InvISIble - cgh.com.sg · InvISIble. Editor’s notE t’s that time of the year when we look upon life with fresh beginnings and make conscious effort to live better. For some, this

Jan−Feb 2014 \\ Issue 128

A Changi General Hospital Magazine

Cover story

stub it out Quit smoking and start the year afresh PAGe 12

SeeIng the

Meet Nurse Clinician Jennifer Lee and other wizards from CGH’s Radiology DepartmentPAGe 6

HeAr tHis Guard your ears against noisePAGe 18

InvISIble

Editor’s notEt’s that time of the year when we look upon life with fresh beginnings and

make conscious effort to live better. For some, this could mean being kinder to

themselves, by paying closer attention to their bodies. Others might take the

New Year as an opportunity to break certain habits to form new ones.

Every year, the use of tobacco kills 5.4 million people worldwide, which

works out to an average of one person every six seconds. At home,

approximately seven Singaporeans die each day from diseases

related to smoking, such as cancer, stroke, heart disease and Chronic

Obstructive Pulmonary Disease (COPD). This issue, CARING tells

you why you should stub out for good by turning that resolution to

quit smoking into a reality (page 12)!Inviting us to go behind the scenes with them this month is the

radiology department (page 6). With their abilities to “see” beyond the naked eye,

it’s clear why these guys are the superheroes of our time. Chinese New Year is just

round the corner and since the Chinese believe that good things come in

pairs, we are presenting you with not one, but two recipes that you can

prepare for your guests (page 22).Till the next issue, eat well and all the best in keeping to your

goals in 2014!

Supervising EditorLim Ee Guan

EditorTang Pin-Ji

ContributorsAlexander Yang Joann ChiaRobing Ng

TranslatorYip Lai Mei

PhotographersAhmad IskandarErwin Tan

Publishing Consultant Publicitas Publishing([email protected])

EDITORIAL GO GREEn!This publication was printed on paper produced by an environmentally-friendly mill and pulp obtained from sustainable forests.

Share your copy of with others or recycle it. CARING is also available online at www.cgh.com.sg/CARING

TELL Us!We want to hear from you. Drop us an email at [email protected]

Issue 128January/February 2014

is a bi-monthly magazine published by Changi General Hospital

MICA (P) 146/01/2013. Company registration number: 198904226R. All rights reserved. No part of this publication can be reproduced in any form or by any means without the permission of the publisher. The views and opinions expressed or implied in are those of the authors or contributors and do not necessarily reflect those of the publisher.

sUbscRIbE TO cARInG! To subscribe, go to www.cgh.com.sg/CARING or email [email protected]

A brand new year, a brand new start. Quit smoking today for a healthier you!

i

sUpERvIsInG EDITOR, Lim Ee Guan EDITOR, Tang pin-Ji

Feature: living smokE

frEE pAgE 12

CONTENTSJANUARY/FEBRUARY 2014

透视眼30放射线部门的超级英雄

保健小笔记28

促进活跃的生活方式27东区全新的社区邻里支持项目

享受健康无烟的生活34新的一年，新的开始…今天就戒烟吧！

22

ISSUE 128

CARING JANUARY//FEBRUARY 2014

12

YOUR SAY24SUBSCRIBE TO CARING25

22 HEAlTHY EATSPumpkin crabmeat soup and Samsui chicken with ginger dip

HEAlTH NOTES04

lIvING SmOkE FREE12

A brand new year, a brand new start. Quit smoking today!

NEIGHBOURS FOR ACTIvE lIvING15

Community support programme to help the needy in the east

Gp FIRST02Make your family doctor your first stop!

CROSSING FRONTIERS IN mEdICINE16

CGH-EH Alliance Scientific Meeting 2013

pROTECT YOUR HEARING18

Guard your ears against noise-induced damage

SEEING THE INvISIBlE06

Radiology’s super-powered heroes

06

家庭医生36您第一时间的救援

保护您的听觉38如何预防噪声所造成的听力受损

吃出健康42三水鸡沾姜汁

Text by Robing Ng and Lim Ee Guan

Make Your FaMilY DocTor Your FirsT sTop!

Go to the GP? But they can only treat coughs and fevers, right?” Many people seem

to regard GPs (General Practitioners, or family doctors) as only being able or willing to treat the simplest of illnesses. The reality is that your friendly neighbourhood GP is able to help manage a fairly wide range of medical conditions.

“The Eastern Health Alliance, the

regional health system for eastern Singapore (www.easternhealth.sg) works regularly and closely with GPs in the region to support and help them treat and manage patients so that these can continue to remain well in the community. An example of this is the Community Health Centres that support GPs in

03

CARING JaNuarY//FeBruarY 2014

Text by Robing Ng and Lim Ee Guan

At press time, more than 132 GP Clinics across eastern Singapore have signed up to be part of GPFirst and the number continues to grow. Participating GP Clinics will display this decal prominently in their premises.

Information about GPFirst is made available through brochures at participating GP Clinics, CGH, and our EH Alliance partner organisations. A dedicated website

managing their patients who have chronic conditions such as diabetes.

To encourage more people to visit their GPs first for their healthcare needs, the Eastern Health Alliance launched the GPFirst programme in January 2014, partnering closely with CGH (an Eastern Health Alliance Foundation partner) and many GP clinics in eastern Singapore.

“We are in regular contact with our GP partners and we know their capabilities well. They play a key role in helping us provide the most appropriate, accessible care for our community,” explained Mr TK Udairam, Group CEO for the Eastern Health Alliance. “The GPFirst Programme is our way of encouraging our community to tap the wealth of expertise our GPs have to manage many medical conditions.” A NovEL GP−HosPItAL PARtNERsHIP GPFirst (www.gpfirst.sg) is a first-of-its-kind partnership between hospital and family doctors that focuses on actively educating and encouraging patients to first visit their GP clinic if they have mild to moderate symptoms or non-urgent conditions (see list on right).

In the event a GP decides that the patient’s condition is serious enough to warrant going to the A&E, the patient will be referred to the CGH A&E department with a special GPFirst Referral Form. The GP will provide an assessment of the patient's condition on this Referral Form and patients with these Forms will be given priority at CGH’s A&E. Such GPFirst referrals will also entitle the patient to a $50 subsidy on the prevailing A&E fee at CGH.

GPFirst referrals will also entitle the patient to a $50 subsidy on the prevailing A&E fee at CGH

Cold and flu with the following symptoms

• Sore throat

• Fever

• Flu-like symptoms of cold and running nose

• Earache

• Symptoms that persist for more than 3 days

There is no need to visit the hospital to treat a cold or flu.

StrainS or SprainS with the following symptoms

• Mild to moderate pain

• Swelling with no deformity

• Bruises

There is no need to visit the hospital when you have a strain or sprain.

nauSea and Vomiting with the following symptoms

• Vomiting

• Mild to moderate pain in the abdominal area

• Diarrhoea

However, do visit the A&E immediately if this is accompanied by:

• Signs of dehydration

• A severe headache

• A head injury

The list above is not in order of severity, nor is it exhaustive. To know more about various common conditions and how your GP can help you, visit www.gpfirst.sg.

See your GP for these common conditions:

*Key terms and conditions:• This scheme is open only to participating GP Clinics in eastern Singapore.

Polyclinics are not included.• The original GPFirst Referral Form must be produced together with the Patient’s

NRIC / Passport / Work Passes, at the point of registration at the CGH A&E.• The 50% subsidy will only be applicable at CGH A&E.• The programme is subject to change without prior notice.

(www.gpfirst.sg) provides information on the programme, the medical conditions that can be treated by GPs, a regularly updated list of participating GPFirst Clinics, and the terms and conditions governing the programme.

CoMING UP // GPFIRst

LEss CoFFEE FoR JUNIoRs?

Caffeine consumption among children and young adults has increased over 70 per cent

over the past three decades, with caffeine-laden energy drinks being the fastest-

growing segment of the drinks industry. Parents might find it wise to buck this trend,

however. A new study from the University Children’s Hospital Zurich showed that

pubescent rats experienced delayed brain development and reduced

deep sleep when they took in the human equivalent of three to four cups of coffee a day. The study, supported by the Swiss National Science Foundation, also found

that caffeine caused these rats to remain timid and cautious instead of

becoming more curious with age.

ALL oR NotHINGSmokers, listen up. If you’ve been trying to stub out,

eliminating tobacco use completely from your environment

might be the way to go. Researchers at the University of

California, San Diego School of Medicine surveyed 1,718

adult smokers and found that those who were completely

banned from smoking at home consumed fewer cigarettes

– some even managed to quit successfully. The ban was

particularly effective in reducing smoking among females

and persons aged 65 and over. These findings, which

were published in a recent report in the online edition of

Preventive Medicine, underscore the importance of smoking

bans in changing smoking behaviours and reducing tobacco

consumption among individuals.


More Than Just a saying Turns out there is truth in the saying, "An apple a day keeps the doctor away". Through mathematical models, researchers at the University of Oxford analysed how giving an apple a day would affect the most common causes of vascular mortality in the UK among residents aged 50 years and over. They concluded that this would be effective in the prevention or delay of around 8,500 vascular deaths _ a result similar to prescribing statins, but without the possible side effects such as diabetes and muscle disease.

HEALtH NotEs

BRAIN KNows BEst Should you feel hungry or exhausted, skip the artificially sweetened

stuff and reach for the real thing instead. If you don’t, there’s a high chance that you’ll seek calorie-rich alternatives later,

according to recent research published in The Journal of Physiology. The study, conducted

at Yale University School of Medicine, implies that it is difficult to trick your brain by providing

it with sweet flavours that contain no energy. This is because our pleasure in consuming sweet

solutions is highly driven by how much energy they provide, and our brain registers more satisfaction

when we take in sugar compared to artificial sweeteners.

05


Text by Alexander Yang

sEEING The iNvisiBleraDiologY’s super− powereD heroes

07


sEEING The iNvisiBleraDiologY’s super− powereD heroes

ith quiet presence, Dr Chong Le Roy trains his sharp eye on medical images

from many sources every day. Each internal image of a patient’s

body comes from various scanners at the Radiology Department of Changi General Hospital (CGH). The ultrasound scanner uses ultrahigh frequency sound waves to form

w

from head to toe. The amount of knowledge and information required is immense.”

Dr Chong, whose sub-specialty is in bone and joint imaging, reports daily on scans

from various parts of the body, such

as the musculoskeletal system, body, spine and brain.

His considerable experience allows him to piece the pictures together for accurate diagnosis. Yet, the human body remains enigmatic in many ways and he finds himself learning something new every day.

Dr Chong’s work relies on an exotic array of machines. These are housed in the Radiology Department, a place not unlike Charles Xavier’s School for Gifted Youngsters. Like the mutants of the X-Men comic and film series, the Department’s inhabitants perform on a daily basis what no mere mortal can. Disconcertingly, they peer beneath the surface of your skin to see flesh,

images. The magnetic resonance imaging (MRI) scanner relies on superconducting magnets cooled with liquid helium. The bone mineral densitometry uses low doses of radiation to form different images for clinical diagnosis. Each method of imaging provides different clues to the patient’s affliction. It is Dr Chong’s task to interpret the images.

It is not an easy job. He explains: “A radiologist needs a strong working knowledge of anatomy and medical physics, as well as diseases that can occur

Top right: Meet the heroes of CGH's Radiology Department: (L-R) Dr Chong Le Roy, Ms Jennifer Lee, Ms Leong Suet Fen and Ms Kerene Ong Mei Ling

CovER stoRY // sEEING tHE INvIsIBLE

A radiologist needs a strong working knowledge of anatomy and medical physicsblood and bone – every last vein and capillary exposed to their piercing vision. Superman could not do better.

These electronic marvels rest silently in their allotted rooms, seemingly mysterious in their functions to the uninitiated. However, a gentle nudge from any one of the trained staff awakens them to perform life-saving procedures.

The MRI scanner, for instance, resembles a large space capsule that houses a patient in its hollow centre. It is used to image the brain, heart, musculoskeletal structure and other aspects of the body.

DR CHoNG LE RoY Consultant radiologist As someone savvy in IT and who enjoys physics, Dr Chong thought, as a medical student, that he would enjoy radiology. The father of three graduated from medical school in Australia and trained as a radiologist in Singapore. Every day he spends at work continues to delight him. True to his intellectual nature, he says, “The best part of the job for me is the kick I get when I make a subtle yet significant finding, when I diagnose a rare condition no one suspected, or when I am able to piece together little clues from various sources to arrive at a logical conclusion, and be proven right.”

tHE“X−MEN” oF RADIoLoGY

It helps diagnose illnesses like stroke and colorectal cancer.

One of the wizards working this machine is Ms Leong Suet Fen, a Senior Radiographer who works with outpatients, inpatients and trauma patients. She checks their identities and explains the procedures in detail before positioning them to be scanned. Tweaks are made to the scanning sequence depending on the patient’s condition.

Suet Fen also specialises in Bone Mineral Densitometry (BMD), another area of scientific magic. Patients are given

Ms Kerene Ong doing what she loves at the ultrasound room

09


a light dose of X-rays to acquire a reading of bone density. The consequent analysis helps in the diagnosis of osteoporosis and assessment of fracture risks.

The Department also possesses a diagnostic sonographic scanner. This is the machine so often found in television scenes with a mother smiling at a screen displaying the foetus inside her. The sonographic

scanner in CGH is handled by Kerene Ong, a young woman

whose face lights up on the topic of sonography.

Kerene trained in Diagnostic Radiology at Nanyang Polytechnic and in Sydney before joining the Department in 2010. She enjoys working with sonography in part for the human connection. “A CT scan can be quite quick, but a sonography can take up to 30 minutes. This allows me more time to interact with patients.”

It is not all rosy, however. Sometimes, patients in the Dangerously Ill List category get admitted. These patients, who may have just experienced severe trauma or been discharged from surgery, are unable to respond to the radiographer. Due to their highly unstable conditions, Kerene has to image them with haste, while thinking up ways and means to produce optimal images without a cooperative patient.

As if that wasn’t enough to keep Kerene on her toes, each patient comes

with a unique set of challenges, depending on his or her situation. Experiences like these have made

Kerene the adept sonographer she is today.

The professionalism of the Radiology Department is the result of a bold and

open approach to innovation. No case better illustrates this

than the Department’s pioneering of Peripherally Inserted Central Catheter (PICC) practices. Formerly the preserve of trained

doctors in Singapore, this practice involves snaking a

long, thin catheter through an incision in the patient’s arm

to the edge of his heart. Once the catheter has been inserted, it

is used to deliver medication such as

Ms KERENE oNG MEI LING Ultrasound−trained radiographer Kerene graduated with a degree in radiography from the University of Sydney under a scholarship from CGH. In addition to general radiography, she specialises in sonography. A friendly soul and self-professed ‘people person’, she relishes the fact that sonography gives her more time to spend with patients than the other fields of radiography. Kerene’s sociable nature also sees her organising get-togethers for hospital staff and leading the orientation of new personnel to the Department.


antibiotics and to take blood samples.The Department was the first in

Singapore to free its doctors from this time-consuming practice. In 2010, Jennifer Lee Wan Hwee, a Nurse Clinician, was sent to Fletcher Allen Healthcare in Vermont, USA, to undergo training in this delicate operation. She then came home to practise under a doctor. A hundred cases later, she was proficient enough to insert the catheter independently.

Today, Jennifer’s warm and feisty character makes her the perfect teacher to train others on PICC. She has organised workshops for nurses across Singapore and was even invited to train nurses in India – a testament to the Department’s lead in this area.

To some, the melding of human skill and high-tech machinery that defines the Radiology Department might sound like sophisticated science fiction. Dr Chong proffers reality: “Radiology is fundamentally a diagnostic test, albeit a very good one. Radiologists recognise the limitations of the information that medical imaging can provide, and manage these accordingly by considering probabilities and whatever clinical information is available. Radiology is rarely clear-cut black or white, but rather consists of many shades of grey.”

How many shades of grey? “About 50,” he deadpans.

Radiology is rarely clear-cut black or white, but rather consists of many shades of grey

Ms JENNIFER LEE wAN HwEE Nurse Clinician A Nurse Clinician with an effervescent nature, Jennifer started out as a staff nurse in Tan Tock Seng Hospital and worked at Kandang Kerbau Hospital before joining Changi General Hospital. She has been with CGH for more than 12 years and pioneered the practice of independent insertion of the PICC into patients by nurses. As one of the most experienced staff in the Department, she has gone through thick and thin with its doctors and patients, including the uncertainty and terror of SARS in 2003. Today, her work undergirds the fluid operations of the Department in the areas of policy, safety practices and the supervision of personnel.

11


The Department recently augmented its capabilities with new imaging techniques such as MR elastography, which diagnoses

early-stage cirrhosis

of the liver. It has

more exciting developments

ahead, with a new Picture

Archiving and Communication

System set to improve workflow and

a holistic programme

but rather consists of many shades of grey

that includes post-radiography access to patients under consideration. The Department is ready to flex and adapt to serve an increasing number of patients.

“The abdomen, the chest, and the brain will be forever shut from the intrusion of the wise and humane surgeon,” so proclaimed Sir John Eric Erichsen in 1873. As Surgeon-Extraordinary to Queen Victoria herself, many cast their faith in his words. He was wrong. The super-powered heroes of the Radiology Department continue to make the invisible visible and push the standards of medical science in the service of its patients.

Ms LEoNG sUEt FEN senior Radiographer (MRI) Suet Fen started her radiographic journey after winning the MOH Overseas Specialist Award in 2002. She graduated with a BSc (1st class Honours) in Diagnostic Radiography from the London South Bank University and holds a master’s degree in Magnetic Resonance Technology from the University of Queensland. Outside of her radiographic professionalism, Suet Fen’s gentle efficiency ensures that important functions in the Department, such as the Radiological Information System and the Picture Archival and Communication System, run smoothly. She also makes sure that the Department meets the high standards for accreditation set by Joint Commission International (JCI).

Every day, Dr Chong Le Roy pieces pictures together to arrive at an accurate diagnosis


wHY sHoULD I qUIt sMoKING? When you stop smoking, you greatly reduce your risk of heart attack, stroke, cancer and lung disease. Cigarette smoking is the leading cause of COPD (chronic obstructive pulmonary disease). Here are some other compelling reasons why you should stop smoking:+ Your clothes, hair, breath, home

and car will start smelling better.+ You will have more energy to do

what you enjoy. Climbing the stairs or walking will also not leave you feeling as breathless as before.

+ You will have fewer wrinkles, and morning coughs will be a thing of the past.

+ You can treat your family to more meals together with the money saved from not buying cigarettes.

+ You will not be endangering people around you with secondhand smoke. According to Dr John Law, Consultant

A brand new year, a brand new start. Quit smoking today and offer you and your loved ones a healthier, smoke-free future

LIvING sMoKE FREE

Text by Joann Chia

of Respiratory Medicine at CGH: “Inhalation of secondhand smoke is called passive smoking. At least 250 chemicals in secondhand smoke are known to be toxic or cancer-causing. In adults, secondhand smoke can cause coronary heart disease and lung cancer. In infants, it causes sudden death. In pregnant women, it causes low birth weight. Youths exposed to secondhand smoke at home are one-and-a-half to two times more likely to start smoking than those not exposed. There is no safe level of exposure. Any exposure is harmful, and secondhand smoke can spread from a smoking area to a non-smoking area, even if the doors between the two areas are closed and ventilation is provided. Only a 100% smoke-free environment provides effective protection.”

PossIBLE sIGNs oF CHRoNIC oBstRUCtIvE PULMoNARY

DIsEAsE Are you a smoker with:+ A cough that produces a lot of

mucus?+Shortness of breath when engaging in physical activity?+ Wheezing with a whistling or squeaky sound when you breathe?+ Chest tightness?+ Frequent occurrence of colds or flu?

If your answer is yes to some or most of these symptoms, you may be suffering from chronic

obstructive pulmonary disease, or COPD. Cigarette smoking is the

leading cause of COPD. Those who suffer from this disease will find it harder

and harder to breathe over time.

DISTRACT YOURSELF

Have a ‘Rescue Kit’ on hand to distract you from your cravings. Things to include: Sugar-free sweets, healthy snacks and handheld games to keep your mind busy.

DELAY THE URGE

Feeling the urge now? The cravings will pass, so delay the urge to smoke by drinking some water or popping a mint into your mouth.

DEEP BREATHING

Breathe in, breathe out… Deep breathing exercises help you to relax and are an effective way to overcome cravings.

DRINK SLOWLY

Keep your hands and mouth busy by sipping on a glass of milk or water slowly. This is another way to overcome the urge to smoke.

4 D's toCoPE wItH CRAvINGsRemember these four D’s and use them to tide through the addiction cravings:

Continued on next page

13

FEAtURE // LIvING sMoKE FREE


CoNFEssIoNs oF A CoPD sUFFERER Truck driver Mohammad Sukhaimi bin Abdul, 58, had been smoking since he was 12. He smoked two packets a day and had tried but failed to quit many times. Last year he fell ill and found it very hard to breathe. That was when doctors diagnosed him with COPD.

Sukhaimi spent five days in hospital and came out a changed man. COPD is incurable, but with medication, symptoms can be relieved. Today, more than a year since his last stick, he notices a difference in his quality of life.

“I used to feel breathless when walking up the stairs. I feel slightly better now since I stopped smoking. It has been difficult since most of my friends are smokers. Sometimes I have the urge to smoke but I control myself. I tell myself that if I don’t stop, I may die early.”

wHEN IN DoUBt… sEEK HELP! Changi General Hospital operates Singapore’s Smoking Cessation Counselling and Service with a team of experienced nurses and pharmacists.

“The CGH smoking cessation programme comprises counselling, behavioural therapy and pharmacotherapy,” said Dr John Law, Consultant of Respiratory Medicine at CGH. “Studies

For appointment booking or enquiries, please call 6850 3333.

How oUR LUNGs woRK

1Air travels down the windpipe

into bronchial tubes in the lungs.

2 The bronchial tubes branch

out into thousands of finer tubes in the lungs called bronchioles. These tubes end in tiny round air sacs called alveoli.

3 The alveoli walls are lined

with small blood vessels called capillaries. Oxygen passes through the alveoli into the bloodstream through capillaries, and carbon dioxide is removed from the blood through the capillaries into the alveoli.

4 The airways and alveoli are

elastic and when we breathe in, each sac is inflated like a small balloon. With COPD patients, less air flows in and out of the airways because:

P The airways and air sacs have lost their elasticity.

P The walls between the air sacs are destroyed.

P The airway walls are thick and inflamed.

P The airways produce more mucus than usual, causing a clog.

studies have shown that quit attempts by going ‘cold turkey’ are associated with high failure rate

have shown that quit attempts by going ‘cold turkey’ are associated with a high failure rate. A combination of counselling, behavioural and pharmacotherapy can significantly improve quit rate. A variety of nicotine replacement therapies in the form of tablets and patches are available. Medication such as Xyban and Champix can also be effective. The choice of

pharmacotherapy depends on the patient’s profile and preference.”

How tHE PRoGRAMME woRKs+ All smokers are given brief counselling and

smokers who are agreeable for intensive counselling are referred to certified smoking cessation counsellors.

+ They then undergo an intensive counselling session. Medication may be prescribed.

+ After discharge, they are followed up by counsellors from the Quit Line (a collaboration between CGH and HPB) at

regular intervals. + Some smokers may be referred

to the outpatient smoking cessation clinic for

follow-up.

15

HEARt to HEARt // NodAL

Text by Robing Ng

a New NeighBourhooD sUPPoRt

he South East Community Development Council and Eastern Health (EH) Alliance have jointly

developed a new community-based initiative – the Neighbours for Active Living programme in the eastern region of Singapore, to facilitate active living and ageing-in-place within the community.

This programme establishes community support structures to help the needy in looking after their needs such as helping to coordinate medical appointments, linking to the various social services to meet their needs and reintegrating them to the community. This programme also aims to strengthen the community engagement and build cohesiveness by providing community support.

t

Have you heard? The latest buzzword in the east is Neighbours for Active Living – the name of a joint community support programme

that aims to facilitate active living and ageing-in-place within the community. CARING tells you what it is!

All the Programme volunteers will undergo a two-day ‘Friend-a-Senior Camp’, which teaches them how to effectively communicate and interact with the elderly. They also learn how to conduct a basic intake and social needs assessment of the elderly and their families through a holistic framework which encompasses health, social, psychological and

environmental components, and carry out intervention

strategies and care plans to address

psycho-social needs where necessary.

To find out more about the Neighbours for the Active Living programme, or if you are interested

to become a Neighbours’

volunteer, please contact the team at DID: 6426 7517 / 6426 7518.


Right: SUTD President, Professor Thomas Magnanti presents 20 popular American inventions to kick off his speech, “Educating Technology Leaders for Design-Driven Innovation”

aspects of medicine to improve patient outcomes and influence the quality of doctors for generations to

come. Said the Guest of Honour, Minister for Health Mr Gan Kim Yong, at the opening ceremony of the ASM, “More

than ever, cross-disciplinary care teams are being brought together to find new and more effective

CGH-EH Alliance Scientific Meeting 2013Text by tang Pin−Ji // photos by Ahmad Iskandar of vamos Photography

FroNTiers iN MeDiciNe

N ovember marks an important month

in the Changi General Hospital (CGH)-Eastern Health (EH)

Alliance calendar. Each year, the CGH-EH Alliance Scientific Meeting (ASM) convenes professionals from various disciplines in CGH and the EH Alliance cluster to showcase their work, interact and share their experience.

2013 was no different. Held on 22 and 23 November at CGH and St Andrew’s Community Hospital (SACH), the ASM presented its theme, “Academic Medicine – Thinking Across, Moving Ahead” through plenary sessions and workshops that spanned the tracks of Clinical Medicine, Education,

Innovation, Research and Sports Medicine. It examined how academic medicine

could impact and complement the clinical

CRossING

17

CELEBRAtE // ANNUAL sCIENtIFIC MEEtING 2013 B


Left: Minister for Health Mr Gan Kim Yong presents his speech at the opening of the ASM. Above: Checking out the winning entries of the poster competition at the CGH Atrium

solutions to old and persistent problems, or to find better and smarter ways of doing things. As I understand it, the intent is to encourage us to think across disciplines and subject matter in seeking answers, so that we can mine new perspectives and ideas.”

“The theme also spurs us to look for insight and answers from beyond the healthcare industry as knowledge, inspiration and innovation are not constrained by professional domains. This premise further challenges us to start thinking about how we can go about nurturing such a cross-disciplinary culture within our healthcare ecosystem to yield fresh ideas and better solutions,” added Mr Gan.

Keynote speakers for the event included Professor Thomas Magnanti, President of the Singapore University of Technology and Design (SUTD) and Professor Chen Chao-Long, Superintendent of the Chang Gung Memorial General Hospitals and University in Kaohsiung, Taiwan.

we push ourselves to think across disciplines and national borders in the pursuit of better ways to provide patient care

Attendees at the opening ceremony of the ASM also witnessed the signing of a Memorandum of Understanding (MOU) between CGH, EH Alliance and SUTD, in which $1 million was contributed to the HealthTech Innovation Fund to fuel 10 projects over the next two years. The collaboration aims to synergise SUTD’s engineering skills with CGH’s medical knowledge to encourage better designs for the hospital and its equipment, as well as to improve medical devices, hospital communications and methods of data analysis.

Mr Gerard Ee, Chairman of the EH Alliance, was “optimistic and confident” about what the collaboration could achieve for its staff and patients. “Ideas cannot percolate in isolation,” he said, “and that is why we push ourselves to think across disciplines, industry and even national borders in the pursuit of better ways to provide patient care and solutions to healthcare challenges.”

Signing of the Memorandum of Understanding between CGH, EH Alliance and SUTD

soUND vs NoIsE Our sense of hearing warns us of impending danger and enables us to communicate and interact with others. Every day, we hear different sounds and noises around us, be it at home, at work or in public places. Sounds and noises are generated by vibration energy known as sound waves. As a willing listener, what we like to hear is sound. As an unwilling listener, what we don’t want to hear is noise.

wHEN oUR HEARING BECoMEs AFFECtED...…

The cochlear hair cells in our inner ear are like

the bristles of a new toothbrush. Each tiny hair will move and bend according to the sound waves that enter our ears. Excessively loud noises over a prolonged period will cause the hair cells to bend extensively. If we do not take care of our hearing, the hair cells will start looking like a used toothbrush after years of damage. Most of the time, this damage is irreversible and it results in permanent loss of hearing.

Text by Joann Chia

Our hearing, like most good things in life, should never be taken for granted. Once lost, it can never fully be recovered

PRotECt YoUR

HEARING


19

How to sPot tHE EARLY sIGNs oF NoIsE…INDUCED HEARING Loss

Do you hear a ringing or buzzing sound in your ears when it’s quiet or at night?

Do you have difficulty sleeping or have problems

concentrating?

Is it difficult to hear clearly when you are in a noisy place?

Do you have hearing loss in the higher frequencies range?

Do you have a tendency to speak louder unknowingly?

Do you have to continually ask people to repeat what

they’ve just said?

Do you tend to increase the volume of your TV or radio?

sPECIAL REPoRt // PRotECt YoUR HEARING

Continued on next page

Our ears are divided into three parts: Outer, middle and inner

Our outer ear gathers sounds and noises in the form of sound energy

In response to changing air pressures, the eardrum vibrates and sets three tiny bones in motion

This travels down the ear canal to a membrane called the eardrum, which separates the outer and middle ear

➊

Sound is measured in decibels (dBA). Excessive sound or noise that is above 85 dBA is considered harmful to our hearing, resulting in noise-induced hearing loss

60−65 dBA Normal city noise

85−90 dBA Prolonged exposure

may cause hearing loss

10−20 dBA Barely audible

40−50 dBA quiet, pleasant sound

100−120 dBA Noise at this level

is annoying

How LoUD Is too LoUD?

How wE

➋

➌

HEAR


21

There are thousands of cochlear hair cells in the inner ear and these bend as the waves pass, generating impulses that travel to the brain

These bones vibrate against the snail-shaped cochlea, sending fluid waves into the inner ear

➍

➎

sPECIAL REPoRt // PRotECt YoUR HEARING

140+ dBA A single exposure may cause

permanent hearing loss

120−130 dBA For most people, this is

the pain threshold

While it’s true that people above 60 years of age have a higher risk of hearing loss, anyone can lose their hearing for a variety of reasons, especially in today’s society where the use of earphones are so common among the younger generation.

Noise-induced hearing loss is a gradual process which is painless, invisible and usually irreversible.

PREvENtIoN AND EAR CARE tIPs

Source: Ms Joyce Lim, Senior Tinnitus Counsellor, Department of Otolaryngology, CGH

In the brain’s hearing centre, sound energy has been converted into electrical impulses, which are now being decoded

➏

+ Be aware that prolonged exposure to loud sounds can cause hearing loss.

+ If you listen to personal music players regularly, limit the volume and the duration of your listening with earphones. These deliver sounds directly into the ears.

+ Wear hearing protection if you are exposed for prolonged periods to sound levels exceeding 85 dBA.

+ Educate the young on the importance of protecting their hearing and show them how they can do so.

+ Do not put any foreign objects inside your ears.

+ When you have trouble hearing, see an ear specialist or have a hearing check done.

+ Avoid or walk away from very noisy environments; wear properly fitted hearing protection.

Add a dash of gold to your festive feast with this hearty brew

PUMPKIN CRABMEAt soUPCHINEsE NEw YEAR sPECIAL

Source: CGH Dietary and Food Services

Preparation time: 20 minutesCooking time: approx. 45 minutesserves five

what you’ll need • Pumpkin, trimmed and cut into chunks (50g)

• Crabmeat (50g)

• Ginger (2 slices)

• Spring onion (1 small sprig)

• Egg whites (2)

• Stock (1.5 litres)

• Salt (½ tsp)

• White pepper (1 tsp)

• Sugar (2 tsp)

• Corn starch (for thickening)

Method1. Place pumpkin chunks and stock in a heavy pot

and bring to a boil. Reduce the heat and simmer for 30 minutes.

2. Put spring onion and ginger slices on top of the crabmeat and steam for 5 minutes. Set aside.

3. Blend the pumpkin and stock until smooth.

4. Return pumpkin to the heavy pot and bring to another boil.

5. Add seasoning and thicken the soup with corn starch.

6. Turn off the heat and swirl in the egg white.

7. Divide the soup into 5 bowls, garnish with crabmeat and serve.

Nutitional info (per serving)Energy 40kcal

Carbhydrates 6.4g

Protein 3g

Fat 0.3g

Fibre 1.4g

Cholesterol 6.5mg

Sodium 286mg

HEALtHY EAts // PUMPKIN CRABMEAt soUP

2323


As we usher in the new year, pay homage to our heritage with this traditional dish

sAMsUI CHICKEN wItH GINGER DIP

Method1. Wash the chicken and set it aside.

2. Bring water to a boil in a large pot. Add chicken to the pot, ensuring the water covers the chicken.

3. Cover the pot with a lid, reduce heat and simmer for 25 minutes.

4. Place ingredients for the ginger dip in a mixing bowl, mix well and set aside.

5. Chop chicken into bite-sized pieces and serve with ginger dip.

Nutitional info (per serving)Energy 332kcal

Carbohydrates 2.6g

Protein 29g

Fat 22.8g

Fibre 0.1g

Cholesterol 150mg

Sodium 304mg

what you’ll need• Whole chicken (1.5kg)

• Water (enough to cover the chicken)

• Ginger, flattened (1 knob)

GINGER DIP what you’ll need• Ginger, blended (200g)

• Spring onion (15g)

• Cooking oil (2 tsp)

• Salt (1 tsp)

• Stock (4 tbsp)

• Sugar (1 tsp)

• Sesame oil (2 tsp)

HEALtHY EAts // sAMsUI CHICKEN wItH GINGER DIP

Preparation time: 20 minutesCooking time: approx. 50 minutesserves ten

JaNuarY//FeBruarY 2014 CARING

wE wANt to HEAR FRoM YoU!What would you like to see in CARING? Which was your favourite story this month? Drop us a message at [email protected] and your letter could be published in next month’s issue! Email us with ‘Your Say’ as the subject header and include your full name, age, address and contact number.

YoUR sAY

DERRIK sHEN

Dear , I chanced upon Issue 126 of your magazine and am much inspired by 67−year−old william Gan. I am a 61−year−old retiree who keeps fit by jogging regularly and working out at the gym at Pasir Ris East CC. However, I have poor eating habits and indulge in unhealthy food, especially those which are spicy and oily. I’m not fat, but I aspire to have a nice muscular body with six−pack abdominals. After reading your article on william, I am determined to lose all my excess fats and achieve my ideal physique. I am going on a very strict diet that comprises healthy food low in carbohydrates. I hope that

can carry more inspiring articles for senior citizens. 24

GwEN wEE, EUNos

Dear , my mother suffers from

osteoporosis and I was happy to share with her your guide to

healthy bones in the last issue. The infographics were very useful in helping my husband and I to better understand her condition. As my family members

are generally small-framed, I have also shared the article with my children to educate them on how they may boost

their bone health from a young age. Thank you, , for

watching out for my family!

NUR ADILAH MD IBRAHIM

Dear , I love this magazine! I’ve even subscribed to it online, so that I don’t miss out on any of its issues. Ever since started being distributed at Tampines MRT station, I have become a regular reader and often keep a look out for your staff who hand them out. Thank you for putting together such a cool magazine!

EDITOR, CARING MAGAZINE CHANGI GENERAL HOSPITAL PTE LTD

CORPORATE AFFAIRS 2 SImEI STREET 3 # LEvEL 2CHANGI GENERAL HOSPITAL

SINGAPORE 529889

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27

医者心语 // 社区邻里支持项目

南社区发展理事会和东部医疗联盟携手在宝岛东部

开展了一个全新的社区项目，叫NodAL, 其目的是在社区里促进活跃和老而不衰的生活方式。

项目里包括了设立社区性援助框架，以为有需要的群体提供日常所需的援助如安排医生预约、根据个别需要和各社区援助组织搭建联系桥梁、以及帮助他们重新融入社区生活等。

该项目也希望通过提供社区援助增强居民的参与度以及促进社区和谐。

东

原文 Robing Ng

一项全新的社区

邻里支持项目您听说了吗？宝岛东部的最新时髦术语是NodAL。这个联合社区支持项目的目的是在社区的年长群体里促进活跃和老而不衰的生活方式。《关怀》与

您分享其中的来龙去脉！

所有的项目志愿者都会参加一个为期2天的《结识一位年长者》的培训营，参与者将学习到如何有效的和年长者

沟通。他们也将学习到如何为年长者和他们的家人进行基本的经济状况和社会需要评估，该评估的全面性框架包含了健康、社会、心理、以及环境等各

指标。志愿者也可在有需要时开展干预性策略和护理计划以迎合年长者的心理和社会需求。

若您想知道更多有关NodAL项目的详情，或有兴趣成为该项目的志愿者，请拨电6426 7517或6426 7618与我们联系。


咖啡因不宜于幼童在过去的30年内，幼童以及年轻成人的

咖啡因摄取量增加了超过70%，并且以饮料工业所生产的含咖啡因能量饮料为增长最快的类别。父母们可

得注意一下了：苏黎世儿童大学医院的一项新研究显示，当发育期的老鼠

每天喝下相等于人类摄取量的3至4杯咖啡后便出现了脑部发育减缓以

及深睡眠减少的现象。这项得到瑞士国家科学基金支持的研究也发现了咖啡因确实对这些老鼠产生了影响，它们

并没有随着年龄增长而增加好奇心，反倒是维持了胆怯

和谨慎的表现。

斩草要先除根吸烟的朋友们，请注意了！您要想戒烟的话，那不妨在您的日常环境里实行禁烟令，这可能是一个不错的办法。加州大学圣地亚哥医学院的研究员们考查了在加州的1,178名成年烟客后发现那些在家中禁止吸烟的会相对少吸一些，有的甚至成功戒掉了烟瘾。禁烟对于帮助妇女以及65岁及以上的人群减少吸烟特别奏效。该调查结果刊登了在网络版的《预防医学杂志》的一篇近期报告里，它阐述了通过禁烟来改变吸烟习惯以及减少吸烟的重要性。

CARING NoveMBer//DeceMBer 2013

俗话说得好俗话说得好：一日一苹果，医生远离我。这句话确实有真谛。牛津大学的研究员们通过了一些数学模型分

析了在英国50岁及以上的居民若每天吃一粒苹果将会如何影响心血管病死亡率的常见导因。他们得出的

结论是这将能够有效的拖延8,500起心血管病死亡病例的发生。这和给病人开抑制素类药物处方有异曲

同工之处，但却少了这药物的副作用—由于服用此药而引发的副作用可导致上千起的糖尿病以及肌肉疾

病病例。

HEALtH NotEs

以假乱真瞒不过我们的大脑当您感到饥饿或疲倦时，跳过那些添加了人工甜味剂的食品，直接

吃“正品”吧！根据刊登在《生理学杂志》的一项近期研究显

示，吃含人工甜味剂的食品来解除饥饿和疲倦感的

人群大有可能在吃完后不久便渴望吃卡路里含量高

的食品。这项在耶鲁大学医学院进行的研究结果意

味着若想通过不含能量的人工甜味剂来蒙骗人体的

大脑确实不易。这是由于我们从甜食中所获得的

快感是直接取决于它所能提供的能量。因此和含

人工甜味剂食品比较起来，当我们吃下“正品”甜食时

我们的大脑记录了更多的满足感。


29

原文 Alexander Yang

医生集中精神，二话不说的钻研每天从各处送到他面前

的医学图像。每张烙印了病人五脏六腑的医学图像都

是源自樟宜综合医院放射线部门里的各台扫描仪器。超声波扫描仪使用超声波来形成图像；磁共振成像扫描仪使用的是经过液态氦冷却的超导磁体；骨密度测试则使用少量的辐射来形成各种图像以便进行临床诊断。每种图像取成法各有千秋，它们能够为病人苦楚的来源提供不同的线索。庄医生的任务是针对这些图像进行解剖。

庄

放射线部门的超级英雄

透视眼

31


封面故事 // 透视眼

兽便会苏醒过来为病人提供治疗，拯救他们的生命。

就那磁共振成像扫描仪来说，它看似一个极为庞大

的太空梭，可将病人储藏在其空心里。它用于为脑部、心脏、肌骨结构以及身体

其他部位进行图像拍摄。它有助于诊断中风和

结肠直肠癌等疾病。其中一名和这台机器一起工作

的魔法师是任职资深放射线技师的梁雪芬女士。无论是门诊、住院、或受创伤的病人，雪芬都一一把他们接到放射线部门接受放射线检查。她首先确认病人的身份，为他们详解检查的流程后准确无误的帮助病人挪到正确扫描位置。各部位扫描的先后次序也会根据病人的情况加以调整。

雪芬也专长于骨密度测试（Bone Mineral Densitometry），其测试可称的上是一项科学性魔术。病人服用少量的X射线以获得骨密度的数据。这些数据经过分析后能有助于诊断关节炎以及评估骨折的风险程度。

部门里也设有一台声像图扫描仪。像这样的仪器经常在电视萤光幕上出现，尤其在那些看着荧幕上出现胎象而喜出望外的妈妈的剧

这可不是件容易的差事。他解释说： “做为放射线技师应当对解剖结构、医学物理、以及从头到脚所可能发生的病痛有丰富的知识。我们所需要掌握的知识和讯息相当庞大。”

庄医生擅长于骨骼和关节图像解剖，他每天都得汇报无数有关身体各部位的图像，如肌肉与骨骼系统、身体、脊椎以及脑部的扫瞄图像。他多年的经验能让他从图像中看出蛛丝马迹，并且做出准确的诊断。然而，人体的构造在许多方面仍然高深莫测，而他每天都能学习到新的东西。

31

庄医生在工作上必须依赖许多不同的仪器。这些仪器设在放射线部门里，这个地方颇似卡通片《查尔斯.西雅威尔天赋异禀青年学校》里的情景。就像卡通片里的突变异种一样，部门里的这些仪器怪兽每天都在做着人所不能之事。他们具有让人心生惧怕的神力，他们的锐眼能够透视您身体的皮、骨、血、肉、甚至经脉。这样的神力相信就连超人也自叹不如。

这些电子猛兽静默的瘫睡在各自的房间里，其功能神秘多样。在外行人看来，它们的内部运作复杂的叫人难以想象。然而，只要通过接受过专业训练的员工轻触按钮，这些神

放射线部门的超级英雄

（左－右）：放射线顾问

庄克奇医生，临床护士李

菀惠，高级放射线技师

（磁共振成像）梁雪芬，

超声技师王美玲

庄克奇医生放射线顾问医生他擅长于信息科技并且热爱物理学。因此庄医生在读医的时候觉得自己应该会喜欢放射线学。已经为三人父的庄医生毕业于澳洲的一所医学院，并且在新加坡实习成为合格的放射线技师。他的工作仍然能够每天给他带来惊喜。对于知识拥有永无休止渴望的他说：“这份工作最好之处是每当我做出一个微妙但却相当重要的发现时、以及我诊断出一个无人猜想到的稀有病症时、又或者当我能够将不同的信息来源所提供的蛛丝马迹拼凑在一起并且获得一个准确判断时，我便得到说不出的满足感。”

放射线学的X战警

情里经可看见。该声像图扫描仪由王美玲管理，她是一个对声像图扫瞄技术充满热诚的有为青年。

美玲在南洋理工学院以及悉尼的学府完成了诊断性放射线学的课程后在2010年加入樟宜综合医院的放射线部门。她喜欢从事声像图扫描的工作，其大部分的原因是由于可以与病人有更深一层的沟通。“电脑断层扫描所需的时间可以很短，但声像图扫瞄的时间则可长达30分钟。这可让我有更多的时间和病人沟通。”

然而，这份职业也有它的难处。有时候医院住进来一些生命垂危的病人。这些病人有的或者刚受到严重创伤、有的则可能刚接受

完手术而因此无法和放射线技师配合做检查。由于他们的病情高度不稳定，美玲因此必须在极短的时间内为他们做扫描，同时得在病人无法配合的情况下想方设法拍摄出最佳的图像。

此外，由于每个病人都有不同的情况和需要，这也加剧了这份工作的挑战性。所幸，这些经历让美玲在工作中获得不少历练，其而塑造出她今天成为一名称职的声像图扫瞄技师。

放射线部门的专业操守是它对创新持有着大胆和开放的态度的结果。熟不知该部门在引入外周导管手术（Peripherally Inserted Central Catheter）所做的先锋示

王美玲超声技师美玲获得了樟宜综合医院的奖学金到悉尼大学深造，并且获得放射线学的学位。除了综合放射线学，她专门从事声像图扫瞄术。美玲为人友善并且声称喜欢和人沟通。她因此觉得比起其他的放射线学专科，声像图扫描这一科更能够让她从工作中获得乐趣，因为她和病人有更多时间沟通。个性外向的美玲也常为医院的员工举办聚会，以及带领部门的新职员熟悉工作环境。

做为放射线技师应当对解剖结构及医学物理有丰富的知识

对超声技师王美玲而言，声像图扫描能够让她从工作中获得乐趣，因为这让她和病人有更多时间沟通。

33


封面故事 // 透视眼

范。这个程序向来由受过训练的医生执行，在病人手臂上的外周静脉植入一条细长的插管一直通到头端位于心脏的边缘为止。插管为病人提供药物如抗生素以及抽取血液样本。

放射线部门是首个在新加坡免去医生做这项费时程序的理疗机构。在2010年，临床护士李菀惠被派往位于美国佛蒙特州的弗莱彻艾伦医疗保健中心接受有关这项程序的培

训。回国后她在一位医生的指点下在实践中累积经验。经过100个病例的临床实习后，她便能独挑大梁，自己为病人植入插管。

如今，为人既友善又满腔热忱的菀惠也成为了导师，给他人提供培训。她为新加坡各家医疗机构的护士举办实验班，并且还被受邀到印度去为当地的护士提供培训，奠定了放射线部门在这方面的领导地位。

对于许多人来说，放射性部门所提倡的人类技能和高科技机械的完美结合或许听似一个极为高端的科幻梦想。但庄医生说了一句实话：“虽然这是非常有用的知识，但放射线学最终只是一项诊断性测试。放射线技师明白到医疗图像所能够提供的信息有所局限，于是他们通过机率分析以及其他的临床信息来帮助他们做出判断。放射线学往往并不是黑白分明的，而是有许多不同等级的灰色组成。”

那到底有多少种灰色呢？“约50种。”他补充道。

已经拥有一个能应对多种疾病的庞大机械库的放射线部门最近又添置了新的图像技术如磁共振弹性成像，这个技术用于诊断早期的肝硬化。此外，部

门还有其他更精彩的发展动向在后头。一个崭新的图像存档和沟通系统将有助改善工作流程、以及一项包括了为病人而设的

放射线测试后获取信息的全盘性项目也正在酝酿中。该部门也做好了

扩充的准备以为逐渐增加的病患们服务。

约翰·埃里克·埃里克森勋爵在1873年说:“腹部、胸部和脑部必须保持永久的封闭

状态，避免睿智和人道的外科医生的侵入。”既被封为维多利亚女

皇的特钦外科医生，有许多人因此相信了他的话。但如今却证明了他的

话大错特错。放射线部门的超级英雄为了它的病人们继续不断的让肉眼所不

能视者现身，挑战医疗科学的极限。

梁雪芬高级放射线技师（磁共振成像）雪芬的放射线医疗职业生涯从2002年她荣获了由卫生部颁发的海外专科师奖状开始。她毕业于伦敦南岸大学，并且拥有诊断性放射学的第一荣誉学位。她也拥有昆士兰大学的磁共振科技硕士学位。除了她的放射线正业以外，雪芬温文尔雅的谈吐和行政工作方面的才能让她被看中兼顾部门里一些重要功能的运作，如放射线信息系统以及图像存档和沟通系统。她也确保部门的内部程序达到国际医疗卫生机构认证联合委员会所列出的指标。

李菀惠临床护士菀惠是一位满腔热忱的临床护士，她在陈笃生医院从普通护士开始做起。之后调职到竹脚妇幼医院，最后才来到樟宜综合医院。她在樟宜综合医院工作已有12年，并且是开拓护士独立执行外周导管程序的先锋者。做为部门里最资深的医疗员工，她曾与医生和病人们共度无数患难，其中包括了那段可怕的非典时期。如今她的工作是掌管部门里的政策、安全措施、以及督促其他员工，以确保整个部门的运作顺畅。

新的一年，新的开始。今天就开始戒烟，为您和您的亲人创造一个健康，无烟的未来

享受健康无烟的生活

我为什么应该戒烟？+ 您的衣服、头发、口腔、家和车

子再也不会有烟味了。+ 您将会变得更有精神来做你喜欢

做的事情。就连爬楼梯或步行时也不会像之前一样气喘吁吁的。

+ 您将会减少皱纹，也能祛除一贯的早晨咳嗽。

+ 您可以把买香烟的钱统统存起来，请你的家人吃几顿大餐。

+ 您身边的人也不会遭受到吸二手烟而带来的危害。据樟宜综合医院呼吸内科部

门与重症疗的顾问，刘力木医生说：“吸二手烟也被称为被动吸烟。在二手烟里就轻易含有至少250种有毒或致癌的化学物质。在成人当中，二手烟可引起冠状动脉心脏疾病和肺癌。在婴儿当中，会导致猝死。在孕妇当中，

原文 Joann Chia

将会减少婴儿出生体重。在家中经常吸二手烟的年轻人，比起在家中没有吸二

手烟的年轻人，开始吸烟的可能性也多出一个半到两倍。吸二手烟没有

任何的安全水平。以任何方式接触到二手烟都会危害身体。即使把隔着这两

区的门在可以通风的情况下都关闭，二手烟还是可以从吸烟区扩散到非吸烟区的。只有在100％的无烟环境下，才能提供有效的保障。”

若有疑问…就要寻求帮助！

樟宜综合医院连同拥有一批经验丰富的护士和药剂师，经营新加坡戒烟辅导服务中心。

樟宜综合医院呼吸内科部门与重症疗的顾问刘医生说：“樟宜综合医院的戒烟计划包括辅导、行为上和药物上的治疗。研究显示，突然戒除烟瘾，失败机率很高。只有通过定期的辅导、行为和药物治疗才能够显著提高戒烟率。现在有以片剂或补丁形式的各种烟碱替代疗法。就如Xyban和Champix，都是很有效的药物。药物治疗取决于患者的个人病例和选择。”

戒烟计划的运作方法+ 嗜烟者都得接受短期的辅导过程。过后，

若嗜烟者同意接受更深入辅导的话，他们就会被转介到认证的戒烟辅导员。

+ 他们就会接受更深入的辅导过程。也可能会同时接受药物治疗。

+ 出院后，戒烟热线（樟宜综合医院和新加坡保健促进局的一项联合计划）的辅导员会定期跟进他们的情况。

+ 一些嗜烟者则会被转介到科门诊接受跟进情况。

分散您的注意力身上记得携带“救援包裹”来分散您想吸烟的注意力。包裹可以包括以下物品：无糖份的糖果、富有营养的零食和能够让您动脑筋的手提电动游戏。

拖延想吸烟的冲动现在就有吸烟的冲动吗？烟瘾会慢慢褪掉，所以您可以喝点水，或吃个薄荷糖来拖延想吸烟的冲动。

深呼吸呼、吸…深呼吸练习能够帮助您放松身心，是克服烟瘾的有效方法。

慢慢地喝饮料为了使双手和嘴巴繁忙，您可以尝试慢慢地喝一杯牛奶或温水。这是另一种克服烟瘾的方式。

应对烟瘾4小贴士当烟瘾再犯时，记住要用以下方法来帮您度过烟瘾期:

您是否是个拥有以下症状的嗜烟者+ 咳嗽时会产生大量的痰液？+ 体育活动时经常感到呼吸困难？+ 呼吸时会喘息或传来吱吱叫的声音？+ 胸口会感到发闷？+ 容易患上感冒？

根据以上的症状，若您的答案有任何的“是”的话，您很有可能患上慢性阻塞性肺病，或简称为COPD。吸烟是慢性阻塞性肺病的主要原因。患有这种疾病的病患久而久之呼吸会变得越来越困难。

慢性阻塞性肺病患者的自白 58岁的货车司机，Mohammad Sukhaimi bin

Abdul（索海米）， 12岁时就开始吸烟。每

天抽上两包香烟的他也曾尝试戒烟不果。去年当他病

倒时感到呼吸困难。医生这时才检验出他已经患上了慢性阻塞性

肺病。在医院接受五天的治疗后，索海米整个

人都变得焕然一新。慢性阻塞性肺病是无法治

愈的疾病，但是随着定期的服药可以缓解症状。

戒烟长达一年多的时间后，今天的索海米感觉到

生活素质有明显的区别。

“以前，当我爬楼梯的时候会觉得喘不过气来。戒烟之后我感觉稍微好了一些。因为身边的朋友都有吸烟，所以戒烟的过程的确很困难。有时候还是会有想吸烟的冲动，但是我学会控制自己。我告诉自己，如果不停止的话，我的寿命将会被严重缩短。”

我们肺部的运作方式

1 空气从我们的气

管传入肺部的支

气管。

2 这些支气管随之拓

展到肺部上千数被

称为细支气管的细管去。

细支气管的另一端有被称

作为肺泡的微小气囊。

3 肺泡壁衬有叫做微

血管的小血管。氧

气穿过肺泡，通过微细管

进入血液，并利用这些微

细管在肺泡中将二氧化

碳从血液中祛除掉。

4 我们的气道和肺泡

富有弹性，所以当

我们吸气时，每个气囊

就会像小气球一样膨胀

起来。

慢性阻塞性肺病患者们，

气道上会减少空气流动，

这是因为：

P 气道和气囊已经失去

了弹性。

P肺泡壁已经遭到毁

坏。

P气道壁因厚实而导致

发炎。

P气道上产生比平常

更多的痰液，造成

堵塞。

欲知详情或预约服务，请拨打6580 3333。

35

特写 // 看护者的精神压力


原文 Robing Ng 和 Lim Ee Guan

家庭医生，您的首选!

邻里诊所通常都只能治好普通的伤风感冒，不是吗？” 大多数的人也许

觉得家庭医生（或“家庭主治全科医生”，或“GP”）只会医治普通常见的病情，如咳嗽或感冒。实际上，您家附近的邻里诊所设备齐全，能够治疗各种病症和病况。

“在东部地区的区域卫生

系统，东部医疗联盟 (www.easternhealth.sg)，与地区的邻里诊所有了密切的合作关系，从而帮助治疗和管理病人，使他们能够安全无病痛纠缠的情况下受诊。其中的例子就包括了社区健康中心, 竭力地支持邻里诊所，帮助它们照料患有慢性疾病，如糖尿病的病人。

37


原文 Robing Ng 和 Lim Ee Guan

为了鼓励更多国人前往邻里诊所向家庭医生求诊，相应他们的保健需求，东部医疗联盟，连同樟宜综合医院(东部医疗联盟基金会合作伙伴)，以及许多位于新加坡东部地区的邻里诊所携手研制了一项新计划，在2014年1月正式推出这次的GPFirst项目。

“我们和这些家庭医生合作伙伴们有频繁的联系，也知道他们很

您可从参与该项目的邻里诊所、东部医疗联盟的合作机构和樟宜综合医院正在分发的信息小册子中了解更多详情。该项目也有增设了官方网站(www.gpfirst.sg) 来提供该项目的信息。网站也例出在什么样的病况下，是可以向家庭医生求诊，还有参与该项目所有邻里诊所的最新名单以及参与该项目的附带条件。

能干。在社会里，他们扮演了举足轻重的角色，来提供最妥善，最方便的医疗服务。”东部医疗联盟的集团总裁，乌代潤先生(TK Udairam) 清楚地表示。“GPFirst该项目是我们帮助鼓励国人，向这些拥有丰富专业知识的家庭医生求诊，毕竟他们的诊所设备齐全，能够医治各种病况。”

创新的联盟企划GPFirst是一项首创家庭医生与医院的联盟企划，专注于教育国人并鼓励他们在轻微到稍微的病况下或者非紧急情况下，应该先向邻里诊所的家庭医生求诊（见边栏）。

若家庭医生觉得病人的情况严重，并决定把病人送入樟宜综合医院急诊部时，病人将会以特别的GPFirst推荐表格来进行转介。这些表格的内容包含了家庭医生简短的诊断和评估报告。此外，以推荐表格进入急诊部的病人都会得到受诊的优先权，急诊部的医药费也会获得50元的津贴。

截至记者发稿时，现已有超过132 间位于东部地区的邻里诊所报名参与该项目的一部分，而数目还将会继续增长。参与该项目的邻里诊所都会在诊所里明显的角落，贴上为了该项目而设计的贴花。

以推荐表格进入急诊部的病人都会得到分诊区的

优先权，急诊部的医药费也会获得50元的津贴

一般的感冒症状

• 喉咙不适

• 发烧

• 伤风

• 耳痛

• 维持超过三天以上的所列病症

伤风感冒并不被列为紧急病况，所以您并不须要到医院的急诊部求诊。

扭伤所导致的迹象

• 稍微疼痛

• 浮肿

• 瘀青

扭伤迹象并不被列为紧急病况，所以也不须要到医院的急诊部求诊。

头晕及呕吐与其症状

• 呕吐

• 腹部疼痛

• 泻肚子

但是您如果有以下的同等病况，请立刻往急诊部求诊

• 脱水迹象

• 剧烈头疼

• 头部受到伤害

该次序并不代表各病历的严重性。欲知有关该项目的详情及进一步了解您的家庭医生或邻里诊所的医生如何提供适当的医疗服务，请游览我们的网站www.gpfirst.sg.

如果您有以下的症状或病况，

请务必到临近的诊所或向您的

家庭医生求诊:

*项目章程:• 该项目只限于新加坡东部的邻里诊所。政府诊所并不列入该项目之内。• 病人必须把填好的GPFirst推荐表格附上身份证/工作准证/护照交给登记处。• 50元的津贴只限于樟宜中央医院的急诊部。• 以上的质询内容在打印期间全属正确。本医院没有义务把在任何情况下所有修改过的内容通知民众。

家庭医生 // 第一时间的救援

声音 vs 噪音我们的听觉，除了能够预警我们即将面临的危险，也能够使我们在日常生活中与他人沟通和拥有互动。不论是在家中、办公室或在公共场所，我们每天都会听到不同的声音与噪音。这些声音与噪音是被称为声波的振动能量所产生的。这两种音很容易分辨：若愿意听到的话，就是声音；若不愿意听到的话，就是噪音。

当我们的听觉受到影响时... 耳朵内层里的耳蜗毛

细胞就像是一把新牙刷的刷毛。每根微小的毛发

会随着音波而移动和弯曲。长期的过大噪音会造成毛细胞极度弯曲。若不乘早呵护我们的听力，这些毛细胞就会像一把用过很久的牙刷，经过长年累月的磨损而逐渐被损坏。但是不像牙刷那么简单，毛细胞一旦损坏了，就会导致我们永久失去听觉。

原文 Joann Chia

我们的听觉，就好比生命中最宝贵的东西，不应该被视为理所当然的事情。一旦失去了，就永远无法完全恢复原有的听觉

保护您的

听觉


39

如何发现噪音性听力受损的早期征兆

在安静的地方或到了晚上时，您的耳朵是否有出现耳鸣或嗡嗡声？

您是否面临失眠的问题，或者有困难集中精神？

在嘈杂的地方，你是否很难听得清楚？

在较高的频率中，您的听力是否已经受损了？

您是否在不知不觉中比常人更大声说话？

您是否经常听不清楚，而且需要人家跟您重复他们所讲的话？

- 您是否发现自己通常都会

调高您的电视或收音机的音量？

医者心语 // 保护您的听觉

请阅下一页

我们的耳朵被分为三个部分：外层，中层和内层

耳朵的外层以音波的能量搜集各种声音和噪音

为了应对不断变化的空气压力，耳膜就会开始振动，从而启动里面的三个小骨头

音波会随着耳道传到外层和中层交接处的耳膜，也被称作为耳鼓

➊

声音是以分贝（dBA）衡量的。85分贝以上过大的声音或噪音会损害我们的听力，造成噪声性听力受损

60−65 分贝一般城市的喧嚷

85−90 分贝长时间的接触可能会造

成听力受损

10−20 分贝几乎听不见

40−50 分贝安静，或令人悦耳的声音

100−120 分贝这个阶段的噪音很嘈杂，不悦耳

怎样的音量才是过大的噪音呢？

➋

➌

耳朵听到

声音的时候


41

内层成千上万的耳蜗毛细胞会随着流体的音波传递摇动，产生脉冲传到大脑

小骨头的振动会继而把音波变为流体，利用蜗形的耳蜗送到耳朵的内层

➍

➎

140+ 分贝接触一次的话很可能造成

永久失去听力

120−130 分贝对于大多数人来说，

这是痛阈

虽然60岁以上的乐龄人士听力受损的风险更高，任何人都可以基于不同的原因而失去听觉。

尤其是在当今的社会里，年轻人使用耳机是如此普遍，风险也会随着提高。

噪声性听力受损是一个渐进的过程；无痛，看不见，也不能恢复原有的状态。

预防和呵护耳朵小贴士

来源：林美凤小姐，高级耳鸣辅导员，耳鼻喉部门，樟宜综合医院

在大脑的听觉中心，这些脉冲将被解码，让大脑知道这是什么声音

➏

医者心语 // 保护您的听觉

+ 首先，你得知道长期听到过大的声音和噪音会造成听力受损。

+ 若经常播放音乐的话，由于声音是直接被传到耳朵里，请限制音量和用耳机的时间。

+ 若有长时间接触到85分贝以上的声音，请佩戴听力保护器。

+ 倡导年轻人尽早呵护他们的听力，并以身作则给他们看。

+ 请勿把异物放进耳朵里。

+ 若有听力的困难时，尽早到专科医生去做个听力检查。

+ 避免或远离非常嘈杂的环境; 经常佩戴合适的听力保护器。

JaNuarY//FeBruarY 2014 CARING

Source: CGH Dietary and Food Services

这农历新年，与家人一起分享一道富有

南洋风味的传统佳肴

做法

1. 把鸡洗干净后备用。

2. 用大锅把水煮开。然后把鸡放入锅中，确保整只鸡被淹没在水里。

3. 盖上锅盖，降低热度，用慢火焖煮25分钟。

4. 把做姜汁的材料倒入搅拌碗里搅拌均匀，备用。

5. 将煮熟的鸡切成块状，搭配姜汁上桌。

营养成分（每份）卡路里 332大卡碳水化合物 2.6克蛋白质 29克脂肪 22.8克纤维 0.1克胆固醇 150毫克钠 304毫克

所需材料

• 整鸡1只（约1.5公斤）• 水（足够淹盖整只鸡）• 姜，锤扁（1大块）

姜汁所需材料

• 姜，用搅拌器搅拌（200克）• 青葱（15克）• 食用油（2茶匙）• 盐（1茶匙）• 高汤（4汤匙）• 糖（1茶匙）• 麻油（2茶匙）

准备时间：20分钟

烹煮时间：50分钟

供10人份

吃出健康 // 三水鸡沾姜汁

三水鸡沾姜汁

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InvISIble - cgh.com.sg · InvISIble. Editor’s notE t’s that time of the year when we look upon life with fresh beginnings and make conscious effort to live better. For some, this