The Star Online: Lifestyle: Health
The Star Online: Lifestyle: Health |
| Posted: 27 Oct 2012 06:07 PM PDT Low testosterone is increasingly recognised as a complex condition linked to many bodily functions and overall health. LOW testosterone causes symptoms that can adversely affect a man's quality of life and disrupt his daily routines. Men with low testosterone also have a strong likelihood of developing the various conditions of metabolic syndrome, which increases the risk of heart disease and diabetes. Previously, we have emphasised the message that testosterone deficiency is not to be taken lightly or to be brushed off as a side effect of aging. This message is also underscored in a new book by consultant urologist Datuk Prof Dr Tan Hui Meng, Testosterone: Secret To Healthy Aging For Men, which takes a comprehensive view of testosterone deficiency, its effects, the safety and efficacy of testosterone replacement therapy (TRT), and how TRT complements general health maintenance. We need to change our mindset regarding testosterone – from thinking of it merely as a sex hormone to accepting its role in influencing overall men's health. In the book, Prof Tan reiterates that men lag behind women in terms of health status and outcomes. This discrepancy is the result of healthcare policies and resource distribution that disadvantage men, as well as men's own attitudes that put themselves at risk. It is a universally-known fact that men practise poor preventive health or health maintenance. Many men only seek healthcare when they are severely ill, as a result of years of unhealthy lifestyle practices. Men have to realise that there is no shortcut to maintaining good health. Staying healthy and well begins as early as young adulthood (between 18 and 39 years), through middle age (40 to 64 years), and well into old age (65 years and beyond). Prof Tan also emphasises that nothing occurs in isolation in health. That is why testosterone deficiency and its treatment have to be viewed within the overall context of health maintenance. As Prof Tan explains in great length in his book, the hormone has effects on many systems in the body, travelling as far as the brain and bones. In fact, one of the most significant effects of testosterone is on the heart. Research shows that there is a strong link between men's sexual health and the heart. For instance, we now know that erectile dysfunction (ED) and testosterone deficiency are not just sexual dysfunctions, but are also risk factors for heart disease and metabolic conditions. Heart disease and metabolic conditions are serious problems for men today, therefore, testosterone deficiency and ED, as markers for heart disease and metabolic syndrome, should be instantly recognised and treated. The good news is that low testosterone can be treated, and it will have benefits beyond the bedroom. Improving testosterone levels can reduce abdominal obesity, improve cholesterol levels, improve insulin sensitivity, and help men better control their diabetes. Studying and treating low testosterone has given doctors the opportunity to take a revolutionary approach to men's health – by looking at sexual dysfunctions as central aspects in managing the overall health of men. In his book, Prof Tan also hypothesises that normalising testosterone levels not only contributes to good health throughout life, but may one day even be able to prolong life. His proposal is based on research that reveals that mortality risk increases with lower testosterone levels. Many studies have demonstrated that low testosterone "spells shorter lives". At the same time, many studies have also proven that TRT has positive effects on cardiovascular disease, metabolic syndrome and osteoporosis. Therefore, men who receive TRT to treat their testosterone deficiency would be prolonging their lives by delaying premature deaths from these conditions. Will TRT be able to increase life expectancy or delay the effects of ageing? Prof Tan writes that research around the world is looking into this, and the answers may appear in the near future. There is no doubt that testosterone plays a crucial role in men's general health. Therefore, having healthy testosterone levels is central to maintaining good health. Before considering therapy, men should realise that they can maintain normal testosterone levels through lifestyle changes. They should make the effort to reduce the amount of fat in their body, as fat cells suppress the production of testosterone. However, TRT may be necessary in many men who are unable to improve their testosterone levels through lifestyle changes. Additionally, TRT complements a healthy lifestyle, because it increases energy levels and lean muscles, enabling men to become more physically active. As more research is done on TRT and further advances are made to enhance its efficacy and safety, we may see this therapy playing an even bigger role in men's health. ·Testosterone: Secret To Healthy Aging For Men costs RM50 and is available by calling Karvina or Jamie at 03-5639 1777, e-mailing perandro@streamyx.com, or faxing 03-5639 1870. The book can be posted or couriered to any address within Malaysia at no additional charge. Proceeds from sales of this book support research funds of the Malaysian Men's Health Initiative. 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 disclaims any and all liability for injury or other damages that could result from use of the information obtained from this article. |
| Posted: 27 Oct 2012 06:07 PM PDT Join the 'International Physicians For The Fight Against Incorrigibly Nonsensical, Illogical and Irritating Medical Claim Forms'. Seriously. IS the patient pregnant? If yes, why? If not, why? Before you think this is from an absurdist, post-modernist novel, let me assure you it is all too real. This is one of the questions in one of the medical insurance claim forms that poor suffering doctors like me are required to fill out, if not daily, then at least once a week. If you are a doctor, you could ignore the question completely if you think it too inane to deserve your consideration. You could also scratch a bold, black, diagonal line across it. Or you could try to answer it. "Yes, my patient is pregnant. She made love with the idea of conceiving. She succeeded!" "She didn't want a child, but she was careless!" "I have no idea. She did not discuss her reproductive strategies with me." Why was my patient not pregnant?! "She didn't want a child?" "She subscribes to the GINK (Green Inclinations No Kids) philosophy." "She tried hard, but she failed. Any suggestions?" The box for "age" measures five by two centimetres. That's nice, but even if my patient were Methuselah, all I need (and believe me, my handwriting is huge and legible) is a box measuring two by one centimetres. "Name all the doctors who have consulted the patient, and when, and the medical conditions she suffered from" comes with an answer box that also measuresfive by two centimetres. This impossibly small answer box will only invite the answer "None" by the harassed, but polite doctor, or "Are you crazy? I need a box 10 times the size of this one!" by the irate, overworked, expressive, but honest doctor. "When did the medical condition start?" If it were coronary artery stenosis, it is not possible to answer. Could be a year or a decade. The same goes for diabetes or arthritis. Or, for that matter, most chronic diseases. Cancer is always a genetic disease (read "DNA", not whether your ancestors had cancer or not), and the correct answer should be 10 to 20 years. It takes that long for the accumulated mistakes in the DNA of your wayward cell to become cancerous, for a malignant lesion to be seen on imaging scans, for the cancer to cause you to be ill. For cancers with a hereditary component, the answer should be "in the womb", or even "10 or 100 generations ago!" My advice to doctors is to write: "Cancer surgery/biopsy was on 'such and such' a date." Do not try to answer the question directly or scientifically. You could put your patient in peril when she makes her claim. I have filled out forms where 80% of my answers are "Not Applicable", and 20% have to be written in minuscule script: tiny words overflow the illogically small boxes onto the edges of the form. I called up the insurance company to enquire if I could furnish them with a wieldy and elegant essay that captures all the information they want. "No, our claims clerk is only taught to read information in boxes, columns and rows. An essay will be too difficult for his brain to process!" Once in a while, a patient shoves a "Total & Permanent Disability (TPD)" form under my nose. A patient with advanced cancer is usually not permanently and totally disabled. If anything, most of my patients lead full, rich lives. The patient may be disabled one day, but this is usually not for some time. However much I persuade my patient and the insurance agent that the TPD form is inappropriate, they will not budge. And so I end up writing down how many degrees the right knee can bend, whether the left crooked middle finger can straighten itself, and if the palsied lower limb is dragged along the ground or lifted high. Again, an essay would be good, and again, this is not acceptable to the insurance company. Is reading and writing essays a slowly dying art? Like the art of designing intelligent forms? There is a form I fill out now that is three pages long. "What does the patient suffer from?" is followed by 76 boxes, each against a disease condition. All that is required of me is to tick the "cancer" box and sign my name. Easy enough, but what about tree-hugging and green living? Doctors, I hope I have struck a chord in you that makes you say, "Hey, that's my irritating experience too." If so, join the "International Physicians For The Fight Against Incorrigibly Nonsensical, Illogical and Irritating Medical Claim Forms". To join the society, just write a letter or an essay. That will suffice. For those not inclined to do so, I am in the midst of designing the application form. There will only be a few big logical boxes. You will not be asked for your age, gender, sexual orientation, race or religion. All this information is confidential, unnecessary and irrelevant. This also applies to most forms for that matter, government issue or otherwise. > Dr Albert Lim Kok Hooi is a consultant oncologist. For more information, or if you are a doctor who wishes to join Dr Lim's proposed society, email starhealth@thestar.com.my. |
| Posted: 27 Oct 2012 06:06 PM PDT Dr Amir Azlan Zain, president of Arthritis Foundation Malaysia, shares how exercise can help alleviate and manage the painful symptoms of arthritis, a condition that causes inflammation of the joints. MANY of us take our joints for granted. Issues like joint health and joint mobility are not the sexiest topics around to be sure. And they certainly aren't as attention grabbing as How to get six-pack abs in 10 days, but our joints play a much more integral role in our daily lives than they are given credit for. To begin with, we actually need our joints to move around. Without our joints, we would just be stiff skeletons with no way to move our bodies. A joint is a part of our body that connects two or more of our bones. Special tissues called ligaments, connect the bones and our muscles hold everything together. There are many different types of joints. Among them are the ball-and-socket joints at our shoulder and hips that let us swing our arms or do the hula. Meanwhile, the hinge joints like our knee and elbow joints, let us bend and unbend parts of our bodies. In every way, our joints assist our movements, whether you are walking, running or even picking your nose. However, as we age, illnesses like arthritis can affect joint movement and mobility. Essentially, arthritis is the inflammation of one or more joints. There are over 100 different types of arthritis, and most of them cause pain, stiffness and swelling of the joints. The condition is seen in every age group, and is found in men, women and children, although it mainly affects the elderly. People in the age group of 50-66 are the most affected. Arthritis involves the breakdown of cartilage, which normally protects a joint and allows it to move smoothly. Cartilage also absorbs shock when pressure is placed on the joints, such as when you walk. When cartilage is damaged, the bones rub together and cause pain, swelling (inflammation) and stiffness. This disease can severely affect people's lives. Because arthritis usually causes pain in areas around the hips and knees, a person's ability to perform even the most basic of movements (such as standing and walking) can be affected. Many are still unaware about the disease. The common perception is that arthritis occurs only with age. Often, people take painkillers to relieve the symptoms of arthritis instead of seeking medical attention. However, if left untreated, minor symptoms of arthritis can potentially take on a more severe and permanent form. World Arthritis Day, held by The Arthritis Foundation, is part of a global effort to increase awareness on the various forms of arthritis, and to call on individuals and policymakers to take action to reduce the burden of arthritis around the world. The Arthritis Foundation was founded in Atlanta, United States, in 1948, and is the largest non-profit organisation dedicated to supporting the cause. World Arthritis Day was established in 1996 by Arthritis and Rheumatism International, and is observed in over 50 countries each year in the month of October. This year, the celebration takes on the theme of "Move to Improve", and highlights the importance of exercise in tackling the disease. Consultant rheumatologist Dr Amir Azlan Zain, president of Arthritis Foundation Malaysia, shared his thoughts on the importance of healthy living in maintaining joint health during a recent roundtable interview at Sunway Medical Centre in Petaling Jaya. Determining the main causes of arthritis can be difficult, but risk factors that can contribute to an individual developing this problem include age, genetics, being overweight and having sustained a previous injury. Those with physically demanding jobs such as assembly line workers or construction workers, as well as those who participate in certain high-level sports, are also thought to be at a greater risk of developing arthritis. According to Dr Amir, leading a sedentary lifestyle can elevate one's risk of developing arthritis, if only for the simple fact that being physically inactive actually leads to poorer muscle strength and muscle tone. While joint pain is caused primarily by the thinning of cartilage, factors like muscle strength and tone also play a role in reducing the risk of developing arthritic symptoms, as well as managing pain. Increased muscle strength and tone can actually lessen the likelihood of getting pain. Dr Amir notes that an estimated 30-40% of the workforce worldwide suffer from lower back pain due to working long hours (with a poor posture) that can contribute to the problem. Up to 30% of people aged 65 and above have also been shown to suffer from osteoarthritis, a form of arthritis that results from repetitive strains and increased mechanical loading on the joints. It doesn't take a genius to figure out that being overweight or obese can certainly aggravate the problem. The excess amount of weight impacts weight-bearing joints such as the knees, and can increase the pain of arthritis. Fortunately, the advent of modern and powerful treatments like steroids and non-steroidal anti-inflammatory drugs make treating an acutely painful joint relatively easy. The difficult part remains in managing the condition of a joint after an episode of inflammation has resolved. For one, it is important to exercise regularly to maintain joint function, especially on hinge joints that allow the movements of the limbs and fingers. The weakness that comes from the disuse of the joints can lead to muscle atrophy and other degenerative effects of arthritis. It is hence important to retain the functional movements of an affected joint to mitigate the risk of permanent damage and disability. Exercises like walking, yoga and tai chi can help an arthritic patient manage the symptoms of the condition. Yoga especially, is a good activity that promotes muscle tone and strength without actually stressing the joints, says Dr Amir. Related Story: |
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