Monday, February 26, 2007

Why you should Vaccinate against Chickenpox

This is one of the commonest comments from Parents:

I think it is better for my child to get Chickenpox. We all went through it and it is more natural that way!

Sound familiar?

But I have never heard a parent say something like,

I think it is better for my child to get Meningitis or

I think it is better for my child to get Polio.

I think the main reason is that most unlike Meningitis or Polio where there might be long term serious disabilities, most parents assume that Chickenpox has no long term effects on the child.

But is this assumption true and what are the facts?

The fact is that in most cases Chickenpox is a mild disease and most children recover without long lasting effects, BUT in some cases Chickenpox can cause long term disabilities and even death.

Why you should consider vaccinating your child:

A few points for you to think about:

1. There is a small chance that your child might develop serious complications like long term brain damage from chickenpox encephalitis (brain infection) or might even die from widespread chickenpox infection. An article published in the Singapore Medical Journal gives 8 cases of chickenpox complications. (Click Here) One child died, another was left with poor memory and behavioural changes. The rest although fully recovered, went through the illness with neurological problems such that they lost their sense of balance and there are also some who suffered from kidney problems during the length of the illness.

2. Consider the child pictured above who is one of my patients. He unfortunately had chicken pox as a baby and was left with a line of chicken pox marks on his face. You might think this is only a small thing, but he certainly was very sensitive about having his picture taken, which is why he tried to cover his face with his hand. The scars are having an impact on his sense of self esteem.

3. If the child has chickenpox, it would be a week long illness where the child will be uncomfortable and also infectious. Inevitably the people whom the child have contacted prior to the illness will start to panic and wonder if their own kids have contracted chickenpox. I even had one pregnant lady who was so worried that she would get chickenpox. If you vaccinate your child against chickenpox, then you really don't have to worry about these things.

4. In adulthood, chickenpox can be very severe with the lesions covering the entire body and face. If your child does not contract chickenpox as a child, he may still get it during adulthood.

Here is another common misconception:

Even if I vaccinate my child, he will still get Chickenpox!

If this were really the case, why would we even give Chickenpox vaccinations?

The fact is:

Children who have been vaccinated have a 75%-85% chance of protection against Chickenpox and the ones who still get it have a milder disease.

One of my patients asked me:

If I get vaccinated against Chickenpox, I will get Shingles later in life!

Quite the opposite is true! And this is another reason why you should consider vaccinating against Chickenpox.

Shingles, better known in Singapore as "Seh Zhua" (Snake) is a reactivation of the chickenpox virus when the immune system is weakened. When one suffers from an episode of chickenpox, some of the virus take up residence in the body and lie domant until something occurs to reactivate it.

When you vaccinate yourself or your child against chickenpox, you are essentially giving your body a deactivated virus which does not cause chickenpox, but is still recognized by the body as chickenpox. Thus the body's immune system arms itself against this particular virus and stores the information in memory. The next time when the body gets exposed to the real chickenpox virus, it mounts an effective response so that the chickenpox virus does not have any chance of replicating in the body and causing the chickenpox symptoms.

So if you never get chickenpox, you will not be harbouring the virus in your body and thus will not get Shingles later in life.

More information on Shingles may be found by clicking this


Chickenpox is a disease that can be avoided. There is no compelling reason NOT to vaccinate yourself or your children. So please consider the facts and make an informed decision on your family's health!

Friday, February 16, 2007

Chinese New Year Opening Times

We would like to wish every one a very Happy and Prosperous Year of the Pig! Remember to eat moderately and avoid Suckling Pig if your cholesterol is high (well at least try not to eat too much).

Our clinic will be closed on the 1st and 2nd day of the New Year and we will be opened half day on the 3rd. The opening times are as follows:

17 Feb Sat 8.30am to 12.30pm
18 Feb Sun Closed
19 Feb Mon Closed
20 Feb Tues 8.30am to 12.30pm
21 Feb Wed Business as usual

Friday, February 09, 2007

New Vaccine that protects Women against Cervical Cancer

There is good news in the fight against Cervical Cancer. A new vaccine has been recently launched in Singapore which is designed to reduce the risk of women developing Cervical Cancer significantly.

How does it work?

There is a virus called the Human Papillomavirus (HPV) that is spread through sexual contact. About 50% of sexually active females with become infected with the HPV in their lifetimes. It has been found that infection with the virus will predispose the person to develop Cervical Cancer later in life. So if you can prevent the person from getting the infection in the first place, you can prevent the development of Cervical Cancer.

How common is Cervical Cancer?

Over 490,000 cases of cervical cancer are diagnosed annually worldwide. Up till the introduction of this vaccine, the primary way of dealing with cervical cancer was to detect it early through regular Pap Smears. It is recommended that sexually active women have a Pap Smear at least once every 3 years. When Cervical Cancer is detected in the early stages, it is easily treated. Cervical Cancer can be life threatening when detected late.

How effective is this Vaccine?

There are many different strains of the HPV. This vaccine protects against two of the most common strains that cause 70% of Cervical Cancers. Aside from protecting against Cervical Cancer, the vaccine also protects against the development of Anal and Genital Warts.

Who should get the vaccine?

It is recommended that the vaccine be given to girls 9 to 26 years of age preferably before any sexual contact.

What is the schedule like?

The vaccine should be given at 0, 2 and 6 months.

Where can I get vaccinated?

You should be able to get this vaccination at your Family Doctor or Gynaecologist.


This is real breakthrough against one of the commonest cancers affecting women and its introduction should see the incidence of Cervical Cancer in woman reduced significantly.

Other Resources

Link to Vaccine website
Fact Sheet on Human Papilloma Virus
Link to News Article

Friday, February 02, 2007

My Baby Won't Stop Crying!

My two kids are now 7 and 4 so nowadays,the kind of prolonged crying is usually due to tantrums which are easy to handle, because I know that they are just being naughty. But when they were newborn it was very different. I was a young medical officer in the hospital undergoing training then, and did not know as much as I know now. So when my 1 month old son, James started crying incessantly, I panicked like any first time parent would.

What Crying Means

Before my son was born, I remember being worried about being a parent. It is not as if you go for courses to prepare for such a thing. I am the kind of person who would read through the instruction manual for my handphone before using it, so I was hoping my son would come with an instruction manual! But no, parenting is "on the job" training. By the time you get proficient at taking care of your newborn, they become toddlers and you start "on the job" training again. The skills you learn are only useful for your second child, which is why by the second child, when the pacifier drops on the ground, you simply rinse it instead of sterilizing it before sticking it back into the baby's mouth.

Anyway, I learnt that looking after a newborn is pretty straightforward. They only do five things. Eat, sleep, cry, pass motion/urine and breathe. So as a parent, you only need to learn how to feed, get them to sleep, pacify their crying, change their diapers and bathe them. Now, crying is the only way the baby communicates with the parent. And at that age, the baby only communicates a few things with you. So when the baby cries, he might be saying:

1. I'm hungry, feed me Mummy
2. Time to change my diaper
3. I am in pain eg teething and colic
4. I am lonely, play with me
5. I am sick

So if you always go through the checklist, you will find some reason for the crying and rectify the problem accordingly.

What is the normal crying pattern?

Up to about 6 weeks of age, the average baby would sleep and when awake will start crying or fussing. They might cry for about 3 hours a day. By about 6 weeks they begin to have periods where they will be awake without crying. By 6 months they will be able to smile and play with you.

Infant Colic (Crying on and on and on.......)

In the first 3 months of life, the baby may have prolonged periods (more than 3 hours) of incessant crying where a cause is not found. He may look like he has abdominal pain and draws his arms and legs towards the body and cries till he is red in the face. It is a distressing condition for most parents especially first time parents or even for 2nd time parents experiencing it for the first time.

It is important to make sure your child is not sick before assuming that he has infant colic. So measure their temperature and look out for signs that the child is sick, then go through the checklist of why the child is crying. If in doubt, always bring the child to the doctor for a proper assessment.

What to do after I have gone through the checklist?

Remember the "Rule of 5 Ss" by Paediatrician Harvey Karp who rediscovered the ancient techniques of soothing the baby:

1. Swaddling: Make sure you learn how to wrap baby up firmly
2. Side or Stomach: Lie your baby on the side or stomach
3. Shushing" as loud as they cry
4. Swing (Sway) them from Side to Side
5. Sucking: Use the Nee Tu (Pacifier) or Bottle

For more information on Infant Colic, please click here


Remember that most cases of infant colic only lasts for up to 3 months after which things get better. Once you ensure that the baby is not sick and that everything else on the checklist is covered, DON'T STRESS! Prolonged crying is not going to cause long term harm to the baby, despite what the older folks will say about the testes dissappearing if the baby is allowed to cry for too long. Our Chinese Culture does not look favourable upon a parent who does not try to stop the baby from crying, so aside from looking after the baby, we also have to please our family members and this adds to the stress levels. Just understand that it is not your fault that the baby has colic and there is not much else that can be done except to be patient and go through it!

Reference: John Murtagh: Patient Education 4th ed, McGraw Hill, 2005