The Star Online: Lifestyle: Health
The Star Online: Lifestyle: Health |
| Posted: 20 Oct 2012 08:27 PM PDT Double suture and twist your way to double eyelids. THE eyes are said to be the windows to a person's soul. Audrey Hepburn once said: "The beauty of a woman must be seen from in her eyes, because that is the doorway to her heart, the place where love resides." Women have different ideas about beauty. To some, having double eyelids makes their eyes look bigger, brighter, and to some extent, more beautiful. Others are unfazed by not having this feature. A fact that cannot be denied is that having double eyelids makes applying cosmetics much easier. For Rachel Saw Teih Ching, her eyes are key to making her look more attractive. Working in sales, her days are spent meeting clients, and she feels that looking good is important in her line of work. Every morning for the past seven years, this 27-year-old avid diver has consistently spent half an hour in front of the mirror every day, applying and reapplying liquid eyeliner to accentuate her eyes – all to create an illusion of bigger and brighter eyes. Although aids like double eyelid glue and eyelid tape or crease tape can be used to give temporary double eyelids, Saw finds that these items do no good for her. "I've tried using the eyelid tapes, but even with it on, it makes no difference to the way I look," Saw says. Ways to obtain double eyelids Other than the use of makeup and eyelid tape, a double eyelid surgery, known as blepharoplasty, can help women achieve double eyelids. There are two types of surgery – incision and non-incision. The incision procedure requires the surgeon to make a significant cut on the upper eyelid to remove the skin in order to form a crease on the eye. The non-incision procedure uses sutures to create the crease instead. The problem with the non-incision method is that it does not last as long as the incisional method. Here is where the double suture and twist (DST) procedure comes in. According to Dr David Low Teck Wai, "DST is a widely used technique in Japan since its invention in 2001, and its innovative technique, developed by Dr Akihiro Minami, has been shown to yield comparable results to incision procedures." Dr Low learnt how to carry out the procedure under the guidance of Dr Akihiro, and is one of the few qualified doctors in Malaysia familiar with the DST method. "DST is a relatively simple procedure. "Anaesthetics are first injected before the procedure begins. "The surgeon makes three small punctures on the upper eyelids of each eye. Two sutures are then used to pass through those punctures using a specific twisting technique so that the sutures are twisted around each other about four to five times. "After minimal suturing, the double sutures are then tied together to create a fold on the upper eyelid. "When the patient opens his or her eyes, the underbelly of the skin is pulled inwards, resulting in a natural looking crease," Dr Low explains. It takes about 40 to 60 minutes to complete the procedure on both eyes. It is the norm for patients who undergo any sort of surgery to bruise or swell. With DST, there is a great variation among individuals with regards to swelling and bruising. Some may have minor bruising or swelling, while others may not have it at all. However, those who encounter swelling can rest assured that it will subside within seven days. According to Dr Low, some patients even find it comfortable to go about their daily routine, like grocery shopping, immediately after undergoing the procedure. A possible setback is achieving symmetrical eyelids. If symmetry is not achieved after a week, the patient can seek a reversal, where sutures will be removed, and choose to redo the sutures again. A reversal can be done as soon as the day after the procedure. Too long a wait can result in scarring of the eyelid. The effects of the procedure can be permanent, while some last about five years, and the sutures can be taken out to reverse the effects. Changing one's image Upon hearing about the DST procedure, Saw made the decision to set up an appointment with Dr Low. Her biggest reason for getting double eyelids is to boost her self-confidence. Accentuating the eyes with makeup, and undergoing certain aesthetic procedures, to achieve bigger and brighter eyes are common. However, not everyone is comfortable with permanently changing the way you look. Saw's decision to get double eyelids were met with disapproval from her parents. "They didn't know what the procedure would do to me, and said it's risky. "After explaining to them how simple, safe and reversible the process is, they eventually gave in and supported my decision," Saw recalls. After undergoing the procedure, she says she now feels more confident about herself. To those who fear pain, Saw says that the anaesthetic injection before the procedure didn't hurt, and only 'felt like an ant bite'. Suitable candidates According to Dr Low, the procedure is not meant for all. The best candidates are those with thin skin, or those who do not have a lot of fat around their eyelids. In addition, those who have complex eyelid problems like asymmetric eyes, and sleepy or droopy eyes, are not suitable candidates. He lists smokers as being at a higher risk of prominent scarring when undergoing the incisional method, and advises them to look into the DST procedure instead. Men are not excluded from his list as he explains that men have undergone this procedure. It is of vital importance for anyone who is thinking of undergoing a double eyelid procedure to conduct research into the different types of procedures. "Make sure that the doctor is sufficiently qualified and experienced, regardless if the person is suited for DST or blepharoplasty. Ensure that you ask a lot of questions before deciding, and get a thorough assessment of your suitability," Dr Low advises. It is also important for you to look for a certified medical practitioner, and ensure that the centre and the doctor is registered with the Malaysian Medical Council. |
| Posted: 20 Oct 2012 08:26 PM PDT Around 8% of women in their childbearing years have asthma. How will this affect the child? PREGNANCY is usually a time that is filled with excitement in a woman's life. However, if you have a condition like asthma, you might be concerned about how it can affect the health of your unborn child. Asthma is the most common serious medical condition that can potentially complicate pregnancy. During an asthma attack, the foetus may not receive enough oxygen. After the birth of your child, you might have worries as to whether your asthma medications will affect your breast milk. However, all this does not mean you should avoid getting pregnant at all costs if you're asthmatic. With a thorough medical management plan and avoidance of known triggers, you will be able to reduce your risks and increase your chances of having a safe pregnancy. Therefore, you need to be aware of the precautions that should be taken to manage your condition effectively to prevent serious complications and protect your baby. It's important to be aware that the advent of pregnancy can alter your asthma condition. Approximately one-third of women with asthma report improvement during pregnancy, while another one-third become worse, while the other third remain the same. Studies have suggested that those with severe asthma are more likely to worsen, while those with mild asthma are more likely to improve or stay the same. Symptoms tend to become apparent during weeks 24-36 of pregnancy. Within three months after you have delivered your baby, any changes in the severity of asthma will normally return to what you were experiencing before pregnancy. Asthma medications and pregnancy You may think that you need to stop taking your asthma medications once you become pregnant, worrying that it might harm your foetus. Don't do this, because the risks of uncontrolled asthma are much worse than the risks of taking asthma medications during pregnancy. Instead, consult your doctor so that an individualised treatment plan can be created, and appropriate medication changes can be made, if necessary. If possible, asthma care should be combined with obstetric care, and doctors from both sides should work as a team. In general, inhaled medications are preferred due to their localised effect, with only small quantities entering the bloodstream. Numerous studies have indicated no increased risk of pre-eclampsia, premature birth, low birth weight or congenital malformations in women who used inhaled medications. Apart from this, older medications that have been tested during pregnancy are also preferred. During the first trimester, medication use will be limited as much as possible, as the foetus is forming. Your doctor will plan your treatment by taking into account a careful balance between medication use and symptom control. Asthma medications and breastfeeding Medications that can be used during pregnancy are generally safe for consumption when breastfeeding as well. Oral steroids sometimes penetrate into breast milk, but only in small amounts, and not in harmful quantities. Take note that asthma medications will not affect your ability to produce breast milk. A recent study conducted in the UK that was published in the American Journal of Respiratory and Critical Care Medicine found evidence of improvement in lung function in children who were breastfed as babies by mothers who had asthma. The study suggests that overall, breastfeeding is beneficial for lung development, as well as strengthens the immune system and overall health of the baby. Asthma that is not controlled well poses serious risks to both mother and child. The mother might develop pre-eclampsia or hypertension during pregnancy, which can also harm the baby. A severe asthma attack can also lead to maternal hypoxemia, which is a dangerously low amount of oxygen in the arterial blood. Uncontrolled asthma raises the chances of your baby being born premature, to be underweight at birth, and to need longer hospitalisation after birth. At worst, uncontrolled asthma can lead to a miscarriage because of the lack of oxygen to the foetus. Severe asthma attacks should not be ignored. If at any time, you experience severe chest tightness and difficulty in breathing, go to the nearest hospital emergency department immediately. Once you're there, you will be given oxygen and "rescue" medications that are safe for you and your unborn child. Frequent monitoring is important for pregnant women with asthma, so that any problems can be identified and given the required attention. To make sure your growing foetus is receiving an adequate supply of oxygen throughout your pregnancy, go for monthly check-ups with your doctor to monitor your symptoms and lung function closely. After 28 weeks of pregnancy, you should monitor foetal movements every day on your own. You can do this by observing foetal activity or number of kicks, and writing them in a notebook. Communicate these observations to your physician. During your third trimester, you may need to undergo some tests to evaluate foetal well-being, such as electronic heart rate monitoring and ultrasonic determinations. It is best to avoid known triggers for asthma attacks. Doing so can improve your symptoms, and reduce the amount of medication you need to take. Here are some guidelines: ·After you get pregnant, you may find that your asthma symptoms or sensitivity to some triggers changes. Therefore, together with your healthcare provider, review the action plan for asthma you've been using before you were pregnant, and make changes if needed. ·Don't smoke, as it dangerously reduces oxygen supply to the foetus. It can also greatly increase your likelihood of experiencing a severe asthma attack at some time during the pregnancy. ·Stay away from people who smoke, as second-hand smoke is also harmful. ·Avoid having allergy-causing pets, or at least, restrict them to a part of the house away from your bedroom. ·Identify things you are allergic to, and make it a point to avoid them. Talk to your doctor about medicines like antihistamines that you can take to treat your allergies. ·Cover pillows, mattresses and box springs in special dust mite-proof casings. ·If you are prone to having gastroesophageal reflux disease (GERD) such as heartburn, take steps to manage it, because it can worsen asthma. Try breaking up your three main meals into four or five smaller meals throughout the day. Also, avoid lying down right after eating. ·Exercise should be carried out carefully, and under the supervision of a doctor. ·Keep your distance from people with colds or flu to prevent yourself from being infected. Colds and flu can exacerbate asthma symptoms. On the whole, the asthma medications you take are not a major problem for the health of your baby. However, it's highly important that you take them regularly, according to how your doctor prescribed them. The best way to keep asthmatic symptoms under control is through regular monitoring, avoidance of known triggers, having a basic knowledge of medical management during pregnancy, and an individualised medication plan. Managing your asthma well will help ensure a pregnancy and delivery that is as healthy and normal as a woman without asthma. > Dr Norzila Mohamed Zainudin is a consultant paediatrician and paediatric respiratory physician. This article is courtesy of Positive Parenting Programme by Malaysian Paediatric Association and is supported by an educational grant from GlaxoSmithKline. The opinions expressed in the article are the view of the author. For more information, please visit www.mypositiveparenting.org. |
| Posted: 20 Oct 2012 08:24 PM PDT You need to thoroughly check whether the intended place of birth and attending obstetrician and midwives have the necessary measures in place to ensure a safe childbirth. HOME birth was the norm until the advent of modern medicine in the 20th century. There were disastrous consequences for many mothers, and many babies delivered at home succumbed at the time of childbirth or soon after. The overwhelming majority of women and babies in Malaysia are likely to have a safe delivery and birth. The neonatal mortality (deaths in the first four weeks of life) rate was 4.4 per 1,000 total births in 2009, compared to 14.77 per 1,000 total births in 1980. This compares with two to four per 1,000 live births in 2009 in developed countries. The maternal deaths, attributable to problems in pregnancy or at birth, were 28 per 100,000 maternities in 2009, compared to 59 per 100,000 maternities in 1980. This compares with six to nine per 100,000 maternities in 2009 in developed countries. The home birth rate declined from 50% in 1938 to less than 1% in 1955 in the United States; from about 80% of births in the 1920s, to about 2% in 2001 in the United Kingdom; and from 95% in 1950 to 1.2% in 1975 in Japan. The data in Malaysia is sparse. There has been a resurgence of interest in home birth in some developed countries, with an increasing number of women willing to consider this option. The Changing Childbirth report (2003) of the Department of Health of the United Kingdom reported that it is believed that if women had true choice, the home birth rate would be around 8–10%, and not 2%. However, in Holland, which always had the highest home birth rate in Europe, there has been a decline of 34% to 24% in the past decade, especially since 2009. With the relative increase in home births in developed countries, data about its risks and benefits in the modern-day setting will grow, thereby enabling doctors to provide the relevant information to assist women make an informed decision about the place of birth. Hospital birth Most Malaysian women give birth in a hospital, with nursing care provided by trained midwives. Normal deliveries in public hospitals are usually carried out by midwives, and on some occasions, medical students and trainee midwives. Doctors, including specialists, are available for any problems that may arise. Depending on the seniority and experience of the doctors, they will perform assisted vaginal deliveries, Caesarean sections, and manage any problem(s) that the patients might have. The majority of normal deliveries, as well as all assisted vaginal deliveries and Caesarean sections in private hospitals, are done by specialists, who also manage any problem(s) that may arise. The advantages of hospital birth include having direct access to specialists like obstetricians, anaesthetists and paediatricians or neonatologists, who are specialists in the care of the newborn; access to epidurals or spinals for pain relief; and availability of a special care baby unit if the newborn has any problems. These advantages are available in the Health Ministry's general hospitals, university hospitals, armed forces hospitals and the bigger private hospitals. Although these facilities are limited in some of the Health Ministry's district hospitals, there is a referral system in place for any mother in labour who has complications, to be transferred to a hospital where such facilities are available. Choices of the type of care are available in the private hospitals and the majority of the Health Ministry's general hospitals, university hospitals and armed forces hospitals. Doctors and midwives will provide information about what is available. If it is not done, the patient and her relatives have a right to request for such information. The patient has the choice of a private hospital. It may be one that is near home or one where her regular obstetrician practises. In the case of public hospitals, the choice is usually limited to one that is near the patient's home. Different midwives will provide care during labour in all hospitals. Different doctors will also be attending to labouring patients in the Health Ministry's general hospitals, university hospitals and armed forces hospitals, unlike in private hospitals, where it is usually the same doctor who has provided care during pregnancy. The mother who has delivered in a public hospital is often moved from the labour ward to a postnatal ward, and sometimes may be discharged early if there are no problems because of the need for beds in these hospitals, which have a high workload. The situation is different in a private hospital where the patient can stay in the same room for as long as she likes, depending on the willingness to pay. Home birth If the pregnancy has been uncomplicated and both mother and foetus are well, the mother may opt to have a home birth. The labour and delivery in a home birth is no different from that of a hospital birth. The supporters of home birth often quote the 24% home birth rate of Holland, which has the highest home birth rate in Europe. However, there is a need to remember that the Dutch healthcare delivery system is able to support home birth. Although the risk of death to babies in planned home births has been reported to be double or thrice that of planned hospital births, the overall risk of death is low. The advantages of home birth include being in a familiar and relaxing environment, which enables the mother to cope better with labour; no separation from spouse or children; care by a midwife with whom one is familiar with; immediate bonding with the newborn and the family; and lower cost. Studies of home birth experiences report an increased sense of control, empowerment and self-esteem, and an overwhelming preference for home birth. Home birth is not suitable if the mother has diabetes, high blood pressure or any other chronic medical condition; had a previous Caesarean section; developed pregnancy complications like anaemia, high blood pressure or pre-term labour; multiple pregnancy; the foetus is not presenting by the head; or the pregnancy is past the due date. It is important to remember that complications may develop during labour despite an uncomplicated pregnancy, and transfer to hospital will also be necessary if labour is not progressing. There could be delay in such a transfer, which may expose the foetus to risks. A study in the United Kingdom reported that about 40% of first time mothers and 10% of women who have previously given birth are transferred to the hospital from planned home birth. The reasons include maternal exhaustion, premature rupture of membranes, high blood pressure, failure to progress, non-reassuring foetal status, cord prolapse and haemorrhage. A successful home birth will require a team comprising an experienced midwife and an obstetrician. An alternative plan must be in place should transfer to a hospital be necessary (and the availability of a paediatrician who will examine the baby within 24 hours of birth). It is vital that the midwife is competent within the home birth environment, and that the obstetrician has made a careful assessment of the patient's suitability for home birth. Planning for a home birth will require a detailed discussion with the midwife and obstetrician. Maternity homes are operated by doctors or midwives in the private sector, and birth centres by the Health Ministry. The facilities and advantages are somewhat between that of hospital and the home. Questions to ask It is often stated that the most dangerous journey a human being takes is at the time of birth. There are about 450,000 to 500,000 births annually in Malaysia. Whilst the vast majority have happy outcomes, there are some in which there are tears of sadness rather than tears of joy. The basic questions when deciding on where to give birth that all pregnant women need to have answers to include: ·Are the physical facilities designed for safety? ·How long does it take to be transferred from the place of delivery to the operating theatre? ·Are there adequate equipment for monitoring in labour and normal delivery, and the immediate management of complications in mother and baby? ·Is an obstetrician involved in the care, and what is his or her name? ·Is an anaesthetist and/or paediatrician available, and what is his or her name? ·Are there sufficient skilled midwives employed and deployed effectively? ·Does the medical and midwifery staff have the right skills to deal with emergencies? ·What pain relief modalities are available? ·What if a complication happens in labour? ·What if an instrumental vaginal delivery or Caesarean section is required? ·Are there written policies, standards, procedures and guidelines for obstetric emergencies? ·Will there be an opportunity to develop a personal birth plan? ·What are the costs of antenatal care and delivery, and the treatment of complications? Most health care facilities, obstetricians and midwives would provide answers willingly. Otherwise, the pregnant woman has to actively seek them. If there is reluctance to provide answers to legitimate concerns or the answers are unsatisfactory, it may be prudent to consider changing to another healthcare facility and/or obstetrician and/or midwife. The pregnant women's choice of where to give birth can influence whether she and baby have a happy or sad outcome. Healthcare facilities, obstetricians and midwives who put a premium on patient safety and quality of care are less likely to have poor outcomes for both mother and baby. Having a baby is a huge responsibility. The parents-to-be owe it to themselves and their unborn child to check thoroughly whether the intended place of birth, and the attending obstetrician and midwives have the necessary measures in place to ensure pregnancy and childbirth is as safe as it can possibly be. n>Dr Milton Lum is a member of the board of Medical Defence Malaysia. This article is not intended to replace, dictate or define evaluation by a qualified doctor. The views expressed do not represent that of any organisation the writer is associated with. For further information, e-mail starhealth@thestar.com.my. The information provided is 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 does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this column. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information. |
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