The Breast Centre @ Changi advocates regular health screening as early detection saves lives

UNITED AGAINST CANCER

中文由第27页起

LOW IN TESTOSTERONE? Learn how this hormone affects men’s health

EHA & SUTD’S PARTNERSHIP A new MOU for medical innovations

MY GP ANSWERS Our General Practitioners talk about migraine and shellfish allergy

JAN−FEB 2017 Changi General H o spi t al Magazine

A H E A LT H I E R , H A P P I E R L I F E

EDITOR’S NOTE

Supervising Editor Lim Ee GuanEditor Cherry LuiContributorsJean AngusNg Ming ChuenStefanie CaiOoh Yi HuiTranslatorsYip LaimeiAlan Li Photographer Andy HoDesign & Production Publicitas ContentEmail: yourcontent@publicitas.comMedia Specialist: Mey LeongEmail: mey.leong@publicitas.com Materials: Doreen LauEmail: doreen.lau@publicitas.com

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is also available online at www.cgh.com.sg/CARING

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is published bi-monthly for Changi General Hospital by Publicitas Content

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MCI (P) 162/12/2016. Company registration number: 198904226R. All rights reserved. Copyright © 2017. No part of this publication can be reproduced in any form or by any means without the permission of the publisher. The views and opinions expressed or implied in are those of the authors or contributors and do not necessarily reflect those of the publisher.

USEFUL NUMBERS

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A Note fr om the Editor Feeling good about our physical appearance translates into greater

self-confidence. As the famous saying goes, “when you look good, you feel goodˮ. Fortunately, you don’t need to spend a lot or have an

expensive makeover to look good; it starts with taking care of yourself and being in the pink of health. For those who would like to achieve healthy, glowing skin, our dermatologist talks about what you can do about common skincare problems (page 2).

In light of World Cancer Day – a global event that takes place on 4 February every year to raise awareness about cancer – we debunk some misconceptions about breast cancer and share the story of a woman who overcame this disease (page 10). We hope that this will serve as an inspiration to those currently battling cancer.

In other sections, you will also find tips on guilt-free feasting during Chinese New Year (page 19), and an interesting feature on testosterone deficiency syndrome (TDS) and how it affects a person’s body and well-being (page 20). We also talk about the renewed partnership between Eastern Health Alliance (EHA) and Singapore University of Technology and Design (SUTD) as they continue to focus on medical innovations and talent development in healthcare engineering (page 16).

Happy reading and stay healthy! Cherry Lui Editor

CONTENTSISSUE 146

JAN – FEB 2017

02 BE HAPPY IN YOUR OWN SKIN CGH dermatologist talks about

common skincare issues

06 SPEAK UP FOR YOURSELF How to be assertive

10 LET'S TALK ABOUT CANCER Some misconceptions about breast

cancer, and a chat with the head of The Breast Centre @ Changi

14 COMMUNICATING EFFECTIVELY WITH THE ELDERLY Overcoming communication

difficulties due to old age

16 WHAT'S NEW EHA and SUTD sign new MOU;

introducing the country’s first Business Resilience Programme

19 A HEALTHY START TO THE YEAR OF THE ROOSTER

Mindful eating for the new year

20 ARE YOU TESTOSTERONE-DEFICIENT?

How testosterone affects your body and well-being

22 YOUR GPs CAN TREAT THESE CONDITIONS!

A GPFirst series

24 HEALTHY EATS Seafood focaccia with spicy salsa

25 SUBSCRIBE TO CARING

27 散发自信美，助您重获美肤樟宜综合医院皮肤专科医生分享常见皮肤问题

31 您认识癌症吗？与樟宜综合医院乳房中心主任一同探讨乳癌的迷思与论据

35 健康自在迎鸡年 迎新年的同时也要注意饮食

36 新鲜事 东部医疗联盟与新科大签署新谅解备

忘录

38 您的家庭医生能治疗这些病症！

“家庭医生首选”系列

40 吃出健康 海鲜佛卡夏面包搭配辣味莎莎酱

Feedback 1800 850 2823Feedback 1800 850 2823

16 36

24 40

22 3802 27

2 J A N – F E B 2 01 7 C A R I N G 2 J A N – F E B 2 01 7 C A R I N G

BE HAPPY IN YOUR OWN

C A R I N G J A N – F E B 2 0 1 7 3 C A R I N G J A N – F E B 2 0 1 7 3

FEATUREHEALTH NOTES

Text by Cherry Lui

Dr Regina Lim, Chief of CGH’s Dermatology department, shares her thoughts on common skincare concerns and what you can do about them

WHAT ARE YOUR TIPS IN MAINTAINING HEALTHY SKIN? Some individuals are born with flawless skin and this may be inherited to some degree. However, the majority of us experience some skin problems such as acne, eczema or psoriasis at some point in our lives. Some people are also bothered by the appearance of skin pores, the size of which is actually genetically determined. Pores may look more obvious as you age, as there is less collagen to support the skin.

Cleansing your skin, especially at the end of the day, helps to clear makeup, grime, dust, sweat and bacteria that accumulate on it throughout the day. These impurities can clog your skin pores, making them look larger. You may also start to develop black heads and acne spots. Use a cleanser that is gentle to the skin, as harsh ones can strip it of its natural moisture and make it too dry. It is also important not to wash too frequently as this can aggravate some skin conditions. Facial cleansing twice daily and after excessive perspiration should suffice.

You should also moisturise the skin after cleansing. Use a moisturiser that suits your skin type. For individuals with sensitive skin, fragrance-free products are preferred.

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HOW YOUR SKIN CHANGES THROUGH THE YEARS

20sAcne and seborrhoeic

dermatitis (dandruff and flaky scalp) are common

problems at this age.

30s Photodamage from sun exposure may start to

appear. It is important to use regular sun protection

from an early age to minimise the damaging

effects of ultraviolet radiation on the skin.

40s More photoageing

may be seen, the skin may start to lose some tone, and fine wrinkles

may start to appear.

50sHormonal changes

with menopause may lead to drier skin. In

addition, deeper wrinkles may start to develop.

Extrinsic ageing varies depending on the individual's level of sun exposure

C A R I N G J A N – F E B 2 0 1 7 5

FEATUREHEALTH NOTES

WHAT DO PEOPLE GENERALLY NEGLECT WHEN IT COMES TO SKINCARE? Sun protection and the use of sunscreen. Use a broad spectrum sunscreen, which gives you protection against UVA and UVB radiation. UVA is mainly responsible for premature ageing as it damages collagen and elastin, causing wrinkles to appear prematurely. Meanwhile, UVB causes sunburn and DNA damage.These types of radiation can also cause skin cancer.

You need to apply sunscreen at least 20 minutes before sun exposure and at least every two hours thereafter, or more frequently after swimming, heavy perspiration or towelling off. For those who have more sensitive skin, opt for sunblocks with titanium dioxide or zinc oxide. HOW DIFFERENT ARE MENʼS SKIN FROM WOMENʼS, AND HOW DOES IT AFFECT THEIR SKINCARE ROUTINE? The male hormones give men more facial hair and also increase their skin thickness by about 20 per cent compared to women’s. They also have a higher collagen density and their skin produces about four times the amount of sebum compared to women. Thus men’s skin tend to be more susceptible to acne and clogged pores. Having to groom facial hair regularly can also make men more prone to infections.

Thus, it is important for men to clean their face properly to remove excess oil and prevent impurities from clogging their pores. It is also necessary to protect their skin from excessive sun exposure as this ages skin faster and increases their risk of cancer. WHAT ARE THE MOST COMMON SKIN CONDITIONS AMONG SINGAPOREANS?I see a lot of patients with eczema in my clinic. It is one of the most common skin problems, not just in Singapore, but in many parts of the world. It is caused partly by genetics and the environment. We can’t change our genetic makeup but we can do something about the environmental triggers.

If you are diagnosed with eczema, you should be using moisturiser for your dry skin on a daily basis. I normally advise patients to moisturise their skin at least twice a day especially after taking a shower. In general, if you suffer from eczema, you will notice that you have itchy skin when the environment is warm or when you feel stressed, so reducing your exposure to these factors is recommended.

You should also protect your skin

from direct exposure to detergents and substances with harsh chemicals, and use protective gloves when handling these products.

If you have hand eczema, you should apply moisturiser after washing your hands. Products that are fragrance-free and have less excipients (substances used to stabilise a drug) are better tolerated by the skin. Using a gentle soap for cleaning also helps.

HOW DOES OUR SKIN CHANGE AS WE AGE?Both intrinsic and extrinsic ageing of the skin happen. Intrinsic ageing occurs as people get older. The skin becomes less elastic and firm, and fine lines and wrinkles start to appear. The skin also becomes thinner and drier. There is less underlying fat and connective tissues, leading to hollowed cheeks and eye sockets, which make the face look older as well.

Meanwhile, extrinsic ageing (see facing page) varies depending on the individual’s level of sun exposure over the years, skin type and other environmental factors, such as smoking and diet. It is advisable to stop smoking, eat healthily and sleep well to keep your skin looking young for as long as possible.

Effects of sun damage, such as solar lentigines (sun-induced dark spots) and spider veins (veins that are visible through the skin), can also create a blotchy complexion. If you had excessive sun exposure, you may have rough, leathery skin with deep wrinkles.

WHAT CAN BE DONE IF MY SKIN IS ALREADY DAMAGED BY THE SUN?It is never too late to start looking after your skin. It is important to pay close attention to sun protection and regularly use a moisturiser and sunblock. Topical treatments such as retinoids and hydroquinone can be used judiciously under the care of a dermatologist to reduce the appearance of pigmentation and repair photodamage to some degree.

Laser treatment can address both the pigmentation as well as improve the texture and appearance of the skin. However, it can be costly and may have side effects. Patients need to consider these cosmetic options carefully before trying them. These treatments can help but will not be able to turn back time entirely, so expectations should be realistic.

6 J A N – F E B 2 01 7 C A R I N G

Assertiveness is a healthy way of communicating. It is the ability to speak up for ourselves in a way that is honest and respectful. However, being assertive

does not come naturally to everyone. Some people communicate in a way that is too passive while others might be too aggressive. An assertive style is a good balance between these two.

For example, imagine you are standing in line at the train platform and someone tries to cut your queue. You may respond in a passive manner by saying nothing to the person. Later, however, you may complain to your friends and family, which will make you feel better in the short term. It does not resolve the problem, leading to continued annoyance and anger about the interaction for the rest of your day.

FOR YOURSELF

Text by Stefanie Cai

Being assertive is a sure-fire way to communicate effectively with others

SPEAK UP

PASSIVE ASSERTIVE AGGRESSIVEHold your needs in

Express needs clearly but respectfully

Force your needs or opinions on others

May blame and guilt-trip

others indirectly

Treat others with respect

Bully others or enforce your needs

to others

Often “too nice” to others and don’t

get what you want

Consider the needs of others as well

as your own

Only your needs matter

Always give in to others

Often compromise

Do not compromise, must get your own way

Damage relationships as resentment

and anger build up if own needs are not met

Have strong, healthy

relationships with others

Damage relationships with others

Keep quiet and agree with everything

Use clear language to get

point across

Resort to shouting and/or physical

aggression

Damage self-esteem Build self-esteem Damage self-esteem

C A R I N G J A N – F E B 2 0 1 7 7

MENTAL WELLNESS

To understand what it means by being assertive, here are the differences among communication styles:

HOW DO YOU REACT?

Alternatively, you may respond in an aggressive manner by grabbing the person by the shoulder, saying loudly, “Hey! Who do you think you are? What makes you so important that you don’t have to wait in line like the rest of us?” This may make you feel better in the short term, but you will probably also spend the rest of the hour feeling annoyed and angry about the interaction. It is possible that the other person will shout back at you and the situation will escalate, leaving you in a bad mood.

A more assertive response could be to gently tap the person on the shoulder and say in a clear but respectful voice, “Excuse me, there is actually a line here. Please wait for your turn like the rest of us.” Chances are, you will get a more positive response to this. Perhaps the other person will apologise and move to the back of the line, or they may explain their reason for rushing and you may feel happy to do them this favour. Even if they continue to respond badly – your assertiveness does not always guarantee that

8 J A N – F E B 2 01 7 C A R I N G

Stefanie Cai is a Clinical Psychologist at Health Wellness Programme, Eastern Health Alliance

Practise saying “No”

If you have a difficult time turning down requests, try

saying “No, I can’t do that now.” Do not hesitate to be direct. If you have an explanation

for it, keep it brief.

others will not be aggressive – you could at least feel good knowing that you did your best and assert yourself. Being assertive can also boost your self-esteem and earn the respect of others.

ASSERTIVENESS: THE KEY TO GOOD MENTAL HEALTH People develop different styles of communication over time based on their life experiences and cultures, and tend to stick to the same communication style over time. In Asian cultures, individuals commonly use passive communication to avoid conflict and appear respectful. However, a lack of assertiveness (either being passive or aggressive) has been found to be linked with a lack of confidence, low self-esteem, chronic stress, depression, anxiety, anger issues, relationship and/or parenting problems, workplace bullying, etc. Simply put, if you don’t feel good about yourself, it is difficult to ask for what you need.

Communicating clearly, confidently and respectfully is essential for effective interaction with others. Learning to be assertive can sometimes be a challenging activity. It requires a shift in thinking and behaviour, and an openness to learn from others. As with most learning, acquiring this trait requires time, practice, and support from peers. It is important to be consistently mindful that assertiveness is a two-way process, which involves not only respecting oneself as a person but also respecting the rights of the other person.

TIPS TO BE ASSERTIVE

C A R I N G J A N – F E B 2 0 1 7 9

MENTAL WELLNESS

Use “I” statements

Use “I want”, “I need” or “I feel” instead of “You” statements. For example, instead

of saying to a fellow colleague, “Hey, where’s the report you were supposed to submit last Friday? You are holding

up the whole project,” you may try saying, “Hey, I am feeling a little stressed because I don’t

have that report yet.”

Use body language

Communication does not just involve verbal responses. You have to look

convincing too. Present yourself in a confident manner even if you are not

feeling it. Maintain a neutral or positive facial expression, upright posture, and lean slightly forward. Make regular eye contact but do not stare. Do not wring your hands

or use dramatic gestures. You can practise this in front of a mirror

or in front of your friends.

Keep your

emotions in checkConflict is difficult for everyone.

Maybe you are angry, frustrated, or feel like crying. Although these feelings

are normal, they may get in the way of resolving conflict. If you are feeling too emotional to start a conversation,

wait a little while if possible. Then work on keeping calm through breathing

slowly.

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DID YOU KNOW?

World Cancer Day is observed on 4 February every year to raise

awareness about the disease. This year, its tagline – “We Can.

I Can” – highlights a positive and proactive approach to the

fight against cancer.

C A R I N G J A N – F E B 2 0 1 7 1 1

Cancer is a leading cause of deaths worldwide. In fact, in Singapore, about 37 people are told that they have cancer every day, according to the Singapore Cancer Society.

COVER STORY

Though the disease is not always fatal, diagnosing cancer is not easy because not all types of cancer show early signs and symptoms. Warning signs do not appear until the disease becomes advanced. Thanks to medical developments in recent years and growing awareness of signs and symptoms, early detection and appropriate timely treatment mean that survival rates are likely to increase.

THE FIGHT AGAINST BREAST CANCER Breast cancer is the second leading cause of death in women today. According to the National Cancer Centre Singapore, 1 in 16 Singaporean women will develop breast cancer by the age of 80, with a lifetime risk of 6.5 per cent. The incidence rate is expected to rise with increasing life expectancy and an ageing population.

It generally shows no major symptoms in the early stage, but knowing the warning signs can help with early detection. As a tumor develops, a person may notice lumps in breasts, changes in breast skin and the nipples, breast pain, and enlarged lymph nodes.

Regular health screening may detect breast cancer early, when treatment is likely to work best – as proven by the inspiring story of Ms Nancy Tan (name changed to protect patient’s privacy), a cancer survivor.

Ms Tan, a sprightly 67-year-old, was diagnosed with breast cancer in April 2016. It came as a surprise because she did not experience any symptoms or pain. It was early detection through mammography screening that saved her life.

She acted quickly after her diagnosis and underwent a mastectomy. It has been

L E T ’ S TA L K A B O U T

CANCERHere are some facts and misconceptions about breast cancer, and a quick chat with the Director of The Breast Centre @ Changi

Text by Cherry Lui

1 2 J A N – F E B 2 01 7 C A R I N G

a challenge coping with the physical and emotional impact of cancer, but her family and friends have been a tremendous source of support. She was fortunate that her breast cancer was detected early, and the treatment involved only one operation. She is now cancer-free.

To those battling cancer, she advises, “Never give up, because when there’s

COMMON MISCONCEPTIONS ABOUT BREAST CANCER

1Under-wired bra, antiperspirant and powder

can cause breast cancer.There is no scientific evidence to show that any of these can cause breast cancer. The development of the disease is usually a complex interplay of various factors, including genetic predisposition, immune system, hormonal fluctuation, environmental pollution, and lifestyle, among others.

2 By going for regular mammograms, I am

safe from breast cancer.Mammograms do not prevent breast cancer. They are tools to detect

early curable breast cancer so as to increase survival.

3If my mammogram is normal, I am

assured that I will not get breast cancer.

While mammography is the best screening tool for breast

cancer available today, it cannot detect all breast cancer. This is because normal breast tissue can hide breast cancer, especially if the cancer is small and in young women

whose breast tissue is denser. Certain types of cancer are also not readily seen on mammogram. In certain cases, an ultrasound or MRI scan may be required. The doctor will assess and advise you accordingly.

4Organic foods can

prevent breast cancer. Organic foods have become increasingly popular lately. However, more research is needed to indicate the significance of consuming organic fruits and vegetables to prevent breast cancer. Chemicals in conventionally grown fruits and vegetables are regulated at a safe level by government agencies such as the Health Science Authority (HSA) and Agri-Food & Veterinary Authority of Singapore (AVA). Thus, conventionally grown fruits and vegetables are safe for consumption.

5If the lump in my breast is painless, it cannot

be cancerous. In a research study conducted by The Breast Centre @ Changi and published in the Singapore Medical Journal, 52 per cent of 1,000 women surveyed thought that a breast lump is cancerous only if there is pain in the breast. However, majority of cancerous breast lumps are painless, especially in the early stages. Never ignore any breast lump, no matter how small or painless because early diagnosis and treatment result in the best outcome.

About half of those surveyed also thought that the removal of the whole breast was the only treatment for breast cancer. This is a myth. If detected early, breast cancer can be treated with only surgery; in certain

cases, a lumpectomy (removal of cancerous tissues) is

sufficient. Chemotherapy may not be required.

hope, you have already won half the battle. A cancer diagnosis is not the end. If you notice negative thoughts creeping in, do not dwell on them. The difficulty I am facing today is that I don’t know what my future will be. I do not have the answer yet but I try to overcome it by taking this journey step by step, one day at a time.”

C A R I N G J A N – F E B 2 0 1 7 1 3

Tell us about your job as a breast surgeon. I juggle being a cancer surgeon, a reconstructive surgeon and a psychologist. An important part of my job is assessing the psychological readiness of my patient in accepting the diagnosis and treatment – to give them information, time and support they need to make informed decisions about their own breast health. A breast cancer diagnosis can be overwhelming, both physically and mentally. Most

women will have surgery, which can affect the shape of one or both breasts and cause scarring. Such body changes can affect their self-esteem and the way they relate to other people, especially close family and friends. What is unique about The Breast Centre @ Changi? It offers a one-stop comprehensive breast service in the testing, diagnosis and treatment of all

breast conditions. Staffed by dedicated doctors (pictured below), nurses and allied healthcare workers, the wards, operating theatres and radiology suitesat The Breast Centre are well-equipped with advanced technology and equipment. It is also the first centre in Singapore to use ultrasound elastography to assess breast lesions and to provide the doctor with more information in assessing if a patient needs a biopsy.

COVER STORY

CGH WOMEN’S PUBLIC FORUM

In each stage of your life, your health needs differ. Let our industry experts clue you in on how to “glowˮ at any age. Find out how to improve your health and total well-being through simple regimens designed to help you maintain supple skin and be fit. You can also learn about breast health and essential supplements for good health.

Are you ready to live healthily and happily throughout your 20s, 40s and 60s? Join the popular Women’s Public Forum: Date: 11 March 2017, Saturday Time: 9am – 11am Venue: CGH Training Centre, Level 1, Auditorium

Sign up and learn more about common conditions that affect women today. To register, please email your name, contact number and number of participants to public_forum@cgh.com.sg, or call 6426 7271 between 9am and 6pm (closed from 12pm to 2pm) on weekdays. Admission is free.

Professor Tan Su-Ming, Senior Consultant and Director of The Breast Centre @ Changi90 SECONDS WITH...

The team behind The Breast Centre (from left): Dr Lee Wai Peng, Prof Tan Su-Ming, Dr Andrew Clayton Lee, Dr Jaime Seah Chin Mui

1 4 J A N – F E B 2 01 7 C A R I N G

Communicating effectively with the elderly Having a good relationship with ageing parents or loved ones starts with listening and understanding the cause of their communication difficulties

1 4 J A N – F E B 2 01 7 C A R I N G

Text by Cherry Lui

Communicating effectively with the elderly

C A R I N G J A N – F E B 2 0 1 7 1 5

Caring for the elderly is often challenging due to their communication difficulties, which are commonly caused by hearing

impairment, brain lesions (e.g. stroke and brain tumours) or declining memory, sight or vision. Medical conditions such as dementia and Parkinson’s disease or structural body changes (e.g. trauma to head and neck) also affect their communication capabilities.

Age-related vision impairment and hearing problems may result in difficulties in speaking, understanding, reading and/or writing. For example, hearing problems may make it harder for the elderly to know if someone is talking to them. They may also have difficulty following a conversation. Vision problems can make it difficult to read letters, newspapers and instructions on a medicine bottle.

There are two guiding principles to remember when you’re facing these issues:• Communication is a two-way street.

The speaker and the listener are both responsible for improving the way they communicate with each other. Any conversation is a collaborative effort and it is never just one personʼs

FEATURE

responsibility. Listening to one another is very important.

• Adjusting to limitations is necessary. When talking to someone with a hearing problem, for instance, conversing in a quiet room is often more effective. Assistive hearing devices also facilitate communication.

Here are some useful tips when communicating with the elderly: • Simplify. Instead of using jargon or medical

terms, use simple words that are easier to understand when talking to them.

• Assure them that they matter. Communicate with kindness and involve them in the conversation.

• Give information. Help them make informed decisions by sharing information in the way they prefer. Drawing or doing a demonstration can be helpful.

• Ease into it. Avoid sharing too much information too quickly. Slow down and allow them to process the details as unfamiliar information can be overwhelming.

SPEECH THERAPY AT CGH

Old people with communication impairment arising from medical conditions can benefit from speech therapy. At CGH, speech therapists assess and treat patients who are facing difficulties with speech, language, voice and/or swallowing. Under the careful guidance of speech therapists, patients undergo a period of rehabilitation to maximise their communication functions.

On 1 December 2016, the CGH speech therapists (left) celebrated Speech Therapy Day by reaching out to the community. As part of the outreach programme, they collaborated with four eldercare services – St Luke’s Eldercare at Tampines, PCF Sparkle Care at Changi Simei, Aspiration Elderly Lodge, and Foo Hai Elderly Lodge. The therapists conducted activities to raise awareness about communication and swallowing difficulties in the local community. Besides sharing some safe-feeding precautions, they also equipped staff and caregivers with strategies to enhance communication, and suggested some activities to increase engagement of residents.

For more information on CGH speech therapy services, please email Ask_a_therapist@cgh.com.sg

1 6 J A N – F E B 2 01 7 C A R I N G

EHA and SUTD strengthen partnership with new MOUThe two institutions will continue to focus on medical innovations and promoting talent development in healthcare engineering

Text by Cherry Lui

Dr Lee Chien Earn, Group CEO of EHA (left), with Professor Chong Tow Chong, Provost of SUTD

The Eastern Health Alliance (EHA) and Singapore University of Technology and Design (SUTD) renewed their

strategic alliance through a Memorandum of Understanding (MOU). It aims to develop solutions for better healthcare, nurture future generations of healthcare engineers, and cultivate healthcare innovation in Singapore.

The five-year MOU builds on a partnership that began in 2013 with a three-year MOU, which tapped on the symbiotic relationship between health institutions and academia. The partnership targets to develop innovative patient-care solutions to current healthcare challenges, and provide SUTD students with exposure to the growing field of healthcare

engineering. Under the first MOU, EHA and SUTD funded 13 projects (see facing page) worth S$2.2 million, S$1.2 million more than the initial grant under the HealthTech Innovation Fund.

At the official signing of the new MOU held at SUTD, Group CEO of EHA, Dr Lee Chien Earn said, “We are delighted to extend our collaboration with SUTD to realise patient-centric solutions and develop breakthrough medical technologies. With the renewed partnership, we will continue to share our healthcare expertise and tap on SUTD’s design and technical capabilities to drive medical innovations that promote recovery and enable excellence in clinical care.”

WHAT'S NEW

EHA and SUTD strengthen partnership with new MOU

C A R I N G J A N – F E B 2 0 1 7 1 7

EDUCATION A KEY FOCUS UNDER NEW MOUThe partnership also seeks to advance research, innovation and education. There will be a special focus on the latter to encourage more SUTD students to specialise in healthcare engineering, a growing multi-disciplinary field.

Professor Chong Tow Chong, Provost of SUTD, said, “Demand for healthcare engineers and architects is anticipated to grow as Singapore’s population ages, requiring more sophisticated medical equipment and procedures, and fresh thinking about health facilities and cost-effective care delivery.”

“SUTD aims to offer engineers and architects the best education to address these challenges, while partnering EHA and CGH to provide them with real-world experience. This combination will be essential for training technically grounded leaders and engineers who will be able to help enhance the healthcare landscape through technology and design. I hope that our partnership will lead to significant medical and healthcare breakthroughs that will benefit the community,” Professor Chong added.

To promote talent development in that sector, EHA and SUTD will co-develop new modules, which will provide students from the Engineering Product Development pillar with an overview of Singapore’s healthcare landscape and innovation opportunities in healthcare engineering. The module is designed to nurture the next generation of healthcare engineers who will be equipped with a robust understanding of healthcare and basic principles of medicine.

SUTD students will work alongside industry professionals and researchers to gain valuable clinical and industry insights. They will immerse themselves within clinical environments, and observe procedures and medical devices to discover unmet clinical needs. Students will then work on transforming their ideas to solve these needs into feasible medical devices, which can be commercialised and deployed in clinical environments.

SUTD student representatives (from left) Chin Joon Keat, Joanne Tan Huishan, Ching Tsz Him

The partnership also seeks to advance research, innovation and education

PATENTED INNOVATIONS

Under the first MOU, three patents have been filed from internships, capstone projects and proposals funded by the HealthTech Innovation Fund.

Body Fluid Drainage Device It automates the process of draining abnormal collections of fluid from body cavities. As it allows pre-selection of volume and rate, it minimises human intervention and enhances safety and efficiency through precise measurements. It is also designed for comfort and mobility, and can be used in both inpatient and outpatient settings.

Lung Simulation Model for Education This device simulates lung contractions and breathing movements to train medical personnel. By providing a realistic representation of the human lung, it prevents reliance on static models, mannequins and animal lungs for training to improve outcomes and enhance clinical skills.

BWard Real-time Blood Sensing and Wound Monitoring Device A sensing, monitoring and alerting device, BWard detects active re-bleeding at the site of extraction. It differentiates blood from other body fluids and provides continuous monitoring for bleeding in patients who have undergone surgery or experienced traumatic injury. It can also be used to monitor bleeding or disconnected tubing during hemodialysis. The use of BWard streamlines the process of regular inspection and allows medical staff to attend to more urgent medical needs.

1 8 J A N – F E B 2 01 7 C A R I N G

PSYCHOLOGICAL RESILIENCE FOR BUSINESSESIntroducing Stay Prepared – B-PREP, a programme that aims to help employees deal with the psychological impact of crises and emergencies

Text by Ooh Yi Hui

1. BE POSITIVE Train your brain to look out for good things. Think about positive events in your daily life.

2. EXERCISEDo stretches, walk around or climb the stairs in between tasks to boost your mood and prevent aches and pains.

3. APPRECIATEHelp another person to feel better. Text, email or write a thank-you note to someone who did something nice for you.

4. RELAXFocus on taking slow, deep breaths. Tasks are more manageable when your brain thinks you are calm and at ease.

HOW TO OVERCOME

ADVERSITIES AT WORK

1 8 J A N – F E B 2 01 7 C A R I N G

While the importance of personal mental health is well understood, less recognition is given to the need

for organisations to be prepared for traumatic incidents in the workplace. Employees are susceptible to psychological and emotional trauma when large-scale disasters or accidents occur.

To establish a model for psychological resilience and enable companies in Singapore to manage the psychological and emotional impact of emergencies, threats and crises, the Stay Prepared – Business Psychological Resilience Programme (B-PREP) is created. Temasek Foundation Cares established this pilot programme in partnership with Changi General Hospital (CGH) and the Singapore Business Federation.

It was officially launched on 7 September 2016 in a ceremony attended by Mr K Shanmugam, Minister for Home Affairs and Minister for Law. “We need our workplaces to be areas where people are alert, they are able to be trained and they understand. It’s not just preventing, being alert or responding. We may not always be able to prevent an attack, but what we certainly can do is how we respond the day after the attack,” he said about the threat of terrorism.

Funded by the Temasek Emergency Preparedness Fund, Stay Prepared – B-PREP aims to help employees develop core skills and competencies to manage and respond to emotionally stressful situations. A B-PREP Steering Committee comprising 14 partners and chaired by Temasek Foundation Cares Board Member Mr Koo Tsai Kee was set up to drive the initiative forward.

B-PREP will be rolled out in three phases. The CGH team from Trauma Recovery and Corporate Solutions (TRaCS) will conduct a baseline study and consultation on the psychological crisis support readiness of

Temasek and nine of its portfolio companies. Through the baseline study, a guiding framework for building organisational psychological resilience will be developed by the TRaCS team and made available through the Singapore Business Federation for adoption by the local business community at large.

“Businesses will learn to implement appropriate processes for coordinated response, and share their knowledge and best practices with one another. We see B-PREP contributing to the government’s important programmes in this area, such as SGSecure and Total Defence,” said Mr Lim Boon Heng, chairman of Temasek.

Dr Lee Chien Earn, CEO of CGH, shared: “We believe in the importance of a supportive work environment to enable employees to give their best. Programmes such as B-PREP foster a culture of mutual care and concern – ‘heartware’ that enables employees to find joy and meaning at home, at work and in the community. We are privileged to be able to tap on our experiences in building corporate resilience to support Temasek Foundation Cares in the delivery of B-PREP.”

A HEALTHY START TO THE YEAR OF THE ROOSTER

REMEMBER "88888" FOR GOOD HEALTH

BURN 500KCAL* OF FOOD WITH THESE ACTIVITIES PREPARE A HEALTHIER YU SHENG

Text by Cherry Lui and Ng Ming Chuen

Physical activity Duration

Male (75kg) Female (55kg)

Cycling (21km/h) 50 minutes 1 hour 10 minutes

Jogging (9.6km/h) 1 hour 1 hour 20 minutes

Ballroom dancing 1 hour 15 minutes 2 hours

Simple household chores

1 hour 40 minutes

2 hours 40 minutes

Walking (3.2km/h) 1 hour 50 minutes 2 hours 35 minutes

Stop eating when you are approximately

80% full

Get 8 hours

of sleep

Have dinner before

8pm

Walk at least

8,000 steps a day

Drink

8 glasses of water a day

According to the Health Promotion Board, yu sheng can be high in calories because of the oil, plum sauce and the deep-fried crisps used. Here’s how you can serve a less sinful version of this dish:

• Use less oil to significantly reduce the calories.

• Use less plum sauce and pickles because these are highly sweetened.

• Add more fresh vegetables. *Estimated value. Reference: Ainsworth, B.E., Haskell, W.L., Whitt, M.C.,et.al. 2000. Compendium of physical activities; an update of activity codes and MET intensities. Med. Sci. Sports Exerc., 32(9) S498-S516.

With the holiday feasting, you can easily gain 0.5kg to 1kg of weight with an additional 500kcal of food intake daily for a week. Festive foods that contain 500kcal include one serving of yu sheng, two slices of bak kwa, three pieces of fried nian gao (glutinous rice cake), four slices of kueh lapis (spiced layered cake), or five pineapple tarts.

If you are worried about unwanted calories, follow the tips below:

Celebrating Chinese New Year is all about symbolism and tradition, from the fireworks on the first night of festivities

that aim to ward off evil spirits, to the “red packets” signifying good fortune and prosperity. The eve of Chinese New Year is also a time for family members to get together for a meal, and there are traditional foods, such as yu sheng (raw fish salad) and bak kwa (barbecued meat), that are eaten during this period.

Exercise more, practise mindful eating, and other tips for the festive season

C A R I N G J A N – F E B 2 0 1 7 1 9

WHAT'S NEW

2 0 J A N – F E B 2 01 7 C A R I N G

Besides erectile dysfunction, here’s how testosterone deficiency affects your body and well-being

TESTOSTERONE-DEFICIENT?

Text by Jean Angus

ARE YOU

C A R I N G J A N – F E B 2 0 1 7 2 1

• Weak or no morning erection• Difficulty achieving orgasm• Feeling down or depressed• Tiredness• Loss of concentration• Hot flushes and sweats• Weight gain• Development of male breasts• Loss of muscle and strength• Loss of body hair

DIAGNOSIS AND TREATMENT TDS can be confirmed through various tests,

including a blood test that measures the amount of testosterone and other

hormones affecting testosterone levels in the blood. The tests are usually performed in the morning when testosterone levels are at their highest. Your doctor may also ask you to complete a detailed questionnaire that will help in assessing symptoms of TDS, and perform tests to rule out other conditions such as prostate cancer.

Several treatment options are available for men with TDS.

These include testosterone gel or oral capsules, or intramuscular

injections of testosterone. Your doctor will recommend the most suitable form of treatment for you.

You can also make lifestyle changes to boost testosterone levels. Get enough sleep and maintain a healthy weight. Regular physical activity sends out testosterone-boosting signals to the brain, so exercise regularly. Consciously reduce stress in your life to enhance your body’s ability to release testosterone. Following these simple steps can also lead to improvements in your overall health.

FEATURE

Walk into any health store today and you will find a wide variety of herbal supplements for men. From

tongkat ali root to royal jelly (from honey bees) and pine bark extract, there are plenty of off-the-shelf options for men who would like to boost their testosterone levels.

It can be tempting to try supplements if you think you have a problem with sexual function, especially if you are a man approaching middle age. However, not all of these supplements are scientifically proven and improper use may cause unpleasant side effects. It is important to address the probable cause of the issue – testosterone deficiency.

Testosterone is an important sex hormone produced naturally by the testicles. It is necessary to maintain men’s reproductive health, muscle mass and strength, energy and general sense of well-being. While it is normal for testosterone levels to decline as a man ages, some men may experience testosterone deficiency syndrome (TDS), in which hormone levels drop so low that it has noticeable impact on their health. Risk factors for TDS include obesity, Type 2 diabetes, high blood pressure, and heart disease – all of which are rising in Singapore.

“About one in four men aged 45 and older here suffer from some form of testosterone deficiency. However, many do not suspect that they have a problem until they face difficulty in getting or maintaining an erection or have weak erections. While these are the symptoms men perceive to have the greatest impact on their quality of life, they should be aware of other symptoms of testosterone deficiency and seek help early for this highly treatable condition,” said Dr Ng Foo Cheong, Senior Consultant and Chief of Urology at Changi General Hospital.

WHAT ARE THE SYMPTOMS? Seek medical advice if you are experiencing: • Difficulty in getting or maintaining

an erection

Testosterone is necessary to maintain men’s reproductive health, muscle mass and strength

2 2 J A N – F E B 2 01 7 C A R I N G

In January 2014, Eastern Health Alliance (EHA) launched the GPFirst programme to encourage patients in eastern Singapore to

see their general practitioners (GPs) for mild to moderate medical conditions rather than head to the emergency department first. In this regular series, our EHA community GPs offer advice on common ailments Caring readers might face.

Visit www.gpfirst.sg or see your GP for more information on common conditions such as cuts, bruises, mild scalds, nausea, headaches, sprains and fevers. Read on to learn more about migraine and food allergies.

YOUR GPs CAN TREAT THESE CONDITIONS

MIGRAINEQuestion: I am in my early 40s and I work as a sales representative for a pharmaceutical company. I often travel from clinic to clinic, and lately I’ve been having frequent headaches, especially in the afternoon and after long hours out in the sun. I often get an intense pounding pain on one side of my head and sometimes experience pain near my eyes. I had a headache with blurred vision and vomited twice yesterday while I was on my way home. Should I head to the A&E for frequent severe headaches like this?

Answer: It sounds like you suffer from migraine, which has two main types: migraine with an aura (a warning sign that occurs before the headache), also known as classic migraine, and migraine without an aura, also known as common migraine.

People who suffer from migraine usually develop a one-sided headache that is pulsating in nature. The pain can be moderate to severe in intensity. It is most commonly present with nausea and/or vomiting. Usually, the headache worsens gradually and can last between four and 72 hours. People with

migraine tend to avoid bright light or loud noises, and find solace in a quiet and dark room.

Those with classic migraine experience the aforementioned symptoms with the addition of an aura, which can be visual (e.g. flashes of light), a sensation (e.g. a feeling of “pins and needles” down the limb) or affect speech (e.g. inability to speak). An aura can last up to 60 minutes and the headache follows within an hour. However, some patients may experience an aura without a headache.

A GP will be able to diagnose migraine based on your medical history. He would usually advise remedies such as proper rest in a dark and quiet room. Use of painkillers can sometimes help to further alleviate the headache. If vomiting or nausea is the main issue, the GP usually recommends anti-nausea medication, which can be given orally or through injection (if needed). He may also prescribe medication to prevent migraine if it is deemed regular enough to be disruptive to the patient’s lifestyle and well-being.

Most of the time, migraine is triggered by:• Foods such as chocolate, oranges, tomatoes

or cheese• Bright light or excessive noise, strong odour or

extreme weather• Emotional or physical stress, exercise/physical

exhaustion or oversleeping• Contraceptive pills, monosodium glutamate

(MSG) • Menstruation, hunger, or physiological effects

of shift workDr Tan Shi Ching is a family physician practising at Raffles Medical Group (Tampines 1 and Changi City Point). He received his MBChB from the University of Manchester and Diploma in Family Medicine (GDFM) from Singapore. He is currently the Physician Leader of RMG’s Tampines cluster and in the midst of pursuing a Master of Medicine in Family Medicine.

C A R I N G J A N – F E B 2 0 1 7 2 3

FOOD ALLERGIES Question: I am a 30-year-old male who enjoys good food. I went for a buffet dinner yesterday and helped myself to a few servings of seafood, including fresh oysters, clams, mussels and snow crabs. I was about to head home when I felt cramps in my stomach, accompanied by slight nausea and swelling around my upper lip. I did recall episodes of mild reactions after consuming seafood on two previous occasions, but they were nothing serious because the symptoms went away shortly. When I reached home, the cramp worsened. There was a tingling sensation on my tongue and there was swelling around my left eye. Rashes also started to develop on my body. I applied some anti-itch cream (which helped a little) and fell asleep. Fortunately, I felt better the next morning, but the swelling around my eye remained. I am unsure which seafood I am specifically allergic to, and wonder why the symptoms are more severe this time around. What should I do if this happens again? When should I visit the A&E?

Answer: It is likely that you have shellfish allergy, in which your body has allergic reactions to crustaceans (such as prawns, crabs and lobster)

and/or mollusks (such as clams, mussels, oysters and scallops). It is advisable to avoid all of the aforementioned seafood unless advised by your doctor, as most people have allergies to both groups. Your immune system ʽremembersʼ the food and reacts more vigorously with repeated exposure.

Food allergy is caused by the bodyʼs immune system overreacting to the protein in the food consumed. Recent studies revealed that Singaporeans are mostly allergic to (in decreasing order) shellfish, egg, cow’s milk, peanut, tree nuts and fish.

A GP can treat most mild food allergy by prescribing antihistamines or bronchodilator (medication that relaxes lung muscles), while injectable epinephrine could be used for more severe cases. Self-injectable epinephrine pens may be prescribed by your GP, while oral steroids may be used as supplementary therapy to maximise the effectiveness of the treatment.

You have severe food allergy if you experience two or more of these symptoms:• Respiratory symptoms such as difficulty

breathing, stridor or wheezing• Fainting spells, giddiness or incontinence (signs

of low-blood pressure). Note: It is considered a severe allergy if you experience low-blood pressure even without other symptoms after consuming food you are allergic to.

• Rashes, swelling of the lip, tongue or throat• Persistent abdominal pain or vomiting

If you have been diagnosed with food allergy, it is important to carefully read the labels of the food you purchase, consume or eat. It is also advisable to understand the ingredients in the dishes you would like to order and ask how the food is prepared when eating out. If you have severe food allergy, it is recommended that you also carry an epinephrine pen with you (be sure to check its expiry date upon use). Should you experience severe allergic reactions, it is advisable to call 995 immediately.

Dr Ang Kai Kok

Migraine-sufferers are usually able to identify what their triggers are and avoiding them tends to prevent an attack. It is recommended to keep a headache diary to help identify the trigger factor if you are unsure.

Visit your GP if you are unwell and experiencing symptoms listed below so that he can assess your condition and determine whether a referral to the A&E is required for further investigation:• Sudden and severe headache• Disturbed consciousness• Neurological signs such as unilateral weakness

of limb or slurring of speech• Headache triggered by cough or exertion or

while engaged in sexual activity• Neck stiffness• Fever• If you are experiencing headaches and you are

above 50 years old, immunocompromised, or suffering from cancer

Dr Tan Shi Ching

FEATUREMY GP ANSWERS

Dr Ang Kai Kok is a general practitioner at Zenith Medical Clinic in Punggol (punggolgp.com). He received his MBBS in Singapore. He advocates medical practices based on good scientific evidence.

24 J A N – F E B 2 0 1 7 C A R I N G

HEALTHY EATS

Warm and crusty, this hearty bread with zesty sauce makes a great quick and simple meal

PREPARATION TIME MAKES 3 hours 2 loaves

WHAT YOU’LL NEEDFocaccia Bread flour (300g/11 oz) Instant yeast (1 ½ tsp) Salt (1 tsp)Chilli flakes (2 tsp)Black and white sesame seeds (1 tbsp) Low-fat milk (150ml/5 fl oz/ cup)Olive oil (2 tbsp)Prawns/shrimps (85g/3 oz, peeled and diced)Crabmeat (30g/1 oz) Squid (40g/1 ¼ oz), cleaned and diced)Spring onions/scallions (10g/ oz, diced)

Salsa Tomatoes (2 medium, seeded and diced)Avocados (¼ peeled, pitted and cut into small cubes)Coriander/cilantro leaves (1 sprig, chopped)Garlic (2 cloves, peeled and chopped)White wine vinegar (2 tbsp)Salt (a pinch)Lemon juice (1 tsp)Olive oil (2 tbsp)Onion (¼, peeled and diced)Black peppercorns (1 tbsp, finely crushed)Red chilli (½, seeded and chopped)Fish curry powder (1 tsp)

METHODPrepare salsa. Combine salsa ingredients in a bowl and mix well. Cover and refrigerate for at least two hours. Meanwhile, sift flour, yeast and salt into mixing bowl. Add chilli flakes and sesame seeds, and stir to mix well, then add milk and olive oil. Knead until a smooth, soft dough is formed. Add prawns, crabmeat, squid and spring onions to dough and mix well. Leave dough to rest for 20 minutes at room temperature. Preheat oven to 210°C (410°F). Roll out the dough to 0.5cm (¼in) thickness. Leave to rest for another 20 minutes at room temperature. Bake for 12 minutes, or until focaccia is golden brown and crusty. Remove from heat and set aside to cool before slicing into desired portions. Serve warm, with salsa on the side.

NUTRITIONAL INFO (PER SLICE)Calories 70 kcalCarbohydrates 8.4gFat 2.8gCholesterol 15.7mgFibre 0.5g

This recipe was first published in A Cookbook for Diabetics by a Dietitian and a Chef, which is now available at all major bookstores

SEAFOOD FOCACCIA WITH SPICY SALSA

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FEATURE保健小笔记

C A R I N G J A N – F E B 2 0 1 7 2 7

散发自信美助您重获

美肤

2 8 J A N – F E B 2 01 7 C A R I N G

拥有完美肌肤的秘诀是什么？有些人很幸运，能够拥有与生俱来的好皮

肤，而这在某程度上是因为遗传所致。但

是，大多数的人都会在某个年龄阶段碰到皮

肤问题，如痤疮、湿疹、银屑病等。有些人

也会因毛孔粗大而感到困扰，但其实毛孔的

大小早已由基因所决定。毛孔是皮肤的一个

基本组成部分，而随着逐渐老化，肌肤会因

胶原蛋白的流失而失去支撑，以致毛孔变得

更明显。

在结束忙碌的一天后清洗肌肤，有助去除

所累积在肌肤上的化妆品、污垢、灰尘、汗

液和细菌。这些杂质会阻塞您的毛孔而使其

看起来更大，肌肤也会开始出现黑头，甚至

痤疮。您可使用温性洗面乳，因为刺激性的

洗面乳会去掉皮肤的天然水分而使其变得干

燥。您也需注意不要过度清洗，以避免原有

的皮肤问题变得更严重。每天在大量出汗后

清洗脸部两次就已足够。

您也应在完成洁净的步骤后涂抹润肤霜，

以补充在清洗时皮肤所流失的水分。请选用

一个适合您肤质的润肤霜。有敏感肌肤问题

的朋友最好是使用不含香精的护肤品。

人们在护肤上最常忽略的是什么？保护皮肤不受到阳光伤害和防晒霜的使用。

选用广谱性防晒霜能够保护您的皮肤不受到

原文 Cherry Lui

樟宜综合医院皮肤科主任ReginaLim医生分享常见的皮肤问题及如何有效应对

FEATURE保健小笔记

C A R I N G J A N – F E B 2 0 1 7 2 9

皮肤如何随着年龄的增长而变化

20岁痤疮与脂溢性皮炎（也就是头皮屑）是这个年龄层的常见皮肤问题。

30岁由于暴露在阳光下而造成的光伤害或许会在这个阶段开始出现。一定要在年轻时养成使用防晒霜的习惯，这样能把紫外线对皮肤所带来的伤害减到最低。使用温和的护肤品以避免引起

刺激性反应。

40岁皮肤会出现更多光衰老的迹象，皮肤也可能开始变得松弛，而细纹也会逐渐出现。

50岁更年期的到来导致荷尔蒙失调，使得皮肤变得更干燥。此外，细纹也开

始加深。

皮肤外在的老化则因人而异，这个和他们接触阳光的程度、皮肤类型和其他环境因素如吸烟和饮食等息息相关

3 0 J A N – F E B 2 01 7 C A R I N G

FEATURE保健小笔记

UVA和UVB紫外线的伤害。UVA紫外线会

损害皮肤里的胶原蛋白及弹性蛋白，从而

导致皱纹提早出现。UVB紫外线则导致皮

肤晒伤和对其DNA造成伤害。UVA和UVB

紫外线两者都与皮肤癌有密切的关系。您必

须在接触到阳光前的至少20分钟涂上防晒

霜，并在之后每两小时涂抹一次；在游泳、

大量出汗或用毛巾擦干身体后还要涂的更频

密一些。有敏感性皮肤的朋友可考虑使用含

有二氧化钛（titaniumdioxide）或氧化

锌（zincoxide）的防晒霜。

男性和女性的皮肤有什么差别，而他们是不是应该有不同的护肤流程呢？男性荷尔蒙不仅使男士们产生更多的脸部

毛发，它也会使其皮肤厚度较女性的高出

20％。男性的胶原蛋白密度不但较女性

高，且生产的皮脂量也高出女性四倍。

因此，他们的皮肤较容易患上痤疮和毛孔

阻塞的问题。

男性因此应多注意彻底清洗脸部，以除

掉多余的油脂，这样才能避免杂质阻塞皮肤

毛孔。男性也要注意护肤，不要过度暴晒，

因为这样会使皮肤老化的更快，且增加患上

皮肤癌的风险。

新加坡人常见的皮肤问题有哪些？您有什么秘诀来应对这些问题？在我的病人中，有很多都患有湿疹问题。

这是一个很常见的皮肤问题，不仅是在本

地，世界各地也有很多人被此问题所困扰。

它主要是因为遗传基因及环境因素所引发。

我们虽然无法改变我们的基因结构，但我们

可针对环境条件而做出调整。湿疹患者的皮

肤一般较干燥，因此应每天使用润肤霜。我

通常会建议患者在洗完澡后每天涂抹润肤霜

至少两次。一般上，湿疹患者的皮肤会在气

温上升或感到压力时变得很痒，因此避免碰

到这些情况将有效避免痕痒发作。他们也应

避免直接接触洗洁剂和含有刺激性化学物质

的东西，并且在使用这些产品时戴上防

护手套。那些手部有湿疹的患者应在每

次洗完手后涂抹润手霜。不含香精和辅

料的产品较适合湿疹患者使用。换成较

温和配方的洁净剂也有助避免皮肤受到

刺激。

随着肌肤逐渐老化，它们会起怎样的变化呢？皮肤的内在和外在都会随着年龄的增长而

老化。皮肤内在的老化是我们每个人都会经

历的。皮肤会变得松弛及失去弹性，细纹

和皱纹也会开始产生。此外，皮肤也会变更

薄、更干燥。皮肤底层的脂肪和结缔组织会

减少，使脸颊和眼窝显得更凸，从而使人看

起来更老。皮肤外在的老化则因人而异，

这个和他们接触阳光的程度、皮肤类型和其

他环境因素如吸烟和饮食等息息相关。及早

戒烟、保持健康均衡的饮食及获得充足的睡

眠，将有助肌肤看起来永远年轻。

阳光对皮肤所带来的伤害如晒斑和蜘蛛

状血管会使皮肤出现斑点。若您曾大量暴晒

的话，您可能会拥有粗糙的皮肤且出现很深

的皱纹。

如果我的皮肤已被阳光晒坏了，还能补救吗？想要认真照顾好您的皮肤永远都不嫌晚。保

护皮肤不受阳光伤害是非常重要的，还要定

期使用润肤霜和防晒霜。您也可在皮肤医生

的指导下，谨慎进行局部治疗如使用内甲酸

膏及氢醌膏。它们有助减少皮肤色素的沉

淀及在某程度上对阳光所造成的伤害进行修

复。其它治疗法还包括激光护理，它不但能

改善皮肤色素，还能改善其皮肤的质感和外

观。但这些治疗法的费用都相当昂贵，并可

产生副作用。患者因此应慎重考虑这些美容

外科治疗法的利与弊后才做决定。我们也要

清楚明白这些治疗法只能起一定程度上的作

用，而并不能让岁月倒流，因此也不应抱以

太高的期望。

C A R I N G J A N – F E B 2 0 1 7 3 1

与樟宜综合医院乳房中心主任一同探讨乳癌的迷思与论据

您认识 癌症吗？

原文: Cherry Lui

封面故事

3 2 J A N – F E B 2 01 7 C A R I N G

在全球，癌症是死亡的首要导因之一，而根据新加

坡防癌协会的数据，本地每天被诊断出患癌的人

数约有37人。

虽然并非所有癌症都会致命，但要诊断癌症并不是件

容易的事。这是因为不是所有癌症在初期阶段都会出现症状

或征兆，而多数癌症是到了晚期才出现征兆的。然而，随着

近年来医药领域的发展及人们对其症状、征兆及及早接受治

疗的意识有所提升，因而改善了存活率的可能性。

与乳癌的搏斗 乳癌是目前导致女性死亡的第二号杀手。根据全国癌症中心的数据，本地每16名女性中便有1人在活到80岁前患上乳癌，其终身患病风险为6.5％。患病率估计将随着平均寿命的延长和人口老化而提高。乳癌在初期阶段通常不会

呈现出任何明显症状。对乳癌症状有所认知将有助及早发现这个病症。当肿瘤日渐成长时，患者可能会注意到乳房有硬块、乳房周围的皮肤与乳头发生变化、疼痛淋巴腺扩大。定期做身

体检查可及早发现乳癌，并且大大提高治疗的成效。Nancy Tan女士（非真实姓名）就是一名乳癌幸存者。活泼的Nancy现年67岁，并在去

年4月被诊断出患上乳癌。突如其来的噩耗使她措手不及，因为她完全没有察觉到任何症状或疼痛。她之所以

能够保住性命，是因为她在做乳房X光检查时及早发现了症状。她在获得确诊后便抓紧时间做了

双乳房切除手术。要应对癌症所带来的生理和心理压力确实是项挑战，但她的家人与朋友给予了她极大的支持。Nancy算是一个幸运儿，因为她

及时发现癌症，因此她的治疗方法基本上只需一次手术，之后便无需其它跟进的治疗了。

对于那些正在与癌症搏斗的患者，她直称：“千万不要放弃，因为当你还怀着希望时，你其实就已经成功一半了。

被确诊患癌并不等于生命就此走到

尽头。如果你发现自己开始出现负面想法，切记不

要一直去想它。对我而言，我现在所面对的困难就是不知道未来会如何。我现在没有答案，但我会走一步算一步，一天天设法克服它。”

您知道每年的2月4日被定为世界癌症日，主要是为提高人们对这个病症的认知与意识。今年世界癌症日的主题为“我们能，我能”，标志着一个正面、积极的态度来对抗癌症，并且体现各种癌症都有其应对方法。

C A R I N G J A N – F E B 2 0 1 7 3 3

乳癌：迷思与论据

1有线胸罩、止汗剂及爽身粉会导致乳癌。

至今并没有任何科学研究证明这些会导致乳癌。乳癌

的形成通常是因复杂且多元的因素相互影响所引发。这些因

素可能来自遗传、免疫系统、激素波动、环境污染、不适当

的生活作息等。

2经常进行乳房X光检查可防止乳癌形成。

照X光并不会防止乳癌形成。X光是用于侦测早期可

治疗乳癌的工具，并不能防止乳癌形成。

封面故事

3乳房X 光的结果若是正常就代表不会患上乳癌。

虽然X光是目前最有效的乳癌侦测工具，但它却无法

发现所有的乳癌。那是因为乳癌可能隐藏在一般的乳房细

胞组织中，尤其是当癌细胞体积细小或是在乳房细胞组织

较密集的年轻女性身上。某些癌细胞无法通过X光侦测，而

某些情况也可能需要进行超音波或是MRI扫描。医生会适

当判断并给予意见。

4有机食品可预防乳癌。

有机食品日渐盛行。但有机蔬果对于预防乳癌的功

效却有待更多研究证实。通过普通方法种植的蔬果所用的

化学物是受到政府组织如卫生科学局及新加坡农粮局所管

制，因此一般皆可安全食用。

5乳房内的硬块若无疼痛就不是乳癌。

根据樟宜综合医院乳房中心所进行的调查，在1,000名受

访女性中，有52%认为乳房肿瘤仅有导致疼痛时，才是乳癌。但

其实，大多数的乳癌硬块皆不会导致疼痛，尤其是在初期阶段。

千万别不理会任何乳房硬块，无论大小或有无疼痛，因为提早发

现与治疗有助取得最佳结果。

有半数受访的女性也认为，切除整个乳房是乳癌的唯一治疗

方法。事实并非如此。若能及早发现乳癌，患者仅需接受手术就

能获得治疗；某些情况，接受乳房肿瘤切除手术即可，而无需接

受化疗。这项调查结果被刊登在《新加坡医疗期刊》里。

3 4 J A N – F E B 2 01 7 C A R I N G

请说说您做为一名乳房外科医生的工作范围 做为乳房外科医生，我得兼任癌症外科医生、修复重建外科医生和心理医生的多种角色。被诊断患上乳癌是一件使病人身心受到极大压力的事。大多数女性患者会接受手术，从而影响其一边或两边乳房的形状，同时还会留下疤痕。这些生理上的变化会影

响她们的自尊心，以及她们和其他人相处的方式，尤其是其亲朋好友。

樟宜综合医院的乳房中心有什么 特色？ 樟宜综合医院乳房中心提供一站式的综合性乳房医疗服务，它具备检验、诊断和治疗所有乳房疾病的能力。位于新加

坡樟宜综合医院内的乳房中心设备齐全，并且拥有专门的医生、护士与综合保健医护人员、病房、手术室和放射室，以及先进的科技和配备。它也是新加坡首家使用超声波弹性成像来评估乳房病变的医疗中心。这种成像技术能给医生提供更多信息，让其评估病人是否须做活组织检查。

封面故事

“健康的光辉”座谈会

您的健康在不同的人生阶段将有不同的需要。让我们的专业人士为您讲解如何在任何年龄皆可容光焕发。发现通过简单步骤增进整体健康，保持弹性肌肤与健美身材。您也有机会学习有关乳房与整体健康的保健知识。准备好迎接健康

快乐的20、40、与60岁人生吗？快约您的姐妹一同出席吧！时间：2017年3月11日（星期六）时间：上午9点至11点地点：樟宜综合医院培训中心，1层礼堂

请将您的登记详情（姓名、联络电话号码和参与人数）电邮到public_forum@cgh.com.sg或致电64267271。电话开放时间为周一至五上午9点至傍晚6点（中午12点至下午两点除外）。入场免费。

90秒问答访谈...樟宜综合医院乳房中心高级顾问医生陈愫明博士

乳房中心的工作团队（左起）：Lee Wai Peng医生、陈愫明博士、Andrew Clayon Lee医生、Jaime Seah Chin Mui医生

想要健康生活，切记实行“88888”

若想要消耗约500卡路里的话，您可做以下活动 “捞”出健康

原文：Cherry Lui and Ng Ming Chuen

体力活动

需花时间

男性(75公斤) 女性(55公斤)

骑脚车(每小时21公里) 50分钟 1小时10分钟

跑步(每小时9.6公里) 1小时 1小时20分钟

跳社交舞 1小时15分钟 2小时

做简单的家务 1小时40分钟 2小时40分钟

步行(每小时3.2公里) 1小时50分钟 2小时35分钟

吃到约8分饱 就别再吃了

获得8小 时睡眠

在晚上8点 前吃晚餐

每天步行最少8,000步

每天喝 8杯水

根据保健促进局，鱼生的卡路里含量也相当高，主要是因加入了油、酸梅酱和油炸脆饼。以下教您较健康的鱼生做法，让您高枕无忧地吃出好滋味。

• 少放点油，可大量减少鱼生 的卡路里含量

• 少酱少腌菜，可减少糖分含量

• 多点新鲜蔬菜

资料来源:Ainsworth,B.E. ,Haskell ,W.L . ,Whit t ,M.C.,et .al .2000.Compendiumofphysicalactivit ies;anupdateofactivitycodesandMETintensit ies.Med.Sci .SportsExerc. ,32(9)S498-S516.

多运动、饮食多注重，新一年教您如何保持健康体魄

C A R I N G J A N – F E B 2 0 1 7 3 5

健康自在迎鸡年

农历新年是一个深具意义且富有特色的传统节日，从除夕夜放烟花烟火驱妖魔，到发送象征吉祥如意的红包皆是

过年不可或缺的习俗，当然更少不了新年期间让人垂涎三尺的美味佳肴。年除夕是一家大小与亲朋戚友齐聚一堂共

进年夜饭的日子，而饭桌上通常都会摆满各式

各样的佳肴。一个人若在一个星期内每天多摄取500卡路里的话，其体重将会增加0.5公斤到1公斤不等。含有500卡路里的食物就包括1份鱼生、两片肉干、3片年糕、4片印尼千层糕或5块黄梨酥。

新鲜事

3 6 J A N – F E B 2 01 7 C A R I N G

东部医疗联盟与新科大签署谅解备忘录加强合作关系两家机构将着重于促进医疗创新与培养保健护理工程人才

原文：Cherry Lui

东部医疗联盟集团行政总裁李建恩医生与新加坡科技设计大学教务长张道昌教授 东部医疗联盟与新加坡科技设计大

学今天签署一份谅解备忘录，重新确认其策略性联盟，旨在研发出更

好的保健护理方案、培育下一代保健护理工程师，及在本地营造可促进保健护理创新的环境。这份为期5年的谅解备忘录以两家机构

于2013年所签署为期3年的谅解备忘录为基础，目的是通过医疗机构与学术机构的共生关系来研发创新的病人护理方案以便应对

当前的保健护理挑战。同时，这项合作也能让新科大的学生接触到日渐扩大的保健护理工程领域。在第一份谅解备忘录签署后的期间里，东部医疗联盟和新科大资助了13项总值高达220万新元的项目，与原先保健科技创新基金（HealthTechInnovationFund）所拨款的100万新元相比高出120万新元。在新科大举办的备忘录签署仪式上，

东部医疗联盟集团行政总裁李建恩医生

C A R I N G J A N – F E B 2 0 1 7 3 7

新鲜事

新科大学生代表（左起）：Chin Joon Keat、Joanne Tan Huishan、Ching Tsz Him

表示：“我们非常高兴能延续与新科大的合作，实现以病人为本的医疗护理方案，并且研发具突破性的医疗科技。有了这项更新后的合作伙伴关系，我们将继续分享我们在保健护理方面的专业知识，并借助新科大在设计和科技方面的才能来推动医疗创新，提高病人康复率及使临床护理更加精益求精。”

教育是新备忘录的关注重点 这项合作伙伴关系也旨在推广研究、创新及教育，并对后者尤其重视，为的是鼓励新科大的学生专修保健护理工程学。这是一个日渐扩大的多学科领域。新科大教务长张道昌教授说：“保健护

理工程师和建筑师的市场需求预计将随着新加坡人口老化而提高，人口老化需要更高端的医疗器材和流程，以及对医疗设备的全新构思和更具经济效益的护理流程。”“新科大旨在为工程师和建筑师提供最

好的教育以应对这些挑战。通过与东部医疗联盟和樟宜综合医院合作将能够让他们获得实践经验。这样的结合将能够确保我们

培育出具备扎实科技基础的领导者和工程师。他们能够运用科技和设计来改善保健护理蓝图，从而让世界变得更美好。我希望我们的合作伙伴关系能在医疗和保健护理方面取得重大突破，让更多人受益。”张教授补充道。为了促进这个领域的人才培养，东部医

疗联盟和新科大将联手设计新的教学单元，为修读工程产品研发的学生提供一个更立体的框架，让他们了解有关新加坡的保健护理蓝图和保健护理工程学里所潜在的创新机会。该教学单元是为了培育出下一代的保健护理工程师，让他们对保健护理领域和医学的基本原则都具备深度的了解。新科大的学生将和业内的专业人员和研

究员一起工作，以获得宝贵的临床和行业知识。他们将置身于临床环境里，借此观察护理流程和医疗仪器的运作，以便发掘还未有应对方案的临床需求。学生们之后将着手把其构想转化成可行的医疗设备，将其商业化并运用在临床环境里。

获专利的创新发明

在签署第一份谅解备忘录后的期间里，共有三项实习与总结性学习报告与计划书获保健科技创新基金资助，获颁专利权。

体液引流仪器这个仪器把囤积在体腔内异常液体量的引流过程自动化。此仪器可预先设定好引流量和频率，因此把人工操作减到最低。通过受控制和精准的量度，它提高了病人护理的安全性及效率。其设计也考虑到舒适性和流动性，并且可用于门诊及住院两种环境中。

肺部模拟设备这个模拟设备以模拟膈肌收缩和呼吸动作来训练医疗人员。通过真实的肺部表现，该设备免去了培训时对于静态模型、人体模型和动物肺脏的依赖，从而提高培训效果和临床技术。

血液渗漏及伤口监测系统这是一个集合了感应、监控和警惕为一体的仪器。它能够监测到静脉导管抽取的部位是否有重新出血的迹象。此仪器能够识别血液和其它体液，并且能够为动完手术的病人和受创伤的病人进行持续性的失血监测。它也能够用于监控病人在进行血液透析治疗时是否有失血或管道松脱的情况。血液渗漏及伤口监测系统增强了需要定期人工操作的流程，从而让医护人员抽身去照顾那些病情更为紧急的病人。

这项合作伙伴关系也旨在推广研究、创新及教育

3 8 J A N – F E B 2 01 7 C A R I N G

偏头痛问题：我在一家药剂公司担任行销员，年龄在

40岁左右。我经常需外出到不同的诊所，而最

近，我时常在中午时分及在太阳下晒了太久后

感觉头痛。我头部的一侧会出现剧烈的疼痛，

有时候也会发生在前面靠近眼睛的部位。昨

天在回家的路上，我的头痛又发作了，而且还

弄得我的视力模糊，甚至还吐了两次。我这样

经常发生严重头痛的情况，是否应该到急诊部

门求医？

解答：据您所描述，您可能是患上了偏头痛。偏头

痛可分为两种：有先兆的偏头痛，也称为典型偏头

痛，以及无先兆的偏头痛，也称为普通偏头痛。

一般，患者头部的其中一侧会感觉剧烈疼

痛。疼痛的程度从中等到严重不等。其中一

个常见的症状是作呕和／或呕吐。头痛会逐

渐恶化，并且可维持4到72小时。这类型的

您的家庭医生能治疗这些病症！东

部医疗联盟于2014年1月份

推出了“家庭医生首选”计

划，为的是要鼓励居住在新

加坡东部的病人在碰到轻微或中度的医

疗状况时首先向家庭医生求助。在这个

专栏里，东部医疗联盟的社区家庭医生

将帮助《关怀》的读者解答一些常见的疾

病问题。

浏览www.gpfirst.sg或咨询您的

家庭医生更多有关常见的医疗状况，如割

伤、撞伤、轻微烧伤、呕吐、流鼻血、伤风、

蚊虫咬、头痛、扭伤及发烧。以下是读者发

来有关偏头痛和食物过敏的提问。

头痛患者通常会回避灯光明亮或声音嘈杂的地

方。他们会选择到安静和阴暗的房间休息。

有先兆偏头痛患者的症状和以上相同，但多

了一个——在头痛前会出现先兆。它们可能是视

觉上的先兆（看见灯光闪过）、感觉上的先兆（四

肢有针刺的感觉），或是语言上的先兆（无法发

声）。每种先兆可长达60分钟，然后患者一般会

在1小时内感觉头痛。可是，也有些患者可能出现

先兆但最后却没感觉头痛。

家庭医生将能够根据您的病史诊断出您是否

患上偏头痛。他通常会为病人建议一些较简单的

治疗法，如到阴暗和安静的房间休息。服用止痛

药有时也有助缓解头痛。若是出现呕吐和/或作

呕的病人，家庭医生则会给病人口服或注射止呕

药。若病人的头痛经常发作并且影响到其生活，

家庭医生便有可能会给病人开一些药物来避免

偏头痛的发作。

偏头痛一般是由以下几种因素引发：

• 饮食如巧克力、柑橘类、番茄或乳酪

• 强烈的灯光或过度的杂音、强烈的气味、恶劣

的天气

• 情绪上或身体上的压力、做运动／极度消耗

体力、睡太多

• 避孕药、味精

• 月经、饥饿、从事轮班工作

陈斯庆医生是莱佛士医疗集团（Tampines1和樟宜坊）的家庭医生。他拥有曼彻斯特大学的医学和外科手术双学位，以及新加坡的家庭医学毕业文凭。他目前是莱佛士医疗集团淡滨尼区的首席家庭医生，并且正在修读家庭医学硕士学位。

C A R I N G J A N – F E B 2 0 1 7 3 9

FEATURE

食物过敏问题：我是一名30岁的男性，对美食尤其钟

爱。昨天我和一群朋友去吃自助晚餐，我当时

吃了不少海鲜，其中包括生蚝、蛤、贻贝和雪

蟹。当我正要回家时，我感觉腹部绞痛、还带

轻微的作呕，上唇也肿了起来。我记得之前有

过吃了海鲜后身体出现轻微反应的两次经验，

但当时症状很快就缓解了。因此我也不以为

然，便开着车回家去。到家后，腹部绞痛变得

更加严重。我的舌头有刺痛的感觉，左眼还肿

了起来。我的身体也开始出现皮疹。我在痕痒

的部位涂了一些止痒膏（有点帮助）后，就睡着

了。所幸，当我第二天早上起来时，我觉得好多

了，但眼部的肿胀还是没消下去。我不确定究

竟是对哪一种海鲜过敏，也不明白为何这次的

症状会这么严重。若同样的情况再发生，我应

该怎么办？要注意哪些症状来决定是否马上到

急诊部门求医？

解答：您很有可能是对贝壳类动物过敏。对贝壳类

过敏有两种：“甲壳类动物”过敏（如

虾、螃蟹和龙虾等）和“软体动物类”

过敏（如蛤、贻贝，生蚝和扇贝

等）。除非您得到医生许可，

否则建议您别吃以上所

述的海鲜类，因为多数

人对这两种海鲜类都

会过敏。您的免疫系

统“记得”这些食物，

并且在屡次接触后会

引起越发激烈的反应。

食物过敏是由于免疫

系统对食物里的蛋白质做出

过度反应所致。近期的研究显

示，国人最容易产生过敏的食物（以降序

排名）包括贝壳类动物、鸡蛋、牛奶、花生、坚果类，

最后是鱼类。

家庭医生能治疗大多数轻微的食物过敏反应，

并会给病人开抗组织胺药或支气管扩张药，若情况

严重，他则会为病人注射肾上腺素。家庭医生也能

为病人提供肾上腺素自动注射器，同时教导其如何

使用该药物。口服的类固醇也能做为辅助性治疗以

达到最佳效果。

如果您有以下两个或以上的症状，您便有严重

食物过敏体质：

• 呼吸性症状，如呼吸困难、喘鸣或喘息

• 晕厥、晕眩或大小便失禁（低血压的症状）。

注意：在知情的情况下吃下您过敏的食物后出

现低血压的症状（不带其它症状），就属严重

过敏。

• 皮疹、嘴唇／舌头／喉咙肿胀

• 腹部持续疼痛或呕吐

若您被诊断出有食物过敏，请细读您所购买和

食用的食品标签上的说明。同时也建议您在外用餐

时向服务员了解菜肴里所使用的食材和烹煮方式。

若您知道自己有严重食物过敏，那您应随身携带一

支肾上腺素自动注射器（记得要查看有效日期）。

若您有严重的食物过敏反应，请立即拨打995

求助。

由洪开国医生提供解答

家庭医生解答

洪开国医生是位于榜鹅的顶峰西药房的家庭医生(punggolgp.com)。他在新加坡考取了其内外全科医学学士学位。他提倡使用具有良好科学依据的医疗实践。

偏头痛患者一般都知道会导致头痛发作的因

素有哪些，因此避免触碰到这些“导火线”便能避

免头痛发作。若您不确定导致您头痛发作的因素，

建议您开始记录下每次头痛发作的经过，这样有

助您确认引起头痛的导因。

若您觉得身体不适并且有以下症状，建议您去

看家庭医生，让他为您做检查并评估您是否需去

急诊部门做进一步检查：

• 突然发生从未有过的剧烈头痛

• 意识受影响

• 神经系统的症状如单侧软弱或言语不清

• 在咳嗽、使力或性交时引起头痛

• 颈部僵硬

• 发烧

• 50岁以上或癌症和免疫系统疾病患者出现头

痛症状

由陈斯庆医生提供解答

4 0 J A N – F E B 2 0 1 7 C A R I N G

吃出健康

暖暖的香脆外皮搭配上火辣酱，这不但简单易做，还能满足您的口腹之欲

准备时间 出炉3小时 2条面包

所需材料 面包粉佛卡 300克（11盎司）

夏面包 速发酵母 1½茶匙 盐 1茶匙 辣椒干片 2茶匙 黑和白芝麻 1汤匙 低脂牛奶 150毫升（5液盎司／ 杯） 橄榄油 2汤匙 虾仁 85克（3盎司），去壳，切丁 蟹肉 30克（1盎司） 墨鱼 40克（1¼ 盎司），

清洗干净，切丁 青葱 10克（ 盎司），切丁

莎莎酱 番茄 2粒，中等大小，去子，切丁 鳄梨 ¼粒，去壳，去果心，切小块状 香菜 1根，切碎 大蒜 2瓣，去皮，切碎 白酒醋 2汤匙 盐 少许 橄榄油 2汤匙柠檬汁 1茶匙 洋葱 ¼ 个，去皮，切丁 黑胡椒粒 1汤匙，碾碎 红辣椒 ½,条，去籽，切碎 鱼味咖喱粉 1茶匙

做法准备莎莎酱。把莎莎酱的材料倒入碗里，搅拌均匀。密封后放入冰箱，存放至少2小时。这个时候，把面粉、酵母和盐筛入一个搅拌碗里。加入辣椒干片和芝麻，搅拌均匀后加入牛奶和橄榄油。把所有材料揉成一个松软滑嫩的面团。把虾仁、蟹肉、墨鱼和青葱加入面团里，搅拌均匀后，让面团在常温里发酵20分钟。把烤箱预热至210摄氏度（410华氏度）把面团搓至0.5公分（(¼寸）的厚度。让其在常温里再发酵20分钟。放入烤箱烘烤12分钟，或至面包成金黄色和外皮变得松脆。从烤箱取出后，放一旁让其降温，最后把面包切成心仪的份量。趁热上桌并搭配莎莎酱即可食用。

营养信息（每份）卡路里 70千卡碳水化合物 8.4公克脂肪 2.8公克胆固醇 15.7毫克纤维 0.5公克

该食谱首次出版于《ACookbookforDiabeticsbyaDietitianandaChef》现已在各大书局出售。

海鲜佛卡夏面包搭配辣味莎莎酱