Baby-Friendly Hospital Initiative

Issue 2 / 2012
A quarterly publication of the National University Hospital
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08
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Behind The
Scene
The Heart Of
Healthcare
NUH Receives
Award For Fair
Employment
Practices
Baby-Friendly
Hospital Initiative
The National University Hospital is working towards being
one of the first baby-friendly hospitals in Singapore to be
certified by the World Health Organization (WHO).
Early this year, the Baby-Friendly Hospital Initiative
(BFHI) was formally launched in Singapore by the Health
Promotion Board and ABAS (Association of Breastfeeding
Advocacy Singapore).
MICA(P) No. 238/09/2011
NUH news bites
02
Working Towards
A Baby-Friendly
Hospital
T
he BFHI initiative aims to help mothers
breastfeed exclusively in a maternity hospital
by requiring the healthcare institution to
practise the “10 Steps to Successful Breastfeeding”
and adhering to the International Code of Breastmilk
Subsitutes.
“Many people will agree that breastfeeding is
the best for babies and helps to achieve better
mother and baby health outcomes. Every time we
inform, encourage, and teach one mother about
breastfeeding, we give her child a good head start
in life. Making the NUH baby-friendly means we
are able to reach out to more families,” explains Dr
Yvonne Ng, Consultant, Department of Neonatology
and Chairperson of the NUH BFHI Steering
Committee.
New mummy Denise Teoh gets a helping hand from Lactation Consultant Wong Lai Ying on breastfeeding her baby.
NUH has been a strong advocate of breastfeeding for many
years. In 2007, the hospital launched a six-month Clinical Practice
Improvement Programme project that saw exclusive breastfeeding
rate increase from 54% to about 75%.
In NUH, all the nurses working in the maternity and neonatal wards
are trained to advise and offer support to breastfeeding mothers.
Since 2010, midwives and nurses have been helping mothers
initiate skin-to-skin contact with their newborns within the first hour
of birth. While establishing early skin-to-skin contact is already
common practice among mothers who deliver normally, the
hospital is looking to do the same among mothers who deliver via
C-section without compromising patient safety.
NUH also actively encourages “rooming in” where the baby
remains by the mother’s side.
“Rooming-in helps a mother get used to her baby’s feeding
patterns and to recognise the cues from the baby, which in turn
helps to make breastfeeding a success,” explains Lactation
Consultant Wong Lai Ying.
Madam Denise Teoh, who gave birth to her first child Ashur in
April shares her experience in breastfeeding. “At first the baby was
not really latching on correctly and he was only nibbling on the
nipples. I was a bit worried that he was not drinking enough milk.
Fortunately the lactation consultant was there to teach me how to
latch the baby. And that to me, was very encouraging and helped
put me on the right track.”
The BFHI “10 Steps To Successful
Breastfeeding”
1. Have a written breastfeeding policy that is
routinely communicated to all health care staff.
2. Train all health care staff in skills necessary to
implement this policy.
3. Inform all pregnant women about the benefits
and management of breastfeeding.
4. Help mothers initiate breastfeeding within one
half-hour of birth.
5. Show mothers how to breastfeed and maintain
lactation, even if they should be separated from
their infants.
6. Give newborn infants no food or drink other than
breastmilk, unless medically indicated.
7. Practise rooming in - that is, allow mothers and
infants to remain together 24 hours a day.
8. Encourage breastfeeding on demand.
9. Give no artificial teats or pacifiers to
breastfeeding infants.
10.Foster the establishment of breastfeeding
support groups and refer mothers to them on
discharge from the hospital or clinic.
T
he NUH Urology Centre now offers acupuncture as a
complementary treatment for male sexual health conditions
such as erectile dysfunction, overactive bladder and
chronic pelvic pain due to prostatitis (inflammation of the prostate
gland).
“Acupuncture may be considered by patients who experience
side effects like headache or hot flushes using western medicine,
or those with chronic pelvic pain whereby conventional medicine
may be sub-optimal and have adverse effects such as drowsiness
or gastric pain,” says Dr Richard Tan, Senior Resident Physician
with the Urology Centre.
A patient who has seen results from the treatment is 25-year-old
Jason*, who injured his groin in a road traffic accident. Although
the surgery was successful, Jason continued to experience pain
which affected his ability to walk for 10 months after the accident.
The pain also affected his ability to maintain an erection during
intercourse. The father of an 11-month-old boy had to rely on
painkillers for almost a year but the medication offered little relief.
Then, his urologist at NUH suggested acupuncture.
Once a week for over 10 weeks, Jason would spend half an hour
at the clinic, lying on a bed with needles stuck in his body. While
03
he is still receiving treatment, Jason is hopeful that his ordeal
will be over soon as the pain has lessened after three or four
sessions.
Besides the Urology Centre, acupuncture is also offered at the
Acupuncture Clinic for patients with lower back pain, neck and
shoulder pain, degenerative arthritis, as well as those receiving
post-stroke rehabilitation treatment.
*not his real name
Is Your Child Sleeping Enough?
W
ake up, take breakfast, change for school, off to
playgroup or childcare centre, lunch, shower, nap, wake
for activities, dinner, shower, go home, more play or
story time, sleep — that’s a typical day for a Singaporean child with
working parents.
With such a schedule, our preschool children generally get to settle
in bed only at 10pm.
A team of paediatricians from NUH recently published a study
based on a cross-sectional questionnaire survey of 372 children
attending local childcare centres, showing that those aged
between two and six years old in Singapore are not getting enough
sleep, compared to their Caucasian counterparts. This is a cause
of concern as insufficient sleep could affect the children’s long term
health and learning abilities, the researchers say.
that more than 40% of the study population display behaviours like
“difficulty in waking up” and “waking up tired”.
They also expressed concern on how sleep deprivations are
associated with the increased incidence of learning disorders,
unintentional injuries, obesity, impaired immunity and mood and
anxiety disorders.
Associate Professor Stacey Tay, Senior Consultant, Division of
Paediatric Neurology, NUH, and one of the study’s authors, shares
her observation that many children and teenagers are quite sleepdeprived. “They see me in the clinic for headaches, dizziness and
poor attention in class. But once they started sleeping longer, many
of their physical problems improved,” she says, adding that some
children showed “markedly improved academic ability.”
Two-year-olds here sleep an average of 9.1 hours at night and take
2.2 hours of nap in the day. Six-year-olds here sleep an average of
8.8 hours at night and take 1.6 hours of nap in the day. Compared
to their Swiss counterparts, local children in the study age
range have a consistently shorter duration of sleep. The biggest
difference was amongst the two-years-olds where local toddlers
sleep two hours lesser on average.
The paediatricians note there is currently no evidence that daytime
nap is as good as uninterrupted sleep at night. The study found
NUH news bites
Needle Therapy In Urology
Two-year-olds here sleep almost two hours less than Swiss children of that age.
NUH news bites
04
Same-Day Amniocentesis Test Results
– Now Available At NUH
I
t was 6:30pm in the evening on 12 December 2011. The
phone call that Florence Koh waited for the whole day
finally came.
“Florence, I have good news for you. The first test result is
out. It is clear. Your baby is normal,” from the other end of
the phone came the voice of Associate Professor Mahesh
Choolani, Senior Consultant with the NUH Department of
Obstetrics and Gynaecology.
A/Prof Mahesh could hear a distinctive sigh of relief.
That very morning at 10:30 am, Florence had come to the
hospital for her amniocentesis procedure. Into her 18 weeks
of pregnancy, Florence was there to find out if her unborn
baby had Down syndrome .
Two weeks before, she had taken a Triple Test, a type of
Down syndrome screening blood test at another hospital.
That test indicated that she was at high risk of carrying a
baby with the genetic condition. The test at NUH was meant
to validify the first test result.
Eight hours after the amniocentesis at NUH, the result was
out, much to her and her husband’s relief.
The second-time mother said, “When I got the Triple Test
result, I cried for two days straight! I couldn’t imagine what
was going to happen. But when A/Prof Mahesh called
me, I was so happy that I wanted to go out to celebrate
immediately.”
Florence is one of the first mothers-to-be to receive their
amniocentesis test result on the same day using a new
technology called FlashFISH.
Traditionally, an amniocentesis test result is available between
24 to 48 hours after the procedure using traditional FISH
(florescence in situ hybridisation). Or, it can take up to three
weeks using conventional chromosome analysis (karyotyping,
which is the standard technique to detect a range of fetal
abnormalities). FlashFISH can deliver the result in hours.
A/Prof Mahesh says, “Women who undergo amniocentesis
have two big fears: the first, will they miscarry because of the
amniocentesis and the guilt associated with that, and second
and more importantly, is their baby normal? The first night
after the amniocentesis is usually the hardest, for both the
parents. With FlashFISH, many parents will be able to have a
big part of their anxiety allayed.”
Over a thousand women in Singapore are expected to
benefit from FlashFISH each year. A/Prof Mahesh, who led
in the development of FlashFISH, hopes that it can one
day become the standard of care for all women who need
amniocentesis.
F
or over a week in May, patients and visitors to NUH were
greeted with a not-so-usual sight at the main entrance to
the hospital – a real patient bed. The set up was a highlight
of the hospital’s annual hand hygiene day to help patients and
visitors understand more about healthcare-associated infections.
The interactive display was designed to educate patients and
visitors on the types of bacteria found in a healthcare environment
and that good hand hygiene remains the most effective way to
prevent infection.
This year’s programme also featured a lecture by Ms Claire
Kilpatrick, Consultant of the “Clean Care is Safer Care
Programme” with the World Health Organization (WHO) for staff,
as well as a video to promote the importance of hand hygiene.
The video will be adopted by WHO as an example to illustrate the
positive progress which countries all over the world have made
with hand hygiene improvement. Catch the video on YouTube
http://www.youtube.com/watch?v=S7jLn2-FdJA today!
Do
wash your hands before and
after visiting
keep to two visitors at any
one time
Don’t
visit if you are unwell
touch any medical
equipment
sit on patient beds
cover your nose and mouth
with tissue when you sneeze
or cough
touch or assist other
patients without first
washing your hands
A typical ward setting was displayed at the lobby to help passers-by
understand the need to observe hand hygiene in the ward.
Helping Hands,
Moving Hearts
A
s part of this year’s NUH Allied Health Day celebrations, some
300 volunteers comprising staff and Allied Health professionals
like medical social workers, dietitians, therapists, radiographers
and pharmacists, spent a Saturday morning in May to provide individual
health counseling to 150 needy families and elderly in Taman Jurong.
Eighty-year-old retiree Mr Mon Bin Salam was one of the participants
who turned up at the event.
“My wife and I are not working, so I am happy that I could receive a
free health screening and goodie bag. I learnt from the pharmacist
that my asthma inhaler was depleting and I was advised to start using
my new inhaler. He even accompanied me home and showed me
how to use my inhaler properly. I am very happy,” he said.
Eighty-year-old Mr Mon Bin Salam having his eye checked at the “Helping Hands, Moving
Hearts” community outreach event.
The participants also received groceries worth a total of $7,500
contributed by NUH staff and partially sponsored by NTUC Fair Price.
Into its second year, the annual programme was held jointly with the
South West Community Development Council and the Healthcare
Services Employees’ Union.
NUH volunteers helping Mr Mon Bin Salam bring back his bags of grocery.
NUH news bites
Clean Hands Save Lives
05
NUH news bites
Behind The Scene
When one mentions hospital, doctors, nurses and allied health professionals are often the first to come to
mind. In reality, delivery of healthcare involves more people who work behind the scene. Lifeline features a
team of “unsung heroes” at NUH – the people who are responsible for taking care of the “nitty gritty” details of
hospital operations.
06
Chen Hai Yan, 37 years old
Housekeeping
Mohammad Saad, 62 years old
Central Portering
A typical day for Ms Chen Hai Yan begins
at seven o’clock in the morning.
“I’m 62, but I can still run!” quips Mohammad Saad whose main job
is to wheel patients from the Accident & Emergency department to the wards for the
past 13 years.
Geared up with her trolley of cleaning
tools, Ms Chen makes her way to the first
ward assigned to her for the day.
Porters like Mr Saad play a crucial role in ensuring patients are safely escorted to the
right place in the shortest time possible.
As part of his job, Mr Saad has to ensure the trolley bay is sufficiently stocked so
that there is always a bed trolley or wheelchair available when needed.
Recounting one of his most fulfilling moments in his years with the hospital, Mr Saad
shares how he once helped a woman who delivered in a taxi.
“I had to help her out of the taxi and rushed her to the delivery suite. Luckily, both
mother and baby were fine,” he says.
When asked what he enjoys most about his job, Mr Saad says it is the opportunity
to work and interact with people from all walks of life.
For instance, while wheeling patients, he sometimes takes the initiative to explain to
the patient where he is being brought to.
He also helps his nursing colleagues with simple tasks where he can, such as taking
the patients’ blood pressure, before they go for further examination.
It is evident from Mr Saad’s modest and friendly nature that he enjoys working
alongside others to make the patient’s experience at the hospital a more comfortable
one.
From wiping the dust off counter tops,
vacuuming the floor, changing bed sheets
and pillow cases to emptying the waste
bins, she cleans her way through the
ward, making sure it is spick and span in
time for the next patient who is due to be
admitted.
Housekeeping may seem like a “simple
and straightforward” job to many, but it is
clear from her neat and tidy appearance
that it is one that she takes much pride in.
“I always feel happy every time a patient
walks into a clean room, and that it brings
a smile to his or her face,” says Ms Chen.
“I also feel proud knowing that I’ve played
a small part in the patient’s experience at
the hospital - by helping to create a clean
and conducive environment for him to
recover comfortably.”
It is because of meticulous individuals like
Ms Chen that the wards in the hospital
remain clean, sanitised and in tip-top
condition.
Sorting a week’s worth of laundry can prove to be a daunting task to
many. But for Mr Luisito Abillaneda, pressing, matching and stacking
hundreds of linen and laundry sets is a breeze.
From matching the right tops and bottoms of patient attires to folding
bed sheets, pillow cases and curtains, the man with a pleasant and mild
disposition smiles his way through the task, methodically topping up the
fresh laundry trolleys that would later make their way to the operating
theatres and wards across the hospital.
Mr Luisito says he recognises the importance of his role in making sure
staff and patients get clean and neatly pressed clothes on time.
When asked how he feels his job makes a difference, the man of few
words said after pausing for a moment,
“If you have clean clothes, you will feel better, happier.”
Ricky Pek,
58 years old
Catering
One can say Mr Ricky
Pek is an expert at
“sweetening” a patient’s
stay at the hospital.
A pastry chef with over
30 years of experience,
Mr Pek adds a touch of
sweet on the patients’
daily meals with an
array of puddings and
brownies. He also takes
care of special birthday
cake requests from the
wards.
Patients who spend their birthdays at NUH will receive a
complimentary birthday cake.
“Once, a long-staying patient asked
to meet me. He enjoyed the cakes I
baked and wanted to meet the person
behind the many desserts he enjoyed
after every meal. I was touched to
receive such a compliment.”
Bueno Saw, 26 years old
Pest Control
Armed with a can of pesticide slung on his shoulder,
Mr Saw, affectionately known to his colleagues as Nick,
makes his rounds at NUH three times a week where he
inspects the nooks and crannies for any “unwelcomed
guests”.
“Knowing that I have put a patient’s
mind at ease by maintaining a
clean, pest-free environment to help
him or her in the recovery brings
satisfaction to the work that I do
everyday.”
NUH news bites
Mr Luisito Abillaneda, 42 years old
Linen and Laundry Room
07
07
NUH excellence & accolades
The Heart of Healthcare
NUH Staff Bags Six Healthcare Humanity Awards
08
Every year, the Healthcare
Humanity Award is given out to
outstanding workers who are
inspirational role models and
who go the extra mile to offer
care, warmth and comfort to the
sick and infirmed.
This year, NUH is proud to count
among the 61 recipients, six of
its most outstanding employees.
Congratulations!
The
Caregiver
Hospitals operate 24/7. When most
people are asleep at night, there is a team
of professionals who continue to work to
ensure that patients are taken care of.
Nurse Manager Goh Boon Geok, a
permanent night coordinator for 16 years, is
one of them.
The Big
Sister
Working at night does not translate to
slower pace. Manpower deployment, tight
bed situations are but the norm. Often
times, the night coordinator also has to
double up as the extra pair of hands in
times of need, such as transporting patients
when the porters are busy. In spite of the
hectic work, NM Goh makes it a point
to find time for patients and their family
members holding vigil in the hospital - be
it to offer them a drink or just offering them
words of comfort.
Dedication towards her patients goes
beyond the hospital wards for NM Goh.
On days that she is off duty, she would visit
her patients at home, checking on their
condition and teaching their caregivers on
how to better care for their loved ones. In
one instance, she visited a patient daily
after his discharge from hospital to help
dress his wounds until his caregiver was
more confident to dress the wounds
independently.
Mdm Chong Sock Fong, wife of a patient
who has since passed on, has found
comfort in the nurse-turn-friend. She said,
“We never had to care for a patient before
and we would often find ourselves at a loss.
We would call Boon Geok and she would
always come to our help even if it was in
the middle of the night… nurses are really
noble.”
At the age of 62, Senior Assistant Nurse
Koh Chye Eng, could have retired but she
decided to keep working to help patients in
need.
“The hospital needs nurses, so I am staying.
There are many patients who still need to be
cared for,” the ENT clinic nurse says matterof-factly.
SAN Koh, a nurse for 40 years, will go the
extra mile for her patients despite a busy
clinic schedule, as she sees each patient as
an individual. Having a reasonable number
of cancer patients in the ENT clinic, Chye
Eng often foregoes her lunch time without
hesitation to counsel a newly diagnosed
patient.
Mr Dave Cheow, whose nasopharyngeal
cancer has been in remission for nine
years, has to make regular trips back to
the hospital for follow-up consultation. He
describes SAN Koh as a big sister who
contributes to the warm and family-like
ambience, which makes coming to hospital
feel like “coming back home”.
“Everytime she asks about my well being,
it is with compassion and sincerity. She
always encourages me, and I see her as the
shining guidance of motivation and hope,”
shares Mr Cheow.
In the last four years, she has travelled overseas six
times as a volunteer on various relief mission trips,
leaving her tracks in Bangladesh, Sri Lanka, Indonesia,
Haiti and Pakistan. Each time, she would embark
on her journey with a heavy heart as she knows that
she will be witnessing victims of Mother Nature –
earthquakes and floods. However, the thought of how
she can do her part to help would give her the strength
to carry on.
She is none other than Senior Staff Nurse Lim Hui
Shan. Drawing from her work experience as a nurse at
the hospital’s Emergency Department, SSN Lim would
help out in health screening, administer injections and dispense medication.
“These trips have taught me about humility and I have become more appreciative
of the health system back home. At work, I have learnt to be more empathetic
towards my patients,” she says.
The Teacher
A veteran with 33 years
of experience, Senior
Nurse Educator Lee
Geok Yian is both a
competent nurse and
nurturing mentor at
work - be it coaching
her junior colleagues
to present their
research findings at
conferences, or to show
them the finer points
in communicating
with patients and their family members. Outside
her work hours, SNE Lee is an active volunteer
for various community programmes such as
promoting breast cancer awareness and working
to improve the well being of needy elderly
persons.
The Mother
The Believer
“Mother” – that is what some of her patients call her
without her knowledge.
Care and compassion
do much to brighten
someone’s day.
It is probably her “naggy” nature that earned
Professor Yap Hui Kim, Head and Senior Consultant
with the Division of Paediatric Nephrology (Kidney),
Dialysis and Renal Transplantation that moniker, as
she never fails to ask her young patients how they are
doing and whether they need help with any troubles or
concerns.
One of her “sons”, and now, her co-worker at
NUH, Medical Social Worker Benjamin Png, vividly
remembers that “she would always take the time to explain to me about my
medical condition, and why I was required to take several medications.”
“When working with children or teenagers, you have to remember that they are not
adults. They often make decisions without knowing the consequences. You need
to patiently remind them of how important their decisions are,” says Prof Yap.
Besides clinical work, Prof Yap also spearheaded the Paediatric Renal
Replacement Programme that has helped about 125 children since its inception
in 1984. Under the programme, needy young renal patients are able to receive
peritoneal dialysis at a subsidised rate. The programme also started an annual
camp in 2000, giving those who are receiving dialysis a chance to participate in
activities like healthy kids do.
Working with cancer
patients, Senior Staff
Nurse Myint Myint
Than knows that too
well.
Always wanting to serve,
SSN Myint Myint left
Myanmar for Singapore
10 years ago to be an enrolled nurse. Over the
years, she continues to upgrade her skills, at the
same time juggling work and raising a teenage
daughter.
“My motivation is simply to deliver the best care for
my patients. At the ward, I always make an effort
to know my patients and their family members,
and to encourage them to focus on the positive
things in life. I am glad I am able to cheer them up,
even if it is for a short while.”
NUH excellence & accolades
The Volunteer
09
NUH news bites
10
NUH Receives Award For
Fair Employment Practices
I
n April, NUH was one of seven organisations in Singapore to
receive the Special Mention Award presented by TAFEP, or the
Tripartite Alliance for Fair Employment Practices.
The Award was an endorsement of the hospital’s efforts in
implementing fair, responsible and inclusive employment practices.
The first healthcare institution to detail re-employment guidelines in
the Collective Agreement with the Union, NUH continues to embrace
and invest in technology to help mature workers remain productive at
work.
The hospital is also credited with having a structured recruitment
process, clear and consistent staff retention practices, as well as
flexible working hours and childcare arrangement for its employees.
Ms Clara Wee, Director of Human Resource Department, NUH receiving the TAFEP
award from BG(NS) Tan Chuan Jin, Minister of State for the Ministry of National
Development & Ministry of Manpower.
“At NUH, our people are our pride. We embrace diversity; provide fair and ample
opportunities to help our staff achieve their full potential. We work hard to create an
inclusive work environment so that our staff can deliver the best possible care to our
patients.” – Ms Clara Wee, Director, Human Resource, NUH
Paying It Forward
T
he National University Cancer Institute, Singapore (NCIS)
recently launched its volunteers programme with the aim
to create a more conducive and caring environment for
its patients.
Forty volunteers have since come onboard.
Ms Low Miaw Chin, a 45-year-old freelance accountant, is one
of them.
A patient-turned-volunteer, Ms Low’s motivation for volunteering
is simple: to pay it forward.
Ms Low remembers being hospitalised in NUH 10 years ago,
having just completed her mastectomy three days earlier and
had rubber tubes attached to her body to drain fluid from her
lymph nodes.
Doing her part to help cancer survivors is Ms Low Miaw Chin (centre), volunteer with NCIS.
“My mind started wondering into negative thoughts painting
a gloom future. Then an old lady came up to my bedside and
introduced herself. She told me that she was 80 years old and
shared that she had a mastectomy when she was 40. She then
pulled the curtains around my bed and showed me her scar. Her
face was radiant despite her loss of a breast.”
Now, Ms Low is herself a living proof of cancer survivorship.
“I hope to play a part, even if it is just a small one, in making a
patient’s battle with cancer a little easier.”
Later, Ms Low learnt that the old lady had been actively visiting
patients all over Singapore to share her experience.
Seeing the living proof that there is life after cancer, Ms Low’s
heart lightened.
To be an NCIS volunteer, please call 6772 5737 or email
[email protected].
NUH news bites
11
Ms Sandra Choo (centre, second row) presents her latest book “Ward 43” to the team who cared for her late father.
“Ward 43”
- A Book Dedicated To Healthcare Workers At NUH
T
he work and passion of the team of staff at National
University Hospital’s Ward 43 have been captured in a book
simply titled “Ward 43”.
Written by IT-project-manager-turned-writer, Ms Sandra Choo, the
book is based on her own experience with the doctors, nurses
and allied health professionals from the surgical ward at NUH. Her
late father, Mr Choo Chut Pan, had spent the last three months
of his life battling colon cancer at Ward 43. As his main caregiver,
Ms Choo had spent many days by his bedside. Little did the staff
know that while caring for her father, Ms Choo was writing a book
dedicated to him and all the healthcare professionals who took
care of him.
The book “Ward 43: How My Father Challenged Cancer and
Encountered Humanity” was officially launched in March 2012, 15
months after the late Mr Choo passed away.
At the book launch, Ms Choo described herself and her late
father as “not being the easiest people around”. However, over
time, they were won over by the team’s unwavering patience and
compassion.
Ms Choo’s book has moved many who read it, in particular the
team she paid tribute to, one of whom is Nurse Manager of Ward
43, Ms Daphne Ng.
“Working in a hospital can be both stressful and challenging at
times. So it is heartwarming to know that our patients appreciate
us for what we do. Any simple gesture of appreciation acts as
a reminder to us that, if we work as a team, we can overcome
difficult situations and make a difference to our patients,”
says NM Ng.
“Ward 43” is now available at all major book stores.
Welcome Aboard
Doctor
Department
Designation
Associate Professor Rathi d/o Mahendran
Department of Psychological Medicine
Senior Consultant
Dr Mary Beth Son
Department of Paediatrics
Consultant
Dr Suresh Paranjothy
Department of Anaesthesia
Consultant
Dr Teoh Chia Meng
Division of Respiratory Medicine
Consultant
Dr Victor Loh
Division of Family Medicine
Consultant
Dr Joy Chan Boon Min
Department of Ophthalmology
Associate Consultant
Dr Nares Smitasin
Division of Infectious Diseases
Associate Consultant
ask the expert
12
Ask The Expert
Knowing Your Medicine
Patients with heart conditions are often prescribed an array of
medicines. Principal Pharmacist Ms Hooi Pik Yee shares what to take
note of to help patients understand the various pills that they have to
take on a daily basis.
Commonly Prescribed
drugs
Function
What to take note of
Antiplatelets
(Low dose Aspirin)
Blood thinner
This drug can cause gastrointestinal ulceration and gastric
discomfort, and hence should be taken after food. It may cause
bleeding. If there are signs of bleeding (e.g. black stool or
unexplained bruising), see your doctor immediately.
Beta blockers
(Atenolol, Metropolol,
Bisoprolol and Carvedilol)
To control blood
pressure and treat
heart failure
High blood pressure is often asymptomatic and the medication
must therefore be taken on a regular basis unless otherwise advised
by your doctor. Patients may experience giddiness which is due to
a drop in blood pressure. Some may feel fatigue as the drug can
reduce heart rate. If these symptoms persist, consult a doctor and
do not stop taking the medications abruptly on your own.
Angiotensin Converting
Enzyme Inhibitors
(enalapril, captopril and
lisinopril)
To treat blood
This drug can also increase potassium level which is a form of salt
pressure and heart in the body. Therefore, patients on this drug must not take any salt
failure
supplement without asking doctor for advice.
The most common side effect of this group of drug is dry, persistent
cough. If the cough does not go away after a week, see your doctor.
Thiazides
(Hydrochlorothiazide)
To control blood
pressure
This class of drug causes low potassium and sodium levels
(electrolytes disturbance) that may result in confusion. Dehydration
is another common side effect and is very common in elderly
patients. It is often given together with potassium supplement to
prevent low potassium level which is also known as hypokalemia.
Statins
(Simvastatin, lovastatin
and Atorvastatin)
To reduce bad
cholesterol and
increase good
cholesterol
This group of drugs has proven to prevent cardiovascular events
such as myocardial infarction or heart attack. They are also used to
prevent stroke.
This class of drug can cause inflammation of the muscle. If you
experience any unexplained muscle ache, dark colour/tea colour
urine, consult your doctor immediately. Most often the therapy has
to be discontinued temporarily.
Information in this newsletter should not be used as a substitute for medical diagnosis or treatment. Contents in this newsletter may be reproduced with the
permission of National University Hospital.
Please contact:
The Editor, Lifeline
Corporate Communications
National University Hospital, 1E Kent Ridge Road, NUHS Tower Block, Level 13, Singapore 119228.
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