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Friday 28 May 2010

The day when doctor brings bad news. It can happen to anyone.

Under-estimating risks and over-confidence - The day when doctor brings bad news. It can happen to anyone and nobody is exempted.

Friday, May 28, 2010

'I was in denial ... it was sheer stupidity'

Health minister hopes confession about surgery delay will be 'life-saving reminder' to others

05:55 AM May 28, 2010SINGAPORE - He has spoken to many patients in denial when confronted with an illness. But faced with the same situation himself, Health Minister Khaw Boon Wan fell into the same trap.

With a high calcium score and an abnormal electrocardiogram stress test reading, it was obvious to the cardiologists that he needed a coronary angiogram as soon as possible.

"But I was in denial," Mr Khaw, 57, wrote on his blog, in two postings titled 'A lifesaving discovery' and 'Living at cliff's edge'.

This resulted in a "risky six weeks delay", against doctors' advice, before he finally got the angiogram done on May 3. He is now recovering well after undergoing heart bypass surgery on May 4.

It was in March that Mr Khaw, who professed to have been "fit as a fiddle" with normal cholesterol and blood pressure levels, discovered - during a scan for calcium deposits in the heart - that he had a serious problem.

He thought he would be "in the mild or at most moderate range, say around 100. So it was a shock to me when the NHC (National Heart Centre) cardiac radiologist reported a reading of 507 ... I was literally disoriented", Mr Khaw wrote.

NHC medical director Professor Koh Tian Hai pressed him to go for a coronary angiogram that very week, but a "very reluctant" Mr Khaw negotiated for more time to mull over the situation.

When an NHC staff member called up a few times to schedule the angiogram session, "I played delay tactic".

Mr Khaw kept the information from his siblings, when he went to Penang one weekend for Qing Ming, the Chinese tradition of ancestral worship at the graveyard. "I did not want to alarm (them) and I still thought that it was all a false alarm," he said.

But he did confide in labour chief Lim Swee Say, who was most alarmed and thought that he was wrong to postpone the angiogram.

Mr Khaw even intensified his exercise routines - against doctors' advice - to prove he was in top physical form. "I used to run on treadmill three times a week, I increased it to five."

His doctors had also urged him to carry a Glytrin spray, which he should spray under his tongue in the event of angina, so as to bring down his blood pressure while waiting to be taken to hospital.

Mr Khaw faithfully carried the spray with him wherever he went - but only for a few days. "Then I told myself: I am not going to get a heart attack; I am not going to carry this."

Looking back, the Health Minister wrote: "While it is understandable why I did what I did, it was sheer stupidity and madness."

He expressed his gratitude to the NHC, Prof Koh and the NHC Sister who persisted in getting him to finally sit down with doctors and run through his options. "That session pulled me from cliff's edge and got me back on the rational track." Mr Khaw also recalled the comments of a general practitioner (GP) with over 30 years of experience, who had noted that patients who comply well with his advice, especially in taking the lifelong medication, are largely still around.

Those who suffer from a heart attack, stroke or other major complications, come largely from the group who do not comply, or do so half-heartedly - either in denial or over-confidence of the state of their health.

"I was stubborn and was not a good patient for nearly six weeks. I am making this confession so that hopefully, it can be a life-saving reminder to others.

"Please do not follow my example," said Mr Khaw.

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