Healthy Living For Mind & BodyIssue 2 • July - Sept 2009M

ICA (P) 200/08/2008

what’s up doc?

He eases mums into childbirth

the big interview

That sinking feeling

Daddy’s girlsmiles

again

ceo message

ive years after SARS, another infectious bug has transcended our borders. But this time round, we are better prepared to deal with the new menace - Influenza (A) H1N1 virus.

From the moment health authorities sounded the alert, Mount Alvernia has moved swiftly to ensure our patients, doctors, staff and visitors stay safe.

Having dealt with SARS before, we know what precautions to take – temperature screening, taking travel history and donning of proper protective gear. Thankfully, everyone has been understanding and supportive of the steps needed to ensure a safe – and Influenza (A) H1N1-free hospital environment.

With your co-operation, we are able to continue running all hospital facilities and services as per normal, without compromising on patient safety.

Our maternity tours continue – albeit with a few simple precautions such as smaller group sizes and mask wearing. Visitors have been limited to two at any one time and visiting hours have been shortened, but with no exception, our clinics and wards continue to treat and attend to the diverse healthcare needs of all our patients.

In this same spirit, we are also moving ahead with upgrading work at the hospital. In response to your feedback, we are addressing the growing demand for carpark lots and more single rooms.

Further enhancements to the hospital will come in the form of a new parentcraft centre and a new F&B outlet to provide you with better service and more choices. These exciting new developments can be expected to be up and running by the end of the year.

But while we focus on hospital-centric developments, we have not lost sight of off-campus community needs. Given the health concerns of the elderly today, we are providing health screening services for the elderly under the People’s Association’s “Wellness Programme”.

Since May, we have gone out to various Community Clubs and Residents Corners islandwide and to-date, more than 1,100 Singaporeans aged 50 and above have used our health screening services to assess and manage their health.

This community service is an example of a Mount Alvernia Corporate Social Responsibility initiative made possible by staff volunteers, who dedicate some time outside of their normal work hours to ‘give back’ to society in a meaningful and tangible way.

At the end of the day, we remain focused on our mission as a Catholic, not-for-profit institution – to Serve All With Love.

Khoo Chow HuatCEO, Mount Alvernia Hospital

Publisher: Mount Alvernia Hospital 820 Thomson Road, Singapore 574623 Tel: 6347 6688 Fax: 6347 6632

Writer: Rosnah Ahmad Editorial Co-ordinator: Premila Elangovan

Editor: Geraldine Wang Editorial Advisor: Han May Ching

Design TOM Design & Communications For feedback and inquries, please email: myalvernia@mtalvernia-hospital.org

Editorial team

01MyAlvernia

he calls them her angels.

It was the sisters at Mount Alvernia Hospital who helped to make Mrs Angeline Carrie Lau’s four-day stay at Our Lady Ward such a joy even though her baby girl was born prematurely.

“It’s so comforting to have warm, caring and attentive nurses to attend to my every need and their smiles certainly went a long way. You gals are truly angels,” said the homemaker whose 32-week-old baby, Kyra, was delivered in early April 2009.

Although she has two other children, Mrs Lau still found it a challenge to handle her tiny newborn. Kyra weighed only 2kg at birth and she had problems keeping her milk down after feeds.

“Handling her for the first time was nerve-wracking because she was so small and fragile,” Mrs Lau, 30, said in an email interview with My Alvernia.

But with the help of nurses such as Sister Kang, Sister Seah and Sister Devi, Mrs Lau was able to deal with the challenges of nursing a premature newborn.

Sister Kang, for one, took the trouble to look for ways to help Mrs Lau increase the flow of her breastmilk, such as getting her to drink Green Papaya Soup and take Fenugreek herbs.

“She gave me so much encouragement when I was learning to bathe my little one for the first time. Most importantly, she always had a warm smile on her face,” said Mrs Lau, whose two other children are aged five and two.

And when it comes to handling babies, Sister Kang’s “motherly touch” also left a lasting impression on Mrs Lau.

“She has a way with babies. She actually makes an effort to remember all the babies’ names, talk to them and ‘manja’ (pamper) them when they start to cry after a jab or when they just get all fussy for no reason.”

Apart from Sister Kang, Mrs Lau also had fond memories of Sister Seah and Sister Devi. It was Sister Seah who “had so much patience in teaching me how to breastfeed and Kangaroo Care* for my baby”.

*Kangaroo Care is the practice of mothers giving their babies skin-to-skin contact to foster closeness and a feeling of comfort. The practice helps with a baby’s growth and development and is

especially beneficial to premature babies, helping them leave their incubators sooner and achieve deeper, more restful sleep.

This was the second time that Mrs Lau had chosen to have her baby delivered at Mount Alvernia.

“I find the nurses caring and extremely friendly. They always have a smile on their faces even when they have to take your pressure and temperature in the wee hours

of the morning,” she explained.

And so how is little Kyra now?

“She’s doing extremely well,” the proud mum shared.

a note of thanks

Alvernia’s

Daddy’s girl smiles

the big issue

A brain tumour turned her world upside

down, but with surgery, rehabilitation and the

support of caring nurses and family, 2-year old Dayangku Nur Atikah

Najibah binti Pengiran Haji Bahrin (Atikah) is on

the road to recovery.

02 MyAlvernia

03MyAlvernia

smilesagain

Senior Consultant Neurosurgeon Dr Timothy Lee

Toddler overcomes adversity to reclaim her bubbly self

ittle Atikah’s parents first suspected that there was something wrong with their baby when her neck became a bit stiff and her head started tilting to the right.

The once-active baby had also turned into a moody child who would cry non-stop at times.

CT and MRI scans subsequently confirmed that their daughter had a tumour in her brain, with the tumour cells scattered in several locations. The water pressure in her brain was also higher than normal, a condition which could lead to brain damage.

An operation was done in Brunei and this confirmed that Atikah had ependymoma. Her doctor in Brunei recommended either chemotherapy or further brain surgery in a Singapore hospital as the next course of action.

In Singapore, a pediatric oncologist recommended brain surgery after he found that the tumour had spread to both the left and right sides of her neck, as well as residual tumour in the brain. After consulting with senior consultant neurosurgeon Dr Timothy Lee, the family agreed to proceed with surgery and on 21 January 2009, Atikah was admitted to Mount Alvernia Hospital.

Within a month, Atikah was operated on four times. Two of the operations were surgical excisions to remove all the cancer cells. The first took about 16 hours and the second took about 8 hours. The other two were shunt operations to drain excessive water from her brain in order to reduce pressure there. Dr Lee described Atikah’s case as “challenging” but everything went smoothly and the next phase was post-operative recuperation.

ROAD TO RECOVERY All in all, Atikah spent nearly four months recuperating at Mount Alvernia, under the watchful eyes of the nurses at the Critical Care Unit (CCU), and later on, at the St Gabriel Ward for children.

Over time, she grew more and more familiar with the hospital staff, and they to her.

“In the beginning, she didn’t like the nurses to touch her. She would just ignore you,” said Ms Naw Kre Thaw, a staff nurse at the CCU who remembers Atikah well.

But the patient nurses persisted to win her over, singing nursery rhymes and making small talk with Atikah as they tended to her. To brighten up her environment, they also decorated her bed with stuffed toys and cartoon stickers. The CCU permanent night nurse would even sit and play with Atikah after giving her medication.

Before long, Atikah began responding to their voices and touch and could recognise all the nurses who walked in to her room. It was a giant leap forward for the little girl who would only respond to her father before, although her preference for Daddy remained. “She was a real Daddy’s girl. When he was around, she didn’t care about others,” said Nurse Kre.

Despite her tender age, Atikah struck the nurses as a “mature” patient who hardly ever threw tantrums. According to Nurse Kre, she would only cry if her pampers were wet or if she was running a fever.

the big issue

Nursing comfort: Staff Nurse Timna Wong cradles Atikah

Atikah celebrates her discharge with a party with all her new friends.

05MyAlvernia

tumourfacts What is ependydoma? It is a rare form of brain tumour that arises from the ependyma, a tissue in the centralnervous system, which comprises the brain and spinal cord. It can occur in both children (usually in the brain) and adults (often in the spine).

According to Dr Timothy Lee, he sees only one or two cases a year, and they are always children.

What causes it? There is no known cause and it has nothing to do with a person’s genes or his lifestyle.

Are there any symptoms? Frequent headaches; persistent vomiting for more than one week; head tilted towards the right; loss of balance or trouble walking; and irritability.

Once the tumour is removed, will it return?There’s about a 10-20 per cent chance of the tumour returning, said Dr Lee.

A Place for Quiet Reflection & Prayer

And the affable child could find reason to smile even through her pain. One trick the nurses discovered was singing and acting out her favourite children’s nursery rhyme, “If you are happy and you know it...” said Ms Lillibeth Corral Yaco, a senior staff nurse at CCU.

“Whenever she was asked to give a ‘Hi 5’, she would give it to you even when she was very ill and on a ventilator,” shared Nurse Yaco.

PLAY THERAPYAs part of her recovery process, Atikah underwent chest physiotherapy, occupational therapy and speech therapy.

There were suction sessions to extract mucus from her windpipe since she could not cough out phlegm on her own.

Atikah also had two months of occupational therapy, or due to her age, “play therapy” would be a better description.

When occupational therapist Koh Siew Van first saw Atikah, she was “unresponsive to command and was not able to have eye contact”.

Initially, her therapy sessions involved a lot of sensory stimulation using sound and bright coloured objects. The therapist then worked on her motor skills as well as her sitting balance to improve her trunk control.

By the time Atikah had completed her therapy, “she was able to sit independently and walk with minimum support”, Ms Koh said.

Atikah celebrated her second birthday on 27 March 2009 at the CCU, with a party hosted by the nurses and some goodies from Dr Lee. It was attended by her parents and several hospital staff. The birthday girl was, by then, able to taste a little of her favourite chocolate and ice-cream.

Shortly before Atikah was discharged in mid-May, Dr Lee had some good news for her parents: The brain scans done immediately after surgery and three months later showed that all her tumour cells were gone.

“She should be able to grow up normally,” Dr Lee said.

(Right) Part of the care team: Snr Staff Nurse Yaco, Snr Mgr Elizabeth Loh & Staff Nurse Kre from CCU

(Left) Thank you cards personalised by Atikah.

Dr Timothy Lee is a Consultant Neurosurgeon at The Brain and Spine Clinic, Tel: 6472 2022.

For Atikah’s parents, the attention showered on their daughter was not the only thing that caught their attention at Mount Alvernia. They were also pleasantly surprised to find that the hospital had a “Quiet Room”, where they could perform daily prayers as a Muslim.

The Quiet Room is located on Level 1, near the Main Lobby. For directions, please approach the receptionist for help.

Assistant Director of Nursing, Grace Koh

06 MyAlvernia

helping hands

In her 30 over years of nursing, Grace Koh has personally encountered many families faced with the sudden prospect of a loved one –struck by illness or injury –becoming totally dependent on others overnight.

Often the cause is a massive stroke – which tends to affect the elderly – and may result in loss of mobility and speech. However Ms Koh, who is Assistant Director of Nursing at Mount Alvernia, and a certified Entero-Stoma Therapist and Gerontological Nursing expert, has also seen much younger patients bedridden after sustaining serious injuries following an accident.

The good news is that not all conditions are permanent. “Sometimes, with rehabilitation, patients do regain mobility and become independent again,” says Ms Koh.

However she cautions that patience and optimism must prevail, and both the patient and his family must work together to overcome the difficulties along the way.

According to Ms Koh, the initial period of adjustment is the most difficult. “It is not easy for anyone to suddenly lose their sense of independence. One minute you are up and about. The next thing you know, you need someone else to do everything for you – clean you, wash you, feed you. It is a very humbling experience,” she explained.

During that period, patients are often extremely frustrated and may throw tantrums by refusing to eat or talk. “They feel ashamed of their loss of independence,” says Ms Koh.

So how does one help? “Do what the patient wants, not what you want to do for him.” advises Ms Koh. The most important things you can offer in such a situation are a positive attitude and presence. In other words, empathy not sympathy is the key.

For those tempted to overcompensate, Ms Koh warns that being “overly caring” could have just the opposite effect intended. “People do not want you to feel sorry for them. What they need is reassurance. Try to engage them as normally as possible and don’t distance yourself from them just because their circumstances have changed.”

mpathynotSympathy,

please

Caring for a bedridden person - Tips

w Hygiene Help the patient stay clean and dry by sponging with soap and water at least once a day, supplemented by wet wipes at intervals throughout the day.

w Pressure ulcers One of the biggest problems bedridden patients face, these are areas of local tissue inflammation that develop as a result of prolonged compression and friction between the skin and bones. Blood flow to the area is reduced, cutting off the supply of oxygen and nutrients to the skin. If left unattended, infection, sepsis and ultimately necrosis may result.

To detect pressure ulcers, look out for areas of discoloration and hardness on the skin.

Prevention is simple but requires diligent nursing: Ensure that the patient’s body is moved from side to side at least once every two hours.

w interaction Talk to the patient normally – about neighbourhood gossip, family affairs, current affairs or anything that would interest him. This is encouraged even if the patient is not conscious. Touch is also a powerful non verbal form of communication that lets the patient know someone cares.

* The Asian Women’s Welfare Association has published a handbook for caregivers. To get a free copy, visit www.awwa.org.sg

*All information is correct at the time of publication. If you have further questions, please call our Business Office at (65) 6347 6662 for assistance.

New Medisave Claim Limits: Before & After 1 June 2009:

Normal Delivery – 2 Days Stay @ Single Room Before After

Charges Medisave Claim Cash Portion Medisave Claim Cash Portion

Hospital $ 2000 $ 1250 $ 750 $ 1400 $ 600 Doctor $ 1500 $ 550 $ 950 $ 700 $ 800 Total $ 3500 $ 1800 $ 1700 $ 2100 $ 1400

Arthroscopic Procedure – 1 Day Stay @ Single Room Before After

Charges Medisave Claim Cash Portion Medisave Claim Cash Portion

Hospital $ 2500 $ 1100 $ 1400 $ 1475 $ 1025 Doctor $ 4800 $ 750 $ 4050 $ 1125 $ 3675 Total $ 7300 $ 1850 $ 5450 $ 2600 $ 4700

you asked

07MyAlvernia

Medisave now covers moreHigher claim limits, less out-of-pocket cash payment Since 1 June 2009, the Ministry of Health has increased the Medisave withdrawal limits for surgical operations. So if you are opting for surgery at Mount Alvernia, this means you can now tap more into your Medisave account to settle medical bills. To help you understand Medisave claims better, here are some common FAQs:

How much of my Medisave can I use to cover my hospital bills? For a hospitalisation claim, the patient must have stayed in the hospital for at least eight hours (unless he is admitted for day surgery). Medisave now covers up to $450 per day ($400 for hospital charges; $50 for doctor’s daily attendance fees).

For day surgery, Medisave covers up to $300 ($270 for hospital charges, $30 for doctor’s attendance fee).

For surgical operations, the amount varies, depending on the type and complexity of the operation. The maximum amount claimable includes surgeon, anaesthetist and facility fees. A full listing on procedures claimable under Medisave now can be obtained at our Business Office.

Who does my Medisave cover? Medisave can be used for Medisave account holders or their dependants. Dependants refer to spouses, children, parents and grandparents. Grandparents must be Singaporeans or Singapore Permanent Residents.

How many Medisave payers are allowed? A maximum of 10 Medisave payers is allowed. However Medisave withdrawal limits still apply regardless of the number of payers.

Does Medisave cover expenses for maternity cases? Yes, it can be used to pay for hospitalisation for the delivery of the first four children. For the fifth and subsequent child, the parents will need to have a combined Medisave balance of at least $15,000 at the time of delivery to be eligible. The withdrawal limits will also apply.

Can Medisave cover for pre-delivery expenses? Yes, you are allowed to claim an additional $450 from Medisave for antenatal care if you submit your antenatal receipts to us during admission. This will be used to offset your hospital charges.

What if the hospital bill exceeds what my Medisave limit? If the bill exceeds what your Medisave can cover, you will need to pay the balance by cash, cheque, NETS or Credit Card upon discharge.

Can I use future Medisave contributions to pay the difference? No, Medisave claims can only be made based on the Medisave account balance on the day of admission.

Why is my Medisave claim estimated at admission different from that at discharge? Medisave claims are estimated at the time of admission and point of discharge. Upon admission, the estimate is based on the intended length of stay and type of operation scheduled for. Upon discharge, the estimate is updated in the Interim Bill to reflect the actual length of stay and procedures done during the stay. The final claim amount will only be known when the Final Bill is issued, after the claim amount has been approved by the CPF Board.

Can I check my Medisave account balance at the hospital?Yes, the hospital can help you check your Medisave account balance on your behalf if you authorise us to do so.

08 MyAlvernia

Can the common flu lead to more serious problems?Yes, it can lead to problems such as pneumonia, myocarditis (inflammation of the heart muscle) and pericarditis (inflammation of the pericardium, a protective lining that surrounds the heart) – especially in the very young and very old.Pregnant women and immuno-suppressed or chronically-ill patients are also at risk of flu-related complications.How can we build up our immunity against the flu virus?Exercise regularly; get adequate sleep; drink lots of water –at least six to seven glasses daily; and eat plenty of fruits and vegetables.Can a flu shot offer us any protection?The influenza virus vaccine is used to stimulate active immunity and provides protection against influenza virus strains, as well as against closely related strains, contained in the vaccine. It can be 80 to 90 per cent effective, depending on the individual. However, the vaccine is not effective against all strains of influenza virus.Flu vaccination is available at Mount Alvernia’s 24Hr Outpatient Dept. For inquiries, please call 6347-6210.Do we need regular flu shots?Flu vaccinations, once a year, are recommended for those who are at high risk of flu or flu-related complications, as well as those who live with, or care for, such individuals. They include women who will be pregnant or planning to get pregnant during the flu season; those with chronic lung (including asthma), heart (except hypertension); kidney, liver, blood, or metabolic disorders; immuno-suppressed patients; and those who take care of the elderly or children under five.Healthcare workers, residents of nursing homes and people who will be travelling overseas during the flu season should also get annual vaccinations.Who should avoid getting flu shots?Flu vaccinations are not recommended for those who are allergic to eggs, chicken protein, formaldehyde, gentamycin; and women in the first 14 weeks of their pregnancy.Is self-medication – buying anti-flu tablets off the counter – recommended when you have the flu?If the symptoms persist more than a few days, it is best to see a doctor. For patients in the higher risk group, self-medication is not recommended.

The patient himself should cover his mouth with a tissue whenever he coughs or sneezes.

The rest of the family should not share eating utensils with the patient and wash their hands frequently. If possible, try not to sleep in the same room as the patient.

If there are family members who are in the vulnerable group, it would be good practice for them – and the patient – to wear masks.

if a person has the flu, what can he and the rest of his family do to avoid spreading the infection?

in the pink

Dr Ho administers a flu vaccination.

The rise of the H1N1 virus as a global health concern is a reminder of how the flu virus can mutate into more dangerous forms from time to time.

According to Dr Ho Li Chin, Senior Resident Medical Officer at Mount Alvernia, there are three main types of the flu virus: Influenza A, B and C. H1N1, which is carried in pigs and transmitted to humans, is a subtype of Influenza A virus. Dr Ho shares with My Alvernia some tips on how to keep the flu bug at bay.

Don’t let it bug you

09MyAlvernia

Is it time for your next health check? Take advantage of our NDP specials for a very comprehensive array of tests – now packaged to give you more value for money. All packages include a full physical examination and review with a medical doctor.

NDP Package One ($400)(Men/Women, 40-50 years) Normally valued at more than $500, this package is the enhanced version of our most popular Alvernia Classic package. The special package includes organ function tests on the thyroid gland, liver and kidneys, venereal disease screening, chest x-ray, Hepatitis A screening, bone mineral profile, and your choice of either treadmill ECG or diagnostic imaging tests.

NDP Package Two ($550)(Men/Women, above 50 years)

Normally valued at $700, this comprehensive package features high sensitivity test for the risk of coronary artery diseases, testing for arthritic joints, screening for testicular cancer (for males) and lung function assessment.

10% off the following tests if added on to the packages above:

- Screening Mammogram- Ultrasound Breast- Ultrasound Pelvis- Ultrasound Abdomen- Bone Mass Densitometry- Treadmill ECG

Note: All prices are before GST.

Our hospital is upgrading its facilities to create a more conducive environment for patients and visitors. By year end, you can look forward to new carpark lots, more room choices and dining options.

We apologise for any inconvenience caused to patients and guests in the meantime and appeal for your understanding and cooperation during the period of renovation.

National Day with Good Health

Mount Alvernia Hospital’s founding Sisters mark their 60th year in Singapore this year and to commemorate the occasion, the Sisters have banded together with doctors and staff of Mount Alvernia and Assisi Hospice to present an evening of songs at:

Church of St Mary of the Angels5 Bukit Batok East Ave 2 Fri, 11 Sept 2009 @ 7.30pm

Admission is free and all are welcome. To reserve your ticket, please email fmdm60years@ymail.com

There will be a collection for palliative and hospice care services by Assisi Hospice.

Celebrating 60 years of service with song

alvernia happenings serve

you better

10 MyAlvernia

Heinto

mumschildbirtheases

Dr Ho Hon Kwok regularly uses stories and anecdotes to break the ice with patients and put them at ease.

This approach helps the Consultant Obstetrician and Gynaecologist’s patients understand the medical scenario at hand and make informed decisions that sometimes have life or death implications.

For Dr Ho, the craft was honed from his earliest days in medicine. He related how as a young doctor working at an A&E unit, he encountered a toddler with an unusual problem – a bead was stuck in the nostril. Instead of opting for a medical procedure immediately, Dr Ho decided to try something less invasive first.

With anxious parents looking on, Dr Ho calmed the crying toddler down and coaxed him into ‘playing a game’ by pressing one nostril and blowing out. The ‘game’ worked – the bead flew out the toddler’s nose and freed him from his predicament.

Today, Dr Ho, 55 runs his own private practice at Mount Alvernia

the big interview

it’s a field often associated with joyful tidings. and by his own admission, the “Joy Factor” is one reason why Dr Ho Hon Kwok chose obstetrics and gynaecology as his area of specialisation. But what’s the story behind delivering babies? Dr Ho shares a few with My Alvernia.

where he has been based since 1996. He was one of the first O&Gs to start a practice here. Why Mount Alvernia and not somewhere else? Dr Ho says it all boils down to the special vibe about the place.

“There is a very serene ambience here. When you talk to the nurses, you also find them very friendly and personable. I also like the fact that it’s a not-for-profit hospital. Surpluses earned by the hospital go towards supporting charitable causes like the Assisi Hospice and other mission activities. By working here, I feel I can indirectly do my part for charity,” he shared.

Besides patient care, Dr Ho also finds time to participate in the hospital’s medical advisory committees and boards. He is currently serving as Chairman of the hospital’s Medical Advisory Board.

“The hospital team is very sincere and committed to continually improve and uphold standards. As a doctor, whether through conducting educational talks or playing an advisory role, I try to share my expertise to help the hospital grow,” he said.

Dr Ho Hon Kwok

11MyAlvernia

Do you think being a man puts you at a disadvantage compared to a female obstetrician and gynaecologist?Perhaps, since there’s this perception that it is easier for a woman to confide in a woman doctor. But in practice, it is not always true that a woman obstetrician can empathise better with her patient or be more sensitive to her needs.

I once had a very shy patient who was with a female obstetrician before she came to me. She had suffered a missed abortion – a condition in which a non-viable foetus is retained in the uterus.

To remove the foetus, the obstetrician needed to put some medicine in the woman’s vagina but the patient could not bring herself to allow the doctor to do so. The doctor’s attempts were unsuccessful and in the end, the patient left the clinic in tears.

When the woman came to me, she was very upset and related what had happened to her. I listened carefully to her and realised I had to think of some other way to help her – so I asked her if she would be able to insert the medicine herself, with my guidance. She agreed and we managed to administer the medicine successfully.

You’re dealing mostly with patients who are not sick in the conventional sense, so what are the qualities that “baby doctors” need to have?I think O&Gs tend to be more easy going people. Babies can arrive at any time, so being on call 24 hours a day is something we must accept as part of the job. We’re also dealing with something that is very personal and intimate, so having the right demeanor is important. If you are not approachable, patients will find it hard to confide in you and you will not be able to help them.

With the government offering more incentives to encourage people to have more babies, have you detected any changes in birth trends?No, I think many Singaporeans still want to stop at two. I suppose the financial crisis may be a contributing factor. Another consideration among couples where both partners work, is the availability of reliable home help. But I do see more older mums among the local population, aged 35 and above.

Incidentally, Dr Ho had a hand in influencing the calming décor you see at some of the wards and clinical areas. “When choosing a color scheme, bear in mind the effect of color on psychology,” he revealed, adding that patient comfort and functionality are also important considerations.

After 13 years, Dr Ho continues to feel right at home at Mount Alvernia. “There are three things I always look for – integrity, commitment and consistency. It’s all here.”

here are three things I always look for - intregrity, commitment and consistency. It’s all here.

12 MyAlvernia

the big interview

How different are your patients today compared to say 20 years ago?Women tend to be well-read and better informed today. The expectations of the doctor are also much higher.

What are some of the common medical concerns that pregnant women face?These usually evolve as the mother goes through the different stages of pregnancy. In the first trimester, they may experience nausea and vomiting, vaginal bleeding, abdominal discomfort and lethargy. As the pregnancy progresses, the mother will want to know how her baby is growing. Towards the later stages, they will start to think about things like the mode of delivery, pain relief available during delivery, and the ability to breastfeed once the baby is born.

There have been cases of mums-to-be, especially the first timers, going to the hospital, only to be sent home because they are still in the early stages of labour. how can a woman avoid such a situation? Doctors usually brief their patients so that they will have a good idea of when is the right time to go to the hospital –when the contractions start to occur once every 10 to 15 minutes. Having said that, ‘false starts’ cannot totally be avoided and I think it is better to be early than late.

In your experience, which year stood out as the year of the big baby boom?Any year considered auspicious in the zodiac calendar tends to see more babies. I recall 1988 was very popular because it was the Year of the Dragon and also because the number eight is considered lucky by the Chinese.

Is it true that fathers can sometimes be more of a hindrance than a help in the delivery room?Well I have yet to see a father here fainting at the sight of blood or his wife’s screams. I think they rarely get in the way. The presence of the father in the delivery room is actually helpful, especially in terms of lending emotional support to the mother.

On a personal note, your bow tie seems to be your trademark. Is there a story behind it?It’s just for practical reasons –a bowtie looks professional and doesn’t get in the way.

What a pity. My Alvernia was hoping that Dr Ho could tell us one more story before we wrapped up.

Dr Ho Hon Kwok is a Consultant Obstetrician & Gynaecologist at HK Ho Women & Fertility Clinic at Mount Alvernia Medical Centre, Tel: 6353 8833.

1. Bring the chicken stock to a boil.2. Add the rest of the ingredients to the stock.3. Lower the fire and simmer for 15 minutes.4. Transfer soup into herbal pot or slow cooker.5. Steam or slow cook the soup for 2 hours.6. Add salt to taste.

IngredientsChicken stock, 350 mlOld ginger smashed, 20 gmChopped chicken, 150 gmRed dates, 8 pcsChinese mushroom, 4White wine, a splashSalt to taste

Serves 1

Chicken

13MyAlvernia

MushroomRed Date Soup

deliciously healthy

Nutrition Content:One serving will give:380 kilocalories 31gm Protein 53 gm Carbohydrate 6 gm Fat

Recipe courtesy of Mr Ho Limg Neng, Executive Chef, Mount Alvernia Hospital Nutritional tips courtesy of Ms Lee Hee Hoon, Senior Manager, Nutrition & Dietetics, Mount Alvernia Hospital

Latest Medical Terminology Artery - The Study of paintingsBacteria - Back door to the cafeteriaBenign - What you be after you be eightCaesarean Section - A neighborhood near RomeCat Scan - What dogs do when they enter your yardComa - A punctuation markCongenital - FriendlyDilate - To live longEnema - Not a friendLabor Pain - Getting hurt at workMedical Staff - A Doctor’s caneNitrate - Cheaper than the day rateOutpatient - A person who has faintedPelvis - Cousin to ElvisProtein - In favor of young peopleRecovery Room - Where you have your upholstery doneSeizure - A Roman emperorTablet - A small tableUrine - Opposite of you’re outVaricose Veins - Veins which are very close together

the best medicine

14 MyAlvernia

hat sinking feeling

The 20-year-old was so self-conscious that he was reluctant to remove his shirt for examination when Dr James Wong first examined him.

The reason for his bashfulness: pectus excavatum, or sunken chest, a common congenital abnormality.

Dr Wong, a Cardiothoracic Specialist with more than 20 years of experience, explains what the condition is all about.

15MyAlvernia

what’s up doc?

How does a sunken chest develop?The deformity occurs when several ribs and the sternum grow abnormally, producing a caved-in appearance in the anterior chest wall.

Why does it occur?Its exact cause remains unknown. But some cases of sunken chest have been associated with Marfan’s syndrome, a connective tissue disorder; various congenital heart conditions; and chromosomal defects such as Turner’s syndrome, which affects development in females.

It is also common for a person with sunken chest to have associated scoliosis, a condition which results in his spine curving from side to side.

The condition can be familial. I have seen a father and son with similar conditions. I have also seen two families in which both sets of parents do not have sunken chests, yet three siblings in one family and two siblings in the other suffer from the deformity.

How common is the deformity? It affects about one out of every 1000 children and occurs more frequently in boys than girls.

Can a doctor detect sunken chest in a newborn?Usually in the newborn, the chest depression is mild but progresses with age. If left untreated, the deformity becomes more pronounced over time and may get worse during the puberty growth spurt.

Is sunken chest more of a cosmetic problem?Sometimes the condition can lead to medical problems. The inward-facing sternum can apply pressure to the heart and lungs, resulting in restricted organ growth and shortness of breath.

Older children and adults may complain of pain in the area of the deformed cartilages (a form of connective tissues).

Most patients are also affected psychologically – such as losing their self-confidence – especially in severe cases when the chest looks like it has been “punched in” and the shoulder crouched forward with associated scoliosis.

How can the deformity be corrected?In the past, many turned to the Ravitch procedure – an invasive surgery requiring resection of the deformed cartilage and bone – to rectify the problem.

However, these days, a minimally invasive surgery – the Nuss procedure, name after its inventor, Dr Donald Nuss – is often recommended.

During this surgery, a long stainless steel metal bar (or pectus bar) tailored to the patient’s chest deformity is inserted beneath the ribs and sternum, with the curvature of the bar facing backward then flipped over to prop up the chest into the right position.

The metal bar will remain in that position for two to three years until the bones remodel themselves in the new configuration. It will then be removed.

The surgery, which can usually be completed within one hour, will leave only three small incisions.

How much does the Nuss procedure cost?The whole reconstruction process, which includes doctors’ fees, hospitalisation, operation cost, the pectus bar and stabiliser, could cost up to S$18,000 – S$20,000. Additional pectus bars could cost more.

Dr James Wong is a Consultant Cardiothoracic & Vascular Surgeon at The Heart Lung and Vascular Centre at Mount Alvernia Medical Centre, Tel: 6356 6288.

Pectus excavatum, or sunken chest, is a congenital chest wall deformity in which several ribs and the sternum, the long, flat bone located in the middle of the chest, grow abnormally, producing a caved-in appearance in the anterior chest wall.

Consultant Cardiothoracic and Vascular Surgeon Dr James Wong

16 MyAlvernia

Spacious, airy and surrounded by greenery, the obvious choice for the hospice was the convent – but first the Sisters would have to vacate the convent they lived in. Ever generous in spirit, the Sisters moved out to make way – as they had done so many times before with each new hospital extension.

hings have changed since Sister Barbara Pereira first joined Mount Alvernia

Hospital as a young nun.

“The hospital was smaller then and we didn’t have so many medical specialists as we do now,” said Sister Barbara, who is today the Regional Head of the Franciscan Missionaries of the Divine Motherhood (FMDM).

But as the needs of the community evolved and healthcare management became more sophisticated, the hospital grew in size and medical expertise.

Vigilant of changing trends, the FMDM Sisters – who ran the hospital from the founding days until the 1980s – were quick to recognise the need to bring in multidisciplinary medical professionals to beef up the hospital’s capabilities and provide better care for patients.

Their foresight led to the introduction of lay staff into the key hospital management positions, to whom the Sisters eventually handed the reins over completely.

Sr Barbara’s personal journey reflects the hospital’s phases of renewal and growth. In 1990, she stepped down from the position of Assistant Director of Nursing (Medical/Surgical) at Mount Alvernia and left for England to train in palliative care.

With new insights, Sr Barbara returned to Singapore and began planning how Mount Alvernia could develop its hospice care wing – then located within the main hospital itself – into a full-fledged hospice, in keeping with the needs of the times.

“Since the convent was not purpose-built for a hospice, the place had to be renovated and refurbished and we made sure that patients’ rooms all overlooked the garden,” shared Sr Barbara.

In 1992, the Assisi Home & Hospice was officially opened, equipped with 35 beds for the care of patients with cancer and other life-limiting illnesses. The only hospice to offer three services – inpatient, day care and home care – under one roof.

But the learning did not stop there for Sr Barbara. In 1996, she left for England again – this time to train and work in Clinical Pastoral Care. Upon her return to Singapore, her new skills were put to good use as part of the Pastoral Care team which she worked with from 2003-2007.

Today, besides overseeing 44 FMDM nuns in Singapore and Malaysia as Regional Head, Sr Barbara also keeps in touch with what’s happening at Mount Alvernia and Assisi Hospice as a Board member.

Despite the numerous changes throughout the years, Sr Barbara is happy to note one constant “The hospital staff still exhibits a pioneering and compassionate spirit and remains dedicated to the care and service for people of all races,” she said.

Her wish for the future is simple but profound, “I hope that Mount Alvernia will continue to serve as a beacon of hope and peace, so that everyone who comes here will experience the healing love of God in their lives.”

onstantly renewing, ever in touch

up close & personal

Sister Barbara Pereira

Assisi Hospice: surrounded by greenery

A SURGEON’S ART: The next time you walk through the halls of Mount Alvernia, pause for moment to admire the roses. Gracing the walls of the hospital are rose paintings by one of the doctors who used to operate here. Dr Earl Lu (1925-2005) loved art as much as he did surgery and his specialty was: Roses.

he optimist sees the rose and not its thorns; the pessimist stares at the thorns, oblivious to the rose.”

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