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Answers:

Bone Mineral Densitometry

How can I book an appointment?

BMD screening will be held on board the Mobile BMD container, which is currently deployed to selected NHG Polyclinics and Ang Mo Kio Thye Hua Kwan Hospital.

To book an appointment, please contact either:

Please note that a doctor’s referral is required for the BMD Test.

What is a BMD Test?

BMD, or Bone Mineral Densitometry, is a simple and non-invasive examination that uses a special DEXA machine to scan the lower spine and one of the hips, to assess bone mineral content to help detect early loss of bone mass.

By measuring BMD, it is possible to predict fracture risk, thereby aiding doctors to render the necessary medical treatment / therapy to negate the risk.

When should I go for a BMD Test?

Regardless of gender, if you are over 65 years you are at a higher risk of osteoporosis than younger people. However, young people are also just as susceptible for there are no prior obvious symptoms until a fracture occurs.

Do seek a doctor’s opinion should any of the following risk factors apply to you:

  • If you are on long use of steroids
  • If you have a family of hip fracture
  • You are of very poor ambulatory status for an extended period of time
  • You are of thin / small build
  • If you are perimenopausal ("Perimenopausal" is a term applied to the several years preceding menopause)

Hence the following age group, should you think you are at risk, do approach doctor to seek if you need a BMD test.

Gender Age
Female 45 years and above
Male 65 years and above

What are the preparations I need to do?

No fasting is required.

However, the test should not be performed within a period of 72 hours following a nuclear bone scan or within a week following a barium study (barium meal, small bowel barium follow-through or barium enema).

Do not take calcium supplements the day of the examination.

Please bring any previous x-rays to the examination as these may help in the interpretation of results.

How long does the procedure take?

There will be a lifestyle survey to complete prior to the test. A coordinator on board the Mobile BMD will be conducting an interview session with the patient before proceeding to the BMD.

The whole process takes about 10 to 15 minutes.

When can I obtain the results?

Readings from the BMD Test will be available within 5 working days.

Patients can either opt to self-collect their radiological reports from our diagnostics centers, or choose to have it sent directly to their referring centre. Your referring doctor will discuss the results or review with you at your next doctor’s appointment and suggest the necessary medical treatment, if any.

What do the different T-score readings mean?

The World Health Organization has developed definitions for low bone mass (osteopenia) and osteoporosis. These definitions are based on a T-score.

The T-score is a measure of how dense a patient's bone is compared to a normal, healthy 30-year-old adult. For example:

Normal A bone BMD is considered normal if the T-score is within 1 standard deviation of the normal young adult value. Thus a T-score between 0 and -1 is considered a normal result.
Low bone mass (medically termed as osteopenia): A BMD defines osteopenia as a T-score between -1 and -2.5. This signifies an increased fracture risk but does not meet the criteria for osteoporosis.
Osteoporosis A BMD greater than 2.5 standard deviations from the normal (T score less than or equal to -2.5) defines osteoporosis.

Electrocardiography (ECG)

What do I need to prepare before going for ECG? 

 

No fasting is required. You can have a light meal before the ECG test.

Avoid strenuous activities prior to/on the day of the test.

On the day of the test

  • Wear light clothing
  • Do not apply powder, oil and lotion on your body as it may affect the ECG reading. If unavoidable, please kindly inform the staff prior to the test

What can I expect during ECG?

You will be advised to lie on an examination couch in the ECG room. For wheelchair patients, ECG will be done on a sitting position.

Our medical technologist will place a total of 10 self-adhesive pads on your chest, legs and arms. The pads are connected via ECG clips to send readings to the ECG machine.
Note: For patients with dextrocardia (right-sided heart), please inform our medical technologist immediately as placement of pads is different.

Prior and during the test, you are advised to relax and breathe normally to obtain a stable ECG reading.

After the reading is done, the clips will be disconnected from the pads, which will be removed and disposed off.

The whole procedure takes about 5 to 10 minutes.

 Does the ECG test hurt?

             The procedure is totally painless. 

             The adhesive pads may sometimes leave red marks on the skin, but these will fade 
             away in a few days.

 How accurate is the ECG test compared to Cardiac Stress test?

          ECG is also known as Resting ECG. It provides a record of how the heart performs at
          rest.

          Cardiac Stress test, Exercise testing, measures the heart's ability to respond to
          external stress in a controlled clinical environment or simply how the heart works
          under pressure. 

          As long as the patient is at rest, the machine will be able to obtain a precise record
          of the heart's condition. 

Laboratory

Do I need to fast before going for my tests?

Most of the tests do not require fasting, unless stated.

Below are the common tests which require fasting:

  • Glucose
  • Oral Glucose Tolerance test (OGTT test)
  • Lipid panel (total cholesterol, HDL-cholesterol, LDL-cholesterol & Triglycerides)
  • Hypertensive panel (inclusive of glucose, lipid panel, creatinine, electrolytes, urine dipstick and ECG tests)
  • Diabetes monitoring panel (inclusive of lipid panel, glucose, HbA1c, creatinine, electrolytes, urine dipstick and ECG tests)  

 How long should I fast before taking my blood tests?

Venous plasma glucose:

  1. Fast for at least 8hrs. (8 to 12hr recommended)
  2. Patients can drink plain water throughout the night and in the morning of test (to avoid dehydration, ketouria).
  3. Patients can take anti-hypertensive medication in the morning of test with plain water (to avoid excessively high BP due to delay in medication).

Diabetes monitoring panel / Hypertensive panel / Lipid panel:

  1. Fasting for 10 hrs is required.
  2. Patients can drink plain water throughout the night and in the morning of test (to avoid dehydration, ketouria).
  3. Patients can take anti-hypertensive medication on morning of test with plain water (to avoid excessively high BP due to delay in medication).
  4. Omit insulin and oral anti-diabetic agents.

Mammography and BSS

How can I book an appointment?

It is recommended to schedule the appointment one week after your menstruation, when the breasts are less likely to be tender.

To book mammogram appointment at:

  • Polyclinic – please contact 6-275-6443 or send request to here
  • Mammobus – please check our event calendar here

How often should I go for mammogram?

Below is the recommended frequency under the BSS programme:

  • for 40 to 49 years old - once every year (should you decide to go for screening)
  • for 50 years and older - once every two years

However, if you experience any of the following symptoms, you should consult with a doctor immediately:

  • a persistent lump or thickening in the breast or armpit area
  • a change in the size or shape of the breast
  • a dimpling or puckering of the skin (like orange peel)
  • blood or discharge from the nipple
  • a newly retracted (pulled in) nipple

What do I need to prepare before going for Mammography?

On the day of the examination,

  • do not use any body lotion, deodorant, perfume, powder or ointment on your underarms or breasts.
  • wear a comfortable two-piece outfit as you would need to undress from waist up.
  • remove any jewellery from your body.
  • if you are or suspect you are pregnant, you should inform the radiographer before the mammography.

Note for Mammobus Participants:
Please remember to bring along your identity card, registration form and receipt on day of screening.

What can I expect during the mammography process?

A female radiographer will perform the procedure to safe guard your privacy.

Before the examination, the radiographer/coordinator will ask you a few questions regarding your medical history.

During the mammography examination, it is necessary to compress the breast using a plastic plate in order to obtain a more detailed image of the structures in the breast. The compression may be uncomfortable but please inform the radiographers should you experience any extreme discomfort.

When can I obtain the results?

Under the BSS programme, your result will be posted to you within 3 weeks after your mammography.

What is BreastScreen Singapore (BSS)?

BSS is a national breast screening programme, supported by Health Promotion Board; which encourages women aged 50 years and above to go for regular mammography once in 2 years.

Under this programme, participants pay the following subsidized rates:
Singaporean: $50
Permanent Resident: $75
(Usual Rate: $100)

No doctor’s referral is required.

For more information of the BSS programme, please visit http://www.hpb.gov.sg/programmes/article.aspx?id=3324.

Am I eligible under the BSS programme?

To be eligible, participant must fulfill the following criteria:

Requirement 40-49 years old 50 years and older
Singaporean or Permanent Resident    
Have not gone for mammogram for the last 12 months    
Have not gone for mammogram for the last 24 months    
Have no breast symptoms such as breast lumps or blood-stained nipple discharge    
Have not been breastfeeding for the past 6 months    

Can I use my Medisave to pay for my mammography?

Under the Medisave guidelines, participants must fulfill all the criteria below to be eligible for Medisave claim.

  • Singapore Citizens or Permanent Residents
  • Patients who are qualified under the Breast Screen Singapore (BSS) programme
  • Age 50 and above (Based on date of birth of patient)
  • Sufficient Medisave funds under the Medisave 300 scheme
  • Patients can use their own or their immediate family members’ Medisave for their mammogram screening 

Why is mammography not recommended for younger women?

Mammography is beneficial but it is not recommended for women below 40 years old.

Cancer of the breast shows up on a mammogram as a denser mass of tissue when compared with normal breast tissue.

The density of breasts changes with age. Younger, pre-menopausal women have denser breast tissues, so it is possible to mistake the normal breast tissue for cancer. This will lead to false 'positive' results. Older or post-menopausal women have breast tissues which are less dense, so the cancers are better seen on the mammogram.

False 'positive' results create unnecessary anxiety. Also, extra costs will be incurred as repeat tests are required to confirm the results. For these reasons, younger women are not asked to go for mammography. They are encouraged to perform monthly Breast Self-Examinations (BSE) instead.

If you have a family history of breast cancer, you may need to go for mammography before the age of 40. Discuss this with your doctor.  


Spirometry

Who should go for spirometry?

Patients with the following conditions:

  1. Smokers above 40 years of age.
  2. Ex-smokers.
  3. Asthmatics.
  4. Patients with chronic coughs or episodes of wheezing or dyspnea
  5. Patients whose occupations may expose them to respiratory irritants such as fumes and dusts.

What do I need to prepare before going for spirometry?

Medications to avoid before test.
For accuracy of the test results, you are advised not to take any of the following medications (if possible) according to the hours indicated below.

Bronchodilators/Inhalers to be avoided:

6 hours before test 12 hours before test 24 hours before test Bronchodilators to be avoided
  • Atrovent
  • Atrovent
  • Berodual
  • Bricanyl
  • Berotec
  • Buventol
  • Duovent
  • Ipratran
  • Ipratropium
  • Salbuair
  • Saldolin
  • Sabutamol
  • Ventolin
  • Volmax  
  •  Atimos
  • Foradil
  • Foster
  • Oxis
  • Seretide
  • Serevent
  • Symbicort 
  • Spiriva

Tablets to be avoided:

6 hours before test 12 hours before test 24 hours before test Tablets to be avoided
  • Anasma
  • Apo-salvent
  • Asmol
  • Asmalin
  • Brethmol
  • Butylin
  • Dhatalin
  • Medolin
  • Sp-broncovent
  • Zenmolin
  • Bambec
  • Apo-theo LA
  • Nuelin
  • Theolin
  • Theophylline

What can I expect during spirometry?

  1. Your height and weight will be taken.
  2. The test will be performed with you seated upright.
  3. You need to take a deep breathe and exhale hard & fast into the spirometer until you are unable to exhale anymore.
  4. You are not to lean forward during the procedure.
  5. You may be required to repeat the same test a few times to ensure consistent results.
  6. A bronchodilator challenge test (Post test) will be performed upon your doctor's request.
  7. Before performing the post test, you will need to take 1-2 puffs of a short-acting inhaler and rest for at least 15 minutes before repeating Step 3.
  8. The entire spirometry test takes approximately 20 to 45 minutes.
  9. The test results will be assessed and reviewed by your attending doctor for follow-up management.
Spirometry Procedure 1
Spirometry Procedure 2
Spirometry Procedure 3

Ultrasound

What do I need to prepare before going for ultrasound?

Before you come for any ultrasound examination, please follow the below instruction:

Abdomen ultrasound - Do not eat or drink 6 hours before the examination.

Pelvic ultrasound - Full bladder is required. Drink at least 2 glasses of water 1 hour before the examination. Do not empty your bladder.

Other ultrasound examination - no preparation is required.

What can I expect during the ultrasound process?

  1. You will be positioned comfortably lying down on the scanning couch. The room may be darkened in order for the operator to optimize visualization on the monitor. 
  2. A water-soluble gel will be applied over the area to be examined to optimize transmission of the sound waves through the body. 
  3. An ultrasound probe will be moved over the area under examination.

The entire examination is usually completed within half an hour.


X-ray

How can I get a General X-ray done?

A doctor’s referral is required. Please consult your doctor and he/she will order the test if it is necessary.

Can I perform General X-ray if I am pregnant?

If you are pregnant or suspected to be pregnant, please inform our radiographer prior to the test so as to minimize radiation exposure to the fetus.

What do I need to prepare before going for General X-ray?

No fasting or special preparation is required prior to the test.

On the day of your appointment, please remember to bring your NRIC and X-ray request forms.

For Female Patients: 

You will be asked on your last menstruation period by the radiographer and sign a Pregnancy Declaration to declare that you are not pregnant before proceeding with the examination.

What can I expect during the X-ray process?

You will be guided to a changing room to change into a plain gown. All jewelry, metal objects and opaque clothes will need to be removed to prevent interference with the x-ray images.

The radiographer will position and adjust you against the machine or the imaging plate. You are required to maintain the position and stay still when the x-ray is activated. This is to ensure accuracy in results.

You may be required to wait for a while after the x-ray is performed as the radiographer will look through the images to determine if more are required.

When can I obtain the results?

A. Self-collection - You can collect the results within an hour. 

B. Despatch to clinic - The report will be despatched to your referring clinic within 3 working days.

Last Updated 03 June 2014