Category Archives: EZ 40

EZ 40, EZ 61 (2), Medicines & Sciences, Vol 40

Identifying SCOLIOSIS in Children

September 29, 2015 EZ Malaysia Leave a comment

Many scoliotic spines are detected by those who work closely with children, such as a swimming coach or ballet teacher as they will notice slight changes in posture due to the effects it will have on the child. Unfortunately, Scoliosis is often not detected until it is a significant problem.

Why does this happen?

Scoliosis is a condition in which the spine (backbone) bends to the side abnormally. There are 3 directions in which a spine can move, forwards and backwards, twisting left and right and bending left and right. In Scoliosis, the spine adopts the abnormal bending of spine as its new normal. The abnormal bending of spine then becomes permanent and the bones change shape as the scoliosis enlarges and ages, and become more rigid and permanent.

Scoliosis is often not easily detected early. Scoliosis hides beneath the children’s musculoskeletal framework and can often increase to significant levels with only showing minimum hints that it is there. The importance of recognizing and acting on these hints is immeasurable!

Simple Guideline to identifying Scoliosis at an early stage

The child should be viewed from behind, barefoot with the spine easily seen and the legs must be straight, but relaxed.

Start at the pelvis. If the pelvis is higher on one side, this may be an indication that there is a longer leg on one side.
Look at the waistline (the area between the ribs and the pelvis). Check if there is a deeper crease on one side compared to the other.
The shoulder blades should be mirror images of each other. If one shoulder blade is higher than the other, slightly forward compared to the other or twisted, then a scoliosis may be present.
The shoulder girdle (the set of bones that supports the forelimbs) should be level, or closely level. Most people tend to be slightly lower on the dominant side, but this shouldn’t be more than a few millimeters in difference.
Check the position of the neck if it is straight, tilted or bent.
Lastly, look at the spine and the ribs. The spine should be straight and the ribs should not show any signs of a hump forming.

Test for Scoliosis

There is a test called the “Adams forward bending test”, which can be done after the visual check. Ask the child to bend forwards while standing with legs straight. A raised section on either side of the spine strongly indicates that there could be a scoliosis present.

Why Early Detection of Scoliosis helps?

Early detection of scoliosis helps to ensure that early treatment is applied. As scoliotic spines worsen, the treatment options become lesser and the possibility of positive results after treatment also reduces. All children should be screened for scoliosis at least by the age of 8 and this test should be done yearly even if no abnormality is seen.

EZ 40, EZ 61 (2), Medicines & Sciences, Vol 40

Celebrating 20 Years of Excellence

September 29, 2015 EZ Malaysia Leave a comment

In conjunction with OPTIMAX 20 years anniversary celebration, a mobile clinic project was initiated to serve the Malaysian public. This mobile clinic, which is in the form of a 20-footer truck covering over 70 different locations across Peninsular Malaysia including Kuala Lumpur, Selangor, Penang, Kedah, Johor, Negeri Sembilan and Malacca. This project runs from May until early August this year.

The ultimate objective of the mobile clinic project is to reach out to people from all walks of life and preach the fact that prevention is better than cure. Hence, providing free eye screening and echoing the importance of annual eye health screening. Targeted audience include individuals who are too busy to visit an eye specialist due to their daily work schedules or simply taking for granted that their sights are perfect.

2015 marks OPTIMAX’s achievement of 20 wonderful years in the optometric industry. The primary vision of OPTIMAX since it first started until today is still to present extraordinary to push humanity forward and to change lives. As pioneer in the laser vision correction in Malaysia, OPTIMAX has achieved its vision today by making laser vision correction widely available to the public in the region without compromising standards and quality.

Optimax laser technology is a dream come true for many people who relied heavily on glasses or contact lenses in their daily lives. It is as if giving a rebirth for the eyes to again see the world clearly without having to wear glasses or contact lenses. This in the long run is definitely a life changing experience to most and to their love ones.

OPTIMAX has served more than 100,000 patients since 1995 and has established itself as one of the most reputable eye care providers in South East Asia. The long standing corporate history of this successful organization with satisfied clienteles from both local and international are true testaments to the reputation of OPTIMAX for its surgical excellence.

EZ 40, EZ 61 (2), Medicines & Sciences, Vol 40

Combat Adult SCOLIOSIS

September 29, 2015 EZ Malaysia Leave a comment

When we hear about scoliosis, we always think it is only related to children. However, scoliosis is also common in adults.

Types of Scoliosis in Adults

Degenerative Adolescent Idiopathic Scoliosis: The person who had scoliosis as a child and then later develops complications.
De-Novo Scoliosis: Scoliosis that develops spontaneously in adult life and is usually secondary to degenerative changes of either the bone or the disc between the bones.

Symptoms of Scoliosis in Adults

Pain

Symptoms of Scoliosis in adults is usually very different to that of children, with pain being the most common. The pain usually starts as a secondary complication of the scoliosis itself. It usually associated with degenerative changes. Common conditions associated with scoliosis include conditions such as a disc prolapse or spondylosis (spinal degeneration accompanied by pain). Very often the associated conditions on its own may be easily treated, but not when Scoliosis is present.

Common age of patients who present with pain is usually around 35 years. This is the age at which the skeleton reaches full maturity and loses its flexibility, thereby making it less able to adapt to the stresses of the scoliosis. Early pain symptom may alert the person to the underlying scoliosis and then measures can be put in place to prevent the condition from getting worse.

Postural Changes

Even if the spine curve of an adult is at a low degree early on, there is still the possibility of progression. This means that a spine curve of 20 degrees as a child, may progress to 35 degrees by the age of 35 as an adult. Spine curve at 20 degrees may not shown any postural changes, however, by the time the spine curve reaches 35 degrees there will be a definite change to the person’s posture.

Treatment options for Scoliosis in Adults

Treatment options for Scoliosis in adults are very similar to that of children with one exception. Surgical treatment for adult is only done as the final option in very selective cases. This is due to a much higher risk of complications and a significantly slower recovery compared to children.

The usual conservative options are physical therapies such as Chiropractic and Physiotherapy for both children and adults.

In more severe cases pain management can be achieved with prescription drugs. Other options include epidural injections, nerve blocks and facet joint injections.

As with children, a back brace may also be required. The brace of choice for adults and children, is the new dynamic soft brace. In children, the main function of the brace is to prevent progression of the curve of the spine. In adults, the main function of the brace is to help relieve the pain. Better postural improvements may be achieved as the secondary benefit of the brace.

The most important thing in both children and adults, is the early detection of Scoliosis, thereby improving the outcome of any treatment and preventing future complications.

Careline: 1 300 80 77463 (SPINE)
http://www.tags.my http://www.facebook.com/tagsspineandjoint

EZ 40, EZ 61 (2), Medicines & Sciences, Vol 40

BEFORE IT’S TOO LATE

September 29, 2015 EZ Malaysia Leave a comment

by Dr Mecherl Lim MD (MA) Naturopath (ND) , Holistic Kinesiology

Q: How you can educate yourself and remove toxins in the body?
A: When people try to guess my age, they tend to think I am 15 years younger than my chorological age because I look young and fit in the Body, Mind and Spirit. Some people blame it on my Asian Heritage, “NO” The Secret is DETOX & LIVE.

Most people are on diet loaded with Sugar, rely on Packaged Processed Food, Dairy products, Wheat, Yeast, Alcohol, Caffeine, Nicotine, & Chemicals. People carry within their bodies a modern day chemical cocktail derived from industrial chemicals, pesticides, food additives, heavy metals, anaesthetics & residue of pharmaceutical legal & illegal drugs. In addition, many people are suffering from HURRY SYNDROME, No time to Eat, Rest, Meditate, Love, be Loved, Recollect and Reflect, only time to Hurry and eventually get sick. If you belong to this category, you definitely need to educate yourself in my DETOX & LIVE Book which is available now at http://www.michelleherbstherapy.com with detailed information to help you understand why EVERYONE needs a DETOX?

What is Detox?

Eliminating wastes and poisons via the lymphatic, digestive and urinary systems. Secondary routes of elimination are via the SKIN and LUNGS. Bad breath or recurrent skin eruptions may be evidence of the lung’s and skin’s attempt to assist overworked of weakened primary organs of elimination.

All the DIGESTIVE ORGANS play a crucial role in detoxification. The LIVER, in particular, is responsible for oxidising, breaking down or otherwise processing toxins. It filters a litre of blood per minute, straining out ENDOTOXINS, BACTERIA and POISONS.

Some of these toxins are deposited into bile, which is squirted into the INTESTINES by the gallbladder and moved out of the body. Prescription drugs, birth control pills and other hormonal medications, high fat diets, gallbladder diseases and variety of other factors can reduce the quantity and the quality of bile produced. Hepatitis, cirrhosis, biliary disease and nutrient deficiencies can all hamper the liver’s ability to effectively purify blood.

The KIDNEYS receive toxins, and the glomeruli, a specialised apparatus within the kidneys, filters the blood and metabolises water, electrolytes and nitrogen based waste. Heavy metals, long term aspirin consumption and numerous pharmaceutical medications can damage the kidneys and hamper their ability to detoxify these substances possibly leading to cancers. Toxemia is the precursor to AGING, loss of tone and function and permanent degeneration.

In FUNCTIONAL MEDICINE, the bowels are considered the soil of the body, Nutrient absorption, metabolism, and synthesis of many hormones and enzymes, as well as processing and elimination of waste products and toxins, all occur in the BOWELS. The enzymes, proteins, fats and hormones found in every cell of the body are largely the result of what the digestive organs absorb, metabolise, secrete and excrete. Like a chain reaction, intestinal constipation will lead to cellular inflammation.

No discussion of detoxification would be completed without mentioning the organs of elimination. Detoxification programs target organs whose role is to cleanse and protect your body from toxic substances.

Primarily, the liver, kidneys, colon, lymphatic and blood system. Detoxification can target each of these organs individually or all of them together.

What is the difference with other DETOX & INTERGRATED DETOX?

HEALING CRISIS: The most common occurrences during a detoxification programme especially one that focus primary on treating the LIVER without first correcting the environment and the gut is sometimes violent reaction known euphemistical as Healing Crisis. Patients may feel nausea, pain, headache, aggravations of inflammatory symptoms or increased sensitivity to dietary and environmental chemicals. This is caused by stimulation of the Liver detoxification without the correct supplements to support the entire process. This leads to an increase in the production of reactive intermediate harmful substances that causes damage to cells and tissues and increase the production of inflammatory medication.

….to be continued in the next issue. For more information visit http://www.michelleherbstherapy.com

EZ 40, EZ 61 (2), Medicines & Sciences, Vol 40

Oncoplastic Breast Surgery

September 29, 2015 EZ Malaysia Leave a comment

by Dr. Teoh Mei Shi
Consultant Breast, Endocrine & General Surgeon
MBBS (India), MS (USM), Fellowship Breast Oncoplastic Surgery

The news of breast cancer diagnosis is often traumatic and to hear that one needs to remove the whole breast is even more damaging to her physically, mentally, as well as psychologically.

Since historically, treatment for breast cancer has always been radical mastectomy whereby the whole breast and a large portion of the muscle underlying the breast tissue is removed extensively leaving a cosmetically disfiguring appearance and terrible side effects. This has been the mainstay of treatment over the last 100 years and although less aggressive surgery are employed to minimize the side-effects known as modified radical mastectomy or lumpectomy, it is still an unacceptable surgical appearance for many women.

As newer targeted therapies and novel chemotherapy drugs are available to improve survival outcome, surgical techniques and reconstructive methods for breast cancer are also advancing. This has led to a new sub-specialty called “oncoplastic breast surgery”.

Oncoplastic breast surgery is a combination of oncological treatment for breast cancer as well as reconstructive surgery to restore and rebuild the appearance of the breast leaving the patient with a more acceptable appearance. This “cosmetic” outcome can significantly help a woman recover psychologically as well as mentally. This new approach brings a new revolution to treating the woman as a whole rather than just the cancer. It also allows treatment for breast cancer patients to be more appealing and acceptable when one need not fear losing her breasts or her womanhood.

Breast conserving surgery or lumpectomy is the surgical removal of the cancer with a surrounding cuff of normal breast tissue. It is just as effective for smaller tumors and early stage disease but may not be suitable for larger tumor or smaller breast size. Following breast conserving surgery, one still needs to go for radiation therapy to the rest of the breast tissue and also frequent mammography to prevent recurrence. Some women who refuses radiation therapy or long term mammography follow-up instead prefer to opt for mastectomy with immediate reconstruction to reduce their fear and worry.

There are more options now for reconstructive surgery but the choice will depend on many factors like the stage of the cancer, tumor to breast size ratio, tumour histology and biology, fitness of the patient and also the surgeons’ experience. Every patient has different needs too ie. her own self-image and her goals. A multidisciplinary team comprising of breast surgeon, oncologist, radiotherapist, radiologist and pathologist will usually convene to discuss with the patient to ensure the best possible surgical and oncological outcome.

Breast reconstruction can be offered immediately as a single stage during cancer surgery but it could also be in several stages or as a delayed procedure after the cancer treatment is completed. After all, proper oncological treatment for breast cancer still prevails before cosmetic appearance.

Various options for reconstruction are available such as the use of implants, or the use of tissue from the back or belly and even fat grafting. Nipple reconstruction and tattooing of the areola are also possible. Some reconstructive surgeries can be short and in a single setting while most will take longer hours and require several stages to get the ideal shape and appearance. Risks for surgery such as infections, bleeding, implant-related and flap-related complications are relatively low but nevertheless, they do occur on a case-to-case basis.

If appropriate decision is taken, oncoplastic surgery has comparatively similar survival rate and cancer recurrence rate as conventional treatment with mastectomy and lumpectomy. It also does not make diagnosing recurrences and follow up more difficult during after-care surveillance.

In developed countries where incidences of breast cancer are higher and with the availability of screening programmes, there is higher percentage of early detection of breast cancer, therefore more than 70% of the patients will choose to undergo reconstruction. In Malaysia, we are still seeing a significantly higher percentage of late stage breast cancer detection, hence we encounter more mastectomy cases.

More advanced technologies are happening to minimize breast cancer surgery in the future. We are looking at cryoablation, radiofrequency ablation as well as intraoperative radiotherapy where radiotherapy session has been reduced to one session only versus the conventional 25 sessions.

Celebrity actress Angelina Jolie certainly made headlines when she chose to have both her breasts removed as a preventive measure due to an inherited BRCA gene that puts her at high risk of developing breast cancer. She reconstructed her breasts with implants and was also able to preserve her nipple areola complex.

Breast cancer incidences are on the rise in Malaysia, roughly about 1 in 15 women will develop breast cancer in their lifetime. Be breast aware and do not fear as early detection has good survival outcome. Oncoplastic breast surgery will change the revolution for breast cancer treatment. The future tag line for breast cancer surgery would be “No women shall leave the operation theatre without a breast”.

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