- Breast Surgery
- Cancer Center
- Ears, Nose, and Throat
- Emergency Room
- Family Medicine
- Fertility Clinic
- General Surgery
- Internal Medicine
- Medical Imaging
- Nuclear Medicine
- Orthopedics and Sports Medicine/Rehabilitation
- Respiratory Medicine
How to Take Care of a WoundLEARN MORE
When should I see a doctor or nurse?
If your wound is large, soiled, needs stiches, or shows signs of infection, see a doctor immediately. A deep, gaping, or jagged cut that goes right through the skin will most likely need stitches. If your cut is not very deep, it will probably not need stitches. If in doubt, check with your doctor or nurse.
How do I take care of a cut or scrape?
1) Clean the wound
Wash your wound thoroughly with soap and water. If, after washing, there is still dirt, glass, or another substance in your cut, see a doctor or nurse.
2) Stop the bleeding
If your wound is bleeding, firmly press a clean cloth or bandage on it for 20 minutes. You can also help slow the bleeding by holding the cut above the level of your heart. If the bleeding doesn't stop after 20 minutes, see your doctor or nurse.
3) Protect the wound
If available, apply a thin layer of antibiotic ointment (e.g. Bactroban) to the wound. Dress your cut with a clean, dry bandage and change the dressing 1- 2 times a day until the wound heals. Most cuts and scrapes heal on their own within a week, forming a scab in the process. Avoid touching or scratching the scab as this will increase the risk of bleeding, infection, and scarring. If your wound has been treated by a doctor, follow their instructions.
4) Check for signs of infection
Symptoms of infection include: fever, discharge (e.g. pus), a bad odor, increased pain, redness, swelling, warmth, or red streaks around the edge of the cut.
Do I need a tetanus shot?
It depends on how old you are and when your last tetanus shot was. Tetanus is a serious infection that causes fever, muscle stiffness, and can even lead to death. It is caused by bacteria found in dirt.
Most children are vaccinated as part of a routine checkup. After three initial doses of the tetanus vaccine (TD, TDAP), regular booster shots are needed to maintain an effective level of protection, usually every 10 years. It’s also common for adults to be vaccinated or receive a booster during a routine checkup. Check your vaccination record if you have one, or check with your doctor.
For simple wounds (e.g. closed, shallow, or clean), you will need a tetanus booster if you haven’t received one in the last 10 years.
For serious wounds (e.g. open, deep, punctured, or soiled with dirt), you will need a tetanus booster if you haven't had one in the last 5 years.
If you have a serious wound and you haven't received all of your tetanus vaccines (or you’re not sure if you have), you will need a tetanus booster shot and another shot of immunoglobulins to fight any tetanus bacteria that may have contaminated the wound.
Please be aware that supplies of the tetanus vaccine are not always stable in China and availability cannot be guaranteed. It is recommended that you get regular, preventative booster shots to avoid the need for urgent doses.
Gestational Diabetes Mellitus (GDM)LEARN MORE
What is Gestational Diabetes?
Diabetes is a common condition in which the body’s cells are unable to effectively obtain glucose from the bloodstream. Glucose is required to provide the body with energy for day-to-day activities. The hormone insulin moves glucose from the blood into the body’s cells, where it can be used for energy. When the movement of glucose into the cells is delayed, blood glucose levels rise, causing diabetes to develop.
Gestational diabetes is a form of diabetes that occurs during pregnancy and usually goes away after the baby is born. Over 10% of pregnant women will develop gestational diabetes and this usually occurs around the 24th to 28th week of pregnancy.
In pregnancy, the placenta produces essential hormones that help the baby grow and develop. These hormones also partly stop insulin working which is called insulin resistance. Usually pregnant women naturally increase their insulin levels to overcome this block. If the body is unable to produce the extra insulin or becomes more resistant, gestational diabetes develops.
Diagnosis of GDM is based on a fasting 75-g oral glucose tolerance test (OGTT) at 24–28 weeks of gestation in pregnant women not previously known to have diabetes. This test can be performed earlier if there are significant risk factors present or there is a clinical indication.
Once a diagnosis of GDM is made, careful planning for the ongoing management of your pregnancy is important.
How does GDM affect the baby?
As the mother’s excess glucose crosses the placenta into the baby’s bloodstream, untreated or uncontrolled GDM may result in complications for your baby such as:
• Being born very large and with extra fat, thus may make delivery difficult and more dangerous for the baby
• Low blood glucose levels after birth
• Breathing problems
• Requiring admission to a special care nursery
• Problems maintaining body temperature
• An increased risk of developing diabetes or obesity later in life.
How to Treat Gestational Diabetes?
The management and treatment of GDM is a team effort, involving the woman and her partner, her obstetrician, endocrinologist, diabetes educator, dietitian and midwife.
Special attention is paid to home blood glucose monitoring, diet and physical activity. Sometimes insulin injections may be needed. Your treating doctor will discuss with you which treatment option is more suitable for you.
• Start treatment quickly because gestational diabetes can hurt you and your baby.
• Special meal plans and scheduled physical activity
• Daily blood glucose testing
• Insulin injections if needed
Home blood glucose monitoring
Self-monitoring blood glucose (SMBG) is a valuable tool in helping manage GDM. These simple finger prick blood tests will give you an indication on what your blood glucose levels are.
Your diabetes nurse will teach you how to perform home blood glucose monitoring. You will require:
• A blood glucose meter
• Lancet device – for pricking finger
• Testing strips
• Diary to record blood glucose levels.
Blood glucose meters, lancet device and testing strips may be purchased at your local or online pharmacy.
Target of Glucose Control
The blood glucose checks you do at home are a key part of taking good care of yourself and your baby before, during and after pregnancy
Both American Diabetes Association and Chinese Diabetes Society recommend glucose targets for women with GDM are as follows:
Pregnancy Glucose Goals
Fasting or premeal
<95 mg/dL (5.3 mmol/L) and either
<140 mg/dL (7.8 mmol/L) or
<120 mg/dL (6.7 mmol/L)
Food and Exercise
During pregnancy, you may need to change your meal plan to avoid problems with low and high blood glucose levels. For most women, the focus of a good meal plan during pregnancy is improving the quality of foods you eat rather than merely increasing the amount of food eaten. A good meal plan is designed to help you avoid high and low blood glucose levels while providing the nutrients your baby need to grow.
Exercise is a key part of diabetes treatment. Discuss your exercise plans with your diabetes team and ask for guidance. Just as you need to get your blood glucose under control before getting pregnant, it's best to get fit before you get pregnant.
In general, it's not a good idea to start a new strenuous exercise program during pregnancy. Good exercise choices for pregnant women include walking, low-impact aerobics, swimming, or water aerobics. Regular physical activity is not only safe for pregnant women, it benefits health by offsetting some of the problems of pregnancy, such as varicose veins, leg cramps, fatigue and constipation. Exercise after meals may help the muscles use the glucose in the bloodstream, and help keep your blood glucose levels in your target range.
Medication (if needed)
For women with gestational diabetes, meal planning and exercise often work to keep blood glucose levels in control; however, if blood glucose levels are still high, your doctor will probably start you on insulin.
Insulin is the traditional first choice for blood glucose control during pregnancy, because it is the most effective for fine-tuning blood glucose and it doesn’t cross the placenta. Therefore, it is safe for the baby. Insulin can be injected with a syringe, an insulin pen, or through an insulin pump. All three methods are safe for pregnant women.
Weight Goals During Pregnancy
If you start pregnancy weighing too much, you should not try to lose weight. Instead, work with your dietitian or doctor to curb how much weight you gain during pregnancy.
Your dietitian will keep track of your weight gain. If you start pregnancy at a normal weight, expect to add between 25 to 35 pounds (11.5-16.0kg). Women who start pregnancy too thin need to gain more. If you are obese at the start of your pregnancy, work with your dietitian to limit your weight gain to about 15–25 pounds. You can determine your healthy weight by finding your BMI level by using our BMI calculator.
Pregnancy Weight Goals
If your pre-pregnancy weight is…
28~40pounds or 12.5~18.0kg
25~35 pounds or 11.5~16.0kg
15~25 pounds or 7.0~11.5kg
11~20 pounds or 5.0~9.0kg
GDM usually goes away after the baby is born. To make sure, your doctor or midwife will order a special glucose test, the oral glucose tolerance test (OGTT), which is performed 6–8 weeks after delivery. This test will show whether your blood glucose levels are back to normal.
Breastfeeding is good for women with GDM and may also help you lose the weight you gained during pregnancy.
Refer from the website of American Diabetes Association at http://www.diabetes.org/diabetes-basics/gestational/
Immune Therapy and Oncology TreatmentLEARN MORE
What is immuno-oncology (IO) treatment?
Under normal circumstances, the human immune system can identify and remove tumor cells in tumor microenvironment, but tumor cells can adopt different strategies to inhibit the immune system, thus survive and even continue to develop at various stages of the anti-tumor immune response.
Immuno-oncology (IO) treatment or immunotherapy is a treatment that controls and clears tumors by restarting and maintaining the tumor-immune cycle and restoring the body's normal anti-tumor immune response.
Because of its excellent efficacy and innovation, immunotherapy was named the most important scientific breakthrough of the year by Science magazine in 2013. In recent years, good news about immunotherapy has been continuously reported, and it has shown strong anti-tumor activity in the treatment of various tumors. Multiple tumor immunotherapy drugs have been approved for clinical application in dozens of countries around the world, which brings new hopes for cancer patients.
What is the principle of I-O?
Cytotoxic T cells in human lymph nodes are the powerful source in immune system to kill tumor cells. However, in order to prevent "injury" of healthy cells, T cells are also subject to the restriction of "immunization checkpoints", which in turn gives the tumor a chance to grow. Some tumor cells begin to induce "checkpoints" to escape the immune response after being attacked by T cells. PD-1 (Programmed Death 1, Programmed Death Receptor 1) / PD-L1 (Programmed Cell Death 1 Ligand 1, programmed death ligand) signaling pathway is one of the mechanisms. By secreting PD-L1, tumor cells bind to PD-1, initiate programmed cell death of T cells, and allow tumor cells to obtain immune evasion.
The working principle of PD-1 inhibitors is to break the binding of PD-1 and PD-L1 and restart the attack and killing function of T cells on tumor cells.
What disease type could benefit from PD-1?
Currently, PD-1 inhibitors that have been marketed include Pablolizumab (Keytruda) and Nivolumab (Opdivo). US FDA has approved Opdivo for cancer indications of small cell and non-small cell lung cancer, head and neck squamous cell carcinoma, colorectal cancer (MSI-H/dMMR), melanoma, liver cancer, classic Hodgkin's lymphoma, kidney cancer, bladder cancer, etc. Our domestic CFDA approved Opdivo for second-line treatment of non-small cell lung cancer.
Data from PD-1 manufacturer BMS showed that the five-year survival rate of cancer patients who took PD-1 inhibitors increased several times compared with traditional treatments. For patients with non-small cell lung cancer, the survival rate of lung cancer patients receiving traditional treatment is usually less than one year. The three-year survival rate of immunotherapy in lung cancer has reached 30%, and the five-year survival rate can reach 15.6%.
What are the side effects of Opdivo?
Opdivo (nivolumab) is different in mechanism from traditional chemotherapeutic drugs. Most of the adverse reactions during the treatment are mild or moderate. Serious adverse reactions are extremely rare, but the consequences may be very serious. Therefore, it is necessary to monitor the side effects of Opdivo medication. Please read the following information carefully with your family:
（1）Adverse reactions may occur at any stage of the treatment, and it is more likely to occur after the treatment has been started for a period of time because your immune system has been activated and is more likely to have an adverse reaction due to immune hyperfunction.
（2） If you feel chest tightness, wheezing, swollen facial lips or even swollen tongue, it means that you may have a severe allergic reaction. If the situation is urgent, please call 120 for help.
（3） If you have the following discomfort, don't panic and please contact your health care team immediately:
• Pulmonary symptoms: cough, chest tightness and pain, shortness of breath, etc.
• Intestinal symptoms: diarrhea, especially bloody, dark or tarry stools
• Severe stomach pain or tenderness
• Liver and kidney function damage: symptoms as nausea and vomiting, pain in the right side of the abdomen, dark urine, decreased urine output, light colored stool, yellowing of the skin or eyes
• Discomfort caused by hormonal changes: rapid heartbeat, significant weight gain or loss, dizziness, chills and even syncope; thirst and polydipsia, increased urine volume
• Other symptoms include: skin and mucous membrane ulcers, fever, fatigue, lethargy, memory disorders
（4）In addition, the following adverse reactions may occur during treatment, which usually does not affect your normal life. Of course, you can also contact us for further help:
• Loss of appetite sometimes accompanied by nausea
• Mild cough and shortness of breath, sometimes upper respiratory tract infections may occur which can usually disappear spontaneously
• Rash and itching, it is important to note that if you have a large number of rashes, please seek medical advice promptly.
• Constipation or diarrhea
• Muscle and joint pain
（5）Other precautions during treatment
In addition to the above-mentioned adverse reaction, Nivolumab may affect your body's functions by activating your immune system. You need to follow your doctor's regular follow-up. Some related tests are essential for us to assess your physical condition. Blood routine, liver function, and thyroid function are usually checked regularly.
Nivolumab may have little interaction with other drugs, but to ensure medication safety, we will ask you about your medication history in details before each treatment. If you need other medications during the treatment, be sure to let your doctor know that you are using Nivolumab.
Preparations before medication
Please assist your medical team to know your history of allergies and medication before using the medicine to ensure medication safety;
If you have had an autoimmune disease (such as colitis, Crohn's disease, lupus), organ transplant, lungs or breathing problems, please let us know.
Please relax during the medication, keep normal diet, and have proper rest.
At the end of each treatment, we will remind you of the time of next medication. If you missed the appointment, please contact the medical team timely.
What services can Jiahui International Cancer Center provide for patients under I-O?
As the first demonstration center for immuno-oncology (IO) treatment in China, the Immune-oncology Center of Excellence at Jiahui International Hospital has received the first patient and completed the first infusion of O-medicine. (PD-1 antibody drug Opdivo) on August 29.
In cooperation with the affiliated hospital of Harvard Medical School, Massachusetts General Hospital as a strategic partner, Jiahui is committed to providing patients with Opdivo medication assessment and monitoring services based on international standards.
Massachusetts General Hospital, as the teaching hospital under the Harvard Medical School, has been using PD-1 immunotherapy for over 8 years, treating more than 20,000 cancer patients, and is the world's most experienced hospital for providing immunotherapy to Asian patients. At the Cancer Center of Jiahui International Hospital, patients may make an appointment to receive a diagnosis from one or several oncologists at the Massachusetts General Hospital through video or face to face. Now experts from Massachusetts General Hospital provides clinical services at Jiahui for one week per month on average. They will work with the doctors of Jiahui International Cancer Center to sort out the patient's condition and explore an overall treatment plan through multi-angle considerations such as pathology, genetics, and etc.
Please dial (021) 53393266 during working hours (Monday-Friday, 9:00-18:00) for more information. Or leave a voice message at other times and we will contact you as soon as possible.
Men's Mental Health: Stamping Out the StigmaLEARN MORE
There is a silent, global crisis going on in men’s mental health. All around the world, men are turning up in droves to their local Accident and Emergency Departments. They are in pain, but unlike patients with cuts or fractures, their wounds are invisible to the naked eye. Oftentimes, they have suffered in silence for months or years until the burden becomes too heavy to bear.
Silencing the Stigma
Evidence suggests that men are significantly less likely to use clinical services in response to a mental health issue in comparison to women. At Jiahui Health, we want to reduce that stigma.
With appropriate assessment, identification, and intervention, mental illnesses can be successfully treated and managed.
Our mental health specialist is qualified in a variety of clinical methods and approaches to best meet the individual needs of patients. If you or someone you know is suffering from a mental health issue, please don't hesitate to contact us. You are not alone, and help is always at hand.
If you are experiencing recurring negative thoughts and emotions that affect your social life, relationships, work, or day-to-day functioning, you should talk to a mental health specialist. Getting help for depression/anxiety as early as possible gives you the best chance of recovery.
- Cognitive behavioral therapy (CBT) is about gaining perspective on your thought processes with the aim of modifying them from within. CBT focuses on solutions, encouraging patients to challenge distorted thinking and change destructive patterns of behavior.
- Dialectical behavioral therapy (DBT) is a specific type of cognitive behavioral therapy developed to help better treat borderline personality disorder. DBT is skills-focused, giving clients strategies to cope with painful emotions and relationships, including mindfullness, distress tolerance, emotion regulation, and interpersonal affectiveness.
- Solution-focused therapy: whereas traditional forms of therapy analyze problems and past life events, solution-focused therapy concentrates on setting goals and finding practical solutions in real time to find quicker resolutions to problems. This method takes the approach that with appropriate coaching, you are capable of finding your own best solutions.
- Mindfulness means tuning your awareness to the present moment, so that you become consciously aware of your thoughts and their transient nature. Mindfulness teaches you how to detach yourself from negative thought patterns and come to realize that you are not your thoughts. It can be practiced through meditation and has been shown to significantly reduce rumination and worry.
- Emotionally focused therapy (EFT) focuses primarily on relationships, attachments, and bonding. It is often used for couples or families in distress who want to improve their relationship. The therapist and client(s) look at relationship patterns and work together to move the relationship towards a healthier, more positive direction.
Medication options: In severe cases, medication can be prescribed to help patients manage symptoms of anxiety. Prescription medication is meant to provide relief for major symptoms; therapy is still recommended alongside medication to get to the cause of anxiety.
Selective serotonin reuptake inhibitors (SSRIs) are antidepressants that work by increasing levels of serotonin (the chemical in the brain that regulates feelings of wellbeing and happiness).
Call 400-868-3000 to make an appointment with our clinical psychologist.
Benzodiazapines are a family of drugs that produce a calming effect. They work by increasing the activity of a neurotransmitter in the brain called GABA, reducing anxiety, relaxing muscles and inducing sleepiness. Short-acting benzodiazapines are preferred for treatment of insomnia, while longer-acting ones are recommended for anxiety.
Frequently Asked Questions on Radiation TherapyLEARN MORE
Does radiation therapy hurt?
No, radiation therapy does not hurt while it is being given. However, the side effects that people may get from radiation therapy can cause pain or discomfort. Your doctor, and your nurse can help manage side effects.
Will external beam radiation therapy make me radioactive?
No, external beam radiation therapy does not make people radioactive. You may safely be around other people, even babies and young children.
Can I go to work during radiation therapy?
Some people are able to work full-time during radiation therapy. Others can only work part-time or not at all. How much you are able to work depends on how you feel. Ask your doctor or nurse what you may expect based on the treatment you are getting. You are likely to feel well enough to work when you start radiation therapy. As time goes on, do not be surprised if you are more tired, have less energy, or feel weak. Once you have finished your treatment, it may take a few weeks or many months for you to feel better.
What should I bring while on treatment?
• Anti-nausea, pain or anxiety medications that you would normally take during your treatment time
• A sweatshirt to wear over your gown to keep you warm while you are waiting
• Reading materials and music that can help you to relax while you are waiting
Can I drive while I am on treatment?
Driving to and from your treatments is usually not a problem, unless you are taking any medications that have a side effect of drowsiness or another doctor has told you that you cannot drive.
Can I bring my family to the treatment area?
We encourage you to bring a friend or family member with you to your appointments in Radiation Oncology. When you are going back to the treatment area we ask that your support person stay in the lobby area.
Should I eat before treatment?
Unless you are told to do otherwise, please eat as you normally would, don't skip any meals and take your medications as scheduled.
Where can I get food?
• Coffee and crackers are available in the front waiting area
• There is a vending machine available on level 1 of the hospital next to the imaging department
• Patient kitchen: you can order from the Jiahui Patient Kitchen. Please inform us when you needed
• There are many restaurants located in the nearby area
Where do I get my blood drawn?
Depends on your treatment, your doctor may order blood test to be drawn before, during or after your treatment. The frequency of blood draws depends on the area of the body being treated. The blood will be drawn in our clinic by one our nurses or you can have it done at your local hospitals if you chose.
Will my health insurance cover treatment costs?
Our department Billing Office will submit claims to insurance companies, government programs indicated by you. The billing office personnel will verify the completeness of necessary billing forms and supply all the necessary information for the payers to process and pay the claim. Please bring with you any referrals or authorizations which your insurance company requires in order to make payment for services.
When should I contact my doctor?
NOTIFY YOUR DOCTOR IMMEDIATELY FOR ANY OF THE FOLLOWING:
• Shaking or chills or a temperature of 101°F or 38.3° C
• Unusual cough, sore throat, lung congestion or shortness of breath
• Burning discomfort when you urinate
• Redness, pain or sores in your mouth
• Nausea, vomiting or inability to eat or drink for more than 24 hours
• Diarrhea (loose, watery stools) for more than 24 hours
• Constipation (no bowel movement in 2-3 days)
• Bleeding or unusual bruising
• Pain not controlled by your current medications
• Any new or unusual symptom that concerns you
Tell your doctor or nurse if you are having any new problems, even if they do not seem to be related to your radiation treatment. If the issues are in fact not related to your radiation therapy, you will be referred to your primary doctor for discussion.
Instructions after Completing Radiation TherapyLEARN MORE
• On your last day of treatment or during your last on treatment visit, your doctor and/or nurse will discuss what is normal to experience after radiation therapy. You will also receive a follow-up appointment with your doctor, which can vary depending on your doctor's guideline
• Please feel free to contact us at (021) 5339-3269 (Monday to Friday, 9:00am-6:00pm; for other time you can call 400-868-3000; call center will contact the on-call doctor) before your first follow-up appointment with any questions or concerns
• Following radiation therapy, you may continue to have side effects related to your treatments. Below are some guidelines that will tell you what to expect and how to care for yourself after you complete your radiation treatments. Most side effects that you experienced during your treatments will gradually improve. Some may get worse for a few days after treatment before they start to improve. However, some may persist for months or may even be permanent. Your doctor will ask you about your symptoms when you return for a follow up visit:
○ SKIN: If you experienced a skin reaction during your treatments, it may worsen for 7-10 days after your final treatment and then begin to heal. Continue to gently cleanse and moisturize with recommended skin products as instructed by your doctor or nurse. If you notice that areas of your skin become open or weepy, if you have a fever (38.3°C or above) or notice large amounts of thick drainage, contact your radiation doctor or nurse. Once the skin has healed, be sure to protect it from injury and avoid direct sun exposure. Use a sunscreen if you cannot avoid the sun
○ DIET: If you have been on a special diet to control the side effects of your treatment, follow this diet until the side effects have resolved. Then, slowly advance to your normal diet
○ ACTIVITY: As tolerated. Fatigue and weakness can continue for several weeks. You may need to have rest periods and/or pace your activities
• The end of cancer treatment is often a time to rejoice. You are probably relieved to be finished with the demands of treatment and are ready to put the experience behind you. Yet at the same time, you may feel sad and worried. It's common to be concerned about whether the cancer will come back and what you should do after treatment
• When treatment ends, you may expect life to return to the way it was before you were diagnosed with cancer. But it can take time to recover. You may have permanent scars on your body, or you may not be able to do some things you once did easily. You may also have emotional scars from going through so much or you may fear that others view you as different or you may view yourself in a different way. You might talk to a friend who you trust.If you need, please feel free to talk with our social worker or schedule with our counselor
• One of the hardest things after treatment is when you do not know what to expect next. Many cancer survivors feel that they had a lot of information and support during their illness and once treatment ends; they enter a whole new world - one filled with new questions
• There are many emotional demands on you during this time in your life. It is common to feel anxious, depressed, afraid or hopeless. It may help to talk about your feelings. Feel free to talk about these feelings with any member of your treatment team. You can also talk to our social worker and/or our nurse
Really? I Could Have Sleep Apnea?LEARN MORE
“Huuu…snort!…..huummm…gasp!” Your snoring echoes and booms through the night—much to the agony of the person being kept awake beside you. Our ENT doctor would like to remind us that: Apart from affecting the sleep of our families and housemates, snoring could also have a big impact on our health, so we must be on guard when it comes to obstructive sleep apnea.
What is OSA?
Obstructive sleep apnea (OSA) is the most common form of sleep apnea. It occurs when the upper respiratory tract becomes blocked, making breathing more shallow or stop, repetitively interrupting sleep. In serious cases this could happen 30 or more times per hour and lead to high blood pressure, heart attacks, brain problems, or increased risk of accidents.
What are the symptoms?
• Snoring (most common symptom)
• Fatigue or feeling tired during the day
• Headaches in the morning
• Dry mouth or sore throat when you wake up due to breathing through the mouth
• Restlessness, screaming, sleep talking, convulsing, hearing sounds, having hallucinations, or sleep walking while asleep
• Sexual dysfunction
• Night sweats
• Trouble concentrating, forgetfulness, and depression
• Waking up suffocating or gasping due to difficulty breathing
Who gets it?
OSA is more common in males above 30. People who may be more likely to have OSA are those who may:
• Be obese or overweight with a BMI of >25
• Have a thick neck
• Have small airways in their nose, throat, or mouth
• Have enlarged tonsils
• Have a large tongue
• Have diabetes
• Have high blood pressure
• Be at risk of heart failure or stroke
• Use long-term sleep medicine
• Upper respiratory tract inflammation
How is it diagnosed?
You can have your sleep monitored by wearing a device known as a polysomnography (PSG) as you sleep. Once finished, it will generate a diagnostic report. Your doctor will interpret the results to see if you have OSA. Standard diagnosis includes oxygen saturation, thoracic motion, and nasal airflow. Complex diagnosis may include ECG, EEG, or EMG.
How is it treated?
• Life intervention and avoiding working too strenuously
• Using a ventilator applying continuous positive airway pressure (CPAP)
• Surgery in some cases
Treatment can significantly improve sleep quality and reduce the possibility of complications associated with cardiovascular disease and diabetes.
How can it be prevented?
• Quit drinking
• Sleeping on your side
Are you concerned that you might have OSA? We provide sleep monitoring services at home. Visit Jiahui Health for a consultation with our ENT doctor for more information.
1. The National Sleep Foundation, Sleep Apnea (March 21, 2017)
2. Mayo Clinic, Sleep Apnea (March 21, 2017)
The Best Foods to Eat When You Have Breast CancerLEARN MORE
If you or someone you care about has recently been diagnosed with breast cancer, there will be questions. These may include: What should I eat?
During any cancer therapy, remember these four diet tips
• Stay hydrated.Aim for at least 2 liters to 3 liters of fluid per day—about 66 ounces to 99 ounces—mostly from caffeine-free fluids
• Get enough calories.Forget the calculator—the good way to know whether you are eating enough calories for energy is to weigh yourself once or twice a week. If your weight is trending down week after week, speak with a dietitian to make a plan. Remember to eat regularly throughout the day. Small meals five to six times a day typically work well
• Focus on nutrients and get the most nutrients per calorie. Choose foods from the food groups—things like fruits, vegetables, grains, beans, nuts, seeds, meats/eggs and dairy products. A balanced diet helps ensure you are getting the nutrients you need to keep your body strong
• Don't forget protein.Protein helps maintain lean body mass/muscle. Protein is found in meat, poultry, fish, seafood, eggs, beams, lentils, nuts, seeds, soy and dairy products. Smaller amounts of proteins are found in vegetables and whole grains
If you don't have nutrition-related side effects from your cancer treatment that limit your ability to eat and/or digest food, you can follow a generally healthy diet that includes:
Fruits and vegetables: Five or more servings a day
Fruits and vegetables contain antioxidant and anti-estrogen properties. Cruciferous vegetables such as broccoli, cauliflower, kale, cabbage and Brussels sprouts are especially good to include and are rich in phytochemicals.
Whole grains: 25 grams to 30 grams of fiber daily
Whole grains are unprocessed foods that are high in complex carbohydrates,fiber, phytochemicals as well as vitamins and minerals. A study by researchers at Soochow University in Suzhou, China, found that high fiber intakes may have a positive effect by altering hormonal actions of breast cancer and other hormone-dependent cancers.
Nutritious fats: Less than 30 percent of total daily calories
Some studies, including a study by researchers at the Karolinska Institute in Stockholm, Sweden, have suggested that the type of fat you consume may initiate the development of breast cancer. Limit your intake of saturated fat such as beef, lamb,organ meats, butter, cream, etc. and decrease your intake of foods containing trans fats, which also are called hydrogenated oils. Increase your intake of fatty fish like salmon, tuna, herring, and sardines to two to three times every week.
Lean protein—and soy, too
For good protein sources, increase your intake of poultry, fish, and legumes such as beans and lentils. Minimize your intake of cured, pickled and smoked foods. Soy in moderate amounts, which means one to two servings/day of whole soy foods, such as tofu, edamame and soy milk, also can be included. Studies, including research reported in the American Institute for Cancer Research, show that animals metabolize soy differently than humans. Not only is soy safe in moderate amounts, but research shows that soy contains isoflavones, a phytonutrient with anti-cancer properties. Up to three serving of whole soy foods per day does not increase a breast cancer survivor’s risk of recurrence or death.
Alcohol in moderation, if at all
Drinking alcohol is a known risk factor for breast cancer. A large, observational study of 105,986 women suggested that drinking three glasses of wine or more per week throughout life increases a woman’s risk of breast cancer by a small but significant percentage. The study saw a 15 percent increase risk of breast cancer when women drank an average of three to six drinks per week, compared to women who did not drink. Try to avoid intake of alcoholic beverages when possible.
After treatment, maintain a healthy weight
Obese women have higher levels of estrogen circulating in their bodies than women who are in their ideal body weight range. Many studies including a study conducted by researchers from the Iranian Institute for Health Sciences Research in Tehran, Iran, have demonstrated an association between body mass size and breast cancer in post-menopausal women.
Weight reduction should be accomplished through a healthy diet and regular exercise once treatment is completed. Weight loss during treatment is not typically encouraged, as this is often associated with undesired muscle loss, leading to fatigue, a suppressed immune system, and a slower healing process.
Allow your body the nutrients it needs to fight cancer; once treatment is done, consider meeting with a dietitian for individualized recommendations to decrease recurrence risk and support a healthy weight.
Potential cancer fighters in foods
Phytonutrients support human health and are found in plant-based foods, including fruits, vegetables, beans, and grains. Below, find common foods that contain important phytochemicals.
Phytochemical Food Source
Carotenoids Dark yellow/orange/green vegetables and fruits
Isothiocyanates Mustard, horseradish, cruciferous vegetables
Phenolic compounds Garlic, green tea, soybeans, cereal grains, cruciferous, vegetables, flaxseed
Flavanoids Most fruits and vegetables
Orango-sulfides Garlic, onion, leeks, shallots, cruciferous vegetables
Isoflavones Soybeans, legumes, flax seed
Indoles Cruciferous vegetables: broccoli, cauliflower, kale, cabbage, Brussels sprouts
If you have side effects
If you experience nausea, your nutritionist may recommend that you try to eat more foods are cool or at room temperature, because they don’t have a strong odor. Your nutritionist also may advise you to eat lower-fat food since fats take longer to digest.
Don't skip meals entirely if you have nausea, since an empty stomach can make nausea worse. Instead, focus on small bites of food throughout the day. Avoid strong flavors. Feel free to incorporate ginger root into your recipes, as this can help settle a nauseated stomach.
If constipation becomes an issue, your nutritionist may encourage you to eat fiber-rich foods and increase your fluid intake. Low-intensity walking and warm beverages also can help encourage regular bowel movements.
To combat fatigue, choose high-protein snacks and small frequent meals rather than large meals. People often experience more fatigue when they are not eating well, or when they are losing weight during treatment.If experiencing any side effect that affects your ability to eat regularly, ask your care team if you can meet with a dietitian to review individualized nutrition recommendations.
Summary of Lymphedema Risk Reduction PracticesLEARN MORE
Skin Care－Avoid trauma/injury to reduce infection risk
• Keep extremity clean and dry
• Apply moisturizer daily to prevent chapping/chafing of skin
• Attention to nail care; do not cut cuticles
• Protect exposed skin with sunscreen and insect repellent
• Use care with razors to avoid nicks and skin irritation
• If possible, avoid punctures such as injections and blood draws
• Wear gloves while doing activities that may cause skin injury (e.g. washing dishes, gardening, working with tools, using chemicals such as detergent)
• If scratches/punctures to skin occur, wash with soap and water, apply antibiotics, and observe for signs of infection (i.e. redness)
• If a rash, itching, redness, pain, increased skin temperature, increased swelling, fever or flu-like symptoms occur, contact your physician immediately for early treatment of possible infection
• Gradually build up the duration and intensity of any activity or exercise
• Take frequent rest periods during activity to allow for limb recovery
• Monitor the extremity during and after activity for any change in size, shape, tissue, texture, soreness, heaviness or firmness
• Maintain optimal weight. Obesity is known to be a major lymphedema risk factor
Avoid Limb Constriction
• If possible, avoid having blood pressure taken on the at-risk extremity, especially repetitive pumping
• Wear non-constrictive jewelry and clothing
• Avoid carrying a heavy bag or purse over the at risk or lymph edematous extremity
• Should be well-fitting
• Support the at-risk limb with a compression garment for strenuous activity (i.e. weight, lifting, prolonged standing, and running) except in patients with open wounds or with poor circulation in the at-risk limb
• Patients with lymphedema should consider wearing a well-fitting compression garment for air travel. The NLN cannot specifically recommend compression garments for prophylaxis in at-risk patients
Extremes of Temperature
• Individuals should use common sense and proceed cautiously when using heat therapy. Observe if there is swelling in the at-risk limb or increased swelling in the lymph edematous limb and cease use of heat such as a hot tub or sauna
• Avoid exposure to extreme cold, which can be associated with rebound swelling, or chapping of skin
• Avoid prolonged (greater than 15 minutes) exposure to heat, particularly hot tubs and saunas
Postoperative CareLEARN MORE
You may not need to stay in the hospital
• Excisional biopsy
• A bandage should be placed on your breast to cover the incision
• Lumpectomy with either axillary lymph node dissection or sentinel lymph node biopsy usually does not require an overnight hospital stay. This procedure is often performed on an outpatient basis
Note: Mastectomy with either axillary lymph node dissection or sentinel lymph node biopsy usually only requires an overnight stay in the hospital.
After surgery is performed
• The bandage over the incision should be kept dry until your follow-up appointment
• You may have tubes, or “drains” from the breast or underarm to remove fluid; You will receive instructions on caring for them
• Drains, if you have them, may remain in place for 1 or 2 weeks. When fluid lessens to about 1 ounce a day, the drains are removed
• See your doctor for follow-up in 1 or 2 weeks
• You can wear your bra for support
• Use an ice compress on the wound during first 24 hours after surgery to reduce swelling
• You may see drainage on the bandage and that is not unusual
• The wound should be covered at least for 3 days
• You can remove the bandage if it gets wet and replace it with a dry bandage (available from local pharmacies)
• Wash your hands before handling the drain
° Open the valve (bulb will expand). Gently squeeze the fluid from the bulb into the measuring container
° Squeeze the bulb tightly to get all the air out, and use the other hand to close the valve with the stopper
° The vacuum in the bulb will reactivate the suction
• Measure the amount of the drainage every time when you empty it
• Keep a daily record for each drain
• The time to empty the drain(s) are in the morning, midday, and before bedtime
• Empty the drain when it is one third to half full (when the bulb is compressed) or as needed
• Remember to keep a record of the drainage amount for each drain and every time you emptied the drain
• Bring the record with you when return for follow up
• You can continue with daily activities as normal
• Avoid heavy lifting and sports until your follow-up visit
• You may take some painkiller as needed
Please contact us
• If you have acute swelling
• If you have blood coming from the wound
• Fever, temperature>38.3℃
• If you have any concerns please call
Contact number: 86 21 5339- 3128 Monday to Friday,8am to 8pm.
Please contact 400-868-3000 (24/7 hotline) if not in business hours.