2013ISSUE
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YO U R Q UA RT E R LY HE A LT H&WE LLN E SS JOU R N A L
A community of experts for seamless care
Healthcare designed, delivered and centered around patients and caregivers
HealthBUZZ
WeCARE
HealthSense
TouchingLives HealthBites
LO
O
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Eat well & be well; nutrition advice & recipes
HealthMatters Disease know-how, prevention & management
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Health titbits to keep
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Everyday heroes that make a difference
FOODforLIFE!
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Experts share insights & advice
Community partnerships
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News, events & more at JurongHealth
INSIDE NTFGH &JCH
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“ONEHealth expresses our passion in bringing health to every home. In these pages and in future issues, you will find useful articles on chronic diseases, wellness and healthy eating – information designed to be a helpful resource for you and your family to stay healthy and enjoy life to the fullest! “ We, at JurongHealth, are really excited to launch the very first edition of our health and lifestyle magazine – ONEHealth – specially for our community in the west. JurongHealth wants to be your partner in health. We are building our new 700-bed Ng Teng Fong General Hospital (NTFGH) and 400-bed Jurong Community Hospital (JCH) as part of this community to serve you. Through this publication, we will bring you updates on services, programmes and events. A pull-out special feature takes you InsideNTFGH&JCH – set to serve the public by December 2014. Don’t miss HealthBUZZ as it showcases the colourful ‘Let’s Paint a Picture of Health’ programme and the launch of the Lakeside Family Medicine Clinic. In HealthSense, we explore health services and offer an insight into the common conditions treated by our Ear, Nose and Throat specialists. While in WeCARE, we focus on our collaborations with community partners, patients, caregivers and staff – and highlight how an Integrated Care Pathway for Chronic Obstructive Pulmonary Disease aims to offer better quality of care to our patients. Get to know us better with our story on how Staff Nurse Chua Peng Peng found her calling in nursing after a traumatic accident. Turn to TouchingLives for ‘A Calling Discovered’. Equip yourself with health knowledge in HealthMatters and learn the tell-tale signs of diseases. In this issue, we look at the rising threat of influenza and how to protect yourself, the warning signs of phobias and important facts about brittle bone disease. Read on to FOODforLIFE! to find out about delicious ways to enjoy water, the benefits of Omega-3 and a healthy salmon recipe. Our last page, HealthBites, updates you on a fun fact each issue. This round, we encourage you to use our handy guide to first aid essentials. We hope you enjoy this inaugural issue of ONEHealth as much as we have enjoyed putting it together for you. If you are wondering why we named this publication ONEHealth, it is because we would like to be ONE with our community as we keep you well and healthy!
Foo Hee Jug CEO, JurongHealth
O N E H E A LT H
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CONTENTS
C NTENTS PU B L I S HE R JURONG HEALTH SERVICES PTE LTD E DI TO R - I N- C HI E F CASEY CHANG DE PU T Y E DI TO R A ARON LOH CO NT R I B U T I NG E X PE RT S DR EDDY NGATEMO DR EUAN MURUGASU DR GERALD CHUA DR HO YEW MING DR JANE CLAYTON DR LEYLAND CHUANG DR MICHAEL YONG DR RANJIT MAGHERRA DR RAPHAEL CHAN DR SOH POH CHOONG DR SURESH ERNEST DR SURINDER PADA DR THOMAS SOO DR TONY SETIOBUDI ELISA MAK JAVIN TANG KIMMY LIEW RICHARD WOO PU B L I S HI NG CO NS U LTA NT THINKFARM PTE LTD M A NAG I NG DI R EC TO R CHRISTOPHER TAY E DI TO R I A L & DE S I G N SHERALYN TAY SHARON HO DENISE LIM WR I T I NG & PH OTO G R A PHY LINA LEWIS IRIS CHUA JUSTIN LOH LEO GOH C L IENT R E L AT I O NS HI P M A NAG E R JESSIE KEK –––––––––––––––––––––––––––––––––––– 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. MICA (P) 112/06/2013 PRINTED BY KHL PRINTING CO PTE LTD. –––––––––––––––––––––––––––––––––––– For general enquiries, email
onehealth@juronghealth.com.sg
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HealthBUZZ 04 COLOURS OF HEALTH
WeCARE 10 CARING FOR COPD
06
HealthDrive 12 LIFE BLOOD
A community gets involved in ‘Let’s Paint a Picture of Health’
A PARTNERSHIP OF CARE
Lakeside Family Medicine Clinic brings chronic disease management to your door
HealthSense 07 INSIDE THE WORLD OF ENT
The common conditions treated by Ear-Nose-Throat specialists
An integrated model for better COPD care
Blood donation myths debunked; and how you can contribute to this life-saving procedure
TouchingLives 14 A CALLING DISCOVERED
Former Singapore Girl, Chua Peng Peng, soars in another calling – that of nursing
2013 • ISSUE 1
HealthMatters 18 SEASON OF SNIFFS
With worrying news of new flu viruses surfacing, it’s important to learn how to protect yourself this flu season
21
FEAR FACTOR
24
BREAKING POINT
We all have things we’re scared of, but when does a simple fear become a phobia – and how do we recognise the signs?
FOODforLIFE! 27 TIME TO DRINK UP
Water energises your muscles, keeps your digestion primed and gives you glowing skin. Here’s how to make water a way of life
30
HealthBites 33 FIRST AID KIT ESSENTIALS
What to pack for those household emergencies
GET FAT!
Discover the benefits of Omega-3 and try a delicious seared salmon recipe
Osteoporosis is the silent disease that causes painful outcomes if not detected early. Find out if you are at risk
SPECIAL SUPPLEMENT InsideNTFGH&JCH P16 O N E H E A LT H
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HealthBUZZ
Colours of Health
What does health look like to you? Residents in the west imagine and bring to life – their idea of wellness
For one student, health was imagined as a lush forest with towering trees and leafy ferns, while it was a vivid swirl of bright colours for another. These imaginative interpretations of health were all part of JurongHealth’s ‘Let’s Paint a Picture of Health’ programme, a series of three art workshops held between March and April this year. It was run by artist Isabelle Desjeux in collaboration with the South West Community Development Council (CDC). According to JurongHealth’s Community Relations Assistant Director, Tan Hwee Ping, the idea for the programme stemmed from a desire to engage residents in the west in the lead up to the opening of the Ng Teng Fong General Hospital (NTFGH) and Jurong Community Hospital (JCH) from next year. “We had a new length of hoarding at the hospital’s construction site along Jurong Gateway road and we saw this as an opportunity to involve the community to create a stretch of artwork to add colour to the hoarding,” she explained. Some of these art pieces will take pride of place in the new hospital’s dedicated community art space. Fifty participants – aged nine to 90 – from various secondary schools and St Luke’s ElderCare (Jurong East) took part in these workshops, using mediums such as
O4 ONEHEALTH
watercolour paint, pencil and even beans to bring their ideas to life. St Anthony’s Primary School student Amanda, 12, said, “I painted an image of Singapore’s National Day celebration because I want the patients to know that the world is bright and very beautiful. They may think that their world is dark and gloomy but they must hope for a better and more fruitful day.” One of the most meaningful workshop sessions was the one held on 9 April, where student volunteers from four secondary schools and 40 residents from St Luke’s ElderCare (Jurong East) co-created 3-D art using beans. Speaking at the event, Southwest CDC Mayor Dr Amy Khor noted that it was a good platform for building inter-generational bonding, community spirit and promoting health awareness. “We feel that this is really a worthwhile collaboration (that) helps to build a sense of community pride and ownership,” she said. Echoing this sentiment was JurongHealth CEO, Foo Hee Jug. He noted that this project underscored JurongHealth’s commitment to connect with the residents in the west of Singapore. He said: “Our new hospitals are really about the community, and when they are ready from 2014, the NTFGH and JCH will both be places where the community can own and embrace.”
“TREE O
F LIFE By a St Luk Chen Xi Ying, ” e ElderC are resi dent
IGHTEN ERS BR AY” W O L F “ D UP THEei Shan, 14
By A condary hing Se Yuan C
am M hool By Che econdary Sc ah S Hong K
CH” Y BEYA P P e, 12 ool u A g H “ y Lim Xin dary Sch B
“BLOOMING FL OWERS” By Tan Saw
“JOBYin”te Ariffin, 12l adaina ndary Schoo rh u N By co hing Se Yuan C
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“HEART RU
a St Luke ElderC Eng, are resident
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NG PY THI D HAP , 13
AN i Ting NDOM zel Goh Hu School
“RA
HOME” URFitUzgLerald, 13 O L O C eF “A School my Jan
By Ha g Secondary hin Yuan C
ER VASE” “FLOWng Jia Ying,
N” By Ng Jia Hua Yi Seco Wei, 15 ndary Scho ol
By Lia are resident a St Luke ElderC
O N E H E A LT H
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HealthBUZZ
Patients with chronic conditions can be cared for at the Lakeside Family Medicine Clinic – a collaboration with JurongHealth – to ensure that they get the best care at the right place and at the right time
Partnership of CARE The Lakeside Family Medicine Clinic (LFMC) aims to bring greater convenience to patients with chronic conditions in the west. At LFMC, JurongHealth specialists and private family medicine-trained doctors work together to bring “best site care”, explained Associate Prof Cheah Wei Keat, Chairman of JurongHealth’s Medical Board, “Patients currently go to hospitals to see specialists for chronic conditions, such as asthma, high blood pressure or diabetes,” he noted, “However, we know that doctors in the community have the right expertise to manage many of these conditions.” At the LFMC, these patients can receive good care in the community from Family Physicians (FPs) and at the same time be seen to by specialists in the hospital if necessary, he explained. This model of care means FPs like Dr Luke Low, Senior Family Physician and Clinic Manager, can work hand in hand with specialists in regional hospitals. Patients will see their JurongHealth specialist once or twice a year. At other times, LFMC doctors attend to patients whose conditions are stable. The FP can refer the patient to the specialist for treatment should the condition worsen. This approach makes more “judicious use” of specialist resources, he added, and patients with simple and uncomplicated medical conditions can save time and money by seeing a doctor in their community.
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Resources for FPs Under the LFMC and JurongHealth collaboration, 12 FPs with passion and interest in family medicine will be supported by JurongHealth’s multi-disciplinary healthcare team. Dr Thomas Soo, Consultant and Clinical Director, JurongHealth, noted this would empower FPs with more resources and also bring an “integrated ecosystem of care” to the community. Patients can access a range of services for healthcare needs (see facing page).
A doctor at your doorstep Dr Eng Soo Kiang, one of the FPs from the private sector who runs clinics at LFMC, noted that the LFMC model complements the existing primary care infrastructure predominantly made up of polyclinics, solo general practitioners and medical group practices. Not only do patients benefit from fewer hospital visits, Dr Eng observed that it would build better doctor-patient relationships. “Seeing the same family physician again after a visit with their specialist helps to build a trusting therapeutic relationship, foster a better understanding and help a patient navigate the many ups and downs of his or her illness.” Associate Prof Cheah said, “For patients whose chronic conditions are stable, it means a better and more convenient way to prevent, reduce or delay complications from arising and potentially fewer hospital admissions.”
What is Lakeside Family Medicine Clinic?
The Lakeside Family Medicine Clinic brings together primary care doctors (general practitioners and family physicians) and other services so that chronic diseases can be cared for close to home and not just at hospitals.
MONEY MATTERS
Do I get subsidised care? Q What are the payment modes available? Cash, NETS, credit card payments and cheques will be accepted.
Q Is there subsidy available? Yes, CHAS subsidy is available for eligible patients. Visit www.chas.sg
Lakeside Family Medicine Clinic, which opened on 3 June this year, offers: • • • • • • • • • • • • •
ACUTE CARE CHRONIC DISEASE MANAGEMENT DIABETIC COUNSELLING DIABETIC FOOT SCREENING DIABETIC RETINAL PHOTOGRAPHY HEALTH SCREENING HOME CARE LABORATORY TESTS DIETETICS MEDICAL SOCIAL SERVICE PHYSIOTHERAPY PODIATRY DIAGNOSTIC RADIOLOGY
––––––––––––––––––––––– Lakeside Family Medicine Clinic Block 518A Jurong West Street 52 #01-02 Singapore 641518 For appointments, please call 6471 5154 Clinic and call centre operating hours : Monday–Friday : 8.30am to 5.30pm Saturday : 8.30am to 12.30pm Closed on Sunday and public holidays
Q Can I use my Civil Service Card (CSC) or Medifund at the LFMC? CSC and Medifund are not accepted at LFMC.
Q Can I pay with Medisave/CHAS for payment? Yes, you may use your Chronic Disease Management Plan, Medisave* or CHAS.
Q Will my subsidies be carried over when I am referred to a hospital’s Specialist Outpatient Clinic (SOC)? In the event of a referral to a hospital’s SOC, the subsidy will apply only if you are a CHAS card holder. * For chronic diseases, Hepatitis B and HPV vaccinations only. For a list of chronic conditions covered by CHAS, go to www.chas.sg
Q&A O N E H E A LT H
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HealthSense
INSIDE THE WORLD OF
ENT Otorhinolaryngology
(o-toh-rhino-lair-in-joll-oh-gee), commonly known as ENT for earnose-and-throat, is a specialty that deals with a wide range of conditions from runny noses to head and neck cancers. Three ENT specialists from JurongHealth talk about their speciality
” Technology is revolutionising the way we manage hearing loss.” Dr Euan Murugasu S E N I O R CO N S U LTA N T & DI R ECTO R , E N T “As an otologist or ear specialist, I treat a range of ear problems from impacted ear wax (hardened build-up of ear wax) that blocks the ear canal to ear infections, holes in the ear drum, hearing loss, and dizziness (known as vertigo). Currently, we are seeing more of the last two conditions related to our rapidly elderly population. Another area I handle is cochlear implants and implantable assistive hearing devices that are implanted into the ear to transmit sounds directly to the nerves, which in turn transmit them to the brain. This advancement in assistive hearing devices, and neonatal screening programmes mean that many hearing-impaired children are now getting their cochlear implants much earlier and learn to listen and speak earlier so that they can integrate into mainstream education. Technology is also revolutionising the way we manage adults and older patients with inner ear hearing loss.”
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My specialty is rhinology and allergies, and I deal with conditions of the nose — commonly called sinus problems. Chronic runny or blocked nose are often due to allergies, in particular with house mites and dust. I treat patients with medication to alleviate symptoms and may also do skin tests to determine the type of allergy they suffer from. In some cases, I recommend immunotherapy. This treatment slowly builds and develops a person’s tolerance to the allergy-causing source (allergen) so that they no longer get sinus problems. The treatment can be delivered via injection or mouth drops. Other common conditions I handle are sinus infections and blocked sinuses.
”Immunotherapy can be used to build allergy tolerance and cure sinus problems.” Dr Raphael Chan S E NIOR CONS ULTA NT
”Our goal is not only to remove the cancer but also to preserve important functions.” Dr Ranjit Magherra
S E N I O R CO N S U LTA N T
I specialise in surgery for cancers in the mouth, voice box, throat and neck. Nose or nasopharyngeal cancer is the sixth most common cancer in Chinese males in Singapore. I work with a tumour board – an expert team of many different specialists – to determine and customise the best treatment option for every patient. Treatment can take the form of surgery, radiotherapy or chemotherapy, or a combination of these. Our goal is not only to remove the cancer, but also to preserve important functions such as speech and swallowing. This makes the field particularly challenging. I also treat snoring and obstructive sleep apnea (OSA). OSA is a type of severe snoring where breathing is disrupted during sleep. OSA deprives the brain of oxygen and increases the risk of high blood pressure, heart attack and metabolic diseases.
O N E H E A LT H
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WeCARE
Chronic Obstructive Pulmonary Disease (COPD) is the seventh leading cause of death in Singapore and causes nearly 10,000 hospitalisations a year. But it is often underdiagnosed – detected only in its late stages – and undertreated. An integrated care programme by JurongHealth seeks to change all that
Caring for COPD What is COPD? COPD is an umbrella term for chronic lung disease in which air flow in the lungs is obstructed. This is usually caused by irreversible tissue damage from smoking or severe infection. The tissue damage means the lungs cannot fill up with air sufficiently, causing breathlessness.
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5 CARE APPROACHES It’s a long-term lung disease that causes sufferers to cough constantly, produce a lot of phlegm and have difficulty breathing even when they’re at rest. According to Dr Gerald Chua, Head of Medicine, JurongHealth, many patients are not identified in the early stages, so the disease advances to a severe stage that needs medical attention and hospitalisation. Part of the reason for this is the lack of diagnostic equipment at general practitioners (GPs). There is also a lack of services such as smoking cessation counselling – that are important in the long-term management of COPD.
Taking holistic care to the community To address the lack of community healthcare resources, prevent severe attacks and reduce hospitalisation, JurongHealth rolled out a pilot Integrated Care PathwayChronic Obstructive Pulmonary Disease (ICP-COPD) programme in April last year. Instead of just hospital-based care, it covers the “spectrum of care”, said Dr Chua. Patients diagnosed with COPD are jointly managed by JurongHealth specialists as well as GPs with access to a multi-disciplinary healthcare team and services.
Every stable patient is cared for by a JurongHealth specialist and a GP • Multi-disciplinary care bundles are customised according to the severity of condition • A single IT platform ensures every patient has one record that can be viewed by care providers • GPs can refer patients to smoking-cessation counselling and spirometry at Jurong Medical Centre or Alexandra Hospital – no specialist referral is needed • JurongHealth case managers keep in contact with patients, monitor progress and coordinate appointments
INTEGRATED ICP-COPD PROGRAMME
CUSTOMISED CARE BUNDLES
JURONGHEALTH SPECIALIST
SMOKING CESSATION
+
+ +
CONSULTATION
GP
SPIROMETRY (LUNG FUNCTION TEST)
CASE MANAGER OVERSEES EACH PATIENT
Patient empowerment A COPD guidebook has also been created to help COPD patients understand the disease, recognise the early signs and symptoms, and seek the necessary help.
One patient, one record An integrated IT-platform shares patient records with external healthcare partners so that all doctors and healthcare providers have access to the same information.
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HealthDrive
Every four minutes, a unit of blood – the size of your large latte or regular soda – saves a life. With more than 100,000 units of blood needed a year to meet Singapore’s transfusion requirements, every drop counts! By Sheralyn Tay IN CONSULTATION WITH DR THOMAS SOO, CONSULTANT, HEALTH & WELLNESS CLINIC
Life Blood Each unit of blood donated can be processed into three types of blood products, so a single blood donation can help at least three different people. Each blood product can be used for different treatments. Plasma:
Cancer treatments, organ transplants, surgery. SHELF LIFE
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2 years
Red blood cells: Anaemia, blood loss, sickle cell disease, surgery. SHELF LIFE
35 days
Platelets:
Serious burns, shock, bleeding disorders. SHELF LIFE
35 days
Myths Debunked If I give blood, I’ll become fat. There is no link between blood donation and weight gain. Your body only replaces the blood given and does not ‘overcompensate’ to produce excess blood or fat. The myth may arise from a tendency to supplement the blood loss with extra food or tonics that may result in weight gain. From a medical perspective, the only supplements you may need after blood donation are iron pills.
I don’t have enough blood to give. Sure you do! Only about 450ml of blood is drawn during blood donation. That’s just 10 per cent of the blood in the average adult body. In just three days, your body would have replaced the volume of blood donated.
My blood type is too (un)common, so it’s not needed. All blood types are important and needed! Every day, major surgeries, trauma rescue, cancer treatments and premature babies require large amounts of blood. Whether your blood type is common or not, there will be people who need it. Rare blood types are in demand precisely because it’s hard to come by and common blood types can be given to a majority of people.
It’ll hurt! Before donation, a local anaesthetic is usually given to reduce the discomfort during the procedure.
I’ll be very weak after giving blood and it’ll disrupt my schedule. Blood donation takes just an hour of your time. It won’t depress your immune system, make you anaemic or cause you to feel unwell. In fact, a healthy person can donate blood up to four times a year or every 12 weeks!t
Where to donate? Bloodbank@HSA Health Sciences Authority (Opposite Outram Park MRT Station) 11 Outram Road Singapore 169078 Closed on Mondays & public holidays
––––––––––––––––––––––– Bloodbank@Woodlands Woodlands Civic Centre (Opposite Causeway Point) 900 South Woodlands Drive #05-07 Singapore 730900 Closed on Tuesdays & public holidays
––––––––––––––––––––––– Bloodbank@Dhoby Ghaut Dhoby Xchange (Near Exit B) #B1-05/06/07/08/09 11 Orchard Road Singapore 238826 Closed on Thursdays & public holidays
–––––––––––––––––––––––
Did you know? You can donate blood to yourself for elective surgery. The process is called autologous donation. All you need is to donate blood a few weeks before your operation and this will be used for the procedure.
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TouchingLives
A Calling Discovered A terrible accident led Madam Chua Peng Peng, a flight stewardess, to discover a career in service of another kind – that of nursing By Lina Lewis Nursing was never her childhood dream. In fact, in all the 12 years she was an air stewardess with the Singapore Airlines (SIA), she disliked the first aid aspect of the profession. But destiny had other plans for Madam Chua Peng Peng, and her life took an unexpected turn – with the appearance of a cockroach. About four years ago, Madam Chua was driving her husband, Mr Alex Pathy, who was then an air steward with SIA, to the airport when a cockroach strayed into the car and she tried to swipe it away. In a split second, she lost control of her car and it crashed into a tree. “It all happened too fast,” said the 41-year-old mother of a five-year-old son. “I blacked out. When I came to for a minute, I saw my husband slumped in his seat, blood trickling down his face. I heard my son crying and that comforted me, knowing that he was alright.” When she regained consciousness, it was many hours later in a hospital.
Dashed dreams The accident ended the couple’s careers as air crew. Mr Pathy suffered orbital injuries and needed to reconstruct his lower eyelid. Madam Chua, who had quit flying to start a family and had planned to go back to SIA when their son turned one, suffered facial injuries, including a broken nose. “I felt lost, all my hopes dashed. So I asked God to give me a sign,” she said. During her two weeks of hospitalisation, she noticed the nurses around her. The more she watched them busy at work, the more attracted she was to the profession. After she was discharged, Madam Chua came across an advertisement by the Singapore Workforce Development Agency (WDA). “With WDA’s help, I enrolled in Nanyang Polytechnic’s nursing course,” she said, adding that she enjoyed going back to school.
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A new dawn
“Nursing gives me much bigger job satisfaction. It makes my life more meaningful now that I can help other people.”
She has not looked back since. A year ago, after her graduation, Madam Chua joined JurongHealth as a ward nurse. When asked if she misses her job as an air-stewardess, she said: “Of course I do. Flying was very fun, and the money was good. But nursing gives me much bigger job satisfaction. It makes my life more meaningful now that I can help other people. The accident made me realise how fragile and precious life is, and I should never take it for granted.” To those who think the glamourous life of a cabin crew is more rewarding than the oft-unsung role of a nurse, Madam Chua would like to correct that. “Nursing is a bit like being a cabin crew – you need to make your customers comfortable. But the similarity ends there,” she said. “As an air stewardess, I served the passengers whatever they wanted as best as I could and nothing more. There was no affiliation. Once we reached the destination, my job was done and everyone left. But as a nurse, it’s much more personal. I care about the patients, who are appreciative of my efforts. I want them to get better. I’ve had patients whose family members would buy me meals during my busy days. I was very touched. Never had I experienced such gratitude and the warmth was beyond my expectations.”
A calling discovered So in love is Madam Chua with nursing that she encouraged her husband to join her in healthcare. Mr Pathy is now in his final year as a Diagnostic Radiography student at Nanyang Polytechnic. A motivated learner at heart, Madam Chua wanted to learn and do more. About two months ago, she requested for a transfer to the Emergency Medicine Department. “I wanted to be in the thick of the action,” said the dedicated staff nurse, who is now exploring the possibility of furthering her education. “I learn something new every day, and the more I know, the more I realise how little I know.” Her parents, who have always been supportive of her, may move in with Madam Chua to help her and her husband care for their son, especially when the latter graduates from his course. The new arrangement would also make it more convenient for Madam Chua to pursue further education. “I thank God for not only giving me a second chance, but for showing me the light and making my life more meaningful,” she said with a smile.
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SPECIALSupplement
1
A N I N T E G R AT E D H E A LT H C A R E H U B
InsideNTFGH&JCH
JurongHealth is Singapore’s public healthcare cluster formed to facilitate the integration of healthcare services and care processes for the community in the west
ALEXANDRA HOSPITAL Managing Alexandra Hospital since August 2010, JurongHealth is building and growing the capacity and skills needed in preparation for the big move to the Ng Teng Fong General Hospital in December 2014 and Jurong Community Hospital in June 2015.
NG TENG FONG GENERAL HOSPITAL Set to open in December 2014, the Ng Teng Fong General Hospital will serve the community in the west with comprehensive range of clinical and allied health services. The 700-bed acute hospital and the adjoining Jurong Community Hospital will be an integral part of the vibrant live-work-play hub envisioned by the Jurong Lake District Masterplan.
JURONG COMMUNITY HOSPITAL Providing step-down care for patients, the 400-bed Jurong Community Hospital is twinned with the Ng Teng Fong General Hospital for a seamless continuum of care. When it opens in June 2015, it will bring integrated specialist and rehabilitative care closer to the community.
JURONG MEDICAL CENTRE Complementing the acute and step-down care services, Jurong Medical Centre provides residents in the west with a one-stop specialist centre providing services such as outpatient specialists, dental, diagnostic and day surgery services, chronic disease management, health screenings and health promotion programmes. Log on to www.juronghealth.com.sg for more information
AN INTEGRATED HEALTHCARE HUB 16 ONEHEALTH
Our integrated health outreach efforts, community care partnerships, educational programmes and screening initiatives underscore our mission:
stay well, heal, empower We want to ensure that the healthy stay healthy, the sick get well and the community is empowered to manage their wellbeing.
A vision for health & wellness Medical care is not just about treating sickness, but preventing illness, detecting it earlier and managing it to reduce complications. Our vision:
transforming care, seeks to deliver
InsideNTFGH&JCH
A mission of care
A N I N T E G R AT E D H E A LT H C A R E H U B
ANAESTHESIOLOGY AUDIOLOGY CARDIOLOGY CLINICAL MEASUREMENT DENTAL DERMATOLOGY DIETETICS & NUTRITION EAR, NOSE & THROAT EMERGENCY MEDICINE ENDOCRINOLOGY GASTROENTEROLOGY GENERAL SURGERY GERIATRIC MEDICINE GYNAECOLOGY HAEMATOLOGY HAND SURGERY HEALTH & WELLNESS INFECTIOUS DISEASES INTENSIVE CARE MEDICINE INTERNAL MEDICINE LABORATORY MEDICINE MEDICAL SOCIAL WORK NEUROLOGY NEUROSURGERY NUCLEAR MEDICINE OCCUPATIONAL MEDICINE OCCUPATIONAL THERAPY ONCOLOGY OPHTHALMOLOGY OPTOMETRY ORTHOPAEDIC SURGERY PALLIATIVE MEDICINE PHARMACY PHYSIOTHERAPY PLASTIC SURGERY PODIATRY PSYCHOLOGY PSYCHIATRY RADIOLOGY REHABILITATION MEDICINE RENAL MEDICINE RESPIRATORY MEDICINE RESPIRATORY THERAPY RHEUMATOLOGY SLEEP LABORATORY SPEECH THERAPY SPORTS MEDICINE & SPORTS SURGERY UROLOGY
more people-centric care and move away from illness-care to keeping people healthy. Working with community partners we aim to integrate and simplify healthcare so it is accessible and achieve the goal of
bringing health to every home
A COMPREHENSIVE SUITE OF CLINICAL & ALLIED HEALTHCARE SERVICES O N E H E A LT H
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18.2cmW BETTER EMERGENCY CARE The Emergency Department (ED) is designed around our patients’ needs to reduce waiting time through a more efficient workflow. Elderly-friendly features also help improve comfort and reduce anxiety. FASTER & MORE RESPONSIVE Registration, nurse triage and consultations have been streamlined into a single step. Patients are then discharged or admitted. For those who can go home, they can collect their medication and make payment at the same time.
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MOBILE REGISTRATION
NURSE TRIAGE
>
CONSULTATION
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Full registration and payment > discharge > medication
SIMPLIFIED ED PROCEDURES IN JUST 2 STEPS
TYPICAL ED PROCEDURE
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FLEXIBLE, SCALABLE & INTEGRATED The ED design is also more flexible and convertible so that services can be scaled up to meet future increases in demand. The ED is also pandemic-prepared, masscasualty and decon-ready. Patients at the ED who need immediate medical intervention can also rapidly access:
> > > >
Trauma lifts to the operating theatres & ICU Modular resuscitation areas The isolation ward Diagnostic imaging
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>
>
>
>
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REGIONAL HOSPITAL
ICU
Procedural Imaging
OT (L1)A&E Iso Ward LIFT CORE
18.4cmW A WINDOW FOR EVERY PATIENT BETTER AIRFLOW & A VIEW Patients can have soothing views and better ventilation that are conducive for their healing NATURAL LIGHT WITHOUT GLARE Ward towers are orientated to let in an optimal amount of sunlight but with reduced glare and heat
MORE PERSONAL SPACE & PRIVACY Patients are able to sleep on their side looking out of the window, without facing another patient in the next bed
A UNIQUE WARD DESIGN The fan-shaped wards are designed to provide a window for every patient. This improves privacy and is shown to help recovery. The design and east-west orientation of the ward towers also takes advantage of prevailing winds to increase ventilation and double air flow, compared to that of a conventional ward. The layout gives staff more space for manoeuvring when doing bedside procedures and improves infection control.
18.6cmW AN ICU WITH A DIFFERENCE As Singapore’s first and only combined critical care facility to merge an Intensive Care Unit (ICU) with High Dependency (HD) Unit, the NTFGH’s Intensive Care Medicine Department will streamline critical care across the different conventional ICUs (Surgical, Medical, Cardiac and Neurosurgical). This means
critical care is delivered in one location, by one team, with one standard of care.
Garden for ICU patients to enjoy some sunlight and fresh air
Twinning ICU and HD also means patients whose critical condition have stabilised need not be transferred to another ward and can be cared for by the same team. This means lower risk of medical errors, shorter hospitalisation stays and better social support for patients. More than medical care, the ICU is also unique because patients have access to adjacent outdoor areas with natural light, greenery and fresh air.
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Patient Experience New Hospitals Integrated Blocks
700 beds 5000 400 beds 8ight NG TENG FONG GENERAL HOSPITAL
pairs of caring hands JURONG COMMUNITY HOSPITAL
STOREYS of SPECIALIST OUTPATIENT CLINICS OUTPATIENT CLINIC BLOCK WITH A PHARMACY ON EVERY CLINIC FLOOR
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A N I N T E G R AT E D H E A LT H C A R E H U B
1 2 3
The Ng Teng Fong General Hospital and Jurong Community Hospital are envisioned to transform the way healthcare is provided to the community in the west. They are designed to ensure that patient-centred services are delivered in a seamless and integrated way. This flows from the provision of medical care to the design of the hospitals as well as the connectivity to the community. The 700-bed acute hospital is twinned with the 400-bed community hospital so that patients who no longer need acute or critical care can recuperate in a setting better catered to their needs. JurongHealth will manage both hospitals bringing better integration at all levels.
InsideNTFGH&JCH
18.8cmW
18.8cmW MASTER PLAN The Ng Teng Fong General Hospital (NTFGH) and Jurong Community Hospital (JCH) is the first integrated healthcare development designed, built and managed as a single project. This facilitates the seamless transition of care and better resource sharing for more effective and cost-efficient healthcare
IMM
Orientation of Ward Tower for COMMUNITY HOSPITAL away from Toh Guan Road for noise mitigation
R O A D
S
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Devan Nair Institute for Employment and Employability
North-south orientation of Subsidised Ward for NTFGH WARD TOWER for optimal ventilation and avoidance of east-west sun
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T O H
2
G U A N
1
MRT
future development
n tio ec dir ind w
WEST GATE
JEM
Easy visitor access: BRIDGE/PATH Connected basement parking ensures vehicular access. Three different entry and exit points minimise congestion
NTFGH CLINIC TOWER
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NTFGH WARD TOWER
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JURONG COMMUNITY HOSPITAL
3
SMOOTH TRANSITIONS Much thought has gone into the planning to ensure that patients receive seamless and convenient medical care. The twinning of NTFGH and JCH ensures that patients can be treated in the right healthcare setting – be it acute or rehabilitative care. CONNECTIVITY & ACCESSIBILTY The NTFGH Clinic Tower, with its Specialist Outpatient Clinics, is located nearest to the MRT for greater convenience. The hospital buildings are connected via link bridges, which have dedicated pedestrian walkways for visitors to separate them from patients and hospital staff. This improves infection control and ensures privacy. STRATEGIC DESIGN The buildings are orientated away from Toh Guan Road so there is less traffic noise, and patients can have a more restful environment. Lush landscaping and vertical greening also cools the area and filters out noise, adding a touch of nature. WORKING TOGETHER JurongHealth works with community partners in the west, such as General Practitioners, polyclinics, community hospitals, long term care providers, and voluntary welfare organisations to ensure the whole continuum of care is accessible and one step closer to home.
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18.6cmW
THE BIG PICTURE
Integrating and transforming care JURONG COMMUNITY HOSPITAL
“ We have planned,
designed and are jointly building the Ng Teng Fong General Hospital and Jurong Community Hospital with our patients in mind to ensure they receive seamless care for their medical needs.” Mr Foo Hee Jug CEO, JurongHealth
NG TENG FONG GENERAL HOSPITAL
JURONG COMMUNITY HOSPITAL Patients who are stable can recuperate at the Jurong Community Hospital.
12 LEVELS 400 BEDS OUTPATIENT CLINICS
18.4cmW Master Planning
Groundbreaking
2010
2011
Handover of Jurong Gateway Road
2012
2013
Structural Topping Up
2014
Official Official Opening of Opening Ng Teng Fong of Jurong General Community Hospital Hospital
December June 2014 2015
WARD TOWER
CLINIC TOWER
(SPECIALIST OUTPATIENT CLINIC)
NG TENG FONG GENERAL HOSPITAL With a strategically planned emergency department integrated with a state-of-the-art intensive care unit, patients with urgent medical needs can be cared for more efficiently. At the wards, each patient will enjoy a window view.
The SOCs (Specialist Outpatient Clinics) at the Clinic Tower will bring together a diverse multi-disciplinary team of medical experts to manage diseases in a holistic way to prevent complications.
16 LEVELS 700 BEDS EMERGENCY CARE INTENSIVE CARE DIAGNOSTICS & TREATMENT
8 LEVELS 120 CONSULTATION ROOMS DIAGNOSTIC SERVICES PHARMACIES ADMINISTRATIVE SERVICES
18.2cmW GREENING AN URBAN HOSPITAL SUNRISE GARDEN Located between two ward towers, this green space can be enjoyed by patients and visitors to the regional hospital
SPECIALIST OUTPATIENT CLINIC THERAPY GARDEN The Therapy Garden is an informal place for staff and patients to stroll and rest
SOC ATRIUM ROOF GARDEN
Lush LANDSCAPING absorbs and deflects ground level noise COMMUNITY WELLNESS PARK
A healthy environment is also one that is eco-conscious. Bringing the important principles of sustainability into its very heart, the Ng Teng Fong General Hospital and Jurong Community Hospital are designed – in physical infrastructure, water and energy systems and landscape features – to be as carbon-neutral as possible. With highly efficient air-conditioning systems, energy-saving lighting and sunlight-enhancing architectural elements, energy recovery innovations and the use of renewable energy, the hospital buildings will use 30 per cent less energy than existing hospitals. The entire domestic hot water supply will be provided by solar thermal systems, while solar photovoltaic panels will power landscape lighting. This amounts to energy savings of some $5 million – equivalent to the power used by 4,000 5-room HDB flats in a year! Smart water systems will enable the hospitals to use 40 per cent less potable water than a conventional hospital in the region. Rainwater harvesters will store nature’s showers to quench the landscape and water required for the air-conditioning system’s cooling towers will be fully provided by recycled NEWater. For its environmentally-friendly design, the Ng Teng Fong General Hospital and Jurong Community Hospital won the Building Construction Authority’s Green Mark Platinum Award. O N E H E A LT H
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HealthMatters
A Season of Sniffs Most of us have suffered these symptoms before: sneezing, a runny nose, sore throat and cough. So unremarkable it is to fall prey to this ailment that is called the common cold By Iris Chua IN CONSULTATION WITH DR SURINDER PADA, CONSULTANT, INFECTIOUS DISEASES DR LEYLAND CHUANG, REGISTRAR, DEPARTMENT OF MEDICINE
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When the ‘bug’ hits – a few days of rest, plenty of water and easy access to generous stores of tissue paper usually does the trick. The common cold is self-limiting and patients usually recover on their own. However, the same cannot be said of its more deadly cousin – the seasonal flu or influenza. Flu is a highly contagious viral infection that affects the respiratory tract (nose, throat and lungs). In Singapore, we experience the seasonal flu all-year round, with peaks typically occurring twice a year in May to June and November to December.
Cold or flu? The flu and the common cold are respiratory infections, but caused by different viruses. While the flu is caused by the influenza virus alone, over 200 viruses may cause the common cold. Both result in symptoms such as sneezing, a runny nose, sore throat and cough, but symptoms for the common cold are milder and unlikely to lead to serious complications such as pneumonia. In contrast, the flu virus causes more severe symptoms, such as high fever, tiredness, body aches and dry cough. It’s hard to tell the difference from symptoms alone, so if a person is severely sick, a laboratory test may be done to confirm if a person has an influenza infection. Most people with the flu only suffer from mild symptoms and do not need to see a doctor or take antibiotics. However, anyone with severe symptoms such as shortness of breath, fast or difficulty breathing, sudden dizziness, confusion and severe vomiting should consult a doctor. There are antiviral drug such as oseltamivir (Tamiflu®) and zanamivir (Relenza®) but these should be taken only if prescribed by a doctor after a thorough medical examination as they have side effects and are only effective in the first 48 hours of the infection.
When sharing is not caring If you have the flu, you are infectious one day before the onset of your symptoms and up to a week after developing symptoms. Young children and people with weakened immune systems may be contagious for an even longer time. Flu can lead to serious complications, or even death in the elderly, very young children and persons with certain chronic illnesses. It is best to stay home to recover when you have a flu and wear a surgical mask when outdoors, particularly in crowded public areas.
New and dangerous kid on the block
There are three main types of influenza viruses: influenza A, B and C. Seasonal outbreaks and epidemics are caused by influenza A and B, whereas influenza C is less common, and normally results in milder infections. For each type of flu, there are also multiple variations, such as the H1N1, H5N1 and H7N9 – strains that have caused outbreaks in humans and poultry in recent years. Because influenza viruses have the ability to mutate and constantly do, we cannot always guarantee immunity even if we’ve had the flu before or have had a vaccine. People who do not have immunity to these tend to develop severe symptoms. The other danger with ‘new’ strains of flu is that these might spread easily and result in a worldwide pandemic. When novel flu strains such as the H5N1 hit Singapore, daily visits for acute respiratory infections at the polyclinics hit a high of 4,450 – a 46 per cent increase from the previous year. There was also a 43 per cent increase in hospitalisations for pneumonias and influenza, and numbers of acute respiratory infections seen at the emergency departments doubled.
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HealthMatters
Flu flu go away FLU ALERT!
SHOULD I GET VACCINATED? One of the ways to prevent the seasonal flu is through twice-yearly vaccination to protect against the current prevalent strain. In healthy adults, influenza vaccination can prevent 70 to 90 per cent of influenza-specific illnesses. Among the elderly, the vaccine reduces severe illnesses and complications by up to 60 per cent and deaths by 80 per cent. Flu shots are also recommended for healthy individuals, especially if you live with or take care of persons at risk of complications from the flu.
Avian influenza A (H7N9) is a subtype of influenza that is sometimes found in birds. However, many cases of H7N9 infections in both birds and humans were reported in China towards the end of March this year. This was unusual as it was the first time human infections with H7N9 viruses were reported.
A SHOT OF PROTECTION
Vaccines are recommended especially for those:
Good health habits and safe food preparation are helpful in preventing not only the flu, but also the common cold and many other infectious diseases.
• Aged 65 years and older • Aged 6 months to 5 years old • With chronic disorders of
the lungs (including asthma) or the heart • Who suffer from chronic
metabolic diseases (including diabetes); kidney malfunction or blood disorder • With low immune resistance
due to medications or Human Immunodeficiency Virus (HIV) infection • Receiving long-term
aspirin therapy • Expecting and in the second or
third trimester of pregnancy
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“Although influenza can be a serious illness, getting a vaccine is an effective way to make sure we avoid its complications.”
• Wash your hands or clean them with an alcohol-based hand rub frequently • Cover your mouth and nose when coughing or sneezing • Avoid close contact with others when ill • Ensure food is well-cooked to prevent food-borne infections
HealthMatters
Fear Factor When what seems harmless to others but causes intense fear, extreme avoidance or strong negative reactions,
it could be a case of phobia
– a common but undertreated form of anxiety disorder By Iris Chua IN CONSULTATION WITH DR MICHAEL YONG, CONSULTANT & DIRECTOR, PSYCHIATRY
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HealthMatters
The root of fear Even the mere thought of the winged creatures makes Julie’s* skin crawl.
“I can’t even say the word without breaking out in cold sweat,” said the 32-year-old executive.
“I’m breaking out in goosebumps just thinking about them!” Innocuous as they may seem, butterflies “freak” Julie out so much that she avoids leafy pathways and greenery in case she encounters them. Her fear extends beyond the insects themselves. “I can’t even look at butterfly patterns without feeling cold all over,” she added.
“It’s silly, but clowns and painted faces really frighten me! While almost everyone I know enjoys acrobatic circuses and masquerades, they are my biggest nightmare and I’ve never dared to watch a performance.” – 35-year old Mike* * Not their real names
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According to Dr Michael Yong, Consultant Psychiatrist and Director, Psychiatry, JurongHealth, phobias like Julie’s are often a continuation of childhood phobias, which are usually associated with negative experiences. Although there is no particular factor directly responsible for phobias, theories suggest that the condition is mainly caused by environmental conditioning or inherited. “It is difficult to prevent phobias. One thing for sure – although unhealthy for a developing mind and yet traditionally practised – is the habit of parents, grandparents and adults telling a child frightening stories or bad consequences when they want the child to follow their instructions,” said Dr Yong. In Singapore, it’s not clear what the prevalence of phobias are, but some research indicates that men have a 5 to 15 per cent chance of experiencing some form of simple phobia in their life, while it is between 10 and 25 per cent for women. Phobia, Dr Yong explained, originates from the Greek word ‘phobos’, which means morbid fear. “It is generally characterised by feelings of intense fear and avoidance of a particular object or situation,” he said. “(Compared with a common fear), phobia sufferers have a marked and persistent fear that is excessive or unreasonable.” For example, a perfectly benign insect, despite being harmless, can still be the cause of a phobia. This fear, added Dr Yong, may trigger physical changes like increased heart rate, breathing rate, blood pressure, dizziness, light-headedness, nausea, fainting and cause people to run away or be startled. When a fear becomes overwhelming, it can affect normal life. “ People with specific phobias like fear of heights, insects or the dark, differ from people who suffer from social phobia or social anxiety disorder (fear of public situations and scrutiny which leads to embarrassment or humiliation) in terms of impact on social and work life,” said Dr Yong. “A teacher who has fear of spiders may live a rather normal life whereas another teacher with social phobia may have daily struggles in teaching her students.”
When fear takes over Feeling scared is one thing, but overwhelming fear spells a problem.
Most people outgrow their phobia or manage them. However, fears that persist into adulthood tend to be more severe – but can be treated or overcome with these therapies.
Signs of phobia include:
Exposure therapy
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Extreme anxiety that gets in the way of your normal activities
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Feelings of powerlessness
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Knowing that your fear is unreasonable or exaggerated, but unable to control your anxiety
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Going out of your way to avoid what you fear
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Physical reactions: sweating, rapid heartbeat, shallow breathing
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Intense panic
Common phobias: – Fear of ANIMALS – Fear of BLOOD – Fear of HEIGHTS – Fear of the DARK – Fear of INSECTS
Entomophobia Zoophobia Haemophobia Acrophobia Lygophobia
Strange fears: Fear of KNEES Fear of FERNS
– Genuphobia – Pteridophobia
In systematic desensitisation or exposure therapy, the patient is asked to identify the thing they fear, for example, a spider. He or she then creates and ranks scenarios (called a hierarchy of fear). A least fearful scenerio may be a small spider 5 metres away, while, the most fearful scenerio is a large spider that is very close by. The patient imagines these scenerios and uses relaxation along with other coping techniques to overcome their fear gradually.
Medication Medication used to treat depression and anxiety may be useful for certain people who suffer from extreme phobias. These medicines work to reduce the physical reactions, reduce anxiety or balance mood. Medications however, should be used with caution.
EMDR Eye Movement Desensitisation and Reprogramming (EMDR) gets the patient to move their eyes from side to side while visualising their fear. This therapy helps ‘de-tangle’ negative emotions from memories and events to alleviate the anxiety caused by fear triggers.
SUCCESS STORY One young man overcame his fear of heights and flying after several months of systematic desensitisation. From having a fear of flying that caused breathing difficulties, he has learnt how to relax and has been able to go on his honeymoon. While his fears are still there, the significant achievement was in being able to calm himself. Today, he is working towards conquering his fear in a big way – by going bungee jumping one day!
Fear of long words – Hippopotomonstrosesquipedaliophobia O N E H E A LT H
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HealthMatters
Osteoporosis,
‘porous bones’ in Greek, occurs when there is more bone loss than formation. This causes bones to become thin and weak. In severe cases, even an innocent sneeze or an overenthusiastic hug can cause the bones to reach their
Breaking Point By Iris Chua
IN CONSULTATION WITH: DR SURESH ERNEST, SENIOR CONSULTANT, RHEUMATOLOGY DR JANE CLAYTON, CONSULTANT, RHEUMATOLOGY DR HO YEW MING, CONSULTANT, ORTHOPAEDIC SURGERY DR TONY SETIOBUDI, ASSOCIATE CONSULTANT, ORTHOPAEDIC SURGERY DR EDDY NGATEMO, RESIDENT PHYSICIAN, INTERNAL MEDICINE ELISA MAK, DIETITIAN
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Who is at risk? Women tend to lose bone mass more rapidly than men, especially after menopause, due to reduced oestrogen levels. Globally, it is estimated that by the age of 50, two in 100 women would have developed the disease. This rate increases to one in four women by the age of 80. Males tend to develop osteoporosis later in life as their bone mass is greater.
Diagnosing and treating osteoporosis Despite the potential severity of the condition, osteoporosis does not usually cause any outward signs — until a fracture occurs. In some cases, a person with osteoporosis may experience some backache if there is a fracture in the spine. It is recommended that those at risk – menopausal women, heavy smokers and those with a family history of the disease – undergo a bone mineral density scan. It is a painless test that takes only a few minutes and uses less radiation than an X-ray. Treatment for osteoporosis take several forms. Those who have suffered a fracture may see an orthopaedic surgeon to ‘fix’ the break. More important is to treat the underlying causes of the disease, so a patient may also see an endocrinologist or rheumatologist who can better manage the reasons for the weakened bones and prevent the disease from getting worse.
Those at risk include: • Older people • Those with a family history of osteoporosis
• People who previously
fractured a bone – especially if this occurs after 50 years of age
• Those with low body weight • Smokers • Those with celiac disease,
inflammatory bowel disease, overactive thyroid, kidney failure, autoimmune diseases, rheumatoid arthritis and Cushings Syndrome
• People on medication for
epilepsy, blood-thinners or corticosteroids (prednisolone)
Other risk factors: • Excessive consumption of alcohol and/or caffeine
• A low intake of calcium and vitamin D
• Lack of exercise
Medications and supplements may be used to slow the rate of bone loss. A back brace may be used to support the back while the bones heal. More severe vertebral fractures can be treated without an operation. A procedure called a vertebroplasty injects a special ‘cement’ into the bone to increase bone strength. Severe hip fractures that result in loss of blood flow to part of the bone may require hip replacement surgery. Bad wrist fractures may be restored to the original shape and fixed in place with metal plates and screws.
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HealthMatters
Keeping brittle bones at bay
Once bones are weakened by osteoporosis, it is difficult to reverse the damage, but you can slow down bone loss and build bone density with: • Regular weight bearing exercise (e.g. brisk walking, running, etc.), for at least 30 minutes, five days a week. This can help stimulate bone making cells and strengthen the bones • Limiting intake of alcohol and caffeine • Daily exposure to sunlight. Just 5 to 30 minutes of sun exposure, especially in the morning, helps your body produce Vitamin D – an essential nutrient that helps your body absorb dietary calcium • A diet high in calcium AG E G ROUP
1 to 9 years
DA I LY I NTA KE
500mg – 700mg
10 to 18 years
1,000mg
19 to 50 years
800mg
51 years and above
1,000mg
Expectant/ breastfeeding women
1,000mg
Dairy is a good source of calcium A glass of milk contains about 230mg of calcium, while a tub of yogurt contains 240mg – together they make up almost half the recommended daily intake for most adults.
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Essential calcium Calcium is not only used by the body to build strong bones, but also to help muscles and blood vessels contract and expand, produce hormones and maintain a healthy nervous system. When there is not enough calcium in the blood, the body 'pulls' it from the bones, causing bone loss. That is why a diet high in calcium is important.
HealthMatters
What is enough? While the common wisdom is to drink at least eight glasses of water a day – or about 2-litres – Dr Soh Poh Choong, Principal Physician, Emergency Medicine Department, JurongHealth, noted that this is dependent on one’s activity level and health conditions. Those with chronic kidney or heart disease may have to limit their water intake as their bodies cannot handle excessive water load. For healthy people however, the general advice is that the more activity one does, the more water is needed. One gauge would be to monitor the colour of one’s urine, said Dr Soh, “It should be a clear and light yellow colour.” Another important thing to note is that water intake should be increased if one is sick. “When one is ill – especially with a stomach flu with vomiting, diarrhoea or a fever – it is particularly critical to hydrate. Children are also more susceptible to dehydration,” she said, adding that drinking small amounts at frequent intervals helps the body absorb water better.
Drinking habit One area of concern is ensuring adequate water intake in hot and humid climates such as Singapore, noted Dr Soh, a mother of two. While she ensures her sons drink enough water a day, activities of school, homework and play may mean many children are not getting the hydration they need. She said: “Water makes up about 70 per cent of the brain and is an essential element in neurological transmissions. Poor hydration adversely affects a child's mental performance and learning ability.” To nurture the good habit of water drinking, Dr Soh has proposed a ‘Cheers Programme’ – where students and teachers have a sip of water at the end of each lesson period. Already, South View Primary School has agreed to adopt the programme, which will be launched at a later date. “It’s a simple and effective way to inculcate a good habit of drinking water in children,” said Dr Soh.
Your pee tells you if you need water You are in the clear!
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Time to drink up
You are severely dehydrated
There are so many types of water on the
shelves these days, it gets you wondering when the simple act of buying water got so complicated. According to the US Environmental Protection Agency, it’s not that complex. Here are some of the common classifications of water and what they mean. Artesian water, ground water, spring water, well water Water from an underground aquifer which may or may not be treated. Well water and artesian water are tapped through a well. Spring water is collected as it flows to the surface or via a borehole. Ground water can be either. Distilled water Steam from boiling water is re-condensed and bottled. Distilling water kills microbes and removes water’s natural minerals. Drinking water Water intended for human consumption and sealed in bottles or other containers with no additions except safe and suitable disinfectants. Fluoride may be added within limitations. Mineral water Ground water that naturally contains 250 or more parts per million of total dissolved solids.
Q&A
Sip,gulp, guzzle
Get your kid to drink more water! Make it a game. Fill up fancy glass bottle, decorative jar or special water bottle – and make it a goal for your children to finish at least one to two bottles daily.
Delicious water Lemon and mint infused water Add lemon slices and sprigs of fresh mint to a jug of water and allow these to infuse for one hour.
Red dates, longan and wolfberries Add dried red dates, longan and wolfberries into a flask and add hot water. Steep overnight for a comforting drink the next day.
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FOODforLIFE!
Get FAT!
Omega oils are a super nutrient that lowers inflammation, builds brain cells and lowers the risk of heart disease. By Sheralyn Tay IN CONSULTATION WITH ELISA MAK, DIETICIAN
Not all fats are bad for you – in fact, some can boost your health and help your heart. Omega-3 fatty acids are a type of polyunsaturated fat that is actually necessary for our bodies. Like all fats, omega-3 fat is calorie-dense, but its nutritional benefits are multifold. For one, omega-3 fatty acids are an essential building block for membranes and brain cells. They also play an important role in producing a type of hormone that regulates inflammation, blood pressure, organ functions and body temperature. Two compounds in omega-3 fatty acids – eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) – are known to reduce the risk of heart disease by: –
Decreasing levels of triglycerides – a type of fat found in the blood that is linked to heart disease
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Preventing blood platelets from clumping together and potentially reducing the risk of harmful clots
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Causing the structure of the cell membranes to be more fluid, promoting optimal functions of the cell
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Preventing the oxidation process that produces damaging free radicals
Health organisations recommend that people with no pre-existing heart conditions consume oily fish at least twice a week. Those with heart disease are encouraged to take 1,000mg to 4,000mg of omega-3 supplements a day. Even if you are watching your waistline and cutting down on your fats, remember to include some good fats in your meal plan. After all, it’s all about the quality, not just quantity, of calories that matter.
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heart healthy & delicious! Salmon Whether eaten raw as sashimi or lightly grilled with a little lemon, salmon is not only delicious but good for your heart. 100g salmon = 2,100mg omega-3 Tinned sardines Opt for sardines tinned in olive oil and herbs for a lighter, more versatile way to eat this tasty fish. Mash with a little mayonnaise for a creamy spread on crackers. ½ can sardines = 1,500g omega-3
Cod Delicious and silky smooth, cod – steamed in a little soy sauce, ginger strips and Chinese wine – makes for a comforting meal. 100g cod = 300mg omega-3
Flaxseed With its signature flavour that is both nutty and grassy, flaxseed is a great addition to your morning cereal or oatmeal. 1 tablespoon = 1,800mg omega-3
Avocado Creamy rich and delectable, avocados – eaten in salads, as a dip or in a milkshake – avocado is always a treat! ½ avocado = 100mg omega-3
Walnuts Talk about brain food! A handful of walnuts gives you a healthy dose of brain-energising omega-3 oils. ¼ cup walnuts (about 14 halves) = 2,300g omega-3
Cooked soybeans Who knew the addictive pod-shod peas found at every Japanese restaurant were so good for you? ½ cup soybeans = 500mg omega-3
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FOODforLIFE!
Delicious, high in omega-3 and simple JurongHealth’s Executive Chef, Richard Woo, shows you how to prepare seared salmon paired with a fresh tomato salsa, tender sautéed potatoes and crunchy asparagus. It is a complete meal that’s good to look at and better to eat! Serves 4 Seared salmon 4x140g Salmon fillets, seasoned with low-sodium sea salt & cayenne pepper 2tsp Corn oil Preheat oil in a non-stick pan, sear salmon fillet on both sides till brown. Remove salmon fillet from pan and set aside
Sautéed potatoes 480g Potatoes, peeled and thinly sliced 40g Onion, peeled and sliced 1 clove Garlic, sliced 2tsp Olive oil Preheat oil in a non-stick pan, sauté all ingredients till cooked and season to taste.
Tomato salsa ½ Tomato, diced 1tsp Coriander, chopped 1 bulb Shallot, chopped ½ clove Garlic, chopped 1tsp Fresh lemon juice Combine all ingredients in a bowl and season to taste
Assorted vegetables and garnish 180g Fine asparagus, blanched 180g Sliced mushrooms, sautéed 4 Lemon wedges
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To serve Spoon potatoes and mushrooms onto serving plate and top with salmon fillet. Garnish with salsa, asparagus and a lemon wedge.
HealthBites Customise your first-aid kit and include medications for chronic diseases such as asthma inhalers and medications for allergies if needed. Remember to check for expired items at least once a year Insect bites & allergies • Hydrocortisone cream • Calamine lotion • Eye drops
Cuts, scrapes & burns • Saline solution • Antiseptic wash (e.g. hydrogen peroxide) • Antiseptic cream • Gauze • Fabric bandage • Sticky plasters • Sterile gauze • Safety pins or medical tape (to secure bandages) • Tweezers • Sterile cotton balls • Alcohol swab
Minor ailments • • • • • • • • •
Cough mixture Decongestant Antihistamines Throat lozenges Charcoal pills Hydration salts Medicated oil or ointment Paracetamol Eye drops
Additional items • • • • •
Sterile gloves Hand sanitiser Alcohol swabs Medical mask Thermometer
First Aid Essentials Accidents can and do happen – but a well-equipped first aid kit means you can treat many minor injuries at home IN CONSULTATION WITH KIMMY LIEW, HEAD, PHARMACY & JAVIN TANG, PHARMACIST Items shown are for illustrative purposes only
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Look inside to find out
What’s in Your Box?