Liver cirrhosis, an irreversible scarring of the liver, caused Mdm Yee to become a shell of who she formerly was. The complexity of her condition called for a myriad of treatments from different specialists. Instead of working in silos with each specialist examining only one part of the problem, the SingHealth Duke-NUS Liver Transplant Centre brought together healthcare professionals from across disciplines to treat Mdm Yee holistically.

Our Academic Medical Centre is a beacon of hope for many patients, such as Madam Yee Yok Chun. Her speedy recovery from liver cirrhosis and subsequent liver transplant was made possible by integrated care between our specialties and institutions. Mdm Yee's story is published in our latest annual report.

As a couple in their sixties, Mr Wong and Mdm Yee lived a routine life. After completing her daily shift as a dishwasher, Mdm Yee would head to Chinatown to help her husband at a food stall. That changed one fateful evening in 2011 when Mdm Yee did not turn up.

"She wasn't picking up her phone," says Mr Wong. "I was very anxious." He formed a small search party that located Mdm Yee at midnight, sitting alone and confused at the Outram Park bus terminal. This marked the beginning of a spate of disappearing acts and fainting spells.

The situation worsened. "I would black out suddenly, without warning," says Mdm Yee. "I had stitches on my face and head from the falls." She stopped work for her own safety and Mr Wong stayed home to care for his wife. Mdm Yee gradually lost control of her bodily functions and even stopped recognising her siblings.

It was only during a hospital visit in 2016 that doctors discovered Mdm Yee was suffering from liver cirrhosis. It was a genetic disorder which led to the build-up of toxins, causing damage to her brain. She needed a liver transplant urgently, but going on the transplant list meant waiting for years. Eager to donate part of his liver, Mdm Yee's son underwent blood tests to see if he was a suitable donor. Thankfully, tests showed that he was clear of the gene and was the best match.

 The set-up of the Liver Transplant SDDC that same year fast-tracked Mdm Yee's case. A team of surgeons, physicians, allied health professionals, nurses and many others synchronized efforts to expedite the living donor liver transplant for Mdm Yee.

Today, Mdm Yee's fainting spells are behind her. She's learning to walk again with newfound confidence and takes on simple daily chores. "The doctor told me to rest for two years, but I'm looking forward to working again!" says Mdm Yee, her radiant smile a testament to her incredible recovery.

 IN SICKNESS AND IN HEALTH

During the difficult period of Mdm Yee's deteriorating health, Mr Wong put his life on the backburner, stopping work for five years to care for his wife. Financial woes were part of their many worries as they had to live off the support of their children and Mdm Yee's brothers. Thankfully, Mdm Yee's recovery after her transplant progressed smoothly without any major hitches, and Mr Wong has since returned to work.

Home is a three-room flat in Jalan Bukit Merah where Mr Wong handles the household chores and sorts out Mdm Yee's medication. "I haven't cooked in five years, since I became ill. He does that now," says Mdm Yee with a laugh. "He never used to care about things at home but now he does the laundry, mops the floor, everything."

ORCHESTRATING SEAMLESS PATIENT SERVICES

Before the transplant operation, Associate Professor Jeyaraj Prema Raj, Mdm Yee's principal surgeon and Head of the Liver Transplant SDDC, worked closely with the endocrinologist, cardiologist, radiologists, anaesthetist, hepatologists and other physicians, to make sure that both Mdm Yee and her son were fit for surgery. In addition, there was a team of plastic surgeons to help construct the artery, as well as a team that specialised in microvascular surgery.

"We are akin to an orchestra working together to create a harmony of patient services," explains Assoc Prof Raj. "This is medicine at its basic core: the patient and the healthcare professionals caring for her."

Clockwise from top left: Dietitian, physiotherapist, pharmacist, medical social worker and transplant nurse who worked together to coordinate Mdm Yee's care and recovery.
 

Mdm Yee's journey was facilitated by the Liver Transplant Centre, a SingHealth Duke-NUS Disease Centre (SDDC). Read about the journeys of Mdm Yee and other patients like her in our latest annual report