Stop the sniffles

Do you suffer from nose block throughout the day? Find out from Dr Leong on the causes and treatments for nasal congestion. Stop the sniffles!

Singapore Sleep Awareness Week Rocks!

Organised by the Singapore Sleep Society, the Singapore Sleep Awareness Week 2010 is happening on March 19 – 28, 2010… Pretty impressive with string of activities held to educate the public on the importance of good sleep and some common sleep disorders. 

Well, personally, I’ve became a facebook fan of “Sleep an Hour More Movement” and pledged against it… (how i wish i can sleep in more… but i’ll try Of course, had also encouraged my friends to join this movement @ http://www.facebook.com/pages/Sleep-An-Hour-More-Movement/276905042096?ref=mf  coolz! Facebook is a great avenue to share and get quick tips, facts, and solutions to every matter… i like it

On 20 Mar, I stepped into a sleep lab in the Singapore General Hospital… “What’s that??” u must be thinking… well, these are sleeping suites which we house our subjects (aka Sleep patients) where the lab tech wire them up so much that they look like suicide bombers! like this, all strapped up for a Polysomnogram (PSG) test: 

Apparently, this is the most effective way in doing sleep study tests with leads attached to different parts of the body, measuring/ observing… 

• Brain activities (for deep sleep)
• Eye activities
• Muscle activities (Chin for sleep talk, Legs for abnormal leg kickings)
• Sleeping positions (which are the positions that are not obstructing good sleep)
• Heart rhythms (with ECG leads)
• Loudness of Snoring (with Snore Microphone)
• Respiratory function (rate of breathing)
• Chest cavity expansion rate
• Oxygen circulation in Blood 

So many components to a Sleep Study… although this conventional method may be uncomfortable, but it’s proven the most accurate amongst all other improvised devices. So don’t be fooled when someone sell you the idea of using a simplified machine for “comfort sleeping” during the test which end you up in getting an incomplete test, then you’ll have to double torture yourself! haha… 

Sleep study results of an awake person

 

Sample results of someone sleeping… see the calmer waves? determines less activities compared with a person who is awake

Next station displays various Continuous Positive Airway Pressure masks and machines, devices which help force air into the collapsed air passages of sleep apnoea patients… I’ve tried one on… mmm… it really open up your airway and when i start talking, i sounded like Mr Donald Duck! its a kind of  feeling I can’t describe… BUT proven to help give a well-rested quality sleep to those suffering… so I’ll give that a star!

CPAP masks – Nasal, full face, etc

Explaining the different types of CPAP machines – Fixed & Automatic Pressure

Last station was introduction of Progressive Muscle Relaxation (PMR) Exercises where purpose is to achieve a sense of calm that will be conducive to sleep… It generally runs through 17 muscle groups with repetitive tensing and relaxing each muscle just before going to bed… advisable – do it on the bed or near bed just in case u feel sleepy suddenly and you’re all ready for a good night sleep… zzzzZZZZZZ…. 

Check out on some sleep facts and articles at the official site of Singapore Sleep Awareness Week 2010: http://www.singaporesleepsociety.com/ssaw2010

 

The messier it gets, the prosperous it is…

Of course ASCENT staff gets to do our own lo hei too…  Gong Xi Gong Xi!!!

First of all, we would like to thank our Directors for the fat ang bao signifying best wishes and streaming luck for starting the year… 

then, thanks for the 70 bucks YU SHENG so delicious… and of course salmon is yummy… hehe 

Michelle posing with YU SHENG from spring court after preparing the ingredients...

Steps to prepare the YU SHENG was missed out totally as we did not have the list which restaurant staff will usually rattle off… here it is… I guess we’re never too late!

Step 1: Fish slices symbolize abundance or excess through the year (Nian-Nian you-yu) 

Step 2: Pomelo for both luck and auspicious value (Da-ji-da-li)

Step 3: Pepper is then dashed over the ingredients in the hope of attracting more money and valuables (Zhao cai jin bao)

Step 4: Then oil is poured out, circling the ingredients to increase all profits 10,000 times and encouraging money to flow in from all directions (Yi ben wan li & Cai yuan guang jin).

Step 5: Carrots are added to the fish indicating blessings of good luck. (Hong yun dang tou)

Step 6: Then the shredded green radish is placed on the fish symbolizing eternal youth. (Qing chun chang zhu).

Step 7: After which the shredded white radish is added – prosperity in business and promotion at work. (Feng sheng shui qi and Bu bu gao sheng).

Step 8: Peanut crumbs are then dusted on the dish symbolizing a household filled with gold and silver. As an icon of longevity, peanuts also symbolize eternal youth.(Jin yin man wu).

Step 9: Sesame seeds quickly follow symbolizing a flourishing business. (Sheng yi xing long).

Step 10: Deep-fried flour crisps in the shape of golden pillows is then added with wishes that literally the whole floor would be filled with gold. (Pian di huang jin).

Final poses before the actual lo hei…

Dr Leong, Dr Mark and Dr Eng posing...

 

ASCENT gals

Yeah! Let us prosper together… HUAT AH!

Hands-on ENT Workshop for Family Practitioners – 6 Feb 2010

Dr Mark welcoming the GPs at Pine Valley Restaurant

Once again, it’s time of the year… Gong Xi Fa Cai! Its Lou Hei Time…

The first lou hei happened even before new year after the hands-on ENT workshop attended by a focused group of 30 family practitioners at Pine Valley Restaurant (Laguna National Golf & Country Club) last Saturday.

Check out the fantastic view admirable from the function room...

Before that, all three doctors presented these ENT topics at their respective stations:

Station 1:

“Approach To A ‘Sinus’ Patient – How To Syringe The Ear And Douche The Nose”  by Dr Leong Jern-Lin

Station 2:

“Approach To A Giddy Patient – How To Do A Dix Halpike Test For BPPV And The Epley’s Maneuvre ” by Dr Eng Soh Ping

Station 3: “How To Understand A Sleep Study Report & How To Examine The Throat For An FB” by Dr Ignatius Mark Hon Wah

To allow all GPs to have a chance to ask, the group was split up… downside was to have to repeat the presentation more than once… but of course they wouldn’t mind for the benefit of our GPs… awghhhh… so touched… Well, our doctors had also brought some models and made innovative apparatus and “gadgets” to illustrate better while explaining…

“Oh… this model is great… how I wish I had that back in medical school days” exclaimed one of the GPS who’s thrilled over this model which the parts can be dismantled to view the inner part of the ear and assembled back.

Participant figuring out the how the canaliths move

Dr Eng brought along this balloon that contains gravels in it to illustrate how the canaliths (small crystals of calcium carbonate normally attached to the otolithic membrane in the utricle of the inner ear) can get detached and travel from the utricle and collect within the semicircular canals. What happened in a giddy patient is when his/her head moves, the canaliths shift, stimulates sensitive nerve hairs to send false signals to the brain. This is the reason for dizziness and other symptoms. Dr Eng demonstrated the canalith repositioning procedure (CRP), a simple but practical approach done in his clinics with aim to move the displaced canaliths,  stopping these false signals and the debilitating symptoms they can cause.

Dr Eng demonstrating the Canalith Repositioning Procedure

The Nose expert, Dr Leong shared with the GPs on the syringing the ear… He relates an interesting incident where an innovative method was used for the removal of ear cerumen. Due to limitations on an island, Super Soaker Max-D 5000 instead of a syringe was used on the man who had bilaterally impacted cement-like ear cerumen. The article was published in the Canadian Medical Association Journal five years back. Pretty impressive but PLEASE DO NOT TRY THIS AT HOME!!!

Participant get to try out while Dr Leong explains

Innovative method to syringe the ear - using Super Soaker Max-D 500 (but use it when u have no other resources!)

Workshop ended but this is not the end of the day… its lo hei time!! Yeah!!!

Dr Leong with GPs and our sponsors

Dr Mark with GPs - Lo Hei in process!

During dinner, Dr Eng also gave a short presentation on Gastroesophageal Reflux Disease (GERD)… unfortunately I had to leave earlier… missed the session… but let me check it out on the next blog… what’s GERD… 

It was a wonderful evening and this is all thanks to our sponsor, Eisai (Singapore) and organiser, Parkway Health for doing a fantastic job! 

Doctors with Sponsor - Eisai Singapore

 

Doctors with Sponsor (Eisai) and Organiser (Parkway Health)

Singers’ worries…

The hardest thing for a singer is to lose his/her voice… have you ever heard of your singer friends complaining and worrying that they are straining and losing their voices just one day before their actual performance? What should they do to eliminate such worries?

Previously, in the public forum, Dr Eng talks about singers’ nodules. What’s Singer’s nodules? and how do we detect it? 

Here’s another clip from Mayo Clinic introducing vocal cord therapy… she is not singing jibberish… just protecting her voice…

Nasal Irrigation

In the earlier post, I’ve mentioned about “Nasal Irrigation”. 

Here’s an interview which tells you more: 

Many of our patients had expressed that they aren’t too sure of how nasalcare starter kit works. Here’s one more clip for you! 

(disclaimer: this clip is purely for educational purposes and not to promote the brand)

Ear Nose Throat Wellness in You

The public forum “Ear Nose Throat Wellness in You”, concluded last Sat, 23 Jan with more than 100 attendees. Organised by the Parkway group, the event was held in one of the cozy Suites in Raffles Hotel, a splendid location for our doctors to address ENT problems that common people have. 

Dr Ignatius Mark - The Sleep Guru

 

Dr Ignatius Mark, i call him the sleep guru shared with the audience about “A to Zzzz of Snoring”. Quite an interesting talk I must say… he relates a typical family member’s worry…

My husband snores so loud till it causes me to not sleep well. At times, his rhythmic snores will get intercepted with a loud snort and it goes quiet… When he snores, i can’t sleep. When he stops snoring, I get worried that he stops breathing… what should I do?

This is one of the symptoms of Obstructive Sleep Apnoea (OSA), which apnoea means “no breathing”. Dr Mark explained that there is a higher percentage of Asian getting OSA due to the flatter craniofacial structure, which means that the breathing air passage is compensated. The loud snort, which sounds as if there is choking is possibly due to blockage of the nose, soft palate, back of tongue, etc. It may be a single site blockage or in a complex case, multiple sites blockages.

To treat OSA, behavioural changes that improve the quality of life were explored. These includes attempts to lose weight, sleeping on the side, treating nasal problems, avoiding alcohol, quit smoking and of course, practicing good sleep hygiene such as sleeping on regular and sufficient hours. At times, patients may need more than such changes and turn into specific treatment options such as surgery or other non-invasive options like using Continuous positive airway pressure (CPAP) and Bi-level Positive Airway Pressure (BiPAP), which are breathing apparatus that helps people get more air into their lungs and combat sleep apnoea. Dr Mark also advised the crowd that one should first consider if they really need surgery rather than considering surgery techniques first. Generally, patients can consider surgery (1) when there is a simple obstruction; (2) when unable to accept non-invasive treatment; and (3) when upstream obstruction interferes non-invasive treatment.

Dr Leong Jern-Lin addressing questions by the public

 

Next speaker was Dr Leong who went on to tell if Running Noses and Sinus Headaches are due to Food Allergics. He said:

“Allergy can occur in patients as young as 2 year-old. Most allergic patients are in 21 to 30 year-old but allergy is seen to improve with age. Food allergy can cause nasal problems but research had shown that the probability is quite low.”

Nasal problems are common in children and young adults. However, these problems may not just be plain nuisance that may ‘outgrow’ later in life. Severe nasal allergies may cause constant mouth-breathing, disrupted sleep, loss of concentration, behavioural problems and even loss of memory. This often is not recognised by care-givers and family doctors.

A simple, non-invasive skin prick test can be used to diagnose allergy through the application of various allergens onto the skin and observe how the skin reacts to individual allergen. To know the exact allergy the patient is facing, it is often required for a more comprehensive test to be done through taking their blood samples for IgE antibody levels.  

Dr Leong had also shared on the management of allergic rhinitis through the use of medication, nasal irrigation (as promoted in the Oprah Winfrey show using neti pot) and also the application of Sublingual immunotherapy (SLIT). SLIT uses a larger than normal bout of allergen to arrest and cure the allergic disease. . 

Oprah Winfrey Show - Demonstration of Nasal Irrigation using Neti Pot

 

Last but not least, we have our charming Dr Eng, who tickled the audience with his candid descriptions and actions which help the audience to relate both ears and voice issues.

Dr Eng Soh Ping working his charm on the audience

 

Audience interacting with Dr Eng and laughing heartily

 

Dr Eng said that besides hearing, a good pair of ears is required for maintaining balance. He explained that there are 3 sections to the ear, namely outer ear, middle ear and the inner ear where the latter is a processor of sound, transmitting information to the brain.

When relating ear conditions, never did I knew that ear infection is also called the “Singapore Ear”. What a surprise cos I’ve only heard of “Hong Kong Feet”… are we that famous?? haha.. well, i went up to google it and this is what I’ve got from wikipedia:

Otomycosis (also known as Singapore Ear) is a fungal ear infection, a superficial mycotic infection of the outer ear canal. It is more common in the tropical countries. The infection may be either subacute or acute and is characterized by inflammation, pruritus, scaling, and severe discomfort. The mycosis results in inflammation, superficial epithelial exfoliation, masses of debris containing hyphae, suppuration, and pain.

Repeated ear infection especially in the middle ear can result in broken ear drums. The advise is to keep the ear very dry to prevent an infection caused. 

Next, Dr Eng went on talking about voice disorders. Typically, the high risk groups goes to those who uses their voices alot like preachers, teachers, karaoke lovers, etc. However, daily habits may also contribute to voice disorders too. For coffee lovers, the acidity in coffee may cause gastrointestinal reflux, resulting in the tissues of voice box being eroded away slowly. This is the same for buffet lovers and the “supper gang”. Consuming large amount of food will result in additional production of acid in the stomach to aid digestion. When there is no space in stomach, the acid will work the opposite direction and cause  a reflux. Not good for the voice box. Excessive intake of alcohol and smoking will also contribute to voice disorders. So, you know what to do if you don’t want to lose your voice or have a paralyzed voice box!

Voice box nodules which is also known as the Singer’s nodules were also mentioned. The nodules which will obstruct the full closure of the voice box will result in a hollow voice being produced. Dr Eng had mentioned a typical singer with Singer’s nodules — Rod Steward. I’ve got a clip here for your enjoyment.

Right after the session, we can see our doctors enthusiastically answering questions from the public…

The afternoon ended off successfully with sumptuous teabreak and alot of freebies to take home!

Opening of ASCENT Ear Nose Throat SG East

ASCENT doctors are now serving patients in the east of Singapore too!

Our second branch, ASCENT Ear Nose Throat SG East,  is now opened!

Location: 

219 Joo Chiat Place (just along Still road) East Shore Medical Centre, #04-04/08

our signage with new logo...

 

peeping though our new equipment...

 

Probably some of you have not heard of East Shore Medical Centre or have heard of it but not sure where… It’s a newly renovated medical centre with warm and excellent service (probably unnoticed though) and nicely done up facilities… while I’m unsure if all are renovated but the done up wards look fantastic!