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Orchard Road lights up for Christmas - in 'safer' colours Posted: GREEN, red and gold may be traditional Christmas colours, but they are also similar to the ones on traffic lights. Given that this could lead to motorists confusing yuletide decorations with traffic signals, the Orchard Road Business Association (Orba) has decided, from this year, to avoid the use of these colours for the shopping belt's annual light-up that it organises. "While we want to create the festive mood, we have to ensure that motorists will not be distracted by the displays," Orba's executive director Steven Goh said. He explained that initial plans to use silver and gold - which is similar to the amber signal of traffic lights – for this year's display were altered. Instead, the panel of senior Orba and STB representatives which plans and chooses the decorations decided to turn Orchard into a winter wonderland with giant diamonds and snowflakes – all blue and white. Called Christmas on A Great Street, the lights for the 2.2km stretch from Tanglin Mall to Plaza Singapura will be turned on by President Tony Tan Keng Yam tonight in a ceremony at Shaw House Urban Plaza. The light-up will run till Jan 5. The move follows consultations with government agencies, including the Land Transport Authority and the Singapore Tourism Board (STB). STB's director of lifestyle precincts development Tan Yen Nee said event organisers putting up outdoor displays have to consider various guidelines, including those meant to protect road users. The board will continue to facilitate talks between stakeholders and government agencies on the feasibility of decorations for future events, she said. — The Straits Times / Asia News Network

New family policy a beginning Posted: A relaxed population policy will contribute to a rise in the fertility rate by a limited degree – it is unlikely to lead to a population explosion. China's family planning policy is to be eased at long last. The Third Plenum resolution, released on Friday reveals that China is to allow families in which either of the parents is a single child to have a second child, together with other reform. The adjustment is considered to be a breakthrough in relaxing China's family planning policy. However, this step should be a beginning, rather than the end, of family planning policy reform. Compared with the past overriding policy that required most families to have only one child, a relaxed population policy and allowing people to exercise their reproductive rights is a manifestation of greater respect and autonomy for people. Although more families are choosing to have one child or none for a variety of reasons, such as the rising cost of raising a child, there is no need for China to impose the mandatory one-child policy any longer. From a broader view, the central authorities' decision to allow more families to have a second child is meant to reverse the already low fertility rate and maintain the country's young labour resources. A relaxed population policy will contribute to a rise in the fertility rate by a limited degree – it is unlikely to lead to a population explosion. Based on the trial experience of allowing a second child among four cities – Enshi in Hubei province, Yicheng in Shanxi province, Chengde in Hebei province, and Jiuquan in Gansu province – allowing couples to have a second child only raises the fertility rate to a limited extent. Even after granting people in the trial cities more chances to have a second child, the fertility rate remained low. According to the fifth national population census in 2000, the total fertility rate of these four cities was 1.31, a bit higher than the country's overall total fertility rate of 1.22. In 2010, the total fertility rate of the four cities was 1.52 compared with the country's overall rate of 1.18. China has experienced imbalanced demographic development since the strict family planning policy was introduced in the late 1970s. The policy, which should have "advocated" one child for most families, has turned out to be a strict birth control policy under which most families are allowed to have only one child. Since 1992, China's total fertility rate has dropped to under 1.6, well below the replacement level which is widely believed to be 2.1. Since 2000, the fast development of the market economy has shifted the relationship between the costs and benefits of childrearing, which has discouraged more people from having children. The fifth national population census in 2000 showed China's fertility rate was 1.22, but the sixth national population census conducted in 2010 showed the figure was only 1.18. And analysis of data from the National Bureau of Statistics shows China's fertility rate was only 1.05 in 2011. As a result, China's demographic problem is becoming grave. The ratio of the population aged from 0 to 14 years old in the total Chinese population dropped from 33.6% in 1982 to 16.6% in 2010. In 2012 for the first time, China saw a drop in the country's working age population, as the number of people between 15 and 59 years old fell by 3.45 million. What's more, the risks associated with single-child families are manifold: families are bereft of children, as families who observed the family planning policy but later lost their single children are often too old to have a second baby, society is rapidly aging, generation conflicts are becoming more acute and there is a growing gender imbalance and labour shortage. The National Committee on Aging estimated that there will be more than 200 million people aged 60 or above by the end of 2013, and more than 400 million by 2033. China's fast aging society will increase the burdens on households as well as society. The sixth national census showed that in 2010, 118.06 boys were born for every 100 girls. A normal gender ratio is between 103 to 107 boys for every 100 girls. It is widely reported that by 2020 there may be at least 20 million single men who will be unable to marry because of the gender imbalance, which will be a risk to social stability. Confronted by these potential risks, China needs to be aware of the fact that the earlier the population policy is eased, the better it will be. However, the experience of the four pilot cities showed permitting families to have a second child is far from enough, the authorities need to introduce incentives to encourage more qualified families to have a second child. Changdao county in Shandong province has allowed families to have a second child for nearly 30 years, but it has still experienced negative population growth. Simply easing the family planning restrictions to allow more families to have a second child is unlikely to increase the fertility rate to the replacement level at which population development is considered to be sustainable. This is because with the advancement of social and economic development, child-rearing costs are on the rise, too. Meanwhile, the increasing social and economic engagements also weaken the desire to have children. The family planning directives have to be accompanied by supporting policy orientations. To take the example of Changdao county again, even though a second child is permitted, local policy orientations remain the same as those in many other parts that observe the dominant one-child directive. A benefit-oriented mechanism, such as incentives for those who give up having a second child, discourage people from having a second child. Thus, many families, in fact only have a single child. Undoubtedly, China should push forward further family planning policy reform. It is high time that the government grasped the strategic opportunities to promote pro-natalist policies, as well as grant people reproductive choice. The Reform of the family planning policies should aim to build happy families, as well as social harmony based on respecting people's right to have children. At the same time, the reform should be aimed at reducing or evading the risks brought by the country's low fertility rate.

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• Orchard Road lights up for Christmas - in 'safer' colours
• New family policy a beginning
• Study: Spousal abuse most common

Orchard Road lights up for Christmas - in 'safer' colours Posted: GREEN, red and gold may be traditional Christmas colours, but they are also similar to the ones on traffic lights. Given that this could lead to motorists confusing yuletide decorations with traffic signals, the Orchard Road Business Association (Orba) has decided, from this year, to avoid the use of these colours for the shopping belt's annual light-up that it organises. "While we want to create the festive mood, we have to ensure that motorists will not be distracted by the displays," Orba's executive director Steven Goh said. He explained that initial plans to use silver and gold - which is similar to the amber signal of traffic lights – for this year's display were altered. Instead, the panel of senior Orba and STB representatives which plans and chooses the decorations decided to turn Orchard into a winter wonderland with giant diamonds and snowflakes – all blue and white. Called Christmas on A Great Street, the lights for the 2.2km stretch from Tanglin Mall to Plaza Singapura will be turned on by President Tony Tan Keng Yam tonight in a ceremony at Shaw House Urban Plaza. The light-up will run till Jan 5. The move follows consultations with government agencies, including the Land Transport Authority and the Singapore Tourism Board (STB). STB's director of lifestyle precincts development Tan Yen Nee said event organisers putting up outdoor displays have to consider various guidelines, including those meant to protect road users. The board will continue to facilitate talks between stakeholders and government agencies on the feasibility of decorations for future events, she said. — The Straits Times / Asia News Network

New family policy a beginning Posted: A relaxed population policy will contribute to a rise in the fertility rate by a limited degree – it is unlikely to lead to a population explosion. China's family planning policy is to be eased at long last. The Third Plenum resolution, released on Friday reveals that China is to allow families in which either of the parents is a single child to have a second child, together with other reform. The adjustment is considered to be a breakthrough in relaxing China's family planning policy. However, this step should be a beginning, rather than the end, of family planning policy reform. Compared with the past overriding policy that required most families to have only one child, a relaxed population policy and allowing people to exercise their reproductive rights is a manifestation of greater respect and autonomy for people. Although more families are choosing to have one child or none for a variety of reasons, such as the rising cost of raising a child, there is no need for China to impose the mandatory one-child policy any longer. From a broader view, the central authorities' decision to allow more families to have a second child is meant to reverse the already low fertility rate and maintain the country's young labour resources. A relaxed population policy will contribute to a rise in the fertility rate by a limited degree – it is unlikely to lead to a population explosion. Based on the trial experience of allowing a second child among four cities – Enshi in Hubei province, Yicheng in Shanxi province, Chengde in Hebei province, and Jiuquan in Gansu province – allowing couples to have a second child only raises the fertility rate to a limited extent. Even after granting people in the trial cities more chances to have a second child, the fertility rate remained low. According to the fifth national population census in 2000, the total fertility rate of these four cities was 1.31, a bit higher than the country's overall total fertility rate of 1.22. In 2010, the total fertility rate of the four cities was 1.52 compared with the country's overall rate of 1.18. China has experienced imbalanced demographic development since the strict family planning policy was introduced in the late 1970s. The policy, which should have "advocated" one child for most families, has turned out to be a strict birth control policy under which most families are allowed to have only one child. Since 1992, China's total fertility rate has dropped to under 1.6, well below the replacement level which is widely believed to be 2.1. Since 2000, the fast development of the market economy has shifted the relationship between the costs and benefits of childrearing, which has discouraged more people from having children. The fifth national population census in 2000 showed China's fertility rate was 1.22, but the sixth national population census conducted in 2010 showed the figure was only 1.18. And analysis of data from the National Bureau of Statistics shows China's fertility rate was only 1.05 in 2011. As a result, China's demographic problem is becoming grave. The ratio of the population aged from 0 to 14 years old in the total Chinese population dropped from 33.6% in 1982 to 16.6% in 2010. In 2012 for the first time, China saw a drop in the country's working age population, as the number of people between 15 and 59 years old fell by 3.45 million. What's more, the risks associated with single-child families are manifold: families are bereft of children, as families who observed the family planning policy but later lost their single children are often too old to have a second baby, society is rapidly aging, generation conflicts are becoming more acute and there is a growing gender imbalance and labour shortage. The National Committee on Aging estimated that there will be more than 200 million people aged 60 or above by the end of 2013, and more than 400 million by 2033. China's fast aging society will increase the burdens on households as well as society. The sixth national census showed that in 2010, 118.06 boys were born for every 100 girls. A normal gender ratio is between 103 to 107 boys for every 100 girls. It is widely reported that by 2020 there may be at least 20 million single men who will be unable to marry because of the gender imbalance, which will be a risk to social stability. Confronted by these potential risks, China needs to be aware of the fact that the earlier the population policy is eased, the better it will be. However, the experience of the four pilot cities showed permitting families to have a second child is far from enough, the authorities need to introduce incentives to encourage more qualified families to have a second child. Changdao county in Shandong province has allowed families to have a second child for nearly 30 years, but it has still experienced negative population growth. Simply easing the family planning restrictions to allow more families to have a second child is unlikely to increase the fertility rate to the replacement level at which population development is considered to be sustainable. This is because with the advancement of social and economic development, child-rearing costs are on the rise, too. Meanwhile, the increasing social and economic engagements also weaken the desire to have children. The family planning directives have to be accompanied by supporting policy orientations. To take the example of Changdao county again, even though a second child is permitted, local policy orientations remain the same as those in many other parts that observe the dominant one-child directive. A benefit-oriented mechanism, such as incentives for those who give up having a second child, discourage people from having a second child. Thus, many families, in fact only have a single child. Undoubtedly, China should push forward further family planning policy reform. It is high time that the government grasped the strategic opportunities to promote pro-natalist policies, as well as grant people reproductive choice. The Reform of the family planning policies should aim to build happy families, as well as social harmony based on respecting people's right to have children. At the same time, the reform should be aimed at reducing or evading the risks brought by the country's low fertility rate.

Study: Spousal abuse most common Posted: SPOUSAL abuse is the most common form of family violence in Singapore, according to a new study by Pave, the leading agency that deals with such cases. Based on 3,600 cases it has handled over the last 10 years, Pave said the study found that victims who are physically or psychologically abused by their spouses made up 72% of new cases. Pave executive director Sudha Nair said the high rate may not mean that other forms of violence are not prevalent. "It is just that other forms of abuse, such as elder or child abuse, often go unreported; these are the victims who can't fend for themselves and do not come forward to seek help," said Dr Nair. That is why the agency hopes more members of the public can come forward to help identify victims of family violence – whether they are married, children, or elderly. The worsening problem of family violence can be seen by the rise in the number of such cases that went to court. In 1995, the Family Court heard 978 such cases. By last year, the figure had more than tripled to 3,200. "I think it is a concern because families have come under increasing pressure and strain," said Senior Minister of State for Law and Education Indranee Rajah who spoke yesterday at a family violence forum organised by Pave. To tackle this problem, the newly-established Family Justice Committee has issued several recommendations that will be put up for public consultation early next year. Among them, the committee hopes to strengthen community touch-points, such as schools, hospitals and family service centres, so that family violence victims can get help earlier, before cases escalate to the courts. "If you want to save the family and try to make sure the family remains intact, you have to go further upstream," said Indranee, who co-chairs the committee. This means teachers, doctors and lawyers may need to undergo relevant training so they have the skills and knowledge to refer victims for help. Victims could get help at specialist agencies that handle divorce cases or provide mediation services which the committee has suggested setting up. There are currently three specialist family violence centres here. But they mainly provide counselling for victims and perpetrators and do not offer mediation or divorce-related services. Pave welcomes the idea, as the proposed agencies could handle family violence cases that are often complex in nature. For example, its study found that four in five victims have suffered both psychological abuse and physical violence. — The Straits Times / Asia News Network

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• Getting to know ED
• He's a bat, bat kid
• Actor's battle with amyloidosis

Getting to know ED Posted: Facts and fallacies about erectile dysfunction (ED). ERECTILE dysfunction (ED) is the inability to achieve or maintain an erection of the penis, which is satisfactory for sexual intercourse. Being a taboo subject, there are many myths circulating around that are worsened by men not talking openly about it with their doctors. Here are some of the common misconceptions about this condition. ED affects only elderly men Although the majority of men affected by ED are elderly, younger men are not exclusively exempted. In Malaysia, data collected to date are for men above 40 years of age, and it showed a higher prevalence among men above 60 years of age. However, in a study done in Brazil, the prevalence rate was 35% in men 18-40 years of age. So if you are young and have ED, do not fret. You are not alone. If you are above 40 years, up to 50% of men in Malaysia share your problem. In fact, in a recent local study, the prevalence of ED in those above 40 years of age was 69.5%. ED is not dangerous or life-threatening While it is true that ED on its own does not lead to death, it is actually an indicator of other underlying diseases that can shorten your life. It has been proven that ED predicts coronary artery disease, with a lead time of two to five years. In other words, if you have ED, you are at risk of a heart attack in two to five years. Therefore, if you have ED, you should be examined for the health of your heart as well. Both are equally important to men. The presentation of ED by men in the clinic is an opportunity for doctors to screen for other diseases associated with it, and these include diabetes mellitus, testosterone deficiency syndrome, hypertension and high cholesterol levels (hyperlipidaemia). ED is the partner's fault ED is not to be blamed on the partner for not being attractive anymore. Although psychological factors do affect ED, there are other physiological or organic factors involved as well. These include diseases affecting the blood vessels and/or the nerves supplying the penis. Often, men shy away from sex when they are unable to perform, and this can construed by their partners that they are not attractive any more. This misconception can lead to relationships breaking down. Men with ED have no sexual desire This is not entirely true. Men with ED usually do have the desire, but due to the underlying disease affecting the blood vessels or nerves, they are unable to perform. There are men with ED who lack desire. These men either have low levels of testosterone or are affected psychologically by stress or emotion. Masturbation causes ED There is no concrete evidence for this. In normal men, erection is automatic This is not true. Men need stimulation for sexual erection. Non-stimulated erection may occur during sleep or on awakening in the morning, but this is not related to sex. There is also a refractory period before men can have an erection again, and this can last from minutes in younger men to days in older men. This is not ED. An erection means men want sex Again, this is not true. Men may experience a normal physiological erection during sleep or on getting up in the morning. It is not always related to sexual activity. ED needs extensive investigations and treatment is usually delayed ED is diagnosed through doctors asking you some simple questions (taking a history). A questionnaire known as the International Index of Erectile Function (IIEF) may be used. A physical examination and some blood tests will follow to detect any other associated diseases. Treatment will usually then be given. Only in certain complex cases, and this is very rare, will further tests like a Duplex ultrasound, cavernosogram or nocturnal penile tumescence test, be needed. The first step in treatment is lifestyle modification, and this includes maintaining an ideal body weight, cessation of smoking, moderate exercise and a balanced diet. This on its own may improve ED. Needless to say, blood pressure, sugar and cholesterol needs to be controlled. Any psychological factors such as stress need to be tackled as well. The next step is oral medication (tablets to be swallowed). Phosphodiesterase-5 (PDE-5) inhibitors such as sildenafil, vardenafil and tadalafil, are effective in 80% of cases. Often, men shy away from sex when they are unable to perform, and this can construed by their partners that they are not attractive any more. – AFP Caution is needed for those with heart problems. They will need to be assessed carefully by the doctor. If the heart disease is deemed mild, they can be given PDE-5 inhibitors. In moderately severe cases, further tests will be required, while those who have severe disease should not be taking such drugs. Those on nitrate medications also cannot be given PDE-5 inhibitors. The other treatment options are injection of medication (like prostaglandin) directly into the penis using a small needle and syringe, using a vacuum pump device or inserting a penile prosthesis (requiring surgery). Treatment is only temporary and the condition can be cured This is another misconception where some people think that taking just one magical pill will solve it all. If lifestyle modification does not help and taking medication is required, you will probably need to continue taking the medication as long as you want to have erections. The only exception is if it is solely psychological in nature, where counselling or behavioural therapy may cure the problem, and further treatment may not be required. Circumcision reduces ED There is no evidence that circumcision reduces ED. ED treatment increases the size of the penis This is another misconception. ED treatment solves erection, i.e. rigidity and hardness. It does not increase the length or size of the penis. Traditional treatment is cheaper and much better than seeing a doctor Unapproved medications are risky and may contain substances that are detrimental to health. It is not worth the risk. Most of these medications have not undergone stringent tests, and unlike conventional medication prescribed by doctors, have not been proven effective by robust trials. In a review by Ho et al., most of the herbal treatments for ED were tested in animals, and only yohimbine, ginseng and butea superba were tested in humans. ED can be helped. An open discussion with the doctor, especially a urologist, would be beneficial. Do not be embarrassed. References: 1. Martins FG et al. J Sex Med 2009; 7(6):2166-73 2. Ho CCK et al. Curr Urol Rep 2011;12(6):470-8 3. Tong SF et al. Asia Pac J Public Health 2012;24(4):543-55 4. Tan HM et al. J Sex Med 2012;9(3):663-71 > This article is contributed by The Star Health & Ageing Panel, which comprises a group of panellists who are not just opinion leaders in their respective fields of medical expertise, but have wide experience in medical health education for the public. The members of the panel include: Datuk Prof Dr Tan Hui Meng, consultant urologist; Dr Yap Piang Kian, consultant endocrinologist; Datuk Dr Azhari Rosman, consultant cardiologist; A/Prof Dr Philip Poi, consultant geriatrician; Dr Hew Fen Lee, consultant endocrinologist; Prof Dr Low Wah Yun, psychologist; Datuk Dr Nor Ashikin Mokhtar, consultant obstetrician and gynaecologist; Dr Lee Moon Keen, consultant neurologist; Dr Ting Hoon Chin, consultant dermatologist; Prof Khoo Ee Ming, primary care physician; Dr Ng Soo Chin, consultant haematologist.  For more information, e-mail starhealth@thestar.com.my. The Star Health & Ageing Advisory Panel provides this information for educational and communication purposes only and it should not be construed as personal medical advice. Information published in this article is not intended to replace, supplant or augment a consultation with a health professional regarding the reader's own medical care. The Star Health & Ageing Advisory Panel disclaims any and all liability for injury or other damages that could result from use of the information obtained from this article.

He&#39;s a bat, bat kid Posted: Miles has had acute lymphoblastic leukaemia since he was 20 months old. His cancer went into remission, and with his last round of chemotherapy in June, he said he wanted to be Batman. He didn't get to be Batman. Instead, he became Batkid. TO be an aspiring superhero these days, most five-year-olds must enlist clueless younger siblings, restless parents, backyard shrubs, fire hydrants and all manner of pets to serve as their foils and damsels in distress. Not Miles Scott, for whom much of San Francisco morphed into Gotham City recently. He pulled a woman from the cable car tracks as crowds cheered, then busted the Riddler during a bank heist. The Gotham City Chronicle ran a banner headline: BATKID SAVES CITY. Miles has had acute lymphoblastic leukaemia since he was 20 months old. His cancer went into remission, and with his last round of chemotherapy in June, he said he wanted to be Batman. Coordinated by the Make-A-Wish Foundation, and with at least 12,000 volunteers to cheer him on, his wish came true in a spectacular display of communal whimsy. Miles is a leukaemia survivor. After battling leukemia since he was a year old, Miles is now in remission. One of his heroes is Batman, so to celebrate the end of his treatment, the Make-A-Wish Greater Bay Area granted his wish to become Batkid for a day. – MCT "Batkid", as he was known, captured the attention of an entire city, and even, the country. San Francisco seemed to come to a virtual halt, with all eyes on Miles. Local television covered it live, beaming aerial images of his adventures. Members of Congress issued video pleas for help, and President Barack Obama offered kudos in a brief video: "Way to go, Miles, way to save Gotham." Maybe it came at the perfect time in this politically-riven nation. For brief moments, the national focus turned from the political battles in Washington to a child from rural Siskiyou County saving Gotham City. "It was such an authentic wish that anyone could relate to; I'm trying not to cry," said Toni Baca, 30. "We all want to be superheroes." The bat signal went out Nov 14, a beam shining on the side of Miles' hotel. At 10am the next day, San Francisco Police Chief Greg Suhr issued a televised plea for help on a local newscast. "Please, Caped Crusader, we need you," Chief Suhr begged. Miles, dressed in the trademark batsuit, rode in a donated Batmobile – a black Lamborghini tricked out with Batman logos – along streets thronged with people holding signs and rooting him on, occasionally dabbing their eyes. Shalyn Pugh Davis summed up the thoughts of many on Twitter: "Follow SFBatkid adventure and have your faith in humanity restored." Social media had spread the word throughout the week, and people drove in from all around the Bay Area and beyond to support Miles. Not only does the kid have a batsuit, he has a cool ride to go with it, driver included, of course. – MCT "I stayed up late making signs and we carpooled down here," said Shaneh Santos, 22, of Sacramento. "It's moving to be part of something, people driving hours to be part of a special moment for this little boy." San Francisco resident Sara Sanchez came decked out with a huge sign that read "SF <3 Batkid". She said the energy in "Gotham" rivaled the two parades celebrating the San Francisco Giants' recent World Series championships. "Seeing the city come out in support, it makes you really proud to live in a city like this," she said. The San Francisco Chronicle published a special edition of the Gotham City Chronicle, which were to be handed out in Union Square. After demand for copies soared, managing editor Audrey Cooper said the paper would reprint a special edition. "This is what I love about San Francisco," Cooper said by email. "We're a quirky city that loves free-thinkers. We totally understand a five-year-old cancer survivor who wants to dress up like Batman." The staged escapades lasted several hours. Miles' face was mostly hidden by his mask. But one glimpse of his expression showed he was serious, fully engaged in what he alone had to do. Then he stopped for a burger with Batman, who served as his adult sidekick for the day. That was interrupted when a Union Square flash-mob alerted him to a kidnapping in progress. The San Francisco Giants' mascot, Lou Seal, had been taken by the Penguin. Batkid chased the flightless villain around AT&T park and rescued Lou Seal. Before leaving the stadium, Batkid slipped off his mask and whispered something into his father's ear. Smiling, his father led him over to the infield, and then, home plate. Batkid ran the bases as a small crowd cheered. By then, the Batkid campaign embodied more than just a sick boy's wish. It had become a national feel-good moment. "U're (sic) an inspiration to us all," Michelle Obama tweeted Miles. Politicians and other public officials scrambled all day to get out tweets and news releases tying them to Batkid. Batman assists Miles the Batkid, as he prepares to save a damsel in distress on Hyde Street in San Francisco. – MCT Even the US attorney for Northern California, Melinda Haig, announced the arrests of the Riddler and the Penguin. "Edward 'E.' Nigma, a.k.a. 'the Riddler', and Oswald Chesterfield Cobblepot, a.k.a. 'the Penguin', were formally arrested today and charged with multiple counts of conspiracy and kidnapping for their all-too-familiar villainous ways in Gotham City," according to a news release. When it was all over, many in San Francisco hoped the spirit of Batkid would remain. "It's a phenomenal day," said Jeff Myers, chief of emergency medicine for the San Francisco Fire Department. "It's something this boy is going to remember for a long time. And it's just phenomenal for the city." – Los Angeles Times/McClatchy-Tribune Information Services

Actor&#39;s battle with amyloidosis Posted: When actor Michael York found dark rings developing under his eyes, it took three years to diagnose amyloidosis, a rare condition that can have fatal consequences. MICHAEL York, the British-born film and stage actor and star of Cabaret, was blessed with youthful skin. He never needed eye makeup for his roles. So when dark rings began to develop, he knew it was something more than lack of sleep. "I wondered whether it was a virus or something innocuous," he said. "Then in 2009, I was doing a mini-series and noticed it was getting really bad. Because of my profession, I could slap some makeup on, but if I had a shower, they would turn purplish, so I began to think something was amiss." It was more than three years before York discovered he was suffering from the rare and potentially fatal condition, amyloidosis. In spite of his connections and access to the best medical care, things became steadily worse as the hunt for answers took him down one wrong path after another. Amyloidosis is caused by the abnormal production of insoluble proteins that clump together in different parts of the body, eventually causing vital organs to shut down. Because it is unusual and the signs and symptoms are different in each person, it is very hard to recognise. York, 71, spoke about the long road to diagnosis on a visit to London, where he performed in a charity reading at the Old Vic theatre and visited the Royal Free Hospital, north London. It is the only hospital that offers a scan to locate and quantify amyloid deposits in the body. Prof Sir Mark Pepys, director of the Wolfson Drug Discovery Unit at the Centre for Amyloidosis and Acute Phase Proteins, who invented the scan, is now working with GlaxoSmithKline on a drug he hopes could clear the deposits. Late diagnosis is far from unusual and can have dire consequences. Although median survival for Prof Pepys' patients is now eight to 10 years, 20% arrive with irreversible organ failure and do not live so long. York had ignored the rings until he and his wife, photographer Pat, went to Washington for Barack Obama's inauguration and stayed with a close friend, the biologist William Haseltine. "He said, 'What the hell is wrong with your eyes?' Go back to LA and have an eye examination. Because of the weight of his authority, I did," said York. The ophthalmologist said he had Fabry's disease – a disturbing, but incorrect diagnosis, which proved to be, said York, "the first of many". He tried to carry on as normal, but felt tired and ill. The turning point came when he agreed to give a talk on a cruise organised by National Public Radio. "We picked up the boat in Dubai and I started to feel really bad. Everything was swelling up and it was very hot outside and very cold on the boat, and I began to feel so wretched that I don't know how I did my lecture. "Two weeks after that Pat found me comatose on the floor. I'd passed out and was rushed to hospital, and they couldn't determine what it was." He went to the Cedars-Sinai hospital in LA, where doctors decided he had multiple myeloma, a bone marrow cancer, also with a poor prognosis – only 37% of patients survive five years after diagnosis. The treatment did not help. York credits his wife with the eventual breakthrough. She got in touch with Dr Robert Kyle at the Mayo Clinic in Rochester, Minnesota, the multiple myeloma pioneer who is also an expert in amyloidosis, to which it is related. A long email correspondence began. Dr Kyle, 84, no longer sees patients, but introduced the couple to doctors at the Mayo, where tests confirmed amyloidosis. In July last year, York underwent an autologous stem cell transplant – involving the removal of immature blood stem cells from the body, followed by high-dose chemotherapy to get rid of diseased or damaged marrow. The treated stem cells are then reinjected into the body. It is a risky procedure, but the actor sailed through. The rings under the eyes are still there, but York says he no longer feels ill and tired. The scan at the Royal Free recently showed most of the deposits had gone, although his voice and heart muscle have been affected. "I've been reprieved," he said. "I don't know about cured, because it can come back. I'm not looking normal – I could put makeup on, but I don't see the point. This is me now and when people ask about it, I'm able to tell them." Not everyone has the manners to ask. The Globe, a US tabloid, ran a picture of York last year with claims from two cosmetic surgeons that he'd had surgery. York wrote to the journalist offering her the true story and she replied in a one-line email: "Happy you're feeling well." The couple hope the rings below his eyes will eventually disappear. In the meantime, he jokes, he is available for parts for men in dark glasses of a certain age - lots of mafia bosses. – Guardian News & Media.

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