Men, get your prostate checked

This male organ often becomes enlarged with age, leading to problems such as renal failure. However, if detected early it can be treated with medication alone.

TERENCE LEE reports

For Mind Your Body (Straits Times)

25 July 2008

Unfortunately, quite a number of the men do get it.

By the time they hit 80, one in two men in Singapore will have an enlarged prostate gland.

Only men have this organ.

Senior consultant urologist Associate Professor Chia Sing Joo gave the figure during a Prostate Awareness Month 2008 press conference last week.

This prostate disease - medically called Benign Prostate Hyperplasia (BPH) - if left untreated, can lead to complications like bladder stones and even renal failure.

If detected early, it can be treated with medication alone.

Delays will worsen the disease and surgery might then be needed to remove part of the prostate gland, said Prof Chia, who is from Tan Tock Seng Hospital's general surgery department.

Survey results show that 44per cent of men did not visit the doctor despite experiencing symptoms of BPH for at least six months.

The survey was conducted with 480 men above 50 who attended a prostate awareness forum on July 5.

However, Dr Fong Yan Kit, chairman of the Prostate Awareness Month and consultant urologist at Raffles Hospital, said the actual nationwide percentage could be even higher as those at the forum are most likely already aware of the issue.

'This is just the tip of the iceberg,' he said.

A common misconception is that the symptoms - such as a constant urge to urinate - are part of ageing.

Said Associate Professor Kesavan Esuvaranathan, president of the Singapore Urological Association: 'The men think it is normal. All their buddies have it, so it's okay. They think it's just like their hair turning white, nothing to worry about.'

About half of those who went to see a doctor about urinary issues already have their lives disrupted by it, the survey also revealed.

'Elderly men who want to enjoy their retirement and play golf or go on vacation with their spouses will find it tough because they have to constantly visit the loo,' said Prof Kesavan.

Their sex lives may also be affected.

Also, having a family history of BPH and lifestyle habits like lack of exercise, smoking, drinking and a diet with high fat content could increase a man's chances of getting the disease.

There is also another reason men experiencing symptoms associated with the disease should see a doctor early: it may be a sign of prostate cancer, the third most common cancer among men in Singapore, said Prof Chia.

'Symptoms of BPH and prostate cancer are almost indistinguishable - you can't really tell one from the other,' he said.

As part of the Prostate Awareness Month, the Singapore Urological Association is organising a series of subsidised prostate examinations this month. The subsidised rate is $8 for men aged between 50 and 75.

The full cost ranges from $30 to $65, depending on the hospital.

The remaining screening exercises are scheduled as follows:

Tan Tock Seng Hospital, today, 9am to 4pm

Changi General Hospital, tomorrow, 9am to 4pm

Singapore General Hospital, Friday, 9am to 4pm

This is the fifth year the Prostate Awareness Month has been running.

Danger, no sweat

A runner who doesn’t sweat can’t cool down and risks heat exhaustion. TERENCE LEE reports

For Mind Your Body (Straits Times)

11 June 2008

You need to sweat it out if you are a runner. Literally.

Sweating is the main way the body loses heat, therefore it’s crucial for runners to sweat naturally, said Dr Low Wye Mun, a sports medicine doctor at The Clinic @ Cuppage.

Few realise it, but heat exhaustion can occur even when you are not under the searing sun. That means it could happen even you were running a marathon at night. In fact, it happens any time the body is unable lose heat during exercise.

“Wearing light and well-ventilated clothing instead of long-sleeves and long pants helps in the cooling process,” said Dr Low.

If you covered up excessively, heat from our body cannot dissipate because sweat
will remain trapped under the clothing. Keeping the body well-hydrated is also crucial in preventing heat exhaustion.

Dr Low recommends that a runner drink about 250ml of fluids for every 15 to 20 minutes of exercise. Although water is sufficient for hydration, sports drinks boost performance by replacing the salt and glucose lost during such events.

While heat exhaustion is not life-threatening, it can develop into heat stroke. And if left untreated, complications like brain cell damage, organ failure, collapse, and even death may result.

However, heat exhaustion can be difficult to detect during a run.

According to Dr Lim Jit Kheng, a sports orthopaedic surgeon at Mount Elizabeth Hospital, detection of heat injury requires the measurement of the body’s core temperature using a rectal thermometer. While available at all endurance events, this is obviously not an option for runners.

“Furthermore, the symptoms for heat exhaustion are also quite similar to normal physical exhaustion, which include lots of sweating and a reduced but still palpable sense of balance, a feeling commonly expressed as ‘hitting the wall’.”

Once the body temperature rises above 41 deg C, heat stroke sets in. The victim stops
sweating and the skin dries up. Other signs also include unresponsiveness, tiredness and loss of balance. By then, serious medical attention is needed.

To prevent heat injury, both doctors suggested adequate physical preparation for the endurance event. That means not jumping straight into a 42km marathon when you have not conquered shorter distances.

Also, if slated to run in scorching temperatures, it helps to first acclimatise your body by training yourself progressively in hot and humid conditions.

In essence, do whatever it takes to prevent it in the first place. But what can you do if you feel the onset of a heat stroke?

Said Dr Low: “Stop the exercise, move to a cooler place and cool down through the use of cool fluids, fans, and cool wet towels. To paraphrase: its either drink or die.”

Secret TURN ONS

Research has been unable to pin down exact causes of sexual fetishes. TERENCE LEE reports

For Mind Your Body (Straits Times)

July 25, 2008

Two weeks ago, a 36-year-old man caught sniffing a housewife’s armpits was sentenced to 14 years jail and 18 strokes of the cane.

He had molested 23 women, from girls of nine to women in their 50s, in a similar fashion over 15 months.

This is not the first such case here or abroad.

Sexual fetishes, when people are sexually aroused by specific materials or objects and are generally unable to achieve sexual satisfaction without them, are real and diverse. They become fixations, and are more than just sexual kinks.

Psychiatrists say that they are far more common in men than in women, and men prefer to keep their fetishes a secret. However, their obsessions do get them into legal trouble sometimes.

“Most men with fetishes don’t consult us. They’re too shy to do so and they find the problem embarrassing,” said Dr Adrian Wang, a consultant psychiatrist at Gleneagles Medical Centre.

Dr Brian Yeo, consultant psychiatrist at Mt Elizabeth Medical Centre, agreed. “If their fetish could be easily accommodated by their partners, they would see no need to visit a psychiatrist,” he said.

However, Dr Calvin Fones, a consultant psychiatrist, observed that it is very unusual to have consensual agreement between spouses regarding sexual fetishes.

“If something’s done once, the woman finds it kinky. But if done 10 or 20 times, then she thinks it’s perverted. Such fetishes are seldom mutually enjoyable,” he said.

Men with sexual fetishes often suffer from low self-esteem and are unable to relate to the opposite sex, said Dr Yeo. As a result, some men resort to molestation, underwear theft or even stealthily take photos up women’s skirts to achieve satisfaction.

Research has been unable to pin down exact causes of sexual fetishes, but psychiatrists agreed that they usually develop from young.

According to Dr Fones, a sexual fetish usually develops when a teenager or adolescent associates an object with sexual gratification.

“It sticks in his mind and persists until adulthood, like a bad habit,” he said.

While it may be challenging to undo the past, Dr Wang believes a person can still take control.

“The sexual urge is a very basic, primal instinct, but mature adults can decide to satisfy them only under the right circumstances,” he said.

“If a person has a strong urge to press himself against someone’s buttocks, I would teach him to focus on other things, such as distracting himself by listening to music on his MP3 player.”

He said sex therapy is another solution. By improving a man’s sexual relationship and gearing him towards mainstream sexual practices, it is hoped that he will overcome his fetish.

Said Dr Yeo: “For my patients, I’m more pragmatic. If they have to view pornography, I usually move them towards more mainstream stuff, such as heterosexual porn."

Sidebar: One man's motor fetish

“I have sex with cars.”

That was the confession 38-year-old mechanic Briton Chris Donald made to The Sun in March last year.

He also claimed an affinity to motorboats and a jet ski.

Psychiatrists have deemed his motor fetish harmless, and he has even set up a website devoted to his fetish.

There are many forms of sexual fetishes, from the usual obsession with feet, shoes and panties, to the downright unusual.

There is lipophilia, which is an obsession with fat people, and also Capnolagnia, which is a fetish with smoking.

Transvestism is a male arousal from wearing female clothes, while hypnofetishism denotes a fetish for hypnosis.

Coprophilia is an obsession with faeces and formicophilia is an attraction to smaller animals crawling on parts of the body.

Some fetishes may be downright harmful.

For example, apotemnophilia is a fetish with self-mutilated body parts.

There is also crush fetish – a desire to see a sex partner crush insects or animals under the feet.

Lastly, there is even impregnation fetish – which is arousal from the risk of impregnation through unprotected sex.

Before you go on that exotic holiday...

TERENCE LEE gets advice from some doctors on how to travel safe

For Mind Your Body (Straits Times)

July 2, 2008

Two Singaporeans fell mysteriously ill about three months after returning from a trip to Saudi Arabia in December.

The probable cause: drinking brucella-laced camel’s milk, fresh from the camel itself. Brucella is a type of bacteria.

“Just because a food is fresh doesn’t mean it’s safe,” said Dr Lim Poh Lian, senior consultant of the department of infectious diseases at Tan Tock Seng Hospital.

This is especially true for those who travel to countries where standards of hygiene may be lower than their home countries. They could risk contracting illnesses from bacteria, parasites and viruses which may be hidden in food there.

According to the United States Centers for Disease Control and Prevention website, some of the possible illnesses contractable include traveller’s diarrhoea – which can be caused by a wide variety of bacteria and parasites – and hepatitis A. Other less common illnesses include typhoid fever, cholera and stomach flu.

While traveller’s diarrhoea is widespread, it is non-lethal and self-limiting. However, illnesses like cholera and hepatitis A are potentially deadly.

Dr Lim advised travellers to avoid raw and poorly cooked cuisine, especially street food. Unpasteurised dairy products and half-boiled eggs must also be avoided.

Avoid having ice in your drinks too because the water might have come from a standpipe which spouted faecally contaminated water.

However, you could still get diarrhoea even if you ate only well-cooked food. This includes food that has been left standing for a long time, like at a buffet.

“It’s okay to try street food if you’re a 30-something single travelling alone on vacation. But if you have a 71-year-old mother with diabetes and weak health, reconsider,” she added.

Dr Manik Imsiroviv, a general practitioner from Mel & Partners, offered a guideline for eating overseas: “Cook it, boil it, peel it or chuck it.”

That is, trust only yourself or your fellow travellers when it comes to opening a bottle of water or peeling your own fruits. And wash your hands, not with tap water but a sanitiser.

In the event that diarrhoea does occur, the best thing to do is to just let it pass. Also, drink more fluids to avoid dehydration and eat only if you are hungry.

According to Dr Imsiroviv, most traveller’s diarrhoea cases will pass within two to three days without medication. Antibiotics are needed only in more serious cases like bloody diarrhoea caused by the salmonella and shigella bacteria.

Dr Lin Kai Wei, a family physician from International Medical Clinic, advised travellers to take an additional measure: vaccinate themselves before they go on a trip.

He recommended the hepatitis A vaccine as a minimum, but a typhoid shot is also good for added assurance.

However, while these vaccines may prevent the onset of certain illnesses, it is still no substitute for being careful while travelling.