Better Health 28 ENG

The magazine for patients and friends of Bumrungrad International Hospital, Thailand. The magazine for patients and friends of Bumrungrad International Hospital, Thailand.

W e l c o m e<br />

Welcome to<br />

, the magazine <br />

for patients and friends of Bumrungrad <br />

International Hospital.<br />

The brain is the body’s most important and<br />

omplex organ. It is responsible for every aspect <br />

and activity of everyday living. This issue of <br />

focuses special attention on the most<br />

serious threats to brain health. <br />

Brain disorders including dementia, Alzheimer’s<br />

disease, Parkinson’s disease and stroke cause <br />

tremendous loss of life and permanent disability. <br />

Becoming aware of one’s personal risk factors, <br />

and understanding the importance of earlier <br />

diagnosis and treatment, can help prevent brain <br />

disorders and reduce their severity if they occur. <br />

Beginning on page 4, our feature on dementia <br />

and Alzheimer’s updates readers on progress in <br />

diagnosing and treating these serious disorders, <br />

and offers expert advice for caregivers and loved <br />

ones providing critical support to patients. <br />

Stroke is among the world’s leading causes of <br />

death. Hemorrhagic stroke, also called cerebral <br />

aneurysm, is the type of stroke that causes bleeding<br />

in the brain. Our feature on page 8 briefs readers<br />

on what they should know to prevent them, and <br />

what to do if a stroke occurs. <br />

On page 22, we focus on Parkinson’s disease <br />

and recent progress in treating the widespread <br />

condition, and how the right kind of care is giving<br />

a major boost to patients’ quality of life.<br />

As always, we welcome your feedback, ideas <br />

and comments about<br />

. Please feel <br />

free to e-mail us at betterhealth@bumrungrad.com.<br />

We look forward to hearing from you, and here’s <br />

wishing you better health.<br />

<br />

<br />

<br />

<br />

Dr. Jitra Anuras<br />

Senior-Associate <br />

Medical Director<br />

C o n t e n t s<br />

4 Dementia & Alzheimer’s <br />

Helping patients and caregivers<br />

8 Cerebral Aneurysm<br />

What you should know about<br />

hemorrhagic stroke<br />

12 Q&A<br />

14 Epilepsy<br />

Helping parents & kids tackle <br />

the challenges of epilepsy<br />

18 <strong>Health</strong> Briefs<br />

20 M.D. Focus<br />

Get to know our doctors<br />

22 Parkinson’s Disease<br />

The case for earlier detection<br />

26 News from Bumrungrad International<br />

4 14 22<br />

<strong>Better</strong> <strong>Health</strong> magazine is published by Bumrungrad Hospital Public Company Limited and is produced <br />

for Bumrungrad Hospital Public Company Limited by Oakins and Stone Limited, 16 Asoke Court,<br />

Suite 2-A, Sukhumvit 21 Road (Asoke), Klongtoey-nua, Wattana, Bangkok 10110. Tel: +66 (0) 2261 1211<br />

Fax: +66 (0) 2261 1213. www.oakinsandstone.com<br />

No part of this magazine may be reproduced without the written permission of Bumrungrad Hospital <br />

Public Company Limited. 2013 by Bumrungrad Hospital Public Company Limited. All rights reserved. <br />

Publication of advertisements or sponsorships shall not constitute an endorsement by Bumrungrad <br />

Hospital Public Company Limited of the products or services promoted, of the company or organization,<br />

nor of the claims made.<br />

Telephone:<br />

Facsimile:<br />

Out-patient<br />

appointment:<br />

Website:<br />

66 (0) 2667 1000<br />

66 (0) 2667 2525<br />

66 (0) 2667 1555<br />

www.bumrungrad.com


BONE MYTHS & TRUTHS<br />

Busting the myths<br />

about bones and joints<br />

Many widely-held beliefs about bone and joint <br />

health turn out to be falsehoods or half-truths. <br />

Here’s a look at some of the popular myths, <br />

and the facts that prove them wrong.<br />

We live in an age of free-flowing information that <br />

comes at the click of a mouse. That’s a good thing <br />

for the most part, but it sometimes adds to the <br />

challenge of separating the truth from everything else. <br />

A look at the facts will demonstrate that some of the <br />

most widely-believed myths simply aren’t true. <br />

<br />

A bone fracture is less serious<br />

than a broken bone <br />

Many people believe that a bone fracture is a less <br />

serious event than a broken bone. In reality, the <br />

two are identical. Severe fractures can result in a <br />

bone breaking up into two or more separate pieces. Minor <br />

fractures involve a crack in a bone that remains intact, <br />

sometimes called a hairline fracture.<br />

The types and degrees of fractures are numerous, but<br />

each and every one involves a bone that has been broken<br />

and should be examined by a doctor to assess the damage<br />

and repair the break. <br />

<br />

After bones are fully developed,<br />

they don’t change<br />

The model skeletons that helped us learn as kids <br />

never changed, but for real fully-grown adults, <br />

bones have the capacity to change throughout <br />

our lives. Their ever-changing nature can be attributed to <br />

osteoblasts, the cells responsible for generating bone mass. <br />

Osteoblasts react when bones come under stress. They <br />

help boost bone strength to counter the stress, especially <br />

in and around the joints where the stress is concentrated. <br />

Weight-bearing exercise such as moderate jogging is an <br />

effective way to help stimulate bone production. This helps <br />

lower the risk of osteoporosis and promotes faster recovery<br />

for patients with osteoporosis-related problems.<br />

<br />

Osteoporosis is a painful<br />

bone condition<br />

Osteoporosis is a disease that causes loss of <br />

bone mass. But unless a bone has fractured, <br />

osteoporosis doesn’t cause pain. <br />

Osteoporosis can go undetected for years. Without causing<br />

any noticeable symptoms, it gradually eats away at bones. <br />

Detecting osteoporosis is done using a bone densitometry <br />

scan – a test advised for adults beginning at age 40. The <br />

scan is an important element in osteoporosis prevention <br />

and earlier detection. <br />

<br />

Arthritis is a disease for old people<br />

While our arthritis risk increases as we age, <br />

seniors don’t have a monopoly on the disease.<br />

This painful joint condition can strike children,<br />

teenagers and adults of all ages. <br />

It’s true that arthritis can result from the gradual deter-<br />

ioration of joints after years of over-use and wear-and-tear.<br />

But arthritis has many types and multiple causes –<br />

rheumatoid arthritis, gout, psoriatic arthritis, accidents,<br />

infections, etc. – none of which discriminate based on age.<br />

<br />

People with arthritis have<br />

to stop doing . . .<br />

Arthritis patients can encounter challenges<br />

carrying on some of their normal activities, but<br />

treating them as helpless or powerless is not<br />

the answer. <br />

The best way to care for someone with arthritis is give <br />

attentive care. Avoid being over-protective so as not to <br />

encourage the patient becoming too<br />

dependent – a situation that<br />

can affect the physical<br />

and mental well-<br />

being of patients<br />

and caretakers<br />

alike.


CEREBRAL ANEURYSM<br />

Cerebral Aneurysm: What you should<br />

know about hemorrhagic stroke<br />

Each year, cerebral aneurysms cause death and permanent damage to <br />

millions around the world. Here’s what you should know about the<br />

causes of hemorrhagic stroke, and what to do when a stroke occurs.<br />

It’s difficult to overstate the magnitude of the global threat:<br />

According to the World Stroke Organization (WSO), <br />

nearly 15 million people worldwide suffered a stroke <br />

last year, and half of them didn’t survive. Stroke and other <br />

types of cerebrovascular disease continue to rank at or near<br />

the top of the world’s leading causes of death and disability.<br />

Most people have a basic understanding of strokes,<br />

and many have lost loved ones to stroke. Fortunately,<br />

significant progress has been made in stroke diagnosis,<br />

treatment and prevention; patients now have a better<br />

chance of surviving a stroke, and there are better <br />

ways to limits its damaging effects.<br />

Unlike the more common ischemic stroke, which <br />

involves a clot or blockage, hemorrhagic stroke – also<br />

called cerebral aneurysm or brain aneurysm – results<br />

from the dilation or thinning of the wall of an artery <br />

or blood vessel in the brain that eventually tears or <br />

ruptures, allowing blood to flow into the brain. <br />

<br />

The nature of the threat <br />

Cerebral aneurysms are caused by an abnormal <br />

thinning of the wall of a blood vessel or artery carrying<br />

blood to the brain. The normal flow of blood through<br />

the body’s circulatory system exerts constant pressure<br />

on blood vessels – even more so when the patient <br />

has high blood pressure or hypertension. A blood <br />

vessel already weakened by thinning of its wall is<br />

at risk of developing a <br />

balloon-like bulge susceptible <br />

to tearing or rupturing,<br />

an event that can cause<br />

severe brain damage<br />

or even death. <br />

<br />

“We can try to identity a probable cause for a cerebral <br />

aneurysm, but it’s difficult to know precisely why some <br />

areas of the arterial wall are thinner than others,” explains<br />

Dr. Somkiet Siriwimonmas, a neuroradiologist at Bumrungrad.<br />

“It can be due to a congenital abnormality or the consequence<br />

of another disease. While Thailand doesn’t compile statistics<br />

on cerebral aneurysm, it is estimated that the condition is <br />

present in about two percent of the population.”<br />

According to Dr. Somkiet, there are a number of aspects<br />

“ It’s impossible to <br />

determine when the <br />

aneurysm might rupture;<br />

there won’t be any <br />

symptoms to alert the <br />

patient of the potential <br />

threat.”<br />

Dr. Somkiet Siriwimonmas<br />

that add to the medical challenges of dealing with cerebral <br />

aneurysm: It’s impossible to determine when the aneurysm<br />

might rupture; most patients don’t know that they have an <br />

aneurysm; and so long as the blood vessel or artery doesn’t<br />

rupture, there won’t be any symptoms to alert the patient <br />

of the potential threat. <br />

<br />

Accidental detection<br />

Detecting the presence of an aneurysm is often a case of <br />

coincidence or chance. “Detection tends to occur in one of<br />

three scenarios,” notes Dr. Somkiet. “The aneurysm may be<br />

spotted by coincidence when a patient undergoes a CT scan<br />

or MRI while being diagnosed for an unrelated condition; <br />

sometimes it’s found after a patient experiences symptoms <br />

resulting from the aneurysm causing compression of certain<br />

areas of the brain; or it is discovered when the patient has <br />

been admitted after suffering an actual stroke.”<br />

The threat of cerebral aneurysm can feel especially <br />

ominous due to the reality that it cannot be prevented.<br />

Dr. Somkiet points out that while the danger has been <br />

described as a time bomb ticking away inside the


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“ If ever you get a <br />

headache unlike any <br />

you’ve had before,<br />

get to a doctor <br />

immediately.”<br />

Dr. Roekchai Tulyapronchote<br />

head, “there’s no widely-used screening test to detect the <br />

condition, and the methods that are capable of aneurysm <br />

detection require expensive equipment, making their <br />

widespread use impractical. Even with advanced testing, <br />

it’s not possible to predict if or when an aneurysm will <br />

eventually rupture,” Dr. Somkiet adds. “Not all aneurysms <br />

end up causing strokes.” <br />

<br />

When to treat?<br />

Dr. Somkiet notes the distinction between patients who <br />

have suffered a ruptured cerebral aneurysm and those whose<br />

aneurysm has not yet ruptured. “If a cerebral aneurysm <br />

ruptures, it’s critical for the patient to get medical attention<br />

as quickly as possible,” he explains. “For patients who have<br />

an aneurysm that has been detected by coincidence but <br />

hasn’t ruptured, doctors must determine if there is a high <br />

risk of rupture, and whether the aneurysm is located in an <br />

area prone to more severe damage if a rupture occurred.”<br />

Dr. Somkiet continues: “The size of the aneurysm also<br />

must be considered; those larger than seven millimeters are<br />

classified as high risk. We typically recommend treatment <br />

for high-risk situations, while low-risk patients would <br />

typically be monitored frequently for changes in the shape <br />

or size of the aneurysm. In deciding whether to proceed <br />

with treatment, patients should thoroughly consider and <br />

compare the risks of having the treatment versus the inherent<br />

risk of not receiving any type of treatment.”<br />

There are several treatment methods that doctors consider<br />

for patients with cerebral aneurysms. One method employs<br />

a surgical technique to locate the aneurysm and attach a <br />

clip to the affected area. Another surgical treatment option <br />

involves the insertion of a catheter through the femoral <br />

artery into the aneurysm, followed by the packing of coils<br />

onto the affected site. Both methods share the<br />

same objective: to prevent the weakened area<br />

of the arterial wall from growing larger in size,<br />

thereby reducing the risk of a dangerous rupture. <br />

The suitability of each treatment depends<br />

on a number of factors that can vary from<br />

one patient to another. Every aneurysm<br />

has a unique set of disease characteristics. <br />

“Treatment recommendations must consider <br />

the aneurysm’s size and location, and the <br />

patient’s overall physical health must be <br />

factored into the decision,” says Dr. Somkiet. <br />

“Doctors must carefully consider each <br />

situation on a case-by-case basis.” <br />

<br />

Whether or not to treat<br />

One of the more vexing questions that arises<br />

after detection of a cerebral aneurysm is: If no<br />

one can know with certainty whether the aneurysm will <br />

actually rupture or not, is treatment truly necessary? <br />

To help find an answer,<br />

turned to Dr. Roekchai<br />

Tulyapronchote, a neurologist specializing in neurovascular<br />

diseases. “The treatment of cerebral aneurysm aims to <br />

reduce the chances of a future stroke because there is no <br />

Artery<br />

Catheter<br />

Balloon<br />

Stent Angioplasty<br />

Plaque<br />

Closed stent<br />

Expanded stent<br />

Stent<br />

Compressed plaque<br />

Different symptoms, same danger<br />

Not all strokes produce symptoms such as severe headaches, dizziness or loss of <br />

consciousness. Some stroke patients experience only a severe headache which <br />

eventually goes away – but the stroke was real. Twenty-five percent of first-time <br />

strokes are deadly; for second-time strokes, the fatality rate is significantly higher. <br />

10


way of knowing exactly when a stroke will occur, or what <br />

its effects will be,” says Dr. Roekchai. “Data from clinical <br />

research indicates that aneurysms larger than 7mm have<br />

a high probability of rupturing at any time, while those <br />

smaller than 7mm have a less than one percent chance of <br />

rupture – a very insignificant risk. <br />

“But doctors must be mindful of the fact that when <br />

aneurysms rupture, patient mortality rates are as high as <br />

50 percent. Even if they survive, they may face severe<br />

paresis or paralysis for life if treatment isn’t administered <br />

in a timely manner. Personally, I think those patients who <br />

know they have a cerebral aneurysm are fortunate and <br />

should seriously weigh the risks before deciding whether <br />

to undergo treatment or not.”<br />

Dr. Roekchai continues to treat numerous Thai and foreign<br />

patients with cerebral aneurysms and is constantly reminded<br />

of the serious impact that stroke has on a patient’s life. “No <br />

one can predict with certainty whether an aneurysm will <br />

rupture,” he notes, “or how severe the impact will be when <br />

a rupture occurs. For me personally, if I am fully aware of <br />

the risks for myself and have the opportunity to reduce <br />

those risks, I would make that choice, as I have already <br />

been witness to many very serious cases.”<br />

<br />

Final points to ponder<br />

When an aneurysm ruptures, time is critical. “If patients <br />

get medical attention quickly, the potential damage to the <br />

brain can be minimized,” Dr. Roekchai explains, “and the <br />

risk of a stroke recurring is reduced.”<br />

Dr. Roekchai stresses the critical lesson that his many<br />

years’ as a doctor has taught him about stroke: “If ever<br />

you get a headache unlike any you’ve had before, get to a<br />

doctor immediately. We still see too many stroke patients<br />

who, because they looked and acted normally, neglected to<br />

seek medical treatment. Without being properly examined<br />

by a doctor, these patients have put themselves in greater<br />

danger of a second stroke, which is more deadly.” While <br />

that severe headache may turn out to be a harmless event <br />

and not a sign of stroke, the danger of a severe headache <br />

signifying stroke is too great to dismiss without having a <br />

doctor take a look just to be sure.<br />

These symptoms require urgent <br />

medical attention<br />

<br />

Severe headache unlike any before: Everyone has <br />

headaches from time to time. But the onset of a <br />

sudden severe headache unlike previous headaches <br />

requires urgent medical help. <br />

Other signs and symptoms: The simultaneous onset <br />

of a headache together with weakness of the limbs is <br />

a sign of a possible stroke. Urgent medical attention <br />

is necessary, even if the patient appears fine and is <br />

able to walk and talk normally.<br />

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WEIGHT MANAGEMENT<br />

Weight management<br />

key to avoiding<br />

obesity’s heavy toll<br />

As obesity rates continue rising, so does the number of people<br />

afflicted with health problems. Successful weight control<br />

requires a comprehensive weight management approach.<br />

The number of overweight and obese Thais is growing <br />

at an alarming rate. According to the latest figures <br />

from the Ministry of Public <strong>Health</strong>, in 2011 obesity grew <br />

at the fastest rate in a decade. <br />

Among Asia Pacific nations, Thailand now has the fifth<br />

highest obesity rate among people age 15 or older. If the <br />

current pace continues, the number of overweight and obese<br />

Thais – currently around 17 million – will grow by an <br />

additional four million every year. <br />

<br />

A complex issue<br />

Losing excess weight and maintaining a healthy weight<br />

involve much more than the numbers on a scale. The sheer<br />

volume of conflicting information and misinformation, <br />

aggressive marketing tactics, and people’s natural desire<br />

for fast, painless solutions, make it even more difficult to <br />

achieve a healthy body weight. <br />

To get a clearer understanding of the complex issues<br />

involved in weight loss and weight control,<br />

turned to a team of doctors from Bumrungrad’s Weight<br />

Management Center. <br />

<br />

The role of fat<br />

Dr. Chulaporn Roongpisuthipong, a US-board certified<br />

specialist in clinical nutrition,<br />

says the danger from obesity<br />

is related to the excessive<br />

amount of fat that accumulates<br />

over time. “Our weight comes<br />

from bones, muscle and fat;<br />

our health is threatened by<br />

the accumulation of body <br />

fat, especially around the<br />

stomach or belly.” she says <br />

Obesity is typically<br />

determined by the Body Mass<br />

Index (BMI), a calculation<br />

derived from a person’s<br />

height and weight. Over-<br />

weight is defined as a BMI<br />

Dr. Chulaporn Roongpisuthipong above 25, while obesity is a<br />

BMI above 30.<br />

But BMI’s utility also has limitations. “It’s true that BMI <br />

can be used to classify obese people with excessive levels <br />

of fat. But BMI will also classify bodybuilders, athletes <br />

and well-muscled people as being obese even though they <br />

have little fat and aren’t in danger of suffering any obesity-<br />

related health problems.”<br />

Dr. Chulaporn adds that BMI will be less useful for people<br />

with low levels of muscle mass but high levels of body<br />

fat – a group that would receive a normal BMI score yet <br />

be prone to obesity-related health problems. “These people<br />

don’t appear to be obese, and their poor health often comes<br />

as a surprise,” says Dr. Chulaporn. <br />

<br />

<strong>Health</strong>ier weight loss <br />

Dr. Nopawan Kittivat, a specialist in endocrinology, notes<br />

that obesity and overweight are chronic conditions that<br />

should be managed using an integrated approach. Such<br />

an approach would include modifications to diet and <br />

exercise habits. <br />

Doctors also need to consider the option of medication<br />

should diet and exercise fall short of achieving the desired<br />

results. “Lifestyle modification requires motivation and<br />

determination, but it pays off in long-term, lasting effective<br />

ness,” says Dr. Nopawan. “A person can lose a good amount<br />

of weight just by fasting for a<br />

couple days, but the results <br />

are merely temporary and the <br />

weight usually comes back.”<br />

That’s because the initial <br />

weight loss comes mainly from<br />

water and muscles. “In the<br />

long run,” Dr. Nopawan<br />

explains, “the patient will find<br />

it even harder to lose weight<br />

because they have less muscle<br />

than before.”<br />

<br />

Medication’s role<br />

Dr. Nopawan has spent many<br />

years helping obese patients<br />

who also have metabolic<br />

Dr. Nopawan Kittivat<br />

conditions like diabetes and<br />

hypertension. “When a patient’s obesity leads to health<br />

complications, a doctor would typically recommend<br />

medication to promote faster weight loss without causing<br />

additional harm to overall health,” he notes. “Changing<br />

habits sometimes isn’t always effective enough for these<br />

patients, and exercise will be more difficult as the obesity<br />

may be causing joint problems. Medication, therefore, is<br />

an important option to consider.” <br />

16


For these patients, close monitoring by their doctors is<br />

an essential element to prevent complications or side effects.<br />

“Treatment advances and new medical options may be<br />

introduced over the course of time,” Dr. Nopawan explains,<br />

“so it’s important for medical professionals to monitor<br />

developments closely as better treatment options become<br />

available.” <br />

<br />

Surgical treatments<br />

For patients having BMIs above 40 (i.e. those classified <br />

as morbidly obese), and for obese patients having serious <br />

health complications, faster weight loss is better weight loss. <br />

For this group in particular, if they don’t achieve the <br />

desire results from lifestyle modifications and prescription <br />

medication, the next step is to consider surgical treatment <br />

options including bariatric surgery and other weight-loss <br />

procedures. <br />

Bariatric surgery is a highly effective procedure with an <br />

impressive track record for reducing a morbidly-obese <br />

patient’s risk for future obesity-related health problems. <br />

“In deciding whether to recommend bariatric surgery, the <br />

main factors considered by the doctor are the patient’s BMI<br />

and his overall health condition,” explains Dr. Theerapol<br />

Angkoolpakdeekul, a laparoscopic surgery specialist. <br />

“Westerners with BMIs above 40 are classified as<br />

morbidly obese and are likely to benefit from bariatric<br />

surgery.” he says. “Surgery may be also be an option for a <br />

patient whose BMI is around 35, especially if the patient <br />

also has a chronic condition such as GERD, obstructive <br />

sleep apnea, diabetes or heart disease, or has a family <br />

history of coronary artery disease.” <br />

There are two main types of bariatric surgery. The first<br />

involves a surgical reduction in the size of the stomach that<br />

causes the patient to reduce the amount of food consumed.<br />

Stomach size is reduced through the use of gastric banding<br />

or by removing a portion of the stomach. <br />

The other type of bariatric surgery involves a combination<br />

of stomach resizing and restricting the amount of food <br />

The 5 rules for healthy<br />

weight control<br />

1. Choose healthier foods and maintain control over<br />

portion size.<br />

2. Make exercise a built-in part of your schedule.<br />

3. Maintain emotional balance and reduce stress<br />

and anxiety. <br />

4. Stay determined to change unhealthy habits.<br />

5. Make getting enough sleep a high priority.<br />

Did you know…?<br />

S<br />

ome fats are more dangerous than others. <br />

Among the most hazardous to health is <br />

visceral fat, the type that accumulates below <br />

the muscular layer around the belly and<br />

abdominal cavity, an area which includes the <br />

liver, kidneys and intestines. <br />

Excessive visceral fat is more likely to lead to <br />

health problems than subcutaneous fat, a type <br />

of fat that accumulates below the skin surface, <br />

especially around the hips and thighs.<br />

that’s digested. This surgery involves surgical removal of <br />

the stomach combined with a bypass procedure. <br />

“Years ago, bariatric surgery was a highly-invasive<br />

procedure that resulted in significant changes to a patient’s<br />

digestive system structure, and<br />

there were number of potential<br />

complications,” Dr. Theerapol<br />

explains. “The newer generation<br />

of procedures incorporates<br />

less-invasive laparoscopic<br />

technology, which causes less<br />

physical trauma and allows<br />

for a faster recovery.” <br />

<br />

Lasting success<br />

Post-surgery complications <br />

are minimal compared to the <br />

previous generation of surgeries.<br />

“Most patients go home after<br />

just a few days in the hospital,”<br />

notes Dr. Theerapol. “Research Dr. Theerapol Angkoolpakdeekul<br />

has shown that obese patients <br />

who undergo the weight-loss surgery are better able to <br />

control their weight over the long term.” <br />

Obesity is not an issue of aesthetics or physical appearance.<br />

It’s a medical condition and a ticking time bomb that lurks<br />

quietly and patiently before it eventually strikes hard. Getting<br />

your weight under control takes motivation and action. It<br />

also requires a doctor’s close supervision to ensure you lose<br />

the weight in a healthy way, and with the best chance for <br />

life-long success.<br />

18


HEALTH BRIEFS<br />

Higher blood clot risk for<br />

rheumatoid arthritis patients<br />

The findings of a Swedish research study suggest that <br />

patients with rheumatoid arthritis have a greater risk <br />

of blood clots during the decade after the disease is<br />

diagnosed. <br />

Results of the study, published recently in the Journal <br />

of the American Medical Association, are consistent with <br />

earlier studies showing rheumatoid arthritis patients <br />

were at higher risk of blood clots in <br />

the legs, a condition known as <br />

deep vein thrombosis (DVT) <br />

or economy class syndrome. <br />

These and other types of <br />

clots can cause strokes and <br />

heart attacks. <br />

The onset of rheumatoid <br />

arthritis typically occurs in <br />

adults between 25 and 55 <br />

years of age. The disease <br />

causes joint inflammation as <br />

well as painful, stiff, swollen <br />

joints with impaired functioning. <br />

The study tracked 45,000 <br />

Swedish adults with rheumatoid <br />

arthritis and a control <br />

group. The group with <br />

rheumatoid arthritis <br />

experienced blood clots at nearly double the rate of those <br />

who didn’t have the disease.<br />

While it’s not clear that rheumatoid arthritis actually <br />

causes blood clots, researchers suggested that the inflam-<br />

mation resulting from rheumatoid arthritis, or its treatment,<br />

may lead to the higher blood clot risk.<br />

Lack of sleep may be<br />

putting bone health at risk<br />

A<br />

new US study of the relationship between <br />

sleep and bone health shows the dangers of <br />

chronic lack of sleep: Laboratory rats that were<br />

deprived of sleep suffered significant bone health <br />

impairment. <br />

The results of study, published in the journal<br />

Experimental Biology and Medicine, reported that <br />

a chronic lack of sleep harmed bone formation,<br />

affected marrow generation and had a harmful <br />

impact on marrow plasticity. <br />

Researchers believe that, if the effects on laboratory<br />

rats are similar to humans, the lack of sleep may <br />

diminish the body’s ability to ward off bone-related <br />

diseases such as osteoporosis, reduce the body’s <br />

ability to self-repair damage to bones, and may lead<br />

to an increase in the overall rate of bone disease.<br />

Expanding waistlines helping gout<br />

make a painful comeback<br />

You don’t need to be obese to have a higher risk for gout, a form of <br />

arthritis resulting from a build-up of uric acid crystals that leads<br />

to joint redness and painful swelling, especially affecting the big toe as<br />

well as feet, ankles, wrists and hands. Obesity, diabetes, high pressure<br />

and kidney disease are known to increase uric acid production and/or <br />

impair the body’s ability to flush uric acid from the body. <br />

While obese people have the highest rate of gout, a new US study<br />

shows that simply being overweight raises a person’s gout risk. In the<br />

US, the most recent statistics from 2007 through 2010 showed the <br />

incidence of gout was up nearly 50 percent compared to the average gout <br />

rate from 1968 to 1994, with obese adults over three times more likely to <br />

have gout than adults of normal weight. <br />

Researchers estimate that a person’s gout risk increases five percent<br />

for every 3.2kg/7 pounds of additional weight.<br />

Uric acid crystals<br />

20


NEWS FROM BUMRUNGRAD INTERNATIONAL<br />

2nd charity art auction helps<br />

heal young hearts<br />

B<br />

umrungrad International and the Bumrungrad Hospital <br />

Foundation joined forces with the Cardiac Children Foundation<br />

of Thailand and the National <strong>Health</strong> Security Office (NHSO) for <br />

the second charity art exhibition and auction held recently at <br />

Bumrungrad. <br />

A group of Bumrungrad physicians and executives created <br />

more than 200 paintings for the charity auction. Proceeds from <br />

the event are used to provide free heart surgeries at Bumrungrad<br />

for underprivileged Thai children and adults.<br />

Pictured (left to right): Pawarisa Pencharti (Whan Whan); Dr. Num<br />

Tanthuwanit, Medical Director; Dr. Pornpis Petchmunee, Bumrungrad<br />

physician artist; Dr. Sinn Anuras, Group Medical Director; Dr. Winai<br />

Sawasdivorn, Secretary-General, National <strong>Health</strong> Security Office <br />

(NHSO); and Mr. Mack Banner, Hospital CEO.<br />

Conservation efforts boosted by<br />

“Love the Earth…Love Water”<br />

volunteers<br />

A<br />

volunteer force of over 150 executives and staff from Bangkok<br />

Insurance, Bangkok Life Assurance and Bumrungrad Inter-<br />

national Hospital travelled to Ratchaburi province in support of <br />

the B-happy3 “Love the Earth…Love Water” CSR initiative. <br />

The group participated in activities for enhancing conservation<br />

efforts for the area’s wildlife and natural resources, including <br />

brick-making for area homes, assembling salt licks and taking <br />

part in tasks to improve the local water supply. <br />

Bumrungrad medical staff set up a clinic to offer free medical <br />

care for wildlife sanctuary officers, their family members and <br />

community residents of the Phachi River Wildlife Sanctuary.<br />

Pictured: Mr. Voravit Rojrapitada (6th from left) Director & Company<br />

Secretary, Bangkok Insurance PCL.; Mr. Chone Sophonpanich (7th from<br />

left) President of Bangkok Life Assurance PCL.; and Mr. Mack Banner <br />

(8th from left) Bumrungrad Hospital CEO.<br />

Helping to heal hearts in need<br />

B<br />

umrungrad’s Rak Jai Thai charity program was created <br />

by the Bumrungrad Hospital Foundation, in conjunction <br />

with Bumrungrad International, the Cardiac Children<br />

Foundation of Thailand and Thailand’s National <strong>Health</strong> <br />

Security Office (NHSO) to heal hearts in need. <br />

Since the program’s inception, Bumrungrad surgeons and<br />

medical staff have donated their time and medical supplies <br />

to provide free surgeries for needy Thai children and adults <br />

suffering from congenital heart defects and valvular heart <br />

disease who lack access to much-needed surgical treatments. <br />

So far, the program has provided<br />

free surgeries to more than 660 <br />

patients. A typical heart <br />

operation would normally <br />

cost around Baht 500,000. <br />

The program welcomes<br />

donations from the public in<br />

support of its efforts. Donations<br />

can be made via the following<br />

channels:<br />

Online at www.bumrungrad.com/onlinedonation or<br />

By bank transfer to the Bumrungrad Hospital Foundation <br />

(Bangkok Bank savings account # 197-0-111157,<br />

Nana Nua branch). <br />

Please submit a copy of your bank transfer confirmation<br />

receipt to Bumrungrad’s accounting department located<br />

on the hospital’s 4th floor, or you may fax a copy to<br />

0 2667 2031.<br />

Bumrungrad International among Top<br />

50 companies for CSR activities<br />

B<br />

umrungrad International was honored as <br />

one of Thailand’s 50 leading companies for<br />

Corporate Social Responsibility (CSR) practices. <br />

The companies were selected by the Thaipat<br />

Institute. More details can be found in the “CSR<br />

Thailand: 50 Good Practices in 2012” report <br />

published by the Thai Listed Companies <br />

Association (TLCA) CSR Club.<br />

22

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