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I was stubborn, don’t be like me
FOR nearly six weeks, Health Minister Khaw Boon Wan suffered from something that could have killed him – denial.
 Mr Khaw, who underwent a successful coronary artery bypass graft on May 4, confessed that his initial refusal to accept that there was something wrong with his heart was“sheer stupidity and madness”.
His denial lasted six weeks.
Doctors told The New Paper that any delay in getting treatment for heart problems could prove fatal.
Mr Khaw described some of the delay tactics he used on his blog yesterday.
He was told that with a high calcium score and an abnormal electrocardiogram (ECG) stress test reading, he needed a coronary angiogram“ ASAP” (as soon as possible).
The angiogram would ascertain the extent of his heart disease.
But when a nurse from the National Heart Centre Singapore (NHCS) called up a few times to schedule an angiogram, he “siamed” (avoided the issue).
Around this time, he flew off to Penang one weekend for Qing Ming.
Asked about medicine
His sister noticed a package of medicine in his luggage, including aspirin which she recognised, and asked him about it.
He did not want to alarm his siblings and he still thought it was all a false alarm. So he did not disclose the facts.
On another occasion, he confided in Mr Lim Swee Say, Minister in the Prime Minister’s Office and labour chief. Mr Lim was alarmed and thought Mr Khaw was wrong to postpone the angiogram.
“I felt that I was in top physical form,” wrote Mr Khaw.“To prove it, I actually intensified my exercise routines. I used to run on (the) treadmill three times a week; I increased it to five. Each time, I ran at my usual pace of
8km per hour for half an hour.”
He also carried a Glytrin spray with him, wherever he went, but only for a few days. Glytrin spray is used to help the heartwork more easily by dilating blood vessels. It is sprayed under the tongue.
Then Mr Khaw told himself: “I am not going to get a heart attack; I am not going to carry this.”
He said he was lucky that nothing adverse happened during those six weeks.
Mr Khaw wrote: “The cardiologists were anxious because it was not uncommon to have their patients perish before the scheduled angiogram/bypass.”
“I was stubborn...I am making this confession so that hopefully it can be a life-saving reminder to others. Please do not follow my example.”
He also wrote that he was grateful to the heart centre, Associate Professor Koh Tian Hai, medical director of NHCS and (Assistant Director of Nursing) Sister Lim Suh Fen, who persisted and finally scheduled a session on May 3 for him to sit down with the doctors to run through the evidence and the options.
“That session pulled me from cliff’s edge and got me back on the rational track,” he wrote.
DoctorsThe New Paper spoke to said denial is not uncommon especially when there are no outward symptoms.
All the five doctors interviewed say they have seen many such patients in their practice.
Dr Lim Chin Hock, a cardiologist at Mount Elizabeth Hospital with 30 years of experience, said: “They don’t seem to believe that they have heart problems. Out of 10 patients, three patients will be like that.
“They are still quite apprehensive and are not sure whether to go for follow-up treatment. They don’t think they have heart problems, as they say they exercise regularly and eat well.”
In order to convince them, he will conduct tests and prove the condition by investigation.
“It is only through showing them pictures, like the CT scan, that they will be convinced to go for the follow-up treatment,” he said.
Dr Baldev Singh, a cardiologist at Parkway East Hospital who also has 30 years of experience, said that, in general, the more educated ones are the ones who go into denial.
“They do not believe that they are prone to it as they have been exercising and feel fit. Some may have heart problems because of genetic reasons,” he said.
Dr Singh estimated that half the patients he sees have denied that they have heart problems, but once they are diagnosed with it, they accept it.
See the doctor
“The public should know that if they feel unrelenting pain in the heart that will not go away after 20 minutes, it is a sign to see the doctor,” he said.
Dr Stanley Chia, a consultant cardiologist at NHCS, said that many such patients who come for checks and treatment may stop their follow-ups if they find they are feeling fine.
“They think they are all right and choose not to return for appointments,” he said.
Some of these patients end up back at the NHCS through the Accident and Emergency department when they have a heart attack or when some symptoms, like chest pains, surface.
He estimated that this may happen to some10 to 20 per cent of his patients.
“I have patients who come to me, pat their chest and say they are fine. True, many of them are stable, but they have the potential of a heart attack suddenly happening,” he said.
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