Achieving work

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Parkinson’s Disease
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Penyakit Parkinson
4
What is Asthma?
5
Staying in the pink of health
6
Better dental care for our patients
6
MediCare Assistance Scheme
7
7
Skim Bantuan MediCare
7
7
Be a Volunteer
8
Public Forums
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A newsletter fo r p atients • A p r - M ay 2 0 0 8
Achieving work-life balance
There has been considerable debate that achieving
work-life balance is nothing but a nice textbook
concept. But the truth is many working adults are
making unhealthy life choices and favouring workrelated chores and goals over other important areas
of their lives such as family, friends and hobbies.
As a result, many people are experiencing ‘burnout’
due to overwork and increased stress. This condition
is seen in nearly all occupations from blue collar
workers to upper management.
While it may not be possible to achieve a perfect
balance between work and personal life, it is
necessary to make choices regarding different aspects
of your life to achieve harmony.
CASE STUDY
Being single and without family commitments,
Jonathan immerses himself in work. He spends long
hours at work and aims high at the corporate ladder.
While he enjoys work, Jonathan constantly has to
deal with a demanding boss, who calls him even
after office hours, late at night and when he is on
leave.
Even when Jonathan is on medical leave, he forces
himself to keep up with project timelines as he does
not want to be seen as an ineffective worker. But
Jonathan knows that the sheer volume of workload
and stress are slowly degenerating his mental and
emotional health.
priorities and manage his expectations if necessary.
By effectively managing his boss’ expectations, it
will help prevent frustrations on both ends.
2. Schedule ‘down time’
Scheduling ‘down time’ such as coffee breaks and
a walk to the pantry or washroom will help Jonathan
re-charge and work more effectively. Once in a
while, he should take a few days’ leave to recuperate
from work stress, and he should help his boss
understand that he is not able to attend to work
during this period.
Balancing work and personal life can be difficult with
Jonathan’s demanding job (and boss) and if he does
not know how and when to relax. However, there
are still ways where he can strive to strike a balance.
3. Managing thoughts
Jonathan needs to recognise that taking breaks and
saying ‘no’ are not signs of being incompetent. He
should learn to find time to relax and re-charge
himself and set aside personal time to do things he
enjoy.
1. Manage expectations
To be an effective performer, Jonathan needs
space to work on the task at hand and he needs
to prioritise his work. Whenever he feels overwhelmed
by work, he should check back with his boss on his
Often times, it is up to us to achieve our worklife balance. If we set our priorities right and
make our choices based on these priorities,
achieving it will no longer be impossible.
By Mr Henry Lew, Psychologist, NHG Polyclinics
MICA (P) 264/01/2007
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Health Tips
What is Parkinson’s Disease?
Parkinson’s Disease (PD) is named after James
Parkinson, a London doctor who first described his
observations of the disease in 1817. However, it
was only 60 years later that French doctor Jean
Martin Charcot recognised the importance of
Parkinson’s work and named the disease after him.
PD is a chronic and progressive disorder of the
central nervous system that often impairs the
sufferer’s motor skills and speech. At present, no
one knows what causes PD.
Treatment of Parkinson’s Disease
At present, there is no cure for PD, but medications
or surgery can provide relief from the symptoms.
As PD is a deficiency in dopamine (a chemical in the
brain that sends signals to help coordinate muscle
movements), the medications or surgery is to help
replace dopamine in the brain.
Nevertheless, surgery remains the only option for
patients with severe or quickly-progressing PD who
have failed all other medical therapy.
Symptoms of Parkinson’s Disease:
• Trembling of hands, arms, legs, jaw and face
• Rigidity or stiffness of the arms, legs and trunk
• Bradykinesia or slowness of movement
• Poor balance and coordination
When the first signs of PD show, you should seek
treatment as early as possible as it can minimise
the chances of disability and help you maintain the
highest possible quality of life.
As the disease progresses, the shaking or trembling,
which affects the majority of PD patients may begin
to interfere with daily activities such as walking,
talking or completing simple tasks. Other symptoms
may include depression and other emotional changes;
difficulty in swallowing, chewing, and speaking;
urinary problems or constipation; skin problems;
and sleep disruptions.
Common drugs used to treat Parkinson’s
Disease
Who is at risk of contracting Parkinson’s
Disease?
PD is more commonly seen in men than in women.
It usually affects people aged 60 and above, although
it can also affect people who are younger. Currently
there are no tests that can diagnose PD, therefore
the diagnosis is usually based on medical history
and examination. Doctors may even request for
brain scans or laboratory tests to be carried out in
order to rule out other diseases which may mimic
PD.
Levodopa is the most widely used form of treatment
for PD. It combines with carbidopa which delays the
conversion of levodopa into dopamine until it reaches
the brain. This is to replenish the brain's dwindling
supply of dopamine.
Anticholinergic is another type of drug that helps
control tremor and rigidity. Other drugs used to
treat PD are dopamine agonist which acts like
dopamine in the brain and COMT inhibitors which
work by blocking the action of a chemical in the
body (known as catechol-O-methyltransferase) that
breaks down dopamine. Amantadine and selegiline
are also drugs that appear to help reduce the
symptoms.
By Dr Yehudi Yeo, Senior Family Physician and Head of Choa Chu Kang Polyclinic
page 2
Health Tips
page 3
Health Tips
Apakah Penyakit Parkinson?
Penyakit Parkinson dinamakan sempena nama
seorang doktor di London, James Parkinson, yang
telah mencatatkan pemerhatian beliau tentang
penyakit tersebut buat pertama kalinya pada tahun
1817. Namun, hanya selepas 60 tahun kemudian
barulah seorang lagi doktor berbangsa Perancis,
Jean Martin Charcot telah menyedari akan
kepentingan hasil kerja Parkinson dan menamakan
penyakit itu sempena nama beliau.
Penyakit Parkinson ialah satu penyakit kronik dan
gangguan pada sistem pusat saraf yang akan
menyebabkan kelemahan untuk bergerak dan
bercakap. Sehingga sekarang, tiada siapa yang
mengetahui punca Penyakit Parkinson ini.
Gejala Penyakit Parkinson:
• Menggeletar di bahagian tangan, lengan, kaki,
rahang dan muka
• Kekakuan atau kekejangan di bahagian lengan,
kaki dan tubuh
• Pergerakan yang lambat (Bradykinesia)
• Keseimbangan dan koordinasi badan yang kurang
baik
Semakin penyakit ini meningkat, keadaan menggigil
atau menggeletar yang berlaku di kalangan
kebanyakan pesakit Parkinson akan mula
mengganggu aktiviti harian, seperti berjalan, bercakap
atau menyelesaikan tugas yang mudah. Tanda-tanda
lain mungkin termasuk kemurungan dan perubahan
emosi, kesukaran untuk menelan, mengunyah dan
bercakap; masalah urinari (pekencingan) atau
sembelit; masalah kulit;dan gangguan dalam tidur.
Siapa berisiko menghidap Penyakit Parkinson?
Penyakit Parkinson lebih kerap berlaku kepada kaum
lelaki berbanding wanita. Ia melibatkan orang yang
berusia 60 tahun keatas, walaupun ia juga boleh
berlaku kepada orang yang lebih muda. Buat masa
sekarang, tiada ujian yang dapat mengenalpasti
Penyakit Parkinson, oleh itu mengenalpasti penyakit
biasanya berasaskan kepada sejarah perubatan dan
pemeriksaan. Doktor juga mungkin meminta
pengimbasan otak atau ujian makmal dibuat untuk
page 4
mengenalpasti penyakit yang mungkin mirip Penyakit
Parkinson.
Rawatan untuk Penyakit Parkinson
Setakat ini, masih belum ada ubat untuk mengubati
Penyakit Parkinson, tetapi ubat-ubatan atau
pembedahan dapat melegakan gejala-gejalanya.
Oleh kerana penyakit ini adalah dari akibat
kekurangan dopamin (bahan kimia di otak yang
menghantar isyarat untuk membantu koordinasi
pergerakan otot), ubat-ubatan atau pembedahan
akan membantu menggantikan kandungan dopamin
dalam otak.
Namun, hanya pembedahan yang menjadi pilihan
untuk pesakit yang menghidap Penyakit Parkinson
yang sudah teruk atau yang sedang progresif dengan
cepatnya setelah cara-cara perubatan terapi yang
lain gagal.
Apabila tanda-tanda pertama Penyakit Parkinson
mula muncul, anda harus mendapatkan rawatan
segera kerana ia akan mengurangkan risiko
ketidakupayaan dan membantu anda mengekalkan
hidup yang berkualiti yang terbaik mungkin.
Ubat-ubatan yang biasa digunakan untuk
merawat Penyakit Parkinson
Levodopa merupakan jenis rawatan yang paling
kerap digunakan untuk Penyakit Parkinson. Ia
bergabung dengan carbodipa yang melambatkan
proses penukaran levodopa menjadi dopamin
sehingga ia sampai ke bahagian otak. Tujuannya
ialah untuk mengisi semula kandungan dopamin
otak yang semakin menurun.
Anticholinergic ialah satu lagi jenis ubat yang
dapat mengawal tremor (gerak-geri menggeletar)
dan kekakuan. Ubat lain yang digunakan untuk
merawat PD ialah seperti dopamine agonist yang
bertindak sebagai dopamine di otak dan COMT
inhibitors yang bertindak untuk menghalang reaksi
suatu bahan kimia dalam tubuh (dikenali sebagail
catechol-O-methyltransferase) yang mengurai
dopamine. Amantadine dan selegiline juga adalah
jenis-jenis ubatan yang dapat membantu
mengurangkan simptom.
Health Tips
Asthma Control Test
(Suitable for patients 12 years old and above)
Q1 During the past 4 weeks, how often did your asthma
prevent you from getting as much done at work, school
or home?
All of the time
1
Most of the time
2
Some of the time
3
A little of the time
4
None of the time
5
What is asthma?
Asthma is a chronic condition that affects the airways
that carry air in and out of the lungs. When a person
with asthma comes into contact with something that
irritates their airways (also known as an asthma
trigger), the muscles around the walls of the airways
tighten so that they become narrower and the lining
becomes inflamed and swollen. Sometimes, excessive
sticky mucus or phlegm builds up which can further
narrow the airways.
These episodes may be triggered by exposure to an
environmental stimulant (or allergen) such as cold air,
warm air, moist air, exercise or exertion, and emotional
stress. In children, the most common triggers are viral
illnesses such as those that cause the common cold.
What causes asthma?
• You are more likely to develop asthma if you have
eczema or other allergic conditions or a family
history of asthma.
• Many aspects of modern lifestyle such as changes
in housing and diet and a more hygienic environment
may have contributed to the rise in asthma cases
over the last few decades.
• Research has shown that smoking during pregnancy
significantly increases the risk of a child developing
asthma.
• Children whose parents smoke are more likely to
develop asthma.
• Environmental pollution can make asthma symptoms
worse and may play a part in causing asthma.
• Adult onset asthma may develop after a viral
infection.
• Irritants found in the workplace may lead to a
person developing asthma (known as occupational
asthma).
The common symptoms of asthma are:
• coughing
• wheezing
• shortness of breath
• tightness in the chest
Controlling Asthma
To effectively control asthma, you should avoid things
that may cause asthma attacks, keep track of your
symptoms and take medicine. You may also take the
Asthma Control Test to give yourself a snapshot of
how well your asthma has been controlled.
Q2 During the past 4 weeks, how often have you had
shortness of breath?
More than once a day
1
Once a day
2
3-6 times a week
3
1-2 times a week
4
Not at all
5
Q3 During the past 4 weeks, how often did your asthma
symptoms (wheezing, coughing, chest tightness,
shortness of breath) wake you up at night or earlier
than usual in the morning?
4 or more times a week
1
2-3 nights a week
2
Once a week
3
Once or twice
4
Not at all
5
Q4 During the past 4 weeks, how often have you used
your reliever inhaler or nebulizer medication (usually
blue and called salbutamol)?
3 or more times a day
1
1-2 times a day
2
2-3 times a week
3
Once a week or less
4
Not at all
5
Q5 How would you rate your asthma control during the
past 4 weeks?
Not controlled
1
Poorly controlled
2
Somewhat controlled
3
Well controlled
4
Completely controlled
5
With a score of 25, your asthma appears to have been
under TOTAL CONTROL over the last four weeks.
However, if you are experiencing any problems with
your asthma, you should see your doctor or nurse.
With a score between 20 and 24, your asthma
appears to have been reasonably well-controlled but
not totally controlled during the past four weeks. Your
doctor or nurse may be able to help you aim for TOTAL
CONTROL.
With a score of less than 20, your asthma may NOT
BE CONTROLLED during the past four weeks. Your
doctor or nurse can recommend an asthma action plan
to help improve your asthma control.
As asthma symptoms can vary from month to month,
it is worth revisiting the test to see if your score
changes. You can also share your results with your
doctor or nurse to help explain how your asthma is
affecting you.
Remember, asthma does not control your life.
Instead, you can control asthma.
By Dr Jean-Jasmin Lee, Family Doctor, Ang Mo Kio Polyclinic
page 5
Health Tips
Staying in the pink of health
Most women today, especially working mothers,
have to juggle between work life and family. Often
times, their dual responsibilities take so much of
their attention that they neglected their health.
However, without good health, it is impossible to
maintain quality of life, let alone manage it. Therefore,
it is essential to have a well-planned health
programme so that you are able to also take care
of other areas of your lives.
Eat Healthy
• A balanced nutrition which is high in fibre and
low in fats contributes to your well-being.
• Remember to ensure sufficient dietary intake of
calcium to prevent osteoporosis, especially after
menopause. Calcium supplements can fill the gap
if necessary.
Exercise Regularly
• Exercise can help burn calories, strengthen bones,
improve flexibility and relieve stress.
Stress Management
• Love yourself by getting enough sleep and
indulging in activities you enjoy.
• Manage your expectations by setting realistic
goals.
Regular Health Screening
• Keep tabs on your health by going for regular
health checks. Prevention is always better than
cure.
COMMON HEALTH SCREENINGS
MAMMOGRAPHY
Mammography helps to detect very small lumps in
the breasts even before our hands can feel them.
You should go for regular mammography if you are
above 40 years old. You should also conduct your
own regular Breast Self-Examination (BSE). If you
are above 30 years old, you should do BSE once a
month (preferably one week after menstruation
when your breasts are less tender and lumpy).
PAP SMEAR SCREENING
Routine PAP smear is the key to early detection of
cervical cancer, as it is treatable if detected at an
early stage. You should go for a PAP smear once
every three years if you have had sex or are sexually
active.
OPPORTUNISTIC HEALTH SCREENING (OHS)
OHS is a first step to knowing your health status.
It helps in early detection and management of
important health conditions.
(Note: The list above is not exhaustive. Discuss with your
doctor on the types of tests you should undergo.)
To be able to enjoy the various stages of womanhood,
women should eat well, exercise regularly and
manage stress effectively. With that, you will then
be able to achieve quality of life.
By Ms See Yen Theng, NHG Pharmacy
Better dental care for our patients
Patients can now look forward to an improved range of services
and facilities at our upcoming modernised dental centres.
We have combined our dental clinics at Choa Chu Kang and
Woodlands Polyclinics to form a larger regional dental centre at
Woodlands Polyclinic, housing upgraded dental facilities and improved
services for our patients. Patients can also look forward to more
of such regional dental centres in some of our polyclinics soon.
In addition, we have opened our first NHG DentalCare at Woodlands
Polyclinic, which offers non-subsidised intermediate-level services
such as teeth whitening, wisdom tooth extractions, crown, bridge
and denture fabrications and root canal therapy.
New NHG DentalCare at Woodlands Polyclinic
At NHG DentalCare, patients can look forward to a more personalised service with senior dental surgeons,
more advanced treatment and equipment, and shorter waiting time. On top of that, the centre has been
built for barrier-free access for the disabled, with wider passages with ramps, a disabled-friendly toilet within
the centre, and lower registration counter and dentist chairs. This centre also operates extended hours on
Mondays and Fridays from 8am to 8pm and Saturdays from 8am to 4.30pm.
To make an appointment with NHG DentalCare, call 6362 0400.
To make an appointment with our dental clinics, call 6355 3000.
page 6
Our Services
MediCare Assistance Scheme
Providing financial support for our patients
NHG Polyclinics is going the extra mile for patients by
offering the Medicare Assistance Scheme, which offers
financial help to Singaporeans and PRs who are unable
to pay for medical, dental treatment and medicine.
For patients who require financial assistance, they may
speak to their attending doctors or nurses during
consultation, who will then refer them to our financial
counsellors. Depending on the patient’s financial
circumstances, NHG Polyclinics will waive a percentage
of his/her medical and dental fees for a temporary
period before he/she regains self-reliance.
However, patients who are already under the following
schemes will automatically receive full MediCare
Assistance from NHG Polyclinics:
1)
2)
3)
4)
Public Assistance
Work Support Programme (WSP)
Medical Fee Exemption Card (MFEC)
Hospital Medifund 100% (HM 100%)
To find out more about the scheme, call 6355 3000
or speak to our doctors or nurses at any of our
polyclinics.
Skim Bantuan MediCare
Sumbangan Bantuan Kewangan kepada Pesakit
Poliklinik NHG kini lebih prihatin terhadap pesakit kami
dengan menawarkan Skim Bantuan MediCare yang
memberikan bantuan kewangan kepada warga
Singapura dan Penduduk Tetap (PR) yang tidak mampu
membayar kos rawatan kesihatan, pergigian dan ubatubatan mereka.
Bagi pesakit yang memerlukan bantuan kewangan,
mereka boleh memaklumkan kepada doktor atau
jururawat yang merawati mereka ketika konsultasi,
dan seterusnya mereka akan dirujuk kepada penasihat
kewangan kami. Bergantung kepada keadaan kewangan
pesakit, Poliklinik NHG tidak akan mengenakan
sebahagian peratus dari kos rawatan perubatan dan
pergigian pesakit berkenaan untuk satu tempoh yang
sementara sebelum pesakit tersebut mampu
membayarnya sendiri.
Namun, para pesakit di bawah skim-skim berikut akan
menerima bantuan Medicare sepenuhnya daripada
Poliklinik NHG secara automatik:
1) Bantuan Awam/ Public Assistance (PA)
2) Program Sokongan Kerja/ Work Support Programme
(WSP)
3) Kad Pengecualian Yuran Perubatan/ Medical Fee
Exemption Card (MFEC)
4) Hospital Medifund 100% (HM 100%)
Untuk mendapatkan maklumat lanjut mengenai skim
ini, sila hubungi talian 6355 3000 atau memaklumkan
kepada doktor atau jururawat kami di mana-mana
poliklinik kami.
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Specially For You
Be a Volunteer
If you’ve visited our polyclinics recently, you might
have noticed several warm and friendly faces guiding
elderly patients around or helping out at workshops.
No, they’re not our new clinic staff. In fact, they’re
our patients… and they’re also our newly recruited
volunteers!
NHG Polyclinics has introduced an exciting volunteer
programme, and we’re looking for people from all
walks of life to join our growing team. You’ll meet
new friends, learn new skills and, best of all, make
a huge difference to our staff and patients.
So, why not join us as a volunteer today? All it takes
is a big smile, warm heart and passion for helping
others - and you’ll be on your way to brightening
someone’s day!
How can you help?
Whatever your skills and interests, we’ve a wide
range of volunteer opportunities for you to choose
from, including:
• Guiding and ushering patients
• Helping patients take their height and weight
• Providing administrative support
• Organising workshops and forums
• Taking part in community outreach programmes
If you’re 15 and above, are in good general health
and enjoy interacting with people, we’d love to hear
from you!
Please fill up this form and hand it to any of our
polyclinic staff. We will be in touch with you shortly.
Name: (Dr/Mr/Ms/Mrs/Mdm)
__________________________________________
Address:__________________________________
__________________________________________
PUBLIC FORUMS
Your Sexuality at 40,
50 and Beyond (In English)
Learn how to keep your sexual passion alive! Let
the healthcare professionals advise you on the
physical, emotional and psychological changes
that affect men and women after the age of 40.
Also find out more about andropause and
menopause and how you can manage them.
Managing Pain Before
It Manages You
(In Mandarin)
Discover ways to relieve your aches and pains
without the help of medication. Pain experts will
share with you on the alternative remedies,
including acupuncture.
Both forums will be held separately on:
Date:
Sunday, 11 May 2008
Time:
2.30 – 5.00pm
Venue: Suntec Singapore
International Convention
and Exhibition Centre
Registration
Fee:
$10 (includes a goodie bag)
For more information and registration,
call 6496 6681.
Contact number:____________________________
E-mail address:_____________________________
Areas of interest
Guiding and ushering
Helping patients take their height and weight
Administration
Workshops and forums
Community outreach programmes
Others _________________________________
We also welcome schools and organisations that are
interested to take on a volunteer project. Please contact
us at [email protected] or 6355 3000.
Chairperson
Dr Tung Yew Cheong, Woodlands Polyclinic
Editor
Ms Eleanor Toh, Corporate Communications, HQ
Members
Ms Jancy Mathews, Health Promotion & Preventive Care, HQ
Ms Pauline Ang, Singapore Footcare Centre
Ms See Yen Theng, NHG Pharmacy
The information produced is for reference and educational purposes
only. As each person’s medical condition is unique, you should not
rely on the information contained in this newsletter as substitute
for personal medical attention, diagnosis or hands-on treatment. If
you are concerned about your health, please consult a healthcare
professional.
Reproduction of the articles in whole or part without permission is
prohibited.
For advertising rates and enquiries, please call Ms Audrey Lee at
64966696 or email [email protected]
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