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| Pay attention to your pain | ||
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| Your foot hurts A herniated or prolapsed disc can produce a sharp pain in the foot. This disc problem can be missed because there's no back pain. Act now A simple test would be to do 10 cobra poses: Lie on your stomach and while keeping your hips on the floor, arch your back up and slowly straighten your arms. If the pain eases, you could have a slipped disc since these extensions relieve the pressure, so consult a doctor next. Your leg hurts Take note if your leg hurts only when you are walking, running or bearing weight, since this is a common symptom of cardiovascular disease. This kind of pain arises because the arteries supplying the lower limbs narrow. Act now Get a GP to check your cholesterol and blood pressure, since you may be at risk of a heart attack or stroke. Your breath smells bad While 90 per cent of bad breath cases is caused by poor dental hygiene, the rest signal something more sinister. Lung disease, asthma and cystic fibrosis are examples of conditions that can cause highly acidic breath. Act now Visit the dentist to determine if your bad breath is the result of common causes like dry mouth, sinus infection, gum |
| Beware that tickle in your throat | ||
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| By Dr Patrick Chan IT usually starts with a little tickle at the throat. The tickle increases in intensity, and before we know it, we are coughing away. A cough usually goes away after some time. Sometimes, however, it may become frequent and prolonged when the respiratory system is infected or continue to be inhaled by exposure to environmental pollutants such as vehicle fumes, smoke or haze. |
7. Postnasal Drainage (PND) - an irritating trickling of mucous from the nasal passage into the throat caused by nasal allergies.
8. Asthma - an inflammatory condition of the lungs airways.
9. Gastroesophageal Reflux (GERD) - a condition where stomach acid backs up into the oesophagus and upper throat, causing irritation especially when the patient is lying down.
10. Side effects of medications - such as beta-blockers and ACE inhibitors, drugs used to treat high blood pressure.
Complications
Most people think of cough only as an inconvenience. However, prolonged violent chronic cough can bring about complications as a result of the constant intra-thoracic and intra-abdominal pressure to the body system.
These may include headaches, cardiac dysrhythmias (irregular heart beat), insomnia, subconjunctival haemorrhage (red eye), cough-induced vomiting, inguinal herniation, and gastroesophageal reflux.
Hence, do see a doctor if:
- Your cough lasts for more than three weeks.
- You are experiencing shortness of breath, severe pain or fainting.
- You are coughing up blood.
- Your cough is so severe you cannot sleep at night.
- You have concerns about the cause of the cough.
How to prevent coughs
- Avoid direct contact with those with colds and flu, and quarantine yourself if you have similar conditions to avoid passing the germs around.
- Wash your hands frequently during the cough and colds season.
- Wear a mask when the level of air pollutants is high such as during a haze.
- Avoid smoking and smoke-infested places.
- Ensure you meet your children's vaccination schedule to help reduce the risk of diseases such as whooping cough or tuberculosis.
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| The most serious fracture | ||
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| By Jovanda Biston Osteoporosis can lead to fragility fractures (from low trauma) resulting from a fall from standing height or less. Dr Lau Tang Ching, a senior consultant at National University Hospital's division of rheumatology, said that fractures of the hip or spine among the elderly can lead to premature death and loss of mobility. He said that the incidence of osteoporosis-induced hip fractures in Singapore has increased 4 1/2-fold since the 1960s. As the population of Singapore is ageing rapidly, osteoporosis is likely to become an increasingly important health problem. The World Health Organisation said that hip fractures are the most serious form of fracture associated with osteoporosis: they nearly always require hospitalisation, are fatal about 20 per cent of the time and patients become permanently disabled about half the time. Fracture rates increase rapidly with age and the risk of fracture in women over 50 is about 40 per cent, similar to the risk for coronary heart disease. In 1990, there were 1.7 million hip fractures worldwide. With changes in population demographics, this figure is expected to rise to six million by 2050. Dr Leonard Koh, a consultant endocrinologist at Gleneagles Medical Centre, said women are more prone to osteoporosis and osteoporosis-related fractures for several reasons including: - Women undergo menopause, resulting in accelerated bone loss. - Women tend to live longer, hence there are more elderly women than men. - Elderly women may have a weaker muscular system in their bodies than elderly men and hence they have a greater tendency of falling. |
| What you can do to keep your bones strong | ||
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| Regular exercise and the right diet can help reduce the likelihood of bone fractures for those with osteoporosis. Dr Leonard Koh, a consultant endocrinologist at Gleneagles Medical Centre, has this healthy advice: - Exercise 30 to 40 minutes at least three times a week. - Weight-bearing exercises, such as walking, tennis or dancing are beneficial. - Balance exercises such as taiji are good for the elderly. - Include resistance exercises such as free weights too. - Do not over-exercise however. Excessive weight loss or cessation of menstruation can be detrimental to bones. - A balanced diet that is rich in calcium from various food sources is better than relying on a single calcium source such as milk or calcium supplements. - Do include dairy products high in calcium such as milk, cheese and yogurt in your diet. -Those who are lactose intolerant should eat calcium-rich foods such as kai lan, chye sim, spinach, yellow dahl, soya products fortified with calcium and fish such as ikan bilis and sardines. - Calcium supplements are a good and convenient form of calcium. - Vitamin D helps the intestines to absorb calcium from one's diet. To obtain vitamin D, sun exposure on the face, hands and arms is recommended. For fair-skinned individuals, spending about 10 minutes in the sun two to three times a week is adequate. Darker-skinned individuals may require longer exposure. |
| Eating right for bone health | ||
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| By Jovanda Biston Osteoporosis is normally associated with older women. That is because this disease of the skeleton, in which bones become brittle and are prone to fracture, usually occurs in women over 55 years of age. But it can also affect men and younger women. What may be even less well-known is that steps to prevent primary osteoporosis, which commonly occurs after menopause or develops due to age-related bone loss, should ideally be taken from as early as childhood. The World Health Organisation said bone formation is most active during childhood and adolescence and that bone length and girth increase as the teenager grows, ending at early adulthood when peak bone mass is attained. Dr Manju Chandran, a consultant endocrinologist at Singapore General Hospital (SGH), said: "It has often been said that osteoporosis is a paediatric disease that manifests in geriatric times." Dr Chandran is director of SGH's osteoporosis and bone metabolism unit, the country's first and only unit that caters specifically to the management of patients with osteoporosis and other bone disorders. He explained that getting your bones in peak shape during the growth period from puberty to the early 20s is extremely important. It will pay off in your later years. The attainment of peak bone density or mass is heavily influenced by nutrition, hereditary factors, hormonal effects and the environment. The growth years are thus crucial to averting the risk of osteoporosis in later life. Dr Chandran said that people who have a history of an eating disorder in their growing years can develop secondary osteoporosis. This type of osteoporosis occurs as a result of the treatment of another disease or condition, or as a result of the condition itself. Eating disorders such as anorexia and bulimia typically occur during mid to late adolescence - a critical period for bone development. The National Institute of Arthritis and Musculoskeletal and Skin Diseases, the United States government's key agency researching into diseases that affect the bones and joints, found that osteopaenia, or low bone mass, is common in people with anorexia and that it occurs early in the course of the disease. Girls with anorexia are less likely to reach their peak bone density and will thus have a higher risk of getting osteoporosis and fractures throughout their lives. Moreover, Dr Leonard Koh, a consultant endocrinologist at Gleneagles Medical Centre, noted that the primary medical goal when individuals are diagnosed as anorexic, is weight gain and, in females, the return of normal menstrual periods. He said: "For people with eating disorders and osteopaenia or osteoporosis, the eating disorder has to be treated first before the doctor can effectively treat the bone health issues. However, it is often very challenging to get young girls with eating disorders like anorexia to grasp what they are doing to their bodies." Osteoporosis can happen to men too. Dr Koh said that although bone loss in men over 50 years is more gradual as men do not experience menopause, men are not spared from developing osteoporosis. Although the incidence of primary osteoporosis is lower in men, the consequences of osteoporotic fractures are much more serious for men. Dr Koh said a greater proportion of men die after osteoporotic hip fractures than women. Dr Chandran said a man's lifetime risk of suffering from osteoporosis-related hip fracture is greater than that of getting prostate cancer. She added that secondary causes of osteoporosis are also more frequently identified in men than in women. David (not his real name) developed secondary osteoporosis after he started taking steroid medication for his auto-immune hepatitis in April last year. The 40-year-old father of three was referred to Dr Chandran two months later because he complained of frequent backaches. A scan showed that the bone density at his spine and hip was low and in the osteoporotic range. Dr Chandran said the chronic use of steroids can lead to osteoporosis and that David's steroid use was a likely cause of his low bone mass density. David and his wife were surprised by the diagnosis. He said: "We thought osteoporosis was something that happened to people in their 60s and 70s." He added that after Dr Chandran started him on medication for his osteoporosis, he has had fewer episodes of spine and hip aches. But David, who works in the engineering industry, cannot stand or walk for long periods without rest. He said: "I've always enjoyed doing carpentry and home improvement projects. Now I need the help of my teenage son for the strenuous tasks. He's a strong 16-year-old boy." jbiston@sph.com.sg Types of osteoporosis Primary osteoporosis There are two primary kinds of osteoporosis, type I and type II: Type I osteoporosis, or postmenopausal osteoporosis, generally develops in women after menopause when the amount of oestrogen greatly decreases. As a result there is an increase in the resorption of bones, or a loss of substance in the bones. This can lead to fractures of the hip, wrist, or forearm, caused by falls or minor accidents. Type II osteoporosis, also known as age-related or senile osteoporosis, usually happens after the age of 70 and affects women twice as much as men. It often leads to hip and vertebral, or spinal, fractures. Secondary osteoporosis This is caused by other conditions such as hormonal imbalances, diseases, use of steroid and certain kinds of medication. Singapore General Hospital's Dr Manju Chandran said that about 15 to 20 per cent of women and 40 to 50 per cent of men with osteoporosis suffer from this secondary condition. |
