Girlsmiles again He eases mums into childbirth - Mount Alvernia Hospital

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Girlsmiles again He eases mums into childbirth - Mount Alvernia Hospital
Healthy Living For Mind & Body

                                                   MICA (P) 200/08/2008
                                                   Issue 2 • July - Sept 2009
 again                                what’s up doc?
                                 He eases mums
                                  into childbirth
                                   the big interview
                            That sinking feeling
Girlsmiles again He eases mums into childbirth - Mount Alvernia Hospital
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 Huat
              CEO, Mount Alvernia Hospital

              Editorial team
              Publisher:                           Editor:               Writer:                   Design
              Mount Alvernia Hospital              Geraldine Wang        Rosnah Ahmad              TOM Design & Communications
              820 Thomson Road, Singapore 574623   Editorial Advisor:    Editorial Co-ordinator:   For feedback and inquries, please email:
              Tel: 6347 6688 Fax: 6347 6632        Han May Ching         Premila Elangovan
Girlsmiles again He eases mums into childbirth - Mount Alvernia Hospital
a note
of thanks


            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.

                                                                                                                                            MyAlvernia   01
Girlsmiles again He eases mums into childbirth - Mount Alvernia Hospital
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.

                   Daddy’s girl

02   MyAlvernia
Girlsmiles again He eases mums into childbirth - Mount Alvernia Hospital
Senior Consultant Neurosurgeon
         Dr Timothy Lee


                                      MyAlvernia   03
Girlsmiles again He eases mums into childbirth - Mount Alvernia Hospital
the big issue

                                  Toddler overcomes
                                  adversity to reclaim
                                  her bubbly self

Nursing comfort:                                                                                                           Atikah celebrates
Staff Nurse Timna Wong cradles Atikah                                                                                      her discharge with
                                                                                                                           a party with all
                                                                                                                           her new friends.

             ittle Atikah’s parents first suspected that there was       ROAD TO RECOVERY
    something wrong with their baby when her neck became a bit stiff     All in all, Atikah spent nearly four months recuperating at Mount
    and her head started tilting to the right.                           Alvernia, under the watchful eyes of the nurses at the Critical Care
                                                                         Unit (CCU), and later on, at the St Gabriel Ward for children.
    The once-active baby had also turned into a moody child who
    would cry non-stop at times.                                         Over time, she grew more and more familiar with the hospital staff,
                                                                         and they to her.
    CT and MRI scans subsequently confirmed that their daughter had
    a tumour in her brain, with the tumour cells scattered in several    “In the beginning, she didn’t like the nurses to touch her. She
    locations. The water pressure in her brain was also higher than      would just ignore you,” said Ms Naw Kre Thaw, a staff nurse at the
    normal, a condition which could lead to brain damage.                CCU who remembers Atikah well.
    An operation was done in Brunei and this confirmed that Atikah       But the patient nurses persisted to win her over, singing nursery
    had ependymoma. Her doctor in Brunei recommended either              rhymes and making small talk with Atikah as they tended to her.
    chemotherapy or further brain surgery in a Singapore hospital as     To brighten up her environment, they also decorated her bed with
    the next course of action.                                           stuffed toys and cartoon stickers. The CCU permanent night nurse
                                                                         would even sit and play with Atikah after giving her medication.
    In Singapore, a pediatric oncologist recommended brain surgery
    after he found that the tumour had spread to both the left and       Before long, Atikah began responding to their voices and touch
    right sides of her neck, as well as residual tumour in the brain.    and could recognise all the nurses who walked in to her room. It
    After consulting with senior consultant neurosurgeon Dr Timothy      was a giant leap forward for the little girl who would only respond
    Lee, the family agreed to proceed with surgery and on 21 January     to her father before, although her preference for Daddy remained.
    2009, Atikah was admitted to Mount Alvernia Hospital.                “She was a real Daddy’s girl. When he was around, she didn’t care
                                                                         about others,” said Nurse Kre.
    Within a month, Atikah was operated on four times. Two of the
    operations were surgical excisions to remove all the cancer cells.   Despite her tender age, Atikah struck the nurses as a “mature”
    The first took about 16 hours and the second took about 8 hours.     patient who hardly ever threw tantrums. According to Nurse Kre,
    The other two were shunt operations to drain excessive water         she would only cry if her pampers were wet or if she was running
    from her brain in order to reduce pressure there. Dr Lee described   a fever.
    Atikah’s case as “challenging” but everything went smoothly and
    the next phase was post-operative recuperation.
Girlsmiles again He eases mums into childbirth - Mount Alvernia Hospital
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.

As 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          (Left) Thank you cards personalised by Atikah.        (Right) Part of the care team:
not cough out phlegm on her own.                                                                       Snr Staff Nurse Yaco,
                                                                                                       Snr Mgr Elizabeth Loh & Staff Nurse Kre from CCU
Atikah also had two months of
occupational therapy, or due to her
age, “play therapy” would be a better
description.                                     What is ependydoma?
                                                 It is a rare form of brain tumour that arises from the ependyma, a tissue in the central
When occupational therapist Koh Siew Van         nervous system, which comprises the brain and spinal cord. It can occur in both children
first saw Atikah, she was “unresponsive to       (usually in the brain) and adults (often in the spine).
command and was not able to have eye             According to Dr Timothy Lee, he sees only one or two cases a year, and they are always
contact”.                                        children.
Initially, her therapy sessions involved a       What causes it?
lot of sensory stimulation using sound           There is no known cause and it has nothing to do with a person’s genes or his lifestyle.
and bright coloured objects. The therapist
                                                 Are there any symptoms?
then worked on her motor skills as well as
                                                 Frequent headaches; persistent vomiting for more than one week; head tilted towards the
her sitting balance to improve her trunk         right; loss of balance or trouble walking; and irritability.
                                                 Once the tumour is removed, will it return?
By the time Atikah had completed her             There’s about a 10-20 per cent chance of the tumour returning, said Dr Lee.
therapy, “she was able to sit independently
and walk with minimum support”, Ms Koh
Atikah celebrated her second birthday on
27 March 2009 at the CCU, with a party                    A Place for Quiet                       For Atikah’s parents, the
                                                                                                  attention showered on their
hosted by the nurses and some goodies
from Dr Lee. It was attended by her parents
                                                        Reflection & Prayer                       daughter was not the only thing
and several hospital staff. The birthday girl                                                     that caught their attention at
was, by then, able to taste a little of her                                                       Mount Alvernia. They were also
favourite chocolate and ice-cream.                                                                pleasantly surprised to find that
Shortly before Atikah was discharged in                                                           the hospital had a “Quiet Room”,
mid-May, Dr Lee had some good news                                                                where they could perform daily
for her parents: The brain scans done
                                                                                                  prayers as a Muslim.
immediately after surgery and three
months later showed that all her tumour                                                           The Quiet Room is located on
cells were gone.
                                                                                                  Level 1, near the Main Lobby.
“She should be able to grow up normally,”                                                         For directions, please approach
Dr Lee said.                                                                                      the receptionist for help.

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

                                                                                                                                             MyAlvernia   05
Girlsmiles again He eases mums into childbirth - Mount Alvernia Hospital
helping handS

                     not Sympathy,
                                                                                                                         Assistant Director of Nursing,
                                                                                                                         Grace Koh

        n 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.                                                     Caring for a bedridden
                                                                                         person -
     The good news is that not all conditions are permanent.
     “Sometimes, with rehabilitation, patients do regain mobility
     and become independent again,” says Ms Koh.
                                                                               w Hygiene Help the patient stay clean and dry by sponging with
     However she cautions that patience and optimism must                        soap and water at least once a day, supplemented by wet
     prevail, and both the patient and his family must work                      wipes at intervals throughout the day.
     together to overcome the difficulties along the way.
     According to Ms Koh, the initial period of adjustment is the              w Pressure Ulcers One of the biggest problems bedridden
     most difficult. “It is not easy for anyone to suddenly lose                 patients face, these are areas of local tissue inflammation that
     their sense of independence. One minute you are up and                      develop as a result of prolonged compression and friction
     about. The next thing you know, you need someone else to                    between the skin and bones. Blood flow to the area is reduced,
     do everything for you – clean you, wash you, feed you. It is a              cutting off the supply of oxygen and nutrients to the skin. If left
     very humbling experience,” she explained.                                   unattended, infection, sepsis and ultimately necrosis may result.

     During that period, patients are often extremely frustrated                 To detect pressure ulcers, look out for areas of discoloration and
     and may throw tantrums by refusing to eat or talk. “They feel               hardness on the skin.
     ashamed of their loss of independence,” says Ms Koh.                        Prevention is simple but requires diligent nursing: Ensure that
     So how does one help? “Do what the patient wants, not what                  the patient’s body is moved from side to side at least once
     you want to do for him.” advises Ms Koh. The most important                 every two hours.
     things you can offer in such a situation are a positive attitude
     and presence. In other words, empathy not sympathy is the                 w Interaction Talk to the patient normally – about
     key.                                                                        neighbourhood gossip, family affairs, current affairs or anything
                                                                                 that would interest him. This is encouraged even if the patient
     For those tempted to overcompensate, Ms Koh warns that                      is not conscious. Touch is also a powerful non verbal form of
     being “overly caring” could have just the opposite effect                   communication that lets the patient know someone cares.
     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                * The Asian Women’s Welfare Association has published a handbook for caregivers. To
                                                                               get a free copy, visit
     just because their circumstances have changed.”

06   MyAlvernia
Girlsmiles again He eases mums into childbirth - Mount Alvernia Hospital
you asked

Medisave now
covers more
Higher claim limits, less out-of-pocket cash payment                                                    What if the hospital bill exceeds what my
                                                                                                        Medisave limit?
Since 1 June 2009, the Ministry of Health has increased the Medisave                                    If the bill exceeds what your Medisave can
withdrawal limits for surgical operations. So if you are opting for surgery                             cover, you will need to pay the balance by
at Mount Alvernia, this means you can now tap more into your Medisave                                   cash, cheque, NETS or Credit Card upon
account to settle medical bills. To help you understand Medisave claims                                 discharge.
better, here are some common FAQs:                                                                      Can I use future Medisave contributions to
                                                                                                        pay the difference?
How much of my Medisave can I use to                How many Medisave payers are allowed?               No, Medisave claims can only be made
cover my hospital bills?                            A maximum of 10 Medisave payers is                  based on the Medisave account balance on
For a hospitalisation claim, the patient            allowed. However Medisave withdrawal                the day of admission.
must have stayed in the hospital for at least       limits still apply regardless of the number         Why is my Medisave claim estimated
eight hours (unless he is admitted for day          of payers.                                          at admission different from that at
surgery). Medisave now covers up to $450                                                                discharge?
per day ($400 for hospital charges; $50 for         Does Medisave cover expenses for
                                                    maternity cases?                                    Medisave claims are estimated at the
doctor’s daily attendance fees).                                                                        time of admission and point of discharge.
                                                    Yes, it can be used to pay for hospitalisation
For day surgery, Medisave covers up to              for the delivery of the first four children. For    Upon admission, the estimate is based on
$300 ($270 for hospital charges, $30 for            the fifth and subsequent child, the parents         the intended length of stay and type of
doctor’s attendance fee).                           will need to have a combined Medisave               operation scheduled for. Upon discharge,
For surgical operations, the amount varies,         balance of at least $15,000 at the time of          the estimate is updated in the Interim Bill
depending on the type and complexity                delivery to be eligible. The withdrawal             to reflect the actual length of stay and
of the operation. The maximum amount                limits will also apply.                             procedures done during the stay. The final
claimable includes surgeon, anaesthetist                                                                claim amount will only be known when the
                                                    Can Medisave cover for pre-delivery                 Final Bill is issued, after the claim amount
and facility fees. A full listing on procedures
                                                    expenses?                                           has been approved by the CPF Board.
claimable under Medisave now can be
                                                    Yes, you are allowed to claim an additional
obtained at our Business Office.                                                                        Can I check my Medisave account balance
                                                    $450 from Medisave for antenatal care
Who does my Medisave cover?                         if you submit your antenatal receipts to            at the hospital?
Medisave can be used for Medisave                   us during admission. This will be used to           Yes, the hospital can help you check your
account holders or their dependants.                offset your hospital charges.                       Medisave account balance on your behalf if
Dependants refer to spouses, children,                                                                  you authorise us to do so.
parents and grandparents. Grandparents
must be Singaporeans or Singapore
Permanent Residents.                                *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
Girlsmiles again He eases mums into childbirth - Mount Alvernia Hospital
in the pink

           Don’t let it
 bug you
                                           Dr Ho administers a flu vaccination.

             he 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.
                                            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.
                   If a person has          How can we build up our immunity against the flu virus?
                   the flu, what can        Exercise regularly; get adequate sleep; drink lots of water –at least six to seven glasses daily;
                   he and the rest of       and eat plenty of fruits and vegetables.
                   his family do to         Can a flu shot offer us any protection?
                   avoid spreading          The influenza virus vaccine is used to stimulate active immunity and provides protection
                   the infection?           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
     The patient himself should cover       vaccine is not effective against all strains of influenza virus.
     his mouth with a tissue whenever       Flu vaccination is available at Mount Alvernia’s 24Hr Outpatient Dept. For inquiries, please
     he coughs or sneezes.                  call 6347-6210.
     The rest of the family should not      Do we need regular flu shots?
     share eating utensils with the         Flu vaccinations, once a year, are recommended for those who are at high risk of flu or flu-
     patient and wash their hands           related complications, as well as those who live with, or care for, such individuals. They include
     frequently. If possible, try not to    women who will be pregnant or planning to get pregnant during the flu season; those with
     sleep in the same room as the          chronic lung (including asthma), heart (except hypertension); kidney, liver, blood, or metabolic
     patient.                               disorders; immuno-suppressed patients; and those who take care of the elderly or children
     If there are family members who        under five.
     are in the vulnerable group, it        Healthcare workers, residents of nursing homes and people who will be travelling overseas
     would be good practice for them        during the flu season should also get annual vaccinations.
     – and the patient – to wear masks.     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.

08   MyAlvernia

                                                                you better

    National Day with Good Health
Is it time for your next health check? Take advantage      Our hospital is upgrading its facilities to create a more
of our NDP specials for a very comprehensive array         conducive environment for patients and visitors. By
of tests – now packaged to give you more value             year end, you can look forward to new carpark lots,
for money. All packages include a full physical            more room choices and dining options.
examination and review with a medical doctor.              We apologise for any inconvenience caused to patients
                                                           and guests in the meantime and appeal for your
NDP Package One ($400)                                     understanding and cooperation during the period of
(Men/Women, 40-50 years)                                   renovation.

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        Celebrating 60 years of
features high sensitivity test for the risk of coronary    service with song
artery diseases, testing for arthritic joints, screening
                                                           Mount Alvernia Hospital’s founding Sisters mark their
for testicular cancer (for males) and lung function
                                                           60th year in Singapore this year and to commemorate
assessment.                                                the occasion, the Sisters have banded together
                                                           with doctors and staff of Mount Alvernia and Assisi
10% off the following tests if added on to the packages    Hospice to present an evening of songs at:
above:                                                     Church of St Mary of the Angels
                                                           5 Bukit Batok East Ave 2
- Screening Mammogram                                      Fri, 11 Sept 2009 @ 7.30pm
- Ultrasound Breast
- Ultrasound Pelvis                                        Admission is free and all are welcome. To reserve your
                                                           ticket, please email
- Ultrasound Abdomen
- Bone Mass Densitometry                                   There will be a collection for palliative and hospice care
- Treadmill ECG                                            services by Assisi Hospice.

Note: All prices are before GST.
the big interview

      Dr Ho Hon Kwok
      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.

             r Ho Hon Kwok regularly uses stories and anecdotes to         where he has been based since 1996. He was one of the first O&Gs
             break the ice with patients and put them at ease.             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
      This approach helps the Consultant Obstetrician and                  place.
      Gynaecologist’s patients understand the medical scenario at hand
      and make informed decisions that sometimes have life or death        “There is a very serene ambience here. When you talk to the
      implications.                                                        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
      For Dr Ho, the craft was honed from his earliest days in medicine.   hospital go towards supporting charitable causes like the Assisi
      He related how as a young doctor working at an A&E unit, he          Hospice and other mission activities. By working here, I feel I can
      encountered a toddler with an unusual problem – a bead was           indirectly do my part for charity,” he shared.
      stuck in the nostril. Instead of opting for a medical procedure
      immediately, Dr Ho decided to try something less invasive first.     Besides patient care, Dr Ho also finds time to participate in the
                                                                           hospital’s medical advisory committees and boards. He is currently
      With anxious parents looking on, Dr Ho calmed the crying toddler     serving as Chairman of the hospital’s Medical Advisory Board.
      down and coaxed him into ‘playing a game’ by pressing one nostril
      and blowing out. The ‘game’ worked – the bead flew out the           “The hospital team is very sincere and committed to continually
      toddler’s nose and freed him from his predicament.                   improve and uphold standards. As a doctor, whether through
                                                                           conducting educational talks or playing an advisory role, I try to
      Today, Dr Ho, 55 runs his own private practice at Mount Alvernia     share my expertise to help the hospital grow,” he said.

10   MyAlvernia
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

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.

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.

                                                                                                                                   MyAlvernia   11
the big interview

      How different are your patients today compared to                         There have been cases of mums-to-be, especially the
      say 20 years ago?                                                         first timers, going to the hospital, only to be sent
      Women tend to be well-read and better informed today. The                 home because they are still in the early stages of
      expectations of the doctor are also much higher.
                                                                                labour. how can a woman avoid such a situation?
                                                                                Doctors usually brief their patients so that they will have a good
      What are some of the common medical concerns that                         idea of when is the right time to go to the hospital –when the
      pregnant women face?                                                      contractions start to occur once every 10 to 15 minutes. Having
      These usually evolve as the mother goes through the different             said that, ‘false starts’ cannot totally be avoided and I think it is
      stages of pregnancy. In the first trimester, they may experience          better to be early than late.
      nausea and vomiting, vaginal bleeding, abdominal discomfort
      and lethargy. As the pregnancy progresses, the mother will want           In your experience, which year stood out as the year
      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
                                                                                of the big baby boom?
      available during delivery, and the ability to breastfeed once the         Any year considered auspicious in the zodiac calendar tends to see
      baby is born.                                                             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.

12   MyAlvernia

           Red Date

                                                       Ingredients                       Nutrition Content:
                                                       Chicken stock, 350 ml             One serving will give:
                                                       Old ginger smashed, 20 gm         380 kilocalories
                                                       Chopped chicken, 150 gm           31gm Protein
                                                       Red dates, 8 pcs                  53 gm Carbohydrate
                                                       Chinese mushroom, 4               6 gm Fat
                                                       White wine, a splash
                                                       Salt to taste
the best medicine                                      Serves 1

Latest Medical Terminology
Artery - The Study of paintings                        1.   Bring the chicken stock to a boil.
Bacteria - Back door to the cafeteria                  2.   Add the rest of the ingredients to the stock.
Benign - What you be after you be eight
Caesarean Section - A neighborhood near Rome           3.   Lower the fire and simmer for 15 minutes.
Cat Scan - What dogs do when they enter your yard      4.   Transfer soup into herbal pot or slow cooker.
Coma - A punctuation mark
Congenital - Friendly                                  5.   Steam or slow cook the soup for 2 hours.
Dilate - To live long
Enema - Not a friend
                                                       6.   Add salt to taste.
Labor Pain - Getting hurt at work
Medical Staff - A Doctor’s cane
Nitrate - Cheaper than the day rate
Outpatient - A person who has fainted
Pelvis - Cousin to Elvis
Protein - In favor of young people
Recovery Room - Where you have your upholstery done
Seizure - A Roman emperor
Tablet - A small table                                 Recipe courtesy of Mr Ho Limg Neng, Executive Chef, Mount Alvernia Hospital
Urine - Opposite of you’re out                         Nutritional tips courtesy of Ms Lee Hee Hoon, Senior Manager, Nutrition &

Varicose Veins - Veins which are very close together   Dietetics, Mount Alvernia Hospital
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.

14   MyAlvernia
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

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
It is also common for a person with sunken chest to have
associated scoliosis, a condition which results in his spine curving                                               Consultant Cardiothoracic
from side to side.                                                                                      and Vascular Surgeon Dr James Wong
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   How can the deformity be corrected?
of parents do not have sunken chests, yet three siblings in one        In the past, many turned to the Ravitch procedure – an invasive
family and two siblings in the other suffer from the deformity.        surgery requiring resection of the deformed cartilage and bone –
                                                                       to rectify the problem.
How common is the deformity?                                           However, these days, a minimally invasive surgery – the Nuss
It affects about one out of every 1000 children and occurs more        procedure, name after its inventor, Dr Donald Nuss – is often
frequently in boys than girls.                                         recommended.
                                                                       During this surgery, a long stainless steel metal bar (or pectus bar)
Can a doctor detect sunken chest in a                                  tailored to the patient’s chest deformity is inserted beneath the
newborn?                                                               ribs and sternum, with the curvature of the bar facing backward
Usually in the newborn, the chest depression is mild but               then flipped over to prop up the chest into the right position.
progresses with age. If left untreated, the deformity becomes more     The metal bar will remain in that position for two to three years
pronounced over time and may get worse during the puberty              until the bones remodel themselves in the new configuration. It
growth spurt.                                                          will then be removed.

Is sunken chest more of a cosmetic                                     The surgery, which can usually be completed within one hour, will
                                                                       leave only three small incisions.
Sometimes the condition can lead to medical problems. The              How much does the Nuss procedure cost?
inward-facing sternum can apply pressure to the heart and lungs,
resulting in restricted organ growth and shortness of breath.          The whole reconstruction process, which includes doctors’ fees,
                                                                       hospitalisation, operation cost, the pectus bar and stabiliser, could
Older children and adults may complain of pain in the area of the      cost up to S$18,000 – S$20,000. Additional pectus bars could cost
deformed cartilages (a form of connective tissues).                    more.
Most patients are also affected psychologically – such as losing       Dr James Wong is a Consultant Cardiothoracic & Vascular Surgeon
their self-confidence – especially in severe cases when the chest      at The Heart Lung and Vascular Centre at Mount Alvernia Medical
looks like it has been “punched in” and the shoulder crouched          Centre, Tel: 6356 6288.
forward with associated scoliosis.

                                                     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.

                                                                                                                                    MyAlvernia   15
up close & personal

                  ever in touch
                                                                                                                           Sister Barbara Pereira

       hings have changed since Sister Barbara         Spacious, airy and surrounded by              “Since the convent was not purpose-
       Pereira first joined Mount Alvernia             greenery, the obvious choice for the          built for a hospice, the place had to be
          Hospital as a young nun.                     hospice was the convent – but first the       renovated and refurbished and we made
                                                       Sisters would have to vacate the convent      sure that patients’ rooms all overlooked
         “The hospital was smaller then and we
                                                       they lived in. Ever generous in spirit, the   the garden,” shared Sr Barbara.
      didn’t have so many medical specialists
                                                       Sisters moved out to make way – as they
      as we do now,” said Sister Barbara, who is                                                     In 1992, the Assisi Home & Hospice was
                                                       had done so many times before with each
      today the Regional Head of the Franciscan                                                      officially opened, equipped with 35 beds
                                                       new hospital extension.
      Missionaries of the Divine Motherhood                                                          for the care of patients with cancer and
      (FMDM).                                                                                        other life-limiting illnesses. The only
                                                                                                     hospice to offer three services – inpatient,
      But as the needs of the community
                                                                                                     day care and home care – under one roof.
      evolved and healthcare management
      became more sophisticated, the hospital                                                        But the learning did not stop there for
      grew in size and medical expertise.                                                            Sr Barbara. In 1996, she left for England
                                                                                                     again – this time to train and work in
      Vigilant of changing trends, the FMDM
                                                                                                     Clinical Pastoral Care. Upon her return to
      Sisters – who ran the hospital from the
                                                                                                     Singapore, her new skills were put to good
      founding days until the 1980s – were
                                                                                                     use as part of the Pastoral Care team which
      quick to recognise the need to bring in
                                                                                                     she worked with from 2003-2007.
      multidisciplinary medical professionals
      to beef up the hospital’s capabilities and                                                     Today, besides overseeing 44 FMDM nuns
      provide better care for patients.                                                              in Singapore and Malaysia as Regional
                                                                                                     Head, Sr Barbara also keeps in touch with
      Their foresight led to the introduction of
                                                                                                     what’s happening at Mount Alvernia and
      lay staff into the key hospital management
                                                                                                     Assisi Hospice as a Board member.
      positions, to whom the Sisters eventually
      handed the reins over completely.                                                              Despite the numerous changes
                                                                                                     throughout the years, Sr Barbara is
      Sr Barbara’s personal journey reflects the
                                                                                                     happy to note one constant “The
      hospital’s phases of renewal and growth. In
                                                                                                     hospital staff still exhibits a pioneering
      1990, she stepped down from the position
                                                                                                     and compassionate spirit and remains
      of Assistant Director of Nursing (Medical/
                                                                                                     dedicated to the care and service for
      Surgical) at Mount Alvernia and left for
                                                                                                     people of all races,” she said.
      England to train in palliative care.
                                                                                                     Her wish for the future is simple but
      With new insights, Sr Barbara returned
                                                                                                     profound, “I hope that Mount Alvernia will
      to Singapore and began planning how
                                                                                                     continue to serve as a beacon of hope and
      Mount Alvernia could develop its hospice
                                                                                                     peace, so that everyone who comes here
      care wing – then located within the main
                                                                                                     will experience the healing love of God in
      hospital itself – into a full-fledged hospice,
                                                                                                     their lives.”
      in keeping with the needs of the times.          Assisi Hospice: surrounded by greenery

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

    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.
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