Girlsmiles again He eases mums into childbirth - Mount Alvernia Hospital
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Healthy Living For Mind & Body
MICA (P) 200/08/2008
Issue 2 • July - Sept 2009
Daddy’s
smiles
girl
again what’s up doc?
He eases mums
into childbirth
the big interview
That sinking feeling
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 myalvernia@mtalvernia-hospital.org
a note
of thanks
Alvernia’s
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
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
Senior Consultant Neurosurgeon
Dr Timothy Lee
smiles
again
MyAlvernia 03
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.
And the affable child could find reason to
smile even through her pain. One trick the
nurses discovered was singing and acting
out her favourite children’s nursery rhyme,
“If you are happy and you know it...” said
Ms Lillibeth Corral Yaco, a senior staff nurse
at CCU.
“Whenever she was asked to give a ‘Hi 5’,
she would give it to you even when she
was very ill and on a ventilator,” shared
Nurse Yaco.
PLAY THERAPY
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
tumourfacts
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.
control.
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
said.
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
helping handS
mpathy
not Sympathy,
please
Assistant Director of Nursing,
Grace Koh
I
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
Tips
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 www.awwa.org.sg
just because their circumstances have changed.”
06 MyAlvernia
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
07
Total $ 7300 $ 1850 $ 5450 $ 2600 $ 4700
MyAlvernia
in the pink
Don’t let it
bug you
Dr Ho administers a flu vaccination.
T
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 MyAlverniaalvernia
happenings
serve
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 fmdm60years@ymail.com
- Ultrasound Abdomen
- Bone Mass Densitometry There will be a collection for palliative and hospice care
- Treadmill ECG services by Assisi Hospice.
09
Note: All prices are before GST.
MyAlverniathe big interview
eases
mums
Dr Ho Hon Kwok
He
into
childbirth
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.
D
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 MyAlverniaIncidentally, Dr Ho had a hand in influencing the calming décor you see at some of the wards and clinical areas. “When choosing a color
scheme, bear in mind the effect of color on psychology,” he revealed, adding that patient comfort and functionality are also important
considerations.
After 13 years, Dr Ho continues to feel right at home at Mount Alvernia. “There are three things I always look for – integrity, commitment
and consistency. It’s all here.”
here are three things I always look for - intregrity,
commitment and consistency. It’s all here.
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 11the 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 MyAlverniadeliciously
healthy
Chicken
Mushroom
Red Date
Soup
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 &
13
Varicose Veins - Veins which are very close together Dietetics, Mount Alvernia Hospital
MyAlverniaThe 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.
hat
sinking
feeling
14 MyAlverniawhat’s up doc?
How does a sunken chest develop?
The deformity occurs when several ribs and the sternum grow
abnormally, producing a caved-in appearance in the anterior chest
wall.
Why does it occur?
Its exact cause remains unknown. But some cases of sunken chest
have been associated with Marfan’s syndrome, a connective tissue
disorder; various congenital heart conditions; and chromosomal
defects such as Turner’s syndrome, which affects development in
females.
It is also common for a person with sunken chest to have
associated scoliosis, a condition which results in his spine curving 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.
problem?
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 15up close & personal
onstantly
renewing,
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.You can also read
