Here’s What You Should Know About Osteoporosis & Ageing

 

ASSOCIATE PROFESSOR (C) DR G RUSLAN NAZARUDDIN SIMANJUNTAK
Consultant Orthopaedic,
Arthritis & Sports Surgeon
ALTY Orthopaedic Hospital

Osteoporosis is a disease that weakens your bones, making them more prone to fractures.

Often, there are no symptoms. Many people only learn that they have osteoporosis after they experience a fracture and see a doctor.

Because fractures are potentially life-threatening when they occur to older persons, it is good to take steps to prevent this disease from quietly ‘sneaking up’ on you.

YOU CAN GET SCREENED TO FIND OUT HOW HEALTHY YOUR BONES ARE
If you are 65 or older, you should consult your doctor on getting screened for osteoporosis.

Tests such as bone mineral density (BMD) test will provide useful information about your bone health.

Blood profile tests help to detect presence of health conditions that can weaken the bones and increase your risk of osteoporosis.

WHEN SHOULD YOU SEE A DOCTOR AFTER A FALL?
  • When you experience severe pain that don’t improve after taking over-the-counter painkillers
  • When you are unable to move after your fall

After you are admitted, you will be given an imaging test—typically X-ray and, if necessary, magnetic resonance imaging (MRI)—to determine the location and extent of the fracture.

HIP FRACTURES CAN BE COMMON AMONG OLDER PERSONS
Hip fractures usually occur on the long bone of the thigh, called the femur (see image).

A surgery, called hip replacement, helps to address this problem.

A total hip replacement replaces the socket (acetabulum, see image) and the head of the femur.

A partial hip replacement replaces only the femoral head (see image). This is usually an option for older persons with more limited mobility.

The surgery takes place within 2 hours, and you’ll stay in the hospital for around 3 more days. During this period, a physiotherapist will guide you on the exercises that you can do to restore the range of motion of as well as to strengthen your hip.

WORK WITH YOUR HEALTHCARE TEAM TO REMAIN INDEPENDENT & MOBILE
For example, you may use a walker or wheelchair to remain mobile, and you may need to master new techniques (such as for using the toilet, bathing, dressing, etc) that take into account your condition.

 

If you have problems traveling to see your physiotherapist, consult your healthcare team on the possibility of having the physiotherapist visit your home instead.


This article is brought to you by ALTY Orthopaedic Hospital.

 

4 Things Everyone Should Know About ACL Injuries

 

DATO’ DR BADRUL SHAH BADARUDDIN
Consultant Orthopaedic,
Arthritis & Sports Surgeon
ALTY Orthopaedic Hospital

The anterior cruciate ligament (ACL) helps hold the bones called femur and tibia together at the knee joint.

ACL INJURIES ARE ONE OF THE MOST COMMON TYPES OF KNEE INJURIES
They are common among people that perform activities involving regular heavy use of the knees, such as avid football, futsal, and badminton players.

When the ACL is said to be ‘injured’, what really happens is that there is a tear in the ACL. This tear cannot be repaired in the conventional sense—the doctor cannot ‘sew’ or ‘glue’ back the torn ACL.

Instead, a surgery called ACL reconstruction will be necessary.

SOME COMMON SIGNS THAT YOU MAY HAVE AN ACL INJURY
Your ACL may be torn when there is a ‘pop’ sound as your knee is injured. Pain and swelling will occur at the affected knee but may resolve within one or two weeks.

If your ACL is not functional due to a tear, you will feel an instability in your knee.

Be alert for this instability, which will be especially noticeable when pressure is exerted on the knee during activities such as moving and standing.

This instability may be present even when there is no pain, and it could be a sign of an ACL injury.

When this happens, see a doctor to have the knee examined.

ACL INJURIES NEED TO BE ADDRESSED BY AN ORTHOPAEDIC SPECIALIST
If left untreated, continuous use of a knee with a torn ACL may damage surrounding tissues such as the meniscus and cartilage.

This would not only make movement more difficult and even painful, but the treatments involved would be more complex and hence more expensive.

Furthermore, ACL injuries can lead to significant loss of cartilage tissue in the knee and increases the risk of osteoarthritis.

The current recommendation for people with ACL injuries, of any age, is to undergo ACL reconstruction as early as possible (provided they do not also have concurrent osteoarthritis of the knee), especially in active persons.

This is to restore their knee function and to avoid developing further complications in the future.

ACL RECONSTRUCTION INVOLVES THE CREATION OF A NEW ACL TO REPLACE THE TORN ONE
The new ACL can be made from tendons taken elsewhere from your own body or from another person, or from synthetic materials.

Latest advances allow the use of a thin, flexible tube with a camera at one end (called an arthroscope) to guide the surgeon in performing the reconstruction more efficiently.

For the next few months after the surgery, you will be working closely with a physiotherapist to regain full use of your knee.

How soon can you walk and exercise after an ACL reconstruction?

You may walk the next day after surgery (using with crutches), cycling within 6 weeks, and run on a treadmill within 3 months. Sports can resume after 6 months, but contact sports such as football is advisable only after 9 months or 1 year.


This article is brought to you by ALTY Orthopaedic Hospital.

Breaking Depression’s Spiral

Breaking Depression’s Spiral

May 8, 2022   Return

Words Lim Teck Choon

Paul Jambunathan
Consultant Clinical Psychologist & Senior Lecture

Decoding Depression

Depression = Cannot Cope?

Some people experience depression because they are unable to cope with life-changing events, such as financial problems, unemployment, broken relationships, the passing of a loved one and more. Of course, most people will be affected by such events, but people with depression will experience symptoms that will prevent them from functioning normally, and this will persist for a longer period of time than normal.

Other Medical Conditions Can Cause Depression Too

Do you know that our mood can be affected by the levels of certain hormones in our body? Specifically, our thyroid, adrenal and pineal glands, as well as the glands in our sex organs produce hormones that have links to our mood. Therefore, it is possible that any medical problems involving those glands can give rise to depression. In such cases, these problems will have to be addressed in order to help the person overcome his or her depression.

The Depression Gene

Research suggests a strong possibility of a depression gene that can be passed on from parent to children, leaving these children more at risk at developing depression. If you have family members who developed depression, you should be more aware of the symptoms and get help if you have them, as well as practice good stress management techniques (there are books that can offer advice and tips on this). You should also get enough sleep and be physically active every day to keep your spirits up.

As You Can See, Depression Is Not Simply Because You Are Weak

Depression can be an inability to cope with life’s many stresses and pressures, or it could also be a result of a medical condition, or perhaps even a hereditary condition. Or, it could be caused by a combination or all of these factors! Therefore, if you believe that you may have depression, don’t be ashamed. Seek help from a qualified mental health professional instead.

Do You Have Depression?

Mr Jambunathan points out that, according to the latest (fifth) edition of The Diagnostic and Statistical Manual of Mental Disorders (the authoritative reference used by mental health professionals worldwide), someone is diagnosed as suffering from depression if he or she shows at least five of the following symptoms for nearly every day.

Depressed Mood
Feels irritable most of the day, nearly every day for more than two weeks. The person may appear sad, empty or tearful to the people around him or her.

Lack of Interest
The person shows decreased interest or pleasure in most activities, including activities that he or she previously enjoyed, most of each day.

Significant Weight/Appetite Change
Medically, a weight change of five percent (gain or loss) may be an indication of depression.

Change in Sleeping Habit
Some people may have problems falling asleep (insomnia), while others may sleep more excessively than normal (hypersomnia).

Fatigue 
The affected person seems listless and lacking in energy most of the time, often showing little inclination to snap out of the mood.

Guilt
The person feels an excessive or inappropriate amount of guilt over a past incident that triggered the depression. He or she may also feel helpless to change a situation, or feel that he or she is worthless to the people around him or her.

Lack of Focus
He or she has a reduced ability to concentrate or think, and is also indecisive.

Suicidal Thoughts
The thought of death or suicide frequently runs through his or her mind, along with ideas of how to carry them out.

Getting Closer to Happiness

Who to seek help from?

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There are different types of mental health professionals, and it will be good to know what they can (and cannot) do to help you.

  • Counselors are generally the ‘front line’ mental health professionals. They are trained to offer support and counseling to people with emotional problems.
  • Clinical psychologists have at least a Masters degree in clinical psychology. They can offer the services of a counselor as well as more specialized services such as cognitive behavioural therapy (CBT).
  • Psychiatrists are medical specialists who are better equipped to help people with more serious mental disorders such as schizophrenia and depression. Because they are medical doctors, they can prescribe medications when the need arises.

Mr Jambunathan says that it is perfectly fine to visit a counselor first. If the counselor believes, after assessing you, that you require the more specialized services of a psychologist or psychiatrist, he or she will refer you to the right person. “Often, you may also be requested to get a full medical check-up,” he adds, explaining that this is necessary to rule out any medical conditions that may be contributing to your depression. If such conditions exist, they will have to be looked into first.

Not Sure Where to Get Help?

Mr Jambunathan stresses that it is important to turn to qualified mental health professionals for help. Unfortunately, there are certain unscrupulous people who pose as counselors or psychologists, and they will do more harm than good. If you are unsure as to where to find legitimate mental health professionals, you can start at the following places:

  • Counseling services: Malaysian Mental Health Association at http://mmha.org.my/resources/directory-of-councelling-services/
  • Psychiatrists: Malaysian Mental Health Association at http://mmha.org.my/resources/directory-of-psychiatric-services-in-malaysia/
  • Another listing of psychiatrists: Malaysian Psychiatric Association at http://www.psychiatry-malaysia.org/listcat.php?cid=28&all=Y

Confidentiality Guaranteed

Don’t worry about people finding out that you are depressed. Mr Jambunathan assures that mental health professionals will not divulge your status to anyone (even your employer and partner) without your explicit permission. If you have any concerns about confidentiality, you can voice them out – most mental health professionals are used to (and even expect) such a discussion and thus, they will be glad to address your concerns.

What Are The Sessions Like?

Often, the client dictates the pace and nature of the session. The number of sessions depends on the client’s progress and the severity of his or her condition. For clinical psychologists such as Mr Jambunathan, sessions involve listening to the client and asking thought-provoking questions in order to empower the client into finding the determination and drive to make the necessary steps to overcome his or her depression.

Empower Yourself

Mr Jambunathan emphasizes that your recovery will be smoother if you take steps to empower yourself. Firstly, learn more about depression – the causes, the symptoms and the options available to overcome your condition. The knowledge will allow you to be more confident in making educated decisions when it comes to your recovery.

Furthermore, don’t hesitate to ask for second or third opinions if you have doubts about an initial diagnosis, and feel free to ask to be referred to another mental health professional if you are uncomfortable with the one you are currently seeing. Most mental health professionals will be happy to accommodate your request for a second opinion or referrals to another colleague; they will not take it personally, don’t worry!

In the second part of this series on depression, we look at anti-depressant medication and whether they are effective at treating depression. Look out for it in the following issue.

One Step Closer to Happiness

One Step Closer to Happiness

May 8, 2022   Return

Words Lim Teck Choon

Assoc Prof Dr Amer Siddiq Amer Nordin

Consultant Psychiatrist

Universiti Malaya Specialist Centre

All About Antidepressants 

Wait… medications?

Yes, sometimes medications are helpful in overcoming moderate-to-severe depression. Dr Amer explains that these medications, called antidepressants, are prescribed by psychiatrists, who are medical doctors specializing in mental healthcare or psychiatry.

Malaysia Has Good Psychiatric Care

Some of us may not know this, but Malaysia actually offers some of the best psychiatric care in this region. Dr Amer points out that many of the commonly prescribed and effective antidepressants used worldwide are available in Malaysia. Therefore, people with depression can find a good level of medical care in both government and private hospitals. It is only a sad kind of irony that awareness of both depression and its treatment is not widespread enough, causing a number of people with depression to either deliberately or unknowingly miss out on getting treatment.

Thus, if you suspect that you have depression or you believe someone close to you has this condition, Dr Amer gently recommends that you seek appropriate advice and help from a qualified mental health professional. The earlier the treatment, the better are the chances of recovery.

5 Things to Know about Antidepressants

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  1. Dr Amer stresses that antidepressants are not the be all and end all of depression management. They work to reduce the symptoms of depression instead of curing the condition, and are only prescribed when necessary. Some people with depression may be able to overcome it without any need of medication at all.
  2. It may take a couple of weeks before you see the beneficial effects of the antidepressant you are taking. If you believe that you are not getting better even after taking the medication, don’t be too quick to assume that it does not work. Instead, talk to your psychiatrist about your options.
  3. It is, however, possible that certain antidepressants don’t work on you. The psychiatrist will prescribe another type after he or she has performed the necessary evaluation to confirm that your current medication is ineffective.
  4. Take your medications based on the recommended dosage and frequency, and do not stop without consulting your psychiatrist first. Some people stop on their own when they believe that they are getting better, and as a result, their depression comes back, sometimes more severely than before.
  5. Avoid drinking alcohol or taking illegal drugs while you are on medication. Some people believe that the ‘high’ from alcohol or drugs helps them feel better, but research has shown that these substances actually negate the benefits of your medications and can even worsen your depression.

How Antidepressants Work

There are different types of antidepressants available, and each type has its own unique ways of reducing the symptoms of depression. Generally, however, they all work by influencing the way the brain works.

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Our brain cells, or neurons, form a closely connected network called the brain circuit. All information is passed from one neuron to another, carried by substances called neurotransmitters. There are many different types of neurotransmitters, and some of them carry information that affect our mood – for example, serotonin, dopamine and norepinephrine. 

Generally, antidepressants help reduce the symptoms of depression by interrupting the transmission of specific neurotransmitters that trigger a depressive mood. Some work on a single neurotransmitter, while others may work on two or more.

The type of antidepressants prescribed depends on the symptoms and severity of your depression, other health conditions already present and whether you are pregnant or breastfeeding. Sometimes, a psychiatrist may prescribe a combination of two antidepressants for enhanced beneficial effects. If the need arises, additional medications such as mood stabilizers, anti-anxiety medications or antipsychotic medications may also be prescribed to help you better manage your symptoms.

Also, if you experience bothersome side effects, your psychiatrist may switch you to a different kind of medication. If you are also on medications for other health conditions, you should share them with your psychiatrist, as there is a possibility that these medications can react with an antidepressant to create potentially dangerous complications.

But Aren’t Antidepressants Addictive?

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No, not at all, says Dr Amer. Some patients experience withdrawal-like symptoms when they stop taking antidepressants, but this is not a sign that they are addicted to those medications. Rather, it is more likely due to the body needing some time to adjust once the medication is stopped, especially if it is stopped abruptly. These symptoms usually go away on their own. If you experience bothersome side effects, you should let your psychiatrist know. He or she will either offer options to address these side effects or switch you to another type of antidepressant.

Is It True that Taking Antidepressants Will Ruin My Sex Life?

Because antidepressants work by calming your mood and reducing your anxiety, one possible unwanted side effect is that you also become too ‘calm’ to respond in intimate situations. Some people (both men and women) find that their libido is decreased. There are men who also experience erectile dysfunction, while women may experience discomfort during sex due to reduced lubrication. Delayed orgasm may also be experienced by both men and women.

Fortunately, this does not mean that your sex life is ruined if you are on antidepressants. Sometimes these side effects go away on their own, after your body has become used to the medication. If they persist, there are ways to manage these symptoms, such as reassessing the dosage or, if you anticipate having an intimate moment with your partner, taking your antidepressants only afterwards. Switching antidepressants might also be an option if the above doesn’t work.

Don’t stop your medication because it is affecting your sex life, as this may cause your depression to worsen. Instead, talk to your psychiatrist about the issue; he or she will be able to help you in this matter.

Don’t Give Up!

Medication alone is often not enough to help the person overcome his or her depression. Overcoming depression is a day-to-day process, often requiring a lot of energy and focus. Recovery may not be as quick as the person wishes, and in the meantime, he or she may experience broken relationships, loss of jobs and other heartbreaking disappointments.

In such situations, some people may become overwhelmed and feel that they will never become better. They choose to give up instead, thus succumbing to their depression.

It does not have to be this way. While depression is often portrayed as a lone person’s struggle, Dr Amer points out that the road to recovery is often easier with support from the people around that person.

This is why, while he respects a patient’s desire for confidentiality, Dr Amer would advise the patient to let at least one trusted person in on the fact that he or she is trying to overcome depression. This person can provide a listening ear and a shoulder to cry on when the going gets tough for the patient. Additionally, that confidante is welcome to ask for advice from the patient’s mental health professional if the need arises.

Furthermore, support can be obtained from various support groups (either in real life or online at places such as Facebook and Reddit) as well as from various non-profit organizations dedicated to helping people with depression and other mental issues heal.

When the World Shuts You Out, We Are Still Open

That is the motto and rallying cry of the Befrienders, a nonprofit organization established to provide emotional support to those in need. If you need someone to talk to, call the Befrienders at 03-7956 8144 or 7956 8145
(they are available 24 hours a day) or email sam@befrienders.org.my. You can also arrange for face-to-face support by calling the numbers above.

 

The Truth About Cats & Dogs

The Truth About Cats & Dogs

May 8, 2022   Return

WORDS LIM TECK CHOON

How hard is it to raise a dog or a cat? Well, it’s as easy as raising a beloved child – just give all the TLC your heart is capable of, throw in a heap of patience, sit through moments of exasperation when you realize that your little one can get out of hand and a big smile when, in the end, you realize that you will not change any second of the experience – as all the ups and downs are worth it.

HealthToday catches up with Dr Goh Kim Siang, a veterinary surgeon, who touches on a few things that everyone should know before adopting a pet.

THE SECRET HISTORY OF PETS

Humans are the only creatures in this world that keep pets. One of the earliest evidences was the remains of a human cradling a puppy found in what is now Israel, dating back to 10,000 BC.

TRUTH #1

YOUR KIDS AREN’T THE BEST PEOPLE TO DECIDE WHETHER YOU SHOULD ADOPT A PET.

Veterinary surgeon Dr Goh Kim Siang shares that companionship is one of the greatest benefits of having a pet. “For many people, just seeing their pet approach them for a rub or cuddle when they come home from work can be a good antidote to the stress they experience earlier in the day,” he says. He adds that older people may find a pet’s companionship beneficial in staving off loneliness.

“THE KID WANTS A PET!” IS PROBABLY NOT A GOOD REASON TO HAVE ONE.

Just as Mom and Dad will not have another baby just because their kid wants a sibling, it is not a good idea to adopt a pet because of a child’s whim. Dr Goh points out that children will be children – they may get bored easily or become fascinated by something else quickly. They may also eventually decide that having a pet is no fun and they don’t want it anymore.

Dr Goh goes on to say that the ultimate decision to have a pet lies with the grown-ups. After all, like it or not, the care and feeding of the pet will ultimately fall onto them. “Having a pet is a lifelong responsibility,” he emphasizes.

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DR GOH’S CHECKLIST FOR PET OWNERS-TO-BE

  • Does your residence have ample space for the pet to live comfortably in, move around and answer the call of nature?
  • Can you and are you willing to allocate the time and effort every day to feed the pet, bond and communicate with it and, in the case of a dog, take it out for some exercise?
  • Can you afford and are you willing to invest money in nutritious foods, vaccinations, medical check-ups and treatments and more for your pet?

If you hesitate to say YES to any of the above, you may not be ready to adopt a pet yet. Let’s think a bit more about the matter, perhaps even talk to a veterinarian or another responsible and loving pet owner to find out more about what being a pet owner is like.

BLACK PETS NEED MORE LOVE

Do you know that there is a National Black Dog Day in October? The day was created because statistics showed that, in the US, black or dark-furred dogs are often not picked for adoption. Hence, pet shelters, pet welfare organisations and dog lovers all came together to spread the word that a black dog is no less lovable and loyal compared to dogs of other colours. Also, black-furred dogs can be truly adorable, as evidenced by the Black Dogs Project (caninenoir.tumblr.com)!

TRUTH #2

TRAINING GIVES DOG OWNERS & THEIR FURBABIES A GOOD START IN THEIR RELATIONSHIP.

Research has found supporting evidence that training helps to establish a stronger, more harmonious bond between a dog and its owner. According to Dr Goh, it is especially important for adopted dogs which may have experienced abuse in the past – training will teach them to interact peacefully with humans.

WELL, HOW DOES TRAINING BENEFIT MY DOG AND ME?

Your dog and you do not speak the same language. In fact, you and your dog are of entirely different species, so it’s very likely your dog doesn’t think or see the world the same way as you.

Training helps both you and your dog bridge these differences, so that the two of you can develop a system of communication via simple words (“Sit!”, “Come!”, “Stop!”, etc) and touches.

Here are just some of the benefits from such improved communication:

  • Your dog will learn which behaviour is acceptable and which isn’t. This will help your dog to react properly to unpredictable changes and situations that it will come across in real life.
  • It teaches your dog how to interact peacefully with other people as well as with other dogs.
  • You and your dog gain a better understanding of one another. You don’t have to scold or punish your dog often, and your dog will flourish in a less stressful and more loving environment. In the long run, this will promote a stronger bond between you and your dog.

GREAT! BUT I CAN TRAIN MY DOG MYSELF… RIGHT?

Dr Goh advises against this. While there may be books and YouTube videos for those who wish to train their dogs themselves, dogs are like babies. They have their own mind and can react in ways that are different from what’s demonstrated in those books and videos! Hence, what works for one dog may not work as well or even at all for another.

An experienced trainer who has trained many dogs of different personalities and temperament, on the other hand, may know a trick or two to deal with dogs that like to break the rules.

TRAINING IS NOT ABOUT SHOWING THE DOG YOU ARE

In the past, it was commonly believed that you need to establish a firm dominance over your dog to ensure good behaviour and loyalty. However, these methods tend to emphasize punishment over reward, and they often do not work on dogs with already problematic behaviour.

These days, evidence from research on pet behaviour has generated a shift from this ‘I’m the boss!’ style of training to one that emphasizes positive reinforcement and mutual respect between dog and owner. Dr Goh recommends seeking a trainer that adopts such an approach, as this approach has a higher likelihood of success in promoting good communication and stronger affection between the dog and its owner.

TRUTH #3

CATS & DOGS NEED BALANCED AND NUTRITIOUS MEALS AS WELL AS EXERCISE AND MEDICAL CHECK-UPS.

THE FACTS ON FOOD

You can easily purchase nutritionally-complete pet foods from stores or the veterinarian’s clinic to meet your pet’s nutritional needs. However, Dr Goh shares that there are a few things to take note of when picking the right brand for your pet:

  1. Like human foods, pet foods have nutritional information panels (NIPs) on their package. Look at them before buying and take note of the sodium and fat content. Pick ones that have less of these.
  2. Also, check the ingredient list. Ideally, cat and dog foods should have some source of animal protein and fat. You can identify these sources by the presence of ingredients such as beef, chicken, turkey, etc.
  3. If you are unsure or are confused by the numbers and jargon on the food packages, you can always ask for advice or clarification from a veterinarian.

How about cooked foods? Dr Goh shares that it is increasingly common these days for pet owners to prepare their own homemade meals for their cats and dogs. In fact, November 1 is National Cook for Your Pets Day in the US! There are recipes available online for pet owners who wish to go down this route. You can check with your pet’s veterinarian if you have concerns about allergens, nutritional content, etc.

Just no table scraps, please. These are almost always foods with all the nutritious parts already eaten. It is best to delegate the table scraps to the waste bin instead of your pet’s food bowl.

ENERGIZE WITH EXERCISE

You are advised to be physically active for at least 30 minutes every day to maintain a healthy weight and keep the body functioning at tip-top condition. Also, daily physical activity helps to reduce risks of non- communicable diseases such as diabetes, high blood pressure and more.

Cats and dogs can develop these health problems too, especially if they become overweight. Hence, they also need to be physically active every day!

Cats are more independent in nature. Dr Goh points out that they usually get their exercise during their daily rounds around and outside the house.

On the other hand, dog owners often need to allocate some time to take their furbabies out for their daily workout. Dr Goh recommends a 2-3 km walk around the neighbourhood, a simple but enjoyable exercise that allows both dog and human to get their daily workout.

A MEDICAL CHECK-UP ONCE A YEAR

Just like humans, dogs and cats also can develop cancer, high blood pressure and other diseases. Most of these diseases can be treated or managed more successfully when detected early. Hence, Dr Goh recommends bringing your cat or dog to the vet’s clinic for a medical check-up once a year. HT

MALAYSIA, HOW ARE WE DOING SO FAR?

MALAYSIA, HOW ARE WE DOING SO FAR?

May 8, 2022   Return

WORDS LIM TECK CHOON

We take a look at the recent National Morbidity & Health Survey (NHMS) for the answer to this question and it’s… not very good. Nonetheless, it is never too late for Malaysians to take the first steps to improve their health. In fact, let’s take the data in NHMS 2019 both as a wake-up call and a source of motivation to help us become healthier.

THE HEARTS OF MALAYSIANS MAY BE BREAKING

1.7 million Malaysians have three major non-communicable diseases (NCDs), which are also major risk factors for cardiovascular diseases: diabetes, high blood pressure and high blood cholesterol. 

3.4 million Malaysians have two of the above major NCDs. 

A Refuge of Love

A Refuge of Love

May 8, 2022   Return

Previous
Next

Former Secretary-General of the United Nations Kofi Annan once said, “There is no trust more sacred than the one the world holds with children. There is no duty more important than ensuring that their rights are respected, that their welfare is protected, that their lives are free from fear and want and that they can grow up in peace.” Indeed, there is no greater, no nobler a duty than that of raising and nurturing children – and closer to home, the people at OrphanCARE Malaysia Foundation have chosen to dedicate their time and effort in carrying out this very task the best they can.

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Every child needs a family

On the origins of OrphanCARE Malaysia, Noraini Hashim who is the foundation’s trustee says, “OrphanCARE was first established in 2008 under the patronage of HRH Sultanah Pahang, Sultanah Hajah Kalsom. Four years after its establishment, it was granted approval to become a full-fledged foundation. Now, OrphanCARE is managed by a board of 6 trustees chaired by YB Tan Sri Faizah Mohd Tahir.”

So, what does OrphanCARE do exactly? Noraini explains, “We work closely with the Ministry of Women, Family and Community Development to offer a refuge for unwed mothers and babies who may otherwise be abandoned. Also, we place children who are from institutions with suitable families and provide these families with the support they require to parent these children via counseling and ethical adoption services. Our aim is to provide orphans and abandoned babies in Malaysia with the love, care and security of a family.”

Some people may question the need for placing orphaned children with families. They may wonder ‘Won’t orphanages be good enough?’ Noraini begs to differ. “Extensive research has developed a body of evidence showing the harmful impact which institutionalisation has on kids. Kids raised in institutions tend to display significant delays in development and have behavioural problems. In fact, infants who are raised in institutions but moved to families before 6 months of age completely recovered from their development delays whereas those moved to families after 6 months of age recovered only partially.” This is why deinstitutionalisation projects like the one by OrphanCARE are so crucial.

“Via our deinstitutionalisation project, we strive to help change society’s mindset towards orphans so people will recognise that children shouldn’t be left permanently in orphanages. Orphanages should really only be ‘transit points’ before they are placed with families that can bring them up in a proper family structure,” she emphasises.

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A safe haven for babies

Aside from its efforts to deinstitutionalise orphans into family-based care, OrphanCARE was the first to set up baby hatches in Malaysia. “OrphanCARE aims to discourage baby abandonment by creating safe havens for babies born out of wedlock to young mothers, who have kept their pregnancies a secret from their families. These young women who have nowhere to turn for help can be assured that their babies will be placed with caring parents. These ‘safe havens’ are in the form of 3 baby hatches located in Petaling Jaya, Johor Bahru and Sungai Petani respectively.”

“Additionally, we signed a Memorandum of Collaboration with the KPJ Group of Hospital in 2014 allowing us to arrange for adoption of babies at KPJ’s 8 baby hatches in Peninsular Malaysia,” Noraini says. “Since the launch of these baby hatches, we have successfully matched 136 abandoned babies with adoptive parents. Besides that, via our counseling programs, 82 mothers changed their minds and decided to keep their babies instead of giving them up.”

Meet the OrphanCARE team

Asked how she became involved in OrphanCARE, Noraini says candidly, “I’m one of the founding members. I was roped in by the late founder, Dato Adnan Mohd Tahir who strongly believed that every child deserves to be raised in a loving home.”

“Currently, the OrphanCARE team comprises 17 staff – 14 of whom are based at the 2 offices in Petaling Jaya with the remaining 4 staff in the Johor Bahru and Sungai Petani centres.” What about volunteers? “We are open to any helping hand from the community. Those interested can call our centre to register so we can update you on future events. Also, we welcome monetary contributions. You can do so via bank transfer at 86-0086023-8 or cheques made payable to OrphanCARE Foundation.”

Forging ahead

So, what plans does OrphanCARE have for the future? Noraini divulges, “Raising more awareness about deinstitutionalisation is a big part of our plans. Open and clear communication is vital as very few understand what deinstitutionalisation means; this must be targeted at specific audiences involving a range of stakeholders. To bring our deinstitutionalisation program to greater heights, we will also be partnering with government agencies and other NGOs.”

She concludes, “A key provision in the UN Convention on the Rights of the Child states that every child has the right, where possible to know and be cared for by his or her parents. With this in mind, we at OrphanCARE strive to ensure that a day will come when no child in Malaysia will be raised in an institution but in the loving care of a family or their community.”

How can I adopt?

On OrphanCARE’s adoption program, Noraini says, “Public response has been very positive. We receive phone calls and emails enquiring about our program on a daily basis. Currently, we have over 2,000 couples registered in our database. Out of these 2,000 couples, 752 are on the waiting list to adopt.” She adds, “There is also a great need for potential adoptive parents for older children as they are not as in demand as younger kids.”

On the eligibility to adopt, she stresses that couples have to be:

Married for at least 5 years

Childless, if they wish to adopt a baby. Also, they have to produce a fertility report

Malaysian

Residing in Peninsular Malaysia

Living in a safe neighbourhood

Healthy – both mentally and physically

With a combined income of at least RM5,000

If a couple fulfils all the above criteria, they can email their application to admin@orphancare.org.my The registration process will be handled by the OrphanCARE adoption team, followed by screenings, interviews and an 8-hour adoption training session. 

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One of A Kind

One of A Kind

May 8, 2022   Return

“Climate change is real; it’s happening right now. It’s the most urgent threat facing our entire species, and we need to work collectively together and quit procrastinating. We need to support leaders around the world who don’t speak for the big polluters, but who speak for all of humanity, for the indigenous people of the world, for the billions and billions of underprivileged people out there who would be most affected by this.”

Anyone who did not catch last month’s Oscars ceremony telecast or did not read about it in the news might be forgiven for assuming that the above speech was made anywhere but an occasion as glamorous and glitzy as the Oscars. At an event more known for the elaborate designer outfits of celebrities, absurdly expensive gift bags (this year’s celebrity attendees reportedly received gift bags worth 200,000 USD each!) and acceptance speeches which are mostly self-congratulatory at best (and narcissistic at worst), it was indeed a refreshing surprise to see the 41-year-old Leonardo – hailed one of the greatest actors of his generation – use his acceptance speech as a platform to highlight a subject as relevant and pressing as climate change.

As if Leonardo had not already wowed millions around the world with his brilliant and varied performances, his passion for environmental issues (as evidenced by his speech) drew praise from his peers and the public alike. As Ally Brooke from the pop group Fifth Harmony tweeted when news of his much awaited Oscar win broke out: ‘Leo is just sensational and one of a kind!’

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Making it big

Looking at his phenomenal acting career, it is hard to believe that Leonardo once had difficulty landing an agent. He recalls, “One agent even suggested that I change my name to Lenny Williams for the sake of improving my appeal. They thought my name was too ethnic and would limit my jobs.” However, the then 11-year-old was adamant to keep his name. “It did thwart me from acting for several years,” he admits. “But I tried again when I was 13 and finally got an agent to accept me with my name.” 

After several years of regular television work, Leonardo moved on to the silver screen starring alongside Hollywood heavyweights such as Johnny Depp in What’s Eating Gilbert Grape? – a role which snagged him the first of many Oscar nominations to come. Never one to rest on his laurels, he continued to expand his resume with leading parts in notable films like The Basketball Diaries and Romeo & Juliet. But it was his role in the blockbuster epic Titanic which propelled him to superstardom resulting in fan worship among young women – a worldwide phenomena which became known as ‘Leo mania’. Touching on that chapter of his life, he says, “It was a very surreal period. It was so bizarre and intense that I took a break for a couple of years. I had to recharge and refocus.”

The role of a lifetime

Although Leonardo’s career hit a snag after Titanic, he soon bounced back with roles in noteworthy movies under the helm of acclaimed directors like Martin Scorsese and Steven Spielberg. Since then, he has been in as many as 17 features including The Great Gatsby, Django Unchained and of course, The Revenant which won him his first Best Actor Oscar.

Discussing his experience working on The Revenant, he says candidly, “It was physically grueling. The toughest thing for me was getting in and out of frozen rivers. I had on elk skin and bear fur which weighed about 100 pounds when wet. It was a daily challenge not to get hypothermia.” But he does not stop there. “Making this movie was about man’s relationship with the natural world – a world which we collectively felt in 2015 as the hottest year in recorded history. In fact, our production team had to move to the Southern tip [of Argentina] just to find snow,” he emphasises.

Crusader with a cause

So, how does an actor become so invested in things like global warming? “When I took time off after Titanic, I re-evaluated my other great passion – the environment. I’ve been into biodiversity and science ever since I was a kid, probably from watching documentaries about the rain forest at the Natural History Museum. That’s how I was exposed to the wonders of nature. So, I decided to explore this interest by getting actively involved in environmental issues.”  

A man of his word, Leonardo has since contributed significantly to the environmental movement. He was the narrator and producer of The 11th Hour, a documentary exploring the precarious condition of the world’s ecosystems. That aside, he is a founder of The Leonardo DiCaprio Fund (a non-profit organisation which strives to support and raise awareness on various environmental causes), has served on the boards of the World Wildlife Fund (WWF), the International Fund for Animal Welfare and the Natural Resources Defense Council. That’s not all. He even converted his official website into an ecosite! So, the next time you log on to www.leonardodicaprio.com, expect to see updates about his foundation along with news on his latest film ventures.

When asked to describe himself, Leonardo himself seems to sum it up best: “I’m not the kind of person who tries to be cool or trendy. I’m definitely an individual.” And judging by his resume – climate crusader, wildlife champion, acting veteran, film producer – he truly is. Leonardo DiCaprio is an individual, alright – a very remarkable one.

 

References:

One Green Planet. Available at www.onegreenplanet.org

Rolling Stone. Available at www.rollingstone.com

Time Out Hong Kong. Available at www.timeout.com.hk

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Maria & Meldonium

Maria & Meldonium

May 8, 2022   Return

On March 7, when Russian tennis superstar Maria Sharapova admitted to taking meldonium that caused her to fail a drug test, the media became abuzz about the drug.

Meldonium, also known as mildronate, is produced in Latvia and marketed in mostly Eastern Europe and Russia as a drug to treat heart problems such as angina, heart attacks, heart failures and even strokes.

A quick search on the US National Library of Medicine reveals that there were also several studies on the possible beneficial effects of meldonium on Parkinson’s disease and type 2 diabetes, but these studies were conducted on animals, so we have yet to have any conclusive answers on its benefits on human beings.

Meldonium has not been approved by the US Food and Drug Administration (FDA), even though the manufacturer alleged that this is because getting an FDA approval is a costly process. It has been approved for sale in Russia and Eastern Europe, however, hence its use by people in those regions.

Not OK for athletes?

The World Anti-Doping Agency (WADA) is the organisation that maintains the list of drugs and medications prohibited to athletes. According to WADA’s addendum, which contains recent changes to its list, meldonium was added “because of evidence of its use by athletes with the intention of enhancing performance”.

What does this mean?

Well, to get to the answer, we have to be a bit more technical and look at how the drug works on cells.

Meldonium improves circulation by changing the way these cells break down various substances (protein, fat, carbohydrates, etc) into energy.

Normally, this process, called metabolism, occurs in structures in the cell called mitochondria. Meldonium blocks long-chain fatty acids from entering mitochondria, so these structures metabolise carbohydrates instead.

Carbohydrate metabolism consumes less oxygen than fat metabolism, so in cases where oxygen supply in the blood is reduced – such as when there is poor circulation due to atherosclerosis – cells can still stay alive and function.

For athletes, taking meldonium also means that they need less oxygen to reach optimal performance. Under normal circumstances, an athlete’s performance reaches a limit when his or her cells use up more oxygen than the lungs can deliver. But with meldonium reducing the amount of oxygen needed by the athlete’s cells, he or she can now push farther, perform longer and play harder – giving the athlete an unfair edge over other competitors. Hence, the WADA ban.

References:

ABC Australia. Available at www.abc.net.au

Drugs.com. Available at www.drugs.com

US National Library of Medicine. Available at www.ncbi.nlm.nih.gov

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That Dragon, Cancer

That Dragon, Cancer

May 8, 2022   Return

Unlike the more famous professional football player sharing his name, the video game creator Ryan Green is just an ordinary man with a lovely family. Everything changed, however, when his son Joel, then just one year old, was diagnosed with a rare and incurable form of brain cancer.

Radiation therapy and chemotherapy followed. Joel recalls those sleepless nights when they would live out every parent’s worst nightmare: their child in pain, unable to get better, and them helpless to do anything other than to pray and try to be strong.

He decided to pay tribute to Joel the only way he knew how: through a video game. “I was scared I would forget Joel,” Ryan told Today. The game would be a way for the Greens to channel their grief as well as to celebrate every second that Joel was present and how he filled their lives with so much love and sunshine.

The game was developed by Numerous Studios and a rough demo of the game was exhibited in 2010 at a game convention in the USA. That Dragon, Cancer places the player in the shoes of Joel’s caregiver. The player can interact with Joel in many ways, almost like real life. However, the game can cut the heart deeply: the first scene will see the player scrambling to comfort Joel after a radiation treatment – a scene recreated from Ryan’s personal experience. Eventually, the player will share the journey with the Greens as Joel’s condition deteriorates.

The reception was astounding. Players who tried the game choked up and cried, while journalists and bloggers wrote about how that simple demo broke their hearts and inspired them to never take life for granted. Over the next few years, this simple game became one of the most anticipated titles in the video game industry.

Alas, even as the game demo was well received, doctors found that Joel had developed a new tumour. This time, they were not optimistic. They estimated that Joel had four more months left.

Yet, Joel defied expectations and lived for another three years.

Amy calls this a miracle. For every day that Joel was still with them, the Greens would celebrate the boy’s healthy moments. No grief, no tears – those could come later.

Joel Green passed away peacefully in March 24 last year, only five years old, surrounded by those who loved him deeply. Six weeks later, his sister Zoe came into the world. Her presence helped the Greens to heal, love and laugh again, but Ryan says that they would never forget Joel. And with the recent release of That Dragon, Cancer, neither would we.

References:

Today. Available at www.today.com

Wired. Available at www.wired.com

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