Knowing More about Geriatrics

Admitting to seeing a Geriatrician is a big step for most, especially for women but explaining to someone what a Geriatrician is, is quite another matter altogether. So when I suggested to my friend Ella MacDonald that we go and see Dr. Dev Teo, the new Consultant Geriatrician at the Ipoh Specialist Hospital, she looked at me blankly and said, “A what?” I had the same blank look subsequently when speaking to some other friends and figuring that Ipoh had a higher proportion than usual of retirees and aging population, decided to interview Dr. Dev on his medical specialty.

“So why did you choose Geriatrics?” I asked of Dr. Dev Teo. “A geriatrician is a medical doctor who is specially trained to prevent and manage the unique and, oftentimes, multiple health concerns of older adults. Older persons may react to illness and disease differently than younger adults. Geriatricians are able to treat older patients, manage multiple disease symptoms, and develop care plans that address the special health care needs of older adults”, was his reply.

“At what age should a person come to see you?”, was my next question to which he responded with, “Anyone over the age of 50 who presents with multiple disease symptoms would do well to be managed by a Geriatrician. As we’re trained in multiple disciplines, we are familiar with most of the major medical issues connected with the aging process and by providing an ‘umbrella’ management, we can help minimise drug interactions and give referrals to other specialist disciplines when the need arises”.

And the training is certainly long and arduous. Dr. Dev completed his medical degree receiving his MRCP from the Royal College of Surgeons in Dublin, Ireland, followed by housemanship and medical rotation at the Beaumont Teaching Hospital. A stint in general medicine gave him the qualification of Registrar to be followed by post graduate exams which earned him a Diploma in Medicine for the elderly. Not one to rest on his laurels, Dr. Dev then spent 5 years training in Geriatric and General Medicine at the Oxford John Radcliff Teaching Hospital where today he is listed in the General Medical Council as a specialist in Geriatrics.

During this time he had the good fortune to train under Professor Buchan who is a world authority on strokes and stroke management. He also gained extensive experience in working with people with dementia, Parkinson’s disease and falls.

According to Dr. Dev, the major age-related afflictions to be aware of are strokes, diabetes, dementia, Parkinson’s disease, depression, incontinence and for men, prostate problems. For stroke prevention, he recommends being very vigilant about monitoring one’s blood pressure especially if it leans on the high side and to take the blood pressure medication faithfully when prescribed.

On the issue of diabetes which appears to be rampant in Malaysia, Dr. Dev recommends a very stringent curbing on all sugars, white starch (white rice, noodles, white bread) and desserts, and also warns against most fast food which is laden with hidden sugar.

Depression in the elderly is very common and it is time for people to recognise that there is no stigma attached to being depressed. He trains carers on recognising the symptoms of depression and dementia in their elderly family members and urges early treatment for ease and comfort both for the patient and the carers. He is also very patient in explaining to carers and giving tips on how to cope with episodic tantrums and easing the trauma for the dementia patient.

Having worked in ‘Falls Clinics’ extensively, Dr. Dev recommends steps for families of the elderly to minimise the incident of accidental falls at home. As one of the highest causes of death amongst the elderly arises from falls, he has many tips for carers to prevent this. Concurrently he also recommends that people by the age of 60 should have a baseline bone scan done to eliminate the presence of osteoporosis or thinning bones which is prevalent particularly in older women.

Incontinence is a subject that is seldom discussed as there appears to a shroud of embarrassment over the topic. But Dr. Dev maintains that incontinence can be helped with specific pelvic floor exercises for both men and women. Men however should have their prostate checked by the time they reach 60 with both a manual examination as well as a PSA (Prostate Serum Antigen) blood test.

I first went to Dr. Dev as a patient and having experienced his professionalism and gentle yet deeply probing manner, I can certainly vouch for his expertise. Not for him, the I-am-God-the-doctor-and-you-do-as-I-tell-you approach but rather an exploration between equals about the ailments that afflict me and how best to treat them.

Having only been in Ipoh Specialist Hospital for 4 months, Dr. Dev has great plans to run clinics and forums on his favourite topics for the elderly as well as for the care and management of them. Timely ones would be Stroke Recognition, Prevention and Management, Diabetes Prevention and Management and just about any of the diseases that afflict the older person.

Ipoh Echo wishes Dr. Dev much success in the future and looks forward to his public forums.

Tags: Dr. Dev Teo, Geriatrician Dr. Dev Teo, Geriatrics, Ipoh Specialist Hospital

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