Is TransPRK more suitable for me than LASIK if I have glaucoma?

A main concern for glaucoma patients undergoing other laser vision correction procedures like LASIK or ReLEx SMILE is the use of the suction ring intra-operatively, which will cause a sustained increased eye pressure for a minute and this may cause irreversible damage to the already damaged optic nerve. However with TransPRK, there is no suction ring device applied to your eyes. If your glaucoma is mild to moderate and is well-controlled with medications, you should be suitable for the TransPRK procedure even if you have glaucoma.

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Answered By

Dr Tony Ho

Ophthalmologist

Which doctor should I see for joint hypermobility, chronic joint pain and instability?

That’s actually a very good question. Pain doctors are experts at managing chronic pain conditions, while rheumatologists treat systemic autoimmune conditions. I think that in this instance, seeing either a sports doctor or a rheumatologist as a start would be reasonable. If you are more concerned about ruling out a systemic autoimmune illness as a cause for your joint hypermobility, you should probably make a rheumatologist your first port of call. On the other hand, a sports doctor will be able to better manage your joint pain and instability.

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Answered By

Human

How do I know if I need to get a total knee replacement in Singapore?

Osteoarthritis means the “normal” wear and tear of the joints, and the accompanied inflammation (“itis” means inflammation in Latin, typically presented as pain and swelling). It comes with aging, but of course, to varying degrees and different severity. Osteoarthritis itself is not a dangerous disease that will threaten your life or safety per se, so not everybody suffering from osteoarthritis needs to go under the knife to have surgeries.

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Answered By

Dr Henry Chan

Orthopaedic Surgeon

How do I know if I have post partum depression or baby blues?

Sorry to hear that you're going thru such a difficult time. Motherhood is a really tough journey, especially when you're juggling work and family commitments without much help! Personally, I think you're doing a great job so far (I'm a mother too, and I don't know how you can do so much without help), so kudos to you for the hard work and resilience.

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Answered By

Dr Shi Hui Poon

Psychiatrist

How is arthritis diagnosed in a young female with aching finger joints?

Dr Henry has already provided an excellent summary to the different types of arthritis that can occur. Just wanted to add that the cyst could be a simple ganglion from your computer use. Sometimes with excessive pressure, these can develop and the easiest way to manage them is simply to modify your activities. You can certainly see a surgical colleague, but an alternative might be to see a primary care physician for a general assessment, including blood tests etc. , before seeing a rheumatologist or MSK/Sports physician.

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Answered By

Dr Dinesh Sirisena

Sport Medicine

Is a kidney biopsy necessary to find out why there is protein leakage?

Hello, Without knowing all the pertinent details, it sounds like your relative has been advised to go for a kidney biopsy procedure to find out the cause for the protein leakage, which seems like it has faced a sudden jump in a relatively short period of time (ie 2 months). A kidney biopsy is NOT a surgery per se; rather, it is a minor procedure whereby a doctor inserts a thin biopsy needle through the patient’s side to remove a very small amount of kidney tissue. This is then sent to the lab for examination.

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Answered By

Human

What is the age limit for a knee replacement?

Age is just a number, if your mom has been taking care of herself well. The average life span for a Singaporean woman is now 86 years old, according to the Singapore Census 2010. I’ve known patients who are not even 40 years old, and have lost 3 limbs (both legs and right hand) due to poorly controlled diabetes. There are also many patients who are barely 40+ years old, but failed to take care of themselves. Consequently, they suffered from kidney failures, strokes and heart attacks. This is the concept of physiological age, when your body is being kept at a optimal condition.

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Answered By

Dr Henry Chan

Orthopaedic Surgeon

Can heart disease be reversed by lifestyle changes alone?

Yes, those with diabetes have a two to fourfold risk of developing Coronary Artery Disease (CAD) and the extent and severity of CAD depends on the duration of diabetes. Whether the extent of coronary disease will warrant a stent or other treatment depends on the results of the coronary angiogram.

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Answered By

Dr Nandakumar Ramasami

Cardiologist

Does eating too much fish roe cause high cholesterol?

Fish roe is indeed high in cholesterol. Cholesterol is a substance that’s produced by your liver. It helps you to: Process vitamin D Break down foods Make hormones When you hear of "good" and "bad" cholesterol, it's because there are two main kinds of cholesterol: Low-density lipoprotein (LDL), or “bad” cholesterol High-density lipoprotein (HDL), or “good” cholesterol. Regular consumption of fish roe can be unhealthy because it may increase your LDL cholesterol. A 85 grams serving of fish roe provides 407 mg of cholesterol.

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Answered By

Human

Does root planing reduce inflammation and excess gum growth?

Excessive gum overgrowth (hyperplasia) MAY be due to medication such as anti-hypertensives (especially calcium channel blockers such as amilodipine), anti-depressants, anti-convulsants and immunosuppressants. However, there is usually a component of inflammation in the gums due to the presence of bacterial plaque and tartar deposits along the gumline. I do not know if it is possible for overgrown gums to move teeth orthodontically. Certainly, the tooth position may appear different if there is a lot of excess gum tissue present.

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Answered By

Dr Jaclyn Toh

Dentist

Can ReLEx SMILE cause glaucoma?

Indeed, starburst, glare and haloes are known, though uncommon, side effects of laser vision correction (e. g. PRK, LASIK and ReLEx SMILE). The risk tends to be greater in patients with features such as larger than average pupils or high pre-operative refractive errors. ReLEx SMILE is not associated with an increased risk of glaucoma. Though glaucoma can occur in people regardless of whether they have had LVC or not.

How can I differentiate runner's knee from other causes of knee pain?

Assuming there’s no previous trauma (ie. fracture), it's highly unlikely to be arthritis. Arthritis is usually from wear and tear, so usually an older patient would get it. Post-traumatic arthritis can happen, but only if there’s a history of trauma. At your age group and from what you’ve written, Runner’s Knee would be one of the more common problems. A lot of times there’s a combination of some tendinitis as well, so the pain may not totally go away even at rest.

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Answered By

Dr Sean Ng

Orthopaedic Surgeon

What could be cause of episodic, violent coughing?

Thank you for your question. Coughing during or after a cold is often due to postnasal drip (nose mucous dripping down the back of the throat, causing irritation and inflammation of the voice box). The voice box (medical term is larynx) is a very sensitive organ. Once inflamed, minor irritations of the voicebox (e. g from mucous, phelgm, saliva and in some people even a breath of dirty/cold air) will easily trigger a cough reflex. It takes time for the inflammation of the voice box to settle and often, treating conditions of the nose and acid reflux from the stomach may help.

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Answered By

Dr Eng Cern Gan

ENT Doctor

Can coronary artery disease to be treated with only medication and exercise?

Yes, coronary artery disease can be treated with lifestyle changes - exercise along with diet/stopping smoking/losing weight and reducing stress. However in certain kinds of coronary disease (may need both a coronary angiogram and nuclear scan) where there is a severe blockage which is causing impairment of blood flow to a significant part of the heart muscle, it maybe advisable to proceed with heart stent or bypass surgery to prevent a heart attack with poor outcomes including mortality.

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Answered By

Dr Nandakumar Ramasami

Cardiologist

How can one resolve knee pain even after a knee replacement surgery?

Thank you for your question. This is certainly one where consultation from an Orthopaedic surgeon with experience in arthroplasty is necessary - in terms of the knee itself. Perhaps you could share why a repeat operation was required and how long ago it was undertaken? From a pain perspective, is she taking regular analgesia for the symptoms and did she undergo rehabilitation post-operatively? This might improve her strength and ability to mobilise. From a weight perspective, has she consulted a dietician to look at her intake?

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Answered By

Dr Dinesh Sirisena

Sport Medicine

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