter wins a
Betadine gift pack
worth $85
Redesign counters to ease traffic
Tributes
If possible, please think about redesigning
the cashier’s counter at the Specialist
Outpatient Clinics (SOCs). Singaporeans
tend to crowd around “exit areas”,
be it on buses or MRT trains.
Perhaps, a barrier and a different
seating arrangement can help open a
smooth passage for entry and exit (no
costs involved).
I raise this comment after experiencing
“ease of payment” at National
Heart Centre Singapore, Singapore
National Eye Centre and SingHealth
Polyclinics.
– Mr Wong Mun Wah
Facebook us!
Singapore General Hospital
Thank you for your suggestion.
As we upgrade our facilities,
we will review our processes
and work on how to ease congestion further
at bill payment areas.
To avoid crowding at the tight registration
and bill payment area at SOCs, we
request that patients leave their forms in
a tray, be seated and wait for their names
to be called.
Patients who wish to avoid the crowd
and not wait for payment can also register
for our free Service Express, which
allows patients to leave immediately after
consultation. Their bills are settled via
Victoria Jones Preece
Hello, can you help? I am in the UK and we have been advised that my
sister has been admitted. I am aware you will have issues with patient
confidentiality. Can you tell me the best person to contact to get some
details? Her name is Coleman. Thank you.
May 4 at 9.41am
5 people like this
Singapore General Hospital Hi Victoria, I believe we have found
your sister. We do have a female patient by the last name
of Coleman admitted to us two days ago. Please email our
colleague at ims@sgh.com.sg and he will link you up.
May 6 at 10.25am
Victoria Jones Preece You are fantastic, thank you.
May 6 at 11.43am
Manta Ray Lee
Hi, I am Thomas Lee. The following is what I have noticed in the May/Jun
2011 issue of Singapore Health.
Page 25 (Translated text)
... 在 骨 管 也 就 是 骨 中 央 装 置 骨 髓 的 空 隙 , 置 入 导 向 杆 也 可 能 导 致 脂 肪 栓 ...
试 译 :(My suggestion)
... 把 导 向 杆 置 入 骨 管 ( 位 于 骨 干 , 功 能 是 储 存 骨 髓 ) 也 可 能 导 致 脂 肪 栓 ...
May 6 at 12.43am
7 people like this
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May 6 at 8.27am
a standing order through their credit
card, GIRO or SGH cash deposit account.
Documents, including receipts, are
mailed out within seven working days.
Service Express covers bills for consultation,
laboratory and other services
rendered at the SOCs and patients can
use it to pay bills for family members
and other patients. The service is available
immediately for credit card and
cash deposit accounts (the minimum
deposit is $200), and after the bank’s
confirmation for GIRO payments. Application
forms are available at clinic
counters.
Need earlier
appointment
I am a regular patient at National Heart
Centre Singapore (NHCS) and often
wait for a long time for my appointments.
I’ve tried to arrive earlier, so I
can be slotted in at a convenient time.
However, the clinic staff refused to
give me an earlier appointment time,
even when I arrived two hours before
my appointment. – Mr Sammy Nathan
At NHCS, we handle a heavy
patient load. We seek the
understanding and cooperation
of our patients to abide to their
appointment times, to ensure smooth
running of the clinic session and to prevent
disruptions and inconvenience.
Sometimes, the clinic may seem to
be seeing a lull in appointments, but this
could be because patients are undergoing
tests in another section of the clinic
and will return for further consultation.
The doctor may also be using this time
to write up the notes for the previous
patient, order relevant tests, issue prescriptions
or review medical notes.
With a fixed time appointment
system, we hope to minimise your inconvenience
and ensure that you are seen
in a timely manner.
Extra bed
Why do I need to pay for a bed for my
wife when she accompanied me after
my surgery?
– Mr Ben Chong
To keep costs down, we offer
minimum facilities at our
wards. That’s why we charge
for extra beds.
We understand that after surgery, patients
may want a family member to keep
them company in the ward. But we also recognise
that not all patients require a family
member to stay with them there.
In addition to extra beds, which are
available only in Class A single rooms,
I picked up a copy of Singapore
Health when I was visiting a
patient at SGH and have since
been a regular reader. I particularly
like the coverage – a
nice balance between your new
technology, medical information
and focus on people. Keep
it up!
- Dr Linda Fang
I went to Geylang Polyclinic to
see if I could get an x-ray for a
persistent cough, which didn’t
show any signs of going away
despite two courses of antibiotics.
I went on a Monday, which I
would usually avoid because of
the crowd. But I could not delay
the visit as I was scheduled for
surgery the next day. I want to
commend Dr Jason Chan who
saw me and took the time to
answer all the questions I had
about my condition. He was truly
professional and very patient.
- June Long
We are foreigners who started
going to Singapore General Hospital
(SGH) following a friend’s
recommendation.
My mother, who suffers from
long-term ailments, was seen by
Dr Dennis Chua, Medical Officer,
Unit of Occupational Health and
Epidemiology, SGH, and Professor
Tay Boon Keng, Emeritus
Consultant, Department of
Orthopaedic Surgery, SGH.
We were also pleasantly
surprised by the service at SGH,
and felt that the medical care
given was comprehensive, professional
and value for money.
This has greatly changed our
perception of public healthcare
in Singapore and we look forward
to the follow-up visit in the
next few months.
- Ms SL
items such as slippers and toiletries are
also available at a cost. Patients and their
family members can also request for extra
meals, including those offered to Class A
ward patients.
The following are items available on
request and their costs:
Item
Extra meal
Class A ward meal
Slippers
Toiletries pouch
Extra bed
Price (+GST)
$25.68
$18.73
$5.78
$6.63
$44.08

jul⁄ aug 2011 singapore health 15
Tech
Rehab can
be fun
p16-17
Nutrition
Cancer patients
share their
recipes
p18
Connecting the ABCs
There is more to writing than simply using a pen to form letters. It involves
motor, visual and perceptual skills
Poor handwriting isn’t just about
not being able to form ABCs or
1,2,3s properly. A child who struggles
to write properly may have difficulty
making sense of what he sees, insufficient
hand strength, or poor hand control,
balance and coordination.
That is why children who are sent
to occupational therapists for help with
their handwriting difficulties are not
asked to write, but given activities and
games to assess their motor and perceptual
skills, said Ms Natalie Chew, Senior
Principal Occupational Therapist, Singapore
General Hospital.
“We try to figure out the reason for
the child’s writing difficulty, which could
be related to his motor-muscular skills,
or be more of a visual-perceptual deficit.
This means that what they see, what they
process and what they perceive may not
match 100 per cent,” said Ms Chew.
For instance, most people “automatically
complete the picture of a triangle”
when they see three unconnected lines
that roughly correspond
to the shape
of a triangle. But
a child with a
visual-percep-
A child should be able to draw a simple stick
figure by age three, said Ms Natalie Chew.
tual difficulty sees three separate lines.
Kids with this difficulty find it particularly
hard to remember and write Chinese
characters. “So many strokes need to be
connected in a specific way, so children
with visual-perceptual difficulty may find
it challenging to write Chinese characters
well. We don’t address this by getting them
to practise Chinese writing, but we try to
find out why they have this difficulty in
the first place,” said Ms Chew.
Other children may write poorly
because they have less muscle strength
than their peers, “perhaps because
they spend a lot of time indoors and
have less opportunity to use their muscles”,
said Ms Chew.
Writing badly may also be
due to poor control of the hand
that holds the pen or pencil, and
this may be the result of poor body
coordination. “To write neatly, you must
have good posture. If there is less stability
(because of poor posture), there will be less
control of the wrist,” said Ms Chew.
“It’s really about having a holistic perspective
of the problem. Therapy isn’t just
about training them to write,” she added.
Games and exercises to build strength
and develop good posture and coordination
are used to help the child
develop. To strengthen his muscles, the
child may be asked to climb, crawl
or push something heavy. To
develop motor strength
in the muscles of
the hand, he may
Children with
visual-perceptual
deficits may
perceive shapes
differently.
PHOTO: alecia neo
be given playdough to mould or pinch.
Before the child is asked to draw a picture
of a man, an aid known as Mat Man
– a game which involves putting shapes
(representing parts of the body) in their
correct positions to build the figure of a
man – is used to help increase awareness
or perception. “Some kids have very poor
awareness of their own bodies. When
they draw a person, the drawing may not
have a body, or have hands that are sticking
out of the head,” said Ms Chew.
Poor awareness can show up as a difficulty
in differentiating between left and
right. For instance, the child may write
“b” when he means to write “p”. Or, he
may have to constantly look at his hand
when writing. A child with this difficulty
will find it hard to keep up with the rest
of his class when copying notes from
the board.
“If children are constantly being told
by teachers that they need to write better
or faster, they may lose confidence. This
may affect their motivation for learning
in school,” said Ms Chew.
The tripod (left) and the quadropod
(right) methods of holding a pencil.
Which finger?
If your child holds his pen or pencil
in what seems to be an awkward
manner, but has no complaints
or is able to write legibly and
quickly without pain or problems,
it is okay to let him be, said Ms
Natalie Chew, Senior Principal
Occupational Therapist, Singapore
General Hospital.
“We are all made differently,
and some children and adults may
have developed a non-standard
grip,” she said.
Most people are taught one of
two standard ways of holding a
pen or pencil: the tripod, where the
pencil rests on the middle finger;
or the quadropod, where the pencil
rests on the ring finger. The wrist
should generally be relaxed.
Developmental milestones
for hand function and writing
months
• Grasps objects in
palm • Transfers from
6 one hand to another
months
12
These milestones
are a guide to give
parents an indication
of when to expose
their children to various
skills like cutting with
the scissors. Children
develop at different
rates with variations
of three to six months,
or even longer. If there
are concerns, parents
should consult their
paediatrician.
• Picks up small
objects • Can
hold a spoon
years
years
months
3
9
months
• Grasps objects
between thumb
and index finger,
eg. small biscuits
15
• Builds
tower with
two cubes
years
2
18
• Builds tower with six
cubes • Scribbles with
crayons • Turns pages
of book, one at a time
• Builds tower
with four cubes
• Throws a ball
• Shows preference
for one hand
• Builds tower with nine cubes • Copies circle and
cross • Draws man on request • Colours simple pictures
• Recognises capital letters • Can snip paper
with scissors • Can thread large beads on a string
• Builds gate with
• Builds a pyramid with five to six
cubes • Copies a cross cubes • Draws a man with details
• Writes mostly capital • Copies a triangle • Colours pictures
carefully • Writes lower-case
letters, some lowercase
letters • Can do
letters • Copies words • Can cut a
buttons and zippers 5 square within 0.5cm of the line
with help • Can catch
4 a bouncing ball
• Copies a diamond • Writes
simple words from memory
• Knows right from left
6 • Ties shoe laces
(Reference: Peabody Developmental Assessment)
years
years
months

16 singapore health Jul⁄ Aug 2011
Tech
Fun and games
in rehab
Gaming technology is set to
revolutionise rehab therapy
Crowds of kids having fun chasing
cartoon animations projected
onto the floor or groups of friends
gathering for Nintendo Wii parties are
nothing unusual. But now, games like
these are making a foray into a whole
new territory – healthcare.
KK Women’s and Children’s Hospital
(KKH) and Singapore General Hospital
(SGH) are studying these games to see
whether young and old patients who
need rehabilitative therapy can benefit
from them.
At KKH, a team of experts worked
with academics from Singapore Polytechnic
to develop a prototype game, which
uses cartoon images on the floor to entice
children with gait and balance problems
to do their exercises. The kids are asked
to hop after animated frogs and stamp on
crabs emerging from the sand. After each
successful hop or stamp, the frog moves
on and more crabs appear elsewhere in
the sand.
If we get children to
like therapy, we can
overcome a big part of
the challenge. The games
motivate them to
practise to do better
during the next session,
and advance to the next
level of the game.
Ms Ong Ghim Hui, Senior Physiotherapist,
Rehabilitation Department, Kk women’s
and children’s hospital
The game is designed to measure how
these children move – how they use their
legs, how their feet land, and how fast
they stamp or jump. To capture all these,
sensors, which send back measurements
to the therapist for analysis, are attached
to their shoes.
The game is part of the hospital’s
trial to study how customised computer
games can make rehabilitation more fun
for children. Many children find it hard
to concentrate on the repetitive exercises,
which are necessary
for recovery.
Ms Ong Ghim
Hui, Senior Physiotherapist,
Rehabilitation
Department, KKH,
said up to five out of 10
children compromise
their recovery by
not completing the
exercises.
By using games
in therapy, children
can follow and
enjoy their progress
more easily. “In
this way, we hope to
keep them interested
longer. The games motivate
them to practise to do
better during the next session
of the game,” she said. “If we get children
to like therapy, we can overcome a
big part of the challenge.”
Computer games for adults
As older adults also get bored with repetitive
exercises, a similar study is being
carried out at SGH. Researchers there
are experimenting with the Nintendo
Wii gaming technology in a trial study to
evaluate whether using it makes strengthening,
balancing and cardiovascular exercises
more enjoyable and suitable for 60 to
85-year-olds.
Older adults are less likely to participate
in many outdoor sports, so the
Keeping track
To monitor their condition, more than
300 rheumatoid arthritis patients
now use the smartphone health diary
web application that Singapore General
Hospital (SGH) launched in March
– the first such app in the country.
The web app, in the form of a
questionnaire that patients complete
daily, seeks to assess the patient’s
overall condition. It asks the patient
questions such as the level of difficulty
in getting out of bed that day,
buttoning his shirt and doing other
researchers are
looking at using
this technology
to make the exercises
acceptable
to them, said Mr
Kwok Boon Chong,
P h y s i o t h e r a p i s t ,
Department of Physiotherapy,
SGH. “By introducing
exercises through this
technology, we hope older people
will be keen to participate.”
By making therapy more fun, it is
hoped that patients will get the full health
benefits of completing their rehabilitative
exercises. If the technology is found to be
effective, the researchers also hope that
easy-to-follow games can eventually be
done at home, reducing the contact time
between patient and physiotherapist, and
possibly resulting in shorter therapy sessions
and reduced costs.
Potential to transform rehab
While gaming technology in healthcare
is still in its infancy and there is no clear
between patient visits. The patient sees
the doctor every three or four months,
and may not remember all the details,”
said Mr Eugene Sim, Executive, Department
of Rheumatology and Immunoldaily
activities. Patients also key in a
pain score and an overall health
assessment score.
The system then generates
a number, which correlates with
the DAS28, an internationally
recognised scoring system specifically
for the disease, which
tells the patient how good or
bad the arthritis is at that point.
The app also records and trends
the results.
“The app helps to fill the gap
Colourful graphics
are projected onto
the floor to entice
children undergoing
therapy to hop or
stamp accordingly.
international data on its potential role,
those involved in these trial projects feel
that a wider application is possible.
“For broad rehabilitative purposes,
where you’re looking at improving overall
fitness and flexibility, a technology
like the Wii has great potential. Because
we’re relying on an existing technology,
it is easier to introduce it to patients and
less costly, as it is already mass produced,”
said Mr Kwok.
One group of patients who may benefit
from this technology in future includes
stroke patients, whose body functions
have been significantly impaired on one
side. “However, if you want to address
specific impairments, such as gait and
balance, specific software may need to be
created to address such needs in a clinical
way,” said Mr Kwok.
Mr Leo Kee Hao, Senior Lecturer,
School of Mechanical and Aeronautical
Engineering, Singapore Polytechnic, who
spearheaded the development of the floorprojection
game, agreed. “Once the technology
we’ve developed is installed, it can
be used for many things. The key will be to

Jul⁄ Aug 2011 singapore health 17
create content with the clinicians to meet
the different needs of their patients.”
Paradigm shift needed
If studies prove that interactive technology
is popular and effective, researchers
hope to see it being offered alongside conventional
rehab services in therapy for
individual groups.
“While we’re studying how individual
children interact with our floor games,
they can also be used in group therapy
sessions. This will add a further element
of interest for the children by providing a
platform for social interaction and competition,”
said Ms Ong.
Mr Kwok is already testing the modified
Wii software in group therapy.
“We’re testing this in small groups at
the moment and combining it with other
standard exercises,” he said.
But this technology is still some two to
five years away from being implemented
in hospitals. If proven effective, it will
provide patients with an alternative that
may produce better and faster results at a
lower cost.
Disabling pain
Rheumatoid arthritis need not be a disease of
lifelong pain. By Thava Rani
Four years ago, he was struck by
sudden pain in his leg in the middle
of the night. The pain was so
severe that he was unable to walk.
“It felt like I had a knife in my right
knee,” said the otherwise healthy Mr
Chiu Yeo Ding. The 88-year-old piano
tuner was subsequently diagnosed with
rheumatoid arthritis by doctors at Singapore
General Hospital (SGH).
Rheumatoid arthritis is a chronic
inflammatory disorder that affects the
joints and, less frequently, the skin, eyes,
lungs and other organs, according to Mr
Chiu’s doctor, Dr Jon Yoong, Consultant
Physician, Department of Rheumatology
and Immunology, SGH.
“It is the most common autoim-
mune rheumatic disorder and it affects
about one per cent of the population, or
about 45,000 people. About 75 per cent
of patients are women, but it affects all
races, often beginning between the ages
of 20 and 45 years,” he said.
In autoimmune disorders, the body’s
immune system attacks its own tissues.
It still isn’t known what causes rheumatoid
arthritis, but some people seem
more likely than others to develop the
disease. It causes joint stiffness, pain,
swelling and, sometimes, organ damage.
Its severity varies among patients, and
some patients may not realise they have
the disease as the symptoms may be
mild. They may feel persistent tiredness
or mild joint stiffness.
Dr Jon Yoong (left) explains to his patient, Mr Chiu Yeo Ding, why inflammation caused by
rheumatoid arthritis can lead to pain around the joints.
PHOTO: alecia Neo
“It is very important to diagnose
rheumatoid arthritis as early as possible,”
said Dr Yoong. Delayed treatment
can lead to permanent damage of
the organs and joints, and research has
shown that prompt treatment improves
the chances of the joints and organs
remaining healthy.
To diagnose rheumatoid arthritis
accurately, the doctor makes an evaluation
that usually includes blood tests and
x-rays. The patient is prescribed appropriate
medication, and may also see a
rheumatology nurse clinician, physiotherapist
and occupational therapist for
subsequent care.
It is the most common
autoimmune rheumatic
disorder and it affects
about one per cent of the
population, or about
45,000 people. It affects
all races, often
beginning between the
ages of 20 and 45 years.
Dr Jon Yoong, Consultant Physician,
Department of Rheumatology and Immunology,
Singapore General Hospital
Keeping a record of the patient’s condition
between his three- to four-monthly
consultations is important in managing
his condition. At SGH, rheumatoid arthritis
patients are encouraged to maintain a
diary, either via a notebook or the smartphone
web application recently launched
by SGH.
“It helps to empower the patient and,
at the same time, it gives us something
objective to work with. In this way, we
can get an accurate picture of the disease
and make better clinical judgments,” said
Dr Yoong.
ogy, SGH, who played a key role in the
development of the app.
“With this app, the patient can provide
the doctor with more information,
helping the doctor manage the condition
better.”
The IT team took about two months
to develop the app. Mr Bien Michael
Philip Geroche, Systems Specialist, Integrated
Health Information Systems, who
was also involved in the development
of the app, said: “It is accessible via any
smartphone, but we designed it especially
for the iPhone. Being web-based, it
can also be accessed on a desktop.”
The app is offered to all rheumatoid
arthritis patients at SGH, as well as non-
SGH patients.
“While keeping notes in a diary is an
alternative, it is not very practical to
carry one around everywhere. Besides,
the smartphone penetration in Singapore
is incredible,” said Dr Jon Yoong,
Consultant, Department of Rheumatology
and Immunology, SGH. According
to a recent report, smartphones made
up 70 to 80 per cent of all mobile
phone sales in Singapore.
“If the patient is older and not
tech savvy, younger family members
can help out, which encourages the
family to participate in the patient’s
disease management,” he added.
The app is a collaboration between
SGH’s departments of Rheumatology
and Immunology and Information
Technology, and Integrated Health
Information Systems. The app can
be downloaded at https://mobilecare.
sgh.com.sg.
If left untreated, rheumatoid arthritis can
lead to deformity.

18 singapore health JUL⁄ AUG 2011
Nutrition
Eat to heal
Cancer patients share their favourite recipes in
a new cookbook. By Stacey Chia
Ms Angela Mak (extreme right), who found
swallowing painful while on radiotherapy,
contributed her favourite soup recipes.
Just when she needed to keep up her
strength, cancer patient Angela
Mak found that eating became yet
another mountain to scale.
The cancer treatment caused her to
lose her sense of taste and smell, and made
swallowing an excruciating task. She went
from someone who enjoyed dinners and
trying out recipes, to being restricted to
mushy food.
But the assistant professor at Nanyang
Technological University’s (NTU) Wee Kim
Wee School of Communications and Information
found a companion in her baby
daughter. The infant was just starting to eat
semi-solids then. “I had someone to share
porridge and oatmeal with,” said Ms Mak,
who was diagnosed with Stage 3 nose and
throat (nasopharyngeal) cancer five months
after giving birth to her first child.
Ms Mak’s story, related in Sharing Plates,
a new cookbook for cancer patients, is not
uncommon. Other contributors had similar
experiences.
Mr Teo Thiam Chye lost his sense of
taste and smell following facial surgery,
after a relapse of Stage 2 nasopharyngeal
cancer. But he found a way to continue
enjoying his meals. “I’m still able to use
my other senses to enjoy my food – I can
look at the food and I can feel the textures.
I ask my wife if something tastes nice and
if she says yes, I eat more.”
Jimmy, who also had nasopharyngeal
cancer, recalled how ulcers from radiotherapy
made eating pure torture. He would
close his eyes and put his head down to
swallow, so that his family wouldn’t see
him cry. Once a firm believer in Chinese
herbs, he now believes in simplicity. “Papayas,
pineapples, apricot seeds, turmeric
and lemongrass really helped ease the side
effects,” he said.
Nor Asmah, who was told she had
Stage 4 colon cancer and a 50-50 chance of
surviving surgery, found that baking and
beading helped relieve her stress during
treatment. She didn’t let the side effects
of chemotherapy trouble her. She just covered
up the blisters with henna and carried
on cooking.
PHOTOS: ALECIA NEO
The recipes were modified by Ms Chang
Yok Ying, Principal Pharmacist, National
Cancer Centre Singapore (NCCS), who was
the nutritional consultant of the book.
“We wanted patients to still enjoy eating
as a way of weathering their journey
during treatment,” she said.
She said once treatment is over,
the diet is stricter – almost vegetarian
– depending on how severe the condition
is. “We were not looking at reducing calorie
intake, as many physicians are already
concerned about the drastic loss of weight
in patients.”
However, she did adjust the oil, sugar
and salt content. Salt encourages the
proliferation of cancer cells and oil can
promote cancer growth, she said. She
removed one recipe from the original
list, because preserved pork was used.
“Preserved meat contains nitrites which
increase the risk of cancer.”
Much thought also went into garnishing
the dishes. “Making food presentable can
really help improve appetite,” she said.
Ms Chang recommends the soups in
particular, because they retain nutrients
and are easy to eat. “You don’t even have
to chew. Although some vitamin C may
be lost by boiling, you still have nutrients
such as amino acids from the meat.” Her
favourite is Lean Meat Soup with Starfruit
and Sweet and Bitter Apricot Seeds
because of its contrasting tastes. “The
Ms Chang Yok Ying modified the recipes
to make them more healthy.
Recipe
Lean meat soup with
starfruit and sweet and
bitter apricot seeds
Serves 4
Ingredients:
4 medium-sized starfruits
5 honey dates
600g of lean meat
25g of sweet and bitter apricot seeds
2 litres of water
Method:
1 Remove the core and sides of the
starfruits. Slice into pieces
2 Wash the honey dates
3 Wash and blanch the lean meat
4 Put all the ingredients into a
claypot and boil over a slow flame
for two hours
5 Serve
Note: This soup is not suitable for patients with
kidney failure.
soup is very nutritious. Starfruit is high
in dietary fibre, vitamin C, copper, potassium,
and sweetens the soup naturally.”
Ms Chang said the book can benefit
everyone, not just cancer patients. “The
recipes are not only healthy and tasty, but
easy to prepare as well,” she said.
Top cancer-fighting foods
Red beans
have a high antioxidant
rating and can protect cells
from free radicals which
cause cancer
Apples
contain flavanoids and
polyphenols which help
fight cancers
To purchase a copy of Sharing Plates,
which is jointly produced by NTU and
NCCS, please call NCSS’ hotline
6236-9440 or email your order
via www.nccs.com.sg. The
book costs $15 and all proceeds
will go towards
cancer research and
helping families of
cancer patients.
Avocados
are high in vitamins, dietary fibre,
potassium, folic acid and copper
Broccoli
contains isothiocyanates which have
been shown to encourage the body’s
production of cancer-fighting enzymes
Pumpkins
contain alpha-carotene, a strong
antioxidant that boosts immunity
Asparagus
are full of cancer-fighting
compounds like selenium as
well as vitamins A and C
Turmeric
contains curcumin extracts
which help alleviate the side
effects of radiotherapy and
chemotherapy
Potatoes
provide fuel for the body and
are rich in immunity-boosting
vitamin C

Jul⁄ Aug 2011 singapore health 19
Spotlight
Body warming
Staying hydrated and adequately protected from the heat may
save you more than just a sunburn – it may save your life
Beat the heat
with these tips:
Diuretic and some psychiatric
drugs can prevent the body from
losing heat quickly
BY Rachel Chan
The weather’s getting hotter
but it’s not marathoners or
extreme sports enthusiasts who
are catching the attention of
doctors. Doctors who treat people
for heatstroke have noticed the quiet
emergence of another group of patients
seeking treatment for heat-related disorders:
elderly spa clients.
One of them, a woman in her 70s,
fell asleep in the sauna, and was unconscious
by the time staff at the spa found
her. She was rushed to Singapore General
Hospital (SGH) with a very high body
temperature. Doctors managed to cool
her down, by lowering her temperature
to normal, but she later died because of
complications related to other medical
conditions.
At least one other elderly woman is
known to have suffered from heatstroke
after staying too long in a sauna or steam
bath. She too eventually died.
Dr Phua Ghee Chee, Consultant,
Department of Respiratory and Critical
Care Medicine, SGH, said: “(Treating
people for) exertional heatstroke is less
common now, because people are more
aware of the dangers of doing strenuous
exercise or sports without proper hydration
or preparation.”
Older people are usually
not as fit and may suffer
from other medical
conditions, making them
more likely to suffer
from complications
when hit by heatstroke.
Dr Phua Ghee Chee, Consultant, Department
of Respiratory and Critical Care
Medicine, Singapore General hospital
Left: Dr Phua Ghee Chee (right) and Dr Chew Huck Chin (left) are seeing more elderly
spa visitors who suffer from heatstroke. Right: An ICU nurse prepares the misting room.
Nozzles above and below the misting bed ensure the patient’s body is coated all over with
a fine mist of lukewarm water.
An ICU doctor and nurse monitor the patient’s condition during treatment.
“Non-exertional heatstroke – usually
seen in the elderly or extremely young –
is becoming more common. Older people
are usually not as fit and may suffer from
other medical conditions, making them
more prone to suffer from complications
when hit by heatstroke. As for small kids,
they can’t regulate their body temperatures
as well as adults.”
Many people may not realise they are
getting heatstroke until the condition
becomes severe. Many symptoms such as
thirst, profuse sweating, giddiness and
nausea may be dismissed as minor discomforts.
Without treatment, the body
temperature can go sky high, rising to
at least 41°C, and the person
can become confused and
disoriented.
Heatstroke can cause
seizures, brain injury, and
problems with the liver,
kidneys and circulation,
and affect the blood’s ability
to clot. When the body
is severely dehydrated, “blood
pressure drops as blood vessels
dilate, and not enough oxygen is
supplied to the kidneys. Muscles are also
not getting enough blood supply, causing
cells to start leaking enzymes and proteins,
which then clog up the kidneys,”
said Dr Chew Huck Chin, Associate Consultant,
Department of Respiratory and
Critical Care Medicine, SGH.
One of the fastest ways of removing
heat from the body is by spraying it with
a fine mist of lukewarm water. “We spray
the body from all directions with finely
misted room-temperature water. A fan
blows to evaporate this water off the
skin. When water evaporates, it lowers
the body’s temperature very quickly,”
said Dr Phua.
“The bigger the area that is misted,
the faster the body is able to lose heat,”
Dr Phua added. Ice-cold water is unsuitable
because it causes the patient to
shiver – the body’s natural reaction to
keep warm – and that causes heat to be
retained instead.
When rushed to the intensive care
unit (ICU), heatstroke patients may have
low blood pressure and may not be breathing
adequately, so a breathing tube and an
intravenous drip are usually used. An ICU
photos: Alecia Neo
People who are obese or old have
to be particularly careful not to
dehydrate or overheat. Old people
may not be able to move about easily,
turn on the fan or air conditioner
when the weather gets too hot, or
drink as frequently as they should.
But drinking enough water and
sitting in a cool environment are
important in hot weather
When training for a marathon,
be sure to practise outside to
get used to weather conditions.
Running in the gym is vastly different
from running in hot, humid weather
While proper hydration is crucial
before marathons or any exercise,
water may not be best as it doesn’t
help replace the salt lost through
sweating. An imbalance of salts leads
to cramps or weakness of the arms.
Isotonic drinks may be better
Avoid exercise when feeling
unwell, as it can make you more
likely to suffer from heat exhaustion
A quick way of cooling the body
is to dip a sponge or towel in cold
water and press it on the neck,
armpits and groin area. If heat
symptoms persist, seek medical
attention immediately
Thirst is not as good an indicator
of dehydration as the colour of the
urine. A clear colour means the body
is well hydrated
People suffering from multiple
long-term medical conditions such
as hypertension and diabetes
should get out of saunas, hot tubs
or steam rooms when they feel giddy
or faint, have a headache, nausea or
cramps. It’s best to go with someone
who is able to help you if you
suddenly feel sick
doctor and nurse are also with the patient
in the cooling room to monitor his condition.
A rectal thermometer is inserted to
check his temperature.
For very severe cases of heatstroke, a
device known as an endovascular cooler
is inserted into the large blood vessel in
the thigh, much like dialysis, to cool the
blood. Another method is to run water
– through a tube inserted either through
the nose to the stomach, or surgically
– to cool the body. For milder forms of
heat disorders, special cooling blankets
(cooled to low temperatures), cooling
pads or ice packs are used.

20 singapore health Jul⁄ Aug 2011
Spotlight
Giving life with a heart
Insight into the emotionally complex and challenging job of transplant coordinators
BY Annie Tan
supporting recipients
Samuel Tan (not his real name)
suffered from heart failure
and, for many years, was shuttling
in and out of hospital while getting
through polytechnic.
Instead of feeling sorry for himself,
Samuel carried on with his studies,
although he missed doing things boys
his age do, such as playing football.
Meanwhile, Ms Kerk Ka Lee, Heart
and Lung Transplant Manager, National
Heart Centre Singapore (NHCS), was
keeping a lookout for a donor heart for
him. Inspired by his perseverance and
maturity, she said: “He was a bright
young chap with an uncertain future
because of his weak heart, but he persevered
through a long hospitalisation,
juggling his studies and hospital visits.”
At 20, his situation became critical,
and doctors feared he had mere weeks
to live.
After two tries, she found a suitable
heart for him. The heart transplant was
a success and, the following year, he celebrated
his 21st birthday at a party organised
by NHCS Heart and Lung Transplant
Patient Support Group, which includes
staff and patients. One of the staff members
even baked him a cake. After finishing
his studies in poly, he started work
and later attained his bachelor’s degree.
As a heart transplant coordinator,
Ms Kerk is one of those who make the
important call to potential recipients
when a donor heart is available. “If it’s a
patient’s first call from us, he is usually
overwhelmed, happy and will anxiously
wait for more details,” she said. But it’s
not always good news. Sometimes, tissues
don’t match or the heart is unsuitable
for transplant, leaving patients,
understandably, disappointed.
Each year, about 25 to 30 donor hearts
pass through NHCS, but only three to six
of these are suitable for transplant. Once
the heart is removed from the donor, it
must be transplanted within four hours.
Ms Kerk usually has only four to six hours
to make the necessary arrangements.
As soon as she’s informed that a heart
is available, she snaps into action. The
job is emotionally demanding, as many
patients are in a critical condition and,
for them, the operation could be a turning
point in their lives.
The first thing she does is to identify
primary and secondary recipients, in
case the heart is unsuitable for the first
recipient. “Patients are usually selected
based on blood type, body weight and
medical urgency. Other factors include
the waiting period and frequency of hospital
admissions,” said Ms Kerk, who was
an operating theatre nurse previously.
After suitable recipients are selected,
she contacts them to begin a six-hour
fast. She also coordinates tests to determine
the suitability and functionality of
the heart and alerts the medical team,
including the heart surgeon and anaesthetist.
She stays for the whole duration
of the operation and updates the family
of the recipient constantly.
Post-transplant care
Her job doesn’t end there. “After the
operation, a patient’s willpower is very
> Continued on page 21
Ms Kerk Ka Lee (left) fulfils her role as a transplant coordinator by interacting closely with
patients and their families throughout the entire transplant process.
PHOTO: alecia Neo
photo: ellen lim
Ms Tee Ping Sing calls organ donation “the greatest gift one can make”.
BY Valerie Lee
supporting donors
The man knew that a time would
come when his son, suffering from a
kidney problem since he was young,
would need a transplant. So for years,
he prepared for the surgery by keeping fit.
That day came when the son was in his
30s and the father in his 50s.
“When the father was pushed out
from the theatre, he struggled to say
‘thank you’,” said Ms Tee Ping Sing,
Transplant Coordinator, Transplant Section,
Singapore General Hospital.
“That was when I felt that I helped
fulfil a father’s wish – to give his son a
new lease of life. He had wanted to do it
for so long and it was finally done.”
Not all transplants evoke such feelings
of warmth from both the donor and
recipient. Many of the cases that Ms Tee
undertakes often have a flipside. When
the transplant involves a brain-dead
donor – usually a young accident victim
or an older person who has suffered a
fatal stroke – her work is much harder,
both physically and emotionally.
As a donor transplant coordinator,
Ms Tee liaises with the families of
potential organ donors and organises
the donation procedure. Well informed
about all aspects of organ transplant,
Ms Tee, together with a medical social
worker, advises and supports the family
throughout the process.
“I believe in transplants. I have seen
the joy of patients who have undergone
a transplant and recovered. They’re no
longer on dialysis and look so much better
when they come back for reviews,” said
Ms Tee, who specialises in supporting
kidney transplant donors and patients.
“But it can also be very, very stressful
when families strongly object to organ
donation,” she added.
Singapore’s Human Organ Transplant
Act (HOTA) allows for organs such as the
kidneys, liver, heart as well as the corneas
to be removed for transplant from someone
who is brain dead. “Every individual
has the right to make a choice on organ
donation, and that choice will always be
respected. But by choosing to remain in
the system, by not opting out, one can
benefit several seriously ill patients after
he passes on. That is the greatest gift one
can make,” said Ms Tee.
Indeed, HOTA has led to shorter waiting
times for patients waiting in line for
an organ. Kidney failure patients, for
instance, now wait about nine years for
a replacement organ. Also, there have
been 49 deceased kidney transplants on
average every year, versus just five before
HOTA was implemented.
Still, families can – and often do
– turn angry when they have to face the
reality that they have come to the end of
the road, and that their brain-dead relatives
cannot recover or be kept on life
support indefinitely. They confront Ms
Tee with questions such as: How can you
say he is dead? He is still breathing. His
body is still warm. How dare you say he
has passed away? What is brain death?
“What they want is time, time, time
> Continued on page 21

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Jul/Aug 2011 singapore health 23
Viewpoint
Zero sum game
In healthcare, as in life, situations or relationships don’t always have
to be win-lose, where one side profits at the expense of the other,
says Dr Chong Yeh Woei
We may have come across the
term “zero sum game” without
quite understanding its impact
on our daily lives. It describes a
situation where one side wins and the
other loses. For instance, when a cake
is divided into unequal slices, some get
bigger portions than others.
We often try to replace zero sum
games or win-lose scenarios with winwin
situations. When people barter
goods or services, the transaction is
win-win, as both sides consider what
they bought to be more valuable than
what they sold. However, there are also
lose-lose transactions when both parties
suffer. These, together with win-win circumstances,
are regarded as “non-zero
sum” situations.
overall costs are passed to them. At some
point, medical tourists will look to less
costly treatments elsewhere, while local
patients may move to the public sector or
seek treatment with healthcare service
providers in other countries. We may well
become the Monaco of healthcare: If you
cannot afford it, please don’t even bother
to ask.
Another win-lose situation is the loss
of goodwill between doctors and patients,
as fees rise in tandem with property
nition and status they enjoy. This creates
a healthy tension between fees charged
and the professional craft.
When this balance is unhinged by
overcharging, patients may perceive the
value of the doctor’s professional services
as falling short. In particular, should the
treatment result in a poor outcome, doctors
may face unhappy patients and even
legal action. An interesting case in point:
Patients are demanding refunds as an
option to avoid lawsuits.
and kindness and behave respectfully to
senior colleagues, the working environment
suddenly becomes more positive.
I urge everyone to leave negative workplace
dynamics – intrigue, manoeuvring,
backstabbing, envy, jealousy, gossip – at
the door when arriving for work every
morning. Win-win situations can be
gained by treating your nurses, allied
healthcare professionals, medical students
and ward assistants in a civil and
kind manner. After all, we are the leaders
of healthcare, and in today’s world,
an autocratic, narcissistic, destructive or
toxic style of leadership will not be tolerated
much. The effective leader tends to
be self-aware, self-regulated, motivated
by reasons that transcend money or
status, empathic and equipped
with good social skills.
In quieter times, negative
leadership traits
would have surfaced
early in a person’s
The rising cost of
medical space – the
result of rentals being
chased into bubble
territory – is a win-lose
situation. The “loss” will
be felt by patients who
have to pay higher fees,
as increased overall costs
are passed to them.
Cutting a cake unequally will result in a
win-lose situation, as one party gets the
larger share. Similarly, as medical costs rise,
the loser is the patient who has to bear the
increased financial burden.
Why am I talking about
these fancy game theories?
It is because I have
noticed the creeping
onset of more win-lose
situations and lose-lose
situations in the private
healthcare sector.
The rising cost of
medical space – the
result of rentals being
chased into bubble
territory – is a win-lose
situation. As new price
benchmarks are set, landlords
adjust rentals. Banks, perceiving
doctors to be good credit risks,
are happy to lend them more money. This
situation will continue to escalate if no
one puts on the brakes.
The “loss” will be felt by patients who
have to pay higher fees, as increased
values. Private sector doctors are expected
by society to put their patients’ interests
above those of their own. In return, society
allows them the right to self-govern
the profession, and gives them the recog-
On a more optimistic note, we can
have a win-win situation with our professional
colleagues. When we work
together, share information, socialise,
treat junior colleagues with patience
PHOTO: SMA News
career. The very nature of such traits
would have kept such people in their
place and prevented them from moving
into top leadership positions. However,
in today’s very fluid world, marked by
waves of change, innovation, uncertainty
and reinvention, these individuals
can emerge as top dogs based on their
ability to sell themselves.
In the final analysis, the essence of
qualities prized in healthcare is the antithesis
of narcissism. We should be aware
that these toxic leadership styles have no
place in today’s world, and should not be
tolerated in our profession.
Adapted from an article in SMA News January 2011.
Dr Chong Yeh Woei is President
of the 52nd SMA Council.
He has been in private
practice since 1993 and has
seen his fair share of the
human condition.

24 singapore health JUL/AUG 2011
Money Matters
Reading the fine print
When buying an insurance policy, it is important to
understand the clauses that may affect claims later
Mdm Tan switched health insurers
and after the new plan kicked in,
she suffered a mild stroke and was
admitted to hospital. Upon discharge,
she filed a claim with the insurance company,
but her request for the insurer to pay
her medical bills was rejected.
The insurer had learnt that Mdm Tan
was diagnosed shortly before for high
blood pressure. She did not declare the
condition in her insurance application
as she thought it wasn’t serious. But
Mdm Tan’s hospitalisation was deemed
to be related to a preexisting medical
condition that she should – but did not
– declare in her application form.
Keeping premiums affordable
A preexisting condition is an illness or
disability that an applicant has, or has
had, before signing up for an insurance
plan. It is common for insurance contracts
to have a preexisting condition
exclusion, although its definition differs
among insurers, with some more stringent
than others in their definition.
Preexisting exclusions are used to
keep premiums affordable for everyone.
Insurers have to balance between
giving more generous coverage to individuals
versus covering more people at a
basic level.
The likelihood of claims arising
from a preexisting condition
is higher, which means
more claims have to be
paid. If insurers are to
cover these risks, they
would need to charge
higher premiums to
cover the high payouts.
Higher premiums
mean fewer
people can afford
even basic health
insurance, which
does not serve the
public interest.
So, when changing
or replacing an existing
health insurance policy, the
insured person suffering from
preexisting medical conditions may
find himself without coverage for those
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It is important to read the
terms and conditions in a health
insurance policy that may affect
your ability to make a claim when
the need arises.
conditions if the new policy has a preexisting
medical condition exclusion.
Clarify in writing
Besides preexisting conditions, a medical
insurance policy may have other
exclusions. For instance, general outpatient
medical services and alternative or
complementary treatments, including
traditional Chinese medicine (TCM), are
commonly excluded.
Insurers may also restrict coverage or
charge higher premiums for people with
Time lapse
Mr Tee bought a medical expense
insurance policy. Several months later,
he began experiencing bouts of intense
heart palpitations with fainting spells.
He consulted a cardiologist and was
found to have a congenital heart condition
that could be treated with minor
surgery requiring hospitalisation.
Before the surgery, Mr Tee had
asked if the surgical and hospitalisation
costs would be covered under the
policy, but was shocked to learn that
while the policy did cover congenital
disorders, claims for such coverage
could be made only two years after the
start of the policy.
The period specified in his health
Some points to
remember when
purchasing a medical
insurance policy
Be aware of the waiting period and
deferred period
Disclose all information factually
and accurately
Find out the insurer’s definition of
preexisting conditions
Note the exclusions for preexisting
conditions
Find out which services or
treatments (like TCM) are excluded
from coverage
Seek clarification in writing from
your insurer if you are unclear about
any of the above
certain medical conditions, or who are
exposed to occupational hazards, as the
possibility of a claim being made by these
groups is higher than that for people who
are not exposed to these risks.
To avoid having claims rejected or
the policy being declared void by the
insurer, applicants should disclose all
information factually and accurately to
the insurer. They should also be clear
about disclosures or definitions of terms
like preexisting conditions or material
information.
If in doubt, they should check with
their insurers. To avoid any misunderstanding,
clarification should also be
made in writing.
The information is adapted from Your Guide to Health
Insurance and Making Sense of Your Health Insurance
at www.moneysense.gov.sg.
insurance policy is known as the waiting
period and is the time that must
pass before some or all of the healthcare
coverage can begin. During this
time, a claim cannot be made.
Coverage may only come later
Insurers impose a waiting period to
prevent policyholders from buying
policies only after they are aware of
their illnesses and claiming medical
expenses soon after.
Another condition that insurers
may impose is the deferred period – a
period of time that must lapse after
disability or sickness occurs, before
benefits are paid. Benefits may only be
disbursed after the insured person has
been disabled or sick for more than a
set number of days.

JUL⁄ AUG 2011 singapore health 25
People
The art of development
Associate Professor Ng Wai Hoe, Senior Consultant,
Department of Neurosurgery, National Neuroscience Institute,
is a rare breed. Besides being a neurosurgeon, he also has a
PhD in research. Thava Rani finds out what makes him tick
I would most want to discuss medicine
and science with… Galileo Galilei.
I want to talk to someone who has influenced
the field of science and medicine in
a dramatic way.
Like the Industrial Revolution – which
is attributed to a change in people’s thinking
rather than technology – Galileo also
brought about such a change, which made
all other scientific discoveries possible.
I would like to find out what made him
think so differently despite the political
and religious pressure to conform.
I think I am… efficient in time and
resource management, something I only
noticed after my wife pointed that out. I
plan my day in great detail, even the route
I walk within the hospital.
The best analogy for the work I do is…
I guess, that of a brain engineer who
ensures all the connections are in good
working order.
I always wanted to be… a pilot, but then
I developed myopia. I chose medicine
because I had interest in neurosciences.
Later during my training, I also discovered
my passion for surgery. Neurosurgery
was the perfect marriage between
the two.
My motivation is… to see things develop.
I’m definitely not creative in the artistic
sense, but I like to use my creativity to
develop new things – be it a new programme
or clinical service.
I smile when… my patients recover from
operations. Especially in neurosurgery,
the recovery can be quite remarkable.
As a researcher, what makes me smile
is getting to the bottom of a particular
condition and finding innovative ways to
treat it. It’s not just about groundbreaking
discoveries, but about identifying windows
of opportunity where new knowledge
can make a difference.
PHOTO: alecia neo
Associate Professor Ng Wai Hoe hopes patients have a positive outlook on their
condition, and realistic expectations of their recovery.
I’m unhappy when… there’s a bad outcome
from surgery. Doctors are human,
and we become close to our patients, so
bad outcomes affect us just as much.
In neurological diseases… patients
and their family may not fully appreciate
how serious the condition is and the
risks of an operation. Surgery may not
always “fix” things. We can only prevent
the condition from getting worse,
so sometimes, they may have unrealistic
expectations of their recovery – like how
much they will recover and how fast.
My plans for the future include…
embarking on expanding the field of
functional neurosurgery into pain man-
agement, and trying to build our epilepsy
service. I also hope to spend more time
with my son and daughter as they’re still
at a stage when they want to be with their
parents!
The quality I value most in a patient
is… a positive outlook. It’s quite humbling
and inspiring to see a patient stay
positive despite a potentially life-threatening
disease.
To relax means… spending time with
my wife and kids, taking a walk along
the beach or going for a run. I used to run
marathons, but at 40, I don’t think that’s
very good for my joints. So now, 10km is
the max.
Three decades and counting
After receiving numerous awards in more than 30 years as a nurse, Mdm Lim Suh Fen still
experiences joy in winning
By Stacey Chia
If Mdm Lim Suh Fen, Assistant Director
of Nursing, National Heart
Centre Singapore (NHCS), has to
live her life all over again, she said
she would still choose to be a nurse.
Her passion was ignited when she was
caring for her ailing father with whatever
knowledge she had gleaned from working
in a doctor’s clinic. “It inspired me to
join nursing. I love working with people
and having the privilege to care for
patients, whether physically, spiritually or
emotionally.”
Over the years, this passion has brought
her numerous awards, including nursing’s
most prestigious honour here – the
President’s Award for Nurses – last year.
This once-in-a-lifetime award is given to
only three nurses a year. “Being recognised
for my work and contribution has
spurred me on to do even more for my
patients, staff and community,” she said.
With her long years in nursing, people
often tap her wealth of experience. A
recent request was for her to help in the
planning of a new, larger heart centre,
now being constructed on SGH Campus.
The new centre, two times larger than
the current one and set to open by 2013,
will be a digital heart hospital, integrating
clinical systems with technology to
improve processes and patient care.
Scrutinising details
Mdm Lim is no stranger to planning
work. When the current heart centre was
being built, she was asked to set up and
run the one-stop cardiac outpatient
centre.
Armed with that experience
and years of managing
the Cardiac Clinics’ Appointment
Unit and Resource
Centre, she now has a clear
idea what patients need and
how the new building
can meet these
needs.
She is currently looking at the
smallest details – from the layout of
services to the choice of furniture and
fittings – to maximise space and ensure
privacy for patients.
To make sure facilities are easily accessible
to patients, she is focusing on directional
signages and the positioning of
patient greeters at strategic locations. She
also wants to consolidate ancillary services
in clinics, so patients don’t have to
be sent to other departments. “I want
to make sure that from the moment
patients step into the centre, they
can easily find everything. This will
cut their waiting time and ensure
they don’t get lost.”
Despite all the changes brought
about by technology and scientific
advancement which
will be present in the new
building, the focus will
remain on seamless
care delivery. Nursing
will not lose
Wish your
nurse a
Happy
Nurses’ Day
on Aug 1
its patient-centred focus, Mdm Lim said.
Nurses will also be more involved in coordinating
patient care, so a patient’s outpatient
visits can be reduced.
She said the biggest challenge nurses
face now is their role in the job. “Today,
nursing goes beyond the hospital walls.
Nurses not only have close relationships
with patients when they are in hospital,
but extend care when patients return
home, by teaching and supporting their
caregivers in providing continued care.”
Her advice to aspiring nurses comes
from her own experience. “You must have
a lot of passion to want to be with patients
and care for them, as well as to help their
families heal or manage patients’ medical
problems. Caring is central to nursing
and it has to come from within you.”
Mdm Lim Suh Fen was awarded the President’s Award
for Nurses in 2010, in recognition of her outstanding
contribution to the profession.

26 singapore health Jul⁄ Aug 2011
FYI
SingHealth staff raise
funds for needy patients
SaveMoney SaveLives, a SingHealth
Foundation fundraising effort, raised
more than $200,000 – the highest in
the campaign’s history – for needy
patients at SingHealth institutions.
The funds go towards providing quality
medical treatment for needy patients,
as well as caring for their emotional,
mental and financial needs.
Stroke triggers
Researchers at University Medical Centre
in Utrecht studied 250 patients over three
years to identify what might cause blood
vessels of the brain to burst. Ruptured
blood vessels can lead to stroke. Coffee
was responsible for one in 10 cases of
blood vessels bursting. The following are
the various risk factors, all of which trigger
an increase in blood pressure to the brain,
and their contribution to the percentage of
cases of ruptured brain vessels:
Coffee 10.6%
Vigorous exercise 7.9%
Nose blowing 5.4%
Sex 4.3%
Straining to defecate 3.6%
Drinking cola 3.5%
Being startled 2.7%
Being angry 1.3%
Source: BBC.com
The campaign offered participants
the chance to win a lucky draw prize.
Ms Gladys Lin, a research administrator
at National Heart Centre Singapore,
was the lucky winner of a Subaru
Impreza 1.5MT Sedan – a perfect present
for her wedding in September.
The campaign was supported by Atos
Wellness and Motor Image Enterprises.
Lucky couple
unlocks the
secret to
wedded bliss.
Bottle-feeding
increases obesity risk
Babies who are bottle-fed until the
age of two are more likely to be obese
when they start school, a US study
said. Writing in the Journal of Pediatrics,
researchers found that children who
were still regular bottle users
at 24 months were 30% more
likely to be obese when they
reach five and a half years old.
Experts say bottle-feeding can make
babies consume too many calories. The
research found 22% of two-year-olds
studied were using a bottle as their
main drink container, or were put to
bed with a bottle containing a caloriefilled
drink. Nearly a quarter of this
group were found to be
obese by the age of five,
compared with 16% of
children who had not
been using a bottle at
the age of two. This
suggests that parents
should stop using a
bottle by the child’s
first birthday to
reduce the risk of
overfeeding.
Source: BBC.com
Singapore Health issue 11 contest
1. What is the name of the machine
that doctors used to keep Cherie
alive after her heart attack?
2. Which story did you enjoy reading
most in this issue of Singapore
Health?
Closing date: Aug 12, 2011
Send in your answers and stand
to win a two-month supply of
Viartril-S 500mg 90s worth
over $130.
Include your name, age, gender, address
and telephone number. Winners will
be notified via phone or email. Incomplete
or multiple entries will not be considered.
Email: editor@sgh.com.sg
Post: The Editor, Singapore Health,
Singapore General Hospital,
Communications Department,
Outram Road, Singapore 169608
Winners of Contest 10
These winners will each receive a Solax
Memory Foam Pillow worth $55.
1. Cyril Dominic Chelliah
2. Julia Matrawi
3. Ng Siang Cheng
4. Santhi Sabrina
5. Steven Tan Choon Huat
Prizes must be claimed by Sept 2, 2011.
Answer to
In focus
(Page 3):
This multicoloured
fabric-and-string web,
one of several artworks
put up at Singapore
General Hospital
recently, was created by Ms Ketna
Patel, a British Indian artist based in Singapore,
and multimedia artist Foo Ai Wei. The artwork
exaggerates the subtle and encourages the viewer
to see what they may not usually notice.
event Calendar
Eat Smart, Move
More, Love Life!
A group-based programme specially
designed for women who wish to control
their weight
Time Please contact programme
coordinator for exact dates and time
Venue KK Women’s & Children’s Hospital,
Fitness Centre, Level 2, Children’s Tower
Price $275.50 for 10 sessions
Contact For registration, please
call 6394-8782 / 6394-8488
or email sportsmed@kkh.com.sg
SOTA Rocks!
School of the Arts students
will perform jazz, latin, as well as
rock and roll to entertain patients
and visitors
Time 7-7.45pm
Venue SGH, Block 6, Deck on 9
Price Free
Happy Birthday
Singapore!
River Valley Primary School children will
celebrate the nation’s 46th birthday with
song, dance and wushu performances
Time 7-7.45pm
Venue SGH, Block 6, Deck on 9
Price Free
Sleep Disorders
Public Forum
Time 9.30-11.30am
Venue SGH Postgraduate Medical
From
Jul 2
(Sat)
Jul 29
(Fri)
Aug 5
(Fri)
Aug 27
(Sat)
Institute, Block 6, Level 1, Rooms 3 and 4
Price $5 (includes tea break)
Contact For registration, please call
6326-6202 or email gnrsdu@sgh.com.sg
For more information and other
listings, please visit www.singhealth.
com.sg/events or the respective
institution websites.
Publisher
Co-funded
Content Advisor
Tan-Huang Shuo Mei
Group Director, Communications & Service Quality, SingHealth & SGH
Editorial Team
Angela Ng (SGH), Lim Mui Khi (SGH), Tina Nambiar (SingHealth), Nicole Lim (SingHealth), Ann Peters (SingHealth)
Singapore Health is partially funded by SGH Integrated Fund and SingHealth Foundation to advance the health
literacy of patients in SingHealth institutions.
Publishing Agent
Managing Director
Dennis Pua
General Manager
Christopher Chan
Group Editor
Joanna Lee-Miller
Senior Editor
Low Ching Ling
Associate Editor
Jason Lim
Sub-Editor
Winnie Fong
Creative Director
Alex Goh
Art Director
Janice Tan
Senior Designer
Jolene Tan
Executive, Client Management
Jacklyn Ong
Account Manager, Advertising Sales
Jobina Ong
Senior Executive, Publishing Services
Zulkiflee Mohd Ali
For advertising enquiries, please call 6319-3022 or email: jrani@sph.com.sg
All rights reserved. Copyright by SGH (registration
no: 198703907Z). Opinions expressed in Singapore
Health are solely those of the writers and
are not necessarily endorsed by SGH, SingHealth
Group and/or SPH Magazines Pte Ltd (registration
no: 196900476M) and their related companies.
They are not responsible or liable in any way
for the contents of any of the advertisements,
articles, photographs or illustrations contained
in this publication. Editorial enquiries should
be directed to the Editor, Singapore Health, 7
Hospital Drive, #02-09 Block B, Singapore
169611. Tel:+65 6222-3322, Email: editor@sgh.
com.sg. Unsolicited material will not be returned
unless accompanied by a self-addressed envelope
and sufficient return postage. While every
reasonable care will be taken by the Editor, no
responsibility is assumed for the return of unsolicited
material. ALL INFORMATION CORRECT
AT TIME OF PRINTING. MICA (P) 076/06/2011.
Printed in Singapore by Singapore Press Holdings
Limited (registration no: 198402868E).

新 加 坡 中 央 医 院
与 新 加 坡 保 健 服 务
集 团 的 双 月 刊
7 月
8 月
2011
page 29
page 30
page 30
page 31
施 予 第 二 次 机 会
一 段 经 历 ,
两 个 故 事
致 命 剂 量
验 血 之 前 须 禁 食
在 死 亡 关 口 捡 回 一 条 命
一 群 尽 责 的 医 护 人 员 和 一 台 仪 器 , 把 一 名 年 轻 人 从 死 亡 关 口 拉 了 回 来
林 宝 惠 ( 右 ) 在 经 历 心 脏 停 止 跳 动 45 分 钟 的 心 脏 病 后 , 成 功 痊 愈 。 图 为 她 和 母 亲 开 心 的 合 照 。
文 李 君 玲
很 少 人 会 有 像 林 宝 惠 那 样 死 而 复 生 的
经 历 。
去 年 12 月 , 还 15 岁 的 林 宝 惠 因 急 性
心 脏 衰 竭 被 送 入 医 院 , 尽 管 医 护 人 员 进
行 紧 急 抢 救 , 她 的 心 脏 仍 停 止 跳 动 长 达
45 分 钟 。 最 后 , 只 有 在 医 生 使 用 人 工 心
肺 机 来 取 代 林 宝 惠 的 心 脏 和 肺 功 能 后 ,
她 的 生 命 才 慢 慢 地 恢 复 。 林 宝 惠 很 可 能
会 因 此 而 瘫 痪 , 但 很 幸 运 的 她 现 在 已 完
全 康 复 。
如 今 , 她 就 像 其 他 正 常 健 康 的 学 生 一
样 四 处 跑 动 , 今 年 还 准 备 参 加 O 水 准 考
试 。
林 宝 惠 之 所 以 能 活 着 , 除 了 因 为 她
年 轻 和 拥 有 顽 强 的 恢 复 能 力 之 外 , 还 有
一 群 永 不 放 弃 的 医 护 人 员 , 以 及 现 代 科
技 带 来 的 奇 迹 。 那 台 帮 助 林 宝 惠 恢 复 心
跳 的 仪 器 是 一 种 称 为 体 外 膜 式 氧 合 器
( 简 称 ECMO) 的 人 工 心 肺 机 。
从 胸 痛 到 心 脏 衰 竭
一 开 始 , 林 宝 惠 感 到 胸 部 疼 痛 。 她 被 送
到 医 院 进 行 检 查 , 诊 断 结 果 发 现 她 患 上
一 种 罕 见 的 心 脏 肌 肉 炎 , 也 就 是 急 性 病
毒 性 心 肌 炎 。 任 何 年 龄 和 性 别 的 人 都 有
可 能 患 上 这 种 无 法 预 知 的 疾 病 。 过 去 五
年 里 , 新 加 坡 有 九 人 不 幸 罹 患 这 种 疾 病 ,
只 有 三 人 , 包 括 林 宝 惠 , 得 以 存 活 。
医 生 发 现 她 心 脏 的 功 能 只 有 10% 到
20%。 当 时 她 的 情 况 迅 速 恶 化 , 并 出 现
急 性 心 脏 衰 竭 , 医 生 便 立 刻 把 她 送 进 加
护 病 房 进 行 心 肺 复 苏 。45 分 钟 后 , 虽 然
医 生 不 断 增 加 肾 上 腺 素 的 剂 量 , 但 她 的
心 脏 还 是 无 法 恢 复 跳 动 。 于 是 , 院 方 寻
求 ECMO 团 队 的 协 助 。
目 前 , 新 加 坡 一 共 拥 有 六 台 ECMO 仪
器 , 全 设 在 新 加 坡 国 家 心 脏 中 心 , 随
时 准 备 提 供 支 援 。 当 新 加 坡 国 家 心 脏
中 心 接 到 电 话 要 求 使 用 ECMO 仪 器 时 ,
ECMO 团 队 包 括 两 名 操 作 仪 器 的 灌 注 师 、
一 名 心 脏 外 科 医 生 和 一 名 医 生 就 会 乘 坐
救 护 车 、 德 士 或 开 车 赶 到 医 院 。
他 还 是 尽 力 抢 救
新 加 坡 国 家 心 脏 中 心 心 胸 外 科 顾 问 医 生
苏 章 文 第 一 个 抵 达 医 院 。 他 说 :“ 庆 幸
的 是 , 在 ECMO 团 队 抵 达 之 前 , 那 里 的 医
生 和 护 士 已 经 在 为 林 宝 惠 进 行 心 肺 复 苏 。
图 :ALVINN LIM
他 们 的 效 率 很 高 。”
他 也 补 充 道 , 在 多 数 心 脏 衰 竭 的 个 案
里 , 即 使 进 行 了 心 肺 复 苏 , 使 用 ECMO 仪
器 的 结 果 还 是 不 尽 如 人 意 。 即 使 病 人 得
以 存 活 , 器 官 遭 到 损 害 的 可 能 性 也 很 高 。
自 2003 年 起 , 这 台 仪 器 已 抢 救 过 205 个
心 脏 衰 竭 的 病 人 。
ECMO 仪 器 的 运 作 原 理 是 从 病 人 的 腹
股 沟 插 入 两 根 插 管 , 仪 器 内 的 血 泵 会 通
过 一 个 插 管 泵 出 脱 氧 血 液 , 然 后 仪 器 内
的 人 造 肺 会 排 出 二 氧 化 碳 , 把 氧 气 注 入
血 液 中 , 再 通 过 另 一 个 插 管 把 血 液 泵 回
病 人 体 内 。 苏 医 生 说 :“ 血 泵 就 像 有 一
定 血 压 的 心 脏 , 负 责 把 血 液 输 送 到 体 内
各 个 器 官 。 泵 血 过 程 是 持 续 不 断 的 。”
预 后 具 有 不 确 定 性
虽 然 林 宝 惠 的 心 脏 恢 复 跳 动 , 但 她 还 是
处 于 昏 迷 状 态 。 苏 医 生 也 通 知 她 的 家 人
要 做 好 最 坏 的 打 算 。 因 为 即 使 她 活 下 来 ,
也 可 能 因 脑 部 缺 氧 伤 害 而 瘫 痪 。 此 外 ,
苏 医 生 也 不 排 除 她 得 终 生 坐 轮 椅 或 出 现
大 脑 性 瘫 痪 的 可 能 。
七 天 后 , 她 的 心 脏 功 能 恢 复 正 常 , 不
再 需 要 依 赖 仪 器 。 林 宝 惠 笑 着 说 , 苏 医
生 是 她 苏 醒 后 看 到 的 第 一 张 脸 孔 。
苏 章 文 医 生 在 林 宝 惠 因 心 脏 病 陷 入 昏 迷 后 , 以
体 外 膜 式 氧 合 器 来 保 持 她 的 心 脏 跳 动 。
> 文 转 page 28
超 声 聚 焦 医
治 前 列 腺 癌
新 加 坡 中 央 医 院 首 创 非 侵 入 性 前
列 腺 癌 疗 法
原 文 Keith G Emuang
目 前 , 男 性 患 上 前 列 腺 癌 的 几 率 是 30 年
前 的 4 倍 。 每 100 名 被 诊 断 患 上 前 列 腺 癌
的 男 性 中 , 就 有 约 4 人 会 因 病 去 世 。 随
着 新 加 坡 的 人 口 迅 速 老 化 , 这 个 趋 势 预
计 也 将 日 益 加 剧 。 虽 然 能 在 患 病 初 期 测
出 癌 症 , 但 其 治 疗 却 可 能 带 来 后 遗 症 ,
让 病 患 感 觉 丧 失 男 性 尊 严 。
前 列 腺 , 指 的 是 构 成 部 分 男 性 生 殖 系
统 的 附 属 性 腺 。 前 列 腺 癌 的 传 统 治 疗 包
括 前 列 腺 切 除 手 术 、 放 射 治 疗 、 植 入 放
射 性 粒 子 ( 近 距 离 放 射 治 疗 ), 以 及 利
用 低 温 阻 碍 癌 细 胞 的 代 谢 ( 冷 冻 治 疗 )。
新 加 坡 中 央 医 院 泌 尿 科 高 级 顾 问 郑 畏
三 副 教 授 说 :“ 很 不 幸 的 , 现 有 的 治 疗
都 会 引 发 持 久 的 副 作 用 。 这 些 副 作 用 将
对 前 列 腺 癌 症 病 患 的 生 活 素 质 产 生 很 大
的 影 响 。
“ 其 中 , 最 常 见 的 是 尿 失 禁 以 及 性 无
能 。”
尽 管 如 此 , 新 加 坡 中 央 医 院 与 新 加 坡
国 立 癌 症 中 心 合 作 进 行 的 一 项 临 床 试 验 ,
将 能 为 患 有 低 风 险 初 期 前 列 腺 癌 的 病 患
提 供 一 种 无 副 作 用 的 治 疗 选 择 。
这 项 治 疗 运 用 的 是 相 同 于 女 性 子 宫
肌 瘤 治 疗 中 所 用 的 磁 共 振 引 导 超 声 聚 焦
疗 法 。 在 磁 共 振 的 引 导 下 , 外 科 医 生 将
准 确 地 找 到 肿 瘤 及 周 围 的 组 织 , 并 精 准
无 误 地 将 超 音 波 聚 焦 , 把 肿 瘤 “ 烧 除 ”。
这 个 称 作 前 列 腺 癌 磁 共 振 引 导 超 声 聚 焦
距 疗 法 的 手 术 将 不 会 对 肿 瘤 附 近 的 细 胞
组 织 造 成 伤 害 。
直 至 今 年 三 月 , 已 经 有 18 名 来 自 印
度 、 意 大 利 、 俄 罗 斯 以 及 新 加 坡 , 年 龄
介 于 50 至 75 岁 的 局 部 性 低 风 险 前 列 腺 癌
病 患 接 受 治 疗 。 当 中 , 有 7 名 病 患 在 本
地 接 受 治 疗 。 目 前 , 新 加 坡 是 参 与 这 项
世 界 首 创 的 国 际 多 中 心 试 验 的 最 大 临 床
试 验 中 心 。
据 郑 副 教 授 说 , 这 个 非 侵 入 性 的 治 疗
能 在 提 供 有 效 治 疗 的 同 时 , 减 少 对 前 列
> 文 转 page 28

28 新 脉 动 JUL⁄ AUG 2011
新 闻
> 文 接 page 27
超 声 聚 焦 医 治 前 列 腺 癌
腺 功 能 区 以 及 周 围 器 官 结 构 所 产 生 的 有
害 副 作 用 。 不 仅 如 此 , 它 还 能 解 决 病 患
的 另 一 担 忧 。
郑 副 教 授 说 : “ 这 是 一 个 重 要
的 进 展 。 虽 然 前 列 腺 癌 在 初 期
就 能 确 诊 , 不 过 我 们 却 一 直
很 注 意 不 要 给 某 些 病 患 过 度
治 疗 , 譬 如 对 他 们 进 行 前
列 腺 切 除 手 术 或 放 射 性 治
疗 等 。”
“ 这 项 新 疗 法 可 以 算 是 一
种 折 中 的 解 决 方 案 , 尤 其 适
用 于 医 治 患 有 初 期 前 列 腺 癌
的 年 长 者 。”
病 患 可 以 在 新 加 坡 国 立 癌 症 中 心
接 受 这 项 日 间 手 术 。 在 手 术 过 程 中 , 病
患 必 须 躺 卧 , 并 将 双 脚 抬 起 。 医 生 随 后
会 将 一 个 能 量 转 换 器 , 即 一 种 能 把 一 类
能 量 转 换 成 另 外 一 类 能 量 的 器 具 , 置 入
左 起 为 郭 仁 辉 医 生 , 郑 畏 三 教 授 和 邱 文 庆 医 生 。
他 们 是 以 微 创 术 治 疗 前 列 腺 癌 的 其 中 几 位 先 锋 。
图 :101TEAMWORK
病 患 的 直 肠 。 医 生 在 整 个 过 程 都 无 需 在
病 患 身 上 做 任 何 切 口 。
新 加 坡 国 立 癌 症 中 心 肿 瘤 影 像 学 科 主
任 及 高 级 顾 问 邱 文 庆 医 生 说 :“ 有 了 磁
共 振 的 引 导 , 便 能 够 将 几 百 个 单 独 和 通 常
无 害 的 音 波 聚 焦 在 病 患 体 内 深 处 的 某 个 治
疗 点 上 。 当 这 些 音 波 交 错 时 , 所 产 生 的
超 声 波 就 有 足 够 的 能 量 , 破 坏 癌 细 胞 。”
郭 医 生 补 充 , 这 个 概 念 , 就 类 似 利 用
放 大 镜 将 太 阳 光 线 聚 焦 , 由 此 起 火 , 或
在 纸 上 烧 出 一 个 洞 来 。
他 说 :“ 这 项 科 技 非 常 精 确 , 甚 至 能
够 针 对 小 如 一 毫 米 , 也 就 是 半 粒 米 大 小
的 面 积 做 出 治 疗 。”
手 术 进 行 时 , 实 时 磁 共 振 测 温 表 和 三
维 累 积 剂 量 显 示 器 等 仪 器 都 会 帮 助 监 视
新 加 坡 国 立 癌 症 中 心 肿 瘤 影 像 科 高 级 顾 问 医 生 郭 仁 辉 ( 左 ) 以 磁 共 振 影
像 来 准 确 地 找 到 肿 瘤 的 位 置 , 再 将 超 音 波 聚 焦 , 利 用 热 量 把 它 烧 死 。
及 控 制 热 量 的 分 布 , 标 明 应 被 烧 除 的 肿
瘤 部 位 。
由 于 治 疗 需 要 极 高 度 的 准 确 性 , 因 此
病 患 必 须 全 程 保 持 不 动 。 他 们 可 能 需 要
进 行 脊 髓 硬 膜 外 麻 醉 或 全 身 麻 醉 。 整 个
手 术 平 均 需 要 约 三 个 小 时 完 成 。
一 般 上 , 病 患 在 一 、 两 天 内 便 能 够 恢
复 正 常 生 活 , 生 活 素 质 也 不 会 改 变 。
自 2010 年 8 月 开 始 试 验 至 今 , 病 患 除
了 偶 尔 小 便 有 困 难 , 并 没 有 出 现 任 何 严
重 的 并 发 症 。 医 生 也 表 示 , 没 有 病 患 出
现 病 情 复 发 的 情 况 。
郑 副 教 授 说 :“ 希 望 当 这 项 临 床 试 验
成 为 正 规 疗 程 后 , 更 多 患 有 初 期 前 列 腺
癌 的 男 性 能 够 接 受 治 疗 , 恢 复 美 满 的 性
生 活 。”
图 :PHOTOLIBRARY
前 列 腺 癌
前 列 腺 是 男 性 生 殖 器 官 的 一 部 分 ,
它 是 一 个 核 桃 般 大 小 , 处 在 直 肠 之
前 , 膀 胱 之 下 的 腺 体 。 它 环 绕 着 从
膀 胱 输 尿 至 阴 茎 的 尿 道 。
前 列 腺 主 要 需 要 睾 酮 ( 男 性 荷
尔 蒙 ) 以 正 常 运 作 , 其 中 的 作 用
包 括 在 射 精 时 产 生 运 输 精 子 的 精 液
流 体 。
当 前 列 腺 细 胞 异 常 生 长 , 前
列 腺 便 会 扩 大 , 推 向 尿 道 和 膀 胱 ,
阻 碍 正 常 尿 流 。
在 前 列 腺 开 始 生 长 的 癌 细 胞 可
能 会 留 在 前 列 腺 内 , 也 有 可 能 扩
散 至 附 近 的 淋 巴 结 。 在 某 些 情 况
下 , 它 也 可 能 会 扩 散 到 骨 头 、 膀
胱 、 直 肠 或 其 他 器 官 。
前 列 腺 癌 在 发 病 初 期 一 般 不 会
出 现 明 显 征 兆 , 因 此 , 前 列 腺 癌
检 查 尤 其 重 要 。 随 着 病 情 的 恶 化 ,
病 患 或 许 会 发 觉 自 己 频 尿 和 尿 急 ,
但 尿 液 却
减 少 , 或
在 尿 液 中
发 现 血 迹 。
前 列 腺 因 肿 瘤
( 红 色 部 位 )
肿 大 会 阻 碍 正
常 尿 流 。
> 文 接 page 27
在 死 亡 关 口 捡 回 一 条 命
父 母 亲 的 爱
苏 醒 后 , 她 的 手 脚 不 太 能 活 动 , 而 且 只 能
低 声 细 语 。 苏 医 生 把 林 宝 惠 的 康 复 归 功 于
她 父 母 亲 24 小 时 无 间 断 的 悉 心 照 料 。“ 每
天 早 上 巡 房 时 , 我 都 会 看 到 他 们 两 人 。 她
父 亲 放 下 工 作 来 照 顾 她 。 他 会 把 她 从 床
上 抱 到 椅 子 上 , 按 照 理 疗 师 的 指 示 活 动
她 的 手 指 和 腿 。 他 经 常 脸 带 微 笑 , 保 持
乐 观 , 充 满 希 望 。 由 于 护 士 不 能 每 分 每
秒 都 待 在 那 里 , 所 以 她 母 亲 就 帮 忙 照 她 。
她 的 父 母 亲 尽 心 尽 力 地 帮 助 她 活 动 四 肢 ,
以 避 免 她 身 体 僵 硬 。 这 让 我 很 感 动 。”
当 她 出 院 时 , 她 走 路 还 是 有 些 困 难 ,
说 话 还 是 很 小 声 。 院 方 要 求 她 即 使 只 是
感 到 轻 微 的 胸 部 疼 痛 , 也 要 立 刻 回 到 医
院 检 查 。 事 实 证 明 , 这 个 有 坚 强 决 心 的
文 静 少 女 , 是 一 个 战 士 。
出 院 不 到 两 个 月 , 苏 医 生 就 接 到 电 话
说 林 宝 惠 在 医 院 想 见 他 。 她 几 乎 是 蹦 蹦
跳 跳 地 进 入 他 房 间 。“ 我 简 直 不 敢 相 信 ,
因 为 她 出 院 时 , 还 需 要 别 人 搀 扶 才 能 走
路 , 动 作 还 很 笨 拙 。”
林 宝 惠 来 见 他 , 不 是 因 为 胸 痛 , 而 是
想 获 得 苏 医 生 的 批 准 重 返 校 园 。 校 长 建
议 她 休 学 一 年 , 但 她 拒 绝 了 。 她 想 弥 补
失 去 的 时 间 , 在 考 试 中 获 得 好 成 绩 , 将
来 当 个 好 老 师 。
图 :ALVINN LIM
新 加 坡 国 家 心 脏 中 心 灌 注 科 高 级 灌 注 师 庄 璇 珠
推 着 其 中 一 台 抢 救 生 命 的 ECMO 仪 器 。 中 心 共 有
六 台 仪 器 , 随 时 准 备 提 供 紧 急 支 援 。
这 次 经 历 让 林 宝 惠 明 白 考 取 优 异 成 绩
不 是 生 命 的 全 部 。“ 我 的 朋 友 说 我 现 在
变 得 更 加 开 朗 。 我 不 会 过 分 重 视 学 校 和
学 业 , 而 是 会 更 关 心 家 人 和 朋 友 。 有 很
多 跟 我 同 龄 的 人 都 认 为 如 果 他 们 在 学 业
上 的 表 现 不 理 想 , 他 们 就 完 了 。 我 想 告
诉 他 们 不 是 这 样 的 。”
“ 生 命 难 以 预 测 , 你 要 珍 惜 每 一 分 每
一 秒 。”
活 着 真 好
42 岁 的 保 健 业 行 政 人 员 符 先 生 是 另 一
个 被 ECMO 团 队 救 活 的 病 人 。
他 在 吃 午 餐 后 开 车 回 公 司 途 中 突
然 心 脏 病 发 作 。 他 放 慢 车 速 , 慢 慢
地 把 车 驾 回 公 司 。 他 说 :“ 我 呼 吸 急
促 , 而 且 不 停 地 冒 冷 汗 , 也 很 想 吐 。
倒 退 泊 车 变 得 很 困 难 , 当 时 我 知 道 自
己 心 脏 病 发 作 。”
当 他 的 疼 痛 纾 缓 后 , 他 走 进 公
司 召 开 会 议 , 并 告 诉 惊 愕 的 同 事 们
说 :“ 我 必 须 先 离 开 , 我 心 脏 病 发
作 。” 一 个 同 事 开 车 送 他 回 家 , 之
后 再 送 他 到 邻 近 医 院 的 急 诊 室 。 隔
天 , 当 医 护 人 员 在 他 的 左 大 动 脉 进 行
支 架 置 入 术 时 , 他 的 心 脏 突 然 停 止 跳
动 。 他 们 替 他 进 行 心 肺 复 苏 和 使 用 去
纤 颤 器 , 但 一 个 小 时 后 , 他 们 决 定 寻
求 ECMO 团 队 的 支 援 。
跟 ECMO 团 队 一 起 赶 到 医 院 的 新 加
坡 国 家 心 脏 中 心 高 级 顾 问 医 生 陈 廷 毅
说 :“ 当 时 的 情 况 十 分 危 急 。”
医 护 人 员 立 刻 使 用 ECMO 仪 器 来 抢
救 符 先 生 , 并 把 他 转 到 新 加 坡 国 家 心
脏 中 心 做 进 一 步 治 疗 。 由 于 他 的 右
大 动 脉 也 阻 塞 , 因 此 医 生 一 边 使 用
ECMO 仪 器 , 一 边 置 入 另 一 个 支 架 重
新 撑 开 右 大 动 脉 。
陈 廷 毅 医 生 和 其 团 队 利 用 体 外 膜 式 氧 合 器
抢 救 心 脏 病 爆 发 的 符 先 生 。 他 们 一 边 使 用
该 仪 器 , 一 边 重 新 撑 开 阻 塞 的 大 动 脉 。
靠 ECMO 仪 器 和 药 物 镇 静 过 了 五 天
后 , 符 先 生 才 完 全 恢 复 知 觉 。 出 院 后
三 个 月 , 他 做 了 心 脏 绕 道 手 术 , 解 决
另 一 条 动 脉 阻 塞 的 问 题 。
符 先 生 从 小 就 患 上 一 种 称 为 家 族
性 高 胆 固 醇 血 症 的 遗 传 病 , 所 以 他 每
年 都 得 进 行 血 压 和 胆 固 醇 检 查 , 并 且
定 时 运 动 和 控 制 饮 食 。 心 脏 病 发 作 前
两 个 月 , 他 感 到 胸 痛 , 但 休 息 后 就 纾
缓 了 。 这 次 心 脏 病 发 作 让 他 措 手 不 及 。
他 说 :“ 我 事 后 才 了 解 , 胸 痛 的 时 候
就 应 该 马 上 去 看 医 生 。”
这 些 日 子 , 他 更 加 注 意 自 己 的 状
况 和 保 持 心 情 平 衡 。 他 服 用 药 物 控
制 胆 固 醇 水 平 , 而 且 继 续 定 时 做 运
动 。“ 我 在 学 习 放 慢 脚 步 和 更 加 注
意 自 己 的 健 康 。 这 是 我 现 在 最 重 要 的
事 情 。”

Jul⁄ Aug 2011 新 脉 动 29
观 点
施 予 第 二 次 机 会
器 官 捐 献 常 态 化 给 了 许 多 等 待 踏 上 新 生 命 旅 程 的 新 加 坡 人 一 线 新 希 望
文 黄 平 仁 教 授
起 源 于 1818 年 , 有 人 第 一 次 把 “ 移 植
法 ” 描 述 为 “ 将 人 体 细 胞 以 输 血 方 式
从 一 个 人 的 身 上 输 送 到 另 一 个 人 的 身
上 ”。 其 次 在 1905 年 , 眼 角 膜 细 胞 成
了 第 二 个 能 被 移 植 的 人 体 组 织 。 直 到
1945 年 , 器 官 移 植 手 术 首 次 在 美 国 波 士
顿 成 功 地 在 一 对 双 胞 胎 之 间 进 行 肾 脏 移
植 。 相 隔 八 年 后 , 当 医 学 界 对 人 体 免 疫
系 统 有 了 更 深 的 了 解 及 发 现 了 免 疫 抑 制
治 疗 后 , 才 首 次 成 功 地 把 遗 体 的 肾 脏 移
植 到 活 人 体 内 。
从 那 时 起 , 许 多 的 ‘ 第 一 次 ’
接 踵 而 来 — 肺 部 (1963 年 )、 胰 脏
(1966 年 )、 肝 脏 (1967 年 )、 心 脏
(1967 年 )、 骨 髓 (1973 年 )、 小 肠
(1988 年 ), 到 目 前 的 多 器 官 移 植 。 沿
着 上 述 进 展 , 人 们 对 人 体 组 织 分 类 和 免
疫 学 日 益 了 解 也 使 我 们 成 功 地 开 发 免 疫
抑 制 剂 。
在 获 得 诺 贝 尔 医 学 奖 的 得 主 当 中 有
不 少 是 移 植 手 术 的 专 才 , 他 们 包 括 因 在
器 官 移 植 手 术 技 术 领 域 的 先 锋 工 作 而 得
奖 的 卡 雷 尔 (1912 年 )、 因 免 疫 系 统
相 关 工 作 而 得 奖 的 多 塞 特 、 斯 内 尔 以
及 贝 纳 塞 拉 夫 ( 1 9 8 0 年 ) 、 因 免 疫
抑 制 疗 法 得 奖 的 希 青 、 埃 利 恩 和 布 拉 克
(1988 年 )、 以 及 成 功 完 成 人 类 首 个 肾
脏 移 植 的 默 里 和 首 个 成 功 完 成 骨 髓 移 植
手 术 的 汤 姆 斯 (1990 年 )。 这 充 分 肯 定
了 器 官 移 植 手 术 对 于 改 善 人 类 生 活 所 作
出 的 重 大 贡 献 。
在 本 地
在 1970 年 , 我 们 见 证 了 首 起 肾 脏 移 植 手
术 的 成 功 。 于 1990 年 , 便 开 始 进 行 心 脏
和 肝 脏 移 植 , 直 到 2000 年 的 肺 部 移 植 手
术 。 为 了 解 决 人 们 死 后 不 愿 意 捐 献 器 官
而 导 致 可 移 植 的 肾 脏 短 缺 问 题 , 国 会 在
1987 年 通 过 了 一 项 人 体 器 官 移 植 法 令 ,
以 假 定 和 自 愿 同 意 为 基 础 ; 如 果 国 人 不
表 明 自 己 拒 绝 在 死 后 捐 献 肾 脏 , 他 将 被
视 为 自 愿 捐 出 遗 体 内 的 肾 脏 。 在 这 项 法
令 生 效 后 , 遗 体 肾 脏 移 植 率 有 了 显 著 的
提 高 , 从 1979 年 至 1987 年 之 间 每 年 的
4.7 起 已 增 加 到 1988 年 至 2004 年 之 间 每
年 的 40.8 起 。
由 于 眼 角 膜 、 肝 脏 和 心 脏 也 同 样 面 对
捐 献 者 短 缺 的 问 题 , 人 体 器 官 移 植 法 令
在 2004 年 1 月 6 日 修 订 , 将 这 些 器 官 都 列
入 在 内 。 自 2009 年 11 月 1 日 起 , 人 体 器
官 捐 献 法 令 为 了 进 一 步 扩 大 捐 献 者 的 人
数 而 再 次 修 正 。 除 非 个 别 选 择 退 出 捐 献
计 划 , 所 有 21 岁 以 上 、 心 理 健 康 健 全 的
新 加 坡 公 民 和 永 久 居 民 都 受 法 令 约 束 。
人 体 器 官 移 植 法 令 足 以 解 决 我 国 移
植 器 官 的 需 要 吗 ? 在 新 加 坡 , 每 年 都
有 近 500 名 病 人 在 等 待 获 得 器 官 移 植 ,
但 他 们 当 中 有 很 多 人 都 等 不 到 手 术 的
那 一 天 。
心 脏 、 肺 部 和 肾 脏 需 要 在 数 小 时 内 被 移 植 到 受 益 者 体 内 , 但 其 他 器 官 如 眼 角 膜 和 皮 肤 则 可 储 存 备 用 。
新 加 坡 保 健 服 务 集 团 的 管 理 层 和 众 器 官 移 植 协 调 员 , 在 去 年 7 月 份 举 行 的 首 个 新 保 集 团 器 官 移 植 意 识
周 的 感 谢 会 上 合 影 。
使 用 活 体 捐 献 的 肾 脏 或 肝 脏 移 植 已
经 越 来 越 普 遍 。 然 而 , 要 在 一 个 健 康 的
人 身 上 开 刀 并 取 出 器 官 会 涉 及 一 定 的 风
险 和 道 德 争 议 , 因 此 , 它 不 能 完 全 取 代
遗 体 器 官 移 植 。 无 论 是 活 体 还 是 遗 体 器
官 移 植 , 要 满 足 国 人 的 需 要 , 两 者 是 一
样 重 要 的 。
人 体 组 织 和 器 官 的 捐 献
不 但 能 够 挽 救 生 命 , 也
是 一 个 人 能 给 予 另 一 个
人 最 伟 大 的 礼 物 。
在 推 行 人 体 器 官 移 植 法 令 的 过
程 中 , 新 加 坡 卫 生 部 展 开 了 一 项 名
为 “Live On” 的 意 识 运 动 , 以 鼓 励 人
们 在 死 后 捐 献 器 官 。 该 运 动 旨 在 成 为 一
项 以 支 持 器 官 捐 献 的 长 期 公 共 教 育 计
划 , 这 肯 定 是 值 得 支 持 与 赞 扬 的 。 虽
然 有 些 人 认 为 “ 除 非 选 择 退 出 , 否 则
视 为 同 意 ” 的 人 体 器 官 移 植 法 令 过 于
严 苛 , 但 也 改 变 不 了 人 体 器 官 和 组 织
确 实 能 挽 救 生 命 的 事 实 , 而 且 应 该 被
视 为 一 个 人 能 给 予 另 一 个 人 最 伟 大 的
礼 物 。“Live On” 希 望 可 以 推 广 这 样 的
观 念 。
为 人 民 服 务
新 加 坡 保 健 服 务 集 团 在 去 年 宣 布 , 为 了
提 供 更 完 善 的 病 人 护 理 和 治 疗 , 集 团 打
算 整 合 旗 下 所 有 的 器 官 移 植 计 划 并 设 立
综 合 移 植 服 务 中 心 , 旨 在 提 高 公 众 和 旗
下 医 疗 机 构 的 医 疗 护 理 人 员 对 器 官 移 植
的 认 知 。 我 们 以 口 号 “ 生 命 的 礼 物 、 希
望 的 源 头 ” 来 实 行 与 反 应 支 持 人 体 器 官
移 植 法 令 如 同 给 予 他 人 生 命 和 希 望 。
随 着 新 加 坡 朝 向 发 达 国 家 迈 进 , 新
加 坡 人 的 信 念 和 价 值 观 也 必 须 更 具 公 民
意 识 。 珍 惜 生 命 多 于 死 亡 是 关 键 。
15 年 前 , 当 我 在 澳 洲 一 个 肝 脏 移 植
单 位 工 作 时 , 我 发 现 当 地 人 行 善 的 文
化 素 养 很 强 , 以 致 每 个 人 都 认 为 捐 献
器 官 是 理 所 当 然 的 。 我 们 经 常 在 感 恩
仪 式 或 晚 宴 等 公 共 场 合 上 看 到 捐 献 者
一 家 人 当 众 被 表 扬 。 接 受 器 官 捐 献 的
病 人 和 他 们 的 家 属 也 会 非 常 坦 率 且 毫
无 保 留 地 表 达 他 们 被 给 予 机 会 而 获 得
重 生 的 感 激 之 情 。
去 年 , 新 加 坡 国 家 心 脏 中 心 主 办 了
一 个 感 谢 午 餐 会 , 庆 祝 心 脏 移 植 进 入 第
20 年 和 肺 部 移 植 进 入 第 10 年 。 在 餐 会
上 , 我 们 看 到 受 益 于 器 官 移 植 的 病 人
分 享 他 们 在 人 生 转 捩 点 上 的 经 验 , 并 由
衷 感 谢 医 护 团 队 , 尤 其 是 对 匿 名 的 捐 献
者 , 他 们 更 是 万 分 感 激 。
施 予 生 命
你 要 如 何 伸 出 援 手 ? 只 要 您 不 选 择 退 出
人 体 器 官 移 植 法 令 , 在 你 逝 世 后 , 你 的
肾 脏 、 心 脏 、 肝 脏 和 眼 角 膜 都 可 以 挽 救
一 条 生 命 。 你 也 可 以 在 医 疗 ( 治 疗 、 教
育 及 研 究 ) 法 令 下 , 主 动 表 示 愿 意 在 死
后 捐 出 人 体 器 官 移 植 法 令 所 没 有 涵 盖 的
器 官 。
心 脏 、 肺 部 和 肾 脏 必 须 在 数 小 时 内
从 捐 献 者 体 内 取 出 , 然 后 移 植 到 器 官 衰
竭 者 体 内 。 其 他 器 官 如 眼 角 膜 、 皮 肤 和
心 瓣 膜 则 可 被 储 存 到 需 要 时 才 使 用 。
在 新 加 坡 保 健 服 务 集 团 的 综 合 移 植
服 务 中 心 , 眼 角 膜 被 存 放 在 新 加 坡 全 国
眼 科 中 心 的 新 加 坡 眼 库 、 皮 肤 则 储 存 在
新 加 坡 中 央 医 院 的 皮 肤 组 织 库 , 用 来 帮
助 严 重 烧 伤 的 病 人 ; 而 心 瓣 膜 、 血 管 组
织 和 气 管 则 被 存 在 国 家 心 脏 中 心 的 全 国
心 血 管 移 植 片 存 库 。 此 外 , 新 加 坡 中 央
医 院 和 竹 脚 妇 幼 医 院 的 骨 髓 和 肝 细 胞 计
划 则 储 存 治 疗 用 的 血 液 。
最 后 , 让 我 简 洁 地 和 大 家 分 享 一 句
话 来 表 达 器 官 捐 赠 : 把 你 的 器 官 和 身 体
组 织 留 下 , 天 知 道 我 们 这 里 需 要 它 。
黄 平 仁 教 授 是 新 加 坡 中 央 医 院
外 科 手 术 组 处 长 , 掌 管 11 个 外
科 部 门 。 他 也 是 新 加 坡 国 立 癌
症 中 心 的 顾 问 。 黄 教 授 也 任 教
于 杜 克 — 新 加 坡 国 大 医 学 研 究
院 , 同 时 是 研 究 院 的 外 科 总 书
记 处 主 任 。

30 新 脉 动 Jul⁄ Aug 2011
新 闻
致 命 剂 量
你 真 的 知 道 自 己 给 孩 子 吃 了
什 么 药 吗 ?
原 文 Jessica Jaganathan
澳 大 利 亚 调 查 人 员 发 现 , 将 近 一 半 的 受
访 家 长 给 孩 子 服 用 常 见 非 处 方 药 的 剂 量
可 能 有 误 , 使 孩 子 的 健 康 , 甚 至 生 命 受
到 威 胁 。
虽 然 新 加 坡 家 长 在 给 孩 子 服 用 这 类
药 物 时 相 对 来 很 小 心 , 但 服 用 过 量 的 扑
热 息 痛 (paracetamol) 依 然 是 竹 脚 妇 幼
医 院 急 诊 室 三 大 最 常 见 与 药 物 相 关 的 急
诊 之 一 。
竹 脚 妇 幼 医 院 急 诊 科 主 任 兼 高 级 顾
问 黄 纪 铳 副 教 授 说 , 除 了 扑 热 息 痛 , 其
他 常 见 用 错 剂 量 的 药 物 包 括 退 烧 用 的 依
布 洛 芬 (ibuprofen), 以 及 止 咳 和 伤 风
的 药 物 。
同 是 卫 生 部 毒 理 学 指 引 委 员 会 成 员
兼 联 合 主 席 的 黄 副 教 授 说 :“ 非 处 方 药
物 都 必 须 得 到 监 管 机 构 如 卫 生 科 学 局 的
批 准 , 如 果 遵 照 指 示
服 用 , 基 本 上 是 相 对 安
全 的 。”
不 过 , 海 外 研 究 显 示 ,
指 示 不 清 楚 依 然 是 用 药 错
误 的 主 要 原 因 之 一 。 其 他
原 因 包 括 缺 乏 分 配 器 和 测
量 单 位 不 同 。
黄 副 教 授 说 : “ 此
外 , 孩 子 会 长 大 , 适 合 孩
子 年 幼 时 期 的 剂 量 , 会 随
着 他 年 龄 增 长 和 体 重 增 加 而
变 得 无 效 。”
抗 精 神 病 药 物
安 神 药
口 服 降 血 糖 药
抗 糖 尿 病 药
茶 碱
治 疗 呼 吸 系 统 疾 病
( 如 哮 喘 ) 的 药
家 长 可 选 定 其 中 一 人 专 门 负 责 喂 食
药 物 , 以 预 防 孩 子 服 用 过 量 药 物 。
黄 副 教 授 说 :“ 要 不 然 , 人 多 反 而
误 事 。”
同 时 给 孩 子 服 用 不 同 药 物 也 可 能 会
不 小 心 造 成 用 药 过 量 , 所 以 家 长 应 检 查
并 确 保 药 物 不 含 有 相 同 的 活 性 成 分 。
服 用 更 多 不 一 定 更 好 。 黄 副 教 授
说 :“ 口 服 药 物 通 常 需 要 大 约 30 分 钟 至
一 个 小 时 来 发 挥 作 用 。 服 用 更 多 不 会 使
药 效 发 挥 更 快 。”
潜 在 的 副 作 用 会 随 着 服 用 剂 量 和 药
物 种 类 而 有 所 不 同 。 黄 副 教 授 举 例 说
明 , 若 服 用 过 量 的 止 伤 风 或 止 咳 药 水 ,
水 杨 酸 甲 酯
见 于 冬 青 油 和
舒 缓 肌 肉 疼 痛
的 产 品
樟 脑
像 糖 果 一 样 包 装 的
纯 樟 脑 块 可 在 印 度
店 铺 找 到 , 供 宗 教
燃 烧 之 用
一 茶 匙 或 一 片 剂 的 下 列 药 物 足 以 让 一 岁 儿 童 致 命 。
副 作 用 会 在 四 到 六 个 小 时 内 发 作 ; 若 服
用 过 量 的 扑 热 息 痛 , 肝 功 能 衰 竭 会 在 两
至 三 天 后 才 发 生 。
如 果 不 小 心 用 药 过 量 , 应 尽 快 送 孩
子 入 院 。 首 先 , 医 生 将 确 保 孩 子 的 脉
搏 、 呼 吸 和 血 液 循 环 稳 定 , 以 及 呼 吸 道
畅 通 。
然 后 , 医 生 将 替 孩 子 洗 胃 、 催 吐 或
给 他 口 服 活 性 炭 , 以 减 少 身 体 对 药 物 的
吸 收 。 如 果 药 效 已 渗 入 血 液 , 医 生 将 给
孩 子 服 用 解 毒 剂 。
黄 副 教 授 说 , 家 长 在 购 买 药 物 给
孩 子 时 , 如 有 任 何 疑 问 , 应 先 咨 询 药
剂 师 。
抗 心 律 失 常 药
治 疗 心 律 不 齐 的 药
钙 通 道 阻 滞 剂
治 疗 疾 病 如 高
血 压
麻 醉 剂
成 瘾 性 药 物 , 能 舒
缓 疼 痛 和 通 常 用 来
促 进 睡 眠
抗 疟 药
治 疗 疟 疾 的 药
抗 抑 郁 药
避 免 让 儿 童 接 触
有 些 药 物 , 主 要 是 处 方 药 , 对 年 幼
孩 子 来 说 是 有 毒 的 。
竹 脚 妇 幼 医 院 急 诊 科 主 任 兼 高
级 顾 问 黄 纪 铳 副 教 授 说 :“ 我 们 在
急 诊 室 看 过 很 小 的 婴 儿 服 用 如 扑 尔
敏 (chlorpheniramine, 一 种 抗 组
胺 药 ) 的 感 冒 药 后 出 现 间 歇 性 呼 吸
( 也 就 是 呼 吸 暂 停 )。”
一 段 经 历 , 两 个 故 事
一 个 病 人 和 他 的 妻 子 述 说 他 们 俩 如 何 互 相 扶 持 , 为 肝 脏 移 植 手 术 做 好 准 备
原 文 Thava Rani
他 的 故 事
虽 然 知 道 肝 硬 化 很 有 可 能 会 演 变 成 肝
癌 , 但 被 医 生 确 诊 患 上 肝 癌 时 , 安 东 尼
仍 然 感 到 很 震 惊 。 医 生 告 诉 他 , 肝 脏 移
植 手 术 是 他 最 好 的 选 择 。
71 岁 的 安 东 尼 说 :“ 我 尽 我 所 能 维
持 身 体 健 康 , 也 彻 底 改 变 我 的 饮 食 习
惯 。 我 的 太 太 布 丽 姬 特 为 了 配 合 我 , 也
舍 弃 她 最 爱 的 肉 食 。 她 花 了 很 多 时 间 设
计 出 一 道 道 以 鱼 类 为 主 的 创 新 料 理 , 以
及 选 用 松 软 芝 士 和 亚 麻 籽 油 来 准 备 新 鲜
的 沙 拉 。”
在 等 待 新 肝 脏 的 同 时 , 安 东 尼 也 接
受 治 疗 以 免 癌 症 恶 化 。 这 个 过 程 很 辛
苦 , 让 他 精 疲 力 竭 。
曾 经 是 卡 丁 车 发 烧 友 , 安 东 尼 发 现
自 己 比 以 前 需 要 更 多 的 睡 眠 , 甚 至 没 有
多 余 的 精 力 陪 孙 子 们 玩 。 因 此 他 感 到 非
常 沮 丧 。
音 乐 和 心 灵 书 籍 让 他 拥 有 力 量 忍 受
痛 苦 。 他 尽 量 保 持 心 情 开 朗 , 让 每 一 天
过 得 有 意 义 。
他 说 :“ 我 觉 得 知 足 常 乐 让 我 的 生
活 改 变 不 少 。 如 果 我 真 的 离 开 这 个 世
界 , 至 少 我 跟 太 太 和 孩 子 们 都 度 过 了 美
好 的 时 光 。”
在 等 待 器 官 捐 赠 者 时 , 他 的 次 子 艾
伦 决 定 捐 出 他 的 部 分 肝 脏 。
艾 伦 暗 中 跟 器 官 移 植 小 组 进 行 讨 论
安 东 尼 和 他 的 太 太 布 丽 姬 特 正 打 算 接 受 他 们 儿 子
的 建 议 时 , 就 接 到 器 官 移 植 协 调 员 的 好 消 息 。
还 做 了 一 些 必 要 的 检 查 。
安 东 尼 起 初 不 愿 意 接 受 儿 子 的 肝
脏 。 可 是 ,10 个 月 后 仍 等 不 到 好 消 息
时 , 他 决 定 接 受 儿 子 的 捐 赠 。 当 他 要 告
诉 儿 子 他 的 决 定 时 , 电 话 便 响 起 来 了 。
安 东 尼 说 :“ 那 就 像 是 一 通 由 天 使
打 来 的 电 话 。 器 官 移 植 协 调 员 李 慧 玲 通
知 我 说 他 们 有 个 适 合 我 的 肝 脏 , 但 我 必
须 在 一 小 时 内 到 达 医 院 。”
在 等 着 被 推 进 手 术 室 时 , 安 东 尼
说 :“ 那 时 , 我 还 是 有 点 担 心 我 的 身
体 是 否 会 排 斥 新 肝 脏 , 但 结 果 非 常 理
想 。”
动 手 术 至 今 已 过 了 一 年 半 , 安 东 尼
每 天 早 上 起 床 都 心 存 感 恩 。 他 每 天 都 在
图 :101teamwork
祈 祷 , 感 谢 逝 世 的 肝 脏 捐 赠 者 , 以 及 家
人 的 爱 和 支 持 。
安 东 尼 说 :“ 我 真 的 很 幸 福 。 布 丽
姬 特 乐 观 的 态 度 和 活 泼 的 个 性 成 了 我 继
续 走 下 去 的 动 力 。 虽 然 我 的 儿 子 们 生 活
忙 碌 , 但 他 们 每 个 周 末 还 是 会 带 着 一 家
大 小 来 看 我 。 当 布 丽 姬 特 不 在 时 , 我 的
儿 媳 妇 会 帮 忙 照 顾 我 。 在 那 段 黑 暗 的 时
期 , 我 感 受 到 我 的 孩 子 们 给 予 我 的 无 限
支 持 。”
她 的 故 事
布 丽 姬 特 在 柬 埔 寨 经 营 家 族 生 意 。 当 她
丈 夫 打 电 话 告 诉 她 他 得 了 癌 症 时 , 她 感
觉 有 如 心 在 淌 血 。
曾 经 担 任 人 力 资 源 顾 问 的 布 丽 姬 特
(63 岁 ) 说 :“ 当 时 我 最 忧 心 的 是 我 不
在 他 身 边 。 因 为 以 前 每 当 发 生 不 好 的 事
情 时 , 我 总 会 陪 在 他 身 旁 。”
在 接 下 来 的 几 个 月 里 , 为 了 可 以 陪
伴 丈 夫 , 布 丽 姬 特 不 断 地 往 返 新 加 坡 和
柬 埔 寨 两 地 。 她 没 有 刻 意 削 减 她 的 合 唱
团 和 教 会 活 动 , 因 为 布 丽 姬 特 相 信 照 常
生 活 可 让 安 东 尼 保 持 精 神 振 奋 。 更 重 要
的 是 , 她 得 保 持 心 情 开 朗 , 因 为 她 不 希
望 丈 夫 担 心 她 。
尽 管 如 此 , 她 还 是 经 常 感 到 困 扰 。
布 丽 姬 特 说 :“ 每 次 他 接 受 治 疗 后 , 他
的 脾 气 就 会 变 得 很 暴 躁 , 这 也 造 就 了 我
保 持 理 智 的 一 大 挑 战 。 所 以 每 次 回 去 柬
埔 寨 都 能 让 我 暂 时 摆 脱 这 个 状 况 。 这 真
的 对 我 有 很 大 的 帮 助 。”
他 们 的 次 子 艾 伦 是 家 里 唯 一 适 合 捐
赠 肝 脏 给 安 东 尼 的 人 。 不 过 , 当 他 建 议
捐 出 部 分 的 肝 脏 时 , 布 丽 姬 特 却 表 示 不
赞 成 。 因 为 他 还 年 轻 , 有 太 太 和 两 个 孩
子 , 而 且 第 三 个 孩 子 即 将 出 世 。
她 说 :“ 很 多 事 情 都 可 能 出 错 。 或
许 真 的 会 没 事 , 但 风 险 还 是 太 大 了 。 连
我 们 的 长 子 也 游 说 我 们 接 受 他 的 一 番 好
意 。 他 向 我 们 保 证 , 万 一 发 生 了 什 么 事
情 , 他 会 负 责 照 顾 弟 弟 的 家 人 。”
在 一 次 的 肝 脏 互 助 小 组 聚 会 , 一 名
病 人 分 享 他 曾 接 受 他 妹 妹 的 肝 脏 , 那 时
她 还 是 一 位 年 轻 妈 妈 。 这 段 经 历 成 了 转
折 点 , 让 他 们 重 新 考 虑 儿 子 的 建 议 。
布 丽 姬 特 乐 观 的 态 度 和
活 泼 的 个 性 成 了 我 继 续
走 下 去 的 动 力 。
安 东 尼
有 幸 的 是 , 安 东 尼 不 需 要 接 受 儿 子
的 捐 献 。
如 今 , 他 们 的 生 活 已 找 到 新 的 规
律 。 虽 然 有 些 改 变 令 人 难 以 适 应 , 例 如
安 东 尼 的 余 生 都 得 服 用 大 量 的 药 物 , 以
及 不 能 吃 生 食 , 只 能 吃 熟 食 。 要 是 安 东
尼 因 吃 生 食 而 患 上 A 型 肝 炎 , 他 的 免 疫
系 统 将 无 法 抵 抗 感 染 。 这 些 改 变 对 安 东
尼 来 说 只 不 过 是 很 小 的 代 价 。
布 丽 姬 特 看 到 一 家 人 的 关 系 更 为 密
切 , 感 到 非 常 高 兴 。

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