Thursday, April 23, 2009

The Future of Medicine is Here

Hi there,

It has been quite a while since the last post. I've been updating my knowledge and learning a new and exciting kind of medicine - Anti-Aging and Regenerative Medicine. Achieving longevity (long life span) is one thing but more importantly, how do we maintain a good health-span (living healthy for as long as you live till the day you die. Dr Ron Rothenberg describes this as the rectangularization of the functionality curve. This means that we should strive stay as functional as possible for as long as possible.

The specialty of Anti-Aging and Regenerative Medicine is one specialty that aims to achieve this through early detection, prevention and reversal of age related decline. By optimizing our dietary intake, optimal exercise regimes, nutritional supplementation and balanced hormone replacement we believe this can be achieved.

It was thought that our hormones decline because we age. However, we now know that the reverse is true....we age because our hormones decline. This is the basis of the neuro-endocrine theory of aging. With this in mind, by replacing the hormones in a balanced fashion, aging and other declines in bodily functions can be halted and potentially reversed.

The human body has 2 major control or regulatory systems namely the nervous system and the endocrine system. The hypothalamus situated in the brain is the major connection between these 2 systems which work seamlessly with one another. The endocrine system produces hormones which function as messengers to other endocrine organs and non endocrine cells. Through this hormonal symphony, our bodies are able to function the way it does. The major endocrine glands include the pituitary gland, the thyroid gland, the adrenal glands, the pancreas, the testes in men and ovaries in women.

Hormonal imbalances can affect people at various ages from adolescence through adulthood and old age. In adolescence, problems such as acne and premenstrual stress (PMS) are related to hormonal imbalances. Those in their 20's and 30's may suffer PMS, migraines, breast tenderness, fibroids, endometriosis, ovarian cysts, infertility, fibromyalgia and weight gain. Measures taken to balance their hormones may relieve and potentially reverse these conditions. Women who go through menopause often have sleep disorders, hot flashes, bloating and weight gain, low libido and decreased bone mass and strength which respond well to balanced hormone replacement. In men, the term andropause has been given to describe male menopause. Unlike menopause which occurs as soon as a woman stops ovulating, andropause presents more gradually with low libido, reduced energy, reduced muscle mass and increased fat. All these changes in men and women translates to more serious illnesses such as hypertension, diabetes, heart disease and stroke. By replacing waning hormones back to it youthful level, chronic illnesses may be prevented.

When deciding on hormone replacement therapy, it is vital to choose hormones which are identical to the ones produced by our body called Bio-identical Hormones. These bio-identical hormones derived from all natural plants such as soy and wild yam, provide a safe source of hormones for both men and women and is available in the oral or cream form for application onto the skin. Replacement of hormones should be carefully tailored and monitored by well trained physicians to ensure physiologic and balanced replacement of hormones.

I am reminded of a story I heard at an Anti-Aging Conference which struck a cord in me.

" A professor and his medical student were walking along a river bank one day when the student heard a cry for help from a person drowning in the river. The student being a good swimmer jumped into the river and dragged the drowning man up the bank. Seeing the man's lifeless body he starts to administer CPR and to his joy manages to resuscitate the person back to life. They continued their journey along the river and very soon they heard another cry for help. The medical student again swam to the rescue and saved another persons life. These events repeated itself with more and more people drowning and crying for help. The exhausted medical student finally said, " I don't think I can keep going much longer." To this, the wise Professor replied, "Why don't you go up stream and stop whoever is pushing all these people into the river in the first place?"

Finally, the future of medicine is here and we have the means to battle chronic disease at its roots and "prevent people from falling into the river". I am extremely excited to be part of this specialty and look forward to maintaining the health-span of my patients, my family and I.

Wednesday, January 7, 2009

Aerobic Exercise for Health optimization and fat loss

Here is a guide for the physical activity portion of your health optimization program.

As you already understand the first component to good health/weight loss is a proper diet. Next in line is Exercise.

Everyone knows that you need to exercise to achieve weight loss and for health maintenance, but what exercises, how to do it and how frequent? We will cover these areas in an easy to follow guide.

There are 2 major components to exercise: Aerobic, Anaerobic.

Aerobic Exercise promotes fat loss, endurance and cardiovascular benefits depending on how it is performed. There is no better way of losing fat than performing Aerobic exercise at the fat burning zone. How’s do you do this?

First and foremost, lets determine your fat burning heart rate:
(220-age) x 75%

As you perform aerobic activities maintain a heart rate at the fat burning rate +/- 10bpm throughout. You can do this easily if you have a heart rate monitor that is commonly attached to exercise machines or get a heart rate monitor for outdoor activities. Alternatively you could count your pulse rate for 15 seconds and multiply it by 4 every once in a while while exercising. At the fat burning rate, your body will rapidly use up the freely available blood glucose and glycogen stores and start burning fat for energy. Exercising at a heart rate greater than the fat burning zone will result in the body burning protein (muscle) for energy and this is detrimental.

Aerobic Exercises include walking, jogging, cycling, swimming and any other physical activity that increases and maintains heart rate at the fat burning zone. Therefore washing or polishing your car, mopping the floor and climbing up the stairs could be considered aerobic exercises.

You should perform 30 to 45 mins of aerobic exercise at your target heart rate 3 times a week (e.g., Monday, Wednesday, Friday). Alternate aerobic exercises with strength/resistance training on the other days of the week. Finally leave 1 day for your body to relax and recharge.

Sunday, November 9, 2008

Penyakit Buah Pinggang

Ada forumer yang tanya berkenaan sakit buah pinggang jadi saya selitkan maklumat disini untuk kebaikan bersama.

Sedikit mengenai anatomi buah pinggang.

Kita mempunyai dua buah pinggang yang terletak di bawah otot pernafasan utama iaitu diaphragm dan pada bahagian belakang ruang abdomen. Buah pinggnang kiri terletak dibelakang perut manakala buah pinggang kanan terletak di bawah hati. Lokasi buah pinggang boleh dikenal pasti dengan mencari tulang rusuk paling bawah dan mengikut perjalanannya ke belakang sehingga bertemu tulang belakang. Ruang dibawah pertemuan kedua2 garisan ini adalah tempat terletaknya buah pinggang.

Buah pinggang telah dicipta oleh Allah sebagai organ penapis yang begitu komplex dan efficient. buah pinggang akan membuang bahan bahan yang tidak diperlukan oleh badan sebagai air kencing dan menyerap semula bahan2 yang diperlukan oleh badan. Keseimbangan garam (elektrolit) dan acid-base yang sangat penting untuk memastikan badan berfungsi dengan baik semuanya dikawal oleh buah pinggang. Oleh kerana buah pinggang menapis darah, bahan2 toxic juga ditapis dan dibuang dari tubuh sebagai air kencing. Oleh kerana itu buah pinggang sentiasa bekerja keras dan sentiasa menghadapi serangan dari bahan-bahan toxic dalam darah.

Oleh kerana manusia dikurniakan dengan sepasang buah pinggang, seseorang itu masih dapat hidup dengan normal dengan satu buah pinggang yang berfungsi. Apabila kedua-dua buah pinggang rosak maka fungsi buah pinggang perlu dijalankan oleh mesin dialysis.

kerosakan buah pinggang boleh dibahagikan kepada:
1) kerosakan akut (acute renal failure atau ARF): jika dirawat awal mungkin boleh sembuh seratus peratus
2) kerosakan kronik (chronic Renal Failure atau CRF): dimana lama kelamaan pesakit akan memerlukan dialysis
3) Kerosakan akut diatas kerosakan yang telah kronik (acute on chronic renal failure)

Antara punca-punca utama kerosakan buah pinggang termasuk:
Kencing Manis,
Darah tinggi,
jangkitan kuman,
penyakit autoimmune (penyakit dimana antibodi seseorang menyerang organ sendiri),
Batu karang
Ubat2 samada diberi oleh doktor atau herba2 dan lain2 toxin
polycytic kidney/ketumbuhan lain

Simtom dan tanda penyakit buah pinggang:

Oleh kerana fungsi buah pinggang begitu efficient simtom penyakit buah pinggang selalunya dialami apabila penyakit telah advance (iaitu tahap yang teruk). Sebelum itu penyakit ini memang susah dikesan.
Sekiranya sakit disebabkan oleh jangkitan kuman simtom utama merupakan sakit berterusan pada bahagian buah pinggang, demam panas, sakit semasa kencing dan kencing berdarah. Batu karang juga menunjukkan simtom seperti jangkitan kuman tetapi selalunya sakit tidak berterusan tepati datang berulang-ulang dan selalunya tidak demam. Tanda paling awal kerosakan buah pinggang disebabkan kencing manis ialah microalbuminuria (kehadiran microalbumin dalam air kencing dan ini dapat dikesan melalui ujian air kencing.

Simtom-simtom CRF selalunya disebabkan oleh kandungan urea yang tinggi dalam darah (selalunya dikatakan darah kotor kerana urea merupakan bahan kumbahan yang perlu di buang). Antara simtom2 nya termasuk, kurang selera makan, loya dan muntah, gatal seluruh badan, mulut dan peluh berbau hancing, jumlah kencing seharian yang kurang dan pesakit kurang sedar. Doktor sering dapat mengenal pasti seseorang yang mengalami CRF dengan melihat wajah dan warna kulit seseorang kerana berlaku perubahan pada warna kulit dan juga kehadiran tekanan darah yang tinggi. Peringkat seperti ini selalunya memerlukan dialysis terutama jika seseorang tidak dapat menghasilkan air kencing kerana air yang berlebihan boleh melimpah ke paru paru apabila jantung tidak dapat menampung pertambahan air badan. Pada waktu ini orang tersebut akan mengalami sesak nafas dan merupakan kecemasan perubatan.

Untuk mengetahui fungsi buah pinggang saudara/saudari boleh melakukan ujian darah dan air kencing dan doktor dapat memastikan fungsi buah pinggang saudara terutamanya kandungan creatinine dan urea dlm darah. Ujian yang paling tepat merupakan creatinine clearance yang mengkaji bagaimana buah pinggang menapis creatinine dalam darah. Ujian-ujian seperti ultrasound dan CT scan dapat mengenal pasti samada terdapat masalah dari segi struktur iaitu samada saiz buah pinggang normal dan jika terdapat batu karang, cyst atau ketumbuhan. Jika seseorang menghidap CRF buah pinggang akan mengecut.

Cara-cara menjaga buah pingggang:
1) Elakkan penyakit kencing manis dan darah tinggi dengan pemakanan seimbang dan senaman
2) Elakkan pengambilan ubat tanpa rujukan doktor terutama pengambilan ubat tahan sakit yang mudah dibeli di farmasi/pasaraya
3) minum air yang telah ditapis sekurang-kurangnya lapan gelas sehari.
4)Mengelakkan toksin yang terdapat dipersekitaran terutama makanan seperti buah dan sayur yang disembur racun dengan memakan makanan organic


Wednesday, October 22, 2008

Weight Management Essentials

A fellow forumer asked about my weight loss program and even though we have gone over this in our previous blog, here is a run down of how I did it. Remember, no two people are the same but the principle is the same and you will obtain various degrees of weight loss.

Here was my answer:


Sorry for the late reply. How are you? Are you planning to reduce your weight?

I'll tell you how I did it after many years of failed attempts.
The plan is actually quite simple but you have to stick to it no matter what.
First measure your weight in Kg, then your height in meters. Calculate your Body Mass Index by dividing your weight (kg) by the square of your height (m2): weight(kg)/heightXheight (m). Your BMI should be less then 25. BMI of 25 to 30 is overweight and 30 to 35 is obese. You can then calculate your ideal weight by substituting the numbers in the formula to get a BMI of 25.

OK, next measure your waist at the navel. Males should be less or equals to34, females less or equals to 28. Any more than this puts you at a greater risk for heart disease.

So now you have an idea of what you should aim for. Personally, I think the waist measurement is much more important. The BMI may be in the overweight area but may be normal especially if you have lost fat and gained more muscle (fat is lighter than muscle).

Next....get a blood test. You can do this through your GP or from some labs. The basic should include a full blood count, kidney/renal function, liver funtion, Cholesterol profile, fasting blood sugar, Urine analysis.
Hormone imbalances are the commonest cause of weight gain, inability to lose weight or weight loss plateau, and regaining the weight lost.

A thyroid profile is also important to know as inadequate thyroid function may cause weight gain. Get a TSH, Free T4 and Free T3 tested and morning serum cortisol.

BTW, if you are a woman, hormones play a major role in weight gain and loss especially a lack of progesterone. This is indicated by irregular menses, severe PMS symptoms, breast tenderness during menstruation, polycystic ovaries etc. In this case you should check your serum progesterone level on day 21 of your menstrual cycle. Men are also affected by hormone especially if a person is more than 35. There can be a reduction of growth hormone and testosterone which leads to obesity.

OK, got the results back. You can send me the results if you want me to have a look. Some results may seem normal but not optimal and will require correction.

Assuming all your results are normal, we can begin.... If not hormone deficiencies may have to be corrected.

Weight management is about life style change. If you don't change what you're doing it either won't go away or it will come back to haunt you.
The basic diet I follow now is zero or minimal simple carbs like sugar, sweets, chocolates. read labels..if the sugar is an ingredient don't buy it. potatoes are also high in simple carbs.
High complex or low glycemic carbs from fruits (epals, pears, guava-without asamboi, apricots, kiwi), vegetable, whole grain and nuts.
High Protein from fish and poultry, occasionally beef.

So, this is how I lost attention..

2 Weeks Intensive Phase:

Breakfast: Mee Hoon Soup with extra chicken and fish ball, less noodle-1bowl
Only drink plain or better still mineral or RO water.
Lunch: Meal replacement drink (make sure it is a complete meal: carbs,protein, fat, vitamins)- mix with water. (about 250 cal)
Dinner: Meal replacement drink

I drank lots of water for 2 reasons, 1) I thought I was hungry but in actual fact, I was thirsty. This was crucial to learn. After drinking water, I realized I was no longer hungry. 2) It keeps me well hydrated and flushes out all the toxins in my body.

I also took a good multivitamin, which is high in chromium, selenium, zinc and vitamin E. Important factors for optimal bodily enzyme funtions.

You see, most people who tried to do it my way failed within the first week. That's because they were not determined enough and they think it can't be that simple. I'm amazed that people seem to prefer complex solutions. It is this simple. Stick to this and you will be amazed at your own body. Some people argue that a low calorie diet is not good. studies show that reducing calories extends your lifespan. For people who are obese, this is the only way to overhaul that engine and start you metabolism working for you...optimally burning fat and building muscle.

You can change the food you take for breakfast to something else if you want but this is the best.

What next:
After the 2 weeks you will feel a new level of energy and determination as you see your weight reduce. So time for step 2.

Yahooo!! Now you can eat 2 nutritious meals...breakfast and lunch. again no simple sugar, high in protein . As Malaysians you may miss the rice. My advise to you is take a quarter of what you used to take. replace the rest with vegetable and fish or poultry. You may take low glycemic fruits 1 per meal e.g. 1 apple. Also, Remove the skin from the chicken.

Take the meal replacement for dinner so that your stomach does not have to work hard, digesting the food while you sleep. Also remember the vitamins.

At this stage start to exercise to build up muscle. I have the exercise recommendations at my blog. do both cardio and strength. Swimming is a good option as it is weightless, and it is both cardio and strength. Remember, you will be losing both fat and some muscle during the first phase and its time to replace the muscle. You do not want to have flabby skin hanging out do you. I did not exercise during the first stage. There were too many biologic changes to adjust to and you will feel weak the first week as the body detoxifies. All this will go away after 1 week.

Do the second stage till you are happy with your weight. This may take 4-6 months but you wouldn't want to lose any faster. You need time to build your muscle to avoid flab.Even by losing 5 kg, you would have added 5-8 years to a healthy life.

after 3-4 weeks of stage 2, and as your physical activity increases, add a snack of low glycemic fruit at 11am and 4 pm to stabilze your blood sugar and your hormones.

Occasinally you will need to add Liquid L-Carnitine to boost your fat buring if there is a plateau.

I promise you, you will feel so good about yourself. Imagine fitting into clothes when you were in secondary school!! You'll be digging your closet for these!hehehe. So time to go shopping. I did my shopping a bit to early...I lost more weight and had to go shopping again.

People you've not seen for a while will start commenting on how good you look and this is the ultimate self esteem boost I've had for a long time since I've always been known to be fat.

Once your desired weight is achieved, stick to you meal plan. Have the occasional cake or chocolate and see that the occasional treat will not touch your weight as your metabolism can now handle it.

I really hope this will inspire you and wish you all the best in achieving your goal. Contact me at any time and I'll try to help.

Best regards,

Mahathir Mohamed, M.D.
General Physician and Anti-aging Medicine Practitioner.

* Additionally, several substances have come into the spotlight recently, such as the addition of conjugated linoleic acid (CLA), co-enzyme Q10, Alpha Lipoic Acid which some patients will need to boost their fat burning. Amino acids such as L-Glutamine and L-arginine has its role in patients who are deficient in Growth Hormone.

Wednesday, October 15, 2008


I will be including some discussions I've had regarding several illnesses with patients through a health forum. These individuals were kind enough to allow me to share their stories for the benefits of others. This first discussion is on endometriosis.

Hi DrM,

I've been suffering with endometriosis (endo) for more than 10 years. I have undergone 3 major surgery to remove cycst. :( . The cycst appeared on both of my ovaries. Luckily, the gynae managed to save them both from being removed. According to the gynae, the size was as big as an orange.

I'm 37 years old, married for 7 years but no kids and desperately trying to conceive...
my hubby and I have been trying to concieve but unfortunately it did not successful.... :'(
We have tried IUI ( 2 Times), IVF (4 times) but failed.

I have done ultrasound last month and the results shows that the cycst on my left ovary is 40mm and no cycst appear on the right ovary. I am planning to do IVF very soon and seek medical advice from several gynae. However, different gynae gives different opinion. One of them suggest to perform another surgery in ensuring that all cycst is cleared prior to perform IVF. While another gynae suggest to have the cycst aspirated vaginally i.e. using similar IVF method in retriving eggs. Currently, I am not sure what my decision will be... too afraid to go for another surgery. If possible I would swallow anything that can remove this cycst.

Currently, I'm not taking any meds. One of my gynae suggest to take planning pills but i have done that previously, it didn't work... the size of the cycst won't budge..

I have mild asthma and bad migrane. Recently, I have done blood screening test at BP lab and found out that my haematology examination havind slight problem in which MCV is 70fl, MCH is 21pg and MCHC is 30%. The doctor indicated that I probably having thalassaemia and suggest to perform Hgb electrophoresis. However,I have not done it yet.

My father has high blood presurre while my mother has diabetic and severe migraine.

Therefore, I am kindly seeking your advice on this matter.



Thank you for your enquiry. I read your story with great interest and sympathy. You have gone through a lot and you seem to be a very strong and determined person.

As you may not have much time with your doctor to go over things I am sure you must have read and know quite a lot about endometriosis. However, it may be helpful to go over it from a different perspective.

The symptoms you are exhibiting (including the migraine) are symptoms of estrogen dominance. Estrogen is essential for living but can lead to problems if it is unbalanced. The result of too much estrogen relative to progesterone is estrogen dominance. It is the chief cause of PMS, fibroids, endometriosis, Polycystic ovary syndrome and infertility. Under the influence of too much estrogen women feel bloated, irritable, fatigued and have sugar cravings. All these estrogenic effects are supposed to be balanced by progesterone but are often not.

Endometriosis is a very difficult condition to treat and even modern medical technology have not found the ultimate treatment for it. In actual fact we do not know why endometriosis occurs. We know that there is deposits of endometrial tissue in sites other than the uterine wall and there are many theories to speculate how it occurs. However, looking through the history of this illness, it was not mentioned in the olden days. We now believe that there is a relationship between endometriosis and environmental toxins especially from petrochemical products such as plastic, processed food, animal growth hormone and even contaminated water. Petrochemicals contain harmful substanses and many of which act like the hormone estrogen but in a bad way (Xeno-estrogens) and lead to aggravation of endometriosis.

Some studies have also shown that women with endometriosis have antibodies against their own tissue. I equate this state to a confused immune system which attacks its own tissue. Therefore a healthy immune system is also important to fight this illness.

With each monthly cycle, the endometriosis spots responds to ovarian hormones just as the endometrial cells do within the uterus- they increase in size, swell with blood and bleed into surrounding tissue during menstruation. The bleeding (no matter how small) into the surrounding tissue causes inflammation and is very painful, often disabling. Symptoms usually begin 7 to 12 days before menses and become excruciatingly painful during menstruation.

Women with endometriosis often have problems to conceive as a result of inflammation and scarring. We have found that in those who get pregnant, endometriosis is retarded and occasionally cured. This is a result of the high levels of the hormone progesterone. You may have received a progesteron-like medicine from you gyne (provera, norethisterone etc). however, these are progesterone-like (chemical form) and not natural progesterone. The body does not process this progesterone the same way.

My recommendations for management of your condition:

1. I feel that you may benefit from Natural Progesterne (in the form of a cream) in a cyclical manner to control the endometriosis. It is important to use natural, bioidentical progesterone instead of progestins.

2. On top of this, the Usana Vitamins will help you as follows:
i) USANA Essentials Multivitamin, Mineral and Antioxidant (1 tablet 3x/day)
Dian Mills, a nutritionist and former trustee of the British Endometriosis Society in London, reported a double-blind study of dietary supplements that resulted in a 98% improvement in symptoms over those not on supplement. The supplements used were thiamine, riboflavin, pyridoxine, zinc and magnesium. (D.Mills, "The Nutritional Status of the Endometriosis Patient", Endometriosis Association Newsletter, Vol.17, nos.5-6 (1996))

ii) USANA Proflavanol (1 Tablet 3x/day)
Proflavanol contains grape seed extract a potent antioxidant and a potent stimulator of the immune system.

iii) USANA Biomega (1 tablet 2-3 times/day)
Omega 3 fatty acids have been shown to reduce inflammation.

iv) USANA Active Calcium (2 tablets 3x/day - introduced gradually)
Calcium has muscle relaxing effects and have been shown to relieve menstrual cramps

Dr Ray Strand, Author of "What your Doctor doesn't know about nutritional medicine may be killing you" has had success in many patients using the USANA Vitamins.

3. Indole-3-carbinol or DIM
As mentioned previously, endometriosis is related to estrogen dominance or excess. Indole-3-carbinol/DIM is the active ingredient of cruciferous vegetables (broccoli, cabbage, cauliflower etc) which have been shown to modulate estrogen levels.

4. Increase intake of soy and soy products (tempeh, tofu, etc) which contain the substance genestien, another potent estrogen modulator. You may want to try Enerflex forte which is in powder form with the added benefit of blue green algae.

5. Eliminate caffeine

6. Eliminate red meat, dairy foods, and egg yolk for 2 weeks. You may then reintroduce these one by one and see if symptoms recur.
Dr Christiane Northrup M.D, reported patients who became free of endometriosis after eliminating dairy products.

With nutritional approaches, it's important to give them at least 3 months to achieve optimum results.

Other than these measures, keep yourself active with exercise which will also boost your immune system. You will find that your asthma and migraine will also be controlled.

Wednesday, August 27, 2008

Strength Training

Hi there,

Most of us know the benefits of exercise but how do we perform exercises for optimum result in the least amount of time and make it fun?

There are several important components of exercise which include:
1) endurance,
2) strength,
3) speed and reaction time,
4) balance and coordination
5) flexibility
6) neuromuscular relaxation.

In this article, I will focus on strength and resistance training and how to go about starting a program for yourself ( This is meant for a sedentary person just starting to take an interest in his or her own health and not for the advanced athelete so it should be simple enough).

Strength training, obviously increases strength but it also tones the body, burns fat and bulids muscle.

Here is a simple program anyone could try. I recommend that you have with you some light weights to start off say 2 canned foods, unopened bottled water or better still two dumbells.

Some basic principles:

1. Reps: Repetition for 1 single movement described. The number of reps you perform will depend on your fitness goals. If your aim is for strength or muscle size, perform between 6 - 10 reps
If your aim is for muscle tone or endurance, perform between 10 - 15 reps

2. Sets: No of times a set of exercises is performed

3. Optimum Weight required:
The heaviest weight you can lift to obtain the required no of reps for a particular movement. For example, if you plan to perform 6 reps choose a weight which you can only lift 6 times for that particular movement. For absolute beginners start with two 1 kg dumbells and either increase or decrease the weight accordingly.

4. Don't forget to Breathe.

Are you ready?

Start with a warm up session of stretching followed by walking for about 5 min (ideally it should be 10 to 15 min). Walking will increase the blood flow to the muscles which you will then put to work in this program. This is important to prevent injury. After the warm up session, start your work-up from the toes up.

For a start increase your muscle endurance by performing 15 reps of each of the following in sequence:
1. Heel lift :
With the weights in your hands, by your sides or held at shoulder height, raise yourself up on your tip toes and then come back down slowly to standing position. You will feel your calf muscles contracting.

2. dumbell squat-to-bench:
With the weights in each hand by your sides, inhale deeply, then exhale as you squat down until yor buttocks touches the bench. Do not take tension off your thighs by actually sitting on the bench. Return immediately to the starting position.

3. Front Lunge:
Stand erect with your hands on your hips. Inhale and step forward as far as possible until your leading leg is parallel with the floor and your trailing leg is extended as straight as possible. Push back to the starting position and exhale. Repeat with other leg.

4. Abdominal Crunch:
Lie on the floor with your legs bent, your feet flat on the floor. Place your hands on the back of your head, or if you prefer, cross them over your chest. Lift your shoulder blades off the ground moving your elbows towards your knees. Don't try to lift your whole back - just your shoulder blades. Squeeze your abs for a second. Slowly return to the starting position.

5. Dumbell Lateral Raise:
Holding dumbbells, stand slightly bent at the hips. Your knees should also be slightly bent. Your back should be straight, and your arms hanging down, elbows slightly bent.
Keeping your arms locked, slowly raise the dumbbells out to the sides until elbows are level with your shoulders.
Slowly return to the starting position.

6. Hammer Curl:
Stand straight, holding the dumbells at your sides, palms facing inwards.
Keeping your elbows at locked at your sides, slowly lift the dumbells until they almost touch your shoulders. Slowly lower the weights back.

7. One arm dumbell extension:
The one are dumbbell extension can be done either standing or seated, whichever is more comfortable. Take a dumbbell in your right hand then extend your arm up so that you're holding the dumbbell straight up with your palm facing forwards. Keeping your upper arm still and bending at the elbow slowly lower the dumbbell down behind your neck. Raise back to the starting position and repeat for desired reps.

I've chosen these exercises because these are relatively simple. As you gain experience you may add other movement targeted to specific muscle groups.

For a start, perform 1 set of exercise 2-3 times per week then increase gradually. As you gain strength and stamina you can increase the sets accordingly. Try and keep the exercise regular. The more often you exercise, the easier it gets and exercise won't tire you too much.......

Instead you will feel energized.....

Cool Down
Take 5 minutes to walk at a slow pace, swinging arms back and forth, and breathing deeply releasing everything from your mind.

I hope you will take the time to try these strength training exercises and reap its benefits.
Till next time,

Stay healthy.


Sunday, August 3, 2008

Women's Health: Family Planning (Bahasa)

Kebanyakan wanita keliru dengan kaedah untuk merancang keluarga. Berikut, merupakan antara kaedah yang kerap digunakan. Sila pastikan anda memahami setiap kaedah dan risikonya sebelum membuat keputusan.


Implan merupakan kaedah perancangan keluarga untuk jangka masa panjang. Ia berbentuk seperti lidi yang dipasang di bawah kulit pada lengan anda.

Implan (implanon) berkesan mencegah kehamilan selama 3 tahun.

Implan mengandungi hormon progesteron yang mengeluarkan hormon secara berterusan dan menghalang pengeluaran telur. Ia juga menghalang sperma memasuki rahim dengan menukar lendir pada serviks. Perlindungan kehamilan bermula dari hari pemasangan.

Bagaimana implan dipasang?
Doktor akan menjalankan ujian ginekologi termasuk pemeriksaan payudara, pap smear dan ujian kehamilan sebelum memasang implan. Ubat bius akan diberi di tempat pemasangan dan diikuti dengan pemasangan implan. Bahagian lengan akan dibalut untuk mengurangkan risiko lebam. Anda boleh membuka balutan selepas 24 jam. Kebiasaannya, implan akan dipasang antara hari pertama dan kelima haid.

Kesan sampingan implan
Antaranya ialah jerawat, pening kepala, pertambahan berat badan, sengal payudara. Kesan sampingan yang jarang berlaku termasuk rambut gugur, perubahan emosi, perubahan nafsu seks, sakit perut dan senggugut. Implan akan mempengaruhi kitaran haid; kitaran haid tidak menentu, tiada haid.

Pengeluaran implan
Sekiranya anda memasang implan di Klinik Lina, anda akan menerima SMS peringatan apabila implan telah tamat tempoh dan perlu dikeluarkan. Ubat dius akan diberi sebelum insisi dibuat. Selepas implan dikeluarkan, luka akan dibalut.

Sekiranya anda ingin hamil semula, implan akan dikeluarkan dan kesuburan akan kembali dalam bulan pertama.

Implan tidak memberi kesan ke atas penyusuan bayi.

Implan tidak melindungi anda dari jangkitan kelamin.

Untuk keterangan lanjut, sila datang ke Klinik Lina (FG 17, Blok 2A, Jalan PJS2/1, Apartmen Taman Medan Jaya, Selangor. Tel no: 77820005)


IUCD atau intrauterine contraceptive device ialah alat yang dimasukkan ke dalam rahim untuk mencegah kehamilan. Alat ini tidak mengandungi sebarang hormon, dan merupakan segelung wayar kuprum yang bertali.

Waktu paling optima untuk memasukkan alat ini ialah hari terakhir haid. Ia juga boleh dimasukkan selepas keguguran atau bersalin.

Kelebihan IUCD
o Efektif, kesuburan boleh dikembalikan serta-merta selepas IUCD dikeluarkan, sesuai untuk jangkamasa yang panjang
o Tidak mengganggu penyusuan bayi
o Sesuai jika ada penyakit darah tinggi
o Tiada kesan negatif hormon seperti pertambahan berat badan, sakit kepala

Prosedur memasukkan IUCD
Sebelum IUCD dimasukkan, doktor akan melakukan pemeriksaan vagina untuk memastikan kedudukan rahim. Doktor akan memasukkan spekulum untuk melihat servik. Servik dan vagina akan dicuci dengan antiseptik. Doktor akan mengukur saiz rahim sebelum memasukkan IUCD. Anda mungkin akan merasa tidak selesa sewaktu IUCD dimasukkan. Selepas IUCD dimasukkan, doktor akan memotong benang 2-3cm daripada servik. Pemeriksaan ultrasound akan dilakukan untuk menentukan kedudukan IUCD.

Anda akan mengalami sedikit pendarahan selepas IUCD dimasukkan. Anda juga akan mengalami sakit pada bahagian ari-ari selepas IUCD dimasukkan.

Anda mesti berjumpa dengan doktor jika:
o Haid lambat 2 minggu atau tiada haid
o Tidak dapat merasa benang atau dapat merasa bahagian plastik yang keras di dalam faraj
o Pendarahan yang banyak atau pendarahan selepas melakukan hubungan seks
o Senggugut atau sakit sewaktu melakukan hubungan seks
o Sakit ari-ari, sakit di hujung bahu, demam melebihi 38 darjah Celsius, pening, pengsan, lelehan faraj yang tidak normal

Anda dinasihatkan menukar IUCD setiap 3 tahun (bagi Multiload Cu250) dan 5 tahun (bagi Multiload Cu375). Jika IUCD dimasukkan di Klinik Lina, anda akan menerima SMS peringatan jika sampai masa untuk mengeluarkan IUCD.

Prosedur mengeluarkan IUCD
Untuk mengeluarkan IUCD, anda mesti berjumpa dengan doktor. Prosedurnya seperti memasukkan IUCD. Jika benang IUCD tidak dapat dilihat di dalam faraj, anda akan dirujuk kepada pakar ginekologi untuk mengeluarkan IUCD selepas dibius.

Apabila menggunakan IUCD, risiko untuk mengandung masih ada. Jika anda disahkan mengandung, IUCD akan dikeluarkan dan boleh menyebabkan keguguran. Jika anda tidak mahu mengeluarkan IUCD, anda juga berisiko untuk mendapat jangkitan kuman pada bahagian pelvis.

Walaupun IUCD mampu mencegah kehamilan di dalam rahim, ia tidak dapat mencegah kehamilan di luar rahim.

Untuk maklumat lanjut, sila datang ke Klinik Lina (FG 17, No 2A, Jalan PJS 2/1, Apartmen Taman Medan Jaya, Selangor. Tel no: 77820005)


Noriday ialah pil perancang yang mengandungi hormon progestin sahaja.

Bagaimana kehamilan dicegah?
Pil perancang ini mencegah kehamilan dengan cara menukar lelehan di bahagian serviks supaya sperma tidak dapat melepasinya. Ia juga menukar dinding rahim supaya telur yang telah disenyawakan tidak dapat melekat pada dinding rahim.

Cara pengambilan pil Noriday
Mula makan Noriday pada hari pertama haid sehingga habis pek. Ambil pil pada masa yang sama setiap hari.
Pada permulaan mengambil pil Noriday, pencegahan kehamilan alternatif mesti diambil 14 hari yang pertama.
Selepas habis pek pertama, anda perlu meneruskan dengan pek kedua tanpa berhenti, tidak kira jika ada haid atau tidak.

Haid tidak teratur
Kemungkinan haid tidak teratur akan berlaku dengan pengambilan pil Noriday. Kebiasaannya ia berlaku pada bulan-bulan awal sahaja. Anda dinasihatkan supaya tidak berhenti pil tersebut. Sila berjumpa dengan doktor jika tiada haid selama 6 minggu.

Anda diingatkan supaya mengambil pil pada masa yang sama setiap hari. Jika terlupa, ambil pil sebaik sahaja teringat dan ambil juga pada masa yang sama pada hari tersebut. Ini bermakna anda akan mengambil 2 pil pada hari tersebut. Anda mesti menggunakan cara alternatif juga selama 14 hari.
Jika terlupa 2 atau lebih pil berturut-turut, anda dinasihatkan supaya berhenti mengambil pil perancang dan menggunakan cara alternatif sehingga datang haid.
Muntah dan cirit-birit akan mengurangkan penyerapan pil dalam perut. Anda dinasihatkan meneruskan pil perancang dan menggunakan cara alternatif selama 14 hari.
Pil perancang akan berinteraksi dengan antibiotik, ubat sawan, ubat tidur dan ubat arthritis. Pastikan anda memberitahu doktor jika anda mengambil pil perancang.

Anda tidak boleh mengambil pil perancang jika ada penyakit kuning, gatal atau kuning ketika mengandung, pendarahan vagina yang tidak normal, penyakit hati, penyakit darah beku (angin ahmar, serangan jantung, paru-paru).
Pil perancang boleh menyebabkan darah tinggi pada sesetengah wanita.

Anda dinasihatkan supaya berhenti mengambil pil perancang serta-merta dan berjumpa dengan doktor jika:
o Sakit dada, batuk berdarah dan sesak nafas
o Sakit dan bengkak urat kaki
o Sakit dada yang melampau
o Sakit kepala, muntah, pening, pengsan, masalah penglihatan atau pertuturan, lemah tangan atau kaki
o Ketulan pada buah dada
o Sakit pada bahagian perut

Jika anda ingin mengandung semula, berhenti pil perancang dan gunakan cara mekanikal (seperti kondom) selama tiga bulan sebelum merancang untuk hamil.

Anda dinasihatkan supaya berjumpa dengan doktor untuk memastikan cara merancang keluarga yang sesuai untuk anda. Oleh kerana Pil Noriday boleh memudaratkan jika disalahgunakan, ia merupakan ubat preskripsi oleh doktor sahaja.
Sila pastikan anda melakukan pemeriksaan tekanan darah, buah dada setiap bulan dan pemeriksaan pangkal rahim (pap smear) setiap tahun.

Untuk keterangan lanjut, sila datang ke Klinik Lina (FG 17 Blok 2A, Jalan PJS2/1, Apartmen Taman Medan Jaya, Selangor. Tel no: 77820005)


Salah satu cara untuk merancang keluarga ialah melalui suntikan depo. Suntikan depo mengandungi hormon progesteron sahaja. Suntikan depo menukar lendir pada serviks yang menghalang sperma menembusinya. Keadaan hormon yang tinggi juga menyebabkan tiada telur dikeluarkan.

Sebelum diberi suntikan, anda akan diperiksa terlebih dahulu, termasuk pemeriksaan ginekologi dan payudara. Selepas memastikan anda tidak hamil, suntikan akan diberi pada bahagian punggung.

Kekerapan suntikan
Suntikan pertama akan diberi pada hari pertama ke hari kelima haid. Selepas itu, anda akan diberi apoinmen untuk suntikan setiap 2 bulan selama 3 kali. Ini diikuti dengan suntikan setiap 3 bulan. Jika anda menerima suntikan di Klinik Lina, anda akan diberi SMS peringatan untuk suntikan seterusnya.

Suntikan depo boleh menyebabkan haid tidak menentu atau tiada haid. Ia juga boleh menyebabkan penambahan berat badan, sakit kepala dan mual.

Anda tidak boleh menggunakan suntikan depo jika ada penyakit seperti di bawah:
o Darah tinggi
o Penyakit hati
o Herpes sewaktu hamil
o Sakit kuning
o Gatal sewaktu hamil
o Angin ahmar
o Sakit jantung

Suntikan depo tidak akan mengganggu penyusuan bayi.

Untuk keterangan lanjut, sila datang ke Klinik Lina (FG 17 Blok 2A, Jalan PJS2/1, Apartmen Taman Medan Jaya, Selangor. Tel no: 77820005)