Dr Ho King Hee speaks at the seminar.
FOR more than 30 years, Winnie Leong loved indulging in all sorts of salty food.
Although the 72-year-old occasionally complained of weak knees, headaches and back pain, computerised tomography (CT) scans found nothing particularly serious about her health.
However, the septuagenarian got a wake-up call one morning when she fainted after losing her balance, causing to her tumble to the floor and break a leg bone.
After a series of check-ups, she was diagnosed with a minor stroke.
Her case is common yet often neglected.
“When a person reaches an age where the body degenerates faster than regenerates, there are body parts that start to slow down or give way — like weak knees, back pain, headaches and poor blood circulation in the limbs to the extent of numbness. Yet, a physical examination by the doctor might not detect any particular ailment.
“This is when one should be more concerned about lifestyle,” advised geriatrician-in-practice Dr Chan Kian Ming from Gleneagles Hospital, Singapore.
He told the media in an interview at a recent scientific seminar in the city state that change in lifestyle is becoming increasingly important to modern society as it plays a huge role in improving health.
“It might not prolong your longevity to the point of immortality but it will certainly make your golden years happier — you can at least still walk around instead of being bedridden,” he said.
Dr Chan said the 21st century has seen people enjoying longer life expectancy than in the 1950s where people were expected to live only up to an average of 48 years.
“The reasons could be better access to healthcare, early prevention (vaccination), improved pharmaceuticals (antibiotics and oncology drugs), better hygiene, improved nutrition, early screening and diagnosis,” he said.
On how to live a longer life, he said: “Well, unless you are blessed with good genes like the Okinawa centenarian, changes in dietary habits, exercising, psychological well-being and frequent check-ups are vital.”
Dr Chan explained that Okinawans had proven they were among citizens of the world with the lowest mortality rate, adding that they appeared able to withstand a multitude of ageing-induced chronic diseases better than most nationalities and, as a result, are able to enjoy what may be the world’s longest health and life expectancy.
He pointed out that dietary supplements could help improve longevity, depending, of course, on one’s health condition.
“Unless an elderly person is lacking in certain vitamins and nutrients, these dietary supplements can have little effect. The body only needs a certain amount of vitamins and also time to ingest the entire dietary supplements consumed. Overloads can produce the reverse effect,” he explained.
The seminar ‘Managing Aging’, organised by Gleneagles Hospital, discussed issues relating to ageing such as heart failure, joint pains, dementia, declining visual problems and thyroid diseases.
Signs of stroke
Gleneagles Hospital neurologist Dr Ho King Hee spoke on the subject of stroke and how to recognise the signs of an impending attack.
“People tend to be confused over the symptoms of stroke. Generally, focal neurological problems (relating to nerve, spinal cord or brain function) are directly related to stroke.
“Symptoms such as weakness or numbness on one side of the body, clumsiness, double vision and difficulty speaking are the focal symptoms that must not be neglected. Early diagnosis can save lives,” he said.
“Comparatively, symptoms like feeling weak all over the body, tingling of both hands, sweating, and tiredness might confuse the patient — but these cannot be due to stroke. Seeking professional advice is important because people, especially the elderly who are the high risk group, worry about the possibility of stroke,” added Dr Ho who specialises in headaches, nerve disorders and pain.
He explained that headaches, a possible link to stroke, varied according to different symptoms.
“Consultation is vital in diagnosing the types of headache the patient is suffering from. Whether it’s a simple migraine, nerve irritation or tension headache, if the headache has unusual features, we call it a red flag. It can be the worst headache of your life, causing you to lose consciousness or wake up at night to the extent of the headache getting worse and worse since it started days or weeks ago.
“Under such circumstances, this and other red flags, will tell us (doctors) to conduct a scan which might be expensive but it can accurately tell us whether the headache is a ‘safe’ headache.
“However, at times, doctors choose not to scan headaches. Getting to know the health history of patients through consultation will enable doctors to determine how the headaches started and what are the existing conditions of the headaches. In this way, the seriousness of the headaches can be diagnosed.”
Dr Ho said apart from a headache, a neckache is probably the most common pain originating from the body’s musculoskeletal system although the common myths about neckaches could probably have people confused over stiff neck and stroke.
Myth No. 1
Neckaches come from blocked blood vessels and are a symptom of an impending stroke.
Most chronic neck pains come from sensitive and tight muscles in the neck region. They are the equivalent of tension-type headaches felt over the temples or encircling the head. It can be difficult to tell where a neckache like this starts and where the headache begins.
Neckaches can also originate from joints between the bony vertebrae in the neck affected by wear and tear over time. Only very rarely will neck pains arise from blood vessels. In such a case, there is a tear in the wall of a large blood vessel in the neck, and in this exceptional situation, strokes can really occur.
Myth No. 2
It must be because of something I ate.
Dietary factors have almost nothing to do with musculoskeletal pains like neckache. It’s unlikely taking supplements will help ease the pain. In the same way, it’s not necessary to avoid particular foods in order not to worsen the pain.
Myth No. 3
The pain will go away if I exercise more.
This is only partially true. Aerobic exercises like jogging, swimming or cycling improves fitness, reduces stress and
releases natural painkilling chemicals within the body.
But exercises that involve straining such as sit-ups,
pull-ups, push-ups and rowing can actually worsen neckaches because of increased muscle strain. Attempts to strengthen the neck muscles are usually counter-productive.
Myth No. 4
If the neckache continues, I will have to go for surgery.
It all depends on the cause of the neckache. The usual neckache arising from tight and tender muscles should never need surgical treatment. Surgery is usually required when degenerative change in the bones of the neck is so severe that the function of the spinal cord or nerve roots is impaired. In this instance, there can be weakness or numbness of the limbs and the diagnosis is proven with an MRI scan of the neck. Non-surgical treatment is the mainstay of management.
Myth No. 5
The best way to treat long-standing neck aches is to use painkillers.
Frequent use of painkillers can cause long-term side effects. Besides, painkillers do not address the pain mechanisms that lead to the increased sensitivity of the muscles. It can be very helpful to take a different type of medication daily to address the latter problem.
This kind of medication will take longer to work (up to two to three weeks before an effect is seen) but will have a sustained effect.
A course lasting some months is generally recommended after which the medication can be stopped. Visits to a physiotherapist or myofascial therapist for treatment of the painful area, correction of a poor posture and learning the relevant exercises are also generally recommended.
Dr Ho has published extensively on headache epidemiology in Singapore and is the founding president of the Headache Society there.
He also sits on the Pain Advisory Board of Singapore and holds multiple portfolios as external examiner for postgraduate family medicine and neurology exit examinations, and reviewer for regional neurology and local journals.