How do vaccines work?

When pathogens like virus or bacteria enter our bodies and our bodies do not produce enough antibodies to fight them away, we fall sick. 

Vaccines are made from a killed, weakened, or portion of virus or bacteria. Once injected into our bodies, the bodies will create the antibodies against the particular disease. When the virus or bacteria enter our bodies again, our body will recognize this disease and “fight” it.

How do vaccines protect my loved ones and me?

Vaccination builds up your immunity against the disease you are vaccinated. They are the safest way to protect you, your loved ones and your community from serious and sometimes deadly diseases. 

If only a few are immunized, contagious diseases spread easily from one to another. When enough people are immunized, you and your loved ones will be protected from the diseases.

What are the diseases that can be vaccinated for protection?

What causes nausea and vomiting after surgery?

There is a part of our brain called the “vomiting center”. When this portion of our brain is stimulated, it will cause people to feel nauseous and vomit. Nausea and vomiting after surgery is a common problem. Certain people, types of anesthesia, and types of surgery trigger this “vomiting center” easier than others.

Who has a higher chance of experiencing nausea and vomiting after surgery?

The chance of experiencing nausea and vomiting is increased for the following people:

• Children older than 3 years old

• Women, especially young women

• People who are overweight, pregnant, or have anxiety

• People who have a history of motion sickness

What are other factors that increase this risk?

The following factors also increase the chances of experiencing nausea and vomiting after surgery:

a) The type of anesthesia used. In general, most medications used for general anesthesia trigger the “vomiting center” easily. Thus, those who receive general anesthesia instead of local anesthesia are at increased risk

b) The duration of general anesthesia and surgery. The longer the duration, the higher the risk

c) The type of surgery performed. Ear, nose and throat surgery, laparoscopic surgery, gynecological surgery, dental surgery, and cosmetic surgery increase the risk

d) How well the patient recovers after surgery. Those who have pain, low blood pressure, low blood oxygen, or gastrointestinal irritation after surgery are at increased risk

In short, regardless of whether it is because of the medications or surgical procedures, once they stimulate the nerves, they will trigger the brain’s “vomiting center”, resulting in nausea and vomiting.

What are the consequences of nausea and vomiting after surgery?

Persistent nausea and vomiting after surgery increases pain. It might also cause surgical wound bleeding and prolong wound healing time.

Nausea and vomiting can also cause electrolyte and water imbalance, affecting the overall recovery and healing time.

What are some measures to prevent or control nausea and vomiting after surgery?

To a large extent, nausea and vomiting after surgery can be prevented and controlled.Many studies have found that taking anti-nausea medications before surgery can prevent nausea and vomiting after surgery to a certain extent. It has also been found that the effects of using two or more types of anti-nausea medications are better than just using a single type of medication.

This information will help you to:

•      Learn about asthma

•      Understand the types of medicines used to treat asthma

•      Know when to seek medical care

What is asthma?

Asthma is a disease of the bronchioles, the tubes that carry air to the lungs.

When someone has an acute asthma attack, the airways get narrow and may fill with mucus. This makes it hard to breathe. For someone having an asthma attack, it’s like breathing through a narrow straw.

What are the symptoms of asthma?

Symptoms can be different between adults and children. They also vary among individuals. Depending on how fast and how serious the symptoms are, each asthma attack can be very different.

Early symptoms may include:

•      Coughing

•      Wheezing

•      Difficulty speaking

•      Chest tightness

•      Trouble breathing

•      Trouble exercising or playing

How will my doctor treat my asthma?

Inhalers and medicine delivery devices

Most asthma medicines are kept in a small, handheld device called an inhaler. To help the medicine reach the lungs more easily, your child may also use a spacer or a valved holding chamber as an add-on device. Most children can be taught to use inhalers directly or with the right spacer device.

A child who cannot use an inhaler may need to use a nebulizer. This device turns the liquid medication into a mist that can be inhaled through a mouthpiece or mask.

Quick-relief or “rescue” medicines

These medicines are also called bronchodilators. They help to open the bronchioles, making it easier to breathe. Used to treat an acute asthma attack, rescue medicine should be used when asthma symptoms first occur. 

The most common rescue medicine used is albuterol (Ventolin).

Long-term controller maintenance medicines

Controller medicines are used daily to keep asthma under control, reducing the severity and frequency of attacks.

Types of controller medicines include:

1. Inhaled corticosteroids 

These medicines help to decrease swelling and inflammation, making asthma attacks less frequent. They are usually taken every day, even if your child is not experiencing any symptoms.

Examples include Flixotide and Pulmicort.

2. Long-acting bronchodilators  

These help keep the airways from narrowing. They are usually used along with inhaled corticosteroids.

An example includes Seretide.

Oral steroids

Your doctor may recommend steroids taken by mouth (in pill or liquid form) if the asthma is not well controlled. They reduce inflammation and can help the airways become more responsive to inhalers. Steroids usually start to work within about six hours so are not used in acute attacks. Your child should continue to take quick-relief and long-term controller medications while taking oral steroids.

What else do I need to know about asthma?

Follow all instructions you have been given about treating and controlling asthma, including:

•      Recognizing and avoiding asthma triggers

•      Having an asthma action plan with your health care provider

•      Knowing how to use inhalers and related medicine delivery devices 

•      Knowing how to care for, store, and clean the inhaler mouthpiece, face mask, spacer, and valved holding chamber

•      Knowing how to refill prescriptions

When should I seek emergency care?

If your child has any of these warning signs, call 120 or seek emergency medical care immediately.

When your child has been diagnosed with asthma, it is important that he or she is monitored by a healthcare provider. Be sure to take your child to all follow-up healthcare appointments.

What is an X-ray Imaging?

X-ray beams are a form of wavelength radiation with strong, penetrating rays. They pass through all body fluids, soft tissue, and structures easily, except highly dense tissue such as bones. The shades of grey shown on the film or imaging plate indicate the amount of X-ray beams that are passed through the body. Thus, bones that allow little X-ray beams to pass through show up white while lungs which allow more X-ray beams to pass through show up black. The medical imaging doctor interprets differing degrees of gray shades to make a diagnosis. These are the basic principles of X-rays.

What is an ultrasound?

An ultrasound is a form of medical imaging using sound wave frequencies transmission and echoes to create images of the soft tissue and organs within our bodies. These images can be films/pictures or video recordings. Ultrasound physicians interpret the characteristics of these images to make diagnoses.

Ultrasound is a safe and painless test that does not involve exposure to radiation. This test is often down lying down on a bed. Your ultrasound doctor will apply a gel that helps with sound waves transmission over the area that is required to be scanned. After which, he/she will move a probe over the skin surface to obtain images from different angles.

Ultrasound scans usually take less than 30 minutes, depending on the body area that is being examined. Complex ultrasound scans may require more time. 

When is an ultrasound used?

An ultrasound is used when your doctor needs to determine the size, shape and consistency of your internal organs and soft tissue. These organs include the heart and blood vessels, liver, gallbladder, pancreas, kidneys, bladder, thyroid, breast, uterus, and ovaries. Ultrasound can also be used to determine whether lumps are solid tumors or fluid-filled cysts.

Ultrasound is also often used for ultrasound-guided tissue biopsies, because of its excellent ability to locate tissue.

What should I prepare before and after the ultrasound?

No special preparation is needed. Unless specifically advised, you can eat and drink normally before and after your ultrasound test and continue taking medications. Wear comfortable, loose-fitting clothing during the test to expose the body area being examined easier. Sometimes you may be asked to wear a gown. You may also need to remove any jewelry you’re wearing.

For ultrasound scans on certain body area, you may need to:

What limitations does an ultrasound have?

Gas can easily interfere when obtaining images using ultrasound. Therefore, ultrasound is not an ideal method for examining hollow organs containing gas, such as the lungs or digestive tract. Ultrasound is also not useful for examining the internal structure of bones (except for infants).

A urinary tract infection (UTI) is an infection of the urinary tract, which is the path that urine takes when it leaves the body. The parts of the urinary tract that can be infected include the bladder, urethra, and/or kidneys. The following terms refer to the place that is infected.

•      Cystitis (bladder Infection)

•      Urethritis (urethra infection)

•      Pyelonephritis (kidney infection)

It is important to treat UTIs to keep your kidneys healthy.

What causes a UTI?

UTIs, bladder infections in particular, are usually caused by a type of germ (bacteria) called Escherichia coli (E. coli). These bacteria are usually near the anus (the opening through which the feces leave our body). 

Some other bacteria, for example sexually transmitted infections like gonorrhea, chlamydia, and vaginal infections, can also cause UTIs affecting the urethra.

Who has a higher chance of developing a UTI?

Women in general have a higher risk of getting a UTI than men, because the distance between the opening of the urethra and the anus is shorter in women.

The chance of getting a UTI is also increased for people who:

•       Are sexually active or engage in anal sex

•       Use diaphragms or spermicide for birth control

•       Are pregnant or menopausal

•       Have a history of bladder or kidney infection

•       Have conditions that change or block the natural flow of urine, such as kidney stones

•       Have diabetes

Do I need to send my urine for culture to identify the bacteria?

Based on your symptoms, your doctor will decide if you need a urine culture. Your doctor may request for a urine culture test if the UTI is more than a simple bladder infection or if you are pregnant or have repeat infection.

How will my doctor treat my UTI?

Your doctor will give you antibiotic pills to eliminate the bacteria. It is important that you complete the course.

Depending on your symptoms, your doctor may also give you medicine to reduce discomfort and the urge to urinate.

Feel free to talk to your pharmacist about the common side-effects and allergic reactions for the relevant medicines.

What can I do at home to feel better?

•      Continue to finish all the antibiotic pills, even if you start to feel better

•      Drink plenty of water. This helps to flush the bacteria out of the body

•      Avoid caffeine and alcohol. They can irritate your bladder

•      Apply a warm pad to your abdomen to reduce bladder discomfort

How can I prevent getting a UTI again?

DOs

•      Drink plenty of water

•      Practice good perineal hygiene. Always wipe from front to the back

•      Wear cotton underwear. Bacteria grows better in moist places. Cotton does not trap moisture

•      Drink more fluid and void before and after intercourse

DON'Ts

•      Avoid holding your urine. Go to the toilet when you need to

•      Avoid soaking in bathtubs for long periods of time

When should I see my doctor again?

Please contact your doctor if you have any of the following:

•      Persistent discomfort or a condition which worsens after two days of antibiotic therapy 

•      Fever. A temperature higher than 38°C

•      Chills or night sweats

•      Severe flank, back, or abdominal pain

•      Severe nausea, vomiting, or diarrhea

•      Blood in urine

Sore throats are common. A sore throat is often a throat infection or pharyngitis.

Sore throats are usually caused by 2 types of germs—viruses and bacteria. Most sore throats are caused by viruses. Only 10% of sore throats are caused by bacteria. 

You or your child has seen the doctor and is likely to have a sore throat caused by a virus.

Do I need antibiotics?

If your sore throat is caused by a virus, you do not need antibiotics. A sore throat caused by viral infection gets better on its own with at-home care, usually within five to ten days.

What medicines will my doctor give me? 

Your doctor will most likely give you medication and lozenges to relieve your throat pain or discomfort. Depending on your symptoms, doctor may also give you medicines to relieve running nose and cough.

What about alternative remedies?

There are limited evidences on what works and what does not for common alternative remedies. Some of these remedies may not be safe. Check with your doctor before using them.

What are the things I can do at home to feel better?

DOs

•      Get plenty of sleep and avoid talking

•      Drink plenty of fluids to keep your throat moist. This helps with swallowing and prevents dehydration

•      Drink soothing beverages and eat soft foods

•      Gargle with salt water several times a day to help relieve throat pain

•      Add moisture to the air in your home. Use a cool-mist humidifier or vaporizer. Be sure to clean it daily

DON'Ts

•      Avoid spicy foods or acidic foods that irritate your throat

•      Avoid smoking or secondhand smoke

How much salt should I put in my salt water gargle?

About 1/4 to 1/2 a teaspoon (1.5 to 3.0 g) of salt in one cup (250 ml) of warm water.

When can I return to work? When can my child return to school?

You can resume your usual activities as soon as you feel better. Wear a mask if the air pollution is bad to prevent further throat discomfort.

How can I avoid getting a sore throat again?

Reduce your chance of having a viral infection by exercising regularly and eating healthily.

Also practice good hand washing habits, washing your hands with soap and water to prevent the spread of infection.

When should I see my doctor again?

Please contact your doctor if your sore throat does not improve within two days or if you have a fever. 

Also contact your doctor if you have the following symptoms: 

•      Difficulty swallowing

•      Drooling (especially for children)

•      Trouble talking or opening your mouth

•      Hoarseness lasting more than two weeks

•      Body aches, joint pain, or earache

•      Skin rash

•      Nausea or vomiting

•      Constant sleepiness or tiredness

•      Increased thirst or dry and sticky mouth with less urine than usual (one wet diaper or void in six hours) or total lack of tears when crying

When do I need to go to the hospital or emergency department?

Call the ambulance or go to the nearest hospital right away if you have: 

•      Chest pain

•      Difficulty breathing

•      Shortness of breath

With reference to www.uptodate.com

When you have surgery, highly skilled professionals will care for you. Beforehand, learn what to expect and how to prepare. This helps you relax, and may speed your recovery. Read this booklet and ask questions to learn more.

1. Before Surgery

Talking with your Doctor

Your doctor will help you learn about your surgery. Make a list of questions to ask. Your list might include these:

•      How do I prepare for surgery?

•      What day and time do I arrive?

•      Where do I check in?

•      Are there any documents or forms that I need to bring along?

•      How long will I be in surgery?

•      When can I see my family?

Your Pre-op Exam

Your doctor will ask you about your medical history, do a physical exam, and order some tests. It may include:

•      Blood tests, which provide information about your blood and body chemistry

•      An ECG (electrocardiogram) records how your heart functions

•      A urinalysis (analysis of your urine) gives information about your kidneys and bladder

Everyone has blood pressure. Blood pressure is the force of the blood against the walls of your blood vessel walls. 

Some people have blood pressure that is higher than normal. When that happens, we call the condition high blood pressure or hypertension. When your blood pressure is higher than normal, your heart works harder to pump blood. 

When your blood pressure remains high for a long period of time, your arteries can get blocked or damaged, and cause the following problems:

What do the 2 numbers in my blood pressure reading mean?

The top number is the pressure in your arteries when your heart is contracting. The bottom number is the pressure inside your arteries when your heart is relaxed.

What is a healthy blood pressure reading?

The following is a guide to know your blood pressure condition (adults):

Will I know when my blood pressure is high? 

High blood pressure, unless very high or present for many years, usually has no symptoms. Many people do not know when their blood pressure is high. The best way to find out is to have your blood pressure checked by your doctor or nurse. 

It is recommended that all individuals 18 years or older be screened for high blood pressure. Measuring blood pressure is a simple and quick procedure that can be done in most clinics.

What causes blood pressure to become high?

The exact cause of high blood pressure is unknown, however there are several factors that in combination may cause the blood pressure to become high. These factors include smoking, obesity, sedentary lifestyle, and genes.

How can I prevent my blood pressure from becoming high?

The following can help to control your blood pressure from becoming high:

Dear Sir/Madam:

Greetings.

Thank you for choosing Jiahui Medical Endoscopy Center for gastroscopy examination/treatment. We sincerely wish to provide you with the best quality health care patient experience. To fully prepare for your gastroscopy examination/treatment, please pay attention to the following instructions:

Before your gastroscopy

1. Please stop eating and drinking by 8.00pm in the evening before the examination. Please remember to refrain from taking breakfast and drinking water on the morning of the examination. A few days before the examination, please start having light meals. Avoid eating spicy food and smoking. 

2. On the day of examination, please wear comfortable clothing, as you will be requested to change into an examination gown before the examination. You will also be requested to remove and keep your dentures before the examination.

3. Prior to the examination, please let your doctor know if you have any of the following medical conditions: high blood pressure, coronary heart disease, arrhythmias, respiratory disease, coagulation disorders or drug allergy.

4. If you are having the gastroscopy examination without sedatives, please cooperate by swallowing when your doctor is inserting the endoscope. If there is any nausea or vomiting, your doctor may instruct you to take slow deep breaths. Usually with good preparation and cooperation, the examination can be smooth with less unpleasant effects.

5. If needed, your doctor may send some of your gastric tissue or cells for biopsy tests if he or she sees anything suspicious. This procedure is usually harmless.

6. Please let your doctor know if you are taking any of the following blood-thinning medications: aspirin, clopidogrel (brand name Plavix, Talcom etc.), warfarin, etc. If necessary, your doctor might request you to stop taking these medications 5 to 7 days before the examination.

7. We do not recommend the examination be done if you are pregnant or having your period (menstruation).

8. Please tell your doctor or nurse if you have a cold or a blocked nose.

9. On the day of examination, please also remember to bring all your medical records and relevant medical tests results and reports.

After your gastroscopy

1. If you have undergone a gastroscopy without sedatives - After 1 hour, you can resume eating soft and warm food, such as bread, porridge, etc. 

If you have undergone a gastroscopy with sedatives - After 2 hours, you can resume eating a small amount of soft food for easy digestion such as bread, porridge, etc. 

If you have undergone a gastroscopy with biopsy done - After 2 hours, please start on cool fluid diet. Later in the day, you can start eating low residue semi-fluid diet. On the next day, you can resume your normal diet.

• Low residue diet examples: porridge, bread, noodles, small wonton and steam egg custard, etc.

• Fluid diet examples: fruit juice without pulp, lotus root starch paste, clear broth, etc.

2. If you have undergone gastroscopy with treatments performed (such as removal of polyp, hemostasis and foreign body extraction):

• Please have complete rest in bed on that day after the examination. Avoid any strenuous activity for the next three days

• For the first 2 days after the examination, please eat cool low residue fluid diet. Avoid soymilk, milk and carbonated soft drinks. On the third day, you can resume eating soft food. Avoid eating spicy, sour, salty and oily food

3. You can resume your usual medications. Your doctor might ask you to discontinue aspirin and blood-thinning medications such as clopidogrel 3 to 5 days if needed.

4. You may experience some abdominal bloating that will disappear after a few hours after examination. You may also experience some throat discomfort that will resolve a few days later.

5. Please contact your doctor if you have the following symptoms: constant nausea and vomiting, abdominal discomfort, fever and others.

If you experience persistent abdominal pain or blood in stool, please contact your doctor and seek help immediately.

6. If you have undergone sedative gastroscopy: avoid strenuous activity and sudden position change to prevent vertigo when recovering from anesthesia. Avoid driving or operating heavy machinery on the day of examination. 

7. It will be ideal to have someone accompany you home after the examination if you are undergoing a sedative gastroscopy.

8. You will be able to get your pathological report 10 working days after the endoscopy procedure. Your doctor may also arrange a follow-up appointment to explain your examination results/report if required.