Dr Nair

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Don't follow my example: Khaw
Health Minister admits he was in denial about his heart condition and had put off tests
Mr Khaw undergoing cardiac physiotherapy at the National Heart Centre.
His thrice-weekly sessions at the centre also include treadmill exercises.

- PHOTO: MINISTRY OF HEALTH
NEARLY four weeks after undergoing a coronary artery bypass graft, Health Minister Khaw Boon Wan confessed on his blog that he had been in denial about his condition and put off going for tests and treatment for six weeks, against his doctor's advice.In his blog entry dated May 27, Mr Khaw said cardiologists had told him he needed to have an angiogram as soon as possible due to his high calcium score and abnormal electrocardiogram stress test reading. A coronary angiogram would allow doctors to inject a dye into the arteries to ascertain blood flow in the heart. But despite calls from the National Heart Centre to schedule one, Mr Khaw said he put it off and even went to Penang one weekend for Qing Ming.Denial is quite common among patients, said cardiologists, and Mr Khaw's experience is a reminder not to delay health check-ups and follow-up treatments. Most patients experience denial especially when they still feel fit.In fact, to prove to himself that he was in 'top physical form', the 57-year-old minister went against his doctor's advice to ease up on his exercise routines and did the opposite. 'I used to run on (the) treadmill three times a week; I increased it to five. Each time, I ran at my usual pace of 8km per hour for half an hour,' he said. The stubborn Mr Khaw also stopped carrying his Glytrin spray, a medicine applied under the tongue to dilate blood vessels and make it easier for the heart to pump blood around the body. He told himself: 'I am not going to get a heart attack. I am not going to carry this.'
IT COULD HAPPEN TO ANYONE “One patient asked me: How can the Health Minister have a heart problem?” I told him ministers are human beings too. Even doctors get it.”
Cardiologist, Dr. V.P.Nair
Mr. Khaw said in his blog entry dated May 26 that he had been symptom-free. “ I was fit as a fiddle… I had never felt breathless climbing stairs or when running on (the) treadmill, let alone experiences any heart pain or angina,” he said. On May 3, Mr. Khaw finally went for an angiogram which was followed by a bypass the next day. He is now on medical leave until June 13, and goes to the National Heart Centre thrice a week for Cardiac Physio-therapy and treadmill exercises. He said that he was lucky nothing had happened in the previous six weeks as cardiologists had said. “It was not un common to have their patients perish before the scheduled angiogram or bypass” “I am making this confession so that hopefully it can be a life saving reminder to others. Please do not follow my example.” Mr Khaw added. Doctors pointed at least two mistakes Mr Khaw has made. A patient who feels ”all right” may not be so as heart problems can develop without any symptoms at all said Dr V P Nair, a cardiologist with 17 years experience. Doctors also said that, increasing the intensity of exercise when you know that you may have a blockage, could be dangerous.

Urgent need for a large wedding hall(Kalyana mandabam) & cultural centre

Urgent need for a large wedding hall(Kalyana mandabam) & cultural centre.
It is very gratifying to note from the publication in the Straits Times home page b12 of May 19, 2010, titled “Boost for Hindu board” that Hindu Endowment Board will be able to form companies and Joint ventures which will enhance incomes and promote beneficial activities to the people as stated by community Development, youth and sports minister Dr Vivian Balakrishnan. KUDOS to the minister and the HEB. The minister timely primed on the long-awaited vision that the Hindu Endowment Board would be able to form companies and joint ventures to enhance and promote beneficial activities to the community.

One of the ways to achieve this, according to my thinking is to develop the land within the Perumal temple complex in Serangoon Road into a large cultural and commercial hub. I have seen many marriages and other cultural activities with large participation of relatives and guests of the wedding parties and interested groups packed inside the available kalyanamandapams (wedding halls) at the main temples of Singapore. With thousands of people squeezing their way through at the prevailing wedding halls and with increased awareness of culture and religion among the prevailing citizens of Singapore and the newly arrived, the temple activities have gone up exponentially. For example, certain marriages have thousands over guests whereas the various halls in Singapore can accommodate only half or much less than that. To reinforce the point, presently marriages and other religious and cultural functions witness thousands of people packed like sardines inside the available wedding halls at the majority of the temples of Singapore. The cultural shows also attract a larger number of people sometimes over a few thousand. But often it is difficult to get a proper a place and whenever it is available the charges are too exorbitant. If we have a Kalyana Mandhabam and cultural complex to accommodate thousand to three thousand people, this can be given in Toto for a function or even divided into smaller function rooms when there are many such events taking place concurrently be it on weekdays or weekends. Moreover cultural exhibits, artifacts and other activities also can take place in the same place.

The rentals from these events will be substantial and can maintain these halls and theaters. I would strongly advise the ministry of youth and sports together with the Hindu Endowment board and other interested parties to consider this idea seriously and work on it quickly in the Singapore style. Indeed, programmes including marriages of other faiths should also be allowed to make use of the facilities in the true spirit of racial , religious and ethnic harmony as well as integration of existing and newly arrived Singaporeans. Multi story building with underground car park facilities will be the best scenario.

An example is the Swami Vivekananda International Convention Center in Mauritius. It has 17,000sq meters of flexible space which has a convention center, business centre and room facilities. This hall is usually portioned from time to time into different halls to accommodate many faceted activities. It has complete on-site A/V services, moveable partitions to transform the main hall, Indoor Pyrotechnics, Simultaneous Translation Facilities, ATMs and foreign Currency Facilities, Telephone facilities in all meeting rooms and Décor and floral arrangements. It can accommodate 3500 over people, has 10 meeting rooms with independent lighting and 2 permanent registration desks. There are also kitchen facilities to accommodate catering and facilities for disabled persons. It also has Outside broadcast and video taping facilities, Data points in Meeting rooms and Information Kiosks.

Similarly Sree Swaminarayan Mandir, Naesdon London is another model that we can look into. It can accommodate over 4000 people has 50m by 45m in area; the hall has no columns and allows natural light to enter through 4 light wells. It has a kitchen which is fully equipped with modern technology and has been adapted to suit traditional styles of cooking.
Perhaps the Singapore model can be made even better than these and can remain a financially viable world class model as a true heart and soul of the Singapore Indian community.
Dr. V P Nair
Consultant Cardiologist
Tel 62359226, mobile 98460910
Nair Cardiac Medical Centre
Mount Elizabeth medical Centre # 16-08
Singapore 228510

Dr Nair at work

PTCA & Stenting by Dr V P Nair (Radial/ Brachial artery)

PTCA & Stenting by DR V P Nair(Groin approach)

Dr Nair's Russian card

Кардиологический и Общемедицинский центр

Доктора В.П.Наир

Доктор В.П.Наир

Главный консультант-кардиолог

MD, Член Royal College of Physicians (Великобритания), член Royal College of Physicians (Ирландия)

Выпускник Медицинской академии по специальности кардиология (Сингапур), Royal College of Physicians (Ирландия) и Royal College of Physicians (Великобритания), выпускник Royal College of General Physicians (Великобритания), выпускник International College of Angiology (США) и American college of Cardiology ( США).


Mt. Elizabeth Medical Centre Тел.+65-6235-9226

3, Mount Elizabeth +65-6235-9228

# 16-08 (16 этаж) Факс +65-6235-4509

Singapore 228510 +65-6468-7286

После рабочего времени +65-6533-0088

+65-6535-88-33

E-mail: lordsiva@starhub.net.sg or doctor_nair@hotmail.com

Webpage: www.naircardiaccentre.com & http://www.cardiology-nairclinic.com/

Blog: http://www.heartandyou.blogspot.com/

Eating habit and life style - main contributing factors in Cardiac rehabilitation program

Eating habit and life style - main contributing factors in Cardiac rehabilitation program (English Translation of Article Published in Lian He Zao Bao -- April 11, 2010)

Consultant interventional cardiologist Dr V. P Nair (Mount Elizabeth Medical Centre) said that high levels of lipids ( cholesterol and triglycerides) as well as saturated oils and trans fats in the food are bad to our health. They can cause elevation in blood cholesterol level, increase the chance of coronary artery blockage and therefore lead to heart attack and stroke. Eating habits and life style are the main contributing factors in cardiac rehabilitation program.

Many middle aged people would have already been suffering from heart diseases which may be silent in some cases. The most common heart diseases are coronary artery diseases (leading to heart attack), septal defects (holes in the heart), valve diseases, arrhythmias ( heart rate irregularities), heart muscle disease (cardiomyopathy and myocarditis) , hypertension 9 elevated blood pressure), heart failure (water in the lungs)and thyroid heart disease( too much or too little thyroid hormone).

With different types of heart disease, and modern life style, Dr V. P Nair (Mount Elizabeth Medical Centre) pointed out that in general there is an increasing trend of heart diseases, especially coronary heart disease. However, with early detection through health screening, better control of risk factors, and advanced technology , cases of coronary artery diseases can be reduced. But as the general population is getting older, all types of heart disease, including arrhythmias, ischemic heart disease, diabetes induced coronary artery disease and degenerative heart disease, will still be increasing. Dr Nair said, “hypertension, smoking, hyperlipidaemia, diabetes, obesity, lack of exercise, stress and family history are the main risk factors (cause) of coronary artery disease.

Change in life style and eating habits
Through regular checkups, once a person is found to have heart disease, he/she must change his/her life style and eating habits, engage in more regular exercise, quit smoking, eat wisely and avoid being obese. People suffering from hypertension, hyperlipidaemia and diabetes must control their condition well in order to be healthy. Dr Nair advises patients with heart disease to manage their stress through exercise like Yoga, Taiji, and family outing etc as it is good for their health.

Dr Nair described a 55 years old patient with heart disease. He said, “when the patient came to see me, he was having severe chest tightness. Symptom radiated to his neck and arm. He had nausea and he was also sweating profusely. . He also suffered from hypothyroid heart disease treated him for 3 years. He also suffered from other problems like renal disease, chronic backache and spinal disease . He used to smoke 50 cigarettes per day and drink alcohol occasionally. He has family history of hypertension, diabetes and coronary artery disease as well. I performed coronary angioplasty which showed severe blockage of two heart arteries ( coronary arteries). I treated him with balloon angioplasty and two medicated stents (drug eluting stents). After the surgery, he exercises regularly and controls his diet well, and he is now living in a very healthy state and happily working.

He also gave another case, “another patient who is a bus driver. He suffered from heart attack when he was only 28 years old. He was a heavy smoker, loved meat and eggs, and also has family history of heart disease. One day he had severe chest pain and fainted at home. He was diagnosed as a case of heart attack after ECG and blood tests. , His blood cholesterol especially the bad cholesterol (LDL) was very high, but HDL (good cholesterol) was low, his triglycerides level was also elevated.. He was treated with bypass surgery ( CABG) for him. After he was discharged from hospital, I advised him to change his job, quit smoking, start regular exercise, and take care of his health. 10 years later, he had another heart attack; I did coronary artery ballooning with stent inserted. He recovered well and is still living healthily.”

Dr V. P Nair said that prudent eating habit and healthy life style are the main contributing factors in cardiac rehabilitation programme. High cholesterol, saturated and trans fat in the food are bad to our health. They can cause elevation in blood cholesterol level, increase the chance of coronary artery blockage; and therefore lead to heart attack and stroke .

Exercise 3 to 5 times a week
Across all parts of Asia, the prevalence of obesity and type II diabetes continue to climb. The numbers of obese children are increasing, and all these are risk factors for future heart attack. Dr Nair emphasized that we must see the importance of exercise. It is an effective way to reduce weight and prevent heart attacks. Aerobic exercises, like brisk walking, jogging, swimming, riding bicycle, dancing, games etc, are good in improving the health of coronary vessels and overall heart condition. In addition, weight lifting, carrying dumb bell, and push-up are good ways to train both skeletal and cardiac muscles. We must maintain weekly exercise 3 to 5 times a week , and 30 to 60 minutes each time in order to be effective. Relaxation in any form is good to control stress and anxiety.

Sexual life post recovery
Will people who had suffered heart attack continue to have normal sexual life?
Dr Nair said, as long as patients pass the initial phase of recovery, they can continue to enjoy sexual life. “Many people think that after heart attack, sex may cause further heart attack and even death, but this is incorrect. However, anxious about sexual performance and depression are the main factors influencing their sexual life.”
Patients recovering from heart attack usually will experience different degrees of depression, and it is quite normal. Usually 85% of suffers will be free of symptoms of depression after three months. Regular medications, exercise dieting and relaxation will certainly help them to get over this problem.

Mailing Address of Dr. V. P. Nair,
MBBS, MRCP-Ireland, MRCP-UK, FAMS (Cardiology-Singapore)
FRCP-Edinburgh, FRCGP-UK, FRCPI, FRCP (London), FACC (USA), FESC, PBM
Consultant Cardiologist
Mt Elizabeth Medical Centre, 3 Mt Elizabeth, #16-08, Singapore 228510
Tel no: 62359226/8 Fax no: 62354509
Email: lordsiva@starhub.net.sg