Sudden Strike - Hypertension

Sudden Strike - Hypertension

Stroke is often perceived as a problem that comes with old age but in reality, even the young and sporty can be vulnerable. Consultant Neurosurgeon Timothy Lee shares some insights on the condition.

A stroke can affect anyone. Case in point: Popular local radio DJ Rod Monteiro. Despite being relatively young at 44, and leading a sporty lifestyle including running marathons and cycling regularly, Mr Monteiro made the news recently when he suffered a stroke while at work. 

Even children are not spared. Consultant Neurosurgeon Dr Timothy Lee’s youngest patient for stroke was just 12 years old. “He fainted and was found to be bleeding from a congenital blood vessel abnormality. We had to operate on him immediately,” said Dr Lee.

While you may have little control over congenital problems, there are risk factors which can be moderated to prevent or reduce the chance of a stroke. Things you can do proactively include adopting a healthy diet, avoid smoking and controlling diabetes and hypertension if you have the conditions.

Stroke also need not be viewed as a permanently debilitating condition. According to Dr Lee, about half of all patients who suffer a stroke make a good recovery, usually within the first three months. 

Dr Lee’s young patient is one such success story. “He made an excellent recovery and returned to school. He even regained the top position in his class,” shared Dr Lee. 

Q&A

What is a stroke? 

A stroke is a condition where blood flow to the brain is interrupted – either due to blockage or bleeding, starving brain cells of necessary oxygen and glucose, and leading to brain damage which can manifest in impairment to speech, movement and memory.

According to Dr Lee, in most cases (about 80%), the stroke is due to a blocked artery; while bleeding accounts for the rest. Both result in a lack of blood flow to the brain and a build-up of pressure in the brain which leads to the death of brain cells.

How can one tell if someone is having a stroke?

The common signs are weakness or numbness of the limbs and a sudden headache. Transient weakness or numbness are possible warning signs of a blocked artery, while a sudden and unusual headache may be a sign of internal bleeding. Slurring of speech or sudden blurred or double vision are possible tell-tale signs too. 

Does it help if you get to a doctor quickly?

Like most diseases, the earlier you get treated, the better. Prompt treatment can make all the difference in one’s prognosis for recovery. 

Are all strokes the same?

Not all strokes are alike and they can be of different severity. The impact of a stroke depends on how much of the brain is affected and the location. Smaller strokes may result in weakness on one side of the body, difficulty speaking and incontinence. Larger strokes may result in paralysis. Some strokes can be fatal. 

What risk factors should I look out for to prevent a stroke? 

I sometimes use the acronym Cholesterol DISH to summarise the key risks factors that can lead to a blocked artery. ‘D’ is for Diabetes; ‘I’ for ‘I or myself’, which basically means your genetics; ‘S’ is for Smoking; and ‘H’ is for Hypertension. As for the other major cause of stroke –bleeding, the main risk factor to monitor is hypertension.  

Can anything be done to mitigate the occurrence of a second stroke after a patient has suffered the first one? 

You should first try to reduce the risk factors. While you may not be able to do anything about your genetics, you can help yourself by making lifestyle changes such as giving up smoking and opting for a healthier diet. It is also important to get proper medical attention and medication, for example an anti-platelet agent may be prescribed by the doctor to open up the blocked artery. Regular medications may be needed to control diabetes, high cholesterol or hypertension.

What is the treatment for stroke patients?

The primary goal is to restore brain function and prevent future strokes. Besides the use of an anti-platelet agent, surgery to remove a narrowing in the artery may sometimes be required. Post-stroke, rehabilitation may be necessary to help the patient recuperate and recover mobility.

Final words of advice

Listen to your doctors and therapists, and follow their instructions. It is important to control the risk factors and don’t stop your medication without discussing it first with your doctor.

For more information on hypertension & high blood pressure, visit the Mount Alvernia Hospital website. Dr Timothy Lee’s clinic is at Mount Alvernia Medical Centre A, Unit #02-23. Vigilance & treatment for hypertension.

On the ball again – Knee Problems

Plagued by knee problems, goalkeeper Alimin Mohamed thought his professional soccer career was over when he suffered not one, but two major knee injuries. But tenacity and a caring team of doctors and physiotherapists soon got him back on the field.

When football fans watch Tampines Rovers goalie Alimin Mohamed darting around on the pitch in his signature #14 jersey, most are probably unaware that he has a knee full of screws and metal plates. 

The goal keeper of Singapore’s leading football club first joined the high profile football club’s youth academy at 14. Moving up to the Prime League, he was just 19 when he suffered his first knee injury. 

“As the Tampines Stadium football pitch was undergoing maintenance then, the team trained at the field just outside the stadium. Unfortunately, I stepped into a pothole. I thought I’d just twisted my ankle but I heard a loud ‘pop’ from my right knee. That night, it swelled up and was so painful I could hardly walk,” recalled Alimin, now 27, about that fateful day in November 2003.

Anterior Cruciate Ligament (ACL) Injury

The next morning, he consulted orthopaedic surgeon Dr Tho Kam San at Mount Alvernia Hospital. A well-known name among local sportsmen, Dr Tho is also the team physician for the national soccer team. Dr Tho delivered the bad news: Alimin had completely torn his Anterior Cruciate Ligament (ACL), the main tissue holding the joints in the knee together. He would need reconstructive surgery and it would be at least six months to eight months before he could be back on the field. The doctor also cautioned that full recovery was not guaranteed either. 

“It was my first year in the Prime League and the beginning of my professional football career. I was utterly depressed at this major setback,” recalled Alimin. 

Alimin told himself that his best bet was to cooperate with the doctor and maintain his mental strength. “Dr Tho saw how much I wanted to get back on the field and scheduled the operation for the very next day.” During the four-hour surgery, one of the hamstrings in Alimin’s left thigh was used to replace the ACL in the right knee. 

Intensive Sports Physiotherapy

Intensive rehabilitation followed immediately. “Every day for two, three hours, I’d be at Mount Alvernia’s Rehabilitation Centre. There, Senior Sports Physiotherapist Fairuuz bin Saleh started with cold and current treatment on his knee for a fortnight to reduce the swelling. He then guided Alimin to do leg presses to build up his left thigh muscle. 

“The pain was so great, I had to hold back my tears,” grimaced Alimin, “but I persevered because I wanted to play football again.” After getting the green light from Dr Tho, he doubled his rehab efforts, once with his physiotherapist in the morning and a second session swimming or cycling at the gym in the afternoon. It paid off. Just four months later, Alimin was back in training and chasing his soccer dream. 

Although his right knee had completely recovered, Alimin developed a phobia. “I was so afraid I’d hurt it again, I couldn’t perform my best. 2004 was the lowest point in my career. I played some games but almost didn’t make it to the team the next year,” admitted Alimin. “Thankfully, my coach and team mates didn’t give up on me and spurred me on.” 

Everyday, besides two-hour training sessions with his team, Alimin also hit the gym. Dr Tho also advised him to take glucosamine supplements to strengthen his joints. 

By 2006, Alimin was on top of his game again. Appointed captain of the Prime League team, he guided them to win second place and was even promoted to the S League team. Then in December 2009, on the very first day of the pre-season training, disaster struck again. 

Another Torn Ligament!

“I stretched out for a ball and landed awkwardly. This time, although there was no pain or swelling, I knew from my previous experience that I’d injured my right knee again.” Dr Tho confirmed his worst fear; Alimin had torn 80% of the entire ligament and would require surgery again. This time, he had to use a synthetic patella tendon as “I’d run out of hamstrings I could use,” he explained.

Suffering an ACL injury injury twice often spells the end of a sportsman’s career. But the tenacious Alimin refused to give up. Working closely with his physiotherapist, they tackled his daily rehab with a vengeance. After two months, Alimin progressed to jogging. Their concerted effort paid off beautifully. In just three and a half months, Dr Tho pronounced him fit for the field again. 

Since then, Alimin has been playing at his highest level yet. Last year, the Tampines Rovers won the S-League and toured Maldives, Vietnam, Thailand and Iraq, making it to the quarter finals of the Asian Football Federation. Called to the field in the last 30 minutes – ironically because the first goalkeeper suffered an ACL injury – Alimin stopped goal after goal from the Iraqi team. It was one of his finest performances yet. 

Unfortunately, during extra time, the Singapore team scored an own goal and the Iraqis won 1-0. Alimin was disappointed but there was a bitter-sweet consolation. “My coach Steven Tan told me that I’d done a good job and that he didn’t expect that from me as I’d replaced our goal keeper, a key player on the team, at the last minute,” shared Alimin with quiet pride. 

Successful Rehabilitation

Tapping at his right knee, he declared, “I’m so thankful I can make a comeback in my career because Dr Tho successfully operated on my knee twice. I also want to express my gratitude to my physiotherapist Fairuuz who pushed me to my limits to help me bounce back even stronger,” said Alimin, who also credited his family, coach and team mates’ faith in him as driving forces. 

“I’ve benefited from the care at Mount Alvernia Hospital over the last eight years and I truly appreciate the amazing service. Everyone I’ve met has been very experienced and knowledgeable about my condition, and very patient with me. On the day of my discharge, they sent me out on a wheelchair and even carried me into the car! They don’t just say goodbye after you sign the discharge form! I often see them send newborn babies out to the cars too!” said an impressed Alimin. 

When told that it’s a unique Mount Alvernia tradition, Alimin smiled, “That’s one thing about Mount Alvernia Hospital that stands out from the rest. Here, they really take care of you like you’re their child.”

Common knee problems in Singapore include Osteoarthritis of the knee & meniscus tears. Orthopaedic surgeon Dr Tho Kam San is based in Mount Alvernia Hospital and is an expert on common knee problems.

 http://www.mtalvernia-hospital.org/knee-problems.asp

Producing Creative Writing Ideas At The Most Unproductive Period

 

It is not essential that all people have to born with creative writing ideas, rather every person can be creative in his own way. The whole world and the universe are the source of everything. Similarly, great creative writing ideas have their origin around the people. Though everybody cannot not become a writer or a poet, but having good writing ability and creative writing ideas may obtain a man great deal of recognition. Even if, a person has joined an essay writing competition, he should have gotten some creative writing ideas.  If a person has not inherited great talent for writing, it is possible to acquire it through enormous seriousness, learning and great dedication. Instead of all these, a timely innovative barrenness can happen to everyone. It also happens in the case of great authors and poets. Sometimes, a professional writer can get this barrenness due to the excessive workload. There are some practical ways to improve such an unpleasant situation, and gradually overcome this situation. Sometimes, a writer just needs to have a bit of variation necessary in order to overcome such a miserable situation. If an author takes up the business of writing in a 9 to 5 office time format, it is evident that, his mind will experience fatigue.

 

A writer can take a walk by himself in a casual mood, or he may go to a long drive. Sometimes, the open nature and road can produce some great creative writing ideas in mind. Any creative idea is the result of some experience, directly or indirectly. Sometimes, a writer just can take a sip of his favourite brand of coffee in order to release the stress. It is important to get some diversion from the everyday life in order to surmount this difficult situation. Sometimes, the situation just demands a person to go away from the keyboard or pen and paper in order to get back to the real creative self. In fact, it is not a diversion, rather a most important and needed respite from the pile of workloads and humdrum nature of the surroundings.

 

Creative writing ideas float around the people. A great author has the eye to catch them and transfigure those abstract ideals in to written tapestries. A writer may indulge in some quality time with his family and friends or someone special in order to get some rest of mind. Sometimes, it happens that, a writer has great creative writing ideas, but he is busy with some other things. In this case, he can simply, in a short format, jot down his ideas in a diary or in a separate folder. At the time of emergency, this thing may prove to be a great help to the writer. A simple thing can lead to great ideas. For example, Tolkein once saw a hole in the ground, which prompted him to write a creature called Hobbit, in his Lord of the Ring series. A writer should indulge in the very thing that he likes to do at the time of idea crisis.

Selection Of Compelling Topics For High School Debate Competition

 

There is no dearth of compelling topics to debate about for high school kids. If there is a cultural comity in the school, it is a challenging task to find out different topics to debate about for high school. It is a fact that, when a school quite often organizes a debate competition, it is not that easy to find topics, which will make young pupils interested. But still, there are enough ways to make a debate competition full of spirit. In the school, there are always some students, who have immense admiration for this extracurricular activity. A school should make up a debate organization committee to see all these matters. Though it is not always possible to find topics to debate about for high school, a debate organizer can add a twist by introducing different norms in the competition. For example, a group of students can be given a general topic, on the basis of which the competition will be held. If the general subject is the current situation of the world economy, a debate controller can give topics on the basis of this theme in accordance to his choice. This system will add a surprise element in the competition.

 

If a debate organizer only looks for topics to debate about for high school, he should also pay close attention to the other different things too. For example, if there is no surprise element in the competition, the students will shortly find the whole thing boring. A teacher can discuss different topics to debate about for high school, with his students so that they can suggest some fascinating topics also.  A teacher needs to make his students interested in joining such competitions. When a student joins such a competition, he has to indulge in lots of hard work, as well as, pressure. A debate session can enrich the students, as well as, make them prepare for the presenting different ideas in a precise manner. When a person can present his ideas in a confident manner, it is a marvellous thing for him in the world outside the school also. When he would be, in future, facing an interview, this skill will help him a lot.

 

Organizing debate competition frequently can benefit the students greatly. If the cultural committee has a separate wing for organizing debate competitions, it will be beneficial for everyone. People of this committee can independently operate their activities. Both teachers and students should constitute the members of the debating committee. When both parties participate in a single mission, it is evident that the outcome will be positive. Selectors of topics to debate about for high school should concentrate on the current issues too, as they are prominent topics for debate and discussion. A brain storm idea copy should be maintained, where everybody can give their own ideas for the upcoming debate competition. The selected topics must be compatible with the class and age group. It is better to leave out highly controversial topics, and pick out more neutral ones.

Finding New Speech Ideas From The Surroundings

The world is the greatest source of any kind of idea. People, despite that, falter when asked to deliver a speech. It is a wise decision to accept that it is ok to get confused to find relevant speech ideas all of sudden. When a person can accept that situation, only then, he can work on it to get it better. Speech ideas can be found in the surroundings, in the area of expertise, in the politics, foreign policy of the nation, and in everything. One thing to be sure is that, a person needs to be sure about the surroundings and the audience, he is addressing. If his speech ideas comply with the situation only then, he should proceed. A person needs to remember that, the people around him are not also regular speakers. As a result, a little bit amount of mistake will not be highlighted. This consideration can give some confidence in the speaker. A speaker must not start babbling out loud as soon as he gets up on the stage. Even, before, he starts, he should have a precise structure about the upcoming speech of himself in mind. It will help the speaker to stay focused.

If a person is not accustomed to give public speeches, he may run out of the speech ideas. It happens to everybody, but one should not simply give up amid a burst of laughter pouring out like soda water. Rather if, a person can maintain his calm, he can conquer this situation, and become the sensation of the gathering. If a person has a bit oratorical power, he can win over such a situation of running over speech ideas by the sheer power of controlling his nerve. A person can simply pick up some moments from his life, which will be compatible as relevant speech ideas in the occasion. While doing this, he must keep in mind that, he is not meant to deliver a highly didactic speech. Rather his speech in a clear format so that the audience can follow him. While a person chooses an incident from his life as the topic of his speech, he must relate the story to the event he is attending.

When a person thinks of speech ideas, he should think of the type of audience. A learned man cannot expect a group of rapt listener out of a bunch of school kids. Neither can a businessman expect a huge expectation from the people of his family in a wedding party about the story of his success. Instead if, the businessman would relate a story about the bride or the groom with a pleasant presentation, he can get massive applause. A person can get speech ideas from the recent happenings and interpret these in a new light. If a person is attending a situation, where he may be asked to say something, he can make some precaution of storing some potent speech ideas in mind. In this way, he can face the situation bravely.