Ahad, 11 November 2012

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The Star Online: Lifestyle: Health


Peace be with you

Posted: 10 Nov 2012 06:34 PM PST

Commemorating Global Peace Day and the power of intention.

TODAY, Nov 11, is Global Peace Day. All peace-loving people are encouraged to observe one minute of silence for peace at 11.11am, while affirming these words:

I am – Peacekeeper

I am – Family peacekeeper

I am – National peacekeeper

I am – Global peacekeeper

Thousands across the globe are coming together to concentrate together just for one minute on achieving peace on earth. Our common message is Global Peace through Individual Peace.

We believe that peace starts from within us. We have to become peaceful individuals before we can promote peace in our family, our community, our nation and the world.

Since the dawn of human history, we have been fighting. Peace is not only elusive, it is also evasive. That is, peace not only hides from us, but it seems to be running away from us.

So many peace initiatives and so many peace programmes have been implemented, yet there are still on-going and new conflicts and wars. Once peace is achieved in one area, another conflict erupts elsewhere.

It is estimated that there are over 100 armed conflict areas right now, with the worst being the Syrian uprising, and the longest being the Israeli-Palestinian issue. One good news is the possible end of the Bangsa Moro uprising in Mindanao (Philippines) after 40 years of fighting.

Conflicts and wars begin in the minds of the kings, presidents or leaders of opposing groups. If the path of peaceful negotiation, compromise and reconciliation is chosen, then many wars could have been avoided. But it is part of human weakness that some of us are greedy and power-hungry. We are greedy for wealth, property, titles and praise.

Then there are nations that are greedy for wealth, territory and power. Big powerful nations have always bullied or invaded smaller nations, and annexed or colonised them. The story never ends even in the 21st century, despite the hullabaloo about human rights and democracy.

What is right and democratic is always defined by the powerful at the expense of the weaker nations. To the most powerful nations, hegemony overrides the sovereignty, democracy, and right to self-determination of weaker nations. So many unlawful and undemocratic things are done by the most powerful nations against their adversaries or competitors; it is no wonder that peace still evades us.

For peace to prevail, the powerful nations should lead by example, just as we should lead by example in our families and our communities.

It is obvious that this will only happen if the politicians, who will become our leaders, are themselves peaceful and peace-loving. In other words, we can only hope for world peace if we have peaceful politicians, as they decide our policies, including if we go to war.

That underscores our motto of achieving global peace through individual peace.

The 11th of November commemorates the official end of the first World War, which was supposed to be the war that would end all wars, but we now know that humans never get tired of fighting one another, and there have been many more wars since then.

Nevertheless, that the gruesome war finally ended, giving hope to everlasting peace, was celebrated with gusto across the globe. That date continues to be commemorated as Armistice Day or Veterans Day in several countries up to today.

Last year, that day (11.11.11) was first inaugurated as Global Peace Day to give a wider meaning to the need to end all conflicts and wars, and the need to emphasise that we can only achieve peace through becoming peaceful individuals ourselves.

The move was initiated by His Holiness Jegathguru Paramjothiar Mahan, the founder of Universal Peace Foundation, based in Thirumurthi Hills, Coimbatore, India. He is known as the Guru of Happiness, and travels around the world spreading the message of peace and happiness.

He had received divine instructions to inaugurate Global Peace Day; that it was to be launched in Malaysia; and that I was to lead the organising committee.

So last year, with the tireless efforts of my team and the generosity of sponsors, over 3,500 people gathered at Le Marquee, Palace of The Golden Horses, Seri Kembangan, Selangor, to inaugurate Global Peace Day. We watched videos on the horrors of conflicts, wars, and other causes of human suffering, and pledged to continue working for peace.

At precisely 11.11am, we reflected in silence for world peace.

Today, the big commemoration will be celebrated in Thirumurthi Hills. Here in Malaysia, about 500 of us will be gathered at Wisma Tun Sambanthan, Kuala Lumpur, to commemorate the day, and meditate in silence for world peace at 11.11am.

At the same time, thousands of others across the country and across the globe will also be doing the same wherever they are at that time in their own time zones.

If you read this article before 11.11am, then please observe a minute's silence for peace at 11.11am sharp, wherever you are. If you read this article after 11.11am, then do it at any time today.

What can one minute achieve?

Do not underestimate the power of the human mind. Some people have highly gifted or trained minds that can heal disease (psychic healing), control other people's thoughts and movements, create fires and even move objects. But there are very few of these exceptional people.

What about the average ordinary person? Well, everyone's mind has power – even if it is weak. If we combine the intensity of 1,000 ordinary persons, simultaneously focused on a singular intention, then the effect is the sum of all the individual intensities.

So, many ordinary people together can achieve extraordinary things. This applies to many aspects of our lives. Those in management and marketing know what TEAM work can achieve – Together Everyone Achieves More. So it is with the mind and thoughts.

Therefore, if one million people focus their minds simultaneously on achieving world peace, imagine the combined effect. But is all this wishful thinking, or can it be proven by science?

The power of intention

Recently, a dear friend alerted me to the amazing works of Lynne McTaggart, author of the bestseller The Intention Experiment – Using Your Thoughts to Change Your Life and The World.

According to her, it is possible to change not only our life, but also the world around us by using the power of our thoughts.

Through constant, focused and affirmative intents, the mind is able to shape our future. More importantly, many minds working together can influence greater things. Now, if we apply that to a group, community, or even millions of us across the globe, imagine what we can achieve together.

This is in line with what many others have taught before – that you are what you think. Change your thinking, change your life!

The difference is that she and her husband (Bryan Hubbard) are conducting experiments to prove beyond doubt that it is possible. They have established The Intention Experiment, claimed to be the largest mind-over-matter experiment in history (www.theintentionexperiment.com).

The experiments are carried out under stringent conditions. Thousands of people from over 90 countries participate in these experiments, which include healing. One man burned his hands in a gas explosion, and the global healing intention coordinated through this experiment could have possibly been the cause of his miraculous recovery. Various groups converge to send intentions to one another, or to discuss topics on spirituality or science.

Enthusiasts and skeptics from around the world have also joined The Intention Experiment Community, which is an open and free community where people may express their views about the New Age, science and quantum physics, spirituality, religion, healing and philosophy.

The prophets, saints, shaykhs and gurus have long taught us the power of the mind. They meditate and focus their mind on God, peace and truthful living. Their intention is always what is good and right in the sight of God, which will therefore be what is good and right for everyone of us, and for humanity.

Unfortunately, the unwise among us think otherwise, and devote our thoughts and energy towards fulfilling the wishes of our ego and desires, which invariably bring disharmony, discontent and unhappiness, although we may experience the transient joy and elation when our ego and desires are satisfied.

To have peace within yourself, you need to set your goals right, and generate good and correct intents. When these materialise, they will bring peace, prosperity and harmony in your life. Then, and only then, can you be an effective peacemaker.

There can be no peace without peaceful living.

> Dr Amir Farid Isahak is a medical specialist who practises holistic, aesthetic and anti-ageing medicine. He is a qigong master and founder of SuperQigong. For further information, e-mail starhealth@thestar.com.my. The views expressed are those of the writer and readers are advised to always consult expert advice before undertaking any changes to their lifestyles. 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.

Getting started

Posted: 10 Nov 2012 06:32 PM PST

Jatomi Fitness, the newest addition to the Malaysian health club market, is dedicated to helping the average Jane and Joe get started on their journey towards better health and fitness.

THE very thought of exercise can evoke a pretty bleak picture for those unacquainted with physical activity, and especially if the couch is your best friend.

It doesn't help that the general impression of exercising usually entails hours of huffing and puffing on a conveyer belt.

But the fact is, you don't have to be clocking in insane mileage or pushing yourself to exhaustion to reap the benefits of exercise. Even mild physical activities like brisk walking can provide cardiovascular benefits, such as improved heart health, and lower LDL or bad cholesterol levels.

Jatomi Fitness, the newest addition to the Malaysian health club market, is dedicated to helping the average Jane and Joe get started on their journey towards better health and fitness.

By offering educational resources, nutritional information and by ensuring member enjoyment through their MindFit, EatFit and MoveFit programmes, Jatomi hopes to prod the sedentary person into adopting exercise as a lifestyle.

The club's founders are Mike Balfour, James Balfour and Tony Cowen from the UK. Mike, the chairman of Jatomi Fitness Club, was previously the founding owner of Fitness First, one of the world's largest fitness club groups.

The name Jatomi is an amalgamation of the brand's three founders - Ja from James, To from Tony and Mi from Mike. It recently unveiled its premise in Tropicana City Mall, Petaling Jaya, Selangor.

The first thing that caught my attention at the gym is its clean and simple layout. It is lined with state-of-the-art equipment, which include elliptical trainers, rowing machines, stationary bikes and the person-powered Curve treadmills that are used in astronaut training by NASA and purportedly help users burn up to 30% more calories than conventional treadmills.

Another notable feature is its Queenax equipment. Positioned right at the centre of the gym, the Queenax is a modern fitness facility that utilises the ceiling, floors and walls to accommodate suspension training and functional training – two of the latest trends in fitness.

It offers classes like Body Balance, Body Combat, Body Pump, SH'Bam, Yoga and RPM, but places much emphasis on its in-house KeyFit and MoveFit modules.

Based loosely on CrossFit, the notoriously punitive and popular strength and conditioning programme that utilises a short-duration, high-intensity protocol, both modules comprise short workout sessions that are usually broken into 15, 30 or 35 minutes. They are conducted by instructors for gym floor users at no charge on a regular basis.

However, Ben Jobson, product and operations manager of Jatomi Fitness Asia, explains that both KeyFit and MoveFit are designed to introduce gym users to basic functional movements instead of pushing them for performance goals.

"It's CrossFit for the no-so-fit, if you will," he says with a laugh.

Despite his busy schedule, Johnson took the time to take me and my colleague Revathi through a session of KeyFit, a beginner's course tailored to introduce the fitness novice to basic exercise movements before they progress to the more intermediate MoveFit.

Typically, one should attend about six KeyFit classes before moving on to MoveFit, he says.

At this session, we were taught movements like the barbell squat, shoulder presses and bending movements like "good mornings". Johnson also took us through the Queenax and taught us how to do things like push-ups using the TRX cables.

Speaking as someone who has been a member of two other commercial gyms, what I appreciate most about Jatomi is their well-equipped functional area. Foam rollers, kettlebells, skipping ropes and plyometric boxes are accessible to all members at the gym at no extra charge (one gym I had gone to only allowed members to use their functional area if they sign up for their personal training services).

Weight machines to facilitate movements such as the vertical chest press, seated rows, lateral pull-downs, leg extensions and leg curls, are also available at Jatomi.

It is no place for the avid bodybuilder or for those who are aspiring to look like Arnold Schwarzenegger (in the 1970s), but it is certainly adequate for those who are hoping to gain some general fitness and to start working towards better health.

Chief executive officer Elaine Jobson notes that less than 2% of Malaysians exercise on a regular basis. "We got the statistics based on the number of fitness facilities that are available nationwide against a population of 28 million," she tells Fit4Life.

Jatomi Fitness is looking to revolutionise the health and fitness industry in Malaysia, and are focused on boosting the exercising population to match that of Europe and the United States, which is between 12% and 20%.

Besides Tropicana City Mall, Jatomi Fitness has also opened a facility in The Weld in Kuala Lumpur. Prices range from RM150 to RM195 per month.

For more information, check out their website at: http://www.jatomifitness.com/

Pain in the elderly

Posted: 10 Nov 2012 06:31 PM PST

Persistent pain in the elderly is a multifaceted problem, and should be managed with pharmacological therapies and non-pharmacological treatments.

ACROSS the globe, persistent (chronic) pain is one of the most common reasons for the elderly to seek consultation with healthcare professionals.

Persistent pain, by definition, continues to affect the person for prolonged periods of time, and may or may not be associated with a well-defined disease. Different bodies have different defined persistent pain of various durations, ranging from three months to over a year.

Persistent pain manifests in various forms. Among the elderly, persistent pain is frequently associated with musculoskeletal disorders, such as a degenerative spine condition and osteoarthritis. Nighttime leg pain, pain from claudication, cancer pain, neuralgia secondary to diabetes mellitus, amputation, peripheral vascular disease, herpes zoster, and pain due to trauma, are common as well.

In the US, it has been estimated that 21% to 70% of community-dwelling older adults (more than 65 years of age) suffer from persistent pain. Other studies have demonstrated that 35% to 48% of older adults in the community are affected by pain on a daily basis, while up to 85% of elderly people residing in nursing homes experience pain.

Notably, persistent pain also affects Malaysian senior citizens. According to the Community Oriented Programme for the Control of Rheumatic Diseases (COPCORD) Study in Malaysia, pain rates increase with age, with up to 53.4% in the age group of more than 65 years experiencing pain.

Low back pain, knee pain and joint pain are the most common complaints among those studied.

The most common disability in the Malaysian survey is inability to squat (3.1%), largely due to knee joint symptoms.

In fact, it is not surprising to observe such a trend, as the average life expectancy of Malaysians has increased. In 2010, approximately 5.1% of the Malaysian population consisted of people aged more than 65 years.

The increasing prevalence of weight problems (overweight and obesity), diabetes mellitus and cancer worldwide, adds to the pain problem.

The National Health and Morbidity Survey III (NHMS III) indicated that 43.3% of Malaysians were either overweight or obese. One in six Malaysian adults above 30 years old had diabetes, making an estimated 1.4 million in total.

Persistent pain is a multifaceted problem. It is associated with many secondary problems, such as disturbed sleep, depression, impaired physical function and disability, decreased participation in social activities, and higher healthcare costs.

Hence, it is not surprising that persistent pain leads to reduced quality of life, often resulting in substantial strain on the relationship between the patient and their caregivers.

Behaviour, attitudes and beliefs

A major challenge in persistent pain management is the under-reporting of pain. There is growing evidence that help-seeking behaviour is closely associated with individual characteristics, attitudes and causal beliefs.

Increasing age, pain severity, female gender, lower education levels and disability have been associated as salient factors for people to seek help for their pain problem.

Stoic attitudes, ie putting up a brave front in the face of pain, has been identified as another factor that leads to under-reporting among older adults.

It is common to hear statements such as "if you have a pain, put up with it" or "what can't be cured must be endured" among this cohort who suffer from pain.

Furthermore, the belief that pain is a normal part of ageing forms barriers in elderly people to seek help.

Drug selection in pain management depends heavily on an individual's physiological factors. Medications may linger longer in the bodies of older adults due to age-related changes in physiological function. These changes include decline in metabolism capacity and excretion rate in the liver, as well as the kidney.

Changes in fat-to-water ratio also affect the volume of distribution of some medications. Slowing the gastrointestinal tract transit time may prolong the effect of continuous release enteral drugs. The elderly tend to experience anticholinergic effects more easily, which is manifested as incontinence, dry mouth, constipation, increased confusion and movement disorders.

Medication safety issues in older adults

Pain management should be evidence-based, where established guidelines and clinical practice guidelines on pain management are referred to when dealing with elderly patients.

Similarly, older people should not self-medicate without referring to a healthcare provider trained in pain management.

The mere fact that many older adults have polypharmacy issues further complicates the matter. Older adults who are exposed to inappropriate drug choices face higher risk of experiencing adverse drug reactions and drug interactions, compared to younger people.

Many drugs that work well in the younger population may not be appropriate in older adults. For instance, long term use of oral nonsteroidal anti-inflammatory drugs (NSAIDs) with long half lives in full dosages, such as naproxen, piroxicam and indomethacin, are not recommended in older adults due to relatively higher risk of gastrointestinal bleeding, renal failure and heart failure.

The use of tricyclic antidepressants (TCAs) in pain management in older adults who have seizures, cardiovascular diseases, and risk of falling should be managed very cautiously. TCAs are contraindicated in patients who are taking monoamine oxidase inhibitors (MAOIs) or selective serotonin reuptake inhibitors (SSRIs), and for patients who have uncontrolled narrow angle glaucoma, hepatic diseases or heart block.

Treatment in persistent pain

Perhaps the biggest misconception about treatment in persistent pain is that many believe that drugs are a panacea or substitute to non-pharmacological therapies.

Another myth is the belief that NSAIDs are effective for all kinds of pain.

Lastly, many are reluctant to use opiods in pain management, largely due to the concern about addiction issues.

In reality, paracetamol (acetaminophen) remains the first-line recommendation among non-opiod drugs in older adults. NSAIDs and COX-2 inhibitors are useful in nociceptive pain, but not neuropathic pain.

On the other hand, antidepressants and anticonvulsants are indicated for neuropathic pain.

The selection of analgesics must be tailored according to the pathology of pain, as well as the mechanism of action of the drug, apart from considering the efficacy and safety factors in older adults.

Research has shown that generally, older adults have lower risk of developing opiod addiction. Nevertheless, opiod users may develop tolerance to the drug and may need higher doses eventually.

Appropriate selection of analgesics at correct doses and frequency is crucial in the older adult. However, despite having a wide choice of pharmacological agents to choose from, persistent pain is best managed together with non-pharmacological modalities.

There is a growing body of literature that shows the combination of pharmacological therapies with non-pharmacological treatments further improves a patient's functional activities, emotional functioning, as well as quality of life.

Achieving 365 pain-free days and a good quality of life is possible, if appropriate multimodal therapies are discussed and planned together by healthcare providers and the patient.

Multidisciplinary frameworks, involving physicians, pharmacists, nurses, physiotherapists and other related healthcare providers, is crucial to ensure pain-free days in older adults.

> Chin Ken Lee is a lecturer/researcher at the Department of Pharmacy Practice, Faculty of Pharmacy, Universiti Teknologi MARA. 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.

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