These past 3 years, I have had quite a number of clients diagnosed with major or even critical illnesses. Thankfully, all of them survived due to early detection, good healthcare in Singapore and adequate insurance that they have bought.
I will highlight some of the most interesting cases in a series of blog posts over the next few weeks to share with you some salient points I have learnt from each of these clients’ cases.
I will discuss the cause of their illnesses, the treatment regime, its short-term and long-terms costs and how much insurance can cover some of these costs.
The first case in this series is about “Cleo,” who was diagnosed with Colorectal cancer at the beginning of this year. Thankfully, she survived to tell her story and it is interesting because, even if you think you live a healthy lifestyle, you can still get cancer!
HFMD, all parents dread these 4 letters & with good reason. It’s the chicken-pox of the 2010s, where your child cannot go to childcare or school and there’s no cure and no vaccine.
In Singapore, MOH has declared it endemic and there’s a good chance it’ll infect your kids like it happened to my (then) 4yo daughter.
As an insurance professional, I’ve handled many HFMD claims for StarShield babies so far this year (2015) and heard many horror stories regarding the pain & suffering of their toddlers and themselves. My kids are 6 & 5 so I understand their pain and I was somewhat prepared when my 4yo (at that time) daughter got HFMD. So I’m here to share how to be prepared to handle the situation if this happen to your child.
What is HFMD?
Hand Foot Mouse Disease is caused by 2 different families of virus, and like flu, your immune system is only primed for that particular strain in that particular sub-family. If you’re infected by a different virus strain, your prior infection isn’t going to help you.
The symptoms appears 3-4 days after infection and the most common ones are lesions around the joints & mouth, a low level fever and most painful of all, many many ulcers in the mouth. It’s seriously scary to see so many ulcers in your child’s mouth if you’re unprepared so I’d prepare you by showing my daughter’s. 😉 13-14 ulcers in total!
The ulcers are the worse part of the disease. That’ll take about 5-6 days to clear before the doctor can declare your child healthy and non-infectious. HFMD affect different children differently because there’re so many virus that can cause it and these virus particles can survive even when the mucus is dried up. So the best defense against HFMD is to ensure your kids washes their hands before eating anything. Since there’s no vaccine & no treatment available, it’s a waste of time & money to see pediatrician unless your child is below 2 years of age.
Just see a normal GP for liquid Paracetamol or acetaminophen to manage the fever & pain from the ulcers. Some GP prefer to prescribe Ibuprofen and that’s fine because it’s more effective as a painkiller, but the dosage MUST be strictly followed because liver damage is a known effect even with a light dosage. This is why I opted for Paracetamol.
First of all, don’t worry, most HFMD in Singapore don’t result in death. Hospitalisation may be needed if you can’t manage it properly so I’m here to help you manage it properly!
Be prepared to take 1 week leave if you cannot find someone willing to take care of your child. Please don’t ask your parents to take care of your sick child. Elderly has a weaker immune system & if they catch HFMD, they’ll suffer badly!
ENFORCE hand washing for everyone at home if you don’t want everyone to be infected! Also, no kissing and reduce touching to minimize the chance of contaminations and increasing the itch to those blisters.
DO NOT share food! Always pass the food to the child so that his/her utensils never touches what the rest of the family is eating.
Wash your child backside or ensure he/she washes his/her hands after using the toilet because HFMD is passed from feces to the mouth.
Prepare some topical (non-steroid) cream to reduce itching.
Prepare the following if ulcers start appearing. (Painkiller, ulcer cream, watermelon plant powder)
If ulcers becomes bad, prepare plain porridge everyday with some salty or sweet condiments. Everything that goes into the mouth is going to hurt like hell for your child. Sympathise with the pain but ensure your child gets the food down because he/she really needs the nutrients to fight off the infections! (Contrary to many advise, ice cream hurts!) High salt or sugar content hurts the ulcers so plain and warm is good.
Use alcohol swaps to wipe down all the child’s regular toys + surfaces he/she touches everyday like door knobs to minimize cross-contamination. Sterilising the whole house is frankly impossible and since HFMD viruses are not air-borne, just ensuring everyone washes their hands before food and you’d be fine. My 6yo son has close contact with his sister but by following our instructions, he never contracted it.
What NOT to do
Do Not Let your child play in public & spread the virus.
Do Not Bring you child to childcare & expect them to take care of your sick kid.
Do Not Eat all sort of medicine, western or traditional. It’s not going to help. Just ensure your child is well-fed & hydrated.
Do Not Use steroid based cream or medication. (It hinder the child’s development.)
Do Not Punish the child for not following your instructions or being cranky. Trust me, the ulcers are driving him/her crazy enough.
Do Not Overdose your child with painkiller.
Do Not Give lots of kisses & hugs. If you go down, it’ll take twice as long for YOU to recover! Then WHO’s going to take care of you & your child?
Dealing with the ulcers
The most painful ulcers are those at the back of the throat & mouth. Those under the tongue will make it hard for your child to eat anything.
Give painkiller. Follow dosage carefully especially with Ibuprofen. For very young toddlers, watch out for these side-effects & stop the medication immediately and see your doctor.
For Paracetomol or acetaminophen, you can safely increase Paracetomol dosage slightly if needed.
If you believe in Watermelon plant powder, you can spray 2-3 times to the back of the tongue. My girl didn’t like it because it’s so bitter.
Personally, I prefer the ulcer gel because there’s no restriction on dosage.
Clean your hands and carefully apply a dot of ulcer gel on your little finger.
Dap or rub the dot on the ulcer. Repeat until you’ve covered all the ulcers.
For those ulcers at the back of the throat, I squeeze a liberal amount under my daughter’s tongue and ask her to mix it with saliva, gargle & swallow.
If you do all 3, most of the pain will be gone enough for you to feed your child!
Since there’s no cure for HFMD, it’s important your child is able to fight off the infection him/herself. This means he/she must eat or at least drink formula milk that can fulfill the daily nutritional needs.
Plain, bland, soft & warm food is the best. I found plain porridge is the best for my daughter, together with those Taiwanese mock duck or glutten which is not too strongly flavoured. After a few initial tentatively swallows, my daughter manages to finish her porridge in record time! Just remember to spread the porridge in a big plate so it cools down fast!
We’ve tried different food, milo, cold milk & ice-cream. All hurt her badly especially cold stuff.
After food, I find that another round of ulcer gel helps to take the edge off the pain enough for her to sleep soundly.
For hydration, I found that plain water is the best because the sugar in flavoured beverage hurts the ulcers for a long time. If your toddler is young, you can try to thin the milk a bit if he/she is rejecting the milk.
I generally wouldn’t worry about the fever unless your child becomes listless and lethargic, or worse, have a seizure. If you follow the dosage of the painkiller & the fever stays high, quickly seek medical help.
By following these rules, my girl recovered nicely with no weight loss or lasting effects. I hope this article helped you if your child got HFMD.
Most insurers don’t comprehensively cover all aspects of managing childhood disease like HFMD. Fortunately, I know one that does that. From outpatient GP/Specialist costs, to taking care of the taxi fare or parking fees shall your child be hospitalized, to the actual hospital bill. It’s very affordable to boot.
For more information, please email me! firstname.lastname@example.org
Errors? Comments? Questions? Use the comment box below!
(PDPA: Note that by emailing me, you consent to allowing me to email you back regarding HFMD information shared in this article. Don’t sue me later saying your email is in the DNC ah!)
MediShield Life is slated to be launched by end of 2015. It supersedes the current MediShield plan by providing better coverage for all Singaporean & PR while making concessions to premium by subsidizing premium for the elderly.
Many of my clients have asked me if it’s worth to continue their Private Medical Insurance Scheme (PMIS) integrated plans (IP) and my answer to them is YES! MediShield Life does not change the reason for buying an IP in the first place.
The reason is simple. A PMIS policy from any of the 5 insurers is meant to cover an individual who wants to enjoy a higher level of service from hospitals in Singapore. MediShield Life doesn’t provide adequate coverage for this group.
By now, the world has once again heard about Singapore & mistaken us as some China state. Hint to these people, Google ASEAN or South-East Asia. Some people are still hazy about who we are (pun intended.)
But I digress. There are many ways for people to beat the haze but the best is to stay indoors with the air-con on and all doors & windows closed as tightly as possible. If you have put off installing an air-con in the house, please consider doing so now, as the haze will be with us for many more weeks. Look at my post here on how to choose an air-con suitable to your house in Singapore.
Offices are usually the best as the air-cons are maintained by professionals regularly. The air-cons at home, may not be maintained as regularly so do clean them today if you haven’t done so in the last 3 months. I just cleaned mine today & there’re a lot of grey ash on it.
Many people are also turning to air purifiers to help clean the air in their home or office and while many of the good ones are effective, they also tend to be noisy ( >60dB on high setting), not to mention they cost many thousands of dollars.
Let’s take a look at some that I’ve come across.
Air purifiers work by pushing & pulling air through multiple membrane filters. Due to the resistive nature of membrane, the fan motor must be very powerful in order to move enough air to be effective. Hence, you have 2 types of noise, mechanical noise from the motor & wind noise. The situation is worst in air purifiers with HEPA filters because those are so restrictive to air flow, hence some makers like Rainbow & Delphin use water as the main filter + a “L-Lamella” separator cone to reject fine dust.
Rainbow still include a HEPA filter but this results in the motor having to work very hard & it’s really loud when vacuuming. When purifying air, it’s not as annoying but still noisy. The air flow also doesn’t seem as high as the Delphin.
The advantage of water-based system are they’re less restrictive to air flow and thus saves energy + can recycle the air faster. Even if they can’t filter the same amount of dust in 1 cycle, the amount of air they can process in the same amount of time makes up for their lower efficiency. This is especially true for the Delphin system which doesn’t have any membrane filter at all!
Water is also able to dissolve much of the harmful chemicals & odour in the air that membrane filters are not able to remove. This is why many air-purifiers also include a charcoal (or activated carbon) filter which adds to the cost of purchase and maintenance.
OK fine, I just want to know the cheapest & fastest way to purify my air!
Why I’m glad you asked. If you’ve skip the above explanation, that’s fine. I recommend using the air-con as your MAIN air purifier for 2 simple reasons. It’s the most efficient and fastest mover of air in the house, and it’s also very quiet (typically 25dB on Auto).
BUT, obviously the filters in your air-con are not actually very good. Some air-cons have UV and Plasma technology. UV kills virus & bacteria so it only sterilize the air, not filter dust.
Cold Plasma technology is basically air-ionization, which introduce an electrical charge to dust particles so they can stick to another charged surface. However, this introduce a small amount of ozone which is unhealthy with prolonged inhalation. The charged dust particle must still stick to another opposite charged surface before it’s removed from the air so its efficiency is not consistent in every environment.
SO, the best solution is to introduce another filter behind your air-con filter.
It’s an electrically-charged membrane filter with carbon so it’s able to filter particle down to 0.3 micron + the carbon will help to absorb harmful chemicals & odour. It’s not as efficient as a HEPA filter but because the air-con is pushing so much more air through the filter per minute, the result is still very good with noticeably cleaner & neutral smelling air in 10 minutes.
It’s recommended to cover up to 70% of the air-con filter to allow good air-flow so the air-con cooling power is not compromised. Don’t worry, after 1 month, the membrane will turn a icky grey to let you know the filter IS working. The filter is rated to work for 2 months but with this haze, I recommend changing it sooner, when the filter turns completely grey.
Each box contains 2 pieces of 60 x 30cm filter, which is enough to last an air-con blower unit 18 months if you change it every 2 months.
For less than $30 per air-con unit per year, I’d say that’s VERY cheap!
Lastly, for you people who are lazy, you can install the 3M filter OVER the air-con filter so you don’t even need to wash the filter in future. Obviously, the 3M filter will get dirty faster but since the haze wouldn’t last forever, it’s completely fine. 😉
I’ve updated the article with updated satellite & wind direction.
Is the Haze problem finally over?
The haze problem started around 18/06/2013 & reached a peak of PSI 401 at on Fri 21/06/2013. As for 11am today, the sky look fantastically clear & visibility was >2km. After days of shroud, I can finally see Punggol & Sengkang!
So is this the end of the haze? Let’s look at the satellite images.
Strangely, the key factor seems to be the huge reduction of hotspots from 600+ to 100+ this morning. Is it rain? There are some clouds but I’m not sure they brought rain. The good news is the wind has changed direction and is blowing north.
The reason may just be the Indonesians are putting out the fires themselves. If that’s the case, regional government pressure may be working despite the trash talking from some Indonesian ministers.
Will the haze stay away? As long as there are no new hotspots and efforts to put out the fires continue, I guess we can say the worst is over. However, that doesn’t mean the haze will be over because the peat will still smoke for a while after the fire is put out.
Wow! As of 3PM Singapore time 19/06/2013, the 3-hour PSI reading (based on PM10 particle size) is 172. This is the highest I’ve ever seen in Singapore. Only time I’ve seen worse was in Beijing with PSI equivalent at 300+ with visibility down to <10m. As you can see, the visibility now is still over 1km but RSAF didn’t fly today AFAIK.
This is a crop from Singapore Met services’ NOAA-18 satellite taken at 8am this morning. Malacca is worst hit from the looks of this image.
Based on the wind direction, the situation is not expected to improve much over the next few days unless a major downpour put out the fires in Sumatra, like in 1995, where brave Malaysian fire fighters battled futilely to put out the pith fires and are ultimately saved by a massive storm system.
Stay indoors with air-con on. If need be, buy some 3M air-con filters from DIY shops & install behind the normal air-con filters. The charcoal ones will even cut the burnt smell. Drink LOTS of fluid & see a doctor if you have allergic reaction!
BBC Radio 4 recently broadcast a documentary on the effects of the new generation of anti-sleep drugs on health and society.
Drugs, such as modafinil and adrafinil, seem to remove the need for sleep and promote alertness while having minimal side-effects in most users.
Unlike older drugs which prevent sleep, such as amphetamine, these drugs typically don’t feel pleasurable and have few other effects, meaning they are less likely to be used recreationally or lead to compulsive use.
Originally used to treat sleep disorders, there is now a large grey market for these compounds, as people use them to extend their work or play time.
The BBC documentary tackles the possible effects on society of being able to easily manipulate and delete the need for sleep at will, as well as investigating the possible mind and brain consequences of not sleeping for long periods.