Monthly Archives: March, 2011

Internet Diseases

When it comes to the most-searched  topic for Web queries,  there’s no doubt that sex tops the list; next comes health-related matters which take up some 2% of all queries on the search engines. Its not surprising therefore  that there are a variety of internet-related ailments that can arise from reading too much about health matters on the Internet!

Internet addiction has been around for years. How do you know if you’re already addicted or rapidly tumbling toward trouble? Take this Internet Addiction Test here.


Cyberchondria (aka internet self-diagnosis) is another condition first coined in 2000 and refers to  the practice of leaping to dire conclusions while researching health matters online. If that severe headache haunting you in the morning led you to the Web search-engine and convinced you that it is caused by a brain tumour, then the likely diagnosis is probably cyberchondria. People tend to look at the first few results in the search-engine and that froms the basis for them to probe further. For instance, a search on ‘headaches’ could lead to ‘brain tumours’ or ‘meningitis’. The phenomenon has become so pervasive that Microsoft did its own study on the causes of cyberchondria (see here).

Thanks to search engines like Google,many are turning to the Internet for answers to their health issues. New research has revealed four in five Australians are turning to the web for health information and nearly half of those are using Dr Google to make a self-diagnosis.

Leading GPs say people are presenting to the doctor with fears of major health issues when the real problem is minor, while others put off going to their GPs because they believe their issue is not serious.

My advice? While its good for people to know what’s going on in their body, make sure you look at reputable sites only and even then, look at them after your doctor has told you what you have (this will give you a reasonable launching pad to look at other likely possibilities- what doctors call differential diagnoses). One should not scour the internet on the basis of a collection of symptoms only. If there’s one thing the search engines do not have, its the capability of good old human judgement!

Radiation – What’s The Problem?

The media has been awash with articles on the dangers of a radioactive fallout from the damaged Fukushima plant in Japan. But how real is the threat of radiation on health?

Here’s a quick 101 on radiation exposure:

  1. 3 things determine if a radiation blast is harmless or lethal:  the radiation intensity, its duration and whether treatment is available.
  2. Intensity of exposure is measured as millisieverts (mSv).
  3. The duration of exposure is largely determined by the half-life of the various radioactive chemicals produced in a fallout. It can range from 8 days for radioactive iodine to 30 years for cesium-137.

A single Chest Xray is equivalent to natural radiation over 10 days

Its generally true that we are all subject to radiation in our lives and its interesting to see what levels are involved:

US coast-to-coast round-trip airplane flight …………………..0.03 mSv

Natural radiation  for average person per year……………………3   mSv

Chest X-ray ……………………………………………………………………….0.1 mSv

CT scan of abdomen & pelvis  with contrast material…………30 mSv

Single dose required to cause acute radiation sickness……1000 mSv

Single dose required to cause death within weeks………..10,000 mSv


To know whether someone has got  acute radiation sickness, the common symptoms to look for are nausea, vomiting, bleeding and fever (due to invading germs) which can appear within hours of exposure. However, with massive doses of radiation, redness and blistering of the skin can occur. Perhaps, more importantly, the long-term effects can be more disastrous even with much lower doses of radiation – the main danger being cancer, including leukemia. Birth defects have also been known to occur.

Potassium Iodide - useful only against radioactive iodine when consumed before exposure


There seems to be an obsession for potassium iodide tablets but the fact remains that these will only be helpful against radioactive iodine if taken before being exposed. Furthermore, it will have no effect on other radioactive substances, including the feared cesium-137. Once exposed, the best bet is to throw away contaminated clothes and to have a good shower.

There is no specific cure for radiation exposure, with  treatment directed at supportive measures. Hence the paranoia surrounding a radioactive fallout..




Earthquake Season – What To Do If You’re Caught In One

Following close on the heels of the Christchurch quake 2 weeks ago, the current disaster in Sendai,Japan is far more severe especially since the quake started on the sea-bed which resulted in a tsunami (giant forceful waves) wreaking probably more damage than the quake itself.

While it is reasonable to assume that most will panic and try to run for open space (if time permits) in the event of a quake, most international rescue outfits recommend that, in the event of a quake, people should adopt the  traditional drop, cover and hold on tactic. In fact, the Red Cross strongly advises not to try to move (that is, escape) during the shaking of an earthquake. The more and the longer distance that someone tries to move, the more likely they are to become injured by falling or flying debris, or by tripping, falling, or getting cut by damaged floors, walls, and items in the path of escape.

What the  drop, cover and hold on tactic basically means is that DROP to the floor, Take COVER under a sturdy desk or table(if no table- cover your head with your arms), HOLD ON to the table/desk- even if it moves!

In the last decade, another method made the rounds that purportedly was more effective. This is the triangle of life, widely promoted by self-proclaimed earthquake expert Doug Copp. This method proposed that one should not shelter under tables but rather next to it because tables and other solid items will collapse and provide support for an open space just next to it.

The Triangle of Life - widely denounced by most authorities

More aptly, preventive measures form the mainstay of earthquake safety measures and I was quite taken up by the colorful booklet issued by the Tokyo city authorities on 10 Ways To Prepare For an Earthquake., which goes to show the level of preparedness the Japanese have against natural disasters.

Our sympathies go to Japan and her people and the next few weeks will test the resoluteness of the Japanese character as well as the willingness of the international community to assist.

Doctor, Bill Thyself

Bring up the subject of doctors’ bills and many patients will have their anecdotes, but an interesting court trial is currently shaping up in Singapore regarding the way doctors there charge for their services.

A well-known surgeon in Singapore is fighting in the High Court there to disallow the Singapore Medical Council from setting up a disciplinary committee to investigate charges that the surgeon had over-charged her patient from Brunei, who happened to be the Brunei Queen’s sister.

Dr Susan Lim and doctors' charges - how much is too much?


The surgeon, Dr Susan Lim, had begun treatment for breast cancer on the patient in 2001 right till her death in 2007. In the process, she had referred the patient to several colleagues who had their bills directed to her for onward transmission. Here are some astounding facts that were heard in court last week:

The Bill Mark-Ups (courtesy of Straits Times,Singapore,24 Feb 2011)

  • The overall bill for the year 2007 alone came to USD 19.5 million.
  • She charged as high as USD 354,000 per day for her services.
  • The surgeon would inflate her colleagues’ bills dramatically and bill the patient. For instance, doctors’ bill for USD 315 forwarded to her was bumped up to USD 166,000.

When the patient eventually passed away in 2007, the Ministry of Health of Brunei, alarmed at the high fees, complained to their Singapore counterparts. It was alleged the surgeon then gave a 25% discount of the bills accompanied by an apology on “inadvertent mistakes made by her office”; but when this did not work, she then offered to waive all her bills in return for a “letter of good standing” to state that the matter would not be pursued further. The Brunei government did not respond.

In her defence, the lady surgeon said that the patient had been forewarned on her fees of between USD 79,000-168,000 per day and that the patient had agreed to it, saying that the Palace would pay. In addition, the patient had become so dependent on her that no other doctors could provide treatment without her physical presence.

The above anecdote makes grim reading and raises several questions related to medical ethics and human psychology. Can a doctor justify such charges no matter what challenges are faced? Can a patient, assuming he or she is in a mentally fit state, make a financial undertaking  on behalf of  the body paying for the bills? The issue is made complicated by some of the doctors backing the surgeon on the inflated bills. See here.

It also calls attention as to why a developed country like Singapore does not have an approved fixed fee schedule upon which doctors’ charges are based. Most countries have one in place that makes such charges transparent.

Whichever way  you look at it,  healthcare has become an industry; like all industries, standard-operating procedures and adequate legislation must be in place to protect the consumer. This includes a transparent doctors’ fee schedule. Until this is done, Singapore’s credibility as a medical hub is seriously affected.

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