Severe scoliosis can lead to restricted breathing and reduced oxygen levels. Dr Ong Thun How from the Department of Respiratory and Critical Care Medicine at Singapore General Hospital shares how a new machine helps.
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Mdm LF Phang, who is 58 years old, suffers from an excessive curvature of the spine, a condition known as kyphoscoliosis. With her lungs compressed within the smaller chest wall, she has difficulty breathing especially at night when she sleeps.
To improve her oxygen level and ventilation, Mdm Phang was put on the BPAP (bi-level positive airway pressure) machine when she went to consult with
Dr Ong Thun How, Senior Consultant,
Department of Respiratory and Critical Care Medicine, and Director, Sleep Disorders Unit at the
Singapore General Hospital, a member of the
SingHealth Group.
Mdm Phang, who is single, also goes to SGH’s new Non-invasive Ventilation (NIV) clinic every three months for a review. The clinic provides specialised service for patients using BPAP machines. "I'll take my machine along so that the respiratory therapist at the clinic can download my data," said Mdm Phang. "They measure my weight, blood pressure and make sure my oxygen levels are not too low. Dr Ong then examines the data and makes adjustments if needed. The machine is very small and handy."
The machine tracks and stores information regarding Mdm Phang's breathing, such as the amount of air she is breathing in, whether there is a mask leakage, how well she is using the machine, whether she’s using it and how long she’s using it. The NIV clinic is manned by Dr Ong who is a respiratory doctor, a respiratory therapist and a sleep technologist. Together, they help patients like Mdm Phang cope with their breathing difficulties.
How the BPAP machine works
About a third of the 100 patients seen at the clinic are diagnosed with kyphoscoliosis. The team monitors patients who use these machines, downloads data tracked by the machines and gives advice to patients for making optimal use of the machines.
A BPAP machine costs upwards of $3,000. The machines do not just push air into a patient’s body, but also help to keep the lungs inflated to facilitate the absorption of oxygen. When a patient exhales, the BPAP machine will prevent pressure in the airways from falling to zero, Dr Ong said.
"This helps to improve the oxygen level in the patient’s body, and also helps to decrease her carbon dioxide level," she said. "Thanks to the BPAP machine, our patients enjoy a better quality of life, and are able to stay reasonably active."
Mdm Phang said: "I started using the BPAP machine in 2008. It helps me at night and I feel more energetic during the day. I can walk farther and I feel much better."
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