ONEHealth Issue 7

YOU R Q UA RT ER LY H EA LT H & WEL L N ES S J OU R N A L

2015/16 ISSUE

7

Inside NTFGH and JCH Our services & specialties

An Integrated Care Development

Soup for the Soul

Yay or Nay?

Built from the ground up to meet your every healthcare need

Chicken and ginseng go well together

Healthy foods that some must avoid

400 700 beds at Jurong

Community Hospital

beds

at Ng Teng Fong General Hospital

120

Ergonomically friendly consultation rooms. Dual swivel screens

Consultation Room

876 carpark spaces

for better patient-doctor communication at the clinics

Window for every patient

almost every clinic floor of Tower A – NTFGH Clinics

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for better airflow and a view, more personal space and privacy, and natural light without glare

operating theatres

Solar panels

nearly 2,000 square metres of the roof are fitted with photovoltaic panels to supplement the hospitals’ electricity needs

Pharmacy conveniently located on

that are state -of-the-art

5 15

link bridges ensure accessibility

internally within the hospital towers and externally to surrounding developments such as Westgate Mall, Devan Nair Institute for Employment and Employability, and Jurong East MRT station and Bus Interchange

gardens

22,600 square metres of green areas in the hospitals

FAST FACTS

One Queue One Patien . One Bill. t Experienc The stream e. lined proce ss at th Specialist O utpatient Clin e ics gives only a single queu e number and a consolidated single bill for a hassle-free experience

Our new home in numbers

“Coming together is a beginning, staying together is progress, and working together is success.”

- Henry Ford

We’ve officially opened!

The JurongHealth family is excited, inspired and energised as we embrace a new chapter in our journey to transform care and bring health to every home. As the first acute hospital and community hospital in Singapore to be designed and built together as an integrated development, we strive to transform healthcare delivery, treatment and rehabilitation so that patients can receive better care with greater efficiency and convenience.

We welcome you into our new home in Jurong in this issue of ONEHealth. Flip through the pages of Our Brand New Home to read about our official opening and let us take you on a pictorial discovery of Ng Teng Fong General Hospital and Jurong Community Hospital – their grounds, facilities and back-of-house operations.

We are also pleased to begin a new series to introduce you to our specialist clinical and allied health services at JurongHealth. In the first instalment of Inside NTFGH & JCH, we feature the new LIFE Hub at the Jurong Community Hospital. It forms part of our spectrum of transitional care services to help the elderly to recuperate and re-integrate safely back home after they are discharged from the hospital. In addition, learn about some of our pharmacy services to reduce medication errors at home. Also featured are conditions that are managed by our ophthalmology and dentistry departments.

In FOODforLIFE! read about another side of JurongHealth’s dietitians as they share their food quirks. Learn also about some of the food we may perceive as healthy, but which should be avoided by those with health conditions. And finally, if the festive season’s rich food has taken its toll, this simple chicken and ginseng soup is just what you need to settle your system.

The editorial team ONEHEALTH

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C NTENTS PUBLISHER JURONG HEALTH SERVICES PTE LTD EDITOR-IN-CHIEF CASEY CHANG DEPUTY EDITOR AARON LOH EDITORIAL ASSISTANT WU WANWEN CONTRIBUTING EXPERTS DR CHUA CHI SIONG DR JAMIE NG DR LAI YE CHOUNG CHAD HAN CHARLES LEW CHARMAINE ZHENG CLAUDIA CANAVARRO LI YUAN YUAN LIM RUEY JIUN MUTHUKUMARAN GOVINDASAMY SERENE TAY

PUBLISHING CONSULTANT THINKFARM PTE LTD MANAGING DIRECTOR CHRISTOPHER TAY EDITORIAL & DESIGN SHERALYN TAY SHARON HO MYCT BOON SAN THIRI WRITING & PHOTOGRAPHY ADAM KOH BELLA LIM LOUISA FOO CHERYL SIM CLIENT RELATIONSHIP JESSIE KEK LEUNG KIT YING

OUR BRAND NEW HOME

O4 THE GRAND OFFICIAL OPENING

On our special day, we welcomed honoured guests with fanfare and fun

O8 AN INTEGRATED CARE DEVELOPMENT The information in this publication is not meant to take the place of healthcare or services you may need. Please see your doctor or primary healthcare provider about any personal health concerns. All information is correct at time of print.

ONEHEALTH IS PUBLISHED QUARTERLY BY JURONG HEALTH SERVICES PTE LTD. COPYRIGHT IS HELD BY THE PUBLISHER. REPRODUCTION IN PART OR WHOLE WITHOUT PERSMISSION IS PROHIBITED. ALL RIGHTS RESERVED. MCI (P) 064/06/2015 PRINTED BY KHL PRINTING CO PTE LTD. For general enquiries, email

onehealth@juronghealth.com.sg

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Built from the ground up to serve the west

1O SERVING THE WEST – NG TENG FONG GENERAL HOSPITAL Take a pictorial tour

2015/2016 • ISSUE 7

se r ie s The fi r st in a vices r about our se ditions and the con they manage

INSIDE NTFGH &JCH 22 24 LOOK INTO IT

Eye screening and its impact on overall health

FOODforLIFE! 36 OUR DINING QUIRKS

27 STOPGAP MEASURES

JurongHealth dietitians share their food faves and no-no's

Get a better, healthier smile with braces

30 THE DOSE IS RIGHT

Reduce medication error and confusion – speak to our pharmacists

33 A MODEL LIFE

Visit LIFE Hub for a safer and more elder-friendly home

38

YAY OR NAY?

40

SOUP FOR THE SOUL

What’s healthy for some is not for others

Simple and nourishing chicken and ginseng soup

JurongHealth is a public healthcare cluster that operates Ng Teng Fong General Hospital and Jurong Community Hospital, an integrated healthcare development that serves the community in the west.

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OUR BRAND NEW HOME

The grand official opening Ng Teng Fong General Hospital (NTFGH) and Jurong Community Hospital (JCH) were officially opened on 10 October 2015 by Prime Minister Lee Hsien Loong.

The occasion, graced by about 400 special guests and community partners, also reached out to residents with health screenings and a health carnival.

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ON E HE ALT H

From left: Mrs Tan Ching Yee, Permanent Secretary (Health); Mr Cedric Foo (MP for Pioneer SMC); Mr David Ong (MP for Bukit Batok SMC); Dr Chia Shi-Lu (MP for Tanjong Pagar GRC); Mr Chee Hong Tat, Minister of State (Health and Communications & Information); A/Prof Cheah Wei Keat, Chairman, Medical Board, JurongHealth; Mrs Lee Hsien Loong; Ms Grace Foo, Minister for Culture, Community and Youth; Mr Gan Kim Yong, Minister for Health; PM Lee Hsien Loong; Mr Lim Yong Wah, Chairman, JurongHealth; Mr Foo Hee Jug, CEO, JurongHealth; Dr Amy Khor, Senior Minister of State (Health and the Environment & Water Resources); Dr Lam Pin Min, Minister of State for Health; Mr Patrick Tay, member of Government Parliamentary Committee for Health; Mr Ang Wei Neng (MP for Jurong GRC); Ms Rahayu Mahzam (MP for Jurong GRC); Dr Tan Wu Meng (MP for Jurong GRC); MG (NS) Ng Chee Khern, Second Permanent Secretary (Health).

Serving the community NTFGH and JCH – which began operations on 30 June 2015 and 22 July 2015 respectively – made an impact on the community even before their official opening on 10 October 2015. Just four months into operations, NTFGH treated and cared for over 6,300 inpatients and 31,000 outpatients.

The NTFGH Emergency Department also saw 19,000 patients in the same period and received an average of 70 Singapore Civil Defence Force ambulances daily. JCH has also opened about half its 400-bed capacity in three months.

Reflecting on the intense preparation in the months leading up to the move, Mr Foo Hee Jug, CEO of JurongHealth, shared his deep sense of fulfilment in his opening address, “We are happy that the hard work behind the planning, testing and commissioning of the facilities, systems and equipment has allowed us to open smoothly and safely.”

NTFGH and JCH form the first integrated development of an acute general hospital and a community hospital in Singapore. It was planned, designed and built at the same time to achieve a seamless patient experience and to provide right sited care.

Many of the hospital’s features – from its physical layout to its processes – have been developed with patients in mind. Mr Foo emphasised that beyond offering a comprehensive and convenient patient experience within the hospitals, JurongHealth is also committed to serving its community by preventing illness, detecting disease early and managing chronic conditions well. “As the regional health system for the west, we have already started various partnerships and initiatives” he said, adding,

“We will collaborate earnestly with our partners to bring to life our vision of ‘Transforming Care.

Bringing Health to Every Home’ for Singapore and our community.

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OUR BRAND NEW HOME

Fulfilling a critical need Speaking at the ceremony, PM Lee congratulated JurongHealth and highlighted the critical role that NTFGH and JCH play in meeting the healthcare needs of Singapore’s rapidly ageing population. “When fully open, they will have 700 acute and 400 community beds, adding much-needed capacity to our healthcare system,” he said. This is in line with the Healthcare 2020 masterplan. Already, the Government has been expanding and building hospitals, primary care facilities, nursing homes and eldercare centres to meet healthcare demands across the spectrum. PM Lee also noted that JurongHealth’s integrated and patient-centred approach will make an impact on the community.

PM Lee chats with patients during the tour of NTFGH

“I am happy that we now have Ng Teng Fong General Hospital and Jurong Community Hospital built and operating. Because these are new developments, we had the chance to design the buildings from a fresh start, around the patient, ” said PM Lee, who emphasised that hospitals must fit well with other components of the overall healthcare system.

To this end, the government has supported the development of primary healthcare facilities, family medicine clinics, nursing homes and more. “We are putting all the pieces together in

Jurong, designing the whole around the patients, to be patient-centric, not just the hospitals, but also the primary care, after care, nursing homes, outpatient treatment, making sure that they all work together, ” said PM Lee, “[So] the patient gets the right

treatment at the right place. Overall, the system delivers better care for the patient, in a cost-effective way. That is what we will be doing all over Singapore.”

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ON E HE ALT H

Guided tours were held to introduce the community to the hospital

A day to remember After the opening ceremony, PM Lee and other guests-of-honour toured NTFGH and JCH. They visited the fan-shaped wards with a window for every patient, the specialist outpatient clinic, the integrated intensive care unit, community hospital wards and healing gardens. Along the way, Mr Lee stopped to interact with patients, their families and the public – even stopping to take photos along the way.

Residents admire the budding community garden

The ceremony was also made more special with tributes to JurongHealth patient, Mr Tan, who lost his hearing after an infection. He is recovering well and on his way to regaining his hearing with a cochlear implant. Mr Mohamad Salleh, another JurongHealth patient, is an amputee with multiple chronic illnesses.

Not one to give in to his conditions, the multi-talented and multi-lingual busker gave a rousing rendition of Bon Jovi’s ‘It’s My Life’ and the Hokkien song ‘ 要拼才 会贏 ’ (‘work hard to win’) to express his gratitude to his care team at JurongHealth.

The community too had a chance to celebrate the occasion with JurongHealth. A health screening fair and health carnival were held concurrently and welcomed over 1,000 residents. Mr Foo Hee Jug, CEO of JurongHealth said,

“Our best days are before us. We can help make life, health and healthcare more wonderful by the way we approach health and healthcare.”

A health carnival and screening fair attracted over 1,000 residents

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OUR BRAND NEW HOME

NG TENG FONG GENERAL HOSPITAL TOWER

TOWER

Built from the ground up as an integrated healthcare hub, the hospitals comprise three towers: the NTFGH Clinic Tower, the NTFGH Ward Tower and the Jurong Community Hospital — all designed, conceptualised and built as a single integrated concept.

A

NTFGH CLINICS

B

NTFGH WARDS

With 700 beds, the ward tower also houses critical care services, including the Emergency Department, Operating Theatres, Intensive Care Unit and other diagnostic and treatment services.

The Specialist Outpatient Clinics (SOC) at Tower A bring together a diverse multi-disciplinary team of medical specialists to manage various medical conditions.

lar 21 ehicu and v ast Street itors’ E t’s, vis urong Patien point via J entry

Link bridge to Jurong East MRT Station and bus interchange via Westgate

An integrated care development 08

ON E HE ALT H

JURONG COMMUNITY HOSPITAL Patients who require sub-acute and rehabilitative care can be seamlessly transferred to the community hospital.

Y Y WA A L N BOO LEVEL e only ulanc

Amb

te

u -off ro

drop

3

LEVEL OPERATING THEATRES The dedicated complex of 18 operating theatres is equipped with computerised and integrated equipment for smooth, modern and up-to-date surgical management. Using hybrid, 3D and computer precise navigation, state-of-the-art and advanced minimally invasive surgical procedures can be performed.

1

EMERGENCY DEPARTMENT (ED)

An ambulance-only drop-off from Boon Lay Way allows direct access into the ED for critically ill patients. A separate drop-off driveway for walk-in patients is at the opposite side of the building along Jurong East Street 21. The ED is pandemic, mass-casualty and trauma ready with modular trauma suites that can be combined to accommodate a larger care team for severe trauma cases.

LEVEL

4

INTENSIVE CARE UNIT (ICU)

Singapore’s first combined ICU and High Dependency (HD) Unit streamlines care that cuts across the different conventional ICUs (Surgical, Medical, Cardiac and Neurosurgical). This allows patients to be cared for by the same team. The ‘window for every patient’ concept extends to ICU and HD patients as well, and comes with an outdoor garden so that stable ICU and HD patients can enjoy some fresh air.

Patient-centred features are integrated into every aspect of the two hospitals. Ng Teng Fong General Hospital provides comprehensive services to serve all the essential healthcare needs. These include emergency, intensive, surgical, rehabilitative and diagnostic services to serve the 900,000-strong community in the west. With 400 beds, the adjoining Jurong Community Hospital provides a seamless link to sub-acute and rehabilitative care.

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OUR BRAND NEW HOME

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ON E HE ALT H

Serving the West - Ng Teng Fong General Hospital

The hospital is special for many reasons, from its unique design and landscaping to its innovative approach to healthcare. The move to NTFGH is a culmination of an idea that was envisioned in 2009: to serve the community in the west with

seamless patient-centred care that spans the healthcare spectrum and takes a more proactive and preventive approach. Building NTFGH and JCH from the ground up provided the unique opportunity to masterplan for patients to benefit from quality care and seamless transfer between the hospitals when care needs change.

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OUR BRAND NEW HOME

FAN-SHAPED WARD

A window for

every patient

Every patient will enjoy a view, natural sunlight and privacy with the innovative fan-shaped ward. Unlike conventional hospital wards, each patient bed is sited next to a window that provides better ventilation as well as a view with greenery. The space is also optimised so that infection control is enhanced.

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ON E HE ALT H

ventilation The orientation and fan-like shape of the ward tower maximises air-flow, providing improved natural light and ventilation.

greenery Landscaping throughout the hospital offers healing green zones.

privacy A bedside window means that patients enjoy more personal space. They have the option of facing the window with the curtain drawn for added privacy.

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OUR BRAND NEW HOME

THE EMERGENCY DEPARTMENT

Better level of care At the heart of the acute hospital, the Emergency Department (ED) is optimised to be adjacent to various services, such as the Operating Theatres and the Intensive Care Unit (ICU). Two dedicated specially sized and equipped trauma lifts allow for swift transfers to these locations. The ED is also close to radiology, inpatient wards and other procedural services to facilitate smooth and quick transfer of patients across the various care points when necessary.

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Ready to respond Emergency care has been designed to be more responsive, flexible and scaleable. With modular resuscitation rooms within the critical care zone, the trauma-ready room can swiftly double in size to accommodate a larger multi-disciplinary team for major trauma cases. Being in close proximity to Jurong Island, the ED is also prepared for mass casualties, industrial accidents and hazardous material incidents.

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OUR BRAND NEW HOME

OPERATING THEATRES

State-of-the-art

Operating theatres The suite of 18 Operating Theatres is located in the podium block of the acute hospital and is well-connected to all other critical care facilities for swift seamless transfer. The main OTs and day surgery OTs are also co-located in a common Integrated Interventional Platform for better resource sharing and the flexibility to vary their usage.

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INTENSIVE CARE UNIT

ICU

Integrated critical care

The NTFGH ICU is helmed by the first combined Intensive Care Medicine service in Singapore, integrating Surgical, Medical, Cardiac and High Dependency (HD) units into a single facility.

This means critical care can be delivered by a single team with one standard of care and better utilisation of staff and resources. This also reduces the need for the physical transfer of patients between HD and ICU. The ‘window for every patient’ concept extends to the ICU. Stable ICU patients can also be brought out to an adjacent garden for fresh air.

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OUR BRAND NEW HOME

KITCHEN

Behind-the-scenes Keeping the hospital running smoothly are many back-of-house services The hospital’s back-end functions such as kitchen and procurement services are co-located at basement 2 to optimise transport via Automated Guided Vehicles (AGVs). The kitchen, which develops meals in close collaboration with dietitians, prepares close to 3,000 meals for patients at both the hospitals.

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KITCHEN

Meet JurongHealth’s team of new ‘robot’ weightlifters Helping to transport heavy loads is a new crew of AGVs. These driverless, programmable vehicles can transport up to 350kg of supplies such as linen, pharmaceuticals, meals and other hospital stock. These ‘work horses’ do the work of seven people at a go, travel independently around the hospital and even dock themselves when they are done with their tasks.

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OUR BRAND NEW HOME

close at hand

Community care Located just next to NTFGH, patients whose care needs change can be comfortably and conveniently transferred to JCH. Patients can benefit from care that focuses on rehabilitation and recuperation.

Supporting their recovery journey and re-integration back to their home and community are rehabilitative services and life-like simulated environments such as the Mobility Park and LIFE Hub.

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JURONG COMMUNITY HOSPITAL

KITCHEN

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Inside NTFGH &JCH New Series!

INSIDE NTFGH&JCH In the first instalment of this new series, we take a look at the specialties and services offered at both hospitals.

We will be highlighting some services and the conditions they manage and treat.

Look out for upcoming issues of ONEHealth to learn something new about the hospitals and your health!

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JURONGHEALTH CLINICAL & ALLIED HEALTHCARE SERVICES

Ophthalmology (eye) JurongHealth’s team of eye surgeons and consultants treat a wide spectrum of vision problems including age-related macular degeneration, glaucoma, cataracts, diabetic retinopathy, corneal disease, as well as other conditions affecting the eyes. With regular screening, many of these conditions can be spotted and treated early to prevent complications. Learn about the types of diseases and how your eyes can offer clues to your health in ‘Look Into It!’ on page 24.

Dentistry The Department of Dentistry provides general and advanced specialist dental care including dental implants, braces, jaw surgery, aesthetic dental restorations and facial pain therapy with a multidisciplinary, integrated and team-based approach. Its services also include dental surgery, treatment and management of gum disease and orthodontics. On page 27, read ‘Stopgap Measures’ to learn about corrective orthodontics such as braces.

Pharmacy There is more to pharmacy than dispensing medication.

The pharmacy service believes in empowering patients and caregivers with the knowledge to best manage and understand their medication treatment plan. Working with doctors and allied health professionals, JurongHealth’s pharmacists play an important role in managing conditions and providing patient counselling and education. One important service that takes the confusion and potential dangers out of taking multiple medications is the Medication Self-Management Programme featured on page 30, in ‘The Dose is Right’.

Post-acute & Continuing Care The Post-acute & Continuing Care services at JCH deliver transitional care. This approach is holistic and aims to support recovery, return to function and improvement of quality of life. A multi-disciplinary team of doctors, physiotherapists, occupational therapists, podiatrists, speech therapists, dietitians and other services work together to rehabilitate and address physical, social and emotional wellness. As part of the care plan to help patients, especially the elderly, transit safely and with confidence back home, JCH incorporates hands-on rehabilitative programmes in its LIFE Hub and Mobility Park. Learn about the features of LIFE Hub in ‘A Model Life’ on page 33.

ANAESTHESIA* AUDIOLOGY* CARDIAC DIAGNOSTIC LABORATORY SERVICES* CARDIOLOGY DENTISTRY* DERMATOLOGY* DIETETICS & NUTRITION+ EAR, NOSE & THROAT (ENT) – HEAD & NECK SURGERY* EMERGENCY MEDICINE ENDOCRINOLOGY GASTROENTEROLOGY & HEPATOLOGY GENERAL SURGERY* GERIATRIC MEDICINE GYNAECOLOGY HAEMATOLOGY HEALTH & WELLNESS# INFECTIOUS DISEASES INTENSIVE CARE MEDICINE INTERNAL MEDICINE LABORATORY MEDICINE* MEDICAL SOCIAL SERVICES*+ NEURODIAGNOSTIC LABORATORY SERVICES NEUROLOGY NEUROSURGERY OCCUPATIONAL THERAPY*+ ONCOLOGY – MEDICAL & RADIATION OPHTHALMOLOGY* OPTOMETRY* ORTHOPAEDIC SURGERY* PAIN MEDICINE* PHARMACY*+ PHYSIOTHERAPY*+ PLASTIC, RECONSTRUCTIVE & AESTHETIC SURGERY PODIATRY*+ POST-ACUTE & CONTINUING CARE+ PSYCHIATRY PSYCHOLOGY*+ PULMONARY FUNCTION LABORATORY SERVICES* RADIOLOGY*+ REHABILITATION MEDICINE RENAL MEDICINE* RESPIRATORY MEDICINE RESPIRATORY THERAPY RHEUMATOLOGY SLEEP LABORATORY SERVICES SPEECH THERAPY+ UROLOGY* VASCULAR DIAGNOSTIC LABORATORY SERVICES + Service at Jurong Community Hospital * Service also at Jurong Medical Centre # Service only at Jurong Medical Centre

–––––––––––––––––––––––––– Read future issues of ONEHealth to learn more about our clinical specialties and allied health services

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Inside NTFGH &JCH

Ophthalmology

Look into it!

Don’t overlook regular eye screening – it can pick up early signs of disease and prevent it from getting worse By Cheryl Sim IN C ONSULTATION W ITH DR JAMI E N G , A S S O CIA T E CO N S UL T A N T , O PHT HA L M O L O G Y

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According to Dr Jamie Ng, Associate Consultant, Ophthalmology, JurongHealth, some irreversible and potentially blinding conditions such as glaucoma and diabetic retinopathy have no symptoms in the early stages. This makes eye screening the only way to spot these conditions early and slow down or prevent their progression.

Clues to health Getting your eyesight checked is not just for those of us who are short or long-sighted.

In fact, eye screenings are important to detect common eye problems and other diseases in their early stages. This is especially important for those with: • High myopia,

(more than -6.00 dioptres or 600 degrees)

• The elderly • People with chronic

diseases such as diabetes

“Eye health can also be an indicator of overall health. In some cases, the signs of some diseases are visible in, on, or around the eyes long before symptoms appear,”said Dr Ng.

Ring signs High levels of cholesterol can cause a corneal arc: whitish, gray or yellowish deposits around the circumference of the cornea. This arc does not usually affect vision but it indicates an inherited predisposition to high cholesterol and high blood triglycerides.

Corneal arcs are also linked to diabetes and high blood pressure.

Fat clues High cholesterol can also cause the eyes or eyelids to develop plaque-like deposits (xanthelasma). In severe cases, high levels of cholesterol can cause fatty deposits to line the blood vessels in the eye, blocking them or causing a rupture that may cut off blood supply and cause vision loss.

Under pressure A disease of the eyes called hypertensive retinopathy can signal serious complications associated with dangerously high blood pressure. Hypertensive retinopathy also indicates end-organ damage (such as heart and renal impairment) and may be a risk marker of stroke, congestive heart failure and cardiovascular mortality. This means prompt and accurate diagnosis during an eye screening can prevent unnecessary vision loss and systemic complications.

Given these realities, perhaps the old saying ‘the eyes are the windows to the soul’ has some truth in it. The eye, after all, is truly a window into the body and the only place where a doctor can look at a nerve, artery or vein without any invasive procedures. Dr Ng reiterated,

“Because many eye problems and health conditions are ‘silent’, people should not wait until they experience symptoms to see a doctor.

Regular eye screenings, just like health screenings, are important to detect, treat and prevent problems from worsening.“

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Inside NTFGH &JCH

Ophthalmology

How the eye works

Getting an eye exam Unlike a vision test which just checks for vision problems, an eye examination assesses the health and function of the eyes. It may include:

• A test for overall and peripheral (side) vision

The cornea is the transparent layer in front of the eye.

The iris is a pigmented membrane with an adjustable circular opening called the pupil that expands and contracts to control the amount of light entering the eye.

In diabetic retinopathy, high blood sugar levels damage the vessels in the retina, reducing blood flow and causing blindness

• Checking the reflexes of the pupils and the functioning of the eye muscles

Pupil

• An examination of the

Glaucoma is associated with increased pressure within the eye that damages the optic nerve

front and back of the eye using a special upright microscope

• An eye pressure test using air puff tonometry (a device that expels a light jet of air onto the eye)

• Dry eye evaluation During these tests, you may receive eye drops that temporarily enlarge your pupils so that the back of the eye can be viewed.

These drops will blur vision, so it is important not to drive after your screening appointment.

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Age-related macular degeneration (AMD) occurs when the delicate cells in the macula become damaged and cause a loss of central vision

Cornea Iris

In retinal detachment, the retina separates from the underlying layers of the eye due to trauma or the natural ageing process Cataracts cloud the lens of the eye, causing ‘foggy’ eyesight, poor contrast and colour vision, as well as reduced night vision

When to screen?

Children Yearly from age three, at the start of school and then every two years Teens/Adults Once every two years Elderly Once a year after age 60

Stopgap measures

Inside NTFGH &JCH Dentistry

Fixing uneven, crowded or widely-spaced teeth doesn’t just improve your smile, but can improve your dental health as well By Sheralyn Tay IN C O NSULTATIO N WITH DR LAI Y E CH OU N G , A S S O CIA T E CO N S UL T A N T , DE N T IS T R Y

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Inside NTFGH &JCH Dentistry

How braces work Sometimes called ‘railway tracks’ because of their appearance, the nickname for orthodontic braces is suitably apt for another reason:

they keep your teeth on track to develop into a straight and even row.

Crooked teeth can result in uneven gaps and tight spaces, trapping food particles and increasing the risk of cavities.

More importantly, apart from aesthetic reasons and added self-confidence,

braces can impart functional and dental health benefits, explained Dr Lai Ye Choung, Associate Consultant, Dentistry, JurongHealth.

“Braces treatment can improve the fit of the upper and lower teeth so that chewing is more efficient.

A well-aligned set of teeth is also much easier to clean and maintain compared to crooked teeth,” he said. Braces can be used to straighten crooked teeth, create sufficient space for tooth replacement or close gaps for teeth that are too far apart.

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Braces (made of metal or ceramic) are bonded onto teeth and wires are threaded through these brackets and tightened with elastic bands.

The brackets and wires apply sustained pressure to the teeth, and over time, shift them into a more desirable position.

During regular scheduled reviews, an orthodontist will track the treatment progress and adjust the tension and amount of force on the wires to slowly shift teeth into place. When treatment is completed, the braces are removed and patients will be given a set of customised removable retainers to help them maintain the alignment of their teeth.

Types of braces Braces can be made out of stainless steel, ceramic, clear plastic or a combination of materials. The types of braces fall under three categories:

Braces at any age In most cases, it is ideal to start braces treatment after the age of 12 when a child’s permanent teeth have all surfaced. However, explained Dr Lai, the ideal age can vary depending on the type of dental malocclusion.

It is never too late to do braces treatment and adults too can start braces treatment, he added. “Treatment time may be a bit longer compared to children and teenagers as the teeth have to move through denser bone structures.”

1.

Traditional braces consist of brackets, wire and elastic bands

2.

Self-ligating braces

On average, the treatment process ranges from 15 to 24 months, depending on the rate of tooth movement, complexity of the case and the patient's attendance and compliance. “To put it simply, the longer the distance the tooth has to move, the longer the treatment time,” Dr Lai said.

involve only brackets and wire.

They use a gate or clip to keep the wire within the brackets, removing the need for bands.

These are costlier but cause less friction and are more comfortable to use

Braces care and maintenance

Clear aligner therapy

Made of wires and brackets, traditional and self-ligating braces act as traps for food and plaque. This means more care must be taken to protect teeth from stains and cavities.

Brush up on your brushing

Floss every day

Say no to sticky, hard foods

The brackets and wires can make brushing challenging.

Brush at an angle to clean over and under the bracket or opt for a special toothbrush designed to clean around braces better.

Flossing removes food particles from hard-toreach places.

Use a threader for your floss or a special brush-end toothpick called a proxabrush to clean between teeth and under the wires.

Avoid biting into hard foods such as whole apples, ice cubes and corn on the cob. Cut hard foods into small pieces instead. Avoid sticky candy such as gum or caramels as they can be hard to remove.

3.

uses clear plastic overlays instead of brackets or wires.

These removable aligners are worn over the teeth and ‘grip’ them to gradually move teeth into the desired positions.

These are the least visible and comfortable option and are also the most expensive.

They only work for moderate alignment issues and the treatment time is longer

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Inside NTFGH &JCH Pharmacy

The dose is right Multiple medications getting you down?

Clarify the confusion with NTFGH’s outpatient pharmacy medication self-management programme

By Sheralyn Tay

IN C ONSULTATION W IT H M U T H U K U M A R A N G OV I N D A S A M Y , PR IN CIPA L PHA R M A CIS T

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Medication education

With multiple pills to take before and after meals to manage her various chronic conditions, Mdm Lillian Ma, 62, sometimes takes the wrong medication or forgets a dose. To add to her confusion, she has a large stock of medications collected from her previous visits to hospital, some of which have expired. She is not the only patient who sometimes has trouble keeping up with her medication.

To help patients like Mdm Ma, NTFGH’s outpatient pharmacy offers a

The medication self-management programme is especially useful for patients who receive medication from more than one doctor, take several types of medicines for their chronic diseases or are starting a new medication regimen.

The service helps educate patients on:

medication self-management programme. “Started in 2015, the programme aims to educate patients and their caregivers on their medicines and help reduce medication errors,” explained Mr Muthukumaran Govindasamy, Principal Pharmacist, JurongHealth. Patients can even save money by making sure they factor in existing medication before refilling their prescriptions.

Mr Muthukumaran explained, “By learning how to correctly count and record excess medications, patients can avoid accumulating medicines at home.” The service also helps trim medication bills, he added. “On the day of

1.

The details of their medications (generic name, strength, type, side effects, dietary restrictions and safety precautions)

their appointment at the specialist outpatient clinic, patients can record their medication list at home along with the quantity of pills and hand the list to any outpatient pharmacy before seeing their doctor. We will assist the patient by managing his or her medications, checking against their latest prescriptions to avoid duplication and ensuring that he or she has an adequate supply of medications to last till the next medical appointment.” This means the

2.

How to take the correct doses at the right times

pharmacy can accurately and swiftly pack a patient's medication in advance.

The goal of the service is to empower patients to take a more active role in managing their medications and improve medication safety. For patients’ convenience, NTFGH's outpatient pharmacists have even developed a handy medication list in their information brochure on the service (see page 32).

3.

The right way to count and record medications to reduce accumulating excess medications (and reduce their pharmacy bills)

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Patient Medication List Name: NRIC: Clinic:

NO.

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MEDICATION NAME

Speak to N T F G H ’s Outpatie nt Phar macists to lear n how to fill up this for m and cut dow your wa n i ti ng tim e and medica tion bil l dur in your ne g xt med i c al appoin tment.

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QUANTITY

Inside NTFGH &JCH Post-acute & Continuing Care

LIFE Hub showcases some of the best practices to improve safety and independence as well as improve the home care management skills of caregivers.

A Model Life

Interactive and life-sized, LIFE Hub showcases safety solutions in a simulated three-room flat to help patients make an easier transition home By Adam Koh & Bella Lim IN C O NSULTATIO N WITH DR C HUA C HI SI ON G , M E DICA L DIR E CT O R , J UR O N G CO M M UN IT Y HO S PIT A L

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Inside NTFGH &JCH Post-acute & Continuing Care

Learn, Interact, Feel, Experience After a stroke, hip fracture or any prolonged stay in hospital, going home again can be challenging for some.

This is especially so for the elderly if the illness has resulted in changes to their ability to walk or move about freely.

LIFE Hub was conceptualised and built to empower seniors to remain healthy and independent at home, improve the safety of their home environment and educate caregivers on available home care aids and solutions. Dr Chua Chi Siong, Medical Director, Jurong Community Hospital (JCH), explained, “LIFE Hub (which stands for Learn, Interact, Feel, Experience) showcases some of the best practices to improve safety and independence.

“The displays and mock-ups show patients and caregivers how to adapt the home environment to suit changes in physical ability and how to make the home safer for the elderly.” It highlights ways to prevent falls, showcases aids that can be used to improve mobility and gives examples of the adaptations in the home that can support activities of daily living. It also offers tips on maintaining overall wellbeing.

To provide a one-stop solution, the LIFE Hub is located right next to a retail pharmacy that stocks a wide range of assistive devices. Patients and caregivers can conveniently buy wheelchairs and feeding aids to use at home.

A better grip Stroke, dementia or Parkinson’s Disease may affect fine motor skills and make it difficult to handle cups and cutlery. These specialised eating tools help the elderly to feed themselves and support their independence.

Bedroom safety A special adjustable bed with rails prevents falls, improves a caregiver’s ability to offer care and reduces the risk of bed sores. A bedside commode or urinal eliminates the need for night time trips to the bathroom and reduces the risk of falls.

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Aroundthe-house tips Make the home more elder-friendly by including simple adaptations such as a top-loading washing machine or a phone with large buttons.

Safer bathrooms Install grab bars and use special raised seats on toilets to aid standing and sitting.

Kitchen aids Solutions such as a water jug holder can make tasks like getting a drink much easier.

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FOODforLIFE!

Our dining quirks Here’s a little insight into what JurongHealth’s dietitians love to eat (in moderation) and what they won’t eat C O N T RI BU T E D BY C HAD HAN; CH A RL E S L E W ; CLA UDIA C ANA VA RRO ; S E R E N E T A Y ; A N D LIM RUE Y J IUN, D E P A RT M E N T O F D IE TE TICS AN D N U T RI T I O N

They spend their days dispensing nutrition advice to ensure your medical ailments are managed holistically. But have you ever wondered what a dietitian’s own food preferences and occasional indulgences are?

Well, it’s not all brown rice and skinless chicken breasts.

In fact, apart from food preferences, they also have their aversions and notquite-healthy favourites.

The guiding principle, as they often tell their patients, is to have balance and moderation.

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It takes a lot of self-discipline, but I avoid buying nacho chips even though they are among my favourite snack foods.

As they are very high in fat and calories, I only eat them during special occasions or gatherings. My healthy alternative is to have wholegrain rice cakes or rice crackers which are just as crunchy and healthier!

I won’t eat

Fish eyes

As a child I was urged to eat them because there’s an old wives’ tale that eating the eyes of a fish will improve eyesight.

I could never bring myself to eat them, though I do eat fish, especially oily fish, regularly, as they are high in good fats.

I love kettle corn: popcorn coated in butter or caramel.

However, store-bought and cinema varieties are high in fat and sugar or sodium, so I limit myself to sharing a regular-sized bucket whenever I’m at the movies.

As a healthier option, I also make popcorn at home so I can control the amount of oil and use mixed herbs for a healthier treat that still satisfies my cravings!

I won’t eat

Bugs

I have a certain degree of entomophobia (fear of insects), so while many cultures see crickets and grasshoppers as a delicacy and a good source of protein, these crispy critters are not for me!

Claudia Canavarro Lim Ruey Jiun

Serene Tay

I love french fries! So much so that I have an image of them on my mobile phone cover! There is no real healthy substitute for this high-fat treat, but instead of totally avoiding them, I have them very occasionally. A healthy diet should be varied and balanced in order to get the ideal amounts of nutrients and of course, to enjoy the pleasure of eating.

I won’t eat

I eat on the principle of quality, quantity, frequency.

We dietitians are human after all, so we do have our soft spots for food that is not as healthy as it should be. I love pig organ soup with extra liver. While liver is a very good source of iron, organ meat is high in cholesterol, so I limit myself to it as a monthly treat.

While I like ice-cream, I am – like many people of Asian-descent – lactose intolerant, so I have to avoid it and all other dairy products. To ensure I have enough calcium in my diet, I replace dairy milk with calcium-fortified soya milk. On occasion, to enjoy a premium ice-cream, I take lactase enzymes beforehand to help me digest it better, or else, I stick to sorbets as a substitute.

Charles Lew

Balut

Balut is a fertilised duck egg native to the Philippines. Though it is highly nutritious, balut is also very high in cholesterol.

The thought of biting into an unborn duckling is also too ‘fear-factor’ for me.

I won’t drink

Soft drinks

I used to love cola soft drinks but these are extremely high in sugar.

A single can contains 7 teaspoons of sugar

I won’t eat Chad Han

Raw octopus

Sannakji is a raw octopus delicacy native to Korea.

These raw octopus pieces are served still wiggling on the plate. It’s all too much for me!

– equivalent to eating half a bowl of rice! I’ve since swapped to the sugar-free variety and gotten so used to the taste that regular cola drinks taste weird to me now.

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FOODforLIFE!

Food that may be healthy for some could be dangerous for others By Louisa Foo I N C O N S U L T A T I ON W ITH LI Y UAN Y UA N & C HARMAINE ZHEN G, DIETITIANS

YayorNay? Many of the foods we believe are good for us come with a caveat: ‘eat in moderation’. For people with existing illnesses, exercise more care with the additional caveat: 'one man's meat is another man's poison'.

Say no to salads It’s often said that fresh is best! For many fruits and vegetables, this is true as heat and processing can cause the loss of vitamins, minerals and phytochemicals. A fresh salad full of raw vegetables is a great way to get some of your daily intake of vitamins and fibre. However, for people with weakened immune systems, raw fresh fruit and vegetables can harbour harmful pathogens that would otherwise be killed in the cooking process.

Who should avoid salad?

Older adults, pregnant women, those undergoing chemotherapy, or patients who are taking steroids or other immune-suppressants are more susceptible to bacterial infection than an average healthy adult. These groups of people should avoid raw salads. This is especially the case for salads purchased at salad bars as the salad components may be exposed to airborne contaminants. It is also important to avoid raw vegetables or fresh fruit bought from roadside peddlers if you are overseas.

If you fall under the high risk group and still wish to eat salads or raw fruit, it is best to prepare them at home. Always wash salad leaves properly (even ‘ready-to-eat’ varieties) and eat your salad soon after it is prepared.

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Take heed of sashimi Sashimi is a good source of vitamins, minerals and high quality protein that is easily absorbed. Many types of sashimi, such as salmon, mackerel and tuna, are particularly rich in omega-3 fatty acids and beneficial to heart health. However, like many raw foods, uncooked fish has its hazards as it can contain parasites. Improper handling and storage can also result in the growth of bacteria in the flesh of the fish.

Who should avoid sashimi?

People with reduced immunity such as older adults, pregnant women and people who are on a neutropenic diet should avoid sashimi as they are more susceptible to food-borne illnesses. For healthy people, good food hygiene is also important to avoid food-borne diseases and food poisoning. For instance, only eat raw fish that is sashimigraded and consume it as soon as possible. Do not let it sit in the fridge for more than 24 hours.

A neutropenic diet is a protective diet for people with weakened immune systems (such as people with leukaemia or those undergoing chemotherapy). The diet eliminates, as much as possible, exposure to bacteria and other harmful organisms found in food and drinks.

Watch the soya Soya beans are a high-quality protein source containing all the essential amino acids found in meat protein while also being low in saturated fat and high in good fat and fibre. Soya beans and soy-based foods such as bean curd and soya bean milk are sources of calcium, iron and antioxidants known as isoflavones.

Who should avoid soya bean-based products?

People who are on low-protein diets for renal failure should be mindful that apart from limiting meat, they should likewise limit soy-based foods. Soya beans contain high levels of protein as well as phosphorous and potassium, which may tax the functioning of impaired kidneys. Those with soya bean allergies – a rare occurrence in Singapore – should also avoid soy-based foods.

Hold the sports drinks Sports or isotonic drinks are formulated to contain similar concentrations of electrolytes, salt and sugar as the body. These drinks are used to quickly replace fluid and minerals lost due to intense physical activity and sweating. For athletes and those who engage in manual labour, this replenishment is important to avoid cramping and dehydration, while also maintaining energy.

Who should not drink isotonic drinks?

Those with diabetes should be aware that these drinks, while lower in sugar than regular soft drinks, still contain relatively high amounts of sugar. People who are hypertensive or have kidney failure should also avoid or limit isotonic drinks because of the higher salt content. In fact, isotonic drinks in general should be consumed in moderation in the same way as soft drinks. The truth is that unless you have just run a marathon or have engaged in a bout of intense physical labour, these drinks do not offer an energy boost.

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FOODforLIFE!

Soup for the soul

CO NTRIBUTED BY THE DEPAR TM EN T OF DI ETETI CS AN D N U TR I TI ON , JU R ON GHEAL TH

If you are feeling a little overwhelmed from all the festive eating, try this simple, nourishing soup to tame your tummy and reset your system.

Chicken and ginseng soup Preparation time: 40 minutes Serves 8 Ingredients 600g Skinless chicken fillet, scalded in boiling water 1 litre Fat-free and low-sodium chicken broth 20g Ginseng root 10 Seedless red dates 2 tbsp Wolfberries 3 cups Water Ÿ Whole cabbage Optional: 100 ml ½ cup

Rice wine Freshly chopped coriander

Nutrition value (per serving) Calories Protein Fat Carbohydrates Fibre

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348 kcal 16g 8g 11g 2.4g

Method 1. In a large pot, combine scalded chicken pieces, broth, herbs and cabbage. Top up the pot with 3 cups of water and bring the mixture to a boil 2. Once the soup is boiling, reduce the heat and simmer for 20 minutes 3. Remove the cabbage, slice into 2cm strips and return to the soup. Simmer for another 3 minutes 4. Add salt and pepper to taste. If desired, add rice wine 5. Garnish with chopped coriander and serve hot

The best protection is early detection save lives The Mammogram for Early Detection Screening (Meds) @South West offers FREE mammograms for women who: • Reside in the South West district • Are aged 50 and above and have not had a screening in the last 24 months • Hold a Blue / Orange CHAS Card • Have no breast abnormalities • Have no known history of breast cancer at JURONG MEDICAL CENTRE 60 Jurong West Central 3 Singapore 648346 妇女须符合以下条件： • 居住在西南区 • 50岁及以上，并在过去的24个月 内没有进行乳房X光检查 • 蓝 / 橙CHAS卡持有者 • 没有任何乳房异常 （乳房肿块，血染乳头溢液） • 没有诊断过患有乳腺癌

FOR BOOKING To make an appointment, please email appointment@juronghealth.com.sg or call 6716 2222 (Monday to Friday: 8.30am to 5.30pm; Saturday: 8.30am to 12.30pm) and say “South West MEDS”. 欲享有免费乳房X光检查，请拨打裕廊 医疗中心的热线电话 6716 2222 ( 周一至周五: 上午8点30分至下午5点 30分/星期六: 上午8点30分至下午12点 30分) 或电邮: appointment@juronghealth.com.sg 预约，并引述西南社理会的乳房X光检 查计划。

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