Self-care with a little guidance from the experts

SINGAPORE - Earlier this year, Mr Wong Cheong Leng had trouble getting from place to place.

His legs were swollen "like dumplings", he said.

"When I walked up a flight of stairs, I had to stop every few steps to rest," he recalled in Mandarin.

"I got so breathless that I couldn't even talk."

The 54-year-old had frequent episodes of heart failure that resulted in breathlessness and swollen legs. Initially, he was unaware that this was linked to the amount of fluid he drank every day.

Then, he was a trolley pusher for a supermarket. He worked up to 13 hours a day, toiling in a stuffy carpark and under the hot sun. So, he drank plenty of fluids. But it only got him hospitalised.

He was in and out of hospital three times from April to July after feeling out of breath.

Besides that, Mr Wong has underlying heart disease, high cholesterol, hypertension and diabetes. He also has a chronic liver infection and sinus discharge from his right ear, a chronic leg ulcer condition and a tendency for skin infections.

Yet, it was only after his recent hospitalisation at Singapore General Hospital (SGH) in September that Mr Wong learnt how to manage his health.

Before his discharge, a team from the hospital's department of family medicine and continuing care stabilised his symptoms, adjusted his medication and reinforced the importance of self-care to him.

After that, the team continued to monitor his recovery at home, said consultant family physician Dr Ng Lee Beng, who was part of this team.

They made phone calls regularly and visited him at home to make sure that he did not drink more than 800ml, or about four glasses, of fluid a day.

Also, that he took his eight types of medication properly and applies moisturising cream on his legs three times a day to prevent dry skin.

In addition, Mr Wong was taught how to dress his wounds properly and to manage his salt intake.

Said Dr Ng: "The aim is to instil good habits in him, and to make sure that he is diligent and follows through over the long-term."

The scheme that Mr Wong is on is called the "virtual ward". This is where discharged patients at risk of being hospitalised again are followed up by a team from SGH at home for three months.

Mr Wong, who lives in a one-room flat, has not been hospitalised since September.

When Mind Your Body visited him at home three weeks ago, Mr Wong got a clean bill of health from the medical staff. The skin on his legs, for instance, no longer looked like "crocodile skin", said Dr Ng.

While he is now unemployed, he hopes to recuperate further and get a new job. In the meantime, Dr Ng's team has helped him get financial aid through social welfare agencies.

"It's no fun to be in hospital," he said. "I don't want to see the doctor, I want to be my own 'doctor'."

This article was first published on Dec 4, 2014.
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