Handy man

Dr Tay Shian Chao, 39, a consultant at the department of hand surgery at Singapore General Hospital, tells POON CHIAN HUI how he likes using his hands to, well, fix hands.

I decided to specialise in hand surgery because...
I love the precision work and attention to detail that hand surgery demands A hand surgeon has to operate on bones, joints, tendons, nerves and blood vessels - and each requires different skills.

Repairing nerves or blood vessels often calls for very delicate microscopic work and the smallest mistake can result in grave consequences. As it is a relatively new discipline, there is also room for development.

The hands are fascinating because...
They epitomise form and function and enable us to perform numerous tasks in our daily lives.

Hands also play a part in forging relationships as we use them to communicate through gestures. Even activities like dancing and acting involve the use of hands to convey artistic expression.

If I were to give an analogy for what I do I would be an...
Engineer. Engineers are basically problem solvers. Similarly, a hand surgeon figures out what has gone wrong and corrects the problem so that things work seamlessly once more.

To do this, we need to have an in depth understanding of anatomy biomechanics and human physiology. Treatment is not always open surgery though - it can be in the form of medication splinting or minimally invasive
surgery.

I have come across all types of cases...
It is a common misconception that hand surgery is only about putting back fingers that have been amputated. The scope of hand surgery is very wide and some of the conditions that hand surgeons specialise in include carpal tunnel syndrome, trigger fingers, hand and wrist fractures and other painful conditions of the hand and wrist.

A typical day for me would be...
I begin at 7.30am with teaching ward rounds or administrative matters Then I either see patients or perform surgery. Otherwise, I work on my research projects. One of them involves adapting the CT scanner, which is an advanced X-ray machine to capture a "video X-ray" of a person s wrist while in motion This is so that we
can observe the hand s motion patterns which will help us to uncover injuries that would have otherwise remained undetectable.

I try to exercise every day - either a run or swim - before having dinner with my wife, who is 32 and an eye doctor For relaxation I watch a documentary or a DVD movie.

I love patients who are...
Motivated. The outcome of surgery depends on three things - the surgeon, the patient s healing potential and his motivation. Motivation is particularly important as it affects how well a patient performs during rehabilitation, which is critical to regaining good function of the hand.

Patients who get my goat are...
Those who exaggerate their conditions in order to get extended medical leave or to inflate compensation claims.

One little known fact about wrist pain is...
Many wrist pains can be successfully treated. With a detailed medical history and a comprehensive examination with X-rays, a correct diagnosis can be made Common causes of wrist pain include tendinitis ligament injuries arthritis and fractures.

Things that put a smile on my face are...
When I am able to find solutions to difficult problems. These might include correctly diagnosing a patient with a complicated wrist condition, finding a better way to perform a complex surgery or unlocking a research problem that had been considered insurmountable.

It breaks my heart when...
Patients with kidney failure or with poorly controlled diabetes gradually lose their fingers and hands to gangrene from poor blood circulation. These are cases I hope to see less of.

I would not trade places for the world because...
I love working with my hands and enjoy a-well-performed surgery. I also enjoy the mental stimulation that research provides Last but not least, I get to help people every day.

My best tip...
Take care of your hands It is unlikely that squeezing rubber balls or grippers will help ease the pain in your hands or wrists. On the contrary they may worsen the condition and you may develop tendon problems.

Also, try to use a shoulder bag or trolley to transport heavy groceries instead of gripping the plastic bags with your fingers for prolonged periods.

Alternatively, get a bag that has a wider strap preferably with some cushioning as well This reduces the pressure on fingers and hands.

If your pain does not improve seek medical help. Many conditions can be treated without surgery or injections.