Chronic illnesses represent a group of conditions that are characterised by lasting for more than 1 year, requiring medical attention, and possibly affecting one’s daily activities. Chronic illnesses are widespread amongst Singaporeans, especially the elderly. According to Singapore Health Promotion Board (HPB), 1 in 4 Singaporeans aged 40 years and above has at least 1 chronic disease.
In this interview with Dr. Choo Wei Chieh, we spoke about common misconceptions of chronic illness and pitfalls in managing it, and asked for his advice to effectively manage chronic illnesses.
Dr. Choo Wei Chieh was known as the Doctor On Wheels. He started and managed “The Housecall GP” for 15 years. During his years as a home care doctor, he came across many patients with chronic illnesses and possesses much experience in helping patients manage them.
1. What are the Common Types of Chronic Disease?
When most people speak of chronic diseases, they usually refer to the “three highs” colloquially – high blood sugar or diabetes, high blood pressure or hypertension, and high blood lipids or hyperlipidemia. However, there are many other chronic diseases that can last for years such as stroke, heart failure, cancer, Parkinson’s, chronic lung disease (smoker’s lungs), etc.
2. How can Chronic Diseases Affect Our Daily Life?
The chronic disease itself or the complications can affect our daily life, depending on which part of the body is affected. For example, in patients with certain chronic cardiovascular conditions, strenuous sports activities are not recommended. In severe heart failure, patients can be very breathless such that speaking or eating becomes a challenge. On the positive side, our daily lifestyles can also be impacted for the better because of the good or positive changes we are making to manage chronic illness. Eating less salt may make food less enjoyable to a patient, but this certainly helps prevent future complications such as stroke!
3. How are Chronic Diseases Treated?
Chronic diseases often need to be managed for the long term, not just treated. While treatment of chronic illness usually involves doctor’s prescribed medication and therapy to relieve symptoms, the patient’s lifestyle and diet are critical factors that also need to be managed. For example, a diabetic patient’s sugar level may be high even with medications because he or she may be fond of eating sweet foods. If the person controls the diet, he or she may be able to reduce or even stop medications.
4. How Else can Chronic Diseases Affect Our Health? How does One Chronic Disease Lead to Another Disease?
The problem with poorly managed chronic disease is they often lead to complications. Taking diabetes as an example again, poorly controlled diabetes leads to complications in the heart, kidneys, eyes, etc. Diabetes is known to contribute to damages in blood vessels. If this happens in the heart, the patient can develop heart disease or stroke. If this happens in the eyes, it can lead to bleeding in the eyes and subsequent visual impairment.
5. Can Chronic Illness Worsen Overtime?
Yes. Chronic illness can certainly get worse over time. However, if one is able to manage the illness properly, the decline may be less impactful to daily life and function. With some chronic illnesses, the course of the disease often also has ups and downs – periods where it is better and times when it is worse. The key is to manage these “down” periods early and quickly to avoid complications.
6. “Chronic Illnesses are not Common Amongst Youngsters; They Only Occur in the Elderly.” What do You Think of this Statement?
There are a wide range of chronic illnesses that can affect both young and old. However, the underlying disease process can be very different in young patients compared to elderly patients. For example, children and adolescents can also suffer from diabetes but the cause of their diabetes is the lack of insulin secretion from the pancreas, a condition known as Type 1 Diabetes. In contrast, the more common form of diabetes seen in older patients is due to the body being unable to utilise the insulin.
7. “As long as I Maintain a Healthy Lifestyle, I won’t Develop a Chronic Illness.” Is this Statement Accurate?
Maintaining a healthy lifestyle is certainly preferable to an unhealthy one! However, the cause of chronic illness may be due to genetic, environmental and behavioral factors. So a healthy lifestyle can mitigate the behavioral and environmental factors, but one may still be predisposed to chronic illness from genetic factors. For example, diabetes and high blood pressure tend to run in the family.
8. What Chronic Illnesses are More Common to the Home-bound Patients that You Have Seen? Are They the Same as Those in the General Population?
The “three highs” are very common to home-bound patients as one would expect. The other common chronic illnesses include strokes and Parkinson’s disease. One common complication resulting from these diseases is swallowing difficulty that can lead to food going down the lungs and causing infection.
9. In Your Experience, what is a Common Pitfall in Managing Chronic Illnesses?
The common problem I observe with chronic illnesses such as hyperlipidemia and hypertension is that there may be no symptoms discernible to the patient, especially in the early stages. With no discomfort and no perceptible benefit of medications, patients often do not take their medications seriously. Fortunately, these days there are many home-based devices that patients can use to monitor their condition. For example, when patients are able to read a value off their BP set and see it improve with medications, they become more motivated to take their medications.
10. What is Your Advice to Better Manage Chronic Diseases at Home?
Your doctor is only there with you for a short time during the clinic visit. Most of managing chronic illness can be thought of as “homework.” So one should make the home conducive by having the right tools (e.g. monitoring equipment like BP set or glucometer) and environment (e.g. stocking healthy foods, cooking healthily). It also helps to have family and friends at home who are helpful in motivating you to stick with healthy lifestyles and diets. Last but certainly not least, having the support of a medical professional at your fingertips when you need advice is always helpful.
Manage Chronic Illnesses Effectively at Home with Ninkatec
Ninkatec is one of Singapore’s leading home care service providers. We offer a comprehensive range of affordable yet quality home care solutions, with a special focus on assisting the elderly to age comfortably at home. To support you in managing your chronic illness right at home, our care team provides an assessment of the patient’s conditions and recommends the best suited care plan.
We offer the following medical solutions for patients with chronic diseases:
● Virtual Care – A 24/7 monitoring solution that allows round-the-clock medical supervision and support for patients with chronic conditions such as the “three highs” who are at risk of sudden complications.
● Right at Home – A home care plan for patients with chronic and fairly stable conditions but need monthly doctor or nurse visit like a patient with kidney disease, or those who need a urinary catheter.
● Close Connect – Care solutions for chronic illness patients affected by an acute condition who are in need of daily doctor and nurse visit.
With Ninkatec’s 24/7 medical monitoring technology, personalised services and a patient-centric care approach, patients with chronic diseases can comfortably manage their conditions at home with peace of mind.