The Star Online: Lifestyle: Health
The Star Online: Lifestyle: Health |
- Speeding up recovery with physiotherapy
- Falling off the fitness bandwagon
- Helping bipolar patients cope
| Speeding up recovery with physiotherapy Posted: Physiotherapy must not be neglected in the recovery process of bone and joint injuries. PHYSIOTHERAPY is a branch of medical science that aims to facilitate the recovery of affected parts of the body by including and facilitating the wide spectrum of biological systems within the human body. According to the Chartered Society of Physiotherapy, UK, "Physiotherapy is a science-based profession and takes a 'whole person' approach to health and well-being, which includes the patient's general lifestyle." Physiotherapy helps patients get back to health and regain functional physical mobility. Even after extreme physical trauma, physiotherapy sessions are able to help a patient regain his/her original body shape and cope with the new physical condition. For example, physiotherapy sessions are able to reorientate a patient suffering from a limb amputation, by showing him/her new physical skills and routines that use different muscles to leverage on mobility, and thus, recover most basic body functions. Physiotherapy is able to rehabilitate the various systems within the human body, such as: ·The musculoskeletal system: dealing with broken bones, fractures, bone dislocations, damaged cartilage, ligaments, muscle, etc. ·The neuromuscular system: dealing with affected brain functions, spine lesions and nervous system lesions in relation to the muscular system and motor functions. ·The cardiovascular system: focusing on problems concerning the vital processes of the heart and blood circulation functions. ·The respiratory system: healing the body's breathing apparatus. There are many sub-specialities within the field of physiotherapy, and the most popular one is orthopaedic physiotherapy. This well-known physiotherapy specialisation focuses on the musculoskeletal system to get patients, who have injuries or surgical procedures on their bone structure, back to the previous level of function and mobility. Rehabilitation sessions usually take place in the hospital wards, and over time, patients regain physical qualities such as flexibility and muscular strength, as well as range of movement of the joints. An orthopaedic physiotherapist plans and introduces exercise programmes to strengthen, stretch and retrain specific muscles and joints to help patients resume normal activities, like walking, and higher level tasks, such as running and jumping. Orthopaedic physiotherapy also treats and rehabilitates paediatric cases. Orthopaedic measures are sometimes necessary to aid and ensure the correct physical development of a child so as to prevent further deterioration of the child's physical movements. Children with fractures and musculoskeletal conditions such as Perthes' disease, club foot (congenital talipes equinovarus), idiopathic toe walking, as well as biomechanical disorders and neurological development issues, would benefit from this treatment. Physiotherapy sessions are able to help patients with a wide range of physical disabilities and symptoms. For example, frequent headaches, stiffness, weakness, lower back pain or neck pain, can be caused by structural faults within the patient's musculoskeletal system and spine. Consulting a physiotherapist for a thorough check-up will definitely help relieve these painful symptoms. When do you need to visit a physiotherapist? Here are some guidelines: ·Have had an injury recently. It is important to get the injury assessed and treated for speedy recovery. ·Are constantly suffering from muscle or joint aches. Sometimes, your body aches can occur due to wrong posture and imbalances. A physiotherapist can help determine the nature of the discomfort and offer rehabilitative measures. ·Are constantly suffering from headaches, neck or shoulder stiffness. It is better to get a proper diagnosis to find out the cause of the problem rather than just taking pain-killers. ·Are experiencing tingling (pins and needles) sensations. This may indicate that a nerve is being pinched, and a physiotherapist can help you adjust the alignment of your body or retrain some of your muscles and joints to relieve the pressure on the nerve. ·Are prone to injuries. Mishaps may happen due to over-worked muscles, weak joints, posture issues and repetitive movement of joints and bones. A physiotherapist can help identify high-risk movements and offer corrective behaviour modifications to prevent future injuries. When you visit a physiotherapist, it is recommended that you wear comfortable clothing. Otherwise, you may get a change of clothes, which is usually provided at the physiotherapy centres. Bring along your doctor's referral letter, if you have one. This will help your physiotherapist understand your physical condition and better able to work with you. The physiotherapist will first review your health history and discuss your pain, injury or complaint, with you. It is important to point out the exact location of the affected area, and explain how it is affecting your daily activities. He/she will then propose a treatment plan that may include hands-on manual therapy, self-monitoring instruction, and some home exercises. Patients recovering from an injury or surgery are usually referred to a physiotherapist for rehabilitative sessions. If you are in such a situation, be sure to attend all of your physiotherapy sessions. Your body needs time to get adjusted physically, and you also need time to get used to your new physical condition, mentally and emotionally. It is important not to put too much stress on yourself during this transition period. Physiotherapy can definitely help speed up your recovery, especially when you are a willing and responsive participant. Undergoing physiotherapy is a delicate process, and it can be a challenging and tough period for you. If you need to, talk to a counsellor or psychologist. As much as possible, maintain an open communication with your physiotherapist so that he/she can help you regain most of your previous body functions or gain mobility and independence. Dr Ng Swee Soon is a consultant orthopaedic surgeon. For more information, visit www.quillorthopaedic.com. |
| Falling off the fitness bandwagon Posted: It's happened again. You've fallen off the fitness bandwagon and you're having trouble getting back on. The good news is, it's never too late to start, and the sooner you do, the better you will feel. I HAVE a love-hate relationship with fitness. It is the sort of wretched romance that would make Lady Gaga proud, and one so volatile, that I often feel like kicking it, running it over, then hurling it off a cliff. And then I mope about our break-up like a lover scorned, before running back to embrace it. Even for someone who loves exercise, it is possible to drop the ball, and fall off the fitness bandwagon. In just a few months, I went from being over-zealous about eating "clean", and silently judging that guy with a trolley stuffed with cookies and crisps, to drowning in them in one of my many late-night binges. Suddenly, it was "okay" to eat an entire pizza, or have two burgers at a go, before washing them down with a cocktail (or five). Just the other night, I had nasi lemak at three in the morning, simply because I felt like it! Worse, I have been skimping on my workouts. It didn't help that I was constantly tired from work. Often, I was ready to throw in the towel and wallow in self-pity, before I even began. Suddenly, my face was dotted with pimples that haven't been there ever since I grew out of my teenage years. I developed a stye in one eye, and had ulcers beneath my tongue that were so big and painful, eating and drinking became difficult. I was a flabby mess, who was quickly outgrowing her skinny jeans. Whatever happened to those flat, defined abs I had so proudly paraded only months before? I figured that it was only a matter of time before those years of hard work would be undone from my voracious and uncontrollable eating habits, peppered with regular doses of laziness. Currently, I am in the process of weaning off chocolates (my kryptonite), and keeping from having too many cocktails after a hard day at work. I haven't ballooned out of my clothes, but it does get frustrating when I think about how far I've come since my days as a fat kid in school, only to have all that effort gradually go to waste. But as I fight my way back into Fitville, I also have to remember not to kill myself on occasions when I do give in to temptation. In the process of regaining control, I've discovered a few tips that might just help to speed up the journey to getting back into the groove of things: 1. Drink water before a meal It really doesn't get easier than that. Most of us don't drink enough water anyway, and those of us who favour fruit juices and carbonated drinks may suddenly find ourselves a few pounds heavier. If you are often ravenous at meal times, start off with a glass of water first. You might just find yourself feeling more placated, and less inclined to stuff yourself with three whole plates of rice. 2. Toss out the junk When choosing a snack, don't go for just any Tom, Dick or Harry sandwich. Ditch the junk, and go only for diet-worthy snacks such as almonds, walnuts and fruits. Stash some of these nutrient-packed goodies in your backpack or briefcase, so if you ever find yourself hungry while running late for an appointment, you have something to fill your stomach that will not derail your diet. 3. Play the waiting game The next time you are craving for doughnuts, do what you do to a potential date – play the waiting game. Instead of rushing into things and giving in, eat something nutritious and filling, like an apple... then wait for 10 minutes. You might be amazed at how the craving has suddenly vanished, or lessened considerably. Often, the yearning for a sugary snack can be stopped in its track with a healthier and more wholesome alternative. 4. Get off your couch. Now! Life happens, and there will always be days when you will be tempted to skip your workout to go bond with your couch. If you don't have the time or energy for a full workout, know that even mini bursts of physical activity can produce good results. A Stanford University study showed that three 10-minute workouts during the day produced similar results as one 30-minute workout. So get moving and remember that getting off the couch itself is an accomplishment! 5. Set realistic goals You're not going to get those sizzling abs overnight no matter how many sit-ups you do. Plus, every legitimate fitness trainer will tell their clients to stay away from fad diets and workouts that promise instant and unrealistic results. Instead, follow a sustainable exercise routine and eating plan. All this may sound boring, but the main goal here is to achieve a healthy and consistent body mass. Ultimately, it is about maintaining good health. If you stick with your guns and keep pushing, you will look back a year from now and give yourself a pat on the back for a job well done. 6. Stop comparing yourself to others Okay, so your Facebook and Instagram is saturated with pictures of toned and sexy celebs and fitness models, as well as that annoying girl who wouldn't stop posting pictures of her abs (coughs!), and they are making you feel just a tad envious and unfit. But even these folks have their off-seasons and cheat meals. Besides, most of what you see is airbrushed anyway, and many actors gain weight in between projects, and end up with unflattering pictures in the tabloids. So stop comparing yourself to others. You don't have to prove anything to anyone. The only person you should be competing against is yourself. 7. Don't beat yourself up We all mess up sometimes, but that's not the end of the world, and it's certainly no reason to go on a food binge. Instead, just accept that you just ate a slice of cake and skipped gym. And then get right back to eating healthy, and maybe have a salad as your next meal. You don't have to admit defeat and inhale an entire cake just because you feel like your diet is already ruined. Ultimately, we have to ask ourselves – so what if we fall? For me, it is an opportunity to come back fitter, faster and stronger. And to anyone who might be too wimped out to even try to hop back onto that fitness bandwagon because you're afraid you would just fall off it again, don't be. Set your ego and fear of failure aside, and do the best that you can. You will be back on track in no time. As for that annoying girl with the defined abs, she will be back. Sorry, Facebook. Fiona Ho is a certified personal trainer and an exercise enthusiast who continues to hit the weights despite being told that she is looking 'manlier' every day. |
| Posted: 'Regaining My Balance' is a psychoeducation module for bipolar disorder that Dr Kadir Abu Bakar, president of the Malaysian Psychiatric Association, emphasises can help those with the disorder cope better. IMAGINE being caught in a situation where you're precariously perched on a pendulum of extreme mood swings. As clichéd as it sounds, it is like being blackmailed to be an unwilling voyager on a rollercoaster ride whilst blind-folded – never being able to predict when the carriage, travelling at intense speeds, will whisk you upwards, or take a nose-dive to hit rock bottom. In between the two emotional extremes, there are the "normal" days – days that bring challenges and rewards, laughter and tears, hope and regret, determination and resignation. Each night, before you can sleep, you fervently pin all your hopes on some divine intervention: "Please God, make tomorrow a 'normal' day." Bipolar disorder is a serious and complex brain disease that affects specific areas of the brain that regulate mood. According to president of the Malaysian Psychiatric Association and senior consultant psychiatrist Dr Kadir Abu Bakar, it is estimated to afflict approximately 3% of the Malaysian population. Though this may not be a significant number at first glance, the reality is that bipolar disorder ranks among the top 10 most disabling disorders in working age adults worldwide (The World Health Organization 2002), and the socioeconomic impact is considerable. Studies have documented that individuals with bipolar disorder spend substantially more time in the depressive state, as compared to being hypomanic or manic. This is a grave concern as the symptoms of depression, which include persistent and frequent sadness or despair, loss of interest in usually enjoyable activities and chronic fatigue, is far more debilitating. As reported in The Lancet (2013; 381: 1672-82), antipsychotic drugs are effective in the acute and maintenance treatment of bipolar disorder. Although these medications, or pharmacotherapy, are the first-line treatment for bipolar disorder, numerous researchers have indicated that medication alone often fails to bring individuals suffering from bipolar disorder to a sustained remission. Dr Kadir elaborates that even patients who receive adequate pharmacotherapy and strictly follow their prescribed treatments, continue to suffer from relapses, or experience lengthy and debilitating symptoms. In a Spanish study, it was estimated that about 37% of patients relapse into depression or mania within a year, and 60% within two years. Each relapse makes it harder for the patient to gain remission, not only because relapses kill precious brain cells, but also because more issues seem to surface during the course of each relapse, states Dr Kadir. A silver lining Treatment guidelines increasingly suggest that optimum management of bipolar disorder needs the integration of pharmacotherapy with targeted psychosocial treatments. Psychological approaches build on evidence that psychosocial stressors, including family discords, negative life events, or events that disrupt the patient's sleep rhythms, are associated with relapses and worsening of symptoms. A novel psychological intervention model, psychoeducation, developed as a result of the Spanish trial, has emerged as an effective strategy in preventing new episodes of mania or depression, and improving social functioning for patients with bipolar disorder. A major difficulty with bipolar disorder is the inability of the patient to recognize his or her own condition, particularly when in the manic state. Patients often deny their symptoms, which may be perceived as positive feelings. Psychoeducation, Dr Kadir explains, is a form of training for patients and their families to help them cope with their illness, and to avoid relapses by understanding the way treatment works, the need for absolute treatment compliance, and most importantly, to identify early warning signs of relapse, and help them develop well-structured daily habits. Psychoeducation involves providing patients and their families with accurate and reliable information about their diagnosis to empower them to better manage their illness.  Dr Kadir... Psychoeducation opens the door. This is the door of knowledge which will never shut on The evidence for the use of psychoeducation and family-focused therapy as prophylactic adjuncts to medication in people with stabilised bipolar disorders is, at present, quite conclusive. Dr Kadir asserts that psychoeducation can go very far in terms of treating the patient. "Psychoeducation opens the door. This is the door of knowledge, which will never shut on the person who is seeking it. It is akin to asking how far a university education can go towards broadening your perspectives and making you a better person – the answer is very, very far." Citing another chronic illness as an example, if you are ill with diabetes, how far can education and knowing about diabetes help you? Well, you can say, look, this piece of cake is 550 calories; I've already eaten 1,100 calories today. So if I choose to eat that cake, I have to avoid rice for dinner. Then, I also have to remember to administer my insulin jab on time to stabilise my blood glucose levels. Similarly, psychoeducation can help with bipolar disorder. In a large way, it helps the patient lead a normal life, despite illness. The key is to give patients a sense of independence, empowerment, and ultimately, to give them skills to manage their own lives effectively. Modules for living That is why modules like "Regaining My Balance" are important for such patients. "Credit must be given to AstraZeneca, who is the first private corporation in Malaysia to help to promote and heighten awareness of psychoeducation on bipolar disorder," says Dr Kadir. "Regaining My Balance" modules are mainly psychoeducation-focused, although other behavioural factors that may go beyond information (lifestyle regularity, stress management) are included. "To be economically sustainable, psychoeducation protocols need to be made briefer for settings that serve large number of patients and have few resources for clinician training," notes Dr Kadir. Elements of the "Regaining My Balance" psychoeducative programme include: Module 1: Understanding your illness Module 2: Understanding your treatment Module 3: Family education Module 4: Maintaining wellness Module 5: Crisis management Module 6: Recovery strategies It is true for every patient out there that psychoeducation helps prevent a relapse, asserts Dr Kadir. If they recognise relapse, they know what to do during a relapse; they are not ashamed to have a relapse; they don't blame themselves; and they seek help from their doctor. What is crazy, anyway? At the end of the day, it is the families' frustrations that has to be overcome. With each relapse episode, the support group for the patient gets less and less. Dr Kadir has witnessed this all too many times. "The wife gets tired; the sister says 'I give up', the parents don't know what else to do..." In the end, the patient is left alone with the doctor, and he ends up in the mental hospital for a long, long time. Psychoeducation can help deal with a family's frustrations by continuously giving them information on what must be done and what can be done; therefore empowering them to assert hope. "I usually tell families that the relapse rate is 50:50; this gives them hope that treatment will be effective," says Dr Kadir. Hanging on to hope can be a dangerous thing, for it can propel your spirits sky-high, but subsequently, leave you shattered. The sad reality that bipolar patients have to accept is that there are no sure-fire methods or treatments that can fully guarantee the avoidance of a relapse. But does it mean you should just give up, and succumb to your illness by perpetuating a self-fulfilling prophecy? By equipping yourself with knowledge, even when life throws you a difficult situation to handle, you can seek solace and comfort in the fact that it is only the surface of the glass that is cracked; the fundamental you within remains intact. In the words of the famous Greek poet Aeschylus, "I'm not afraid of storms, for I'm learning to sail my ship." |
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