Feeds:
Posts
Comments

Archive for the ‘Health’ Category

If I am the Minister for Health, I will immediately enforce a mobile medical apps software that can be easily downloaded to every phone for the citizens here effective medical sickness reporting and treatment.

The rationale for this mobile medical apps is due to my observation that doctors are spending too much time taking down (or rather scribbling down data) for common questions that could have been answered while the patients are in the waiting room, idling.  In fact, many doctors are language challenged and not able to converse well in Mandarin or Tamil where most of the foreign workers are from and this takes longer service time.  Likewise for parents with this mobile med apps, they can fill in data for their children and sent to the clinic without needing to take time off or during a emergency.

For this mobile medical apps, which I would term, RSF (Report Sick Form), for simplicity, it will have the followings:

Language Preference:

a.  It comes in different languages like English, Mandarin, Tamil, Hindi, French, German etc to cater to a mulitcultural society that Singapore is aspiring.  This is essential if we want to handle infectious disease fast in times of outbreaks.

General Data Like:

a.  Fever (number, frequency, duration etc)

b.  Cough (dry, wet, whooping etc, frequency, duration etc)

c.  Phlegm (white, yellowish, reddish etc)

d.  Pain (location, frequency, duration, intensity etc)

e.  Rashes (location, frequency, duration)

f.  Headaches (frequency, location, intensity)

g.  Sore throat (when started, describe)

Medication Taken:

a.  Western – describe

b. TCM – describe

Infectious Diseases Suspected

a.  Disease suspected:  Dengue/Malaria/Chikungunya/SARS

b.  Reasons:

c.  Suspected Locality or Cluster:

Others:

a.  Food Poisoning suspected

b. Location:

Etc Etc Etc

Conclusion

The above is only a general format that, of course, will be improved with time and usage.  This allow the doctor to focus immediately on other important aspect like helping to derive disease or outbreak clusters like dengue by asking further question to what had been duly filled up at the waiting area. Presently almost all the doctor time is wasted trying to communicate with the patients which can be worsen if there is a language barrier.  This is further complicated by temporary or part-time doctors who have lost the ability to keep up with emerging disease symptoms and cannot ask proper questions while relying on patients to describe. Often the patients are either too sick to remember and perhaps the medical apps with its structured approach can help the incompetent doctors to follow a standard format to derive what is the root cause of the sickness.

Our problem is not that there are not enough doctors but rather the inability to use mobile apps or even pre-filling of forms at the waiting area to reduce doctors workload and move on to more incisive diagnosis, not only to treat the patient properly but to contribute to a national medical database that can effectively derive where the disease clusters are from and will be.

Take Care

Shananarocks

Advertisements

Read Full Post »

I find that our private medical clinics around the various housing estate can improve their efficiency and effectiveness by providing a checklist for patients to fill while waiting for their turn to see the doctor.  This will shorten the need to overall waiting period as the common questions like “Fever”; “Cough for how many days”; “Yellowish or White Phlegm” can be answered ahead of time.  When we see the doctor the pre-filled form could be scanned or even scanned earlier to save time.

Here I want to recount a bad experience the I had yesterday when I visited a “xxxxxxxxxx” Family Clinic in Marsiling area where the resident doctor Dr Tan was away on holidays.  The temporary doctor seemed to be totally out of touch with reality or in possession of any courtesy or diagnostic ability, when  I visited the clinic on 3 Jun 2013 morning with symptoms of cough and flu.  When I enter his clinic after being called by my Catholic name and which also appear in my IC, this doctor Chong asked what is my name. I replied with my Catholic name “xxxxxxx”.  He asked again “what is your name” and should it not be “Tan Ah Kow” (changed intentionally here).  I told him the nurse already addressed me as in my Catholic name.  He said “no!” you should say your name as “Tan Ah Kow”.

Nevertheless, this is not his main problem.  The PROBLEM IS HIS INCOMPETENCY IN DOING simple diagnosis.

This temporary doctor, Chong, asked me what do I have? I replied I have flu. He then asked me to describe my flu.  I said “runny nose”.  He repeated after me like a school kid and wrote it down on his white card and said somemore. I already feeling very groggy and though why could he ask the questions since he is the doctor and know why questions to ask to come to a conclusive diagnosis.  I then said “cough” and my phlegm was whistish and yellowish.  I remember only seeing he write “white” in the card.  I said I got fever and he checked my temperature which confirmed that I had fever at 37.5 degree.

Then I requested for some ringworm or rashes cream due exercise like badminton when I have to wear the same outfit for a while.  He asked to show him the spot behind my back and I said it was red in colour. He was very sacrastic and asked me how do you know it was red in colour. I looked at him in amazement and say of course my wife told me so.

When I went to collect my medication after leaving his office, I was only given panadol and cough medication.  I then requested the nurse to inform him that I require lozenges as I was having a bad sore throat. I thought I said that to him and wondered why he did not go through a checklist like any normal competent doctor would have done so.

When I reach home I realised that he did not give my any antibiotics for my flu that included fever and yellowish phlegm. I called the nurse and requested that she speak to him.  The nurse then came back to say “yes” you can come now to get your antibiotics.   I have to travel back to his clinic again due to his incompetency, often not looking at the patient to do diagnosis but keep looking at his white card to scribble.

The fact that for a simple diagnosis like flu with yellowish phlegm and fever, I wonder why he could have run through a standard checklist given the patient could be very sick and groggy and not able to think clearly.

In fact just before my turn to see him, an Indian patient went in and everyone can clearly hear him say sacrastically “see I can pronouce you nammmmmeeeeeeeee ………..” in a derogatory manner.  However for the earlier Caucasian lady that  he attended to, he was all smiles sounded so polite that could be overheard in the waiting room and in his  best  submissive configuration.  I wonder why this clinic is not sound proof and let everyone hear what the doctors are saying inside.

Anyway, I sure wonder what is truly wrong with this temporary doctor – was he forced to work overtime in the absence of Dr Tan or was he just simply out of touch with the current practise that require the doctor to be more sensitive and alert to patients’ needs. By going through a proper checklist even before going into clinic maybe it helps to alleviate his or her workload.  I truly wonder how many misdiagnosed cases he seen over the years.  I shuddered at that thought.

CONCLUSION

To save time for such incompetent doctors, it is best to have a standardized checklist for common diseases like flu, cough and fever etc.  The doctor can thus save time from questioning these symptoms to the patients and instead focus on asking further questions that can better diagnose the disease. In the case above, it showed the lack of knowledge from a temporary doctor who insisted a groggy patient to tell him the symptoms when he should be in a better position to ask the right questions to come up with a proper diagnosis.

Likewise with some many Chinese and Indian national coming to Singapore, it would be good if the checklist can have both Mandarin and Tamil that will facilitate the patient to check the correct boxes in their languages. The doctor can run along the same column that commensurate with the English version and understand the symptoms ticked accordingly.  Likewise, the groups of patients can consult each other or view a demonstration video tape in the waiting area.  This will greatly reduce the treatment time with doctor and allow the doctor to attend to more patients.  Likewise, the patients need not wait to long and can report back for work or return home if necessary.

No wonder he is only a temporary doctor.  I wonder how many of such doctors had been strike off from the medical list. They are not committed and have no interest in treating patients.   Our medical profession should only select those who have the aspiration to serve others and not to make money in this profession.

Take Care

Shananarocks

Read Full Post »

I read with concerns about Swenson Tan, 22, who lapsed into a coma three weeks ago after being hit by a van. He was declared brain dead by doctors at Changi General Hospital (CGH) on Friday (Mar 8), but his traumatised parents refused to accept the outcome. The full-time national serviceman, who had studied Mechanical Engineering at Ngee Ann Polytechnic, was riding a motorcycle near Hougang Ave 7 when he collided with a van. He suffered serious head injuries and underwent a six-hour operation. (link)

What bothers me is that there are reports of many accident victims who were declared as brain-dead by doctors woke just in time before their life support system were removed.  In 2012, a 17-yr old Steven Thorpe’s parents refused to give up hope – despite four specialists declaring that the 17-year-old was brain dead and wanted to switch off his life support machine. He woke up after a 2-week coma (link).  I thought about it and remember that in 2012 that was an experiment that showed that severed nerves could repair itself quickly in a calcium-free environment.  (link)

This appear to me that it is about time for our doctors here in Singapore to try this on accident or trauma patients with brain injuries, meaning when the accident patients  first admit to the emergency ward, they should be exposed to as little calcium as possible.  This will allow the important nerves in the brain to quickly heal themselves.  Maybe earlier some brain-dead patients who recovered were those who were on heart medication that on calcium-channel blocker medication.  In fact there were some experiment done on this in 2003.

Calcium channel blockers for acute traumatic brain injury. (link)
Langham J, Goldfrad C, Teasdale G, Shaw D, Rowan K.
Source : Clinical Effectiveness Unit, Royal College of Surgeons of England, 35 – 43 Lincoln’s Inn Fields, London, UK, WC2A 3PN. Abstract
BACKGROUND:
Acute traumatic brain injury is a major cause of death and disability. Calcium channel blockers (calcium antagonists) have been used in an attempt to prevent cerebral vasospasm after injury, maintain blood flow to the brain, and so prevent further damage.
OBJECTIVES:
To estimate the effects of calcium channel blockers in patients with acute traumatic brain injury, and in a subgroup of brain injury patients with traumatic subarachnoid haemorrhage.
SELECTION CRITERIA:
Randomised controlled trials in patients with all levels of severity of clinically diagnosed acute traumatic brain injury.
DATA COLLECTION AND ANALYSIS:
Two reviewers independently assessed the identified studies for eligibility and extracted data from each study. Summary odds ratios were calculated using the Mantel-Haenszel method.
MAIN RESULTS:
Six RCTs were identified as eligible for inclusion in the systematic review. The effect of calcium channel blockers on the risk of death was reported in five of the RCTs. The pooled odds ratio (OR) for the five studies was 0.91 (95% confidence interval [95%CI] 0.70-1.17). For the four RCTs that reported death and severe disability (unfavourable outcome), the pooled odds ratio was 0.85 (95%CI 0.68-1.07). In the two RCTs which reported the risk of death in a subgroup of traumatic subarachnoid haemorrhage patients, the pooled odds ratio was 0.59 (95%CI 0.37-0.94). Three RCTs reported death and severe disability as an outcome in this subgroup, and the pooled odds ratio was 0.67 (95%CI 0.46-0.98).
REVIEWER’S CONCLUSIONS:
This systematic review of randomised controlled trials of calcium channel blockers in acute traumatic head injury patients shows that considerable uncertainty remains over their effects. The effect of nimodipine in a subgroup of brain injury patients with subarachnoid haemorrhage shows a beneficial effect, though the increase in adverse reactions suffered by the intervention group may mean that the drug is harmful for some patients. (link)

Comments:  The 2003 experiment were on “acute traumatic brain injury” meaning those patients were still alive and not brain-dead.  Maybe their experiment totally missed the entire point, which is, to ascertain whether a traumatic patient would not become brain-dead if calcium channel blocker medication were rendered immediately  together in a calcium-free environment for the patient to survive pass the brain dead stage and help immediate nerve repairs as demonstrated in the 2012 rats experiments.  Our doctors here should keep abreast with latest developments, especially in traumatic brain  injuries that is so common among the motorcyclists.  Here one motorcyclists dies every two days.  The ministry of health should publish data whether most of the organs harvested were from these pools of dead motorcyclists and whether if our brain-dead procedure should be revamped for progress and ethics reasons.

Take Care

Mikey

cc:  Dr Goh Siang Hiong and Dr Chua Hoe Chin (both my dear secondary four classmates who went on to become good and dedicated doctors in the A&E and Neuro Recovery departments)

Read Full Post »

1.    I often see an elderly woman who uses a common market trolley as a walking aid

Easily available at most supermarket and hardware store but cannot be seated

Easily available at most supermarket and hardware store but cannot be seated

to move slowly but surely across a traffic light junction.  Sometimes I walk beside her to ensure her safety as the green light timed-out.  Nevertheless, most motorists are very considerate here.

However, I would like the authorities to:

a.   Promote cheap and functional “elderly marketing cum seating trolley” that can serve dual function as a marketing trolley, walking aid and in particular those that can be seated to allow others to ferry them easily at traffic crossings.

b. Make available at most supermarket and convenient store (it is also where most of the elderly get their marketing trolley as a walking aid).  Many do not know where to get such specialized trolleys.

Should make available at supermarket and hardware stores in housing estates.  At traffic lights the elderly can be seated comfortably to let others push them safely across the traffic lights before the green light time-out

Should make available at supermarket and hardware stores in housing estates. At traffic lights the elderly can be seated comfortably to let others push them safely across the traffic lights before the green light time-out

2.    Using such “elderly marketing cum seating trolley” allow others to participate:

a.  As it easily allow anyone to ferry the elderly across the traffic lights or zebra crossings since they can now be seated comfortably in such trolleys.

b.  Promote a caring culture when it is within our reach to help the elderly rather then hinder their movements or just walking by their side.

Take Care

Mikey

Ref:

a.  Common Market Trolleys used a (desperate) walking aid by the common folks as it is cheap and easily available and dual usage.  However, mobility still remain painfully slow at traffic junctions but nevertheless it still aid in their balance.

Common Market Trolley As Walking Aid - 2

Common Market Trolley As Walking Aid

Read Full Post »

Alot of people are not aware that the “King of Fruit” the durian is very high in potassium.  Potassium is not necessary a bad thing given as it can balance the high salt (sodium chloride) that we are taking.  Even sometimes we crave for durian is because of the potassium content that is lacking in many diet.  Our isotonic drinks also do not have enough potassium, some calcium or hardly or any magnesium to make up the full electrolyte balance.

So to counter the effects of overeating durian, or “heatiness” we can take some baking soda or sodium bicarbonate to balance its effect.    This is important for those who are diabetics or slight diabetics and too much potassium in a single can also be bad for your health. Of course, for growing teenagers like my sons, potassium is needed to help them grow taller and less aggressive given their high sodium intake.

 

  1. Durian Fruit & High Blood Pressure | LIVESTRONG.COM

    http://www.livestrong.com/article/487194-durian-fruit-high-blood-pressure/

    7 Jul 2011 – An important benefit of durian fruit for your blood pressure is that it is very high in potassium, with 1059 mg per cup. A highpotassium diet

  2. [PDF]

    Durian Induced Hyperkalaemia

    File Format: PDF/Adobe Acrobat – Quick View
    renal failure should avoid food with high potassium contents. Bananas are well known to have high potassium content. However, the ‘king of fruits’ the durian,

So remember!

Baking Soda For Health!

Mikey

Read Full Post »

Reference to my last post “Are Singaporeans Becoming Stupid With Twin Fluoridation Approach” (June 26, 2012), I have just read that MM Lee’s brother had just passed away from kidney cancer.  It seemed that many people here are very careful with their diet, so one likely carcinogen that can reach a vast majority of the very health-conscious populace, is perhaps the water supply.  I am not saying that it could be the case here but for the rest, we should be pretty concern about how we add chemicals or process the water here.

This article is worth reading too.

    Fluoridation Harms Kidney Patient ( Tuesday, December 27, 2005)

     Janet Lail learned to live for years with the constant pain she likens to brillo pads rubbed over scorched skin (ouch) and monthly hospitalizations due to a kidney disease (chronic pyelonephritis) that requires she drink loads of water.

Then suddenly the pain disappeared and her hospital visits became fewer and farther between. Even the doctors were confounded-–nothing had changed – except the water-–it was no longer fluoridated.

Lail’s water provider, the South Blount Utility District in Tennessee opened a new plant in June 2004 and started providing unfluoridated water.
Lail told this story to Lesli Bales-Sherrod, a reporter for the Daily Times of Maryville, Tennessee (1)  ……..

Kidney patients retain as much as 60% more fluoride than do persons in normal health,” writes physician George Waldbott, the leading medical expert on the clinical aspects of chronic fluoride toxicity when he wrote “Fluoridation the Great Dilemma,” published in 1978 with Harvard educated Albert Burgshthler, Phd, university professor and now Editor of the journal, “Fluoride.”    (link)

http://fluoridedangers.blogspot.sg/2005/12/fluoridation-harms-kidney-_113573563709985824.html

The blogger cited that  basing on evidence, after 60 years of water fluoridation delivered to 2/3 of Americans via the water supply and 100% of Americans via their food and beverage supply, American children are grossly overfluoridated Yet, tooth decay is a national epidemic.

According to the National Kidney Foundation, more than 20 million Americans – one in nine adults – have chronic kidney disease.

BAD NEWS FOR AMERICANS

Chancellor dismisses South Blount fluoride lawsuit

www.fluoridealert.org/…/Chancellor-dismisses-SouthBlountfluoride

18 Nov 2008 – Chancellor Telford E. Forgety today dismissed a lawsuit seeking to force South Blount County Utility District to stop fluoridating its water supply

You visited this page on 7/3/12.

Blount County: Fluoride set to flow despite lawsuit

www.fluoridealert.org/…/Blount-County—Fluoride-set-to-flow-despi…

6 May 2008 – The effort to keep fluoride out of the South Blount County Utility District water The only thing they say is that it will prevent cavities,” King said.

Group says South Blount fluoridation plan bites

Lawsuit may follow if utility once again puts compound in water

By Robert Wilson

Thursday, May 1, 2008

MARYVILLE – Opponents of reintroducing fluoride into South Blount County Utility District water say they are considering suing to prevent the action, which is planned in about a week.

But the manager of the district says the utility is moving ahead with putting fluoride back in its 14,000 customers’ water, probably immediately after next week’s regular meeting of the district’s board of commissioners.

Comments:

I simply find it so difficult to comprehend that the dangerous FLUORINE is added simply to ward off CAVITIES.  So to save a few teeth, we poison our entire body especially the kidney that have to work doubly hard to flush out the toxins.  Don’t we already have wide access to fluoride gel and toothpaste that are not orally ingested. Is it WISER???  Maybe if South Blount County were to continue without fluoridation, it may prove that fluorine is truly the main health toxin that paralysed the entire nation and somebody obviously did not want that.  Of course, a nation with full of sick people is a great source of income for the health industry and insurance premium too.  I do hope sensibility prevails.  First it was war that created jobs and income, now I guess health is becoming a major source of income.  Are we truly human, or is human the most intelligent species in this earth.  Some say it is the whale, some say it is the tortoise while others say it could be the monkeys.  I think humans have truly degenerated as we becomes more “civilized”.  We are too afraid to live.

So do we still need fluoridated waters given the fact that almost all toothpaste already have  fluoride compound and as such it is sort of compulsory. So we are in fact double OR OVER dosing ourselves with this seemingly innocuous chemical that is causing so much health problems just to save a few cavities.

I find it mind-boggling.

Take Care

Mikey

Ref:

http://www.fluoridealert.org/health/kidney/blount.html

Interesting video for further discussion on the merits of fluoridation of water supply.  Of course we should trust and support our country’s decision on water fluoridation.  They should know what is good for our health.

The Fluoride Deception exposes the truth about water fluoridation and the phosphate mining industry

Read Full Post »

I have been using a carbon block instead of activated granular in my home water filter.  But after three years there were only some yellowish stain on the cellulose wrapping and neither was there any smell or crumbling of the solid carbon block when I remove the cellulose wrapper.

I am not sure if this is suppose to be the result after three years of daily usage.  Maybe the water simply flow through or around the solid carbon block without any real filtration since the block looks as new and solid.

This youtube video claimed that carbon block filters are better than granular.  I am not too sure.

Any experts out there?

mikey

Read Full Post »

Older Posts »