Friday, August 29, 2008

Adult Vaccination Schedule: Prevention is better than Cure!

One reader wrote to me asking for a table of Adult Vaccination for quick reference. There is currently no official Schedule from MOH so this table is a proposed schedule that I modified from an article by Dr Lam Mun San of Infection & Vaccination Consultants, Mt Elizabeth Medical Centre which was published in the Singapore Family Physician.

I think that as Adults we frequently miss vaccinations because of a few reasons:

1. We are not aware that we need them.
2. There is no legal requirement to do so unless you are going overseas or if you require them for your work.
3. Most people are scared of injections, so it is one thing to bring your child for vaccinations but when it comes to yourself, you cringe!

So hopefully, this post will deal with the issue of ignorance. And if you are scared of injections, maybe you should read my other post on "How to have a painless injection".

Click to Enlarge

What else would you like to know?

More about injections for the elderly, click here
More about vaccinations, click here

Wednesday, August 20, 2008

You can now use your Baby Bonus Card at the clinic!

Great News!

If you have been issued your Baby Bonus card from OCBC or Standard Chartered Bank, you can now use it at our clinic to pay for your Baby's medical expenses including vaccination packages.

Tuesday, August 19, 2008

My Interview on Adult Vaccinations in TODAY paper

I was interviewed on TODAY on the important vaccinations for adults.

The problem with adult vaccinations is that there is no compulsion to get them done and a lot of adults don't even know that certain vaccinations exist. For example, there is a new vaccine against Cervical Cancer which is recommended for girls between 9 to 26 years of age. But there is a general lack of awareness of such a vaccine.  Similarly, the Ministry of Health also recommends for the elderly to get vaccinated against pneumococcal disease and influenza. But again, there are a lot of elderly who do not get their vaccinations done.

Below is the article, please click on the image to read.

Monday, August 11, 2008

Quoted in Today Paper on Ear Wax

Reminder for parents whose kids might be having problems with Ear Wax.

Sunday, August 03, 2008

Cholesterol lowering strategies of Cardiologists who love food!

Now when it comes to preventing heart attack, the Cardiologists are the experts. These are the guys who see people with clogged arteries day in and day out. So it goes without saying that of all people, they should know how to look after their arteries more than anyone else.

During my recent in-camp training, I managed to catch one such specialist buying a plate of bee hoon with a fried egg and a slice of luncheon meat for breakfast. So, naturally, I had to ask him: "Wha, you Cardiologist, eat like that ah? Not afraid of high cholesterol?". He casually told me that indeed his cholesterol levels were high and admitted that he couldn't help it since he LOVED food too much. BUT, he added, he was taking an anti-cholesterol pill which kept his LDL cholesterol levels well below the recommended levels.

Comon', we Doctors are human too. It is one thing to tell our patients what they should do. But when it comes down to things that make us happy, like food, one has to do what is practical. So although the Doctors can tell you what you should be doing in an ideal world, the real secret lies in how they behave themselves, right?

This is what we medical professionals advise our patients: In order to prevent heart disease, you have to:
  1. Excercise 5 times a week at least half and hour of brisk walking each time.
  2. Check your cholesterol levels and keep it under control.
  3. Get rid of your belly fat
  4. Stop smoking
  5. Eat a healthy diet with lots of fruits and vegetables.
  6. Reduce animal fats and oily foods like Tempura, well marbled beef, foie gras, ice-cream, desserts, Char Kway Teow, Hokkien Mee, KFC, Burgers.........
  7. Make sure you manage your blood pressure and diabetes
Now compare that list to what the Cardiologists focus on for themselves:
  1. Don't smoke
  2. Eat all the good stuff but make sure your cholesterol levels are under control. If need be take a pill call a "statin"to lower cholesterol.
What does this tell you? It tells you the difference between the best thing to do and what is practical to do. It also highlights the importance of Cholesterol levels to the development of heart disease. So although all the other factors are important, the 2 things that are achievable and has the highest "benefit to sacrifice" ratio, is smoking and cholesterol.

In the past, we understood that high levels of cholesterol flowing through the blood vessels slowly start being deposited onto the walls of the artery forming plagues. As these plagues get larger, they reduce the area of the lumen (the hollow space in the artery) thus restricting blood flow to the heart. When the blood flow is severely restricted, the heart muscle is starved of blood and you get a heart attack.

So, lowering the cholesterol levels will lower your chances of developing these plagues.

But now the medical community also know that most heart attacks do not occur gradually. Instead, something happens to suddenly block the flow of blood. This occurs when a plague becomes unstable and suddenly ruptures, thus causing an instant blockage.

Here is where the "statins" come in. Not only do "statins" reduce the level of cholesterol in the blood, it has the added function of stablilizing the plague, thus preventing plague rupture. This explains why my friend the Cardiologist, monitors his blood cholesterol levels every 6 months and takes a "statin" to reduce his cholesterol levels to even lower than what is required, because when it comes to cholesterol, the lower the better.

So what should you do?

Well, if you are able to follow the first 7 points, then it is great for you. But if you can't because you love food too much and you don't have time to exercise even once a week, let alone 5 times a week, then, do what our Cardiologist friends do and stop smoking (if you are a smoker) and quickly go get your cholesterol levels checked!

To read my other posts on Cholesterol, please click here.

Disclaimer: This article is not meant to be a scientific dissertation, but merely to provide some off-the-cuff information for our readers. In doubt, please seek advise from your Doctor. Not all Cardiologists are like my two foodie friends. I am sure that most of them lead quite a healthy lifestyle.