The Star Online: Lifestyle: Health
The Star Online: Lifestyle: Health |
| Posted: 08 Oct 2011 05:40 PM PDT DOES your knee hurt when you bend, flex or walk, or when you climb the stairs or kneel whilst gardening? If not you personally, maybe your mum, dad or even someone you know is suffering from the excruciating claws of osteoarthritis (OA). You've probably read countless articles focusing on the disease itself and the drugs used to treat it. There are more than 100 types of known arthritis. Osteoarthritis is the most common form of arthritis afflicting ageing adults worldwide. Hence, we will be focusing specifically on osteoarthritis. It affects the hands, feet, spine, and large weight-bearing joints, such as the hips and knees. This article will centre on what NOT to do when you have osteoarthritis of the knee; many sufferers are unaware that they are aggravating their knee joints by doing the opposite. What will also be covered will be the safer, milder alternative medication options to consider, compared to conventional pain killers. What not to do when suffering from osteoarthritis of the knee: 1. Wearing wrong footwear ● Avoid heels that are too high or too hard. ● Don't wear sandals. Choose shoes that lace up and provide your feet with firm support. Tip: Choose shoes with low heels with firm support. 2. Walking uphill or downhill ● Avoid walking up or down steep inclines or hills. Both put considerable strain on the knee. Tip: Walk on flat terrain instead, whenever possible. 3. Walking on uneven or soft terrain ● Avoid uneven of very soft terrain. Tip: Walk on sidewalks rather than on grass. Choose well-worn paths. 4. Carrying heavy objects ● Try not to carry heavy objects as much as possible. Every extra pound you carry increases the stress on your joints because your knees are your biggest weight-bearing joints. Tip: Try to find someone in your neighbourhood to help when needed. 5. Standing for long periods at a time ● Do not be on your feet for many hours at a time without a break. This puts your knees under considerable strain, even if you do not feel it directly at that moment. Tip: Try to follow this rule: "Never be on your feet longer than one hour at a time". Give yourself a break after every hour, even if only for five or 10 minutes. This gives you renewed strength and protects your knees. 6. Avoid low seats ● Avoid sitting on low chairs. Tip: To really take the load off your knees, choose chairs with a higher seat, preferably one with armrests. 7. Kneeling ● Kneeling, whether at home, at work, or in places of worship, concentrates pressure directly on your knees and should be avoided whenever possible. Tip: Many activities that require kneeling can usually be accomplished using a low stool or chair instead. In summary, one basic rule for osteoarthritis is: "Movement yes, strain no". Now let's talk about safer, milder yet as effective alternatives to conventional pain killers. Most people with osteoarthritis do not nourish their cartilage. Supplying essential nutrients for the body helps to build strong, flexible cartilage. Having a strong flexible cartilage is the first step for healthy joints. Hence, with the right nutritional support, osteoarthritis sufferers can rebuilt and regrow their worn out cartilage. Glucosamine and chondroitin are two clinically proven nutritional compounds used for relief of osteoarthritis and knee pain. Thousands of osteoarthritic sufferers worldwide are taking this combination daily to support their knee health. Glucosamine exists naturally in our cartilage and functions to repair and stimulate new cartilage regrowth. However, as our body ages, less amounts of glucosamine is produced. Chondroitin is another natural compound that is found in joint cartilage which gives rigidity to the cartilage and also acts as a "shock absorber". The synergistic effects of these two ingredients can help relieve joint pains and improve flexibility. Supplementation with glucosamine and chondroitin helps: ● Relieve joint pain ● Rebuilds joint cartilage ● Improves joint flexibility Remember to avoid doing the things that would put a strain on your knee joint. Regular exercise, coupled with a healthy diet, in addition to taking an effective formula of glucosamine plus chondroitin is a sure way to keep osteoarthritis at bay. This article is courtesy of Live-well Nutraceuticals, for more information, please consult your pharmacist or call Live-well INFOline: 03-6142 6570 or e-mail info@live-well.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. Full content generated by Get Full RSS. |
| Posted: 08 Oct 2011 05:37 PM PDT Mental illness has always been kept behind a wall of stigma and discrimination. People are still reluctant to talk about it, and in many respects, it remains a hidden disease. EACH year, World Mental Health Day is celebrated on October 10. This day is significant in drawing attention to issues concerning not only mental illness, but mental well being as well. This year's theme is "The Great Push: Investing in Mental Health". This theme invites a multisectoral approach in removing barriers to mental healthcare, thereby reducing the burden of neuropsychiatric disorders. It also highlights the long term cost effectivenes of investing in interventions for prevention of mental disorders and promotion of mental wellbeing. The World Health Organisation (WHO) describes mental health as "a state of well being in which the individual realises his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community". It is estimated that around 450 million people worldwide have a mental health problem. Unfortunately, in most parts of the world, mental health and mental disorders are not accorded anywhere near the same degree of importance as physical health. It is time issues concerning mental health become a global concern. By the year 2020, the WHO has projected that depression will be the second leading cause of disability in the world. Today, depression is already ranked fourth. Mental health problems affect society as a whole and is therefore a major factor in global development Why invest in mental health? Globally, there is huge inequity in the distribution of skilled human resources for mental health. Shortages of psychiatrists, psychiatric nurses, psychologists and social workers are among the main barriers to providing treatment and care in low- and middle-income countries. Low-income countries have 0.05 psychiatrists and 0.16 psychiatric nurses per 100,000 people, compared to 200 times more in high-income countries. In 40% of the countries, primary healthcare providers do not receive any training in mental health. There are several other barriers to appropriate mental healthcare. Stigma is a major barrier. In many parts of the world, including the developed world, people with mental disorders are victimised for their illness and become targets of unfair discrimination, resulting in little or no access to housing, employment, social welfare or health insurance. People are still reluctant to talk about mental illness, and in many respects, it remains a hidden disease. Another significant barrier to appropriate healthcare is the lack of psychotropic medication at the primary care level. While most countries have an essential drug list that includes basic psychotropic medications, 20% of countries do not have this essential package at the primary care level. Almost half the countries in the world do not have significant mental health legislation, policy, or a national-level programme. This is a major barrier in ensuring the right to healthcare, and accountability in human rights violations. There is also a need to strengthen the voice of users of mental health services and their role in advocacy issues, to ensure that the rights of persons with mental disabilities are fully represented. Mental disabilities, and neurological and behavioural disorders are common in all countries around the world, causing immense suffering and staggering economic and social costs. The gap between the burden of mental illness and the resources used to address the problem is the widest in low income countries. Closing this gap is not only the obligation of the respective governments and the WHO, but also non-government organisations, foundations, communities, families, and mental health professionals. Investing in mental health can generate enormous returns in terms of reducing disability and preventing premature death. Besides increasing the productivity of people with mental illness and their caregivers, commitment in reducing the gap would also instill dignity in their lives and give voice to people with chronic mental illness who continue to suffer from human rights violations by being physically restrained. The economic burden of mental disorders are huge. The core costs in terms of treatment and service fees, and usually long periods of hospitalisation, are much more compared to other types of morbidity, which are usually less chronic. In terms of indirect costs like that due to loss of productivity at work and job retention, the loss is staggering. Since mental disorders generate huge costs in terms of long term treatment and loss in productivity, logically, they would also contribute to poverty. Conversely, insecurity, low income levels and malnutrition contribute to mental disorders. Therefore, this results in a vicious cycle of poverty and mental disorders. Therefore, timely and appropriate investment in mental health intervention can break this vicious cycle and result in decreased overall economic burden of mental disorders. Mental strategies Investments in primary care services have proven to be very cost effective in treating burdensome mental illnesses like chronic schizophrenia. Such investments in service provision is not only required, but worthwhile. Commitment to prevention of mental disorders can also pay rich dividends in the long term. Detection and suitable intervention for depression, delinquent behaviour, suicidality, and substance abuse in childhood and adolescence will result in the mental well being of the potentially productive adult population. In Malaysia, our health indices remain one of the best in the developing world. We have one psychiatrist to a population of 115,000, which is admirable, although ideally, as per the WHO recommendation, it should be one psychiatrist to a population of 50,000. Our primary care services are being equipped to treat simple cases and make appropriate referrals to secondary and tertiary centers. Quality medications are also readily available at all levels, making our healthcare one of the most envied in the developing world. Nevertheless, there is room for improvement. With the burgeoning urban population, and stressful environment in educational institutions and workplaces, we have witnessed an exponential increase in cases of anxiety, depression, alcohol and drug abuse, and suicide. In recognition of the need to invest in mental health interventions, Health Minister Datuk Sri Liow Tiong Lai set up the Mental Health Promotion Advisory Council, which operates under his direct supervision. As a result of the council's recommendation, six schools have been identified as pilot projects for the "Sekolah Minda Sihat" project. This involves special training for school teachers to act as counselors with the capacity to detect and provide necessary intervention for students requiring help. Another pilot project is the "Klinik Kesihatan Minda Sihat", where several primary care clinics have been identified for capacity building that will lead to more comprehensive community mental health services. While the government's efforts in taking a serious view of mental health issues is laudable, the responsibility of investing in mental health falls on all of us. Individuals, groups, charities, and businesses should also be looking to see what can be done to improve our mental health and well being. CSR or corporate social responsibility in mental health issues is dismal compared to some other countries in the region. In addition, corporate houses have not woken up to the fact that depression at the work place, often disguised as physical complaints, can result in absenteeism and loss of productivity. It would be better for big corporations to invest in some form of Employee Assistance Programme in order to take proactive measures to prevent work-place stress and depression. Statistics are unavailable from Malaysia, but in developed countries like the United States, it has been estimated that 35-45% of absenteeism from work is due to mental health problems, namely depression and substance abuse. Social benefits and insurance schemes do not adequately address the needs of persons with mental illness. A caring society must be able to look after the needs of all people with disabilities, including those with mental disabilities. Non-government organisations need to be bold in advocating the needs of persons with mental disabilities, besides the promotion of mental well being for the general population. The extraordinary transformation in ethical, legal, and political responses to the AIDS epidemic or the epidemic of tobacco-related diseases demonstrate that concerted efforts by institutions, professionals, families, and organisations can lead to positive changes in people's lives. This courageous transformation is yet to take place for those suffering from chronic mental illness. The great push in investing in mental health is a timely call in recognition of the huge cost in terms of human misery, disability, and economic costs due to mental illness. As a nation, we should strive to support more and better services for those with mental disabilities as we engage in promotion of mental well being for society in general, so that every Malaysian lives a life that is healthier and richer – a life that is lived with dignity . Dr Andrew Mohanraj is a World Health Organization mental health expert and member of the Mental Health Promotion Advisory Council to the Minister of Health, Malaysia. Full content generated by Get Full RSS. |
| Posted: 08 Oct 2011 05:36 PM PDT Malaysian patients can now opt for a pacemaker that widens their diagnostic possibilities for any future health problems. GETTING a pacemaker inserted is surely a traumatic process. It is not so much the procedure itself – the doctors will relax you with sedatives for that – but the frightening incidents that lead up to the necessity of getting the device implanted at all, and the realisation that your life can never be quite the same again after that. Chief among the differences between your pre- and post-pacemaker life is the fact that you will never be able to undergo an MRI (magnetic resonance imaging) scan again. Now, why should that matter? you ask. Consultant interventional cardiologist Dr Yap Yee Guan says: "The problem is with an ageing population, and the increasing need for MRI as a diagnostic tool for neurological, heart, lung and breast conditions. "The number of MRIs (being done) are increasing yearly. After the age of 65, a person's chances of needing an MRI doubles, and this is the same demographic group that requires a pacemaker." He adds that in the United States, it is estimated that 60-75% of patients with an implantable device will be indicated for an MRI over the lifetime of their devices – a range of about three to eight years. MRIs are valuable imaging tools, particularly for soft tissue structures like the brain and breast. In addition, it offers the distinct advantage over CT (computed tomography) scans of not utilising ionising radiation to produce its images. MRIs use an electromagnetic field instead, which has not been proven to have any immediate or long-term side effects. However, this same electromagnetic field affects pacemakers negatively. For example, in such close proximity, the radiofrequency waves used to generate the electromagnetic field can cause the tips of the pacemaker's lead wires to heat up and damage the heart tissue it is inserted in. (The lead wires are actually completely insulated, except for the tips.) Dr Yap adds: "And heart muscle is not very thick, so if it burns all the way through, it will perforate the heart." The heated wire tips can also cause scarring of the heart tissue, as well as displacing the wires so that they do not function and therefore, endanger the patient's life. Pacemakers are used to regulate the rate and rhythm of arrhythmic hearts. They are prescribed for patients whose hearts are beating too slow or too fast, or with an irregular rhythm, which endangers the patient's life. Like the heart's own signalling system, the pacemaker works on an electrical system, which can be disrupted by the MRI's electromagnetic field. This can result in the pacemaker being reset to a rate that is not suitable for the patient, and even life-threatening. Realising this need, medical device companies have been working on a pacemaker which is MRI-compatible. According to Dr Yap, this included replacing magnetic-sensitive parts or shielding them from external electromagnetic fields. "Patients have it implanted, and can have the relevant mode switched on when they need to undergo an MRI, and then have the mode turned off afterward," he explains. Activating the MRI mode will cause certain features in the pacemaker to be turned off to enable it to be MRI safe, while still performing its basic function of regulating the heart rate and/or rhythm. The first MRI-compatible pacemaker was given the European CE quality and conformity mark in late 2008, while the United States Food and Drug Administration (FDA) just approved its first model earlier this year. This technology has been available in Malaysia since the first quarter of the year, says Dr Yap. In fact, he has already inserted the MRI-compatible pacemaker into two of his patients at Prince Court Medical Centre, Kuala Lumpur. The patients, one male and one female, are both relatively young, in their 40s, he says. With decades more of life ahead of them, their chances of needing an MRI sometime in the future is much higher than that of an older person of similar health status. "For the lady, it (the usage of an MRI-compatible pacemaker) is especially important because of breast cancer screening. "Previously mammograms (X-rays of the breast) were used, but nowadays, doctors are going more towards MRIs because they are more detailed," he says. The patient, 45-year-old sales executive Hew Tong Moy, shares that Dr Yap had described the advantages of having this pacemaker model, especially for females, over other non-MRI compatible models to her. Hew says she doesn't mind the extra cost as long as the pacemaker functions well. According to Dr Yap, the MRI-compatible pacemaker costs about 10% more than the regular ones. Full content generated by Get Full RSS. |
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